Background. Exposure to metals through everyday consumer products, including jewelry, may influence endocrine function, but evidence regarding female hormone levels is limited. Methods. This cross-sectional study included 125 women aged 17–45 years from Basrah, Iraq, categorized into four groups: women who did not wear jewelry (G1, n = 50), women who wore fake (nickel-containing) jewelry daily (G2, n = 27), women who wore gold jewelry irregularly (G3, n = 26), and women who wore gold jewelry daily (G4, n = 22). Blood samples were collected during the mid-cycle phase. Serum levels of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estrogen (E2), progesterone, serotonin (5-HT), and oxytocin were measured using ELISA. Statistical analysis was performed using SPSS. Results. No statistically significant differences were observed among groups for FSH, LH, or oxytocin levels (p > 0.05). Estrogen levels differed significantly between the control group and women wearing gold jewelry irregularly (p = 0.000) or regularly (p = 0.005), as well as between the fake jewelry group and both gold jewelry groups (p = 0.001 and p = 0.010, respectively). Progesterone levels showed a significant difference only between the control group and the fake jewelry group (p = 0.045). Serotonin levels were significantly higher in women wearing jewelry compared with controls, including comparisons between G1 and G2 (p = 0.007), G1 and G3 (p = 0.000), and G1 and G4 (p = 0.000), while no difference was observed between irregular and regular gold jewelry wearers (p = 0.374). Conclusion. Wearing gold jewelry was associated with modest but statistically significant variations in estrogen and serotonin levels, whereas no consistent effects were observed for FSH, LH, progesterone, or oxytocin. These findings should be interpreted cautiously given the cross-sectional design and exploratory nature of the study. Further longitudinal studies with refined exposure assessment are warranted.
Background. Chronic kidney disease (CKD), characterized by the progressive loss of kidney function, is a major global public health challenge. It is associated with increased mortality due to cardiovascular disease and metabolic dysfunction. Hematological abnormalities are common in CKD and may reflect disease severity and progressive renal impairment. Objectives. This study aimed to compare hematological markers between patients with stage 3-5 CKD and healthy controls and to evaluate their association with CKD stage and renal function impairment. Methods. This 6-month cross-sectional comparative study was conducted at Al-Sadr Medical City. A total of 120 participants were included: 60 patients with CKD and 60 apparently healthy controls with comparable age and sex distributions. Adults aged ≥18 years with stage 3–5 CKD were included based on clinical history, laboratory findings, or a previous medical diagnosis. Results. The prevalence of hypertension tended to increase with CKD stage. Serum urea and creatinine levels increased, while eGFR decreased significantly (p < 0.001). Hemoglobin levels and RBC counts decreased, whereas RDW and MPV increased with disease severity, indicating worsening anemia and significant hematological changes. WBC, neutrophil, and monocyte counts were higher in the advanced stages of CKD. Conclusions. Chronic kidney disease is associated with marked and progressive deterioration in hematological parameters. Anemia, increased RDW, and altered platelet indices were associated with declining renal function. Routine hematological parameters are inexpensive and widely available markers associated with CKD stage and may reflect disease severity; however, longitudinal studies are required to determine their prognostic value.
