The study assessed the efficacy and safety of Longidaza® (bovhyaluronidase azoximer, 3000 IU) in patients with lung damage after complicated COVID‑19. Two groups of 30 patients each were compared: the first received Longidaza® via intramuscular injections (3000 IU every five days, 15 injections total); the second was under dynamic observation without active therapy. The trial ran from August to December 2023. Participants were over 18 years old, had lung manifestations after severe COVID‑19, started outpatient treatment within two months after hospital discharge, and provided informed consent. Exclusion criteria included pregnancy, lactation, severe comorbidities, etc. Key parameters after 10 weeks (day 71) were changes in: resting capillary blood oxygen saturation (SpO 2 ,%); laboratory markers (lymphocytes, C‑reactive protein [CRP], D-dimer, fibrinogen). Statistical analysis used Stata 14.0 (significance level: p < 0,05; Mann‑Whitney test). Mean age was 59.8 ± 15.2 years (Longidaza group) and 56.06 ± 13.7 years (observation group). Common comorbidities: hypertension and coronary heart disease. Results: CRP levels decreased more than twofold in both groups (to 3.66 ± 3.84 mg/L and 1.24 ± 0.7 mg/L, respectively). Blood oxygen saturation stayed ≥ 96% in most patients. In the Longidaza group, some parameters were statistically significantly lower — possibly indicating antifibrotic activity. No adverse effects were reported. Conclusion: Longidaza® is safe and potentially effective for preventing and treating early pneumofibrosis and managing established lung fibrosis.
Background: Neoadjuvant therapy has improved the resectability of locally advanced hepatocellular carcinoma (HCC), but treatment-induced tumor necrosis and fibrosis often obscure tumor boundaries, making margin control challenging during non-anatomical hepatectomy (NAH). This study evaluated the efficacy of indocyanine green (ICG) fluorescence imaging for tumor delineation and resection margin control in this patient population. Methods: This retrospective observational study included 110 patients with HCC who received neoadjuvant therapy and subsequently underwent NAH between January 2018 and January 2024. After exclusions, 88 eligible patients were divided into ICG-guided (n=40) and conventional surgery (n=48) groups, with 38 matched pairs (38 vs. 38) after 1: 1 propensity score matching (PSM). Primary outcomes included adequate/positive resection margin rates and boundary identification accuracy; secondary outcomes were perioperative and oncological outcomes. Results: The ICG group demonstrated a significantly higher adequate margin rate (92.1% vs. 73.7%, p = 0.034) and improved tumor boundary identification accuracy (89.5% vs. 63.2%, p = 0.012). The positive margin rate was lower in the ICG group (2.6% vs. 18.4%, p = 0.058). Length of hospital stay was significantly shorter (7.1 ± 2.0 vs. 9.4 ± 2.7 days, p = 0.001), while operative time, blood loss, and postoperative complication rates were comparable. No significant differences in recurrence-free survival (RFS) or overall survival (OS) were observed. Conclusions: ICG fluorescence imaging enhances tumor boundary visualization and may improve resection margin quality in NAH following neoadjuvant therapy for HCC, representing a valuable intraoperative navigation tool.
Introduction: A cleft lip or palate is a congenital malformation that causes a fissure of the lips or palate, and an antenatal diagnosis is essential for its treatment. Objective: The objective of this study was to present a case of a labial cleft in prenatal diagnosis by ultrasound at the Kalaban Coro reference health center. Materials and Methods: This was a case study of a labial cleft discovered during an obstetrical ultrasound. The examination was performed using a VINNO E30 ultrasound machine. Informed consent was obtained from the patient before her participation in the study. Participation in the study was voluntary. The patient's anonymity and confidentiality were guaranteed. Results: The study focused on a 28-year-old housewife. This was her third pregnancy and second delivery, with a history of stillbirth. No medical or surgical history was found. The patient was referred for an obstetrical ultrasound to evaluate the prognosis of delivery. The examination revealed a 34-week-old intrauterine male fetus with a large cleft lip and palate with umbilical cord interposition in the cleft, which was confirmed after birth. Conclusion: Ultrasound is the method of choice for prenatal screening of cleft lip and palate.
