Assessment of lead augmented vector left (aVL on surface electrocardiogram) for confirming atrioventricular nodal reentrant tachycardia

Background: Atrioventricular nodal reentrant tachycardia (AVNRT) stands as one of the most common forms of paroxysmal supraventricular tachycardia (PSVT), encompassing a wide spectrum of clinical presentations and diagnostic challenges. The aim of this study was to evaluate the assessment of lead aVL (surface ECG) for confirming AVNRT. Methods: This was a prospective observational study and was conducted at the Department of Cardiology and Electrophysiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh during the period from February 2019 to January 2020. Results: In our study 41 patients (66.1%) had AVNRT and 21 patients (33.9%) had AVRT on the final evaluation. Total 33.9% of patients had aVL notch on ECG. Among patients who had AVNRT, 46.3% had an aVL notch and among patients who had AVRT, 9.5% had an aVL notch on ECG. The difference was statistically significant (p=0.004). Among 21 patients who had aVL notch on ECG, 6 (31.6%) male patients had AVNRT, 13 (64.8%) female patients had AVNRT, 1 (50%) male patients had AVRT and 1 (50%) female patient had AVRT. Conclusions: In conclusion, the interpretation of electrocardiographic criteria, including the aVL notch, plays a pivotal role in confirming the diagnosis of AVNRT and guiding therapeutic interventions.

Antiplatelet Therapy and Kidney Function in Non-Dialysis Chronic Kidney Disease: A Two-Centre Observational Study in Nigeria

Antiplatelet therapy used in preventing cardiovascular events in chronic kidney disease may be associated with higher risks of bleeding, low efficacy from fewer occlusive atherosclerotic disease), attenuation of the inflammatory process, and changes in the haemogram. We prospectively determined the kidney function, the haemogram, and the lipid profile of participants with and without antiplatelet therapy. The population with a mean age of 69.21 ± 11.73 years, had more women (65.88%), p=0.001. Participants' age was positively correlated with the CKD stage, p<0.001. Bleeding was more common with clopidogrel than aspirin and, less common with advancing CKD. Cardiovascular events were more common in CKD stage 5. The men had higher eGFR but lower platelet count and platelet neutrophil ratio (PNR) than the women, p=0.004, p<0.001, and p<0.001 respectively. The eGFR, bicarbonate, and HDL cholesterol were higher with versus without antiplatelets, p=0.04, p<0.001, and p=0.001 respectively. The platelet count and PNR were higher with antiplatelet therapy and with higher CKD stage, p<0.001 and p<0.001 and, p<0.001 and p<0.001 respectively. Higher platelet count (OR-0.410, 95% CI-0.02-1.04), lower uric acid levels (OR-0.550, 95% CI-0.271-0.948), higher HDL-C (OR-0.486, 95% CI-0.093-1.013), lower LDL-C (OR-0.572, 95% CI-0.082-1.002) and lower triglycerides (OR-1.274, 95% CI-0.755-1.493) were independently associated with antiplatelet therapy. The benefits of antiplatelet therapy in CKD are anchored on its anti-inflammatory, lipid-lowering, and kidney function-improving effects, these synergistically lead to lower cardiovascular events. The increased risk and consequences of bleeding, and reductions in leucocytes and erythrocytes population should be borne in mind to prevent heightening morbidity and mortality rates.

Revisión de la displasia ectodéֹrmica hipohidrótica: diagnóstico, tratamientos y terapias génicas / Hypohidrotic ectodermal dysplasia: a review on diagnosis, treatment, and gene therapies

RESUMEN La displasia ectodérmica hipohidrótica (DEH) es una genodermatosis producida por un defecto monogenético que afecta la proteína ectodisplasina en los tejidos derivados del ectodermo. De acuerdo al mecanismo de transmisión, podemos distinguir tres tipos de DEH: autosómica recesiva, autosómica dominante, o ligada al cromosoma X (siendo ésta la más frecuente). Si bien la expresión fenotípica presenta diferencias de acuerdo al gen afectado, las tres características clínicas de la DEH son: hipodoncia, hipotricosis e hipohidrosis. El tratamiento convencional busca mejorar la calidad de vida del paciente, abarcando intervenciones dentales como ortodoncia e implantes dentales, rutinas dermatológicas para piel seca y escamosa, y el uso de sudor artificial. En los últimos años, la investigación científica desplazó el interés desde estos tratamientos hacia la ingeniería genética, surgiendo alternativas prometedoras que en ciertos ensayos clínicos lograron revertir la enfermedad, como lo es la terapia génica con EDA1 recombinante, o ER004, desarrollada por Schneider, H. A lo largo de la revisión se abordarán los síntomas de la enfermedad, las herramientas para el correcto diagnóstico y los tratamientos disponibles, así como otras condiciones a tener en cuenta en el diagnóstico diferencial.