Background and objective. Postmenopausal osteoporosis is an important public health problem associated with reduced bone mineral density (BMD) and increased fracture risk. Local data on BMD status among postmenopausal women in Basra remain limited. This study aimed to determine the prevalence of osteoporosis and osteopenia among postmenopausal women in Basra and to evaluate demographic and clinical factors associated with BMD status. Methodology. This cross-sectional study was conducted in Basra, Iraq, between September 2022 and September 2024. A total of 390 postmenopausal women aged 45-75 years were recruited from the outpatient clinic of Basrah Maternity and Child Hospital. Data on sociodemographic characteristics, reproductive history, lifestyle factors, and relevant clinical variables were collected using a structured questionnaire. BMD was assessed by dual-energy X-ray absorptiometry (DEXA) at the lumbar spine and femoral neck. Participants were classified as having normal BMD, osteopenia, or osteoporosis according to World Health Organization T-score criteria. Data were analysed using bivariate statistical tests, including chi-square tests for categorical variables and independent-samples t-tests for continuous variables. Results. Among the 390 postmenopausal women included in the study, 102 (26.1%) had osteoporosis, 63 (16.1%) had osteopenia, and 225 (57.7%) had normal BMD. Most participants were aged 50-60 years. Age, height, BMI, education level, smoking status, and physical activity did not differ significantly according to BMD status. Women with abnormal BMD had significantly lower body weight than women with normal BMD (64.3 ± 9.1 kg vs. 76.3 ± 7.2 kg; p < 0.001). Parity distribution differed significantly across BMD groups; however, high parity, defined as ≥5 pregnancies, was not significantly associated with abnormal BMD in the binary analysis (OR = 1.13; 95% CI: 0.51-2.54). BMD status was also associated with breastfeeding history and previous oral contraceptive use, although these findings should be interpreted cautiously because the analyses were not adjusted for potential confounding variables such as age and BMI. Conclusion. Osteoporosis and osteopenia were common among postmenopausal women attending Basrah Maternity and Child Hospital. Reproductive variables showed associations with BMD status in bivariate analyses, but the non-significant association between high parity and abnormal BMD, together with the absence of multivariable adjustment, prevents firm causal interpretation. Further longitudinal studies using adjusted analyses are needed to clarify the relationship between reproductive factors and bone health in this population.
Objectives. To implement an oncology-specific trigger tool for the systematic identification of adverse drug reactions (ADRs) in hospitalized patients receiving antineoplastic therapy and to evaluate trigger yield and positive predictive value. Materials and methods. This prospective observational study was conducted over six months in a tertiary care teaching hospital in Coimbatore, India. A locally adapted 48-item oncology-specific trigger tool comprising laboratory, medication, symptom/clinical, and intervention triggers was used to screen adult oncology in patients receiving chemotherapy with or without radiotherapy. Each trigger occurrence prompted focused chart review. Trigger-linked events fulfilling the study definition of an ADR were treated as confirmed ADR signals, and overlapping signals referring to the same clinical event were consolidated into unique ADR episodes. A clinical pharmacist, in consultation with an oncologist, confirmed ADRs and classified them using CTCAE v5.0 for severity, the Naranjo algorithm for causality, Type A/Type B criteria for predictability, and Schumock–Thornton criteria for preventability. Results. Among 225 hospitalized oncology patients, 1125 trigger occurrences were identified. Review of trigger-positive records confirmed 471 ADR signals, corresponding to an overall positive predictive value of 41.9%. At the patient level, 151 patients (67.1%) experienced at least one confirmed ADR. After consolidation of overlapping trigger-linked signals, 342 unique ADR episodes were identified. Hematological toxicities were the most common (228/342, 66.7%), followed by gastrointestinal events (77/342, 22.5%). Most ADR episodes were CTCAE Grade 2 (191/342, 55.8%), while Grade 3 and Grade 4 events accounted for 20.8% and 2.9%, respectively. On causality assessment, most ADRs were classified as probable (235/342, 68.7%), and 62.0% were considered probably preventable. Conclusions. An oncology-specific trigger tool enabled systematic detection and characterization of ADRs in hospitalized patients receiving antineoplastic therapy, with moderate overall positive predictive value and particularly high yield for several hematology-related and intervention-based triggers. Refinement of lowerspecificity triggers and integration of trigger-based review into routine in patient oncology pharmacovigilance may improve the timeliness and efficiency of ADR detection and support safer clinical management.
