Background: At a global level, over 300 million people are estimated to suffer from depression, equivalent to 4.4% of the world’s population. The presence of depression, anxiety, and stress (DAS) has major consequences for individuals with diabetes. The aim of this study was to determine the prevalence of DAS among adult patients with T2DM in primary health care (PHC) settings in Kosovo and to determine any association between DAS, sociodemographic characteristics, and other risk factors. Methods and Results: This cross-sectional study was conducted in seven Main Family Medicine Centers in Kosovo (Prishtina, Mitrovica, Peja, Prizren, Ferizaj, Gjilan, and Gjakova) from November 2022 to February 2023. The study included 596 adult patients above 18 years of age who were diagnosed with T2DM at least one year ago. By gender, more respondents were female ((F 55.4% vs. M 44.6%); adults aged 30-59 accounted for 38.4%, aged 60+ ‒ 57.7%. Anxiety was the most common type of psychological distress among the subjects (82.0%), depression was second with a prevalence of 74% and stress third with a prevalence of 43.0%. Females were predominant among respondents regarding the three forms of mental health problems: Depression (F 75.8% vs. M 71.8%), Anxiety (F 86.1% vs. M 77.1%), and Stress (F 48.5% vs. M 36.1%) Subjects with only primary education were more likely to be depressed (79.6%, P=0.0072; OR=1.689, 95% CI: 1.153 ‒ 2.477). HbA1C >6.5% was found to be strongly associated with depression (76.4%, P=0.002; OR=2.071, 95% CI: 1.305 ‒ 3.284). Female gender and the presence of comorbidities were found to be significantly associated with anxiety. Female gender, level of education, history of DM in the family, presence of comorbidities, and HbA1c >6.5% were significantly associated with stress. Conclusion: Our study showed that the prevalence of DAS is high in patients with T2DM. Periodic screening of patients with diabetes in PHC settings for early signs of psychological distress using easy and inexpensive validated screening tools like the DASS-21 questionnaire is recommended.
{"title":"Depression, Anxiety and Stress Among Patients with Type 2 Diabetes Mellitus in Primary Health Care in Kosovo","authors":"Mehmedali Gashi, Sanije Hoxha-Gashi, Sefedin Muçaj","doi":"10.21103/article13(3)_oa5","DOIUrl":"https://doi.org/10.21103/article13(3)_oa5","url":null,"abstract":"Background: At a global level, over 300 million people are estimated to suffer from depression, equivalent to 4.4% of the world’s population. The presence of depression, anxiety, and stress (DAS) has major consequences for individuals with diabetes. The aim of this study was to determine the prevalence of DAS among adult patients with T2DM in primary health care (PHC) settings in Kosovo and to determine any association between DAS, sociodemographic characteristics, and other risk factors. Methods and Results: This cross-sectional study was conducted in seven Main Family Medicine Centers in Kosovo (Prishtina, Mitrovica, Peja, Prizren, Ferizaj, Gjilan, and Gjakova) from November 2022 to February 2023. The study included 596 adult patients above 18 years of age who were diagnosed with T2DM at least one year ago. By gender, more respondents were female ((F 55.4% vs. M 44.6%); adults aged 30-59 accounted for 38.4%, aged 60+ ‒ 57.7%. Anxiety was the most common type of psychological distress among the subjects (82.0%), depression was second with a prevalence of 74% and stress third with a prevalence of 43.0%. Females were predominant among respondents regarding the three forms of mental health problems: Depression (F 75.8% vs. M 71.8%), Anxiety (F 86.1% vs. M 77.1%), and Stress (F 48.5% vs. M 36.1%) Subjects with only primary education were more likely to be depressed (79.6%, P=0.0072; OR=1.689, 95% CI: 1.153 ‒ 2.477). HbA1C >6.5% was found to be strongly associated with depression (76.4%, P=0.002; OR=2.071, 95% CI: 1.305 ‒ 3.284). Female gender and the presence of comorbidities were found to be significantly associated with anxiety. Female gender, level of education, history of DM in the family, presence of comorbidities, and HbA1c >6.5% were significantly associated with stress. Conclusion: Our study showed that the prevalence of DAS is high in patients with T2DM. Periodic screening of patients with diabetes in PHC settings for early signs of psychological distress using easy and inexpensive validated screening tools like the DASS-21 questionnaire is recommended.","PeriodicalId":53991,"journal":{"name":"International Journal of Biomedicine","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46243296","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}
