All Articles in april, 2021

Background: The present study was conducted to study the donor profile and to assess the trends of cornea donation. Methodology: This was conducted as a hospital based cross sectional study at a tertiary care centre in Central India for a period of 5 years. Data was retrieved from 70 patients from eye bank who filled form of eye donation at Eye bank of our institution. Sociodemographic profile of donors, cause of death and time since death was recorded. Source of information regarding corneal donation and reason for not willing to donate the cornea for research purpose was recorded from the filled form. Further cornea enucleated were subjected to serology and their utilization for various purposes were recorded in questionnaire. Results: The present study retrieved data from a total of 70 donor forms with mean age of 65.84 ± 18.4 years. Cornea obtained from younger patients were mainly utilized for corneal transplantation whereas that from elderly age group > 60 years were mainly utilized for research/training purpose and the observed difference was statistically significant (p < 0.01). The corneas retrieved and utilized immediately after death were significantly used for optical or therapeutic purposes (p < 0.05). Conclusion: The present highlights the donor profile and trends of corneal donation at the tertiary care facility of Central India. It was observed that though the younger population and older population both are aware regarding corneal donation but still they are less aware on purpose for which cornea can be utilized. Quality of donor cornea is better when death to enucleation time interval was less.

A case of oncocytic papillary cystadenoma in a 72-year old woman, a rare tumor of laryngeal seromucinous glands of unclear nature is presented. The patient had a history of chronic inflammation of laryngeal mucosa and both her age and tumor location were typical. The lesion was resected transorally without complications. Histological findings are shown in the present study. The controversial status of oncocytic papillary cystadenoma as either a true neoplasm or a combination of metaplastic and hyperplastic changes, its resemblance to Warthin’s tumor and optimal approach to treatment are discussed.

58-year-old male patient who came to the dermatology service for a clinical picture consisting of generalized erythematous scaly and pruritic lesions of 2 years of evolution. The clinical judgments provided were: pityriasis versicolor, drop psoriasis, pityriasis rubra pilaris and secondary syphilis (without serology confirming this last hypothesis then). A biopsy of a lesion located on the right costal side was performed. The serology was negative in a second time.

It is difficult to predict how the founder of psychoanalysis, Sigmund Freud, would react to an attempt to link his theory and the method of treating mental disorders based on it [1], with such a purely physical disease as acute pneumonia (AP). It is unlikely that such an innovation could cause full approval and support. However, in this context, we are not talking about psychoanalysis as a therapeutic method for AP. In this case, only the diagnostic features of this technique are of interest

More than 200 countries have been devastated by the SARS-CoV-2 pandemic. The health workers exposed to SARS patients have been confirmed to be infected with coronavirus (SARS-CoV-2), regardless of the degree of their exposure. The increasing complexity of virus existence and heterogeneity has cast doubt on disinfectants as a viable choice. Hence, the present systematic review aims to achieve the comparative analysis of established disinfectants against enveloped and non-enveloped viruses including SARS-CoV and MERS-CoV. Three databases (Pubmed, Google scholar, and Medline) were searched to frame the systematic review. Our comparative analyses with 34 studies have found that 85% ethanol-based hand sanitizers and 7.5% Povidine Iodine based soaps/surgical scrub could be used to deter the SARS-CoV-2 virus as preferred hand sanitizers. For surface eradication, 0.5% sodium hypochlorite or a mixture of glutaraldehyde, Quaternary Ammonium Compounds (QAC), and isopropanol could have more efficacies as compared to hydrogen peroxide, phenol, and QAC alone. Moreover, the accelerated hydrogen peroxide as an active ingredient in the automatic quick surface disinfectant (tunnel system), maybe a positive indication for quick whole-body sanitation. Additionally, the alternative method for avoiding the rapidly increasing chain of infection with SARS and restarting regular life has been exclusively discussed.

Among the abounding lessons we learned from the SARS-C0V-2 pandemic is the uttermost determinant that people are not equal before the severity of COVID-19. Indeed, the disease course differs with age, gender, ethnicity, underlying clinical conditions and virus variants. Other diseases modifying factors are associated with genetic traits such as those driving the immune response, the blood groups, the coagulation system and the ACE2 receptor variants [1-4].

Objective: to determine the incidence of HBV and HCV in pediatric ward. Sitting: 2ed March teaching hospital, sebha Libya. Materials and Methods: this was a prospective hospital base study of pediatric cases admitted to 2ed March teaching hospital during a period from March 2018 to February 2019. Pediatric cases were studied for the incidence of HBsAg and HCV Ab by ELISA, Rapid technique. The positive result was confirmed with line immuno-assay. Results: the study showed positive HBsAg in 12 patients and HCV in 2 cases out 25 cases represented with acute hepatitis from a total of 1763 pediatric cases were submitted in this study, with incidence rate of 0.68% and 0.11% respectively. Conclusion: the incidence of HBV and HCV are low in Sebha, therefore active program need to be applied to control the spread of infection among the population.

Rotavirus induced disease are a main source of dreadful, serious and drying out gastroenteritis in kids (less than five years old). Instead of the worldwide presentation of immunizations for rotavirus longer than 10 years back, rotavirus infections still result in more than 200,000 yearly passings, generally in developing countries. Rotavirus basically infects enterocytes and cause diarrheal through the demolition of absorptive enterocytes. Intestinal secretions are invigorated by rotavirus (non-auxiliary/structural protein) to enactment of the enteric sensory system. Rotavirus diseases can prompt viraemia and antigenaemia (term related with more serious indications of intense gastroenteritis). Rotavirus reinfections are regular throughout the life, even though the sickness seriousness is diminished with rehash contaminations. The resistant relates of assurance against rotavirus reinfection and recuperation from disease is inadequately perceived. This study takes a step forward to the administration of rotavirus disease centers, primarily on control and cure of dehydration, even though the utilization of antiviral and hostile to purgative medications can be demonstrated at some cases.

The administration of a drug substance is an essential step in the management of a patient. It aims either to cure the patient, to prevent a given disease or sometimes to help with the diagnosis. Unfortunately, the action of the drug can go beyond the desired effect, and cause skin-mucous accidents. These accidents, also known as drug-induced attacks, can be isolated or associated with systemic manifestations [1]. Drug eruption is a real public health issue because of the high frequency. In Europe, drug eruption is responsible for about 20% of spontaneous reports of drug accidents. They complicate 2% to 3% of hospital treatments and motivate 1% of consultations, 5% of hospitalizations in dermatology [2]. Some African authors were interested in the subject. Reported prevalence in hospital settings ranges from 0.4% to 1.53% [3,4]. In Mali, there are no national figures. Old statistics from the Department of Dermatology show that about thirty cases occur each year, most of which are represented by severe forms. However, the risk of drug eruption is thought to be very high due to increased local use of drugs without medical advice, the illegal proliferation of drug outlets (‘Street Medicine’). And the lack of enforcement of existing regulations. In addition, some authors believe that the advent of antiretrovirals and the use of antiInfectious infections used to treat opportunistic infections have increased the risk of Drug eruption by 4 to 30 times, particularly in subjects infected with the acquired human immunodeficiency virus (HIV) [2]. This same risk can be observed in leprosy patients on combination chimotherapy. Clinically, the diagnosis of drug eruption is not as easy as one might think because of clinical polymorphism. The responsibility of a drug for the onset of a reaction is also not easy to establish, as in most cases several drugs are administered simultaneously before the onset of the rash. Because of illiteracy, patients find it difficult to make a complete list of the molecules consumed. To this must be added the high frequency of counterfeit medicines circulating both on the street and in private pharmacies. Given the scarcity of African studies and due to local specificities, it seemed interesting to us to undertake a study on Drug eruption in the dermatology department of the Dermatology teaching hospital of Bamako whose purpose is to study epidemiological aspects, clinical, etiological and to identify the molecules responsible in these patients.

