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Nov 2025 DOI 10.14302/issn.2690-4721.ijcm-25-5786
Ornelle Elion Assiana DarrelCorresponding author
In the Republic of the Congo, tuberculosis (TB) remains a major public health concern. Although the GeneXpert MTB/RIF assay is the WHO-recommended first-line diagnostic test, smear microscopy is still used for treatment monitoring and in facilities where molecular testing is limited. Evaluating the diagnostic accuracy of smear microscopy compared to GeneXpert and MGIT culture is essential to guide diagnostic strategies and strengthen TB control in the country. A cross-sectional study was conducted among 92 presumptive pulmonary TB patients at Makelekele Hospital. Sputum samples were analyzed by smear microscopy, GeneXpert MTB/RIF, and MGIT culture. Sensitivity, specificity, positive and negative predictive value were calculated for smear microscopy and GeneXpert, using culture as the reference standard. Culture detected more Mycobacterium tuberculosis than microscopy (49% vs. 32%, P<0.001). Smear microscopy showed a sensitivity of 58% (95% CI: 43–71%) and specificity of 92% (95% CI: 80–97%). GeneXpert detected more MTB (62% vs. 49%, P<0.001) with a sensitivity of 98% (95% CI: 89–100%) and specificity of 72% (95% CI: 58–83%). GeneXpert showed superior sensitivity for TB detection, while microscopy remained specific. Expanding GeneXpert testing across the Republic of the Congo will improve TB management.
Nov 2025 DOI 10.14302/issn.2326-0793.jpgr-25-5573
E. Imiruaye OghenetegaCorresponding author
Advancements in proteomic and genomic technologies have transformed molecular biology by enabling comprehensive analysis of biological systems at the molecular level. This literature review explores the evolution, methodologies, and practical applications of key proteomic and genomic techniques. In proteomics, tools such as two-dimensional electrophoresis, mass spectrometry, Western blotting, Edman degradation, and functional protein microarrays have facilitated high-throughput protein identification, post-translational modification analysis, and biomarker discovery. Similarly, genomic methodologies like PCR, recombinant DNA technology, gel electrophoresis, and Southern blotting have revolutionized gene detection, manipulation, and expression profiling. The review also highlights the interdisciplinary impact of these technologies across clinical diagnostics, oncology, autoimmune disorders, infectious disease surveillance, cardiovascular research, and personalized nutrition. Integrative approaches combining proteomics and genomics are enabling the discovery of novel therapeutic targets, improving disease classification, and advancing precision medicine. Despite current limitations, such as the absence of amplification techniques for proteins and challenges in data interpretation, ongoing innovations promise to bridge these gaps. This synthesis underscores the pivotal role of molecular techniques in deepening our understanding of human biology and accelerating biomedical advancements for improved healthcare outcomes.
Sep 2023 DOI 10.14302/issn.2692-1537.ijcv-23-4660
Amel Jamehdar SaeidCorresponding author
SARS-CoV-2 real-time reverse-transcription PCR (rRT-PCR) is the most effective testing system available to combat COVID-19, given the absence of any specific treatment or vaccine. Moreover, numerous SARS-CoV-2 rRT-PCR kits have been approved under emergency-use-authorization (EUA) worldwide. In this article, we present a comparison of important performance features among five commercial RT-PCR assays. A total of consecutive nasopharyngeal (NPS) samples and oropharyngeal (OP) swabs were collected from 50 COVID-19 patients to analyze sensitivity and specificity. The results showed variations in sensitivity among all the RT-PCR kits examined. The Pishtaz teb assays demonstrated the highest positive percent agreement (PPA) of 95.2% (40/42), followed by Covitech (90.5% - 38/42), DaAn Gene (83.3% - 35/42), Sansure (66.66% - 28/42), and Power check of SARS- CoV-2 panel (64.3% - 27/42). Conversely, all five molecular assays demonstrated a negative percent agreement (NPA) of 100% (8/8). These findings provide a technical baseline for assessing the performance of five distinct commercial PCR assays for detecting SARS-CoV-2. They could prove practical and useful for laboratories seeking to purchase any of these assays for further clinical validation. Highlights ·Compared five COVID-19 RT-PCR kits approved and available by Iran Ministry of Health. ·Pishtaz teb's kit identified the highest number of positive clinical samples.
Oct 2022 DOI 10.14302/issn.2576-9359.jot-22-4303
Morteza Bagheri SeyedCorresponding author
Department of Radiology, School of medicine, Iran University of Medical Sciences
Background Doppler ultrasonography can evaluate vascular and renal parenchymal disorders. In this study, color Doppler patterns in transplanted kidneys were compared with histological diagnosis to develop diagnostic models for transplanted kidney failure. Method 45 kidney transplant patients participated in this prospective study (16 suffered acute tubular necrosis (ATN), and 29 had transplant rejection). All patients had color-Doppler ultrasonography to measure kidney parameters and Doppler indices. Serum creatinine levels also assessed the transplanted kidney's function. Result Ultrasound showed a significant difference between the two groups in iliac and interlobar PSV. The ROC analysis showed a high diagnostic value of the iliac artery PSV, in distinguishing ATN from kidney transplant rejection. Serum creatinine level correlated directly with transplanted kidney volume, renal cortical thickness, and transplanted kidney length, and inversely with interlobar artery PSV and EDV. In graft rejection patients, the only significant inverse correlation was found between serum creatinine level and PSV of the iliac artery and EDV of the intrelobar artery. Discussion and conclusion The iliac artery PSV can differentiate between ATN and rejection after renal transplantation. Evaluation of renal metric parameters along with PSV and EDV of the interlobar artery (in patients with ATN) and iliac artery and interlobar artery (in transplant rejection) help determine renal dysfunction.
Jan 2022 DOI 10.14302/issn.2578-8590.ipj-21-4026
Karabayev M.Corresponding author
Fergana Medical Institute of Public Health, Uzbekistan.
A theoretical paper proposes applications of golden proportion principles to physiological diagnostics. It outlines proposed metrics and discusses validation needs and limitations.
Feb 2021 DOI 10.14302/issn.2381-862X.jwrh-21-3708
Muthyala TanujaCorresponding author
Assistant Professor, Department of Obstetrics & gynecology, All India Institute of Medical sciences, Mangalagiri, Guntur, Andhra Pradesh
Fetal mesentric lymphangioma, a congenital fetal abdominal cystic malformation has a rare occurrence. Antenatal detection, its differential diagnosis, prenatal management options and parental counseling regarding postnatal prognosis of such a case are thus rarely discussed. We report two cases of antenatally detected fetal cystic abdominal mass with a provisional diagnosis of abdominal lymphangioma. Postnatally one of the neonates developed features of intestinal obstruction and required surgical intervention. Intra-operative findings and histopathology report confirmed a mesentric lymphangioma. The other neonate had associated subcutaneous lymphangiectasia in left lumbar region, left sided inguinal hernia, undescended testes and was asymptomatic postnatally and managed conservatively.
Dec 2020 DOI 10.14302/issn.2641-5518.jcci-20-3636
El Guindi WaelCorresponding author
Department of Obstetrics and Gynecology, Franck Joly Hospital, Saint-Laurent-du-Maroni, France
Objective To highlight the value of 3D ultrasound and Doppler angiography imagingin the prenatal assessment of left fetal isomerism. Methods A retrospective offline analysis of volume datasets of 3 fetuses with left atrial isomerism by 3D ultrasound was conducted. Conclusion We believe that parasagittal view demonstrating the heart and the abdominal vessels is easy to obtain and interpret, offer a realistic anatomic image, needs no mental reconstruction of spatial relationships and is very beneficial mainly in detecting the situs. We propose to use 3D ultrasound systematically in suspected cases of atrial isomerism, and better understand and interpret fetal anatomy.
Oct 2020 DOI 10.14302/issn.2379-7835.ijn-20-3418
E. Ahmed FaridCorresponding author
GEM Tox Labs, Institute for Research in Biotechnology, 2905 South Memorial Drive, Greenville, NC 27834, USA
Isolation methods that employ readily-available inexpensive supplies on the open market, which are reliable, as well as economical, such as nucleic acid amplification techniques (NAAT) based on microfluidic technology in low-resource research settings (LRRS) that meets the ASSURED guidelines are essential to develop a noninvasive diagnostic colon cancer screen in stool using micro(mi)RNA molecules. A combination of a microfluidic-based MiRNA stool test with a reliable rolling circle amplification/detection method applied to the quantification of miRNA molecules, result in an affordable sensitive and specific isothermal method for the noninvasive quantitative detection of miRNAs in LRRS. Scientists and engineers have become interested in miRNAs, and they have intensified their efforts to apply emerging simple detection tools to the important bioanalytical challenge of quantifying these small 18-26 nt long molecules. Some of the proposed approaches incorporate novel material, such as simple centrifuges and methods based on microfluidic technology, while others utilize the interesting biological properties of these molecules, such as forming branched RCA structures, allowing for the detection of these biomarker molecules at an attomolar "aM" concentration level, using low cost extraction and isothermal amplification methods in LRRS. We have been interested in studying colorectal cancer (CRC) because it is the 3rd most common malignancy worldwide, and stool can be obtained noninvasively from the patients. We have focused in this research on colon cancer (CC) because it is more common in the USA than rectal cancer (RC). The innovation of our approach lies in the exploratory use of an affordable, quantitative miRNA profiling in noninvasive stool samples in LRRS, whose extracted fragile total RNA is stabilized shortly after excretion from stool by commercially available kits, so it does not ever fragment, followed by quantitative standardized analytical tests that are neither labor intensive, nor require expensive instrumentation, in order to develop apanel of novel miRNA genes for the noninvasive diagnostic screening of early left and right sporadic colon cancers, more economically, and with higher sensitivity and specificity than any other colon cancer screening test currently available on the market. To show the clinical sensitivity and specificity of the proposed quantitative miRNA test using simple methodologies in LRRS,the miRNA results are to be correlated with FOBT, colonoscopy, and pathology data. Standardization establishes test’s performance criteria (sample selection, optimal sample running conditions, preservation and storage), in order to ensure that the assay will perform the same way in any laboratory, by any trained personnel, anywhere in low-resource laboratory settings worldwide.
Jun 2020 DOI 10.14302/issn.2578-2371.jslr-20-3371
Shirale VaishaliCorresponding author
Assistant Professor of surgery in surgery Department at ESIC Medical College and Hospital, MIT Faridabad
We hereby report a scrotal epidermoid cyst presenting as a scrotal mass which a rare entity in the absence of trauma. 36years old male presents with a complaint of left sided testicular swelling and discomfort. The workup included clinical examination, alpha-fetoprotein (αFP) and beta-human chorionic gonadotropin (β-hCG) analyses and scrotal ultrasound. Clinically confused as testicular malignancy. Complete surgical excision of the cyst was performed. Histopathology confirmed epidermoid cyst with no evidence of malignancy.
Jun 2020 DOI 10.14302/issn.2379-7835.ijn-19-3123
E. Ahmed FaridCorresponding author
GEM Tox Labs, Institute for Research in Biotechnology, 2905 South Memorial Drive, Greenville, NC 27834, USA
Isolation methods that employ readily-available inexpensive supplies on the open market, which are reliable, as well as economical, such as nucleic acid amplification techniques (NAAT) based on microfluidic technology in low-resource research settings (LRRS) that meets the ASSURED guidelines are essential to develop a noninvasive diagnostic colon cancer screen in stool using micro(mi)RNA molecules. A combination of a microfluidic-based MiRNA stool test with a reliable rolling circle amplification/detection method applied to the quantification of miRNA molecules, result in an affordable sensitive and specific isothermal method for the noninvasive quantitative detection of miRNAs in LRRS. Scientists and engineers have become interested in miRNAs, and they have intensified their efforts to apply emerging simple detection tools to the important bioanalytical challenge of quantifying these small 18-26 nt long molecules. Some of the proposed approaches incorporate novel material, such as simple centrifuges and methods based on microfluidic technology, while others utilize the interesting biological properties of these molecules, such as forming branched RCA structures, allowing for the detection of these biomarker molecules at an attomolar "aM" concentration level, using low cost extraction and isothermal amplification methods in LRRS. We have been interested in studying colorectal cancer (CRC) because it is the 3rd most common malignancy worldwide, and stool can be obtained noninvasively from the patients. We have focused in this research on colon cancer (CC) because it is more common in the USA than rectal cancer (RC). The innovation of our approach lies in the exploratory use of an affordable, quantitative miRNA profiling in noninvasive stool samples in LRRS, whose extracted fragile total RNA is stabilized shortly after excretion from stool by commercially available kits, so it does not ever fragment, followed by quantitative standardized analytical tests that are neither labor intensive, nor require expensive instrumentation, in order to develop apanel of novel miRNA genes for the noninvasive diagnostic screening of early left and right sporadic colon cancers, more economically, and with higher sensitivity and specificity than any other colon cancer screening test currently available on the market. To show the clinical sensitivity and specificity of the proposed quantitative miRNA test using simple methodologies in LRRS,the miRNA results are to be correlated with FOBT, colonoscopy, and pathology data. Standardization establishes test’s performance criteria (sample selection, optimal sample running conditions, preservation and storage), in order to ensure that the assay will perform the same way in any laboratory, by any trained personnel, anywhere in low-resource laboratory settings worldwide.
Feb 2019 DOI 10.14302/issn.2471-7061.jcrc-18-2526
E. Ahmed FaridCorresponding author
GEM Tox Labs, Institute for Research in Biotechnology, 2905 South Memorial Drive, Greenville, NC 27834, USA.
There is currently no validated micro(mi)RNA diagnostic stool test to screen for colon cancer (CC) on the market because of the complexity of fecal density, vulnerability of stool to daily changes, and the presence of three sources of miRNAs in stool (cell-free from fecal homogenates, exsosomal miRNAs from fecal exosomes, and fecal colonocytes). To address these complexities, we have first carried out a microarray miRNA experiment, using Affymetrix GeneChip miRNA 2.0 Arrays, on immunocaptured and enriched stool colonocytes of 15 subjects (three healthy controls and twelve colon cancer patients [three TNM stage 0-1 (e.g., polyps◻ ³ 1 cm, villous or tubvillous, or with high grade dysplasia), three stage 2, three stage 3, and three stage 4 in triplicates to select a smaller panel of 14 preferentially expressed mature miRNAs associated with colon cancer (12 Up-Regulated, miR-19a, miR-20a, miR-21, miR-31, miR-34a, miR-96, miR-106a, miR-133a, miR-135b, miR-206, miR-224 and miR-302; and 2 Down-Regulated, miR-143 and miR-145). In a subsequent validation study carried out on total small RNA extracted by immunocapture, followed by RT that employed TaqMan® miRNA Reverse Transcription (RT) Kit and a Custom TaqMan RT Primer Pool, absolute quantification of miRNAs, in copies/µl, was measured using a chip-based Absolute QuantStudio 3D Digital PCR analysis. To ensure that we have chosen human and not bacterial small total RNA, we have carried out coextraction protocols with E. coli K1 strain RS18, compare Agilent electrophoretic patterns, and also sequenced random samples throughout this research using mRNA/miRNA sequencing. Our initial quantitative dPCR miRNA data presented herein showe that the quantitative changes in the expression of a few mature miRNA genes in stool, which are associated with right and left colon cancer, would provide for a more convenient, sensitive and specific diagnostic screening markers thatare more useful than those test markers currently available on the market, such as the low-sensitivity (<15%) fecal occult blood test (FOBT); result in better compliance; and is more economical than the invasive and expensive colonoscopy exam in colon cancer, which can be cured if that cancer is detected at the early TNM stages, and that becomes incurable and deadly if not diagnosed before metastasis. Initial test performance characteristics of the miRNA approach showed that the test has a high numerical predictive value in colon cancer. Moreover, underpinning of the miRNA markers as a function of total RNA showed that the test can numerically differentiate between control subjects and colon cancer patients, particularly at the early stages of that curable cancer. We propose to extend our initial research results to a larger prospective and randomized five-years nested case-control study, to validate the expression of the above 14 miRNAs, in stool of 180 individuals in an epidemiologically designed study, using (30 controls and 150 colon cancer patients (thirty precancerous polyps (stage 0-1), forty five stage 2, and seventy-five colon cancer stages 3 or 4). chosen randomly by an epidemiological method from 900 control and CC subjects to allow for an adequate time to collect the required 900 stool samples, as well as allowing for statistically valid analysis, standardized test conditions, and to provide a mean for determining the true sensitivity and specificity of a miRNA-screening approach in noninvasive human stool. Power-analysis has indicated that a total of 180 individuals, which will take us 5 years to enroll in testing, is an appropriate number of subjects to standardize and validate our proposed miRNA screening test. We may find out at the end of the proposed validation study in stool that fewer miRNAs, or even one miRNA, may suffice to serve as an efficient and a quantitative marker for the non-invasive diagnostic screening of colon cancer in human stool. The above approach when combined with bioinformatics analysis, to correlate miRNA seed data with our previously published messenger (m)RNA target data in stool, allows for a thorough mechanistic understanding of how miRNA genes regulate mRNA expression, and would offer a better comprehensive diagnostic screening test for the non-invasive early detection stage (0-1) of colon cancer. In order to show the clinical sensitivity and specificity of the proposed miRNA test, the absolute miRNA PCR values, in copies/µl, will be correlated with FOBT, colonoscopy, and pathology data. Standardization will establish test’s performance characteristics (sample selection, optimal sample running conditions, preservation and storage) to ensure that the assay will perform the same way in any laboratory, by any trained personnel, anywhere in the World. Ultimately, a smaller number of selected validated miRNAs (<10) showing increased and reduced expression could suffice to give quantitative miRNAs colon cancer expression values, useful for the early diagnostic screening of that curable cancer.
