Search results for: diagnostic biomarker

Authors: Dhivyalakshmi Gnanasekaran, Sonali Adole Prasante, Raveendranath Veeramamani, H. Y. Suma

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A rare case of intestinal malrotation with midline descending colon and right sided sigmoid colon was observed in an adult male cadaver aged around 55 years during routine dissection. The descending colon began from the splenic flexure and gradually descended downwards to occupy the midline position and turned to the right side to be continued as sigmoid colon at the level of the fifth lumbar vertebra. In the right iliac fossa some part of loop of sigmoid colon displaced into the right lumbar region before entering into the true pelvis to continue as rectum. This anomalous descending and sigmoid colon was supplied by varying branching pattern of inferior mesenteric artery. It is extremely important to consider this embryological anomaly before any interventional diagnostic procedures like colonoscopy and to enhance the safety of colonic surgery.

Keywords: sigmoid colon, descending colon, hindgut, malrotation

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Authors: Gamal Shiha, Seham Seif, Shahera Etreby, Khaled Zalata, Waleed Samir

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Background: Transient Elastography (TE; FibroScan®) is a non-invasive technique to assess liver fibrosis. Aim: To compare TE and liver biopsy in hepatitis C virus (HCV) patients, genotype IV and evaluate the effect of steatosis and schistosomiasis on FibroScan. Methods: The fibrosis stage (METAVIR Score) TE, was assessed in 519 patients. The diagnostic performance of FibroScan is assessed by calculating the area under the receiver operating characteristic curves (AUROCs). Results: The cut-off value of ≥ F2 was 8.55 kPa, ≥ F3 was 10.2 kPa and cirrhosis = F4 was 16.3 kPa. The positive predictive value and negative predictive value were 70.1% and 81.7% for the diagnosis of ≥ F2, 62.6% and 96.22% for F ≥ 3, and 27.7% and 100% for F4. No significant difference between schistosomiasis, steatosis degree and FibroScan measurements. Conclusion: Fibroscan could accurately predict liver fibrosis.

Keywords: chronic hepatitis C, FibroScan, liver biopsy, liver fibrosis

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Authors: Murray David Schane

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Though years of clinical encounters with patients with autism spectrum disorders and those with a schizoid personality the many defining diagnostic features shared between these conditions have been explored and current neurobiological differences have been reviewed; and, critical and different treatment strategies for each have been devised. The paper compares and contrasts the apparent similarities between autism spectrum disorders and the schizoid personality are found in these DSM descriptive categories: restricted range of social-emotional reciprocity; poor non-verbal communicative behavior in social interactions; difficulty developing and maintaining relationships; detachment from social relationships; lack of the desire for or enjoyment of close relationships; and preference for solitary activities. In this paper autism, fundamentally a communicative disorder, is revealed to present clinically as a pervasive aversive response to efforts to engage with or be engaged by others. Autists with the Asperger presentation typically have language but have difficulty understanding humor, irony, sarcasm, metaphoric speech, and even narratives about social relationships. They also tend to seek sameness, possibly to avoid problems of social interpretation. Repetitive behaviors engage many autists as a screen against ambient noise, social activity, and challenging interactions. Also in this paper, the schizoid personality is revealed as a pattern of social avoidance, self-sufficiency and apparent indifference to others as a complex psychological defense against a deep, long-abiding fear of appropriation and perverse manipulation. Neither genetic nor MRI studies have yet located the explanatory data that identifies the cause or the neurobiology of autism. Similarly, studies of the schizoid have yet to group that condition with those found in schizophrenia. Through presentations of clinical examples, the treatment of autists of the Asperger type is revealed to address the autist’s extreme social aversion which also precludes the experience of empathy. Autists will be revealed as forming social attachments but without the capacity to interact with mutual concern. Empathy will be shown be teachable and, as social avoidance relents, understanding of the meaning and signs of empathic needs that autists can recognize and acknowledge. Treatment of schizoids will be shown to revolve around joining empathically with the schizoid’s apprehensions about interpersonal, interactive proximity. Models of both autism and schizoid personality traits have yet to be replicated in animals, thereby eliminating the role of translational research in providing the kind of clues to behavioral patterns that can be related to genetic, epigenetic and neurobiological measures. But as these clinical examples will attest, treatment strategies have significant impact.

Keywords: autism spectrum, schizoid personality traits, neurobiological implications, critical diagnostic distinctions

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Authors: Wisam H. Benamer, Ehab A. Elfallah, Mohamed A. Elshaari, Farag A. Elshaari

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A challenge for laboratories is to provide bacterial identification and antibiotic sensitivity results within a short time. Hence, advancement in the required technology is desirable to improve timing, accuracy and quality. Even with the current advances in methods used for both phenotypic and genotypic identification of bacteria the need is there to develop method(s) that enhance the outcome of bacteriology laboratories in accuracy and time. The hypothesis introduced here is based on the assumption that the chromosome of any bacteria contains unique sequences that can be used for its identification and typing. The outcome of a pilot study designed to test this hypothesis is reported in this manuscript. Methods: The complete chromosome sequences of several bacterial species were downloaded to use as search targets for unique sequences. Visual basic and SQL server (2014) were used to generate a complete set of 18-base long primers, a process started with reverse translation of randomly chosen 6 amino acids to limit the number of the generated primers. In addition, the software used to scan the downloaded chromosomes using the generated primers for similarities was designed, and the resulting hits were classified according to the number of similar chromosomal sequences, i.e., unique or otherwise. Results: All primers that had identical/similar sequences in the selected genome sequence(s) were classified according to the number of hits in the chromosomes search. Those that were identical to a single site on a single bacterial chromosome were referred to as unique. On the other hand, most generated primers sequences were identical to multiple sites on a single or multiple chromosomes. Following scanning, the generated primers were classified based on ability to differentiate between medically important bacterial and the initial results looks promising. Conclusion: A simple strategy that started by generating primers was introduced; the primers were used to screen bacterial genomes for match. Primer(s) that were uniquely identical to specific DNA sequence on a specific bacterial chromosome were selected. The identified unique sequence can be used in different molecular diagnostic techniques, possibly to identify bacteria. In addition, a single primer that can identify multiple sites in a single chromosome can be exploited for region or genome identification. Although genomes sequences draft of isolates of organism DNA enable high throughput primer design using alignment strategy, and this enhances diagnostic performance in comparison to traditional molecular assays. In this method the generated primers can be used to identify an organism before the draft sequence is completed. In addition, the generated primers can be used to build a bank for easy access of the primers that can be used to identify bacteria.

