1
Expansion and Productive HIV-1 Infection of Foxp3 Positive CD4 T Cells at Pleural Sites of Hiv/Tb Co-Infection
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Christina S Hirsch1 , Joy Baseke2 , John Lusiba Kafuluma3 , Mary Nserko3 , Harriet Mayanja-Kizza2,3 and Zahra Toossi1,4*
Backgrounds: CD4 T-cells expressing Foxp3 are expanded systemically during active tuberculosis (TB) regardless of HIV-1 co-infection. Foxp3+ CD4 T cells are targets of HIV-1 infection. However, expansion of HIV-1 infected Foxp3+ CD4 T cells at sites of HIV/TB co-infection, and whether they contribute to promotion of HIV-1 viral activity is not known. Methods: Pleural fluid mononuclear cells (PFMC) from HIV/TB co-infected patients with pleural TB were characterized by immune-staining and FACS analysis for surface markers CD4, CD127, CCR5, CXCR4, HLA-DR and intracellular expression of Foxp3, HIVp24, IFN-γ and Bcl-2. Whole PFMC and bead separated CD4+CD25+CD127- T cells were assessed for HIV-1 LTR strong stop (SS) DNA by real-time PCR, which represents viral DNA post cell entry and initiation of reverse transcription. Results: High numbers of HIV-1 p24 positive Foxp3+ and Foxp3+CD127– CD4 T cells were identified in PFMC from HIV/TB co-infected subjects. CD4+Foxp3+CD127– T cells displayed high expression of the cellular activation marker, HLA-DR. Further, expression of the HIV-1 co-receptors, CCR5 and CXCR4, were higher on CD4+Foxp3+T cells compared to CD4+Foxp3- T cells. Purified CD4+CD25+CD127– T cells isolated from PFMC of HIV/TB co-infected patients, were over 90% CD4+Foxp3+T cells, and exhibited higher HIV-1 SS DNA as compared to whole PFMC, and as compared to CD4+CD25+CD127– T cells from an HIV-infected subject with pleural mesothelioma. HIV-1 p24+ Foxp3+ CD4+T cells from HIV/TB patients higher in Bcl-2 expression as compared to both HIV-1 p24+ Foxp3- CD4 T cells, and Foxp3+ CD4+T cells without HIV-p24 expression. Conclusion: Foxp3+ CD4 T cells in PFMC from HIV/TB co-infected subjects are predisposed to productive HIV-1 infection and have survival advantage as compared to Foxp3 negative CD4 T cells. |
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2
Immunostimulation During and After R-CHOP Therapy for B-Cell Lymphoma
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Kie Nagai1 , Tetsuhiro Kasamatsu1 *, Chiharu Ohmiya1 , Tomomi Nagashima1 , Hiromi Koiso2 , Akihiko Yokohama3 , Hiroshi Handa4 , Norifumi Tsukamoto5 , Nanami Gotoh1 , Lobna Alkebsi1 , Takayuki Saitoh1 , Kunihiko Hayashi1 and Hirokazu Murakami1
Backgrounds: Many studies show an immune imbalance in the tumor environment; some reports show that the T helper 1 (Th1)/ T helper 2 (Th2) ratio, the number of regulatory T-cells (Treg cells) or CD8+T-cells, and the CD8+Tcell/Treg cell ratio are associated with tumor suppression and expansion. Additionally, chemotherapy was reported to affect the immunity of patients with malignancy. Patients and Methods: Using flow cytometry we measured peripheral blood lymphocytes including non T-cells, as well as T-cell subsets such as CD3+T-cells, CD4+T-cells, CD8+T-cells, Treg cells, Th1 cells and Th2 cells before treatment, at the fourth cycle, and at 1, 3, 6 and 12 months after treatment in 21 patients with B-cell lymphoma receiving R-CHOP therapy. We also analyzed the changes in three immune indexes that reflect anti-tumor immunity (the CD4/CD8 ratio, the CD8/Treg ratio and the Th1/Th2 ratio). Results: Compared to pre-treatment there were significant decreases in the CD4/CD8 ratio between 1 month and 12 months after treatment (p<0.001, for all time points). The CD8/Treg ratio gradually increased with treatment with significant increases observed at 6 months (p=0.009) and 12 months after treatment (p=0.002). The Th1/ Th2 ratio showed a significant increase only before 4 cycles of therapy (p=0.007). Conclusion: Based on the changes in these three immune indexes, we propose that anti-tumor immunity improved after R-CHOP therapy, which enhanced the efficacy of R-CHOP therapy for lymphoma as well as its direct cytotoxic activity. |
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3
Survival Pattern and Its Determinants among Adult HIV-Infected Patients after Initiation of HAART in Dilla Hospital Ethiopia
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Wolde Bekalo Sapa1 ,Nahom Tesfaluul Negassi*2 and Almaz Haile chofore3
Background: In resource poor countries like Ethiopia the survival of patients treated with ART depends on a variety of factors, which might vary greatly with economic, demographic, behavioral and health risk factors. However, factors affecting survival in Ethiopia are poorly understood. The aim of this study is to determine causes of mortality in adult HIVpositive patients receiving highly active anti-retroviral treatment (HAART) in Dilla referral Hospital. Methods: The medical records of 1391 ART patients who enrolled at Dilla Hospital between 2010 and 2014 were reviewed and sociodemographic, clinical, behavioral and immunological data were collected. Multivariable Cox proportional hazards regression model was used to measure risk of death and identify the independent predictors of mortality. Result: Out of 1391 cohorts of adults ART patients 1081 (77.7%) were alive and continued their treatment in the hospital, 128 (9.2%) were reported dead, 111 (8%) were transfer out, and 71 (5.1%) were lost follow up. The probability of remaining alive and on treatment after 60 months of follow up was 89.3% for TB/HIV patients and 91.1% for HIV only infected patients. HIV patients who developed TB had shorter survival time than not developed TB. Death occurred 26% and 52% in the first 3 and 12 months of ART initiation respectively. The overall incidence rate of mortality during ART treatment was 3.5 per 100 person year observations (PYO). In multivariate analysis low body weight BMI <18.5 kg/m2 (HR 3.12, 95% CI 1.39-7.76, P<0.0001), CD4 countless than 50 cells/mm3 (HR 4.55, 95% CI 1.19 – 8.44, p <0.002), anemia, WHO clinical stage III and IV, drug addiction and presence of active TB infection were predictor of survival and statistically significant association with mortality in HIV patients under ART follow up. Conclusion: The presence of lower baseline CD4-cell, TB infection, WHO clinical stage III and IV, lower body weight, anemia, and drug addiction were factors associated with mortality among ART clients. Improving nutritional status, prevention and control of TB and other opportunistic infections were the recalled recommendations to decrease AIDSrelated morality. These determinants should be taken into account by health care providers to enhance better clinical outcomes of ART attendees. |
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4
Phagocytized Silica Particles Cause IL-1β Release and Cell Death in Peritoneal Macrophages
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Riyo Enomoto1,2, Hirofumi Tsuruda1 , Kei Suzuki1 , Yurika Endo1 , Takuya Tsukamoto1 and Eibai Lee-Hiraiwa1,2*
Objective: When cells are incubated with various particles in phagocytosis experiment, the cells include two populations. One is the population which engulfed the particles; the other is the population which did not engulf them. We separated both populations by use of a cell sorter and evaluated the cell death of the population which engulfed the particles to clarify the cytotoxic effect by the phagocytized particles in this study. Methods and Results: Thioglycollate-elicited peritoneal macrophages engulfed 100 nm and 1000 nm of non-crystalline silica and polystyrene particles. Phagocytosis of these particles increased depending on the quantity of added particles. The treatment of the cells with 1000 nm silica particles induced release of lactate dehydrogenase (LDH) and production of interleukin-1β (IL-1β). On the other hand, 100 nm silica particles did not increase the LDH release and the IL-1β production. Polystyrene particles also did not have cytotoxic and inflammatory effects. To elucidate the relation of phagocytosis and cytotoxicity, the cells incubated with 1000 nm silica particles were divided into non-phagocytic and phagocytic population by use of a cell sorter. As most of dead cells stained by propidium iodide were observed in the phagocytic cells population, the phagocytosis of 1000 nm silica particle was associated with cell damage directly. The silica-induced cell death was not accompanied with the externalization of phosphatidylserine in the plasma membrane. Conclusions: These results indicated the following things: (1) The engulfment of certain size of the silica particles induced cell death in the macrophages, (2) The cell death was not typical apoptosis and (3) The cell death was accompanied with the activation of inflammasome. |
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5
Phagocytized Silica Particles Cause IL-1β Release and Cell Death in Peritoneal Macrophages
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Riyo Enomoto1,2, Hirofumi Tsuruda1 , Kei Suzuki1 , Yurika Endo1 , Takuya Tsukamoto1 and Eibai Lee-Hiraiwa1,2*
Objective: When cells are incubated with various particles in phagocytosis experiment, the cells include two populations. One is the population which engulfed the particles; the other is the population which did not engulf them. We separated both populations by use of a cell sorter and evaluated the cell death of the population which engulfed the particles to clarify the cytotoxic effect by the phagocytized particles in this study. Methods and Results: Thioglycollate-elicited peritoneal macrophages engulfed 100 nm and 1000 nm of non-crystalline silica and polystyrene particles. Phagocytosis of these particles increased depending on the quantity of added particles. The treatment of the cells with 1000 nm silica particles induced release of lactate dehydrogenase (LDH) and production of interleukin-1β (IL-1β). On the other hand, 100 nm silica particles did not increase the LDH release and the IL-1β production. Polystyrene particles also did not have cytotoxic and inflammatory effects. To elucidate the relation of phagocytosis and cytotoxicity, the cells incubated with 1000 nm silica particles were divided into non-phagocytic and phagocytic population by use of a cell sorter. As most of dead cells stained by propidium iodide were observed in the phagocytic cells population, the phagocytosis of 1000 nm silica particle was associated with cell damage directly. The silica-induced cell death was not accompanied with the externalization of phosphatidylserine in the plasma membrane. Conclusions: These results indicated the following things: (1) The engulfment of certain size of the silica particles induced cell death in the macrophages, (2) The cell death was not typical apoptosis and (3) The cell death was accompanied with the activation of inflammasome. |
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6
Fatigue in Multiple Sclerosis: Current Concepts and Future Challenges
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Samar S. Ayache1,2,3,* and Moussa A Chalah1,2
Multiple Sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS). During the disease process, affected patients can experience sensory, motor, cognitive and emotional symptoms. Fatigue is also a common and debilitating complain that can affect up to 75% of MS patients at some point during their life [1]. By definition, it is a reversible subjective lack of mental and/or physical energy that can alter normal functioning. The symptom severity can fluctuate in a way that it is usually higher at the end of the day, and during hot or humid environment [1]. |
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7
Immunological Exploration of Primary Metabolite Extracted From Aqueous Stem Extract of Caralluma Fimbriata
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Amit Gupta1 * and Bharat Shinde1,2
Objective: The objective of our study is to determined its immunological property of primary (protein) metabolite extracted from aqueous stem extract of Caralluma fimbriata against specific protein antigens (lactoferrin and Ovalbumin, OVA) pertaining to determine B cell production in vitro by ELISA (enzyme linked immunosorbent assay) and also measured T cell production in vitro using immature bone marrow cells of mice exposed with Incomplete freunds adjuvant (IFA) and Concanavalin (Con) A. Methods: For these studies, estimation of protein from stem extract of Caralluma fimbriata were determined and also determining the total cellular (protein) content in immature bone marrow cells along with variable concentration of Caralluma fimbriata in presence or absence of IFA. In addition, lactoferrin (100 µg/well) and weak antigen i.e. ovalbumin (OVA; 100 µg/well) pertaining to antibody (IgG) production were determined in vitro through Elisa and also measured its proliferative response using Con A (2.5 µg/ml). Results: The results showed that aqueous stem extract of Caralluma fimbriata showed the presence of protein (0.698 mg/ml; 10 µl) content and also showed the enhancement in total cellular (protein) content in presence or absence of IFA which is determined through NanoDrop method. In addition, this aqueous stem extract showed enhancement in anti-lactoferrin and anti-OVA IgG titre in vitro at higher doses as compared to control but there is sudden decline in bone marrow cell proliferation containing Con A at higher doses. Conclusion: Our data suggest that aqueous stem extract of Caralluma fimbriata may help to raise antibodies in vitro against lactoferrin and OVA but sudden decline in Con A proliferative response in bone marrow cells. In other words, aqueous stem extract containing primary metabolite of Caralluma fimbriata could be a potent immune enhancer of B cells in vitro but inhibitor of T cells at higher doses. |
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8
Immunopharmacological Studies of Medicinal Plants
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Amit Guptha*
Medicinal plant products are characterized by the presence of several bioactive (primary and secondary metabolites) constituents that are present. Phytochemical (qualitative and quantitative analysis) and immunopharmacological based studies may provide new compounds in the form of drugs for eliminating intracellular as well as extracellular infections. Several immunopharmacological based reports have shown the action of medicinal plant products and its constituents (i.e. primary and secondary metabolites) against various pathogens i.e. cancer, inflammation, diabetes etc. |
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9
Protein Kinase C-Theta (PKCθ): A Rheostat in T cell Signaling and Cancer
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Pulak Ranjan Nath*
Protein kinase C-theta (PKCθ) is a key enzyme in T lymphocytes signal transduction pathway that works downstream of the activated T cell receptor (TCR) and the CD28 receptor. This protein translocates to the center of the immunological synapse (IS) as T cells encounter an antigen. Depending on the quality and quantity of extracellular antigenic stimuli, PKCθ differentially phosphorylates and activates different effector molecules that mediate signal transduction into distinct subcellular compartments and activate the major T cell responsive transcription factors, NF-κB, NFAT and AP-1. Besides having a major biological role in T cells, PKCθ is also expressed at high levels in gastrointestinal stromal tumors, although the functional importance is not fully clear. The present manuscript shades light on the current understanding on PKCθ in T cell signaling and cancer. |
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10
Differences between studying an islet β cell and studying whole pancreatic islets: immunological implications
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Shoham Rigbi, Boris M Baranovski and Eli C Lewis*
The main role of the pancreatic islet β cell is to release the appropriate amount of insulin upon glucose stimulation. For this reason, islet transplantation has been advancing in the past few years as a therapeutic alternative for patients with diabetes, alongside the exciting field of manipulating β cell differentiation for the sake of β cell transplantation. However, do isolated β cells function the same as β cells within an intact islet? Within islets, β cells are surrounded by other cell types, including endocrine cells, endothelial cells and immune cells, a proximity which appears to be relevant for proper glucose homeostasis. Although insulin and glucose are the main regulators in this scenario, other factors, such as angiogenesis, local anti-inflammatory components and the activity profile of resident macrophages, have a profound effect on the function and fate of β cells. A paracrine interaction between β cells and α cell holds a dramatic effect on β cell function, which is additionally dependent on blood flow through the islet. Another important intercellular communication exists between β cells and endothelial cells, in this case a bidirectional interface. Moreover, β cell survival and proliferation is dependent on the potency of ECM proteins. Further parameters distinguish functionally between the isolated β cell and the intact islet, including the deposition of Zinc by β cells, synchronicity by electrical and calcium routes, the physical innervation of islets and more. In this review, we explore major parameters that relate to differences between the function of the isolated β cell and that of the β cell within an intact islet. These and some yet to be investigated aspects of β cell function should be included in the list of considerations when examining therapeutic targets for β cell–related pathologies and for the prospect of effective β cell replacement therapy |
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11
Intestinal Colonization Resistance and the Cytokine Response Associated with Hyperoxaluria in the Patients with Recurrent Pyelonephritis
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Natalia Stepanova*1, Victoria Driianska2, Natalia Stashevska1 , Georgy Drannik2 and Mykola Kolesnyk1
Introduction and Aims: Hyperoxaluria and the violation of intestinal colonization resistance can be trigger factors in the formation of recurrent pyelonephritis. The aim of our study was to investigate the intestinal colonization resistance and the serum cytokines concentration in the patients with recurrent pyelonephritis depending on the presence of hyperoxaluria. Materials and Methods: The observational cross-sectional study involved 70 women with recurrent pyelonephritis caused by E. coli or S. faecalis, non-stone formers. The state of the patients’ intestinal colonization resistance was evaluated by bacteriological study of feces, determination of secretory IgA (sIg A) and IgA against lipopolysaccharide (LPS) of gramnegative bacteria in saliva and levels of interleukins (IL) -4 - 17, -23 and monocytic chemotactic protein-1 (MCP-1) in the serum. According to the presence of hyperoxaluria, the women were allocated into two groups: the first group of the patients (n = 38) had hyperoxaluria (> 44mg in 24 hours) and the second one (n = 32) didn’t have any hyperoxaluria. The samples of faces had been collecting during the presence of clinical symptoms of pyelonephritis before starting the antibiotic therapy. The cytokines concentrations were analyzed using ELISA and STAT FAX-303 PLUS (Diaclon, France; DRG, Germany; Ukrmedservice, Ukraine). All the statistical analyses were performed using MedCalc. Results: Microbiological studies of the colon microflora showed a lower content of Lactobacillus spp. in 53/70 (76%) in the patients with recurrent pyelonephritis. The blood levels of IL-4, IL-17, IL-23 and MCP-1 in the women with hyperoxaluria were significantly higher compared with the non-hyperoxaluria patients: 62.2 [52.8-74.1] vs 44.5 [35.8-67] pg/ml (P=0.019), and 130.7 [101.3-231.2] vs 103.4 [77.5-133.9] (P=0.03), 123.2±17.1 vs 80.98±29.4 (P=0.03) and 325.2 [211-500] vs 121.4 [104-107.8] (P=0.0003), respectively. The saliva levels of sIg A and IgA against LPS were significantly higher in patients of the first group: 298 ± 104 vs 150.1 ± 79.3 (P<0.0001) and 0.353 ± 0.16 vs 0,211 ± 0.09 respectively. In addition, we identified a moderate direct correlation between the blood level of IL-17 in the patients with recurrent pyelonephritis and daily excretion of oxalate: R=0.54, P=0.03. Conclusions: The deficit of Lactobacillus spp. violates the immune response and oxalate metabolism with formation of hyperoxaluria. The blood cytokines concentration in the patients with recurrent pyelonephritis and hyperoxaluria has not been scrutinized before. The further studies are needed to determine the role of these cytokines in the progression of urolithiasis in hyperoxaluric conditions. |
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12
Antibiotic Resistance and Phylogeny of Bacterial Isolates with Biogeochemical Analysis from Sediments of Eastern Mediterranean Sea
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Ilknur Tuncer* and Nihayet Bizsel
Background: Bacteria in marine environments show different diversity and resistance patterns. In this study, the phylogeny and antibiotic susceptibility levels of bacterial strains isolated from sediments of Eastern Mediterranean Sea (0–1235 m depths) were analyzed in association with geochemical parameters of sediments. Methods: Bacterial isolation was performed and totally 185 isolate whose 16S rRNA gene sequences were deposited into NCBI Gen Bank were assayed with disk diffusion method using eleven antibiotics. Statistical comparison was performed for susceptibility levels of strains and geochemical parameters of stations as grain size and carbon, nitrogen, phosphorus contents of sediment samples. Results and Conclusion: The highest resistance was mostly to amikacin and ceftazidime. While the Bacillus strains with the highest diversity had the highest resistance, the genera Planococcus, Marinobacter, Psychrobacter and Vibrio were susceptible to all antibiotics and even the genera Halobacillus, Fictibacillus, Lysinibacillus, Salinimonas, Photobacterium, Planococcus, Psychrobacter and Vibrio had no intermediate level. The geochemical contents of the sediments and susceptibility levels of the bacterial isolates were not statistically correlated but there was positive correlation between grain size and resistance. Due to the influence of terrestrial and anthropogenic factors, the shallowest stations had the highest resistance and were separated from deep-basins in correlation analysis. |
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13
Retinal Ganglion Cell Layer Thinning Followed By Retinal Nerve Fiber Layer Thinning In Patients with Uveitis
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Ritsuko Yamada1*, Kazuro Yabuki2 , Tadayuki Nishid1 , Ei-ich Okada1 and Nobuhisa Mizuki1
In the model of experimentally induced ischemia- reperfusion injury, retinal ganglion cells (RGC) expressing the gene AP-1 result apoptosis. The inflammation mediators, such as TNF-α, IL-1β, etc. lead RGC to apoptosis, that may lead the thinning of the retinal ganglion cell layer (RGCL) followed by the optic nerve fiber layer (RNFL) thinning. In his study we observed retinal ganglion cell and optic nerve fiber layer thinning in patients with various uveitis, that the pathological features appear obliterative vasculitis, using the optical coherence tomography (OCT) imaging analyses. Subjects were 182 eyes of 91 uveitis patients without glaucoma. Comparison were patients with normal tension glaucoma (NTG). Image analyses were conducted with 3D OCT-2000. As a result average RGCL thickness values in the patients with uveitis were significantly(p<0.01) thinner than those in healthies. Cycle scan findings of RNFL around the optic disc in the patients with uveitis showed significant thinning especially at nasal side. The retinal ganglion cell layer thinning followed by the retinal nerve fiber thinning in the patients with various uveitis was observed, and the thinning was similar to that in patients with glaucoma. The observation of RGCL and RNFL thickness may be useful for the diagnosis and the follow-up of uveitis. |
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14
Importation of Measles into America: How a Travel Clinic Can Help Prevent the Next Outbreak
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Alwyn Rapose*
There were an increased number of cases of measles in the United States (US) in the year 2014 including a major outbreak of measles originating at an amusement park in California. A visitor to the park, who probably was infected with measles during travel abroad, was suspected to be the source patient in the outbreak. This placed vaccination of children with the measles, mumps and rubella (MMR) vaccine at the center of medical, social and even political debate. Our travel clinic is accessed by a large number of persons prior to their travel abroad. Those who are not immune to measles have an opportunity to receive the MMR vaccine at their pre-travel visit. 912 persons were evaluated for in-person travel consultation at our travel clinic in the period January to December 2013 and 963 persons were evaluated during the same period in 2014. In addition to the traditional travel vaccines, 70 doses of the MMR vaccine were administered in 2013. 92 doses of MMR vaccine were administered in 2014. 315 tests for measles serology were performed in 2013, and 350 was the corresponding number for 2014. As seen in our data, among the large number of travelers seen at our clinic, a considerable number was not immune to measles and they were provided the MMR vaccine. The travel clinic thus represents a unique opportunity to increase the uptake of the MMR vaccine in healthy individuals. When these individuals are tested and vaccinated, it helps protect them from infection when they travel abroad and also increases herd immunity against measles in their communities when they return home. |