Pub Date : 2023-06-05DOI: 10.21103/article13(2)_oa12
Violeta Zatriqi, Skender Zatriqi
Background: Tissue expansion (TE) is one of the major developments in reconstructive surgery. The objective of this research was a retrospective analysis of our 10-year experience in correcting burn sequelae, traumas, and scars by the method of TE. Methods and Results: A retrospective study was conducted at the Clinic of Plastic and Reconstructive Surgery at the University Clinical Center of Kosovo (UCCK, Prishtina) from January 2009 to December 2019. The sample included 67 patients (43[64.2%] females and 24[35.8%] males) treated with tissue expanders for reconstructive purposes. The most common indication for TE was burn sequelae, trauma, and scars from previous surgery. One hundred and thirty-five expanders were placed on 67 patients, and 128 operative interventions were performed. Burn sequelae (55.2%) were the main reason for TE. The age of patients was in the range of 0-50 years (mean age of 20.5 years). The predominant age groups were 11-20 years (49.2%) and 21-30 (40.3%). The most common anatomical region for TE was the head, including the face and neck (47.8%), followed by the trunk (22.4%), the lower extremities (16.4%), and the upper extremities (13.4%). Most patients underwent only one (61.2%) or two surgical interventions (31.3%); three surgical interventions were performed in 7.5% of cases. One expander was placed in the vast majority of our patients (83.6%), two expanders in 13.4% of cases, and three expanders in 3.0% Patients with expanders on the head and neck experienced more major complications (12.5%), which ended with the removal of the expander, than those with expanders on the trunk (6.7%) and lower extremities (9.1%). Minor complications most often (18.2%) occurred on the lower extremities. These complications were evidenced by pain and transient ischemia, which did not preclude the attainment of reconstructive goals. Patients of 0 to 10 years of age had only minor complications. Occurrences of major complications were the most frequent in the age groups of 11-20(9.1%), 21-30(11.1%), and 31-40(33.3%) years. Conclusion: The results of our retrospective study on the efficacy of cutaneous expansion procedures are broadly in line with other research reported in the literature. Attention to different aspects of TE, including careful patient selection and meticulous attention to intervention detail, are the main conditions for the success of this reconstructive surgery.
{"title":"Tissue Expansion in Reconstructive Surgery: A 10-Year Experience in Kosovo","authors":"Violeta Zatriqi, Skender Zatriqi","doi":"10.21103/article13(2)_oa12","DOIUrl":"https://doi.org/10.21103/article13(2)_oa12","url":null,"abstract":"Background: Tissue expansion (TE) is one of the major developments in reconstructive surgery. The objective of this research was a retrospective analysis of our 10-year experience in correcting burn sequelae, traumas, and scars by the method of TE. Methods and Results: A retrospective study was conducted at the Clinic of Plastic and Reconstructive Surgery at the University Clinical Center of Kosovo (UCCK, Prishtina) from January 2009 to December 2019. The sample included 67 patients (43[64.2%] females and 24[35.8%] males) treated with tissue expanders for reconstructive purposes. The most common indication for TE was burn sequelae, trauma, and scars from previous surgery. One hundred and thirty-five expanders were placed on 67 patients, and 128 operative interventions were performed. Burn sequelae (55.2%) were the main reason for TE. The age of patients was in the range of 0-50 years (mean age of 20.5 years). The predominant age groups were 11-20 years (49.2%) and 21-30 (40.3%). The most common anatomical region for TE was the head, including the face and neck (47.8%), followed by the trunk (22.4%), the lower extremities (16.4%), and the upper extremities (13.4%). Most patients underwent only one (61.2%) or two surgical interventions (31.3%); three surgical interventions were performed in 7.5% of cases. One