Incidence of local breast cancer recurrence with delayed radiation therapy.

BACKGROUND: The purpose of this research was to examine the probability of ipsilateral breast cancer recurrence in individuals whose RT was delayed after the first chemotherapy and surgery. PURPOSE: To analyze the effect of delaying RT for breast cancer patients (by more than 6 weeks after treatment). METHODOLOGY: A retrospective analysis comprised 136 female breast cancer patients treated at the Baghdad Centre for Radiation Oncology and Nuclear Medicine from 2021 to May 2022. External beam radiation was started more than 6 weeks after chemotherapy was finished for all patients who also had surgery. Clinical examination and ultrasound were part of the follow-up process. RESULTS: Patients' ages varied from 28 to 71, and the majority (83%) had a mastectomy. The majority of cases (95.5%) were diagnosed as invasive ductal carcinoma on histopathology, with 49.6% being at stage 2 and 42.6% being at stage 3. Seventy-six percent of patients tested positive for hormones. Although 10 patients (7.35%) acquired distant metastases within 5 years, only 2 (1.47%) had local recurrence because of the delay in RT. Specifically, 91.1% had complete local control with no evidence of disease spread. CONCLUSION: Delaying RT by more than 6 weeks in patients with breast cancer did not substantially affect local control, according to the results of a new research, the first of its type in Iraq.

Evaluating the potential mediating role of ADAMTS13 activity in the relationship between obesity and the severity of COVID-19: A retrospective cohort study.

Obesity and low enzyme A disintegrin and metalloproteinase with thrombospondin type-1 motif-13 (ADAMTS13) activity have been linked to poor coronavirus disease 2019 (COVID-19). Given that obesity may influence ADAMTS13 activity, it is feasible; however, it remains unclear whether ADAMTS13 activity acts as a mediator between obesity and COVID-19 outcomes. We investigated the link between body mass index (BMI) and COVID-19 outcomes, using ADAMTS13 activity as a mediator. ADAMTS13 activity was measured in 86 hospitalized COVID-19 patients. BMI, ADAMTS13 activity, and COVID-19 outcomes were assessed. Obese patients had a high odds ratio for low ADAMTS13 levels. When different levels of ADAMTS13 activity were considered, the severity of COVID-19 in obese patients was 4.5 times that in the normal BMI group. Furthermore, increased coagulopathy indicators correlated with low ADAMTS13 activity. Patients with elevated ALT and AST levels showed a 3 to 4-fold increase in the chances of low ADAMTS13 activity (OR:3.19, 95% CI:1.22-8.90, P = .021; OR:2.17, 95% CI:0.91-5.27, P = .082, respectively). When ADAMTS13 activity was considered, obese patients had greater COVID-19 severity and slower viral clearance than those with normal BMI. Low ADAMTS13 activity and impaired liver function are associated with poor COVID-19 outcomes. These findings encourage researchers to use molecular component identification to study the effects of obesity on the von Willebrand factor (VWF)/ADAMTS13 axis, COVID-19 pathogenesis, and outcomes.

Impact of aerobic and resistance training on fatigue, quality of life, and physical activity in prostate cancer patients: a systematic review and meta-analysis.

