EXPLORING THE INCIDENCE AND PREVALENCE OF NEW-ONSET AUTOIMMUNE DISEASE FOLLOWING COVID-19 PANDEMIC: A SYSTEMATIC REVIEW.

The correlation between viral infections and the onset of autoimmune conditions has long attracted the scientific community. With the COVID-19 pandemic impacting the world like never before, we have a unique chance to better understand this complex disease and uncover its origin. In light of this, we performed a systematic review of the incidence and prevalence of newly diagnosed autoimmune diseases following the COVID-19 pandemic. We undertook an extensive literature review from 2012 to 2023, by using electronic databases such as Medline, Web of Science, PubMed, Cochrane Library, and supplementary sources like scholarly articles. Our review encompassed various types of studies, including trials, commentaries, and editorials. To evaluate bias, we adopted a recommended approach, employing a two-part tool to scrutinize five distinct domains: selection bias, performance bias, attrition bias, selective reporting, and other biases. In this review, a total of 14 studies were incorporated. On the basis of the findings of the present investigation, the average age of included patients was approximately 56.13 years, and the maximum were male. After the, meticulous examination we stated that there was a significant increase in inflammatory biomarkers, including ferritin, C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer and Interleukins IL-6. The majority of patients had an elevated level of CRP. We conclude that there is a strong association between COVID-19 and a higher risk of various types of autoimmune diseases. In order to develop effective plans for the current pandemic as well as the post-pandemic period that follows, healthcare providers must recognize these autoimmune manifestations.

SIGNIFICANCE OF NEUTROPHIL-LYMPHOCYTE RATIO AND PLATELET-LYMPHOCYTE RATIO AS PROGNOSTIC MARKERS OF DISEASE SEVERITY IN SYSTEMIC LUPUS ERYTHEMATOSUS.

Managing systemic lupus erythematosus (SLE) is challenging because of its diverse symptoms, relapses, and issues related to immunosuppressive therapy. Hence, the management of autoimmune disorder has become a hot topic in this era. Thus, the study aims to predict disease severity in SLE cases by assessing the value of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio. In this study, we included a total of 80 patients, of which 40 were controls and 40 were experimental group. We gathered the demographic data and each patient provided informed consent. Furthermore, the clinical examinations were done, and results were noted. The study compared 40 SLE patients with 40 controls. SLE patients had lower complement levels, higher rates of LN and encephalopathy, and elevated Hs-CRP and ESR. They also showed lower WBC, neutrophil, lymphocyte, and platelet counts, along with higher NLR and PLR. Higher SLEDAI scores correlated with elevated Hs-CRP and ESR, and lower C3. Neutrophils positively correlated with NLR, while lymphocytes negatively correlated with SLEDAI scores, NLR, and PLR. Platelets did not significantly correlate with these markers. SLE patients showed higher rates of LNand encephalopathy, elevated inflammatory markers, and altered blood cell counts. Lower SLEDAI scores correlated with less inflammation and higher C3 levels, potentially indicating disease severity. Neutrophils were closely linked to disease activity, while lymphocytes showed a strong negative correlation. Platelet count was not a significant marker. Understanding these aspects could improve diagnosis and management.

Steroidogenic enzyme gene expression and testosterone production are developmentally modulated by bone morphogenetic protein receptor-1B in mouse testis.

