Search results for: left ventricular dysfunction

Authors: Hossam M. Abdallah, Ali M. El-Halawany, Gamal A. Mohamed, Khalid Z. Alshali, Zainy M. Banjar, Hany A. El-Bassossy

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Hypertension and vascular dysfunction are major components and complications of many diseases like metabolic syndrome. In addition, vascular dysfunction is considered the initial step in diabetic atherosclerosis, the main etiology for mortality and a great percent of morbidity in diabetic patients. In spite of the significant developments in antidiabetic therapy, diabetic complications, particularly seen in long-term diabetes, continue to be seriously deleterious. Herbal drugs are prescribed widely in treatment of different aliment because of their effectiveness, fewer side effects and relatively low cost. Nine plants belong to five different families grown in Kingdom of Saudi Arabia were evaluated for their effect on exaggerated vasoconstriction and impaired relaxation in aortae isolated from metabolic syndrome rats. The aerial parts of Onopordum ambiguum Fresen. (OA), Astragalus abyssinicus Steud. (AA), Pulicaria Arabica Cass. (PA), Echinops sheilae Kit Tan (ES), Aizoon canariense L. (AC), Cleome viscosa L. (CV), Chrozophora oblongifolia (Delile) A.Juss. ex Spreng (CO), Centaurea pseudosinaica Mouterde (CP) and Tephrosia nubica Baker (TN) were dried and extracted with methanol. The effect of thirty minute incubation with the total extracts (10-330 µg/ml) or their fractions on the exaggerated vasoconstriction response to phenylephrine (10nM to 10microM) and impaired vasodilation to acetylcholine (10-330 µg /ml) of aortae isolated from metabolic syndrome animals was studied. Incubating aortae isolated from metabolic syndrome animals with total methanol extract of OA, AA, PA, AC, CV, and TN at concentrations (10-330 microgram/ml) in the organ bath led to concentration dependent alleviation of exaggerated vasoconstriction response to phenylephrine without having beneficial effect on impaired vasodilation to acetylcholine. In conclusion, addition of OA, AA, PA, AC, CV and TN to the standard therapies may provide superior means to alleviate the associated vascular complications.

Keywords: vascular dysfunction, exaggerated vasoconstriction, metabolic syndrome, Saudi plants

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Authors: Shin Ku Kim, Yun Ah Oh, Eun Hee Seo, Chang Min Dae, Yun Jung Bae

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Objectives: The commonly used PRESS technique in magnetic resonance spectroscopy (MRS) has a limitation of incomplete water suppression. The recently developed sLASER technique is known for its improved effectiveness in suppressing water signal. However, no prior study has compared both sequences in a normal human brain. In this study, we firstly aimed to compare the performances of both techniques in brain MRS. Materials and methods: From January 2023 to July 2023, thirty healthy participants (mean age 38 years, 17 male, 13 female) without underlying neurological diseases were enrolled in this study. All participants underwent single-voxel MRS using both PRESS and sLASER techniques on 3T MRI. Two regions-of-interest were allocated in the left medial thalamus and left parietal white matter (WM) by a single reader. The SpectroView Analysis (SW5, Philips, Netherlands) provided automatic measurements, including signal-to-noise ratio (SNR) and peak_height of water, N-acetylaspartate (NAA)-water/Choline (Cho)-water/Creatine (Cr)-water ratios, and NAA-Cr/Cho-Cr ratios. The measurements from PRESS and sLASER techniques were compared using paired T-tests and Bland-Altman methods, and the variability was assessed using coefficients of variation (CV). Results: SNR and peak_heights of the water were significantly lower with sLASER compared to PRESS (left medial thalamus, sLASER SNR/peak_height 2092±475/328±85 vs. PRESS 2811±549/440±105); left parietal WM, 5422±1016/872±196 vs. 7152±1305/1150±278; all, P<0.001, respectively). Accordingly, NAA-water/Cho-water/Cr-water ratios and NAA-Cr/Cho-Cr ratios were significantly higher with sLASER than with PRESS (all, P< 0.001, respectively). The variabilities of NAA-water/Cho-water/Cr-water ratios and Cho-Cr ratio in the left medial thalamus were lower with sLASER than with PRESS (CV, sLASER vs. PRESS, 19.9 vs. 58.1/19.8 vs. 54.7/20.5 vs. 43.9 and 11.5 vs. 16.2) Conclusion: The sLASER technique demonstrated enhanced background water suppression, resulting in increased signals and reduced variability in brain metabolite measurements of MRS. Therefore, sLASER could offer a more precise and stable method for identifying brain metabolites.

Keywords: Magnetic resonance spectroscopy, Brain, sLASER, PRESS

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Authors: Peifei Zhu, Zisheng Li, Yasuki Kakishita, Mayumi Suzuki, Tomoaki Chono

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Segmentation of left ventricle (LV) from cardiac ultrasound images provides a quantitative functional analysis of the heart to diagnose disease. Active Shape Model (ASM) is a widely used approach for LV segmentation but suffers from the drawback that initialization of the shape model is not sufficiently close to the target, especially when dealing with abnormal shapes in disease. In this work, a two-step framework is proposed to improve the accuracy and speed of the model-based segmentation. Firstly, a robust and efficient detector based on Hough forest is proposed to localize cardiac feature points, and such points are used to predict the initial fitting of the LV shape model. Secondly, to achieve more accurate and detailed segmentation, ASM is applied to further fit the LV shape model to the cardiac ultrasound image. The performance of the proposed method is evaluated on a dataset of 800 cardiac ultrasound images that are mostly of abnormal shapes. The proposed method is compared to several combinations of ASM and existing initialization methods. The experiment results demonstrate that the accuracy of feature point detection for initialization was improved by 40% compared to the existing methods. Moreover, the proposed method significantly reduces the number of necessary ASM fitting loops, thus speeding up the whole segmentation process. Therefore, the proposed method is able to achieve more accurate and efficient segmentation results and is applicable to unusual shapes of heart with cardiac diseases, such as left atrial enlargement.