BACKGROUND: Prostate cancer (PCa) is a prevalent cancer with significant morbidity and mortality rates. In most cases, prostate cancer remains asymptomatic until advanced disease manifests with symptoms, such as benign prostate hyperplasia (BPH). Timely detection and better management have improved overall survival in patients with prostate cancer, and fatigue, reduced physical activity, and impaired quality of life (QoL) remain major challenges that impact daily life. OBJECTIVE: This study aimed to systematically review and conduct a meta-analysis to evaluate the impact of aerobic and resistance training on fatigue, quality of life, and physical activity in prostate cancer patients undergoing treatment. MATERIAL METHODS: A comprehensive literature search was conducted using the PubMed, Cochrane Library, and clinicaltrials.gov databases, adhering to the PRISMA guidelines. Twenty studies, involving 1393 participants, were included in the final analysis. The inclusion criteria were Studies that evaluated the effects of exercise interventions relative to passive controls in patients with prostate cancer were included. The primary outcomes of interest were fatigue, QoL, and PA.. Data from eligible studies were extracted, and a meta-analysis was performed using RevMan 5.40. RESULTS: Twenty studies met our inclusion criteria. Data Analysis of the included studies demonstrated a significant improvement in quality of life among prostate cancer patients in the exercise group compared to the control group (SMD=0.20, 95% CI=0.07 to 0.34, P=0.003). However, there was no significant association between exercise and fatigue (SMD=0.07, 95% CI=-0.13, 0.26, P=0.51). Sensitivity analysis did not alter these findings. Regarding physical activity outcomes, the control group exhibited superior performance in the 400-meter walk test (P<0.05). No significant associations were found between exercise and the 6-meter walk test or up-and-go time. CONCLUSION: This systematic review revealed that aerobic and resistance training enhance the quality of life of patients with prostate cancer, although it has a limited impact on fatigue and physical activity levels. These findings advocate a shift in clinical practice and positioning exercise as a core component of comprehensive cancer care. Tailoring exercise regimens according to individual patient needs and treatment stages should become the norm in treatment planning. This approach goes beyond physical wellness and addresses the psychological and emotional facets of cancer management. Moreover, there is an evident need for further research to develop holistic exercise interventions that effectively address the complex dynamics of fatigue, physical activity, and QoL in this patient group.

Interleukin-6 and the determinants of severe COVID-19: A retrospective cohort study.

Cytokines, notably interleukin-6 (IL-6), increase considerably in patients with severe corona virus disease 2019 (COVID-19). This vigorous immune response may cause end-organ failure or death; hence, measuring IL-6 in the context of patient characteristics may help predict outcomes and encourage early comprehensive therapy. This study investigated the association between serum IL-6 levels, COVID-19 severity, and demographic, clinical, and biochemical characteristics. COVID-19 inpatients in NMC hospitals were investigated between November 2020 and November 2021. Several patient variables related to serum IL-6 and COVID-19 severity have been examined. The study included 374 COVID-19 inpatients, 235 of whom had severe disease with a median age of 51. The elderly had an increased risk of severe COVID-19 (73.8%) compared with young adults (71%), with higher white blood cells, D-dimer, Lactate dehydrogenase, creatinine, ferritin, prothrombin time, Procalcitonin, and fibrinogen levels (P < .001). C-reactive protein, troponin, intensive care unit admission, disease severity score, and mortality were significantly associated with higher serum IL-6 levels (P = .05) in the univariate analysis, but this significance disappeared in the multivariate analysis. IL-6, along with other demographic and clinical variables affected COVID-19 severity. These characteristics may predict patients at risk of severe disease and assist in establishing early comprehensive disease outcome strategies. Large-scale clinical research is needed to emphasize IL-6 and COVID-19.

Intestinal tuberculosis and inflammatory bowel disease; the usual challenging differential diagnoses: A case report.

Intestinal Tuberculosis (TB) is a very rare presentation of TB, presenting with a nonspecific symptom that mimics Crohn's disease, making diagnosis challenging. We present a case of intestinal tuberculosis in a 37-year-old female who had long-term abdominal pain and diarrhea and showed all the signs of inflammatory bowel disease (IBD) during a thorough clinical, endoscopic, radiologic, and histologic examination. Seven months of right mid- and lower-abdominal discomfort brought a 37-year-old woman to our hospital with pain, diarrhea, bloating, and tiredness worsening after meals. A CT scan of the abdomen highly suggested inflammatory bowel disease. A colonoscopy revealed a patulous ileocecal valve with terminal ileum ulcerations, ileal stenosis, cecum, and valve ulcers, where biopsies findings suggesting also IBD. While planned to start mesalazine; PCR TB testing of biopsy material confirmed tuberculosis. She recovered well following conventional intestinal TB therapy. Intestinal TB is called the great mimicker because its symptoms resemble different illnesses. Misdiagnosis can lead to incorrect treatment, life-threatening complications, and mortality. This paper's radiology, macroscopy, and histopathology highly suggested Crohn's disease, however, intestinal TB was the diagnosis. TB quadrable treatment significantly benefited patients. Consider intestinal TB in this scenario, especially in patients coming from endemic TB areas is highly recommended. The importance of our case report is increasing the awareness that intestinal TB can mimic inflammatory bowel disease and other disorders such as chronic disease and malignancy, for which the treatment is completely different and could lead to fetal outcome; therefore, we should maintain a high level of suspicion when evaluating patients with nonspecific symptoms, particularly in endemic areas of the disease, to obtain a correct diagnosis and appropriate treatment.