Objective: To observe the predominance of fetal anomalies in pregnant women in a multi-centric setting. Methods: This prospective observational study included 20225 pregnant women who came for antenatal care in University Hospital and fetal medicine units from 2016 to 2019. Fetal anatomical scanning was done for all participants. Results: One hundred eighty-three cases had fetal congenital anomalies, yielding a prevalence of around 0.9%. Third of cases had positive consanguinity, this increased in cases of skeletal and thoracic anomalies. The presence of past history of anomalies was evident in 8.2% mostly with skeletal and heart anomalies. History of drug intake was only verified in 1.6% of cases. Sixty-three women out of 183 (34.4%) were diagnosed to have anomalies in fetal nervous system. Conclusion: Prenatal diagnosis are recommended for early detection of congenital anomalies and counselling.

Background: The aim of the study was to evaluate radiographic features of systemic sclerosis-associated interstitial lung disease. Patients and methods: 116 patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD) from 2010 to 2019 comprised our retrospective study. All patients were subject to high resolution computed tomography (HRCT). ILD patterns were classified into 7 patterns as IIPs and analyzed with pathology. We chose two staging method and two semi-quantitative score methods to evaluate the HRCT performance and analyzed with pulmonary function tests. Results: Ground-glass opacities were the most common presentation on HRCT, followed by interlobular septal thickening, reticular opacities, intralobular interstitial thickening; honeycombing, traction bronchiectasis and nodules can also be observed. The most common pattern of SSc-ILD was nonspecific interstitial pneumonia (NSIP), secondly was UIP. There was no difference in ILD pattern between HRCT and pathology, and revealed a high congruence. The four HRCT evaluating methods presented in this study all had significant relationships with PETs. Conclusion: The most common pattern of SSc-ILD was nonspecific interstitial pneumonia (NSIP). The ILD patterns of HRCT coincide very well with histology, and will replace pathology as the gold standard for diagnosis and evaluation of SSc-ILD.

Background: Lupus Nephritis (LN) occurs in approximately half of all patients with Systemic Lupus Erythematosus (SLE) and it is the most common cause of morbidity and mortality in patients with SLE. Factors associated with poor renal outcome vary among studies, and researches coming from Brazil are scarce. Objectives: To identify the prognostic factors associated to the development of Chronic Kidney Disease (CKD) and End Stage Renal Disease (ESRD) in LN patients followed in a tertiary hospital. Design and Settings: We conducted a retrospective cohort study set in a tertiary hospital in Fortaleza, Ceará, Brazil. Methods: We compiled a total of 214 LN patients diagnosed between 1983 and 2015. Data was collected from medical records and further analyzed using logistic regression. Results: LN prevalence was 53.9%. The cohort had a mean follow-up of 11.2 years (SD ± 7.2 years). At the end of follow-up, 93 of 197 patients (47.2%) had CKD, and 49 of 191 (25.6%) were on regular dialysis. The main factors associated for developing CKD after logistic regression analysis were the following predictors: hypertension (HR 2.80; 95% CI 1.30-6.01; p = 0.008), time between diagnosis of SLE and diagnosis of LN (HR 0.98; 95% CI 0.97-0.99; p = 0.009) and discontinuation of medications (HR 2.41; 95% CI 1.08-5.37; p = 0.03). Conclusion: Hypertension, discontinuation of medications, and time between diagnosis of SLE and diagnosis of LN are independent variables associated with the development of CKD and ESDR in our study. 

Background: Acute kidney injury (AKI) is a major health problem affecting millions of people worldwide. Effective preventative and therapeutic treatments remain to be produced. We aim to determine the association between blood glucose and mortality in critical patients with AKI. Method: This cohort study included 18,703 patients with AKI. The exposure of interest was baseline blood glucose. The outcome was 30-day mortality. Multivariable Cox regression analyses and smooth curve fitting were adopted to assess the independent association between blood glucose and 30-day mortality. Results: We identified 18,703 consecutive individuals with AKI. The average age of the participants was 66.8 ± 16.0 years, and about 42.7% of them were female. The overall 30-day mortality was 16.9%. Through the multivariate COX regression model and smooth curve fitting, we observed that the correlation between blood glucose and 30-day mortality is nonlinear. An inflection point was found at about 5.93 mmol/L. On the left side of inflection point, the effect size was 0.81 (HR: 0.81, 95% CI 0.74-0.89, p < 0.001). On the right side of inflection point, the effect size was 1.02 (HR: 1.02,95% CI 1.01-1.03, p < 0.001). Conclusion: Our study suggested that, among patients with AKI, there was a nonlinearity relationship between blood glucose and mortality in patients with AKI. The optimal of blood glucose associated with the lowest risk of 30-day mortality was around 5.93 mmol/L. 

Background and Objective: Thrombolytic and mechanical thrombectomy therapies are proven treatment methods in patients with acute stroke. Aim is to share our experience in acute stroke therapy with colleagues. Material and methods: In this study we evaluated the patients who underwent MT or MT + IV-tPA between 2018-2019 retrospectively. Demographic features, comorbid diseases of patients, symptom onset-to-gate and symptom gate-to-puncture durations, mRS (Modified Rankin Score) and NIHSS (National Institutes of Health Stroke Scale) score, treatment method and degree of recanalization were listed. Results: MT was applied to 29 patients, MT + bolus IV-tPA was applied to 12 patients and MT + full dose IV-tPA was applied to 7 patients. The mean age was 66 ± 15 years, arrival mRS was 2 ± 2, arrival NIHSS score was 14 ± 5, onset-to-gate duration was 185 minutes and gate-to-puncture duration was 118 minutes. Conclusion: The rate of recanalization, functional independence and mortality were similar to the HERMES study. It was observed a higher rate of intracranial hemorrhage in patients who received bolus or full dose IV-Tpa compared to patients who underwent MT. These results have led us to question the necessity of giving bolus or full dose IV-tPA before MT. Onset-to-gate and gate-to-puncture durations were found longer than the recommended durations. Rapid and effective management of AIS patients will provide good clinical results.

This non-systematic review outlines the current knowledge concerning provenance, chemical composition and properties of apple cider vinegar, its general health effects, as well as the currently available knowledge concerning its action on fat storage, physiological mechanisms of its effects, as well as its safety and recommended dosage for treatment of obesity. 

Introduction: The contents of the retropharyngeal space are limited to fat and retropharyngeal nodes. Primary tumors originating from the retropharyngeal space are rare, therefore, the existence of schwannoma in the retropharyngeal space is infrequent. Method: This paper describes a case of a large schwannoma of the retropharyngeal space excised transorally with the use of co2 laser. This lesion measured about 6/6 x 3/5. Result: No peri-or post-operative complications were encountered. The procedure allowed quick resumption of an oral diet and a return to normal activity for the patient. Conclusion: This is, to our knowledge, the first report of this technique used in the excision of a large retropharyngeal space schwannoma.