Keywords: bacteria chromosome, bacterial identification, sequence, primer generation

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Authors: Dingiswayo Likhona, Arko-Cobbah Emmanuel, Carolina Pohl, Nthabiseng Z. Mokoena, Jolly Musoke

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A distinct strain of Klebsiella pneumoniae (K. pneumoniae), referred to as hypervirulent (hvKp), is associated with invasive infections such as an invasive pyogenic liver abscess in young and healthy individuals. In South Africa, limited information is known about the prevalence and virulence of this hvKp strain. Thus, this study aimed to determine the prevalence of hvKp and virulence-associated factors in K. pneumoniae isolates from one of the largest Tertiary hospitals in a South African province. A total of 74 K. pneumoniae isolates were received from Pelonomi National Health Laboratory Services (NHLS), Bloemfontein. Virulence-associated genes (rmpA, capsule serotype K1/K2, iroB, and irp2) were screened, and the virulence of hvKp vs. classical Klebsiella pneumoniae (cKp) was investigated using Caenorhabditis elegans nematode model. The iutA (aerobactin transporter) gene was used as a primary biomarker of hvKp. An average of 12% (9/74) of cases were defined as hvKp. Moreover, hvKp was found to be significantly more virulent in vivo Caenorhabditis elegans relative to cKp. The virulence-associated genes (rmpA, iroB, hmv phenotype, and capsule K1/K2) were significantly (p< 0.05) associated with hvKp. Findings from this study confirm the presence of hvKp in one large Tertiary hospital in South Africa. However, the low prevalence and mild to moderate clinical presentation suggest a marginal threat to public health. Further studies in different settings are required to establish the true potential impact of hvKp in developing countries.

Keywords: hypervirulent klebsiella pneumoniae, virulence, caenorhabditis elegans, aerobactin (iutA)

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Authors: G. R. Khaliullina, S. L. Blashkova, I. G. Mustafin

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The article presents the results of a study involving 97 patients with different types of orthodontic pathology. Immunological examination of patients included determination of the level of α-defensin and cytokine IL-1β in mixed saliva. The study showed that the level of α-defensin serves as a diagnostic marker for determining the therapeutic measures in the treatment of inflammatory processes in periodontal tissues. Α-defensins exhibit immunomodulating and antimicrobial activity during inflammatory processes and play an important role in the regulation of the pathology of periodontal disease. The obtained data allowed the development of an algorithm for diagnosis and the implementation of immunomodulating therapy in the treatment of periodontal diseases in orthodontic patients.

Keywords: α-difensin, cytokine, orthodontic treatment, periodontal disease, periodontal pathogens

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Authors: Tomáš Dyk, Stanislav Procházka, Martin Drahanský

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The article proposes a new algorithm for detecting damaged areas of the tank barrel based on the image of the inner surface of the tank barrel. Damage position is calculated using image processing techniques such as edge detection, discrete wavelet transformation and image segmentation for accurate contour detection. The algorithm can detect surface damage in smoothbore and even in rifled tank barrels. The algorithm also calculates the volume of the detected damage from the depth map generated, for example, from the distance measurement unit. The proposed method was tested on data obtained by a tank barrel scanning device, which generates both surface image data and depth map. The article also discusses tank barrel scanning devices and how damaged surface impacts material resistance.

Keywords: barrel, barrel diagnostic, image processing, surface damage detection, tank

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Authors: Jurijs Salijevs, Katrina Bolocko

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The integration of artificial intelligence and neural networks has significantly changed full-body imaging and high-resolution 3D mapping systems, and this paper reviews research in these areas. With an emphasis on their use in the early identification of melanoma and other disorders, the goal is to give a wide perspective on the current status and potential future of these medical imaging technologies. Authors also examine methodologies such as machine learning and deep learning, seeking to identify efficient procedures that enhance diagnostic capabilities through the analysis of 3D body scans. This work aims to encourage further research and technological development to harness the full potential of AI in disease diagnosis.

Keywords: artificial intelligence, neural networks, 3D scan, body scan, 3D mapping system, healthcare

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Authors: Erin Micali, Katerina Tolstikova, Cheryl Maykel, Elizabeth Harwood

