Background: Thyroid nodule is a common clinical finding and may be associated with a 5%–7% risk for malignancy. Methods for the detection of malignancy had their own drawbacks, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) may give a promising result to solve this dilemma. The Aim of the Study: This study aims to evaluate NLR and PLR as predictors of malignancy in solitary thyroid nodules. Also, to estimate their effect on tumor size, lymph node metastasis, and extrathyroidal extension. Patient and Methods: Prospective cohort study conducted at Major Teaching Hospital over a period of 1 year. Patients with solitary thyroid nodules were included in the study and according to histopathological results divided into two groups (A: Malignant and B: Benign), blood samples were drawn from participants, and measurement of lymphocyte, neutrophil, platelet, NLR, and PLR was done. Results: Both NLR and PLR were higher in cases of malignancy with a cutoff point for NLR >2.9 associated with 84.8% sensitivity (SN) and 71.4% specificity (SP), while PLR >140.15 associated with 87.9% SN and 71.4% SP. High NLR is further associated with larger tumor size. Conclusion: Both NLR and PLR are good predictors of malignancy of thyroid nodules. NLR of more than 2.9 is associated with larger-size tumors.
{"title":"The role of neutrophil to lymphocyte and platelet to lymphocyte ratios in diagnosing thyroid nodule","authors":"Haider Mihson, Ayad Maikhan, Ali Shuwelif","doi":"10.4103/mj.mj_46_22","DOIUrl":"https://doi.org/10.4103/mj.mj_46_22","url":null,"abstract":"Background: Thyroid nodule is a common clinical finding and may be associated with a 5%–7% risk for malignancy. Methods for the detection of malignancy had their own drawbacks, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) may give a promising result to solve this dilemma. The Aim of the Study: This study aims to evaluate NLR and PLR as predictors of malignancy in solitary thyroid nodules. Also, to estimate their effect on tumor size, lymph node metastasis, and extrathyroidal extension. Patient and Methods: Prospective cohort study conducted at Major Teaching Hospital over a period of 1 year. Patients with solitary thyroid nodules were included in the study and according to histopathological results divided into two groups (A: Malignant and B: Benign), blood samples were drawn from participants, and measurement of lymphocyte, neutrophil, platelet, NLR, and PLR was done. Results: Both NLR and PLR were higher in cases of malignancy with a cutoff point for NLR >2.9 associated with 84.8% sensitivity (SN) and 71.4% specificity (SP), while PLR >140.15 associated with 87.9% SN and 71.4% SP. High NLR is further associated with larger tumor size. Conclusion: Both NLR and PLR are good predictors of malignancy of thyroid nodules. NLR of more than 2.9 is associated with larger-size tumors.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45083701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Gallstone disease (GSD) is one of the most common surgical gastrointestinal diseases. Cholesterol is one of the constituents of gallstones. Hyperlipidemia and GSD are often linked to cholesterol in pathophysiology, and cholecystectomy is associated with hepatobiliary circulation affecting fat absorption. The aim of the study is to assess the lipid profile (LP) changes after laparoscopic cholecystectomy (LC). Methods: Prospective cohort study that included 200 patients with documented GSD and baseline measurement of LP, followed by LC for half of them, and two follow-up measurements of LP after 2 weeks and 1 month. Comparison of the LP between the two groups to estimate the difference that occur due to LC, after that, comparison of the two follow-up measurements with baseline to estimate the effect of these changes with time. Results: Total serum cholesterol (TC) and triglyceride level (TG) were significantly lower from control 1 month after surgery; on pairwise analysis, TG level was lower than baseline on both 2-week and 1-month follow-up measurements. High-density lipoprotein (HDL) was higher than the control after 1 month, on pairwise analysis at 2 weeks, no difference from baseline was found, and a significant difference was found after 1 month. Both low-density lipoprotein (LDL) and very LDL (VLDL) were not different from the control. Conclusion: LC is associated with a reduction of the serum level of both TC and TG and an increase serum level of HDL after 1 month of follow-up.
