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Objective: The purpose of this study was to evaluate the clinical efficacy of extracorporeal shock waves combined with traditional Chinese medicine bone-setting manipulation for external humeral epicondylitis. Methods: Ninety-two patients with external humeral epicondylitis were randomly divided into an observation group and a control group. Patients in the control group were treated with extracorporeal shock waves while those in the observation group with traditional Chinese medicine bone-setting manipulation based on the control group. Patients in both groups were evaluated by the Visual Analogue Scale (VAS), Mayo Elbow Performance Score (MEPS), and Disabilities of the Arm, Shoulder, and Hand Questionnaire (DASH) before and after treatment. The inflammatory factors such as IL-6, IL-10, TNF-ɑ, and clinical outcomes were contrasted before and after treatment. Results: There were statistically significant differences in VAS score, MEPS score, and DASH score between the two groups before and after treatment (p < 0.05). The observation group exhibited a more pronounced improvement in each score compared to the control group. Post-treatment, the inflammatory factors of both groups were significantly lower than pre-treatment levels (p < 0.05), with the observation group showing a more noticeable decrease. The overall effectiveness of the observation group was higher than that of the control group, and the difference was statistically significant (p < 0.05).Conclusion: The combination of extracorporeal shock wave therapy and traditional Chinese medicine bone-setting manipulation can effectively alleviate pain symptoms and improve dysfunction caused by external humeral epicondylitis, while also reducing inflammatory factor expression. This combined treatment may prove more effective than extracorporeal shock wave therapy alone.Clinical Trial: Registration: ChiCTR2200066075.

West Africa’s population is projected to reach 500 million by 2050, exacerbating the need for reliable drought detection and management strategies to ensure food and water security. This study investigated drought detection in West Africa using the Standardized Precipitation Index (SPI) and Standardized Precipitation Evapotranspiration Index (SPEI). The objective is to evaluate the performance of SPI and SPEI in detecting droughts and compare their strengths and limitations. The results revealed that both indices detected droughts effectively, but SPEI was more sensitive to evapotranspiration and temperature change. The findings offer valuable insights into climate change impacts, drought monitoring, and sustainable water resource management in the regions under investigation in West Africa.

The concurrent emergence of dengue fever and the COVID-19 pandemic posed significant challenges to India’s healthcare system, particularly in Western Rajasthan, a region characterized by its arid climate and unique socio-demographic conditions. This study aimed to investigate the clinical and molecular characteristics of dengue during the COVID-19 pandemic, focusing on trends, diagnostic challenges, and serotype distribution. Conducted at Dr. S.N. Medical College, Jodhpur, in 2021, the study included 550 dengue-positive patients confirmed via rapid diagnostic tests and further analyzed using Dengue NS1 antigen and IgM antibody ELISA. Molecular characterization was performed using RT-PCR for serotyping.The results revealed a male predominance (72.36%) and a higher incidence in the 21–30-year age group (39.09%). Urban areas accounted for 67.73% of cases, with significant NS1 and IgM positivity (p = 0.042 and p = 0.004, respectively). Most cases (86.91%) were managed outpatient, though IgM positivity was significantly higher among hospitalized patients (19.19%, p < 0.001), indicating severe or prolonged infections. Platelet counts were above 100,000/mm³ in 86.91% of cases, with only 0.37% showing critically low counts (< 20,000/mm³). Seasonal analysis showed a peak in October (n = 325), correlating with post-monsoon vector breeding. Serotyping identified DENV2 as the dominant strain (97.42%), associated with severe dengue manifestations, including Dengue Haemorrhagic Fever (DHF).The study highlights the dual burden of dengue and COVID-19, emphasizing the need for enhanced vector control, improved diagnostic strategies and public health interventions during overlapping outbreaks. The predominance of DENV2 underscores the importance of serotype-specific surveillance and preparedness to mitigate future dengue epidemics in the region.

