Impact of Aeroallergen Sensitization on Chronic Rhinosinusitis.

PURPOSE: This study investigated the impact of aeroallergens on the development and progression of chronic rhinosinusitis (CRS), with a focus on the specific associations between aeroallergens and CRS according to allergen type, number, and extent of sensitization. METHODS: The medical records of 256 CRS patients were retrospectively analyzed. All were divided into nonallergic, house dust mite (HDM)-allergic, pollen-allergic, and double allergic groups via specific immunoglobulin E (IgE) testing. Clinical characteristics, computed tomography (CT) scores, olfactory functions, and demographic data were compared. Correlation analysis was performed to explore the relationships between the extent of allergen sensitization and CRS severity. Binary logistic regression analysis was used to identify risk factors for hyposmia and anosmia. RESULTS: The allergic group exhibited higher total CT scores than the nonallergic group (P = 0.001). Sensitivity to HDM or pollen allergens alone was not significantly associated with increased CRS severity. No significant differences were observed between the effects of HDM and pollen allergens on CRS severity. However, the double allergic group exhibited significantly higher CT scores (P < 0.001, < 0.001, and 0.003) than the other groups. Although the prevalence rates of anosmia and hyposmia were notably higher in the double allergic group, the difference was not statistically significant. The maximum specific IgE levels to HDM and pollen allergens positively correlated with the CT scores (P = 0.001 and 0.001, respectively). CONCLUSIONS: Allergen sensitization, particularly to multiple common allergens, contributed to CRS severity. CRS patients sensitized to both HDM and pollen allergens tended to experience the diminished olfactory function. These findings underscore the importance of considering the allergen sensitization pattern when assessing CRS severity and its potential progression.

Novel Matrix Metalloproteinase-9 (MMP-9) Inhibitors in Cancer Treatment.

Matrix metalloproteinases (MMPs) belong to a family of zinc-dependent proteolytic metalloenzymes. MMP-9, a member of the gelatinase B family, is characterized as one of the most intricate MMPs. The crucial involvement of MMP-9 in extracellular matrix (ECM) remodeling underscores its significant correlation with each stage of cancer pathogenesis and progression. The design and synthesis of MMP-9 inhibitors is a potentially attractive research area. Unfortunately, to date, there is no effective MMP-9 inhibitor that passes the clinical trials and is approved by the FDA. This review primarily focuses on exploring the diverse strategies employed in the design and advancement of MMP-9 inhibitors, along with their anticancer effects and selectivity. To illuminate the essential structural characteristics necessary for the future design of novel MMP-9 inhibitors, the current narrative review highlights several recently discovered MMP-9 inhibitors exhibiting notable selectivity and potency.

Pharmacological treatment and vaccines in monkeypox virus: a narrative review and bibliometric analysis.

Mpox (earlier known as monkeypox) virus infection is a recognized public health emergency. There has been little research on the treatment options. This article reviews the specific drugs used to treat mpox virus infection and the vaccines used here. Instead of focusing on the mechanistic basis, this review narrates the practical, real-life experiences of individual patients of mpox virus disease being administered these medicines. We conducted a bibliometric analysis on the treatment of the mpox virus using data from several databases like PubMed, Scopus, and Embase. The research on this topic has grown tremendously recently but it is highly concentrated in a few countries. Cidofovir is the most studied drug. This is because it is indicated and also used off-label for several conditions. The drugs used for mpox virus infection include tecovirimat, cidofovir, brincidofovir, vaccinia immune globulin, and trifluridine. Tecovirimat is used most frequently. It is a promising option in progressive mpox disease in terms of both efficacy and safety. Brincidofovir has been associated with treatment discontinuation due to elevated hepatic enzymes. Cidofovir is also not the preferred drug, often used because of the unavailability of tecovirimat. Trifluridine is used topically as an add-on agent along with tecovirimat for ocular manifestations of mpox virus disease. No study reports individual patient data for vaccinia immune globulin. Though no vaccine is currently approved for mpox virus infection, ACAM 2000 and JYNNEOS are the vaccines being mainly considered. ACAM 2000 is capable of replicating and may cause severe adverse reactions. It is used when JYNNEOS is contraindicated. Several drugs and vaccines are under development and have been discussed alongside pragmatic aspects of mpox virus treatment and prevention. Further studies can provide more insight into the safety and efficacy of Tecovirimat in actively progressing mpox virus disease.

Assessment of Saudi Women's Adherence and Experience with Venous Thromboembolism Prophylaxis after Cesarean Section Delivery Using Telemedicine Technology.