Related COVID vaccine production many different strategies was followed by the producers. Observing some rare event of thrombosis after some COVID-19 vaccination, it is interesting to verify if the Target used for the manufacturing can be involved in a different procoagulant activity or not. Some vaccine are suspended in some country or under a deep new verify- investigation by the regulatory agency. (EU or USA). This fact it is relevant. The target SPIKE-PROTEIN FULL LENGTH modified or not or towards the RBD domain can be a relevant factor.

Puerperal acute uterine inversion is a rare obstetric condition observed as a serious complication during the third stage of labor. Reported as one of the causes of postpartum haemorrhage, it commonly requires quick diagnosis and surgical treatment in order to reduce morbidity and lethality. The authors describe a case of uterine inversion with hypovolemic shock after home birth, brought to Hospital Leonor Mendes de Barros. The purpose of this article is to describe a case of acute uterine inversion and its management and a review of aetiology, predictive and risk factors, diagnosis and treatment.

Advanced technologies, such as electrochemical impedance spectroscopy (EIS), are a valuable tool which can enhance and simplify the industrial process monitoring if used correctly. State-of-the-art approaches for screening the cell growth of for example yeast during the brewing process still heavily rely on offline methods such as methylene blue or florescence dye-based staining, and/or the usage of flow cytometric measurements. These methods, while being accurate, are very time consuming and require heavy manual effort. Furthermore, the time span needed to obtain the counting result can lead to a time-delayed response signal and can impact the quality of the final product. In recent studies, applications of low-frequency EIS in the α-regime were used for the determination of cell counts and the metabolic state in Saccharomyces cerevisiae. This method has proven to be a reliable tool which has also shown high potential in industrial scale applications. The online biomass monitoring, as well as viable cell count, for feasibility study was performed in-house at Stiegl Brewery in Salzburg/Austria founded in 1492.

Sildenafil citrate is one of the frontline drugs used to manage erectile dysfunction (ED). Chemically, it is described as 1-[[3-(6,7-dihydro-1-methyl-7-oxo-3-propyl-1H –pyrazolo [4,3-d]pyrimidin-5-yl)-4 ethoxyphenyl] sulfonyl]-4-methylpiperazine citrate (C22H30N6O4 S). It is a highly selective inhibitor of cyclic guanine monophosphate-specific phosphodiesterase type-5. There had been heightened concerns following reports that sildenafil citrate may increase the risk of cardiovascular events, particularly fatal arrhythmias, in patients with cardiovascular disease. So the cardiac electrophysiological effects of sildenafil citrate have been investigated extensively in both animal and clinical studies. This article ties up the various outcomes of the investigations with a view to guiding physicians and patients that use sildenafil citrate to manage erectile dysfunction, especially as it concerns its effect on their cardiovascular function in health and in disease. Sildenafil citrate could impact negatively on ailing hearts, but on a healthy heart, there may not be any such impact, rather, it improves on heart performance as it lowers the blood pressure.

Diffuse alveolar hemorrhage (DAH) is a rare complication of systemic lupus erythematosus (SLE) and carries a high mortality. It was first described by Osler in 1904 as the most devastating pulmonary complication of SLE. We describe a case of a 23-year-old girl recently diagnosed with SLE associated by a class III nephritis treated with oral corticoids and mycophenolate mofetil who developed a Diffuse Alveolar Hemorrhage DAH a few days later. The early diagnosis and the aggressive therapy allowed us to have a favorable outcome.

Dear reader, isn’t it time to turn things around and allow TIME to take its rightful place? In a nutshell, I believe Time should be considered as the primary energy that has created the whole material world and governs the continuous changes in it. In my article “An Intelligent Cosmos: Philosophy of Science”, I discuss that this primary creative energy is, more generally, the Dark Energy in our Universe. I believe that Dark Energy probably has a variety of specific manifestations, and I assume that one of those manifestations is Time. This article is a continuation of my article “An Intelligent Cosmos: Philosophy of Science” 

Episiotomy is a most commonly performed minor procedure. There are various type of episiotomy suturing, in this study two most common types of episiotomy suturing techniques were compare in terms of healing rate. This study concluded that the continuous method of episiotomy suturing is although faster, cosmetically better and associated with less post-operative pain but it heals significantly better than interrupted method of suturing.

Pre eclampsia and IUGR are important causes of maternal and perinatal morbidity and mortality. Pre eclampsia is a multisystem disorder, in normal pregnancies trophoblastic invasion transforms high resistance spiral arteries into low impedance uteroplacental circulation. This uteroplacental circulation remains incomplete in pre eclampsia and IUGR. This study is to correlate the Doppler Findings with the Fetal Outcome in pre eclampsia patiens, and helps decide appropriate time for delivery with least perinatal morbidity.

Introduction: In accordance with the requirements for the preparation of a report, a physician must provide information on scientific research in the following sections to obtain a qualification category of a specialist: 6. Scientific and practical work (participation in scientific and practical conferences, medical scientific societies, presentations, publications); 11.2. List of publications of the attested in scientific journals and collections, abstracts and 11.3. List of speeches at international, all-Russian and republican conferences. Material and methods: The analysis of 5 qualification works of a psychiatrist (1997, 2002, 2008, 2013 and 2018) for the scientific component as part of the mandatory requirements for the processing of documents when they are submitted to the Attestation Commission on the assignment of a qualifying medical category in psychiatry . The depth of the study was 24 years. When working on the material, the following methodical approaches were used: system, complex, dynamic, normative, quantitative and situational. Methods of analysis included: historical, analytical and comparison. For the analysis, methods were used: groupings, absolute values, continuous and selective observations. Results: The psychiatrist GAUZ “KDC” independently or in co-authorship published 223 scientific and educational-methodical publications (total volume of 182.65 conventional author’s sheets), including 90 scientific (39.81) and 143 educational-methodical (142.84) works, in including one monograph and eight textbooks (two of them with the stamp of the Ministry of Education of the Russian Federation). In the e-library (www.e-library.ru) of the Russian Scientific Citation Index (RINC): publications - 31; citations - 123; Hirsch index - 3, publications in the journals of the VAK - 13. (https://elibrary.ru/author). Discussion: The scientific work of a practicing outpatient psychiatrist is assessed both quantitatively and qualitatively, the integral indicator of the psychiatrist’s own participation in each publication of 0.78 conventional printed sheets can be considered as a serious personal contribution to scientific research. In the regulatory framework of indicators and requirements for registration of the report there is no synchronization in the daily work of a practical doctor, his job duties with the statements of the report. When concluding an employment contract with the employer, there is no mention in it that the doctor should engage in scientific work, and it is an integral part of his functional duties and qualification requirements. The scientific work does not mention the “Unified qualification directory of positions of managers, specialists and employees, the section “Qualification characteristics of the positions of employees in the field of health care” for a psychiatrist. Conclusion: The attitude to the Administrative Regulations on the provision of a public service for assigning a qualification category to specialists engaged in medical and pharmaceutical activities should be reviewed in terms of synchronization with the duties of a doctor. The Regulation on the compulsory conduct of scientific research should be introduced, substantiated and provided by the employer or be excluded from the administrative regulations as an independent section and be exclusively recommendatory in nature. Publications of physicians in scientific journals and collections, theses of reports should motivate their interest, and within the limits of the possibilities of the medical institution to have reasonable financial support, fixed in the employment contract. An example of a practical doctor who speaks at international, all-Russian or republican congresses, congresses and conferences is an important indicator of his professional growth, an incentive for the disclosure and development of the potential of the medical institution team and the result of proper administrative and organizational-methodological guidance. The scientific work and publications of a psychiatrist’s practical doctor should be a weighty additional argument in favor of a positive decision on awarding the qualification category he has declared.