Keywords: hough forest, active shape model, segmentation, cardiac left ventricle

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Authors: Yuchien Lin

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This study attempted to investigate the changes in electroencephalography (EEG) and emotion regulation following eight-week inward-attention meditation training program. The subjects were 24 adults without meditation experiences divided into meditation and control groups. The quantitatively analyzed changes in psychophysiological parameters during inward-attention meditation, and evaluated the emotion scores assessed by the State-Trait Anxiety Inventory (STAI), the Positive and Negative Affect Schedule (PANAS), and the Emotion Regulation Scale (ERS). The results were found: (1) During meditation, significant EEG increased for theta-band activity in the frontal and the bilateral temporal areas, for alpha-band activity in the left and central frontal areas, and for gamma-band activity in the left frontal and the left temporal areas. (2) The meditation group had significantly higher positive affect in posttest than in pretest. (3) There was no significant difference in the changes of EEG spectral characteristics and emotion scores in posttest and pretest for the control group. In the present study, a unique meditative concentration task with a constant level of moderate mental effort focusing on the center of brain was used, so as to enhance frontal midline theta, alpha, and gamma-band activity. These results suggest that this mental training allows individual reach a specific mental state of relaxed but focused awareness. The gamma-band activity, in particular, enhanced over left frontoparietal area may suggest that inward-attention meditation training involves temporal integrative mechanisms and may induce short-term and long-term emotion regulation abilities.

Keywords: meditation, EEG, emotion regulation, gamma activity

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Authors: Santhosh K. S. Annayappa, Nupur Pruthi

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The region of dentate nucleus is a common site for various pathologies like hematomas, tumours, etc. We aimed to study in detail the relationship of this region with the vermis, especially the pyramid using microscopic fibre dissection technique. To achieve this aim, 20 cerebellar hemispheres were studied from the 11 cerebellums. Dissection was performed using wooden spatulas and micro dissectors under a microscope following Klingler’s preservation technique. The relationship between the pyramid of vermis and the dentate nucleus was studied in detail. A similar relationship was studied on the MRI of randomly selected trigeminal neuralgia patients and correlated with anatomical findings. Results show the mean distance of the lateral margin of the dentate nucleus from the midline on anatomic specimens was 21.4 ± 1.8 mm (19-25 mm) and 23.4 ± 3.4 mm (15-29 mm) on right and left side, respectively. Similar measurements made on the MRI were 22.97 ± 2.0 mm (20.03-26.15 mm) on the right side and 23.98 ± 2.1 mm (21.47-27.67 mm) on the left side. The amount of white matter dissection required to reach the dentate nucleus at the pyramidal attachment area was 7.3 ± 1.0 mm (6-9 mm) on the right side and 6.8 ± 1.4 mm (5-10 mm) on the left side. It was concluded that the pyramid of vermis has a constant relationship with the dentate nucleus and can be used as an excellent landmark during surgery to localise the dentate nucleus on the suboccipital surface.

Keywords: fiber dissection, micro neurosurgery, the dentate nucleus of cerebellum, the pyramid of vermis

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Authors: Shoaib Rasool

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Migration trends in rural areas of Gujrat are increasing day by day among illiterate people as they consider it as a source of attraction and charm of destination. It affects the life standard both positive and negative way to their families left behind in the context of poverty, socio-economic status and life standards. It also promotes material items and as well as social indicators of living, housing conditions, schooling of their children’s, health seeking behavior and to some extent their family environment. The nature of the present study is to analyze socio-economic conditions regarding life standard of emigrant families left behind in rural areas of Gujrat district, Pakistan. A survey design was used on 150 families selected from rural areas of Gujrat districts through purposive sampling technique. A well-structured questionnaire was administered by the researcher to explore the nature of the study and for further data collection process. The measurement tool was pretested on 20 families to check the workability and reliability before the actual data collection. Statistical tests were applied to draw results and conclusion. The preliminary findings of the study show that emigration has left deep social-economic impacts on life standards of rural families left behind in Gujrat. They improved their life status and living standard through remittances. Emigration is one of the major sources of development of economy of household and it also alleviate poverty at house household level as well as community and country level. The rationale behind migration varies individually and geographically. There are popular considered attractions in Pakistan includes securing high status, improvement in health condition, coping other, getting married then to acquire nationality, using the unfair means, opting educational visas etc. Emigrants are not only sending remittances but also returning with newly acquired skills and valuable knowledge to their country of origin because emigrants learn new methods of living and working. There are also women migrants who experience social downward mobility by engaging in jobs that are beneath their educational qualifications.