expander was placed in the vast majority of our patients (83.6%), two expanders in 13.4% of cases, and three expanders in 3.0% Patients with expanders on the head and neck experienced more major complications (12.5%), which ended with the removal of the expander, than those with expanders on the trunk (6.7%) and lower extremities (9.1%). Minor complications most often (18.2%) occurred on the lower extremities. These complications were evidenced by pain and transient ischemia, which did not preclude the attainment of reconstructive goals. Patients of 0 to 10 years of age had only minor complications. Occurrences of major complications were the most frequent in the age groups of 11-20(9.1%), 21-30(11.1%), and 31-40(33.3%) years. Conclusion: The results of our retrospective study on the efficacy of cutaneous expansion procedures are broadly in line with other research reported in the literature. Attention to different aspects of TE, including careful patient selection and meticulous attention to intervention detail, are the main conditions for the success of this reconstructive surgery.","PeriodicalId":53991,"journal":{"name":"International Journal of Biomedicine","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135752271","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}
Pub Date : 2023-06-05DOI: 10.21103/article13(2)_oa8
Tasneem S A Elmahdi, Mayson Wanasi, Awadia Gareeballah, Mahasin G Hassan, W. Alsharif, Mariam Khogaly Elamin, Zohida A Abdelgabar
Background: Computed tomography (CT) is one radiographic imaging modality that plays an essential role in detecting, characterizing, and assessing the complications of COVID-19. The aim of this study was to determine the distribution of chest CT findings (typical and associated) in 202 Saudi patients with COVID-19. Methods and Results: Medical records of 202 patients diagnosed in Ohod and Al-Madinah National Hospitals (Al-Madinah Al-Monwarahwith) with positive COVID-19 infection from February 1 to March 1, 2021, were analyzed in this retrospective study. A verbal ethical agreement was obtained from the radiology department in these hospitals. Patients' demographic data and chest CT findings were evaluated. The majority of the sample was male 128(63.4%), and the largest age group was 50–64 years (41.1%). The typical chest CT findings for COVID-19 pneumonia (ground-glass opacification) were bilateral in peripheral lung fields (91.58%), subpleural zones (1.98%), and central zones (0.59%). Among COVID-19-associated findings, septal thickening was found in 4(2.0%) cases, air bronchogram in 13(6.4%) cases, lung fibrosis in 3(1.5%) cases, the atelectatic in 5(2.5%) cases, pleural effusion in 15(7.4%) cases, and pulmonary embolism in 1(0.5%) case. There was no significant difference in the COVID-19-associated findings among different age groups and genders. Conclusion: Pleural effusion and air bronchogram were the most common findings associated with ground-glass opacification in unenhanced chest CT.
{"title":"Distribution of Chest Computed Tomography Findings in 202 Saudi Patients with COVID-19","authors":"Tasneem S A Elmahdi, Mayson Wanasi, Awadia Gareeballah, Mahasin G Hassan, W. Alsharif, Mariam Khogaly Elamin, Zohida A Abdelgabar","doi":"10.21103/article13(2)_oa8","DOIUrl":"https://doi.org/10.21103/article13(2)_oa8","url":null,"abstract":"Background: Computed tomography (CT) is one radiographic imaging modality that plays an essential role in detecting, characterizing, and assessing the complications of COVID-19. The aim of this study was to determine the distribution of chest CT findings (typical and associated) in 202 Saudi patients with COVID-19. Methods and Results: Medical records of 202 patients diagnosed in Ohod and Al-Madinah National Hospitals (Al-Madinah Al-Monwarahwith) with positive COVID-19 infection from February 1 to March 1, 2021, were analyzed in this retrospective study. A verbal ethical agreement was obtained from the radiology department in these hospitals. Patients' demographic data and chest CT findings were evaluated. The majority of the sample was male 128(63.4%), and the largest age group was 50–64 years (41.1%). The typical chest CT findings for COVID-19 pneumonia (ground-glass opacification) were bilateral in peripheral lung fields (91.58%), subpleural zones (1.98%), and central zones (0.59%). Among COVID-19-associated