Bone morphogenetic proteins (BMPs) and receptors (BMPR-1A, BMPR-1B, BMPR-2) have been shown to be vital for female reproduction, while their roles in males are poorly described. Our study was undertaken to specify the function of BMPR-1B in steroidogenic enzyme gene expression, testosterone production and reproductive development in male mice, given that Bmpr1b mRNA is expressed in mouse testis and Bmpr1b knockout results in compromised fertility. Male mice were passively immunized for 6 days with anti-BMPR-1B in the presence or absence of exogenous gonadotrophins. We then measured the effects of anti-BMPR-1B on testicular hydroxysteroid dehydrogenase isoforms (Hsd3b1, Hsd3b6, and Hsd17b3) and aromatase (Cyp19) mRNA expression, testicular and serum testosterone levels, and testis and seminal vesicle weight. In vitro testosterone production in response to anti-BMPR-1B was determined using testicular culture, and Leydig cell culture in the presence or absence of gonadotrophins. In Leydig cell culture the contribution of seminiferous tubules and Leydig cells were examined by preconditioning the media with these testicular constituents. In adult mice, anti-BMPR-1B increased testosterone and Hsd3b1 but decreased Hsd3b6 and Cyp19 mRNA. In adult testicular culture and seminiferous tubule conditioned Leydig cell culture, anti-BMPR-1B reduced testosterone, while in normal and Leydig cell conditioned Leydig cell culture it increased testosterone levels. In pubertal mice, anti-BMPR-1B reduced gonadotrophin stimulated seminal vesicle growth. In conclusion, BMPR-1B has specific developmental functions in the autocrine and paracrine regulation of testicular steroidogenic enzyme gene expression and testosterone production in adults and in the development of seminal vesicles during puberty.

Effect of incident angle on weld microstructure and mechanical properties of laser beam welded nitronic -50 austenitic stainless steel joints.

3 mm thick nitronic-50 stainless steel sheets were successfully butt-joined using a 2 kW fiber laser beam welding. Three weld joints were fabricated for different incident angles, namely, 70°, 80° and 90° for the other constant welding process parameters. The effect of incident angle on the weld bead geometry, microstructure evolution, and strength of the laser beam welded joints was studied in detail. The incident angle significantly affected the bead geometry and its orientation. Lowering the incident angle beyond a limit caused the beam shift near the weld root of the joint, where the bead was formed away from the joint line resulting in improper fusion and a defective weld occurred. The microstructure transformed from columnar to an equiaxed dendritic structure at the center of the weld nugget for lower incident angles. Skeletal and lathy ferrite was observed in the joints' weld zone. However, the fraction of lathy ferrite was higher at lower incident angles due to a faster cooling rate. A higher weld joint strength of 1010 MPa (97% of the base metal UTS) was achieved at an 80° incident angle, owing to the formation of more equiaxed dendritic grains and the absence of the secondary phases. All of the tensile test samples showed evidence of ductile failure, and overall, an acceptable level of elongation was achieved.

Effect of low dose phenylephrine infusion on shivering and hypothermia in patients undergoing cesarean section under spinal anesthesia: a randomized clinical trial.

BACKGROUND: Shivering is a common complication of spinal anesthesia. Phenylephrine, due to its peripheral vasoconstrictive effect, may limit the core to periphery redistribution of body temperature following spinal anesthesia, and reduce hypothermia and shivering. We hypothesized that prophylactic phenylephrine infusion would reduce shivering and hypothermia in women undergoing cesarean section under spinal anesthesia. METHODS: A two-arm randomized, double-blind, placebo-controlled trial in term pregnant patients undergoing cesarean section. In the phenylephrine group (n=75) prophylactic phenylephrine infusion was administered at 25 µg/min immediately after initiation of spinal anesthesia and continued until the end of the operative period. In the placebo group (n=75) a normal saline infusion was administered during the same period. The primary outcome was the incidence of shivering; secondary outcomes were severity of shivering, changes in nasopharyngeal (core) temperature, and incidence of hypotension and bradycardia. RESULTS: The incidence of shivering in the phenylephrine and control groups was 24.0% (95% CI 14.3% to 33.7%) and 53.3% (95% CI 42.0% to 64.6%), respectively. The severity of shivering was greater in the control group (P=0.002) and the mean (±SD) end of surgery core temperature was significantly higher in the phenylephrine group (35.84°C ±â€¯0.60) compared with controls (35.61°C ±â€¯0.48) (P=0.009). The incidence of hypotension was higher in controls (53.4% vs. 2.7%; P <0.001) but bradycardia more frequent in group P (P=0.023). CONCLUSION: The incidence of shivering and degree of hypothermia were significantly reduced by a prophylactic phenylephrine infusion during cesarean section under spinal anesthesia.

A rare case of duodenal inversum- A laparoscopically manageable entity.