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Female ASD is seldomly studied separately from males. Further, females with ASD are disproportionately underrepresented in the research at a rate of 3:1 (male to female). As such, much of the current understanding about female rigid repetitive behaviors (RRBs) stems from research’s understanding of male RRBs. This can be detrimental to understanding female ASD because this understanding of female RRBs largely discounts female camouflaging and the possibility that females present their autistic symptoms differently. Current literature suggests that females with ASD engage in fewer RRBs than males with ASD and when females do engage in RRBs, they are likely to engage in more subtle, less overt obsessions and repetitive behaviors than males. Method: The current study utilized a mixed methods research design to identify the type and frequency of RRBs that females with ASD engaged in by using a cross-sectional design. The researcher recruited only females to be part of the present study with the criteria they be at least age six and not have co-occurring cognitive impairment. Results: The researcher collected previous testing data (Autism Diagnostic Interview-Revised (ADI-R), Child or Adolescent/Adult Sensory Profile-2, Autism/ Empathy Quotient, Yale Brown Obsessive Compulsive Checklist, Rigid Repetitive Behavior Checklist (evaluator created list), and demographic questionnaire) from 25 total participants. The participants ages ranged from six to 52. The participants were 96% Caucasion and 4% Latin American. Qualitative analysis found the current participant pool engaged in six RRB themes including repetitive behaviors, socially restrictive behaviors, repetitive speech, difficulty with transition, obsessive behaviors, and restricted interests. The current dataset engaged in socially restrictive behaviors and restrictive interests most frequently. Within the main themes 40 subthemes were isolated, defined, and analyzed. Further, preliminary quantitative analysis was run to determine if age impacted camouflaging behaviors and overall presentation of RRBs. Within this dataset this was not founded. Further qualitative data will be run to determine if this dataset engaged in more overt or subtle RRBs to confirm or rebuff previous research. The researcher intends to run SPSS analysis to determine if there was statistical difference between each RRB theme and overall presentation. Secondly, each participant will be analyzed for presentation of RRB, age, and previous diagnoses. Conclusion: The present study aimed to assist in diagnostic clarity. This was achieved by collecting data from a female only participant pool across the lifespan. Current data aided in clarity of the type of RRBs engage in. A limited sample size was a barrier in this study.

Keywords: autism spectrum disorder, camouflaging, rigid repetitive behaviors, gender disparity

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Authors: V. A. Doss, R. Sowndarya, K. Juila Rose Mary

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Objective: Amino acid neurotransmitter system dysfunction plays a major role in the pathophysiology of depression. The objective of the present study was to identify the amino acids as possible metabolite biomarkers for depression using GCMS (Gas Chromatography Mass Spectrometry) before and after exercise regimen in brain samples of depression induced animal models. Methods: Depression-like behaviour was induced by Chronic Unpredictable mild stress (CUMS). Severity of depression was measured by forced swim test (FST) and sucrose consumption test (SCT). Swimming protocol was followed for 4 weeks of exercise treatment. Brain obtained from depressed and exercise treated rats were used for the metabolite analysis by GCMS. Subsequent statistical analysis obtained by ANOVA followed by post hoc test revealed significant metabolic changes. Results: Amino acids such as alanine, glycine, serine, glutamate, homocysteine, proline and branched chain aminoacids (BCAs) Leucine, Isoleucine, Valine were determined in brain samples of control, depressed and exercised groups. Among these amino acids, the levels of D-Serine and branched chain amino acids were found to be decreased in depression induced rats. After four weeks of swimming exercise regimen, there were improvements in the levels of serine and Branched chain amino acids. Conclusion: We suggest that Serine and BCAs may be investigated as potential metabolite markers using GCMS and their beneficial metabolic changes in Exercise.

Keywords: metabolomics, depression, forced swim test, exercise, amino acid metabolites, GCMS, biomarker

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Authors: Farzad Yavari, Hamid Chegini, Saeed Lotfi

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This paper reviews the comparison of Resin Rich (RR) and Vacuum Pressure Impregnation (VPI) insulation system qualities for stator bar of rotating electrical machines. Voltage endurance and tangent delta are two diagnostic tests to determine the quality of insulation systems. The paper describes the trend of dissipation factor while performing voltage endurance test for different stator bar samples made with RR and VPI insulation system methods. Some samples were made with the same strands and insulation thickness but with different main wall material to prove the influence of insulation system methods on stator bar quality. Also, some of the samples were subjected to voltage at the temperature of their insulation class, and their dissipation factor changes were measured and studied.

Keywords: VPI, resin rich, insulation, stator bar, dissipation factor, voltage endurance

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Authors: Tímea Gerzsenyi, Ágnes M. Ilosvai, László Vanyorek, Emma Szőri-Dorogházi

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DNA isolation is a crucial step in many molecular biological applications for diagnostic and research purposes. However, traditional extraction requires toxic reagents, and commercially available kits are expensive, this leading to the recently wide-spread method, the magnetic nanoparticle (MNP)-based DNA isolation. Different ferrite containing MNPs were examined and compared in their plasmid DNA isolation efficiency. Among the tested MNPs, one has never been used for the extraction of plasmid molecules, marking a distinct application. pDNA isolation process was optimized for each type of nanoparticle and the best protocol was selected based on different criteria: DNA quantity, quality and integrity. With the best-performing magnetic nanoparticle, which excelled in all aspects, further tests were performed to recover genomic DNA from bacterial cells and a protocol was developed.

Keywords: DNA isolation, nanobiotechnology, magnetic nanoparticles, protocol optimization, pDNA, gDNA

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Authors: Bilal Ahmed

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Rehabilitation of congenital and acquired maxillofacial defects is always a challenging clinical scenario. These defects pose major physiological and psychological threat not only to the patient but to the entire family. There has been an enormous scientific development in maxillofacial rehabilitation with the advent of CAD CAM, 3-D scanning, Osseo-integrated implants and improved restorative materials. There are also specialized centers with latest diagnostic and treatment facilities in the developed countries. However, in certain clinical case scenarios, conventional prosthodontic principles are still the gold standards. Similarly in a less developed world, financial and technical constraints are factors affecting treatment planning and final outcomes. However, we can do a lot of benefits to the affected human beings, even with use of simple and cost-effective conventional prosthodontic techniques and materials. These treatment strategies may sometimes be considered as intermediate or temporary options, but with regular follow-up maintenance these can be used on a definitive basis.