ABSTRACT Hypohidrotic ectodermal dysplasia (HED) is a genodermatosis caused by a monogenic defect that affects the protein ectodysplasin in tissues derived from the ectoderm. Depending on the transmission mechanism, we can distinguish three types of HED: autosomal recessive, autosomal dominant and linked to the X chromosome (this being the most frequent). Although the phenotypic expression varies according to which gene is affected, all forms of HED share three clinical characteristics: hypodontia, hypohidrosis and hypothricosis. The conventional treatments have the objective of improving the patient's quality of life, and include dental interventions such as orthodontics and dental implants, dermatological routines for dry skin, and the use of artificial sweat. In recent years, scientific research has focused on genetic engineering to treat HED, developing new promising strategies such as gene therapy with recombinant EDA1, or ER004, developed by Schneider, H. and colleagues. In someclinical trials this strategy effectively reversed clinical manifestations of the disease. Throughout the review we will address HED's symptoms, tools for the correct diagnosis, available treatments and considerations for the differential diagnosis.

Dental fear among the school going-children of Taif, Saudi Arabia

Background: Dental fear is a phenomenon that is founded in most of the populations weather the individual is a child or an adult. Objectives were to understand the aspects and the percentages of dental fear among school going children and determine the nature of dental fear in children and to assess the prevalence of dental fear in school going children of Taif city, Suadi Arabia. Methods: Participants were the school children of Taif city, Saudi Arabia. The Children's fear survey schedule – dental subscale (CFSS-DS) was used that was obtained from an online article with a similar topic and it was in Arabic language. The questionnaire forms were distributed to the school going children and responses collected from them at the end of each school visit. Results: The study included 303 school-aged children. It was discovered that the statement with the highest mean indicating that the child is very afraid was: "Are you afraid of the dentist's drill?" (1.84±1.17). The statement with the lowest mean indicated that the child was not afraid: "Are you afraid of people in white clothes?" (1.18±0.69). The mean CFSS-DS score was 22.05±9.44. According to the CFSS-DS score classification cutoff, 19 (6.3%) of the studied children had dental anxiety. Conclusions: The most feared aspect was the dentist drilling followed and the least feared aspect was people in white coat, with a prevalence of 6.3% of dental anxiety among studied children.

Does nutritional support under programmatic settings result in weight and body mass index changes among tuberculosis patients? Evidence on the impact of nutritional support through Pradhan Mantri Tuberculosis Mukt Bharat Abhiyan under national tuberculosis elimination programme from Ramgarh district of Jharkhand

Background: To increase community participation in tuberculosis (TB) elimination efforts, the government of India has launched ‘Pradhan Mantri TB Mukt Bharath Abhiyan’ (PMTBMBA) under the national TB elimination programme. The scheme allows interested parties (Ni-kshay mitras) to offer nutritional support to TB patients. This study aims to understand the impact of such a support in improving weight and body mass index (BMI) among TB patients as most available evidence comes from research settings. Methods: This is a retrospective cross-sectional study carried out in Ramgarh district of Jharkhand, India, for the period first quarter 2023. Relevant data was extracted from Ni-kshay web portal and TB treatment cards. The data is analyzed using excel 365. Results: Of the 114 participants, 69 received nutritional support during the entire duration of treatment and 45 received support partially. Single factor ANOVA on weight and BMI gain revealed statistically significant difference in mean weight/BMI between the two groups with F (1, 110)=35.4660, p=3.16×10-08 and F (1, 110)=22.9994, p=5.12×10-06. Correlation analysis showed a moderate correlation between the number of nutritional kits received and the weight/BMI gain with correlation coefficients r=0.5, p=1.07×10-07 and r=0.4, p=1.65×10-05 respectively. Conclusions: The study concludes that the impact of nutritional supplementation in programmatic setting is comparable with that of implementation research study settings.

Supportive oncology: a blueprint for patient-centric care

The article emphasizes a paradigm shift toward patient-centric care while providing a thorough examination of the changing supportive oncology landscape. When a patient is diagnosed with cancer, they must not only deal with the medical effects of the illness but also manage difficult emotional, social, and practical issues. Understanding the critical role supportive care plays in improving cancer patients' overall quality of life, this book explores the essential elements of a patient-centric approach. Evidence-based procedures, recommendations, and the incorporation of patient viewpoints are all included in the suggested blueprint for patient-centric oncology care. Healthcare professionals may improve cancer patients' quality of life, foster resilience, and help create a more sympathetic and caring healthcare system by adopting an all-encompassing approach. In the end, the paper makes the case for the broad implementation of supportive oncology as a crucial part of cancer treatment, enabling patients to face their ordeal with dignity and resiliency.

