Parkinson's disease (PD) is a progressive neurodegenerative disorder defined by the selective loss of dopaminergic neurons in the substantia nigra pars compacta. Although oxidative stress and neuroinflammation are widely accepted as core pathological drivers, no disease-modifying pharmacotherapy is currently available. The Nrf2/Keap1/ARE signaling axis represents a pivotal endogenous cytoprotective mechanism and an attractive therapeutic target. Withania somnifera (Ashwagandha) and Amomum subulatum (Large Cardamom) individually exhibit neuroprotective properties; however, their combined potential through Nrf2 modulation has not been systematically explored. Keywords: Parkinson's Disease; Withania somnifera; Amomum subulatum; Nrf2/Kea
Hypoxic-ischaemic encephalopathy (HIE) remains one of the leading causes of neonatal mortality and long-term neurodevelopmental disability worldwide despite major advances in neonatal intensive care and the widespread implementation of therapeutic hypothermia. Traditionally, HIE has been viewed predominantly as a cerebral disorder, with clinical management focused largely on neuroprotection and seizure control. However, growing evidence suggests that perinatal hypoxia-ischaemia induces a complex multisystem response involving profound interactions between cardiovascular dysfunction, acute kidney injury, cerebral autoregulatory failure, systemic inflammation, and metabolic disturbances. Myocardial injury may lead to reduced cardiac output and impaired cerebral perfusion, while renal dysfunction contributes to fluid imbalance, altered drug pharmacokinetics, and amplification of inflammatory pathways that further exacerbate secondary brain injury. Therapeutic hypothermia, although neuroprotective, introduces additional physiological alterations that influence myocardial performance, systemic vascular resistance, and renal blood flow. These interdependent mechanisms have led to increasing recognition of a neonatal cardio-renal-brain axis as a central determinant of neurological recovery following perinatal asphyxia. This review explores current understanding of organ crosstalk in HIE, examines emerging biomarkers and monitoring strategies, and discusses how multimodal haemodynamic assessment may facilitate a transition from protocol-driven treatment toward precision neurocritical care in the neonatal intensive care unit. Keywords: Hypoxic-ischaemic encephalopathy; neonatal haemodynamics; therapeutic hypothermia; acute kidney injury; precision neurocritical care
Nephrotic syndrome and diabetic nephropathy represent two of the most prevalent and clinically significant causes of chronic kidney disease worldwide. Nephrotic syndrome, defined by massive proteinuria (>3.5 g/day), hypalbuminaemia, oedema, and hyperlipidaemia, encompasses a spectrum of primary and secondary glomerulopathies. Diabetic nephropathy, the leading cause of end-stage renal disease globally, arises from complex interplay of haemodynamic, metabolic, and inflammatory mechanisms in the setting of diabetes mellitus. This review provides a detailed examination of the pathophysiology, clinical presentation, diagnostic approach, and current evidence-based management strategies for both conditions. We discuss the key histopathological features distinguishing the two entities, their shared risk factors, and emerging therapeutic targets including SGLT2 inhibitors, endothelin receptor antagonists, and mineralocorticoid receptor antagonists. Understanding these conditions is critical for nephrologists, endocrinologists, internists, and primary care physicians to improve patient outcomes and slow progression to end-stage renal disease. Keywords: nephrotic syndrome; diabetic nephropathy; glomerulosclerosis; proteinuria; SGLT2 inhibitors; chronic kidney disease; podocytopathy; renin-angiotensin system
BACKGROUND Drug gingival hyperplasia is an uncommon pathology encountered during routine work in dental units. OBJECTIVE The purpose of this topic is to present the clinical appearance of gingival hyperplasia caused by medications. There are already three classes of medications that cause hyperplasia and based on data from the literature, the clinical cases encountered and included in this study have been compared. METHODS The study was conducted in a total of 311 patients, out of which 182 patients were included in our study, meeting the inclusion criteria. After each patient's history was recorded and it was found that patients were in their knowledge of chronic illness, undergoing treatment of gingivitis hypertrophic drugs was performed with a clinical examination of oral cavity and assessment by the Vertical Growth Index (GOI) and horizontal for hypertrophy and the index of bacterial plaque. RESULTS Of the data collected during the study, it was observed that 97% of patients with gingival hyperplasia are treated with nifedipine. 84% of patients treated with selected medicines and gingival hyperplasia in the oral cavity have been exposed at period of time for more than 1 year and 1 month. According to the GOI index, in the first rank of this index are about 21% of patients, in the second rank are 52%, in the third rank are 24% and in the fourth grade are 3%. According to the horizontal growth index of gingival hyperplasia, grade 1 included about 61% of patients and grade 2 included about 39% of patients with gingival hyperplasia. Bacterial index divides patients by degrees: grading 0 - 8.2%, grading 1 - 32.4%, grading 2 - 14% and grading 3 - 45.1%. CONCLUSIONS The highest percentage of gingival hyperplasia caused by drugs is due to dosing of nifedipine for a duration of dosing and application for systemic healing for more than 1 year. CLINICALTRIAL -