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15
Emerging Influenza Viruses at Risk in Global Health
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Giulio Tarro*
Since the emergence of a novel aquatic bird Flu agent in humans may be detected in near future, approaches to early diagnosis and prompt therapy are welcome. The swine-origin influenza virus (S-OIV) detected in April 2009 in Mexico, Canada and USA exhibited an unique genome composition not shown before. The emerging new Flu agent can cause outbreaks of febrile respiratory infection from mild to severe diseases throughout the world. This abstract has the purpose to emphasize the possibility of tracking the new influenza virus in the most affected regions of the world and to avoid a sad toll flu-related deaths that might occur. The possible causes of high incidence and mortality rates are discussed as well as their implications on the public opinion and the prevention campaign. |
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16
Cultured Media Containing Bacterial Flora Could Be a Better Alternative to Fecal Transplantation in Treating Recurrent Clostridium Difficile Colitis
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Jeff Mistroff MS IV, Gianna Guzzardo MS III* , Aaron Salem MS III and M. Cornelious Musara MD
Over the past few years, the mainstay of treatment for recurrent Clostridium difficile colitis has become fecal transplantation. Its efficacy over standard antibiotics therapy has been proven in multiple trails. However, there are inherent drawbacks in this treatment modality such as the transfer of unknown pathogens, the cost of testing and processing donor material, and the delay in onset of treatment. These obstacles may be circumvented by the clinical use of cultured media of bacterial isolates mimicking endogenous feces. We propose that such techniques have the potential to reduce the transfer of unknown pathogens to the patient, eliminating the cost of testing and processing the donor’s stool, and by allowing for earlier onset of treatment. By eradicating these pitfalls in the current treatment, future patients could further benefit from treatment with cultured media when compared to fecal transplantation. |
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17
Human Immuno-Deficiency Virus Co-Infection with Hepatitis B Virus and Baseline CD4+ T Cell Count among Patients Attending a Tertiary Care Hospital, Nepal
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Soma Kanta Baral1 *, Sadina Shrestha1 , Jeevan Bahadur Sherchand2 , Keshab Parajuli2 , Bharat Mani Pokhrel2 , Hari Prasad Kattel2 and Diwash Shrestha2
Background: Since 1981, when the first AIDS case was reported, worldwide, more than 34 million people have been infected with HIV. Almost 95 percent of the people infected with HIV live in developing countries. As HBV & HIV share similar routes of transmission by sexual intercourse or drug use by parenteral injection, co-infection is common. Because of the limited access to healthcare & HIV treatment in developing countries, HIV-infected individuals are present late for care. Enumeration of CD4+ T cell count at the time of diagnosis has been useful to initiate the therapy in HIV infected individuals. The baseline CD4+ T cell count shows high immunological variability among patients. Methods: This prospective study was done in the serology section of the Department of Microbiology over a period of one year from august 2012 to July 2013. A total of 13037 individuals subjected for HIV test were included in the study comprising of 4982 males & 8055 females. Blood sample was collected by vein puncture aseptically with standard operational procedure in clean & dry test-tube. All blood samples were screened for HIV as described by WHO algorithm by Immuno-chromatography rapid kits. Further confirmation was done by biokit ELISA method as per the manufacturer’s guidelines. After informed consent, HIV positive individuals were screened for HBsAg by Immuno-chromatography rapid kits (Hepacard). Further confirmation was done by biokit ELISA method as per the manufacturer’s guidelines. EDTA blood samples were collected from the HIV sero-positive individuals for baseline CD4+ T count. Then, CD4+ T cells count was determined by using FACS Calibur Flow Cytometer (BD). Results: Among 13037 individuals screened for HIV, 104 (0.8%) were found to be infected comprising of 69(66.34%) males & 35 (33.65%) females. The study showed that the high infection was noted in active age group (30.76%), housewives (28.7%) & in heterosexual route (80.9%) of transmission. Out of total HIV infected individuals, distribution of HBV co-infection was found to be 6 (5.7%). Baseline CD4+ T cell count of HIV infected patient was found higher (mean CD4+ T cell count; 283cells/cu.mm) than HBV co infected patients (mean CD4+ T cell count; 91 cells/cu.mm). Majority (77.2%) of HIV infected & all co-infected individuals were presented in our center late (CD4+ T cell count;< 350/cu. mm) for diagnosis and care. Majority of co- infected 4 (80%) were late presented with advanced AIDS stage (CD4+ count; <200/cu.mm). Conclusions: The study showed a high percentage of HIV sero-positive & co- infected individuals. Baseline CD4+ T cell count of majority of HIV infected individuals was found to be low. Hence, more sustained and vigorous awareness campaigns & counseling still need to be done in order to promote early diagnosis and management. |
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18
Role of Hypothalamic Pituitary Adrenal (HPA) Axis and Tumor Necrosis Factor (TNF) in Development of Post-Traumatic Nosocomial Pneumonia
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T. Mózes1* , K. Gornicsar2 , A. Grosz1 , Ta. Mózes3 , Kh. Diab1 and E. Madarász4
Background and purpose: Infection after experimental focal ischemia may result from brain-induced immune depression. A strong cytokine mediated anti-inflammatory response was recently observed in stroke patients at higher risk of infection, although infection due to the decreased pro-inflammatory mediators can be expected as well. To investigate this question the following experiment was performed. Methods: 105 over 60 years hip fracture patients were included in the study. Sera and lympho/monocytes were separated from blood samples taken on different days (day 1, 3, 6, 9). Isolated lympho/ monocytes were cultured for one day with or without endotoxin (LPS). TNFα levels in sera and in the culture supernatants were determined by bioassays using WEHI 164 cells. Plasma ACTH and cortisol values were measured by RIA kits. Results: From 105 hip fracture patients 7 nosocomial pneumonia patients were found, (4 survivors and 3 nonsurvivors) furthermore 2 non-survivors with cardiovascular death without infection. On the day of trauma the level of circulating TNFα activity was extremely low in nosocomial pneumonia patients in comparison to uneventful healing patients. In pneumonia patients TNFα started to increase on day 3, increased till day 9 then reached the values of uneventful healing group. In two patients with later cardiovascular complications, extremely high TNF alpha activities were detected throughout the entire observation period. The plasma cortisol values were high in nosocomial pneumonia patients in comparison to uneventful healing persons, and decreased slightly by the 9th post-trauma day. In the two cardiovascular patients, serum cortisol was extremely low on the day of trauma and increased gradually during the investigation period. ACTH level was stable in the sera of uneventfully healing patients, while showed large individual and also time-dependent fluctuations people with post-traumatic complications. Conclusions: An excessive decrease in pro-inflammatory response is a key facilitating factor for the development of infection. |
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19
Mechanisms of Protection With Melatonin By Hepatic Heme-Oxygenase-1 Activation In Burn
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Ganka Bekyarova1* and Maria Tzaneva2
Background: Melatonin, the principal secretory product of the pineal gland, functions as a potent antioxidant and free radical scavenger. Additionally, the antiapoptotic effect of melatonin has been observed. Several studies show that heme-oxygenase-1 (HO-1) possesses antiapoptotic action and prevents hepatic damages. Recent studies indicate that heme-oxygenase-1(HO-1) inhibits apoptosis and exert hepatoprotective effect. The aim: of this experimental study was to investigate the protective effects of melatonin against burn-induced apoptotic injury and the association between the oxidative stress and the changed expression of hepatic HO-1 in burn rat model. Material and method: Melatonin was applied immediately after the burn. The expression of hepatic 4-hydroxynonenal (4-HNE), as marker of liver peroxidative injury, hepatic HO-1, marker of antioxidant defense and apoptosis-related genes Bcl-2 and Bax was evaluated using light immunоhistochemistry. Results: Burns caused an increased expression of HO-1, 4-HNE, Bax and Bax/Bcl-2 ratio and induced apoptosis of sinusoidal endothelial cells (SECs) in liver tissue. Melatonin treatment augmented the increase in HO-1 expression, decreased both burn-induced peroxidative damage and hepatic apoptosis as evidenced by reduced expression of Bax, enhanced expression of Bcl-2. Conclusion: Our present data suggest that melatonin suppresses burn-induced liver injury through HO-1 activation, attenuation of lipid peroxidation and modification of Bax/Bcl-2 ratio. |
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20
Surface Engineering of Recombinant RNA Coliphage Qβ to Display gp41 MembraneProximal External-Region Epitopes from HIV-1
,
Alain Bopda Waffo1, 2*, Loveline N. Ngu3,4, Rana L. Singleton1 , Timothy Egbo1 , Josué L. Simo11,13, Carrie A. Sanders1 , Georgia E Ambada3,7, Nadesh N. Nji3 , Apeh A. Ngoh8 , QianaL. Matthews1,14, Boakai K. Robertson1,14, Thibau F. Tchouangueu3,13, Abel Lissom3,7, , Swapnil Bawage1, 2, ColinceTchadji3,7 Arinze S. Okoli10, Charles O. Esimone9 , Rebecca Chukwuanukwu12, Wilfred Mbacham4,5,6, Lazare Kaptue11, Godwin W. Nchinda3*
Introduction: The membrane proximal external region (MPER) of HIV-1 envelope glycoprotein-41 (gp41) is targeted by several broadly neutralizing antibodies whose conserved linear epitopes are promising targets for vaccine design. However, a formidable challenge has remained the difficulty to design and deliver MPER based immunogens for the efficient induction of such broadly neutralizing HIV-1 specific antibodies (bnAb). This is mainly because the linear bnAb MPER epitopes are poorly accessible to the immune system. The overall objective of this study therefore was the development of a novel RNA Qβ phage display system not only for monitoring anti-MPER specific antibody responses but equally as potential immunogens in future HIV-1 vaccine designs. Method: To overcome the challenge of effective presentation of MPER to the immune system we have selectively engineered the surface of the RNA coliphage Qβ to expose all MPER bnAb epitopes. Briefly, DNA representing a 50 amino acids consensus region within the HIV-1 gp41 MPER was fused in frame with the minor coat protein A1of the Qβ phage. Three variant MPER expression cassettes were obtained with the MPER cDNA in frame with the minor coat protein A1 gene, including pQβMPER, pQβMPERHis and pQβMPERN. The expression cassettes were used for the production of QβMPER recombinant phages after transformation of E. coli HB101 strain. Antigencity of the phages was assessed with plasma from long standing anti-retroviral naïve HIV-1 infected people from the CIRCB AFRODEC cohort while immunogenicity studies were done in female Balb/c mice. Results: The initial titers of all recombinant phages including QβMPER, QβMPERHis and QβMPERN were 104 plaque forming units/ml (pfu/ml). This was significantly lower (P<0.001) relative to the 108 pfu/ml of wild type phage, but was scaled up to 1014pfu/ml. The fusion of MPER and Qβ genes was confirmed by RT-PCR followed by gel electrophoresis and sequencing. Specific recognition of some reported bnAb epitopes within MPER were confirmed in ELISA using the three recombinant QβMPER phages together with an MPER restrictive peptide as antigens and the bnAb 4E10, Z13e1, 2F5 and 10E8 as antibodies. Next the prevalence of MPER-specific antibodies was determined in plasma from long standing antiretroviral naïve HIV-1 infected participants of the CIRCB AFRODEC cohort. The greater majority (84%) of participants’ plasma showed MPER peptide specific reactivity with anti-MPER specific IgG antibody titers ranging from 200 to 409600 comparative to background IgG antibody titer with the Qβ phage alone as antigen or plasma from seronegative participants. In immunogenicity studies in Balb/c mice the recombinant phages QβMPERN and QβMPERHis induced significantly high Anti-MPER-specific IgG antibody responses (P<0.04) in at least 60 % of mice following three inoculations of each recombinant phage. Conclusion: Thus, these novel recombinantQβMPER phages can be used to monitor MPER-specific immune responses in HIV-1 exposed or infected people. In addition the recombinant QβMPER phages could be used as immunogens either alone as demonstrated here in mice or in combination with other strategies for the induction of MPER specific immunity against HIV-1. |
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21
Analysis of Bruton’s Tyrosine Kinase Deficiency in Patients with Presumed X-Linked Agammaglobulinemia
,
AJ Álvarez-Márquez, C Abad-Molina, MA Montes-Cano, A Núñez-Roldán, B Sánchez*
X-linked agammaglobulinemia (XLA) is a fully penetrant X-linked recessive disorder characterized by the early onset of recurrent bacterial infections, profound hypogammaglobulinemia and a marked decrease in the number of B-lymphocytes [1]. The gene defective in XLA has been identified as a non-receptor proteine tyrosine kinase, BTK (Bruton´s tyrosine kinase) [2,3]. Over 600 mutations have been described in the BTK gene and they are spreaded throughout the gene [4]. Mutational analysis has revealed that there is considerable heterogeneity in the clinical spectrum of XLA, with atypical individuals having small numbers of mature B lymphocytes and some immnoglobulin production [5]. Analysis of Btk protein expression in primary cells of XLA patients has shown that the large majority of individuals do not express protein regardless of their mutation [6]. As it is yet known Btk is expressed not only in B cells but also in granulocytes and monocytes. In the present work we applied a flow cytometric test employing whole blood to detect Btk expression in monocytes to identify XLA patients. |
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22
Epstein - Barr virus Reactivation Associated with an Increased Thymidine Kinase and Normalized by an Immuno Modulatory Nano-Therapy: Three Case Reports
,
GLADY Gilbert
Epstein-Barr Virus (EBV), a common human herpes virus known to infect most of the world population, has been mentioned in the context of many diverse human pathologies while its participation during its latency phase is more and more often demonstrated in a growing number of chronic malignancies.The biological diagnosis of the virus activity is carried out using serological parameters on the one hand, and the measurement of the viral load on the other hand. Thymidine kinase (TK) is a key enzyme in the regulation of the intranuclear thymidine pool during cell cycle progression. The rise in its plasma level therefore systematically reveals an uncontrolled cellular proliferation evoking, of course, at first a neoplastic process. Nevertheless, EBV being a DNA virus, its reactivation or even a persistent primary infection are also likely to cause an increase in the blood level of TK.Using three examples, we will show that the neutralization of EBV by an immunomodulatory nano-therapy called Bio Immune (G)ene Medicine (BI(G)MED), is accompanied by a normalization of plasma levels of TK, thus underlining the close link between the virus and this marker of cell proliferation. |
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23
Immune Status and Red Cell alloimmunization among SCD Patients in Côte d’Ivoire
,
Liliane K Siransy1,2*, Dasse S Romualde1 , Richard Yeboah1 , Patricia A Kouacou1 , Honoré Adou1 and Sansan Hien1
Sickle cell disease is the most popular genetic disease in the world. In Côte d’Ivoire, the SCD prevalence is 12%. As such, SCD is a public health problem. Few studies are really investigating the relative levels of Th1, Th2 and Th17 types in black Africans and in the occurring of alloimmunization. This works attempts to identify the cytokine pattern produced by these patients during the course of the disease as Th1 cytokines, Th2 cytokines and Th17 and the relationship with alloimmunization. Patients and Methods: This is a prospective study followed at the National blood Transfusion Center in Abidjan, Côte d’Ivoire. Cytokines were measured by using Bio Legend’s LEGEND plexTM Human Inflammation Panel assays. We used Grifols DG gel® system to perform the immune hematology tests. Results: We recruit 50 patients with a diagnosis of sickle cell disease (SCD). Of these, only 31 have benefited from the research of irregular agglutinins (62%), comprising 14males (45.16%) and 17 females (54.84 %). The overall alloimmunization prevalence of 16.12%. The prevalence of alloimmunization was significantly greater in males than in females (60%). According to alloimmunization, we note an increased levels of IL-10 in non alloimmunized patients with SCD, when compared with alloimmunized and the levels of IL-4 was higher in alloimmunized patients compared to non alloimmunized. Lower IFN-γ levels were detected in non alloimmunized and alloimmunized SCD patients. Concerning IL-17, there was a small increase in patients without alloantibodies compared to those with. However no significant differences were noted in the 2 groups. Conclusion: The impact of biomarkers in the occurrence of alloimmunization is a constant preoccupation of researchers. Due to lack of financial aspect, small number of patients was enrolled. Even, we cannot draw any definitive conclusion; however our study brings data regarding the functioning of the immune system in SCD giving valuable insight. |
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24
Q&A on the Paper of Kurukulasuriya et al. (2017) on IBD Vaccine Efficacy Against a Canadian Variant IBDV Strain in Broiler Chickens
,
Dr. Stephane Lemiere*
Kurukulasuriya, et al. (2017) are reporting the efficacy of two IBD vaccines against an early (6 days post-hatch) challenge with a variant Canadian IBDV strain in broilers. A modified live vaccine(UNIVAX BD) administered by SQ route at 1 dayof-age delayed infection whereas an HVT-IBD vector vaccine (VAXXITEK HVT+IBD) administered in ovodid not protect. Furthermore, the authors suggested that the HVT-IBD vector induced immunosuppression responsible for an earlier IBDV challenge strain replication in the bursa. The data presented in the paper showed no evidence of VAXXITEK HVT+IBD vaccine take since the mean IBD ELISA antibody titer at D35 in the vaccinated/non-challenged group was not significantly different from that of the non-vaccinated group. It wasmuch lower than the expected one based on previous studies performed in the same conditions : in ovo vaccination of broilers [1,2]. Since there is no evidence of vaccine take, the other potential effects (immunosuppression and earlier IBDV replication in the bursa) observed in that group cannot be attributed to the vaccine. Since its launch in 2006 in Brazil, VAXXITEK HVT+IBD has been licensed in more than 75 countries and more than 80 billion birds have been vaccinated. VAXXITEK HVT+IBD is protecting against a wide variety of IBDV strains including the classical, the very virulent and different variant strains. To our knowledge, noabsence of efficacy nor bursa depletions have been so far officially reported as long as the vaccine has been administered properlyto healthy embryonated eggs or to healthy one-day-old chicks. |
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25
Protective Effect of Myrianthus Arboreus Leaves Aqueous Extract in AcetaminophenInduced Liver Toxicity in Rats
,
Nwachoko N1 *, Essien EB2 and Ayalogu EO3
Owning to changes in living pattern of humans and constant environmental changes, different life challenging diseases now exist. Traditional system has clam that some of these diseases could be cured with plant. Plants and their components are source of large amount of drugs. This study was design to examine the protective effect of Myrianthus arboreus leaves extract against acetaminophen induced liver toxicity in rats. A suspension of 750 mg/kg acetaminophen was administered once every 72 hours to induce toxicity in the rats. Oral administration of 500, 1000 and 2000 mg/kg body weight of the extract and 100 mg/kg of silymarine (reference drug) were administered for 10 days. The result of effect of pretreatment with Myrianthus aboreus leaves on the enzyme makers of tissue damage in acetaminophen induced toxicity showed significant different when compared with the result of group induced without pretreatment. The values of AST, ALT and ALP in the untreated group significantly (p<0.05) increased. Elevated serum level in these enzymes revealed the integrity and functionality of the liver. Thus the increased value of these enzymes indicates damage to the liver by the induced acetaminophen. Also the values of non-enzyme markers (T.B., ALB and TG) for the treated groups decreased when compared with the untreated group. The significant different in the values between the groups pretreated with Myrianthus aboreus leaves and the untreated group showed that MA extract could protect the liver. |
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26
A Still Rare Case of Congenital Afibrinogenemia
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Imane Tlamçani1 *, Asmae Krich2 , Fatima Zahrae El Hamdi3 and Moncef Amrani Hassani4
Congenital afibrinogenemia is characterized by the decrease or the absence of fibrinogen synthesis. It is a rare pathology that is transmitted autosomal recessive mode, with variable clinical demonstrations. The biological diagnosis consists in the presence of traces or absence of fibrogen with blood incoagulability. The coverage of this disease bases itself on the preventive treatment and replacement therapy based on fresh frozen plasma or fibrinogen concentrate. Through this case, we recall the various aspects of these rare condition clinical, biological, genetical as well as therapeutic plans. |
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27
Active Specific Immunotherapy (ASI) and Gcmaf Forte in Management of Metastatic Invasive Carcinoma–Overview of the Therapeutic Modalities and A Case Report
,
Roni Moya, Mike KS Chan, Dmitry Klokol* and Shing Yi Pan
Metastatic cancer is often a fatal disease with low survival rate that in a course of its progression implies a pathogenic cascade involving inflammation, overexpression of reactive oxygen species, loss of DNA repair, genome instability, neoangiogenesis, epithelial infiltration, collagen destruction, and immunosuppression and apoptosis evasion by cancer cells. Understanding the cross-interaction mechanism between the immune co-stimulatory and inhibitory molecules on one side and tumors cells is a key point in the development of a successful immunotherapeutic strategy to fight aggressive cancers. The Active Specific Immunotherapy (ASI) and the GC protein Macrophage Activating Factor (GcMAF) are two immunotherapies capable of modulating the innate and adaptive immunity against cancer. The aim of this work is to present a case of an invasive metastatic carcinoma treated with ASI and GcMAF Forte and discuss the potentials of the individualized immunotherapy in advanced forms of cancer. Immunotherapy improves status of immune system and as a result it increases patient’s life span (and probably survival rate). In conclusion, the ASI and GcMAF Forte may offer a promising prospective immunological biomedical approach to boost immunity and enhance life expectancy in patients with metastatic cancer. |
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28
A New Monoclonal Antibody-Based Biosimilar GnRH Antagonist
,
Gregory Lee
GHR106 is a monoclonal antibody generated against an oligopeptide corresponding to that in the extra cellular domains of human GnRH receptor. The humanized forms of GHR106 exhibit almost identical biological properties to those of decapeptide GnRH antagonists such as Antide and Cetrorelix. The Fc region of humanized GHR106 has been replaced with IgG4 subtype to eliminate activities of effector function. Therefore, the newly humanized GHR106- IgG4Fc can be used clinically as biosimilar GnRH antagonists of higher molecular size, and longer half-life (hrs. vs. days) for therapeutic treatments of fertility-related health conditions without complications arising from the effector functions of immunoglobulins. |
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29
A Quality Improvement Project to Increase the Rate of HPV Vaccination Initiation in Adolescents
,
Olivia Stranges
