All Articles in december, 2022

Background: Liver Transplantation (LT) is the definitive treatment for Autoimmune Hepatitis (AIH) in patients with decompensated cirrhosis, liver failure and hepatocellular carcinoma. Outcomes of LT in AIH among black-Africans are not well-defined. We performed a single-center retrospective-review of adult LT patients. The study period was from 1st August 2004-31st August 2019. The primary aim was to document 1- & 5- year patient and graft survival. A secondary aim was to compare the survival of black-Africans to Caucasians. Data was analyzed using survival-analysis. Results: A total of 56 LT were performed for AIH. Sixty-seven percent (n = 38/56) had confirmed AIH on explant histology. Of these, the majority i.e., 79% (30/38) were female and 21% (8/38) were male. There were equal numbers of black-African 42% (n = 16/38) and Caucasian 42% (n = 16/38) patients. Rejection was four-times higher in black-Africans as compared to Caucasians. Forty-four percent (n = 17/38) had an acute rejection episode and 13% (5/38) had chronic rejection. Recurrence was found in four black-African females. Post-LT patient survival at 1- and 5- years was 86.5% and 80.7%, and graft survival was 94% and 70.8% respectively. The 5- year patient survival was insignificantly lower for black-Africans (73.9%) as compared to Caucasians (83.7%) (p - value 0.26, CI 6.3 - 12.2). Five-year graft survival was significantly lower among black-Africans (55%) as compared to Caucasians (84.8%) (p - value 0.003 CI 3.8 - 8.1)Conclusion: Black-Africans had a four-fold higher rate of rejection compared to Caucasians. Recurrent AIH was only found in patients of black ethnicity. Similar 1- & 5- year patient survival rates were observed between the two ethnicities. The 5-year graft survival among black-Africans was significantly lower than Caucasians.

Understanding the magnitude of the local magnetic fields generated by neurons is critical to assessing the feasibility of novel magnetic field sensors to record in vivo neuronal activities at cellular resolution. However, the strength of the magnetic fields induced by individual neurons and neuronal networks has not been systematically studied. This step is critical for evaluating and benchmarking the ability of different magnetic field sensors to record neuronal activities with far better spatial and temporal resolution. Herein, FEM exemplary models and open-source computational libraries are used to calculate the magnetic fields generated by individual neurons and neuronal networks at micrometer distances. Our theoretical results show that the magnetic field generated by a single-neuron action potential can be detected by ultra-high sensitivity sub-pT magnetic field sensors, which opens the door to future in vivo decoding of neuronal activities through custom neural networks. We anticipate that the identification of single-neuron signals with high-sensitivity magnetic devices will allow the interface of nanoscale devices to interpret biological signals supported by machine-learning techniques capable of monitoring and predicting the localized activities underlying brain computations.

In this article, an interesting phenomenon has described the geometries and vibrational frequency of the stable AuN clusters with N = 26 to 35. We have found nine out of ten clusters are having the very same C1 symmetry, except the cluster N = 33 (D2). The finite-differentiation method has been implemented within the density-functional tight-binding (DFTB) approach. The effects of the range of interatomic forces were calculated and the desired set of system eigenfrequencies (3N-6) are obtained by diagonalization of the symmetric positive semidefinite Hessian matrix. Mainly, we have observed the vibrational spectra and the range comes in between 2.04 and 347.32 cm−1 at ground state, ∆E = 0. Most significantly, all the clusters have revealed double-state degeneracy. The vibrational spectrum is strongly dependent upon the size, shape, and structure, at the same time, the stretching and the bending mode of the atoms with respect to the bond length plays a major role. We have compared some of our results, which have an excellent agreement, with the less availability of the experimental and the theoretical predictions.

The stem rot disease has emerged globally as a major threat to oilseed Brassica's productivity and seed quality. The generalist causal pathogen Sclerotinia sclerotiorum (Lib.) de Bary shows large variability in their aggressiveness and pathogenicity. Revealing the pathogen's metabolic profile and signaling components in host-pathogen interaction is fundamental in understanding host resistance to the disease. In this study, the metabolites released by the pathogenic strains of S. sclerotiorum under the axenic culture have been identified using the untargeted high-resolution UPLC-QTOF-ESI-MS/MS. The analysis of the ethyl acetate extracts of the S. sclerotiorum culture revealed ten major secondary metabolites namely, sclerin, sclerotinin-B, sclerone, melanin, bostrycoidin, botcinin-D, botcinin-A, gliovirin, scleramide, and botcinic acid. The later six metabolites are being reported for the first time in the culture extract of the S. sclerotiorum pathogen. Based on the overlapping and unique informative peaks in the chromatograms, the six S. sclerotiorum strains were grouped into three major clades in the phylogenetic analysis. The clustering based on metabolic profiles does not substantiate the diversity based on morphology or virulence differences over the host. The findings of the study signified the metabolites secreted under the axenic conditions are varies based on their growth and developmental stages and may not necessarily be the determining factors for their differential aggressiveness and virulence to their host. 

