Immune-mediated neuropathy related to bortezomib in a patient with multiple myeloma
Published on: 3rd January, 2022
Treatment options in multiple myeloma (MM) based on novel agents are often limited by dose-related neurotoxicity. Bortezomib, a highly active reversible proteasome inhibitor, frequently causes peripheral neuropathy (PN). Bortezomib-induced PN (BIPN) is characterized by a length-dependent, sensory, axonal polyneuropathy (PNP) with predominant small fiber-affection. Following dose reduction or drug discontinuation, BIPN resolves within 3-4 months in the majority of patients. The pathophysiological mechanisms of BIPN are unclear. Rare cases of a severe demyelinating or mixed BIPN with prominent motor involvement have been attributed to autoimmune or inflammatory reactions. A case report, including nerve pathology, is presented of a 59-year-old man with stage III IgG-κ MM who was treated with bortezomib on the occurrence of progressive disease. After the fourth cycle, he developed a painful distal symmetric sensory PNP followed by gait instability and muscle weakness increasing over 3 months despite early cessation of bortezomib.Neurological examination revealed a distal flaccid tetraparesis mainly of the lower limbs with sensory loss and severe ataxia, electrophysiological features of a mixed axonal-demyelinating PNP, and pathomorphological evidence of neuritis. Steroid treatment was initiated, and partial recovery of the neurological symptoms within 6 months was observed. While a neurotoxic effect may explain the initial distal sensory disturbances, the worsening of neurological dysfunction after bortezomib withdrawal and the clinical pattern with steroid-responsive muscle weakness predominantly of the legs are consistent with an immune-mediated mechanism. This is in line with the sural nerve biopsy findings. Toxic BIPN followed by an immune-mediated BIPN in the same patient has not been reported before.
Severe brimonidine eye drop intoxication in a neonate as an accidental oral ingestion
Published on: 4th January, 2022
OCLC Number/Unique Identifier: 9396214367
Brimonidine tartrate eye drops are a topical agent used to treat glaucoma in children over 2 years of age and adults. It is banned for children younger than 2 years of age because post-marketing studies have shown serious side effects. Colic is common in infants, which worries parents. And parents often use herbal and chemical medicines to solve this problem. We present a 12-day-old newborn with brimonidine eye drop intoxication, in which the drug was mistakenly administered orally to treat the colic problem.
The sugarcane byproducts to a food security in an ecofriendly way: A review
Published on: 4th January, 2022
OCLC Number/Unique Identifier: 9396210354
This article addresses, in an integrated way, the main aspects of the by-products obtained from sugarcane processing summarizing their most important and economic characteristics, their composition, and most relevant uses as options for industrial diversification, all taken as a review.
Pediatric brainstem glioma
Published on: 3rd January, 2022
OCLC Number/Unique Identifier: 9396216057
Background and objectives: Brainstem gliomas are tumors of the central nervous system which have varying presentations and clinical courses. This study aims to analyze the frequency, clinical and therapeutic aspects of brainstem glioma.Methods: We retrospectively analyzed the data from the record of the patients treated for brainstem glioma under the age of 20 between January 2007 and July 2020 in the Radiation Oncology department of the Ibn Rochd UHC.Results: There were fifteen patients (10 males and 5 females). The mean age of onset was 12 years (range 8 - 14 years). The duration of symptoms varied from 1 month to 2 years. Nine of the patients had intracranial hypertension due to hydrocephalus, six had cranial nerve deficits at presentation, and five patients had cerebellar signs. The lesion was pontine in 12 cases. None of the patients had a tumoral resection, nine had a ventriculo-peritoneal shunt insertion for the hydrocephalus and three had a Stereotactic biopsy that revealed one astrocytoma grade 1, one low grade glioma and one glioblastoma. The radiotherapy was indicated in all the cases but only nine patients had a 3D radiotherapy with a total dose of 54 Gy. Three patients received chemotherapy. Six patients are still alive, two are lost to follow up and seven patients are dead with a mean survival period of 8 months.Conclusion: Brainstem glioma is a devastating disease with a bad prognosis. The clinical presentation is variable and the management is multidisciplinary. Our study illustrates the importance of treatment by radiation.