Duodenal inversum is a rare disease not frequently encountered in clinical practice. The diagnosis is usually made late due to its rarity. Many other causes of abdominal pain like ulcer disease, pancreatitis, malrotation are mostly thought of initially and the diagnosis is usually missed. Only a few cases of duodenal inversum present with outlet obstruction. Duodenojejunostomy is perhaps the ideal management for duodenal inversum if the patient presents with outlet obstruction. Our intention is to create awareness of such a rare disease with an available definitive treatment option in the form of minimally invasive surgery. One such case of a 31-year-old man is described that was successfully managed by laparoscopic duodenojejunostomy.

Facile synthesis of metal nanoparticle-loaded polymer nanocomposite with highly efficient an optically enhanced biocidal and anticancer agents.

In this work, we prepared silver nanoparticles (AgNPs)-loaded poly(2,5-dimethoxyaniline;PDMA) nanocomposite via a simple chemical oxidative method to develop new effective biocidal and anticancer agents systems. In situ UV-vis and fluorescence spectroscopy has been used to monitor the formation of PDMA/Ag is strongly dependent on the concentration of PDMA in the present system. The FTIR and XRD studies exhibit that the rate of polymer formation and oxidation state of PDMA/Ag nanocomposite, which confirmed the AgNPs is strongly binding with the PDMA matrix. SEM and EDAX analysis revealed the presence of uniform size and the highest percentage of AgNPs (42.1%) in the PDMA/Ag nanocomposite. TEM and size distribution analysis revealed the presence of spherical AgNPs with an average diameter of 25 nm in the PDMA/Ag nanocomposite. In addition, the PDMA polymer with embedded AgNPs exhibited excellent antibacterial performance against Escherichia coli and Staphylococcus aureus. Interestingly, the prepared PDMA/Ag nanocomposite exhibited enhanced bactericidal performance compared with the PDMA polymer, presumably because of the antibacterial properties of the AgNPs substrate. The anticancer effects of combined treatment with PDMA polymer and AgNPs were evaluated using a series of cellular and biochemical assays. The findings from this study revealed that the PDMA/Ag nanocomposite treatment significantly inhibited cell viability and proliferation of the human cervical cancer cell line (HeLa). The PDMA/Ag nanocomposite exhibits better antibacterial and anticancer activities compare to pristine PDMA.

Assessment of patient medication adherence among the type 2 diabetes mellitus population with peripheral diabetic neuropathy in South India.

OBJECTIVES: The present study attempted to explore the relationship between non-adherence with medication and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus (DM) in a private hospital located in South India. METHODS: A prospective study was carried out from January 2015 to December 2015. This study included 86 type 2 DM patients with diabetic peripheral neuropathy. The patients were followed-up for three months, once a month. Blood samples were taken to test for fasting blood sugar (FBS), postprandial blood sugar (PPBS) and HbA1c. A Morisky scale questionnaire was used to assess patients' medication adherence and a biothesiometer was used to screen the degree to which patients were affected by diabetic peripheral neuropathy. Patient counselling, which focused on the need for maintaining glycaemic control and the importance of medication adherence, was carried out during each follow-up. RESULTS: Of the 120 screened subjects, 86 patients were included in the present study. A majority (76.7%) were overweight, and 51% had DM for the past 11-15 years. ANOVA was used to compare patients' glycaemic status, peripheral diabetic neuropathy screening and medication adherence in all three follow-up visits, and p < 0.0001 was considered as significant. Significant improvement in medication adherence and reduction of the peripheral diabetic neuropathy severity (p < 0.0001) were observed from patients' first to third visits. CONCLUSIONS: Patient education is prudent for improving medication adherence, a result that can potentially promote optimal glycaemic control and can reduce the prevalence of diabetic peripheral neuropathy in patients with DM. Health-care practitioners play a pivotal role in educating the diabetic population about medication adherence.

Bilateral disciform keratitis in Reiter's syndrome.