Background: The proposal that MALDI-ToF mass spectrometry could be used as a direct, rapid and affordable diagnostic tool in clinical laboratory medicine has moved from a theoretical possibility to a reality for Microbiology. Several studies have proposed the application of this technology in obstetric and gynaecological evaluation of patients. In particular, we have proposed that the adoption of MALDI-ToF mass spectrometry in examination of maternal pregnancy urine samples for the detection of Downs syndrome. Methods: A retrospective collection of 20 Down Syndrome and 100 non-aneuploid pregnancy urines at 12 to 14 weeks gestation, collected in 2007-2008 from high risk pregnancy cohorts, were examined by MALDI-ToF mass spectrometry in the mass/charge range between 1000 and 100000 m/z. Normalisation of spectral data was defined using mass bins of 100 m/z expressed as a percentage of the total ion count of the mass spectra from 2000 to 11000 m/z. Of the ninety 100 m/z bins, forty-six were identified as m/z bins at which statistically significant differences in spectra occurred between Downs and control/non-aneuploid samples. Based on the differences and variance, for values at these bins, weighted scores of the probability of being Downs were assigned. Comparative algorithms consisting of various mass bins were tested for ability to distinguish Down syndrome from non-aneuploid pregnancy. Results: Although various algorithms could distinguish Downs from non-aneuploid controls, it was found that gestational age was a confounding factor and that if separated into gestational age matched cohorts the ability to distinguish the groups improved dramatically e.g. whilst a 19 bins algorithm separated 100% of Downs from non-aneuploid pregnancies for a 9% false positive rate in the mixed gestational ages group; a two bin algorithm distinguished 100% of Downs for a 6% false positive rate for the 12 weeks gestational age pregnancies. Conclusion: Normalised MALDI-ToF mass spectra, at 2000 to 11000 m/z, of maternal urine gives rise to gestational age specific screening tests algorithms for Downs’s syndrome.

The incidence of obstetric acute renal failure remains significant in developing countries. The aim of our study is to define the risk factors involved in the occurrence of ARF during pregnancy or during the immediate postpartum period and to evaluate its evolutionary profile in terms of epidemiology, etiopathogenesis, and therapeutic management over the years in Morocco. This is a retrospective study conducted in the maternal-infant resuscitation service of the Ibn Rochd University Hospital of Casablanca, over the period from January 2020 to August 2023, including 95 patients. The current incidence in our series over this period was 22.2%. The mean age of our population was 33 ± 7.74 years [18-43 years], 67.3% of patients were in the gestational period, compared to 33.7% in the immediate postpartum period. Fourteen patients were primiparous (8.6%), 27.4% had a history of miscarriage, and 10.7% had a history of pre-eclampsia. Oligo-anuria was initially identified in 24 patients. The most frequent etiology was pre-eclampsia (56.7%), followed by hemorrhage (27%) and sepsis (19.3%). The evolution was marked by recourse to hemodialysis in 62% of cases, with a maternal mortality of 26%. The existence of heart disease, the context of pre-eclampsia, and the use of diuretics and vasoactive drugs were significantly correlated with maternal survival. No factor was correlated with secondary recovery from ARF. The development of health structures and the optimization of screening strategies are the keywords for prevention.

A 61-year-old patient with autosomal dominant polycystic kidney disease (Irazabal class 1E) in whom renal function had decreased and kidney size had increased over the past 3 years (change in serum creatinine, 1.3 mg/dL to 1.5 mg/dL; change in total kidney volume, 5632 cm3 to 7301 cm3) was treated with tolvaptan 60 mg/day. After 8 years of tolvaptan treatment, serum creatinine remained at 1.51 mg/dL, and total kidney volume was at 6812 cm3. Adequate salt intake and good weight control may have resulted in good outcomes, even in patients with treatment-resistant giant cystic kidney disease.