Impact of Growth Temperature of Lead-Oxide Nanostructures on the Attenuation of Gamma Radiation.

Chemical bath deposition (CBD) technique is utilized to grow lead-oxide (PbO) nanostructures (NSs) over PbO seed fabricated by physical vapor deposition (PVD) method on glass substrates. The effect of growth temperatures 50 and 70 °C on the surface topography, optical properties, and crystal structure of lead-oxide NSs has been studied. The investigated results suggested that the growth temperature has a huge and very considerable influence on the PbO NS, and the fabricated PbO NS has been indexed as the Pb3O4 polycrystalline tetragonal phase. The crystal size for PbO thin films grown at 50 °C was 85.688 nm and increased to 96.61 nm once the growth temperature reached 70 °C. The fabricated PbO nanofilms show a high rate of transmittance, which are ∼70 and 75% in the visible spectrum for the films deposited at 50 and 70 °C, respectively. The obtained Eg was in the range of 2.099-2.288 eV. Also, the linear attenuation coefficient values of gamma-rays for shielding the Cs-137 radioactive source increased at 50 °C. The transmission factor, mean free path, and half-value layer are reduced at a higher attenuation coefficient of PbO grown at 50 °C. This study evaluates the relationship between synthesized lead-oxide NSs and the radiation energy attenuation of gamma-rays. This study provided a suitable, novel, and flexible protective shield of clothes or an apron made of lead or lead oxide to protect against ionizing radiation that meets safety rules and protects medical workers from ionizing radiation.

Agricultural Robot-Centered Recognition of Early-Developmental Pest Stage Based on Deep Learning: A Case Study on Fall Armyworm (Spodoptera frugiperda).

Accurately detecting early developmental stages of insect pests (larvae) from off-the-shelf stereo camera sensor data using deep learning holds several benefits for farmers, from simple robot configuration to early neutralization of this less agile but more disastrous stage. Machine vision technology has advanced from bulk spraying to precise dosage to directly rubbing on the infected crops. However, these solutions primarily focus on adult pests and post-infestation stages. This study suggested using a front-pointing red-green-blue (RGB) stereo camera mounted on a robot to identify pest larvae using deep learning. The camera feeds data into our deep-learning algorithms experimented on eight ImageNet pre-trained models. The combination of the insect classifier and the detector replicates the peripheral and foveal line-of-sight vision on our custom pest larvae dataset, respectively. This enables a trade-off between the robot's smooth operation and localization precision in the pest captured, as it first appeared in the farsighted section. Consequently, the nearsighted part utilizes our faster region-based convolutional neural network-based pest detector to localize precisely. Simulating the employed robot dynamics using CoppeliaSim and MATLAB/SIMULINK with the deep-learning toolbox demonstrated the excellent feasibility of the proposed system. Our deep-learning classifier and detector exhibited 99% and 0.84 accuracy and a mean average precision, respectively.

Long COVID-19 prevalence among a sample of infected people in Erbil city.