The vaccination rate of the human papilloma virus vaccine [9vHPV] is low, with only 63% of eligible females and 50% eligible males receiving the vaccine in 2016. The aim of this quality improvement project was to increase the initiation rate of HPV vaccination at Smyrna Pediatrics by 20%, from 3.6% to 4.3% over four weeks. Two physicians, one nurse practitioner, and two medical assistants implemented this quality improvement initiative. There is a lack of education and standardized communication about HPV and 9vHPV to prevent against the virus. A standardized script was created so that all conversations between healthcare professionals and patients and their parents or guardians included the wording of the 9vHPV being recommended rather than optional. Educational material from the CDC was the standard handout given to each adolescent and their parent or guardian. Standardized education and communication was to be provided at each adolescent visit of the 125 eligible adolescents seen during the four-week implementation period, 4% (n = 5) agreed to receive the 9vHPV vaccine. With a baseline of 3.6% (n = 4), there was an 11.1% increase of initiation of 9vHPV. The use of standardized education documents presented to all patients and their parents or guardians established health education as the mainstay of the project and provided information about the importance of prevention and protection from the virus that the vaccine prevents. The implementation of results over a longer period of time may prove to be more effective for the practice’s increase of vaccination rates overall. |
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30
The Prevalence of Undernutrition and Associated Factors among Children Aged One to Five Years in Siyambalanduwa MOH Area
,
A.M.U.P.Kumari1 * and S. Ginige2
Aim: High prevalence of child undernutrition is a well-known issue in rural areas of Si Lanka. Identification of real burden, underlying specific causes and addressing those issues will help to improve the nutritional status of those children. Objective: To describe the prevalence of undernutrition and associated factors among children aged one to five years in Siyambalanduwa MOH area. Methodology: A community based cross-sectional study was conducted among 421 child-mother pairs in Siyambalanduwa MOH area using two stage cluster sampling method. Data collection done by using pre tested interviewer administered questionnaire. Relevant anthropometric measurements were done according to WHO slandered guidelines. Statistical analysis was done using SPSS 20. The chi-square test was used, and P<0.05 was considered for statistically significant. Results: Overall 41% of children aged 1-5 years were undernourished in Siyambalanduwa MOH area. Among the study subjects 24% were underweight, 25.7% were stunted, 16.4% were wasted, 9.2% were both underweight & stunted, 6.8% were both, underweight & wasted, 0.5% were both stunted & wasted and 9.9% were underweight & stunted g & wasted. Only the low total monthly income (P<0.001) and low birth weight (P<0.001) were significantly associated with child undernutrition. Conclusions and recommendations: Prevalence of undernutrition among children aged 1-5 years is unacceptably high and urgent efforts to reduce undernutrition should be a priority. Future studies should focus on assessing how to reduce the burden of undernutrition with low cost interventions. |
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31
Anti-Gbm Disease in Children: Outcomes and Association with Systemic Vasculitis
,
Renuka Chauhan1 *, Andrew Maxted2 , Satyapal Rangaraj3 and Lampros Fotis3
Anti-Glomerular Basement Membrane (anti-GBM) disease is a rare autoimmune disorder affecting the glomerular and alveolar basement membranes. Diagnosis is based on the detection of anti-GBM autoantibodies, along with renal or lung biopsy. Some patients are both anti-GBM and ANCA positive, reflecting an association with systemic vasculitis that has been reported only in some adult cases. Dual positivity of anti-GBM and ANCA is associated with poorer prognosis and higher relapse rates therefore more aggressive and longer treatment is essential. In this case, series we report four cases of children diagnosed with anti-GBM disease that we also screened for signs of systemic vasculitis. |
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32
Predictive Clinical Value of Rheumatoid Factor and Anti-Citrullinated Protein Antibodies as Diagnostic Tools in Cases with Non-Arthritic Chronic Hepatitis C Viral Disease
,
Wael Mahmoud Tamer1 * and Mohammed S Eltoukhy2
Background: Rheumatoid arthritis is a chronic immunological disease that causes destruction and deformity of joints. Chronic hepatitis C infection cases could develop rheumatic like clinical presenting profile. Raised rheumatoid factor in chronic HCV infection considerably reduces the diagnostic privilege of rheumatoid factor for rheumatoid arthritis coexisting with HCV infection. Aim of the work: To determine the value of anti-citrullinated protein antibody levels in cases having chronic HCV infection in comparison to rheumatoid factor. Methodology: The research team recruited 150 non-arthritic study subjects having chronic hepatitis C virus infection rheumatoid factor and anti-citrullinated protein antibody levels were assayed for all study subjects for statistical analysis. Results: Rheumatoid factor +ve study subjects had statistically significantly more frequent within female gender. (p value=0.027) Rheumatoid factor high +ve cases had statistically significantly had more frequent fatty liver and higher platelets than on high RF +ve cases. (P value =0.020, <0.038 consecutively) Conclusion: HCV cases with joint involvement were not implemented in the current research study that prevented statistical estimation of the sensitivity of anti-citrullinated protein antibody for arthritis in this cohort. Racial and ethnic differences should be put in consideration in future research studies that are recommended to be multi centric in fashion. |
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33
The Prevalence of Anaemia among Reproductive Age Group (16-45 Yrs) of Women in the RMG Concentrated Area, Savar, Dhaka
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Shamima Nasrin Shadia1 , Sadia Afrin2 , Rabiul Islam3 and Moazzem Hossain4 *
This was a retrospective study and record of hemoglobin level of reproductive age group (16-45 yrs) of women in the Ready Made Garment (RMG) concentrated area, Savar, Dhaka. Descriptive statistics were used. Results were expressed as percentages/proportions, means and average. The objective of this study is to determine prevalence of Anaemia among women of reproductive age group who are working in Garments. In this study hemoglobin level of one thousand one hundred and five women of reproductive age (16-45 years) were analyzed in lab. The prevalence rate of any anemia was 71.22%. The majority of anemic women were in the category of mild (53.48 %) to moderate (14.67%) and severe Anaemia was 3.07%. Though the most affected age group was 21-25 years but the difference noted was statistically significant. The study substantiates the existence of mild to moderate form of anemia among women of reproductive age and underlines the need for iron supplementation to all reproductive women especially during the antenatal period with more attention to the most affected regions of the country. |
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34
Disseminated Nontuberculous Mycobacteria in HIV-Infected Patients
,
Gebrehiwet Tesfahuneygn* and Gebremichael Gebreegziabher
Nontuberculous mycobacteria are ubiquitous in the environment and are increasingly implicated in human diseases worldwide. Currently, there are more than 150 species of Mycobacterium and it is likely that more will be discovered. The rapid increase in identified species in recent years is due to improved culturing techniques and more precise differentiations of species. The application of highly active antiretroviral therapy for the treatment of HIV disease dramatically reduced rates of all opportunistic infections including nontuberculous mycobacteria. Despite this decline, nontuberculous mycobacterium remains one of the most commonly encountered opportunistic infections in AIDS patients. Disseminated nontuberculous mycobacteria infections are seen exclusively among immunocompromised hosts, including those with AID. Disseminated disease is most commonly seen in association with profound immunosuppression. In HIV infected patients, dissemination does not typically occur unless the CD-4+ T-lymphocyte count is below 50/uL. Structural lung disease, such as chronic obstructive pulmonary disease, silicosis, pneumoconiosis or prior TB infection, predisposes to pulmonary infection. Nodular bronchiectasis is very strongly associated with nontuberculous mycobacteria infections. Disseminated Mycobacterium avium complex disease was one of the first opportunistic infections recognized as part of the syndrome of AIDS .Interest in disseminated Mycobacterium avium and nontuberculous mycobacteria infections increased as a result of the HIV epidemic, and therapeutic strategies to treat and prevent these diseases must be focused. Prevention and treatment regimens were lifelong because cure of nontuberculous mycobacteria was not achievable in AIDS patients with profound immune suppression. |
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35
Comparative Analysis of Igg Responses to Recombinant Qβ Phage Displayed MSP3 and UB05 in Dual HIV-Malaria Infected Adults Living in areas differing in Malaria Transmission Intensities
,
A Lissom3,7, FH Ouambo3,14, R Megnekou5,7, MI Okeke18, LN Ngu3,4, PM Netongo4,5, AA Ngoh3,8, CA Sanders1 , S Bawage1,2, TF Tchouangueu3,20, CJ Tchadji3,7, AS Okoli10, GD Njambe Priso3,7, R Garcia15, A Gutiérrez15, GO Chukwuma3,12, CO Esimone9 , EA Achidi14, W Mbacham4,5,6, L Kaptue11, RFG Leke5 , CG Park16,17, VPK Titanji19, AB Waffo1,2,13 and GW Nchinda3 *
Immunoglobulin G (IgG) specific responses against Plasmodium falciparum merozoite antigens such as the merozoite surface protein 3 (MSP3) and UB05 are known to play critical roles in parasiteamia control and protection from symptomatic illness. However when there is intense perennial malaria transmission coupled with concurrent infection with the human immunodeficiency virus type 1 (HIV), knowledge of IgG antibody response profiles is limited. In this study we assessed the impact of dual HIV-Malaria infections on IgG subclass responses to MSP3 (QβMSP3) and UB05 (QβUB05) in individuals living in two areas of Cameroon differing in malaria transmission intensity. We observed differences in antigen specific IgG and IgG subclass responses which were dependent upon the antigen type, malaria transmission intensity, HIV infection, malaria infection and dual HIV-malaria infections. Individuals living in high malaria transmission areas irrespective of HIV or malaria status had significantly higher IgG responses to both antigens (P=0.0001 for QβMSP3, P=0.0001 for QβUB05) than their counterpart from low transmission areas. When dual HIV-Malaria infection is considered significantly higher QβMSP3 specific IgG1 (P=0.0001) and IgG3 (P=0.04) responses in double negative individuals was associated with protection against malaria in low transmission areas. Increased QβUB05 specific IgG1 responses (P=0.0001) in double negative individuals were associated with protection in high transmission areas in contrast to significantly higher IgG3 responses to QβUB05 (P=0.0001) which were more relevant to protection in low malaria transmission areas in the same population. These findings imply that QβMSP3 might not be suitable as a standalone vaccine in areas differing in transmission intensity. However, antigenicity of UB05 most likely predicts immunity in both low and high transmission areas and could be used either alone or in combination with other antigens for vaccine studies in areas differing in transmission intensities. Understanding immune responses to QβUB05 and QβMSP3 could thus enable the development of efficacious vaccines or commensurate immunotherapeutic strategies suitable for areas differing in malaria transmission intensity. |
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36
Does Blood Group influence on Tomato likeliness?
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Muhammad Imran Qadir and Ayesha Munir*
Objective of the recent study was to tally blood grouping with Tomato likeliness. The entire of 170 subjects. The subjects were scholars of Bahauddin Zakariya University Multan, Pakistan. Blood analysis is an important diagnostic tool within health care. So, I checked the blood group of different students of my fellows by venipuncture method. Mostly had blood groups B+ and O+. While lowest were of AB- blood groups. The overall 0f 170 students, half of the total were of B+ and O+ blood groups. Then, I concluded that most of the people like tomatoes and having different blood groups |
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37
Contemplate of Nail Fungus Infection among Different Scholars of University
,
Muhammad Imran Qadir and Ayesha Munir*
The basic objective of this research was too well informing the people about nail fungus infection. This is the contemplate (survey) of nail fungal infection among different scholars of university. Nail fungal taints are the utmost communal illnesses of the nails, making half of our nail uncharacteristic. This infection is most common in adults. So, for this project we took the feedback about the awareness of this infectious disease from different scholars of Bahauddin Zakariya University Multan, Pakistan. They all gave various types of information about this infection. Then I concluded from this feedback that knowledge on nail fungus infection was higher in females than in male, some were suffering from this infection, someone’s relatives, friends, and neighbors were agonizing. Even there were some who were not aware of this fungal disease. |
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38
Audit to See the Effect of Nicotine Addiction on Pulse Rate
,
Muhammad Imran Qadir and Hina Batool*
Objective of present study was to see the effect of nicotine addiction on pulse rate. Nicotine can cause cardiovascular diseases and it also affect pulse rate by increasing its speed. So it was concluded that the docents who are addicted to tea have higher pulse rate and who are not addicted to tea they have normal or slow pulse rate. |
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39
Wheezing in Childhood- not Always Asthma -Review
,
Atiar Rahman1 * and Nafisa Rahman2
Wheezing in infancy and childhood is a common condition; however it is not a single disorder and can be due to causes other than asthma. Wheezing is a musical, expiratory sound due to narrowing and hyper responsiveness of the intra-thoracic and extra thoracic airways. Not all wheezing is asthma. Wheezing-associated respiratory illnesses in children are often described as asthma; however while most children with asthma show symptoms of wheezing. Wheezing, coughing and breathlessness are common in young children, and can all be symptoms of conditions other than asthma. Bronchiolitis refers to a first episode of wheezing, with respiratory distress triggered by a viral infection. Episodic wheezing refers to discrete episodes of wheezing without intermittent symptoms. Unremitting wheezing refers to distinct episodes of wheezing with intermittent symptoms, such as coughing or wheezing at night or in response to exercise, crying, laughter, mist, or cold air. Environmental conditions that increase the rate of bacterial and viral infections are risk factors for transient wheezing, but its relationship to asthma remains unclear. Children with frequent simple colds and other common childhood infections in infancy are less likely to develop persistent wheezing in later childhood. Many preschool children with viral induced wheezing will outgrow these symptoms, and do not have asthma. Generally, asthma is identified by the presence of cough, wheeze and breathing difficulty, together with features of atopy (or a family history of atopy or asthma) and impaired lung function evidenced by spirometry. It is important to explain to parents/ carers that wheezing in an infant or preschooler does not mean the child will have asthma or allergies by primary school age. In preschool-aged children with recurrent wheeze (e.g. four or more episodes per year), consider using the Asthma Predictive Index, to estimate whether children are likely to have asthma during primary school years. Asthma Prediction Index has some major criteria and minor criteria. Major criteria are diagnosis of asthma in one or both parent, Diagnosis of atopic dermatitis during the first 3 yr. of life, Sensitization against >1 allergen, Minor criteria- Milk, egg, or peanut sensitization. Associated with respiratory infections, Eosinophilia >4%. In the first 3 years of life if anyone who have 1 major criteria or 2 minor criteria is present in one episode, the possibility of asthma in 6-13 years is 59% but 2 episodes possibility is 77%. Investigation -Chest X-Ray, spirometry, CT scan of Chest and Fiberoptic Bronchoscope. It is usually not necessary if history of “classic” asthma or, patient response to salbutamol and or steroid; then only spirometry should be done. But need other investigation when Chronic cough (>1 month), recurrent pneumonia, persistent signs or symptoms are seen despite therapy. Bronchomalacia, esophageal dilatation, foreign body aspiration, vocal cord dysfunction, viral pneumonia allergic rhinitis, bronchiectasis, cystic fibrosis, heart failure, acute chest syndrome of sickle cell anemia, use of beta blockers, etc. All these conditions described can present with wheezing and certainly do not characterize asthma. Here we reported six case series having wheeze but ultimate diagnosis was not asthma. |
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40
Interlink Between the Blood Pressure and Ladyfinger Likeness
,
Muhammad Imran Qadir and Nazia Muneer*
Goal and the intension of the recent course were to show the connectivity between the blood pressure and ladyfinger likeness. Blood pressure or BP is the pressure exerted on the walls of the blood vessels when the blood circulates. Blood pressure is measured by the device called sphygmomanometer. The normal range of the blood pressure is 80mmHg to 120mmHg. The first is the diastolic blood pressure and the later is systolic blood pressure. Ladyfinger is the green vegetable which helps in controlling the blood pressure. During the sampling, we made a Performa about the connectivity of blood pressure and ladyfinger likeness. Gross of 188 colleagues were involved in this Performa study to which we questioned about their blood pressure. These colleagues are the undergraduate students of Bahauddin Zakariya University. It was concluded that the males who like ladyfinger have higher blood pressure and the females who dislike ladyfinger also have the high blood pressure. |
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41
Awareness about Color Blindness among University Student
,
Muhammad Imran Qadir* and Iqra Ali Yameen
Basic purpose of this survey studies was to check awareness level about color blindness among university students. Color blindness is color vision deficiency (CVD), which occurs due to genetic disorder in specialized cell of eye. Patients suffering with color blindness are unable to differentiate between certain colors like red, green and blue. Red-green deficiency is common among all patients. A questionnaire was prepared to estimate awareness of university students about color blindness. It is concluded from this survey studies that mostly students are unaware about etiology and recent treatments of color blindness. |
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42
Extracorporeal Immunopharmacotherapy of Autoimmune Diseases
,
Voinov VA*, Ilkovich MM, Isaulov OV, Novikova LN, Karchevsky KS and Baranova OP
The article aims to analyze pathogenetic mechanisms of autoimmune diseases development including disorders of both cellular and humoral immunity. The standard drug therapy with corticosteroids and cytostatic leads to a number of side effects such as lipid metabolism disorders (Kushing-syndrome), arterial hypertension, diabetes, and osteoporosis each of which is to be additionally treated. Chimeric monoclonal antibodies (rituximab, natalizumab, etc.) can also cause complications. Therefore apheresis therapy with removal of autoantibodies, circulating immune complexes and other pathological metabolites is pathogenetically justified. However, the greatest effect is reached by means of extracorporeal immunopharmacotherapy when, besides antibodies removal by means of plasmapheresis one performs selection of lymphocytes and their temporary incubation with corticosteroids and cytostatics, which are then returned to the patient. Such targeted immunosuppression is much more effective then “pulse therapy” with minimum negative consequences for the body. At the same time a supporting drug therapy can be carried out with half smaller doses. |
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43
Assessment of Inter-Connection between Suriphobia and Individual’s Blood Glucose Level: A Questionnaire Centred Project
,
Ghalia Batool Alvi*, Muhammad Imran Qadir and Baber Ali
Blood sugar level is actually the estimation of the total glucose sugar content in the one’s blood. Insulin and Glucagon are the two key hormones responsible for maintaining homeostasis which sustain blood glucose level. Hypoglycemia and Hyperglycemia are the two conditions associated with blood sugar level. In case of hypoglycemia, blood glucose level falls below the normal level of glucose in the blood while hyperglycemia is the condition of elevated blood glucose level than the normal range. Different tests are available to test the blood glucose level of an individual. The central objective of this project was to assess the inter-connection between one’s being suriphobic and their blood sugar level at fasting. Phobia is a word associated with the condition of extreme fear from a series of specified events. Suriphobia or mice fear is the term used for those individuals who extremely fear from mice, rats, rodents etc. This study was a questionnaire based project to assess the fact that if there is any inter-connection between people’s being suriphobic and their blood glucose level at fasting. For this purpose blood sugar level of the sample population was calculated using Glucometer. Statistical Analysis point towards the significant results if this study as the calculated p-value was exact of the standard p¬-value which is p ≤ 0.05. Therefore, the fact that there is a significant relation between individual’s being Suriphobe and their Blood Glucose Level at fasting is proved. |
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44
Relationship between Normal Blood Pressure and Body Weight
,
Muhammad Imran Qadir and Hafiz Shahid Hussain*
The objective of the present study was to compare any relationship between normal blood pressure and body weight. Normal blood pressure is very crucial for our life. Blood pressure is important because it provides oxygen and nutrients to our tissues and organs, this pressure cause the blood to flow throughout the body via arteries. Blood pressure is developed when our heart pumps the blood on contraction with heart beats. Body weight of human is measured in kilograms. Body weight fluctuation occurs due to the water amount in our body. There are many methods to access the body weight like dual-energy X-ray absorptiometry and the percentage of muscles, fats and bones in a human body. We used an instrument known as Sphygmomanometer. We measured weight of individuals, made individual stand on the machine and kept aside all the things and accessories like mobile phone, heavy jackets and shoes. We used a spring scale to measure and weight of a body. In this project, a questionnaire was prepared and asked the subjects about their blood pressure and measured the weight. |
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45
Bitter Gourd relish and Pulse Rate Relationship
,
Imran Qadir and Maryam Farooq*
The objective of present project “Bitter Gourd relish and Pulse Rate Relationship” was to investigate the normal pulse rate of subjects and relate with likeliness of bitter gourd. Subjects that took part in this project were 219 in number. Pulse rate is a means of physical examination of patient’s body and diagnosing the problem. Pulse rate is the beats (blood pumping to body) of heart in a minute. The status (regular, fast, low, strong) of pulse indicated the physical state of subject. Bitter gourd, a vegetable enrich in phytonutrient, anti-oxidants, dietary fiber and vitamin C, also disliked by subjects because of its bitterness. A protocol was followed to find a relationship for pulse rate measurement and questionnaire. Assistance of every subject helped in survey completion. Results were obtained by t-Test and relationship was observed that helped in doing conclusion. P-value was nonsignificant which meant no relation between bitter gourd and pulse rate measurement. |
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46
Opinions about Mumps Disease and its Severity among Different Individuals
,
Muhammad Imran Qadir and Tayyaba Nisar*