Background. Several hematological alterations involving cellular components of the blood have been reported in patients with type 2 diabetes mellitus (T2DM) and may contribute to the development of diabetesrelated complications. Chronic hyperglycemia increases oxidative stress, which can affect red blood cells, white blood cells, and platelets. Glycated hemoglobin (HbA1c) reflects glycemic control over the preceding three months and is widely used to assess disease management. Objective. To evaluate the association between selected hematological parameters from the complete blood count (CBC), and glycemic control in patients with T2DM. Methods. This cross-sectional, exploratory study included 50 patients with T2DM, who were divided into two groups based on their HbA1c level into a good glycemic control group (n = 25, HbA1c < 7%) and poor glycemic control (n = 25, HbA1c ≥ 7%). CBC parameters and HbA1c levels were measured. Group comparisons between groups were performed using the independent sample t-tests and Pearson’s correlation analysis was used to assess the relationship between hematological parameters and HbA1c. Results. Patients with poor glycemic control had significantly higher mean WBC count (7.90 ± 1.72 vs. 6.53 ± 0.89 × 109 /L, p < 0.001), neutrophil count (4.98 ± 1.57 vs. 3.91 ± 0.82 × 109 /L, p < 0.004), platelet count (286.88 ± 54.18 vs. 216.48 ± 39.33 × 109 /L, p < 0.001)), and mean platelet volume (10.44 ± 2.11 vs. 8.21 ± 0.86 fL, p < 0.001) compared with the good control group. No significant differences were observed in RBC parameters. Platelet count showed a significant positive correlation with HbA1c (r = 0.516, p < 0.001). In addition, WBC count (r = 0.485, p = 0.001), neutrophil count (r = 0.431, p = 0.002), and mean platelet volume (MPV) (r = 0.598, p < 0.001) were also significantly positively correlated with HbA1c levels. Conclusion. Poor glycemic control in this cohort of patients with T2DM was associated with higher WBC, neutrophil, and platelet counts, as well as increased MPV. These results suggest a potential correlation between subclinical inflammation, platelet activation, and hyperglycemia. However, given the small sample size and the exploratory cross-sectional design of the study, the findings should be interpreted with caution and confirmed in larger prospective studies before any clinical utility can be established.
Background. Pheochromocytomas and paragangliomas are neuroendocrine tumors with similar morphology, secretory function and oncological behavior. Such tumors may produce symptoms ascribable to the episodic release of catecholamines (such as adrenaline or noradrenaline), a mass effect, or malignant spread; however, they may also be non-secretory and present asymptomatically as incidentalomas. Case report. We present the case of a 60-years-old male who underwent resection of a non-secretory retroperitoneal paraganglioma and later went on to develop disseminated intravascular coagulation. Thrombotic complications are described in the literature among malignant or secretory tumors, but appear to be rare among low-risk non-secretory PPGLs. Conclusion. This case underscores the importance of considering severe infectious etiologies, such as Clostridioides difficile infection, in the differential diagnosis of consumptive coagulopathy in patients with paraganglioma.
Background. Skin cancer is one of the most common cancers in Iraq and worldwide. Basal cell carcinoma (BCC) constitutes the majority of diagnosed skin cancers, accounting for approximately 80% of cases. Several risk factors are associated with the development of BCC in humans; the main one is sunlight, particularly UVB radiation, for which the amount and duration of exposure are the most important determining factors. Objectives. This descriptive and exploratory study was conducted to describe the frequency of histopathological subtypes of basal cell carcinoma and to identify potential correlations with certain clinical factors. Materials and methods. A cross-sectional descriptive study was conducted by reviewing the pathological reports of 86 patients diagnosed with basal cell carcinoma who presented to the outpatient clinics of Al-Kindi Teaching Hospital and Baghdad Teaching Hospital between January and December 2024. Demographic data, clinical characteristics, and histopathological subtypes were analyzed using descriptive statistics. Exploratory analysis between categorical variables was performed using Fisher’s exact test. Results. The study included 86 patients (47 males and 39 females) with a mean age of 62.21 ± 12.95 years. The face was the most common anatomical site involved (80.23%). Pigmented basal cell carcinoma (52.33%) and nodular basal cell carcinoma (39.53%) were the most frequently identified histopathological subtypes. No statistically significant associations were observed between histopathological subtypes and age, sex, skin type, lesion site, or clinical presentation (p > 0.05). Conclusion. This descriptive study indicates that basal cell carcinoma tends to affect elderly patients, those living in urban areas, and people with outdoor occupations. The face is the most commonly affected site, as it is the major body area exposed to sunlight in Iraq. Clinically, plaques and nodules were the most common presentations, with the pigmented variant being the most common pathological subtype.