findings, septal thickening was found in 4(2.0%) cases, air bronchogram in 13(6.4%) cases, lung fibrosis in 3(1.5%) cases, the atelectatic in 5(2.5%) cases, pleural effusion in 15(7.4%) cases, and pulmonary embolism in 1(0.5%) case. There was no significant difference in the COVID-19-associated findings among different age groups and genders. Conclusion: Pleural effusion and air bronchogram were the most common findings associated with ground-glass opacification in unenhanced chest CT.","PeriodicalId":53991,"journal":{"name":"International Journal of Biomedicine","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42480451","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}
Pub Date : 2023-06-05DOI: 10.21103/article13(2)_ra3
R. Hussein, Othman Abahussein
Human papillomavirus (HPV) in the genital region is a frequently occurring sexually transmitted disease that can result in genital warts and various types of cancer. Most sexually active individuals acquire HPV at a certain point during their lifetime, but fortunately, several of the most harmful HPV types are preventable with vaccinations. All boys and girls aged 9 to 12 should get the HPV vaccine, although it can be given to individuals up to age 45. The HPV vaccine triggers an immune response that helps the body recognize and fight off the virus. There are currently two different HPV vaccines available: Gardasil and Cervarix. Gardasil guards against the two HPV strains that most commonly result in cervical cancer (CC) and various additional strains that can result in genital warts or other types of cancer. Cervarix only offers protection against the two forms of HPV that trigger CC. Mild side effects may occur, but more severe side effects are rare. Despite the availability of HPV vaccination, vaccination rates remain suboptimal in many countries. Raising awareness and expanding access to HPV vaccination are critical steps toward reducing HPV-related diseases. This article explores the basics of HPV and the role of vaccination in preventing its spread.
{"title":"The Need for Increased HPV Vaccination Awareness and Access","authors":"R. Hussein, Othman Abahussein","doi":"10.21103/article13(2)_ra3","DOIUrl":"https://doi.org/10.21103/article13(2)_ra3","url":null,"abstract":"Human papillomavirus (HPV) in the genital region is a frequently occurring sexually transmitted disease that can result in genital warts and various types of cancer. Most sexually active individuals acquire HPV at a certain point during their lifetime, but fortunately, several of the most harmful HPV types are preventable with vaccinations. All boys and girls aged 9 to 12 should get the HPV vaccine, although it can be given to individuals up to age 45. The HPV vaccine triggers an immune response that helps the body recognize and fight off the virus. There are currently two different HPV vaccines available: Gardasil and Cervarix. Gardasil guards against the two HPV strains that most commonly result in cervical cancer (CC) and various additional strains that can result in genital warts or other types of cancer. Cervarix only offers protection against the two forms of HPV that trigger CC. Mild side effects may occur, but more severe side effects are rare. Despite the availability of HPV vaccination, vaccination rates remain suboptimal in many countries. Raising awareness and expanding access to HPV vaccination are critical steps toward reducing HPV-related diseases. This article explores the basics of HPV and the role of vaccination in preventing its spread.","PeriodicalId":53991,"journal":{"name":"International Journal of Biomedicine","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44278965","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}
Pub Date : 2023-06-05DOI: 10.21103/article13(2)_oa6
S. M. Ahmed, Tariq E. Elmissbah, Ammar Bayoumi, M. Ibrahim, E. Elshibli, A. Abbas, Sannaa M A Osman
