Use of the Anatomage Virtual Table in Medical Education and as a Diagnostic Tool: An Integrative Review.

Studies on human anatomy mainly depend on cadaver dissection. New technology devices have progressed to improve anatomy teaching, such as the 3D Anatomage virtual dissection table. There is a shortage and deficiency in information about the uses and benefits of the Anatomage table. The aim of this article was to review and assess the current evidence about the advantages of the Anatomage virtual table in medical education and curricula of medical courses, and its utility in diagnosis. The current study is a comprehensive systematic review. A search was conducted on online medical and scientific databases. Twenty-nine articles relevant to the content of the current research topic were selected. Based on this review, the use of the Anatomage table is valuable for anatomy learning outcomes, and most of the research supported it as an important anatomy tool in addition to cadaveric dissection. The Anatomage table in association with human dissection can improve knowledge retention of anatomy. It is an important tool for understanding organ variation. Anatomage is now considered an important tool for the educational training programs of medical students and residents and for disease diagnosis and prognosis. Anatomage can make the curriculum more interesting and valuable. Utilizing the Anatomage table can help medical and paramedical students and residents by assisting them to understand anatomy in a better way. It will also improve radiological knowledge and facilitate pre-planning for surgeries. Finally, it has a crucial role during exceptional circumstances such as pandemics.

Integration of immunoinformatics and cheminformatics to design and evaluate a multitope vaccine against Klebsiella pneumoniae and Pseudomonas aeruginosa coinfection.

Introduction: Klebsiella pneumoniae (K. pneumoniae) and Pseudomonas aeruginosa (P. aeruginosa) are the most common Gram-negative bacteria associated with pneumonia and coinfecting the same patient. Despite their high virulence, there is no effective vaccine against them. Methods: In the current study, the screening of several proteins from both pathogens highlighted FepA and OmpK35 for K. pneumonia in addition to HasR and OprF from P. aeruginosa as promising candidates for epitope mapping. Those four proteins were linked to form a multitope vaccine, that was formulated with a suitable adjuvant, and PADRE peptides to finalize the multitope vaccine construct. The final vaccine's physicochemical features, antigenicity, toxicity, allergenicity, and solubility were evaluated for use in humans. Results: The output of the computational analysis revealed that the designed multitope construct has passed these assessments with satisfactory scores where, as the last stage, we performed a molecular docking study between the potential vaccine construct and K. pneumonia associated immune receptors, TLR4 and TLR2, showing affinitive to both targets with preferentiality for the TLR4 receptor protein. Validation of the docking studies has proceeded through molecular dynamics simulation, which estimated a strong binding and supported the nomination of the designed vaccine as a putative solution for K. pneumoniae and P. aeruginosa coinfection. Here, we describe the approach for the design and assessment of our potential vaccine.

Anatomical, histochemical and surface ultrastructural characteristics of cavum nasi of the common quails (Coturnix coturnix. Erlangeri).

Ten normal, mature and common quails were used to study in detail the gross anatomy, histochemical and surface ultrastructural characteristics of the nasal cavity. The relationship between the structure and function of the nasal cavity also were assessed. The quail nasal cavity was divided into the vestibule, nasal cavity proper and fundus. The nasal cavity began rostrally by two slit-like external nares located laterally in the middle third of the upper beak. A previous authors stated that no rostral concha but the current study record that the rostral nasal concha was located opposite the nostrils and exhibited a C-shaped appearance in transverse section and was 5 mm long and 3 mm wide. The middle nasal concha was narrow and elongated. The caudal nasal concha was spherical, located caudodorsal to the rostral nasal concha and measured 2 mm in diameter. The infraorbital sinus was a roughly triangular cavity situated immediately rostral to the orbit. The histological and surface ultrastructural study of the nasal cavity of common quail did not studied previously. Histologically, the cavum nasi was composed of three regions: vestibule, respiratory and olfactory. The vestibule was lined with stratified squamous epithelium that was keratinized rostrally and non-keratinized caudally. The respiratory region was covered by pseudostratified columnar epithelium. Intra-epithelial mucous glands were present in the respiratory region and displayed a strong reaction with Alcian blue. The lining epithelium in the olfactory region was pseudostratified and contained olfactory, supporting and basal cells.

Improved Pain and Function in Knee Osteoarthritis with Dexamethasone Phonophoresis: A Randomized Controlled Trial.