Keywords: emigration, life standard, families, left behind, rural area, Gujrat

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Authors: Naim Izet Kajtazi

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Introduction: There are few reported cases of ipsilateral weakness following ischemic or hemorrhagic stroke. In these rare cases, ipsilateral weakness is typically the result of damage to uncrossed components of the corticospinal tract (CST), which were recruited in response to previous CST injury. Patients and Methods: We report a series of six cases of acute ipsilateral weakness or numbness following a hemorrhagic or ischemic stroke from three medical institutions in Saudi Arabia. Results: Three of these patients presented with right-sided weakness caused by an ipsilateral right hemispheric stroke, while two exhibited left-sided symptoms and one had only left-sided numbness. In all six cases, the ipsilateral corona radiata, internal capsule, basal ganglia, insula, and thalamus were involved. No concomitant opposite hemisphere or brainstem lesion in none of the patients was evident. Two patients had previous strokes affecting the brainstem and left corona radiata, respectively. A complete stroke workup to reveal the cause of the stroke was carried out, however, no functional MRI was performed. Conclusion: Ischemic or hemorrhagic stroke may indeed result in ipsilateral weakness or numbness, though in very rare cases. We assume that the most likely mechanism of their ipsilateral weakness subsequent to the ipsilateral stroke was a functional reorganization favoring CST pathways within the ipsilateral hemisphere.

Keywords: stroke, weakness, MRI brain, stroke unit

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Authors: Heru Al Amin

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Sarcoidosis is a granulomatous inflammatory disorder of unclear etiology that can affect multiple different organ systems. Isolated cardiac sarcoidosis is a very rare condition that causes lethal arrhythmia and heart failure. A definite diagnosis of cardiac sarcoidosis remains challenging. The use of multimodality imaging plays a pivotal role in the diagnosis of this entity. Case summary: In this report, we discuss a case of a 50-year-old woman who presented with recurrent palpitation, dizziness, vertigo and presyncope. Electrocardiogram revealed variable heart blocks, including first-degree AV block, second-degree AV block, high-degree AV block, complete AV block, trifascicular block and sometimes supraventricular arrhythmia. Twenty-four hours of Holter monitoring show atrial bigeminy, first-degree AV block and trifascicular block. Transthoracic echocardiography showed Thinning of basal anteroseptal and inferred septum with LV dilatation with reduction of Global Longitudinal Strain. A dual-chamber pacemaker was implanted. CT Coronary angiogram showed no coronary artery disease. Cardiac magnetic resonance revealed basal anteroseptal and inferior septum thinning with focal edema with LGE suggestive of sarcoidosis. Computed tomography of the chest showed no lymphadenopathy or pulmonary infiltration. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) of the whole body showed. We started steroids and followed up with the patient. Conclusion: This case serves to highlight the challenges in identifying and managing isolated CS in a young patient with recurrent syncope with variable heart block. Early, even late initiation of steroids can improve arrhythmia as well as left ventricular function.

Keywords: cardiac sarcoidosis, conduction abnormality, syncope, cardiac MRI

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Authors: Abraham J. Rizkalla, Tristan D. Yan

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Atrial myxoma is the most common primary cardiac tumor, and can result in cardiac failure secondary to obstruction, or systemic embolism due to fragmentation. Traditionally, excision of atrial an myxoma has been performed through median sternotomy, however the robotic approach offers several advantages including less pain, improved cosmesis, and faster recovery. Here, we highlight the less well recognized advantages and technical aspects to robotic myxoma resection. This video-presentation demonstrates the resection of a papillary subtype left atrial myxoma using the DaVinci© Xi surgical robot. The 10x magnification and 3D vision allows for the interface between the tumor and the interatrial septum to be accurately dissected, without the need to patch the interatrial septum. Several techniques to avoid tumor fragmentation and embolization are demonstrated throughout the procedure. The tumor was completely excised with clear margins. There was no atrial septal defect or mitral valve injury on post operative transesophageal echocardiography. The patient was discharged home on the fourth post-operative day. This video-presentation highlights the advantages of the robotic approach in atrial myxoma resection compared with sternotomy, as well as emphasizing several technical considerations to avoid potential complications.

Keywords: cardiac surgery, left atrial myxoma, cardiac tumour, robotic resection

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Authors: Tarek Duzan, Walid Eddib

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The marine shallow carbonate reservoir (G- Eocene) is one of the biggest mature water drive reservoir of Waha Oil Company. The cumulative oil produced up to date is about to eighty percent of the booked original oil in place at ninety five percent of Water cut. However, the company believes that there is a good amount of remaining oil left need to be recovered. Many laboratory studies have been conducted to see the possibility drain the commercial oil left behind using two types of gases, namely, carbone dioxide and enriched hydrocarbon gas injection. The conclusions of those cases were inconclusive Technically and Economically. Therefore, the company has decided to verify another Tertiary Recovery (EOR) technique that may be applied to the interested reservoir. A global screening criteria and quick Laboratory chemical tests have been conducted by using many types of chemical injection into real rock samples. The outcomes were unique economically and provide a significant increase in the commercial oil left. Finally, the company has started conducting a sector pilot plan before proceeding with a full plan. There are many wellbores available to use in a potential field Enhanced Oil Recovery.