Background. Fibroblast growth factor receptor 2 (FGFR2) is a protein involved in numerous biological processes, including embryonic development, angiogenesis, tissue maintenance, and cancer progression. Aim of the study. To evaluate FGFR2 mRNA expression levels in breast cancer patients and assess its potential as a diagnostic biomarker using RT-qPCR. Methodology. Fifty blood samples were analyzed (25 from breast cancer patients and 25 from healthy controls). Two milliliters of each specimen were used for extraction of ribonucleic acid (RNA) and synthesis of complementary DNA (cDNA) from the extracted RNA, followed by evaluation of FGFR2 gene expression using RT-qPCR. The 2−ΔΔCt method was used for relative quantification of FGFR2 mRNA expression, normalized to the β-actin reference gene. Results. FGFR2 gene expression analysis demonstrated a significant 7.5-fold increase in expression (p < 0.05) in the breast cancer group compared with the control group. Conclusion. FGFR2 gene expression was significantly higher in breast cancer patients than in healthy controls, suggesting that FGFR2 may represent a potential non-invasive biomarker for breast cancer. Further studies with larger cohorts and protein-level validation are needed.
Background. Erythematotelangiectatic rosacea (ETR) is one of the most common chronic dermatoses of the face, characterized by persistent erythema, flushing, and telangiectasia, mainly associated with neurovascular dysregulation. Botulinum toxin type A (BoNT-A) has been proposed as a possible treatment for ETR. However, data on its efficacy and safety in Iraqi patients are lacking. This prospective uncontrolled cohort study aimed to evaluate clinical outcomes following intradermal BoNT-A injection in Iraqi patients with facial ETR. Methods. This prospective, single-arm, uncontrolled interventional study enrolled 40 patients with ETR. Demographic data, clinical presentation, and treatment-related information were collected. BoNT-A was administered intradermally, and patients were followed for 5 months. Clinical response was assessed using ETR severity scores at baseline and during follow-up visits at 2 weeks, 1 month, 3 months, and 5 months. Improvement in severity category was considered a treatment response. Results. The mean age of the patients was 36.7 ± 4.15 years. Most patients were female (75%) and had Fitzpatrick skin type III (65%). At baseline, 52.5% of patients had moderate ETR and 22.5% had severe ETR. At the end of 5 months, 72.5% of patients were classified as having mild ETR, and no patient remained in the severe category. Overall, 25 patients (62.5%) showed improvement in severity category. Longer symptom duration (≥2 years; OR = 3.19, p = 0.040), more pronounced dryness (OR = 3.12, p = 0.032), and higher baseline ETR severity (moderate: OR = 5.4, p = 0.004; severe: OR = 6.82, p = 0.005) were associated with poorer response in multivariate analysis. Conclusion. In this prospective uncontrolled cohort, intradermal BoNT-A injection was associated with improvement in ETR severity scores over 5 months and was generally well tolerated. However, because the study lacked a control group, definitive conclusions regarding efficacy cannot be drawn. Treatment outcomes appeared to be influenced by baseline disease severity, symptom duration, and skin dryness.
Background. Steroid cell tumors of the ovary are exceedingly rare sex cord–stromal neoplasms that may produce androgens and cause virilization, a particularly striking presentation in postmenopausal women. Case report. We report the case of a 72-year-old woman who presented with progressive abdominal pain, hirsutism, and male-pattern alopecia. Cross-sectional imaging revealed a well-defined solid-cystic right adnexal mass with mild heterogeneous enhancement on CT and T2 hyperintensity with facilitated diffusion on MRI, suggestive of a hormonally active ovarian tumor. The lesion was assigned MR-ORADS category 4. Serum testosterone was markedly elevated, while other tumor markers remained within normal limits. Management. The patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Histopathology confirmed a steroid cell tumor, not otherwise specified (NOS), of the right ovary, staged as pT1c2. Postoperatively, serum testosterone normalized, and the patient’s virilizing features began to regress. Conclusion. This case highlights the crucial role of integrated imaging, biochemical evaluation, and pathological correlation in the early diagnosis and management of androgen-secreting ovarian tumors in postmenopausal women.
