Abortion is one of the leading causes of maternal death in Cameroon, despite numerous policies and strategies put in place to reduce it by 2030.This study aims to describe the epidemiologic aspects of abortions within...Abortion is one of the leading causes of maternal death in Cameroon, despite numerous policies and strategies put in place to reduce it by 2030.This study aims to describe the epidemiologic aspects of abortions within hospitals in the city of Yaoundé in 2023. Methods: This was a descriptive cross-sectional study with prospective data collection in the maternity wards of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, and the Yaoundé Central Hospital for 7 months, from the 1st of November 2022 to the 31st of May 2023. The variables studied were demographic and clinical characteristics, means of recourse and post-abortion contraception. The frequency of abortions was calculated as the ratio of the number of abortions to the number of deliveries. The calculation of numbers and frequencies was used to describe the study population, and to highlight the sociodemographic and clinical characteristics of the patients recruited. Quantitative variables were expressed as mean ± standard deviation. Data were collected numerically and classified according to type, then analyzed using Epi-info version 7.2 software. Microsoft Office Excel 2013 was used to produce figures and tables. Results: During the study period, 169 patients were selected out of 1882 patients who had consulted for gynaecological emergencies;but only 164 of them accepted to participate. The frequency of abortions was 9.6% (169/1882). The age group of 25 to 29 years was the most represented, with 29.3% (48/164). They were mainly single 76.2% (125/164), and housewives 33.5% (55/164). The notion of previous abortion was found in 30.5% (50/164) of them. Approximately 19.5% of patients (32/164) reported to have conceived while using contraception, 56.2% of whom (18/32) used male condoms. At the time of admission to the emergency unit, the predominant symptom was bleeding in 70.7% of cases. The abortions were mainly spontaneous, in 75% of cases (123/164). In cases of induced abortions, 24.4% (10/41) of them took place after 14 weeks. Unexpected pregnancy was the main reason for termination in 46.3% of cases (19/41). Regarding induced abortion, 58.54% (24/41) of them resorted to voluntary medical termination. The mortality rate was 1.2%. The acceptability rate of a modern contraceptive method before discharge was 31.7%. Conclusion: Although frequent in our environment, data relating to abortion remain under-evaluated. Abortions occur mainly among young, single women, with a still very high proportion of induced abortions. The acceptability of post-abortion contraception remains poor. Prevention of unwanted pregnancies and risk factors is necessary to reduce the burden of abortions in low-income countries.展开更多
Ossiculoplasty remains a challenging surgical procedure,with outcomes heavily influenced by diverse anatomical and pathological factors.Over the decades,numerous scoring systems have been developed to predict the prog...Ossiculoplasty remains a challenging surgical procedure,with outcomes heavily influenced by diverse anatomical and pathological factors.Over the decades,numerous scoring systems have been developed to predict the prognosis of ossiculoplasty,each emphasizing different variables such as ossicular status,middle ear environment,and surgical history.This paper provides a comprehensive review of the evolution of prognostic scoring systems,including Austin's original ossicular classification,Bellucci's otorrhea staging,the Middle Ear Risk Index(MERI),the Ossiculoplasty Outcome Parameter Staging(OOPS),and the recently introduced Ear Environment Risk(EER)scale.While these systems have significantly contributed to preoperative assessment,each presents notable limitations in encompassing all variables affecting surgical success.Therefore,the aim of this paper is to provide a review of the ossiculoplasty prognostic scores and show the benefits,innovations and gaps associated with each.To address these gaps,a novel,modified scoring system is proposed,incorporating previously overlooked but clinically significant factors such as tympanic membrane status,type of tympanoplasty,ossicular replacement material,CT scan findings,and the presence of complicated ear conditions.By synthesizing elements from historical scores with updated clinical insights,the proposed system aims to provide a more holistic and predictive framework for preoperative evaluation.Future multicenter studies are encouraged to validate the efficacy and prognostic power of this new scoring system,with the goal of improving surgical planning and patient counseling in ossiculoplasty.展开更多
The cloud-fog computing paradigm has emerged as a novel hybrid computing model that integrates computational resources at both fog nodes and cloud servers to address the challenges posed by dynamic and heterogeneous c...The cloud-fog computing paradigm has emerged as a novel hybrid computing model that integrates computational resources at both fog nodes and cloud servers to address the challenges posed by dynamic and heterogeneous computing networks.Finding an optimal computational resource for task offloading and then executing efficiently is a critical issue to achieve a trade-off between energy consumption and transmission delay.In this network,the task processed at fog nodes reduces transmission delay.Still,it increases energy consumption,while routing tasks to the cloud server saves energy at the cost of higher communication delay.Moreover,the order in which offloaded tasks are executed affects the system’s efficiency.For instance,executing lower-priority tasks before higher-priority jobs can disturb the reliability and stability of the system.Therefore,an efficient strategy of optimal computation offloading and task scheduling is required for operational efficacy.In this paper,we introduced a multi-objective and enhanced version of Cheeta Optimizer(CO),namely(MoECO),to jointly optimize the computation offloading and task scheduling in cloud-fog networks to minimize two competing objectives,i.e.,energy consumption and communication delay.MoECO first assigns tasks to the optimal computational nodes and then the allocated tasks are scheduled for processing based on the task priority.The mathematical modelling of CO needs improvement in computation time and convergence speed.Therefore,MoECO is proposed to increase the search capability of agents by controlling the search strategy based on a leader’s location.The adaptive step length operator is adjusted to diversify the solution and thus improves the exploration phase,i.e.,global search strategy.Consequently,this prevents the algorithm from getting trapped in the local optimal solution.Moreover,the interaction factor during the exploitation phase is also adjusted based on the location of the prey instead of the adjacent Cheetah.This increases the exploitation capability of agents,i.e.,local search capability.Furthermore,MoECO employs a multi-objective Pareto-optimal front to simultaneously minimize designated objectives.Comprehensive simulations in MATLAB demonstrate that the proposed algorithm obtains multiple solutions via a Pareto-optimal front and achieves an efficient trade-off between optimization objectives compared to baseline methods.展开更多
Background:Mastitis caused by different pathogens including Streptococcus uberis(S.uberis)is responsible for huge economic losses to the dairy industry.In order to investigate the potential genetic and epigenetic regu...Background:Mastitis caused by different pathogens including Streptococcus uberis(S.uberis)is responsible for huge economic losses to the dairy industry.In order to investigate the potential genetic and epigenetic regulatory mecha‑nisms of subclinical mastitis due to S.uberis,the DNA methylome(whole genome DNA methylation sequencing)and transcriptome(RNA sequencing)of milk somatic cells from cows with naturally occurring S.uberis subclinical mastitis and healthy control cows(n=3/group)were studied.Results:Globally,the DNA methylation levels of CpG sites were low in the promoters and first exons but high in inner exons and introns.The DNA methylation levels at the promoter,first exon and first intron regions were nega‑tively correlated with the expression level of genes at a whole‑genome‑wide scale.In general,DNA methylation level was lower in S.uberis‑positive group(SUG)than in the control group(CTG).A total of 174,342 differentially methylated cytosines(DMCs)(FDR<0.05)were identified between SUG and CTG,including 132,237,7412 and 34,693 DMCs in the context of CpG,CHG and CHH(H=A or T or C),respectively.Besides,101,612 methylation haplotype blocks(MHBs)were identified,including 451 MHBs that were significantly different(dMHB)between the two groups.A total of 2130 differentially expressed(DE)genes(1378 with up‑regulated and 752 with down‑regulated expression)were found in SUG.Integration of methylome and transcriptome data with MethGET program revealed 1623 genes with signifi‑cant changes in their methylation levels and/or gene expression changes(MetGDE genes,MethGET P‑value<0.001).Functional enrichment of genes harboring≥15 DMCs,DE genes and MetGDE genes suggest significant involvement of DNA methylation changes in the regulation of the host immune response to S.uberis infection,especially cytokine activities.Furthermore,discriminant correlation analysis with DIABLO method identified 26 candidate biomarkers,including 6 DE genes,15 CpG‑DMCs and 5 dMHBs that discriminated between SUG and CTG.Conclusion:The integration of methylome and transcriptome of milk somatic cells suggests the possible involve‑ment of DNA methylation changes in the regulation of the host immune response to subclinical mastitis due to S.uberis.The presented genetic and epigenetic biomarkers could contribute to the design of management strategies of subclinical mastitis and breeding for mastitis resistance.展开更多