Introduction: There have been significant advances in the treatment of spondylarthritis (SpA) in recent years. Despite these advances, there is still a proportion of patients who experience multiple changes in biologic, which may correspond to difficult-to-treat spondylarthritis (SPA DaT). Unlike rheumatoid arthritis, there is no consensus definition for this concept. The aim of our study is to determine the prevalence of multi-switchers with spondylarthritis, identify their characteristics, and analyse the number and reasons for switching in a Moroccan population. Patients and methods: This is a comparative cross-sectional study that included patients with SpA diagnosed according to the 2009 ASAS criteria admitted to our department for targeted treatment. Sociodemographic data, comorbidities, and clinical, paraclinical, and therapeutic characteristics were collected for each patient. Multi-switchers who had received at least two biologics were considered to be SpA DaT. Their prevalence was estimated, and a comparison was made with a control group of non-multi-switchers (SpA-non-DaT). Results: Two hundred and ten patients were included, 56.2% of whom were men, 63% with a long average disease duration. The prevalence of multi-switchers was 32.7%. Compared to the control group, patients in the DaT group were predominantly female (53.6% versus 39%, p=0.04), had more axial involvement (76.8% versus 91.5%, p=0.003) and peripheral joint involvement (88.4% versus 67.4%, p= 0.001) and associated fibromyalgia (33.3% versus 66.7%, p = 0.980), CsDMARD use (97.1% versus 31.9%, p= < 0.001), and corticosteroid use (34.8% versus 11.3%, p= < 0.001). Disease activity, BASDAI, ASDAS and CRP at the start of biotherapy were higher in the SPA DaT group (BASDAI: 21.8% versus 20.6%, p=0.08), (ASDAS: 46.4% versus 54.6%, p = 0.03), BASFI (27.5% versus 41.8% p=0.04) CRP (: 14.19±4.73 mg/l versus 13.7±2.1 mg/l, p = 0.01). Similarly, the time between diagnosis and use of the first biologic was longer (4 [2.25–6] years versus 3 [1–4] years, p = 0.03). All patients in the DaT group had received anti-TNFα, and 22.9% had received anti-IL17. Analysing switches between biologics in this difficult-to-treat group, the first switch was linked to primary failure in 59% of cases, secondary failure in 29% of cases, and an adverse effect in 12% of cases. In the second switch, primary and secondary failure were observed in 64% and 33% of cases, respectively, and adverse effects in 3%. Regarding the third switch, 83% had primary failure and 17% had secondary failure. Conclusion: This study reveals a significant prevalence of patients with multiple treatment changes in the Moroccan population, highlighting the need for a larger patient sample to better define this condition.
Benzene toxicity can lead to a range of serious health impairments, including various forms of anemia and several types of cancer, such as multiple myeloma, lymphoma, and leukemia. It is crucial to minimize exposure to benzene in industrial and environmental settings to protect public health and prevent these potentially life-threatening conditions. To investigate the potential impact of benzene exposure on the hematological profile of workers and to compare the results with those of a healthy, non-exposed population. A comparative cross-sectional study was conducted from July to November 2022 with Benzene workers at the Kosti benzene stations in Sudan were divided into two groups for a study: an exposure group consisting of eighty-seven individuals who were exposed to benzene, and an unexposed group of eighty-seven individuals who had no exposure. Blood samples were collected from all participants in Ethylene Diamine Tetra Acetic Acid (EDTA) tubes for Complete Blood Count (CBC) analysis. The results indicated that the mean values for Red Blood Cells (RBCs) count were significantly higher in the exposure group compared to the control group. Similarly, the lymphocyte count showed a significant increase in the exposure group versus the control group (P<0.001). Additionally, the Mean Cell Hemoglobin Concentration (MCHC) was also significantly elevated in the exposed individuals compared to the healthy participants (P<0.001). Conversely, the mean values for Mean Cell Volume (MCV) were significantly lower in the exposure group compared to the control group. Hemoglobin (Hb) levels were also significantly reduced in the exposed group versus the control group (P<0.001). The packed cell volume (PCV) was lower in the exposure group compared to the control (P<0.001). Other hematological significant decreases were observed in Mean Cell Hemoglobin (MCH), Neutrophil count, Monocyte count and Platelet (PLTs) count (P < 0.001). No significant differences were found in the mean values of Total White Blood Cells (TWBCs) count and Eosinophil count between the exposed and non-exposed groups. This analytical comparative study highlights the substantial influence of benzene exposure on the hematological parameters of Sudanese workers, indicating notable disparities in hematological variables, thus emphasizing the need for occupational exposure monitoring and protective strategies for benzine workers.