Evaluation of the LumiraDx SARS-CoV-2 antigen assay for large-scale population testing in Senegal
Published on: 5th January, 2022
OCLC Number/Unique Identifier: 9391752258
Purpose: Real-time reverse-transcription polymerase chain reaction (RT-PCR)-based testing remains the gold standard for the diagnosis of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Due to the high diagnosis demand of SARS-CoV-2 and the limited resources for RT-PCR testing, especially in Low-Income Countries (LICs), antigen-based methods are being considered as an option. The aim of this study was to assess the performance of LumiraDx SARS-CoV-2 antigen assay for large population screening compared to RT-PCR.Methods: This evaluation was conducted on 4146 participants including travelers and participants under household survey and vaccine evaluation studies before injection of the first dose. Oropharyngeal and nasopharyngeal swaps were collected from each participant into 2 mL of viral transport medium (VTM) and 400 μl of VTM were used to assess the performance of LumiraDx SARS-CoV-2 antigen assay, compared to RT-PCR. Results: The prevalence of SARS-CoV-2 of the cohort was 4.5% with RT-PCR and 4.1% with LumiraDx antigen test. Compared to the RT-PCR, the sensitivity and specificity of the LumiraDx antigen SARS-CoV-2 test were 82,7% [95% CI 74.1-89,7] and 99.9% [95% CI 99.6-99.9] respectively. Given the RT-PCR threshold cycle (Ct) range, the sensitivity was 92.1% [95% CI 84.6-96.3] when the Ct value was below or equal 33 cycles, and 38.1% [95% CI 18.9-61.3] when it was above 33 cycles. The inter-rater reliability showed a kappa coefficient of 0.88 when considering all the patients and 0.94 for Ct values below 33 cycles. Conclusion: Our data have shown that the LumiraDx platform can be considered for large-scale testing of SARS-CoV-2.
Incidence and features of heparin-induced thrombocytopenia in mechanical heart valves and immunologic cardiac diseases
Published on: 5th January, 2022
OCLC Number/Unique Identifier: 9391755940
Background: Heparin-induced thrombocytopenia/thrombosis (HIT/T) is characterized by a fall in platelet count 5-10days after starting heparin therapy and is diagnosed with specific 4-T clinical features and laboratory tests. This complication is relatively common in Cardiothoracic surgery patients. Objective: To evaluate the positive and negative predictive value of various HIT laboratory tests and assess any correlation between HIT, the underlying diagnosis, underlying procedure, and mechanical cardiac devices. Patients and methods: The patient’s medical records were correlated with two laboratories HIT diagnostic tests, the pan-specific screening test with IgG, IgA, and IgM antibodies, followed by HIT specific IgG ELISA. Results: Total n = 80 patients were assessed, 48% (n = 38) were HIT screen pan-specific negative and 50% (n = 40) were HIT pan-specific positive and 2 cases were inconclusive. 17% (n = 14) were both pan-specific and specific HIT IgG ELISA positive. There were 5 atypical cases. One patient had Eosinophilic myocarditis and was HIT ELISA IgG neg. Argatroban was given on clinical grounds with successful recovery. One patient with Sarcoidosis had an aggressive course and received IV Immunoglobulin (IVIG) but succumbed secondary to liver failure. One patient progressed to gut ischemia and had surgical intervention but succumbed. Two patients with mechanical heart valves were on Argatroban but relapsed and responded to IVIG therapy. Conclusion: Our study indicates that 9/16 (> 50%) HIT-positive patients had valve replacement or cardiac devices suggesting that like knee arthroplasty there is a high incidence of HIT in patients with mechanical heart valves and cardiac devices and this warrants further prospective study.