Keywords: maxillofacial defects, obturators, prosthodontics, medical and health sciences

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Authors: Sayed Ali Garossi, Azar Heidarizadi, Shahla Mohammad Ganji

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Context: Colorectal cancer is the second type of cancer-related mortality globally. Expression of cas8 (caspase 8) is closely connected to growth and metastasis of colorectal cancer.Cas8/Rip1 plays a vital role in the apoptosis pathway and resistance to chemotherapy. The aim of the present study is to investigate the pattern of gene expression in colorectal cancer and compare the differences using Real-Time PCR to find a potential biomarker candidate for colorectal cancer. Methodology: This study conducted real-time PCR to evaluate gene expression of Cas8 in colorectal cancer patients. The gene-specific primer sequences exon–exon junction was designed by OLIGO7 software for the expression of the gene under investigation. Forty-six patient samples without any chemotherapy were selected, including tumoral tissue and adjacent normal tissue samples. The age of the patients was 50 and the size of the tumors was 5.5 cm. The categories were before and after age 50. Findings: Here, we found that Caspase 8 was overexpressed in CRC tissues compared to corresponding adjacent colon tissues (Cas8: 5.2 vs. 1 ratio); high expression of Cas8 was associated with poor overall survival and independent risk factors for the prognosis of CRC patients. Conclusion: In conclusion, our study pioneered the reporting of high Casp8 expression as a predictor of poor prognosis and chemical resistance in CRC patients.Cas8 overexpression suppressed Cas 8 / Rip1-dependent apoptosis and activated the proliferation of tumor cells by activating necroptosis. The necroptosis pathway has also emerged as a new approach to anti-tumor in cancer treatment.

Keywords: Cas8, necroptosis, apoptosis, Real-Time PCR

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Authors: Sushmita Roy Chowdhury, Steve Holding, Sujoy Khan

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The immunogenic responses of the lung towards the fungus Aspergillus fumigatus may range from invasive aspergillosis in the immunocompromised, fungal ball or infection within a cavity in the lung in those with structural lung lesions, or allergic bronchopulmonary aspergillosis (ABPA). Patients with asthma or cystic fibrosis are particularly predisposed to ABPA. There are consensus guidelines that have established criteria for diagnosis of ABPA, but uncertainty remains on the serologic cut-off values that would increase the diagnostic specificity of ABPA. We retrospectively analyzed 80 patients with severe asthma and evidence of peripheral blood eosinophilia ( > 500) over the last 3 years who underwent all serologic tests to exclude ABPA. Total IgE, specific IgE and specific IgG levels against Aspergillus fumigatus were measured using ImmunoCAP Phadia-100 (Thermo Fisher Scientific, Sweden). The Modified ISHAM working group 2013 criteria (obligate criteria: asthma or cystic fibrosis, total IgE > 1000 IU/ml or > 417 kU/L and positive specific IgE Aspergillus fumigatus or skin test positivity; with ≥ 2 of peripheral eosinophilia, positive specific IgG Aspergillus fumigatus and consistent radiographic opacities) was used in the clinical workup for the final diagnosis of ABPA. Patients were divided into 3 groups - definite, possible, and no evidence of ABPA. Specific IgG Aspergillus fumigatus levels were not used to assign the patients into any of the groups. Of 80 patients (males 48, females 32; mean age 53.9 years ± SD 15.8) selected for the analysis, there were 30 patients who had positive specific IgE against Aspergillus fumigatus (37.5%). 13 patients fulfilled the Modified ISHAM working group 2013 criteria of ABPA (‘definite’), while 15 patients were ‘possible’ ABPA and 52 did not fulfill the criteria (not ABPA). As IgE levels were not normally distributed, median levels were used in the analysis. Median total IgE levels of patients with definite and possible ABPA were 2144 kU/L and 2597 kU/L respectively (non-significant), while median specific IgE Aspergillus fumigatus at 4.35 kUA/L and 1.47 kUA/L respectively were significantly different (comparison of standard deviations F-statistic 3.2267, significance level p=0.040). Mean levels of IgG anti-Aspergillus fumigatus in the three groups (definite, possible and no evidence of ABPA) were compared using ANOVA (Statgraphics Centurion Professional XV, Statpoint Inc). Mean levels of IgG anti-Aspergillus fumigatus (Gm3) in definite ABPA was 125.17 mgA/L ( ± SD 54.84, with 95%CI 92.03-158.32), while mean Gm3 levels in possible and no ABPA were 18.61 mgA/L and 30.05 mgA/L respectively. ANOVA showed a significant difference between the definite group and the other groups (p < 0.001). This was confirmed using multiple range tests (Fisher's least significant difference procedure). There was no significant difference between the possible ABPA and not ABPA groups (p > 0.05). The study showed that a sizeable proportion of patients with asthma are sensitized to Aspergillus fumigatus in this part of India. A higher cut-off value of Gm3 ≥ 80 mgA/L provides a higher serologic specificity towards definite ABPA. Long-term studies would provide us more information if those patients with 'possible' APBA and positive Gm3 later develop clear ABPA, and are different from the Gm3 negative group in this respect. Serologic testing with clear defined cut-offs are a valuable adjunct in the diagnosis of ABPA.