Sep 2018 DOI 10.14302/issn.2578-2371.jslr-18-2174
Meriam SabbahCorresponding author
Department of gastroenterology, Habib Thameur Hospital, Tunis, Tunisia.
A rare case of association between primary sclerosing cholangitis and Paget's disease emphasizing the diagnostic difficulties in front of increased alkaline phosphatase is reported. The association between sclerosing cholangitis and Paget's disease wasn’t yet described and could thus be coincidental. However, our observation underlines the benefit of dosing ALP isoenzyme to characterize the bone or hepatic origin of ALP and therefore, help to guide the diagnosis.
Jun 2014 DOI 10.14302/issn.2372-6601.jhor-14-378
Kulma-Kreft MonikaCorresponding author
Department of Radiotherapy and Medical Oncology, Gdynia Cancer Center, Gdynia
Progressive multifocal leukoencephalopathy (PML) is a rare complication associated, inter alia, with rituximab-based lymphoma treatment. PML diagnosis is made easier with the criteria recently published by the American Academy of Neurology. Unambiguous diagnosis of PML can be achieved by demonstration of the histopathological triad comprising:(1) demyelination, (2) bizarre astrocytes and (3) enlarged oligodendroglial nuclei together with detection of viral particles by electron microscopy. However, symptoms of PML may be similar to those observed during lymphoma progression into the central nervous system (CNS). Here we report the case of a patient with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP who developed clinical signs indicating PML. Intravital diagnostic methods failed to yield an unequivocal diagnosis of PML or lymphoma progression in the CNS. However, a post-mortem examination of brain biopsy specimens performed by electron microscopy demonstrated lesions typical for PML and the presence of viral particles. In addition, immunohistochemical assays identified a massive infiltration of lymphoma cells. The case thus suggests either the extremely rare coexistence of two complications: lymphoma CNS infiltration and PML or induction structural CNS lesions by lymphoma infiltration indistinguishable from PML. The presented findings thus highlight the need for a further review of the current diagnostic criteria for PML.
Feb 2014 DOI 10.14302/ISSN.2372-6601.JHOR-13-344
Raddaoui EmadCorresponding author
Department of Pathology, King Khalid University Hospital; College of Medicine, King Saud University.
Context: Fine needle aspiration cytology (FNA) is increasingly replacing excisional lymph node biopsy in the assessment of various lymphoid lesions. Recent changes in the classification of non-Hodgkin’s lymphoma, namely the WHO (World Health Organization) Classification of Tumors of Haematopoietic and Lymphoid Tissues has considerably expanded its classification of lymphomas based on the molecular and cytogenetic profiling and immunophenotyping. FNA diagnosis includes varied cytomorphologic diagnostic categories; one of them is the atypical/suspicious. Objective: The atypical/suspicious category constitutes about 20 % of all cases studied by FNA cytology. The objective of this study is to determine the definition and the outcome of this unique category. Design: A retrospective analysis of 34 fine needle aspirations with the diagnosis of atypical/suspicious cases were obtained during the period between 1995 –2000, and the histological and/or clinical follow-up was performed. Results: Flow cytometry was performed on all of the atypical/suspicious lesions. It was positive/diagnostic in 16 (47%) and negative in 18(53%) cases. Excisional follow-up biopsy was obtained in 30 cases. Of these 7(21%) confirmed to be negative, 17(50%) Non-Hodgkin’s lymphoma and 6 (18%) Hodgkin’s Lymphoma. Conclusion: The atypical/suspicious category by fine needle aspiration is a crucial diagnosis as it has proved to represent some type of lymphoma in about two third (68%) of cases.
Jun 2026 DOI 10.14302/issn.2642-9241.jrd-26-6332
de Melo PhilipCorresponding author
Respiratory diseases remain a major contributor to hospital morbidity and mortality worldwide, particularly among elderly patients and individuals with severe pulmonary compromise. Accurate prediction of respiratory mortality is clinically important for triage, resource allocation, ICU utilization, and early intervention. Traditional statistical models frequently demonstrate limited predictive sensitivity because respiratory mortality is influenced by complex interactions among demographic, diagnostic, physiologic, and severity-related variables. In this study, a machine learning framework was developed to predict in-hospital mortality among patients with respiratory disease using administrative and clinically derived variables, including age, sex, length of stay (LOS), diagnostic descriptions, risk of mortality and severity scores. A Random Forest classifier with balanced class weighting was developed and implemented to address nonlinear relationships and class imbalance within the dataset. Initial modeling demonstrated good overall discrimination performance, with receiver operating characteristic area under the curve (ROC-AUC) values approaching 0.84; however, mortality recall remained limited because deceased patients represented a minority class within the original dataset. To improve mortality detection, a physiologically informed synthetic augmentation strategy was developed. Synthetic clinical variables included oxygen saturation, ICU status, ventilator support, sepsis status, systolic blood pressure, creatinine, and lactate levels. Conditional physiologic consistency rules were incorporated during augmentation to preserve clinically plausible relationships among respiratory failure, hemodynamic instability, and organ dysfunction. The augmented dataset substantially improved model sensitivity and balanced mortality classification performance. Final model evaluation demonstrated strong predictive capability, achieving approximately 97% classification accuracy with balanced precision and recall across mortality classes. Confusion matrix analysis revealed marked reduction in false-negative mortality predictions compared with baseline modeling approaches. Feature importance analysis identified physiologic instability markers, respiratory severity classifications, LOS, and diagnostic respiratory categories as dominant predictors of mortality. These findings suggest that hybrid simulation-augmented machine learning frameworks may provide a valuable strategy for respiratory mortality analytics, particularly in datasets with limited real-world mortality prevalence and incomplete physiologic representation.
Apr 2026 DOI 10.14302/issn.2994-6743.ijstd-25-5899
W. Ruddock MarkCorresponding author
Background Sexually transmitted infections (STIs) continue to rise globally, with >1 million new cases reported daily in 2020. In England, newly diagnosed STIs increased by 23.8% in 2022 compared to 2021. Many infections remain asymptomatic yet contribute to infertility, pregnancy complications, and neonatal morbidity. While routine screening often focuses on Chlamydia trachomatis, broader detection is limited by laboratory turnaround times and restricted test panels. Methods We analysed 6003 home-collected urine and/or swab samples submitted for sexual health screening in the UK. Samples were tested in the laboratory for 10 bacterial and viral pathogens. A total of 5859 urine and 1627 swab samples were processed, with paired samples assessed for diagnostic agreement. Results The most common infections detected in urine were Ureaplasma urealyticum (12.1%), Mycoplasma hominis (8.6%), and Chlamydia trachomatis (2.4%). Swabs showed similar prevalence, with Ureaplasma urealyticum (11.6%) most frequent, followed by Mycoplasma hominis (10.4%) and HSV-2 (4.4%). Paired urine–swab samples demonstrated strong agreement, though swabs improved HSV detection. Conclusions Ureaplasma urealyticum was the most prevalent STI detected, yet only Chlamydia trachomatis is routinely screened in England. Comprehensive laboratory testing of home-collected samples could reduce the hidden burden of STIs, infertility, pregnancy complications, and neonatal infections, while offering confidential and accessible diagnostics.
Feb 2026 DOI 10.14302/issn.2576-6694.jbbs-26-5964
Flanagan DennisCorresponding author
The combination of ultrasonography (US) and cone beam computed tomography (CBCT) has been proposed as a multimodal imaging strategy capable of uniting realtime softtissue assessment with highresolution threedimensional visualization of osseous structures. This study critically evaluated whether such integration provides measurable diagnostic or workflow advantages in mandibular imaging. Despite strong theoretical justification, the combined use of US and CBCT failed to demonstrate clinically meaningful improvements in diagnostic accuracy, confidence, or efficiency when compared with CBCT alone. Fundamental physical mismatches, hardware incompatibilities, geometric constraints, and operatordependent variability limited the anticipated synergistic benefits. These negative findings underscore the importance of reporting unsuccessful integration attempts to guide future research and prevent premature clinical adoption of technically incompatible imaging paradigms.
Nov 2025 DOI 10.14302/issn.2470-0436.jos-25-5503
H. Nelson MarkCorresponding author
Purpose Create a new diagnostic and therapeutic framework for patients with Exudative Age-Related Macular Degeneration (ARMD) and choroid imaging biomarkers of non-neovascular choroidal pathology who have persistent neovascular exudation during the course of monotherapeutic interventions. Methods Retrospective, longitudinal case series study of 25 eyes from 23 patients with the referral diagnoses of treatment resistant Exudative ARMD who had persistent neovascular exudation despite various monotherapies. Inclusion criteria required choroidal imaging biomarkers of non-neovascular pathology including a thickened subfoveal choroid (greater than 300 microns) and vessels (subjectively dilated choroidal vessels in Haller’s layer) on Optical Coherent Tomography (OCT), choroidal neovascularization on IVFA and OCT Angiography (OCTA), as well choroidal leakage noted on indocynanine green videoangiography (ICG). Treatment consisted of OCTA and ICG - Directed Photodynamic Therapy (PDT) Triple Therapy, hereafter described as Combination Therapy, to areas of choroidal hyperpermeability and choroidal neovascularization. Combination therapy consisted of an anti-Vascular Endothelial Growth Factor (VEGF) intravitreal injection on Day 0 followed by half-fluence PDT and 2 mg intravitreal triamcinolone acetonide on Day 3-14. Results All study patients had treatment resistant Exudative ARMD defined as persistent subretinal and/or intraretinal fluid during their course of monotherapeutic interventions. Complete resolution of all exudation occurred in 23 eyes (92.0%) at 8 weeks. The mean duration of action was 155.6 weeks, with 72.0% of eyes leak free greater than 100 weeks. The mean vision at baseline was 0.46 ± 0.42 LogMAR, best corrected visual acuity (BCVA). 8 weeks after treatment, the vision was 0.35 ± 0.38 LogMar, an improvement of over one line, and this was maintained at one year. The baseline central subfield thickness (CST) was 296.4 ± 136.1 microns and improved by 111.4 ± 105.4 microns at 8 weeks after treatment. Treatment duration was negatively associated with the Caucasian race. Conclusions Patients with subretinal and/or intraretinal fluid secondary to Exudative ARMD should have a complete baseline multimodality imaging study to confirm the presence of neovascularization and whether choroidal hyperpermeability coexists. This study shows that patients with Exudative ARMD and persistent neovascular exudation despite monotherapuetic interventions often have choroidal biomarkers of non-neovascular choroidal pathology and that ICG and OCTA-directed PDT Triple Therapy resulted in complete resolution of all exudation in 92.0% of patients at 8 weeks with a reduction in central subfield thickness (CST) of 111.4 microns. The vision improvement at 8 weeks was 0.11 ± 0.38 LogMar and was sustained over 1 year. The mean duration of action was 155.6 weeks, with 72.0% of eyes leak free greater than 100 weeks. Additionally, this study shows that the treatment that addresses both pathological processes is successful and should be considered as a primary protocol when the biomarkers are present at baseline or as a secondary protocol if indeed the neovascular leakage is persistent despite monotherapy. Summary Patients with an Exudative ARMD with persistent neovascular exudation despite anti-VEGF monotherapy and who have imaging biomarkers of non-neovascular choroidal pathology often have two pathophysiological processes: choroidal hyperpermeability and angiogenesis. A proposed framework provides the rationale for OCTA and ICG-directed PDT Triple Therapy which successfully resolves 92% of the leakage that was persistent after various monotherapeutics.
Sep 2025 DOI 10.14302/issn.2768-0207.jbr-25-5706
Nakamura YusukeCorresponding author
Artificial Intelligence (AI) is emerging as a transformative force across many sectors, with healthcare representing both one of the most promising and most challenging areas of application. This review summarizes current and future applications of AI in healthcare, focusing on its potential to improve diagnosis, therapy, chronic disease management, and overall patient care, while also alleviating physicians’ workload. Recent literature demonstrates that AI systems can reduce diagnostic errors/delays by mitigating cognitive biases, support imaging and pathology through improved accuracy and speed, and prevent prescribing errors by integrating pharmacogenomic and clinical data into decision-support systems. In chronic disease management, AI-powered wearable devices enable continuous monitoring and early detection of conditions such as atrial fibrillation, thereby reducing the risk of stroke and long-term disability, particularly in elderly people. Therapeutic applications include AI-driven drug discovery, personalized oncology, and tailored medicine that integrates multi-omics and lifestyle data. Beyond direct medical intervention, AI contributes by automating routine tasks, optimizing workflows, and facilitating greater patient–clinician interaction. Despite these benefits, significant challenges remain, including issues of data quality, privacy, security, equity, and the need for transparency and trust in “black box” systems. Looking ahead, the integration of multimodal data, digital twins, and robotics is expected to advance more comprehensive, equitable, and human-centered care. We conclude that, when applied ethically and responsibly, AI should not replace clinicians but rather serve as a powerful partner that enhances medicine by restoring empathy and humanity.
May 2025 DOI 10.14302/issn.2379-8572.joa-25-5504
Hachemi MohamedCorresponding author
Introduction Angiosarcoma is a rare malignant tumour from fast-evolving and aggressive vascular endothelial cells that accounts for 1% of all sarcomas. The sinus location of angiosarcoma is exceptional. The clinical polymorphism of this tumour may cause a delay in diagnosis. Risk factors are not always understood. However, a history of radiation therapy for locoregional cancer and/or lymphedema is most commonly found. The prognosis remains bleak with an overall five-year survival of 35 to 40%. Objectives The authors discuss the diagnostic, therapeutic and prognostic modalities and difficulties of this tumour. Observation: The authors report a case of maxillary sinus angiosarcoma confirmed by radio-induced secondary CD34 immunohistological staining in a 40-year-old man having a history of hemangioendothelioma treated with conservative endoscopic surgery and adjuvant radiotherapy 15 months earlier. Discussion This lesion is rare in the ENT sphere and may be confused with a benign tumor in its early stages. Only histological examination with immunohistochemistry can confirm the diagnosis (factor VIII, CD34 and CD31 antigens). Treatment consists of a wide resection followed by radiotherapy, hence the need for early diagnosis in the metastatic phase, first-line treatments include doxorubicin or paclitaxel weekly. Conclusion Radio-induced angiosarcoma is a rare malignant tumour, it occurs in patients who have received conservative treatment and radiation therapy for nasosinusitis cancers. Angiosarcomas of the nasal passages remain a diagnostic and therapeutic challenge due to their local and general aggressiveness.