Age, smoking, hypertension, and aortic aneurysm: Interactions and risks
Published on: 6th January, 2022
OCLC Number/Unique Identifier: 9391753907
Background/Aim: Aortic aneurysm is the bulging of a weakened portion of the aorta. The aorta is the major blood vessel that feeds blood (carrying oxygen, nutrients and water) to the tissues of the body. When a portion of the wall of the aorta becomes weak, blood pushing against the vessel wall can cause it to bulge like a balloon (aneurysm) leading to aortic dissection (a tear in the wall of the aorta that can cause life-threatening bleeding or sudden death). Blood pressure is the force arterial blood exerts on the wall of the artery. When this pressure is consistently high above 140/100 mmHg it is referred to as hypertension. As an individual gets older over time, physiological functions of the body depreciate leading to some abnormalities. Smoking is the consumption of tobacco mostly by inhalation of the smoke that is produced from burning the tobacco. This review article examines the close interactions between age, smoking, hypertension and aortic aneurysm, with a view to understanding mechanisms by which these factors predispose a patient to an aortic aneurism. It is also to observe if these factors interfere with treatment and recovery from aneurysms. Conclusion: After careful review, it is observed that age and smoking are risk factors for hypertension, and together with hypertension, the three factors predispose an individual to high risk for aortic aneurysm.
Evaluation of the effect of titanium dioxide and gold nanoparticles surface treatment on the flexural strength of polymethyl methacrylate heat cure denture base resin
Published on: 11th January, 2022
OCLC Number/Unique Identifier: 9390769614
Aim: The purpose of this study was to evaluate the effect of Titanium dioxide and Gold nanoparticles surface treatment on the flexural strength of Polymethyl methacrylate (PMMA) Heat cure denture base resins.Materials and methods: A total of thirty PMMA Heat cure denture base resin test samples were fabricated of size 65 x 10 x 2.5 mm (rectangular shaped) according to ADA specification no.2. The samples were divided into three groups as Conventional PMMA heat cure denture base resin samples (GROUP I, n = 10 CONTROL), PMMA Heat cure denture base resin samples coated with Titanium dioxide nanoparticles (GROUP II, n = 10) and PMMA Heat cure denture base resin samples coated with Gold nanoparticles (GROUP III, n = 10). GROUP II and GROUP III PMMA Heat cure denture base resin test samples were coated by Magnetron sputtering. Flexural strength of GROUP I, GROUP II and Group III was evaluated by a three-point bend test using a Universal testing machine and the mean values were obtained.Results: The Mean flexural strength of GROUP I, GROUP II and GROUP III samples were 114.79 MPa, 142.48 MPa and 154.70 MPa respectively. On comparative evaluation of the flexural strength among the three groups GROUP III PMMA Heat cure denture base resin samples exhibited the highest flexural strength followed by GROUP II and least by GROUP I. The statistical analysis by ANOVA had shown that there is significance in flexural strength among the groups tested (p - value = 0.000*).Conclusion: Within the limitations of the study, PMMA heat cure denture base resin coated with Gold nanoparticles showed the highest flexural strength followed by PMMA Heat cure denture base resin coated with Titanium dioxide nanoparticles. Conventional PMMA Heat cure denture base resin without any surface treatment showed the least flexural strength.
Khat use and users readiness to quit khat, qualitative research in the case of street people in Addis Ababa
Published on: 6th January, 2022
OCLC Number/Unique Identifier: 9395221764
Khat is a huge green plant that thrives at high elevations throughout the region ranging from southern to eastern Africa, and in the Arabian Peninsula. However, chewing Khat became common among the young (youth). The objectives of this study were to investigate the khat use behavior, users’ self-understanding, and their readiness of stopping using khat among street people in Addis Ababa, Ethiopia. A Semi-structured interview was used to collect information from street people in Addis Ababa. 15 participants were individually interviewed and 11 of them were males and the rest 4 were female participants. The data acquired from the interview was analyzed using descriptive and thematic analysis. Chewing Khat was identified as a common activity among the youth living in the streets of Addis Ababa. Most of the participants have an awareness of the use of khat and its effects on their health but they are still struggling to stop it. While the readiness to stop using khat was investigated and the addiction behavior and the lifestyle of the participants were affecting them from stooping chewing Khat.