{"title":"The effect of laparoscopic cholecystectomy on lipid profile","authors":"Ali Shuwelif, Haider Mihson, Ayad Maikhan","doi":"10.4103/mj.mj_45_22","DOIUrl":"https://doi.org/10.4103/mj.mj_45_22","url":null,"abstract":"Background: Gallstone disease (GSD) is one of the most common surgical gastrointestinal diseases. Cholesterol is one of the constituents of gallstones. Hyperlipidemia and GSD are often linked to cholesterol in pathophysiology, and cholecystectomy is associated with hepatobiliary circulation affecting fat absorption. The aim of the study is to assess the lipid profile (LP) changes after laparoscopic cholecystectomy (LC). Methods: Prospective cohort study that included 200 patients with documented GSD and baseline measurement of LP, followed by LC for half of them, and two follow-up measurements of LP after 2 weeks and 1 month. Comparison of the LP between the two groups to estimate the difference that occur due to LC, after that, comparison of the two follow-up measurements with baseline to estimate the effect of these changes with time. Results: Total serum cholesterol (TC) and triglyceride level (TG) were significantly lower from control 1 month after surgery; on pairwise analysis, TG level was lower than baseline on both 2-week and 1-month follow-up measurements. High-density lipoprotein (HDL) was higher than the control after 1 month, on pairwise analysis at 2 weeks, no difference from baseline was found, and a significant difference was found after 1 month. Both low-density lipoprotein (LDL) and very LDL (VLDL) were not different from the control. Conclusion: LC is associated with a reduction of the serum level of both TC and TG and an increase serum level of HDL after 1 month of follow-up.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43116581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute invasive fungal sinusitis (AIFS) is an uncommon and usually life-threatening clinical condition. Mortality in AIFS is very high. The colonization of the fungi at the sinonasal tract does not indicate the infection. The status of the immune condition of the patient plays an integral part in different manifestations of AIFS. AISF is an aggressive type of fungal infection and often leads to a fatal situation, particularly in patients who are immunocompromised. Diagnostic nasal endoscopy, as well as a computed tomography scan, is warranted in these patients. Magnetic resonance imaging improves diagnostic accuracy and assesses the spread of the disease into orbit and the brain. Histopathological and microbiological examinations confirm the diagnosis. To save lives, early diagnosis and treatment are essential. Therefore, clinicians need to have a high level of suspicion for this illness. Management of AIFS requires a multidisciplinary approach with significant predictors of survival being surgical debridement and antifungal treatment. Patients require urgent hospitalizations with intravenous antifungal therapy and surgical debridement. As soon as AIFS is identified, antifungal medication should begin. Higher survival rates are achieved with complete endoscopic resection of the disease than with incomplete resection. Liposomal amphotericin B has a more favorable outcome and fewer side effects than amphotericin B. The mainstays of AIFS management continue to be early surgical debridement and antifungal treatment. This review article discusses the epidemiology, etiopathogenesis, clinical features, investigations, and current treatment options of AIFS.
{"title":"Management of acute invasive fungal sinusitis","authors":"S. Swain","doi":"10.4103/mj.mj_42_22","DOIUrl":"https://doi.org/10.4103/mj.mj_42_22","url":null,"abstract":"Acute invasive fungal sinusitis (AIFS) is an uncommon and usually life-threatening clinical condition. Mortality in AIFS is very high. The colonization of the fungi at the sinonasal tract does not indicate the infection. The status of the immune condition of the patient plays an integral part in different manifestations of AIFS. AISF is an aggressive type of fungal infection and often leads to a fatal situation, particularly in patients who are immunocompromised. Diagnostic nasal endoscopy, as well as a computed tomography scan, is warranted in these patients. Magnetic resonance imaging improves diagnostic accuracy and assesses the spread of the disease into orbit and the brain. Histopathological and microbiological examinations confirm the diagnosis. To save lives, early diagnosis and treatment are essential. Therefore, clinicians need to have a high level of suspicion for this illness. Management of AIFS requires a multidisciplinary approach with significant predictors of survival being surgical debridement and antifungal treatment. Patients require urgent hospitalizations with intravenous antifungal therapy and surgical debridement. As soon as AIFS is identified, antifungal medication should begin. Higher survival rates are achieved with complete endoscopic resection of the disease than with incomplete resection. Liposomal amphotericin B has a more favorable outcome and fewer side effects than amphotericin B. The mainstays of AIFS management continue to be early surgical debridement and antifungal treatment. This review article discusses the epidemiology, etiopathogenesis, clinical features, investigations, and current treatment options of AIFS.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44806108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Tinnitus is a common otologic symptom found in the outpatient department of otolaryngology. Patients with COVID-19 infection have complained of tinnitus. However, in the present COVID-19 epidemic, it has received little attention. Objective: The goal of this study was to see how common tinnitus was among COVID-19 patients in a tertiary care teaching hospital. Materials and Methods: This is a prospective study that looked at 28 COVID-19 participants who had tinnitus. COVID-19 infection was confirmed in all of them using a nasopharyngeal swab reverse transcription–polymerase chain reaction (RT-PCR). The detailed history-taking clinical examination of the ear was done for the assessment of tinnitus and its outcome was analyzed. Results: There were 28 COVID-19 patients presented with tinnitus out of 212 patients infected with severe acute respiratory syndrome coronavirus-2. There were 16 (57.14%) men and 12 (42.85%) women out of 28 COVID-19 patients with tinnitus, with a male-to-female ratio of 1.33:1. Seven (25%) of the 28 patients had hearing loss, whereas 4 (14.28%) had balance issues. Out of 28 patients, 5 (17.85%) had symptoms of migraine. Conclusion: This study shows that COVID-19 patients may be affected by subjective otoneurological symptoms like tinnitus. Tinnitus is more common in male COVID-19 patients than in female. The associated symptoms of hearing impairment and balance issues should be anticipated along with tinnitus. More research is needed to figure out the specific pathophysiological process that causes this subjective ringing sensation in COVID-19 patients.
