International Journal of Applied and Basic Medical Research最新文献

Background: Zinc status is suboptimal, and requirements are known to be increased in human immunodeficiency virus (HIV) infected individuals. Some aspects of the association between zinc status and HIV disease severity in African children still constitute a knowledge gap.

Objectives: The objective of this study was to compare serum zinc levels with the disease severity in HIV infected Nigerian children.

Materials and methods: Fifty-three randomly selected HIV infected children attending pediatric anti-retroviral clinics in Ogbomosho, Nigeria, were studied. Data from their social demographics, the WHO disease stages and zinc levels were determined and analyzed to test associations.

Results: The mean age of the 53 participants was 9 ± 1.3 years with, male-to-female ratio of 2.1:1. Of the 53 children, 32 (60.4%), 13 (24.5%) and 8 (15.1%) were from WHO clinical stage I, II and III. Zinc levels in the subjects ranged from 0.017 to 3.18 ng/ml. Nine (17.0%) children had deficient zinc levels below 0.05 ng/ml. The mean serum zinc level was 1.959 (±0.95), 1.607 (±1.28), and 1.435 (±1.36).ng/ml in the subjects from WHO clinical HIV stage I, II and III, respectively. P = 0.05. Four (50.0%) of the 8 children with advanced HIV stages were zinc deficient compared with the 5 (20.0%) of the 40 in the nonadvanced HIV class, P < 0.01.

Conclusion: Zinc deficiency is a significant challenge of HIV infected children with advanced disease. Screening of children with advanced HIV disease for zinc deficiency should be routine, and deficiencies should be corrected.

Traditionally, competency-based assessment is a criterion-referenced assessment that should be continuous and frequent, with ample feedback opportunities. In this criterion-referenced assessment, the progress of a student is measured against a "set standard reference." As the objective of a competency-based medical curriculum (CBMC) is the acquisition of competencies by the learners, evidence must be available to "chart the learning curve" of the trainee during a training period. This evidence can be generated by ipsative assessments, which are sequentially conducted assessments in which the performance of a trainee in an assessment test is compared with his/her previous assessment test. These ipsative assessments provide opportunities to track the educational development of any individual trainee and help in self-assessment. Given the enormous potential of ipsative assessment in the individualized, longitudinal, and educational development of medical undergraduates and given that competency-based medical curricula and ipsative assessment are complementary to each other in many ways, it has been suggested that ipsative assessment must be a part of medical training programs. In this article, we provide a conceptual framework for incorporating ipsative assessment activities into the undergraduate CBMC.

Background: Pterygium is a common ocular surface disorder characterized by fibrovascular growth onto the cornea. Its pathogenesis is multifactorial, involving chronic inflammation, oxidative stress, and systemic factors.

Aim: To evaluate the associations between pterygium severity and systemic indicators including complete blood count (CBC), lipid profile, and random blood sugar (RBS).

Methods: A retrospective observational study was conducted. Records of patients with clinically diagnosed pterygium were reviewed. Sociodemographic, clinical, and laboratory data were analyzed across grades using Kruskal-Wallis, Chi-square, and Spearman correlation tests.

Results: Ninety-eight patients were included. The mean age was 40.8 ± 14.2 years. Grade II was the most common (41.8%), with nasal involvement predominating (88.8%). Most CBC indices did not vary significantly; however, eosinophil counts were lower in Grade IV (P = 0.04). Lipid parameters and RBS showed no significant differences. Hematocrit correlated negatively with disease severity (ρ = -0.212, P = 0.03).

Conclusion: While systemic parameters were largely comparable across grades, advanced pterygium was associated with reduced eosinophil counts and lower hematocrit, suggesting possible systemic inflammatory and oxidative stress mechanisms. Larger prospective studies are needed to validate their role as prognostic markers.

Background: Delayed gastric emptying (DGE) is the most common complication following palliative gastrojejunostomy (GJ) for gastric outlet obstruction. Whether roux-en-Y (RY) reconstruction offers a clinical edge over the loop configuration remains unclear.

Materials and methods: The prospective cohort study included 41 patients who received either RY (n = 19) or loop (n = 22) GJ. The main study endpoint consisted of composite DGE (ISGPS Grades A/B/C) within 30 days. The research used multivariable logistic regression to determine independent risk factors.

Results: DGE occurred in 22% overall, significantly less with RY (5%) than loop (36%; P = 0.024). RY remained protective after adjustment (adjusted odds ratio: 0.10; P = 0.053), while malignancy and male sex increased risk. Length of stay and serious morbidity were similar across groups.