Extraction of DNA from face mask recovered from a kidnapping scene
Published on: 7th January, 2022
OCLC Number/Unique Identifier: 9395237994
Deoxyribonucleic acid (DNA) extraction has considerably evolved since it was initially performed back in 1869. It is the first step required for many of the available downstream applications used in the field of molecular biology and forensic science. Blood samples is one of the main body fluid used to obtain DNA. This experiment used other body fluids such as saliva, sweat tears and mucus. There are many different protocols available to perform nucleic acid extraction on such samples. These methods vary from very basic manual protocols to more sophisticated methods included in automated DNA extraction protocols. This experiment used extraction kit (Zymo research). The DNA result from isolated saliva samples on the facemask range from 133.7, 213.6, 599.1 and 209.1 mg/ml. theoretically; such DNA is of much quantity and quality and can be used for forensic investigation when recovered from a crime scene. The DNA from isolated tears samples on the face mask ranges from 707.7, 202.5, 99.2, and 62.6 mg/ml. Theoretically, such DNA is of much quantity and quality and can be used for forensic investigation when recovered from a crime scene. The DNA from isolated tears samples on the face mask ranges from 615.3, 66.2, 78.5, and 68.2 mg/ml. theoretically, such DNA is of much quantity and quality and can be used for forensic investigation when recovered from a crime scene. Extracted DNA from saliva and sweat produced visible bands on agarose gel, mucous stain produce obscure band on agarose gel and the tears stain produce invisible bands. DNA from sweat satin, saliva stain, mucus stain and tears stain in face mask can be used as alternative for forensic investigation.
Genetic identification of three exhumed human remains at a hospital in Ghana: a forensic case report
Published on: 7th January, 2022
OCLC Number/Unique Identifier: 9395224000
DNA identification is very important in cases of high decomposition of dead bodies, in which the bodies cannot be identified by physical means.To compare the results of DNA typing, it is necessary to have related subjects with which to perform comparative analyses. Such tests are normally performed by comparing DNA profiles from people known to be immediate family members of the presumptive victim, such as parents or children because they share half of their genetic material with the unidentified.We report on how DNA analysis was used to solve a case of mixed-up bodies at a local mortuary in Ghana, West Africa. Two families and three buried human remains were in contention in this case. The first body (E9) was buried three months before exhumation. The second body (E11) was buried two and a half months before exhumation whiles the third body (E10) was buried a month before exhumation. Exhibit E5 was taken from an alleged child of the deceased, E11. Toenails of the exhumed bodies were sampled by a pathologist and used for DNA extractions using the QIAamp DNA Investigator Kit. Profiles from relatives were generated for comparison purposes. All samples gave a quality amount of genomic DNA after quantification. DNA was amplified with a GlobalFiler PCR amplification kit. Profiles from relatives were generated for comparison purposes.The human remains (exhibit E11) cannot be excluded as the biological father of the child (exhibit E5) because they share common alleles at all 23 genetic loci. The applicable combined paternity index was 17218125604.492 assuming a prior probability of 0.5. The probability of paternity is 99.99999999%. Based on this relationship testing, one of the bodies was successfully identified and handed over to the family for re-burial.
Rapid and sensitive identification of cow and buffalo species and gender in tissue/meat samples impounded from different spots in Delhi NCR India by Real Time PCR
Published on: 12th January, 2022
OCLC Number/Unique Identifier: 9395225158
The objective of this study was to obtain a fast, accurate and reliable method of species identification of unknown biological samples for forensic applications, especially in illegal trade of animals as well as meat fraud. Meat fraud and adulteration not only affects the market but also increases the risk of religious and ethnic conflicts around the world [1]. In this study, species-specific and gender differentiating Real time PCR technique was employed to analyse 15 meat samples collected from a suspected site. Out of 15 samples collected from suspected site, 54% and 13% samples were of Cow and buffalo origin respectively. All 54% cow samples were of male while one each of buffalo were of male and female origin. Two samples were inconclusive. These findings indicated that species and gender-specific PCR is very sensitive and can be used for forensic species identification and the detection of meat fraud and adulteration.
