Gallstone Ileus: A Rare Case of Intestinal Obstruction, Presented in a Chronic Kidney Disease Patient on Haemodialysis
Published on: 5th February, 2025
The prevalence of gallbladder stones is higher in Chronic Kidney Disease (CKD) patients and it has been shown to increase with the advancement of the disease stage, from 7.7% in stage 1% to 21.3% in stage 5. Gallstone ileus is a rare complication which presents in just 0.3% - 0.5% of patients with cholelithiasis. A 61-year-old female patient, with a known case of CKD on maintenance hemodialysis, (thrice a week) with primary disease of hypertensive and diabetic nephropathy; presented with multiple episodes of loose stool, vomiting, and diffuse abdominal pain for 2 days. Abdomen Ultrasonography (USG) was suggestive of intestinal obstruction. CT abdomen with oral contrast revealed grossly dilated jejuna loops with air-fluid levels and transition zone in the pelvis, in distal jejunal loops/proximal ileum with ovoid intraluminal filling defect cystic polyp and collapsed bowel loops. The patient underwent exploratory laparotomy in view of persistent small bowel obstruction. Resection and anastomosis of the mass-bearing small bowel segment were performed. On cutting and opening the specimen, a large stone was revealed. This gallstone was causing bowel obstruction-gall stone ileus. A gallstone 2.6 cm x 2.1 cm has traversed through a cholecysto-duodenal fistula and got stuck in the proximal ileum, causing small bowel obstruction. The lesson learned is uraemia can cause gastrointestinal symptoms like anorexia, abdominal pain, vomiting, and ileus and hence mimic serious differentials of the acute abdomen like gallstone ileus. Thus no stone should be left unturned especially when the prevalance of gallstones is high in chronic kidney disease patients.
A Case of Rapidly Progressive Renal Failure with Unearthed Amyloidosis
Published on: 4th February, 2025
Amyloidosis-associated kidney disease commonly manifests with chronic glomerular symptoms including heavy proteinuria predominantly albuminuria. Clinical presentation ranges from full-blown nephrotic syndrome, hematuria, and hypertension to renal failure. In India patients with chronic kidney disease are mainly attributed to hypertension and diabetes but an underlying etiology such as amyloidosis needs to be unearthed and shouldn’t be ignored as an etiology. We report a case of a 60-year-old man with hypertension and hypothyroidism who presented with frothy urine for several years, b/l pedal edema for 15 days. Over the past 3 months, there was a serial increase in creatinine. As per CKD-EPI equation, the patient was CKD-4. As the patient was suspected to be rapidly progressive renal failure; a renal biopsy was planned. Biopsy reports were suggestive of Amyloidosis. Glomerular, vascular, and tubulointerstitial deposition of amyloid was seen. Based on renal biopsy and IHC staining; the patient’s diagnosis was AA-associated secondary renal amyloidosis. Thus in this case renal amyloidosis was an unearthed etiology.
Bifurcations and control studies in Circadian Rhythms in Drosophila
Published on: 7th February, 2025
Bifurcation analysis and Multiobjective Nonlinear Model Predictive Control (MNLMPC) calculations were performed on a model of circadian oscillations of the Period (PER) and Timeless (TIM) proteins in Drosophila. The MATLAB program MATCONT was used to perform the bifurcation analysis. The optimization language PYOMO was used along with the state-of-the-art global optimization solvers IPOPT and BARON for the MNLMPC calculations. The bifurcation analysis revealed oscillation causing Hopf bifurcations while the MNLMPC calculations revealed the existence of spikes in the control profiles. Both Hopf bifurcation points and the control profile spikes were eliminated using an activation factor involving the hyperbolic tangent function.
The Limitation of Determination Structure of the Agreed Rate of Return for Public-Private Partnership (PPP) Road Projects and Improvement in South Korea
Published on: 5th February, 2025
Public-Private Partnership (PPP) road projects are being promoted worldwide to encourage road investments; however, research on the appropriate rate of return for these projects is insufficient. This is likely because the return on investment for PPP road projects is determined through negotiations between the government and the private sector, a process that remains confidential. The rate of return for PPP road projects is not only a key indicator for evaluating project performance but also a potential driver for future government financial subsidies. Therefore, research on the appropriate rate of return for PPP road projects is necessary for the sustainability of these projects.This study, based on the concept that both the government and the private sector share the anticipated risks of the project, quantifies six types of risks and proposes a model for predicting the appropriate rate of return. The model is able to explain approximately 68% of the cases in South Korea’s PPP road projects. The risk with the greatest influence on the rate of return was found to be an economic risk, while the least influential was regulation change risk.Due to the confidentiality of data related to PPP road projects, this study only utilized 54 cases from South Korea. It is hoped that a wider range of data will be collected and further research on the appropriate rate of return will continue to enhance the sustainability of PPP road projects.