Mar 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5429
O. Makanjuola RasheedCorresponding author
Malaria and bacteraemia are significant public health concerns and economic threats. In Africa, the intensity for simultaneous transmission and co-infection of Plasmodium spp and other bacteria pathogens are extremely high. It is believed that malaria suppress the immune system and enable the translocation of bacteria in the gastrointestinal tract to other cellular compartments in the body. Some of the factors that contributed to the co-emergence of these pathogens are poor access to clean water, sanitation and hygiene (WASH), poor infection control measures, inefficient health care systems. In addition, the similarities in the clinical signs and symptoms of these febrile diseases and the fact that the etiologic diagnostic testing can be complex, costly, and limited are the reasons why clinicians in resource-constrained setting often prescribe antibiotics empirically prior to or without laboratory testing to prevent severe outcomes in any patient hospitalized with malaria. However, this indiscriminate use of antibiotics has been identified as the driving force for antibiotic resistance, which is already at alarming rate in malaria endemic nations. In developed countries where malaria had been previously eradicated, there are increasing reports of imported malaria with concurrent bacteraemia. In this review, we emphasized the role of malaria in the indiscriminate use of antibiotics and the fact that eliminating malaria in Africa is one of the best strategies to address the emergence and the global spread of multi-drug resistance organisms.
Oct 2024 DOI 10.14302/issn.2691-5014.jphn-24-5310
Alsaeed GihadCorresponding author
Cystic neck masses are uncommon in children, and a minority of them are soft. Internal jugular vein phlebectasia (IJVP) is a rare cause of soft neck cysts. It presents usually as a unilateral soft neck mass of changing size. In most cases it is unilateral, right sided and predominantly in males. Imaging study modalities are diagnostic and helpful for observation and follow up. In the vast majority of cases, it decreases in size with time requiring only conservative treatment. However, surgery might be necessary in large or complicated phlebectasia. IJVP is underdiagnosed or misdiagnosed especially in pediatrics, with few cases documented in medical literature. To improve awareness of presentation and management-plan of this rare case, the authors present an extremely rare case of huge left internal jugular phlebectasia in a 14 year-old boy worsened and complicated over years of wait and see approach that needed surgical treatment.
Aug 2024 DOI 10.14302/issn.2372-6601.jhor-24-5108
Zakaria Baniamer AnsamCorresponding author
Hereditary thrombotic diseases, or inherited bleeding disorders, are a group of genetic conditions that disrupt normal blood coagulation. These diseases result from mutations in genes encoding blood coagulation factors or other regulatory proteins, impairing the body's ability to regulate bleeding and clotting. The most common inherited clotting disorders are hemophilia A and B, which are associated with deficiencies in clotting factors VIII and IX, respectively. Von Willebrand disease (VWD) is another prevalent disorder characterized by a deficiency or dysfunction of the Von Willebrand factor, a protein essential for coagulation. Additionally, the Factor V Leiden mutation is linked to an increased risk of blood clots. The prevalence of inherited coagulation disorders varies significantly by region and subpopulation. It is estimated that 5,000 to 10,000 male newborns are born with hemophilia A or B each year. Von Willebrand disease is much more common, affecting about 1% of the global population. The Factor V Leiden mutation is found in significant percentages of certain populations, with 3–8% of Caucasians being carriers. While antithrombin deficiency is more common in some areas, the incidence of other inherited clotting disorders, such as Factor XI, protein C and S deficiencies, and VWD, varies widely worldwide. This study discusses the incidence of inherited clotting disorders and their impact on affected individuals and their families. It also covers new advancements in disease management, alternative therapy approaches, and contemporary diagnostic techniques, aiming to improve diagnoses, treatments, and outcomes for patients with hereditary clotting disorders.
Jun 2024 DOI 10.14302/issn.2998-4785.ijne-24-5138
Isea RaúlCorresponding author
The work emphasizes the need for additional research to create novel biomarkers based on the use of microRNAs as a less invasive and precise diagnostic technique for identifying diseases in newborns.
Apr 2024 DOI 10.14302/issn.2998-4211.jalr-24-4926
Bahadur Khan FaizaCorresponding author
This article has been retracted on 20 March 2025. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2998-4211.jalr-25-5855) The research is focused on neuroinflammation a normal physiological process which is known to be associated with neurodegenerative diseases could be the potential targeted therapy via the microglia cells, it starts with defining Alzheimer’s; a neurodegenerative disease which causes deposition of Aβ (amyloid beta) protein in the cerebral cortex as well as NFT (neurofibrillary tangles) in the hippocampus and basal ganglia. The paper then describes process of neuroinflammation, microglia’s role, apolipoprotein E4 gene in relation to Alzheimer’s, which leads to different stem cell research and how pruning microglia as well as targeting microglia receptors in the brain is being used in current research trials, we included multiple meta-analysis showing microglia receptors being targeted currently by emerging drugs like propofol, antibodies CSF1R inhibitor etc, which are currently under trial phase, the research ends with concluding potential diagnostic markers like sirt1 considered to be an anti-aging protein which can be used as therapeutic interventions and Lps effect on Sirt 1. A Microglia initiated target therapy in Neuroinflammation for Alzheimer’s Patients.
Mar 2024 DOI 10.14302/issn.2997-2108.jcc-20-3675
Yuan ZhengCorresponding author
Pemphigus vulgaris is an autoimmune-mediated blistering disease. Cervical involvement is rare. A 38 year old nulliparous woman with PV on oral prednisolone and azathioprine was referred to the Gynaecology service for an abnormal cervical cytological smear showing low-grade squamous intraepithelial lesion. She was asymptomatic, 10 pack-year smoker, and reported no abnormal vaginal bleeding. Colposcopy was unsatisfactory with inadequate visualisation of the transformation zone due to severe cervico-vaginitis. A small focus of aceto-white epithelium was seen, surrounded by peeling, friable epithelium. HPV DNA test was negative. Punch biopsy demonstrated metaplastic squamous epithelium with intraepidermal suprabasal blister formation with acantholysis. Well-vascularised dermal papillae lined residual basal cells, giving rise to a tombstone appearance. There was no evidence of CIN/CGIN or invasive malignancy. An ulcer was also seen in the left buccal region. Repeat colposcopy after 6 weeks showed a small ulcerated area at the biopsy site with rolled healing edges, and a separate small ulcer. Cervical smear and colposcopy 6 months later were unremarkable. The incidence of cervical pemphigus vulgaris may be underestimated because women with pemphigus are often managed by Dermatologists without gynaecological input. In many published cases, cervical involvement was only detected after gynaecological examination due to symptoms such as dyspareunia, post-coital bleeding or vaginal discharge. Cervical smears of patients with pemphigus vulgaris typically display acantholysis, which may be misinterpreted as reparative, inflammatory, or neoplastic change. There have been reports of unnecessary hysterectomy due to such misdiagnoses. Review by an experienced cyto-pathologist is required in the event of diagnostic uncertainty.
Nov 2023
Md. Khursid Alam AnsariCorresponding author
Uroscopy is the first documented laboratory test in medicine and is a fundamental diagnostic tool in the Unani system of medicine. Proper sample collection, handling, and identification are important to insure valid results in uroscopy.There are certain do’s and don’ts about the sampling mentioned in the text of the Unani medicine that should be followed. Generally, a urine sample is collected by the patient himself or herself, hence they must be educated to avoid contamination to ensure the purity of the sample. Despite this, there is a chance for error or malpractice hence collected samples should be identified for sufficiency and originality. There is a certain factor that can cause an erroneous result that must be avoided. Unani scholars have mentioned that sometimes patients brought other similar fluids or animal urine to test the competence of the physician or to mislead the diagnosis. To deal with such a situation differentiation of urine with other liquors should be made. The method of sample collection and identification for uroscopy are systematically summarized in this paper.
Oct 2023 DOI 10.14302/issn.2641-4538.jphi-23-4622
Geinoro Alleyo TarikuCorresponding author
The Ortho-poxvirus virus, which causes monkey pox, is a member of the Poxviridae genus. It was initially found in primates. In 1970, the Democratic Republic of the Congo reported the first instance of monkey pox. From there, it spread to a number of countries both inside and outside of Africa. There are two genetic varieties of monkey pox, which have been spread to people through respiratory droplets, and touch with objects contaminated by an affected person and consequently is often encountered in work situations. Among the countries with the worst effects are Nigeria and the Democratic Republic of the Congo. Non-human primates, rats, squirrel, and or mice are just a few of the creatures that can become infected by monkey pox. Although the origins of monkey pox infections are unknown, rodents from Africa and non-human primates like monkeys may contain the viruses and infect humans. Monkey pox is more likely to naturally infect rodents. Monkey pox has symptoms and lesions that are difficult to distinguish from smallpox in its clinical manifestations. Fever, chills, migraines, tiredness, tonia, swollen lymph nodes, back pain, and myalgia are some of the clinical symptoms of monkey-pox. A few examples of diagnostic tests include immune-fluorescent antibody assays, enzyme-linked immune-sorbent assays, and real-time polymerase chain reactions. A specialized vaccine that offers complete protection against by them on key-pox virus exists, yet there is no specific therapy for human monkey infection and interaction with the vaccinia virus. Smallpox vaccination can give cross-immunity with partial protection against infection and a reduction in symptom severity. Unfortunately, community health effects in the view of one health approach has not been addressed in vast. Therefore, the objectives of this review paper are to discuss the community health effects of monkey pox and to emphasize the role of one health approach against monkey pox.
Aug 2023 DOI 10.14302/issn.2574-4496.jtc-23-4674
Almegbe MaysanCorresponding author
A case report of primary thyroid leiomyosarcoma with literature review. It discusses diagnostic pitfalls, histologic criteria, and management options.
May 2023 DOI 10.14302/issn.2693-1176.ijgh-23-4451
Bajaj AnubhaCorresponding author
A clinical image and brief discussion of cutaneous mastocytosis describe presentation, dermoscopy, and diagnostic clues. The note underscores when to evaluate for systemic involvement.
Mar 2023
Oleg BodinCorresponding author
The visual presentation of the results of the analysis of cardio graphic information is an important element of the diagnostic process. The article discusses the issues of visualization of the state of the heart, notes the importance of a visual representation of the processes of the functioning of the heart for diagnosis. The Delaunay triangulation is considered and it is proved that on its basis it is possible to approximate an arbitrarily complex surface. An algorithm for constructing a surface model of the heart based on Delaunay triangulation has been developed. The issues of texture generation are covered in detail. The texture is a convenient tool for displaying the state ofthe heart, as it allows you to visually show the place of possible damage on the surface of the heart.
Oct 2022 DOI 10.14302/issn.2381-862X.jwrh-22-4315
Nazempour AnahitaCorresponding author
OB/Gynecologist, fellowship of infertility and IVF, Sarem fertility and infertility research center (SAFIR), Sarem women’s hospital, Tehran, Iran.
Background Polycystic ovary syndrome (PCOS) is a serious multifactorial disorder. This study intended to assess the effect of cinnamon supplementation on estradiol level, and fasting- and two-hour (2 hpp) insulin and sugar levels in women with PCOS. Material and Methods This study was a double-blinded randomized clinical trial (RCT), conducted between January 2019 until December 2020, at Gynecology Clinic Sarem Women’s Hospital in Tehran, Iran. Patients with PCOS, 130 subjects (65 person/ group) were diagnosed using Rotterdam diagnostic criteria. All participants received daily treatment consisting of 1500 mg metformin and 1000 mg cinnamon per day for 12 weeks. An evaluation of serum AMH level was conducted before and after the completion of therapy. Results Cinnamon supplementation significantly reduced the estradiol, fasting glucose and 2hpp glucose, fasting insulin and 2 hpp insulin, BMI and weight levels after intervention. The highest reduction was observed in fasting glucose, 2 hpp insulin, and estradiol groups after intervention (P<0.05). There was a significant difference between the means of BMI (P<0.01), fasting sugar (P<0.01), and 2 hpp glucose (P<0.01) before and after intervention. Conclusion Cinnamon supplementation, as a safe herbal product, can be prescribed with metformin to improve the symptoms and complications of PCOS.
Sep 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4328
Dias De Souza GleimCorresponding author
Radiologist at Núcleo de Radiologia e Imagenologia do Hospital Regional da Asa Norte-HRAN-Distrito Federal-Brasília-Brazil
Objectives To evaluate the diagnostic accuracy of chest CT for the diagnosis of COVID-19 associated with the clinical presentation and in relation to the PCR-RT. Sensitivity, specificity, positive predictive value and negative predictive value, gender, age group and degree of lung involvement will be evaluated. Methods We evaluated 1545 patients with chest CT, delineating the age range and degree of lung involvement, and 306 patients with chest CT and PCR-RT. Results Of the 1545 examinations, 53% were men and 47% were women, there was greater involvement in the 50-59 age group. In the pulmonary study, 55.05% were COVID-19. In the degree of lung involvement 37.70% were mild, 35.76% were moderate, and 26.54% were severe. In the distribution by age, there was a greater involvement between 50-59 years with 56% between moderate (27.6%) and severe (28.0%). Between tomography and PCR-RT, the sensitivity was 68.8%, specificity 59.5%, accuracy 91.3%, with prevalence 31.9%, positive predictive value 44.3% and negative predictive value 80.3%, in females, sensitivity 55.3%, positive predictive value 37.1%, negative predictive value 75.3%, in males, sensitivity 81.6%, positive predictive value 50, 6 and negative predictive value 86.6%.The sensitivities are different between the genders with p of 0.005 and specificity of 0.938, with age effect, starting at 45 years we have a p of 0.057 that decreases to 0.006 at 80 years for sensitivity and specificity. Conclusions The sensitivity and accuracy of CT scan in relation to PCR-RT was significant. Sensitivity increases with prevalence and in the older age group and in men.
Aug 2022 DOI 10.14302/issn.2835-2165.jfsh-22-4263
Mazhar WaqarCorresponding author
Pakistan
In Pakistan, production of poultry has been evolved as a good alternate of beef and mutton. In this study multiplex PCR approaches were adopted to differentiate and detect avian mycoplasma in a single PCR reaction as a step forward in the economization of PCR detection. From the total of 25 samples, 25 (100%) had a positive Mycoplasma isolation result. The biochemical test yielded the highest number of isolations, with MG accounting for 10/25. Commercial DNA-based PCR kits have been developed as a result of recent advancements in diagnostic techniques for Mycoplasma infections. Tetracyclines, fluoroquinolones, tilmicosin, tylosin, spiramycin Infections should be reduced as much as possible.
Jul 2022 DOI 10.14302/issn.3070-3360.ijco-22-4231
Mulani AmanCorresponding author
PG-Scholars(rognidan) DPU. D.Y.Patil vidyapeeth's, Dr.d.y.patil College of Ayurved and research center pimpri pune-18
Nidana Panchaka is one of Ayurveda's several diagnostic procedures. It is the most significant way for determining the source of an illness, as well as predicting its prognosis. Nidana Panchaka comprises of five items which are Nidana (etiological factors), Purvaroopa (primordial symptoms), Roopa (signs and symptoms), Upashaya (like and dislike) and Samprati (etiopathogensis) (etiopathogensis). Diagnosis of sickness depends on Tridoshas which are Vata, Pitta, Kapha which are responsible for any disease that arises in the body. These imbalances in the Doshas of the body are caused by etiological variables such as a person's lifestyle and eating habits. Prior to seeking therapy for a condition, a proper diagnosis is required. There are numerous additional procedures for diagnosing the ailment, such as Ashtavidha Pareeksha, Dashavidha Pareeksha, and Chaturvidha Pareeksha, but the focus of this article is on the significance of Nidana Panchaka.
May 2022 DOI 10.14302/issn.2766-8681.jcsr-22-4162
Wang LingCorresponding author
Department of Intensive Care Unit, People’s Hospital of Qiandongnan Miao and Dong Autonomous Prefecture, Kaili, Guizhou 556000, China
Alveolar-arterial oxygen pressure difference (P(Aa)O2) can reflect pulmonary ability to exchange oxygen; it shows good correlation with the oxygenation index (OI), which is important in diagnosing acute respiratory distress syndrome (ARDS). This study explored the ability of P(Aa)O2 in diagnosing ARDS in pneumonia patients. Methods We selected patients with community-acquired pneumonia and sepsis in the intensive care unit (ICU) of the People’s Hospital of Qiandongnan Miao and Dong Autonomous Prefecture; we measured P(Aa)O2 and the OI under anoxic conditions upon their admittance to the ICU. We divided the patients into ARDS and non-ARDS groups. We compared the differences in P(Aa)O2 and OI; we analyzed the correlation between P(Aa)O2 and ARDS. To assess the diagnostic ability of P(Aa)O2 for ARDS, we drew the receiver operating characteristic (ROC) curve. Result We found that P(Aa)O2 in the ARDS group was greater than in the non-ARDS group (t = 8.875, P <0.001); the OI in the ARDS group was smaller than in the non-ARDS group (t = –6.956, P <0.001). There was a positive correlation between P(Aa)O2 and ARDS (r = 0.718, P <0.001). The area under the ROC curve for P(Aa)O2 in the diagnosis of ARDS was 0.931 (0.873–0.988); the cutoff value was 214.70 mmHg, the sensitivity was 89.50%, and the specificity was 85.00%. Conclusion We conclude that P(Aa)O2 is a good reference index in diagnosing ARDS.