Meat species identification has become essential with the increasing events of frauds like the illegal slaughter of cows, meat adulteration, and substitution. Food scam directly influences public well-being, trade, and wildlife. In Pakistan, donkey meat is used as adulterants for cow meat and is considered Haram in Islamic concepts. In this study PCR, based detection methods are used for identification purposes. The mitochondrial gene cytochrome b has been used in this study to identify the origin of meat specie. Specie-specific primers of cyt b of cow and donkey were used for identification. DNA from different binary ratios of cow and donkey meat was extracted by the phenol-chloroform method. Ratios were made from 1-10 and extracted DNA was subjected to PCR to amplify the target fragment of the cyt b gene. Primers were sensitive to identifying species origin in all meat ratios. Multiplex PCR was designed to identify both species and the results were analyzed by gel electrophoresis. Fragment size of 309bp for cow and 475bp for donkey was observed.Results of the current study conclude that PCR assays, including multiplex PCR, is efficient and has a high sensitivity for even small amount of meat. It is concluded that multiplex PCR is useful and reliable for adulterated meat detection.

Strep throat, a common affliction known for its hallmark symptom of a severe and sudden sore throat, is caused by the bacterium Streptococcus pyogenes, classified under Group-A Streptococcus (GAS) [1]. This condition not only impacts millions globally but also carries the risk of severe complications if left untreated [2]. Understanding strep throat goes beyond recognizing its symptoms; it entails an appreciation of its transmission dynamics, potential complications, and the evolving landscape of treatment and prevention strategies [3].

Due to the adverse environmental impacts of synthetic plastics, biodegradable plastics development for both industrial and commercial applications is essential for the present scenario. In addition to the non-degradability of petroleum-based plastic and its impacts, so it is very important to find an alternative to petroleum-based plastic. Starch-based bioplastics are an excessive substitute for petroleum-based plastics due to their significant properties compared with natural sources. This research aims to formalize five new formulas of bioplastic by combining two sources of starch, extracted from various biomass sources, its properties and comparison between them. The moisture content shows 2.07% and 0.984% for samples F and B respectively and that indicates that the samples which contain a high amount of corn starch have less moisture content. The highest results of biodegradation percentages were 68.27% and 52.6% which are for samples A and D respectively, and the lowest biodegradation percentage were 34.33% and 31.29% which are for samples F and B respectively.

Context: Illicit and performance-enhancing drug (PED) use is prevalent among athletes.Aims: We examine the prevalence of PED use among amateur athletes, identify the common characteristics and associated risk factors for illicit PED use and measure the perception and awareness among gym members regarding the safety and effects of illicit drug use.Settings and design: This cross-sectional study was conducted among adult male and female gym center attendees in Riyadh, Saudi Arabia.Methods and materials: Self-administered Arabic and English questionnaires were used for data collection. Statistical analysis used: SPSS version 26 was used to perform t- and chi-square tests.Results: This study included 379 participants, of whom 59.6% were male, 52.8% were between 26 and 35 years of age, and a majority of the participants had normal (47.5%) or overweight (40.9%) body mass index. Our study revealed a high prevalence (48.5%) of PED use among gym athletes in Riyadh, Saudi Arabia. Moreover, the true prevalence might have been higher due to the possibility of underreporting by some participants because of the sensitivity of the subject. Protein powder was the most commonly used type of PED. Of all the participants, 22.3% reported anabolic androgenic steroid use. Side effects of PEDs were observed in 19% of the study participants.Conclusion: The results of this study should encourage public health researchers and health advocates to design and implement behavioral interventions to educate the public on the benefits, risks, and contraindications of dietary supplements used by athletes to enhance their body performance.Key messages•    Performance-enhancing drug (PED) use is prevalent among both professional and amateur athletes.•    Gym athletes in Riyadh, Saudi Arabia, report increasing PED use.•    Side effects and negative health impacts are associated with illicit PED use.•    Misinformation on the risks and benefits of PEDs is a major public health concern.•    More efforts should be implemented in public awareness about the risk of using PED targeting younger populations.