Keywords: allergic bronchopulmonary aspergillosis, Aspergillus fumigatus, asthma, IgE level

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Authors: Huong M. T. Nguyen, Hoa A. P. Nguyen, Mai P. T. Nguyen, Ngoc D. Ngo, Van T. Ta, Hai T. Le, Chi V. Phan

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Wilson’s disease (WD) is an autosomal recessive disorder of the copper metabolism, which is caused by a mutation in the copper-transporting P-type ATPase (ATP7B). The mechanism of this disease is the failure of hepatic excretion of copper to bile, and leads to copper deposits in the liver and other organs. The ATP7B gene is located on the long arm of chromosome 13 (13q14.3). This study aimed to investigate the gene mutation in the Vietnamese patients with WD, and make a presymptomatic diagnosis for their familial members. Forty-three WD patients and their 65 siblings were identified as having ATP7B gene mutations. Genomic DNA was extracted from peripheral blood samples; 21 exons and exon-intron boundaries of the ATP7B gene were analyzed by direct sequencing. We recognized four mutations ([R723=; H724Tfs*34], V1042Cfs*79, D1027H, and IVS6+3A>G) in the sum of 20 detectable mutations, accounting for 87.2% of the total. Mutation S105* was determined to have a high rate (32.6%) in this study. The hotspot regions of ATP7B were found at exons 2, 16, and 8, and intron 14, in 39.6 %, 11.6 %, 9.3%, and 7 % of patients, respectively. Among nine homozygote/compound heterozygote siblings of the patients with WD, three individuals were determined as asymptomatic by screening mutations of the probands. They would begin treatment after diagnosis. In conclusion, 20 different mutations were detected in 43 WD patients. Of this number, four novel mutations were explored, including [R723=; H724Tfs*34], V1042Cfs*79, D1027H, and IVS6+3A>G. The mutation S105* is the most prevalent and has been considered as a biomarker that can be used in a rapid detection assay for diagnosis of WD patients. Exons 2, 8, and 16, and intron 14 should be screened initially for WD patients in Vietnam. Based on risk profile for WD, genetic testing for presymptomatic patients is also useful in diagnosis and treatment.

Keywords: ATP7B gene, mutation detection, presymptomatic diagnosis, Vietnamese Wilson’s disease

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Authors: L. Ramirez, E. Guillén, J. Sánchez

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Some of the main goals about telecare such as monitoring, treatment, telediagnostic are deployed with the integration of applications with specific appliances. In order to achieve a coherent model to integrate software, hardware, and healthcare systems, different telehealth models with Internet of Things (IoT), cloud computing, artificial intelligence, etc. have been implemented, and their advantages are still under analysis. In this paper, we propose an integrated model based on IoT architecture and cloud computing telehealth center. Analytics module is presented as a solution to control an ideal diagnostic about some diseases. Specific features are then compared with the recently deployed conventional models in telemedicine. The main advantage of this model is the availability of controlling the security and privacy about patient information and the optimization on processing and acquiring clinical parameters according to technical characteristics.

Keywords: analytics, telemedicine, internet of things, cloud computing

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Authors: Mahesh Hariharan, Rajan Balasubramaniam, Sharath Kumar Shetty, Shanthala Yadavalli, Mohammed Ahetasham, Sravya Devarapalli

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Acute abdomen is one of the most common clinical conditions requiring a radiological investigation. Ultrasound is the primary modality of choice which can diagnose some of the common causes of acute abdomen. However, sometimes the underlying cause for the pain is far more complicated than expected to mandate a high degree of suspicion to suggest further investigation with contrast-enhanced computed tomography or magnetic resonance imaging. Here, we have compiled a comprehensive series of selected cases to highlight the conditions which can be easily overlooked unless carefully sought for. This also emphasizes the importance of multimodality approach to arrive at the final diagnosis with an increased overall diagnostic accuracy which in turn improves patient management and prognosis.

Keywords: acute abdomen, contrast-enhanced computed tomography scan, magnetic resonance imaging, plain radiographs, ultrasound

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Authors: Dianis Wulan Sari, Takeo Minematsu, Mikako Yoshida, Hiromi Sanada

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Introduction: Pruritus is diagnosed as itching without macroscopic abnormalities on skin. It is the most skin complaint of elderly people. In the present study, we conducted a dermatological study to examine the risk factors of pruritic skin and predicted how to prevent pruritus especially in the elderly population. Pruritus is caused several types of inflammation, including epidermal innate immunity based on keratinocyte responses and acquired immunity regulated by type 1 or 2 helper T (Th) cells. The triggers of pruritus differ among inflammation types, therefore we did separately assess the pruritus-associated factors of each inflammation type in an effort to contribute to the identification of intervention targets for preventing pruritus. Therefore, this study aimed to investigate the factors related with actual condition of pruritic skin by examine the skin properties. Method: This study was conducted in elderly population of Indonesian nursing home. Basic characteristics and behaviors were obtained by interview. The properties of pruritic skin were collected by examination of skin biomarker using skin blotting as novel method of non-invasive skin assessment method and examination of skin barrier function using stratum corneum hydration and skin pH. Result: The average age of participants was 74 years with independent status was 66.8%. Age (β = -0.130, p = 0.044), cumulative lifetime sun exposure (β = 0.145, p = 0.026), bathing duration (β = 0.151, p = 0.022), clothing change frequency (β = 0.135, p = 0.029), and clothing type (β = -0.139, p = 0.021) were risk factors of pruritic skin in multivariate analysis. Conclusion: Risk factors of pruritic skin in elderly population were caused by internal factors such as skin senescence and external factors such as sun exposure, hygiene care and skin care behavior.

Keywords: aging, hygiene care, pruritus, skin care, sun exposure

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Authors: Naveen Kumar Challa, Pavan Verıkıcherla, Madhubalan, Ashısh Sharma

