Myocardial perfusion imaging (MPI) is an important non-invasive imaging method, which allows the assessment of perfusion in the cells of the myocardial wall. The images are obtained after administration of a radiopharmaceutical at rest and/or after maximal stress (physical effort or pharmaceutical stress). Infarction areas or scars will not show any uptake of the radiopharmaceutical, neither in rest nor at stress (fixed defects), while the ischemic area will show reduced uptake at stress with recovery to normal perfusion at rest (reversible defects). MPI is a complex technique and it requires an experienced team to foresee, avoid, correct or minimize the artifacts that might appear in all the phases of the study In this paper, we will present the most important categories of artifacts, based on the category of problem where they were generated. We will also present some solutions for limiting these artifacts or for recognizing and minimizing their effect for those which cannot be avoided.
Introduction: The incidence of cholelithiasis has recently increased in the pediatric population, although it remains a rare disease among children. The purpose of this study is to highlight the management and the appropriate time to perform surgery. Materials and Methods: We performed a retrospective study over 10 years (2010-2010) and we found 123 patients who presented with biliary lithiasis and who underwent surgery in our department. We divided the study population into two groups depending on the time of admission and we found that in the 2010-2015 period we had a number of 33 patients, while in the last 5 years we admitted 90 patients with this diagnosis. Patients with other conditions such as bile duct atresia, choledochal cyst, hepatoblastoma that required a cholecystectomy were excluded from our study. Results: After analyzing the two groups we concluded that the number of surgical procedures increased from 33 to 90, which represents a 2.6 times increase. There was no significant difference between the two groups regarding the average age on admission (12.6 +/- 3.37 in the first group vs. 13.91 +/-3.34 in the second group). Surgical management of lithiasis cholecystitis registered an important difference in the two groups. In the first group, 9 patients (27.3%) underwent classic cholecystectomy while 24 (72.7%) – patients benefited from the laparoscopic approach, while in the second group just one patient underwent open surgery with 89 (98.9%) patients undergoing laparoscopic surgery. The percentage of patients who benefited from surgery in the same hospitalization remained high in both groups studied with a statistically significant p-value (p = 0.0417). Conclusion: The number of cases with cholecystitis and lithiasis is increasing in the pediatric population. Surgical management for these patients has become similar to that of adult patients, with minimally invasive surgery becoming the gold standard approach.
Introduction: Brucellosis is a zoonotic disease which is also known as Mediterranean fever. It is acquired from the handling of infected animals or consuming contaminated milk or milk products. The incubation period varies from 1-3 weeks to several months before clinical disease appearance and it shows multiorgan involvement. This study focuses on the varied presentation of this disease and laboratory findings. Materials and Methods: This is a retrospective study, where the past 15 years data of cases diagnosed with brucellosis was studied in a tertiary care center in South India. Patient demographics, clinical presentation, duration of stay in the hospital, hematological and biochemistry profiles were collected and analyzed in SPSS. Results: More number cases were found among the male gender (70%), mostly in the 20- 40 years age group (40%). 95% of cases reported fever, 40% with arthralgia (29% generalized in nature), and 32% with a headache. A Positive Pearson correlation between CRP and NLR, and CRP and PLR were found, which was statistically significant. Mean laboratory values were documented. 37% of patients were found to have hepatosplenomegaly on ultrasound Conclusion: Most of the patients were admitted as cases with pyrexia of unknown origin. Our study focused on the different clinical presentations and laboratory findings of brucellosis and will help give a better understanding and outline during brucellosis case diagnosis and management in a cost-efficient manner.
Nowadays, the chemical compounds of organophosphate cause biological contamination due to their presence in the environment and production of metabolites, which endanger the health of humans and organisms. Thus, it is crucial to use a safe method to eliminate the contamination of these compounds. The objective of the present study was cloning and surface expression of the engineered enzyme of organophosphorus hydrolase in E. coli and comparing its function with the non-engineered enzyme. The present study aimed at improving the function of the organophosphorus hydrolase enzyme by expressing this enzyme along with Ice nucleation protein (INP) on the surface of bacterial cells. For this purpose, the OPH enzyme coding sequence was cloned in the pET28a-InaV-N plasmid and sent into E. coli, the strain of BL21 (DE3) and protein expression was evaluated at 37° C after 16 hours of induction. To examine the site of expression of the recombinant protein, cell components (cytoplasm, inner membrane, and outer membrane) were separated and the results were analyzed by using SDS-PAGE. The results revealed that OPH enzyme protein was presented as a protein fusion with a molecular weight of 58 KDa next to the INP anchor on the surface of the outer membrane of the cell. The specific activity of the resulting protein was calculated at 3828.8 U/mg after incubation of this enzyme in the vicinity of the substrate at 37° C. based on the results of the present study, it seems that the expression of engineered enzyme and its presentation on the cell surface is an achievement in using the cell as a degrading agent of organophosphate toxins and eliminating the costs of downstream processes such as purification and refolding of protein.