AIM:To identify factors predicting the clinical response of ulcerative colitis patients to granulocyte-monocyte apheresis (GMA). METHODS:Sixty-nine ulcerative colitis patients (39 F,30 M) dependent upon/refractory to ...AIM:To identify factors predicting the clinical response of ulcerative colitis patients to granulocyte-monocyte apheresis (GMA). METHODS:Sixty-nine ulcerative colitis patients (39 F,30 M) dependent upon/refractory to steroids were treated with GMA. Steroid dependency,clinical activity index (CAI),C reactive protein (CRP) level,erythrocyte sedimentation rate (ESR),values at baseline,use of immunosuppressant,duration of disease,and age and extent of disease were considered for statistical analysis as predictive factors of clinical response. Univariate and multivariate logistic regression models were used. RESULTS:In the univariate analysis,CAI (P = 0.039) and ESR (P = 0.017) levels at baseline were singled out as predictive of clinical remission. In the multivariate analysis steroid dependency [Odds ratio (OR) = 0.390,95% Confidence interval (CI):0.176-0.865,Wald 5.361,P = 0.0160] and low CAI levels at baseline (4 < CAI <7) (OR = 0.770,95% CI:0.425-1.394,Wald 3.747,P = 0.028) proved to be effective as factors predicting clinical response. CONCLUSION:GMA may be a valid therapeutic option for steroid-dependent ulcerative colitis patients with mild-moderate disease and its clinical efficacy seems to persist for 12 mo.展开更多
A 3-year-old Persian queen was referred to Teaching Veterinary Hospital while 3 neonates' umbilical cords were entangled with the queen's tail hair.Close inspection of the cat showed that the umbilical cords o...A 3-year-old Persian queen was referred to Teaching Veterinary Hospital while 3 neonates' umbilical cords were entangled with the queen's tail hair.Close inspection of the cat showed that the umbilical cords of 3 kittens had twisted around together and entangled with the moms' hairs in the base of tail region.Also this complex has been warped around the left tarsus of one of the involved kittens and caused swelling and skin darkness in the involved limb.Operation was carried out urgently.After cutting the queen's involved hairs the kittens were released.Then the twisted umbilical cords and the hairs were isolated from the umbilical cord and the involved leg was released from the umbilical cords and the twisted umbilical cords were separated from each other.During one week follow up,dry gangrene occurred in the distal extremity of the injured limb and consequently,amputation was performed on the distal part of tibia.Our clinical findings suggest that long hair coats of queens could be a maternal life threatening factor for neonates' life.展开更多
Objective:To investigate clinical,pathological and mycological findings in canaries,in which pox lesions and Aspergillus fumigatus(A.fumigatus)infection were observed simultaneously.Methods:This study was performed on...Objective:To investigate clinical,pathological and mycological findings in canaries,in which pox lesions and Aspergillus fumigatus(A.fumigatus)infection were observed simultaneously.Methods:This study was performed on a breeding colony(about 100 canaries)affected by fatal wasting disease.Necropsy was undertaken on 10 severely affected canaries,and gross lesions were recorded.Samples from internal organs displaying lesions were obtained for histopathological evaluation.Tracheal swap samples of internal organs of the all infected animals with lesions at necropsy were cultured in Sabouraud Dextrose Agar for mycological examination.Results:At necropsy,caseous foci were determined in the lungs,on the air sacs,liver,spleen,heart.Swelling of the eyelids,diffuse hemorrhages in the subcutaneous tissue with small papular lesions of the skin were other typical necropsy findings.Histopathologically,pathognomonic eosinophilic intracytoplasmic inclusion bodies,which called Bollinger bodies,in both skin cells and vacuolated air way epithelial cells confirmed canary pox infection.Moreover,histopathological examination of the white-yellowish caseous foci revealed necrotic granulomatous reaction consisting of macrophages,heterophil leukocytes and giant cells encapsulated with a fibrous tissue.After the culture of the tissue samples,the formation of bluish green colonies confirmed A.fumigatus infection.Conclusions:Canary pox has been known as the disease that can result in high losses in a short time,as a re-emerging disease that has not been present during recent years in canary flocks in Iran.So,the current paper provides useful information to prevent misdiagnosed of canary pox disease which can cause secondary mycotic infection.展开更多
Objective: To confirm the efficacy of non-antibiotic treatment with prostaglandin F2α(PGF2α) in dairy cows affected by severe clinical endometritis in (30±3) days in milk. Methods: Cows with clinical endometrit...Objective: To confirm the efficacy of non-antibiotic treatment with prostaglandin F2α(PGF2α) in dairy cows affected by severe clinical endometritis in (30±3) days in milk. Methods: Cows with clinical endometritis Ⅲ (n=399) were aligned into three groups randomly. The first group (n=115) received PGF2α, the second group (n=84) received intrauterine infusion (IUI) of oxytetracycline 10% + PGF2α, and the third group (n=200) received IUI. Cows were inseminated following estrus. The pregnancy status, parity, calving and artificial insemination season, ovaries with corpus luteum at the time of treatment, dystocia, body condition score and treatment groups were included in data analysis. Results: Total pregnancy rate was 40.1% after the first insemination and 94.2% after the third insemination. Overall pregnancy rate of treated cows with IUI+PGF2α(84.5%) was significantly lower than the treated cows with PGF2α(98.3%) or IUI (96%) (P<0.05). The first service pregnancy rate of inseminated cows in summer (14.3%) was lower in comparison with cows inseminated in spring (40.4%), fall (41.4%) and winter (51.7%) (P<0.05). Conclusions: PGF2α could treat severe clinical endometritis in dairy cows with corpus luteum in comparison with other treatments.展开更多
Erectile dysfunction （ED） has been found to frequently precedes the onset of coronary artery disease （CAD）, representing an early marker of subclinical vascular disease, included CAD. Its recognition is, therefore...Erectile dysfunction （ED） has been found to frequently precedes the onset of coronary artery disease （CAD）, representing an early marker of subclinical vascular disease, included CAD. Its recognition is, therefore, a ＂window opportunity＂ to prevent a coronary event by aggressive treatment of cardiovascular risk factors. The artery size hypothesis （ASH） has been proposed as a putative mechanism to explain the relationship between ED and CAD. Since atherosclerosis is a systemic disorder all major vascular beds should be affected to the same extent. However, symptoms at different points in the system rarely become evident at the same time. This is likely the result of smaller vessels （i.e. the penile artery） being able to less well tolerate the same amount of plaque when compared with larger ones （i.e. the coronary artery）. If true, ED will develop before CAD. We present a case in which ED developed after a coronary event yet before a coronary recurrence potentially representing a late marker of vascular progression. Reasons for this unusual sequence are discussed as they might still fit the ASH.展开更多
