Gene and protein expression of epithelial to mesenchymal transition for intestinal and anal fistula: a systematic review

Purpose@#Intestinal fibrosis is a common complication of inflammatory bowel diseases. However, the possible involvement of epithelial-mesenchymal transition (EMT) has been scarcely investigated. This systematic review aims to search through research papers that are focusing on messenger RNA (mRNA) and protein expression profile in EMT in fistula or in intestinal fibrosis. @*Methods@#Electronic exploration was performed until April 24, 2019 through PubMed, Ovid, Science Direct, and Scopus databases with the terms of “fistula” OR “intestinal fibrosis” AND “epithelial-mesenchymal transition”. Two independent reviewers scrutinized the suitability of the title and abstract before examining the full text that met the inclusion criteria. For each study, the sample types that were used, methods for analysis, and genes expressed were identified. The list of genes was further analyzed using DAVID (Database for Annotation, Visualization, and Integrated Discovery) and KEGG (Kyoto Encyclopedia of Genes and Genomes) pathway. @*Results@#There were 896 citations found; however, only 3 studies fulfilled the requirements. Among the EMT-related genes, 5 were upregulated genes at mRNA level while 6 were at protein level. However, only 2 downregulated genes were found at each mRNA and protein level. Of the 4 inflammation-related genes found, 3 genes were upregulated at mRNA level and 1 at protein level. These genes were confirmed to be involved in the development of inflammatory induced fibrosis and fistula through EMT. Results from quantitative real-time polymerase chain reaction analysis were consistent with the process of EMT, confirmed by the western blot protein analysis. @*Conclusion@#Many significant genes which are involved in the process of EMT in fistula and intestinal fibrosis have been identified. With high-end technology many more genes could be identified. These genes will be good molecular targets in the development of biomarkers for precision drug targeting in the future treatment of intestinal fibrosis and fistula.

New model for the prediction of visual outcomes in young children with mechanical ocular conditions and comparison with other models

Purpose: Herein, we compared the efficacy among the Ocular Trauma Score (OTS), Toddlers Ocular Trauma Score (TOTS), and Pediatric Ocular Trauma Score (POTS) for prognosis prediction in Indian children who had mechanical ocular conditions causing traumatic cataract. Methods: This prospective, interventional study recruited consecutive children undergoing operation for traumatic cataracts caused by mechanical eye injuries at Drashti Netralaya. The following details were obtained from their medical files: the circumstance and time of injuries, penetrating injury type, initial and final visual acuity (VA), time of operation, and associated eye diseases. Specific variables were employed to determine the OTS, TOTS, and POTS. For all patients, the final and predicted VA determined using all scores were compared using Fischer’s exact test. Accuracy, specificity, and sensitivity were evaluated for all the scores by using the area under receiver operating characteristic curve. Results: We enrolled 124 eyes. Patients’ mean value for age was 4.6 ± 1.29 years; 44 (35.41%) and 74 (64.5%) were female and male patients, respectively. Visual outcomes significantly improved after operation, and the outcomes did not differ between closed? and open?globe injuries (P = 0.162). The actual and predicted VA did not exhibit a statistically significant difference among the three scores. TOTS and POTS were more suitable for evaluating low?risk injuries, whereas the OTS could more efficiently examine high?risk cases. Conclusion: TOTS and POTS were more accurate than the OTS in VA prediction after operation in toddlers with traumatic cataracts caused by mechanical globe injury. TOTS and POTS were more suitable for evaluating low?risk injuries, whereas the OTS could more efficiently examine high?risk cases. All the examined scores can be helpful in estimating VA following treatment

Diagnostic Significance Of Adenosine Deaminase And Lymphocytes In Suspected Tuberculous Pleural Effusion