Background: Saliva is a specimen that is easily collected by non-invasive means and does not require well-trained staff; it could be helpful in measuring inflammatory markers to determine COVID-19 severity. The aim of this study was to investigate saliva as an alternative specimen for measuring inflammatory markers IL-10, IL-4, and IL-1β among COVID-19 patients in relation to disease severity. Methods and Results: This cross-sectional study was conducted among COVID-19 patients in a fever clinic, isolated hotels, and hospitals providing care for positive COVID-19 patients and in public health centers for negative control patients in Jeddah, Saudi Arabia. A total of 151 subjects participated in this study, including 101 patients with COVID-19 and 50 healthy controls. Patients with COVID-19 were categorized according to the severity of their symptoms into mild (n=50) and severe cases (n=51). The salivary concentrations of IL-4, IL-10, and IL-1β were measured using sandwich MyBioSource ELISA Test Kits. The age of the study population ranged from 19 to 70 years old, with a mean age of 43.3±13.0 years. The distribution of the study population showed that more of the patients were men (65[64.4%]) than women (36[35.6%]) (P=0.004). The frequency of severe infection in men was higher than in women (35[68.6%] and 16[31.4%], respectively, P=0.008). The group of severe cases was significantly older than the group of mild cases (47.9±11.03 years and 38.64±13.82 years, respectively, P=0.0007). The volume of saliva was the smallest in severe COVID-19, compared to mild cases and controls (P=0.0000 in all cases). The salivary levels of IL-4, IL-10, and IL-1β were greater in the severe cases than in mild cases and controls (46.14±11.61 pg/mL, 12.86±1.99 pg/mL, and 27.45±11.47 pg/mL versus 19.31±5.72 pg/mL, 7.96±2.12 pg/mL, and 6.59±1.90 pg/mL, respectively; P=0.0000 in all cases). The salivary levels of IL-4 and IL-10 in mild cases were greater than in controls (19.31±5.72 pg/mL and 7.96±2.12 pg/mL versus 15.30±4.36 pg/mL and 6.02±0.89 pg/mL, respectively; P=0.0329 and P=0.000, respectively), but salivary IL-1β levels in mild cases did not differ from controls (6.59±1.90 pg/mL vs. 6.03±2.28 pg/mL, P=0.9129). Conclusion: Saliva could be used as an alternative sample in measuring IL-10, IL-4, and IL-1β with the suggestion of using IL-10 and IL-4 as markers for predicting disease severity.
{"title":"Saliva as Alternative Specimen for Measuring Inflammatory Markers Interleukins (IL10, IL-4, and IL-1β) in Association with Disease Severity among COVID-19 Patients","authors":"S. M. Ahmed, Tariq E. Elmissbah, Ammar Bayoumi, M. Ibrahim, E. Elshibli, A. Abbas, Sannaa M A Osman","doi":"10.21103/article13(2)_oa6","DOIUrl":"https://doi.org/10.21103/article13(2)_oa6","url":null,"abstract":"Background: Saliva is a specimen that is easily collected by non-invasive means and does not require well-trained staff; it could be helpful in measuring inflammatory markers to determine COVID-19 severity. The aim of this study was to investigate saliva as an alternative specimen for measuring inflammatory markers IL-10, IL-4, and IL-1β among COVID-19 patients in relation to disease severity. Methods and Results: This cross-sectional study was conducted among COVID-19 patients in a fever clinic, isolated hotels, and hospitals providing care for positive COVID-19 patients and in public health centers for negative control patients in Jeddah, Saudi Arabia. A total of 151 subjects participated in this study, including 101 patients with COVID-19 and 50 healthy controls. Patients with COVID-19 were categorized according to the severity of their symptoms into mild (n=50) and severe cases (n=51). The salivary concentrations of IL-4, IL-10, and IL-1β were measured using sandwich MyBioSource ELISA Test Kits. The age of the study population ranged from 19 to 70 years old, with a mean age of 43.3±13.0 years. The distribution of the study population showed that more of the patients were men (65[64.4%]) than women (36[35.6%]) (P=0.004). The frequency of severe infection in men was higher than in women (35[68.6%] and 16[31.4%], respectively, P=0.008). The group of severe cases was significantly older than the group of mild cases (47.9±11.03 years and 38.64±13.82 years, respectively, P=0.0007). The volume of saliva was the smallest in severe COVID-19, compared to mild cases and controls (P=0.0000 in all cases). The salivary levels of IL-4, IL-10, and IL-1β were greater in the severe cases than in mild cases and controls (46.14±11.61 pg/mL, 12.86±1.99 pg/mL, and 27.45±11.47 pg/mL versus 19.31±5.72 pg/mL, 7.96±2.12 pg/mL, and 6.59±1.90 pg/mL, respectively; P=0.0000 in all cases). The salivary levels of IL-4 and IL-10 in mild cases were greater than in controls (19.31±5.72 pg/mL and 7.96±2.12 pg/mL versus 15.30±4.36 pg/mL and 6.02±0.89 pg/mL, respectively; P=0.0329 and P=0.000, respectively), but salivary IL-1β levels in mild cases did not differ from controls (6.59±1.90 pg/mL vs. 6.03±2.28 pg/mL, P=0.9129). Conclusion: Saliva could be used as an alternative sample in measuring IL-10, IL-4, and IL-1β with the suggestion of using IL-10 and IL-4 as markers for predicting disease severity.","PeriodicalId":53991,"journal":{"name":"International Journal of Biomedicine","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47753457","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}
