International Journal of Applied and Basic Medical Research最新文献

Introduction: Hypospadias is a common congenital malformation, with proximal hypospadias occurring in 20% of cases and having a higher incidence of complications than distal hypospadias. Surgical reconstruction varies between single-stage and multi-stage procedures, with no consensus on the optimal approach.

Objectives: This study aimed to compare the outcomes of single-stage and staged repairs for proximal hypospadias in a lower middle-income country, focusing on complications, operative time, patient satisfaction, and overall surgical success.

Materials and methods: An ambispective observational study was conducted at King George's Medical University, Lucknow, from May 2014 to February 2020. Sixty patients with proximal penile hypospadias and chordee were selected (29 from previous medical records and 31 were enrolled prospectively) and divided into two groups of 30 each: single-stage reconstruction and staged repair. Data on demographics, follow-up duration, complications, reoperations, and satisfaction were collected. The Hypospadias Objective Scoring Evaluation (HOSE) system as well as cosmesis was used to assess outcomes at 6-week follow-up.

Results: The mean age was 3.8 years for single-stage and 4.5 years for staged repair, with no significant age difference (P = 0.725). The mean operating time was 90 min for single-stage and 210 min for staged repair. Complication rates, including meatal stenosis and urethral stricture, showed no significant differences. However, graft rejection occurred in four staged repair cases (P = 0.112). The staged repair group had higher reoperation rates (26.67% vs. 13.33%, P = 0.062) and longer hospital stays (26.47 vs. 13.87 days, P = 0.0001). Staged repair achieved better slit-like meatus shapes (83.3% vs. 60%, P = 0.021) and higher satisfaction with residual skin (P = 0.004). HOSE scores showed significant advantages for staged repair in the urinary stream (P = 0.048) and erection outcomes (P = 0.001).

Conclusion: Staged repair showed better cosmetic outcomes and satisfaction in specific areas but required more operative time and hospital stay. Single-stage reconstruction was more cost-effective and had fewer reoperations. The choice of procedure should consider patient-specific factors and resource availability.

Background: Autopsies often require determining the sex of unidentified corpses, particularly in cases of decomposition, mutilation, or mass disasters. Sternal bone measurements can be used in establishing the sex of unidentified corpses where the body is in advanced stages of putrefaction or in a mutilated condition.

Aim: This study focuses on the sternum, a robust bone aiding in anthropological sex and age determination, trying to provide precise data for sex identification in decomposed or mutilated bodies, and using digital imaging to eliminate subjectivity in manual autopsy measurements.

Materials and methods: It was a cross-sectional discriminant study done by analyzing 250 adult computed tomography (CT) scans, excluding those under 25 or over 80 and with sternal trauma or deformities. The study visually assessed normal thoracic skeletal anatomy in the CT chest. DICOM viewers obtained three-dimensional sternum images for measurements, and statistical analysis was done with SPSS software.

Results: Mean measurements, except the sternal index, were significantly higher in males. Mesosternal length showed the highest predictive power (females [73.4%] and males [76.2%]). Combining multiple parameters increased accuracy (females [75%], males [82.5%]).

Conclusion: This study thus concludes that sternal bone imaging is a valuable tool for sex determination. The seven parameters analyzed exhibit sexual dimorphism, with mesosternal length being the most accurate. These findings aid future sex determination in mass fatality incidents, explosions, or advanced decomposition. Importantly, this research provides specific data for the Indian population, addressing the need for diverse reference values.

Background: Depression affects millions globally, with existing treatments having many side effects. Withania somnifera (WS) shows potential as an antidepressant and neuroprotective agent, possibly by influencing brain-derived neurotrophic factor (BDNF)-related pathways.

Aim: This study evaluated the effect of WS alone and in combination with fluoxetine on neuritin, NARP, and BDNF Exon-III gene expression in the hippocampus of male Wistar rats subjected to chronic unpredictable mild stress (CUMS).