Background: Telemedicine technology is widely used especially after the COVID-19 pandemic. It can be used to give medical advice as well as follow up with the patients at home in the outpatient setting. Low molecular weight heparin, such as enoxaparin, decreases the risk of venous thromboembolism after cesarean delivery. Objective: assessing postcesarean women's adherence and experience to enoxaparin thromboprophylaxis regimens in the outpatient setting via telephone calls. Methods: prospective cohort study was conducted in the Maternity and Children Hospital (MCH). Postcesarean women were interviewed at the postnatal ward in the MCH. The participants were followed up for 10 days of the delivery to assess their adherence to and experience with enoxaparin thromboprophylaxis. Suboptimal adherence was defined as the missing of one or more doses of enoxaparin. Results: 170 women participated in this study. The majority of them (78.8%) were fully adherent to enoxaparin while 21.2% missed at least one dose. The most-reported causes for suboptimal adherence were perceived lack of necessity (44.4%), forget to take the injection (30.6%), feeling of high load going to the primary care unit to take injection (27.8%), and fear of injection (11.1%). Conclusion: Telemedicine technology could be used to assess patients' adherence. The study results showed that the majority of participants were fully adherent to postcesarean enoxaparin but more than 20% of the participants were suboptimal adherent. Proper patient education techniques could influence patients' adherence and potentially decrease the risk of DVT in those populations.

Microleakage and Bacterial Adhesion with Three Restorative Materials Used to Seal Screw-access Channels of Implant Abutments: An In vitro Study.

BACKGROUND: Proper sealing of screw-access channels against microbial microleakage is advisable for the long-term success of screw-retained implant prosthesis. OBJECTIVE: This study aimed to compare the bacterial adhesion and microleakage with three restorative materials, namely, composite resin, acrylic resin and bis-acryl, that are used to cover the access channels of screw-retained implant prostheses, using polytetrafluoroethylene tape as a spacer material. MATERIALS AND METHODS: In this in vitro study, 18 titanium straight abutments (Hex-lock® Zimmer) were torqued into implant analogs, which were then subdivided into three groups. The samples of each group were filled with polytetrafluoroethylene tape and sealed with the three restorative materials (Group A: composite resin; Group B: acrylic resin; Group C: bis-acryl). Measurements of surface bacterial adhesion and internal microleakage were then recorded. The results were statistically analyzed using Kruskal-Wallis and Chi-square tests. RESULTS: No significant difference was found between the investigated materials in terms of their sealing effectiveness against microbial microleakage (P = 0.06). Regarding bacterial adhesion, composite resin showed the highest number of surface adhesion, but there was no significant difference between the three materials (P = 0.081). CONCLUSION: The results of this study suggest that composite resin, acrylic resin and bis-acryl materials could be used alternatively in sealing the implant access channel owing to no significant differences in terms of microleakage and bacterial adhesion.

A rare acute haemorrhagic stroke and severe multiorgan dysfunction following massive honeybee stings.

The venomous sting of honeybees causes a variety of medical problems. The severity and duration of a honeybee sting reaction can vary between patients and at different occasions in the same person. Clinical manifestations range from local and systemic allergic reactions to serious manifestations. The systemic manifestations include, among others, encephalitis, polyneuritis, bleeding manifestations, rhabdomyolysis and renal failure. Despite the high incidence of insect stings, very few reports of stroke have been described in the literature; however, serious complications should always be suspected. Here, we report the case of a previously healthy 13-year-old boy who presented to Wad Medani Children Hospital, Sudan, with an altered mental state and severe anaphylaxis, following numerous stings of honeybees. He also had intracranial haemorrhages, renal failure, petechial rash and shock.

Knowledge, attitude, and perceptions towards the 2019 Coronavirus Pandemic: A bi-national survey in Africa.

The current Coronavirus (COVID-19) pandemic has impacted and changed lives on a global scale since its emergence and spread from China in late 2019. It has caused millions of infections, and thousands of deaths worldwide. However, the control of this pandemic still remains unachievable in many African countries including Egypt and Nigeria, despite the application of some strict preventive and control measures. Therefore, this study assessed the knowledge, attitude, and perceptions of Egyptians and Nigerians towards the COVID-19 pandemic. This study was designed as a cross-sectional community-based questionnaire survey in both countries. Participants' demography, knowledge, attitude, and perceptions towards the COVID-19 outbreak were obtained using a convenience sampling technique. Data collected were subjected to descriptive statistics and logistic regression analysis. A total of 1437 respondents were included in this preliminary report. The mean knowledge score was 14.7±2.3. The majority of the respondents (61.6%) had a satisfactory knowledge of the disease. Age (18-39 years), education (College/bachelors), and background of respondents were factors influencing knowledge levels. The attitude of most respondents (68.9%) towards instituted preventive measures was satisfactory with an average attitude score of 6.9 ± 1.2. The majority of the respondents (96%) practiced self-isolation and social-distancing but only 36% follow all health recommendations. The perception of most respondents (62.1%) on the global efforts at controlling the virus and preventing further spread was satisfactory with an average score of 10.9 ± 2.7. Only 22% of the respondents were satisfied with their country's handling of the pandemic. An apprehensive understanding of the current status in Africa through studies like KAP is crucial to avoid Africa being the next epicenter of the pandemic. For the populace to follow standard infection prevention and control measures adequately, governments need to gain the trust of citizens by strengthening the health systems and improving surveillance activities in detecting cases, to offer the optimum health services to their communities.