Stroke as a disease entity has significantly increased the morbidity, incapacity, and mortality in Sri Lanka. In the west, it is the 3rd most common cause of death. In addition to that, it is a disturbing and restrict...Stroke as a disease entity has significantly increased the morbidity, incapacity, and mortality in Sri Lanka. In the west, it is the 3rd most common cause of death. In addition to that, it is a disturbing and restricting cerebrovascular disease with a substantial amount of remaining shortage leading on to emotional and financial burden on the family and society. A hospital-based retrospective study was conducted at Teaching Hospital Batticaloa, Sri Lanka from July 1, 2016, to October 31, 2016. During the study period, data were collected from the medical records. Out of 34 patients, 21 (61.8%) were males and 13 (38.2%) were females. The male to female ratio was 1.6:1. Out of 34 patients, 17 (50%) were affected in the left side and 17 (50%) were affected on the right side. The most common risk factor was hypertension with 79.4%, and next to that diabetes mellitus (41.2%), smoking (23.5%), alcohol (20.6%), past history of Stroke (17.6%) and ischaemic heart disease (IHD) (14.7%). Stroke due to infarction is more common than haemorrhage. In this study, both right and left sides were affected equally. In order to prevent this devastating stroke, acknowledgment of risk factors for stroke is prime importance for the healthcare workers as well as public.展开更多
Background: Urinary tract infection caused by Escherichia coli is a frequently observed condition both in humans and animals. Uropathogenic E. coli (UPEC) has been shown to have a pathogenicity island that enables the...Background: Urinary tract infection caused by Escherichia coli is a frequently observed condition both in humans and animals. Uropathogenic E. coli (UPEC) has been shown to have a pathogenicity island that enables them to infect the urinary tract. Because there is little information about the presence of UPEC-associated virulent genes in animal isolates this work was carried out with the intent to enhance the understanding about the strains of E.coli that cause infections in animals. Results: We screened 21 E. coli strains isolated causing urinary tract infection in domestic animals. Primers were designed to amplify urinary infection-associated genes. Nine genes, papA, tcpC, fyuA, tpbA, Lma, hylA, picU, tonB, and flicC were then amplified and sequenced. Different from the human isolate CFT073, all the animals E. coli lack some of the pathogenesis-associated genes. Genes encoding for proteins used to scavenge iron appear not to be so necessary during animal infections as they are in human infection. In further investigation of phenotypic properties, it was observed that animal UPECs have significantly more impaired ability to form biofilms than human UPEC strain. Conclusions: This study identified significant differences between human and animal UPECs. This may have its roots in the fact that it is difficult to determine if an animal has symptoms. Future studies will focus on some of the observations.展开更多
<div style="text-align:justify;"> <strong>Background:</strong> Data on spontaneous intracerebral haemorrhagic (SICH) are scarce in Africa. Our objectives were<span "="">...<div style="text-align:justify;"> <strong>Background:</strong> Data on spontaneous intracerebral haemorrhagic (SICH) are scarce in Africa. Our objectives were<span "=""> to determine the prevalence of SICH, describe the clinical profile, aetiology and evaluate the prognosis (fatality case, functional outcome) of patients in a tertiary health care hospital in Cameroon. <b>Methods:</b> This was a hospital-based retrospective cohort</span><span "=""> </span><span "="">which included patients with SICH and followed up for 6 months after stroke. Subarachnoid haemorrhage, cerebral venous thrombosis with bleeding or bleeding related with ischemic or brain tumour were excluded. Predictive factors were obtained using multiple logistic regression and survival by Kaplan Meier method. <b>Results:</b> The prevalence of SICH was 37% with male predominance (64.0%), a mean age of 55.6 ± 11.8 years. Deep coma was found in 30.3% on admission. The basal ganglion was the most frequent location of haemorrhage (85.1%) while intraventricular blood effusion, mass effect, cerebral oedema and herniation occurred in 31.4%, 25.7%, 8.8% and 5.0% respectively. Hypertension (57.5%) was the most common aetiology. The mean length of hospitalization was 9.0 ± 7.7 days and chest infection (30.7%) was the most frequent complication. The cumulative case fatality rate after 24 hours (day 1), during admission, month 1 and month 3 was 9.6%, 39.9%, 46.0%, 59.8% respectively. On multivariate analysis, GCS < 9 [OR (95% CI) = 3.538 (1.086 - 11.526), p = 0.036] and NIHSS 15 - 24 [OR (95% CI) = 7.498 (1.306 - 43.029), p = 0.024] were independent predictors of in-hospital mortality while mass effect [OR (95% CI) = 3.563 (1.217 - 10.432), p = 0.020] and hyperthermia [OR (95% CI) = 4.645 (1.341 - 16.085), p = 0.015] predict poor functional outcome. Six</span>-<span "="">month survival was 37.8%. <b>Conclusion:</b> About one</span>-<span "="">third of stroke patient were haemorrhagic. Hypertension is the leading CVRF and aetiology of spontaneous ICH. About 1 over 2 patients with SICH would die within 3 months while 50% of survivors would have a poor functional outcome at 6<sup>th</sup> month.</span> </div>展开更多
Group discussion teaching technique for small groups and encouragement of critical but constructive and creative thinking for finding new and efficient solutions can lead to provision of better health and medical serv...Group discussion teaching technique for small groups and encouragement of critical but constructive and creative thinking for finding new and efficient solutions can lead to provision of better health and medical services that is defined in clinical setting, as the clinical psychology finds a way for curing and education. The present study was conducted with the aim to compare the effects of creative group teaching and educational booklet on interpersonal skills of midwives in a clinical setting. The present study was conducted on 97 midwifery graduates working in hospitals in Kerman Province, in two groups of educational booklet (49 midwives) and educational workshop (48 midwives) who participated in a 3-day creative teaching workshop in summer 2015. Creative problem-solving teaching intervention group was taught through educational workshop method, including small group and team working, group discussion and mini lectures. Midwifery 1 intervention group was provided with an educational booklet validated by professors of Nursing and Midwifery School for independent and individual study by midwives working in Kerman Province hospitals. The two groups were matched in terms of personal details. Hospitals were randomly selected, and midwives were selected by quota sampling. Interpersonal communication skills of both groups were assessed before and after intervention, and two months later using Interpersonal Communication Skills Test. The results obtained were analyzed in SPSS-16 using descriptive statistics, including frequency and percentage, mean and standard deviation, and inferential statistics including U-Mann-Whitney, paired t, independent t, repeated measures ANOVA tests at significance level of P P P P P < 0.001). Both teaching methods improved midwives’ interpersonal communication skills. Therefore, standardized educational booklets which produce cost-effective similar results are recommended.展开更多
Introduction: The incidence of acute renal failure (ARF) increases with age. In Senegal, few studies have described the epidemiology of ARF in the elderly. The aim of our study is to establish the epidemiological prof...Introduction: The incidence of acute renal failure (ARF) increases with age. In Senegal, few studies have described the epidemiology of ARF in the elderly. The aim of our study is to establish the epidemiological profile of elderly patients with ARF, identify the causes of ARF in the elderly and assess treatment and prognosis. Methods: We conducted a descriptive and retrospective study over a five-year period from 2011 to 2015 involving patients aged 60 and over, treated for ARI during the study period. Data entry and analysis were done on Epi info 7.3. Results: We included a total of 45 patients. The prevalence of ARF was 3.34%. The mean age was 70.31 years (60 - 83) and the sex ratio was 3.5. Phytotherapy was found in 68.9%, hypertension was found in 68.9%, and diabetes was found in 31.1%. Prostate hypertrophy was found in 53.4% of patients. Pre-renal ARF was the most common (46.6%). Most of the cases, 66.67%, were at Stage 3 of KDIGO. The most common etiologies were respectively tumor (35.5%) and infection (20%). The most common complications were respectively hyperkalemia (33.3%) and hyponatremia (33.3%). Recovery was complete in 62.6% of cases, partial in 37.8% of patients and 13.3% of patients ended up on chronic hemodialysis. Mortality was 4.4%. Conclusion: Herbal medicine, hypertension and diabetes are frequently associated with ARF in the elderly. This justifies increased monitoring of the elderly subject with these conditions in order to subject him to early and appropriate care.展开更多
