International Journal of Health Sciences-IJHS最新文献

Objectives: This study aims to assess the correlation between clinical features and mortality in human immunodeficiency virus (HIV)-infected individuals with COVID-19.

Methods: A systematic literature search was conducted for cohort, cross-sectional, and case series that reported co-infection with HIV and COVID-19 published from January to September 2020. Clinical features such as age, comorbidities, CD4⁺T lymphocyte counts, HIV RNA levels, and antiretroviral regimens were evaluated using meta-analyses and systematic reviews. Meta-analysis was performed using Stata 15.0 software.

Results: A total of 24 articles with 939 cases of HIV/COVID-19 co-infection were included in this study. The overall mortality rate was 10.3% (97/939). Older age and comorbidities including hypertension, diabetes, renal insufficiency, chronic obstructive pulmonary disease/asthma, and tumors were significantly associated with increased mortality (95% confidence interval 0.005-0.050, 0.042-2.294, 0.390-2.754, 0.513-2.848, 0.348-3.743, and 1.943-7.101, respectively, P = 0.021, 0.043, 0.012, 0.008, 0.022, and 0.005). There was no significant correlation between mortality and CD4⁺T lymphocyte count <200/μL or >500/μL, HIV RNA level below the detection limit, or antiretroviral drugs (including tenofovir) (all P > 0.05). Improved HIV treatment, complex immune interactions, study population variability, and lack of direct SARS-CoV-2 targeting by ART likely obscure the correlation between CD4⁺ counts or ART and COVID-19 mortality in HIV patients.

Conclusion: HIV-infected individuals with COVID-19 have a similar prognosis to the general population. However, older age, comorbidities (hypertension and diabetesetc.), and lower CD4⁺ T-cell counts are associated with increased mortality. Mainstream anti-HIV drugs do not offer significant protection against COVID-19.

Objectives: Vitamin B12 (Cobalamin or Cbl) plays a crucial role in normal human growth and development, as well as in neurological, cardiovascular, and immune systems. Previous studies reported association of high levels of cobalamin with solid cancers, hematological disorders, and liver diseases. Reporting the frequency of comorbid diseases with high serum Vitamin B12 level in patients attending KSAMC at Madinah.

Methods: This is a retrospective, cross-sectional study on data collected during 1 year (May 2022-May 2023) from 3511 report, patients with high cobalamin blood level (normal upper limit 771 pg/mL) as determined in our laboratory on COBAS^® were included. Patient's clinical diagnosis, medication history and other laboratory parameters performed were also checked for disease comorbidities.

Results: Our results revealed statistically significant increase in serum Vitamin B12 in patients with diabetes mellitus, with the use of this vitamin as supplement therapy 53.2% (the predominant comorbidity), together with liver, blood, chest, kidney, thyroid and neurological diseases, and various solid tumors. A positive correlation was found between serum Vitamin B12, age and laboratory parameters including aspartate aminotransferase, gamma-glutamyl transferase, and direct bilirubin, and a negative correlation was seen between serum Vitamin B12 level, serum albumin (ALB), red blood cell count, hemoglobin, and free T3 (FT3). While, no significant correlation with the rest of the checked parameters was detected.

Conclusion: This study found high serum level of Vitamin B12 associated with various disease entities, for example, (diabetes mellitus treated with Vitamin B12 as supplement therapy, liver, blood, chest, kidney, thyroid, neurological diseases, and various solid tumors), so when Vitamin B12 is high, further investigations will be recommended. Most of the comorbidities were benign in Saudis, followed by Egyptians with predominance of female-aged 50-70 year old.

Objective: This study aims to determine the prevalence of Occult Hepatitis B and C Infections among Egyptian injection drug users (IDUs) and identify key risk factors contributing to their occurrence within this high-risk group.

Methods: In this cross-sectional study, 200 Egyptian IDUs were assessed. Participants were negative for Hepatitis B surface antigen and hepatitis C virus (HCV) RNA, with anti-HCV positive patients who achieved sustained virologic response after treatment included. Quantitative polymerase chain reaction (PCR) was used to detect HCV RNA in plasma and peripheral blood mononuclear cells, while HBV DNA was identified via nested PCR. Comparisons were made between Occult Hepatitis B infection (OBI) positive and OBI negative subgroups, as well as between other comprehensive income (OCI) positive and OCI negative subgroups. A significance level of 0.05 was set, with P-values below this indicating statistical significance. Statistical comparisons between OBI and OCI-positive and negative groups were performed using the Mann-Whitney U test and Chi-square test.