Background. Vitamin D has biologically plausible roles in tuberculosis-related immunity, bone metabolism, and functional recovery. This systematic review synthesized the evidence on the relationship between serum vitamin D status and clinical function in tuberculosis spondylitis and evaluated whether existing studies addressed kyphotic deformity. Materials and methods. This systematic review followed the PRISMA 2020 statement, and a protocol was prepared a priori. PubMed, ScienceDirect, the Cochrane Library, and Google Scholar were searched for studies published between January 1, 2015, and December 31, 2025. No language restrictions were applied during the search. Eligible studies included randomized controlled trials and observational studies enrolling patients with tuberculosis spondylitis that reported serum 25-hydroxyvitamin D status and/or vitamin D supplementation, with at least one clinical function outcome, including pain assessed by the Visual Analog Scale (VAS), disability assessed by the Oswestry Disability Index (ODI), neurological status, or kyphotic angle. Preprints reporting original data were prespecified as eligible. Two reviewers independently performed study selection and data extraction. Risk of bias in the included randomized trials was assessed using the Cochrane RoB 2 tool. Results. Two randomized controlled trials, including 128 patients from Indonesia and China, met the inclusion criteria. Oral vitamin D supplementation at 10,000 IU daily increased mean serum 25(OH)D levels from 28 ng/mL to 67 ng/mL by week 8. Significant inverse correlations were observed between serum vitamin D levels and pain (r = −0.580, p < 0.01) and disability (r = −0.492, p = 0.02). Vitamin D supplementation was also associated with a higher clinical success rate and a lower incidence of adverse events. Neither study assessed kyphotic angle. Conclusions. The available evidence is limited but suggests that vitamin D supplementation may improve clinical function in patients with tuberculosis spondylitis. The relationship between vitamin D status and kyphotic deformity remains insufficiently studied and requires adequately powered trials with standardized radiographic assessment.
Background. Müllerian duct anomalies are uncommon congenital malformations of the female reproductive tract. A unicornuate uterus with a non-communicating rudimentary horn containing functional endometrium is a rare subtype that may present with cyclic pelvic pain, dysmenorrhea, hematometra, endometriosis, infertility, and adverse reproductive outcomes. Objective. To describe the clinical presentation, multimodality imaging findings, diagnosis, and management of a unicornuate uterus with a non-communicating rudimentary horn containing functional endometrium in an adolescent patient and to highlight the role of imaging in guiding treatment. Case presentation. A 16-year-old female presented with a 6-month history of progressively worsening cyclic lower abdominal pain, exacerbated during menstruation. Physical examination revealed mild suprapubic tenderness without palpable pelvic masses. Routine laboratory investigations were within normal limits. Initial transabdominal pelvic ultrasonography demonstrated asymmetric uterine morphology suggestive of a Müllerian duct anomaly. Imaging findings and diagnosis. Pelvic MRI demonstrated a right-sided unicornuate uterus with a separate non-communicating left rudimentary horn containing functional endometrium. Renal ultrasonography showed no urinary tract abnormalities. These findings established the diagnosis of a unicornuate uterus with a non-communicating functional rudimentary horn. Management and outcome. The patient underwent laparoscopic excision of the rudimentary horn and ipsilateral fallopian tube. Histopathological examination confirmed rudimentary uterine tissue lined by functional endometrium. At 3-month follow-up, the patient reported complete resolution of cyclic pelvic pain with no postoperative complications. Conclusion. Unicornuate uterus with a non-communicating rudimentary horn should be considered in adolescents presenting with cyclic pelvic pain. MRI is the imaging modality of choice for accurate anatomical characterization and surgical planning. Early diagnosis and appropriate surgical management can effectively relieve symptoms and reduce the risk of long-term gynecological and obstetric complications.
