Cyclophosphamide (CYP) is a potent alkylating chemotherapy with broad clinical utility in cancer treatment. Benzene (BZ) is a ubiquitous solvent which poses threat to human health as it causes hematological disorder and liver damage. This study was designed to evaluate the influence of BZ co-exposure on rats undergoing CYP treatment with special consideration to some biomarkers associated with liver and blood tissue. Twenty-four male Wistar rats were divided into four groups (n = 6) and were orally treated with CYP or exposed intranasally to BZ individually or in combination for 28 days. The results revealed that exposure to either BZ or CYP caused significant increase in the plasma transaminases, alkaline phosphatase and bilirubin content related to control group. Significant decreases in hepatic superoxide dismutase, catalase and reduced glutathione concentrations were also observed. Similarly, exposure to either the compound affected the biomolecules by causing the significant increase in the plasma Advanced oxidized protein products and hepatic malondialdehyde concentration. The exposure to either BZ or CYP also caused an alteration in hematological parameters and significantly increased the pro-inflammatory markers: myeloperoxidase enzyme, NF-κB and TNF-α relative to control. The combined exposure to BZ and CYP demonstrated the enhanced toxic effect inferred from the examined biomarkers when compared with their individual treatments. In conclusion, this study therefore proves the enhanced toxicity of CYP chemotherapy when animals are co-exposed to BZ in the environment. It may therefore be recommended that individuals undergoing CYP treatment should avoid exposure to BZ to guide against the enhanced side effect of this anticancer drug.
Fragmented QRS (fQRS) is an electrocardiographic marker that reflects conduction abnormalities caused by myocardial scarring, fibrosis, or structural remodeling. Over the past two decades, fQRS has gained increasing attention for its diagnostic and prognostic implications in cardiovascular diseases (CVDs). In ischemic heart disease, fQRS is strongly associated with myocardial infarction, scar burden, and adverse cardiac outcomes, including ventricular arrhythmias and sudden cardiac death. Beyond coronary artery disease, fQRS has also been linked to poor prognosis in non-ischemic cardiomyopathies and heart failure, where it correlates with impaired ventricular function, arrhythmic events, and limited response to cardiac resynchronization therapy. Moreover, fQRS is observed in arrhythmogenic conditions such as Brugada syndrome and in structural disorders including congenital heart disease, myocarditis, and infiltrative cardiomyopathies, serving as a marker of myocardial fibrosis and a predictor of arrhythmogenic risk. The clinical utility of fQRS lies in its simplicity, availability, and low cost, as standard 12-lead electrocardiography is universally accessible. Its incremental prognostic value beyond conventional parameters such as left ventricular ejection fraction highlights its potential to refine risk stratification and guide therapeutic strategies, particularly in identifying candidates for implantable cardioverter-defibrillators. However, widespread clinical adoption is limited by inconsistent definitions, lack of standardization, and variability in interpretation. Future directions include large-scale validation studies, integration with multimodality risk assessment, and the application of artificial intelligence to improve automated detection and predictive accuracy. Overall, fQRS represents a promising, non-invasive tool that could enhance the management of patients across the spectrum of CVDs.
Objective: Pilonidal sinus is a disease that occurs with a sinus abscess in the sacrococcygeal region, especially in young men. This study investigated whether positive family history is a predisposing factor for the disease and whether it influences the age of onset in patients who have undergone pilonidal sinus surgery. Materials and Methods: A total of 148 patients who underwent pilonidal sinus surgery at our clinic between January 2022 and January 2023. Age, sex, and family history were evaluated, and the family history was further detailed via telephone interviews. Results: The study included 148 patients, 124 (83.8%) were male and 24 (16.2%) were female. Family history was reported in 21.6% (n = 32) of the patients. Among those with a positive family history, 84.38% (n = 27) had paternal lineage involvement, and 15.62% (n = 5) had maternal lineage involvement. The mean age was 26.31 ± 7.69 years in males and 22.25 ± 8.02 years in females, with the difference being statistically significant (z = 2.35; p < 0.05). Discussion: While familial predisposition is notable in a subset of pilonidal sinus disease cases, it is insufficient alone to predict disease onset or severity. Multifactorial influences–genetic, anatomical, and behavioral–must be considered.