Results: OBI was found in 32% of IDUs, while OCI was detected in 42% of IDUs, and was present in 53.6% of seropositive individuals. All OBI patients showed a significant increase in all liver function tests, while OCI patients had significant elevations in alanine transaminase and aspartate transaminase values. HIV coinfection was identified in 39.1% and 26.1% of OBI and OCI cases respectively. OBI and OCI coinfection were detected in 31 patients.

Conclusion: Hidden infections such as OBI and OCI remain an overlooked public health issue in Egypt's IDU population. These findings highlight the need for targeted strategies to address these reservoirs of infection and could inform similar approaches in countries with comparable HBV/HCV epidemiology.

Objective: The current study was conducted to investigate the effect of intermittent fasting (IF) with a low-carbohydrate-high-protein (LCHP) diet on blood glucose control in streptozotocin (STZ)-nicotinamide-induced type 2 diabetic rats (DR).

Methods: Thirty male Wistar rats were divided into six groups (n = 5) including a group of normal rats (NR) that received a control diet (CD) (50% carbohydrates, 17% protein, and 33% fat) with ad libitum (AL) feeding. The remaining 5 groups were DR injected with STZ and fed on CD or LCHP diet (40% carbohydrates, 30% protein, and 30% fat) for 6 weeks, either AL or IF (with a time-restricted feeding of 16 h followed by 8 h feeding period). There was a standard control group treated with metformin and fed on CD with AL feeding. A random blood glucose was measured. Changes in body weight and feed intake (FI) were monitored weekly.

Results: Feeding rats on LCHP and IF and their combination significantly reduced FI, body weight gain, blood glucose (P < 0.001), and improved insulin resistance (P < 0.05) with no effect on the insulin levels (P > 0.05). LCHP and IF decreased the levels of triglycerides and very-low-density lipoprotein and showed a possible protection against atherosclerosis by reducing the atherogenic index (P < 0.01). Furthermore, LCHP+IF greatly alleviates the pancreatic histopathological changes induced by STZ and showed the normal histological structure of the Langerhans islets.

Conclusion: IF with a LCHP diet could be effectively used in improving the indicators of glucose control, and reversing pancreatic histopathological alterations in type 2 diabetes.

Objective: Gastrointestinal stromal tumor (GIST) is the most common type of mesenchymal tumor accounting for 2.2% of all malignant gastric tumors. Mesenchymal stem cells (MSCs) play crucial roles in gastric carcinogenesis. In addition, Helicobacter pylori has been linked to GIST as it induces an epithelial response that can home MSCs to the stomach mucosa. This study aimed to investigate the relationship between H. pylori-infected gastric mucosa and the development of CD117-positive GIST and evaluate the prognosis of H. pylori-infected gastric mucosa of GIST patients that received anti-CD117 therapy.

Methods: This is a retrospective study conducted on H. pylori-infected GIST patients diagnosed between 2015 and 2021. The follow-up period was performed for a minimum of 2 years. Clinicopathological factors for each patient were collected from cases selected from the Registry of Pathology and Surgery Departments at Assiut University Hospitals.

Results: There was a statistically significant difference between our study population regarding the overall survival of studied patients, disease-free survival of studied patients, and the relationship between H. pylori-infected gastric mucosa and development, grading, therapy response, and overall survival of GIST except in status at last follow-up.

Conclusions: Our study is the first to reveal that H. pylori infection is linked to a worse prognosis for GIST patients. H. pylori has the potential to be used as a strong predictive biomarker for GIST individuals in the future. Clinical research with large samples as well as prospective designs are needed to confirm this connection.

Objective: Dasatinib (DTB) is a second-generation tyrosine kinase inhibitor that was found it could help with lung cancer treatment. However, DTB has low aqueous solubility and poor bioavailability due to its incomplete absorption and high first-pass effect. The objective of this study was to improve DTB's solubility, delivery, and efficacy as a potential lung cancer treatment by developing an inhalable DTB-nanoemulsion (DNE) formulation.

Methods: The DNE formulation was prepared by the spontaneous emulsification method, using oleic acid as the oil phase and a mixture of Kolliphor RH 40 and dipropylene glycol as surfactant. Compared with free DTB, the DNE formulation enhanced the aqueous solubility, flow property, and delivery of DTB to the lungs with a good fine-particle dose, fine-particle fraction, and mass median aerodynamic diameter.

Results: The DNE formulation was safe on lung cancer cells when the cell viability and toxicity were evaluated and IC₅₀ values were found to be 0.0431 μg/mL and 0.0443 μg/mL on A549 and Calu-3 cells, respectively. Moreover, DNE formulation significantly increased its anti-cancer effectiveness against A549 and Calu-3 lung cancer cells by interfering with cell cycle progression through apoptosis or cell cycle arrest.