Venom has a very complex and exclusive nature which has been introduced by recent advances in omics technologists. These methods have revealed a new insight into venom studies as venomics. Envenoming by venomous animals is a global concern due to the distribution of important medical species around the world. Treatment of envenomed victims is dependent on accurate and fast identification of animal species with different detection methods. In recent years, new methods have been introduced based on molecular and immunological techniques. Precise diagnosis of species of venomous animals is an essential factor for treatment with specific antivenoms. Venomics and antivenomics data sets help in the selection of specific antivenoms or production of novel antivenoms with greater efficacies.

Background: A misguided auto-reactive injury is responsible for several types of central nervous system (CNS) conditions in pediatrics. We propose that, in some of these conditions, the adaptive immune system has a common cellular immune pathogenesis, driven predominantly by T cells, despite variability on the phenotypical clinical presentation. Methods: We have characterized the CD4+/CD8+ adaptive immune response (AIR) on pediatric patients presenting with clinical symptoms compatible with Neuroimmune Disorders (NID). Flow cytometry with deep immunophenotyping of T cells was performed on peripheral blood obtained during the acute clinical phase and compared to an age-matched cohort group (Co). Results: We found that pediatric patients with confirmed NID, exhibit a pattern of dysregulation of CD4+ lineages associated with autoimmune processes. Discussion: The autoimmune associated CD4+ dysregulation was associated with patients with NID, as compared to healthy controls and patients with non-autoimmune diagnoses. If we can improve our capacity for early accurate diagnosis and meaningful disease monitoring of pathogenic T cell subsets, we can both expedite disease detection and may serve as a guide to the administration of effective immunotherapeutic agents.

We describe successful percutaneous coronary intervention (PCI) of significantly diseased ostial left main (LM) and distal LM bifurcation (Medina 1,1,1) in a patient with a reduced left ventricular ejection fraction and a recent valve-in-valve balloon-expandable TAVR using the DK-Crush technique with the support of a percutaneous left ventricular assist device.

Acute pulmonary damage and vascular coagulopathy appear to be frequent in patients with SARS-CoV-2 infection relation to corona-virus. The inflammatory process accompanying the infection and excessive coagulation state is one of the most important causes of patient loss.

Background: In Wilms’ tumor, the time elapsed between clinical diagnosis and the start of treatment is clearly associated with morbidity and mortality. As treatment delay can influence patient survival, identification of possible causes can mitigate the consequences arising from prolonged diagnostic uncertainty. Objective: To ascertain whether an initial diagnosis of Wilms’ tumor in the emergency department influences patient prognosis depending on the type of referral for definitive treatment. Patients and methods: Retrospective chart review of 98 children receiving treatment for Wilms’ tumor at the Brazilian National Cancer Institute (INCA) between April 2003 and December 2016. Patients were categorized into two groups: those referred directly from an emergency public department to INCA and those first transferred to another hospital before being referred to INCA. Results: Of the 98 cases included in the study, 42.9% were direct referrals and 57.1% were indirect referrals. Presence of an abdominal mass was the most common presenting complaint, followed by abdominal pain. In cases with larger tumors, the mean tumor volume was greater than reported elsewhere in the literature, suggesting longer disease duration. Significantly higher tumor volumes were observed in patients with a palpable abdominal mass as compared to those with the second most frequent complaint (abdominal pain). Conclusion: The findings of this study support the hypothesis that patients diagnosed with kidney masses in the emergency department are at greater risk of delayed diagnosis when they are referred first to a non-specialized outside hospital than when referred directly to a specialized cancer treatment unit.

Currently, the emergence of highly virulent mutants in Europe and the United States has caused refractory recurrent Clostridium difficile infection (RCDI) to be a problem in clinical practice. In 2013, the Netherland group demonstrated breakthrough therapeutic efficacy in fecal microbial transplant (FMT) treatment clinical trials for RCDI, and FMT treatment is rapidly gaining attention. In addition to RCDI, FMT treatment has been attempted in various gastrointestinal diseases such as inflammatory bowel disease, irritable bowel syndrome and chronic constipation, as well as extragastrointestinal diseases. In this review, I would like to describe the current status, complications and prospects of FMT treatment.

Despite critical care advances, robust antibiotic therapy and improved strategies in early detection and prevention of infection, the incidence of morbidity and mortality from neonatal sepsis worldwide in preterm and low birth weight neonates remains overwhelmingly high. Neonatal sepsis is characterised by a clinical syndrome of systemic signs of infection and bloodstream bacteraemia in newborns within the first months of life. The risk of sepsis in neonates is inversely proportional to gestational age and birth weight due to deficiency in humoral immunity and the need for more invasive supportive neonatal intensive care unit interventions. Adverse effects such as necrotising enterocolitis associated with antimicrobial therapy are serious enough to warrant exploration of alternative therapeutic strategies. Immunoglobulin replacement therapy offers hope of enhancing immune competence and reducing infection rates in vulnerable populations. It is evident from the relevant studies to date that the benefits offered by intravenous immunoglobulin prophylaxis may not be significant enough for routine hospital implementation. Further research to better understand the mechanisms underlying immunodeficiency will lead to the realisation of alternative therapeutic and prophylactic interventions.

Background/aim: Amitriptyline belongs to class of known as tricycline antidepresant (TCA) that is being used to treat anxiety and depressive states. It may help improve mood and feelings of well-being, relieve anxiety and tension, help to improve sleep and increase energy level. The study investigated the effect of amitriptyline on learning and memory using eighteen (18) healthy Swiss mice of both sexes weighing 16 – 25 g. Method: The animals were divided into three (3) groups consisting of six (6) animals each. Group 1 served as the control group, Group 2 was administered with amitriptyline at a dose of 3 mg/kg body weight dissolved in 3 mls of distilled water, and used to test for learning, while Group three was also given similar administration like Group 2, but used to test for memory. All the animals were tested for learning and memory performance using Novel object recognition task and Morris water maze test. Results: The results obtained from the Novel object recognition task showed that there was a significant decrease (p < 0.05) in total object approach in acquisition trial of amitriptyline treated group when compared to the acquisition trial of the control group. There was a significant decrease (p < 0.05) in retention trial of amitriptyline group when compared to retention trial in the control group. There was a significant decrease (p < 0.05) in total duration exploring objects in acquisition trial of amitriptyline treated group when compared to the acquisition trial of the control group. There was a significant increase (p < 0.05) in total duration exploring objects in retention trial of amitriptyline treated group when compared to the retention trial of the control group. There was a significant decrease (p < 0.05) in the index of habituation of amitriptyline treated group when compared to the control group. The index of discrimination showed a significant increase (p < 0.05) in amitriptyline treated group when compared to the control group and a significant decrease (p < 0.05) in amitriptyline group when compared to the control group. In the Morris water maze test, Day 1 – 3 were for acquisition training, day 4 – 6 reversal training, day 7 the probe trial day and day 8 the visible platform day. During acquisition training in the Morris water maze test, there was no significant difference in Swim latencies in day 1 and 2. However in day 3, there was a significant increase (p < 0.05) in swim latency of group compared to control group and a significant decrease (p < 0.05) in swim latency of amitriptyline treated group compared to the control group. During reversal training in day 1, 2 and 3, there was no significant difference in swim latency among the three groups. Results for the retention quadrant in the probe trials showed a significant decrease (p < 0.01) in amitriptyline group when compared to the control group. Conclusion: Results suggest that amitriptyline impairs learning and memory functions.