Introduction: Birth weight has historically been used as an indicator to assess fetal growth, and newborns below the 10th percentile for a given gestational age have generally been associated with poor outcomes. Current knowledge about the functional capacity of the immune system in the first weeks of life highlights the importance of infections as one of the most important causes of morbidity and mortality in newborns. Objective: To identify risk factors for the onset of immunodeficiency in births with restriction of the fetal growth at the Mariana Grajales Gynecological-Obstetric Hospital in the municipality of Santa Clara, Villa Clara province, from January 2016 to December 2023. Material and Methods: A descriptive, cross-sectional, and retrospective study was carried out in births with restriction of the fetal growth at the Gynecological-Obstetric Hospital of the municipality of Santa Clara, Villa Clara province, from January 2016 to December 2023. The universe was made up of 44 patients. Results: The main risk factor was a history of admission, which represented 56% of the total, followed by not breastfeeding, which in turn represented 40% of the total cases analyzed. Conclusions: It is important to understand the risk factors for the development of immunodeficiency, as well as the warning signs, in order to understand the mechanism of its onset and prevent conditions from leading to the underlying cause.
Background: A person’s physical attractiveness of a person is one of the first traces of information that can be obtained from the individual. Objective: To determine the characteristics that express self-esteem in adolescents between 15 and 17 years of age who attend the Orthodontics consultation of the Marta Abreu Teaching Polyclinic with malocclusions. Methodological Design: A descriptive, observational study was carried out in the Department of Stomatology, in the period from March 2023 to March 2024. The sample consisted of 30 adolescents selected through non-probabilistic sampling, the techniques and instruments for collecting information were the Medical History, Coppersmith Questionnaire, Psychosocial Impact of Dental Aesthetics Questionnaire and semi-structured interview, the results were processed in the SPSS version 15.0 program. Results: As results, it is described that in relation to self-esteem and the distribution of the categories, the medium level is the most frequent, the female sex is the one with the highest incidence, young people experienced a negative impact on their personal image that influences the development of self-perception. Conclusions: Malocclusions affect the self-esteem of adolescents.
The COVID-19 pandemic has led to a substantial proportion of survivors experiencing persistent, multisystem sequelae, encompassing respiratory dysfunction, neuromuscular impairments, cardiovascular complications, and psychological disorders. These heterogeneous and complex late effects pose significant challenges for rehabilitation professionals in conducting comprehensive assessments and designing tailored interventions. This review integrates data from multicenter studies to elucidate the clinical manifestations of COVID-19 sequelae, evaluate the validity and reliability of existing assessment instruments, and examine the efficacy of diverse rehabilitation modalities. Emphasis is placed on the pivotal role of multidisciplinary teams, the feasibility of tele-rehabilitation platforms, and the incorporation of innovative technologies—such as virtual reality, wearable sensors, and artificial intelligence—in optimizing rehabilitation outcomes. By systematically analyzing rehabilitation pathways across different sequelae, this paper aims to furnish evidence-based recommendations to refine clinical protocols, enhance the efficiency of rehabilitation services, and ultimately facilitate functional recovery and quality-of-life improvements for individuals affected by long COVID.