Collection and evaluation of indigenous buck semen at the coastal region of Bangladesh
Published on: 12th January, 2022
OCLC Number/Unique Identifier: 9395223799
Evaluation of semen characteristics is an important and prior for semen preservation. The aim of this study was to collection and evaluation of indigenous buck semen in the coastal region of Bangladesh. The semen was collected from bucks through artificial vagina method. The colour, odour, volume, viscosity, mass activity, consistency, concentration and individual sperm motility were analysed and recorded after collection from pre-selected four bucks. The colour and odour of all buck (B) semen were creamy white to milky white and fishy smell, respectively. In this study, we found that the average volume of B-1, B-2, B-3 and B-4 were 0.74, 0.98, 0.42 and 0.60 ml, respectively. The average grading of viscosity of B-1, B-2, B-3 and B-4 were 3.2, 3.8, 2.6 and 3.0, respectively. The average grading of mass activity of B-1, B-2, B-3 and B-4 were 3.6, 3.2, 2.4 and 3.4, respectively. The consistency of B-1, B-2, B-3 and B-4 were 4.2, 4.8, 2.8 and 4.0, respectively. The concentration of B-1, B-2, B-3 and B-4 were 1.58, 1.94, 0.62 and 1.54 ×109 per ml of semen volume. The average percentage of individual sperm motility of B-1, B-2, B-3 and B-4 were 81, 71, 66 and 80%, respectively. Viscosity, mass activity, consistency, concentration and individual sperm motility were significantly (p < 0.05) correlate with each other. It may be concluded that the data about semen of the bucks are in acceptable level for preservation. Further study will be designed for the evaluation of viability and motility of sperm before and after freezing as liquid semen.
Agaricus brasiliensis (Sun mushroom) and its therapeutic potential: A review
Published on: 10th January, 2022
In recent decades, the chemical, nutritional, and functional properties of edible mushrooms have attracted considerable attention, resulting in numerous reports on their health-associated benefits. One among such edible mushrooms, Agaricus brasiliensis, is native to Brazil and is an important food supplement. This review discusses the therapeutic potential of Agaricus brasiliensis and summarizes the current studies on this edible mushroom.
Impact of the COVID-19 infection on the “benign” nature of the illness of Schönlein-Henoch
Published on: 11th January, 2022
OCLC Number/Unique Identifier: 9391761803
The incidence of COVID-19 in children has been variable. Although now the number of infected children worldwide, and in particular nationally, is small, they are not protected from the infection. Moreover, in the most severe cases septic shock, metabolic acidosis, irreversible bleeding, and coagulation dysfunction have been registered.In February 2021 a 17-year-old boy showed for examination with complaints of pain in the upper part of the abdomen, accompanied by involvement of the ankle joints, the appearance of a rash on the lower extremities with the characteristic of hemorrhagic vasculitis, and a positive test for COVID-19. The characteristics of the skin purpura, the abdominal pain, and the arthralgia led us to the diagnosis of Schönlein-Henoch purpura. The verification of past COVID-19 infection was done by the established high titer of specific IgG antibodies. The clinical evolution of the disease went beyond its generally accepted benign nature - the first manifestation of the illness had been followed by four more relapses, which necessitated new hospitalizations and a change in the therapeutic approach.COVID-19 infection is the cause of a more aggressive course of vasculitis.
Fatal acute necrotizing pancreatitis in a 15 years old boy, is it multisystem inflammatory syndrome in children associated with COVID-19; MIS-C?
Published on: 13th January, 2022
OCLC Number/Unique Identifier: 9396181492
Acute pancreatitis in childhood is not common and viral and bacterial infections, bile duct diseases, medications, systemic diseases, trauma, metabolic diseases, and hyperlipidemia are among the most common causes in them. Acute necrotizing pancreatitis is even rarer. The clinical presentation of Multisystem Inflammatory Syndrome in Children associated with COVID-19 (MIS-C) includes fever, severe illness, and the involvement of two or more organ systems, in combination with laboratory evidence of inflammation and with or without laboratory or epidemiologic evidence of SARS-CoV-2 infection. We present a case of a 15 years old boy with fatal acute necrotizing pancreatitis that fulfilled MIS-C definition based on RCPCH (Royal College of Pediatrics and Child Health) and CPSP (Canadian Pediatric Surveillance Program) criteria.