Failed limb salvage by microsurgery, resolved by super-microsurgery

Advances in perforating artery flaps have improved reconstruction in various body parts, particularly the lower extremities, offering benefits in patient quality of life and reduced public health service costs. The use of flaps and microsurgery extends beyond trauma to address conditions like osteomyelitis, tumor resection, osteoarthritis, and post-radiation necrosis. Notably, the superficial circumflex iliac artery perforator flap (SCIP) is highlighted for its thin profile and utility in limb coverage, minimizing donor site morbidity. Microsurgical techniques contribute to limb salvage, reducing amputation risks in severe fractures and post-osteosynthesis complications. A 29-year-old male with cerebral palsy suffered bimalleolar fracture from a high-energy motor vehicle accident. Initial ALT flap reconstruction failed, leading to flap removal and osteosynthesis exposure. After 48 hours, removal of the flap was necessary due to venous thrombosis. Salvage with SCIP flap involved anastomosis to perforators of both posterior tibial artery and vein. This case details a patient with a bimalleolar fracture post-motorcycle accident, initially treated with conventional microsurgery using an ALT flap. Complications arose from venous thrombosis, necessitating flap removal. Salvage was achieved through a SCIP flap with supermicrosurgery techniques, employing 0.5 mm anastomosis for improved functionality and reduced complications in flap recovery and donor site comorbidities. Successful outcomes in microsurgery and supermicrosurgery necessitate comprehensive training. Specialized limb salvage centers must possess specific equipment and instruments for these techniques. The literature reviewed doesn't indicate contraindications related to the patient's mental state for the execution of microsurgery and supermicrosurgery.

Chemoprotective effect of arbutin on azoxymethane-induced aberrant crypt foci in rat colon via modulation of PCNA/Bax protein

Arbutin is utilized in traditional remedies to cure numerous syndromes because of its anti-microbial, antioxidant, and anti-inflammatory properties. This study aimed to evaluate chemopreventive effects of arbutin on azoxymethane (AOM)-induced colon aberrant crypt foci (ACF) in rats. Five groups of rats were used: normal control group (rats injected hypodermically with sterile phosphate-buffered saline once per week for two weeks) and groups 2-5, which were subcutaneously inoculated with 15 mg/kg AOM once a week for two weeks. AOM control and 5-fluorouracil (5-FU) control groups were fed 10% Tween orally daily for 8 weeks using a feeding tube. The treated groups were fed 30 and 60 mg/kg arbutin every day for 2 months. ACF from the AOM control group had aberrant nuclei in addition to multilayered cells and an absence of goblet cells. The negative control group displayed spherical cells and nuclei in basal positions. Histological examination revealed a reduced number of AFC cells from colon tissues of the 5-FU reference group. Arbutin-fed animals showed down-regulation of proliferating cell nuclear antigen (PCNA) and up-regulation of Bax protein compared to AOM control. Rats fed with arbutin displayed a significant increase of superoxide dismutase (SOD) and catalase (CAT) activities in colon tissue homogenates compared to the AOM control group. In conclusion, arbutin showed therapeutic effects against colorectal cancer, explained by its ability to significantly decrease ACF, down-regulate PCNA protein, and up-regulate Bax protein. In addition, arbutin significantly increased SOD and CAT, and decreased malondialdehyde (MDA) levels, which might be due to its anti-proliferative and antioxidant properties.

Rho GTPase activating protein 21-mediated regulation of prostate cancer associated 3 gene in prostate cancer cell

The overexpression of the prostate cancer antigen 3 (PCA3) gene is well-defined as a marker for prostate cancer (PCa) diagnosis. Although widely used in clinical research, PCA3 molecular mechanisms remain unknown. Herein we used phage display technology to identify putative molecules that bind to the promoter region of PCA3 gene and regulate its expression. The most frequent peptide PCA3p1 (80%) was similar to the Rho GTPase activating protein 21 (ARHGAP21) and its binding affinity was confirmed using Phage Bead ELISA. We showed that ARHGAP21 silencing in LNCaP prostate cancer cells decreased PCA3 and androgen receptor (AR) transcriptional levels and increased prune homolog 2 (PRUNE2) coding gene expression, indicating effective involvement of ARHGAP21 in androgen-dependent tumor pathway. Chromatin immunoprecipitation assay confirmed the interaction between PCA3 promoter region and ARHGAP21. This is the first study that described the role of ARHGAP21 in regulating the PCA3 gene under the androgenic pathway, standing out as a new mechanism of gene regulatory control during prostatic oncogenesis.