Circulating tumor DNA (ctDNA) has emerged as a transformative biomarker in tumor precision medicine, enabling noninvasive insights into tumor genetics and dynamics across the entire disease continuum from diagnosis to treatment monitoring. Over the past two decades, significant advances from early cell-free DNA discovery to sophisticated high-sensitivity digital PCR and next-generation sequencing technologies have successfully facilitated the accurate detection and precise quantification of ctDNA at extremely low variant allele frequencies in peripheral blood samples. Comprehensive mechanistic studies reveal that ctDNA release reflects multiple biological processes including tumor cell apoptosis, necrosis, active secretion mechanisms, and complex microenvironmental influences that affect circulating DNA stability. Recent analytical innovations—including advanced droplet digital PCR platforms, targeted deep sequencing approaches, sophisticated variant-filtering algorithms, miniaturized microfluidic devices, and integrated artificial intelligence/machine learning pipelines—have substantially enhanced both sensitivity and specificity for ctDNA detection across diverse clinical scenarios. Current clinical applications span multiple domains including early cancer detection, minimal residual disease assessment, real-time tumor progression monitoring, comprehensive heterogeneity profiling, and personalized treatment guidance across multiple cancer types including colorectal, lung, breast, pancreatic, melanoma, hematologic, and gynecologic malignancies. Ongoing collaborative efforts in standardization protocols, analytical optimization, and comprehensive ethical governance frameworks aim to systematically address persistent challenges including low ctDNA abundance in early-stage disease, false positives/negatives, patient data privacy concerns, and ensuring equitable global access to these advanced diagnostic technologies. Future research directions emphasize developing ultrasensitive nanotechnology platforms, implementing long-read sequencing methodologies, advancing multi-omics integration strategies, and deploying AI-driven interpretation systems to fully realize ctDNA's transformative potential in precision oncology.
Background: Khat chewing practices are common in the Arabian Peninsula and in Eastern Africa, including Ethiopia. Khat chewing is popular among adolescents in Ethiopia. However, there are no studies on the practice of Khat chewing among early adolescents in school children in the eastern part of the country, where the majority of khat in the country is produced and exported. Objective: This study aimed to assess khat chewing and associated factors among early adolescent school children in Haramaya district from September 1 to 30, 2023. Methods and Materials: A school-based cross-sectional study was conducted in Haramaya District from September 1 to 30, 2023. A total of 592 early adolescent school children were selected sampling technique with simple random sampling. Trained data collectors collected data structured questionnaires. The data were entered into EpiData version 4.6. The data were then exported to the SPSS version 23 statistical package for further data processing and analysis. Descriptive statistical tests and bivariate and multivariate logistic regression analyses were used to determine predictors of Khat chewing among early adolescents. The level of significance was set at a P value of less than 0.05. Results: The current prevalence of khat chewing was 38.9% (CI: 34.0%-42.1%). Among the studied variables, male sex [AOR=2.47; 95% CI: (1.61-3.86)], peer pressure [AOR=3.67; 95% CI: 2.45-5.40)], easy availability of khat [AOR=1.95; 95% (1.01-3.78)], and living with khat chewers [AOR=7.48; 95% CI: (4.60-12.16)] were significantly associated with current khat chewing practices. Conclusion: Khat chewing is prevalent among early adolescents in elementary school in the study area. The factors most strongly associated with khat chewing were male sex, peer pressure, living with khat chewers and easy availability of khat. The findings suggest the need to create public awareness among the community, particularly for adolescents and their parents.