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Aim: Aim of the study was to find whether any difference exists in pupil mydriasis measured with Orbscan in non-diabetic and type 2 diabetic patients at various intervals after installation of Tropicamide 0.8% and Phenylephrine 5%. Methods: the Observational study conducted at a tertiary care eye hospital during September 2014 to March 2015. 240 eyes from 120 patients (40 non-diabetic, 80 diabetic) were dilated with Tropicamide 0.8% and Phenylephrine 5%. One drop of a drug was installed twice. The second drop is installed at 20 minutes after installation of the first drop. In two groups’ pupil diameter was measured before installation of drops and also at 15, 30, 45 and 60 minutes after installation of the first drop using both Orbscan. Result: Mean age of the non-diabetic group is 48.67 ± 7.93 years; Diabetic group is 59.97 ± 8.77 years. Mean duration of Diabetes was 7.01 ± 5.05 years. Mean pupil diameter measured with Orbscan before installation of the drops and also at 15, 30, 45 and 60 minutes after installation of first drop in non-diabetic group was 4.18 ± 0.64mm, 6.15 ± 0.41mm, 7.76 ±0.34, 9.59 ± 0.30, and 9.97 ± 0.10 mm respectively and for the diabetic group it was 4.00 ± 0.56 mm, 5.53 ± 0.52 mm, 7.018 ± 0.58mm, 8.25±0.51mm and 9.18 ± 0.46mm respectively. The mean difference between the mean pupil diameters of the non-diabetic and diabetic group shows a significant difference (P< 0.01) at all intervals except before dilatation. There is a significant negative correlation (r = 0.78 – 0.92) between the duration of diabetes and pupil dilatation at all intervals after installation of the drops. There is also significant difference (P< 0.005) in the mean values of pupil diameter between non retinopathy diabetic subjects and diabetic retinopathy subjects at all intervals after installation of drops. Conclusion: People attending eye clinic, whose pupil mydriasis values falls below the normal may be referred for diabetic evaluation. If normative data is established for the pupil size in Indian population using Orbscan then the values fall under normative data could be a predictor for diabetes. This would in turn help ophthalmologist to detect the diabetes at an early stage and prevent the complications resulting from the diabetes.

Keywords: diabetes mellitus, pupil diameter, orbscan, tropicamide

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Authors: Paul Feyi Waboso

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This case report presents a 57-year-old female patient with a history of colon cancer, colostomy, and immunocompromise, who presented with an unusual bilateral vulval abscess, more prominent on the left side. Due to the atypical presentation, an MRI was performed, revealing a pelvic collection and a fistulous connection between the pelvis and vulva. This finding prompted an urgent surgical intervention. This case highlights the diagnostic and therapeutic challenges of managing complex abscesses and fistulas in immunocompromised patients. Introduction: Vulval abscesses in immunocompromised individuals can present with atypical features and may be associated with complex pathologies. Patients with a history of cancer, colostomy, and immunocompromise are particularly prone to infections and may present with unusual manifestations. This report discusses a case of a large bilateral vulval abscess with an underlying pelvic fistula, emphasizing the importance of advanced imaging in cases with atypical presentations. Case Presentation: A 57-year-old female with a known history of colon cancer, treated with colostomy, presented with severe pain and swelling in the vulval area. Physical examination revealed bilateral vulval swelling, with the abscess on the left side appearing larger and more pronounced than on the right. Given her immunocompromised status and the unusual nature of the presentation, we requested an MRI of the pelvis, suspecting an underlying pathology beyond a typical abscess. Investigations: MRI imaging revealed a significant pelvic collection and identified a fistulous tract between the pelvis and the vulva. This confirmed that the vulval abscess was connected to a deeper pelvic infection, necessitating urgent intervention. Management: After consultation with the multidisciplinary team (MDT), it was agreed that the patient required surgical intervention, having had 48 hours of antibiotics. The patient underwent evacuation of the left-sided vulval abscess under spinal anesthesia. During surgery, the pelvic collection was drained of 200 ml of pus. Outcome and Follow-Up: Postoperative recovery was closely monitored due to the patient’s immunocompromised state. Follow-up imaging and clinical evaluation showed improvement in symptoms, with gradual resolution of infection. The patient was scheduled for regular follow-up visits to monitor for recurrence or further complications. Discussion: Bilateral vulval abscesses are uncommon and, in an immunocompromised patient, warrant thorough investigation to rule out deeper infectious or fistulous connections. This case underscores the utility of MRI in identifying complex fistulous tracts and highlights the importance of a multidisciplinary approach in managing such high-risk patients. Conclusion: This case illustrates a rare presentation of bilateral vulval abscess with an associated pelvic fistula.

Keywords: vulval abscess, MDT team, colon cancer with pelvic fistula, vulval skin condition

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Authors: F. Garousi, Sz. Veres, É. Bódi, Sz. Várallyay, B. Kovács

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Specific leaf area (SLA; cm2leaf g-1leaf) is a key ecophysiological parameter influencing leaf physiology, photosynthesis, and whole plant carbon gain and also can be used as a rapid and diagnostic tool. In this study, two species of soluble inorganic selenium forms, selenite (SeIV) and selenate (SeVI) at different concentrations were investigated on maize plants that were growing in nutrient solutions during 2 weeks and at the end of the experiment, amounts of SLA for first and second leaves of maize were measured. In accordance with the results we observed that our regarded Se concentrations in both forms of SeIV and SeVI were not effective on maize plants’ SLA significantly although high level of 3 mg.kg-1 SeIV had negative affect on growth of the samples that had been treated by it but about SeVI samples we did not observe this state and our different considered SeVI concentrations were not toxic for maize plants.

Keywords: maize, sodium selenate, sodium selenite, specific leaf area

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Authors: Markéta Chmelíková, David Ullrich, Iva Burešová