Apr 2022 DOI 10.14302/issn.2689-5773.jcdp-22-4123
Vladimir ZaichickCorresponding author
Background Thyroid benign (TBN) and malignant (TMN) nodules are a common thyroid lesion. The differentiation of TMN often remains a clinical challenge and further improvements of TMN diagnostic accuracy are warranted. The aim of present study was to evaluate possibilities of using differences in trace elements (TEs) contents in nodular tissue for diagnosis of thyroid malignancy. Methods Contents of TEs such as silver (Ag), aluminum (Al), boron (B),, beryllium (Be), bismuth (Bi), cadmium (Cd), cerium (Ce), cobalt (Co), chromium (Cr), cesium (Cs), iron (Fe), gallium (Ga), mercury (Hg), iodine (I), lanthanum (La), lithium (Li), manganese (Mn), molybdenum (Mo), neodymium (Nd), nickel (Ni), lead (Pb), praseodymium (Pr), rubidium (Rb), antimony (Sb), scandium (Sc), selenium (Se), samarium (Sm), tin (Sn), thallium (Tl), uranium (U), yttrium (Y), and zinc (Zn) were prospectively evaluated in nodular tissue of thyroids with TBN (79 patients) and to TMN (41 patients). Measurements were performed using a combination of non-destructive instrumental neutron activation analysis with high resolution spectrometry of short- and long-lived radionuclides (INAA-SLR and INAA-LLR, respectively) and destructive method such as inductively coupled plasma mass spectrometry (ICP-MS). Results It was observed that in TMN tissue the mean mass fractions of Be, Fe, I, Sc, and Se are approximately 1.9, 1.7, 14, 3.1, and 1.6 times, respectively, lower while the mass fraction of Ga, Mo, and Rb 62%, 51%, and 33%, respectively, higher than those in TBN tissue. Contents of Ag, Al, B, Bi, Cd, Ce, Co, Cr, Cs, Hg, La, Li, Mn, Nd, Ni, Pb, Pr, Sb, Sm, Sn, Tl, U, Y, and Zn found in the TBN and TMN groups of nodular tissue samples were similar. Conclusions It was proposed to use the I mass fraction, as well as I/Ga, I/Mo, and I/Rb mass fraction ratios in a needle-biopsy of thyroid nodules as a potential tool to diagnose thyroid malignancy. Further studies on larger number of samples are required to confirm our findings and proposals.
Mar 2022 DOI 10.14302/issn.2572-3030.jcgb-22-4121
Pierre Diaga SARRCorresponding author
Laboratory of Clinical Cytology, Cytogenetics and Reproduction Biology, Aristide Le Dantec Hospital, Dakar-Senegal
Introduction Genomic mutations in TP53 gene in association with etiological risk factors have been associated with oral carcinogenesis. Herein, we screened for genomic variants of TP53 predisposing to oral cancers in Senegalese patients. Methodology 88 patients with confirmed diagnostic were recruited after informed consent. Blood samples were collected from each patient to perform DNA extraction, PCR amplification of all coding exons of TP53 followed by Sanger Sequencing of PCR products. Nucleotide sequences were analysed with Genalys software. 94 blood donors with no cancer diagnosis were also recruited as controls for association study between the most common variants identified in patients and predisposition to oral cancers. Results Sequence analysis showed that 52.27% of patients carry at least one mutation in TP53. Eleven genomic variants were identified, 7 variants already reported in databases and 4 new variants. The most recurrent variants in this study already reported as cancer-related variants were Pro72Arg (rs1042522; Arginine frequency estimated at 31.26%) and a 16 bp insertion in intron 3 (rs59758982; allelic frequency estimated at 26.25%). Haplotype analysis between these variants showed a strong linkage disequilibrium (D’ = 0.999, r2 = 0.153 and p-value < 0.05). However, association study did not find any significant association with susceptibility to oral cancer (p-value > 0.05). Conclusion Our study highlighted that despite the absence of association between the two most common cancer-related variants in Senegalese patients diagnosed with oral cancer, their strong LD suggested that they could be transmitted together in a common haplotype which may be implicated in oral carcinogenesis.
Feb 2022 DOI 10.14302/issn.2689-5773.jcdp-22-4065
Zaichick VladimirCorresponding author
Prof., Dr. Vladimir Zaichick, Medical Radiological Research Centre, Korolyev St. 4, Obninsk 249036, Russia.
Thyroid malignant nodules (TMNs) are the most common endocrine cancer. The etiology and pathogenesis of TMNs must be considered as multifactorial. Diagnostic evaluation of TMNs represents a challenge, since there are numerous benign and malignant thyroid disorders that need to be exactly attributed. The present study was performed to clarify the possible role of some trace elements (TEs) as cancer biomarker. For this aim thyroid tissue levels of copper (Cu), iron (Fe), iodine (I), rubidium (Rb), strontium (Sr), and zinc (Zn) were prospectively evaluated in malignant tumor and thyroid tissue adjacent to tumor of 41 patients with TMNs. Measurements were performed using energy-dispersive X-ray fluorescent analysis. Results of the study were additionally compared with previously obtained data for the same TEs in “normal” thyroid tissue. From results obtained, it was possible to conclude that the common characteristics of TMNs in comparison with “normal” thyroid and visually “intact” thyroid tissue adjacent to tumor were drastically reduced level of I. It was supposed that the drastically reduced level of I content in cancerous tissue could possibly be explored for differential diagnosis of benign and malignant thyroid nodules.
Feb 2022
Gobato RicardoCorresponding author
Green Land Landscaping and Gardening, Seedling Growth Laboratory, 86130-000, Parana, Brazil.
Using samples of small cell lung tumors, a research team led by biologist Dr. Raymond discovered two new ways to induce tumor cell death. By activating ferroptosis, one of two subtypes of tumor cells can be targeted: first, iron-dependent cell death due to oxidative stress, and second, oxidative stress. Therefore, cell death can also be induced in a different way. Both types of cell death must be caused by drugs at the same time to eliminate the majority of the tumor mass. It is currently in clinical trials for cancer treatment. Auranofin, which inhibits the production of protective antioxidants in cancer cells, has been used to treat rheumatoid arthritis for decades. Future clinical trials using this combination therapy will determine the extent to which this targeted treatment option improves the prognosis of small cell lung cancer patients. It is currently in clinical trials for cancer treatment. Lung cancer is the leading cause of cancer death in the United States. Despite evidence of molecular abnormalities in biological specimens, progress in this disease is hampered by the lack of diagnostic markers useful for clinical practice. The majority of patients with lung cancer are still diagnosed at an advanced stage, when prognosis is poor. This article reviews new strategies being studied for the early detection of lung cancer. These strategies involve new methods of imaging (including low-dose computed tomography CT scanning), DNA analysis, and proteomic-based techniques. These strategies have not only improved our understanding of lung cancer but show promise in offering better survival to patients with this deadly disease. Of paramount importance in the search for methods of early detection is the need for the identification of the ideal population to screen, a multidisciplinary approach, and validation of promising techniques.
Aug 2021 DOI 10.14302/issn.2326-0793.jpgr-21-3917
Tarassishin LeonidCorresponding author
Department of Pathology, Albert Einstein College of Medicine, United States.
50 years ago the Enzyme Immunoassay Enzyme-Linked Immunosorbent Assay, mostly known as ELISA was developed. This is a powerful but simple method that is very widely used in the diagnostic practice, as well as in biomedical research. During this time a number of ELISA modification were developed that significantly increased its properties, especially the senstivity, such as avidin-biotin assay, immuno-PCR, nano-ELISA and finally, the digital ELISA. This short review describes the principles of ELISA and the evolution from a conventional assay to the modern ultra-sensitive method. Most of the immunological methods have two components: antigen and antibody. The high specificity of their interaction gives a possibility to detect one of them if other one is included in the reaction as a specific partner. The simplest method for antigen detection in the presence of the antibody is immune diffusion (radial immune diffusion in that case), which practically the formation of precipitate of the “antigen-antibody” complex, when the target antigen diffuses from well into agarose containing the specific antibody. Unfortunately, this assay, as well as other traditional methods, like hemagglutination or complement fixation, have a low sensitivity and are unwieldy.
Aug 2021 DOI 10.14302/issn.2689-5773.jcdp-21-3890
MERAD ZakariaCorresponding author
Department of pathological anatomy and cytology, Hospital Center of Sidi Bel Abbes, Faculty of Medecine, Djilali Liabes University, 22000, ALGERIA.
Splenic hydatid cyst is very rare, caused by the parasite echinococcus granulosus. Humans are considered an accidental intermediate host in the development of the parasite cycle. It poses a diagnostic dilemma with other cystic masses despite improved medical imaging techniques often requiring exploratory surgeries for fear of missing out on a malignant tumor. Total or partial splenectomy remains the treatment of first choice and the most effective. We report a case of solitary splenic hydatid cyst and discuss the different differential diagnoses and therapeutic modalities.
Jul 2021 DOI 10.14302/issn.2689-5773.jcdp-21-3905
Javier Torres Gómez FranciscoCorresponding author
Dr. Torres Pathology and Cytology Laboratory (CITADIAG SL) San Leandro square. 41003, Seville. Spain.
This essay reflects on the craft of diagnostic pathology, using color and pattern as a narrative lens. Through case vignettes, it illustrates how morphology, staining, and visual reasoning translate into clinical answers. The perspective emphasizes communication, uncertainty management, and the human dimension of laboratory work.
May 2021 DOI 10.14302/issn.2690-4721.ijcm-21-3835
Montes MilagrosaCorresponding author
Biodonostia Health Research Institute, Vaccine Preventable Diseases Group; Osakidetza Basque Health Service, Donostia University Hospital, Microbiology Department, 20014 San Sebastian, Spain.
Objective Real-time surveillance of SARS-CoV-2 variants of concern (VOC) is of essential public health importance. Rapid Antigen Detection Tests (RAgDT) have become first-line COVID-19 diagnostic methods in many regions, but this strategy can hamper the surveillance of the virus variants due to their decentralized performance. The aim of this study was to assess the usefulness of the remaining sample of a widely used RAgDT (Panbio) for the surveillance of the B.1.1.7 VOC using molecular methods. Methods Symptomatic individuals and asymptomatic close contacts of confirmed cases were routinely screened for SARS-CoV-2 infection using the RAgDT in Primary Health Care Centers. After performing the test, the extraction tubes containing the remaining biological material of RAgDT-positive cases were sent to the clinical microbiology laboratory where RT-PCRs detecting key mutations of the VOC were conducted. Results A valid result was obtained in 1770/1812 (97.7%) RAgDT-positive cases. Variant B.1.1.7 was detected in 34.7% of the patients, increasing from 0% to 87.7% between the weeks beginning January 4 and March 15, 2021. Conclusion The sample remaining after performing the Panbio RAgDT allowed to monitor the emergence and circulation of the B.1.1.7, greatly improving the population screened for the molecular study of SARS-CoV-2 variants.
Apr 2021 DOI 10.14302/issn.2372-6601.jhor-21-3801
Qing XinCorresponding author
Department of Pathology, Harbor-UCLA Medical Center, 1000 West Carson Street, Torrance, CA 90502, USA.
Lennert lymphoma (lymphoepitheloid lymphoma) is an extremely rare variant of peripheral T-cell lymphoma, not otherwise specified. Here we report a case of Lennert lymphoma diagnosed in a 57-year-old woman. She had a three-year history of waxing and waning lymphadenopathy with a rapid increase in size in the past four months before presentation. A needle biopsy and a fine needle aspiration were non-diagnostic due to extensive necrosis. The patient underwent a right neck lymph node excisional biopsy which showed the lymph node architecture was effaced by numerous and sometimes confluent clusters of epithelioid histiocytes and infiltration of small lymphocytes. Extensive necrosis was present. Immunohistochemical stains revealed a mixed population of B- and T-cells with the T-cells showing diminished T-cell markers CD3, CD5, and CD7. Flow cytometric analysis detected a small population (7% of total lymphocytes) of CD4-positive T-lymphocytes with loss of CD3, CD5, and CD7 expressions. PCR-based T-cell receptor gene rearrangement studies showed positive results (clonal peaks) in both gamma and beta genes. Stains for microorganisms were negative. The overall findings indicate Lennert lymphoma. To our knowledge, this is the first reported case of Lennert lymphoma with extensive necrosis. The patient is undergoing chemotherapy. The diagnosis of Lennert lymphoma can be challenging, particularly in cases with extensive necrosis. Our case highlights that adequate sampling is important in the investigation of patients with suspected Lennert lymphoma. A careful pathologic examination with ancillary studies including flow cytometry, immunohistochmistry, and cytogenetic and molecular studies leads to the accurate diagnosis.
Apr 2021 DOI 10.14302/issn.2470-0436.jos-21-3710
David G. Diciano Jr.Corresponding author
Introduction Large impaled object in the orbital region causes severe visual impact and requires specialized care within the shortest time possible. Objectives In this case report, we discussed the approach and management of a patient that presented with a penetrating orbitocranial injury, from management at the emergency unit, diagnostic imaging, referral to other subspecialty, surgical and medical intervention, and post-operative care. Discussion A 36-year old male had an impaled toilet brush on the supero-nasal aspect of the right orbit, with visual acuity of 6/60 and lacerated upper eyelid. The globe had minimal movement on all gazes, but pupil was reactive to light with no afferent defect. On plain cranial and orbital CT-scan, the foreign body entered the anterior and medial aspects of the right orbit penetrating the right superior orbital wall, right medial lamina papyracea, and the lateral and inferior border of the right frontal sinus with its distal tip at the intracranial region at the right frontal lobe compressing the medial rectus along its tract. Two hours after injury, patient underwent wound exploration, removal of foreign body, repair of eyelid laceration, right craniotomy, frontal contussectomy, duraplasty, and JP-drain insertion under general anesthesia. Intraoperatively, there was note of transected canaliculus and avulsed conjunctiva. The medial rectus was intact and attached. The frontal lobe was contused with embedded fragments of right posterior orbital bone with 3cm opening on the dura. Post-operatively, Fluconazole was added to the medications after culture results of the toilet brush tip tested positive for fungal elements. Patient was discharged after 21 days with visual acuity of 6/6 on both eyes and improved ocular movement. Conclusion These types of injury warrants thorough and systematic history taking and physical examination, acquiring pertinent imaging modalities to better visualize the extent of injury, and execute surgical and medical intervention that is multidisciplinary.
Apr 2021 DOI 10.14302/issn.2692-1537.ijcv-21-3741
Assegid SahiluCorresponding author
MD, MPH, Associate Professor of Epidemiology Jimma University, Jimma, Ethiopia
Background Ethiopia confirmed its 1st case of COVID-19 on Friday 13th February 2020. The burden increased dramatically by August/2020. The conditions that led to this rise were not reviewed. Objective To exploreCOVID-19 related phenomena in Ethiopia during 2019-2020. Materials and Methods Review of journals, books, and letters to editors, e-sources, news, personal experiences, observations, and communications. Results The zoonotic source of SARS- CoV-2 (Severe Acute Respiratory Distress Syndrome- Coronavirus-2) is not confirmed. The precedent events; and exact mechanism of COVID-19 is not clear. Dynamic models were required on the time line of dynamics of COVID-19; dynamics of infectiousness of COVID-19, and mechanism of transmission of COVID-19. Incubatory carriers might have been missed. Screening based on temperature had been problematic. The time spent in the development of diagnostic test for COVID-19 might have contributed to the early spread. Uninterrupted flights to China during the epidemic by Ethiopian Airlines as well as uninterrupted domestic flights; IDP (Internally Displaced People); and others put Ethiopia (and other countries) at great risk. Demographic adjustment may not be applicable for Ethiopia due to lack of census which had to be conducted every 10 year, was conducted only in 2007. This adds to the problem of error projection. The impact of HIV (Human Immuno-Deficiency Virus Disease) and war in Ethiopia before 2000 might have had affected people who would be now old age and who would be at the most risk of death. This made the impact of COVID-19 to appear low as revealed by the lower number of COVID-related deaths in Ethiopia. There were also hesitations inconsistencies in case definitions; implementations of quarantine; and burial regulations. Conclusion Even though uninhibited foreign flight to China as well as domestic flights; inconsistencies in the implementation of regulations pertaining to COVID-19 have contributed to COVID- 19 emergence in Ethiopia, the absence of census; the demographic impact of HIV and war before 2000 might have made the impact of COVID-19 to appear low as revealed by the lower number of COVID-related deaths in Ethiopia. Recommendation Accurate and current evaluation of the impact of COVID-19 in Ethiopia may require the absence of census; demographic consequences of HIV; and war before 2000 into consideration.