Objective To evaluate the association of GGN repeat polymorphism of androgen receptor(AR)with ovarian reserve and ovarian response in controlled ovarian stimulation(COS).Methods This genetic association study was cond...Objective To evaluate the association of GGN repeat polymorphism of androgen receptor(AR)with ovarian reserve and ovarian response in controlled ovarian stimulation(COS).Methods This genetic association study was conducted among a total of 361 women aged≤40 years with basal FSH≤12 U/L undergoing the GnRH-agonist long protocol for COS in a university affiliated IVF center.GGN repeat in the AR gene was analyzed with Sanger sequencing.The primary endpoint was the number of antral follicle counts(AFCs),and the secondary endpoints were stimulation days,total dose of gonadotropin(Gn)used,total number of retrieved oocytes,ovarian sensitivity index,and follicular output rate.Results The GGN repeat in exon 1 of the AR gene ranged from 13 to 24,and the median repeat length was 22.Based on the genotypes(S for GGN repeats<22,L for GGN repeats≥22),the patients were divided into 3 groups:SS,SL,and LL.Generalized regression analysis indicated that the number of AFCs in group SS was significantly lower than those in group SL(adjusted β=1.8,95%CI:0.2-3.4,P=0.024)and group LL(adjusted β=1.5,95%CI:0.2-2.7,P=0.021).No significant difference was observed in the number of AFCs between group SL and group LL(P>0.05).Generalized regression analysis indicated no significant differences in ovarian stimulation parameters among the 3 groups,either before or after adjusting for confounding factors(P>0.05).Conclusion GGN repeat length on the AR gene is associated with AFC but not with ovarian response in Chinese women,indicating that AR gene polymorphisms may affect ovarian reserve.展开更多
Insulin resistance(IR)is widely recognized as a key contributor to metabolic disorders,and various surrogate indices have been developed to estimate IR in clinical and research settings.The hyperinsulinemic-euglycemic...Insulin resistance(IR)is widely recognized as a key contributor to metabolic disorders,and various surrogate indices have been developed to estimate IR in clinical and research settings.The hyperinsulinemic-euglycemic clamp is considered the gold standard method for assessing insulin resistance due to its precision;however,its complexity limits its widespread clinical application.Consequently,surrogate indices derived from fasting and post-load glucose and insulin levels have been developed to estimate IR,facilitating early detection and risk stratification in metabolic disorders.This mini-review discusses the clinical utility,strengths,and limitations of key IR indices,including the homeostasis model assessment of IR,quantitative insulin sensitivity check index,Matsuda index,and triglyceride-glucose index.Overall,the evidence presented to date suggests that these indices provide valuable estimates of IR in various popula-tions.Yet,their applicability varies depending on ethnic background,disease status,and clinical setting.Integrating these indices into routine clinical practice and research could improve metabolic risk assessment and guide preventive interventions.Further investigations are necessary to refine their accuracy and determine optimal cut-off values for various populations.展开更多
Portal hypertension(PH)is a major complication of chronic liver disease,often leading to serious clinical consequences such as variceal bleeding,ascites,and splenomegaly.The current gold standard for PH diagnosis,name...Portal hypertension(PH)is a major complication of chronic liver disease,often leading to serious clinical consequences such as variceal bleeding,ascites,and splenomegaly.The current gold standard for PH diagnosis,namely,hepatic venous pressure gradient measurement,is invasive and not widely available.Transient elastography has emerged as a non-invasive alternative for assessing liver stiffness(LS),and recent studies have highlighted the potential role of splenic stiffness(SS)in evaluating PH severity.This narrative review summarizes the available evidence on the utility of splenic transient elastography in assessing PH.We evaluated its diagnostic accuracy,technical challenges,and clinical applications,particularly in distinguishing between cirrhotic PH(CPH)and noncirrhotic PH(NCPH).A comprehensive literature search was conducted using the PubMed database,focusing on studies that assess splenic elastography in the diagnosis and prognosis of PH.This review compares splenic elastography with other non-invasive imaging modalities,including MR elastography and shearwave elastography.Additionally,we examined the role of SS using elastography in predicting the presence of esophageal varices and its potential impact on reducing the need for endoscopic screening.Studies have demonstrated that splenic elastography correlates well with PH severity,with cut-off values ranging between 45 kPa and 50 kPa for significant PH detection.Splenic elastography,when combined with platelet count and LS measurements,improves diagnostic accuracy and risk stratification for the occurrence of variceal bleeding.Despite its clinical promise,technical challenges such as patient positioning,body habitus,and probe selection remain key limitations.Notably,splenic elastography may be particularly useful in diagnosing NCPH,where LS remains normal but PH is present.Splenic transient elastography is a valuable adjunct in the non-invasive assessment of PH.Its ability to predict varices,differentiate between CPH and NCPH,and reduce unnecessary endoscopies suggests that it should be incorporated into routine hepatology practice.Future research should focus on refining SS cut-offs,evaluating its cost-effectiveness,and integrating splenic elastography into clinical guidelines for PH management.展开更多
Artemisia dracunculus L.,or tarragon,is a perennial herb from the Asteraceae family that is extensively cultivated for its aromatic leaves,which are valued for its preventative and therapeutic properties in both cooke...Artemisia dracunculus L.,or tarragon,is a perennial herb from the Asteraceae family that is extensively cultivated for its aromatic leaves,which are valued for its preventative and therapeutic properties in both cookery and traditional medicine.This study aims to investigate the antibacterial,antioxidant,and anti-inflammatory properties of A.dracunculus(tarragon)essential oil(ADEO),with estragole(57.23%)identified as the major compound through gas chromatography-mass spectrometry(GC-MS)analysis.ADEO exhibited varying degrees of antibacterial activity,with Escherichia coli showing higher resistance inhibition zone(IZ)=14.7±0.58 mm,minimum (inhibitory concentration(MIC)=2%and minimum bactericidal concentration(MBC)=4%),while Bacillus subtilis(IZ=24.05±2.11 mm and MIC=MBC=0.125%)and Staphylococcus aureus(IZ=18.69±1.45 mm,MIC=0.0612%and MBC=0.125%)were more sensitive to its actions.Antioxidant ability was assessed using 1,1-diphenyl-2-picrylhydrazil(DPPH),2,2′-azinobis(3-ethylbenzothiazoline-6-sulfonic acid)(ABTS),xanthine oxidase inhibition,and beta-carotene bleaching assays.ADEO showed remarkable antiradical effect on DPPH(IC_(50)=127.05±3.47μg/mL)and ABTS radical(IC_(50)=89.60±8.73μg/mL)as well as significant inhibition of xanthine oxidase(IC_(50)=47.9±2.04μg/mL)and lipid peroxidation(IC_(50)=231.63±5.21μg/mL).ADEO also showed significant anti-inflammatory activity by inhibiting the enzymesCOX-1(IC_(50)=59.2±2.43μg/mL),Cyclo-oxygenase-2(COX-2)(IC_(50)=74.68±1.34μg/mL)and 5-lipooxygense(5-LOX)(IC_(50)=93.18±1.87μg/mL),which are involved in the inflammatory pathway.These findings suggest that ADEO,with its high estragole content,holds promising potential as a natural antibacterial,antioxidant,and anti-inflammatory agent for preventive and therapeutic applications.Further research is needed to explore its safety and efficacy in clinical settings.展开更多
Polyphenols,a diverse group of naturally occurring compounds found in plants,have garnered significant attention for their potential therapeutic properties in treating neurodegenerative diseases(NDs).The Wnt/β-cateni...Polyphenols,a diverse group of naturally occurring compounds found in plants,have garnered significant attention for their potential therapeutic properties in treating neurodegenerative diseases(NDs).The Wnt/β-catenin(WβC)signaling pathway,a crucial player in neurogenesis,neuronal survival,and synaptic plasticity,is involved in several cellular mechanisms related to NDs.Dysregulation of this pathway is a hallmark in the development of various NDs.This study explores multiple polyphenolic compounds,such as flavonoids,stilbenes,lignans,and phenolic acids,and their potential to protect the nervous system.It provides a comprehensive analysis of their effects on the WβC pathway,elucidating their modes of action.The study highlights the dual function of polyphenols in regulating and protecting the nervous system,providing reassurance about the research benefits.This review provides a comprehensive analysis of the results obtained from both in vitro studies and in vivo research,shedding light on how these substances influence the various components of the pathway.The focus is mainly on the molecular mechanisms that allow polyphenols to reduce oxidative stress,inflammation,and apoptotic processes,ultimately improving the function and survival of neurons.This study aims to offer a thorough understanding of the potential of polyphenols in targeting the WβC signaling pathway,which could lead to the development of innovative therapeutic options for NDs.展开更多