CONTEXT: Tuberculosis is a major public health problem in India. Tuberculous pleural effusion is a paucibacillary manifestation of the Tuberculosis, so isolation of Mycobacterium tuberculosis is difficult, biomarkers being an alternative for diagnosis. Pleural fluid Adenosine deaminase (ADA) level is being used in diagnosis of Tubercular pleural effusion. The combination of ADA and pleural fluid lymphocyte count is being recognized as a better method for increasing the specificity of ADA test. The present study was conducted to analyze the diagnostic usefulness ofAIM: ADA alone (? 40U/L) compared with the combination of ADA and pleural fluid lymphocyte count ( ? 50% ). SETTINGS AND DESIGN: METHODS AND MATERIAL:Retrospective study. Study was conducted for a period of one year from May 2017 to April 2018. A total of 110 pleural fluid samples data was analysed. SPSS 20STATISTICAL ANALYSIS USED: statistical software. ADA level in Tuberculous pleural effusion ranged from 40U/L to 112U/L with mean value ofRESULTS: 69.4U/L. Sensitivity, Specificity, Positive predictive valve (PPV) and Negative predictive values (NPV) for ADA alone were 93.2%, 76.4%, 82% and 90.6% respectively. For ADA and lymphocyte count the Specificity and PPV increased (98% and 98.1% respectively) with hardly any decrease in sensitivity or NPV (89.8% and 89.5% respectively). CONCLUSION: Combined use of ADA and pleural fluid lymphocyte count increases the specificity and PPV when compared to the specificity of ADA test alone in diagnosing Tubercular pleural effusion

Ayurvedic Management of Aaghataja Sandhivata w.s.r. to Knee Osteoarthritis: A Case Study

The most commonly diagnosed arthritis is Knee Osteoarthritis. The main possible causes of Knee Osteoarthritis can be trauma, overweight, old age, lifestyle, calcium deficiency etc. In modern medicine, the available treatment for osteoarthritis is NSAIDS, Ca supplements, and at last, joint replacement. The present case study is about knee osteoarthritis which is caused due to trauma. Panchakarma (Snehana, Swedana, Janu Basti, Matra Basti) has a significant role in the management of Osteoarthritis. So, here’s an attempt to show its efficacy, along with oral Ayurvedic medications, which will be helpful for further studies.

COMPARATIVE STUDY OF CASE BASED LEARNING WITH TRADITIONAL TEACHING METHODS IN BIOCHEMISTRY FOR FIRST YEAR MEDICAL STUDENTS

Background: Case based learning (CBL), is a learning method aids learner to reorganize, elaborate their information and provide connection between current and new information. Moreover CBL is student centered, taken in small groups where teacher acts as facilitator or guide. This study was planned to perceive the need for initiating CBL, this study aimed to compare the biochemistry teaching among first year medical students with that of traditional teaching. Methods This is an observational study conducted from August 2021 to December 2021. This research study was conducted on 99 students of First year MBBS students. Ten ideal case scenarios on the topic of protein energy malnutrition(PEM) in children and acid base balance were prepared, and pre validated by the faculty of Biochemistry, Paediatrics and Surgery medical education department in our institution. CBL was introduced and total three sessions were conducted and compared with traditional teaching. Results The mean (±SD) value of the score of gain in knowledge was 3.90±1.86 (n=99) for the batch of students who attended case based learning while the mean (±SD) gain in knowledge for the batch who underwent, traditional learning ( TL) was 2.60±2.29 (n=99). A paired t-test comparing didactic lectures with self-directed learning showed that the scores following didactic lectures were more compared to SDL and the results were statistically significant. An unpaired t-test comparing case based learning to SDL also showed statistically significant gain in knowledge following didactic lectures. Conclusion This study clearly showed that CBL is more effective over traditional teaching for our first year MBBS students and for covering a wider area.

Understanding the Negative Public Perception on Vaccination in West Coast and East Coast Peninsular Malaysia