Marfan syndrome is a dominant autosomal genetic disease of the connective tissue, leading to various complications. Cardiovascular complications are the main ones, with dilation of the aorta and aortic dissection which is the main cause of death. Double dissection with different sites of departure is scarcely reported by the literature. We reported the case of a 22-year’s-old young patient admitted for acute chest and abdominal pains, and cardiogenic shock. Investigations reported a double dissection of the aorta with a recent one of type A and an old one of type B. Ghent diagnostic criteria were used to allow the diagnosis of Marfan disease. Surgical management corrected successfully the type A dissection.Early diagnostic and adequate management of aortic complications can reduce the high mortality rate of patients with Marfan syndrome.

In the long run people around the globe particularly those who live in underdeveloped Countries in Africa, especially in Ethiopia a large number of communities has a misconception that disease may be transmitted by utilizing health service due to a lack of trust in health service delivery system, Most of the population strongly related with religion, they claimed that it is sin or God or Allah driven. According to a health behavior model, knowledge and practice are contributing factors for increasing healthcare seeking among patients with low levels of trust [1,2]. 

Clustered regularly interspaced short palindromic repeat (CRISPR), a potent gene-editing tool was found in 2012. CRISPR is a genetic engineering technique that enables genome editing in living creatures and is based on the bacterial CRISPR-Cas9 antiviral defense mechanism. It is simpler, less expensive, and more accurate than previous gene editing techniques. It also has a wide range of valuable uses, including improving crops and treating genetic diseases. Plant science has benefited more from the CRISPR/Cas9 editing technique than medical science. CRISPR/Cas9 has been used in a range of crop-related research and development domains, including disease resistance, plant development, abiotic tolerance, morphological development, secondary metabolism, and fiber creation, as a well-developed cutting-edge biotechnology technique. This paper summarized the role of the CRISPR-CAS9 tool in modern agricultural science.

Background: Parapneumonic pleural effusion is a relatively common entity and continues to be a major cause of morbidity in children. However, managing this disease is still a matter of controversy between surgical and non-surgical options. With the advancement of mini-invasive surgery, video-assisted thoracoscopic surgery (VATS) has become a mainstay in the treatment of parapneumonic effusion in children. This study aimed to evaluate the clinical characteristics and pathological features of parapneumonic pleural effusion in children and to explore the feasibility and safety of the thoracoscopic approach in the pediatric population.Methods: The clinical data of all patients who underwent VATS for parapneumonic effusion between 2007 and 2021 were analyzed retrospectively. Factors that were documented included demographic criteria, clinical manifestations, preoperative examinations, therapeutic procedures, intraoperative findings, postoperative complications, and outcomes.Results: Totally, 35 patients with a mean age of 5.14 ± 3.9 years were operated on thoracoscopically. The mean duration of evolution before VATS was 9 days ± 4. All children were hospitalized in a Pediatric Continuing Care Unit. Antibiotic therapy was administrated in combination in all cases. Corticosteroid therapy was used in 2 patients. Thoracentesis was performed in 6 patients. Thoracostomy tube drainage was placed before surgery in 11 patients. The average duration of drainage before VATS was 6 days ± 4. VATS decortication and/or debridement was indicated as second-line in 23 patients. The average duration of the surgery was 51 minutes (20 min - 115 min). There is no conversion to open surgery and no intraoperative procedure-dependent complication. 4 children have early complications after the VATS and one patient had a late postoperative complication. There were no deaths during the hospital stay or follow-up. Conclusion: In skilled hands, VATS is safe, feasible, and effective in the management of parapneumonic pleural effusion in children with excellent outcomes.

Fragaria vesca L. (Rosaceae), called “wild strawberry”, “woodland strawberry”, “Alpine strawberry”, “Carpathian strawberry” or “European strawberry” is grown naturally throughout much of the Northern Hemisphere and produces fruits. The plant can be spread mostly by stolons as well as by the seeds to establish new populations.

Although emotion management is essential to mental health, public health has not paid much attention to emotional conditions or disorders. By analyzing a nine-year diagnostic trend and sociodemographic characteristics of two mental disorders: Hwabyung and Intermittent Explosive Disorder (IED), this study demonstrated the importance of managing emotions precautionarily.Data reconstructed from the National Health Insurance Service were used to analyze the yearly diagnostic trend in the two mental disorders characterized by anger.Hwabyung was more common among women and middle-aged individuals, despite the varied number of diagnoses by year. Between 2010 and 2018, IED diagnoses gradually rose, with the average rate of increase the highest in the 20s for male IED diagnoses in 2017. The low prevalence of the IED in Korea compared to other Western countries and the gender and age differences in both Hwabyung and IED diagnoses suggest the role of cultural influences related to emotions (or emotional management).Especially in light of the world’s emphasis on resilience to COVID-19, these results indicate how public emotional management is essential during stressful situations. The results also highlight the need for community mental health programs tailored to gender and age.