Rationale: Pulmonary Arterial Hypertension (PAH) is a progressive vascular remodeling disease with elevated pulmonary vascular resistance that is lethal. While therapeutic progress was recently made with endothelin, nitric oxide, and prostacyclin pathway-based therapy for the treatment of PAH, the disease is currently incurable with a high cost of morbidity and mortality. Sotatercept, a new activin receptor IIA-Fc fusion protein, may prove to be a game-changer as a therapeutic agent for the treatment of PAH by regulating the growth factor signaling aberration of PAH.Methods: It is a narrative review of evidence for the drug Sotatercept for Group 1 PAH from a systematic literature search for clinical trials, mechanism studies, and regulatory data up to 2024. Pivotal clinical trials such as PULSAR, SPECTRA, STELLAR, and ZENITH were evaluated for efficacy, safety, and comparative results.Results: Sotatercept is a TGF-β family member ligand trap that rebalances activin/BMP signaling to target vascular remodeling. Clinically, striking effects were shown with exercise (40.8 m improvement in STELLAR 6MWD), pulmonary hemodynamics (PVR reduction of 146-240 dyn·s·cm-5 in PULSAR), as well as clinical measures (76% reduction of composite morbidity/mortality through ZENITH). On the background with an acceptable drug safety profile of predominantly hematologic effects, as well as injection site reaction, benefits were achieved. Comparison with analyses implies at least similar, if superior in some dimensions, efficacy of current PAH therapies.Conclusion: Sotatercept is a new therapeutic option for PAH as the first drug to act on the activin/BMP pathway. With its strong effect on several clinically relevant end points, it is a “fourth pillar” of PAH therapy. Clinical trials will determine its place in the algorithm, ascertain other combinations, and potentially identify its utility for other types of pulmonary hypertension.

Introduction: Cognitive impairment is defined as a new deficit in at least two areas of cognitive functioning. These may include disturbances in memory, executive functioning, attention or speed of information processing, perceptual motor abilities, or language. It has been shown that cognitive impairment is associated with the severity of kidney disease. Methods: The study was a descriptive research design, with participants purposively sampled from the general chronic kidney disease population which included haemodialysis and peritoneal dialysis patients at Steve Biko Academic Hospital in Pretoria, Gauteng Province, South Africa. Hundred and fifty-one participants (76 hemodialysis & 75 peritoneal dialysis patients), 58% were males, and 42% were females aged 19-61 years. To establish the prevalence of cognitive impairment by testing the level of cognition the Mini-Mental State Examination was utilized to provide a brief screening test to quantitatively assess the cognitive abilities and cognitive changes of patients while on dialysis. Results: Ninety-nine percent (99%) of the recruited population reported no cognitive impairment, irrespective of dialysis modality, demographic characteristics, and socio-economic status. Conclusion: Despite the findings highlighting that the majority of the chronic kidney disease population at Steve Biko Academic Hospital reported no cognitive impairment, it is crucial to increase awareness of the potential effects of cognitive impairment on daily activities, quality of life, and treatment adherence. Early detection and management of cognitive impairment can significantly impact the quality of life and adherence to treatment among these patients. Further research is needed to understand the prevalence and impact of cognitive impairment in different populations and to develop effective interventions for its prevention and management.

Familial hypocalciuric hypercalcemia (FHH) is one of the rare reasons for hypercalcemia. FHH is an autosomal dominant disease that is inheritable. The most common calcium sensitive receptors (CaSR) develop because of the inactivation of. In addition, they also develop due to the function loss of AP2S1 and GNA11. The FHH sickness is characterized by hypercalcemia, hypocalciuria, the regular or increased level of the parathyroid hormone, and normal renal function. The symptoms of hypercalcemia are usually not observed. It is often diagnosed by calculating the calcium/creatine clearance ratio of a 24-hour urine sample, and then genetically looking at it. FHH is usually a benign disorder, and when symptomatic and rarely complications develop, calcimimetics are used or parathyroidectomy can be performed. In conclusion, FHH is a benign and genetically transmitted, moderate cause of hypercalcemia. It is rare and usually asymptomatic.

Inclusively new to econophysics studies, herewith proposed technoeconophysics as part of techno-economy, econophysics & sociophysics to interpret the description between probability and hypothesis found between fractal realms and econophysics of markets, physics markets, or stock markets any chaotic evidence [exergy destructive] could present if effective & efficient criterion doesn’t comply. A more precise iterative study ought to be held to configure how fractal dimension is involved in the techno-econophysics study of the Helium Nat Gas Project which is not integer, but also proofed numerically & analytically.