Objective of present study was to evaluate the knowledge of mumps disease. Opinions of different students were asked about Mumps in Bahauddin Zakariya University. Swelling of parotid glands is a common symptom of this disease and these glands are present on one or both sides of face. Mumps is a viral disease and pass from one person to another person and also transmitted by respiratory droplet. A person is usually immune for his life when an infection has completed its period once. It was concluded from present study that maximum subjects including male and female about 97% said it was viral disease while minimum 1% said it was bacterial disease.Maximum76% male and female answered that their friend had not suffered from mumps while. Maximum 79% male and female said it was not transmitted from parents to offspring. Maximum 91% male and female answered that there was no need of treatment. |
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47
Relation between Katsaridaphobia and Blood Glucose Level
,
Faryal Batool* and Muhammad Imran Qadir
Blood glucose refers to the amount of sugar (glucose) in your blood, also known as Serum Glucose Level. Increased blood sugar level for a long time can damage the blood vessels. Normal Fasting Glucose level in blood is 70 – 100 mg/dl, while sugar level after two hours of eating (Random) must be below 140 mg/dl. In this project, we are discussing about phobia of cockroaches named as Katsaridaphobia. Main objective behind this study was to find interrelation between katsaridaphobia and blood glucose level. This project was carried out by conducting a questionnaire in 130 students of university. A simple glucometer was used to measure sugar levels of students. . Student’s t-test was performed for statistical analysis. |
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48
Association of Chicken Likeness with Blood Glucose Level
,
Muhammad Imran Qadir and Salma Batool*
The target of the existing study was to relate chicken likeness with blood glucose level. Blood glucose level or blood sugar level or blood sugar level concentration is the level of the glucose existing in the blood of homo sapiens and mammals. Sum total of 100 students participate in the current research. We made a question sheet and got access to the blood sugar level of the participants. The participants were the students of Bahauddin Zakariya University, Multan, Pakistan. At the end we concluded that there is no relation between chicken likeness and blood sugar level. |
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49
Relation of Tea Likeliness and Normal Breathing Rate
,
Muhammad Imran Qadir and Iqra Rafique*
The objective of the present study was to link tea likeliness and normal breathing rate. A person’s respiratory rate is the number of breaths, he takes per minute. The average respiratory rate for a human being is 16 breaths per minute but it may vary from 12 to 20 breaths per minute. Statistical analysis was done by using SASS software in which t-Test was applied to determine the relation of tea likeliness and normal breathing rate and p-value less than 0.1 was taken as a standard value. It was deduced from the present study that there is no relation of tea likeliness and normal breathing rate in humans. |
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50
Interconnection between Blood Glucose and Freckles
,
Muhammad Imran Qadir and Aqsa Asghar*
The aim of the present study was to correlate between blood glucose level and freckles. Blood glucose level is tested by a meter called glucometer. Total of 146 students includes in this performance study which we question about their blood glucose level. During the sampling we made a connection between blood glucose level and freckles. These colleagues are an undergraduate student at Bahauddin Zakariya University |
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51
Relation of Temperature and Study
,
Muhammad Imran Qadir and Madiha Saeed*
Objective of the study was to correlate study and temperature. A processor is connected to the sensors for draining the output signal to decide a body temperature of the person apply a scale mapping of a majority of target temperatures to correspondent output signals taken over a predestined range of surrounding temperatures. The motive for the study asserts some theoretic form. It was concluded from the study that male with low temperature study more and female with high temperature study more. |
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52
Questionnaire Based Study on Relation between Normal Pulse Rate and Skin Texture
,
Muhammad Imran Qadir and Hira Raheem Akbar*
The basic and foremost objective of the recent study was to correlate normal pulse rate and skin texture. The basic purpose was to assess the role of pulse rate in skin texture. Pulse rate also known as the number of contractions produced by heart in one minute determines heart rate. It varies from slow to fast according to body needs to intake oxygen and release carbon dioxide. Persons with age of eighteen or more have heart rate ranging between 60 and 100 beats per minute. Children with age 6 to 15 have heart rate ranging between 70 and 100 beats per minute. Skin Texture also known as skin type. There are many sorts of skin raging from dry to oily, but three skin types are of major concern; Dry, Oily and Normal. Dry skin is a sort of skin type with lowest moisture. A person with normal skin will not be facing skin problems like acne or blackheads. A person with normal skin will not be facing skin problems like acne or blackheads. |
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53
Blood Oxygen Level Plays Vital Role in Regulating Skin Texture
,
Muhammad Imran Qadir and Hira Raheem Akbar*
The objective of present study was the assessment of role played by blood oxygen level in skin type. The basic purpose of my project was to investigate relation between blood oxygen level and skin texture. Blood oxygen level can also be termed as Peripheral oxygen saturation (SpO2 ) or Oxygen Saturation Level. Peripheral Oxygen saturation is defined as the proportion of oxygen-concentrated hemoglobin corresponds to the total hemoglobin (concentrated + non-concentrated) in the blood. The human body needs and maintains a very proportionate and peculiar balance of oxygen in the blood. 95–100 percent is considered as normal blood oxygen levels in humans Hypoxemia is a condition which occurs when blood oxygen level becomes less than 90 percent. Skin type also known as skin texture, refers to the surface of skin which is either regular or irregular. There are many significant types of skin. Dry skin texture appears to be rough but smooth. Oily skin type is shiny. Normal skin type is healthy and fresh skin and it appears to be very consistent. It was found from results that blood oxygen level plays an important role in determining the skin texture of body. It has become clear that when need of tissues is fulfilled by oxygen, there will be no pigmentation and skin will be fresh, young and healthy |
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54
Conjunction between the Ladyfinger Likeness and Human Normal Body Temperature in Fahrenheit
,
Muhammad Imran Qadir and Nazia Muneer*
The purpose of this study was to show the conjunction between the ladyfinger likeness and human normal body temperature. Normal body temperature in human is the temperature range in Homo sapiens. Normal body temperature in human ranged as 97.7 to 99.5 ºF. It is balanced by the process of thermoregulation. The optimum temperature in the human is 98.6 ºF which is 37.0 in degrees. Ladyfinger is the vegetable which is used to cook. Ladyfinger also improves the vision quality because in it vitamin A is present. During the project designing, we designed the project related to the linkage of likeness of ladyfinger with the normal body temperature. 131 companions were joined in this project studies to whom we asked about their normal body temperatures. These companions were the undergraduate students of University. We took the thermometer. Then we selected the site at which we wanted to measure the temperature. Students came to us one by one. Firstly one student came to us. We placed the thermometer in the mouth. The readings appeared on the thermometer after few seconds and we calculated the reading and noted down on the page. It is excluded that there is no conjunction between the ladyfinger likeness and human normal body temperature. |
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55
How Normal Breathing Rate Can Affect Nail Biting Habit
,
Muhammad Imran Qadir, Sadia Batool*
Objective of the present study was to find the effects of normal breathing rate on nail biting habit. In present study, total 140 subjects participated. These all participants were the students of Bahauddin Zakariya University, Multan, Pakistan. In present study, survey based training had given an important advancement. Watch was used to calculate normal human breathing rate per minute. Subjects were allowed to sit in normal condition. Then one by one their breathing rate was calculated. After that asked question from them about their nail biting habit and put their breathing rate values in yes or no portion according to their answers. Concluded from recent research that there is no effect of normal breathing rate on nail biting habit. |
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56
Connection of Body Temperature with Fear of Rides
,
Muhammad Imran Qadir and Alishba Rasheed*
The present study was done in order to evaluate connection between body temperature and fear of rides. About 120 disciples of Baha Uddin Zakariya University took part in this study. Isothermal, also known as the normal temperature of body is one of the most important factors in maintaining the metabolic activities of the body that are vital for life. It normal value is 37 °C. It can be measured by using mercury thermometer [1]. It is measured on certain body positions like forehead, mouth and rectum. Fear of rides is common among people who have other phobias like claustrophobia, acrophobia etc. Those people whose body temperature is 97 are more afraid of rides as compared to those people who have low body temperature. |
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57
A Survey to Evaluate the Impact of Ailurophobia on Blood Oxygen Level
,
Irtiqa Masood* and Muhammad Imran Qadir
The blood oxygen level is a measure of amount of oxygen circulation in the blood. The blood oxygen level test also known as ‘blood gas analysis’ estimates the proper working of the lungs and it performs different measurements. Pulse oximeter, a noninvasive device that helps to detect or estimate the level of carbon dioxide and oxygen saturation in the blood. Normal pulse oximeter reading has a range of 95 to 100 percent. 200 individuals were selected and asked about the fear of cats and their peripheral oxygen saturation was estimated using pulse oximeter device. The results calculated from M Stat software and student’s t-test revealed that there is a significant impact of cat phobia on peripheral oxygen saturation. The calculated p-value was significant depicting the correlation between blood oxygen level and ailurophobia. |
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58
Extracorporeal Immunotherapy in Oncology
,
Voinov VA*, Orlov SV, Karchevskii KS and Isaulov OV
Tumors development is closely related to the immune system state and in immunosuppression tumors occur many times more often. The quality of the immune defense depends on how the recognition system functions for malignized tumor cells and its timely destruction. However, the immunosuppression state may be a result of the tumor process itself. The tumor itself generates soluble molecules that inhibit the killer activity of lymphocytes and macrophages, which allows tumor cells to survive in the body. Therefore, it is justified to perform apheresis therapy aimed at removal of such inhibitors, and targeted restoration of cytotoxic activity of leukocytes, which should contribute to the tumor cells apoptosis. This method of extracorporeal immunopharmacotherapy is indicated not only in far-advanced cases, but also after any radical operations, when metastases are not detected and even chemotherapy is not carried out. |
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59
Does Blood Oxygen Level influence on Tomato Likeliness?
,
Muhammad Imran Qadir and Ayesha Munir*
Blood oxygen level is used to calculate how much oxygen and carbon dioxide red blood cells are transferring. A blood oxygen level analysis also examines the stability of acids and bases, recognised as pH balance, in the blood. The main topic of this research is the tomato likeliness. As some people likes more tomatoes than others and they use tomato in different ways. The main topic of this research is the tomato likeliness. As some people likes more tomatoes than others and they use tomato in different ways. |
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60
What is the Connection between Normal Body Temperature and Chicken Likeness?
,
Muhammad Imran Qadir and Salma Batool*
The objective of current study was to co-relate normal body temperature with chicken likeness. Body temperature is the normal temperature of the body. Usual body temperature may change in different situations such as by age, person, time of the day and activity. Thermometer is the instrument used to find out the temperature of the body. Total of 150 students took part in the recent study and they were the students of Bahauddin Zakariya University, Multan Pakistan. We arranged the instrument and then measured their body temperature. At the end we can concluded that there is a strong relation between these two variables. The male and female individuals with high body temperature are chicken lovers. |
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61
A Unique Vaccine with Multiple Applications
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GP Talwar1 *, Jagdish C Gupta1 , AD Krishnan2 , AS Mustafa3 , SA Zaheer4 , HK Kar 5 , R Mukherjee6 , R Rani7 , S Bhaskar7 , P Reddi8 , V Saini9 , SE Hasnain10, Akhilesh K Tyagi 11, Anil K Tyagi12, Somesh Gupta13, Dipankar Nandi14 and Shilpi Purswani15
The immune system consists of molecules and cells (and their products) to keep the Body free of afflictions. Clinical problems arise as and when there is failure or inadequate immunological response. How can the immune system be fortified against an undesirable infection? This is done by making of a vaccine against that infection. This article describes the development of a Vaccine against Leprosy. Most of us (>90%) are immune to this disease. The few, who become victims to leprosy, manifest pitiable symptoms. Interestingly this vaccine has found multiple applications. It is a potent invigorator of immune responses. |
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62
The Sea Star Igkappa Gene and The Ophuirid Igkappa Gene Vaccinations to HRP (Horse-radish Peroxydase)
,
Michel Leclerc
The main point of the sea star immunology, of the ophuirid immunology remain the discovery of the INVERTEBRATE PRIMITIVE ANTIBODY (IPA), the IGKAPPA GENES, with Ig sites which imply the COMPLEMENT SYSTEM, to be initiated: 9 component genes from C1 to C9 have been updated these last years, in sea star genome, in ophuirid one. These primitive antibodies were obtained after immunizations to the enzyme HRP (Horse-radish peroxydase). It is the first time we observe vaccinations in invertebrates. We have discovered, for the first time also, in these same Invertebrate a FC receptor gene, a Fab gene which corroborate the presence of IPA. The transcriptomes are given. It is the first time, we can speak of Adaptative Immunity, in Echinoderms, in Invertebrates Since many years, even since a century long, the notion of Antibody was out of the speech of immunologists. To speak of that made you as an outlaw. It is time to look with genomic studies which confirm which assert now evidence that 3 classes of Echinoderms out of 5 possess an Igkappa gene, a FC receptor gene. I recall these classent: the Asterids with Asterias rubens, the Ophuirids with Ophiocomina nigra and the Crinoïds. |
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63
Multimodal Approach with CAR-T and CAR-NK Cells for Synergistic Action to Treat Cancer
,
Shanthi Vadali
Recent years have seen a craze about the T-cell immunotherapy for B-cell malignancies, and there is growing interest in NK-CAR therapy. In this paper, I discuss the similarities and differences between the CARs in the NK and T-Cells. Further, explore the possible theoretical concept of a multimodal approach towards treating cancer. Whether the two genetically modified cells could provide an added advantage acting synergistically to complement each other’s therapeutic qualities or counteract each other’s downfall. This short communication is an attempt to pique interest to understand the mechanisms of NK cell and T cell biological interaction in the presence of a therapeutic weapon “CAR” to target tumor. |
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64
The Effects of Intraoperative Hypothermia Review of the Molecular Mechanisms of Action in Therapeutic Hypothermia
,
Valentina Pop-Began* and Valentin Grigorean
During surgery the patient may lose heat during and after surgery through the contribution of several factors: ambient temperature, cold fluid infusion, the position on the operating table, surgical skin preparation methods, type of surgery, conventional surgery or laparoscopy, and the loss increase of the heat by opening the serous cavities, thoracic or abdominal [1]. They add other factors, depending on patients: the elderly are more prone to heat loss, sex; women lose less heat, the existence of associated diseases, as peripheral vascular diseases, endocrine diseases, cachexia, physical constitution or presence of pregnancy. Temperature of the patient’s body lowers in relation to prolonged patient stay in a cool room of resuscitation. The heat loss of the skin tissue in the operating room is important and is expressed at approximately 100 W [2]. More important than the relationship between temperature of the operating room and patient’s skin, the microclimate, which is established between operators fields and patient. Another important factor is body surface area exposed having significant area reported at weight. Hypothermia is aggravated by cold fluid administration, abdominal or thoracic wounds. The use of cold solutions in urologic surgery exposes the central temperature drop, which is more marked if intervention is performed under epidural anesthesia [3]. In epidural anesthesia, hypothermia is due to redistribution of heat between the center and periphery, the thighs being established to intense vasodilatation and heat loss [4, 5]. All measures taken to prevent heat loss are important for prevention of coagulation disorders. Hypothermia reduces oxygen release in half, reducing the liver’s ability to metabolize citrate and lactic acid and cause arrhythmia. The existence of hypothermia in surgical patient reflects failure thermoregulatory mechanisms [1-3]. |
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65
A Very Rare Benign Giant Osteoma in Tempero-Parieto-Occipital Region
,
Morshed MH*, Khan UKS, Hoque S, Roy T, Raihan HA and Sarker AC
Osteoma is a slow growing benign mesenchymal osteoblastic tumor formed by mature bone tissue. The most common site reported is the fronto-ethmoidal region and neighboring sinuses. Involvement of the temporal and occipital squama is extremely rare. Like giant osteomas in other locations of the skull, they can reach large volumes but are essentially benign and potentially curable by excision. The author presents a case of giant osteoma in Temporo-Parieto-Occipital region in a teenage girl. |
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66
Outcome of External Ventricular Drainage in Spontaneous Intracerebral Haemorrhage with Ventricular Extension in different GCS Score
,
Mahamudul Haque Morshed
Background: Intracerebral Haemorrhage (ICH) is a medical emergency of the highest degree with frequent early neurological deterioration or death. External ventricular drainage (EVD) is the procedure of choice for the treatment of spontaneous intracerebral haemorrhage with ventricular extension or blood within the ventricles, acute hydrocephalus and increased intracranial pressure in patients of intracerebral haemorrhage and subarachnoid haemorrhage (SAH) with hydrocephalus and its sequelae. Objective: The aim and objective of this study was to predict the outcome of pre operative GCS following external ventricular drainage in spontaneous intracerebral haemorrhage with ventricular extension. Method: In this was prospective observational studies, a total number of 60 cases were taken purposively for a period of July, 2015- March, 2017 diagnosed by CT scan of brain at Department of Neurosurgery, Dhaka Medical College Hospital. All the patients, fulfilling the inclusion and exclusion criteria, were enrolled for the study. For assessing outcome of EVD in post operative patients and evaluating the efficacy of EVD surgery in follow ups. Glasgow Coma Scale and Glasgow Outcome Scale scoring method for patient assessment were used for outcome of EVD surgery. Result: A total of 60 patients were included in this study, age range was 45 to 86 years. Majority patients, 24 (40.0%) were from 61-70 years of age. The mean age was found 62.0±20. It was observed that 24 (40.00%) patients had GCS 5. GCS 6 was observed in 14(23.33%) patients. GCS 5 and 6 were not found post operatively in any cases. GCS 7 was observed in 14 (23.33%) cases. Whereas, GCS 8, 9, 10 were found in 11 (18.33%), 13 (21.66%), 10(16.66%) cases respectively and 4 cases were died on first post operative day. In most cases GCS level rose to 2 points. GOS at 7th POD died total 12 (20.00%) cases. It was observed that 48 (80.00%) patients were alive Moderate disability existed in 12(25.00%) cases. Again, severe disability and persistent vegetative cases observed in 14(29.16%), 9(18.75%) cases. Glasgow Outcome Scale at 3 months follow up of my study patients, it was observed that total died patients 16 (26.66%). Conclusion: According to my study, majority of the study patients survived following EVD in spontaneous ICH with ventricular extension but most cases was unfavorable outcome which was statistically. |
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67
Outcome of External Ventricular Drainage in Spontaneous Intracerebral Haemorrhage with Ventricular Extension in different GCS Score
,
Mahamudul Haque Morshed
Background: Intracerebral Haemorrhage (ICH) is a medical emergency of the highest degree with frequent early neurological deterioration or death. External ventricular drainage (EVD) is the procedure of choice for the treatment of spontaneous intracerebral haemorrhage with ventricular extension or blood within the ventricles, acute hydrocephalus and increased intracranial pressure in patients of intracerebral haemorrhage and subarachnoid haemorrhage (SAH) with hydrocephalus and its sequelae. Objective: The aim and objective of this study was to predict the outcome of pre operative GCS following external ventricular drainage in spontaneous intracerebral haemorrhage with ventricular extension. Method: In this was prospective observational studies, a total number of 60 cases were taken purposively for a period of July, 2015- March, 2017 diagnosed by CT scan of brain at Department of Neurosurgery, Dhaka Medical College Hospital. All the patients, fulfilling the inclusion and exclusion criteria, were enrolled for the study. For assessing outcome of EVD in post operative patients and evaluating the efficacy of EVD surgery in follow ups. Glasgow Coma Scale and Glasgow Outcome Scale scoring method for patient assessment were used for outcome of EVD surgery. Result: A total of 60 patients were included in this study, age range was 45 to 86 years. Majority patients, 24 (40.0%) were from 61-70 years of age. The mean age was found 62.0±20. It was observed that 24 (40.00%) patients had GCS 5. GCS 6 was observed in 14(23.33%) patients. GCS 5 and 6 were not found post operatively in any cases. GCS 7 was observed in 14 (23.33%) cases. Whereas, GCS 8, 9, 10 were found in 11 (18.33%), 13 (21.66%), 10(16.66%) cases respectively and 4 cases were died on first post operative day. In most cases GCS level rose to 2 points. GOS at 7th POD died total 12 (20.00%) cases. It was observed that 48 (80.00%) patients were alive Moderate disability existed in 12(25.00%) cases. Again, severe disability and persistent vegetative cases observed in 14(29.16%), 9(18.75%) cases. Glasgow Outcome Scale at 3 months follow up of my study patients, it was observed that total died patients 16 (26.66%). Conclusion: According to my study, majority of the study patients survived following EVD in spontaneous ICH with ventricular extension but most cases was unfavorable outcome which was statistically. |
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68
Antibody Responses Specific to Hepatitis B Virus Vaccine in Children Exposed InUtero to Antiretroviral Therapy
,
Thibau F Tchouangueu1,2, Laure B Kouitcheu Mabeku2 , Abel Lissom 1,7, Loveline N Ngu1,8, Salomon B Tchuandom2,9, Jules C Tchadji1,7, Larissa Djukouo1,8, Carole S Sake Ngane1,10, Alfred A Ngoh1,11, Hervé F Ouambo1,12, Georgia Ambada1,7, Anna Gutiérrez3 , Charles O Esimone4 , Chae Gyu Park5, 13, Alain Bopda Waffo6, 14, 15 and Godwin W Nchinda1 *