Azotobacter was selectively isolated and purified from the soil samples of Xinjiang Salt Lake Scenic spot, the fermentation technology of exopolysaccharides (EPS) by Azotobacter was optimized, and the antioxidant activity of exopolysaccharides (EPS) was studied. The bacteria were isolated and purified from the soil samples by the scribing method and the 16SrRNA gene was used for molecular identification. The carbon source, fermentation time, inoculation amount and pH of target bacteria in the exopolysaccharides (EPS) fermentation process were optimized through single-factor experiments and their antioxidant activity was measured. Eight types of Azotobacter were isolated and purified from the soil samples of Salt Lake scenic spot. Among them, As101, which showed 99.58% homology with Azotobacter salinestris, was selected as the target strain. Through single-factor experiments which used exopolysaccharides (EPS) yield and exopolysaccharides content as indexes, the optimal conditions for the As101 fermentation process were determined as follows: fermentation temperature 35, fermentation time 96h, pH 7 and mannitol as carbon source. Exopolysaccharides content from Azotobacter salinestris  was 61.35% and the yield was 6.34 g/L. The results of the exopolysaccharides (EPS) antioxidant activity experiment under optimal conditions showed that As101 EPS had excellent scavenging ability against DPPH free radical, ABTS free radical and hydroxyl free radical, with IC50 values of 6.11 mg/ml, 2.42 mg/ml and 9.57 mg/ml, respectively. As101 with high yield and high exopolysaccharides content was isolated from saline soil in a special environment of Xinjiang, and the EPS obtained showed excellent antioxidant activity. The Azotobacter found in this study would provide the material basis for further opening up the adsorption of exopolysaccharides on heavy metals and the improvement of saline-alkali soil and contribute to further understanding of the structure and other activities of exopolysaccharides derived from Azotobacter.

Saliva is produced by and secreted from salivary glands. It is an extra-cellular fluid, 98% water, plus electrolytes, mucus, white blood cells, epithelial cells, enzymes, and anti-microbial agents. Saliva serves a critical role in the maintenance of oral, dental, and general health and well-being. Hence, alteration(s) in the amount/quantity and/or quality of secreted saliva may induce the development of several oro-dental variations, thereby the negatively-impacting overall quality of life. Diverse factors may affect the process of saliva production and quantity/quality of secretion, including medications, systemic or local pathologies and/or reversible/irreversible damage. Herein, chemo- and/or radio-therapy, particularly, in cases of head and neck cancer, for example, are well-documented to induce serious damage and dysfunction to the radio-sensitive salivary gland tissue, resulting in hypo-salivation, xerostomia (dry mouth) as well as numerous other adverse Intra-/extra-oral, medical and quality-of-life issues. Indeed, radio-therapy inevitably causes damage to the normal head and neck tissues including nerve structures (brain stem, spinal cord, and brachial plexus), mucous membranes, and swallowing muscles. Current commercially-available remedies as well as therapeutic interventions provide only temporary symptom relief, hence, do not address irreversible glandular damage. Further, despite salivary gland-sparing techniques and modified dosing strategies, long-term hypo-function remains a significant problem. Although a single governing mechanism of radiation-induced salivary gland tissue damage and dysfunction has not been yet elucidated, the potential for synergy in radio-protection (mainly, and possibly -reparation) via a combinatorial approach of mechanistically distinct strategies, has been suggested and explored over the years. This is, undoubtfully, in parallel to the ongoing efforts in improving the precision, safety, delivery, and efficacy of clinical radiotherapy protocols/outcomes, and in designing, developing, evaluating and optimizing (for translation) new artificial intelligence, technological and bio-pharmaceutical alternatives, topics covered in this review.