Abstract — Access to relevant health indicates people’s likelihood of survival, including craft of indigenous healing and its related practitioners-izinyanga . However, the emergence of a dreaded novel corona virus - COVID-19 that has engulfed almost the whole world has necessitated the need to revisit the state of traditional healers in South Africa. This circumstance tended to expose the reality of social settings in various social structures and related policies including the manner coloniality reveal its ugly head when it comes treatment between western and African based therapeutic practices in this country. In attempting to gain a better understanding of such experiences, primary and secondary sources were consulted when collecting data that perusal of various literature in this instance including face-to-face interviews with traditional healers working on the street of Tshwane Municipality in South Africa. Preliminary findings revealed that the emergence of this deadly virus coincided with the moment when the government agenda was focussed on fulfilment of its promise of addressing the past inequity practices, including the transformation of medical sector. This scenario can be witnessed by the manner in which government and related agencies such as health department keeps on undermining indigenous healing practice irrespective of its historical record in terms of healing profession and fighting various diseases before times of father of medicine, Imhotep. Based on these preliminary findings, it is recommended that the government should hasten the incorporation of African knowledge systems especially medicine to offer alternatives and diverse to assess the underutilised indigenous African therapeutic approach and relevant skills that could be useful in combating ailments such as COVID 19. Perhaps, the plural medical systems should be recognized and related policies are formulated to guarantee mutual respect among citizens and the incorporation of healing practices in South African health sector, Africa and in the broader global community.
: Background: Testicular rotation can occur at any age. The possibility to save the testicle is the fastest possible surgical intervention which is indicated by the presence of acute pain even at rest. The time element is more important to diagnose and proceed further with surgical intervention. Testicular damage is a consequence which mainly depends on the moment of onset of symptoms, at the time when the symptoms are diagnosed, the earliest action to be performed is surgical intervention. Sometimes medical tests are needed to confirm a diagnosis, or to help identify another cause for symptoms; for example, the urine test, that is used to check for infection, associated with the scrotal ultrasound test. Control of blood flow to the longitudinal supply vessels of the testicles is indicated. The sign that indicates testicular rotation is a reduction in blood flow. This is the element which is distinguished from ultrasound examination. Surgery may be needed to determine if the patient’s symptoms are caused by the rotation of the testis or any other condition. Discussion: As a surgical intervention of the emergency, the torsion of the test depends very much on the duration of the torsion, as the success in the life of the testicle depends on the fastest surgical intervention. From the previous clinic, it is noted that in any case presented to the pediatric patient diagnosed with testicular rotation, there is always a link with personal history that the patient refers to the presence of a previous episode of testicular trauma. Literature supports this fact very logically. Conclusions: Salvation without testicular atrophy depends closely on establishing the diagnosis of testicular rotation as soon as possible. Following the logic above, it can be said that the diagnosis for rotation should be performed as soon as possible, to avoid consequences that will not be favorable for the patient.
Background: Multimodality, the occurrence of multiple modes in the distribution of the data is a less-discussed issue in the area of count regression models. Objectives: To assess the suitability of Hermite regression model to predict the factors affecting the number of symptoms among pregnant women. Methods: This study is focused on comparing the performance of various count regression models when the dependent variable is both overdispersed and multimodal. The data is obtained from a community based prospective study of anxiety, depression during pregnancy and its relationship to pregnancy outcomes. Poisson, negative binomial, Hermite and generalized Hermite regression models were fitted to find the relationship between the variables. The models were compared using fit indices along with the estimates and standard errors. Distribution of randomized quantile residuals was also assessed to determine the goodness of fit of the models. Results: Based on the values of fit indices and tests, Hermite regression was chosen as the best to establish the relationship between the response variable, number of somatic symptoms and the predictors. The model identified parity, stress and depression as the factors affecting number of somatic symptoms in pregnant women. Conclusions: The Poisson and negative binomial model may not accommodate multimodality as they are framed based on unimodal distributions. The Hermite regression approach is an ideal approach for count data, as it can handle both overdispersion as well as multimodality.