Keywords: chemical lab. test, ASP, rock types, oil samples, and global screening criteria

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Authors: Rachelle Angeli Maranon

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This research explored the relationships of a child’s family condition, sex and subjective well-being (SWB) to gain some understanding of the experiences of both transnational and non-transnational families. A descriptive-correlational design was used to study the variables. Participants included 52 male and female children from Iloilo and Kabankalan cities, representing the family conditions in this study. Data were gathered using a semi-structured interview guide. Responses were analyzed using Mann-Whitney U Test. The results showed that the SWB of non-transnational children was significantly higher compared to their transnational counterparts (U = 134, p = .00). Also, analysis between females and males indicated a significant difference only on some aspects (U = 318, p = .71). Some recommendations were suggested to better understand the plight of the left-behind children.

Keywords: left-behind children, mothers, subjective well-being, transnational families

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Authors: Benseghir Omar, Bahmed Mohamed

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In this work, we presented a numerical study of the phenomenon of heat transfer through the laminar, incompressible and steady mixed convection in a closed square cavity with the left vertical wall of the cavity is subjected to a warm temperature, while the right wall is considered to be cold. The horizontal walls are assumed adiabatic. The governing equations were discretized by finite volume method on a staggered mesh and the SIMPLER algorithm was used for the treatment of velocity-pressure coupling. The numerical simulations were performed for a wide range of Reynolds numbers 1, 10, 100, and 1000 numbers are equal to 0.01,0.1 Richardson, 0.5,1 and 10.The analysis of the results shows a flow bicellular (two cells), one is created by the speed of the fan placed in the inner cavity, one on the left is due to the difference between the temperatures right wall and the left wall. Knowledge of the intensity of each of these cells allowed us to get an original result. And the values obtained from each of Nuselt convection which allow to know the rate of heat transfer in the cavity.Finally we find that there is a significant influence on the position of the fan on the heat transfer (Nusselt evolution) for values of Reynolds studied and for low values of Richardson handed this influence is negligible for high values of the latter.

Keywords: thermal transfer, mixed convection, square cavity, finite volume method

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Authors: Amil Suleimanov, Aigul Saduakassova, Denis Vinnikov

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Objective: To assess functional visceral fat (VAT) activity evaluated by ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) as a predictor of metastases in colorectal cancer (CRC). Materials and methods: We assessed 60 patients with histologically confirmed CRC who underwent 18F-FDG PET/CT after a surgical treatment and courses of chemotherapy. Age, histology, stage, and tumor grade were recorded. Functional VAT activity was measured by maximum standardized uptake value (SUVmax) using ¹⁸F-FDG PET/CT and tested as a predictor of later metastases in eight abdominal locations (RE – Epigastric Region, RLH – Left Hypochondriac Region, RRL – Right Lumbar Region, RU – Umbilical Region, RLL – Left Lumbar Region, RRI – Right Inguinal Region, RP – Hypogastric (Pubic) Region, RLI – Left Inguinal Region) and pelvic cavity (P) in the adjusted regression models. We also report the best areas under the curve (AUC) for SUVmax with the corresponding sensitivity (Se) and specificity (Sp). Results: In both adjusted for age regression models and ROC analysis, 18F-FDG accumulation in RLH (cutoff SUVmax 0.74; Se 75%; Sp 61%; AUC 0.668; p = 0.049), RU (cutoff SUVmax 0.78; Se 69%; Sp 61%; AUC 0.679; p = 0.035), RRL (cutoff SUVmax 1.05; Se 69%; Sp 77%; AUC 0.682; p = 0.032) and RRI (cutoff SUVmax 0.85; Se 63%; Sp 61%; AUC 0.672; p = 0.043) could predict later metastases in CRC patients, as opposed to age, sex, primary tumor location, tumor grade and histology. Conclusions: VAT SUVmax is significantly associated with later metastases in CRC patients and can be used as their predictor.

Keywords: ¹⁸F-FDG, PET/CT, colorectal cancer, predictive value

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Authors: A. Lubis, R. Widayanti, Z. Hikmah, A. Endaryanto, A. Harsono, A. Harianto, R. Etika, D. K. Handayani, M. Sampurna

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Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: neonatus lupus erythematous, maternal autoantibody, clinical characteristic, multiple organ manifestation

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Authors: Adrienne Kline, Jaydip Desai

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Electroencephalogram (EEG) is a noninvasive technique that registers signals originating from the firing of neurons in the brain. The Emotiv EEG Neuroheadset is a consumer product comprised of 14 EEG channels and was used to record the reactions of the neurons within the brain to two forms of stimuli in 10 participants. These stimuli consisted of auditory and visual formats that provided directions of ‘right’ or ‘left.’ Participants were instructed to raise their right or left arm in accordance with the instruction given. A scenario in OpenViBE was generated to both stimulate the participants while recording their data. In OpenViBE, the Graz Motor BCI Stimulator algorithm was configured to govern the duration and number of visual stimuli. Utilizing EEGLAB under the cross platform MATLAB®, the electrodes most stimulated during the study were defined. Data outputs from EEGLAB were analyzed using IBM SPSS Statistics® Version 20. This aided in determining the electrodes to use in the development of a brain-machine interface (BMI) using real-time EEG signals from the Emotiv EEG Neuroheadset. Signal processing and feature extraction were accomplished via the Simulink® signal processing toolbox. An Arduino™ Duemilanove microcontroller was used to link the Emotiv EEG Neuroheadset and the right and left Mecha TE™ Hands.