{"title":"Tinnitus in COVID-19 patients: Our experiences at an eastern Indian tertiary care teaching hospital","authors":"S. Swain, Somadatta Das","doi":"10.4103/mj.mj_3_22","DOIUrl":"https://doi.org/10.4103/mj.mj_3_22","url":null,"abstract":"Background: Tinnitus is a common otologic symptom found in the outpatient department of otolaryngology. Patients with COVID-19 infection have complained of tinnitus. However, in the present COVID-19 epidemic, it has received little attention. Objective: The goal of this study was to see how common tinnitus was among COVID-19 patients in a tertiary care teaching hospital. Materials and Methods: This is a prospective study that looked at 28 COVID-19 participants who had tinnitus. COVID-19 infection was confirmed in all of them using a nasopharyngeal swab reverse transcription–polymerase chain reaction (RT-PCR). The detailed history-taking clinical examination of the ear was done for the assessment of tinnitus and its outcome was analyzed. Results: There were 28 COVID-19 patients presented with tinnitus out of 212 patients infected with severe acute respiratory syndrome coronavirus-2. There were 16 (57.14%) men and 12 (42.85%) women out of 28 COVID-19 patients with tinnitus, with a male-to-female ratio of 1.33:1. Seven (25%) of the 28 patients had hearing loss, whereas 4 (14.28%) had balance issues. Out of 28 patients, 5 (17.85%) had symptoms of migraine. Conclusion: This study shows that COVID-19 patients may be affected by subjective otoneurological symptoms like tinnitus. Tinnitus is more common in male COVID-19 patients than in female. The associated symptoms of hearing impairment and balance issues should be anticipated along with tinnitus. More research is needed to figure out the specific pathophysiological process that causes this subjective ringing sensation in COVID-19 patients.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45976265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Diagnosis of bowel injury may be considered one of the difficulties in penetrating abdominal trauma. Aim of the Study: The aim of this study is to estimate the predictive ability of procalcitonin in diagnosing bowel injury in multiply injured patients. Patient and Methods: In a cross-sectional study at the Emergency Department of Al-Kindy teaching hospital over 1 year, patients were had penetrating abdominal trauma, and measurement of procalcitonin to all participants to estimate its predictive ability. Results: Procalcitonin was found to be a single independent predictor of bowel perforation with sensitivity of 90.3%, specificity of 80.6%, and cutoff point of 4.5 ng/ml. Conclusion: Procalcitonin level of more than 4.5 ng/ml in cases of penetrating abdominal injury may be considered an aiding predictor for bowel perforation, thus shifting the treatment toward surgical intervention.