Bladder carcinomas have a great propensity for divergent differentiation with more that 90% being Transitional cell carcinoma. Several histological variants have been have described so far; they are not only morphologically unique but also have significant prognostic and therapeutic differences making their timely identification of paramount importance. Osteoclastic giant cell variant of urothelial carcinoma is very rare type with controversial management. Studies from China have documented higher incidence and severity of illness in COVID-19 positive cancer patients. We report an unusual case of Osteoclastic giant cell variant of urothelial carcinoma in a 63 yrs old male patient associated with simultaneous COVID-19 infection.

Aim of this work is to analyze the coronavirus viral surface properties related the pattern of electrical features. This chemical physical property is relevant and crucial to set profile of diffusion, severity of disease, efficacy of therapeutic strategy and in order to search new way to fight COVID-19 and the NEW VARIANT. The phenomena of immune evasion and the different pattern of efficacy towards variants of some vaccine or some antibodies combination produce the need to verify if considering the electrical feature of viral surface can be a right tool or not. As result of this research it is possible to submit to the scientist that the viral surface properties and electrical feature can be an element to be considered in various preventive or treatment measure. The specificity of action of some vaccine or antibodies seem to tell us that also the aspecific methods are useful. A specific chemico physical factors can influence the electrical charges viral surface behavior. Hpertonic saline solution, humidity, electrical charge barrier in mask are simply example of the effect. That can be obtained action on viral surface chemico -physical properties.

The onset of the pandemic has caused widespread concern about the rapid spread of the infection and serious concern about the lack of specific treatment for it. Calls and demands for strict compliance with sanitary and anti-epidemic measures, a sharp reduction in direct contacts and movements of people with the introduction of quarantine measures in large regions and even countries have become a familiar modern reality. All these efforts do not yet allow us to see and feel their positive results, and the next wave of infection destroys hopes for the likelihood of achieving rapid and complete success in the fight against this evil. At the same time, a detailed analysis of the material accumulated during this period allows us to identify the most problematic links in the process of diagnostics and providing care to such patients and to note the reasons that require priority solutions.

Radiation of different wavelengths can kill living organisms, although, the mechanism of interactions differs depending on their energies. Understanding the interaction of radiation with living cells is important to assess their harmful effects and also to identify their therapeutic potential. Temporally, this interaction can be broadly divided in three stages – physical, chemical and biological. While radiation can affect all the important macromolecules of the cells, particularly important is the damage to its genetic material, the DNA. The consequences of irradiation include- DNA damage, mutation, cross-linkages with other molecules, chromosomal aberrations and DNA repair leading to altered gene expression and/or cell death. Mutations in DNA can lead to heritable changes and is important for the induction of cancer. While some of these effects are through direct interaction of radiation with the target, radiation can interact with the surrounding environment to result in its indirect actions. The effects of radiation depend not only on the total dose but also on the dose rate, LET etc. and also on the cell types. However, action of radiation on organisms is not restricted to interactions with irradiated cells, i.e. target cells alone; it also exerts non-targeted effects on neighboring unexposed cells to produce productive responses; this is known as bystander effect. The bystander effects of ionizing radiations are well documented and contribute largely to the relapse of cancer and secondary tumors after radiotherapy. Irradiation of cells with non-ionizing Ultra-Violet light also exhibits bystander responses, but such responses are very distinct from that produced by ionizing radiations.

The isolation of phytase using Pichia Pastoris under methanol/sorbitol co-feeding induction technique was investigated. The biological activity of extracellular phytase after optimization with co-substrates induction in 4 liters fermentor (NBS) increased to 13250 U/ml. This led to a 509 fold increases in comparison to the other type of phytase. This effect was studied via induction with sorbitol/methanol in fermentation by Pichia Pastoris GS115 (Mut+) at 20 °C. The interference of by products; methylal, hexamine and (S)-(+)-1,2-propanediol with release of phytase in Pichia Pastoris under methanol induction were detected and cannot be repressed by methanol induction alone. The TLC was used for glycerin analysis under methanol/sorbitol induction and the results were lesser compare to that obtained during phytase production under methanol induction alone. This work showed the higher expression of heterologous proteins and by fed batch fermentation; the expression identified an advantage of producing a significant activity of phytase. Practical applications Plant derived products including sorbitol have been used as alternative medicines for the therapeutic treatment of various diseases, food supplements and could be used in many manufacturing processes. It serves as a culture media for bacteria, and helps to distinguish the pathogenic E. coli O157:H7 from its most other strains. Cells growing on methanol require high oxygen consumption. Sorbitol was used as an alternative cheap co-feeding for the production of proteins and is a non-repressing carbon source for AOX1 promoter with no effect on the level of r-protein at its induction phase. This report describes the isolation of phytase using Pichia Pastoris under methanol/sorbitol co-feeding induction techniques, and sorbitol showed to be a promising co-substrate, as it could enhance both cell growth and targeted protein productivity. This co-feeding and fed-batch induction technique was used for recombinant phytase production in a small and large scale production and the metabolites were analyzed.

Introduction: In endodontically treated teeth, dentinal defects such as microcracks can progress to a vertical root fracture and lead to tooth loss. Objective: The present study aimed to evaluate, by micro-computed tomography analysis, the formation of dentinal microcracks during filling removal in endodontic retreatment of root canals filled with gutta-percha and Total Fill BC bioceramic sealer. Methods: Twenty mesial roots of mandibular molars were instrumented and obturated with gutta-percha and Total Fill BC sealer and then the filling material was removed with rotary Protaper Retreatment files. The specimens were scanned before instrumentation, after filling and after retreatment. The transversal images obtained after filling were compared with the images obtained after removal of the filling material. A descriptive statistical analysis was performed. Results: Among the 24.444 cross-sections analyzed, 5.67% presented some type of dentinal defect, with 0.51% in the initial images, 2.58% in the post-filling images and 2.58% in the post-retreatment images. All the dentinal defects identified in the images obtained after the retreatment were already present in the corresponding images after the filling. New dentinal microcracks were not observed after removal of the filling material. Conclusion: Retreatment of mesial roots of mandibular molars filled with a silicate-based root canal filling material do not influence the formation of dentinal microcracks.

In this work the statistical and squeezing properties of light-driven by sub-harmonic generation with two-mode coherent light are studied. With interaction Hamiltonian of both two-mode coherent and sub harmonic generation, we have driven master equation of system under consideration. From the master equation, the solution of the C-number Langevin equation is derived. It helps us to solve quadrature variance, quadrature squeezing, mean, and variance of photon number for light produced by sub-harmonic generation with the two-mode coherent light state. And the result shows that; the squeezing occurs in plus quadrature with the maximum squeezing of 87%. The photon statistics of the system under consideration is subpoissonian in which both mean & variance are increasing as kappa increase.