Keywords: brain-machine interface, EEGLAB, emotiv EEG neuroheadset, OpenViBE, simulink

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Authors: Mark Pizzato

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How do ideas, images, and emotions in stage-plays and videos affect us? Do they evoke a greater awareness (or cognitive reappraisal of emotions) through possible shifts between left-cortical, right-cortical, and subcortical networks? To address these questions, this presentation summarizes the research of various neuroscientists, especially Bernard Baars and others involved in Global Workspace Theory, Matthew Lieberman in social neuroscience, Iain McGilchrist on left and right cortical functions, and Jaak Panksepp on the subcortical circuits of primal emotions. Through such research, this presentation offers an ‘inner theatre’ model of the brain, regarding major hubs of neural networks and our animal ancestry. It also considers recent experiments, by Mario Beauregard, on the cognitive reappraisal of sad, erotic, and aversive film clips. Finally, it applies the inner-theatre model and related research to survey results of theatre students who read and then watched the ‘To be or not to be’ speech in 8 different video versions (from stage and screen productions) of William Shakespeare’s Hamlet. Findings show that students become aware of left-cortical, right-cortical, and subcortical brain functions—and shifts between them—through staging and movie-making choices in each of the different videos.

Keywords: cognitive reappraisal, Hamlet, neuroscience, Shakespeare, theatre

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Authors: Sadia Munir

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The aim of this study is to investigate changes in placental development and vascular dysfunction which subsequently affect feto-maternal health in pregnancies complicated by gestational diabetes mellitus (GDM). Fetal and postnatal adverse health outcomes of GDM are shown to be associated with disturbances in placental structure and function. Children of women with GDM are more likely to be obese and diabetic in childhood and adulthood. GDM also increases the risk of adverse pregnancy outcomes, including preeclampsia, birth injuries, macrosomia and neonatal hypoglycemia, respiratory distress syndrome, neonatal cardiac dysfunction and stillbirth. Incidences of type 2 diabetes in the MENA region are growing at an alarming rate which is estimated to become more than double by 2030. Five of the top 10 countries for diabetes prevalence in 2010 were in the Gulf region. GDM also increases the risk of development of type 2 diabetes. Interestingly, more than half of the women with GDM develop diabetes later in their life. The human placenta is a temporary organ located at the interface between mother and fetal blood circulation. Placenta has a central role as both a producer as well as a target of several molecules that are involved in placental development and function. We have investigated performed a Pubmed search with key words placenta, GDM, placental villi, vascularization, cytokines, growth factors, inflammation, hypoxia, oxidative stress and pathophysiology. We have investigated differences in the development and vascularization of placenta, their underlying causes and impact on feto-maternal health through literature review. We have also identified gaps in the literature and research questions that need to be answered to completely understand the central role of placenta in the GDM. This study is important in understanding the pathophysiology of placenta due to changes in the vascularization of villi, surface area and diameter of villous capillaries in pregnancies complicated by GDM. It is necessary to understand these mechanisms in order to develop treatments to reverse their effects on placental malfunctioning, which in turn, will result in improved mother and child health.

Keywords: gestational diabetes mellitus, placenta, vasculature, villi

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Authors: Ajeevan Gautam, Gulam Anwer Khan, Pratibha Pokhrel

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Introduction: Dermatoglyphics is the science which deals with the study of dermal ridge configuration on the digits, palms and soles. It is grooved by ridges and forms variety of configurations. The aim of the study was to identify dermal ridge patterns on fingertip of hypertensive patients and in normal population and to compare patterns among them. Methods: The subjects of the study were 130 hypertensives and 130 non-hypertensives cases of Kathmandu Valley aged between 40 to 80 years. Case history was recorded after consent finger prints were taken. Different parameters as whorl, loop, arch and composite patterns were studied and analysed. Result: It revealed, increased whorl pattern in hypertensive. It showed 65.69% whorl, 29.23% loop and 5.07% arch patterns in right hand of hypertensive people. In control, it was found to be 34.46% whorl, 58.15% loop and 5.38% arch patterns respectively. Similarly in left hand 63.69% whorl, 32% loop and 4.30% arch in hypertensive group. In control group it was 60.15% as loop, 35.69% as whorl and 15% as arch. Discussion: Based on findings of the result, it was concluded that the whorl, loop and arch patterns observed as 65.69%, 29.23% and 5.07% respectively in hypertensive cases in right hand. Similarly in left hand, it was found to be 4.30% as arch, 32% as loop and 63.69% as whorl patterns, but in normotensive subjects these patterns were recorded as 36.43%, 58.15%, 5.38% in right hand and 35.69%, 60.15%, 4.15% in left hand as whorl, loop and arch respectively.

Keywords: arch, dermatoglyphics, hypertension, loop, whorl

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Authors: Talal Asif, Maya Kosinska, Lucas Georger, Krish Sardesai, Muhammad Shah Miran

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This article presents a case review and literature review focused on the challenges of managing subaortic membranes (SAM) in young adult patients with mild aortic regurgitation (AR) or aortic stenosis (AS). The study aims to discuss the diagnosis of SAM, imaging studies used for assessment, management strategies in young patients, the risk of valvular damage, and the controversy surrounding prophylactic resection in mild AR. The management of SAM in adults poses challenges due to limited treatment options and potential complications, necessitating further investigation into the progression of AS and AR in asymptomatic SAM patients. The case presentation describes a 40-year-old male with muscular dystrophy who presented with symptoms and was diagnosed with SAM. Various imaging techniques, including CT chest, transthoracic echocardiogram (TTE), and transesophageal echocardiogram (TEE), were used to confirm the presence and severity of SAM. Based on the patient's clinical profile and the absence of surgical indications, medical therapy was initiated, and regular outpatient follow-up was recommended to monitor disease progression. The discussion highlights the challenges in diagnosing SAM, the importance of imaging studies, and the potential complications associated with SAM in young patients. The article also explores the management options for SAM, emphasizing surgical resection as the definitive treatment while acknowledging the limited success rates of alternative approaches. Close monitoring and prompt intervention for complications are crucial in the management of SAM. The concluding statement emphasizes the need for further research to explore alternative treatments for SAM in young patients.