{"title":"Procalcitonin as predictor of bowel injury in penetrating abdominal injury","authors":"Ayad Maikhan, Ali Shuwelif, Haider Mihson","doi":"10.4103/mj.mj_47_22","DOIUrl":"https://doi.org/10.4103/mj.mj_47_22","url":null,"abstract":"Background: Diagnosis of bowel injury may be considered one of the difficulties in penetrating abdominal trauma. Aim of the Study: The aim of this study is to estimate the predictive ability of procalcitonin in diagnosing bowel injury in multiply injured patients. Patient and Methods: In a cross-sectional study at the Emergency Department of Al-Kindy teaching hospital over 1 year, patients were had penetrating abdominal trauma, and measurement of procalcitonin to all participants to estimate its predictive ability. Results: Procalcitonin was found to be a single independent predictor of bowel perforation with sensitivity of 90.3%, specificity of 80.6%, and cutoff point of 4.5 ng/ml. Conclusion: Procalcitonin level of more than 4.5 ng/ml in cases of penetrating abdominal injury may be considered an aiding predictor for bowel perforation, thus shifting the treatment toward surgical intervention.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46336285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The coronavirus disease 2019 (COVID-19) pandemic is extensively impacting national and international public health. Routine childhood immunization is projected for being adversely affected by COVID-19 mitigation measures. Consequently, vaccine preventable disease outbreak might be a big problem to encounter in the near future. Objectives: The aim of the study is to evaluate the prevalence of vaccination delay and explore the barriers leading to that and parents' attitude toward the importance of vaccination timelines. Materials and Methods: A cross-sectional study was carried out during the period between of May 1st and of August 1st, 2021. A sample of 400 parents attending vaccination unit with their under 2-year-old children were selected from health-care centers from Al-Karkh directorate. Results: The study shows that 266 (66.5%) of the parents were mothers, 134 (33.5%) were fathers, 288 (72%) of them were aged 30 y ears or less, 210 (52.5%) of them were college graduate or higher educational level, 302 (75.5%) of them did not have a health worker in their family, 292 (73%) of them had <3 children. This study revealed that 274 (68.5%) of the parents reported a delay in their children's vaccination timeliness, 198 (49.5%) of which was significant delay of more than 1 month and 76 (19%) was a delay of 2–4 weeks only. 126 (31.5%) reported an on-time vaccination. This study also showed a highly significant association between vaccination delay and history of COVID-19 infection in the family. This study demonstrated that curfew and difficulty in transportation 154 (38.5%) and fear of getting COVID-19 infection 142 (35.5%) were the most encountered barriers for vaccination delay. This study also showed that 51% of the parents had good level of attitude toward the importance of vaccination timeliness for their children. In addition, it showed a significant association between the level of attitude with the age and educational level of the parents and with having a health worker in the family. Conclusion: We conclude that 68.5% of sample had vaccination delay since the COVID-19 pandemic has started and good level of attitude toward the importance of vaccination timeliness. This indicates the need for strict recommendation about the importance of routine immunization schedule and need to commit to it even during pandemic situations.
{"title":"The impact of COVID-19 pandemic on routine childhood immunization in Baghdad/Al-Karkh","authors":"N. Khesro, M. Sabri, Roaa Sami","doi":"10.4103/mj.mj_33_21","DOIUrl":"https://doi.org/10.4103/mj.mj_33_21","url":null,"abstract":"Background: The coronavirus disease 2019 (COVID-19) pandemic is extensively impacting national and international public health. Routine childhood immunization is projected for being adversely affected by COVID-19 mitigation measures. Consequently, vaccine preventable disease outbreak might be a big problem to encounter in the near future. Objectives: The aim of the study is to evaluate the prevalence of vaccination delay and explore the barriers leading to that and parents' attitude toward the importance of vaccination timelines. Materials and Methods: A cross-sectional study was carried out during the period between of May 1st and of August 1st, 2021. A sample of 400 parents attending vaccination unit with their under 2-year-old children were selected from health-care centers from Al-Karkh directorate. Results: The study shows that 266 (66.5%) of the parents were mothers, 134 (33.5%) were fathers, 288 (72%) of them were aged 30 y ears or less, 210 (52.5%) of them were college graduate or higher educational level, 302 (75.5%) of them did not have a health worker in their family, 292 (73%) of them had <3 children. This study revealed that 274 (68.5%) of the parents reported a delay in their children's vaccination timeliness, 198 (49.5%) of which was significant delay of more than 1 month and 76 (19%) was a delay of 2–4 weeks only. 126 (31.5%) reported an on-time vaccination. This study also showed a highly significant association between vaccination delay and history of COVID-19 infection in the family. This study demonstrated that curfew and difficulty in transportation 154 (38.5%) and fear of getting COVID-19 infection 142 (35.5%) were the most encountered barriers for vaccination delay. This study also showed that 51% of the parents had good level of attitude toward the importance of vaccination timeliness for their children. In addition, it showed a significant association between the level of attitude with the age and educational level of the parents and with having a health worker in the family. Conclusion: We conclude that 68.5% of sample had vaccination delay since the COVID-19 pandemic has started and good level of attitude toward the importance of vaccination timeliness. This indicates the need for strict recommendation about the importance of routine immunization schedule and need to commit to it even during pandemic situations.