Who found it easy to avail nutritional support through direct benefit transfer under national TB elimination programme in Eastern India: an early evidence from Jharkhand

Background: National TB Programme of India launched Nikshay Poshan Yojana (NPY) through Direct Benefit Transfer (DBT) in April 2018, to provide financial support for additional nutritional requirement during TB treatment. This study aims to understand the enabling attributes in availing Nikshay Poshan Yojana (NPY) through Direct Benefit Transfer (DBT) among notified TB patients from the Indian state of Jharkhand for the year 2019. Methods: This is a retrospective cross sectional descriptive study using secondary data obtained from Nikshay web portal for the Indian state of Jharkhand in the year 2019. State level data on TB Notification and NPY DBT scheme is downloaded from the Nikshay portal in excel format and analysed using Excel 2016 version. Odds Ratio and P value are calculated and analysed to prove any statistically significant associations. Results: The study found higher odds (1.08, 95% CI: 1.03, 1.14; P value 0.004) of having patients who belong to 15 to 65 years, female sex (odds ratio 1.05, 95% CI: 1.01, 1.09; P value 0.018), seeking care in public sector (odds ratio 4.05, 95% CI: 3.83, 4.27; P value <0.00001) and with drug sensitive TB (DS TB) (odds ratio 1.39, 95% CI: 1.1, 1.59; P value <0.00001), among those who received at least one instalment of DBT. Conclusions: TB patients belonging to productive age group, female sex, seeking care in public sector and with DS TB have higher odds of receiving NPY among the study population.

Impact of Nikshay Poshan Yojana on tuberculosis outcomes: preliminary evidence from eastern India

Background: National TB programme of India implemented Nikshay Poshan Yojana (NPY) through direct benefit transfer (DBT) in April 2018. This is to address the dual evils of under nutrition and unfavourable outcomes among tuberculosis patients in the country. This study aimed to understand the impact of Nikshay Poshan Yojana (NPY) through direct benefit transfer (DBT) on the outcomes of notified TB patients from the Indian state of Jharkhand for the year 2019. Methods: This was a retrospective cross sectional descriptive study using secondary data obtained from Nikshay web portal for the Indian state of Jharkhand for the year 2019. State level data on TB notification and NPY DBT scheme was downloaded in excel format and analysed using Excel 2016 version. Results: The study found higher odds (odds ratio 3.14, 95% CI: 2.97, 3.33; p value <0.00001) of having successful outcomes, among those who received at least one instalment of NPY. The risk of lost to follow up (LTFU) was 2.44 times (95% CI: 2.2-2.8, p value: 3.9×10-43) higher among those who did not receive any DBT payments as compared to those who received at least one DBT instalment. Conclusions: The ‘individual and health system enablers’ have a crucial role to play in successful TB treatment outcomes than NPY. However, LTFU rate reduces significantly with timely payment of NPY. This would facilitate improved treatment adherence and thus a favourable outcome.

Construction of multi-epitope vaccine against the Rhipicephalus microplus tick: an immunoinformatics approach

@#Rhipicephalus microplus, known as the hard tick, is a vector for the parasites Babesia spp. and Anaplasma marginale, both of which can cause significant financial losses to the livestock industry. There is currently no effective vaccine for R. microplus tick infestations, despite the identification of numerous prospective tick vaccine candidates. As a result, the current research set out to develop an immunoinformatics-based strategy using existing methods for designing a multi-epitope based vaccination that is not only effective but also safe and capable of eliciting cellular and humoral immune responses. First, R. microplus proteins Bm86, Subolesin, and Bm95 were used to anticipate and link B and T-cell epitopes (HTL and CTL) to one another. Antigenicity testing, allergenicity assessment, and toxicity screening were just a few of the many immunoinformatics techniques used to identify potent epitopes. Multi-epitope vaccine design was chosen based on the antigenic score 0.935 that is promising vaccine candidate. Molecular docking was used to determine the nature of the interaction between TLR2 and the vaccine construct. Finally, molecular dynamic simulation was used to assess the stability and compactness of the resulting vaccination based on docking scores. The developed vaccine was shown to be stable, have immunogenic qualities, be soluble, and to have high expression by in silico cloning. These findings suggest that experimental investigation of the multi-epitope based vaccine designed in the current study will produce achievable vaccine candidates against R. microplus ticks, enabling more effective control of infestations.

Etude descriptive des mouvements anormaux en neurologie en milieu hospitalier universitaire au nord du Bénin / Descriptive study of the movement disorders in neurology department at the university hospital in northern Benin