BACKGROUND: Long-term effects of the disease were founded and described as post-COVID-19 syndrome post-COVID syndrome are the symptoms that develop and last for four weeks or even months and cannot be explained by an alternative diagnosis; symptoms may remain for >3 months. The cause of persistent symptoms is unclear. Objectives: This study aimed to Estimate the prevalence of residual symptoms among a sample of people infected with COVID-19 who survived and recovered in Erbil city and to find out the relation between the severity of the disease and post-COVID-19 syndrome. And to know the incidence of post-COVID-19 syndrome in chronic disease patients. PATIENTS AND METHODS: This cross-sectional study was conducted in 6 primary health care centers in 6 municipalities in Erbil city, Kurdistan region, Iraq. A convenience sample of randomly selected 300 patients was involved in the study depending on inclusion criteria. For one year, starting from March 1, 2021, until the end of February 2022. RESULTS: The prevalence of post-COVID syndrome among the 300 cases was 54.67%. Of these cases, 11.7% had one symptom, 26% had two signs, and 17% had with three or more symptoms. There was a significant statistical association between persistent symptoms and the severity of COVID-19. Also, there was a substantial statistical association between persistent symptoms and chronic disease, most (67.9%) respondents with post-COVID-19 syndromes suffered from chronic disease, and the p-value was 0.001. There was a significant statistical association between persistent symptoms and disease duration; most (73%) of cases with post-COVID-19 syndrome got the disease from 7 to 14 days, while 54.5% of them struggled with COVID-19 for >14 days. CONCLUSION: Most people who have recovered from COVID-19 have many long-lasting symptoms that make it hard to go about their daily lives. This is now called a post-COVID syndrome. Getting to this status could have been caused by several things. Age, gender, whether a person has a chronic disease, disease severity, and duration are all things to consider, Even though all COVID-19 victims should be kept an eye on for long-term evaluation and treatment of post-COVID symptoms.

Fabrication and Characterization of High-Quality UV Photodetectors Based ZnO Nanorods Using Traditional and Modified Chemical Bath Deposition Methods.

Ultraviolet (UV) photodetectors (PDs) based on high-quality well-aligned ZnO nanorods (NRs) were fabricated using both modified and conventional chemical bath deposition (CBD) methods. The modified chemical bath deposition (M-CBD) method was made by adding air bubbles to the growth solution during the CBD process. The viability and effectiveness of M-CBD were examined by developing UV PDs based on ZnO NRs. The ZnO nano-seed layer was coated on a glass substrate utilizing radiofrequency (RF) sputtering. The impact of the different growth-times on morphology, growth rate, crystal structure, and optical and chemical properties were investigated systematically using different characterization techniques, such as field-emission scanning electron microscopy (FE-SEM), X-ray diffraction (XRD) analysis, UV-VIS double beam spectrometer, and energy dispersive X-ray analysis (EDX), respectively. The Al/ZnO UV PDs based on ZnO nanorods were fabricated with optimum growth conditions through the two methods of preparation. This study showed that the synthesized ZnO NRs using the M-CBD method for different growth times possess better properties than the conventional method under similar deposition conditions. Despite having the highest aspect ratio and growth rate of ZnO NRs, which were found at 4 h growth duration for both methods, the aspect ratio of ZnO NRs using the M-CBD technique was comparatively higher than the conventional CBD method. Besides, the UV PDs fabricated by the M-CBD method at 5 V bias voltage showed high sensitivity, short response time, quick recovery time, high gain, low dark current, and high photocurrent compared with the UV PD device fabricated by the conventional CBD method.

A severe refractory COVID-19 patient responding to convalescent plasma; A case series.

INTRODUCTION: Although some medicines are under research, currently, no specific antiviral drug has been approved to target 2019 novel coronavirus. In this report two severe cases of 2019 novel coronavirus disease (COVID-19) patients have been described who received convalescent plasma (CP). CASE REPORT: Two male cases (a 46-year-old and a 56-year-old) after being diagnosed with severe COVID-19, they deteriorated despite supportive care and antiviral therapy. They started to improve with CP infusion both clinically and radiologically. Finally they were discharged in a very well condition with negative virology tests. CONCLUSION: CP might be an effective therapy for severe COVID-19 patients.