Mar 2021 DOI 10.14302/issn.2575-1212.jvhc-21-3767
Abdishakur Hassan FaysalCorresponding author
Advanced Scientific Group, Abu Dhabi, United Arab Emirates
Antibodies and antibody fragments, especially single-domain antibodies known as nanobodies, are important tools in diagnostics, research, and therapeutics. In a conventional antibody, light and heavy chains contribute to the formation of the antigen binding site. In addition to conventional antibodies, old and new world camels also have heavy-chain antibodies (hcAbs), which lack the light-chain antibodies that usually bind to the antigen, as well as single domain antibodies, the VHH domain, which are the smallest antigen-binding fragments and have high solubility, stability, and specificity. A VHH library against E. coli lipopolysaccharide (LPS) was produced using the camel immune system. E. coli strains from dead camel calves were isolated to extract the LPS and used to immunize a 2-year-old female camel. After isolating mononuclear lymphocytes for RNA extraction and amplification of the VHH gene, the PCR product was cloned into the pF1AT7 Flexi vector and transformed into JM109 E. coli competent cells by heat shock, resulting in a comprehensive VHHs library with 6.9 × 104 cfu/µg. The VHHs were expressed and screened with ELISA and PCR. Eleven colonies were positive by PCR, six of which were sequenced and submitted to Genbank compared with GenBank data to confirm the production of nanobodies with a similarity >90%.
Feb 2021 DOI 10.14302/issn.2690-0904.ijoe-21-3727
Keshavarz VajihehCorresponding author
Department of Occupational Health, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.
Background and Purpose Providing health care is the basic right of people(1). Diagnostic radiology is one of the main procedures in health care services and proper benefiting from this technology is brought only under well planning and management(1). Supervision of the available condition and its comparison with the recommended standards is a key role in assessing assurance from the benefit of these instruments (2). Data show that more than 80% of patients referring to these hospitals need radiology image (3).Improper service causes repetition of radiography and even wrong diagnosis, as a results threatening health of the patients (3) lack of protective barrier leads to the exposure of the staff to X-ray which is obviously carcinogen us (4). It happens that the instruments are not working properly, like of symmetry in X-ray field, defects in collimators, lack of adjusting ray field and X-ray, low quality or defective developing machine, lack of proper protective barrier, using low quality film and drugs, lack of protective barrier for children, all of which cause severe hazards for the patients and staff (4). Materials and Methods The crucial aim of medical services is to provide the public with their needs which are very important. The sensitivity of such services is to such an extent that in case of lack of care, the hazards are too high. In evaluation of health services, the first thing is to evaluate the device used. Methods, efficiency, profits and their combination for prevention and eradication of diseases are also important. Therefore to gain this goal, it is necessary the obtain results comparable with recommended standards. The purpose of this study was to access the conditions of radiology units at Mazandaran University hospitals and compare them with the standards of ICRU NCRP and ICRP. Radiology unit is the most expensive section of any hospital for its instruments, manpower and space provided. In a study conducted in 51centers on radiology staff, radiography room and protective barrier, ray leakage, the outcome were 89%, 82%, 77% and 37% respectively. It was found that the condition of these centers regarding the protective barriers is very unsuitable due to unawareness of the leakage (5, 6).Considering the mentioned necessities, in this study, the condition of radiography centers affiliated to the Mazandaran University of Medical Sciences was studied for the type and the rate of problem, in order to provide a proper solving method. Results Data were collected through, observation, interviewing and filling questionnaire. Results show that, the situations of the radiology units are for from international standard, to such an extent that it is matched clout 50%. Conclusion The results showed that, none of the dark rooms are standard, and do not have proper alarm signal. In 63% of these units there no tiling system about staff protection from radiation. Defects in radiography room, protective barrier and lack looking rays were 60%, 51% and 47% respectively. Referring to the obtained data, periodic supervision, and obeying of the standards are necessary.
Oct 2020 DOI 10.14302/issn.2576-6694.jbbs-20-3517
S.U. DOSSOU CamilleCorresponding author
Laboratoire de Recherche en Biologie Appliquée, Ecole Polytechnique d’Abomey-Calavi (EPAC), University of Abomey-Calavi, 01 BP 2009 Cotonou, Benin.
Background of the Study African countries are facing frequent blackout. Thus in sub Saharan region, due to frequent power cut, the laboratory professionals find sometimes difficulty to carry out earlier diverse diagnostic tests. Objective The aim of this work is to evaluate the feasibility of enzyme immunoassay tests in the absence of a conventional source of electricity. Methods We developed a battery-powered experimental device, which was then applied to diagnose measles. The samples included 45 sera randomly selected from non-haemolysed serum samples received and stored at the National Public Health Laboratory of Benin. The experimental device is composed of two devices (Devices 1 and 2). The Device 1 provided an average temperature of 34.47 °C, 20 min after starting. With Device 2 an average temperature of 20.32 °C is obtained 15 min after starting. Results With the experimental device the same rate of measles antibody-positive sera (44.68%) was obtained as recorded from the test using the standard equipment of laboratory. The experimental device detected 18 negative and 8 intermediate results against respectively 19 and 7 by the standard equipment. The analysis of the results of both equipments shows a concordance rate of 93.33% with a kappa reproducibility coefficient of 0.89. Conclusion The device conceived in our study is a simply equipment allowing the realization of the enzyme immunoassay tests, in this case the ELISA anti-measles test. The rate of concordance obtained shows that this device can be used with commercial kits and at temperatures close to those recommended by the manufacturer without altering the results.
Oct 2020 DOI 10.14302/issn.2641-4538.jphi-19-3115
D Mwalimu CharlesCorresponding author
Muhimbili University of Health and Allied Sciences - Dar es Salaam
Africa Region has the highest burden of malaria with an estimated of 3.5 million more malaria cases in 2017 compared 212 million cases in reported in 2016. Data collected from 2015 to 2017, shown no global progress in reducing malaria cases. In Mainland Tanzania, malaria control interventions have significantly led to the reduction in malaria prevalence from 18.1% in 2008 to 7.3% in 2017. Despite of these achievements, malaria burden is still highly heterogonous with some regions including urban peripheral areas of Dar es Salaam, presenting persistent malaria transmission ranging from 2 to 57%. Material and Methods A cross- sectional population based survey was carried out in Ilala Municipality in Dar es Salaam; data was collected from 2nd to 31 April, 2019. Multistage cluster sampling was used to select the households where individual member were conveniently selected to participate in the study. Structured questionnaire were administered by the trained researcher assistants to assess individual risk factors for malaria. Rapid Malaria diagnostic test (mRDT) was used to identify individual exposed to malaria infection. Measure of association used was prevalence odds ratio (POR). Multivariate regression model used to determine prevalence odds ratio, variable with p- value < 0.05 were considered as independent risk factor for persistent malaria transmission. Results A total of 830 participants were recruited in the study, mean age was 24yrs ±20.4SD. Majority 489 (58.9%) were female, 459 (55.3%) were >18 yrs old, primary or no education were 687 (82.8%), farmer or unemployed were 639 (77%). Msongola ward contributed 406 (48.9%). Overall malaria prevalence in the study areas was (4.5%). Nets ownership was 141 (16.9%), usage was 121 (85.8%).Low proportion of net ownerships (POR: 7.67, 95% CI: 4.23, 24.6), residing in the households surrounded by mosquito breeding sites POR: 20.07, 95% CI: 7.03, 57.29) and residing in houses with unscreened windows (POR: 1.21, 95% CI: 1.26, 3.40) were independently associated with malaria infection. Conclusion Low nets ownership, residing in the households surrounded by mosquito breeding sites and in households with unscreened windows was independent factors associated with risk of malaria in the areas. Promotion of ITNs coverage, application of biolarvicides through community engagement and house screening was recommended to reduce the risk of malaria infection in the areas.
Jun 2020 DOI 10.14302/issn.2574-4526.jddd-20-3410
Darouichi M.Corresponding author
Institute Medical Champel, 1206, champel, Geneva, Switzerland
Glandular-cystic bladder cystitis is a rare, benign non-tumor condition, preferentially located on the area of the bladder trigone and can simulate a malignant tumor. It is a benign reactive metaplasia of the bladder submucosa, characterized by hyperplasia of the islets of Von Brunn and cystic. It is classified among reactive epithelial anomalies of the urothelium, such as islet hyperplasia of Von Brünn, cystitis, glandular cystitis, nephrogenic metaplasia and epidermoid metaplasia. It presents a clinical diagnostic challenge having the expression of a simple recurrent cystitis and misleading the radiological diagnosis evoking a malignant tumor of the bladder. Its certainty diagnosis is histological. We report the case of a 38-year-old young man who consulted for recurrent cystitis. The CT scan showed a vegetative tissue structure of the middle and left medial vesical floor, sawtooth 3 cm long axis suspecting a tumor of the bladder. The patient underwent transurethral resection of the bladder lesion. The histological and immunohistochemical examination concluded with glandular and cystic cystitis (minor form). In the light of this observation, we will discuss the diagnostic difficulties, the pathophysiological mechanisms, the radiological aspects, the anatomopathological, therapeutic features and the prognosis of this rare condition. The literature regarding this entity has been reviewed and the differential diagnosis was discussed.
Jun 2020 DOI 10.14302/issn.2688-5328.ijp-20-3386
Pruneti CarloCorresponding author
Dept. of Medicine and Surgery, Clinical Psychology, Clinical Psychophysiology and Clinical Neuropsychology Labs., University of Parma, Italy.
How to define pain? One of the most accredited definition is certainly “An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage" (IASP (International Association for the Study of Pain - 1986) and World Health Organization (WHO) 1. However, what are the essential components of pain experience? Certainly many factors are involved such as, among others: Perceptual ability / suitability / subjective threshold; The "subjective" experience; Multidimensionality; Occasionally or chronicity. All these components have to be taken into consideration in the treatment of these disorders which, very often, require a multidisciplinary approach. From a clinical psychological point of view, much can also be offered at a diagnostic level, from the reception to listening to the patient's suffering, to the evaluation with standardized tests and psychophysiological analysis procedures in order to arrive at an effective personalization of treatments
Jun 2020 DOI 10.14302/issn.2691-8862.jvat-20-3320
Ataie AminCorresponding author
Babol university of medical science, Department of Toxicology and Pharmacology, Iran
By increase the incidence of infection of coronavirus disease 2019 (COVID-19), diagnostic factors for early identification of high-risk individuals are important. On the other hand, more infections are in older patient, comorbidities, and male patients. Identification of components that related to severity of COVID-19 contributed to ACE2 and TMPRSS2 genes, which are critical for viral infection. It was found that adding enzyme copy, hrsACE2, lures the virus to attach itself to it instead of the actual cells… It inhibits the virus from infecting the cells in the lungs and other organs.
Jun 2020 DOI 10.14302/issn.2372-6601.jhor-20-3372
Ozcelik FatihCorresponding author
University of Health Sciences, Sultan 2. Abdulhamid Han Training and Research Hospital, Department of Medical Biochemistry, Istanbul, Turkey
Immune thrombocytopenia currently called under its’ new name, immune thrombocytopenic purpura (ITP) is a disease characterized by thrombocytopenia, in which the body attacks its own platelets due to the disorders in immune system. The pathophysiology of this disease includes increased platelet destruction and most megakaryocyte production in bone marrow. The most common clinical manifestation of ITP is mild or severe progressive bleeding that could result in death. ITP is generally named as primary or secondary ITP according to thrombocytopenia severity, disease duration, bleeding status and secondary occurrence of the disease. Currently for diagnosis, despite the blood count, antiglobulin test and laboratory tests that can detect platelet-bound antibodies, they are not enough for definitive diagnosis. Like the difficulty in diagnosis, ITP treatment is quite complicated which varies depending on age, characteristics and risk of the patient. It is classified as first, second and third-line treatment options. Also, depending on the condition of patients, combined treatment might be an option which increases the complexity of the treatment. Unfortunately, discussions related to different clinical applications in diagnosis and treatments continue recently. For this reason, we considered that preparation of a review containing recent updates in diagnostic approaches and treatment options in ITP will be remarkable and beneficial for physicians interested in this subject.
May 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3353
Mango LucioCorresponding author
Head for Higher Education in Healthcare, University of International Studies (UNINT) – Rome, Italy
In recent decades was observed a gradual increase in the detection of thyroid nodules in the adult population. Given the increase in prevalence of nodules, a similar trend to the growth in the incidence of thyroid cancers was found. The reasons for this increased incidence for thyroid cancer are controversial. Increased incidence is caused by an improvement in diagnostic techniques or does not result from an overdiagnosis, but represents a real increase in the incidence of thyroid cancer? Whatever the reality, the fact of an increased incidence of thyroid cancer for certain involves problems to global health which in any case must be evaluated and corrected.
May 2020 DOI 10.14302/issn.2692-1537.ijcv-20-3341
Klepikov IgorCorresponding author
MD, Professor, Retired
A timely review discusses acute pneumonia in the context of COVID‑19, covering diagnostics, imaging patterns, supportive care, and evolving therapeutics. It highlights uncertainties and priorities for coordinated research and clinical pathways.
Apr 2020 DOI 10.14302/issn.2691-5014.jphn-20-3297
Bittmann StefanCorresponding author
Department of Pediatrics, Ped Mind Institute (PMI), Gronau, Germany
A concise overview synthesizes early knowledge on COVID‑19 in pediatrics, covering transmission, clinical spectrum, diagnostics, and prevention, and pointing to priorities for longitudinal study.
Mar 2020 DOI 10.14302/issn.2471-2140.jaa-20-3236
Sanikidze TamarCorresponding author
Tbilisi State Medical University, Tbilisi, Georgia
Objective Search of pathogenetic mechanisms and risk factors of atherosclerosis in the employees of the cleaning service in Tbilisi. Materials and Methods As a result of a preliminary survey and examination of 200 employes of Tbilisi cleaning service aged 25-45 years (2014-2016), 22 patients with angina, hypercholesterolemia, intimae-media thickness > 0.65 mm, were selected into I group, and 23 individuals without these disorders into II group. In the blood plasma of the selected patients the intensity of oxidative metabolism parameters, TAA and MDA were determined. The variance and correlation analysis (АNOVA) was used for conducting the comparative analysis of the levels of studied parameters. Results In the combined group (I+II) there are several reliable correlations between the Age -TCol, Age-MDA, BMI-Tg, BMI-MDA, LDLChol-HDLChol, LDLChol–TChol, HDLChol-TChol, LDLChol-MDA, LDLChol-TAA. no correlation between these parameters in individual groups (I and II) was found. That indicates that we have an imaginary correlation related to the large intergroup difference between the average values of the group indicators, that is the values of various indicators change during the development of the pathological process, but there is no causal relationship between these alterations. The reliable TAA-MDA correlation in the combined group (I+II) is related to the high anticorrelation between these parameters and the significantly higher average value of TAA in the low-risk group (II) in comparison to the high-risk group (I). Conclusion The results analysis indicates both the diagnostic value of redox status indicators and their leading role in the atherogenesis processes. In populations with a high risk of atherosclerosis, monitoring of serum TAA is recommended.
Feb 2020 DOI 10.14302/issn.2329-9487.jhc-21-3743
Elqatni M.Corresponding author
Département de Médecine Interne, Hôpital Militaire d'Instruction Med-V, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V- Rabat- Maroc.
A case report of a common iliac artery aneurysm revealing underlying Behçet’s disease. It reviews diagnostic clues, vascular complications, and multidisciplinary management.