Introduction : Il n'y a aucune donnée publiée sur les mouvements anormaux (MA) au Bénin. Objectif : Etudier la fréquence, les caractéristiques cliniques et évolutifs des MA au CHUD-B/A au nord-Bénin en 2020. Matériel et méthodes : Il s'agissait d'une étude transversale descriptive avec collecte de données sur 5 ans (1er juillet 2015 - 30 juin 2020) en neurologie au CHUD/B à Parakou au Nord-Bénin. Le diagnostic et la classification des MA a été fait par un neurologue selon les critères cliniques du Consensus Statement of International Parkinson and Movements Disorders Society (MDS), et les critères révisés de Jinnah 2014 pour la dystonie. Les autres mouvements hyperkinétiques sont retenus selon les critères de Reich 2010 et les critères de Allen 2003 pour le syndrome des jambes sans repos (SJSR). Résultats : 2250 patients ont été inclus. L'âge moyen des patients MA au diagnostic était de 52,57 ± 20,77ans [1-80ans]. L'âge moyen au début des symptômes était de 49,16 ± 20,85ans [1-80ans]. Le sex-ratio était de 2,58. La fréquence des MA dans le service était de 5,73% (129/2250) et 6,68% (117/1805) en consultation ambulatoire. Les MA identifiés étaient : tremblement (72,09%), akinésie-parkinsonisme (41,08%), dystonie (7,75%), chorée (6,2%), myoclonie (3,1%), dyskinésie (2,33%), ballisme (2,33%), athétose (0,78%), akathisie (0,78%) et le SJSR (0,78%). Le parkinsonisme représentait 2,36% (53cas). Les causes des MA étaient dégénératives (27,91%), idiopathiques (27,13%), vasculaires (13,95%), iatrogènes (11,63%). Le tremblement essentiel 57,14% (28cas) touchait surtout les sujets entre 25-60 ans et n'était pas associé à l'âge (p=0,795) ni aux antécédents familiaux (p=0,417). L'évolution des MA était marquée par leur amélioration partielle 33%, une rémission complète 10,85%, le décès 7,75%. Conclusion : Les MA sont fréquents en Neurologie au CHUD/B-A. Une prise en charge optimale est nécessaire pour améliorer la qualité de vie des patients.

Introduction: There are no published data on movement disorders in Benin. Objective: We aimed to study the descriptive epidemiology, the clinical spectrums and the evolution of MD in the university hospital center of Parakou (CHUD-B/A) in northern Benin in 2020. Material and methods: It was a descriptive cross-sectional study with data collection over 5 years from 07/01/2015 to 06/30/2020 in the neurology department of CHUD-B/A. Diagnosis and classifications of MD was made by a neurologist according to clinical criteria of the Consensus Statement of International Parkinson and Movements Disorders Society (MDS), Jinnah 2014 revised criteria for dystonia, Reich 2010 for other hyperkinetic MD and Allen 2003 criteria for restless legs syndrome (RLS). Statistical analysis was made by Epidata Analysis software. Results: 2250 patients were included. The mean age of patients with MD at diagnosis was 52.57 ± 20.77years with extremes of 1 to 80 years. The mean age at onset of symptoms was 49.16 ± 20.85years [1-80years]. The sex ratio was 2.58. The frequency of MD in the department was 5.73% (129/2250) and 6.68% (117/1805) in outpatients. The MD identified were: tremor 72.09%, akinesia and parkinsonism 41.08%, dystonia 7.75%, chorea 6.2%, myoclonus 3.1%, dyskinesia 2.33%, ballism 2.33%, athetosis 0.78%, akathisia 0.78% and RLS 0.78%. Parkinsonism accounted for 2.36% (53cases). The causes of MD were degenerative (27.91%), idiopathic (27.13%), vascular (13.95%), iatrogenic (11.63%). Essential tremor (28cases) affected patients between 25-60years (57.14%). Evolution was marked by partial improvement (33%), complete remission (10.85%), and death (7.75%). Conclusion: MD are common at CHUD-B/A. Optimal management is necessary to improve the quality of life of patients.

Aspects épidémiologiques du lymphome de Burkitt chez l'enfant à Bouaké / Epidemiological features of childhood Burkitt's lymphoma in Bouake

ntroduction.Le lymphome de Burkitt (LB) est le lymphome malin non hodgkinien le plus fréquent chez les enfants Africains. L'objectif de notre étude était d'étudierles caractéristiques épidémiologiques des enfants atteints de lymphome de Burkittà Bouaké.Méthodologie. Il s'agissait d'une étude rétrospective et transversale à visée descriptive réalisée sur une période de 5 ans (2017-2021) dans l'Unité de Cytologie et Biologie de la Reproduction du Laboratoire Central du Centre Hospitalier et Universitaire de Bouaké, Côte d'Ivoire.Toutes les cytoponctions de masse chez les enfants de moins de 15 ans chez qui l'on suspectait le LB ont été inclus dans notre étude. Les paramètres analysés étaient: l'incidence, l'âge, le sexe, le niveau socio-économique et le siège du LB. Résultats.Nous avons colligé 59 cas de lymphome de Burkitt, soit une incidence de 12 cas par an. L'âge moyen était de 10 ans avec des extrêmes de 4 et 15 ans. La tranche d'âge 8 et 11 ans (47,6 %) était la plus touchée. On notait une prédominance masculine avec un sex-ratio de 2,1. La majorité des patients (86,4 %) étaient issus de famille de niveau socio-économique faible. Le siège abdominal du lymphome de Burkitt était le plus fréquent avec 42,4% des cas, suivi des atteintes ganglionnaires (27,1%), maxillo-faciales(27,1%) et inguinoscrotales (3,4%).Conclusion.Le lymphome de Burkitt est le cancer pédiatrique le plus fréquent en Côte d'Ivoire. Il survient préférentiellement chez les garçons et siègeessentiellement dans la région abdominale.