The use of antiretroviral (ARV) has been one of the most effective means of preventing vertical transmission of the human immunodeficiency virus (HIV) to exposed children born of HIV infected mothers. Nevertheless, responses to childhood vaccination against Hepatitis B virus (HBV) infections remain suboptimal in HIV exposed uninfected children irrespective of maternal ARV prophylaxis. In a cross-sectional study we have assessed the impact of in-utero exposure to ARV on paediatric HBV vaccination. Anti-HBV surface antigen specific antibodies (anti-HBs abs) were measured in plasma specimens from 44 healthy children unexposed to both HIV and ARV (HU), 25 HIV-exposed uninfected children naïve to intrauterine exposure to ARV (HEU.AR - ), 29 ARV and HIV-exposed uninfected children during pregnancy (HEU.ARV +), 50 children vertically infected with HIV but naïve to intrauterine exposure to ARV (HEI.ARV - ) and 22 children vertically infected with HIV with in utero exposure to ARV (HEI.ARV +). The protective seroconversion rate after childhood HBV vaccination (anti-HBs ≥10 mUI/ml) among HEU.ARV + children (58%) was significantly lower relative to both HEU.ARVc - (100%, P=0.0010) and the healthy unexposed children (92 %, P=0.0069). Similarly, HEI.ARV + children also had significantly lower anti-HBs IgM antibody responses when compared to both HU (p=0.0003) and HEI.ARV - (0.0001) children respectively. Thus in-utero exposure to ARV probably contributes in reducing HBV vaccine antibody response rate in both HIV exposed uninfected and vertically infected children after childhood vaccination. Nevertheless, the overall impact of ARV was to improve anti-HBs IgG responses in HIV infected children suggesting a possible role in immune reconstitution leading to improved IgG antibody responses. |
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69
Biostatistical Analysis on Chronic Disease Risk
,
Bin Zhao1 *, Xia Jiang2 , Jinming Cao3 and Kuiyun Huang1
Introduction: Approximately one-third of all college students aged 18-29 were classified as overweight or obese, increasing their risk for chronic disease. Nutritional knowledge is an important first step to developing strategist to improve the food choices of college students and promote healthy lifestyle behaviors. Therefore, the purpose of this study was to determine the current nutritional knowledge of students enrolled in courses within the Human Performance and Leisure Studies (HPLS) Department at Hubei University of Technology (HBUT). Methods: Paper based surveys were used to administer the 56-question Nutritional Knowledge Questionnaire (NKQ) for students enrolled in HPLS courses in spring 2017. Results: Response rate was 65.6% (n=236). Gender distribution was equal among the surveyed students (45.3% male vs. 53.8% females). The majority reported majoring in sports science and fitness management (SSFM) (76.7%), were between 18-24 years old (86.9%) with a self-identified ethnic origin of Chinese Xinjiang person (89.8%). The average nutritional knowledge score was 49.2 +/- 9.8 or 44.8%. Knowledge of diet-disease relationship was higher in females (5.4 +/- 1.9) compared to males (4.8 +/- 2.3), p = 0.03. Conclusion: In this study, we found a need to improve nutritional knowledge in college students enrolled in select HPLS courses in the spring of 2017 at HBUT. The findings highlight a gap in nutrition education and the opportunity to develop courses or programs aimed at healthful eating for students majoring in SSFM or attending HBUT. |
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70
Cholera Toxin B Subunit and Peptide LKEKK Inhibit TNF-α Signaling in Intestinal Epithelial Cells and Reduce Inflammation in a Mouse Model of Colitis
,
Elena V Navolotskayaa1 *, Vladimir B Sadovnikov1 , Valery M Lipkin2 and Vladimir P Zav’yalov3
Cholera toxin B subunit (CT-B) and synthetic peptide LKEKK corresponding to the sequence 16-20 of thymosin-α1 and the sequence 131-135 of interferon-α2 (the concentration range of 100-5000 µM) significantly reduced TNF-α-stimulated pro-inflammatory cytokine expression and increases the expression of the anti-inflammatory cytokine IL-10 in human Caco-2 intestinal epithelial cells. In a mouse model of dextran sodium sulfate-induced colitis CT-B and peptide, LKEKK (20 mg/kg body weight orally for 14 days) decreased the production of TNF-α and IL-6, as well as the severity of inflammation. Thus, CT-B and peptide LKEKK are able to suppress inflammation in vitro and in vivo. |
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71
Study on Preparation of New Purified Vero Cell Rabies Vaccine
,
Ashish Sahai
Rabies is a 100% vaccine-preventable disease. A cheap, rabies vaccine for humans that could be used in mass vaccination campaigns would be a valuable weapon against rabies. Despite the existence of safe and effective vaccines, rabies disease still causes an estimated more human deaths a year in the endemic areas in Asia and Africa. Rabies virus is single stranded negative sense RNA from genus lyssavirus and _ family rhabdoviridae. |
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72
Elucidation of Molecular Mechanism of the Nonopioid Β-Endorphin Action Using Synthetic Peptide TPLVTLFK
,
Elena V Navolotskaya
The review presents data on nonopioid action of β-endorphin and its synthetic fragment 12-19 (TPLVTLFK, octarphin), a selective agonist of a nonopioid β-endorphin receptor. Using tritium labeled octarphin, the receptor distribution in the body has been studied. It was discovered on immune cells (peritoneal macrophages, T and B-lymphocytes), endocrine (adrenal cortex, hypothalamus), cardiovascular (cardio myocytes) systems. Characteristics of the binding specificity showed that only unlabeled β-endorphin can displace the labeled octarphin from the complex with the receptor, the α-endorphin, γ-endorphin and enkephalins tested in parallel were inactive. The peptide was found to increase the activity of inducible NO-synthase (iNOS), soluble guanylate cyclase (sGC) and the content of cGMP in target cells. The results obtained suggest that the activating effect of octarphin and β-endorphin mediated through the nonopioid receptor is realized in the following way: increasing iNOS expression → increasing NO production → increasing sGC activity → increasing intracellular level of cGMP. |
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73
Open Northeast Passage Record - NGC 40 New Global Warming Energy Source
,
WP Sokeland
In 2018 and 2019, the Arctic ice volume was increasing due to the reduction of SN1006 and V606 Aquilae heat delivering incoming debris stream particles or a decrease in strength. When the volume of ice on our planet was increasing in 2018-19, the planet was impacted by the new heat source of planetary nebula, PN, NGC 40. Currently the strength of PN NGC 40 is overcoming the loss of strength of the SN 1006 and V606 Aquilae and the Arctic ice volume started decreasing in March 2019. Particular longitude locations moving eastward from the initial impact point of PN NGC 40 show the effects of the PN NGC 40 hotspot passing over their locations. Shipping time through the Northeast Passage will increase for 2019 and for years thereafter. The ten-year measles outbreak that occurred from 1981 to 1991 will repeat for the period 2019 to 2029. |
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74
Tuberculosis in Saudi Arabia: Prevalence between Saudis and Non-Saudis from 2013 to 2018 with a special concern about regions of the KSA
,
Reham Yahya1 * and Najwa alharbi2
The Kingdom of Saudi Arabia is one of the largest Arab countries with a moderate annual problem of tuberculosis that is either pulmonary or extra-pulmonary. TB is still one of the most significant health troubles in the KSA, affecting different nationalities (Saudis, non-Saudis), ages, provinces, and genders. The control of TB still faces some challenges in different provinces of the KSA. Data were collected, arranged, analyzed and presented in tables and figures. In this retrospective study, we appraised TB surveillance data for the period between 2013 (1434H) and 2018 (1439H). Data were handled using Microsoft Excel and SPSS version 23. Data were checked for normality using Shapiro-Wilk normality test at 0.05 levels to determine whether they are parametric or nonparametric. Chi-squared, Kruskal Wallis, and analysis of variance tests were used to evaluate trends at a significance level of p< 0.05. Statistical analyses were performed using IBM-SPSS version 23 for Mac OS. We appraised TB surveillance data for the period between 2013 (1434H) and 2018 (1439H). The data included the region of the country (province), age, sex, and nationality (Saudis, non-Saudis). The study evaluated the impact of TB on various nationalities (Saudis and non-Saudis), age groups (0-14, 15-34, 35-55, more than 55 years old), and genders (males and females). Non-Saudis had a higher incidence rate than Saudis in 2013-2018. The number of cases and incidence rates of TB recorded in males between 2013 to 2018 were about two to three times greater than estimates for females. The Makkah, Riyadh, and Jeddah regions attract enormous numbers of non-Saudi migrant workers, who account for ~60% of all TB cases in the KSA. Assessing the main TB risk factors contributing to high TB rates in non-Saudi workers is essential. Furthermore, periodical accurate studies, including evidence-based studies for optimum surveillance, avoidance, spread risk, inspection, control procedures and treatment of TB, should be conducted. These assessments would lead to evaluating the strengths and weaknesses of KSA-NTP’s TB action plan. |
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75
Antitumor Immunity as Determining Factor for Prevention of Post-Surgery Cancer Recurrence
,
Xin Chen1 , Qi Wang2 , Xu Zhang3 , Hui Zhang3 and Kangla Tsung3 *
Cancer surgery is the oldest modality in cancer management and remains an effective cancer treatment that excises visible tumor and can result in long-lasting clinical cure. Yet the mechanism for the ability of surgery to cure cancer is not understood. The conventional thinking is that surgery effectively excises all tumor before it spreads and that results in cure. However, with more recent studies to detect circulating tumor cells that can still persist after tumor excision, it is now increasingly clear that early tumor spread before clinical detection is a common process of cancer development. Then the important paradoxical question is how does a local therapy such as surgical excision cure a systemic disease like cancer? We hypothesize that the interaction between tumor metastasis and antitumor immunity answers this question. The model, which we call “post-surgery tumor recurrence window model”, suggests that establishment of cancer metastases has an L –shaped kinetics following removal of the primary tumor. Similarly, pre-surgery concomitant antitumor immunity will also decay following surgery due to lack of antigen stimulation. Whether a new metastasis can establish is determined by the balance between these two processes. Here we present animal study evidence to support this model. We also present examples of how this model may be applied to predict post-surgery prognosis in individual cancer patients. |
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76
Antibiogram and Molecular Analysis of Clinical Bacteria Isolates from the Three Geographical Regions of Ondo State, Nigeria
,
Ajayi AO1 *, Olajubu FA1 , Fadipe DO2 and Babaleye DO1
This study shows diversified forms of multidrug resistant bacteria agents that were obtained from designated health facilities in Ondo State, Nigeria. One hundred and fifty (151) clinical bacteria isolates collected from designated hospitals in Ondo, Okitipupa, Owo and Akure were identified. From Ondo North (SSH, Ikare and FMC, Owo), Seventy (70) bacterial isolates were obtained and this includes 15 (21.4%) Gram +ve organisms consisting of Staphylococcus spp, Bacillus spp, Streptococcus spp, and Corynebacterium spp. While 55 (78.6%) of the isolates were Gram-ve of various species. In Ondo Central (SSH, Akure and Trauma Centre, Ondo), Sixty-five (65) bacterial isolates obtained comprises 16 (24.6%) Gram+ve species of Staphylococcus and Streptococcus only. While 49 (75.4%) were Gram-ve bacterial species. Similarly, Ondo South (SSH, Okitipupa), Thirty-three (33) bacterial isolates were obtained, 8 (24.2%) were Gram+ve of the species of Staphylococcus, Streptococcus and Enterococcus. While 25 (75.8%) were Gram-ve of diverse species. Thirty two (32) of the 151 isolates subjected to antibiotic susceptibility test were extremely resistant to both the convectional antibiotic discs and the E-tests strips. These resistant strains were further identified molecularly with their plasmid profile studied. This is of epidemiological significance and shows the necessity to sort alternative therapy for these multiple antibiotic resistant strains and improve our health management services. |
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77
Side Effect Driven Conversion to Belatacept for Kidney Transplant Recipients in a Clinical Setting
,
Elizabeth Cohen1 , Richard N Formica2 , and Ramesh K Batra3 *
Maintenance immunosuppression after kidney transplantation is critical to graft and patient survival. However, the optimal immunosuppressive medication may differ for patients based on adverse effects. Here we report one-year outcomes of 73 kidney transplant patients converted from tacrolimus to belatacept because of adverse effects at least 90 days after transplant. |
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78
Immunoglobulin Isotypes, C3 – C4 Complement Components, Absolute Eosinophils and Allergen Specific IgE as Biomarkers Correlated to Preschool Wheeze Children
,
Mohamed El-jwhri1 , Rashad Shawgi1 *, Abdulla Elmansoury2 and Ibtisam Kaziri3
Wheeze chest is a common problem among preschool children, and represents a common disorder characterized by airways obstruction. Almost half of children manifest wheeze chest symptoms before the age of six. Their parents report at least one attack within this period. This study aimed to assess the relationship between the immunoglobulin (IgA, IgM, IgG, and IgE), complement, and the level of eosinophils with children’s wheeze chest. Moreover, the level of IgE with the numbers of the attacks per year, age, family history, and eosinophilic count. A total number of a randomized (n=73) preschool children were involved in this study, divided into 2 groups, (n=52) patients with recurrent wheezy chest attacks and (n=21) controls. Samples were analyzed for immunoglobulin isotypes; complement C3, C4, Eosinophils, and specific IgE allergen test. Number of attacks were strongly correlated with IgE with a P-value of (P=0.001), as well as the manifestation with a P-value of (P=0.002), while age was weakly correlated with IgE with a P-value of (P=0.005). The other variables in this study were found to be insignificant, correlating with IgE. Regarding specific allergens, 20 different types were evaluated in patients who had elevated levels of IgE, and the findings were that all patients were not only allergic to 1 type but unlikely to many. Most definitely the majority of the cases shared Dermatophagoides Peter (8 patients) and Dermatophagoidesf ariaeni (7 patients) allergens and so the list goes descending in the number with 2 allergens were not found, Cladosporium herbarum and Penicillium notatum. |
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79
Plasmid Profiling of Antibiotic Resistant Organisms Isolated From Hospital Effluents Discharged Into Nworie River Imo State
,
Chiegboka Nneamaka Alice1 * and Ezeanowai Chikezie F2
The emergence of multiple antibiotics resistant in bacteria and the indiscriminate use of antibiotics contribute to the dissemination of resistant pathogen in the environment. Hospital effluents are potential sources of antibiotic resistant bacteria, which if released into the rivers leads to the contamination of the water by the resistant strains which are potential threat to human health as they might have direct access to man or transported from sea animals to man through food. Plasmids are major mechanism for the spread of antibiotic resistant gene in bacteria population. Plasmid profiling is one of the methods used to determine and characterize antibiotic resistance traits in bacteria. In this study, Samples were collected using sterile sample bottles at three different locations of Nworie River (Two Federal Medical Center and the third behind Umezuruike hospital) in Imo State. A total of eighteen isolates were screened for antibiotic susceptibility. The isolates were tested against ten (10) different antibiotics using the disc diffusion method. Eight (8) isolates were found to be resistant to at least five antibiotics. While the plasmid DNA were extracted using the TENS extraction method and separated by agarose gel electrophoresis. Four of the resistant strains had plasmid DNA. |
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80
In Silico Prediction of Multi-Epitopes Vaccine from the Fusion F Protein Against Respiratory Syncytial Virus
,
Marwa Karrar Hussein1 , Yassir A Almofti2 *, Khoubieb Ali Abd-elrahman3 , Mashair AA Nouri2 and Elsideeq EM Eltilib2
Respiratory Syncytial Virus (RSV) is the major cause of the lower respiratory tract illness (RTI) in the elderly and in immunocompromised patients and children under 5 years of age. The disease causes deaths of approximately 500 infants each year. Conventional vaccine against the disease demonstrated immunological pitfalls to enhance T-helper responses and developed non-neutralising antibodies. This study aimed to predict epitopes from the fusion F protein of SRV that elicit the immune system and acted as safer efficacious vaccine. A total of 199 strains of RSV were retrieved from the NCBI database. The immune epitope database analysis resources (IEDB) were used for epitopes prediction against B and T cells. The population coverage was also calculated for the proposed epitopes against the whole world. Only two epitopes (441-YVSNK-445 and 440-DYVS-443) successfully passed all B cell prediction tools and demonstrated higher score in Emini and Kolaskar and tongaonker software. Thus were proposed as B cells epitopes. For T cells, a total of 177 epitopes were found to interact with MHC-I alleles. Among them four epitopes (53-YTSVITIEL-61; 250-YMLTNSELL-258, 198-YIDKQLLPI-206, and 450-VSVGNTLYY-458) were proposed since they interacted with the highest number of alleles and the best binding affinity to MHC-1 alleles. Moreover, a total of 397 core epitopes were found to interact with MHC-П alleles. However, the best four core proposed epitopes that interacted with higher number of MHC-II alleles were 217-IETVIEFQQ-226; 250-YMLTNSELL-258; 477-FYDPLVFPS-485 and 505-FIRKSDELL-513. Strikingly the epitope 250-YMLTNSELL-258 successfully interacted with both MHC-1and MHC-П alleles. The population coverage was 48.61% and 99.64% for MHC-I and MHC-II epitopes, respectively, and 100% for all T cells epitopes. Taken together ten epitopes successfully proposed as vaccine candidate against RSV. In vivo and in vitro clinical trials studies are required to elucidate the effectiveness of these epitopes as vaccine. |
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81
Computational Prediction of Multi-Epitopes Vaccine from Envelope E Protein against Louping Ill Virus via Reverse Vaccinology
,
Khadiga Osman Yousif1 , Yassir A Almofti2 *, Khoubieb Ali Abd-elrahman3 , Mashair AA Nouri2 and Elsideeq EM Eltilib2
Louping ill disease is a zoonotic viral disease caused by louping ill virus in the genus Flavivirus. It belongs to the tick-borne flavivirus that is a part of the tick-borne encephalitis virus complex.The envelope E protein of louping ill virus is the major structural protein that plays an important role in membrane binding and inducing a protective immune response.The aim of the present study was to design multi epitopes vaccine from the envelope E glycoprotein against louping ill virus using immunoinformatic tools that elicited humoral and cellular immunity. Eighteen envelope E protein sequences were retrieved from NCBI and subjected to various immunoinformatics tools from IEDB to assess their conservancy, surface accessibility and antigenicity as promising epitopes against B cells. The binding affinity of the conserved predicted epitopes was analyzed against MHC-I and MHC-II alleles of the T cells. The predicted epitopes were further assessed for their population coverage. For B-cell 25, 18 and 12 epitopes were predicted as linear conserved epitopes, surface accessibility and antigenic respectively. However, nine epitopes overlapped all the B cell prediction tools. Among them three epitopes (205-TAEHLP-210,336-KPCR-339 and 349-SPDV-352) were proposed as B cell epitopes. For T cell, 75 epitopes were found to interact with MHC-I alleles. The epitopes 130-YVYDANKV-138and356-MLITPNPTI-364 were proposed as a peptide vaccine since they interacted with the highest number of MHC-1 alleles.Moreover a total of 195core epitopes were found to interact with MHC-II alleles. The core epitopes 130-YVYDANKV-138, 219-WFNDLALPW-227, 415-VIGEHAWDF-423 and 462-VALAWLGLN-470 interacted with higher number of MHC-II alleles and proposed as vaccine since they demonstrated high affinity to MHC-II alleles.The population coverage epitopes set for MHC-I and MHC-II alleles was 74.69% and 99.98%, respectively. While the epitopes set for all T cell, proposed epitopes was 100%. Nine epitopes were predicted eliciting B and T cells and proposed as vaccine candidates against louping ill virus. However, these proposed epitopes require clinical trials studies to ensure their efficacy as vaccine candidates. |
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82
Computational Analysis for Prediction of Multi Epitopes Vaccine against Blue Tongue Virus Serotype 4 from VP5 and VP7 Proteins
,
Marwa Abdelrahman1 , Yassir A Almofti2 *, Khoubieb Ali Abd-elrahman3 , Mashair AA Nouri2 and Elsideeq EM Eltilib2
Blue Tongue Disease (BTD) is a non-contagious insect transmitted disease of ruminants caused by double stranded RNA virus. This study aimed to predict an effective multi-epitopes vaccine against BTD from VP5 and VP7 as immunogenic proteins using immunoinformatic tools. The VP5 and VP7 proteins sequences were retrieved from GenBank of National Center for Biotechnology Information (NCBI). The sequences of each protein were aligned for conservancy using Bioedit software. Immune Epitope Database (IEDB) analysis resources were used to predict B and T cell epitopes. The proposed MHC-1 epitopes of both proteins were further subjected to molecular docking to show minimum binding energy of each epitopes. In our results, two epitopes (235-SEEV-235 and 85-PDPLSP-90) from VP5 and two epitopes (79-PISPDYTQ-86 and 297-PIFPPN-302) from VP7 were proposed as B cell epitopes since they were shown to be linear, surface accessible and antigenic epitopes. For T cells, MHC-1 binding prediction tools showed multiple epitopes strongly interacted with BoLA alleles from both VP5 and VP7. Among them three epitopes, (257-KLKKVINAL-265, 487-QMHILRGPL-495 and 350-VMMRFKIPR-358) fromVP5 protein and four epitopes (86-QHMATIGVL-94, 315-TLADVYTVL-323, 17-TLQEARIVL-25 and 10-TVMRACATL-18) from VP7 protein interacted with the highest number of alleles and demonstrated best binding affinity to MHC-1 alleles. Thus were proposed as a vaccine candidate from VP5 and VP7 proteins. All the epitopes from VP5 and VP7 that interacted with MHC-1 alleles when subjected to molecular docking against the sheep b_microglobulin alleles demonstrated biologically significant higher binding affinity which expressed by their lower global and attractive energy. In conclusion, eleven epitopes were predicted as promising vaccine candidates against BTD from the VP5 and VP7 immunogenic proteins. These epitopes require to be validated experimentally through in vitro and in vivo studies. |
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83
Autoimmune Disease, Deceptional vs Logical Matrices & Informational Fidelity
,
Alexandros Senarelis-Sinaris
The continuous interplay between concreteness & randomness, the incessant interchange of conceivable, perceivable, comprehensible with the unknown, the mysterious, the abstruse & the consequential fractals from which infinite geometrical nexuses of bonds, forms of connections, pathways & associations appear as mazy combinations in a single cluster of seconds, with the true values alongside the false values to get involved & entangled to alterate, exchange perpetually their bipolar products to emerged matrices of obscure data, in which their noisy action & omnidirectional behavior of the reverberating echo of the abstract result confuses, bias & warps into one the physio-logical with the abnormal, the real with the mirroring, the tangible with the imaginery, the rational with the aberrant, the conscious with the subconscious, the psyche with the somatic, developing as a result an unconscious field of causative potentiallity, a kymatic burst of unexplained interactions & interpretations, which swirl the embedded hidden elements of distortion & delusion, in the end this horrorous deceptive complicated morphoma comes as the ultimate form of abyssal functioning against the humble simplicity and substract expression of the luminous linear true path of taintless logic. |
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84
The Situation of Patients and the medical Health Care in Future
,
Elisabeth TM van der Gulik