Keywords: subaortic membrane, management, case report, literature review, aortic regurgitation, aortic stenosis, left ventricular outflow obstruction, guidelines, heart failure

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Authors: A. F. Suleimanov, A. B. Saduakassova, V. S. Pokrovsky, D. V. Vinnikov

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Relevance: Epithelial ovarian cancer (EOC) is the most lethal gynecological malignancy, with relapse occurring in about 70% of advanced cases with poor prognoses. The aim of the study was to evaluate functional visceral fat activity (VAT) evaluated by ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) as a predictor of metastases in epithelial ovarian cancer (EOC). Materials and methods: We assessed 53 patients with histologically confirmed EOC who underwent ¹⁸F-FDG PET/CT after a surgical treatment and courses of chemotherapy. Age, histology, stage, and tumor grade were recorded. Functional VAT activity was measured by maximum standardized uptake value (SUVₘₐₓ) using ¹⁸F-FDG PET/CT and tested as a predictor of later metastases in eight abdominal locations (RE – Epigastric Region, RLH – Left Hypochondriac Region, RRL – Right Lumbar Region, RU – Umbilical Region, RLL – Left Lumbar Region, RRI – Right Inguinal Region, RP – Hypogastric (Pubic) Region, RLI – Left Inguinal Region) and pelvic cavity (P) in the adjusted regression models. We also identified the best areas under the curve (AUC) for SUVₘₐₓ with the corresponding sensitivity (Se) and specificity (Sp). Results: In both adjusted-for regression models and ROC analysis, ¹⁸F-FDG accumulation in RE (cut-off SUVₘₐₓ 1.18; Se 64%; Sp 64%; AUC 0.669; p = 0.035) could predict later metastases in EOC patients, as opposed to age, sex, primary tumor location, tumor grade, and histology. Conclusions: VAT SUVₘₐₓ is significantly associated with later metastases in EOC patients and can be used as their predictor.

Keywords: ¹⁸F-FDG, PET/CT, EOC, predictive value

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Authors: Singh Deepeshwar, Suhas Vinchurkar

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Similar to neuroimaging findings through functional magnetic resonance imaging (fMRI) assessing regional cerebral blood oxygenation, the functional near infrared spectroscopy (fNIRS) has also been used to assess hemodynamic responses in the imaged region of the brain. The present study assessed hemodynamic responses in terms of changes in oxygenation (HbO), deoxygenation (HbR) and total hemoglobin (THb) on the prefrontal cortex (PFC), bilaterally, using fNIRS in 10 participants who performed three voluntary regulated breathing (pranayama) practices viz. (i) Left nostril breathing (LNB), (ii) Right nostril breathing (RNB); and (iii) Alternating nostril breathing (ANB) and compared with normal breathing as baseline (BS). For this, we used 64 channel NIRS system covering left and the right prefrontal cortex. The normal breathing kept as baseline (BS) measures as regressors in the investigation of hemodynamic responses when compared with LNB, RNB and ANB. In the results, we found greater oxygenation in contralateral side i.e., higher activation on the left prefrontal cortex (lPFC) during RNB, and right prefrontal cortex (rPFC) during LNB, whereas ANB showed greater deoxygenation responses on both sides of PFC. Interestingly, LNB showed increased oxygenation on ipsilateral side i.e., lPFC but not during RNB. This suggests that voluntary regulated breathing produced an immediate effect not only on contralateral but ipsilateral sides of the brain as well. In conclusion, breathing practices are tightly coupled to cerebral rhythms of alternating cerebral hemispheric activity during particular nostril breathing. These results of the specific nostril breathing do not support previous findings of contralateral hemispheric improvement while left or right nostril breathing only.

Keywords: hemodynamic responses, brain, pranayama, voluntary regulated breathing practices, prefrontal cortex

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Authors: Saut Samuel Simamora

Abstract:

PURPOSE: Nucleus drop is one of the most feared and severe complications of modern cataract surgery. The lens material may drop through iatrogenic breaks of the posterior capsule. The incidence of the nucleus as the complication of phacoemulsification increases concomitant to the increased frequency of phacoemulsification. Pars plana vitrectomy (PPV) followed by endofragmentation and secondary intraocular lens (IOL) implantation is the choice of management procedure. This case report aims to present the outcome of PPV for the treatment dropped nucleus after cataract surgery METHODS: A 65 year old female patient came to Vitreoretina department with chief complaints blurry vision in her left eye after phacoemulsification one month before. Ophthalmological examination revealed visual acuity of the right eye (VA RE) was 6/15, and the left eye (VA LE) was hand movement. The intraocular pressure (IOP) on the right eye was 18 mmHg, and on the left eye was 59 mmHg. On her left eye, there were aphakic, dropped lens nucleus and secondary glaucoma.RESULTS: The patient got antiglaucoma agent until her IOP was decreased. She underwent pars plana vitrectomy to remove dropped nucleus and iris fixated IOL. One week post operative evaluation revealed VA LE was 6/7.5 and iris fixated IOL in proper position. CONCLUSIONS: Nucleus drop generally occurs in phacoemulsification cataract surgery techniques. Retained lens nucleus or fragments in the vitreous may cause severe intraocular inflammation leading to secondary glaucoma. The proper and good management for retained lens fragments in nucleus drop give excellent outcome to patient.