Conclusion: The nanoemulsion formulation has the potential to be an effective carrier for DTB, which could possibly be used to treat lung cancer.

Objective: In spite of great advance in the management of hepatocellular carcinoma (HCC), the prognostic factors are still obviously not understood. The role of tumor budding (TB) and tumor-infiltrating lymphocytes (TILs) in HCC as pathological parameters affecting prognosis stands principally unknown.

Methods: Seventy-four surgical resection pathology specimens of HCC patients were used. Assessment of TB and TILs were performed using hematoxylin-eosin-stained slides. Follow-up data were collected over a 5-year period to determine disease-free survival rates, overall survival (OS) rates, and how they related to TB, TILs, and other clinicopathological factors.

Results: There was a significant statistical association between high-grade TB and lymphovascular embolization (LVE), tumor necrosis, and grade of HCC with P = 0.003, 0.036, and 0.017, respectively. The positive TILs group showed a statistically significant correlation with histological grade, LVE, and serum alpha-fetoprotein (AFP) level with P = 0.002, 0.006, and 0.043, respectively. Multivariate analysis using the Cox proportional hazard model revealed that TILs are not an independent pathological factor for disease-free and OS, although TB is an independent pathological factor for both.

Conclusions: In all HCC patients, TB was seen, and there was a significant link between the grade of the HCC and the presence of tumor necrosis, LVE, and high-grade TB. The majority (92%) of HCC patients had TILs, and there was a strong relationship between the histological grade, LVE, and serum AFP level. While TILs show variation of the immunologic reaction to the tumor, TB tends to suggest a hostile biologic nature and a bad prognosis.

Objective: The differentiation between reactive atypical changes and dysplasia/carcinoma in the daily cases of cholecystectomies is a routine histopathological challenge. Up to our knowledge, no immunohistochemical marker can definitely differentiate between these two changes. Many promising markers have been proposed to be helpful tools in this situation. One of them is B-cell lymphoma-2 (BCL-2) immunohistochemical stain. Therefore, this study aims to evaluate its usefulness as a marker that might be helpful in such challenging cases.

Methods: From the archive of the histopathology laboratories of Qassim University Medical City and King Fahad Specialist Hospital in Qassim, five dysplastic/neoplastic gallbladder cases were collected (in the shape of formalin-fixed, paraffin-embedded blocks) as well as five cholecystitis with reactive atypical changes cases. Two slides from each block were prepared: One was stained with H&E and the other was stained immunohistochemically with BCL-2. The slides were evaluated by two histopathologist consultants in the same sitting using multiheaded microscope to confirm the original diagnosis and to evaluate the BCL-2 staining.

Results: Five dysplastic/carcinoma cases and five cholecystitis with reactive atypia were collected. The original diagnoses were confirmed by two pathologists. They also confirmed that all the BCL-2 stained slides (with the exception of one reactive case) were negative for BCL-2 immunohistochemical stain.

Conclusion: BCL-2 immunohistochemical stain is not a promising marker in the differentiation between reactive epithelium and dysplasia/carcinoma in the gallbladder.

Objective: The alarming increase in vitamin D deficiency (VDD) has been shown to result in compounded risks of major health problems globally. As sickle cell disease (SCD) children are already health compromised, the co-morbidities escalate early in life, demanding an early detection, to minimize the adverse effects. This study determined vitamin D levels in children with SCD without a crisis to check for probable associations with inflammation and infections if any.

Methods: SCD children aged 5-16 years, in a steady state, were enrolled in the study after taking necessary consent and ethical clearance. Hb, serum calcium, vitamin D, and high-sensitivity C-reactive protein (hsCRP) levels were analyzed.

Results: VDD was seen in most of the children with SCD irrespective of gender and age. Males aged 5-10 years showed significance (P = 0.0375) with vitamin D and white blood cell (WBC) (P = 0.0015) but males aged 11-16-year age group exhibited a very strong-positive correlation with vitamin D (r = 0.9862) and a very strong-negative correlation with Hb (r = -0.9819) and hsCRP (r = -0.9907). Among females, the 11-16-year age group patients exhibited a significant association with vitamin D (P = 0.0487), Ca (P = 0.0118), Hb (P = 0.0007), and hsCRP (P = 0.0001) levels. Correlation "r" values in this age group show a strong-negative correlation with WBC levels (r = -0.6525) as well as hsCRP (r = - 0.6550).

Conclusion: The increased deficiency of vitamin D in SCD children should be addressed at early ages of life, to reduce the occurrence and severity of associated comorbidities.