@#Introduction: Vaccination is a biological process that improves immunity level of an individual towards certain diseases. Vaccination is generally given to all newborn and kids. Most countries oblige their citizens to be vaccinated as early as new-born age. The aim of this research is to study the perception on vaccination intake and the associated factors that lead to its refusal among parents in east coast and west coast peninsular Malaysia. Methods: Primary data were collected using self-administered questionnaire and were distributed to assess the study objectives. Total 240 questionnaires were distributed equally in west coast and east coast study area. Questionnaire consists of demographic data, perception aspects and factors that may lead to the negative perceptions. Results: There is significant association between perception and religion, education level and side effect factor in east coast with majority of the respondents are Muslims (40.83%) while there is no significant association between education level and side effect factor (p>0.1) in west coast with majority of respondents are Muslims (51.67%) too. This study found that perception regarding vaccination is influenced by the religion restrictions in east coast of peninsular Malaysia and not in west coast region. The other factors associated with vaccination refusal varies according to education level, and regional basis. Conclusion: Most of the respondents who have negative perception regarding vaccination are from East Coast region as they are more prone into Islamic teachings. All the possible factors of vaccination refusal are accepted by the respondents but varies in its prevalence as the leading factor determined that caused the vaccination refusal are religion restriction and the least percentage for the factor is time restriction.

Prognostic significance of serum cortisol and serum albumin in patients of ischemic stroke

Background: Stroke is the second most common cause of mortality worldwide and a major contributor to morbidity and chronic adult disability. To study the prognostic significance of serum cortisol and serum albumin in patients of ischemic stroke was the objective.Methods: This hospital based observational cohort prospective study was undertaken in the Department of Medicine in collaboration with the Departments of Radio diagnosis and Pathology, Jawahar Lal Nehru Medical College and Hospital, AMU, Aligarh from January 2017 to November 2018. By convenience method for sampling, 102 patients who were admitted with the diagnosis of acute ischemic stroke to IPD of JNMCH, Aligarh, on clinical as well as radiological grounds were taken into study.Results: Mean cortisol was 450.84±190.35 nmol/L. The (mean±SD) of serum cortisol was 258.10±77.91 ng/ml in patients with good outcome and 585.77±113.34ng/ml in patients with poor outcome. (p<0.05, r= 0.812). Mean serum albumin was 2.83±0.76 gm/dl. The (mean±SD) of serum albumin was 3.47±0.64mg/dl in patients with good outcome and it was comparatively lower in patients with poor outcome (2.38±0.45mg/dl). (p <0.01, r=-0.659).Conclusions: Serum albumin, serum cortisol are prognostic indicators of functional outcome at 3 months in patients of ischemic stroke.

Management Of Metabolic Syndrome Through Ayurveda

Metabolic syndrome is defined as a constellation of interconnected physiological, biochemical, clinical and metabolic factors that directly increase the risk of cardiovascular disease and Type 2 Diabetes Mellitus. It is a major and increasing public health problem and clinical challenge worldwide in the wake of urbanization, increasing obesity and sedentary life style. Metabolic syndrome defined by IDF (2006) as presence of Central obesity with any one of the 3 factor i.e., Raise Triglyceride, Reduced HDL, Raised BP or Raised FBS. It increases 5 fold risk of Type II DM and 2 fold risk of Cardio-vascular disease. Worldwide prevalence of Metabolic syndrome ranges from 10% to 84% depending upon the Region (Urban/Rural), Composition (sex, age, race, ethnicity) of Population. IDF estimates that 1/3rd of world Adult population have Metabolic Syndrome. According to NCEP - ATP III CRITERIA 2001 Metabolic syndrome varies from 8 to 43% in men and 7 to 56% in women around the world. Lifestyle modification remains the initial intervention of choice as majority of people have sedentary lifestyle high socio economic status high BMI and are overweight. So lifestyle modification combine with specific Ayurvedic therapies i.e., Palliative (Shaman), Panchkarma (Shodhan), Sadhvrit (good conduct/ethical regimen for balanced state), Exercise and Diet, Yogic Practices etc. could be effective in the Management of Metabolic Syndrome.

Screening of Medical Students’ Intention to Practice Mobile – Learning in Malaysia

@#Introduction: The twenty-first-century learning is adopting the student-centered learning techniques and the teachers are mainly facilitators to direct the process of learning and so social media and mobile applications became an important learning platform. Mobile learning (M-learning) is the practice of learning activities through a portable device such as cellular phone or a personal digital assistant. The aim of this research is to screen the medical students’ intention toward the adoption of M-learning and to determine factors affecting the intentions of the medical students to practice M-learning. Methods: A cross-sectional study among medical students was performed through a questionnaire based on the Theory of Reasoned Action and the Technology Acceptance Model. The study included 129 students in different stages of the medical study. Results: Results showed that the factors affecting the students’ inten¬tion to practice M-learning include the students’ attitude, perceived usefulness, perceived ease of use, and availability of resources. In the current sample 82.7% of students are already using M-Learning; 41.7% are using it for assessment, 22.8% are using it for learning and 35.5% are using it for both. Conclusion: It was concluded that most medical students have higher intention to adopt M-learning and they are mostly using it for assessment purposes rather than in learning.