Earlier in our laboratory, the role of various individual sperm impairing microorganisms on sperm parameters and female infertility has been elucidated at higher doses. As, multiple bacterial species tend to exert more pathogenic effect in comparison to single organism hence, present study was carried out to evaluate that if consortia of these sperm impairing organisms can lead to infertility in female mice at sub fertility dose. For this, impact of individual bacterial strains of Escherichia coli, Pseudomonas aeruginosa, Pseudomonas aeruginosa, Klebsiella pneumoniae and consortia of Escherichia coli and Pseudomonas aeruginosa, Escherichia coli and Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumoniae was examined on the motility, viability of mouse spermatozoa and fertility outcome. The results showed that the individual bacterial strains of E. coli, S. marcescens and K. pneumoniae could led to immobilization of spermatozoa by agglutination and P. aeruginosa led to immobilization of spermatozoa without agglutination. Also, all of them led to 100% sperm death in 45 min of incubation. In case of consortia of bacterial strains, the results showed sperm agglutination in all the cases and they were able to induce 100% sperm death at 30 min of incubation time. Further, in vivo studies were carried out to evaluate the impact of individual bacterial strains and consortia of bacterial strains on the fertility outcome in female Balb/c mice. For this, female mice were administered intravaginally with 101 cfu/20µl of individual bacterial strains or consortia of strains for 10 consecutive days or PBS. The results showed that both individual bacterial strains and consortia of bacterial strains were able to efficiently colonize the mouse vagina. Further, control group receiving phosphate buffer saline and groups receiving individual bacterial strains showed all the pregnancy related changes viz. abdominal distension, string of pearls on palpation as well as delivery of pups on completion of gestation period and delivery of pups. The histological examination of reproductive organs viz. uterus and ovary, of the female mice receiving PBS or individual bacterial strains showed the formation of corpus luteum in the ovary and the formation of decidua’s in the uterus, indicative of pregnancy. However, mice receiving consortia of bacterial strains did not show any pregnancy related changes throughout the experiment. Thus, these results indicate that the presence of consortia of sperm impairing microorganisms in vaginal milieu is efficient in provoking infertility even at subfertility doses.

The use of Information Technology (IT) has made our live comfortable at present however, it has also generated certain health concerns. The disproportionate exercise of IT, with indication to accessible literature, has been consistently interrelated with psychopathological indications counting the problems of aggression as well. Although this issue was not much focused in Pakistan, this study was planned to determine the connection among the expenditure of IT and aggression in Pakistani youth. The query incorporated 200 conveniently chosen Pakistani youth between 16 to 24 years of age from 4 cities. The Aggression Scale of Buss & Perry was used along with a demographic information questionnaire. The study was hypothesized that among Pakistani youth elevated utilization of IT would be positively correlated with higher levels of aggression. It was significantly proved by the results that elevated utilization of IT is positively and significantly correlated with aggression. The findings of this study may be helpful to psychologists, counsellors, parents and teachers in diagnosing problems of the Facebook generation.

The oocyte is the female gamete that contributes not only half of the genetic material but also all of the cytoplasm to the zygote, supplying the transcripts, proteins, mitochondria and other components necessary for early embryonic development. The intrinsic oocyte quality is one of the main factors affecting the embryo yield, the implantation rate and the rate of healthy offspring. It is obvious that a fertilized oocyte must reach the blastocyst stage within 6–9 days in the proper culture conditions to have a significant chance of inducing a pregnancy and producing an offspring. The ability to sustain the first week of embryonic development is clearly influenced by the follicular status from which the oocyte is obtained indicating that this developmental potential is inherent within certain oocytes. Since most early embryos that do not reach the blastocyst stage are blocked at or close to the maternal to zygotic transition (MZT)-stage, which occurs at the eight-cell stage in cattle, one could speculate that incompetent oocytes fail to appropriately activate the embryonic genome. Oocyte selection based on glucose-6-phosphate dehydrogenase (G6PDH) activity has been successfully used to differentiate between competent and incompetent bovine oocytes. Recently, molecular regulation of genes regulating biological process of Brilliant Cresyl Blue staining (BCB) selected oocytes and embryos was investigated to explain their variation in quality and developmental potentiality. This short review will highlights some of these efforts that have been done in this interesting area of research.

Introduction: Sodium-glucose cotransporter 2 inhibitors such as empagliflozin (EMPA) protect against diabetic kidney disease. Prostaglandin E2 (PGE2) the main renal product of cyclooxygenase-2, inhibits vasopressin (AVP)-water reabsorption in the collecting duct (CD). The novelty of this study is that for the first time, we examined if EMPA affects the renal PGE2/EP receptor system and determined if CD responses to EMPA prevent water loss. Methods: Four groups of adult male mice were studied after 6 weeks of treatment: control (db/m), db/m+EMPA (10 mg/kg/day in chow), type 2 diabetic diabetic/dyslipidemia (db/db), and db/db+EMPA. Tubules were microdissected for quantitative polymerase chain reaction (qPCR) and CD water transport was measured in response to AVP, with or without PGE2. Results: Hyperglycemia and albuminuria were attenuated by EMPA. Renal mRNA expression for COX, PGE synthase, PGE2 (EP) receptor subtypes, CD AVP V2 receptors and aquaporin-2 was elevated in db/db mice, but unchanged by EMPA. Urine PGE2 levels increased in db/db but were unchanged by EMPA. AVP-water reabsorption was comparable in db/m and db/m+EMPA, and equally attenuated to 50% by PGE2. In db/db mice, AVP-water reabsorption was reduced by 50% compared to non-diabetic mice, and this reduction was unaffected by EMPA. In db/db mice, AVP-stimulated water transport was more significantly attenuated with PGE2 (62%), compared to non-diabetic mice, but this attenuation was reduced in response to EMPA, to 28%. Conclusion: In summary, expression of renal PGE2/EP receptors is increased in db/db mice, and this expression is unaffected by EMPA. However, in diabetic CD, PGE2 caused a greater attenuation in AVP-stimulated water reabsorption, and this attenuation is reduced by EMPA. This suggests that EMPA attenuates diabetes-induced excess CD water loss.

Background: Adipose tissue is one of the main sites of energy homeostasis that regulates whole body metabolism with the help of adipokines. Disruption in its proper functioning results in adipose tissue remodeling (primarily hypertrophy and hyperplasia) which directly influences the secretion of said adipokines. Obesity characterized as chronic low-grade inflammation of the adipose tissue is one such condition that has far reaching effects on whole body metabolism. Inflammation in turn results in immune cells infiltrating into the tissue and further promoting adipocyte dysfunction. Purpose: In our study we explored this adipose tissue-innate immunity axis by differentiating adipose tissue derived stem cells (ADSCs) into white and beige adipocytes. We further stimulated our cultures with lipopolysaccharide (LPS), flagellin, or meteorin-like, glial cell differentiation regulator (METRNL) to trigger an inflammatory response. We then evaluated Toll-like receptor (TLR) mRNA expression and secretion of interleukin (IL-6), interleukin-8 (IL-8), brain-derived neurotrophic factor (BDNF), and nerve growth factor (NGF) in these cultures. Results: We found that TLR2 is the highest expressed receptor in adipocytes. Further, LPS and METRNL are strong activators of TLR2 in white and beigeBMP7(-) adipocytes. TLR4 was not significantly expressed in any of our cultures despite LPS stimulation. TLR9 expression is upregulated in ADSCs upon LPS and METRNL stimulation. IL-6 and IL-8 secretion is increased upon LPS stimulation in white adipocytes. METRNL activates both IL-6 and IL-8 expression in adipocyte cultures. Lastly, BDNF and NGF is secreted by all adipocyte cultures with beigeBMP7(-) and beigeBMP7(+) secreting slightly higher amounts in comparison to white adipocytes. Conclusion: ADSCs and adipocytes alike are capable of expressing TLRs, but white adipocytes remain the highest expressing in both control and stimulated cultures. TLR2 is highly expressed in white and beige adipocytes whereas TLR4 showed no significant expression. LPS and METRNL trigger IL-6 and IL-8 secretion in adipocytes. Products of white adipocyte “browning” are capable of secreting higher amounts of BDNF and NGF in comparison to white adipocytes.