Dec 2019 DOI 10.14302/issn.2372-6601.jhor-19-3094
Zaichick VladimirCorresponding author
Radionuclide Diagnostics Department, Medical Radiological Research Centre, Obninsk, 249036, Russia.
Prostate specific antigen (PSA) does not provide the high reliability and precision that is required for an accurate screening for prostate cancer (PCa). The aim of our study was to search for a simple, rapid, direct, preferably non-invasive, and highly accurate biomarker and procedure for the screening for PCa. For this purpose the levels of bromine (Br) and zinc (Zn) were prospectively evaluated in expressed prostatic fluid (EPF). Also Zn/Br concentration ratio was calculated for EPF samples, obtained from 38 apparently healthy males and from 33, 51, and 24 patients with chronic prostatitis (CP), benign prostatic hyperplasia (BPH) and PCa, respectively. Measurements were performed using an application of energy dispersive X-ray fluorescent (EDXRF) microanalysis developed by us. It was found that in the EPF of cancerous prostates the levels of Zn and Zn/Br were significantly lower in comparison with those in the EPF of normal, inflamed, and hyperplastic prostates. It was shown that “Sensitivity”, “Specificity” and “Accuracy” of PCa identification using the Zn and Zn/Br levels in the EPF samples were all significantly higher than those resulting from of PSA tests in blood serum. It was concluded that the Zn and Zn/Br levels in EPF, obtained by EDXRF, is a fast, reliable, and non-invasive diagnostic tool that can be successfully used by local, non-urologist physicians at the point-of-care to provide a highly effective PCa screening and as an additional confirmatory test before a prostate gland biopsy.
Nov 2019 DOI 10.14302/issn.2372-6601.jhor-19-3084
Elyamany AshrafCorresponding author
Ass. Professor of Medical Oncology, SECI, Assiut University, Egypt.
Background Identifying biomarkers for early detection of hepatocellular carcinoma (HCC) remains quite challenging. In this study we aimed to estimate the number of TIE2-expressing monocytes (TEMs) cells, which display pro-tumoral activities and are defined as CD14+, TIE2+, and angiopoietin-2; and its potential use as a possible diagnostic marker in HCC patients complicating HCV induced cirrhosis. Methods Current study was conducted on 112 patients. They were divided into two groups: Group I (78 patients) with HCC complicating HCV induced cirrhosis; and group II chronic hepatitis C patients (34 patients). Both groups were compared to (age and sex-matched) healthy persons as group III (38 persons). Result The number of the circulating TEMs: CD14+ and TIE2+ monocytes were significantly higher in the peripheral blood of HCC patients than HCV LC patients and healthy controls, sensitivity and specificity for HCC diagnosis were respectively: CD14 (89.7%, 83.3%), TIE 2 (76.9%, 83.3%), and Ang-2 (76.9%, 66.7%). Moreover, analysis of the P-value and the odd’s ratio showed that CD14 has the highest predictive value for HCC. Conclusion Our results suggest that TEMs and Ang-2can be used as diagnostic markers for HCC, especially among the high-risk group of patients.
Aug 2019 DOI 10.14302/issn.2470-5020.jnrt-19-2983
Léhleng AGBACorresponding author
Neurology Department, University Hospital Center of Kara, Kara University, PoBox 18 Kara (Togo)
Although it is a vaccine-preventable disease, tetanus is frequently found in sub-Saharan Africa. Because of its rarity, this disease poses two problems for doctors of the 21st century: to make early diagnosis in order to refer patients to appropriate care structures, and to continue to ensure correct prevention of an affection that few current doctors have met. In it generalized form, the diagnosis of tetanus is easy, but when the beginning is localized, tetanus can be change with other diseases leading to a diagnostic wandering and a delay of adequate management. We report a case of tetanus in an 18-year-old male, who was received for neck pain and stiffness of the neck with a positive Kernig sign associated to fever since 48 hours. Initially treated for meningitis, the patient will develop at day 3 of hospitalization, the signs of generalized tetanus which led to evoked the diagnosis of tetanus. This diagnosis was reinforced by the notion of a rusty nail injury to the soles of the right foot 3 weeks before hospitalization and the absence of anti-tetanus vaccination. After using tetanus serum and vaccination with antibiotics (Metronidazole and Penicillin) and Diazepam in association with stripping of the wound under the foot, the patient was improved. This case illustrates that any neurological sign with the first trismus must evoke until proof of the contrary, a tetanus especially in case of association with a wound even if the immunization schedule is up to date.
Aug 2019 DOI 10.14302/issn.2572-3030.jcgb-19-2955
N Pak VladimirCorresponding author
Research scientist, Toronto, Ontario, Canada
This review revisits alpha‑fetoprotein (AFP) and AFP receptor biology beyond their classic role as oncofetal markers. It summarizes signaling, tumor biology, and clinical implications across malignancies, including diagnostic, prognostic, and therapeutic angles. The authors highlight opportunities and limitations for AFP‑targeted interventions.
May 2019 DOI 10.14302/issn.2329-9487.jhc-19-2787
Bouomrani SalemCorresponding author
Department of Internal medicine. Military Hospital of Gabes. Gabes 6000. Tunisia
Introduction Cardiac non-specific inflammatory pseudotumors (NSIPT) are exceptionally associated to Behçet's disease (BD) and represent a real diagnostic and therapeutic challenge. The meaning and the mechanisms of this association are not yet well understood. The purpose of this paper is to study the epidemiologic, therapeutic, and evolutionary characteristics of cardiac NSIPT during BD Methods Systemic review of all reported cases of cardiac NSIPT associated with BD. Results We found only 6 cases of NSIPT associated with BD. Of these six patients, 4 were men (66.66%) and 2 were women (33.33%): Sex ratio =2. The average age was 26.66 years (9-35 years). The pseudotumor was unique in all cases. The chronology of occurrence of these NSIPT compared to the underlying angiitis was variable: inaugural of the disease in 4 cases, and complicating a previously known BD in 2 cases. The surgery was performed in all cases. It was carried out for diagnostic purpose in 4 cases, and therapeutic in the other 2. Additional medical treatment based on systemic corticosteroids with or without immunosuppressants was indicated in 4 patients. The evolution was favorable in 5 cases and a single case was quickly fatal. Recurrence of NSIPT was reported in one patient (20%). Conclusion The results of this review suggest a very likely association between BD and cardiac NSIPT; especially because of the scarcity of these two conditions in the general population, and the epidemiological characteristics clearly different from those of cardiac NSIPTs in the general population. The pathogenic mechanisms common to these two conditions (immune, inflammatory, reactive, and vascular) reinforce this causal link. The main differential diagnoses of these pseudotumors during BD remain cancer and intracardiac thrombosis.
May 2019 DOI 10.14302/issn.2642-9241.jrd-19-2773
Klepikov I.Corresponding author
Professor Renton, Washington, USA
This commentary examines pneumonia as infection and inflammatory syndrome, parsing diagnostic criteria and implications for antimicrobial stewardship.
Mar 2019 DOI 10.14302/issn.2471-2140.jaa-19-2699
M.M. Masoud HassanCorresponding author
Molecular Biology Department, National Research Centre, El-Tahrir st., Dokki, Giza, Egypt.
Xanthine oxidase is a commercially important enzyme with wide area of medical applications to develop diagnostic kits. Xanthine oxidase was extracted, purified and characterized from sheep liver (SLXO). The purification procedure involved acetone precipitation and chromatography on DEAE-cellulose and Sephacryl S-300 columns. The sheep liver xanthine oxidase was homogeneously purified 31.8 folds with 3.5 U/mg specific activity and 24.1% recovery. SLXO native molecular weight was 150 kDa and on SDS-PAGE appeared as single major band of 75 kDa representing a homodimer protein. Isoelectric focusing of the purified SLXO resolved into two closely related isoforms with pI values of 5.6 and 5.8. The apparent Km for xanthine oxidase at optimum pH 7.6 was found to be 0.9 mM xanthine. FeCl2 and NiCl2 increased the activity of SLXO, while CuCl2 and ZnCl2 were found to be potent inhibitors of the purified enzyme. Allopurinol inhibits SLXO competitively with one binding site on the purified molecule and Ki value of 0.06 mM.
Feb 2019 DOI 10.14302/issn.2689-5773.jcdp-19-2611
Y. S. Lee CameronCorresponding author
Private Practice in Oral, Maxillofacial and Reconstructive Surgery. Aiea, HI 96701 USA. Clinical Professor of Surgery. Department of Periodontology and Oral Implantology. Temple University Kornberg School of Dentistry. Philadelphia, PA 19140 USA.
An anatomical variant of the Stafne bone cavity (SBC) located in the right subcondylar region of the mandible is presented. Such an occurrence of the SBC in this region near the parotid gland is considered rare and poses a diagnostic challenge for the dentist and radiologist. Knowledge of head and neck clinical anatomy and imaging studies such as plain film panoramic radiographs and cone beam CT scans can assist the clinician in arriving at a correct definitive diagnosis without surgical intervention.
Jan 2019 DOI 10.14302/issn.2379-7835.ijn-18-2469
Kawasaki YoheiCorresponding author
Biostatistics Section, Clinical Research Center, Chiba University Hospital, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8677, Japan
Background Docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) are categorized as omega-3 poly unsaturated fatty acids (PUFAs) that are present in fish oil, etc. DHA and EPA omega-3 PUFAs have a well-established fasting serum triglycerides (TG) lowering effect that may result in normal lipidemia in hyperlipidemic patients. In general, omega-3 PUFAs, such as DHA and EPA, can be ingested easily, and because they are highly safe, they are assumed to be suitable for controlling fasting serum TG in the serum of those who do not require drug treatment. To the best of our knowledge, however, almost all systematic reviews on the effects of omega-3 PUFAs on lowering fasting serum TG are directed at patients fulfilling the diagnostic criteria of dyslipidemia. Objectives To review and confirm the preventive effect of omega-3 PUFAs against hypertriglyceridemia or the effect on nondrug treatment in patients with a mild disease, a systematic review was conducted to determine whether there was a fasting serum TG-lowering effect in subjects without disease and those with a slightly higher triglyceride level who consumed DHA and/or EPA orally compared to those with placebo or no intake of DHA and/or EPA. Search Methods We evaluated articles from searches of PubMed (1946-February 2016), Ichushi-Web (1977-February 2016), and J Dream III (JST Plus, 1981-February 2016; JMED Plus, 1981-February 2016). The keywords were set as follows: “DHA” or “docosahexaenoic acid” or “EPA” or “eicosapentaenoic acid” and “TG” or “triglyceride” or “triglycerol” or “triacylglycerol” or “neutral lipid.”. In addition to the literature group obtained by the database search, we included participants not suffering from any disease (i.e., excluding mild hypertriglyceridemia). Eligibility Criteria Before the test selection process, the following inclusion criteria were defined. Participants were healthy men and women including those with mild hypertriglyceridemia (fasting serum TG level, 150-199 mg/dL [1.69-2.25 mmol/L)). Intervention was defined as orally ingested DHA and/or EPA. Comparison was made to placebo intake or no intake of DHA and/or EPA. Results were measured for the fasting serum TG level. The test design was RCT, and quasi-RCT. Data Abstraction Various characteristics were extracted from original reports using a standardized data extraction form, including the author of the study, research year, research design, subject characteristics (sex, age, sample size), period, dose of DHA and/or EPA (mg/day), and comparison group. Main Results We identified 37 documents for review. Among the 37 reports used to integrate literature results, 25 revealed a decrease in fasting serum TG level due to the oral ingestion of DHA and/or EPA. Sixteen studies on subjects without disease and 21 on subjects with slightly higher fasting serum TG levels were separated and stratified analysis was conducted. Ten of the 16 (normal TG participant) and 15 of the 21 studies (slightly higher TG participant) respectively, indicated that at least 133 mg/day of DHA and/or EPA intervention provided a statistically significant decrease in the fasting serum TG level between an intervention group versus a placebo group.
Dec 2018 DOI 10.14302/issn.2575-1212.jvhc-18-2487
Fernando Díaz-OteroCorresponding author
Centro Nacional de Investigaciones Disciplinarias en Microbiología Animal, Instituto Nacional de Investigaciones Forestales, Agrícolas y Pecuarias. Carretera México-Toluca, Km. 15.5, C.P. 05110, México D.F.
Parasitic infection by the Fasciola hepatica (F. hepatica) promotes susceptibility towards other infections, such as Mycobacterium bovis. As consequence, could affect diagnostic tests for this disease. Hence, the objective of this study was to assess the impact of F. hepatica coinfection on the most commonly used immunodiagnostic bovine tuberculosis (bTB) tests in field conditions in an enzootic area for both diseases. Thus, from a dairy herd located in Hidalgo State, México, displaying a 59.2% and 28% prevalence of fascioliasis and bTB, respectively. Sixty-one cows were analyzed based on their response towards bTB immunodiagnostic tests, such as Single Intradermal Comparative Tuberculin Test (SICTT), gamma-interferon test (BOVIGAM) and enzyme-linked immunosorbent assay (ELISA), along with the assessment of the F. hepatica parasite load and serodiagnosis by ELISA. Three study groups were formed according to test results. Group 1: coinfected (n=22). Group 2: non-parasitized cows, and positive for bTB tests (n=13) and Group 3: parasitized cows without tuberculosis (n=26). In addition, a group of cows kept in fascioliasis - and tuberculosis-free zones were included (Group 4, n=10). A non-parametric Kruskal-Wallis test and a Dunn test were applied to analyze the results. In Group 1, significant differences were observed regarding IFN-γ production, but not for antibody levels to M. bovis or reactivity towards bovine PPD in relation Group 2. While, Groups 1 and 3 did not display difference in antibody levels against F. hepatica. Differences were observed regarding tuberculosis and Fasciola diagnostic tests when both coinfected and infected groups were compared to controls. It is concluded that F. hepatica coinfection in tuberculous animals studied, depressed the production of IFN-γ towards bovine PPD under in vitro conditions, but its reactivity to the SICTT not show to be altered.
Nov 2018 DOI 10.14302/issn.2578-8590.ipj-18-2490
Hinzpeter JaimeCorresponding author
Medical Doctor, University of Chile, Clinical Hospital, Santiago Chile
A short editorial underscores the bridge between basic sciences and clinical medicine. It emphasizes how mechanistic knowledge informs diagnostics and therapy, and calls for curricula that strengthen this continuum.
Oct 2018 DOI 10.14302/issn.2326-0793.jpgr-18-2312
Saad Zaghloul Salem MohammadCorresponding author
Professor of Medical Genetics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
All aspects of life activities in living cells are mediated/executed and regulated by a vast number of networks, comprising a wide spectrum of components, starting with simple biomolecules and ending with the whole organism, and functioning within a precisely organized tight framework. Proper mediation of cellular activities necessitates their inclusion within the context of structured and organized network systems capable of regulating/coordinating and synchronizing the countless numbers of biological processes occurring within living cells. The number of biological networks and pathways within the living cell is considerably huge, being dependent on the structural complexity and functional capabilities of the cell. Pathogenesis and progression of human diseases result from functional disturbances of biological networks within the cell as disturbed network function leads to deleterious effects on physiological processes dependent on, and mediated by, affected network(s). Ensuing pathological processes, defined by the nature of disturbed networks and the specific organs or tissues affected, pave the way for the development of pathognomonic and characteristic disease entities. As most network functions are dependent on relatively small number of key regulatory biomolecules, i.e. enzymes/proteins and signal transducing factors, it follows that functional disturbances of biological networks and pathogenesis of disease states can be attributed, in most instances, to quantitative and/or qualitative abnormalities of these key regulatory molecules. Study and analysis of the structural designs and the functional mechanisms of biological networks would have crucial and important impacts on many theoretical and applied aspects of biology, in general, and of medical sciences in particular. Meticulous study of biological networks represents an important and integral aspect in study of biology. Interpretation and analysis of key information deduced from observing and analyzing structural designs and functional characteristics and dynamics of biological networks discloses and defines the basic framework within which life activities in living cells are initiated, adapted to physiological requirements, maintained, and terminated upon completion of their aims. More important, however, is the contribution of this information to proper understanding of the different mechanisms responsible for regulating and synchronizing the functions and performances of the vast spectrum of different network categories within the cell. In addition to its vital scientific significance, discovering and defining the key pivotal structural and regulatory molecules within life-mediating networks, and along different pathways responsible for controlling functional dynamics of the network, represent an indispensable diagnostic approach insistent for designing proper therapeutic approaches to diseases caused by network defects.