Assessment of arsenic intoxication on human and murine tissues reveals complex toxicity resulting in variety of health damages most especially liver injury. Eulophia gracilis (E. gracilis) is an important medicinal orchid that elicits health benefit in folkloric medicine related to its antioxidant properties. However, scholarly literature lacks information on the role of E. gracilis in sodium arsenite-induced hepatic toxicity. Therefore, we assessed the influence of E. gracilis extracted in aqueous-methanol solvent on sodium arsenite-induced dysfunctional liver organ and genotoxicity in rats. Rats were intragastrically exposed to sodium arsenite (5 mg/kg) once in 7 days and concurrently with oral treatment of E. gracilis extract (200 mg/kg body weight) daily for 14 consecutive days. Arsenic-exposed rats displayed dysfunctional liver pathology through significant increases (p < 0.05) in plasma transaminases. Liver homogenate of intoxicated rats showed significantly declined (p < 0.05) redox activities of superoxide dismutase, catalase, arylesterase and deficit in reduced glutathione and Vitamin C alongside with severe diffuse vacuolar degeneration in liver architecture. Immunohistochemical analysis of liver showed an upregulated expression B-cell lymphoma 2 protein (BCL-2 protein) with concomitant low expression of tumor suppressor p53 protein coupled with clastogenicity depicted by increased frequency of micronucleated polychromatic erythrocytes (mPCEs) in the bone marrow of intoxicated rats. However, treatment with E. gracilis mitigated liver damage and improved the antioxidant enzymes and molecules in co-treated animals. Additionally, E. gracilis alleviated sodium arsenite-facilitated alteration in expression of BCL-2 and p53 proteins in liver, abrogated surges in the frequency of formation of mPCEs in bone marrow and reduced pathological lesions in the examined liver organ of rats co-treated with E. gracilis. Overall, E. gracilis suppressed liver dysfunction associated with sodium arsenite exposure via abrogation of oxidative stress and genotoxicity in male rats.
Background: Serological markers like anti-CMV IgG, IgM, and IgG avidity are used to diagnose cytomegalovirus (CMV) infection. This study assessed the seroprevalence of CMV antibodies and the predictive value of the CMV IgM index for low IgG avidity. Materials and methods: A total of 5,666 serum samples collected between January 2017 and June 2021 were analyzed for CMV IgG and IgM using chemiluminescence immunoassay. IgG avidity was tested by enzyme-linked immunosorbent assay in 40 IgG-positive and borderline/positive IgM samples. Results: Anti-CMV IgM seroprevalence was 4.3%. Low IgG avidity was detected in 2 of 40 cases (5.0%). Receiver operating characteristic (ROC) analysis identified 2.26 as the optimal IgM index cut-off, yielding 100% sensitivity, 86.8% specificity (area under the curve = 0.895, p = 0.06). Conclusions: High CMV IgM index values may indicate low IgG avidity but are not sufficient alone. Results should always be interpreted alongside avidity testing. Threshold use without confirmation is not recommended.
Antimicrobial resistance genes (ARGs) are found in microplastics, which are becoming more widely acknowledged as environmental substrates that may link ecological reservoirs to human illness. These particles create selective microenvironments by adsorbing antibiotics, metals, and biocides, promoting the creation of biofilms, and facilitating horizontal gene transfer. Human exposure through ingestion, inhalation, and skin contact is a problem due to the prevalence of microplastics in aquatic, terrestrial, airborne, and food-chain systems. This review highlights methodological limitations, synthesizes current understanding of the environmental mechanisms and clinical significance of ARGs linked to microplastics, and underscores the need for interdisciplinary surveillance and action. It identifies policy gaps and proposes integrated approaches to mitigate risks at the intersection of plastic pollution and antibiotic resistance within a one health paradigm.
Objective: To evaluate serum proprotein convertase subtilisin/kexin type 9 (PCSK9) levels in polycystic ovary syndrome (PCOS) patients according to body mass index (BMI) and investigate their association with lipid parameters and long-term cardiovascular risk. Methods: A total of 80 women with PCOS were divided into two groups: normal weight (BMI < 25, n = 40) and overweight/obese (BMI ≥ 25, n = 40). Serum PCSK9 levels were measured via enzyme-linked immunosorbent assay. Lipid profiles, hormone levels, and 30-year Framingham cardiovascular risk scores were analyzed. Results: Serum PCSK9 levels were significantly higher in the overweight/obese group (27.6 ng/ml) compared to the normal weight group (9.5 ng/ml) (p < 0.05). PCSK9 showed positive correlations with LDL-C, total cholesterol, AMH, and Framingham risk scores. No significant correlation with homeostatic model assessment of insulin resistance or insulin was observed. Conclusion: Elevated PCSK9 levels in overweight/obese PCOS patients may indicate an increased long-term cardiovascular risk. PCSK9 may serve as a biomarker linking metabolic and reproductive disturbances in PCOS and could be a future therapeutic target.