Pub Date : 2023-06-05DOI: 10.21103/article13(2)_oa20
E. Mishina, M. Zatolokina, Alisa A Yakovleva
Background: Immunosuppression caused by cancer or cytotoxic drugs, aging, and comorbidities makes cancer patients not only more susceptible to COVID-19, but also more likely to progress to a severe form and increase the incidence of serious complications. The epitheliotropy of this virus is of interest to the study of skin changes and the degree of their manifestation in patients with malignant neoplasms. In this regard, the aim of our research was to study the morphogenesis of changes in the structural components of the skin in cancer patients with COVID-19. Methods and Results: We examined the features of morpho-functional changes in skin components in 80 cancer patients who died in Kursk and the Kursk region for the period January 2021–February 2022. Group 1 included cancer patients with no history of COVID-19, whose cause of death was peritonitis due to colorectal cancer; Group 2 included cancer patients whose cause of death was viral pneumonia caused by COVID-19. Each group was further divided by sex and age. The research material was skin fragments. The results of histological and morphometric studies of the skin show that lymphocytic infiltration was typical for all age subgroups of cancer patients with COVID-19, which had higher numbers of lymphocytes per 100 cells than cancer patients without COVID-19. Infiltrative-inflammatory changes are observed in the skin, the severity of which depends on the patient's age. For the age subgroup of 76-85 years without COVID-19, a more pronounced increase in the ratio of the reticular layer to the papillary layer was characteristic, due to a decrease in the thickness of the papillary layer. Pronounced thickening of the papillary layer was found in all age subgroups of cancer patients with COVID-19, compared with the same age subgroups in cancer patients without COVID-19. Conclusion: It is possible to predict more frequent skin manifestations in cancer patients who have had a new COVID-19 infection, the mechanism of which is mainly due to changes in specific leukocytes, T-lymphocytes, and macrophages and their infiltration of skin tissues.
{"title":"Morphogenesis of Changes in the Structural Components of the Skin in Cancer Patients with COVID-19 in Older Age Groups","authors":"E. Mishina, M. Zatolokina, Alisa A Yakovleva","doi":"10.21103/article13(2)_oa20","DOIUrl":"https://doi.org/10.21103/article13(2)_oa20","url":null,"abstract":"Background: Immunosuppression caused by cancer or cytotoxic drugs, aging, and comorbidities makes cancer patients not only more susceptible to COVID-19, but also more likely to progress to a severe form and increase the incidence of serious complications. The epitheliotropy of this virus is of interest to the study of skin changes and the degree of their manifestation in patients with malignant neoplasms. In this regard, the aim of our research was to study the morphogenesis of changes in the structural components of the skin in cancer patients with COVID-19. Methods and Results: We examined the features of morpho-functional changes in skin components in 80 cancer patients who died in Kursk and the Kursk region for the period January 2021–February 2022. Group 1 included cancer patients with no history of COVID-19, whose cause of death was peritonitis due to colorectal cancer; Group 2 included cancer patients whose cause of death was viral pneumonia caused by COVID-19. Each group was further divided by sex and age. The research material was skin fragments. The results of histological and morphometric studies of the skin show that lymphocytic infiltration was typical for all age subgroups of cancer patients with COVID-19, which had higher numbers of lymphocytes per 100 cells than cancer patients without