Background: it is necessary to know the challenges that Cuban dentistry and higher education must face in order to act in the face of economic limitations, its relationship with science, technology and innovation, and the training of professional skills to achieve the goal of Vision 2030. Objective: assessment of economic limitations and integration with science, technology and innovations in relation to the challenges of 2030 Vision and the level of specific and transversal competencies in the training of professionals in the health area. Methods: a descriptive-cross-sectional investigation was carried out, from March to May 2021, at "Marta Abreu" University Polyclinic, in Santa Clara, Villa Clara. Theoretical methods were used: analysis-synthesis and inductive-deductive; empirical ones: survey and documentary review; the mathematical to determine the absolute values and percentage. Results: some challenges were identified: absence of appropriate technology, limited adoption of initiatives in health promotion and prevention, understanding of alarm signals, following a path of constant learning and improvement, real restrictions in the integration with science and innovation, and promote practical investigations based on students' researching, communication and knowledge updating skills. Conclusions: Cuban dentistry has objective economic limitations, which can be overcome with its integration into science, technology and innovation, and the promotion of skills that allow them to act creatively in the most diverse scenarios.
Introduction: The success of kidney transplantation depend on the effectiveness in certain key factors including excellent donor compatibility, immunosuppression and good surgical techniques. Exciting prospects in kidney transplantation is envisaged especially with the launching of standards and guidelines for the establishment and coordinating organ/tissue transplantation services by the Federal Government of Nigeria in March, 2025. We have come a long way with our five year experience in kidney transplantation. The use of branded immunosuppressive agents, excellent HLA/DSA typing and compatibility as well as ‘top notch’ surgical and medical team of experts have exponentially achieved a favorable outcome. Challenges are not unusual but we are hopeful that the future is promising and will offer more advancement in ‘tips and tricks’ of successful lifelong kidney transplantation. We report our experience in kidney transplantation over a 5 year period in our center. Methodology: This is a retrospective cohort study involving patients who had kidney transplantation in our facility over a 5 year period from January 2020 to December 2024. A proforma was designed to obtain existing records from our data base. Data analysis was conducted using Python with its libraries including Pandas, Numpy and Matplotib. P value of less than 0.05 was considered statistically significant. Results: Descriptive Statistics showed that a total of 104 patients had kidney transplantation surgery over the prescribed period. 66.35% were males while 33.65% were females. The average age of recipients was 46.27 years with a range of 24 to 72 years while the average age donors was 26.12 years with a range of 18 to 50 years. The average length of hospital stay after donor nephrectomy was 4.14 days while the average length of hospital stay for recipients post-surgery was 9.50 days with a range of 7-12 days. The etiology of renal failure were mainly long-term hypertension in 38.46%, diabetic mellitus in 29.81%, combination of both comorbid condition in 28.85%, autoimmune disease in 1.92% and genetic factor in 0.96%. Prognosis six months post-surgery was good in 82.69% and only 17.31% had unfavorable outcome. No donor mortality was observed. Conclusion: We have come a long way with our 5 years experience in management of end stage kidney disease in tropical Africa with excellent outcome. Though challenges are inevitable, the future still hold a promising exiting prospects as we envisage progressive experience and welcome new innovations including the use of minimal access techniques to achieve improved results.
Background: Blood transfusion is an effective treatment for saving millions of lives, even though transfusion-transmissible infections are the major problem. The prevalence of transfusion-transmissible infections varies between different geographical populations. This study aims to assess the prevalence of transfusion-transmissible infections and associated factors among blood donors at Woliso Blood Bank, South West Shewa Zone, Oromia, Ethiopia. Method: An institutional-based cross-sectional study design was conducted. A structured and pre-tested questionnaire was used to collect data through a face-to-face interview. The data was entered in Epi Data version 3.1, and exported to STATA version 17.0 for data cleaning and analysis. A binary logistic regression analysis was performed to identify factors associated with outcome variables. Odd ratios along with the 95% confidence interval were used to present the finding and statistical significance was reported with a p-value of 0.05. Results: The overall prevalence of transfusion-transmissible infections was 9.5% (95% CI 6.3-12.9%). Participants without formal education [AOR=4.84; 95% CI= 1.09, 21.46], unprotected sexual intercourse with multiple partners [AOR=4.77; 95% CI= 1.38, 16.44], and participants with a lower frequency of blood donation [AOR=2.85; 95% CI: 1.16, 6.99] were significantly associated with transfusion transmissible infections. Conclusions: The prevalence of transfusion-transmissible infections was high in this study area. Educational level, unprotected sexual intercourse with more partners, and a number of blood donations were found to be independent predictors of transfusion-transmitted infections. Blood banks and regional health offices should work to mobilize the community and improve health promotion through prevention and control considering the associated factors identified.