Applications of convolutional neural networks in chest X-ray analyses for the detection of COVID-19
Published on: 20th January, 2022
OCLC Number/Unique Identifier: 9391752257
Throughout global efforts to defend against the spread of COVID-19 from late 2019 up until now, one of the most crucial factors that has helped combat the pandemic is the development of various screening methods to detect the presence of COVID-19 as conveniently and accurately as possible. One of such methods is the utilization of chest X-Rays (CXRs) to detect anomalies that are concurrent with a patient infected with COVID-19. While yielding results much faster than the traditional RT-PCR test, CXRs tend to be less accurate. Realizing this issue, in our research, we investigated the applications of computer vision in order to better detect COVID-19 from CXRs. Coupled with an extensive image database of CXRs of healthy patients, patients with non-COVID-19 induced pneumonia, and patients positive with COVID-19, convolutional neural networks (CNNs) prove to possess the ability to easily and accurately identify whether or not a patient is infected with COVID-19 in a matter of seconds. Borrowing and adjusting the architectures of three well-tested CNNs: VGG-16, ResNet50, and MobileNetV2, we performed transfer learning and trained three of our own models, then compared and contrasted their differing precisions, accuracies, and efficiencies in correctly labeling patients with and without COVID-19. In the end, all of our models were able to accurately categorize at least 94% of the CXRs, with some performing better than the others; these differences in performance were largely due to the contrasting architectures each of our models borrowed from the three respective CNNs.
Squamous cell carcinoma in a retrorectal cystic hamartoma
Published on: 20th January, 2022
OCLC Number/Unique Identifier: 9395224616
Retrorectal cystic hamartomas (HCR) (“tailgut cyst” in English-language literature) are congenital cystic tumors derived from vestiges of the hindgut. Its incidence is low, being more frequent in adult women. They are variable in size, uni or multiloculated. They can be lined with several types of epithelia (squamous, transitional, mucinous,...) in a same cyst and can contain mucus. Lesions usually present during adulthood due to pain, discomfort, rectal bleeding, infection, or malignant transformation. The incidence of malignancy is low, being adenocarcinoma and neuroendocrine the most frequent tumors associated to HCR. We present a case of HCR associated with squamous cell carcinoma and discuss aspects of the treatment.
Prevention of workplace violence in ED nursing using the implementation of an educational program and a new reporting tool
Published on: 7th January, 2022
The Emergency Department (ED) is a place that regularly deals with acute scenarios and people that are generally sensitive in nature. In a fast-paced environment such as this, people can be emotionally charged and react in different ways. Unfortunately, nurses in the ED tend to be most affected. Literature shows that workplace violence incidents that occur tend to involve ED nurses. Furthermore, ED nurses are more inclined to have an attitude that makes them think that any acts of transgression are “part of the job” and incidents usually go underreported. Moreover, reporting tools are usually difficult to use and tend to be a barrier to reporting workplace violence. In this evidence-based project, ED nurses will participate in an educational prevention program that will help equip them with the knowledge and awareness that is needed to decrease the incidence of workplace violence. Furthermore, a new, easy-to-use reporting tool will be implemented for ED staff. An implementation of an easier reporting tool and an education prevention program on the incidence of workplace violence will help reduce the number of future incidents of workplace violence. The purpose of this evidence-based project is to create a “zero tolerance” workplace culture for ED nurses that ultimately decreases the incidence of workplace violence. Based on research, an educational program and new reporting tool will be implemented at an urban community hospital in Westchester. Included is a purpose statement, and operational and conceptual definition, PICO questions, and an evidence-based practice protocol for workplace violence.
Uncommon first diagnosis of metastatic papillary thyroid carcinoma with “signet-ring” cells morphology through pericardial effusion
Published on: 20th January, 2022
OCLC Number/Unique Identifier: 9396216816
Malignant pericardial effusion is a usual and crucial exacerbation in malignancies. In some cases, pericardial effusion may be the first manifestation of the disease. Neoplastic pericarditis is extremely rare in thyroid cancer. Hereby, we describe the case of a 54-year-old man submitted to the hospital for chest pain and dyspnea. Clinical and radiological examinations were suggestive of pericardial effusion and mediastinal lymphadenopathy. The patient underwent pericardial drainage and surgical biopsy of a paratracheal lymph node. Pericardial biopsies were also taken. Histology study was compatible with metastatic papillary thyroid carcinoma with “signet-ring” cell morphology. Extended study of thyroid gland and function was performed and he was referred to oncologists for further treatment. Clinical presentation and histology are discussed emphasizing the rare correlation between pericardial pathology and metastatic thyroid carcinomas as the first diagnosis. Histopathologic findings of “signet-ring” cell morphology are very challenging for a differential diagnosis between thyroid carcinoma and other metastatic adenocarcinomas.
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