Reiter's syndrome is commonly associated with conjunctivitis and rarely with uveitis. Bilateral disciform keratitis at presentation is a very rare manifestation in Reiter's syndrome. A 13-year-old boy developed bilateral disciform keratitis with oligoarthritis following an episode of conjunctivitis. In addition he had suspected bacterial keratitis with hypopyon in the left eye as a possible secondary infection of an epithelial defect that is a feature of Reiter's keratitis. Empirical treatment with intensive topical antibiotics as a therapeutic trial completely resolved the hypopyon and the disciform keratitis settled with topical steroid treatment. The patient achieved a best corrected vision of 20/20 in both the eyes 6 weeks after the treatment. Bilateral disciform keratitis can occur as a complication of Reiter's syndrome. Also the possibility of secondary infection of the epithelial defect needs to be borne in mind.

Postnatal expression of bone morphogenetic proteins and their receptors in the mouse testis.

TGF-beta superfamily members including bone morphogenetic proteins (BMPs) and their receptors (BMPR-1A, -1B and -2) have been shown to be important for reproductive function in both males and females, while information on the role of BMPs in males is limited. Functional studies on select BMPs and BMP receptors have demonstrated vital roles for these proteins in somatic and germ cell proliferation, steroidogenesis and overall fertility. In order to gain insight into the importance of these genes during postnatal reproductive development in males, our study was undertaken to specify the distribution of BMP and BMPR mRNA in male reproductive and steroidogenic tissues and quantify these genes in the testis using the mouse as our model. We screened testis at two, four, six and eight weeks of age for the expression of ten BMPs and three BMP receptors using RT-qPCR. All three BMP receptor mRNAs - Bmpr1a, Bmpr1b and Bmpr2, and ten BMP mRNAs - Bmp2, Bmp3, Bmp3b, Bmp4, Bmp5, Bmp6, Bmp7, Bmp8a, Bmp8b and Bmp15 were expressed in mouse testis at all stages screened. Testicular expression of genes varied within age groups and at specific developmental stages. Our study establishes an extensive BMP system in mouse reproductive and steroidogenic tissues.

An updated view of leptin on implantation and pregnancy: a review.

The hormone leptin, which is thought to be primarily produced by adipose tissue, is a polypeptide that was initially characterized by its ability to regulate food intake and energy metabolism. Leptin appears to signal the status of body energy stores to the brain, resulting in the regulation of food intake and whole-body energy expenditure. Subsequently, it was recognized as a cytokine with a wide range of peripheral actions and is involved in the regulation of a number of physiological systems including reproduction. In the fed state, leptin circulates in the plasma in proportion to body adiposity in all species studied to date. However other factors such as sex, age, body mass index (BMI), sex steroids and pregnancy may also affect leptin levels in plasma. In pregnant mice and humans, the placenta is also a major site of leptin expression. Leptin circulates in biological fluids both as free protein and in a form that is bound to the soluble isoform of its receptor or other binding proteins such as one of the immunoglobulin superfamily members Siglec-6 (OB-BP1). Although the actions of leptin in the control of reproductive function are thought to be exerted mainly via the hypothalamic-pituitary-gonadal axis, there have also been reports of local direct effects of leptin at the peripheral level, however, these data appear contradictory. Therefore, there is a need to summarize the current status of research outcomes and analyze the possible reasons for differing results and thus provide researchers with new insight in designing experiments to investigate leptin effect on reproduction. Most importantly, our recent experimental data suggesting that reproductive performance is improved by decreasing concentrations of peripheral leptin was unexpected and cannot be explained by hypotheses drawn from the experiments of excessive exogenous leptin administration to normal animals or ob/ob mice.

Bilateral infectious keratitis after a laser in situ keratomileusis enhancement procedure.

We report a case of bilateral infectious keratitis occurring as a complication of bilateral simultaneous laser in situ keratomileusis enhancement procedures. Corneal scraping from the interface of both eyes grew Staphylococcus aureus. The infection cleared after treatment with fortified cefazolin, fortified gentamicin, and ciprofloxacin eyedrops. The patient was left with bilateral paracentral corneal scars. When bilateral surgery is performed, bilateral infection may occur as a rare complication.