This comprehensive review presents the objectives and research framework for investigating radiation-induced coronary artery disease (RICAD) among young patients from a medical physics perspective. RICAD poses a silent threat to this population, necessitating a comprehensive understanding of its incidence, risk factors, long-term outcomes, mitigation strategies, underlying mechanisms, and predictive models. The study aims to investigate the incidence and prevalence of RICAD among young patients who have undergone radiation therapy for various medical conditions. The research involving RICAD amongst young patients has benefited greatly from the guidance and molding provided by the literature review, which has advanced our understanding of medical physics. By analyzing existing data and conducting longitudinal studies, the research intends to provide insights into the frequency of RICAD occurrence within this specific demographic. Identifying the risk factors associated with RICAD development in young patients is crucial for effective prevention and management. The research will explore factors such as radiation dose, treatment techniques, and patient-specific characteristics to determine their influence on RICAD incidence. This analysis will facilitate the development of targeted interventions and risk stratification strategies This study emphasizes how crucial it is to look into RICAD in pediatric patients concerning a medical physics standpoint. We can endeavor to improve the top leadership and outcomes for those who are most susceptible by comprehending the incidence, factors associated with risk, long-term consequences, mitigation measures, underlying mechanisms, and models for prediction linked with RICAD.
Background: Chronic liver disease (CLD) is a progressive deterioration of liver functions for more than six months, which includes the synthesis of clotting factors, and other proteins, detoxification of harmful products of metabolism, and excretion of bile. Viral hepatitis is one of the main causes of CLD. Objective: The main objective of this study is to determine the prevalence and associated risk factors of hepatitis B infection among patients visiting the medical referral clinic at Hawassa University Comprehensive Specialized Hospital, Sidama region, Ethiopia. Methods: A cross-sectional study was conducted on patients attending a medical referral clinic at Hawassa University Comprehensive Specialized Hospital, Sidama region, Ethiopia during the study period from October 2019 to August 2021 by reviewing the medical cards of 329 patients. The collected data was analyzed by data software and outcomes are presented by tables, figures, and statements. Result: A total of 195 adult patients with a sign and symptoms of CLD were included in this study. Of these 143 (73.3%) male and 52 (26.7%) female participated in the study. The mean age of the participant was 33.5 years (SD ±12) most of the patients were in the 26-35 age range. The majority 57% of the study participants were rural residents. Considering marital status 66.7% of the study participants were married. The most common cause of chronic liver disease is caused by chronic HBV (79.5%) followed by Hepatosplenic Schistosomiasis (5.6%) with positive HBsAg 0% and 3% respectively. Among 195 chronic liver disease patients, 143 (73.3%) were male and 21 (62.1%) were positive for HBsAg which were statistically significant with (COR 2.9 and 95% CI 1.4-6.). Of those who were Child-Pugh Class A (113) were positive for HBsAg 103 (52.8) (COR, 5.5; 95% CI, 2.2–14; P-Value 0.0001) and compensated patient where (COR, 8; 95% CI, 3.5–19; P-Value 0.0001) for which both are statically significant. Risk factors associated with HBV among chronic liver disease the following were significantly associated with hospital admission (COR, 53.4; 95% CI, 1.5–8; P-Value 0.002) and blood transfusion (COR, 0.22; 95% CI, 0.1–0.5; P-Value 0.0001). Conclusions: The present study has shown that HBV (79.5%) was highly prevalent among patients with chronic liver disease. Screening all possible close contacts (relatives) of patients with HBV and giving immunization to this group and if possible giving public immunization of HBV is recommended to halt HBV infection. Most patients in this study group are compensated 57.4% and Child Class A 59.5% which gives time to implement treatment to decrease disease progression to the worsen. and this study will give insight into availing appropriate medication for treatment