New contributions to the development of health care give a different look to the place of the patient. It appears that the outcome of medical treatments may depend of the specific medical and physiological condition of the patient and even other kind of conditions outside the patient may contribute to the results of the whole of medical treatment. New entities as effectiveness, participation of the patient, ethics, technics, digitization, multidisciplinary approach of research and consultation, deliver a total different look to the way as to how health care has to be secured. New specializations in medical law, medical management, tend to be developed day by day. New specializations of medicine will bring more effectiveness in using medical procedures. For example, translational medicine tends to find the best effective way of setting up new treatments, new scientific investigations. The introduction of personalized, predictive and preventive medicine, the translational medicine and precision medicine will enhance the implementation of scientific findings. Every contribution in this development has to consider the effect to the result in the health care system. The importance of the condition of the patient remains always the leading motive. |
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85
Delving into Emotional Wounds, Addressing Them as Issues to be Solved, as One of the Reasons We Choose to be Incarnated: with Personal Research into their Origins
,
Audrey Yeardley
As we all begin our lives by walking on to the stage in Act One/Scene One; and into the kind of Drama that’s usually entitled on the lines of ‘My Life, ‘ I’m going to begin with something that David Lorimar (one of the founders of the Scientific & Medical Network) once said: that the Anecdotal has as much worth as any other evidence, in scientific research. I’m not sure who first said: “Nothing‘s ever happened, until it‘s happened to you,” but they got that right! |
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86
Using GH-Method: Math-Physical Medicine, Fourier Transform, and Frequency Segmentation Pattern Analysis to Investigate Relative Energy Associated with Glucose
,
Gerald C Hsu
This paper provides research findings on glucose created relative energy by using sensor collected glucose data from a period of 376 days from 5/5/2018 to 5/15/20. The dataset is provided by the author, who uses his own type 2 diabetes metabolic conditions control, as a case study via the “math-physical medicine” approach of a nontraditional methodology in medical research. |
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87
Lived Experiences of Individual Living with Human Immunodeficiency Virus Ages 18-30 in Dasmariñas City Cavite
,
Lourence L Castro* and Marielle P Gaitan
An undergraduate thesis presented to the faculty of College of Nursing, Cavite State University, Indang Cavite, in partial fulfillment of the requirements for the degree of Bachelor of Science in Nursing, with Contribution no. SP CON NO.__________. Prepared under the supervision of Dr. Evelyn M. Del Mundo. |
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88
Corneal Endotheliitis Associated with a Methicillin Resistant Pyogenic Liver Abscess
,
Christopher Schiefer1 , Samuel Asanad1 *, Benjamin Rubin2 , Wuqaas M Munir1 and Osamah J Saeedi1
Endotheliitis is the inflammation of the corneal endothelium resulting in edema and subsequent loss of vision. Bacterial causes of corneal inflammation primarily of the epithelium with subsequent, secondary involvement of the endothelium have previously been described. Notably, however, there are no reports of isolated endotheliitis related to a bacterial pathogen. We report, for the first time, a case of corneal endotheliitis associated with a pyogenic liver abscess caused by methicillin resistant Staphylococcus aureus (MRSA). Treatment targeting the underlying source of infection led to visual recovery in our patient. |
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89
Corneal Endotheliitis Associated with a Methicillin Resistant Pyogenic Liver Abscess
,
Christopher Schiefer1 , Samuel Asanad1 *, Benjamin Rubin2 , Wuqaas M Munir1 and Osamah J Saeedi1
Endotheliitis is the inflammation of the corneal endothelium resulting in edema and subsequent loss of vision. Bacterial causes of corneal inflammation primarily of the epithelium with subsequent, secondary involvement of the endothelium have previously been described. Notably, however, there are no reports of isolated endotheliitis related to a bacterial pathogen. We report, for the first time, a case of corneal endotheliitis associated with a pyogenic liver abscess caused by methicillin resistant Staphylococcus aureus (MRSA). Treatment targeting the underlying source of infection led to visual recovery in our patient. |
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90
Evolutive Immunologic and Toxicologic Approach in Some Neuroinflamatory and Degenerative Disease like SM, DA, PD
,
Luisetto M1 *, Akram Muhamad2 , Gaber Ibrahim3 , Behzad Nili Ahmadabadi4 , Farhan Ahmad Khan5 , Ahmed Yesvi Rafa6 and Oleg yurevich latish7
In order to better, understand some neurologic process is fundamental to use an evolutionary approach. Imaging can help in measuring efficiency of brains wasting system in the various subject. The brain glimphatic systems is well studied today but an accurate measure of the real efficiency of the system is needed. Aim of this work is to submit to the researcher a working method to measure this parameter to verify if possible to use the brain glymphatic system as new therapeutics strategy |
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91
Controlling Type 2 Diabetes via Artificial Intelligence Technology (GH-Method: Math-Physical Medicine)
,
Gerald C Hsu
In this paper, the author describes his methodology of developing an artificial intelligence (AI) based Glucometer to assist diabetes patients to control their glucose and HbA1C conditions. |
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92
Effective age resulting from Metabolic Changes
,
Gerald C Hsu
In this research note, the author reviewed his past 8-years data from 2012 through 2019 by focusing on the relationship between his metabolism and overall health conditions. He decided to write this paper regarding his “Effective Age” using the GH-Method: math-physical medicine approach. |
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93
Transplantation of Mesenchymal Stem Cells in Treating Patients with Severe COVID-19: A Systematic Review and Meta-Analysis
,
Attapon Cheepsattayakorn1,2* and Ruangrong Cheepsattayakorn3
The objective of the study is to perform a critical review, exploration, and strong summary of the roles of mesenchymal stem cell transplantation in treating various diseases, including COVID-19. A comprehensive search was carried out in mainstream bibliographic databases or Medical Subject Headings, including Scien Direct, PubMed, Scopus, ISI Web of Science, and websites of the news. The search was applied to the articles that were published between January 2020 and April 2020. Needed article information was extracted from each article by : 1) direct information including journal (research article, review article, meeting abstract, conference abstract, correspondence, author index, editorial board meeting abstract, discussion), book chapter, title, authors, abstract, full text documents of candidate studies, websites of the news, publishing year; 2) study period; 3) research (study) method used; 4) types of mesenchymal stem cells; and 5) types of human organ system disorder or disease studied. With strict literature search and screening processes, it yielded 6 articles from 76 articles of initial literature databases and websites of the news (January 2020 to April 2020). Anti-inflammatory and immunomodulatory properties of MSCs in the treatment of respiratory diseases were confirmed by at least 17 clinical studies and more than 70 clinical trials are registered in this issue that are available at: https:// www.clinicaltrials.gov. MSC transplantation improves the treatment outcome of COVID-19 patients may be due to controlling inflammatory response and promoting tissue regeneration and repair. In conclusion, Human MSCs are currently being evaluated as a stem cell treatment for a number of diseases, particularly severe COVID-19 and have been demonstrated to be safe in clinical trials. There are some promising reports to apply MSCs therapy to treat COVID-19. MSCs may possibly be one of the most ideal therapeutics, or a combination of treatment to treat patients with COVID-19. Nevertheless, further studies are urgently needed to investigate and optimize a number of variables in the human MSC culture environment by developing a bioprocess that can be operated in accordance with the Good Manufacturing Product (GMP). |
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94
A1C Variance Study and PPG Prediction Methodology over Six Periods Using GH-Method: Math-Physical Medicine
,
Gerald C Hsu
In this case study, the author analyzed, predicted, and interpreted a type 2 diabetes (T2D) patient’s hemoglobin A1C variances based on six periods data utilizing the GH-Method: math-physical medicine approach by applying mathematics, physics, engineering modeling, and computer science (big data analytics and AI). He believes in “prediction” and has developed five models, including metabolism index, weight, fasting plasma glucose (FPG), postprandial plasma glucose (PPG), and hemoglobin A1C. All prediction models have reached to 95% to 99% accuracy. His focus is on preventive medicine, especially on diabetes control via lifestyle management. |
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95
Building up fundamental strength to fight against COVID-19 for patients with chronic diseases and complications
,
Gerald C Hsu
Introduction This paper describes qualitatively and quantitatively the actions to protect some patients with chronic diseases and complications during this COVID-19 period. |
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96
Escaping Cytokine Storm for the Poor
,
Xu Chen
Since the Covid 19 broke out, people are all looking for the cure. Many people died from this fat al disease; and cytokine storm is one of the most dangerous complications. For some low-income people, they are not eligible to be tested for Covid; and they might not get the proper medical care. In these cases, self-care procedures, such as exercise, clear the airway, handwashing, wearing mask, taking meds on time, and proper diet become crucial in deciding the prognoses. This research is about a case study of a patient who is not eligible for a Covid 19 lab test; and how she dealt with a severe flu-like disease |
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97
Therapeutic Apheresis in Pediatrics with Neurological and Hematological Diseases
,
Rolf Bambauer*¹ and Ralf Schiel²
The advantages of therapeutic apheresis (TA) with hollow fiber membranes are a complete separation of the corpuscular components from the plasma and due to increased blood flow rate higher efficacy [1]. The use of therapeutic apheresis in pediatric patients, which increasing more and more, has always been restricted by technical difficulties and the low incidence of diseases requiring this kind of treatment. The development of new, more sophisticated membranes and new adsorption technologies allow the most selective separation of plasma components. TA has been successfully introduced in a variety of autoantibody-mediated diseases [2]. The updated information on immunology and molecular biology of different neurological and hematological diseases are discussed in relation to the rationale for apheresis therapy and its place in combination with other modern treatments. The different diseases can be treated by various apheresis methods. Pathogenetical aspects are demonstrated in these diseases, in which they are clarified. TA has been shown to effectively remove the autoantibodies from blood and lead to rapid clinical improvement. For the neurological and hematological diseases, which can be treated with TA, the guidelines of the Apheresis Application Committee (AAC) of the American Society for Apheresis (ASFA) are cited [3, 4]. |
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98
To Acu or not to Puncture?
,
Alexandros Senarelis-Sinaris
Even though acupuncture and its reputed role in Traditional Chinese Medicine appears as a true value in East & West, from heart’s “perspective” it feels really as a false value. Acupuncture behaves as a stressor. Its way of approaching the skin, and especially the sensitive mechanoreceptors, fits more in challenging the nociceptors (pain receptors), rather than any other kind of basic skin receptors, such as haptic-stretch-pressure & vibration. This kindling mechanism, this external source of algorithmical conglomerative stress onto the skin, and consequently to other biological systems of the organism which are connected/entangled with it from the embryological phase of the three germ layers, has inevitably a direct link with the autonomic nervous system; the hypothalamic-pituitary-adrenal (HPA) axis with cortisol production, and the sympathoadrenal medullary (SAM) axis which activate the sympathetic nervous system, which dedicates energy to more relevant bodily systems to acute adaptation to stress. The above-mentioned neurobiological mechanisms are the basic major systems that respond to stress, and by extension they can affect through it (stress caused by acupuncture) the immune system. |
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99
A Novel Link between Early Life Allergen Exposure and Neuroimmune Development in Children
,
Nataliya M Kushnir-Sukhov, MD
As COVID-19 unprecedented situation significantly increased the time families spend indoors, the awareness of unhealthy living conditions negatively impacting immune system and early neurodevelopment of children is of crucial importance. We retrospectively reviewed unrelated cases of the children with confirmed multiple indoor allergen sensitization due to prolonged exposure to unhealthy indoor environment with infestation and water damage, who, in addition to multiple health problems related to allergy and asthma, also developed neuroimmune complications and growth delay. Documented early in life atypical neurologic and behavioral changes were common in all cases. Clinical analysis did not establish other causative reason aside from prenatal and early life exposure to unhealthy living conditions. Alternaria Alternara and Penicillium/Aspergillus molds were found in all homes and sensitization was confirmed in all cases. Significant similarities in the symptoms recorded in all three families led us to a hypothesis that, likely, a significant level of the immune response to external immunogenic pathological stimulus such as mold spore protein, mycotoxin protein, dust mite protein, decay-related volatile particles (VOC) skewed a balance of the neuroimmune interactions, and further affected neuronal network establishment. As all children exhibited significant spectrum of the systemic inflammatory conditions early in life, coupled with inability to follow normal neurodevelopment, we hypothesize that an overwhelming activation of the aggressive immune mechanisms by the epigenetic factors led to glia activation, cytokine storm and break of tolerance. We hypothesize that developing immune system exhibited aggressive responses due to environmental danger signals; subsequently TH-1 or TH-2 switch enables multiple clinical syndromes development with atypical presentation due to the described novel mechanism. An increased due to the COVID-19 lock-down may increase an amount of exposure of vulnerable people to indoor biological particles and volatile organic compounds present in unhealthy buildings. It is of crucial importance to identify and remediate indoor exposure factors that can decrease immune protection, especially against infectious pathogens such as novel coronavirus. |
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100
HDFx and Methylated DNA; With Histones Upregulated in Macrophages/ Monocytes Derived From Animal Survivors Subjected to Traumatic, Endotoxin, and Hemorrhagic Shock: Importance of Epigenesis and Potential Reasons for Resistance to Bacterial, Fungal and Viral Infections
,
Burton M Altura1-5, Lee S. Mestel1 , Anthony Carella1 and Asefa Gebrewold1
Each year approximately 60,000 people die from hemorrhagic shock in the U.S.A. with about two million deaths worldwide [1]. Deaths from traumatic shock, worldwide, has been difficult to estimate, due to battles/wars in many countries, but is thought to be more than two million victims/year [1]. Many reasons for these large numbers of deaths are known [for review, see1], for example, inadequate therapeutic measures, unavailability of adequate blood/ plasma/fluid replacement, seeing the patient too late, and unavailability of trained ER personnel, among the major reasons [for recent review, see1]. Another predominant reason for large numbers of hemorrhagic and traumatic shock deaths is the risk of sepsis in many of these victims, resulting in septic shock having mortalities in excess of 40- 75%, depending upon locality, with the lower numbers in the U.S.A. Lastly, and most important is “natural resistance of the body to infectious microorganisms” (i.e, bacteria, funguses, viruses, parasitic organisms, etc.). What is responsible for “natural resistance” has been studied for more than 150 years. We know that the “innate” and “adaptive” immune systems are key elements in defense against infectious microorganisms [2, 3]. But, which elements of these systems make-up major aspects of “resistance” and “host defense” still remains to be worked out. Using starfish, more than 140 years ago, the pioneer/father of immunology, and Nobel Laureate, Elie Metchnikoff, believed that white blood cells and macrophages were key to host-defense [4]. He also believed the body develops molecules/substances, which are key to resistance to infectious microorganisms [4]. |
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101
HDFx, a Natural Biologic is Associated with Elevated DNA Methylation, Reduced DNA Oxidation and Telomerases Down-regulation in Macrophages and Monocytes Derived from Surviving Animals Subjected to Experimental Shock and Burns: Males vs. Females and Relation to Resistance Against Bacterial & Viral Infections
,
Burton M Altura1-6, Asefa Gebrewold1 , Lee S Mestel1 and Anthony Carella1
Circulatory shock and burns are significant and sustained states of hypoperfusion and lead to decreases in circulating blood volume combined with decreased tissue and organ oxygenation. This hypoperfusion state often causes sepsis resulting in a state of “multiple organ failure” [1-3]. Due to severe body burns, battle field casualties are most susceptible to the latter resulting in numerous loss of lives. |
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102
Investigation the importance of metabolism on body weight and glucose for 8.5 years using GH-Method: math-physical medicine (No. 300)
,
Gerald C Hsu
The author uses GH-method: math-physical medicine (MPM) approach to investigate three sets of correlation between: (1) Weight vs. Metabolism Index (2) Glucose vs. Metabolism Index (3) Weight vs. Glucose - Weight is measured in early mornings and Glucose consists of daily average glucose, including both fasting plasma glucose (FPG) and three postprandial plasma glucose (PPG). He utilized time-series analysis on both his “daily data” and his “annual data” for comparison. His selected study period was 8.5 years (3,124 days) from 1/1/2012 through 7/23/2020. The reason for this specific time period was due to his weight (M1) and glucose (M2) data collection starting on 1/1/2012 along with the calculation of his metabolism index (MI) values. It is clear that, through his sophisticated math-physical medicine of metabolism and then statistical method of time-series analysis, all of these three biomarkers, weight, glucose, and metabolism index are proven to be highly correlated to each other. The following order ranking of correlation coefficients remained to be true between daily data and annual data: M1&MI > M2&MI > M1&M2 Daily: 84% > 72% > 61% Annual: 91% > 81% > 67% In other words, if you manage your metabolism (4 medical conditions and 6 lifestyle details) by controlling your disease conditions and monitoring your lifestyle details, your body weight and glucose will reduce accordingly. The author’s analyses is based on his personal biomarkers of two million data within 8.5 years (3,124 days) has further proven a simple and clean conclusion that has already been observed by many clinical physicians and healthcare professionals from their patients. |
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103
Features of Pathogens, Epidemiology, and Diagnosis of COVID-19 and Reliable Suggestion: Aiming to Solve the Confusion in Clinical Practice
,
Yangyi Jin and Hequan Li*
In past several months, the worldwide outbreak of COVID-19 infection is unstoppable, which results in millions of people infected and thousands of people dead. However, there are still something controversial in the virus mechanism, the epidemiological feature and the diagnose criterion of COVID-19, while we also have some consensus. The structure of SARS-CoV-2, the pathogen of COVID-19, is roughly similar with other coronavirus such as SARS-CoV and bat-CoV, but by sequencing the amino acid, recombination of virus particles, and observation in Electron microscope, it is obvious to find the some slight difference between the protein of SARS-CoV-2 and others’. The spike protein of SARSCoV-2 has a stronger ability to binding ACE2 than SARS-CoV. The carrier of SARS-CoV-2 is just as other respiratory viruses, like droplet, aerosol and surface, and the fecal-oral transmission is proved to be an efficient pathway. In clinical practice, the elder and the patients with comorbidity are more susceptible to infection and have poorer prognosis, while pediatric patients is the very opposite of it. Nucleic acid test represented by RT-PCR is a helpful method for diagnose, yet it has weaknesses of false negative in suspicious patient and resurgence in discharge patient. Serological and immunological test, reported not suitable for diagnose alone in early period, can be another reliable method that benefit the accuracy of diagnosis criterion when combined with RT-PCR. |
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104
A simple formula based on postprandial plasma glucose prediction using 5,640 meals data via GH-Method: math-physical medicine (No. 301)
,
Gerald C Hsu
This article is based on the continuation of the author’s research work, a simple and practical, yet highly accurate postprandial plasma glucose (PPG) prediction formula for type 2 diabetes (T2D) patients. His methodology is the developed GH-Method: math-physical medicine (MPM) which has been utilized repeatedly in the past decade. The predicted PPG formula-based on the status of fasting plasma glucose (FPG), carbs/sugar intake amount, and postmeal walking steps are as follows: Predicted PPG = 0.97 * FPG + (carbs/sugar grams * 1.8) - (post-meal walking steps in thousand * 5) The conclusive results have the order of values m1 / m2 /m3 / prediction accuracy %. Case A: 1.8 / 5.0 / 0.97 / 99.8% Case B: 2.0 / 5.0 / 0.945 / 99.9% Case C: 2.2 / 5.0 / 0.92 / 99.9% Exercise is important, contributing ~3% higher than food, is easily achieved compared to the required knowledge of diet. As a result, the author spent four years to study food nutrition. Most T2D patients are seniors; therefore, he suggests that walking is the best form of exercise. However, the most difficult part of exercise is the behavior psychology related to the issue of “discipline and persistence”. T2D patients need to walk between 2,000 to 4,000 steps after each meal. The author walks an average of 4,300 steps after each meal. On the other hand, diet (carbs/sugar amount and nutritional balance) requires much more and deeper knowledge of food nutrition in order to control diabetes. Therefore, the author developed an AI-based tool to assist T2D patients. For non-tech patients, the following simple guidelines can assist with meal intake: Starchy food: Eat an amount half of your fist or hand at most Colorful vegetables: Eat an amount limited to one fist or hand. Green vegetables: Eat an amount limited to 2.5 fists or hands. Please note: you must combine two types of vegetable together in order to get the total intake limitation. The author highly recommends the patients to measure their FPG at least several times a quarter, in order to get a quarterly average FPG value. The other three PPG values can then utilize the formula-based predicted PPG to control their overall diabetes conditions. The described method mentioned above in regard to the predicted PPG formula along with the post-meal walking exercise and carbs/sugar intake amount can help patients control their diabetes without painful and troublesome fingerpiercing glucose measurements. The author has been measuring his glucoses for 8.5 years (3,126 days) with fingerpiercing glucose testing combined with his 10-years of diabetes research work. He hopes this article can provide useful guidelines to other diabetes patients to take back their lives from this dreadful chronic disease. |
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105
Vector(y) & Verticality for Victory -the Form of Good Health
,
Alexandros Senarelis-Sinaris
Vector (a quantity possessing both magnitude and direction, represented by an arrow the direction of which indicates the direction of the quantity and the length of which is proportional to the magnitude; such a quantity with the additional requirement that such quantities are to transform in a particular way under changes of the coordinate system). • Vectory (a Scandinavian company specialised in solutions incorporating inertial sensors). • Verticality (position at right angles to the horizon). |
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106
What is on a mouth’s mind?
