Neurological illnesses, in particular, stroke, are a major cause of ailment and health risk around the world and often leave people with long-term disability. Stroke survivors often face problems with moving, thinking, and their mental health, which significantly reduces their quality of life. In the past, physical, occupational, and speech therapy were the main types of therapy used in rehabilitation for stroke. These methods use the brain’s innate plasticity, i.e., its ability to reorganize and adapt after an injury, to bring back lost functions. Previous assessments of brain-computer interfaces (BCIs) for rehabilitation after a stroke have frequently failed in terms of clinical outcomes, long-term effectiveness, and/or with reintegration. Thus, it is imperative to review the therapeutic effectiveness, feasibility, and technological progress in BCI-based rehabilitation. This review focuses on recent trends in BCI stroke rehabilitation as well as BCI hybridization, recognizing the effect of emotions and stroke feedback on emotional status change. The review also focuses on clinical issues, existing constraints, and future possibilities related to improving motor and cognitive results. This study focuses on clinical applications, current stroke treatment issues, and new developments.
OBJECTIVE This study aimed to assess the accuracy of CTAS and ESI and examine their correlations with hospitalization rates, 24-hour mortality, and resource utilization. METHODS: A prospective cohort study collected CTAS and ESI data from patients at the Maharaj Nakorn Chiang Mai Hospital Emergency Department (ED) between January and June 2018. RESULTS: A total of 413 patients were included. Higher triage severity was associated with increased hospitalization rates and higher 24-hour mortality (p < 0.05). Resource utilization in the ED also tended to be higher for patients with more severe triage levels (p < 0.05), with the exception of specific procedures such as defibrillation, external pacing, intramuscular drug administration, and complex procedures. There was good statistical agreement between CTAS and ESI triage levels (weighted kappa = 0.67). CONCLUSION: Both CTAS and ESI levels correlate with hospitalization rates and 24-hour mortality. Resource utilization in the ED increases with higher triage severity levels. The good agreement between CTAS and ESI triage levels suggests that the two systems perform comparably in emergency severity assessments.
Diabetes mellitus (DM) is a major global health concern closely associated with cardiovascular diseases, particularly diabetic cardiomyopathy (DCM), which can develop independently of hypertension or coronary artery disease. Chronic hyperglycemia in DM promotes oxidative stress and inflammation, driving myocardial dysfunction and fibrosis. The NLRP3 inflammasome, a cytosolic multiprotein complex, is a central mediator linking metabolic stress to innate immunity. In both type 1 and type 2 DM, it senses injurious stimuli including mitochondrial reactive oxygen species (ROS), ATP, and advanced glycation end-products (AGEs) activating caspase-1 and triggering the release of pro-inflammatory cytokines IL-1β and IL-18, thereby promoting inflammation and pyroptotic cell death. This review focuses on NLRP3 inflammasome activation in the diabetic heart, emphasizing upstream regulators such as thioredoxin-interacting protein (TXNIP) and NF-κB and downstream consequences including cardiomyocyte death, fibrosis, and contractile maladaptation. Therapeutic approaches targeting NLRP3 range from conventional drugs, including metformin and SGLT2 inhibitors, to specific inhibitors such as MCC950 and colchicine, highlighting their cardioprotective potential. Emerging evidence on microRNA-mediated regulation, exosomal signalling, and inter-organ communication further elucidates how systemic inflammation contributes to heart failure in diabetic patients. Despite progress, significant gaps remain regarding the cell-type specificity, temporal dynamics, and epigenetic control of NLRP3 activation in the diabetic myocardium, limiting translation of preclinical findings into effective therapies. Understanding these mechanisms may enable precise, targeted interventions to mitigate inflammation-driven cardiac injury in DM.
Onychomycosis is a common chronic fungal infection of the nails, typically caused by dermatophytes, but increasingly recognized as involving non-dermatophytic moulds. Chaetomium globosum is known to be a rare etiological agent of opportunistic human onychomycosis and skin infections. A 30-year-old healthy male football player from the University of Basrah presented with a year-long history of brownish-yellow discoloration and thickening of the right big toenail. Nail scrapings and clippings were cultured on Sabouraud dextrose agar (PDA) with and without cycloheximide at 25°C for one week, resulting in rapid fungal growth. Microscopic and macroscopic identification was based on perithecial morphology and ascospore characteristics. The isolate was confirmed through repeated culturing and comparison with established diagnostic criteria. Abundant dark perithecia developed on SDA without cycloheximide, showing charac- teristic features of C. globosum: dark brown ostiolate perithecia surrounded by septate hairs and lemon-shaped, olive-brown ascospores (8.75-12.5 × 7.5-10 μm). No growth was observed on cycloheximide-containing media. These features are consistent with previously described C. globosum morphology. This report documents the first confirmed case of onychomycosis caused by C. globosum in Iraq, expanding the known geographic distribution of this rare fungal pathogen.
OBJECTIVE This study aimed to develop and validate a novel Electrolyte-Inflammation Risk Score (EIRS) integrating serum electrolytes and high-sensitivity C-reactive protein (hs-CRP), to predict glycemic control and cardiovascular risk in patients with type 2 diabetes mellitus (T2DM). METHODS A cross-sectional case-control study was conducted at Sri Lalithambigai Medical College, Chennai, involving 100 participants (50 patients with T2DM and 50 age-matched healthy controls). Fasting blood glucose, HbA1c (measured by HPLC using the Bio-Rad D-10 system), serum sodium, potassium, and chloride (measured using an ion-selective electrode on the Roche Cobas), magnesium (measured by the xylidyl blue colorimetric method), and hs-CRP (measured by a particle-enhanced immunoturbidimetric assay) were measured. Statistical analysis included independent t-tests, Pearson correlation, multivariate logistic regression, and ROC curve analysis (SPSS version 28.0; p < 0.05). RESULTS T2DM patients exhibited significant electrolyte imbalances compared with controls: elevated potassium (5.40 ± 0.65 vs. 4.16 ± 0.82 mmol/L), increased sodium (142.6 ± 3.5 vs. 138.2 ± 2.3 mmol/L), reduced magnesium (1.8 ± 0.4 vs. 2.1 ± 0.3 mg/dL), and markedly elevated hs-CRP (4.8 ± 2.1 vs. 1.1 ± 0.7 mg/L; all p < 0.001 or p < 0.05). Multivariate logistic regression identified elevated sodium (OR = 2.84, 95% CI: 1.23–6.57, p = 0.015), elevated potassium (OR = 3.42, 95% CI: 1.45–8.08, p = 0.005), elevated hs-CRP (OR = 4.73, 95% CI: 2.15–10.41, p < 0.001), and higher BMI (OR = 1.12 per kg/m², 95% CI: 1.01–1.24, p = 0.031) as independent predictors of HbA1c > 8%. The EIRS, which is based on the four laboratory parameters, achieved an AUC of 0.847 (95% CI: 0.765–0.929, p < 0.001) at an optimal cut-off of ≥ 4 points, with 84% sensitivity and 78% specificity. High-risk patients (score 6–8) had 100% poor glycemic control and a 78% incidence of cardiovascular events, compared with 67% and 33% in moderate-risk and 13% and 8% in low-risk patients, respectively. CONCLUSION The EIRS effectively identifies patients with T2DM at high risk of poor glycemic control and cardiovascular complications, offering a practical tool for the simultaneous assessment of metabolic and inflammatory risk.