Keywords: secondary glaucoma, complication of phacoemulsification, nucleus drop, pars plana vitrectomy

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Authors: Min-Ju Jo, Min-Young Um, Moonsung Choi, Sooim Shin

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Type 2 diabetes (T2D) is characterized by insulin resistance, the inability of β-cell and the dysfunction of mitochondria. To characterize effects of Cassia tora extract on mitochondrial dysfunction related T2D, the reduced glutathione level, amount of mitochondrial complexes and activities of mitochondrial complexes were measured. Three groups of mice were modeled; a control group was fed a normal diet, a diabetic group was fed a diabetic diet high in fat and carbohydrates, and a third group was fed a diabetic diet + 70% ethanol extracted Cassia tora seeds for 12 weeks. The amount of mitochondria was determined by Bradford assay after isolation of mitochondria in liver from each group. During isolation of mitochondria, cytosolic fractions of the tissue were collected to measure the reduced glutathione level. Interestingly, high level of the reduced glutathione was observed in Cassia tora treated group and decreased activities of mitochondrial complexes in Cassia tora treated group compared to the diabetic diet group. It indicates that Cassia tora has the potential to increase the reduced form of glutathione functioned as an important antioxidant in cells, and to reduce mitochondrial metabolic compensatory mechanism.

Keywords: antioxidant, Cassia tora, diabetes, electron transport chain, glutathione, mitochondria, spectrophotometry

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Authors: Ferruh Taspinar, Gulce K. Seyyar, Gamze Kurt, Eda O. Okur, Emrah Afsar, Ismail Saracoglu, Betul Taspinar

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Overweight and obesity has been associated with postural balance. The aim of this study was to investigate the relationship between body composition and balance. One hundred and thirty two young adults (58 male, 74 female) were included in the study. Mean age of participants were found as 21.21±1.51 years. Body composition (body mass index, total body fat ratio, total body muscle ratio) and balance (right anterior, right postero-medial, right postero-lateral, left anterior, left postero-medial, left postero-lateral) were evaluated by Tanita BC-418 and Y balance test, respectively. Pearson correlation analysis was used to evaluate the correlation between the parameters. Significance level in statistical analysis was accepted as 0.05. According to results, no correlation was found between body mass index and balance parameters. There was negative correlation between total body fat ratio and balance parameters (r=0.419-0.509, p˂0.05). On the other hand, positive correlation was found between total body muscle ratio and balance parameters (r=0.390-0.494, p˂0.05). This study demonstrated that body fat and muscle ratio affects the balance. Body composition should be considered in rehabilitation programs including postural balance training.

Keywords: balance, body composition, body mass, young adults

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Authors: Asaad Alhabsi, Alyaqdan Algafri

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Aim: Reporting 83 years old man with history of left upper eyelid swelling post 4-lids blepharoplasty diagnosed based on clinical presentation and Radiological imaging with pseudoaneurysm of frontal branch of Superficial Temporal Artery post blepharoplasty. METHODS: 83 years old who presented to a Tertiary ophthalmic center with painless left upper eyelids swelling for 2 months post 4-lids blepharoplasty. Left subcutaneous, sub-brow lesion, in the supertemporal pre-septal area, large mass found and excised surgically. Then he developed recurrent larger mass twice first time treated with aspiration of blood, second time diagnosed with superficial temporal artery (STA) pseudoaneurysm of frontal branch treated with endovascular embolization. RESULTS: Pseudoaneurysm of superficial temporal artery (STA) is a rare, presenting usual post head or face trauma .literature reported few cases of such conditions post operatively, and no reported cases post blepharoplasty. CONCLUSIONS: Surgical intervention is the gold standard of treatment either directly by dissecting the aneurysmal sac and ligate both ends, or endovascular method of injecting thrombin or embolization which was done in this patient by interventional radiologist.

Keywords: superficial temporal artery, pseudoaneurysm, blepharoplasty, Oculoplasty

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Authors: Dae-gun Kim, Hyun-joo Kang

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Purpose: The purpose of this study was to investigate the effects of aging on center of pressure, gait angle and gait time. Methods: 29 healthy female college students(FCS) and 28 elderly women (EW) were recruited to participate in this study. A gait analysis system( Gaitview, Korea) was used to collect the center of pressure in static state and gait angle with gait time in dynamic state. Results: Results of the center of pressure do not have significant differences between two groups. In the gait angle test, the FCS showed 1.56±5.2° on their left while the EW showed 9.76±6.54° on their left. In their right, the FCS showed 2.85±6.47° and the EW showed 10.27±6.97°. In the gait angle test, there was a significant difference in the gait time between the female college students and elderly women. A significant difference was evident in the gait time. The FCS on the left was 0.87±0.1sec while the EW’s was 1.28±0.44sec. The FCS on the right was 0.86±0.09sec and the EW was 1.1±0.21sec. The results of this study revealed that the elderly participants aging musculoskeletal system and subsequent changes in their posture altered gait angle and gait time. Therefore, this widening is due to their need to leave their feet on the ground longer for stability slowing their movement. Conclusions: In conclusion, it is advisable to develop an exercise program for the elderly focusing on stability the prevention of falls.