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The paper maps the possibilities and limits of diagnosing selected personality and performance characteristics of military leadership and psychology students in the context of coping with challenging situations. Individuals vary greatly inter-individually in their ability to effectively manage extreme situations, yet existing diagnostic tools are often criticized mainly for their low predictive power. Nowadays, every modern army focuses primarily on the systematic minimization of potential risks, including the prediction of desirable forms of behavior and the performance of military commanders. The context of military leadership is well known for its life-threatening nature. Therefore, it is crucial to research stress load in the specific context of military leadership for the purpose of possible anticipation of human failure in managing extreme situations of military leadership. The aim of the submitted pilot study, using an experiment of 24 hours duration, is to verify the possibilities of a specific combination of psychodiagnostic to predict people who possess suitable equipment for coping with increased stress load. In our pilot study, we conducted an experiment of 24 hours duration with an experimental group (N=13) in the bomb shelter and a control group (N=11) in a classroom. Both groups were represented by military leadership students (N=11) and psychology students (N=13). Both groups were equalized in terms of study type and gender. Participants were administered the following test battery of personality characteristics: Big Five Inventory 2 (BFI-2), Short Dark Triad (SD-3), Emotion Regulation Questionnaire (ERQ), Fatigue Severity Scale (FSS), and Impulsive Behavior Scale (UPPS-P). This test battery was administered only once at the beginning of the experiment. Along with this, they were administered a test battery consisting of the Test of Attention (d2) and the Bourdon test four times overall with 6 hours ranges. To better simulate an extreme situation – we tried to induce sleep deprivation - participants were required to try not to fall asleep throughout the experiment. Despite the assumption that a stay in an underground bomb shelter will manifest in impaired cognitive performance, this expectation has been significantly confirmed in only one measurement, which can be interpreted as marginal in the context of multiple testing. This finding is a fundamental insight into the issue of stress management in extreme situations, which is crucial for effective military leadership. The results suggest that a 24-hour stay in a shelter, together with sleep deprivation, does not seem to simulate sufficient stress for an individual, which would be reflected in the level of cognitive performance. In the context of these findings, it would be interesting in future to extend the diagnostic battery with physiological indicators of stress, such as: heart rate, stress score, physical stress, mental stress ect.

Keywords: bomb shelter, extreme situation, military leadership, psychodiagnostic

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Authors: Guanghua Lu, Zhenhua Yan

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To investigate the estrogenic contamination and potential risk of Taihu Lake, eight active biomonitoring points in the northern section of Taihu Lake were set up and located in Wangyuhe River outlet (P1), Gonghu Bay (P2 and P3), Meiliang Bay (P4 and P5), Zhushan Bay (P6 and P7) and Lake Centre (P8). A suite of biomarkers in caged fish after in situ exposure for 28 days, coupled with six selected exogenous estrogens in water, were determined in May and December 2011. Six target estrogens, namely estrone (E1), 17b-estradiol (E2), ethinylestradiol (EE2), estriol (E3), diethylstilbestrol (DES) and bisphenol A (BPA), were quantified using UPLC/MS/MS. The concentrations of E1, E2, E3, EE2, DES and BPA ranged from ND to 3.61 ng/L, ND to 17.3 ng/L, ND to 1.65 ng/L, ND to 10.2 ng/L, ND to 34.6 ng/L, and 3.95 to 207 ng/L, respectively. BPA was detected at all sampling points at all test periods, E2 was detected at 95% of samples, E1 and EE2 was detected at 75% of samples, and E3 was detected only in December 2011 with quite low concentrations. Each individual estrogen concentration measured at each sampling point was multiplied by its relative potency to gain the estradiol equivalent (EEQ). The total EEQ values in all the monitoring points ranged from 5.69 to 17.8 ng/L in May 2011, and from 4.46 to 21.1 ng/L in December 2011. E2 and EE2 were thought to be the major causal agents responsible for the estrogenic activities. Serum vitellogenin and E2 levels, gonadal DNA damage, and gonadosomatic index were measured in the in situ exposed fish. An enhanced integrated biomarker response (EIBR) was calculated and used to evaluate potential feminization risk of fish in the polluted area of Taihu Lake. EIBR index showed good agreement with the observed total EEQ levels in water. Our results indicated that Gong bay and the lake center had a low estrogenic risk, whereas Wangyuhe River, Meiliang Bay, and Zhushan Bay might present a higher risk to fish.

Keywords: active biomonitoring, estrogen, feminization risk, Taihu Lake

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Authors: A. Maciejak, M. Kiliszek, G. Opolski, D. Tulacz, A. Segiet, K. Matlak, S. Dobrzycki, G. Sygitowicz, B. Burzynska, M. Gora

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Introduction and aims: Acute myocardial infarction (AMI) is one of the most severe cardiovascular diseases affecting millions of patients each year worldwide. An early and accurate diagnosis of AMI is essential for optimal treatment. Therefore, new approaches that can complement and improve current strategies for AMI diagnosis are urgently needed. Recent studies have revealed the presence of stable circulating myocardial-derived microRNAs (miRNAs) in human peripheral blood, suggesting that such miRNAs could serve as potential biomarkers of infarction. The present study aimed to identify differentially expressed circulating miRNAs in ST-segment elevation myocardial infarction (STEMI) patients. Materials and methods: miRNA expression profile analysis was performed using Exiqon Serum/Plasma Focus microRNA PCR panel in plasma samples of n=16 patients on the first day of AMI (admission) and in samples from the same patients collected six months after AMI. Selected miRNAs were validated by RT-qPCR using serum samples from an independent set of n=14 AMI patients. Results: The profiling study identified 46 species of plasma miRNAs that were differentially expressed (p < 0.05) on admission compared to six months after AMI. The validation in the independent group of patients confirmed that miR-133b and miR-22-5p were significantly up-regulated upon AMI. Conclusions: Our results suggest that miRNA expression profiling provides better understanding of the changes that occur in the acute phase of MI in the myocardium and could be useful in determination of the potential role of extracellular miRNAs as paracrine signaling molecules. miR-22-5p represents a novel promising biomarker for the diagnosis of acute myocardial infarction.