Background: Chronic rhinosinusitis (CRS) is a heterogeneous and multifactorial inflammatory disease of the nasal and paranasal mucosa. To date, no internationally standardized uniform classification has been developed for this disease. Usually, a phenotype classification according to CRS with (CRSwNP) and without (CRSsNP) polyposis is performed. However, through a variety of studies, it has been shown that even within these phenotypes, different endotypes of CRS exist, each with a different underlying inflammatory pathophysiology. In this mini-review, we aim to outline the essential immunological processes in CRSwNP and to highlight the modern therapeutic options with biologics derived from this disease. Methods: Current knowledge on the immunological and molecular processes of CRS, especially CRSwNP, was compiled by means of a structured literature review. Medline, PubMed, national/international trial and guideline registries as well as the Cochrane Library were all searched. Results: Based on the current literature, the different immunological processes involved in CRS and nasal polyps were elaborated. Current studies on the therapy of eosinophilic diseases such as asthma and polyposis are presented and their results discussed. Conclusion: Understanding the immunological basis of CRSwNP may help to develop new personalized therapeutic approaches using biologics. Currently, 2 biologics (dupilumab, omalizumab) have been approved for the therapy of CRSwNP (polyposis nasi) in Europe.

This paper focuses on the mental health burden on medical and healthcare residents during the 1st wave of COVID-19 pandemic crisis in 2020 describing the activities of a mental health service for residents (NAPREME) in a public university, UNIFESP, Sao Paulo, Brazil; and a preliminary study showing an increasing of depressive symptoms and depression among residents. Data is related to the screening interviews of medical residents and healthcare multi-professional residents who sought the mental health service from March to December 2020. A comparison was conducted with the same period in 2019 (covering a period when Covid-19 was not affecting the Brazilian population). There was a 22% demand increase in 2020. Of the total amount who sought treatment: 23% were medical residents, 22% nursing residents, and the remaining distributed among other professions; and 58% were first year residents and 34% second year. Data from the BDI questionnaire showed some variance between the two years: the mean score for 2020 was 24.67 (± 7.86) which is in the depression range, higher than the mean score of 19.91 points in the previous year (± 10.15) which is only in the depressive symptoms range (p < 0.005). In the pandemic period there was an increase in residents with depression from 49% to 70%. Depression, anxiety, stress and burnout syndrome were observed, demanding psychological and psychiatric care for this population. Assessment of residents’ mental health will continue during 2021, during the 2nd wave of COVID-19 and an additional analysis will be conducted along the year.

Introduction: Psychiatric emergencies constitute between 1% - 10% of general emergencies in Spain, of which a quarter will end up being hospital admissions. There is little literature on patients who are referred from general to specialized hospitals. Methods: Cross-Sectional study of all the patients referred in 2018. Sociodemographic variables and clinical variables, such as diagnosis and discharge destination, were analyzed. An analysis was performed by comparing means with the Chi Square test. Results: 433 derived emergencies were analyzed. Most of the patients were women. The main reason for derivation were suicide attempts. Of those patients, 40% required hospitalizations. More than 50% of the derived emergencies were referred to the home and followed up on an outpatient basis. Conclusion: Most derived emergencies are referred to the home after evaluation. This implies that most are not life-threatening and that with adequate tools for evaluating suicide risk, we could avoid transfers and improve the resolution of these cases.

This literature review is concerning with liquid chromatography specifically high performance liquid chromatography (HPLC), Ultra high performance liquid chromatography (UHPLC), chromatography theory, chromatographic parameters, monolithic columns, principles of green chemistry and its application ingreen chromatography.

Background: The main cause of adrenal insufficiency (AI) in paediatric patients is prolonged treatment with corticosteroids. Determination of plasma cortisol (PC) during ACTH test is the most used adrenal function indicator in clinical practice. However, determination of salivary cortisol (SC), a simple test especially useful in children in order to avoid invasive procedures, can be used as an alternative technique for the diagnosis of adrenal disease. Methods: A two-year prospective study (January 2014-January 2016) in paediatric patients (2-18 years of age) treated with corticosteroids for more than fifteen days, who were investigated for suspected AI. Low-dose ACTH test was used to determine adrenal function and samples for SC and PC were obtained simultaneously in basal situation and during the test (at 30, 60 and 90 minutes). Results: 230 samples (118 PC-112 SC) of 30 studies belonging to 20 patients (4 males), mean age 10.93 years ± 3.69 SD. Pearson’s correlation coefficient showed a positive correlation between PC and SC (r = 0.618, p < 0.001). All the studies with some determination of PC higher than 18 μg/dL (n = 8) had a SC peak higher than 0.61 μg/dL with a specificity of 66.67% and a sensitivity of 93.94% (ROC analysis). Conclusion: Measurement of SC is a less invasive, easier and quicker test than PC to measure plasma free cortisol levels. In our study, a SC peak in low-dose ACTH test higher than 0.61 μg/dL was able to discriminate patients without AI, and proved to be a useful tool in the initial evaluation of children with suspected AI.Introduction The activation of the hypothalamic-pituitary-adrenal axis in response to critical illness and the resulting release of cortisol from the adrenal cortex are essential to stress adaptation. Adrenal insufficiency (AI) is described as the inability of adrenal glands to produce an appropriate hormonal secretion not only under stress but also in basal situation. Therefore, a low baseline plasma cortisol (PC) (< 5 μg/dL) and a poor cortisol response to stimulation with exogenous adrenocorticotropic hormone (peak < 18 μg/dL) are some of the defining criteria of this condition [1,2]. It is well known that the main cause of AI in paediatric patients is prolonged treatment with exogenous corticosteroids, which is an iatrogenic cause derived from the increasing complexity of paediatric pathologies and the increased use of prolonged high-dose corticosteroid therapy. In clinical practice, adrenal function is usually assessed by the total PC (determined by low-dose ACTH test). This implies the placement of a vascular access which is often a traumatic experience for children. PC includes protein-bound fraction and serum-free cortisol. The latter constitutes the biologically active form of the hormone and is responsible for glucocorticoid activity on peripheral organs. Most of the circulating cortisol is bound to plasma proteins (over 90%), such as cortisol-binding globulin (CBG) and albumin, whereas only about 10% of circulating cortisol is free. Hence, the measurement of plasma-free cortisol level has been considered more representative of adrenal function (especially in critically ill adults and children) [1,2], because some conditions, such as hypoalbuminaemia or hypoproteinaemia (frequent in critically ill patients or in patients with cirrhosis), may lead to misinterpretation of adrenal function with an overestimation of the prevalence of AI. But the direct measurement of free PC is a laboratory-dependent and time-consuming procedure that is not available for routine use. Salivary cortisol (SC) is one of the several indirect methods available to determine free PC [3], as SC levels accurately reflect free PC [4] even in cases of hypoalbuminaemia or CBG abnormality [1,5]. For this reason, in the last years, this technique (SC) has been introduced as a non-invasive tool in the diagnosis of adrenal cortical disorders, for its simplicity and applicability in the paediatric population. However, few studies to date have evaluated the usefulness of SC as a diagnostic method in children with AI. No interactions between exogenous corticoids and SC have been described [6]. The aim of the present study was to assess the usefulness of determining salivary cortisol levels as a diagnostic tool in children with suspected secondary iatrogenic AI. 