Background:Diabetes,a metabolic disease marked by endocrine dysfunctions,significantly impacts oxidative stress pathways.This study explores the protective effects of lemongrass extract(LE),citral,and lemongrass extra...Background:Diabetes,a metabolic disease marked by endocrine dysfunctions,significantly impacts oxidative stress pathways.This study explores the protective effects of lemongrass extract(LE),citral,and lemongrass extract-synthesized silver nanoparticles(LE-AgNP)against hyperglycemia-induced oxidative stress by modulating the Nrf2 pathway,which is crucial for antioxidant responses.Methods:Various techniques characterized the nanoparticles,including ultraviolet–visible spectroscopy,dynamic light scattering,zeta potential analysis,Fouriertransform infrared spectroscopy,scanning electron microscopy and transmission electron microscopy.Seventy rats,divided into seven groups,were used for in vivo experiments.Type 2 diabetes was induced using streptozotocin(65 mg/kg)and nicotinamide(90 mg/kg).After six weeks,biochemical parameters such as total antioxidant capacity,malondialdehyde,Nrf2,and Nrf2 miRNA were evaluated in pancreas tissue and blood serum,along with serum blood glucose levels.Results:LE-AgNP significantly improved weight gain,reduced food and water intake,and lowered blood glucose levels in diabetic rats.LE and citral did not significantly alter these parameters but prevented the decline in Nrf2 gene expression.LE-AgNP showed a significant increase in Nrf2 gene expression compared to the diabetic control group.Conclusions:This study highlights the potential of LE,citral,and especially LE-AgNP in mitigating oxidative stress induced by diabetes.LE-AgNP demonstrated superior therapeutic benefits,including improved oxidative stress conditions and hypoglycemic effects.展开更多
文摘Abortion is one of the leading causes of maternal death in Cameroon, despite numerous policies and strategies put in place to reduce it by 2030.This study aims to describe the epidemiologic aspects of abortions within hospitals in the city of Yaoundé in 2023. Methods: This was a descriptive cross-sectional study with prospective data collection in the maternity wards of the Yaoundé Gynaeco-Obstetric and Paediatric Hospital, and the Yaoundé Central Hospital for 7 months, from the 1st of November 2022 to the 31st of May 2023. The variables studied were demographic and clinical characteristics, means of recourse and post-abortion contraception. The frequency of abortions was calculated as the ratio of the number of abortions to the number of deliveries. The calculation of numbers and frequencies was used to describe the study population, and to highlight the sociodemographic and clinical characteristics of the patients recruited. Quantitative variables were expressed as mean ± standard deviation. Data were collected numerically and classified according to type, then analyzed using Epi-info version 7.2 software. Microsoft Office Excel 2013 was used to produce figures and tables. Results: During the study period, 169 patients were selected out of 1882 patients who had consulted for gynaecological emergencies;but only 164 of them accepted to participate. The frequency of abortions was 9.6% (169/1882). The age group of 25 to 29 years was the most represented, with 29.3% (48/164). They were mainly single 76.2% (125/164), and housewives 33.5% (55/164). The notion of previous abortion was found in 30.5% (50/164) of them. Approximately 19.5% of patients (32/164) reported to have conceived while using contraception, 56.2% of whom (18/32) used male condoms. At the time of admission to the emergency unit, the predominant symptom was bleeding in 70.7% of cases. The abortions were mainly spontaneous, in 75% of cases (123/164). In cases of induced abortions, 24.4% (10/41) of them took place after 14 weeks. Unexpected pregnancy was the main reason for termination in 46.3% of cases (19/41). Regarding induced abortion, 58.54% (24/41) of them resorted to voluntary medical termination. The mortality rate was 1.2%. The acceptability rate of a modern contraceptive method before discharge was 31.7%. Conclusion: Although frequent in our environment, data relating to abortion remain under-evaluated. Abortions occur mainly among young, single women, with a still very high proportion of induced abortions. The acceptability of post-abortion contraception remains poor. Prevention of unwanted pregnancies and risk factors is necessary to reduce the burden of abortions in low-income countries.
文摘Ossiculoplasty remains a challenging surgical procedure,with outcomes heavily influenced by diverse anatomical and pathological factors.Over the decades,numerous scoring systems have been developed to predict the prognosis of ossiculoplasty,each emphasizing different variables such as ossicular status,middle ear environment,and surgical history.This paper provides a comprehensive review of the evolution of prognostic scoring systems,including Austin's original ossicular classification,Bellucci's otorrhea staging,the Middle Ear Risk Index(MERI),the Ossiculoplasty Outcome Parameter Staging(OOPS),and the recently introduced Ear Environment Risk(EER)scale.While these systems have significantly contributed to preoperative assessment,each presents notable limitations in encompassing all variables affecting surgical success.Therefore,the aim of this paper is to provide a review of the ossiculoplasty prognostic scores and show the benefits,innovations and gaps associated with each.To address these gaps,a novel,modified scoring system is proposed,incorporating previously overlooked but clinically significant factors such as tympanic membrane status,type of tympanoplasty,ossicular replacement material,CT scan findings,and the presence of complicated ear conditions.By synthesizing elements from historical scores with updated clinical insights,the proposed system aims to provide a more holistic and predictive framework for preoperative evaluation.Future multicenter studies are encouraged to validate the efficacy and prognostic power of this new scoring system,with the goal of improving surgical planning and patient counseling in ossiculoplasty.
基金appreciation to the Princess Nourah bint Abdulrahman University Researchers Supporting Project number(PNURSP2025R384)Princess Nourah bint Abdulrahman University,Riyadh,Saudi Arabia.
文摘The cloud-fog computing paradigm has emerged as a novel hybrid computing model that integrates computational resources at both fog nodes and cloud servers to address the challenges posed by dynamic and heterogeneous computing networks.Finding an optimal computational resource for task offloading and then executing efficiently is a critical issue to achieve a trade-off between energy consumption and transmission delay.In this network,the task processed at fog nodes reduces transmission delay.Still,it increases energy consumption,while routing tasks to the cloud server saves energy at the cost of higher communication delay.Moreover,the order in which offloaded tasks are executed affects the system’s efficiency.For instance,executing lower-priority tasks before higher-priority jobs can disturb the reliability and stability of the system.Therefore,an efficient strategy of optimal computation offloading and task scheduling is required for operational efficacy.In this paper,we introduced a multi-objective and enhanced version of Cheeta Optimizer(CO),namely(MoECO),to jointly optimize the computation offloading and task scheduling in cloud-fog networks to minimize two competing objectives,i.e.,energy consumption and communication delay.MoECO first assigns tasks to the optimal computational nodes and then the allocated tasks are scheduled for processing based on the task priority.The mathematical modelling of CO needs improvement in computation time and convergence speed.Therefore,MoECO is proposed to increase the search capability of agents by controlling the search strategy based on a leader’s location.The adaptive step length operator is adjusted to diversify the solution and thus improves the exploration phase,i.e.,global search strategy.Consequently,this prevents the algorithm from getting trapped in the local optimal solution.Moreover,the interaction factor during the exploitation phase is also adjusted based on the location of the prey instead of the adjacent Cheetah.This increases the exploitation capability of agents,i.e.,local search capability.Furthermore,MoECO employs a multi-objective Pareto-optimal front to simultaneously minimize designated objectives.Comprehensive simulations in MATLAB demonstrate that the proposed algorithm obtains multiple solutions via a Pareto-optimal front and achieves an efficient trade-off between optimization objectives compared to baseline methods.