COVID-19. Infiltrative-inflammatory changes are observed in the skin, the severity of which depends on the patient's age. For the age subgroup of 76-85 years without COVID-19, a more pronounced increase in the ratio of the reticular layer to the papillary layer was characteristic, due to a decrease in the thickness of the papillary layer. Pronounced thickening of the papillary layer was found in all age subgroups of cancer patients with COVID-19, compared with the same age subgroups in cancer patients without COVID-19. Conclusion: It is possible to predict more frequent skin manifestations in cancer patients who have had a new COVID-19 infection, the mechanism of which is mainly due to changes in specific leukocytes, T-lymphocytes, and macrophages and their infiltration of skin tissues.","PeriodicalId":53991,"journal":{"name":"International Journal of Biomedicine","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44632600","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}
Pub Date : 2023-06-05DOI: 10.21103/article13(2)_oa2
H. Yusupova, G. Abdullaeva, G. Khamidullaeva, F. Alikhodzhaeva
Background: Arterial hypertension (AH) is one of the main factors causing a high risk of cardiovascular complications and mortality. The existence of a relationship between high blood pressure (BP) and the risk of developing central nervous system pathology, primarily stroke, and cognitive impairment, has been shown. The purpose of this study was a comparative assessment of the effect of 12-month antihypertensive therapy (AHT) with the inclusion of nitrendipine (NIT) or amlodipine (AML) on cognitive functions (CF) in hypertensive patients. Methods and Results: The study included 111 patients of both genders aged 30-75 years with AH Grades 1-3 (ESC/ESH, 2018). All patients underwent the following examinations: assessment of traditional risk factors, physical examination, clinical and biochemical laboratory methods, 12-lead ECG, echocardiography, pulse contour analysis, and 24-hour ambulatory blood pressure monitoring, neuropsychological tests (Mini-Cog test, Montreal Cognitive Assessment (MoCA) test, Hospital Anxiety and Depression Scale (HADS), and self-assessment questionnaire for memory, attention, thinking, ability to cope with one's affairs, and ability to make decisions). After the screening stage, all patients were discontinued from previous therapy and assigned to the 2 regimes of AHT. Group 1 included 58 AH patients who received NIT as monotherapy or as part of combination AHT; Group 2 included 53 patients who received AML as monotherapy or as part of combination AHT. Correlation analysis between the parameters of DBPP and the MoCA test revealed a weak but statistically significant negative correlation between the total MoCA score and the average 24-h SBP (rs=-0.33, P=0.015). In addition, there was a weak but statistically significant negative correlation between the total MoCA score and the daytime SBP variability and daytime DBP variability (rs=-0.40 and rs=-0.35, respectively, P=0.000 in both cases). A weak but statistically significant negative correlation was found between the total Mini-Cog score and PWV and PPc (rs=-0.24, P=0.01 and rs=-0.27, P=0.007, respectively). Analysis of the office BP indicators showed high antihypertensive efficacy of 12-month therapy in both groups, regardless of the therapy regimens. A comparative analysis of the effect of AHT with the inclusion of NIT or AML on CF in AH patients showed the advantages of combined AHT with the inclusion of NIT. Amlodipine treatment did not significantly affect any test score. Thus, in Group 1, after 12 months of therapy, there was an increase in the total Mini-Cog score from 3.8±1.08 points to 4.55±0.75 points (P<0.001), while in Group 2, there was a non-significant decrease in this score from 4.26±0.98 points to 3.92±0.95 points (P>0.05). There was also an increase in the total MoCA score in Group 1 from 23.3±2.8 points to 25.08±2.6 points (P<0.001), while in Group 2, there was a non-significant decrease in this score from 24.06±2.73 points to 23.07±2.7 points (P>0.05). I