BACKGROUND: Intraarticular corticosteroid injection is an adjunct to core treatments for relief of moderate-to-severe pain in osteoarthritis (OA) patients. This randomized controlled trial was conducted to determine the effect of dexamethasone phonophoresis (DxPh) on knee OA. PATIENTS AND METHODS: Forty six female patients with knee OA were randomized into two equal groups. The study group received DxPh over the medial side of the knee, transcutaneous electrical nerve stimulation (TENS), and quadriceps strengthening exercises. Control group received ultrasound therapy and the same TENS and exercise program. Pain was assessed using the visual analog scale (VAS) and the pain subscale of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pre- and posttreatment. Functional mobility was assessed by the Timed Up and Go (TUG) test, total WOMAC, and the joint stiffness and physical function subscales of WOMAC. The minimal clinically identifiable difference was used to calculate treatment effect sizes of both modalities, which was compared to intraarticular steroid injections. RESULTS: The VAS, TUG, and WOMAC scores improved with both modalities. Pain intensity improved by 50.6%-58.0% in the study group (VAS and pain subscale of WOMAC, respectively) compared to 17.8%-28.6% for the control group. Functional mobility showed a higher rate of improvement in the DxPh group compared to control (37.7 vs. 17.5% for TUG and 53.2 vs. 23.0 and 56.1 vs. 26.4% for the joint stiffness and physical function subscales of WOMAC, respectively). Posttreatment results revealed statistically and clinically significant improvement in pain intensity and functional mobility in the DxPh group. CONCLUSION: DxPh resulted in a greater improvement in pain and function in patients with knee OA than therapeutic ultrasound combined with exercise and TENS. The effect size of phonophoresis was clinically significant and higher than that reported for intraarticular steroid injection from pooled data in the literature.

Percutaneous Carillon Mitral Contour System Deployment Followed by CRT-D Implantation: First Case Report from Oman.

Mitral valve regurgitation (MR) is a common problem in patients with cardiac issues especially those with dilated cardiomyopathy (DCM) due to mitral annular dilatation and malcoaptation of the mitral valve leaflets. Although DCM is associated with high mortality rates, there has been no global agreement about the best method of treatment. Treatment of MR in such cases can be done by surgery, which has many limitations due to high-risk concerns. MR may also be managed by other alternatives such as mitral-clip and transcoronary venous mitral annuloplasty using the Carillon® Mitral Contour System®. Combined therapy with a cardiac resynchronization therapy defibrillator (CRT-D) and mitral contour can be used in such cases with valuable improvement in general condition in many patients. In our case, we used the Carillon Mitral Contour System for treatment of severe MR in a 64-year-old patient with severely impaired systolic function after implantation of a CRT-D.

The Predictive Value of Multidetector High Resolution Computed Tomography in Evaluation of Suspected Sputum Smear Negative Active Pulmonary Tuberculosis in Egyptian Zagazig University Hospital Patients.

The aim of this work is to study the usage of multi-detector HRCT chest in diagnosing pulmonary TB cases whose sputum smears are negative and making a correlation between their CT features and their sputum culture results. This study was carried out from December 2014 to December 2016 at Zagazig university hospitals, Radiodiagnosis department. It included 150 patients. Their ages ranged between 10 to 70 years with a mean age 40 years. They were referred from the outpatient respiratory medicine clinic of the hospital. All patients had been presented clinically with suspicion of PTB. Their clinical features and HRCT findings were investigated to predict the risk for PTB. We then designed provisional HRCT diagnostic criteria based on the results to rank the risk of PTB. A positive tuberculin skin test alone among clinical laboratory findings was significantly associated with an increase of risk of PTB. Centrilobular nodules, large nodules, tree-in-bud appearance and the main lesion being located in S1, S2, and S6 lung segments were significantly associated with an increased risk of PTB. At HRCT 40 out of 44 patients with class III ranking showed active pulmonary TB. 12 out of 51 patients presented with class II ranking and 8 out of 40 were ranked as class I. The sensitivity, specificity and positive likelihood ratio of class I ranking HRCT criteria to diagnose active pulmonary TB were 95%, 40% and 1.4, respectively. Class II ranking results were 85%, 72%, 3, respectively. Finally class III ranking results were 45%, 90%, 11.5, respectively. Cases suspected of having active pulmonary TB whose smears are negative can benefit from MD HRCT chest findings to predict those patients of high risk with good reproducibility.

Effect of diet on Shiga toxin-producing Escherichia coli (STEC) growth and survival in rumen and abomasum fluids.

The gastrointestinal tract of ruminants is the main reservoir for Shiga toxin-producing Escherichia coli (STEC) strains, potentially pathogenic for humans. We used for the first timerumen fluid in which no exogenous carbon source or other supplement was added to compare acid resistance and growth of STEC in physiological physico-chemical conditions. We showed that acidic conditions resulting from the combination of high volatile fatty acid concentration and moderately acidic pH did not alter the survival of STEC, and that human non-O157:H7 STEC isolates were able to persist in the rumen contents in spite of acid stress, low oxygen availability and nutrient deprivation, in the same manner as bovine STEC isolates do. Furthermore, our results support the hypothesis that a grain-rich diet may induce mechanisms of STEC acid resistance in the rumen that allow STEC survival in the abomasum.