文摘Background:Mastitis caused by different pathogens including Streptococcus uberis(S.uberis)is responsible for huge economic losses to the dairy industry.In order to investigate the potential genetic and epigenetic regulatory mecha‑nisms of subclinical mastitis due to S.uberis,the DNA methylome(whole genome DNA methylation sequencing)and transcriptome(RNA sequencing)of milk somatic cells from cows with naturally occurring S.uberis subclinical mastitis and healthy control cows(n=3/group)were studied.Results:Globally,the DNA methylation levels of CpG sites were low in the promoters and first exons but high in inner exons and introns.The DNA methylation levels at the promoter,first exon and first intron regions were nega‑tively correlated with the expression level of genes at a whole‑genome‑wide scale.In general,DNA methylation level was lower in S.uberis‑positive group(SUG)than in the control group(CTG).A total of 174,342 differentially methylated cytosines(DMCs)(FDR<0.05)were identified between SUG and CTG,including 132,237,7412 and 34,693 DMCs in the context of CpG,CHG and CHH(H=A or T or C),respectively.Besides,101,612 methylation haplotype blocks(MHBs)were identified,including 451 MHBs that were significantly different(dMHB)between the two groups.A total of 2130 differentially expressed(DE)genes(1378 with up‑regulated and 752 with down‑regulated expression)were found in SUG.Integration of methylome and transcriptome data with MethGET program revealed 1623 genes with signifi‑cant changes in their methylation levels and/or gene expression changes(MetGDE genes,MethGET P‑value<0.001).Functional enrichment of genes harboring≥15 DMCs,DE genes and MetGDE genes suggest significant involvement of DNA methylation changes in the regulation of the host immune response to S.uberis infection,especially cytokine activities.Furthermore,discriminant correlation analysis with DIABLO method identified 26 candidate biomarkers,including 6 DE genes,15 CpG‑DMCs and 5 dMHBs that discriminated between SUG and CTG.Conclusion:The integration of methylome and transcriptome of milk somatic cells suggests the possible involve‑ment of DNA methylation changes in the regulation of the host immune response to subclinical mastitis due to S.uberis.The presented genetic and epigenetic biomarkers could contribute to the design of management strategies of subclinical mastitis and breeding for mastitis resistance.
文摘AIM:To identify factors predicting the clinical response of ulcerative colitis patients to granulocyte-monocyte apheresis (GMA). METHODS:Sixty-nine ulcerative colitis patients (39 F,30 M) dependent upon/refractory to steroids were treated with GMA. Steroid dependency,clinical activity index (CAI),C reactive protein (CRP) level,erythrocyte sedimentation rate (ESR),values at baseline,use of immunosuppressant,duration of disease,and age and extent of disease were considered for statistical analysis as predictive factors of clinical response. Univariate and multivariate logistic regression models were used. RESULTS:In the univariate analysis,CAI (P = 0.039) and ESR (P = 0.017) levels at baseline were singled out as predictive of clinical remission. In the multivariate analysis steroid dependency [Odds ratio (OR) = 0.390,95% Confidence interval (CI):0.176-0.865,Wald 5.361,P = 0.0160] and low CAI levels at baseline (4 < CAI <7) (OR = 0.770,95% CI:0.425-1.394,Wald 3.747,P = 0.028) proved to be effective as factors predicting clinical response. CONCLUSION:GMA may be a valid therapeutic option for steroid-dependent ulcerative colitis patients with mild-moderate disease and its clinical efficacy seems to persist for 12 mo.
文摘A 3-year-old Persian queen was referred to Teaching Veterinary Hospital while 3 neonates' umbilical cords were entangled with the queen's tail hair.Close inspection of the cat showed that the umbilical cords of 3 kittens had twisted around together and entangled with the moms' hairs in the base of tail region.Also this complex has been warped around the left tarsus of one of the involved kittens and caused swelling and skin darkness in the involved limb.Operation was carried out urgently.After cutting the queen's involved hairs the kittens were released.Then the twisted umbilical cords and the hairs were isolated from the umbilical cord and the involved leg was released from the umbilical cords and the twisted umbilical cords were separated from each other.During one week follow up,dry gangrene occurred in the distal extremity of the injured limb and consequently,amputation was performed on the distal part of tibia.Our clinical findings suggest that long hair coats of queens could be a maternal life threatening factor for neonates' life.
基金Supported by a grant for Scientific Research from Vice Chancellorof Research of Shahid Bahonar University of Kerman.Iran(Grant No.MP/342/41)
文摘Objective:To investigate clinical,pathological and mycological findings in canaries,in which pox lesions and Aspergillus fumigatus(A.fumigatus)infection were observed simultaneously.Methods:This study was performed on a breeding colony(about 100 canaries)affected by fatal wasting disease.Necropsy was undertaken on 10 severely affected canaries,and gross lesions were recorded.Samples from internal organs displaying lesions were obtained for histopathological evaluation.Tracheal swap samples of internal organs of the all infected animals with lesions at necropsy were cultured in Sabouraud Dextrose Agar for mycological examination.Results:At necropsy,caseous foci were determined in the lungs,on the air sacs,liver,spleen,heart.Swelling of the eyelids,diffuse hemorrhages in the subcutaneous tissue with small papular lesions of the skin were other typical necropsy findings.Histopathologically,pathognomonic eosinophilic intracytoplasmic inclusion bodies,which called Bollinger bodies,in both skin cells and vacuolated air way epithelial cells confirmed canary pox infection.Moreover,histopathological examination of the white-yellowish caseous foci revealed necrotic granulomatous reaction consisting of macrophages,heterophil leukocytes and giant cells encapsulated with a fibrous tissue.After the culture of the tissue samples,the formation of bluish green colonies confirmed A.fumigatus infection.Conclusions:Canary pox has been known as the disease that can result in high losses in a short time,as a re-emerging disease that has not been present during recent years in canary flocks in Iran.So,the current paper provides useful information to prevent misdiagnosed of canary pox disease which can cause secondary mycotic infection.
文摘Objective: To confirm the efficacy of non-antibiotic treatment with prostaglandin F2α(PGF2α) in dairy cows affected by severe clinical endometritis in (30±3) days in milk. Methods: Cows with clinical endometritis Ⅲ (n=399) were aligned into three groups randomly. The first group (n=115) received PGF2α, the second group (n=84) received intrauterine infusion (IUI) of oxytetracycline 10% + PGF2α, and the third group (n=200) received IUI. Cows were inseminated following estrus. The pregnancy status, parity, calving and artificial insemination season, ovaries with corpus luteum at the time of treatment, dystocia, body condition score and treatment groups were included in data analysis. Results: Total pregnancy rate was 40.1% after the first insemination and 94.2% after the third insemination. Overall pregnancy rate of treated cows with IUI+PGF2α(84.5%) was significantly lower than the treated cows with PGF2α(98.3%) or IUI (96%) (P<0.05). The first service pregnancy rate of inseminated cows in summer (14.3%) was lower in comparison with cows inseminated in spring (40.4%), fall (41.4%) and winter (51.7%) (P<0.05). Conclusions: PGF2α could treat severe clinical endometritis in dairy cows with corpus luteum in comparison with other treatments.
文摘Erectile dysfunction （ED） has been found to frequently precedes the onset of coronary artery disease （CAD）, representing an early marker of subclinical vascular disease, included CAD. Its recognition is, therefore, a ＂window opportunity＂ to prevent a coronary event by aggressive treatment of cardiovascular risk factors. The artery size hypothesis （ASH） has been proposed as a putative mechanism to explain the relationship between ED and CAD. Since atherosclerosis is a systemic disorder all major vascular beds should be affected to the same extent. However, symptoms at different points in the system rarely become evident at the same time. This is likely the result of smaller vessels （i.e. the penile artery） being able to less well tolerate the same amount of plaque when compared with larger ones （i.e. the coronary artery）. If true, ED will develop before CAD. We present a case in which ED developed after a coronary event yet before a coronary recurrence potentially representing a late marker of vascular progression. Reasons for this unusual sequence are discussed as they might still fit the ASH.
文摘Stroke as a disease entity has significantly increased the morbidity, incapacity, and mortality in Sri Lanka. In the west, it is the 3rd most common cause of death. In addition to that, it is a disturbing and restricting cerebrovascular disease with a substantial amount of remaining shortage leading on to emotional and financial burden on the family and society. A hospital-based retrospective study was conducted at Teaching Hospital Batticaloa, Sri Lanka from July 1, 2016, to October 31, 2016. During the study period, data were collected from the medical records. Out of 34 patients, 21 (61.8%) were males and 13 (38.2%) were females. The male to female ratio was 1.6:1. Out of 34 patients, 17 (50%) were affected in the left side and 17 (50%) were affected on the right side. The most common risk factor was hypertension with 79.4%, and next to that diabetes mellitus (41.2%), smoking (23.5%), alcohol (20.6%), past history of Stroke (17.6%) and ischaemic heart disease (IHD) (14.7%). Stroke due to infarction is more common than haemorrhage. In this study, both right and left sides were affected equally. In order to prevent this devastating stroke, acknowledgment of risk factors for stroke is prime importance for the healthcare workers as well as public.