Predominance and association risk of Blastocystis hominis subtype I in colorectal cancer: a case control study.

BACKGROUND: Blastocystis, a genetically diverse intestinal parasite with controversial pathogenic potential, has increasingly been incriminated for diarrheal illness in immunocompromised individuals including colorectal cancer (CRC) patients. The aim of the current study was to assess the possible association between Blastocystis infection and CRC condition in Makkah, Saudi Arabia (KSA). METHODS: Stool samples were collected from 80 non-cancer (NC) and 138 cancer subjects including 74 CRC patients and 64 patients with other cancers outside gastrointestinal tract (COGT). Molecularly confirmed Blastocystis isolates were genetically grouped and subtyped using multiplex polymerase chain reaction with restriction fragment length polymorphism (PCR-RFLP) and sequence-tagged site primers-based PCR (PCR-STS), respectively. RESULTS: Blastocystis hominis were confirmed in 29.7, 25 and 15% among CRC, COGT and NC patients, respectively. Obtained Blastocystis isolates were initially categorized into 2 groups (A and C), which were subsequently subtyped into 3 different subtypes; subtype-I (38%), subtype-II (44%) and subtype-V (22%). Interestingly, subtype-I was the most predominantly detected subtype (54.5%) among CRC patients with a significant association risk (COR 7.548; 95% CI: 1.629-34.987; P = 0.004). CONCLUSION: To the best of our knowledge, the current study is the first to provide genetic insights on the prevalence of Blastocystis hominis among CRC patients in Makkah, KSA. Moreover, the study suggests for a possible association between subtype-I of Blastocystis hominis and CRC, which could indicate a potential influence of Blastocystis on CRC condition. Further studies are required to confirm this association risk and to investigate the possible underlying mechanism of postulated carcinogenic influence of Blastocystis hominis subtype-I.

A wireless emergency telemedicine system for patients monitoring and diagnosis.

Recently, remote healthcare systems have received increasing attention in the last decade, explaining why intelligent systems with physiology signal monitoring for e-health care are an emerging area of development. Therefore, this study adopts a system which includes continuous collection and evaluation of multiple vital signs, long-term healthcare, and a cellular connection to a medical center in emergency case and it transfers all acquired raw data by the internet in normal case. The proposed system can continuously acquire four different physiological signs, for example, ECG, SpO2, temperature, and blood pressure and further relayed them to an intelligent data analysis scheme to diagnose abnormal pulses for exploring potential chronic diseases. The proposed system also has a friendly web-based interface for medical staff to observe immediate pulse signals for remote treatment. Once abnormal event happened or the request to real-time display vital signs is confirmed, all physiological signs will be immediately transmitted to remote medical server through both cellular networks and internet. Also data can be transmitted to a family member's mobile phone or doctor's phone through GPRS. A prototype of such system has been successfully developed and implemented, which will offer high standard of healthcare with a major reduction in cost for our society.

Experimental study for early diagnosis of prepatent schistosomiasis mansoni by detection of free circulating DNA in serum.

Sensitive and specific diagnostic methods of schistosomiasis at an early stage of infection are crucial to avoid irreversible pathological reactions induced by eggs. This study aimed to evaluate the PCR technique for detection of free circulating Schistosoma mansoni DNA in serum in the early prepatent period in experimentally infected mice, in comparison to the commonly used indirect hemagglutination assay (IHA) for the detection of bilharzial antibody and stool examination. Sixty-four mice were experimentally infected with S. mansoni, and every 3 or 4 days through the 8 weeks postinfection (p.i.), serum samples were collected from randomly chosen four infected mice, then pooled and examined for circulating DNA and bilharzial antibody. The results showed that the earliest deposition of eggs in the small intestine was observed at the fifth week p.i., and the eggs were detected in feces in the seventh week p.i. PCR detected free circulating DNA of S. mansoni starting from the third day p.i., while IHA failed to detect infection up to the eighth week p.i. It is concluded that detection of free circulating DNA by PCR can be used as a valuable test for early diagnosis of prepatent S. mansoni infection.