Introduction.Burkitt lymphoma (BL) is the most common non-Hodgkin malignant lymphoma in African children. The objective of our study was to investigate the epidemiological characteristics of children with Burkitt lymphoma in Bouaké. Methodology.This was a retrospective and cross-sectional descriptive study conducted over a period of 5 years (2017-2021) in the Cytology and Biology of Reproduction Unit of the Central Laboratory of the University Hospital Center of Bouaké, Ivory Coast. All mass cytology samples in children under 15 years of age suspected of BL were included in our study. The parameters analyzed were: incidence, age, sex, socio-economic status, and location of BL. Results.We collected 59 cases of Burkitt lymphoma, with an incidence of 12 cases per year. The average age was 10 years with a range from 4 to 15 years. The age group of 8 to 11 years (47.6%) was the most affected. There was a male predominance with a sex ratio of 2.1. The majority of patients (86.4%) came from families with low socio-economic status. The abdominal location of Burkitt lymphoma was the most common at 42.4% of cases, followed by lymph node involvement (27.1%), maxillofacial (27.1%), and inguinoscrotal (3.4%). Conclusion.Burkitt lymphoma is the most common pediatric cancer in Ivory Coast. It predominantly affects boys, with a high incidence in the abdominal region.Affiliations

Association of vitamin D receptor gene polymorphisms with type 2 diabetes mellitus in Taif population: a case-control study / Associação de polimorfismos do gene do receptor de vitamina D com diabetes mellitus tipo 2 na população Taif: um estudo de caso-controle

Abstract Several reasons may underlie the dramatic increase in type2 diabetes mellitus. One of these reasons is the genetic basis and variations. Vitamin D receptor polymorphisms are associated with different diseases such as rheumatoid arthritis and diabetes. The aim of this study is to investigate the possible association of two identified mutations ApaI (rs7975232) and TaqI (rs731236). Eighty-nine healthy individuals and Fifty-six Type 2 Diabetic (T2D) patients were investigated using RFLP technique for genotyping and haplotyping as well. The distribution of Apal genotypes was not statistically significant among the control (P=0.65) as well as for diabetic patients (P=0.58). For Taql allele frequencies of T allele was 0.61 where of G allele was 0.39. The frequency distribution of Taql genotypes was not statistically significant among the control (P=0.26) as well as diabetic patients (P=0.17). Relative risk of the allele T of Apa1 gene is 1.28 and the odds ratio of the same allele is 1.53, while both estimates were < 1.0 of the allele G. Similarly, with the Taq1 gene the relative risk and the odds ratio values for the allele T are 1.09 and 1.27 respectively and both estimates of the allele C were 0.86 for the relative risk and 0.79 for the odds ratio. The pairwise linkage disequilibrium between the two SNPs Taq1/apa1 was statistically significant in control group (D = 0.218, D' = 0.925 and P value < 0.001) and similar data in diabetic groups (D = 0.2, D' = 0.875 and P value < 0.001). These data suggest that the T allele of both genes Apa1 and Taq1 is associated with the increased risk of type 2 diabetes. We think that we need a larger number of volunteers to reach a more accurate conclusion.

Resumo Várias razões podem estar subjacentes ao aumento dramático da diabetes mellitus tipo 2. Um desses motivos é a base genética e variações. Os polimorfismos do receptor da vitamina D estão associados a diferentes doenças, como artrite reumatoide e diabetes. O objetivo deste estudo é investigar a possível associação de duas mutações identificadas ApaI (rs7975232) e TaqI (rs731236). Oitenta e nove indivíduos saudáveis ​​e 56 pacientes com diabetes tipo 2 (T2D) foram investigados usando a técnica RFLP para genotipagem e haplotipagem também. A distribuição dos genótipos Apal não foi estatisticamente significativa entre o controle (P = 0,65), bem como para os pacientes diabéticos (P = 0,58). Para as frequências do alelo Taql, o alelo T foi de 0,61, onde o alelo G foi de 0,39. A distribuição de frequência dos genótipos Taql não foi estatisticamente significativa entre o controle (P = 0,26), bem como os pacientes diabéticos (P = 0,17). O risco relativo do alelo T do gene Apa1 é 1,28 e a razão de chances do mesmo alelo é 1,53, enquanto ambas as estimativas foram < 1,0 do alelo G. Da mesma forma, com o gene Taq1, os valores de risco relativo e razão de chances para o alelo T são 1,09 e 1,27, respectivamente, e ambas as estimativas do alelo C foram de 0,86 para o risco relativo e 0,79 para o odds ratio. O desequilíbrio de ligação par a par entre os dois SNPs Taq1 / apa1 foi estatisticamente significativo no grupo de controle (D = 0,218, D' = 0,925 e valor P < 0,001) e dados semelhantes em grupos diabéticos (D = 0,2, D' = 0,875 e valor P < 0,001). Esses dados sugerem que o alelo T de ambos os genes Apa1 e Taq1 está associado ao aumento do risco de diabetes tipo 2. Achamos que precisamos de um número maior de voluntários para chegar a uma conclusão mais precisa.