,
Alexandros Senarelis-Sinaris
In time, the wrong choice of words, along with faulty behavioural settings (errors), can influence one’s emotional and physical responses negatively. |
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107
Can Cinnamon Spice Down Autoimmune Diseases?
,
Swarupa Pahan1 and Kalipada Pahan*1,2
Autoimmune diseases are one of the dreadful group of human diseases that have always been of keen interest to researchers. Due to complex and broad-spectrum nature, scientists are not yet able to pinpoint the pathogenesis of and delineate effective therapy against this group of diseases. However, it is becoming clear that a decrease in number and function of T regulatory cells (Treg), an increase in autoreactive Th1/Th17 cells and associated immunomodulation and inflammation participate in the pathogenesis of many autoimmune diseases. Cinnamon (Cinnamonum verum or Cinnamonum cassia) is a widely used natural spice and flavoring ingredient and its metabolite sodium benzoate (NaB) is a food-additive and FDA-approved drug against nonketotic hyperglycinemia (NKH) and urea cycle disorders (UCD). Recent studies indicate that cinnamon either in powder or extract form and NaB are capable of modulating different autoimmune pathways as well as protecting animals from different autoimmune disorders. Here, we have made an honest attempt to delineate such pieces of evidence with available anti-autoimmune mechanisms and analyze whether cinnamon supplements could be used to control the fury of autoimmune disorders. |
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108
Transcutaneous Vagus Nerve Stimulation is Associated with Lower Mechanical Ventilation and Mortality in COVID-19 Patients: An interim Safety Analysis
,
Patrick Nemechek
Objective: To evaluate the safety and efficacy of transcutaneous vagus nerve stimulation in preventing respiratory failure and improving survival in hospitalized COVID-19 patients. Design, Setting, and Participants: Interim analysis of an ongoing single-arm, uncontrolled open-label, observational trial to assess the transcutaneous vagus nerve stimulation (tVNS) in hospitalized SARS-CoV-2 infected subjects. Eligible subjects are 18 years old or older requiring hospitalization for COVID-19pneumonia. Results: The 25 subjects enrolled with a mean age of 52.2 (22-80). Mechanical ventilation was required in only 2 (8%) cases. One survived and 1 one died. Although 4 (16%) of the 25 hospitalized subjects died, only 1 (4%) was attributed to respiratory failure. Relative to other reported COVID-19 hospitalization outcomes data, our mortality rate of 16% (4 of 25) is lower than many other reported cohorts 10.2% – 50%. Only 8% (2 of 25) of subjects required mechanical ventilation comparing favorably to 7.4%-79% of subjects requiring mechanical ventilation in other cohorts. Adverse events associated with tVNS occurred in only 2 subjects (8%) and consisted of reversible oral paresthesia and orthostatic hypotension. Conclusion and Relevance: In this interim report of tVNS in COVID-19 pneumonia, patients had a low rate of adverse events, infrequent use of mechanical ventilation, and a high rate of survival. Several other studies have shown a wide range of in hospital mortality (14-50%) and the requirement of mechanical ventilation (7-79%). The interim analysis found the mortality rate and the frequency of mechanical ventilation to be less than almost all other large COVID-19 cohorts. Only mild and self-limiting adverse events tVNS occurred in 2 subjects highlighting the safety of vagus stimulation. The study is slated to enroll a minimum of 50 subjects. Trial Registration: ClinicalTrials.gov Identifier: NTC04379037 |
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109
From Coral to Coal
,
Alexandros Senarelis-Sinaris
From coral to coal. A course from life to decay; from fluid plasticity to sedimentary rigidity; from tropical reef polyps expansion to combustible oxidative free radicals reaction; from expression to suppression; from flourish to perish. All these contrasting dynamics, this vivid antithesis of an integer ecosystem to a compressed peat bog, this endless colorful miracle of delight to a blackish stratum shell of scorn, get to be defined by a single letter; an “r”. The reflection that stands in between and makes all the difference; the reflection that stands in between and as a pivotal criterion reverberates opposed conditions and qualities; the reflection that stands in between and as a sword decides and divides. Which way it will be: light or darkness, real or unreal, allostasis or allostatic load, neuroinflammation or neuroprotection, progressive neurodegeneration or cell control and communication, gamma synchrony or hyperexcitability, well-being or mind-body infirmity, is determined by a serious consideration and careful thought. The conceptual operation of inverting a system or event with respect to a plane. A level of existence and cogitation, or development in accordance with a vectoring, a direction, orientation and attention. And for all the above, the mind-eye mirror connection which perceives and interprets, and creates a neuronal abstract substrate of bound distinct circuits that form as a whole memory, undoubtedly holds the key |
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110
COVID-19 Perceptional Disparity Among Dental Practitioners in Tricity (Chandigarh, Panchkula and Mohali)
,
Sumit Garg1 , Shivani Gupta2 , Rajesh Kumar Gupta*3 and Preety Gupta4
Background: Coronavirus (SARS-CoV-2) made the headlines after its initial breakout in Wahan, China in December 2019. Viral by genome, lethal by nature, strongly contagious by character succeeded in making a new chapter in everyone’s life in a very short span making it a pandemic Objectives: The aim of this study was to assess perceptional disparity among dental practitioners regarding the Coronavirus Disease 2019 (COVID-2019) pandemic. Material and methods: A total of 300 participating dentists were randomly included in this cross sectional survey. A self structured, closed ended questionnaire was administered to each participant to record demographic and professional characteristics followed by their knowledge regarding corona virus. Statistical analysis was performed using SPSS Version 20 and Multivariable linear regression analysis was carried out Results: It was found that only 33.3% of the clinicians had high knowledge regarding corona virus and only 38.5% of the respondents know the correct incubation period. About 65 % of the practitioners did not know about the diagnostic test available for corona virus and only 4.3 % of them gained knowledge rom journals or print media The above responses indicate a low knowledge among the dental practitioners regarding corona virus. Conclusions: The knowledge and practice scores were found to be worrisome, which is important to combat COVID-19. They are advised to follow the Centers of Disease Control and Prevention (CDC) and World Health Organization (WHO) guidelines in their clinics, and sensitize their staff so that no stone is left unturned in defeating this pandemic. |
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111
Red Tide: Why a Biologic, HDFx, and Magnesium Could be used to allay Inflammatory and Lung Problems Caused by Algal Blooms: Hypothesis
,
Burton M Altura1-6
Over the past decade, there has been a growing concern over invasion of Florida Gulf Coastal Waters and beaches by several algal blooms created by “red tides”. These algal blooms create various toxins that pose high risks for marine life, livestock, birds, and humans [1, 2]. The algae become so numerous that they discolor gulf waters and beaches. Since the 1980’s, red tides have been seen in many countries throughout the globe (i.e., South America, Central America, Japan, caribbean, South Pacific regions, etc.). |
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112
What we learned from the Covid-19 Outbreak in 2020
,
Elisabeth van der Gulik
The onset of worldwide contamination of an unknown subject brought a lot of fear around the world. The first thought was that reducing of interpersonal distance and reduction of travelling would undermine contamination. Rather quickly the origin of the evil in the form of a Covid-19 virus became clearer after energetic investigation in only several weeks. Rapidly it has been decided that a vaccination would be helpful to attack the problem. |
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113
Cytokines: The Game Changer in Pathogenesis of Covid-19
,
P D Gupta
A small particle of the size about 100 micrometers (SARS-V2) has shaken the world. In some Covid-19 patients a severe immune reaction was found in which cells release too many cytokines into the blood too quickly. Cytokines are regulators of host responses to infection, immune responses, inflammation, and trauma. In addition, cytokines activate those cells, stimulating them to produce more cytokines. Normally, this feedback loop is kept in check by the body. Some cytokines act to make disease worse. Cytokine storms might explain why some people have a severe reaction to corona viruses while others only experience mild symptoms. They could also be the reason why younger people are less affected, as their immune systems are less developed and so produce lower levels of inflammation-driving cytokines. Since, in early 2020, Covid -19 became pandemic, globally multi-pronged research started to get rid of corona virus 2 (SARSCoV-2) [1, 2]. For such a task, it was necessary to understand the pathogenesis of covid-19, due to the fact that SARS-CoV-2, is new and its mechanism of action and its interrelationship with the human body organs is not fully known yet. Nevertheless, it is known that all viruses and bacteria when invade the body interact with the immune system, inflammation starts and if the immune system cannot get rid of the invaders, pathogenesis starts. |
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114
Low ASH1L Expression as Potential Diagnostic and Prognostic Biomarker for Renal Cell Carcinoma
,
Chaoxiang Lv1, 2#, Qiqi Zhang1 , Yuanguo Li2 , Mingwei Sima2, 3, Yiming Zhang4 , Yue Sun1, 2, Jinbiao Liu5* and Tiecheng Wang
As an important methyltransferase, ASH1L played main roles in cell differentiation, embryonic development and autoimmune response. It had been reported that its abnormal expression was closely related to the progression of some diseases. In the current study, we found that ASH1L was low expressed in renal cell carcinoma, and its low expression was positively correlated with tumor progression. Patients with low ASH1L expression had poor OS and RFS, and it had excellent clinical diagnostic value. Furthermore, lower ASH1L expression in dead than survival patients, and multivariate regression Cox analysis confirmed that low ASH1L expression was a predictor for poor prognosis of patients with renal cell carcinoma. Gene-set-enrichment-analysis showed that the DNA-repair, reactive-oxygen-species pathway and Myc-target V2 signaling were significantly enriched to the low ASH1L expression phenotype. Taking together, our findings demonstrated that the low ASH1L expression was likely to be useful as a promising prognostic indicator for renal cell carcinoma. |
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115
Is COVID-19 an Immune Complex Disease and are Billions Vaccinated Concomitantly Dosed with an Immunomodulatory Effector-Checkpoint Viral Mimetic Fc Receptor ?
,
Fred M Cowan* and Charles C Rories*
COVID-19 has often been presented as a hundred diseases of diverse systems and organs needing many specialist experts to study and treat each aspect of this vast scope of pathological complexity in isolation. Alternatively, over the preceding decades, the Merck Manual, numerous publications, and certain patents have described systemic antigen-antibody immune complex diseases caused by viral and other infections with diverse symptoms similar to those of COVID-19. COVID-19 and systemic immune complex disease also selectively impact the same risk groups. Although, immune complex has been identified at sites of COVID-19 pathology in several publications, a recent study reported the unexpected finding that circulating immune complex (CIC) is not elevated in sera or a good biomarker for COVID-19 pathology. |
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116
Study of Clinical-Pathological Discrepancies in Autopsies
,
Adriana Ubirajara Silva Petry*I and Adriana Vial RoeheII
Background: Autopsy is a traditional method in pathology for the study of diseases or injuries, being key to elucidate the cause of death. However, the number of autopsies has been decreasing progressively. Design and Context: Retrospective cross-sectional study to analyze the presence of discrepancy between clinical and pathological diagnoses as to the cause of death according to the Goldman criteria, verify the epidemiological profile of the main causes of death, and tabulate the number of procedures conducted annually. Method: Analyzing clinical records and autopsy reports from the Department of Pathology and Legal Medicine of the Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA) from 1963 to 2012 and performing statistical analysis on the data collected. Results: The predominant age group was of dead fetuses (30.6% of all cases). The main cause of death was infection (68.4% of diagnoses). After a peak in the early 1980s, there was a progressive drop in the rates of postmortem examination. In the 1990s, the average number of autopsies fell by 58% in relation to the previous decade, and the last decade of the Century registered a decrease of 80% as compared to the average of the 1980s. According to the Goldman criteria, there was discrepancy between ante- and postmortem diagnoses as to the cause of death in 26.2% of the cases. Conclusion: The rates of discrepancy between clinical diagnoses and autopsy findings regarding the cause of death remain high, even though medicine has become more and more advanced in technology. |
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117
Diagnostic Pattern of Adult Acute Leukemia in Benghazi Medical Center/ Libya
,
Hanan HUSSINI1 , Khalid ELMAHDI2 , Huda kutrani3 and Aisha NASEF*4,5
Objective: To study the demographic characters and diagnostic tools of acute leukemia among adults in Benghazi/ Libya. Patients and Method: A retrospective cross sectional analysis of 54 cases of AML and ALL was conducted at hematology department at Benghazi medical center (BMC) from January 2013 to December 2014. Demographic data, Complete Blood Picture (CBC), Peripheral Blood Film (PBF), Bone Marrow Aspiration (BMA), immunophenotyping as well as cytogenetic if applicable were evaluated. Result: Forty-two (77.8%) were diagnosed as AML and twelve (22.2%) as ALL. The median age for diagnosis of AML was 43 years. with male to female ratio 1.3:1 while for ALL the median age was 20 years, and male to female ratio was 2:1. Anemia was noted in (90.5%) and (100%) for AML and ALL, respectively. Thrombocytopenia was detected in (83%) for both types. Almost half of AML patients (47%) and (41%) of ALL cases presented with leukocytosis. Blasts were detected in more than two third (74%) of PBF of AML and (75%) in ALL patients. CD13 and CD33 and cyMPO were the most common positive myeloid presenting antigens. However, in ALL B-lymphoid markers CD10 and CD19 were the major positive antigens. Conclusion: AML was most common than ALL in adults, AML was common in middle age while ALL in young age group. Hematology departments require urgent improvement of diagnostic services in Libya in order to ensure good clinical management. |
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118
Stroke and Adverse Effects on The Immune and Cardiovascular Systems: The Danger of the Rise and Use of Psychedelic Drugs for Depression and PTSD
,
Burton M Altura1-6 and Bella T Altura1,3-6
Depression and post-traumatic stress disorder (PTSD), in the past two decades, has been a growing problem among adults and our youth. For hundreds, if not thousands of years, plant-based psychedelic drugs, such as psilocybin and peyote, have been utilized for medical purposes by numerous native tribal people As early as 1950, lysergic acid diethylamide (LSD), a synthetic mood-altering drug, a report was published that this drug and other psychedelics could be useful in the treatment of psychological and psychiatric problems [1]. Albert Hofmann, the Sandoz scientist who first synthesized LSD in 1938, years later, said that the mind-altering effects of psychedelic drugs are totally unpredictable [2]. Since these early days, numerous mood-altering drugs have been synthesized for potential treatment of depression and PTSD. |
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119
Stroke and Adverse Effects on The Immune and Cardiovascular Systems: The Danger of the Rise and Use of Psychedelic Drugs for Depression and PTSD
,
Burton M Altura1-6 and Bella T Altura1,3-6
Depression and post-traumatic stress disorder (PTSD), in the past two decades, has been a growing problem among adults and our youth. For hundreds, if not thousands of years, plant-based psychedelic drugs, such as psilocybin and peyote, have been utilized for medical purposes by numerous native tribal people As early as 1950, lysergic acid diethylamide (LSD), a synthetic mood-altering drug, a report was published that this drug and other psychedelics could be useful in the treatment of psychological and psychiatric problems [1]. Albert Hofmann, the Sandoz scientist who first synthesized LSD in 1938, years later, said that the mind-altering effects of psychedelic drugs are totally unpredictable [2]. Since these early days, numerous mood-altering drugs have been synthesized for potential treatment of depression and PTSD. |
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120
Tamoxifen for Five Years?
,
Xu Chen
Tamoxifen is an effective anti-cancer drug in breast cancer treatment. However, very few women could do the complete 5-year treatment due to the side effects of the medication. The irregular bleeding, osteoporosis, and hormonal imbalance symptoms always cut the time short. Since every woman is different in body weight, genetic compose, reproductive history, and personal habits, the treatment with tamoxifen should also be different. Moreover, since estrogen has the similar positive effects as Vitamin K2 in bone formation; tamoxifen, as a estrogen blocker, should be used with proper vitamin K2 supplement, to which, current medical world has not paid enough attention. |
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121
What Do All Autoimmune Diseases Have in Common?