Nazla (Catarrh) is a condition in Unani medicine that involves the flow of catarrhal fluids, or mucus, from the brain downwards into the throat and chest, leading to symptoms similar to what we consider a cold today. This condition is characterized by congestion, irritation in the respiratory pathways, and in some cases, can progress to more serious respiratory complications if left untreated. While preparing a detailed catalogue of Unani medical manuscripts housed at the Telangana Government Oriental Manuscripts Library and Research Institute (TGOMLRI) in Hyderabad, a significant discovery was made: a concise yet vital manuscript titled Risala Tahaffuz min al-Nazla (A Treatise on the Prevention of Cold and Catarrh), cataloged under Accession No. 8880. This manuscript, written by the eminent physician Muhammad ibn Zakariyyā al-Rāzi (865–925 AD), offers invaluable insight into the traditional understanding and prevention of the common cold. Al-Rāzi, also known as Rhazes in the Latin world, was one of the most influential figures in the history of medicine, contributing profoundly to clinical practices and medical theories that remained relevant for centuries. This treatise, written in Arabic, reflects al-Rāzi's keen focus on preventive medicine, specifically on measures to avoid the onset of cold and catarrhal conditions. It is a paper manuscript, notable for its brevity, consisting of only 8 pages. Each page contains 14 lines, with an average of 16 letters per line, displaying a compact and highly structured layout that suggests its use as a practical guide. Its focus on prevention rather than solely treatment is particularly notable, as it aligns with al-Rāzi’s broader medical philosophy emphasizing lifestyle and precautionary health measures. Moreover, Risala Tahaffuz min al-Nazla outlines remedies based on herbal medicine, prescribing specific herbs and natural compounds known to alleviate symptoms of cold and prevent its occurrence. These herbal prescriptions include ingredients that are easily available in Unani medicine and have historically been used for their anti-inflammatory, expectorant, and warming properties, which can relieve respiratory congestion and discomfort. Interestingly, another copy of this treatise exists in Iran, underscoring the historical and scholarly connections between Indian and Persian centers of Unani medicine. This manuscript’s discovery in Hyderabad adds to the rich collection of Unani medical texts in India, showcasing the traditional medical knowledge that continues to be studied for its relevance to modern alternative medicine practices. Through such manuscripts, Unani medicine remains an enduring part of the cultural and scientific heritage in regions with strong historical ties to Persian medical traditions. The concise nature of Risala Tahaffuz min al-Nazla and its practical content makes it a valuable text for both historical research and contemporary applications, providing insights into how ancient Unani physicians approached the common cold with holistic, plant-based remedies.
Pulmonary alveolar microlithiasis (PAM) is one of the rare lung diseases, in which an otherwise healthy individual develops diffuse alveolar calcifications. It is reported to be caused by mutation of the SLC34A2 gene. Patients who are eventually diagnosed with PAM usually present late when progression to cor pulmonale has already developed, or for other reasons not related to the disease itself when their clinical work up results incidentally reveal much worse findings than the patient’s actual state. Unlike the familiar information that no effective treatment other than lung transplant, cardiokinetics, diuretics, oxygen, and repeated bronchoalveolar lavage were reported with relatively satisfactory results and chest X-ray changes. In this report, we focus on the relation between clinical, radiologic and histologic findings, in which clinical scenario was first mistaken for interstitial fibrosis or suspected metastasis, and on literature review. Chest radiography, bronchoalveolar lavage and lung wedge biopsy were the main steps to reach the diagnosis of PAM. Gradual improvement after conservative treatment was noted prior to discharge. Then clinic appointment for follow up and family members surveillance was scheduled. A rare disease incidentally diagnosed by high awareness of the attending physician and simple methods that points to a question of disease prevalence in Jordan.