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46667530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Bone marrow-derived mesenchymal stem cells (bmMSCs) are one of the most promising therapeutic methods in modern medicine. These cells are grown in tissue culture media, commonly supplemented with fetal bovine serum (FBS), but such supplement carries a number of drawbacks, such as immunological reaction and composition variation. Another supplement known as insulin-transferrin-selenium could act as serum replacement and help enhance the experimental results and therapeutic value of MSCs. Objective: The objective was to investigate the effect of tissue culture supplement in regard to bone marrow MSCs viability, proliferation, and differentiation potential. Materials and Methods: Human bmMSCs were grown in tissue culture plates at seeding density of 5 × 103 cells/cm2. The cells were divided into two groups, 10% FBS supplement or insulin-transferrin-sodium (ITS) supplement. The viability of the cells was assessed with live/dead cells kit (ethidium homodimer-1 and calcein). Cell proliferation was assessed with MTS assay, while multilineage differentiation potential was assessed with human MSC functional identification kit. Results: Our results showed that the viability of MSCs was comparable between FBS and ITS supplement groups at 24 h and 48 h intervals. Both groups showed similar proliferation capacity after 48 h and 72 h of incubation with no significant statistical difference. The cells from both groups were able to differentiate into osteoblasts, adipocytes, and chondrocytes. Conclusion: Insulin-transferrin-selenium supplement could be used as an alternative to FBS in laboratory experiments and clinical applications (such as cell therapy) to avoid the drawbacks of FBS and enhance the outcome of these applications.
{"title":"The impact of media supplement on the viability, proliferation, and differentiation potential of bone marrow-derived mesenchymal stem cells","authors":"N. Khamees","doi":"10.4103/mj.mj_49_22","DOIUrl":"https://doi.org/10.4103/mj.mj_49_22","url":null,"abstract":"Background: Bone marrow-derived mesenchymal stem cells (bmMSCs) are one of the most promising therapeutic methods in modern medicine. These cells are grown in tissue culture media, commonly supplemented with fetal bovine serum (FBS), but such supplement carries a number of drawbacks, such as immunological reaction and composition variation. Another supplement known as insulin-transferrin-selenium could act as serum replacement and help enhance the experimental results and therapeutic value of MSCs. Objective: The objective was to investigate the effect of tissue culture supplement in regard to bone marrow MSCs viability, proliferation, and differentiation potential. Materials and Methods: Human bmMSCs were grown in tissue culture plates at seeding density of 5 × 103 cells/cm2. The cells were divided into two groups, 10% FBS supplement or insulin-transferrin-sodium (ITS) supplement. The viability of the cells was assessed with live/dead cells kit (ethidium homodimer-1 and calcein). Cell proliferation was assessed with MTS assay, while multilineage differentiation potential was assessed with human MSC functional identification kit. Results: Our results showed that the viability of MSCs was comparable between FBS and ITS supplement groups at 24 h and 48 h intervals. Both groups showed similar proliferation capacity after 48 h and 72 h of incubation with no significant statistical difference. The cells from both groups were able to differentiate into osteoblasts, adipocytes, and chondrocytes. Conclusion: Insulin-transferrin-selenium supplement could be used as an alternative to FBS in laboratory experiments and clinical applications (such as cell therapy) to avoid the drawbacks of FBS and enhance the outcome of these applications.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49188232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fungal infection in the oral cavity is considered a marker of immunosuppression in certain chronic conditions such as cancer patients on immunosuppression medications and human immunodeficiency virus infections. Currently, coronavirus disease-2019 (COVID-19) pandemic is causing immunocompromised conditions of patients and inviting superadded infections such as local Candida infections such as oral candidiasis and invasive fungal infections. The role of opportunistic fungal infections in the morbidity and mortality of COVID-19 infections remains less established. Overuse of antibiotics for the treatment of COVID-19 infections is also thought to hamper normal flora in the oral cavity which is also an important risk factor for aggravating opportunistic fungal infection in the body. Here, an 18-year-old immunocompetent male presented with a white patch on the dorsal surface of the tongue, which developed 1 week after relieved from COVID-19 infection. The microbiological test of the whitish patch over the tongue confirmed candidiasis.