Objectives. To describe the use of digital technology in nursing practice in Romania and to examine whether participation in digital technology training is associated with nurses’ perceptions of professional efficiency, administrative simplification, quality of care, institutional support, technical difficulties, and resistance to change. Material and methods. A cross-sectional, questionnaire-based observational study was conducted between February 2026 and April 2026 among 137 nurses employed in public and private healthcare institutions in Romania, recruited by convenience sampling. Data were collected using a 20-item, self-administered online questionnaire developed for this study. Ordinal Likert responses were summarized as frequencies and percentages; comparisons by training status used the Mann-Whitney U test, associations among ordinal scores used Spearman’s rho, and internal consistency of the perceived-benefit items was assessed using Cronbach’s alpha. The significance threshold was set at p < 0.05. Results. Of the 137 nurses included in the study, 108 (78.8%) were female, 132 (96.4%) currently used digital tools, and 56 (40.9%) had attended digital technology training in the previous two years. Most participants used digital technology several times per day (121; 88.3%), and 87 (63.5%) rated its contribution to professional efficiency as very high. Trained nurses reported significantly higher scores for perceived efficiency (mean rank 80.00 vs. 61.40; U = 1652.0, Z = −3.147, p = 0.002), administrative simplification (U = 1565.5, Z = −3.533, p < 0.001), quality of care (U = 1274.0, Z = −4.714, p < 0.001), and institutional support (U = 1054.5, Z = −5.449, p < 0.001). No significant difference was found for technical difficulties (U = 1932.5, p = 0.125) or resistance to change (U = 1954.0, p = 0.150). Conclusions. Digital technology was broadly integrated into routine nursing work and was generally perceived favorably. Prior training was associated with more positive perceptions of benefit and support, but not with fewer technical barriers, suggesting that education and organizational support are complementary rather than interchangeable. The cross-sectional design precludes causal inference
Background. Self-care is a cornerstone of chronic heart failure (HF) management, yet its relationship with disease-specific knowledge in routine outpatient care remains insufficiently characterized. Objectives. To evaluate the association between HF knowledge and self-care behaviors among outpatients with chronic HF. Materials and methods. This cross-sectional study enrolled consecutive adults with chronic HF attending the outpatient clinic of a specialized cardiovascular hospital. Heart failure knowledge was measured using the Dutch Heart Failure Knowledge Scale (DHFKS; range 0-15, with adequate knowledge defined as ≥10), and self-care behaviors were assessed using the Self-Care of Heart Failure Index (SCHFI; three domains standardized to 0-100, with adequate self-care defined as ≥70 in all domains). Results. A total of 265 patients were included (mean age 69.9 ± 13.3 years; 55.1% female). Overall, 17.7% of participants had adequate HF knowledge, and 18.1% reported adequate self-care behaviors. HF knowledge showed a moderate positive correlation with self-care behaviors (Spearman’s ρ = 0.383; p < 0.001). In an exploratory multivariable logistic regression model adjusted for age, sex, and NYHA functional class, HF knowledge remained independently associated with adequate self-care (adjusted odds ratio per 1-point increase in DHFKS score, 2.543; 95% confidence interval 1.868-3.460; p < 0.001). In this exploratory model, no other included demographic or clinical variables showed an independent association with adequate self-care. Conclusions. In this cohort of outpatients with chronic HF, both HF knowledge and self-care behaviors were suboptimal. Disease-specific knowledge was independently associated with better self-care, whereas no other included sociodemographic or clinical variables showed an independent association with adequate self-care in the exploratory multivariable model. These findings should be interpreted with appropriate caution.