In Ghana, there is evidence of the direct influence of climate change on the environment, such as rising temperatures, variable rainfall, and precipitation. These manifestations affect various facets of Ghana socio-economic structure especially with its high reliance on sectors that are particularly sensitive to climate change like agriculture. In the settlements of Bonsua and Amoawi in the Offinso South District, the study concentrated on the influence of climate change variables on food crop production and how farmers are adapting to the various climate change measures. Out of the total of 650 staple food crop farmers in the dorminated selected communities namely, Amoawi and Bonsua, 160 farmers were chosen for the study using systematic random sampling. The study included both primary and secondary data. Descriptive cross sectional survey was employed for the study. The data collection instrument employed was Structured and semi-structured interviews. SPSS was used to analyse the data. The data collected for the study were analysed using both descriptive and inferential analytical tools. Findings from the study indicate that climate change is a challenge to food crop production since agriculture activity in the two communities are mostly rain feed (97.5%). The majority of the crops grown in the two areas are climate change vulnerable. Another study finding reveals that most respondents have modified their coping mechanisms such as such as growing different crop varieties, early and late planting, irrigation and soil conservation to deal with how climate change is affecting agriculture. Therefore, the study suggests that both government and non-governmental organizations should support farmers in building irrigation systems to continuously irrigate their food crops during the dry season, increasing their farm productivity.

Aim: To evaluate the hemodynamic changes and side effects during endotracheal intubation with Macintosh laryngoscope and intubating laryngeal mask airway.Materials and methods: A prospective, simple randomized, comparative study on 100 patients 18 years - 60 years of age, divided into two groups: Group A comprising intubation with Macintosh laryngoscope and Group B intubation through ILMA.Results: Total intubation time (in seconds) of group A was 24.38 + 3.26 seconds and of the group, B was 42.94 + 1.24 seconds. At 2,4 and 6, a higher rise in mean heart rate was noted in group A (p < 0.05). At 2,4,6 and 8 minutes difference in mean SBP and mean DBP of the two groups was statistically significant with a p - value of < 0.05 with a significant increase of mean SBP and mean DBP in patients of group A. The difference for all complications was not significant between the two groups.Conclusion: Intubation via intubating laryngeal mask airway can be done as an alternative to direct laryngoscopy using a Macintosh blade as intubation via intubating laryngeal mask airway has shown to have lesser hemodynamic changes.

Nocardia is a ubiquitous organism and often causes serious fatal infections in immuno-compromised individuals. Staphylococcus aureus infection stimulates an inflammatory response that causes lung damage and facilitates subsequent chronic infection. Patients of allergic bronchopulmonary aspergillosis (ABPA) on steroids and immunosuppressants are particularly at risk of these infections. We present the case of a middle-aged man who was diagnosed to have ABPA by serological and radiographic criteria. He presented with fever, cough, and mucopurulent sputum. Subsequent sputum culture for bacteria and fungus revealed the growth of Staphylococcus aureus and Nocardia spp. respectively.

Being one of the basic principles of clinical research, informed consent is definitely a legal responsibility and ethical duty for health professionals.

Introduction: Sonographic scan tests are real-time procedures but the female reproductive systems are subject to continued changes beyond the mid-menstrual period. Therefore a second test may be useful after mid-menstrual ultrasound tests among women with infertility who first had normal ultrasound tests during the mid-menstrual period. Aim: The aim of this study is to find out whether physiological changes beyond the mid-menstrual period in the female reproductive system could develop into findings that could be missed at the first ultrasound test among women with infertility during mid menstrual period. Method: One hundred and forty (140) women participated in this study, over a period of 12 months. The inter-observer correlations were carried out. The ultrasound test measured the diameters of the endometrium and ovarian follicle. The study was carried out during the mid-menstrual cycle when normal changes are optimal. The subjects were women of childbearing age (18 years - 40 years) with 28 days cycles who were referred from the fertility clinic. Women who had previous pelvic surgery, women on fertility therapy, and women who were unsure of the date were excluded from the study. Only women who met the inclusion criteria were selected for the study. The selection was by convenience sampling method. The women underwent the first phase of the ultrasound test during the mid-menstrual cycle. Those who had ultrasonographic-positive infertility reports were returned to the referral clinic. Only women who had normal ultrasonographic fertility reports were included in the second phase of further ultrasonographic tests. The scans were carried out further for four days for this second phase study and the result was again compared with normal values. (Endometrium Normal range 7.4 mm - 13.5 mm and ovarian follicles normal range 17.4 mm to 23.5 mm). Results: The first phase of the scan showed 108 (77%) of the women had positive infertility results for endometrium and ovarian follicles, while 32 (23%) of the women had a normal ultrasonographic result and were rescanned over days. The findings of the second phase scan showed that 10 subjects (7.30%) showed new abnormalities, Findings were distributed in three sub-groups in this second phase of the study. Sub-group A, 4 (2.67%) had enlarged unruptured follicles, sub-group B, 6 (4.30%) had an endometrial cavity filled with fluid, sub-group C, 22 (15.70%) subjects still had normal scans who may be referred for other studies. Conclusion: Women with infertility who had a normal scan at the mid-menstrual cycle should be followed up with a second-phase ultrasound scan before other tests.