Background: Cockroaches considered pests, are a valuable biological resource and people avoid cockroaches due to their appearance or movement that cause psychological disgust. Nonetheless, it’s noteworthy that cockroaches are among the hardy insects that have endured on earth for several million years and possess remarkable abilities to cure illnesses. Throughout the world, especially in East Asia, cockroaches have been used for the benefit of human health due to their biologically active molecule(s), which can be applied to a range of medical conditions. Aim & objective: This review study explores the potential role of cockroaches in the medical field by reviewing various research studies. Different studies show that the immune system of cockroaches serve as a model for possible advancements in antibiotic research. Cockroach extract, gut microbiome, hemolymph, anti-microbial, anti-cancer and cosmetic properties which could be used as treatment of diseases/therapy. It’s interesting to note that cockroach allergens are utilized in allergen-specific immunotherapy (ASIT), and that cockroach body parts, saliva, and waste can cause asthma and allergies. Effective in treating allergic rhinitis/conjunctivitis, allergic asthma, and stinging insect hypersensitivity, ASIT has the potential to modify the course of the disease. Research will aid in the creation of innovative cockroach allergy treatment and diagnosis, which may eventually result in the avoidance and management of allergic asthma. Methodology: We reviewed many literature articles from online electronic databases that were PubMed, EMBASE, Google Scholar databases and many more national and international relevant articles were studied in-detail. Results & Conclusion: Cockroaches are often viewed as pests but they possess several positive aspects that are frequently overlooked and their ability in medical research, disease control and ecological roles highlight their importance beyond mere nuisance. These positive aspects may highlight the importance of re-evaluating our perception of these remarkable insects. Precision diagnosis and management may become future developments in cockroach immunotherapy, allowing for accurate identification of the problematic allergen.
Background: Reference range of uric acid is narrow and at the cut-off of 7 mg/dl is defined as hyperuricemia, correct estimation of uric acid play an essential role in management of patient. The objective of this study was to find out the variation in serum uric acid values measured by two different analyzers, i.e., wet and dry chemistry. Materials and method: Serum uric acid was measured in 227 blood samples received in clinical biochemistry laboratory for analysis of uric acid over a period of two months by two different instruments, i.e., wet chemistry instrument based on colorimetry method and dry chemistry instrument based on reflectance spectrophotometry. Results: The mean difference of serum uric acid between two methods was 0.89 mg/dl which was statistically significant (t =12.92, p < 0.001) and Pearson correlation coefficient was 0.9688. The Bland-Altman (BA) plot analysis showed the maximum difference between wet and dry chemistry from -1.15 mg/dl to 2.93 mg/dl, with a mean difference of 0.89 mg/dl. Samples were further categorized on the basis of gender, out of 227 patients enrolled 142 (63%) were males and 85 (37%) females. The BA plot demonstrated limit of agreement ranging from -1.55 to 3.57 mg/dl in female patients and -0.83 to 2.48 mg/dl in male patients. Conclusion: Good correlation exists between wet and dry chemistry, however the two methods are not similar. While interpreting the laboratory findings of uric acid, the method used must be checked carefully and during the follow up period switching of the method for uric acid estimation should be avoided.
It has been understood that in 2019, coronavirus disease 2019 (COVID-19), believed to have originated in the city of Wuhan, China, and caused by the coronavirus, has a wide range of disease potential, from asymptomatic cases to acute respiratory distress syndrome (ARDS). Some risk factors have been identified for COVID-19-related ARDS (CARDS) patients. These risk factors include old age, the presence of chronic diseases, male gender, and smoking. During the monitoring of patients in intensive care units, there are significant changes in clinical findings, vital signs, and some laboratory findings, especially. Currently, there is still no specific treatment available for both COVID-19 and CARDS.
Hyphal aspergillus fungi, which are widespread in nature, usually cause lung infections in immunosuppressed patients. Musculoskeletal involvement of these fungi is not well defined. Joint infection due to aspergillus species is called invasive aspergillosis. This systemic infection is associated with high mortality and morbidity. In this article, we report a case of septic arthritis due to aspergillus in the knee joint in a young non-immunosuppressed patient, which is very rare in the literature.