Introduction: This study focuses on the Malaria endemic in the Thar Desert- The most populated desert in the world. Malarial endemicity in a desert environment is a unique and rare geographical presentation, as malaria is usually common in areas where there is rainfall and water stagnation - like ponds, fields, etc. In this study, we want to highlight the unique clinical presentation, lab findings, and reason behind the existence of malaria in the desert. Most importantly we also would like to share our innovative idea to eliminate breeding sites using Quadcopters and drones. Materials and methods: Study type – Prospective observation study, Study duration – October 2020 to December 2020, Sample size-103 cases, Inclusion criteria – all smear-positive Malaria cases, Exclusion criteria – Cases Referred to higher centers because of complications.Tools used for breeding site identification – Quadcopters and Drones with HD cameras. Since the area to be surveyed was vast (>30km), it was very difficult to do a manual survey in the harsh desert climate. The patients’ demographics, Clinical Presentations, and laboratory parameters were collected systematically in a predesigned format and entered into an excel sheet. The finding of our study was compared with the malaria cases from different parts of the country. Results: All malaria was identified as Plasmodium vivax. The mean age group was 36 years (min-21 and max-56). Clinical features- out of 103 cases, 78% of the patients presented with all 4 symptoms of fever, chills, headache, and bodyache.22% presented with atypical isolated symptoms of abdominal pain, vomiting, myalgia, severe joint pain. 77% of patients had mild hepatosplenomegaly, 7 patients presented with hypotension, and 2 were in sepsis. Lab parameters – 88% of the patients had anemia, of which 5% had severe anemia, 40% had leucopenia while 6% had leucocytosis.87%had thrombocytopenia, out of which 56% had a platelet count less than 50,000/ml. 2% had mild AKI, bilirubin levels were elevated in 53%, and 36% had transaminitis. Using technology, the survey of the entire area was done in 1 week and all the breeding sites were eliminated on the same day of identification and a drastic drop in malaria cases was noted. Conclusion: We conclude that desert malarial presentation of Plasmodium vivax is unique in clinical presentation and lab derangements compared to other malarial cases. Usage of technology like quadcopters and drones for breeding site identification played a major role in curtailing cases drastically in a very short period in an effective way.
Background: The incidence of congenital diaphragmatic hernia (CDH) has been reported to be 1 in 2000-5000 newborns. The late presentation can occur in 5-30% of all cases and it can be harder to diagnose, as symptoms are usually vague and non-specific. Methods: We performed a retrospective review of chart files of all patients admitted to our hospital with the diagnosis of congenital diaphragmatic hernia between 2010 and 2021. Result: Of the ninety-two cases of CDH treated in our hospital between 2010 and 2021, twenty-six (28%) were late presenting. In the late-presenting CDH group, we found a slight female preponderance, with fifteen female patients (58%) and eleven male patients. A posterolateral left defect in the diaphragm was noted in fifteen cases (58%), a right defect was noted in just one case (4%) and ten patients (38%) were diagnosed with an anterior diaphragmatic hernia. The age at diagnosis varied from 2 months to 14 years. Associated anomalies were noted in just four cases. In all cases, a thoracoabdominal radiograph was performed and ten patients also had a CT scan. Primary repair was performed in 25 of the 26 patients. The mortality rate in our study population was 11%, we reported 3 cases with unfavorable evolution. Conclusion: CDH presenting beyond the neonatal period is a usual finding and it represents a true diagnostic challenge.