Growth kinetics, antigen profiling, and proteinase activity of Egyptian Trichomonas tenax isolates derived from patients having oral infections.

The role of Trichomonas tenax as a pathogen had been clearly implicated in various pathological processes that arise outside the boundaries of the mouth. Although a relationship between the increased occurrence of this protozoan and progression of periodontal disease has been demonstrated, the ability of T. tenax in causing oral infections and the precise mechanism of tissue damage is not well known. The present study aimed to investigate different isolates of T.tenax from individuals having oral infections. Plaques and/or calculi samples were collected from 70 individuals who were diagnosed as having periodontitis and/or gingivitis, then subjected to parasitological examination and culture on modified trypticase, yeast and iron medium (TYI-S-33). Isolates successfully maintained in culture were further subjected to analysis of protein profile of lysates by Sodium Dodecyl Sulfate-Polyacrylamide Gel Electrophoresis (SDS-PAGE) and analysis of proteinases by non-denaturing gelatin-SDS-PAGE. Comparison of growth kinetics of seven T. tenax isolates showed a wide variability in the growth characteristics. Protein profiles of the seven isolates revealed a total 53 bands ranged in molecular weight (MW) from 5 to 95kDa using 12% resolution gel. Also, T. tenax isolates were found to possess 19 proteinase bands ranged in MW from 14 to 66kDa. The proteolytic bands were intensified by a cysteine proteinase activator and totally disappeared by treatment with a cysteine proteinase inhibitor suggesting that the proteinases were of cysteine proteinases type. The high frequency of T. tenax detected (28.6%) along with the variability in protein profiling and proteolytic activity of the isolates supports the possible pathogenicity of T. tenax and clarifies a conclusion that different strains with possibility of variable pathogenic potential may exist.

In vitro amoebicidal activity of ethanol extracts of Arachis hypogaea L., Curcuma longa L. and Pancratium maritimum L. on Acanthamoeba castellanii cysts.

Acanthamoeba castellanii causes amoebic keratitis which is a painful sight-threatening disease of the eyes. Its eradication is difficult because the amoebas encyst making it highly resistant to anti-amoebic drugs, but several medicinal plants have proven to be more effective than the usual therapy. This study aimed to evaluate the in vitro amoebicidal activity of ethanol extracts of Arachis hypogaea L. (peanut), Curcuma longa L. (turmeric), and Pancratium maritimum L. (sea daffodil) on A. castellanii cysts. Acanthamoeba were isolated from keratitic patients, cultivated on 1.5% non-nutrient agar, and then incubated with different concentrations of plant extracts which were further evaluated for their cysticidal activity. The results showed that all extracts had significant inhibitory effect on the multiplication of Acanthamoeba cysts as compared to the drug control (chlorhexidine) and non-treated control, and the inhibition was time and dose dependent. The ethanol extract of A. hypogaea had a remarkable cysticidal effect with minimal inhibitory concentration (MIC) of 100 mg/ml in all incubation periods, while the concentrations of 10 and 1 mg/ml were able to completely inhibit growth after 48 and 72 h, respectively. The concentrations 0.1 and 0.01 mg/ml failed to completely inhibit the cyst growth, but showed growth reduction by 64.4-82.6% in all incubation periods. C. longa had a MIC of 1 g and 100 mg/ml after 48 and 72 h, respectively, while the concentrations 10, 1, and 0.1 mg/ml caused growth reduction by 60-90.3% in all incubation periods. P. maritimum had a MIC of 200 mg/ml after 72 h, while the 20-, 2-, 0.2-, and 0.02-mg/ml concentrations showed growth reduction by 34-94.3% in all incubation periods. All extracts seemed to be more effective than chlorhexidine which caused only growth reduction by 55.3-80.2% in all incubation periods and failed to completely inhibit the cyst growth. In conclusion, ethanol extracts of A. hypogaea, C. longa, and P. maritimum could be considered a new natural agent against the Acanthamoeba cyst.