Innovation is the usage of strain for development in healthcare. Predominant component science and sturdy personal quarter opposition have given a beginning to a revolution in new health technology. These are converted by using rigorous making an attempt into medicines, vaccines, devices and diagnostics that can additionally be used efficiently in numerous affected character populations. Innovation starts off evolved with invention and depends upon tasks. it truly is on the flip pushed via the incentives that have interaction with the private quarter in pursuit of a social welfare objective, greater fitness for all by ability to create the large majority of a new medication on the market nowadays, the non-public vicinity has created a unique - however fragile - mannequin for innovation that consists of with it sensible outcomes for the management of a load of sickness. Fitness-related applied sciences enhancements led thru the introduction of today’s medicine are estimated to have decreased human mortality with the resource by upwards of 50% between 1960 and 1990 [1]. Every advanced and growing international region has demonstrated this benefit. All areas have made improvement in human enhancement global places has dropped by way of extra than 1/2, from 1.1 billion in 1975 to five hundred tens of hundreds of thousands in 1999 [2]. accelerated global immunization insurance engaging in 80%-90% of infant inner the past due Nineteen Nineties [3] has had a giant effect at the infant mortality price, which all via the remaining 25 years fall thru 50% in the least developed global locations. Four for this cause Pharmaceutical innovation has been a necessary thing in assisting governments to reap their primary healthcare coverage desires.

The stomatognathic apparatus is currently understood as a complex functional unit in its muscular, skeletal, dental, and neurological parts; in particular, it is now commonly acknowledged that the craniofacial district is connected to the type of occlusion not only functionally but also morphologically. Occlusion is the result of the adaptation of dental organs that can adapt through the periodontium and cranial bones through sutures, with the “neurological direction” of the function and tone of the perioral, lingual, and craniocervical muscles

Modern-day biology is witnessing a data explosion with a vast amount of information generated from ongoing genome and sequencing projects. The abundance of data from genome sequences, functional genomics and another high throughput (HTP) technique with the potential of computing has led to rising of a new discipline namely ‘bioinformatics’. Bioinformatics is a young but fast-growing field for biological data collection, organization, interpretation, and modeling. Tools and techniques for bioinformatics are derived from multidisciplinary combinations of varied disciplines from natural and physical sciences. Previously various disciplines were carved out as and when sufficient specialization was achieved. However, now bioinformatics is borne out of an alliance between existing disciplines from life and non-life. Bioinformatics encompasses new foundations for the collection, organization, and mining of gene/ protein sequences, three-dimensional structures, and biochemical functions, for modeling biological processes of functioning cells. DNA sequencing performed on an industrial scale has produced a vast amount of data to analyze. Although the Human Genome Project is officially over, improvements in DNA sequencing continue to be made. The field of forensic science is increasingly based on biomolecular data and many European countries are establishing forensic databases to store DNA profiles of crime scenes of known offenders and apply DNA testing.

Introduction: Cardiovascular diseases are the leading cause of death in the world, headed by coronary artery disease, which is secondary to atherosclerosis. The latter recognizes classic risk factors such as diabetes, high blood pressure, tobacco, and dyslipidemia and other less classic factors such as chronic inflammation of rheumatoid arthritis. Many studies have highlighted the correlation between this chronic inflammation and clinical coronary disease but very few have focused on the anatomical correlation. Objective: To describe the correlation between the chronic biological inflammation of rheumatoid arthritis and anatomical coronary lesions on angiography. Method: This observational, retrospective, single-center study, including over 10 years, of patients with rheumatoid arthritis, confirmed the EULAR 2010 criteria and presented with coronary artery disease requiring coronary angiography. Patients with missing data or in whom coronary angiography was not done were excluded (n = 14). We divided then the patients according to the existence or not of chronic inflammation to study the impact of the latter on the existence (Stenosis < 50% vs. stenosis ≥ 50%), the extent (single vs. multivessel disease), and the severity of the coronary lesions (syntax score < 32 vs. ≥ 32). Results: 202 patients (49♂/153♀) aged between 30-75 years with a history of rheumatoid arthritis have had a coronary event requiring coronary angiography, were included; The mean ejection fraction at baseline was 57.3% +/- 5.8 (37 vs.-65%). 75% of them were ≥ 65 years old. 55% were diabetics, 61% with hypertension, 38% with dyslipidemia, and 19% were smokers. Chronic inflammation was diagnosed in 70% of them on non-specific parameters (ESR, CRP, fibrinogen, anemia, and rheumatoid factor). All patients had coronary angiography, which made it possible to identify the coronary lesions according to their existence (Stenosis < 50%: 51 patients vs. stenosis ≥ 50%: 151 patients), the extent (single: 86 patients vs. multivessel disease: 116 patients) and the severity of the coronary lesions (syntax score < 32: 142 patients vs. ≥ 32: 60 patients). Chronic inflammation of rheumatoid arthritis was correlated in bivariate and multivariate analysis (after excluding the impact of other risk factors) with the existence and extent of coronary lesions (p < 0.05) but not with their severity (p > 0.05). Discussion: The two limitations of this work are the monocentric nature of the study and the absence of specific inflammatory parameters such as anti-CCP antibodies. Strengths are anatomical correlations and multivariate analysis. Chronic inflammation apart from any influence of the various risk factors predisposes to the existence and extent of coronary lesions (p < 0.05). The severity of coronary lesions assessed by Syntax Score was not correlated with chronic inflammation, although other studies suggest that this inflammation is the cause of complex lesions.Interpretation: Rheumatoid arthritis is associated with an increase in cardiac morbidity and mortality. Atheromatous lesions are more frequent in those patients than the existence of classic cardiovascular risk factors would suggest. Several explanations could account for this risk: the inflammatory syndrome and its impact on the cardiovascular risk factors and the vessel and the deleterious effect of the treatments. This requires stricter screening and management of risk factors in rheumatoid arthritis.