Effect of Cigarette Smoking on the Academic Achievement Among Management and Science University Students

@#Introduction: Cigarette smoking is showing an increasing prevalence among university students nowadays. Smoking includes the act of smoking cigarette containing tobacco and/or other ingredients or just inhaling the cigarette smoke. Smoking has many known physical side effects that include psychological or cognitive effects. Therefore, the aim of this research is to identify the effect of cigarette smoking on the academic achievement among university students. Methods: A cross-sectional study was conducted among 136 students including 113 male and 23 female aged 18 to 29 years from Management and Science University with 30 non smoker students. The questionnaire included items about the social demographic characteristics, smoking status, the study styles and the academic achievement of the participants. A frequency statistics, descriptive statistics and chi square test were used to analyze the collected data using SPSS version 25. Results: Among the smoker students, 51.5% came to class early, 80.8% attend classes regularly, 49.3% studied on weekends and 39.7% planned sufficient time to study for exam. Mean CGPA for smoker students is 2.6. Conclusion: Smoking is proven to be associated with low academic performance among university student.

Study of the Pattern of Cell Phone Usage Associated With Side Effects Among University Students: Case Study in a Malaysian University

@#Introduction: Cell phone is a device that has been used almost every day for all age groups. It connects everyone and everything around the world as it provides various social platforms. However, not many people realized that cell phone is a source of non-ionizing electromagnetic waves that can be associated with various physical effects. Therefore, the aim of this research is to identify the physical side effects associated with exposure to the electromagnetic waves emitted by cell phone use and to detect if these effects are associated with specific pattern of use. Methods: A cross-sectional study was conducted on 166 participants randomly selected from university students. Results: showed that those suffering side effects associated with cell phone usage are usually using more than one cell phone (79%) since about 5 – 10 years (41.9%) for more than 5 hours daily (65.7%) for entertainment (34.3%) and making about 1-5 calls daily (41%) with average call duration 1 – 30 min (56.2%). 66.7% of them started using cell phone at age 7 – 12 years old, mostly handheld (61%), at their right side (40%), at all times of the day (64.8%). Most common side effects associated with cell phone usage include ear pain (52.4%), headache (79.5%), fatigue, anxiety or insomnia (57.8%), tremors and eye pain beside statistically significant (P<0.05) complain of dry mouth (56.6%) and/or bad odor mouth (46.4%). Conclusion: There is a specific pattern associated with occurrence of side effects due to cell phone use.

Anticonvulsant evaluation of 2-pyrazolines carrying naphthyl moiety: An insight into synthesis and molecular docking study

A series of N-substituted-3-(napthalen-2-yl)-5-substituted phenyl-4,5-dihydropyrazole-1-carbothioamide derivatives (4a-n) were synthesized with the view of structural requirements of pharmacophore for potential anticonvulsant agents. The synthesized compounds were assayed intraperitoneally (i.p.) and subcutaneously (s.c.) in mice against seizures induced by MES and scPTZ methods, respectively.Neurologic deficit was evaluated by rotarod method. Among the tested compounds, 4g, 4i, 4j and 4n emerged as the most active molecule in the MES model at a dose of 30 mg/kg at 0.5h comparable to standardscarbamazepine and phenytoin. In the scPTZ test,4e and 4l were found to be most active compounds at the lowest dose of 30 mg/kg at 0.5h, in the management of the convulsive disorder. Molecular docking studies of the titled compounds were also donewith 3D crystal structure of human cytosolic branched chain amino transferase (hBCATc) enzyme and compound 4e was found to have five hydrogen bond interactions with the most important active site residues.In neurotoxicity studies, except compounds 4b, 4c, 4h and 4k, rest of the compounds showed no sign of toxicity.