Introduction: One of the cornerstones and common causes of kidney stone formation is the volume of fluid consumed during a 24- hour that influences on forming that by several mechanisms. Since fluid intake decreases during Ramadan, one of the common questions posed is whether Ramadan fasting is associated with the precipitating of stone formation. The present study was aimed to investigate the effect of Ramadan fasting on precipitating and Inhibitors of stone formation in patients with a history of renal kidney disease. Methods: The study population included all of the patients with kidney stone diseases who were seen at the Clinic of Urology and Nephrology affiliated with Baqiyatallah hospital during the month of Ramadan in 2014 and 2015. The number of 66 patients was chosen and included in the study through randomized simple sampling. All subjects underwent blood tests like serum uric acid, serum phosphate, serum calcium, and serum sodium. Samples were tested in terms of volume, magnesium, uric acid, Calcium, Phosphate, Sodium, citrate, oxalate, Calcium oxalate supersaturation, Calcium Phosphate supersaturation, Uric acid supersaturation. Results: Sixty-six eligible patients were included that the mean age was 48.35±12.10 years. Fourteen men and 52 women were included. There were no significant differences in the mean pH of urine, urinary sodium, urinary oxalate, super- saturated levels of calcium oxalate in the urine, urinary phosphate levels, and super-saturated levels of urinary calcium phosphate between the two groups (P>0.05). The average volume of urine, urinary magnesium, urinary calcium, urinary citrate, the uric acid level in the non-fasting group was higher than the fasting group (P0.05). There was no difference in the mean super-saturated level of uric acid between the two groups (P=0.035). Conclusion: There was controversial evidence on the effect of Ramadan fasting on kidney stone formation and there is not enough evidence in the present study that Ramadan fasting precipitates risk factors associated with calculus formation
Background: We wanted to evaluate the effectiveness of oral everolimus alone and in combination with capecitabine treatment on colorectal cancer-induced peritoneal carcinomatosis animal model. Methods: Caco-2 colon adenocarcinoma cells were injected intraperitoneally to BALB/cOlaHsd-Foxn1nu mice to establish peritoneal carcinomatosis. Mice were divided into four groups (everolimus, everolimus plus capecitabine, capecitabine, control group) with 2 mice in each group. Treatment was initiated 5 days after inoculation of Caco-2 cells. 7.5 mg/kg everolimus was administered orally every 2 days. 2.1 mmol/kg capecitabine was administered orally every 5 days a week. 22 days after inoculation of Caco-2 cells, mice were sacrificed. Results: The mean weight of the tumor was 25 ± 7.07 mg in the control group (n=2); 0.7 ± 0.7 mg in the everolimus group (n=2); 0.28 ± 0.36 mg in the capecitabine group; 0.48 ± 0.07 mg in the everolimus plus capecitabine group. Conclusion: Tumor samples excised from BALB/cOlaHsd-Foxn1nu mice revealed that everolimus alone, and in combination with capecitabine suppressed tumor growth. However, a comparison of tumor weights revealed no statistically significant difference within the four groups (p=0.227). To reach statistically significant data, the sample size should be increased.
Ulcerative colitis is one of the idiopathic inflammatory diseases of the large intestine with an unknown cause, which occurs in recurrent attacks of inflammation in the lining of the mucosa and below the intestinal mucosa. Impaired mucosal immune responses, the involvement of inflammatory cytokines such as IL-1, TNF-α, and IL-6, and other inflammatory mediators such as arachidonic acid metabolites play an important role in the immunopathogenesis of ulcerative colitis. Based on medical findings on the pathogenesis of the disease, new therapies have focused on the responses of the intestinal immune system and the inflammatory process. However, the widespread use of treatments such as aminosalicylates and corticosteroids continues. Most of these drugs have severe side effects. Some patients do not respond well to these treatments and sometimes have to undergo surgery and colectomy. Therefore, extensive studies are being conducted to control and prevent disease to use natural treatment methods such as the use of antioxidants with the approach of removing free radicals that prevent the destruction of cells and tissues in the body. Today, various studies have pointed to the effects of herbal medicines as a complementary treatment in inflammatory diseases. Their low cost and high effectiveness have attracted the attention of researchers in this field. The aim of the present study is a comprehensive review of modern and traditional treatments based on herbal medicines in the field of ulcerative colitis.
Chronic hepatitis can resolve spontaneously or progress to more advanced stages, i.e. fibrosis, cirrhosis, and liver cancer, respectively. Two million deaths each year are attributed to liver diseases globally. Chronic liver disease and cirrhosis comprise 11th position in leading causes of death worldwide. Viral infections account for the etiologic factor of most cases of hepatitis. Almost the only available way for the treatment of end stages of hepatitis is liver transplantation. The biggest problem with this therapeutic approach is the number of liver transplant donors is less than the number of recipients. Therefore, more advanced methods must investigate. Recently, gene therapy by the utilization of stem cells yielded promising results in clinical and preclinical investigations to the treatment of liver diseases. Novel genome editing tools such as TALENs and CRISPR/Cas9 consider as powerful genome correction approaches and can employe for iPSCs gene editing. This paper highlights the various aspects of gene therapy through stem cells for liver diseases