Keywords: center of pressure, gait angle, gait time, elderly women

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Authors: Ankush Kalra, Mirza Masroor, Usha Manaktala, B. C. Koner, T. K. Mishra

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Introduction: Pre-eclampsia affects 3-5% of pregnancies worldwide and increases maternal-fetal morbidity and mortality. Reduced placental perfusion induces the release of biomolecules by the placenta into maternal circulation causing endothelial dysfunction. Zinc dependent matrix metalloproteinase-2 (MMP-2) may be up-regulated and interact with circulating factors of oxidative stress and inflammation to produce endothelial dysfunction in pre-eclampsia. Aim: To study the functional genetic polymorphism of MMP-2 gene (g-1306 C>T) in pre-eclampsia and its effect on serum MMP-2 levels in these patients. Method: Hundred pre-eclampsia patients and hundred age and gestation period matched healthy pregnant women with their consent were recruited in the study. Serum MMP-2 levels in all subjects were estimated using standard ELISA kits. MMP-2 gene (g.- 1306 C>T) SNPs were genotyped using whole blood by ASO-PCR. Result: The pre-eclampsia patients had higher serum levels of MMP-2 compared to the healthy pregnant (p < 0.05). Also the MMP-2 genotype was associated with significant alteration in the serum MMP-2 concentration in these patients (p < 0.05). Conclusion: This study results suggest an association of MMP-2 genetic polymorphism and serum levels of MMP-2 to the path physiology of hypertensive disorder of pregnancy.

Keywords: allele specific oligonucleotide polymerase chain reaction (ASO-PCR), enzyme linked immunosorbent assay (ELISA), matrix metalloproteinase-2 (MMP-2), pre-eclampsia

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Authors: Uwonkunda Jeanne, J. Godwin Prem Singh, Anjaneyalu Subbiah

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HIV/AIDS is known to affect an individual not only physically but also mentally, socially, and financially. It is a syndrome that builds a vacuum in a person affecting his/her life as a whole.

Keywords: People living with HIV, social dysfunction, stigma, and Social support.

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Authors: H. Hadjeris, R. B. Ghoul, Lekhlaf, M. Nebbal

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Introduction: Adenoid cystic carcinomas of the lacrimal gland or orbital cylindroma constitute the second cause of epithelial tumors of this gland. It is a malignant tumor usually developed at the expense of the salivary glands; its orbital location is exceptional. It is a rare clinical entity, formidable by its malignancy and local aggressiveness; the recurrence rate is high. Materials and methods: Clinical case: 63 years old woman who presents with irreducible no pulsatile painful left exophthalmos with inflammatory chemosis and a decrease in visual acuity with a moderate intracranial hypertension syndrome that has been evolving for 03 months. Antecedent; a biopsy of the tumor was made; the histological examination was in favor of an adenoid cystic carcinoma of the lacrimal gland. Lesion assessment: computed tomography and brain MRI: show an intra and extra-conical mass; with sinus (ethmoido-frontal) and cerebral (left frontal) extension strongly enhanced after injection of contrast product surrounded by edema around the lesion, associated with left frontal bone lysis extension assessment: unremarkable treatment: Patient operated by left frontotemporal approach, a total exenteration was performed with macroscopically complete excision of the frontal lesion and wide frontal craniectomy with craniofacial reconstruction, followed by complementary radiotherapy. Results: The patient was seen again after 3 months in consultation; she does not present any signs in favor of a recurrence. Conclusion: Adenoid cystic carcinomas of the lacrimal gland are rare malignant tumors; they are very infiltrating and invasive. The prognosis is strongly linked to the treatment time.

Keywords: adenoid cystic, lacrimal gland, orbital location, fronto-temporal approac

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Authors: Yassir AbdelRazig, Eren Ozguven, Ren Moses

Abstract:

While there exists a greater understanding of the differences between the driving behaviors of older and younger drivers, there is still a need to further understand how the two groups perform when attempting to perform complex intersection maneuvers. This paper looks to determine if, and to what extent, these differences exist when drivers encounter permissive left-hand turns, pedestrian traffic, two and four-lane intersections, heavy fog, and night conditions. The study will utilize a driving simulator to develop custom drivable scenarios containing one or more of the previously mentioned conditions. 32 younger and 32 older (+65 years) participants perform driving simulation scenarios and have their velocity, time to the nearest oncoming vehicle, accepted and rejected gaps, etc., recorded. The data collected from the simulator is analyzed via Raff’s method and logistic regression in order to determine and compare the critical gaps values of the two cohorts. Out of the parameters considered for this study, only the age of the driver, their experience (if they are a younger driver), the size of a gap, and the presence of pedestrians on the crosswalk proved significant. The results did not support the hypothesis that older drivers would be significantly more conservative in their critical gaps judgment and acceptance.

Keywords: older drivers, simulation, left-turn, human factors

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