Background and objectives. Dry eye disease (DED) is a multifactorial condition that affects ocular surface homeostasis and may cause ocular discomfort and visual disturbance. Although hormonal contraceptives are widely used, their influence on tear film stability and ocular surface health remains debated. This review evaluates the available evidence regarding the association between hormonal contraceptive use and DED. Materials and methods. A structured literature search was conducted in PubMed, ScienceDirect, and Google Scholar for primary studies published in English or Indonesian between 2010 and 2025. Nine observational studies met the eligibility criteria and were included in this review. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools appropriate for cross-sectional, case-control, and cohort studies. Results. The included studies suggest that hormonal contraceptive use may be associated with DED, particularly through effects on tear production, tear film stability, and ocular surface integrity. Some studies reported reduced tear secretion, shorter tear break-up time, increased dry eye symptoms, or ocular surface alterations among hormonal contraceptive users. Evidence also suggests that prolonged hormonal contraceptive use may be associated with histological and cytological changes, including reduced goblet cell density and conjunctival epithelial metaplasia. However, findings were not consistent across all studies. Conclusions. Hormonal contraceptives, particularly oral and combined formulations, may represent potential contributing or exacerbating factors in DED. However, because of heterogeneity among studies and methodological limitations, a definitive causal relationship cannot be established. Further well-designed longitudinal studies are needed to clarify the ocular effects of different hormonal formulations, dosages, durations of use, and delivery systems.
Background and objectives. HIV infection requires integrated medical and psychosocial care, as quality of life, stigma, and comorbidities significantly influence patient outcomes. This study aimed to describe quality-of-life impairment, perceived stigma and discrimination, psychological support needs, and common comorbidities among adult patients living with HIV/AIDS receiving care at a tertiary infectious diseases department in Suceava, Romania. Materials and methods. This was a descriptive cross-sectional study including 35 adult patients living with HIV/AIDS recruited from the Infectious Diseases Department of the “Saint John the New” County Clinical Emergency Hospital in Suceava between December 2023 and May 2024. Quality-of-life and psychosocial data were collected using a questionnaire that included all items from the WHOQOL-HIV BREF instrument together with additional psychosocial and stigma-related questions developed by the authors. Clinical and comorbidity data were extracted from medical records. Results. Most participants rated their quality of life as neither poor nor good (62.9%), while 17.1% reported poor quality of life. Physical pain had at least a moderate impact in 80.0% of patients. Fear about the future was frequently reported at a high level. The most frequent comorbidity category was digestive disease (48.6%), with chronic hepatitis being the most frequent digestive diagnosis (17.1% of the total sample). Neurological comorbidities were present in 34.3% of patients, with HIV encephalopathy identified in 14.3%. Frequent perceived discrimination was reported by 51.4% of patients, while 42.9% reported that perceived discrimination from healthcare providers occurred quite often. The majority of patients (82.9%) were receiving antiretroviral therapy at the time of admission. Conclusions. This study describes quality-of-life impairment, perceived stigma and discrimination, psychological support needs, and common comorbidities among patients living with HIV/AIDS. The findings highlight the need for integrated care addressing both medical and psychosocial dimensions of HIV infection.
Background. Ureteral stents have been an essential tool in urology for over 40 years. However, their use carries the risk of complications, including forgotten ureteral stents, which occur when a stent remains inside the body past its intended removal time. This report aims to highlight the potentially fatal complications of neglected ureteric stents as its progression may occur exceptionally fast. Case report. A 24-year-old male was referred with previous lithotripsy procedure and bilateral double-pigtail stents placed 2 years prior, but was then lost to follow-up. The abdominal radiography and unenhanced CT scan revealed encrustations of both stents, fragmented right stent with the distal segment migrated into the urinary bladder and urethra, emphysematous pyelonephritis, kidney stones, and acalculous cholecystitis. The patient was planned for surgery but underwent septic shock and passed away within hours upon admission. Conclusions. Although ureteric stents offer many advantages, a forgotten or retained stent can be a potentially fatal but avoidable complication. Early identification of these cases can help reduce the morbidity and mortality associated with neglected ureteric stents.