Coronary Artery Disease (CAD) is the most common type of heart disease and a major cause of mortality worldwide. This study highlights the significance of hypertension as a risk factor in patients with CAD and compares its prevalence to those of EUROASPIRE IV (EUS-IV), ESC Atlas of Cardiology (Atlas) and Cyprus Survey of Coronary Heart Disease of 2006 (CY-2006). A retrospective, observational study was conducted, by the Registry of Cyprus Heart Survey, where 375 individuals with chronic CAD were examined in Nicosia General Hospital Cardiology Clinics, between the years 2011 and 2014. Their medical history regarding hypertension was noted and the data was analyzed using Microsoft Excel software. The total prevalence of hypertension, based on the past medical history of the patients was 59%.Out of these, 52% were found to have elevated blood pressure on their visit to the Cardiology Clinic. The total mean systolic blood pressure amongst the study group was 136 mmHg, with no significant differences between males and females (136 mmHg and 134 mmHg respectively).The findings of the present study are the same compared to those of the CY-2006 (52% both), but slightly higher than the findings of EUS-IV (52% vs. 42.7%) and significantly higher than those recorded in the Atlas (52% vs. 24.8%). The results show that there is still much potential to improve hypertension management in patients with established CAD.

Non-Hodgkin's lymphoma involving the ovaries is unusual and may cause confusion for the clinician since its presentation could resemble other, more frequent tumors. Malignant lymphoid cells may occur in the ovary either as a primary neoplasm or as a secondary manifestation of a disseminated occult or known disease. The most common presenting symptoms or signs of malignant lymphomas involving the ovaries are abdominopelvic pain or mass. 

Multiple Sclerosis (MS) is a chronic and often progressive condition that affects the Central Nervous System (CNS) and as a result has negative consequences on a person’s physical condition, functioning, mood, and Activities of Daily Living (ADL) [1]. 

Smart agriculture applications (monitoring, sensing, automation and control) of micro-climate and environmental conditions for different agriculture production sectors and scales, decision-makers and researchers need to take it into consideration to strengthen the efforts of mitigation and adaption of climate change impacts as well as maximize the natural resources use efficiencies and food production. Motivate the farmers to implement smart agriculture applications, especially in developed and poor countries, strong cooperation for technology transfer and build up the technology infrastructure of information and communication (ICT) plus the internet of things (IoT).

Thousands of tons of biodegradable organic waste generates in urban and rural areas every day, creating disposal problems. Urban organic waste can be converted into valuable output products (vermicompost, vermin-liquid, and earthworms) by applying a vermicomposting technique that had different. Implementing green roofs via soilless culture systems as micro-scale farms led to increasing natural resource use efficiencies as well as producing fresh food. The integration of both techniques will create not just reduce pollution and climate change impacts but also for increasing food production and security in urban, enhance the lifestyle and increase public awareness of environmental issues. This process is profitable at any scale of operation.