Secondary Tumors of the Urinary System: An Imaging Conundrum

Imaging features of metastases to the urinary system may closely mimic primary urinary tract tumors, and differential diagnosis by imaging alone may be problematic or even impossible in some cases. The main purpose of this article was to familiarize radiologists with imaging findings of metastasis to the urinary system on cross-sectional imaging, with an emphasis on abdominal and pelvic computed tomography and magnetic resonance imaging. In addition, we review the clinical importance and implications of metastases to the urinary tract and provide information on diagnostic work-ups.

A case of urinary tract infection caused by Raoultella planticola after a urodynamic study

Abstract Here we report the case of a patient who developed urinary tract infection after a urodynamic study. The causative agent was Raoultella planticola, a rare opportunistic pathogen that usually invades immunocompromised patients. While a urinary tract infection with R. planticola has been previously described, this is the first report in which an R. planticola infection developed after a urodynamic study. We postulate that the mechanism of infection was direct invasion of the urinary tract from contaminated urodynamic study equipment. Here, we discuss the role played by isotonic solutions in facilitating bacterial reproduction.

Vision screening of ophthalmic nursing staff in a tertiary eye care hospital: outcomes and ocular healthcare-seeking behaviours

Objectives: This study aimed to evaluate ocular healthcare-seeking behaviours and vision screening outcomes of nursing staff at a tertiary eye care hospital

Methods: This study was conducted between April and September 2016 among all 500 nurses employed at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. Data were collected on age, gender, use of visual aids, the presence of diabetes, a history of refractive surgery and date of last ocular health check-up. Participants were tested using a handheld Spot[Trade Mark Sign] Vision Screener [Welch Allyn Inc., Skaneateles Falls, New York, USA]

Results: A total of 150 nurses participated in the study [response rate: 30.0%]. The mean age was 41.2 +/- 8.9 years old. Distance spectacles, reading spectacles and both types of spectacles were used by 37 [24.7%], 32 [21.3%] and 10 [6.7%] nurses, respectively. A total of 58 nurses [38.7%] failed the vision screening test. Visual defects were detected for the first time in 13 nurses [8.7%]. With regards to regular eye checkups, 77 participants [51.3%] reported acceptable ocular healthcare-seeking behaviours; this factor was significantly associated with age and the use of visual aids [P <0.01 each]

Conclusion: A high proportion of participants failed the vision screening tests and only half displayed good ocular healthcare-seeking behaviours. This is concerning as ophthalmic nurses are likely to face fewer barriers to eye care services than the general population

Parental modeling as predictor of filial obligation in young adults

Filial obligation plays a vital role in family functioning and interaction with parents. The role of parental modeling as a factor contributing to filial obligation was explored in 200 men and women with an age range between 25 to 35 years with mean age of 28.27[+/- SD 2.38]. It was hypothesized that parental modeling would predict filial obligation [i.e. Contact and Family Ritual, Conflict Avoidance, Assistance, Self-Sufficient and Personal Sharing]. In addition, the gender differences on Filial Obligation were also examined. The Self-developed Parental Modeling Questionnaire [PMQ] and Felt Obligation Measure [FOM; Stein, 1992] along with a Structured Interview Schedule were used. The Linear Regression analysis and t-test were employed for statistical analysis of data. The results indicated that parental modeling is a significant predictor of filial obligation in young adults. Further, gender differences were observed on four domains of filial obligation except for Self-Sufficient sub-domain. The implications of results for healthy parent child interaction are discussed

A reliable method for evaluating upper molar distalization: Superimposition of three-dimensional digital models / 대한치과교정학회지

OBJECTIVE: The aim of this study was to evaluate the reliability of measurements obtained after the superimposition of three-dimensional (3D) digital models by comparing them with those obtained from lateral cephalometric radiographs and photocopies of plaster models for the evaluation of upper molar distalization. METHODS: Data were collected from plaster models and lateral cephalometric radiographs of 20 Class II patients whose maxillary first molars were distalized with an intraoral distalizer. The posterior movements of the maxillary first molars were evaluated using lateral cephalometric radiographs (group CP), photocopies of plaster models (group PH), and digitized 3D models (group TD). Additionally, distalization and expansion of the other teeth and the degrees of molar rotation were measured in group PH and group TD and compared between the two groups. RESULTS: No significant difference was observed regarding the amount of molar distalization among the three groups. A comparison of the aforementioned parameters between group PH and group TD did not reveal any significant difference. CONCLUSIONS: 3D digital models are reliable to assess the results of upper molar distalization and can be considered a valid alternative to conventional measurement methods.