Background. Remnant cholesterol (RC), a component of triglyceride-rich lipoproteins, has recently gained attention as an emerging metabolic and cardiovascular risk factor. Insulin resistance (IR) is a central mechanism underlying metabolic-associated fatty liver disease (MAFLD) and plays a key role in lipid metabolism disturbances. Increasing evidence suggests that RC may be closely linked to IR and MAFLD; however, the interrelationship among these conditions remains incompletely understood. Objective. This review aims to summarize and critically evaluate current evidence regarding the associations between remnant cholesterol, insulin resistance, and metabolic-associated fatty liver disease, with an emphasis on potential pathophysiological mechanisms and clinical implications. Methods. A narrative review of the literature was conducted, focusing on epidemiological, clinical, and experimental studies that examined remnant cholesterol, insulin resistance, and MAFLD. Relevant articles were identified through published studies in peer-reviewed journals, with particular attention to recent findings. Results. Accumulating evidence indicates that elevated remnant cholesterol levels are associated with insulin resistance and adverse metabolic profiles. Insulin resistance contributes to altered hepatic lipid handling, promoting the accumulation of triglyceride-rich lipoproteins and remnant particles. Clinical and population-based studies have demonstrated significant associations between remnant cholesterol and MAFLD, while mechanistic studies suggest shared pathways involving hepatic lipid accumulation, inflammation, and metabolic dysregulation. Conclusion. Current evidence supports a close relationship between remnant cholesterol, insulin resistance, and MAFLD. Remnant cholesterol may represent an important metabolic marker linking dyslipidemia to hepatic and systemic insulin resistance. Further well-designed clinical studies are required to clarify causality, define clinical thresholds, and determine whether targeting remnant cholesterol could improve metabolic and hepatic outcomes in patients with MAFLD.
Background. The prevalence, isolation rates, and distribution of Cutibacterium acnes (C. acnes) phylotypes among acne patients in the Iraqi population are currently unknown. Aim. To isolate C. acnes and determine the distribution of its phylotypes among patients with acne vulgaris, and to compare these findings with those from age- and sex-matched healthy controls. Method. In this cross-sectional study, seventy swab samples were collected from patients with clinically diagnosed acne vulgaris and 70 from age- and sex-matched healthy participants. Samples were cultured under anaerobic conditions. Molecular identification and phylotype differentiation were performed using multiplex polymerase chain reaction (PCR). Results. C. acnes was isolated from 37/70 (52.8%) acne patients and 65/70 (92.8%) healthy controls. All isolates from acne patients belonged to the IA2 phylotype (100%). In contrast, isolates from healthy controls showed greater phylotype diversity, including IA2 (32.3%), IB (43.1%), and type II (24.6%). The difference in phylotype distribution between the two groups was statistically significant (p = 0.0001). Conclusion. Acne lesions demonstrated a marked loss of C. acnes phylotype diversity, with complete dominance of the IA2 phylotype, whereas healthy controls harbored a broader range of phylotypes. These findings support the association between phylotype IA2 and acne pathogenesis.
Background and objectives. Early detection of colorectal cancer (CRC) is important to enable early treatment decisions and improve prognosis. Carcinoembryonic antigen (CEA) is a tumor marker that has been associated with prognosis in CRC. The aim of this study was to evaluate the associations between preoperative CEA and disease-free survival (DFS) or overall survival (OS) in CRC. Materials and methods. This study was a retrospective cohort study conducted at Wahidin Sudirohusodo Hospital, Makassar, Indonesia. Medical records were obtained from 2013 to 2014. Data on age, sex, histopathology grade, CEA level, tumor location, DFS, and OS were obtained. CEA was classified as normal (< 5 ng/mL) or increased (≥ 5 ng/mL). Results. This study included 100 participants. Most participants were male (n = 55, 55%) and 50–59 years old (n = 32, 32%), with intermediate CRC (n = 72, 72%) and malignant cells located in the rectum (n = 37, 37%). Fifty-one participants had normal CEA (51%) and 49 participants had increased CEA (49%). Participants with normal CEA had a longer DFS time compared to participants with increased CEA (26.53 ± 2.86 months versus 18.29 ± 2.06 months; p = 0.026). Mean OS time was longer in participants with normal CEA levels compared to participants with increased CEA levels (58.39 ± 1.09 months versus 58.30 ± 1.03 months; p = 0.953). Conclusions. CRC patients with high preoperative CEA levels had a significantly shorter DFS time but not a significantly shorter OS time. No association found between preoperative CEA and overall survival in CRC.