Oct 2018 DOI 10.14302/issn.2372-6601.jhor-18-2396
Tawfik Amin AnwarCorresponding author
Surgical Oncology Department, South Egypt Cancer Institute Assiut University, Egypt.
Although surgery is the main treatment for solid tumors, it could enhance the growth and metastasis of minimal residual cancer. In this review article we have discussed the perioperative changes in cancer cells and surrounding environment as well as the alterations in the immune system. Several trials are ongoing to develop new diagnostic and therapeutic options for minimal residual cancer after surgery.
Oct 2018 DOI 10.14302/issn.2637-6075.jpae-18-2336
C.N Angaye TariwariCorresponding author
Department of Biological Sciences, Faculty of Science, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria.
Environmental impact of anthropogenic activities from industrial sources, have become a threat to biodiversity. Water samples were collected from rivers around the flow station, and analysed from some physicochemical parameters and hydrocarbon contents. Result of the physicochemistry was reported for: pH (6.58± 0.04 - 6.76±0.01), conductivity (168.30±13.98 - 194.57±3.78 µS/cm), conductivity 8.29±0.04 - 10.66±0.02 NTU, salinity (0.07±0.00 - 0.09± 0.00 mg/l), and Total Solids (83.96±1.49 - 103.66±0.60mg/l). Other elemental analysis includes: sulphates (2.43±0.01 - 4.28 ±0.02 mg/l), nitrates (0.19±0.01 - 0.28±0.01 mg/l), carbonates (1.14±0.07 - 2.06±0.07 mg/l), calcium (8.45±0.10 - 11.70±0.25 mg/l), magnesium (1.14±0.07 - 2.56±0.03 mg/l), and sodium (4.37±0.15 - 5.62±0.03 mg/l). The values of THC and TPH were 0.92±0.08 - 1.51±0.03, and 0.37±0.13 - 0.76±0.07 mg/l respectively. Generally, the result indicated mild level of contamination in terms of Hydrocarbon contents. However, diagnostic data emerging for physicochemistry and some elemental property indicates the water is unfit for consumption. Notwithstanding, the order on contamination were reported as; downstream > midstream > upstream. Therefore this study concludes that there should be frequent monitoring of the recipient water bodies associated with the flow station in order to check anthropogenic activities, and conserve biodiversity.
Sep 2018 DOI 10.14302/issn.2641-5526.jmid-18-2328
Fröhlich EckhartCorresponding author
Department of Internal Medicine 1, University of Tübingen, Otfried-Müller-Straße 10, D 72076 Tübingen
Background: Monitoring ultrasonic probe quality remains an important problem which impacts diagnostic accuracy. Here we present a quantitative method to assess probe quality primarily based on measuring probe maximum contrast (dB) and dynamic range. Method: Contrast relevant parameters of 26 transducer models manufactured by five manufacturers were measured with a novel Random Void Phantom (RVP) approach. 3D-data were acquired and analysed to determine image quality. Results: Acoustic contrast values ranging from 15dB to 36dB were observed. Conclusion: By examining artefact producing side lobes, the novel RVP approach presented here permits a quantitative assessment of ultrasound probe quality.
Jul 2018 DOI 10.14302/issn.2576-9383.jhhr-18-2120
Gaurav DhawanCorresponding author
A myeloma case is described with laboratory artifacts including increased anion gap, pseudohyperphosphatemia, and pseudohyponatremia. The report explains mechanisms behind paraprotein‑related assay interference and diagnostic pitfalls.
Mar 2018 DOI 10.14302/issn.2690-4829.jen-18-2000
Marcolongo LoredanaCorresponding author
National Research Council, Italy.
This editorial frames the journal’s mission to spotlight enzyme research with clear application pathways. It invites submissions on biocatalysis, diagnostics, and therapeutics, emphasizing reproducibility and real‑world impact.
Mar 2018 DOI 10.14302/issn.2574-4496.jtc-18-1986
Kumar Sahoo ManasCorresponding author
Consultant Nuclear Medicine & PET/CT, Department of Nuclear Medicine &PET-CT. Medanta-The Medicity, Gurugram, India.
A clinical perspective on optimizing thyroid care spans diagnostics, surgical indications, and long‑term follow‑up, aiming to align practice with patient goals and evidence.
Feb 2018
Paganelli RobertoCorresponding author
Department of Medicine & Sciences of Aging University "G. 'Annunzio", Chair of Clinical Immunology and Rheumatology, Chieti – Pescara, Italy
The possibility of tailoring treatment on specific characteristics of patients – i.e. personalized medicine – has received attention in the field of rheumatic diseases since biological DMARDs targeting a unique pathway have become available. However the idea of personalized rheumatology has advanced slowly, at different paces in different disease groups, and it is only now surfacing in the recommendations for assessment and treatment of rheumatoid arthritis (RA). Many of the difficulties encountered stem from the recognition that many rheumatic diseases are not a single entity but encompass different subsets identified on the basis of genetic traits, cellular and molecular characterization both in blood and in tissues, laboratory markers and clinical manifestations (most notably in SLE). These differences suggest a multiplicity of pathogenetic triggers, whose various combination results in slightly or very diverse presentations. Developments in companion diagnostics and the identification of distinct subsets within complex syndromes are going to allow the definition of predictive biomarkers able to reduce poor treatment outcome, thus ensuring that we are treating “the right patient with the right drug”.
Dec 2017 DOI 10.14302/issn.2997-2086.jfs-17-1846
Amin RuchiCorresponding author
Pediatric Surgery, Children’s Hospital of Wisconsin
Introduction: Data support the use of both ultrasound (US) and magnetic resonance imaging (MRI) in the prenatal prognostication of congenital diaphragmatic hernia (CDH). The aim of this study was to examine our experience and learning curve with both of these diagnostic tools in the setting of a new fetal program. Materials and Methods: This is a case series performed as a quality improvement measure. Fetuses were identified at a single tertiary institution with both ultrasound lung-to-head ratio (LHR) and MRI fetal lung volume from December 2012 until July 2016. Prenatal and postnatal data were collected. Statistical analysis was performed and a p-value of <0.05 was considered significant. Results: Twenty-one patients met inclusion criteria. Inaccurate LHRs were found in 26.9% (7/26) of patients, with the lack of a four-chamber heart view as the most common inaccuracy (5/26, 19.2%). Patients with only some or no stomach in the thoracic cavity on fetal MRI had 100% survival to discharge. Discussion: Accurate prenatal prognostication of CDH is challenging. We identified a pitfall in attaining LHR that can be easily identified, and that may influence the accuracy of the measurement. Furthermore, stomach position on MRI is a relatively newly described quick, easy, and reproducible metric for predicting prognosis.
Nov 2017 DOI 10.14302/issn.2324-7339.jcrhap-17-1679
Tesfahuneygn GebrehiwetCorresponding author
Tigray health research institute, Mekelle
Background: Point-of-care diagnostic tests (POCTs) are increasingly used in both developing and developed countries. They allow same day testing and treatment at remote locations where no laboratory support is available. Quality control measures, which are routinely used in laboratories, have not been widely implemented for POCTs. This aimed to assess the integrity of the entire laboratory testing process, and aims to educate and improve performance in quality of HIV rapid testing. Methods: A health facility based cross section study was conducted from April to June 2016.Randomly selected health facilities were participated in the external quality assessment. Onsite evaluation and panel test were used to collect data using structured checklists and formats. Data was entered and analyzed using SPSS version 16. Results: Between April to June 2016, a total of 60 health facilities (145 testing points) from governmental health facilities (hospitals and health centers) were participated in the study. Among the participated testing points 41% have no designated area, 40% have no clean water for hand washing and 51% have no national test algorithm. The average performance of testing points was varies from 89.6% to 99.1% (Laboratory 99.1%, ANC 90.4%, TB clinic 91.4% and VCT 89.6%). In a multivariable logistic regression model, didn’t follow national testing algorithm to report client test results have statistical significance. Conclusions: High quality test results underpin accurate diagnosis and appropriate treatment for patients. But in the study area the score of proficiency testing result and coverage of training is slightly low comparing to other findings. Therefore following national testing algorithm to report client test results, training and monitoring are critical points to improve the proficiency testing score of testing points.
Nov 2017 DOI 10.14302/issn.2576-6694.jbbs-17-1744
Mahjoubi FrouzandehCorresponding author
Department of Clinical Genetics, National Institute of Genetic Engineering and Biotechnology, Tehran, Iran
Aim: Colorectal cancer is one of the most commonly diagnosed cancers in the world. Cell adhesion molecules play an important role in the progression of various cancers. It has been shown that the high level expression of some Cell adhesion molecule could be a new diagnostic factor for several cancers. Vascular cell adhesion molecule 1(VCAM1) is a cell surface glycoprotein that is expressed in the endothelium activated by cytokine. Generally, VCAM-1 expression level is very poor in normal adult tissue endothelial cells. According to the above explanation, this study was conducted to investigate the expression of VCAM-1 in tumoral tissues and adjacent normal tissues in Iranian colorectal cancer patients to its relation with clinicopathological Features in patients with cancer. Methods: In this study, 60 tumoral tissues and 39 adjacent normal tumor tissues were evaluated using reverse transcription-polymerase chain reaction (RT-PCR) technique. Conclusion: A significant correlation was found between VCAM-1 expression level and the stage, lymph nodes involvement, tumor progression factor of cancer and sex. Interestingly, VCAM-1 expression not observed in tumors with stage0. No association was seen between VCAM-1 expression and other clinical features such as age, size of the tumor, metastasis and the number of lymph nodes. These findings suggest that VCAM-1 expression level may reflected disease progression and elevation in VCAM-1 has prognostic significance in patients with colorectal carcinoma.
Sep 2017 DOI 10.14302/issn.2470-5020.jnrt-17-1738
Kokou Mensah GUINHOUYACorresponding author
Clinique neurologique, CHU SylvanusOlympio, BP 57, Lomé-Togo
Myasthenia is a rare neurological condition with risk of death in case of inappropriate management. The outcome of this pathology is very bad in developing countries with inadequate technical Platform. We underlined the main difficulties of diagnostic and the management of Myasthenie and antisynthetase antibody syndrome in a 44 years-old Togolese man.
Sep 2017 DOI 10.14302/issn.2474-7785.jarh-17-1727
Akazawa ManabuCorresponding author
Public Health and Epidemiology, Meiji Pharmaceutical University
Background: Healthcare services provided to patients should vary depending on disease severity. However, disease severity bias, a type of selection bias, is a commonly encountered problem in administrative database studies. Herein, we selected chronic obstructive pulmonary disease (COPD), which commonly affects elderly Japanese citizens, for the development and validation of a severity classification system based on a health insurance claims database. Methods: Patients who received COPD-related diagnostic codes in 2011 were selected from a commercially based health insurance claims database. COPD patients were randomly divided into two groups to develop and validate severity scores. A principal component analysis was used to estimate factor loadings used to weight calculations of COPD severity scores. Score validity was evaluated using a linear trend test to predict COPD treatment costs and acute exacerbation events. Results: Using records from 880 patients, ten variables were created: acute exacerbation events, emphysema diagnoses, laboratory test and oxygen therapy procedures, prescribed anticholinergic, inhaled corticosteroid (ICS), short acting beta-agonist, and long acting bronchodilator (LABA) agents, asthma diagnosis and patient birth years. Factor loadings from LABA and ICS prescriptions had the strongest impacts on estimated severity scores (0.50 and 0.49, respectively). Among 300 validation group patients, scores were found to associate with increasing trends of median costs and exacerbation risks (p for trend < 0.05). Conclusions: Estimatedseverity scores would help to predict COPD-related medical costs and exacerbation events. For further clinical implementation, this classification system should be re-evaluated using clinical lung functions information indicative COPD severity and treatment choices.
Aug 2017 DOI 10.14302/issn.2574-4526.jddd-17-1498
DAROUICHI.MCorresponding author
Champel Medical Institute, radiology and gynaecology, Geneva, Switzerland.
A rare association mature cystic teratoma (MCT) with endometrioma in the left ovary is reported in English literature. Coexistence MCT and endometrioma in the same ovary is extremely rare and its diagnostic is a challenge clinically and radiologically. To our knowledge we report the third case coexistence of a nonneoplastic endometrioma and benign neoplastic mature cystic teratoma in ovary.
Aug 2017 DOI 10.14302/issn.2470-5020.jnrt-17-1530
Suslo RobertCorresponding author
Gerontology Unit, Public Health Department, Health Sciences Faculty, Wroclaw Medical University,
It is crucial for the society, the government and the medical community to retrieve the full and reliable statistical information on malignant brain neoplasms (C71-C71.9 ICD-10) to adjust the medical financing, staff and equipment properly. In order to retrieve information useful for public health policies, data from the years 2006-2012 concerning relevant cases registered by the Polish public healthcare insurance provider Narodowy Fundusz Zdrowia in Lower Silesia region of Poland (NFZ) and by the Polish national neoplasms registry Krajowy Rejestr Nowotworow (KRN) were analyzed. The number of new malignant brain neoplasms cases registered by the KRN has risen slightly in the years 2006-2012. At the same time the number of cases reported by the NFZ rose dynamically, which means a significant increase in medical care intensity, and thus also workload on the medical facilities and stuff associated with the care for grossly the same amount of brain malignant neoplasms patients and, supposedly, their longer survival times. It indicates that the level of public financing of the malignant neoplasms of brain treatment shall be adjusted adequately. The study revealed growing popularity among reporting Polish physicians of the least specific malignant neoplasms of brain ICD-10 categories, despite the rapid diagnostic techniques development and availability. It is alarming since the medical statistics data quality in the field of malignant brain neoplasms is deteriorating that way and proper evaluation of treatment costs and planning future financial allocations by both the public healthcare insurance provider NFZ and the Polish government becomes difficult.
Jun 2017 DOI 10.14302/issn.2329-9487.jhc-17-1536
Md. Kamrul HossainCorresponding author
Over the last few decades, many research works highlighted the role of miRNAs on cardiac diseases. Ischaemic heart disease (IHD) or coronary heart disease is a condition that is mainly caused by atherosclerosis. It has been established that microribonucleic acids regulate many factors that are involved in the development and pathophysiology of IHD. As a result, there are great potential opportunities for miRNAs to be used as a biomarker for disease differentiation, as well as novel drug targets or therapeutics for the treatment and also as a diagnostic approach. As it is now evident that miRNAs play critical roles in the disease mechanisms, this review article tried to focus on the pathway, in which; the miRNAs stimulate the IHD to develop. By understanding the mechanisms, it will be possible to present a complete strategy of IHD treatment and also solving all the impediments that are highlighted in this article. Still, there are a number of limitations and obstacles on the way of developing a proper therapeutic approach that can be approved and well accepted. This review is mainly dependent on the potential of miRNAs as a promising arena on the field of cardiac treatment and the possible obstacles that are needed to be explored and overcome.
Jun 2017 DOI 10.14302/issn.2471-2175.jdrt-17-1481
Prakash Sasankoti Mohan RaviCorresponding author
Oral Medicine and Radiology, Subharti Dental College, India.
Background: Studies have unveiled lower levels of serum vitamin D in autoimmune diseases and the role of vitamin D in inhibition of helper T cells proliferation, stimulation of regulatory T cells, diminishing of B-lymphocyte differentiation and inhibition of immunoglobulin secretion has been discussed in the literature. Oral lichen planus (OLP) is an autoimmune mucocutaneous disorder in which cell mediated immunity plays an important part and so it may also be related to serum vitamin D levels. Aim: To estimate serum vitamin D in oral lichen planus patients of North India, compare it to the controls and to evaluate various factors influencing vitamin D level in OLP cases such as sun exposure, gender, psychosocial factors, meteorological influences, religion and diet. Methods and Material: Venous blood samples of 102 clinically diagnosed oral lichen planus patients and 102 age and sex matched controls were obtained for the study and serum vitamin D levels were estimated using Vitek Immunodiagnostic Assay System, an automated bench-top immuno-analyzer, based on the Enzyme Linked Fluorescent Assay. The data was analyzed using chi-squared test and t-test. Results: Mean vitamin D in OLP cases and controls was 20.40 ng/ml and 32.67 ng/ml respectively. Vitamin D3 deficiency was more in OLP cases (70.6%) as compared to controls (34.3%) and insufficiency was more in controls (35.3%) as compared to OLP cases (16.7%). These differences were statistically significant. Conclusion: Although vitamin D deficiency was found more in OLP cases pointing towards the possible co-relation of vitamin D and OLP, yet insufficiency was seen more commonly in controls which revealed that this important vitamin was lacking in North Indian population.