Introduction: This study aimed to develop a bibliometric map of scientific research concerning complementary and alternative medicine (CAM). Methods: Türkiye was chosen as the country of focus for this study. The data forming the basis of the analysis was retrieved from the Scopus database. VOSviewer (version 1.6.20) was utilized for bibliometric mapping, and Harzing’s Publish or Perish program was employed for data tabulation. Results: Searching for the phrases ‘complementary and alternative medicine,’ ‘alternative medicine,’ or ‘complementary medicine’ within the ‘article title, abstract, keywords’ fields yielded 61,327 documents. Upon examination in Türkiye, the study included 771 articles, 120 review articles, 13 conference papers, 19 book chapters, and one book. Conclusion: The analysis indicates that Türkiye has progressed in CAM research, aligning with global trends.
Background: We aimed to investigate the effect of antioxidant and homocysteine (Hcy)-reducing therapy on atherosclerosis in this study. We used folic acid and B12 as Hcy-reducing therapy. Materials and methods: A total of 32 male Wistar albino rats with an average weight of 200-300 grams were used in this study. After all the animals were sacrificed at the end of 4,5 months, blood samples were collected to analyze SOD, CAT, GLUT, GSH-PX, Hcy, TG, and total cholesterol. Results: In treated groups, antioxidant enzymes were determined at various levels. The changes of antioxidant enzymes showed that antioxidant vitamins decreased oxidative stress, as well as partly. This finding suggests that antioxidant vitamins might have slowed or perhaps stopped atherogenesis. Conclusion: Antioxidant vitamins are effective in preventing oxidative stress induced by hypercholesterolemia, but this beneficial effect has not been definitively proven in clinical study. Therefore, we need more primary and secondary prevention studies on this subject.
Cancer and its associated treatments often compromise the immune system, predisposing patients to opportunistic infections, including those caused by multidrug-resistant bacteria (MDRB). This study investigated the resistance patterns of bacterial pathogens isolated from cancer patients and evaluated the antibacterial efficacy of ethanolic leaf extracts of Ageratum conyzoides and Tridax procumbens at a concentration of 200 mg/mL against these MDRB pathogens. A retrospective analysis was conducted on data from cancer patients attending a tertiary healthcare facility. Bacterial isolates were identified from blood samples and screened for antibiotic susceptibility patterns. The susceptibility of MDRB isolates to the ethanolic leaf extracts of A. conyzoides and T. procumbens was assessed as a potential alternative therapy. The study revealed that breast cancer was the most prevalent type (38%) among the patient population (n = 160). In addition, the most common bacterial pathogens isolated from cancer patients included Escherichia coli (12 isolates), Klebsiella pneumoniae (15), Streptococcus pneumoniae (9), Shigella dysenteriae (10), Staphylococcus aureus (12), Klebsiella aerogenes (6), and Salmonella typhi (7). These pathogens exhibited significant multidrug resistance to conventional antibiotics. For instance, Staphylococcus aureus showed high resistance to cotrimoxazole (83%), ceftazidime (67%), erythromycin (75%), and cefuroxime (83%), whilst retaining susceptibility to gentamycin. Conversely, the ethanolic extracts of A. conyzoides and T. procumbens demonstrated inhibitory zones ranging from 8.26 ± 0.15 mm to 25.22 ± 0.83 mm and 8.30 ± 0.20 mm to 23.22 ± 0.83 mm, respectively against MDR bacterial pathogens evaluated. Findings revealed that Streptococcus pneumoniae was most susceptible to A. conyzoides (25.22 ± 0.83 mm), whilst T. procumbens exhibited notable activity against MDRB pathogens. Additionally, the combination of T. procumbens extracts and ofloxacin exhibited synergistic effects against Salmonella typhi. This study underscores the vulnerability of cancer patients to opportunistic bacterial infections and highlights the potential of A. conyzoides and T. procumbens as alternative sources of antibacterial agents. Hence, further purification and characterization of these extracts are recommended for developing effective therapeutic options against MDRB pathogens evaluated.