{"title":"Post-COVID-19 candidiasis of the tongue in an 18-year old male","authors":"S. Swain, P. Jena","doi":"10.4103/mj.mj_56_22","DOIUrl":"https://doi.org/10.4103/mj.mj_56_22","url":null,"abstract":"Fungal infection in the oral cavity is considered a marker of immunosuppression in certain chronic conditions such as cancer patients on immunosuppression medications and human immunodeficiency virus infections. Currently, coronavirus disease-2019 (COVID-19) pandemic is causing immunocompromised conditions of patients and inviting superadded infections such as local Candida infections such as oral candidiasis and invasive fungal infections. The role of opportunistic fungal infections in the morbidity and mortality of COVID-19 infections remains less established. Overuse of antibiotics for the treatment of COVID-19 infections is also thought to hamper normal flora in the oral cavity which is also an important risk factor for aggravating opportunistic fungal infection in the body. Here, an 18-year-old immunocompetent male presented with a white patch on the dorsal surface of the tongue, which developed 1 week after relieved from COVID-19 infection. The microbiological test of the whitish patch over the tongue confirmed candidiasis.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48482093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A number of learning competencies have to be attained by the medical students during their training period, as very limited time is available for them. This calls for the need to help medical students in their journey to become competent by facilitating the process of acquisition of knowledge and skills. The purpose of the current review was to explore the importance of feedback in medical education, identify the potential barriers to its effective delivery, and identify the strategies to overcome them. An extensive search of all materials related to the topic was carried out on the PubMed search engine, and a total of 17 articles were selected based on their suitability with the current review objectives. Keywords used in the search include feedback and medical education in the title alone only. Feedback in medical education is one of the most essential strategies to enhance learning. The findings of some of the studies have shown that feedback is not always beneficial and that students feel that feedback is not that much important as medical educators believe about it. In conclusion, acknowledging the significance and scope of feedback in medical education, the need of the hour is to include the same in every stage of the teaching–learning process. However, the effectiveness of feedback is significantly influenced by a wide range of teacher-, student-, and environment-related factors, and there is a definite need to take appropriate measures to address the challenges posed by these factors.
{"title":"Feedback in medical education: Identification of barriers and potential strategies to overcome them","authors":"S. Shrivastava, P. Shrivastava","doi":"10.4103/mj.mj_10_22","DOIUrl":"https://doi.org/10.4103/mj.mj_10_22","url":null,"abstract":"A number of learning competencies have to be attained by the medical students during their training period, as very limited time is available for them. This calls for the need to help medical students in their journey to become competent by facilitating the process of acquisition of knowledge and skills. The purpose of the current review was to explore the importance of feedback in medical education, identify the potential barriers to its effective delivery, and identify the strategies to overcome them. An extensive search of all materials related to the topic was carried out on the PubMed search engine, and a total of 17 articles were selected based on their suitability with the current review objectives. Keywords used in the search include feedback and medical education in the title alone only. Feedback in medical education is one of the most essential strategies to enhance learning. The findings of some of the studies have shown that feedback is not always beneficial and that students feel that feedback is not that much important as medical educators believe about it. In conclusion, acknowledging the significance and scope of feedback in medical education, the need of the hour is to include the same in every stage of the teaching–learning process. However, the effectiveness of feedback is significantly influenced by a wide range of teacher-, student-, and environment-related factors, and there is a definite need to take appropriate measures to address the challenges posed by these factors.