A reliable method for evaluating upper molar distalization: Superimposition of three-dimensional digital models / 대한치과교정학회지

OBJECTIVE: The aim of this study was to evaluate the reliability of measurements obtained after the superimposition of three-dimensional (3D) digital models by comparing them with those obtained from lateral cephalometric radiographs and photocopies of plaster models for the evaluation of upper molar distalization. METHODS: Data were collected from plaster models and lateral cephalometric radiographs of 20 Class II patients whose maxillary first molars were distalized with an intraoral distalizer. The posterior movements of the maxillary first molars were evaluated using lateral cephalometric radiographs (group CP), photocopies of plaster models (group PH), and digitized 3D models (group TD). Additionally, distalization and expansion of the other teeth and the degrees of molar rotation were measured in group PH and group TD and compared between the two groups. RESULTS: No significant difference was observed regarding the amount of molar distalization among the three groups. A comparison of the aforementioned parameters between group PH and group TD did not reveal any significant difference. CONCLUSIONS: 3D digital models are reliable to assess the results of upper molar distalization and can be considered a valid alternative to conventional measurement methods.

Unusual Malignant Solid Neoplasms of the Kidney: Cross-Sectional Imaging Findings

Malignant kidney neoplasms are the most frequently encountered solid kidney masses. Although renal cell carcinoma is the major renal malignancy, other solid malignant renal masses should be considered in the differential diagnosis of solid renal masses that do not contain a macroscopic fatty component. In this pictorial essay, we present the imaging findings of a primitive neuroectodermal tumor, primary liposarcoma of the kidney, primary neuroendocrine tumor, leiomyosarcoma, synovial sarcoma, malignant fibrous histiocytoma, sclerosing fibrosarcoma and renal metastasis of osteosarcoma.

Role of Anxiety on Patient Intolerance during Bronchoscopy.

Aims: There are no current data about the adverse effects of anxiety on patient intolerance during bronchoscopy.The aim of our study was to assess the correlation between anxiety and patient intolerance during bronchoscopy. Study Design: Retrospective research study Place and Duration of Study: Department of Pulmonary Diseases, Cerrahpasa Medical Faculty, between January 2010 and 2013 March. Methodology: Data from 94 patients were analyzed. The mean age of the patients was 59 years. Bronchoscopy was performed for lung cancer in 54, pulmonary nodules in 26 and pulmonary infiltration in 14 patients. Hospital Anxiety Depression scale was used to appraise the anxiety symptoms. Cytologic examination of bronchoalveolar lavage, and sputum samples were performed in each patient when available. Results: The anxiety or fear profile of the patients before bronchoscopy were as follows: dyspnea (78%), malignant disease (74%), nasal, laryngeal or tracheal irritation (70%), bronchoscopic findings (68%), and hemorrhage (42%). Bronchoscopic examination was intolerable in 14 cases while there was great difficulty to perform the procedure in 18 patients. Cytologic analysis revealed severe in 18, moderate in 22, and mild dysplasia in 25 patients while it was normal in 29 subjects. Hospital Anxiety Depression scale was over eight in 33 patients. The scale was over eight in 13 out of 14 patients who were intolerant to bronchoscopy. Cytology revealed severe in one and moderate dysplasia in another patient intolerant to bronchoscopy. Conclusions: Anxiety appears to be the predominant factor for patient intolerance during bronchoscopy. Pulmonary function, atypical or dysplastic cytomorphological changes in sputum or bronchoalveolar lavage cytology did not show correlation with patient performance.