文摘Background: Urinary tract infection caused by Escherichia coli is a frequently observed condition both in humans and animals. Uropathogenic E. coli (UPEC) has been shown to have a pathogenicity island that enables them to infect the urinary tract. Because there is little information about the presence of UPEC-associated virulent genes in animal isolates this work was carried out with the intent to enhance the understanding about the strains of E.coli that cause infections in animals. Results: We screened 21 E. coli strains isolated causing urinary tract infection in domestic animals. Primers were designed to amplify urinary infection-associated genes. Nine genes, papA, tcpC, fyuA, tpbA, Lma, hylA, picU, tonB, and flicC were then amplified and sequenced. Different from the human isolate CFT073, all the animals E. coli lack some of the pathogenesis-associated genes. Genes encoding for proteins used to scavenge iron appear not to be so necessary during animal infections as they are in human infection. In further investigation of phenotypic properties, it was observed that animal UPECs have significantly more impaired ability to form biofilms than human UPEC strain. Conclusions: This study identified significant differences between human and animal UPECs. This may have its roots in the fact that it is difficult to determine if an animal has symptoms. Future studies will focus on some of the observations.
文摘<div style="text-align:justify;"> <strong>Background:</strong> Data on spontaneous intracerebral haemorrhagic (SICH) are scarce in Africa. Our objectives were<span "=""> to determine the prevalence of SICH, describe the clinical profile, aetiology and evaluate the prognosis (fatality case, functional outcome) of patients in a tertiary health care hospital in Cameroon. <b>Methods:</b> This was a hospital-based retrospective cohort</span><span "=""> </span><span "="">which included patients with SICH and followed up for 6 months after stroke. Subarachnoid haemorrhage, cerebral venous thrombosis with bleeding or bleeding related with ischemic or brain tumour were excluded. Predictive factors were obtained using multiple logistic regression and survival by Kaplan Meier method. <b>Results:</b> The prevalence of SICH was 37% with male predominance (64.0%), a mean age of 55.6 ± 11.8 years. Deep coma was found in 30.3% on admission. The basal ganglion was the most frequent location of haemorrhage (85.1%) while intraventricular blood effusion, mass effect, cerebral oedema and herniation occurred in 31.4%, 25.7%, 8.8% and 5.0% respectively. Hypertension (57.5%) was the most common aetiology. The mean length of hospitalization was 9.0 ± 7.7 days and chest infection (30.7%) was the most frequent complication. The cumulative case fatality rate after 24 hours (day 1), during admission, month 1 and month 3 was 9.6%, 39.9%, 46.0%, 59.8% respectively. On multivariate analysis, GCS < 9 [OR (95% CI) = 3.538 (1.086 - 11.526), p = 0.036] and NIHSS 15 - 24 [OR (95% CI) = 7.498 (1.306 - 43.029), p = 0.024] were independent predictors of in-hospital mortality while mass effect [OR (95% CI) = 3.563 (1.217 - 10.432), p = 0.020] and hyperthermia [OR (95% CI) = 4.645 (1.341 - 16.085), p = 0.015] predict poor functional outcome. Six</span>-<span "="">month survival was 37.8%. <b>Conclusion:</b> About one</span>-<span "="">third of stroke patient were haemorrhagic. Hypertension is the leading CVRF and aetiology of spontaneous ICH. About 1 over 2 patients with SICH would die within 3 months while 50% of survivors would have a poor functional outcome at 6<sup>th</sup> month.</span> </div>
文摘Group discussion teaching technique for small groups and encouragement of critical but constructive and creative thinking for finding new and efficient solutions can lead to provision of better health and medical services that is defined in clinical setting, as the clinical psychology finds a way for curing and education. The present study was conducted with the aim to compare the effects of creative group teaching and educational booklet on interpersonal skills of midwives in a clinical setting. The present study was conducted on 97 midwifery graduates working in hospitals in Kerman Province, in two groups of educational booklet (49 midwives) and educational workshop (48 midwives) who participated in a 3-day creative teaching workshop in summer 2015. Creative problem-solving teaching intervention group was taught through educational workshop method, including small group and team working, group discussion and mini lectures. Midwifery 1 intervention group was provided with an educational booklet validated by professors of Nursing and Midwifery School for independent and individual study by midwives working in Kerman Province hospitals. The two groups were matched in terms of personal details. Hospitals were randomly selected, and midwives were selected by quota sampling. Interpersonal communication skills of both groups were assessed before and after intervention, and two months later using Interpersonal Communication Skills Test. The results obtained were analyzed in SPSS-16 using descriptive statistics, including frequency and percentage, mean and standard deviation, and inferential statistics including U-Mann-Whitney, paired t, independent t, repeated measures ANOVA tests at significance level of P P P P P < 0.001). Both teaching methods improved midwives’ interpersonal communication skills. Therefore, standardized educational booklets which produce cost-effective similar results are recommended.
文摘Introduction: The incidence of acute renal failure (ARF) increases with age. In Senegal, few studies have described the epidemiology of ARF in the elderly. The aim of our study is to establish the epidemiological profile of elderly patients with ARF, identify the causes of ARF in the elderly and assess treatment and prognosis. Methods: We conducted a descriptive and retrospective study over a five-year period from 2011 to 2015 involving patients aged 60 and over, treated for ARI during the study period. Data entry and analysis were done on Epi info 7.3. Results: We included a total of 45 patients. The prevalence of ARF was 3.34%. The mean age was 70.31 years (60 - 83) and the sex ratio was 3.5. Phytotherapy was found in 68.9%, hypertension was found in 68.9%, and diabetes was found in 31.1%. Prostate hypertrophy was found in 53.4% of patients. Pre-renal ARF was the most common (46.6%). Most of the cases, 66.67%, were at Stage 3 of KDIGO. The most common etiologies were respectively tumor (35.5%) and infection (20%). The most common complications were respectively hyperkalemia (33.3%) and hyponatremia (33.3%). Recovery was complete in 62.6% of cases, partial in 37.8% of patients and 13.3% of patients ended up on chronic hemodialysis. Mortality was 4.4%. Conclusion: Herbal medicine, hypertension and diabetes are frequently associated with ARF in the elderly. This justifies increased monitoring of the elderly subject with these conditions in order to subject him to early and appropriate care.
文摘Objective To evaluate the association of GGN repeat polymorphism of androgen receptor(AR)with ovarian reserve and ovarian response in controlled ovarian stimulation(COS).Methods This genetic association study was conducted among a total of 361 women aged≤40 years with basal FSH≤12 U/L undergoing the GnRH-agonist long protocol for COS in a university affiliated IVF center.GGN repeat in the AR gene was analyzed with Sanger sequencing.The primary endpoint was the number of antral follicle counts(AFCs),and the secondary endpoints were stimulation days,total dose of gonadotropin(Gn)used,total number of retrieved oocytes,ovarian sensitivity index,and follicular output rate.Results The GGN repeat in exon 1 of the AR gene ranged from 13 to 24,and the median repeat length was 22.Based on the genotypes(S for GGN repeats<22,L for GGN repeats≥22),the patients were divided into 3 groups:SS,SL,and LL.Generalized regression analysis indicated that the number of AFCs in group SS was significantly lower than those in group SL(adjusted β=1.8,95%CI:0.2-3.4,P=0.024)and group LL(adjusted β=1.5,95%CI:0.2-2.7,P=0.021).No significant difference was observed in the number of AFCs between group SL and group LL(P>0.05).Generalized regression analysis indicated no significant differences in ovarian stimulation parameters among the 3 groups,either before or after adjusting for confounding factors(P>0.05).Conclusion GGN repeat length on the AR gene is associated with AFC but not with ovarian response in Chinese women,indicating that AR gene polymorphisms may affect ovarian reserve.