Materials and methods: Thirty male Wistar rats were divided into five groups (n = 6 each): normal group (NG), disease control (DC), standard treatment (ST), WS, and combination group of fluoxetine and WS (FW). Depression was induced using CUMS, except in the NG. The sucrose preference test confirmed depression at the end of 3^rd week and assessed treatment effects at the end of 7^th week. Gene expression in the hippocampus was analyzed through real-time PCR at the end of 7^th week.

Results: After 7 weeks, the ST, WS, and FW groups showed a significant increase in sucrose preference compared to the DC group. The ST and FW groups showed significant upregulation of all three genes selected in the present study. Comparison between NG and FW groups showed no significant difference in gene expression.

Conclusion: This study highlights the antidepressant effects of WS by demonstrating its effect on BDNF-associated gene expression. Fluoxetine combined with WS demonstrated additive effects which proves an adjuvant role of WS in the treatment of depression. Further studies involving human subjects are essential to validate the antidepressant effects of WS and its additive effects with fluoxetine.

Chondroid syringoma (CS) is a rare benign skin adnexal neoplasm. Its incidence is very low among all primary skin tumors. Diagnosing it clinically can be difficult as it closely resembles other benign salivary or adnexal neoplasms. Until now, only a few cases have been reported from the periorbital region. Clinically, it can be mistaken for epidermal cysts, but ectopic salivary glands are a close differential diagnosis. To diagnose it, a complete removal is usually required, followed by a histopathological examination. We present a unique case of a 45-year-old female patient with a CS in her right supraorbital ridge and review the pertinent literature.

Kounis or allergic vasospastic angina has been described after exposure to several foods, drugs, and insect bites and stings. Mast cell degranulation during a hypersensitivity allergic or anaphylactic reaction leads to inflammatory mediators causing coronary spasm and thrombosis. A 44-year-old female with no comorbidities presented with sweating, dizziness, rashes, chest tightness, and epigastric discomfort 1 h after oral amoxicillin clavulanate. Electrocardiogram (ECG) showed ST segment changes along with elevated troponin I. Suspecting Kounis syndrome, she was administered pheniramine maleate, hydrocortisone, and oral antiplatelets along with intravenous fluids. Chest tightness was better, and ECG improved in 60 min. Since systemic adrenaline was to be avoided for fear of coronary vasospasm, for airway edema, nebulized adrenaline was administered. She recovered completely and was discharged after 48 h. This case highlights coronary vasospasm during an ongoing allergic reaction and its management with antihistamines, steroids, and antiplatelet drugs. Nebulized adrenaline was safely given with ECG monitoring for airway edema.

Background and aim: In the liver, glucose appears to affect gene transcription. High blood sugar boosts bile acid (BA) synthesis and mRNA expression of the cholesterol-7α-hydroxylase (Cyp7a1) gene, a key BA regulator. Fenugreek, also known as Trigonella foenum-graecum (TFG), is one of the few recognized powerful herbs to have anti-diabetic properties. However, whether it has an interaction when given along with metformin (MET) is unclear.

Methodology: In the present study, we evaluated the effect of TFG alone and in combination with MET on random blood sugar (RBS) and Cyp7a1 gene expression in high fat diet and Streptozotocin (STZ; 30 mg/kg, i.p.)-induced diabetic male Wistar rats.

Results: The MET, TFG, and combination of MET + TFG (CBN) significantly lowered the RBS levels (P < 0.0001, P < 0.009, and P < 0.002) of diabetic rats. All groups upregulated Cyp7a1 expression. MET upregulated it by 4.8-fold, whereas the TFG and CBN groups upregulated it by a substantial amount of 50.2-fold and 50.4-fold, respectively.

Conclusion: This study has found that the administration of MET and TFG in combination may have an undesirable pharmacological interaction on blood glucose levels and BA synthesis. This information becomes critical for people who wish to take MET with TFG for ostensible better glucose management. It is advisable to avoid combining them. Moreover, the current investigation has proven Cyp7a1 to be an essential therapeutic target for both MET and TFG due to its involvement in both, BA synthesis and anti-diabetic effect.