Mar 2017 DOI 10.14302/issn.2476-1710.jdt-16-1262
Schoenfeld R.Corresponding author
Martin Luther University Halle-Wittenberg, Department of Psychology, Halle, Germany
Background. Emotional deterioration is frequently found in patients with chronic kidney disease, but some patients are affected by depressed mood without fulfilling the criteria of a depressive disorder. Those patients might rather suffer from an apathy symptom. Apathy as a symptom of a medical disease is accompanied by loss of motivation and interest, cognitive impairments, and emotional distress. Our study tested how groups of apathetic and depressed chronic kidney disease patients responded to a single haemodialysis session on measures of mood. Methods. 21 haemodialysis patients were assigned to subgroups (depressed, apathetic only, without depression and apathy) according to clinical relevant cut-offs. Sensitive questionnaires were administered to monitor mood state in general and mood changes before and after a single haemodialysis session in the chronic kidney disease patients. The results were compared to 20 age-matched healthy controls receiving no treatment. Results. Fortheen dialysis patients had eighter apathy or depressen and seven had neighter apathy nor depression. Mood state was seriously affected in all haemodialysis patients with depressed patients showing the largest effect compared to healthy controls. Patients with apathy and patients without apathy and depression were comparable in their mood state. We observed a positive mood change after the haemodialysis only in patients without apathy and depression. Their mood state improved significantly and reached nearly the level of healthy controls. Conclusions. The absence of a short-term mood change in apathetic dialysis patients makes them comparable to dialysis patients with depression. We argue that apathetic patients lack the probable mood brightening effect of the haemodialysis. The lack of emotional improvement by dialysis sessions could also lead to decreased adherence of the patients. Hence, apathy seems to be a serious symptom in chronic kidney disease that is worth to be considered at least in the diagnostic process. Accompanying psychotherapeutic care for these patients would be desirable
Dec 2016 DOI 10.14302/issn.2379-8572.joa-16-1369
Klessinger StephanCorresponding author
Department of Neurosurgery, nova clinic Biberach, Eichendorffweg 5, 88400 Biberach, Germany.
The purpose was to discover if medial branch blocks (MBBs) of the cervical spine can be used as a diagnostic tool to identify patients with somatosensory tinnitus. MBBs are a diagnostic tool to confirm the diagnosis facet joint pain in patients with neck pain. It is not known, if MBBs are also suitable for testing other symptoms than pain. However, the existence of neural connections between the auditory system and the cervical region can be assumed. Included were 22 consecutive patients presenting with tinnitus, who had received MBBs in a ten years’ period. Patients were tested with a MBB with bupivacaine and triamcinolone. Injections were performed with fluoroscopic visualization using established techniques. The mean follow-up time was 6.2 weeks. Tinnitus was analyzed through the global clinical impression of the patient. Seven patients (31.8 %) experienced a significant improvement of the tinnitus. In one patient a thermal radiofrequency neurotomy was done after positive response to two MBBs. The pain relief and a significant reduction of the tinnitus sustained at the follow-up examination 20 weeks after the denervation. No statistically significant difference was found in age, gender, duration of symptoms, additional neck pain or vertigo, or side or level of the intervention. This pilot study shows the feasibility to identify patients with somatosensory tinnitus with MBBs. Further studies with the primary intention on tinnitus are necessary to prove the significance of MBBs. After a positive response to MBBs, treatment with radiofrequency neurotomy is the rational consequence.
Oct 2016 DOI 10.14302/issn.2572-3030.jcgb-16-1276
Hayashi TakumaCorresponding author
Dept. of Obstetrics and Gynecology, Shinshu University School of Medicine, Japan,
Human uterine leiomyosarcoma (LMS) is neoplastic malignancy that typically arises in tissues of mesenchymal origin. The identification of novel molecular mechanism leading to human uterine LMS formation and the establishment of new therapies has been hampered by several critical points. We earlier reported that mice with a homozygous deficiency for proteasome beta subunit 9 (PSMB9)/b1i, an interferon (IFN)-g inducible factor, spontaneously develop uterine LMS. The use of research findings of the experiment with mouse model has been successful in increasing our knowledge and understanding of how alterations, in relevant oncogenic, tumour suppressive, and signaling pathways directly impact sarcomagenesis. The IFN-g pathway is important for control of tumour growth and invasion and, has been implicated in several malignant tumours. In this study, experiments with human tissues revealed a defective PSMB9/b1i expression in human uterine LMS that was traced to the IFN-g pathway and the specific effect of somatic mutations of Janus kinase (JAK1) molecule or promoter region on the transcriptional activation of PSMB9/b1i gene. Understanding the molecular mechanisms of human uterine LMS may lead to identification of new diagnostic candidates or therapeutic targets in human uterine LMS.
Aug 2016 DOI 10.14302/issn.2574-4496.jtc-16-1129
Silva FriedaCorresponding author
Nuclear Medicine Section, Radiological Sciences Department, School of Medicine, University of Puerto Rico
Objective: Radiation exposure to the general public and patients undergoing diagnostic or therapeutic procedures is of great concern, especially to the medical community. Revision of Nuclear Regulatory Commission rules several years ago yield new recommendations for the administration of therapeutic doses of 131-Iodine that included the release criteria. The guidelines for ambulatory treatment included patient education and radiation safety measures to minimize exposure and contamination. Our goal in this study was to evaluate patient compliance with the radiation safety instruction protocols given to them before the therapeutic dose and monitor radiation levels in different house areas at different times after an ablation therapy of 3700MBq or more. Method: Patients with well differentiated thyroid cancer being evaluated for ablation therapy with 131-Iodine were invited to participate. A thorough set of instructions on radiation protection were given verbally and in writing. Patient house was assessed with a Geiger Muller detector at 24 and 72 hours or above to obtain direct radiation levels in several areas. Patient radiation levels were also monitored. Results: A total of 12 patients have been included, 11 females and 1 male, median age was 53 years. Tumor histology was 10 papillary, 2 papillary-follicular variant and 1 follicular carcinoma; 92% of the cases were T1, N0, M0. Home location was urban in 77% and rural in 33% of the patients; 67% of the patients had an educational level between 9-12 grade. Radioiodine doses range from 3441-5994MBq. None of the patients had a relatives or companion in the house. Mean patient exposure 24 hours after the dose at 1 meter was 12mrem/hr, 0.120mSv/h; this represented a retained dose of 2181MBq (59mCi). Only one patient (T1, Nx, M1) had an exposure rate at 1 meter of 100mrem/hr (1mSv/hr) at 24 hours. At 72 hours the exposure changed to 4mrem/hr, 0.040mSv/hr, retained dose of 725.2MBq (19.6mCi). Higher exposure rates in the house were at 24 hours in the bed and pillows (7mrem/hr), kitchen trash (13mrem/hr) and bathroom sink (8mrem/hr). The exposure rates at the toilet and shower were similar (3-4mrem/hr). There was a significant decreased in the exposure rate at 72 hours in all house areas. Patients with the higher exposure rates were those with metastatic disease, and small living facilities. Patients living in rural or urban location had no difference in the exposure rate. The educational levels were not related either to the exposure rate. Conclusion: Patient compliance with radiation protection instructions and Nuclear Regulatory Commission release criteria was good. Radiation exposure levels in the house areas are safe. Special instructions must be design to minimize contamination in the bathroom and kitchen Caution is recommended in the release of patients with extensive metastatic disease and doses of 5920MBq or more.
Aug 2016 DOI 10.14302/issn.2473-1005.jdoi-16-1167
Singh Nayyar AbhishekCorresponding author
Reader, Department of Oral Medicine and Radiology, Saraswati-Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India
Context: The present study was undertaken to do a comparative evaluation of the role of Cone Beam Computed Tomography (CBCT) imaging and Orthopantomography (OPG) for pre-operative implant planning in combination with sinus grafting procedures in order to assess sinus anatomy and morphology and the existing bone height in three dimensions. Aims: To assess sinus anatomy and morphology and the existing bone height in three dimensions. Materials and Methods: Pre-operative assessment of maxillary sinuses for implant planning using CBCT imaging was performed on 20 sinuses (17 patients). These patients were subjected to orthopantomographs and CBCT imaging both pre-operatively and post-operatively. CBCT imaging helped to decide the type of sinus augmentation procedure best suited for the patients as per the individual needs and depending on the residual alveolar bone height, timing of implant placement, sinus morphology, anticipation of complication and comparative analysis between pre-and post-procedural gain in vertical alveolar bone height and increase in bone density. Statistical Analysis: The results were tabulated and statistically analyzed using Paired and Unpaired t-tests. Results: In the majority of cases, there was a concordance between the treatment type based on pre-operative and post-operative CBCT scans. The assessment of sinus morphology revealed a significantly higher detection rate of abberations in the form of sinus mucosal hypertrophy and septae on CBCT which were imperceptible on routine radiographs. The most appealing result was that vertical alveolar bone height could be measured precisely and there was a significant increase in surgical confidence and a significantly better prediction of complications when using CBCT imaging. Conclusions: A pre-operative planning based on CBCT imaging seems to improve sinus diagnostics and helps to execute a better treatment plan. Also, it is a good tool for the comparison of vertical alveolar bone height pre-and post-operatively following sinus augmentation procedures using various graft materials.
Jul 2016 DOI 10.14302/issn.2572-5424.jgm-16-1066
Harrison SanjayCorresponding author
Northern Deanery, UK
Lactic acidosis is a condition commonly encountered in the hospital setting particularly in critically ill patients and is very often used as a diagnostic adjunct when encountering cases of ischaemia or other hypoperfusion states. Despite its use many clinicians have long forgotten the biochemical mechanisms that give rise to hyperlactataemia. One reason for this is because the basic science regarding lactate metabolism is taught in the early years of the medical undergraduate course, and unless one specialises in metabolic medicine, is unlikely to encounter it again. In this article we aim to elucidate the basic mechanisms of lactate metabolism and the accompanying acidosis, and illustrate various clinical settings that give rise to this biochemical abnormality.
Jun 2016 DOI 10.14302/issn.2372-6601.jhor-16-976
Busuttil DP.Corresponding author
Consultant Haematologist, Department of Pathology, Mater Dei Hospital, Msida, MSD 2090, Malta.
A case of acute symptomatic polycythaemia vera is presented with diagnostic work‑up, risk stratification, and acute management considerations. The discussion highlights thrombotic risk and cytoreductive strategies.
Jun 2016 DOI 10.14302/issn.2578-2371.jslr-16-1068
Seetahal ShivaCorresponding author
Heart of Florida Regional Medical Center, Davenport, FL
A case report of massive splenic rupture with atypical presentation. It covers diagnostic work‑up, stabilization, and operative decision‑making.
Jun 2016 DOI 10.14302/issn.2574-4526.jddd-16-1077
Yu Wen-LiangCorresponding author
Department of Intensive Care Medicine, Chi Mei Medical Center, Tainan, Taiwan
Two cases of CMV esophagitis presenting with distinct clinical and endoscopic features are presented. Diagnostic clues, histopathology, and antiviral therapy considerations are highlighted, emphasizing vigilance in immunocompromised hosts.
Apr 2016 DOI 10.14302/issn.2379-7835.ijn-16-943
KAL DéréCorresponding author
Laboratory of Medical Biochemistry; Unit training and research of Medical Sciences- Alassane OUATTARA University (Cote d’Ivoire).
Unlike developed countries, monitoring of the alimentation quality is important in developing countries. In recent years, several methods of assessing food consumption using simple tools the 24-hour diet recall have been proposed. This individual dietary diversity score (IDDS) is a simplified method for assessing the quality of diets, defined as the number of food groups represented in the diet over a period of time. We conducted an individual qualitative food consumption survey based on the 24 hours recall method. It was an Interviewer-administered questionnaire was used to collect information.The classification terciles of Dietary Diversity score was obtained from the 14 food groups recommended by FAO. 200diabetic and 200 hypertensive patients regularly followed in the same hospital (University hospital of Treichville) were included in this study without any distinction about treatment. The average of individual dietary diversity score was to 5.6 ± 1.58 for diabetic against 6 ± 1.94 food groups consumed the day before by hypertensive. Hypertensive patients in our study seemed o better diversity their diet with 8% of them who had a high score against 0.5% for diabetic. The food groups most consumed by our population were cereals, white tubers, other vegetables, fish and oils and fats at the expense leafy vegetables, vitamin A fruits, other fruits and legumes, nuts and seeds. In terms of anthropometric factors, we found the influence of waist circumference on food diversification in diabetic and not from hypertensive. Considering the importance of dietary diversity to nutrition and health, these results show the need to mobilize efforts for ensuring that people have better access to and knowledge about adequate nutrition. Despite the fact that this study has to be performed and that comparisons with other countries are required to harmonize the methodology, our results show the interest of the use of a simple tool to assess the quality of the food within the population. Using of this tool is certainly a future solution for a rapid diagnostic of diets quality.
Mar 2016 DOI 10.14302/issn.2329-9487.jhc-13-335
P. Desai ArpanCorresponding author
Interventional Cardiologist, Vadodara, Gujarat, India.
Objective: To find out the diagnostic accuracy of admission ECG against coronary angiography (CAG) to predict the ARA in patients with USAP /NSTEMI. Background: In USAP even though multiple active plaques are documented, one critical lesion would be responsible for the index episode of angina. Contrary to STEMI there is no standard methodology to identify the Angina related artery (ARA) in USAP.Therefore we plan to determine whether admission ECG could predict the ARA in patients with USAP/NSTEMI. Patients and Methods: 250 eligible patients with USAP/NSTEMI undergoing coronary angiography were enrolled in the study. After locating the ARA , the patient’s admission ECG was compared with CAG finding to study whether it has any predictive value for identifying ARA. Results: Sensitivity of the admission ECG for LAD as ARA was 73.6%, Specificity was 93.5%, PPV was 90%, NPV was 81.8%, +LR 10.4, Posterior probability 0.89, -LR 0.29, Posttest odds 0.22. Similarly for RCA and LCx ,Sensitivity was 63.1%, Specificity was 93.7%, PPV was 90.5%, NPV was 72.7%, +LR 9, Posterior Probability 0.89, -LR 0.35, Posttest odds 0.33. For the LM and TVD, Sensitivity was 66.6%, Specificity was 98.5%, PPV was 91.4%, and NPV was 92.5%, +LR 33, Posterior Probability 0.89, -LR 0.33, Posttest odds 0.08. Conclusion: With high +LR, Admission ECG is moderately sensitive and highly specific for detecting culprit artery.
Feb 2016 DOI 10.14302/issn.2324-7339.jcrhap-15-828
E.E Enwereji,Corresponding author
College of Medicine, Abia State University, Uturu, Nigeria
Introduction Working with people who are HIV positive is a herculean task and relevant theories to assist them medically, psychologically, economically, socially and otherwise are necessary. People who are living positively with HIV and AIDS are usually ridiculed, discriminated against, rejected and isolated. Using theories to work with them will help to cushion the negative impacts of HIV and AIDS, especially stigma which has been identified as a major barrier to health care and quality of life in illness management. The fundamental human rights of people living positively with HIV and AIDS should be protected since majority of such rights are usually trampled upon. The review aimed at discussing the potential benefits of using theories to assist people living positively with HIV and AIDS to cope with their various and varying situations in life. Materials and Method: Information for this study was collected by extensive review of recent literature on theories for assisting people living positively with HIV and AIDS. The paper reviews theories that influence long-term behaviour change among people living positively with HIV and AIDS. It assesses the need for using these theories to improve HIV and AIDS intervention in developing countries including Nigeria. In this study, eleven behaviour theories were reviewed. Result It was noted that some of the theories promoted adherence as well as helped to explain the benefits of adherence to HIV and AIDS medication. Also a good number of the theories assisted researchers in designing effective intervention strategies. Conclusion: Further research is needed to determine the effective theories that will increase adherence to long-term treatment regimens of HIV and AIDS. Such theories can be used to alleviate the potential burnout of Caregivers and people living positively with HIV and AIDS who travel long distances for diagnostic procedures and work long hours without adequate remuneration, support and supervision.