Analysis of Acoustic Parameters of Voice Jitter and Shimmer in Children with Dysphonia after Laryngeal Surgery
Published on: 4th February, 2025
The article conducted a study of computer acoustic analysis of Jitter and Shimmer voice parameters in children with dysphonia after laryngeal surgery. The study found that children with dysphonia had significantly lower preoperative Jitter and Shimmer scores (574359, 587, and 2.3) compared to healthy children (1316743.376 and 4.84). At 1 month after surgery, affected children showed a decrease in Jitter and Shimmer indices compared with these acoustic indices before surgery. However, at 2 months, there was a significant increase in Jitter and Shimmer scores, and at 3 months, Jitter and Shimmer scores were comparable to Jitter and Shimmer scores in healthy children without dysphonia. The results of the study show that the method of analyzing the acoustic parameters of the voice Jitter and Shimmer allows a phoniatrist to objectively assess the occurrence of a voice disease in patients with dysphonia, and this method is the most accurate criterion for determining the pathologies of dysphonia and determining the treatment program for the disease.
Exploring the Potential of Medicinal Plants in Bone Marrow Regeneration and Hematopoietic Stem Cell Therapy
Published on: 31st January, 2025
Blood cell production through hematopoiesis within the bone marrow serves both to maintain blood equilibrium and to respond to tissue injury and infectious demands. Hematopoietic stem cell (HSC) therapy developments have revolutionized medical treatment approaches for anemia leukemia and bone marrow failure caused by chemotherapy or radiation exposure. The therapeutic compounds present in medicinal plants have traditionally supported blood health and researchers now understand these plants could help regenerate bone marrow tissue. The analysis investigates how phytochemicals affect HSC proliferation and differentiation while supporting HSC survival. The medicinal plants Panax ginseng, Astragalus membranaceus, and Curcuma longa receive special attention for their documented ability to enhance hematopoiesis in preclinical and clinical settings. This review examines the challenges that include standardization issues, toxicity concerns, and regulatory barriers alongside future perspectives about combining plant-based therapies with traditional treatments to improve bone marrow recovery and health results.
Fetal Bradycardia Caused by Maternal Hypothermia: A Case Report
Published on: 31st January, 2025
A 27-year-old pregnant woman presented with acute pyelonephritis for the first time in her pregnancy. We admitted the patient for treatment. On the second day, her fetus had bradycardia as a result of maternal hypothermia. Infusion of warmed fluid and providing a warm blanket were the definite treatment in this case. However, the fetal heart rate gradually returned to normal after rewarming the patient. We discharged the patient in a good state after one week. No complications were noticed.
The Role of Mitochondria in Chronic Wound Healing (Mitotherapy): Signaling and Therapeutic Implications
Published on: 31st January, 2025
Mitochondria are essential intracellular organelles that significantly influence various cellular processes, including metabolism, stress response, and cell fate. Their precise regulation is crucial for maintaining both organelle and cellular homeostasis. Wound healing is a complex, multifactorial process that relies on the coordinated actions of multiple cell types and numerous cellular mechanisms. Dysregulation in this process can lead to chronic wounds, which pose substantial challenges for healthcare systems and present limited treatment options due to their intricate pathogenesis. Recent research has increasingly focused on the role of mitochondria in wound healing, revealing their involvement in critical processes such as metabolism, apoptosis, and redox signaling. Mitochondrial dynamics play a vital role in wound healing by adapting to cellular demands and environmental cues. Moreover, mitophagy, the selective degradation of damaged mitochondria, is crucial for maintaining mitochondrial integrity and function during the healing process. Mitochondria are not only pivotal in energy production but also in calcium homeostasis and the generation of mitochondrial reactive oxygen species, which are essential for signaling during wound repair. As wound healing progresses through distinct yet overlapping stages mitochondria facilitate the energy demands of repair and contribute to cytoskeletal remodeling necessary for wound closure. Understanding the multifaceted roles of mitochondria in wound healing could lead to novel therapeutic approaches for chronic wounds. Future research should prioritize investigating mitochondrial dynamics and functions in human tissues to develop targeted strategies for enhancing wound healing outcomes.
The Inverse Relationship between Acute Myocardial Infarction and Dissolved Oxygen Levels in Water
Published on: 7th February, 2025
Stroke and acute myocardial infarction are primary global causes of mortality. Statistical studies have shown that acute myocardial infarction is responsible for around 9 million deaths each year. Ischemic stroke and myocardial infarction have a significant role in global adult physical disabilities. While reperfusion is vital for tissue recovery, it may paradoxically, inadvertently increase damage through oxidative stress, inflammation, and cell death. Early reperfusion procedures are currently the sole therapy to reduce infarct size. There are many mysteries about heart biology. It is not known the source of energy for myocardial tissues. The heart-beating force (120 mm Hg) cannot explain how erythrocytes are impelled through almost 95,000 km of capillaries in less than 5 minutes. A better knowledge of how the heart is oxygenated should allow the development of new therapies.
Insights into the Complexity of Paradoxical Antioxidants Behavior. And the Reasons for it’s almost Zero or no Effect on Stroke
Published on: 31st January, 2025
Antioxidants are groups of compounds that neutralize free radicals and Reactive Oxygen Species (ROS) in the cell [1]. Antioxidant activity in food and beverages has become one of the most interesting features in the science community. These antioxidants provide protection against damage caused by free radicals played important roles in the development of many chronic diseases including cardiovascular diseases, aging, heart disease, anemia, cancer, and inflammation [2].
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