文摘Insulin resistance(IR)is widely recognized as a key contributor to metabolic disorders,and various surrogate indices have been developed to estimate IR in clinical and research settings.The hyperinsulinemic-euglycemic clamp is considered the gold standard method for assessing insulin resistance due to its precision;however,its complexity limits its widespread clinical application.Consequently,surrogate indices derived from fasting and post-load glucose and insulin levels have been developed to estimate IR,facilitating early detection and risk stratification in metabolic disorders.This mini-review discusses the clinical utility,strengths,and limitations of key IR indices,including the homeostasis model assessment of IR,quantitative insulin sensitivity check index,Matsuda index,and triglyceride-glucose index.Overall,the evidence presented to date suggests that these indices provide valuable estimates of IR in various popula-tions.Yet,their applicability varies depending on ethnic background,disease status,and clinical setting.Integrating these indices into routine clinical practice and research could improve metabolic risk assessment and guide preventive interventions.Further investigations are necessary to refine their accuracy and determine optimal cut-off values for various populations.
文摘Portal hypertension(PH)is a major complication of chronic liver disease,often leading to serious clinical consequences such as variceal bleeding,ascites,and splenomegaly.The current gold standard for PH diagnosis,namely,hepatic venous pressure gradient measurement,is invasive and not widely available.Transient elastography has emerged as a non-invasive alternative for assessing liver stiffness(LS),and recent studies have highlighted the potential role of splenic stiffness(SS)in evaluating PH severity.This narrative review summarizes the available evidence on the utility of splenic transient elastography in assessing PH.We evaluated its diagnostic accuracy,technical challenges,and clinical applications,particularly in distinguishing between cirrhotic PH(CPH)and noncirrhotic PH(NCPH).A comprehensive literature search was conducted using the PubMed database,focusing on studies that assess splenic elastography in the diagnosis and prognosis of PH.This review compares splenic elastography with other non-invasive imaging modalities,including MR elastography and shearwave elastography.Additionally,we examined the role of SS using elastography in predicting the presence of esophageal varices and its potential impact on reducing the need for endoscopic screening.Studies have demonstrated that splenic elastography correlates well with PH severity,with cut-off values ranging between 45 kPa and 50 kPa for significant PH detection.Splenic elastography,when combined with platelet count and LS measurements,improves diagnostic accuracy and risk stratification for the occurrence of variceal bleeding.Despite its clinical promise,technical challenges such as patient positioning,body habitus,and probe selection remain key limitations.Notably,splenic elastography may be particularly useful in diagnosing NCPH,where LS remains normal but PH is present.Splenic transient elastography is a valuable adjunct in the non-invasive assessment of PH.Its ability to predict varices,differentiate between CPH and NCPH,and reduce unnecessary endoscopies suggests that it should be incorporated into routine hepatology practice.Future research should focus on refining SS cut-offs,evaluating its cost-effectiveness,and integrating splenic elastography into clinical guidelines for PH management.
文摘Artemisia dracunculus L.,or tarragon,is a perennial herb from the Asteraceae family that is extensively cultivated for its aromatic leaves,which are valued for its preventative and therapeutic properties in both cookery and traditional medicine.This study aims to investigate the antibacterial,antioxidant,and anti-inflammatory properties of A.dracunculus(tarragon)essential oil(ADEO),with estragole(57.23%)identified as the major compound through gas chromatography-mass spectrometry(GC-MS)analysis.ADEO exhibited varying degrees of antibacterial activity,with Escherichia coli showing higher resistance inhibition zone(IZ)=14.7±0.58 mm,minimum (inhibitory concentration(MIC)=2%and minimum bactericidal concentration(MBC)=4%),while Bacillus subtilis(IZ=24.05±2.11 mm and MIC=MBC=0.125%)and Staphylococcus aureus(IZ=18.69±1.45 mm,MIC=0.0612%and MBC=0.125%)were more sensitive to its actions.Antioxidant ability was assessed using 1,1-diphenyl-2-picrylhydrazil(DPPH),2,2′-azinobis(3-ethylbenzothiazoline-6-sulfonic acid)(ABTS),xanthine oxidase inhibition,and beta-carotene bleaching assays.ADEO showed remarkable antiradical effect on DPPH(IC_(50)=127.05±3.47μg/mL)and ABTS radical(IC_(50)=89.60±8.73μg/mL)as well as significant inhibition of xanthine oxidase(IC_(50)=47.9±2.04μg/mL)and lipid peroxidation(IC_(50)=231.63±5.21μg/mL).ADEO also showed significant anti-inflammatory activity by inhibiting the enzymesCOX-1(IC_(50)=59.2±2.43μg/mL),Cyclo-oxygenase-2(COX-2)(IC_(50)=74.68±1.34μg/mL)and 5-lipooxygense(5-LOX)(IC_(50)=93.18±1.87μg/mL),which are involved in the inflammatory pathway.These findings suggest that ADEO,with its high estragole content,holds promising potential as a natural antibacterial,antioxidant,and anti-inflammatory agent for preventive and therapeutic applications.Further research is needed to explore its safety and efficacy in clinical settings.
基金financially supporting this work through the Large Research Group Project under Grant no.R.G.P.2/509/45
文摘Polyphenols,a diverse group of naturally occurring compounds found in plants,have garnered significant attention for their potential therapeutic properties in treating neurodegenerative diseases(NDs).The Wnt/β-catenin(WβC)signaling pathway,a crucial player in neurogenesis,neuronal survival,and synaptic plasticity,is involved in several cellular mechanisms related to NDs.Dysregulation of this pathway is a hallmark in the development of various NDs.This study explores multiple polyphenolic compounds,such as flavonoids,stilbenes,lignans,and phenolic acids,and their potential to protect the nervous system.It provides a comprehensive analysis of their effects on the WβC pathway,elucidating their modes of action.The study highlights the dual function of polyphenols in regulating and protecting the nervous system,providing reassurance about the research benefits.This review provides a comprehensive analysis of the results obtained from both in vitro studies and in vivo research,shedding light on how these substances influence the various components of the pathway.The focus is mainly on the molecular mechanisms that allow polyphenols to reduce oxidative stress,inflammation,and apoptotic processes,ultimately improving the function and survival of neurons.This study aims to offer a thorough understanding of the potential of polyphenols in targeting the WβC signaling pathway,which could lead to the development of innovative therapeutic options for NDs.
文摘Background:Diabetes,a metabolic disease marked by endocrine dysfunctions,significantly impacts oxidative stress pathways.This study explores the protective effects of lemongrass extract(LE),citral,and lemongrass extract-synthesized silver nanoparticles(LE-AgNP)against hyperglycemia-induced oxidative stress by modulating the Nrf2 pathway,which is crucial for antioxidant responses.Methods:Various techniques characterized the nanoparticles,including ultraviolet–visible spectroscopy,dynamic light scattering,zeta potential analysis,Fouriertransform infrared spectroscopy,scanning electron microscopy and transmission electron microscopy.Seventy rats,divided into seven groups,were used for in vivo experiments.Type 2 diabetes was induced using streptozotocin(65 mg/kg)and nicotinamide(90 mg/kg).After six weeks,biochemical parameters such as total antioxidant capacity,malondialdehyde,Nrf2,and Nrf2 miRNA were evaluated in pancreas tissue and blood serum,along with serum blood glucose levels.Results:LE-AgNP significantly improved weight gain,reduced food and water intake,and lowered blood glucose levels in diabetic rats.LE and citral did not significantly alter these parameters but prevented the decline in Nrf2 gene expression.LE-AgNP showed a significant increase in Nrf2 gene expression compared to the diabetic control group.Conclusions:This study highlights the potential of LE,citral,and especially LE-AgNP in mitigating oxidative stress induced by diabetes.LE-AgNP demonstrated superior therapeutic benefits,including improved oxidative stress conditions and hypoglycemic effects.
