Pulmonary sequestration is a rare bronchopulmonary foregut malformation characterized by the abnormal development of non-functional lung tissue enclosed by visceral pulmonary pleura, supplied by a systemic arterial blood supply, and lacking communication with the bronchial tree. The blood supply commonly arises from the thoracic or abdominal aorta. We reported a 44-year-old female who presented with vomiting and recent weight loss of about 20 kilograms in the last 6 months. The physical and biochemical examination was unremarkable. A contrast-enhanced abdominal CT scan reveals signs of superior mesenteric artery syndrome (SMAS), including a decreased aortomesenteric angle and aortomesenteric distance. The lower chest sections show an irregular consolidative lesion in the posterior segment of the Left lower lobe supplied by an aberrant aneurysmal vessel from the celiac artery, consistent with intralobar pulmonary sequestration (ILS). To our knowledge, co-occurrence of SMAS and ILS with a celiac aneurysmal feeder has not been previously reported, as both conditions affect organs of different locations and embryological origins. A literature review was conducted to examine the presentation and vascular supply of ILS.
Background: Background: Metabolic syndrome (MetS) is a cluster of risk factors, including abdominal obesity, dyslipidemia, hyperglycemia and hypertension that markedly elevate the incidence of cardiovascular diseases and type 2 diabetes. Objective: This study aimed to evaluate the diagnostic value of serum angiopoietin-like protein 4 (ANGPTL4) and Caveolin-1 (Cav-1), as novel agents in diagnosing MetS in patients older than 50 years. Methods: A case-control study (January–April 2025) included 60 cases with MetS and 30 matched-healthy participants of the same gender and age (50 years) from hospitals in Diyala Governorate, Iraq. MetS was diagnosed by harmonized definition (3 features: elevated waist diameter, triglyceride 150 mg/dL, low HDL-C, BP 130/85 mmHg and fasting glucose 100 mg/dL). Results: Serum ANGPTL4 (142.78 22.53 vs. 69.29 30.80 ng/mL, p-value 0.001) and Cav-1 (16.12 2.87 vs. 8.51 1.59 ng/mL, p-value 0.001) were significantly elevated in the MetS group. Receiver Operating Characteristic (ROC) analysis demonstrated exceptional diagnostic performance, with an Area Under the Curve (AUC) of 0.97 for ANGPTL4 and 0.99 for Cav-1. Binary logistic regression analysis identified both biomarkers as significant independent predictors of MetS. Conclusion: Serum ANGPTL4 and Caveolin-1 levels exhibited outstanding diagnostic performance for MetS in Iraqi adults aged 50 years, reflecting underlying lipid dysregulation and endothelial dysfunction. These biomarkers showed significant potential for enhancing early detection and clinical management, warranting validation in a broader population
Objective : To evaluate the prognostic accuracy of the C-reactive protein (CRP)/albumin ratio in predicting severe acute pancreatitis (SAP) and its correlation with clinical complications. Methods : This retrospective observational study included 40 adult patients diagnosed with acute pancreatitis between January and August 2024. Patients were categorized by severity using the Revised Atlanta Classification into moderately severe or severe groups. Laboratory data, clinical characteristics, and imaging findings were compared. Receiver operating characteristic (ROC) analysis with Youden’s Index evaluated the CRP/albumin ratio predictive performance and logistic regression identified independent predictors of SAP. Results : The CRP/albumin ratio was significantly higher in SAP patients (median 5.0 [IQR 0.93–12.62]) compared to non-SAP (1.58 [IQR 0.28–8.6], p = 0.0187). ROC analysis showed an area under the curve (AUC) of 0.809 for the CRP/albumin ratio, superior to CRP alone (AUC 0.479) and comparable to the Ranson score (AUC 0.88). An optimal cut-off value of 4.22 provided 76.9% sensitivity and 85.2% specificity. Multivariable logistic regression identified absence of intestinal transit (p = 0.033) and splenic vein thrombosis (p = 0.026) as independent predictors of SAP. The CRP/albumin ratio correlated significantly with both these complications. Conclusions : The CRP/albumin ratio is a valuable, non-invasive, and readily available prognostic marker for early identification of severe acute pancreatitis. Its predictive accuracy is comparable to established scoring systems and may aid in triage and clinical decision-making.
The mainstay generic therapies of cancer including chemotherapy, are partly effective in a subset of the patient population due to the complexity and heterogenous nature of the disease. Nevertheless, the inherent variability of cancer has steered cancer therapy towards the concept of precision medicine. The approach focuses on matching effective and accurate treatment on the genetic profile of a patient and different unique characteristics that distinguishes one patient from another. Currently, precision oncology has been driven by various innovations including liquid biopsy, next generation sequencing (NGS) and multi-omics integration. Recent advances in next generation-based sequences have enabled the analysis of analytes including circulating DNA and genomic DNA. Liquid biopsy has enabled minimal invasion alternative and real-time monitoring of tumour dynamics and analysis of treatment responses. Moreover, emerging technologies including artificial intelligence and nanotechnology has enhanced the sensitivity of liquid biopsy. Similarly, multi-omics integration offers insights into the interactions between transcriptomic, proteomic, epigenomic and genomic enabling the unravelling the complex molecular mechanism driving carcinogenesis. These advances have resulted in the discovery of novel biomarkers and diverse therapeutic targets for different types of cancers. However, despite the promising advancements, challenges remain, such as concerns on data privacy, need for clinical validation and computational limitations. Ongoing research is, therefore, critical to embrace precision oncology in routine clinical care.
Objective : To synthesize current evidence on mechanisms, diagnostic evaluation, and treatment of infertility in PCOS, with emphasis on phenotype-specific implications and integrative management. Methods : A narrative review was conducted using PubMed, Scopus, and Web of Science from January 2015 to March 2024. Search terms included “PCOS,” “infertility,” “phenotype,” “letrozole,” “metformin,” “gonadotropins,” and “ART.” Eligible studies involved human females aged 18–45 years, written in English, and focused on PCOS-related infertility. Randomized trials, meta-analyses, and international guidelines were critically assessed for methodological rigor and clinical relevance. Results : PCOS accounts for 70–80% of anovulatory infertility, with marked variability across phenotypes. Phenotype A, combining hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology, carries the greatest reproductive and metabolic burden. Biomarkers such as AMH, testosterone, DHEAS, fasting insulin, and HOMA-IR improve risk stratification. Lifestyle modification restores ovulation in up to 60% of overweight patients. Letrozole is superior to clomiphene, while gonadotropins and ART are effective in resistant cases. Metformin enhances ovulatory and pregnancy outcomes in insulin-resistant women. IVF protocols using antagonists and agonist triggers improve safety by reducing ovarian hyperstimulation syndrome. Psychological comorbidities, particularly anxiety and depression, are frequent and negatively affect fertility outcomes. Conclusion : PCOS-related infertility requires a personalized, multidisciplinary approach. Integration of phenotype-based assessment, bio-marker evaluation, lifestyle intervention, and tailored reproductive strategies optimizes outcomes. Addressing metabolic and psychological dimensions further improves reproductive success and long-term health.