Background: Levofloxacin (LVFX) is widely used for many respiratory, urinary, and oral infections. Although rare, tendinopathy and tendon rupture have been reported in patients treated with LVFX as adverse effect. However, the exact mechanism is not fully elucidated. In this study, we investigated the effects of LVFX on tendon cells and tendon tissue. Method: Murine tendon cell line TT-D6 cells were treated with LVFX. Total RNA was extracted from the treated cells and quantitative reverse-transcription polymerase chain reaction (RT-PCR). LVFX-treated TT-D6 cells were subjected to cell proliferation assays and reactive oxygen species production assays. In addition, LVFX was administered to rats, and total RNA was extracted from tendon tissue and quantitatively analyzed for mRNA expression using quantitative RT-PCR. Results: Proliferative capacity in TT-D6 cells treated with various concentrations of LVFX showed no significant differences in any of the group comparisons. Quantitative RT-PCR analysis in TT-D6 cells showed that collagen 12a1 (COL12A1) expression was significantly decreased in the LVFX-treated group compared with the control group. The expression of matrix metalloproteinase-2 and tissue inhibitor of metalloproteinase-2 was significantly increased in the LVFX group. On the other hand, there were no significant differences in mRNA expression of decorin, matrix metalloproteinase-9, and Collagen1a1. ROS production was significantly upregulated in LVFX-treated rats, and COL12A1 expression was significantly decreased in LVFX-treated rats compared with controls in tendons collected from LVFX-treated rat models. Conclusions: Taken together, COL12A1 reduction may be involved in tendon injury and tendon rupture in LVFX administration, suggesting that increased ROS production may be involved.
This case report details successful percutaneous management of cement embolization, a known complication of kyphoplasty, in a 60-year-old female with osteoporotic compression fractures undergoing T7 and T8 vertebral augmentation. Kyphoplasty, a procedure involving the injection of polymethyl methacrylate (PMMA) cement into the vertebral body, can result in cement leakage with the potential for serious negative outcomes, including pulmonary embolism. In this patient, post-procedure imaging revealed cement extravasation extending into paravertebral veins with embolization terminating in the right ventricle. Traditional treatment options for cement emboli include anticoagulant therapy or operative embolectomy, both of which are either limited in their efficacy, or have significant added risk that must be weighed. However, this report demonstrates the successful use of a percutaneous cement retrieval approach as a viable option for cement retrieval. With retrieval success and the development of an asymptomatic pulmonary embolism, this approach to treatment proved effective in managing the patient's condition without the need for more invasive surgical interventions. This case adds to the current body of literature on cement extravasation in vertebral augmentation procedures, highlighting the importance of careful procedural planning, real-time monitoring, and prompt response to complications. Also, we highlight the use of newer interventional tools that can make cement retrieval more effective.
Background: Tuberculosis (TB) remains a significant public health concern globally, especially among HIV-positive individuals. The study aimed to investigate the factors associated with mortality among HIV/TB co-infected patients receiving antiretroviral therapy (ART) in Dire Dawa, Ethiopia. Methods: A retrospective follow-up study was conducted at Dilchora Referral Hospital among 434 HIV/TB co-infected patients enrolled in ART from January 2008 to January 2023. Standardized checklist was used for data collection and taken from patient’s medical cards and database system. Binary logistic regression was used to identify baseline factors associated with mortality. Results: The study found a mortality rate of 31% among HIV/TB co-infected patients. Factors such as WHO clinical stage III (AOR: 9.3, 95% CI: 3.03, 28.34) and WHO clinical stage IV (AOR: 11.3, 95% CI: 3.5, 36.34) and underweight and overweight body mass index were (AOR: 2.6, 95% CI: 1.35, 4.83) and (AOR: 21.4, 95% CI: 8.24, 55.5), poor ART adherence (AOR: 4.24, 95% CI: 2.25, 7.98), alcohol consumption (AOR: 3.15, 95%: 1.69, 5.87), and smoking (AOR: 4.12, 95% CI: 2.32, 7.29) were associated with increased odds of mortality. Conclusion: The study underscores the importance of identifying and addressing baseline factors that contribute to mortality in HIV/TB co-infected patients. Interventions targeting factors like clinical staging, adherence to ART, and lifestyle habits could help reduce mortality rates in this population.