Association of vitamin D receptor gene polymorphisms with type 2 diabetes mellitus in Taif population: a case-control study

Abstract Several reasons may underlie the dramatic increase in type2 diabetes mellitus. One of these reasons is the genetic basis and variations. Vitamin D receptor polymorphisms are associated with different diseases such as rheumatoid arthritis and diabetes. The aim of this study is to investigate the possible association of two identified mutations ApaI (rs7975232) and TaqI (rs731236). Eighty-nine healthy individuals and Fifty-six Type 2 Diabetic (T2D) patients were investigated using RFLP technique for genotyping and haplotyping as well. The distribution of Apal genotypes was not statistically significant among the control (P=0.65) as well as for diabetic patients (P=0.58). For Taql allele frequencies of T allele was 0.61 where of G allele was 0.39. The frequency distribution of Taql genotypes was not statistically significant among the control (P=0.26) as well as diabetic patients (P=0.17). Relative risk of the allele T of Apa1 gene is 1.28 and the odds ratio of the same allele is 1.53, while both estimates were 1.0 of the allele G. Similarly, with the Taq1 gene the relative risk and the odds ratio values for the allele T are 1.09 and 1.27 respectively and both estimates of the allele C were 0.86 for the relative risk and 0.79 for the odds ratio. The pairwise linkage disequilibrium between the two SNPs Taq1/apa1 was statistically significant in control group (D = 0.218, D' = 0.925 and P value 0.001) and similar data in diabetic groups (D = 0.2, D' = 0.875 and P value 0.001). These data suggest that the T allele of both genes Apa1 and Taq1 is associated with the increased risk of type 2 diabetes. We think that we need a larger number of volunteers to reach a more accurate conclusion.

Resumo Várias razões podem estar subjacentes ao aumento dramático da diabetes mellitus tipo 2. Um desses motivos é a base genética e variações. Os polimorfismos do receptor da vitamina D estão associados a diferentes doenças, como artrite reumatoide e diabetes. O objetivo deste estudo é investigar a possível associação de duas mutações identificadas ApaI (rs7975232) e TaqI (rs731236). Oitenta e nove indivíduos saudáveis e 56 pacientes com diabetes tipo 2 (T2D) foram investigados usando a técnica RFLP para genotipagem e haplotipagem também. A distribuição dos genótipos Apal não foi estatisticamente significativa entre o controle (P = 0,65), bem como para os pacientes diabéticos (P = 0,58). Para as frequências do alelo Taql, o alelo T foi de 0,61, onde o alelo G foi de 0,39. A distribuição de frequência dos genótipos Taql não foi estatisticamente significativa entre o controle (P = 0,26), bem como os pacientes diabéticos (P = 0,17). O risco relativo do alelo T do gene Apa1 é 1,28 e a razão de chances do mesmo alelo é 1,53, enquanto ambas as estimativas foram 1,0 do alelo G. Da mesma forma, com o gene Taq1, os valores de risco relativo e razão de chances para o alelo T são 1,09 e 1,27, respectivamente, e ambas as estimativas do alelo C foram de 0,86 para o risco relativo e 0,79 para o odds ratio. O desequilíbrio de ligação par a par entre os dois SNPs Taq1 / apa1 foi estatisticamente significativo no grupo de controle (D = 0,218, D' = 0,925 e valor P 0,001) e dados semelhantes em grupos diabéticos (D = 0,2, D' = 0,875 e valor P 0,001). Esses dados sugerem que o alelo T de ambos os genes Apa1 e Taq1 está associado ao aumento do risco de diabetes tipo 2. Achamos que precisamos de um número maior de voluntários para chegar a uma conclusão mais precisa.

Screening for coronary artery disease using primary evaluation with coronary CTA in aviation medicine (SUSPECT): study design

Background: Sudden in-flight incapacitation of aircrew may cause an airplane crash. Important causes are major adverse cardiac events, such as myocardial infarction and sudden cardiac arrest. Aircrew of the Royal Netherlands Air Force (RNLAF) are required to undergo periodic cardiac screening, including bicycle exercise-testing. Unfortunately, this modality lacks diagnostic accuracy for relevant coronary artery disease (CAD) in low-risk populations similar to military aircrew. Cardiac CT, however, comprising Coronary Artery Calcium score (CACS) and coronary CT angiography (CCTA), is able to adequately detect (subclinical) CAD with high negative predictive values in low-risk populations and may provide opportunity for early interventions. Methods: This was a prospective, single-center, cohort study of 250 military aircrew. Asymptomatic aircrew ?40 years are asked to undergo a voluntary cardiac CT following routine aeromedical examination. Prevalence and severity of CAD will be described according to the CAD-RADS system, including coronary artery calcium score (CACS) and high risk plaque features. The primary endpoint is relevant CAD, defined as a composite of a coronary stenosis ?50% and/or CACS >100 Agatston Units. The secondary endpoint is ‘aeromedically significant CAD’, defined by national military regulations as a left main stenosis of >30%, any luminal stenosis ?50%, and/or an aggregate coronary stenosis of ?120%. Conclusions: The aim is to assess the value of cardiac CT for routine aeromedical screening in asymptomatic Dutch military aircrew aged ?40 years, in comparison to the current cardiac screening protocol which includes an exercise ECG. Trial Registration: Clinical trial registered on clinicaltrials.gov number NCT05508893.