Background: Like other viruses, the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) appears to be responsible for several autoimmune complications. The occurrence of autoimmune hemolytic anemia has been described in several case reports. This AIHA was also noticeable by the important number of blood transfusions required for COVID-19 (coronavirus disease 2019) patients. By investigating RBC coating autoantibodies, this article attempts to clarify the autoimmune aspect of the anemia in the context of SARS-CoV-2 infection. Results: A large population of COVID-19 patients selected at Saint-Luc University Hospital showed an average of 44% DAT positivity. In this population, the intensive care patients were more prone to DAT positivity than the general ward patients (statistically significant result). The positive DAT appeared « transmissible » to other RBCs via COVID-19 DAT-positive patient’s plasma. Conclusion: The strongest hypothesis explaining this observation is the targeting of cryptic antigens by autoantibodies in COVID-19 patients.

We analyze optomechanically induced Transparency and asymmetric Fano-line shape Profile in a two-mode cavity system, coupling at weak and strong coupling regimes. The model system consists of one mechanical mode and two optical modes. The transmission shows nonreciprocal behavior. Both the forward transmission and backward reflection for the system are analyzed for both optic-optic and mechanical-optic cavities by considering various system parameters. The output spectra lead to sharp asymmetric Fano-resonance and tunable transparency. Double line-shape profile is observed in the output Spectrum. Our proposal provides a new platform for application in quantum telecommunications and a photonic device like optical Switches.

When grouping children with psoriasis depending on TaqI (T/C) genotypes of the VDR gene, the youngest age of disease onset and the longest duration of dermatitis (5.60 ± 0.77 years and 4.90 ± 0.68 years, respectively) showed up in case of the CC genotype. In case of the TT genotype, disease onset coincided with an older age, and the history of present illness was the shortest (10.26 ± 0.64 years and 2.59 ± 0.58 years, respectively). PASI (20.32 ± 3.43) and BSA (40.00 ± 6.11) severity indices were the highest and of statistically significant difference to those in other groups in the presence of the CC genotype. In case of the TC genotype, the index PGA (2.80 ± 0.15) was the lowest and made a statistically significant difference to the values of other groups. A negative correlation between vitamin D levels and the PASI, PGA, BSA was identified in children holding CC and TC genotypes. Conclusion: The clinical presentation of dermatitis and its epidemiological features in children with psoriasis, namely the age of disease onset, duration of exacerbation, body surface area and the intensity of psoriasis symptoms depend on vitamin D serum levels and genotypes of the TaqI polymorphic variant of the VDR gene.

Oguta LGA is surrounded by 44 oil wells located around different communities. Preliminary investigations indicated that crude wastes were not properly managed and oil spillage occurred regularly in the LGA. Therefore, assessment of both radionuclide contents in yam matrix and health risks in Oguta was carried out to determine possible radiological health risks associated with improper management of crude wastes, and also evaluate haematological health profile in the LGA for future reference and research. A well calibrated NaI (Tl) detector was deployed for the radiological investigation, and about 5 ml of blood samples were collected from 190 participants each from Oguta and the control LGAs for haematological assessment. Mean activity concentrations due to 40K, 226Ra and 232Th in yam samples from Oguta LGA were 189.99 ± 59.14 Bqkg-1, 23.75 ± 5.69 Bqkg-1 and 30.99 ± 9.51 Bqkg-1, respectively while mean activity concentrations due to natural radionuclides in yam samples from control LGA were 110.40 ± 78.53 Bqkg-1, 10.12 ± 3.34 Bqkg-1 and 18.39 ± 8.74 Bqkg-1 for 40K, 226Ra and 232Th, respectively. Committed effective dose equivalent values in Oguta and the control LGAs were 704.95 ± 183.30 μSvy-1 and 403.65 ± 172.19 μSvy-1, respectively which are less than world average value of 1.1 mSvy-1. Crucially, one-way ANOVA at α0.05 has indicated that effects of radiological parameters due to natural radionuclides in yam from Oguta are significantly different from effects of radiological parameters due to natural radionuclides in yam from the control LGA. However, the percentage contributions of natural radiation exposures to incidence of cancer in Oguta and the control LGAs are just 1.7% and 1.4%, respectively, and haematological investigations have shown that overall health of the communities in the study LGAs has not been compromised due to environmental and human factors. Hence, natural radioactivity may have been elevated in Oguta but the concentration levels are not yet alarming. Radiological health risks could result from consistent exposure to those natural radionuclides in the long term.

The article describes the necessary conditions for the phenomenon of thermal energy release in a magnetic fluid placed in a high-frequency rotating magnetic field. The minimum amplitude of the magnetic field was calculated and the thermal power released (by the rotating spherical nanoparticles in the viscous medium) was estimated. The estimations were based on the assumption that the magnetic relaxation times (τN and τB) and the magnetic field rotation period (τrot) meet the condition: τN>>τrot>>τB. The principle of operation and construction of the device generating a high-frequency rotating magnetic field is described. Preliminary experimental studies were carried out using a magnetic fluid with magnetite nanoparticles that indicated magnetic relaxation as the cause of the released heat. The value of the absorption rate in the experiment and its dependence on the strength of the magnetic field were determined.

Purpose: Some physiological events in women’s life such as pregnancy and lactation can be associated to a condition known as Transient Osteoporosis of the Hip (TOH); if not promptly diagnosed it can lead to significant consequences such as femoral neck fracture. In this paper we describe a case of bilateral TOH, focusing on the importance of early treatment and how it influenced the outcome. Methods: A 40 years old post-delivery woman came to our attention for hip pain and a left femoral neck fracture was diagnosed. Magnetic resonance (MRI) showed bilateral edema of the femoral head. She underwent total hip replacement on the left side; toe-touch weight bearing and pharmacological therapy were prescribed for the right hip. Results: MRI at nine months showed complete regression of the femoral head and neck edema; the patient was clinically asymptomatic. Conclusion: If not promptly diagnosed and treated, TOH can potentially evolve in fracture. Many therapeutic strategies have been suggested since now; we believe that avoiding weight bearing on the involved hip as early as possible is the key to recovery.

One of the primary constraints in upland rice cultivation is the disease blast (Magnaporthe oryzae), which can provide reduction up to 100% of the grain yield The use of silicon with beneficial microorganisms (bioagents) can be an alternative for the control of this disease and to provide an increase in the productivity of the rice grain. The objective of this work was to study the effect of rates of silicon with bioagents in blast suppression and grain yield of upland rice. The methodology used was tests carried out in field conditions, in two different areas: Capivara and Palmital farms, during the growing season 2015/2016. The experimental design was in a split-plot scheme with four replications. In the main plots were the silicon fertilization rates (0, 2, 4 and 8 ton ha-1) and in the subplots was the bioagents (1-without bioagents, 2-Pseudomonas fluorescens, 3-Burkholderia pyrrocinia, 4-Trichoderma asperellum, 5-a mixture of the three bioagents). The results showed that the use of 2 ton ha-1 of silicon with a mixture of bioagents was the best treatment to control leaf blast. Besides, from rates, 2 to 6 ton ha-1 of silicon in Capivara Farm and up to 8 ton ha-1 of silicon in Palmital Farm provided the highest grain yield. A mixture of bioagents provided the highest grain yield. In this sense, it was concluded that the best recommendation to connect blast control, grain yield and reduced amount of silicon was the use of 2 ton ha-1 of silicon with the mixture of bioagents.