Breast cancers missed during screening in a tertiary-care hospital mammography facility.

BACKGROUND: Breast cancer is the most common cancer in females worldwide. Screening with mammography for early breast cancer detection is standard community practice in many countries. OBJECTIVE: Identify causes of missed breast cancers during screening. DESIGN: Retrospective, observational. SETTING: Department of radiology at a tertiary-care hospital mammographic screening facility. PATIENTS AND METHODS: All women who came with initial negative screens from July 2015 to July 2018 were retrospectively reviewed and followed-up for their second or subsequent mammographic screening. Missed breast cancer was defined as a cancer that was detected on a subsequent mammogram with an initial negative screen. Mammograms were interpreted by two radiologists as per BIRADS (Breast Imaging Reporting and Data System) lexicon. Causes of missed breast cancers were categorized as imaging acquisition (IA), imaging feature (IF) and imaging interpretation (II). True (occult) incident breast cancers were also documented. Percentage estimations for these causes were calculated. MAIN OUTCOME MEASURES: Breast cancer detection on follow-up screening. SAMPLE SIZE: 943 women. RESULTS: Of 15 (1.6%) screening-detected breast cancers, 7 cases (46.6%) were missed on the initial screen; 3 (43%) of these were II related, 2 (28.5%) of each were IA and IF. The remaining true (occult) cases were detected on either the second (5 cases) or third screens (3 cases). CONCLUSION: Improved screening facilities, quality mammographic acquisition and interpretation, double reading, and implementation of an organized screening program may help to avoid missed breast cancers. LIMITATIONS: Retrospective, small sample, single center, and short duration study. CONFLICT OF INTEREST: None.

Visceral Adiposity Index and the Degree of Hepatic Fibrosis and Inflammation in Egyptian Patients with Chronic Hepatitis C.

INTRODUCTION: Many clinical studies suggest a direct association between hepatic fat content and visceral adiposity and the progression of fibrosis. AIM: This work aims to clarify the relation between the Visceral Adiposity Index (VAI) and severity of necroinflammatory activity and liver fibrosis in Egyptian patients with chronic Hepatitis C Virus (HCV) infection. MATERIALS AND METHODS: A cross-sectional study, over a period of six months, was performed on 50 chronic HCV patients subjected to routine laboratory investigations, abdominal ultrasonography, measurement of Waist Circumference (WC), calculation of Body Mass Index (BMI) and VAI, ultrasound guided liver biopsy and assessment of hepatic fibrosis by METAVIR staging. RESULTS: A total of 50 HCV positive patients, 29 (58%) males and 21 (42%) females were included in the study. Age ranged from 29-60 years (44.4±8.4). BMI was ranged from 20.3 to 41.4 kg/m2 (31.7±5.5). VAI for males was 0.4±0.2 and for females was 0.5±0.3. There were significant positive correlations between VAI and BMI, Triglycerides (TG), fibrosis stages, grades of liver inflammation and FIB-4 Fibrosis-4 score. There were significant negative correlations between VAI and high density lipoprotein, platelets and haemoglobin. CONCLUSION: There is an association between visceral obesity represented by VAI and the severity of hepatic inflammatory response in chronic hepatitis C patients. Other studies are recommended to measure the clinical implication of visceral obesity on the response to the novel directly acting antivirals.

Descriptive epidemiology of a cholera outbreak in Kaduna State, Northwest Nigeria, 2014.

INTRODUCTION: Cholera is an acute gastrointestinal infection caused by Vibrio cholerae, which may lead to severe dehydration and death if not treated. This analysis is aimed at highlighting the magnitude, pattern and trend of cholera outbreak that occurred in Kaduna State in 2014. METHODS: We obtained the 2014 cholera line-list from the Kaduna State Disease Surveillance and Notification officer (DSNO). We described the outbreaks in time, place and person using Epi-info 7 and Health Mapper. RESULTS: A total of 1468 case-patients and 54 deaths were recorded, giving a case fatality rate (CFR) of 3.68%. Female case-patients were 809(55.08%). The median age for case-patients was 15 years, with an age range of 0.04-90 years. Age specific case fatality rate (ASCFR) is highest among the > 60 years. Seven (30%) out of the 23 local government areas (LGAs) in Kaduna State were affected by the cholera outbreak in 2014. Igabi LGA has the highest attack rate (150.46 per 100,000 population) while Chikun LGA has the lowest attack rate (12.22 per 100,000 population). Chikun LGA records the highest CFR (17.54%). Cholera infection spread across LGAs sharing the same borders. The outbreak started from the first epidemic week of 2014 and lasted over 33 weeks. CONCLUSION: Our analysis revealed a protracted cholera outbreak that gradually increases in magnitude throughout the first half of 2014 and spread within contiguous LGAs. We recommended the strengthening of the state's diseases surveillance system towards timely detection and early response to disease outbreaks in the future.