Conclusions: RY-GJ may markedly reduce postoperative DGE without added morbidity. Despite promising findings, the small sample size and nonrandomized design warrant cautious interpretation. Further validation in randomized trials is needed before routine use.

Background: As a leading cause of global morbidity, myocardial infarction (MI) is a primary focus of medical research. The isoproterenol (ISO)-induced model of cardiac injury is a cornerstone of this work, providing a validated experimental system that simulates the human condition. This study investigated the cardioprotective potential of dapagliflozin (DAPA), a sodium-glucose cotransporter-2 (SGLT2) inhibitor, against ISO-induced myocardial injury in adult male rats.

Materials and methods: Thirty-two rats were divided into four groups; Control group, DAPA-only group: DAPA (1 mg/kg/day, orally, 14 days) + saline, ISO-only: Saline (orally, 14 days) + ISO (100 mg/kg/day, days 13-14) and fourth group, DAPA + ISO: pretreated with DAPA 1 mg/kg/day orally) for 14 days, followed by ISO 100 mg/kg, subcutaneously days 13-14. DAPA's protective effects against ISO-induced MI were evaluated by assessing cardiac damage by measuring serum biomarkers of heart injury while simultaneously evaluating oxidative stress through lipid peroxidation levels and antioxidant activity in cardiac tissue. Histopathological examination revealed structural changes in myocardial tissue, complemented by molecular analysis quantifying the expression of key apoptotic regulators.

Results: Biochemical analysis revealed that DAPA significantly reduced ISO-induced elevations in cardiac troponin-I, creatine kinase-MB, lactate dehydrogenase, and oxidative stress markers; malondialdehyde, superoxide dismutase, and reduced glutathione. DAPA also attenuated inflammatory cytokines: tumor necrosis factor-alpha and interleukin-6 (IL-6). Histopathological examination of heart tissues demonstrated that DAPA mitigated ISO-induced myocardial necrosis and inflammatory infiltration, preserving cardiac architecture. Moreover, DAPA downregulated the pro-apoptotic protein (Bax) expression and upregulated the anti-apoptotic protein (Bcl2) levels in the heart.

Conclusions: These findings suggest that DAPA exerts multimodal cardio-protection beyond its antidiabetic action, positioning it as a promising adjunct therapy for ischemic heart disease. Further clinical studies are warranted to validate its translational potential.

Purpose: The purpose of this study was to determine the effects of daily consumable dosage of garlic on type 2 diabetic male rats.

Materials and methods: Charles foster male rats were randomly divided into four groups: control group, obese, fed with high-fat diet (HFD), diabetic fed with HFD followed by intraperitoneal streptozotocin treatment-35 mg/kg body weight; and diabetic rats fed with garlic (60 mg/day). Anthropometric and blood parameters were measured at 7^th, 14^th, 21^st, and 28^th days.

Results: The food intake, water consumption, and body weight were significantly (P ≤ 0.05) reduced in the garlic-treated rats as compared to the diabetic rats on the 28^th day. After 28^th day, the levels of triglyceride and total cholesterol declined significantly (P ≤ 0.05), while high-density lipid levels increased in the garlic-treated group as compared to the diabetic group (P ≤ 0.05). Blood glucose levels were significantly reduced at 30 min and 120 min of oral glucose tolerance test in garlic garlic-treated group. The activity of superoxide dismutase, catalase (CAT), glutathione reductase, glutathione-S-transferase, and reduced glutathione (GSH) were significantly higher in the garlic-treated group compared to the diabetic group (P ≤ 0.05) on the 28^th day. Glutathione peroxidase activity and lipid peroxidase level were reduced in the garlic-treated group compared to the diabetic group (P ≤ 0.05).

Conclusions: Garlic reduced food and water intake, body weight, oxidative stress as well as improved lipid and glucose metabolism, suggesting its effectiveness for diabetes and overall metabolic health in a daily consumable diet.