Background: Treatment options for metastatic unresectable osteosarcoma are limited, and there is no standard approach after the failure of first-line chemotherapy. Conventional chemotherapy in the second and subsequent lines typically yield a median progression-free survival (PFS) of less than 4 months, with objective response rates ranging from 3 to 29%. The activity of anti-vascular endothelial growth factor receptor multi-tyrosine kinase inhibitors (TKIs) in bone sarcomas has been demonstrated. We present a case of metastatic osteosarcoma exhibiting a durable response to regorafenib treatment. Case: We discuss a 30-year-old male with metastatic osteosarcoma who had extensive bone and lung metastases and was ineligible for metastasectomy. The patient had received all active chemotherapy regimens in the early and metastatic stages except ifosfamide. Next generation sequencing analysis of resected tumor tissue revealed a possibly pathogenic missense mutation (P.G472E) in NOTCH1 gene. Due to the presence of heart failure with a reduced ejection fraction, chemotherapy was not considered, and regorafenib was initiated. After four cycles of regorafenib, a partial metabolic response was achieved. The patient was followed up without progression under regorafenib for 15 months, without requiring dose reduction. Unfortunately, the treatment had to be interrupted for an extended period due to challenges with recurrent tumor infection and the necessity for repeated surgeries. Following successful wound site control, we restarted full-dose regorafenib and achieved a metabolic partial response again. Conclusion: To our knowledge, this case represents the longest achieved PFS with regorafenib in metastatic osteosarcoma. TKIs can provide a durable clinical response in metastatic osteosarcoma patients. Clinical and molecular biomarkers are required to determine which patients are most likely to benefit from these treatments.
Introduction: This study aims to investigate the clinical characteristics, therapeutic approaches, and factors influencing length of hospital stay of pneumothorax (PNO) cases. Materials & methods: This study employed a retrospective approach. Data were collected from January 2019 to April 2023, encompassing sociodemographic information, toxic habits, medical history, clinical signs, PNO characteristics, treatment modalities, evolution, and complications. Results: The study encompassed 158 PNO cases, predominantly males (89.2%) with a median age of 51 years [33-62]. Primary spontaneous pneumothorax accounted for 62.0% of cases, while secondary spontaneous pneumothorax (PSS) constituted 33.5% with chronic obstructive pulmonary disease as the leading cause (34.0%), followed by tuberculosis (20.8%). Drainage was the primary treatment (91.8%), with favorable outcomes in 84.2% of cases. PSS cases were associated with unfavorable evolution and longer hospital stays. Factors associated with prolonged hospitalization included female gender, PSS, total PNO, and surgical treatment. Conclusions: This study provides valuable insights into factors influencing prolonged hospitalization of PNO cases in Souss Massa Region. Understanding these factors can aid healthcare professionals in optimizing patient management and improving outcomes.
Epistaxis is bleeding from the nasal cavity and/or nasopharynx. It is classified as anterior, which accounts for 90% of bleeding, and posterior, in the rest 10% with a more severe clinical picture. Apart from environmental factors and anticoagulant medications, epistaxis can be caused by nasal and paranasal tumors. In case of reoccurring epistaxis, nasal congestion, swelling and numbness of the face, ulceration on the skin, growths in the nose or unilateral headaches should be suspected of tumor formations. In this paper, a case of a 70-year-old male patient is presented, who came to the otorhinolaryngology clinic because of reoccurring nosebleeds and a month long feeling of nasal congestion. After the initial treatment of the epistaxis, further processing revealed an expansive soft tissue formation in the right middle and lower nasal passages. The patient is referred for surgery, and invasive squamous cell carcinoma is diagnosed based on the pathohistological findings.
Candida auris, a fungal species, has emerged as a global menace due to its drug-resistant nature, leading to widespread invasive infections. Currently, there is no vaccine to prevent C. auris. The study was attempted to ascertain the structure and role of an unannotated hypothetical protein (HP) (accession no. QWW22972.1) from C. auris utilizing various bioinformatics tools. In this study, HP was found to be stable and polar, located in the cytoplasm. Various tools like NCBI-CD search, ScanProsite, InterPro, and SMART, identified it as a member of the Ran family of GTP-binding nuclear proteins that involves facilitating nucleocytoplasmic transport, including the import and export of proteins and RNAs during the interphase of mitosis. The protein’s secondary structure analysis indicated a dominance of the alpha helix. Its three-dimensional (3D) structure, modeled via the SWISS-MODEL server using a template protein with a 94.15% sequence identity, was validated by PROCHECK, QMEAN, Verify3D, and ERRAT tools. After YASARA energy reduction, a more stable 3D structure was visible. Furthermore, protein-protein interactions were obtained from STRING server, and active site were derived from the computed atlas of surface topography of proteins server. However, this study may enhance understanding of the molecular foundation of the HP and help identify potential therapeutic targets.