Keywords: acute myocardial infarction, circulating microRNAs, microRNA expression profiling, miR-22-5p

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Authors: Soo Dong Cho, In-Ohk Ouh, Byeong Sul Kang, Seyeon Park, In-Soo Cho, Jae Young Song

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An VP2 gene from the current prevalent CPV (Canine Parvovirus) strain (new CPV-2a) in the Republic of Korea was expressed in a baculovirus expression system. Genomic DNA was extracted from the isolate strain CPV-2a. The recombinant baculovirus, containing the coding sequences of VP2 with the histidine tag at the N-terminus, were generated by using the Bac-to-Bac system. For production of the recombinant VP2 proteins, SF9 cells were transfection into 6 wells. Propagation of recombinant baculoviruses and expression of the VP2 protein were performed in the Sf9 cell line maintained. The proteins were detected to Western blot anlaysis. CPV-2a VP2 was detected by Western blotting the monoclonal antibodies recognized 6x His and the band had a molecular weight of 65 KDa. We demonstrated that recombinant CPV-2a VP2 expression in baculovirus. The recombinant CPV-2a VP2 may able to development of specific diagnostic test and vaccination of against CPV2. This study provides a foundation for application of CPV2 on the development of new CPV2 subunit vaccine.

Keywords: baculovirus, canine parvovirus 2a, Dog, Korea

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Authors: Meriem Mansouri, Fatiha Bendali Saoudi, Noureddine Soltani

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Biological control presents a means of control for the protection of the environment. Bacillus thuringiensis israelensis Berliner 1915 is an inseticide of biological origin because it is a bacterium of the Bacillaceae family. This biocide has a biological importance, because of its specific larvicidal action against Culicidae, blood-sucking insects, responsible for several diseases to humans and animals through the world. As well as, its high specificity for these insects. Also, the freshwater mites, this necessarily parasitic group for aquatic species such as the Physidae, also have an effective biological control against the Culicidae, because of their voracious predation to the larvae of these insects. The present work aims to study the effects of the biocide Bacillus thuringiensis var israelinsis, against non-target adults of water mites Eylais hamata Koenike, 1897, as well as its associated host species Physa marmorata Fitzinger, 1833. After 12 days of oral treatment of adults with lethal concentration (LC50:0.08µg/ml), determined from essays on 4th instar larvae of Culex pipiens (hematophagous insects). No adverse effect has been recorded for adult individuals of Eylais hamata, contrary, snail Physa marmorata were sensitive for this dose of Bti. In parallel, after treatment at the Bti by LC50, the enzyme stress bio marker glutathione S-transferase, was measured after 24, 48 and 72 hours. The enzymatic activity of GST has increased after 24 and 48 hours following treatment.

Keywords: biological control, Bacillus thuringiensis var israelinsis, culicidae, hydrachnidia, enzymatic activity

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Authors: Irlana C. do Mar, Thayna A. Ferreira, Dayane S. Rezende, Bruno A. M. Figueira, José M. R. Mercury

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This work presents a low-cost Mn starting material to synthesis manganese oxide octahedral molecular sieve with Mg²⁺ in the tunnel (Mg-OMS-1), based on the Mn residues from Carajás Mineral Province (Amazon, Brazil). After hydrothermal and cation exchange procedures, the Mn residues transformed to a single phase, Mg-OMS-1. The raw material and the synthesis processes were analyzed by means of X-ray diffraction (XRD), Scanning electron microscopy (SEM) and Infrared spectroscopy (FTIR). The tunnel structure was synthesized hydrothermally at 180 °C for three days without impurities. According to the XRD analysis, the formation of crystalline Mg-OMS-1 was identified through reflections at 9.8º, 12º and 18º (2θ), as well as a thermal stability around 300 ºC. The SEM analysis indicated that the final product presents good crystallinity with a homogeneous size. In addition, an intense and diagnostic FTIR band was identified at 515 cm⁻¹ related to the MnO₆ octahedral stretching vibrations.

Keywords: Mn residues , Octahedral Molecular Sieve, Synthesis, Characterization

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Authors: Maria Cristina B. Cabanag, Elijinese Marie S. Culangen

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Pregnancy is a period in a woman's life wherein the body may undergo different physiological changes. These changes can be attributed to the interplay of hormones in the body but can mask a more sinister type of disease such as malignancy on rare occasions. Colorectal cancer (CRC) in pregnancy is an epidemiologically rare disease worldwide. To our knowledge, no available studies were reported in the Philippines at the time of this writing, posing a dilemma for its appropriate diagnosis and management. Signs and symptoms of colorectal malignancy may camouflage a normal pregnancy and, when overlooked, impedes an appropriate approach. This case of a 38-year-old elderly primigravid who presented with hematochezia on her 25th week of gestation. She was diagnosed with rectal adenocarcinoma later in pregnancy which warranted a predicament regarding her appropriate care and management. This paper explores the repertoire of the different diagnostic and treatment approaches to colorectal cancer in the second trimester of pregnancy, with the least possible maternal and fetal hazards.

Keywords: cancer in pregnancy, chemotherapy in pregnancy, colorectal cancer, hematochezia in pregnancy

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Authors: Andrew Anis Fakhrey Mosaad

Abstract:

Introduction: There are many different types of sleep disorders, each with serious implications for a person's health and a large financial burden on society. Method: This review offers a framework based on the International Classification of Sleep Disorders to aid in the diagnosis and treatment of sleep disorders. Differentiating between primary and secondary insomnia is covered, along with pharmacological and nonpharmacological therapy options. Common abnormalities of the circadian rhythm are mentioned along with their therapies, such as light therapy and chronotherapy. This article discusses the identification and management of periodic limb movement disorder and restless legs syndrome. The therapy of upper airway resistance syndrome and obstructive sleep apnea are the main topics of discussion. Conclusion: The range of narcolepsy symptoms and results, as well as diagnostic procedures and treatment, are discussed. The causes, outcomes, and treatments of many types of insomnias, such as sleep terrors, somnambulism, and rapid eye movement (REM) behavior sleep disorders, are discussed.

Keywords: diagnosis, treatment, sleep disorders, insomnia

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