Structures of eye bottom were extracted using multiscale texture gradient method and color characteristics of macular zone and vessels were verified in CIELAB scale. The difference of average values of L*, a* and b* coordinates of CIE (International Commision of Illumination) scale in patients with diabetes and healthy volunteers was compared. The average value of L* in diabetic patients exceeded such one in the group of practically healthy persons by 2.71 times (P < 0.05), while the value of a* index was reduced by 3.8 times when compared with control one (P < 0.05). b* index exceeded such one in the control group by 12.4 times (P < 0.05). The integrated index on color difference (ΔE) exceeded control value by 2.87 times (P < 0.05). More pronounced differences with ΔE were followed by a shorter period of MA appearance with a correlation level at -0.56 (P < 0.05). The specificity of diagnostics raised by 2.17 times (P < 0.05) and negative prognostic index exceeded such one determined with the expert method by 2.26 times (P < 0.05). Keywords—Diabetic retinopathy, multiscale texture gradient, color spectrum analysis.
Corona virus disease which originated from Wuhan in China has engulfed the whole globe COVID-19 is leading the list of diseases people are extremely concerned about, followed by cancer and HIV/AIDS, according to the study by market research and analysis company Velocity MR This disease has brought around many changes in the lives of people The medical officials and scientists are working all day long to find a cure for this disease or to create a vaccine But the question that rises is will there ever be a cure? Will the world be normal again? For how long will this disease cause a havoc in the life of the people? And many such questions which still remain unanswered But in this article we have discussed about how will the world change after COVID-19 pandemic
Background: An outbreak of gastroenteritis occurred in December 2019 after students of a Senior High School in Accra were served with kenkey and fish during their dinner. An investigation was conducted to characterize the affected people, the source of contamination, the etiologic food and agent. Methods: An epidemiological study was conducted with cases selected from the student population who were ill. Controls were selected from among students who also ate from the school canteen during dinner but were not ill. Food history of each case and control was taken to assess their exposure status. Epi Info 7 was used to analyze the data obtained from the outbreak. Attack rates and odds ratios were calculated to determine the risk of foodborne infection for each of the foods consumed by the population. The source of contamination of the foods was ascertained by conducting an environmental risk assessment at the school. Results: Data were obtained from 126 students, out of which 57 (45.2%) were cases and 69 (54.8%) were controls. The cases presented with symptoms such as diarrhea (85.96%), abdominal cramps (66.67%), vomiting (50.88%), headache (21.05%), fever (17.86%) and nausea (3.51%). The peak incubation period was 18 hours with a minimum and maximum incubation periods of 6 and 50 hours respectively. From the incubation period, duration of illness and the symptoms, non-typhoidal salmonellosis was suspected. Multivariate analysis indicated that the illness was associated with the consumption of the fried fish served, however this was statistically insignificant (AOR 3.1.00, P = 0.159). No stool, blood or food samples were available for organism isolation and confirmation of suspected etiologic agent. The environmental risk assessment indicated poor hand washing practices on the part of both the food handlers and students. Conclusion: The outbreak could probably be due to the consumption of the fried fish that might have been contaminated with Salmonella sp. as a result of poor hand washing practices in the school. Keywords—Case control study, food poisoning, handwashing, Salmonella, school.
Abstract—Lung cancer is one of the most common malignancies and primary cause of death due to cancer worldwide. Non-small cell lung cancer (NSCLC) is the main subtype in which majority of patients present with advanced-stage disease. Herein, we analyzed differentially expressed genes to find potential biomarkers for lung cancer diagnosis as well as prognostic markers. We used transcriptome data from our 2 NSCLC patients and public data (GSE81089) composing of 8 NSCLC and 10 normal lung tissues. Differentially expressed genes (DEGs) between NSCLC and normal tissue and between early-stage and late-stage NSCLC were analyzed by the DESeq2. Pairwise correlation was used to find the DEGs with false discovery rate (FDR) adjusted p-value 0.05 and |log2 fold change| 4 for NSCLC versus normal and FDR adjusted p-value 0.05 with |log2 fold change| 2 for early versus late-stage NSCLC. Bioinformatic tools were used for functional and pathway analysis. Moreover, the top ten genes in each comparison group were verified the expression and survival analysis via GEPIA. We found 150 upregulated and 45 down-regulated genes in NSCLC compared to normal tissues. Many immnunoglobulin-related genes e.g., IGHV4-4, IGHV5-10-1, IGHV4-31, IGHV4-61, and IGHV1-69D were significantly up-regulated. 22 genes were up-regulated, and five genes were down-regulated in late-stage compared to early-stage NSCLC. The top five DEGs genes were KRT6B, SPRR1A, KRT13, KRT6A and KRT5. Keratin 6B (KRT6B) was the most significantly increased gene in the late-stage NSCLC. From GEPIA analysis, we concluded that IGHV4-31 and IGKV1-9 might be used as diagnostic biomarkers, while KRT6B and KRT6A might be used as prognostic biomarkers. However, further clinical validation is needed.
A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration. Keywords—Critical care, early warning systems, emergency medicine, heart rate variability, hemodynamic instability, rapid response team.