Background: Spinal cord injury (SCI) results in severe physical impairments and significant lifestyle disruptions, including paralysis, increased dependence on caregivers, and a tendency toward social isolation. These challenges deeply affect the psychological health and overall quality of life (QOL) of those impacted, especially in younger patients. Investigating the psychological and QOL outcomes in individuals with stable SCIs is crucial for developing tailored rehabilitation strategies.

Aim: The study aimed to investigate the psychological health and QOL in patients with stable SCIs.

Materials and methods: This observational cross-sectional study involved patients with stable traumatic SCIs recruited through WhatsApp support groups from two major centers in India. Eligible participants were adults who were at least 1-year postinjury. Those with severe head injuries or nontraumatic spinal injuries were excluded. Participants provided sociodemographic information and injury history and completed assessments evaluating psychological health and QOL. Data were analyzed using IBM SPSS software, and statistical significance was determined through Chi-square tests.

Results: Psychological distress was identified in 26.2% of the participants. Younger participants exhibited significantly poorer QOL in the psychological domain (P = 0.02). Employment status showed a significant association with the physical domain (P = 0.037) and overall QOL scores (P = 0.046). Socioeconomic status was significantly correlated with both the psychological (P = 0.004) and social domains (P = 0.009).

Conclusions: The study underscores the considerable impact of SCI on psychological health and overall QOL, with younger individuals disproportionately affected. Healthcare providers should prioritize the integration of psychological support and counseling in SCI rehabilitation programs.

Background: ROS1, a proto-oncogene, drives cancer through chromosomal fusions. The G2032R and D2033N mutations, common in ROS1-rearranged non-small cell lung cancer, hinder crizotinib treatment. We investigate these mutations' impact on ROS1 structure through molecular dynamics (MD) simulations, revealing destabilization. Our findings shed light on how these mutations contribute to cancer development.

Materials and methods: The crystal structure of human ROS1 (PDB ID: 7z5x) served as the template for homology modeling and further mutation insertion of G2032R and D2033N substitutions introduced using Swiss-PdbViewer. The MD simulations were conducted on the wild-type (WT) and mutant ROS1 kinase domains to explore the structural changes and interactions.

Results: The initial model of the human ROS1 crystal structure was constructed, incorporating missing loop residues and then utilized for the MD simulation studies. The examination of conformational changes in WT, G2032R, and D2033N mutant ROS1 proteins involved observing alterations in the C-alpha protein. We observed that the mutations resulted in deviations in the MD trajectory over the 500 ns period. Consequently, the MD simulations unveiled significant conformational changes induced by the G2032R and D2033N mutations, affecting protein stability and dynamics, particularly in regions such as the ATP binding and active sites.

Conclusion: Our study constructed an initial model of the human ROS1 and used it for MD simulation studies to examine the conformational changes in ROS1 mutants. Notably, our observations revealed that the mutations caused deviations in the MD trajectory. The G2032R and D2033N mutations significantly alter ROS1 structure, affecting its stability and dynamics, offering key insights into their role in cancer disease development.

Introduction: Rheumatoid arthritis (RA) is a systemic, chronic, and inflammatory autoimmune disease with a strong genetic component. ARL15 gene variant rs255758 has been reported as a candidate for RA susceptibility. A replication study was performed on this variant by taking 188 RA cases and 310 healthy non-RA controls from northwest India in a case-control association study design.

Materials and methods: DNA isolated from collected blood samples was analyzed by genotyping of the variant on real-time polymerase chain reaction using TaqMan Allele Discrimination Assay and statistically analyzed.

Results: The variant was found to follow Hardy-Weinberg Equilibrium (P = 0.079) in the control group. The variant was significantly associated with RA susceptibility in the present studied population cohort (P = 0.024) with C as a risk allele and increased risk in the recessive model (CC vs. CA + AA; P = 0.004).

Conclusion: The present study corroborates the earlier findings on the role of ARL15 gene variant rs255758 in RA and further contributes to its genetic etiology.