,
Huang Wei Ling
Looking at the history of medicine, many therapies have been used, since ancient history, with the most diverse cultures, many doctors and great names were in the past but still exert great influence on our medicine. |
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122
Objectivity and Practice of Peripheral Blood Smear Examination for Childhood Anemia Diagnosis in Benghazi Children Hospital /Libya
,
Lubna S OSHIBI1 and Aisha NASEF2,3
Introduction: Anemia is a common disease in children. Peripheral Blood Smear (PBS) require effort and human resource. In this study, we will evaluate objectivity of PBS ordering practice in Benghazi Children Hospital/Libya. Method: A retrospective study of PBS reports of 318 child in 2015 was conducted. Data collected include cause of PBS request, along with other relevant demographic, clinical and laboratory details. Kappa statistic was used for analyzing degree of agreement of results between PBS and Complete Blood Count (CBC) in anemia diagnosis. Results: Our study showed that Hematologists and 88.7% by general pediatricians requested only 6.9% of PBS. Anemia was main cause of request in 36.2%. Only 33.7 % of OPD cases referred with suspect of anemia were revealed to be anemic upon PBS examination and 45.4 % referred with no suspect of anemia were revealed to be anemic upon examination in total study population, but not in Neonate. In 65.1%, there was an agreement between diagnosis of anemia by CBC and PBS. There was accordance of 76.6% between exclusion of anemia by CBC and PBS. Hypochromic microcytic anemia was diagnosed in 93 cases (29.2%), macrocytic anemia was diagnosed in 5%, and 65.7% were not anemic. Conclusions: PBS examination is none objectively ordered and over utilized by Pediatricians in outpatient settings and for routine practice with less yield. Establishing laboratory guidelines for improving utility of PBS, careful and complete justified requests, discussion with laboratory staff, and continuous auditing practice are noticeable needs in the Benghazi Children Hospital. |
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123
A Clinical Study on Pancytopenia in Pregnancy in Women of Rural Haryana
,
Jayati Nath1* and Krishna Sheth2
Pancytopenia is defined as reduction of all the three cellular elements of blood- resulting in anemia, leukopenia and thrombocytopenia. This clinical study was undertaken in a tertiary care medical college serving Gurugram district of Haryana, North India. 50 pregnant patients were found with pancytopenia, most were multigravidae, presented at term, commonest complaints being pain abdomen & leaking per vaginum, postpartum hemorrhage being the most commonly encountered complication. |
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124
Immunoregulatory Effects of Imuno TF® (transfer factors) on Th1/Th2/Th17/Treg Cytokines
,
Carlos Rocha Oliveira,1 Rodolfo de Paula Vieira,2,3,4 Anderson de Oliveira Ferreira,5 Any Elisa de Souza Schmidt Gonçalves6 and Hudson Polonini5,*
Transfer factors are known since 1955 due to their activities on the immune system. Although the reports on the effects on diverse immune mechanisms, their role on Th1, Th2, Th17 and Treg responses was still not described. In this sense, the present work focused on the evaluation of such immune responses. For that, human lymphocytes, and mice thymic, splenic and Peyer’s cells were stimulated with Lipopolysaccharides and Concanavalin A, and then treated with isolated transfer factors (Imuno TF®). The culture medium was harvested and the quantification of Th1 cytokines (IL-2 and IFN-γ), Th2 cytokines (IL-4, IL-5, and IL-13), Th17 cytokine (IL-17), Treg cytokine (IL-35), inflammatory cytokines (IL-6 and TNF-α), and antiinflammatory cytokine (IL-10) was performed, as well as the quantification of mRNA levels. Imuno TF® positively regulated Th1 cytokines, while decreased Th2 cytokines. It also increased levels of mRNA and secretion of the anti-inflammatory cytokine IL-10, whereas it reduced levels of mRNA and the secretion of pro-inflammatory cytokines IL-6 and TNF-α. Finally, it reversed the hypersecretion of IL-17 and did not promote significant changes in IL-35 secretion. This highlights the role of Imuno TF® in the regulation of the immune responses. |
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125
Pre-Solid-Organ-Transplant COVID-19 Vaccination
,
Attapon Cheepsattayakorn1,2*, Ruangrong Cheepsattayakorn3 and Porntep Siriwanarangsun1
Vaccine such as influenza vaccine, is administered in stable transplant recipients, although live attenuated virus vaccines are contraindicated, generally due to risk of disseminated infection [1, 2]. Neither efficacy, safety, nor durability are well known in transplant recipients due to exclusion of them from recent COVID-19 vaccine trials [1, 2]. Currently, there are no SARS-CoV-2 vaccine platforms using attenuated live virus approved in phase III trials. Nevertheless, if they are approved for use, concerns, including potential decrease in efficacy in immunocompromised patients, potential for vaccine-related allograft rejection, unknown durability of the immune response, and long-term safety data still exist. |
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126
Glyceryl Tribenzoate: A Food Additive with Unique Properties to Be a Substitute for Cinnamon
,
Swarupa Pahan1 , Sridevi Dasarathi2 and Kalipada Pahan*1,2
Cinnamon is a regularly used natural seasoning and flavouring material throughout the world for eras. Recent laboratory studies have demonstrated that oral cinnamon may be beneficial for different neuroinflammatory and neurodegenerative disorders such as multiple sclerosis (MS), Parkinson’s disease (PD), Alzheimer’s disease (AD), and Lewy body diseases (LBD). However, cinnamon’s certain limitations (e.g. unavailability of true Ceylon cinnamon throughout the world, impurities in ground cinnamon, etc.) have initiated an interest among researchers to find an alternate of cinnamon that can potentially deliver the same efficacy in the diseases mentioned above. Glyceryl tribenzoate (GTB) is a U.S. Food and Drug Administration (FDA)-approved flavoring ingredient that is used in food and food packaging industries. It has been found that similar to cinnamon, oral GTB is capable of upregulating regulatory T cells and suppressing the autoimmune disease process of experimental autoimmune encephalomyelitis, an animal model of MS. Moreover, both GTB and cinnamon metabolite sodium benzoate (NaB) have the potency to attenuate neurodegenerative pathology in a mouse model of Huntington disease (HD). Here, we have also demonstrated anti-inflammatory property of GTB in astrocytes and macrophages, a property that is also seen with cinnamon and its metabolite sodium benzoate (NaB). Therefore, here, we have made a sincere attempt to discuss the similarities and dissimilarities between cinnamon and GTB with a focus whether GTB has the potential to be considered as a substitute of cinnamon for neuroinflammatory and neurodegenerative disorders. |
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127
Impact of Corona Virus
,
Sudha Bansode
Coronaviruses are a group of related RNA viruses that cause diseases in mammals and birds. In humans and birds, they cause respiratory tract infections that can range from mild to lethal, mild illnesses in humans include some cases of the common cold (which is also caused by other viruses, predominantly rhinoviruses). While more lethal varieties can cause SARS, MERS, and COVID-19. In cows and pigs they cause diarrhea, while in mice they cause hepatitis and encephalomyelitis. Coronaviruses constitute the subfamily Orthocoronavirinae, in the family Coronaviridae, order Nidovirales, and realm Riboviria. They are enveloped viruses with a positive-sense single-stranded RNA genome and a nucleocapsid of helical symmetry. The genome size of coronaviruses ranges from approximately 26 to 32 kilobases, one of the largest among RNA viruses. They have characteristic club shaped spikes that project from their surface, which in electron micrographs create an image reminiscent of the solar corona, from which their name derives. |
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128
Anti-inflammatory Effect of the Peptide LKEKK
,
Elena V Navolotskaya1*, Vladimir B. Sadovnikov1 , Dmitry V Zinchenko1 , Vladimir P Zav’yalov2 , Arkady N Murashev1
We have established that the peptide LKEKK (Np5) corresponding to the sequence 16-20 of thymosin-α1 and to the sequence 131-135 of interferon-α2, in the concentration range 50 300 µg/ear reduces in a dose-dependent manner phorbol ester 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced skin edema in mice .Tested in parallel peptide with inverted sequence (iNp5, KKEKL, 150-300 µg/ear) was inactive, indicating high specificity of the Np5 action. In the concentration range of 5 20 µM Np5 significantly decrease the TNF-α-induced production by normal human keranocytes of pro-inflammatory mediators IL-6 and IL-1β. Thus, Np5t has a pronounced anti-inflammatory activity in vivo and in vitro. |
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129
Voriconazole is Less Effective than Other Triazoles for Treatment of Histoplasmosis
,
Melinda Smedema1 , Michelle Durkin1 , Heather Largura1 , Deborah Blue1 , Andrew Hanzlicek1 , Lawrence J Wheat1 and Chadi A Hage*2
Background: Voriconazole is used to treat patients with histoplasmosis who are intolerant to itraconazole because of potential drug interactions. Hendrix reported higher mortality in patients treated with voriconazole than itraconazole raising the question if the Histoplasma isolates became less susceptible to voriconazole during treatment in those who failed treatment. Methods: Primary and failure isolates from a patient who failed treatment with fluconazole were incubated with increasing concentrations of voriconazole. Results: In vitro exposure of the patient’s primary isolate to voriconazole increased its MIC from 0.007 mcg/mL to 1.0 mcg/ mL (128-fold). Exposure of the failure isolate increased the MIC from 0.125 mcg/mL to 4 mcg/mL (32-fold). Exposure to voriconazole did not increase the MIC of the primary isolate to itracunazole but did increase the MIC of the failure isolate from 0.007 to 0.030 mcg/mL (4-fold). Conclusion: In vitro exposure Histoplasma capsulatum increased MICs to voriconazole 32 to 128-fold which could be a cause of treatment failure reported by Hendrix. |
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130
Relationship Between Lifestyle in Relation to Food Quality, Food Quantity and Exercise Versus Estimated Risk Probabilities of Having 5 Metabolic Disorder Diseases Using 8 Pathologies of Metabolic Syndrome’s Intra-Cellular Pathways and Collected Data Over 6.5 Years Based on GH-Method: Math-Physical Medicine (No. 497)
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Gerald C Hsu
The author was a professionally trained mathematician, physicist and engineer. His view of health and medicine is similar to his past experience on designing a physical object such as a building structure or a working machine, which he calls an “object”. The object’s strength or its expected lifespan is similar to the health conditions and longevity of a human being based on the following three key factors: (1) The original strength of the object’s material which is similar to the genetic factors of a human body. Generally speaking, the genetic (not “epigenetic”) portion only contributes 15% to 30%, approximately 20% or less, of having various chronic diseases. (2) The quality of engineering design and construction or manufacturing of this object are similar to the fundamental influential causes, including lifestyle details, life-long bad habits, and environmental damaging factors on human health. Among the external causes, one category that has the most impact on health is food, particularly with processed foods causing the most damage. Therefore, he tries to exclude all kinds of processed foods from his own food category. (3) The object suffers from different operational problems due to external forces or impacts which are similar to various diseases affecting humans. After the object suffers from external forces or impacts such as an earthquake or hurricane, we must use some structural reinforcements to fix the problems or replace the malfunctioned parts of the machine. These engineering after-actions are similar to the medical “treatments” post-injury/infection provided to patients by doctors. The medical treatments include medication interventions (either oral drugs or biochemical injections), necessary surgeries or organ transplants, which are similar to the engineering repair of the damaged object. Nevertheless, all type of medical treatments bring some degree of traumatic effects on the human body. In addition, up to now, there are no medications which can cure chronic diseases induced by metabolic disorders. The different medications given to patients only suppress the symptoms of different chronic diseases and do not deal with the root causes. Therefore, they are not able to reverse, repair, or cure chronic diseases. |
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131
Investigation of Food and Relative Risk Probability of Having Five Different Diseases, Including Diabetes Using Collected Food Data Over A 6.5-Year Period Based on GHMethod: Math-Physical Medicine (No. 492)
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Gerald C Hsu
The author is a professionally trained mathematician, physicist and engineer. His view of health and medicine is similar to his past experience on designing a physical object, such as a building structure or a working machine, which he calls an “object”. The object’s strength or its expected lifespan is similar to the health conditions and longevity of a human being based on the following three key factors: (1) The original strength of the object’s material which is similar to the genetic factors of a human body. (2) The engineering design and site construction of this object are similar to the fundamental influential causes, including lifestyle details, life-long habits, and environmental factors, on the human health. Among those external causes, if the author has to pick up one category which has the most influence above of all that is the “food”. (3) The object endures different operational problems due to external forces or impacts which are similar to various diseases suffered by humans. After the object experiences external forces or impacts, we use some structural reinforcements to fix the building’s damaged cracks or replace the malfunctioned part of the machine. These engineering actions are similar to the “medical treatments” doctors provide patients. The medical treatments, including medication interventions (oral drugs or biochemical injections), necessary surgeries, or certain organ transplants are similar to the engineering repair of the damaged object. This article emphasizes the relationship between causes and results such as symptoms of diseases. It particularly addresses the inter-relationship of 5 selected diseases: cancers, cardiovascular diseases (CVD), chronic kidney diseases (CKD), diabetic retinopathy (DR), and type 2 diabetes (T2D), where the most important cause for most diseases is “food”. This food category in his study contains 25 defined elements include input data of food are collected via the developed iPhone APP. There are 5 elements for “Food Quantity”: breakfast amount, lunch amount, dinner amount, amount of between-meals snacks and fruits, and the average daily food consumption amount. In addition, there are 20 selected elements for “Food Quality” (see Figure 1). The combined Food score is the average value of both food quantity score and food quality score. |
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132
Effects of Histobulin (Immunoglobulin/Histamine Complex) on Depression and Anxiety in Chronic Urticaria: Psychiatric Manifestations or Psychiatric Comorbidities of Chronic Urticaria?: A Case Report
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Hyuk Soon Kim1 and Geunwoong Noh2*
Background: Psychiatric comorbidities of chronic urticaria (CU) have been reported and examined recently. The prevalence of mental disorders and emotional distress is high in patients with CU. This is a case report in which Histobulin was found to be effective for psychiatric manifestations in chronic spontaneous urticaria (CSU). Case Presentation: Three cases of CSU accompanying psychiatric manifestations (PMs) were treated with Histobulin. One patient with CSU with severe depression showed clinical changes in depressive symptoms in parallel to changes in allergic symptoms during treatment. Histobulin clearly improved not only CSU but also the accompanying PMs in one patient and slightly improved them in another patient. The PMs were not improved by an antihistamine (H1 blocker) in any case. Histobulin is effective not only for allergic manifestations (AMs) but also for PMs of CSU. Conclusions: PMs as well as AMs of CSU were improved by Histobulin therapy. PMs were suspected to be a part of the clinical manifestations in CSU, possibly through histamine-mediated mechanisms. These conditions were suggested to be ‘allergic psychiatric manifestations (APMs)’ or ‘histamine-mediated psychiatric manifestations (HPMs)’. Further study of PMs based on histamine-mediated mechanisms, including allergies, may be necessary. Accordingly, it should be clarified whether the PMs of CSU are a part of the clinical manifestations of CSU or are psychiatric comorbidities of CSU. |
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133
Investigation of Expected Longevity Using Medical Conditions and Lifestyle Details to Calculate A Female Patient’S Health Age Based on GH-Method: Math-Physical Medicine (No. 490)
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Gerald C Hsu
The author was a mathematician and an engineer. His view of longevity is similar to his past experience on designing and building a structure or a machine which he calls an “object”. The expected lifespan of an object is similar to the longevity of a human being based on the following three factors: (1) The availability of good and strong building materials that are similar to the genetic factors of a human body health conditions. (2) The engineering design and site construction of this object are similar to the lifestyle, life-long habits, and environmental factors which are related to the health of the human body. (3) The building’s damaged cracks or the machine’s malfunctioned parts under external forces are similar to the medical conditions and symptoms of disease in the human body. If the object suffers from operational problems due to external forces that is similar to the human body being affected by various diseases, then we can repair the object such as adopting the reinforcement of the building structural part or replacing the operational part of the machine. They are similar to the medical treatments including medication interventions, different surgeries, or organ transplants. Once the author understood the analogy and similarity between an engineering object and a human body, he can then distinguish the differences among genetic reason, lifestyle maintenance, disease control, and medical treatments. It is extremely difficult, almost impossible at present time, to change our genes because we cannot select our biological parents; however, we can focus on our daily lifestyle management to either prevent from having diseases or controlling the progression of existing diseases. |
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134
Mesenchymal stem cells-derived Extracellular Vesicles: A Promising COVID-19 Therapy?”
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Manoj Kumar*1, Aditya Saini1 , Sunil Hinduja2 and Sanjeev Bhoi3
Coronavirus disease 2019 (COVID-19) is a pandemic viral disease caused by severe acute respiratory syndrome coronavirus type-2 (SARS-CoV-2). Originated in Wuhan, China in December 2019, COVID-19 soon spread all around the world [1]. As per the WHO, till 4th August 2021, Globally, 200,174,883 confirmed cases of COVID-19, including 4,255,892 deaths and 3,984,596,440 vaccine doses have been administered [2]. |
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135
The Change in Health Biomarkers for Bodyweight and Glucoses Between the PreVirus Period and COVID-19 Period Based on GH-Method: Math-Physical Medicine (No. 468)
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Gerald C Hsu
This paper describes the author’s quantitative improvements on his weight and glucose resulting from lifestyle modifications. Special attention has been placed on both the pre-virus period from 5/5/2018 to 1/18/2020 (total 624 days with 1,934 meals and snacks) and the COVID-19 quarantined period from 1/19/2020 to 6/16/2021 (total 514 days with 1,536 meals). This article emphasizes on bodyweight, glucoses, and glucose fluctuations (GF) during the two compared periods. In general, his health conditions of weight and glucoses in the COVID-19 period (514 days) are better than his health conditions in the pre-virus period (624 days). The COVID-19 pandemic is more than 100 times worse than SARS that occurred in 2003, in terms of its spreading speed, fatality number, and emotional impact on the world population. People belonging to the “vulnerable” groups” such as the elderly, with existing chronic diseases and history of complications, require special attention to their health conditions and lifestyle management during this COVID-19 quarantine period. In this particular period, the author achieved better results on both his diabetes control and overall metabolism management. The knowledge and experience he has gained in the past 11 years of medical research and his developed metabolism index (MI) model along with his four diabetes prediction tools assisted him in many ways. During the quarantine period, he has stopped traveling and suffered no jet-lag, eating home-cooked meals, maintaining nutritional balance, continuing his daily walking exercise of 16,000 steps (~10.7 km or 6.7 miles each day), sleeping 7.2 hours each night, living a stressfree life, avoiding negative news of politics and the pandemic, and keeping a regular daily life routine. The author enjoys conducting medical research, which is his obsessive hobby, and does not need to make a living off his work. Therefore, he feels no pressure at all to continuously perform research over the past 11 years. As a result, he has actually turned the COVID-19 crisis into his health advantage! |
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136
Assessment of a Clinical Case for A Female Patient with Type 2 Diabetes Using the 2021 Consensus Report on Type 2 Diabetes Remission Discussions Sponsored by American Diabetes Association Based on GH-Method: math-physical medicine (No. 506)
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Gerald C Hsu
This 73-year-old female patient has suffered from type 2 diabetes (T2D), hypertension, and hyperlipidemua for over 20 years. She started taking Metformin in 1999 and ceased taking it on 1/7/2019. As of 4/3/2019, her HbA1C level was at 6.6%. Since 4/4/2019, she implemented a lifestyle management program which not only focuses on diet and exercise but also factors in sleep, stress, life routines and habits, as well as environmental factors. In this article, the author applies the final conclusions from the American Diabetes Association (ADA) 2021 consensus report regarding “T2D Remission”. For this clinical case, he analyzes the patient’s present conditions to determine if she satisfies the criteria of “T2D remission” or not. The defined criteria of “remission” include timespan of at least one year, HbA1C level less than 6.5%, fasting plasma glucose (FPG) level less than 126 mg/dL, and estimated HbA1C (eA1C) values based on the mean continuous glucose monitoring (CGM) glucose data less than 6.5%. In conclusion, according to the ADA 2021 consensus report, this female patient is in “remission” for T2D. In summary, over the past year from 9/5/2020 to 9/5/2021, her average lab-A1C is 6.3%, mean CGM FPG value is 102 mg/dL, and CGM eAG is 5.7%. First, the selected one year satisfies the timespan requirement cited in the 2021 consensus report. Her set of glucose data has been collected over ~3 years, after post-Metformin (started on 1/7/2019) and her initiation of lifestyle management program that began on 4/4/2019. Second, all of her A1C values, both lab-tested and CGM eA1C, are less than 6.5% and her mean CGM FPG level is less than 126 mg/dL. Finally, she keeps a regular routine with quarterly medical examinations to monitor various diabetes complications, including macrovascular, micro- vascular, neural, and hormonal systems. |
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137
Association between parvovirus B19 virus and childhood acute lymphoblastic leukemia: A cross-sectional study in Tehran; Iran
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Fahimeh Ehsanipour1 , Mohammad Faranoush2 , Samileh Noorbakhsh*3, Fattaneh Babaei4 and Azim Mehrvar5
Objective: The propose of study was to determine the viral load of Parvovirus B19 in children with proven acute lymphoblastic leukemia (ALL) Methods: A cross-sectional study designed in pediatric ward of Rasoul-e-Akram Hospital (educational, third referral) in Tehran, Iran (2015 – 2016). Sixty-nine children (mean age: 6.57 ± 4.25 years) in preservative phase of ALL selected. BMA had done, and the viral load for Parvovirus B19 determined by quantitative PCR. Results: Type of ALL was Pre B cell: 76.8%; Pro B cell: 14.5% and T-cell type: 7.8%. Low viral load determined in 18.8% (n=13); intermediate in 39.1% (n=27). High and very high viral load observed in 27.1% 15 (n=15) and 20.3% (n=1) of cases respectively. Viral load was related to Pro B cell type (p = 0.050) and lymphadenopathy (p = 0.040), but not related to gender (p = 0.350) and severity of ALL (p = 0.403); like hepatosplenomegaly, anemia, thrombocytopenia or need to transfusion. Conclusion: Parvovirus B19 is a common viral infection in young Iranian population. Near one-third of childbearing age, women in Iran are at risk for primary Parvovirus B19 infection. Here, to evaluate the possible role of parvovirus B19 Infection in the etiology of ALL, 42 % of ALL cases had high and very high viral load (21.7% and 20.3); the low or intermediate viral load is detectable in all cases. The viral load was related to Pro B cell type of ALL (p = 0.050) and the presence of lymphadenopathy. However, there is no relationship observed between Parvovirus B19 viral load and the severity of ALL and gender. It probably might be due to viral detection in the early stages of the ALL. |
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138
Factors, Contributing to Set up Effective Experimental Research
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Elisabeth van der Gulik
Imagine how to start a new research department and you will find many suggestions: how to find the right expertise, how to find investment, how to organise an effective research system. |
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139
A Prayer from a Vegan Doctor
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James A. Thompson, M.D.
Lord please save us from the poor choices of food we pile on our plates. We are often unaware of how it determines our fate. |
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140
Effect of Food Allergy among Patients Affected by Delta and Omicron Variants-A Case Study
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Swapan Banerjee1*, Saiya Pal2 and Pallab Bera3
Background: The variants of SARS-CoV-2 have been affecting people globally since 2020. The Delta variant, mainly in India and the omicron variant in multiple countries since Nov 2021, has infected millions of people; many died out of them. Amongst all factors, food allergy is one factor that also accelerates many infected people’s comorbidities and overall health status during the pandemic. Aims: The study aimed to assess the role of some common food allergies in Delta and Omicron infected people in the Indian population. Methods: The study was designed with 50 covid positive home-isolated patients (out of 62) infected by both the mentioned variants from April 2021 until 15th January 2022. However, they were not severely ill but had comorbidities such as diabetes, obesity, hepatomegaly, etc. After the negative test result, each participant was requested to attend a telephonic interview for 15 minutes. Further, they were offered free online diet consultation considering the fatigue and some allergic symptoms. ATLAS-Ti-9 software was used for the fundamental analysis. Results: Based on their self-referred serological allergy test (SAT), we found that 23 samples of milk (46%), 14 (28%) samples of citrus fruits, 12 (24%) patients were allergic due to mustard oil and other detections too based on the positive interpretation (+ to +++) of specific IgE (IU/ml). The patients were facing type-1 hypersensitivity but no other severe allergic issues. Conclusions: Food allergy accelerated respiratory syndromes and comorbidities, mainly among the infected (Delta and Omicron) patients who could also have a high chance of hypersensitivity due to some common ingesting allergens. |
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141
Secondary Adverse Effects of Anti- Vascular Endothelial Growth Factor Therapy in Choroidal Circulation Case Report
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Arturo Solís Herrera
Recent research has shown that abnormal production of vascular endothelial growth factor (VEGF) is an often finding in ocular pathologies involving neovascularization. The regulating factors that set the production of VEGF are not well understood, and only the presence of hypoxia in tissues is the most studied factor. But the regulation of oxygen levels in tissues is also not well elucidated, so therapies in this regard were not efficient. The availability of technology that allows to manufacture antibodies to the measure, allowed to design antibodies Anti VEGF. However, its therapeutic effects are far from what is expected because more is unknown than is known about VEGF. Therefore, its side effects as well as adverse effects are frequent, and even exceed its positive effects. The antiangiogenic effect of anti-VEGF antibodies is not selective, that is, it does not distinguish between normal vessels and neo-forming vessels. In this paper we report the adverse effects on the blood vessels of retinal and choroidal tissue of the intraocular application of anti-VEGF antibodies, and its impact on the form and function of these tissues. |
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142
Patience and Time, they will do it all
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Arjun Rangaraj, Archana Pradeep, Kishore Warrier, Samundeeswari Deepak, Vishal Paisal and Satyapal Rangaraj
Uveitis, intraocular inflammation of Uvea, is a major cause of blindness worldwide [1]. Depending on the site of inflammation, it is classified as anterior, intermediate, and posterior or pan uveitis, with anterior uveitis being the most common [2]. Children and Young People (CYP) may account for 33% of Uveitis [3]. The commonest associations with Uveitis in CYP are Juvenile Idiopathic Arthritis (JIA) and parasitic infections; 25% are idiopathic in nature [3, 4]. |
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143
The True Mechanisms Behind Immune Checkpoint Inhibitor Therapy for Cancer
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Kangla Tsung*, Zhang Xu, Zhanghui and Tanlun Research Participants Group
Immune Checkpoint Inhibitor (ICI) therapy is the most exciting development in cancer treatments in recent years. As of the end of 2021, more than a hundred of clinical trials have been carried out by several major drug makers and research hospitals all over the world just to explore the use of ICI antibodies in almost every type of cancer and under various clinical settings. These clinical trials have resulted waves of good news in every year’s major academic conferences and FDA approvals, and now ICI therapy is in the move to take over traditional therapy to become the major player in clinical management of cancer. On the other hand, most of these clinical trials have failed to show clear benefits in most cancer patients, and only few have been reported in public. In real-world clinical setting, ICI antibodies are being massively and sometimes abusively prescribed for almost every desperate situation with clear clinical benefit in only a few (<10%). Yet, the enthusiasm behind ICI therapy is not dampened by the massive clinical failure but has been growing. The reason for the consistent enthusiasm among clinicians and patients is the miracle-like clinical responses seen in some of the responders that even including late-stage hopeless cases. Every clinician wants to repeat this miracle in the next seemingly identical patient, and every patient and their family members want to believe that they are in line for that miracle. But the reality is disheartening in that clinicians do not see the predictable repeat of miracle-like responses in seemingly identical patients and most patients selecting ICI therapy as the last straw in life did not benefit from it, if not hurt by it. What then are the reasons that ICI therapy is so impressive when working and so unpredictable in responses? This review attempts to draw some mechanistic aspects based on our own experiences in ICI therapy and to come up with a different explanation for the unexplained clinical observations. The goal of this review is to alert the clinical field about the danger and irreversible damages that wrongly used ICI antibodies may cause, and at the same time to introduce some preliminary criteria to select proper patient for the benefits and to avoid the harms of ICI therapy |