Virtual autopsy is a significant innovation in the field of forensic medicine and medicolegal investigations. This systematic review aims to evaluate the accuracy and practical utility of virtual autopsy in medicolegal investigations. The Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were followed in the conduct of this systematic review. The literature search encompassed an extensive database including PubMed, ScienceDirect, Cochrane Library, and Google Scholar. Studies published from 2014 to 2024 were included in the analysis. The quality of the included studies was evaluated using the proper tools suited to the study design. The synthesis and analysis of data included a narrative summary of study characteristics, aims and objectives, techniques, and main findings of the study. Sample sizes in the selected studies ranged from 16 to 145 cases. The most common virtual autopsy techniques used were postmortem computed tomography (PMCT). Some studies used PMCT and conventional autopsy, while some studies used only PMCT, and a few studies applied combinations of PMCT and conventional autopsy, along with other techniques such as postmortem magnetic resonance, PMCT angiography, and traditional invasive autopsy to evaluate various conditions in medicolegal investigations. This systematic review concludes that virtual autopsy offers significant benefits, such as noninvasiveness and the ability to document findings digitally, but its limitations in differentiating ante mortem and postmortem changes, lack of tissue sampling, and challenges in soft tissue analysis restrict its ability to fully replace conventional autopsies.

Objectives: Environmental factors may influence Parkinson's disease (PD) severity and progression. This study investigated the impact of chronic fluoride exposure on the clinical characteristics and short-term progression of idiopathic PD (IPD) in a rural North Indian cohort.

Materials and methods: A prospective observational study enrolled 52 IPD patients from fluoride-endemic (n = 25) and nonendemic (n = 27) regions. Baseline assessments included demographics, disease severity through the movement disorder society unified Parkinson's disease rating scale (MDS-UPDRS), and cognitive function using the Hindi mental state examination (HMSE). Patients were followed for 6 months to evaluate clinical progression.

Results: At baseline, patients from fluoride-endemic areas had higher total MDS-UPDRS scores (68.2 ± 15.4 vs. 58.1 ± 14.3, P = 0.017), with significant differences in Part III motor scores (50.0 ± 10.4 vs. 42.5 ± 9.4, P = 0.008) and Part II activities of daily living (11.4 ± 4.0 vs. 9.4 ± 3.2, P = 0.05). During follow-up, the endemic group showed greater worsening in total MDS-UPDRS scores (4.0 ± 3.2 vs. 2.2 ± 3.0, P = 0.08) and a significant increase in nonmotor symptoms (Part I) compared to the nonendemic group (0.14 ± 0.36 vs. -0.40 ± 0.20, P = 0.036). Cognitive decline did not differ significantly.

Conclusion: Chronic fluoride exposure is associated with increased disease severity and may accelerate short-term progression in IPD. These findings highlight the potential role of environmental neurotoxins as modifiable factors influencing PD outcomes and underscore the need for targeted public health interventions in fluoride-endemic regions.

Background: Metabolic syndrome (MetS) encompasses a constellation of cardiometabolic risk factors, yet its phenotypic diversity remains underexplored.

Aim: The study aimed to identify sex-specific latent phenotypes of MetS using key clinical indicators and to evaluate their association with metabolic risk.

Materials and methods: We conducted a latent class analysis among 440 adults aged 20-55 years using five indicators - waist circumference, systolic and diastolic blood pressure (BP), high-density lipoprotein (HDL) cholesterol, and Homeostatic Model Assessment of Insulin Resistance (HOMA-IR). Sex-specific models and sensitivity analyses were used to assess measurement invariance and model robustness.

Results: A three-class model demonstrated optimal fit (lowest Bayesian Information Criterion, entropy ≥0.99). Class 1 (43%) was predominantly low-risk, with minimal abdominal obesity and no hypertension. Class 2 (23%) represented a hypertensive-adiposity phenotype, characterized by universal elevated waist circumference and systolic hypertension but moderate insulin resistance. Class 3 (35%) was marked by pronounced insulin resistance and dyslipidemia, with high HOMA-IR and triglycerides (TG) despite minimal hypertension. Sex-stratified models fit significantly better than pooled models (G ² = 130.4, P < 0.001), revealing differential indicator profiles - men showed higher low-HDL prevalence, whereas women exhibited greater diastolic load. Sensitivity analysis collapsing BP indicators confirmed class stability and preserved metabolic gradients. Bolck-Croon-Hagenaars - weighted analysis revealed a stepwise increase in fasting blood sugar and TG across classes.

Conclusion: Our findings highlight three robust cardiometabolic phenotypes with distinct sex-specific profiles. The hypertensive-adiposity and insulin-resistant classes suggest divergent risk pathways requiring tailored interventions. Even the low-risk group exhibited intermediate lipid elevation, supporting the need for universal lifestyle counseling alongside precision screening strategies.