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46468154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objectives: Entamoeba histolytica is a human enteric protozoan, which is the causative agent of amebiasis. The host activates a series of immunological responses to protect against the parasite after contact with the ameba and further invasion of the gut epithelium layer. As a result, the ameba has developed a variety of evasion mechanisms to hold out the immune response and continue to survive and cause disease. The calreticulin (EhCRT) is one of the immunogenic molecules of E. histolytica that induces an immune response in the human host. Increase in the expression of the EhCRT gene could provide control mechanism that allows the parasite to adapt and survive in host tissues. Aim of the Study: This study was designed to detect the EhCRT gene of E. histolytica by real-time polymerase chain reaction (PCR) in stool samples of children with amebiasis and its roles in host–parasite relationship via measuring the concentration of tumor necrosis factor alpha (TNFα) and interleukin 25 (IL25) by enzyme-linked immunoassay (ELISA) technique in their serum. Materials and Methods: A total of 86 diarrheal fecal samples were collected from children in age <1 year to 13 years suspected to be infected with E. histolytica during the period from December 30, 2020, to September 1, 2021. Microscopically positive samples were the subject to conventional PCR and real-time PCR for the detection of E. histolytica HM1:IMSS strain using (Psp) gene sequences and detection of calreticulin (EhCRT) expression. Blood was withdrawn from each child included in the study for ELISA test to measure the level of IL25 and TNFα. Results: Fecal samples for microscopic examination revealed that 71 (82.6%) children had amebic colitis, E. histolytica gene was detected in 44 samples (71%) using conventional PCR, and the immunogene EhCRT was expressed in 36 stool samples using real-time PCR. The results of the recent study showed highly significant elevation in the level of TNFα and IL25 in the amebic group (Eh+ve PCR). The majority of amebic children were in the age group of 1–4 years, had mucoid, acute, and with primary episodes of diarrhea. Conclusion: E. histolytica is a protozoan parasite highly prevalent among diarrheal children and is responsible for gastrointestinal amebiasis in the human host. The PCR is a useful tool in the diagnosis of E. histolytica infection. It is clear that the expression of the calreticulin gene (EhCRT) concedes with the duration of diarrhea a virulence factor that plays a role in host pathogenic pathways. The findings of this study showed that the level of TNFα in the serum of children infected with amebic colitis (Eh gene + ve) is significantly increased during the course of infection and the cytokine IL25 exhibits a significant drops in the same children.
{"title":"Detection of EhCRT gene expression in Entamoeba histolytica-Infected children and its correlation with interleukin 25 and tumor necrosis factor alpha","authors":"N. Khalaf, H. Khalil, Ahmed Abood","doi":"10.4103/mj.mj_21_22","DOIUrl":"https://doi.org/10.4103/mj.mj_21_22","url":null,"abstract":"Objectives: Entamoeba histolytica is a human enteric protozoan, which is the causative agent of amebiasis. The host activates a series of immunological responses to protect against the parasite after contact with the ameba and further invasion of the gut epithelium layer. As a result, the ameba has developed a variety of evasion mechanisms to hold out the immune response and continue to survive and cause disease. The calreticulin (EhCRT) is one of the immunogenic molecules of E. histolytica that induces an immune response in the human host. Increase in the expression of the EhCRT gene could provide control mechanism that allows the parasite to adapt and survive in host tissues. Aim of the Study: This study was designed to detect the EhCRT gene of E. histolytica by real-time polymerase chain reaction (PCR) in stool samples of children with amebiasis and its roles in host–parasite relationship via measuring the concentration of tumor necrosis factor alpha (TNFα) and interleukin 25 (IL25) by enzyme-linked immunoassay (ELISA) technique in their serum. Materials and Methods: A total of 86 diarrheal fecal samples were collected from children in age <1 year to 13 years suspected to be infected with E. histolytica during the period from December 30, 2020, to September 1, 2021. Microscopically positive samples were the subject to conventional PCR and real-time PCR for the detection of E. histolytica HM1:IMSS strain using (Psp) gene sequences and detection of calreticulin (EhCRT) expression. Blood was withdrawn from each child included in the study for ELISA test to measure the level of IL25 and TNFα. Results: Fecal samples for microscopic examination revealed that 71 (82.6%) children had amebic colitis, E. histolytica gene was detected in 44 samples (71%) using conventional PCR, and the immunogene EhCRT was expressed in 36 stool samples using real-time PCR. The results of the recent study showed highly significant elevation in the level of TNFα and IL25 in the amebic group (Eh+ve PCR). The majority of amebic children were in the age group of 1–4 years, had mucoid, acute, and with primary episodes of diarrhea. Conclusion: E. histolytica is a protozoan parasite highly prevalent among diarrheal children and is responsible for gastrointestinal amebiasis in the human host. The PCR is a useful tool in the diagnosis of E. histolytica infection. It is clear that the expression of the calreticulin gene (EhCRT) concedes with the duration of diarrhea a virulence factor that plays a role in host pathogenic pathways. The findings of this study showed that the level of TNFα in the serum of children infected with amebic colitis (Eh gene + ve) is significantly increased during the course of infection and the cytokine IL25 exhibits a significant drops in the same children.","PeriodicalId":33069,"journal":{"name":"mjl@ lmstnSry@ lTby@","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45633628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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