Percutaneous coronary angioplasty is a minimally invasive procedure aimed at unclogging a coronary artery with a low complication rate (with a serious complication rate of 3% to 7% and a mortality rate of 1.2%). Device entrapment during PCI is a rare but life-threatening complication that occurs in < 1% of PCIs and balloon entrapment comes second after coronary guidewires. We present the case of 68-years-old man, smoker, hypertensive and type2 diabetic that presents angina with evidence of ischemia on myocardial tomoscintigraphy and in whom the radial coronary angiography reveals a tight calcified mid LAD stenosis. During his PCI and after dilatation with an NC balloon 2.5 × 12 the latter refuses to deflate and remains trapped in the lesion with the appearance of pain and ST-elevation despite several attempts to dilute the product in the inflator and to burst it by overexpansion. Traction on the balloon resulted in the deep intubation of the guiding-catheter, which comes in contact with the trapped balloon, and the rupture of the latter’s hypotube, which remains inflated at the site of the lesion and mounted on the 0.014 guidewire. We put a second 0.014 guidewire distally in the LAD and twisted with the distal part of the first guidewire, then we introduced a second balloon 2.0 × 20 over the second guidewire until the distal part of the guiding-catheter and inflated to trap the stucked balloon. We gradually removed this emergency assembly that allowed us to retrieve the trapped balloon. The control injection revealed a thrombotic occlusion of the LAD treated by thrombectomy and anti-GPIIbIIIa followed by a DES 2.75 × 28 placement. The patient was discharged 48 hours later with a good LVEF. The possible balloon entrapment mechanisms are an acute recoil of a highly calcified lesion with compression of the incompletely deflated balloon, which seems to be the case in our patient, strangulation of the proximal balloon end by the guiding-catheter if the balloon is removed before complete deflation and break or bend of the hypotube. The solutions in case of undeflatable balloon entrapment are to dilute the product in the inflator, to burst it by overexpansion, to pierce it through a stiff guidewire (or through its other end on a Microcatheter or OTW balloon), to cut its outer part and let it empty passively, to introduce a second guide-wire and perform a Buddy-Balloon or to transfer the patient to Surgery. Material entrapment remains a rare but life-threatening complication, its eviction requires the choice of material size and gentle manipulations (small balloons in the event of a calcified lesion) and its management uses different techniques, the choice of which depends on the clinical and anatomical situation. 

Introduction: Atrial Septal Defect (ASD) is the most common congenital heart disease, accessible to percutaneous closure in 90% of cases. The closure procedure is performed usually under local anesthesia and TTE by femoral access. The association of OS-ASD with an azygos continuation of the inferior vena cava is very rare (< 0.1/1000 births) making femoral access impossible. Only a few cases are mentioned in the literature, here we describe the procedure as faithfully as possible. Important clinical finding: We present a case of a 32-years-old female candidate for percutaneous closure of OS-ASD with right cavity dilatation who present during her procedure an unusual guidewire path suspecting an azygos continuation of the inferior vena cava, confirmed by CT angiography, making impossible the closure via the femoral approach. Therapeutic intervention: After being confronted with the categorical patient refusal of the surgery, we performed successfully the procedure; one month later; under general sedation by internal jugular approach. We finished with manual compression before extubating the patient. Outcomes: The follow-up was favorable at the cost of a hematoma at the puncture site and brachial plexus compression, which regressed after 3 days. Conclusion: We opted for general anesthesia and intubation to guide the procedure by TEE. We placed it in the aorta, which gave us good stability to continue successfully the procedure. We underestimated the risk of complication at the puncture site, which could have been avoided by using a vascular suture device or more prolonged compression. Main takeaway lesson: Percutaneous closure is the reference treatment for OS-ASD. In case of is associated with an azygos continuation of the inferior vena cava, the right internal jugular vein remains a reasonable approach; it requires discussion and rigorous preparation by the whole team. The management of the puncture site in this situation remains delicate and requires great concentration. 

Background: The rapid increase in the popularity of internet use and video games is associated with multiple consequences and comorbidities; therefore, investigating this issue is important, especially now that the number of people playing video games has reached approximately 2.2 billion people worldwide.Method: This paper reviews the existing literature on Google Scholar and PubMed to examine the association between internet gaming disorder (IGD) and attention deficit hyperactivity disorder (ADHD) between 2013 and 2020.Result: The reviewed studies reveal a statistically significant association between ADHD and IGD. The reviewed studies demonstrate that ADHD is a predictive factor for the development and persistence of IGD and affects the severity of IGD symptoms.Conclusion: Especially among those with ADHD, IGD causes life distress and social life impairment. This review indicates a statistically significant association between ADHD and IGD; however, longitudinal studies are needed to assist the direction of this association and make relevant and appropriate recommendations to prevent its consequences and comorbidities.