A cross-sectional study on breast cancer awareness among female students in Al-Rayan colleges in Al Medina Al Munawara

Background: This study aims to evaluate breast cancer awareness among AL-Rayan colleges female students in Al Medina Al Munawara Methods: A cross-sectional study was conducted among 291 female students from Al-Rayan medical colleges in Al Medina Al Munawara, Saudi Arabia. Data was collected through an Arabic version of the modified breast cancer awareness measure (Breast CAM) version 2 which is a validated and reliable then administered online and distributed via social media platforms. Analysis was done by IBM SPSS version 28 and involved descriptive statistics, including frequency distributions and percentiles, while factors associated with awareness levels were analyzed using Kruskal-Wallis test and Mann-Whitney test Results: The participants' mean awareness level was 17.2±7.5 out of 31, out of the total participants 52.6% had a poor awareness level. Out of the participants surveyed, only 42.6%, accurately understood the recommended frequency of conducting self-examinations each month, as secondary prevention only 33% of participants were aware of the best time to start mammography. Only a limited percentage of participants (37.8% and 47.1% respectively) demonstrated knowledge of early menopause and late menopause as potential contributing factors. There was a significant relationship between awareness level and age (p=0.001) and academic year (p=0.001). Conclusions: The findings highlight the importance of continued efforts to educate and raise awareness about breast cancer and its early detection methods among young women. the study demonstrated varying levels of understanding among participants. The overall knowledge assessment indicated that a considerable proportion of participants had moderate knowledge of breast cancer.

Oral manifestations found among illicit drugs users

Illicit drug use is an intricate challenge that currently affects an individual's health and overall well-being. This review study provides insight into the availability of information regarding the examination of the signs, treatment approaches, and broader consequences related to health problems among individuals who use drugs. The clinical indicators of drug consumption on oral health encompass issues such as dry mouth (xerostomia), gum problems, teeth grinding (bruxism), and dental cavities. These manifestations contribute to immediate discomfort and elevate the risk of long-term dental complications, underscoring the pressing need for intervention and care. Effective management strategies involve a comprehensive approach, incorporating preventive measures, timely treatment, and a compassionate understanding of the unique challenges faced by drug users. Preventive efforts, such as education and regular dental check-ups, serve as critical components in mitigating the clinical manifestations. Treatment strategies, including restorative procedures and periodontal therapy, play a pivotal role in addressing immediate oral health concerns. However, the management of oral health issues extends beyond the dental chair. Acknowledging the hurdles faced by individuals who use drugs, including economic factors and social prejudice, underscores the significance of adopting a comprehensive approach to providing support and assistance. Integrating oral health services with substance abuse treatment presents a promising avenue for comprehensive healthcare. This collaborative approach addresses oral health issues and acknowledges the bidirectional relationship between substance abuse and oral health. In summary, it is essential to comprehend the relationship between illicit drug use and oral health. By implementing management strategies, we can potentially reduce suffering, improve quality of life, and enhance health for individuals affected by substance abuse. This holistic approach emphasizes the significance of acknowledging and addressing these population’s health requirements within a broader healthcare framework.

Fostering a safe psychological environment and encouraging speak-up culture in primary care setups

Patient safety is a critical concern in healthcare, and encouraging healthcare employees to speak up and voice their concerns plays a pivotal role in preventing avoidable harm to patients. Establishing a safe environment and fostering a supportive psychological climate within healthcare organizations, particularly in primary care settings, is essential for achieving better patient outcomes and enhancing overall organizational performance. This review emphasizes the importance of a safe environment and supportive psychological climate in primary care, enhancing patient outcomes and organizational performance. Speaking up leads to timely error correction, mitigates unsafe practices, and upholds ethical standards despite barriers like hierarchy, fear of retaliation, and inadequate policies. In the quest to foster a culture of speaking up, diverse interventions have emerged, ranging from comprehensive training initiatives to initiatives promoting psychological safety and establishing clear communication channels. Leadership development programs play a vital role in encouraging employee voices and fostering a positive environment for open communication. To advance further, research must evaluate intervention impact and contextual nuances for more tailored strategies. In conclusion, psychological safety is vital for speaking up and enhancing employee engagement, communication, and patient outcomes. Overcoming implementation challenges and fostering a culture of safety and open communication empower healthcare employees to contribute to continuous improvement in patient care. Leadership development plays a pivotal role in nurturing this culture envisioning a safer, compassionate healthcare ecosystem.