{"title":"Effect of Nitrendipine and Amlodipine on Cognitive Functions of Patients with Arterial Hypertension","authors":"H. Yusupova, G. Abdullaeva, G. Khamidullaeva, F. Alikhodzhaeva","doi":"10.21103/article13(2)_oa2","DOIUrl":"https://doi.org/10.21103/article13(2)_oa2","url":null,"abstract":"Background: Arterial hypertension (AH) is one of the main factors causing a high risk of cardiovascular complications and mortality. The existence of a relationship between high blood pressure (BP) and the risk of developing central nervous system pathology, primarily stroke, and cognitive impairment, has been shown. The purpose of this study was a comparative assessment of the effect of 12-month antihypertensive therapy (AHT) with the inclusion of nitrendipine (NIT) or amlodipine (AML) on cognitive functions (CF) in hypertensive patients. Methods and Results: The study included 111 patients of both genders aged 30-75 years with AH Grades 1-3 (ESC/ESH, 2018). All patients underwent the following examinations: assessment of traditional risk factors, physical examination, clinical and biochemical laboratory methods, 12-lead ECG, echocardiography, pulse contour analysis, and 24-hour ambulatory blood pressure monitoring, neuropsychological tests (Mini-Cog test, Montreal Cognitive Assessment (MoCA) test, Hospital Anxiety and Depression Scale (HADS), and self-assessment questionnaire for memory, attention, thinking, ability to cope with one's affairs, and ability to make decisions). After the screening stage, all patients were discontinued from previous therapy and assigned to the 2 regimes of AHT. Group 1 included 58 AH patients who received NIT as monotherapy or as part of combination AHT; Group 2 included 53 patients who received AML as monotherapy or as part of combination AHT. Correlation analysis between the parameters of DBPP and the MoCA test revealed a weak but statistically significant negative correlation between the total MoCA score and the average 24-h SBP (rs=-0.33, P=0.015). In addition, there was a weak but statistically significant negative correlation between the total MoCA score and the daytime SBP variability and daytime DBP variability (rs=-0.40 and rs=-0.35, respectively, P=0.000 in both cases). A weak but statistically significant negative correlation was found between the total Mini-Cog score and PWV and PPc (rs=-0.24, P=0.01 and rs=-0.27, P=0.007, respectively). Analysis of the office BP indicators showed high antihypertensive efficacy of 12-month therapy in both groups, regardless of the therapy regimens. A comparative analysis of the effect of AHT with the inclusion of NIT or AML on CF in AH patients showed the advantages of combined AHT with the inclusion of NIT. Amlodipine treatment did not significantly affect any test score. Thus, in Group 1, after 12 months of therapy, there was an increase in the total Mini-Cog score from 3.8±1.08 points to 4.55±0.75 points (P<0.001), while in Group 2, there was a non-significant decrease in this score from 4.26±0.98 points to 3.92±0.95 points (P>0.05). There was also an increase in the total MoCA score in Group 1 from 23.3±2.8 points to 25.08±2.6 points (P<0.001), while in Group 2, there was a non-significant decrease in this score from 24.06±2.73 points to 23.07±2.7 points (P>0.05). I","PeriodicalId":53991,"journal":{"name":"International Journal of Biomedicine","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42674856","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}
Pub Date : 2023-06-05DOI: 10.21103/article13(2)_oa1
Shukhrat Masharipov, G. Abdullaeva, G. Khamidullaeva, D. Zakirova, A. Abdullaev
The aim of our study was to assess the effect of polymorphic markers of the AGT T704C (M235T) rs699 and NOS3 G894T (Glu298Asp) rs1799983 SNPs on the risk of the development of treatment-resistant hypertension (TRH). Methods and Results: The study included 178 patients (mean age of 56.67±11.12 years) with AH Grades 1-3 (ESC/ESH, 2018), who were on outpatient treatment at the Republican Specialized Scientific and Practical Medical Center for Cardiology. Genomic DNA samples were isolated from the peripheral blood leukocytes by using the DiatomТМ DNA Prep 200 Kit (Isogen Laboratory LLC, Moscow, Russia) according to manufacturer`s protocol. A multiplex RT-PCR assay was used to detect the AGT T704C (M235T) rs699 SNP and NOS3 G894T (Glu298Asp) rs1799983 SNP. We studied the distribution of the AGT T704C (M235T) rs699 polymorphism in 61 Uzbek patients with TRH (cases) and 117 Uzbek patients with non-TRH (controls) (Group 1) and the distribution of the NOS3 G894T (Glu298Asp) rs1799983 polymorphism in 61 Uzbek patients with TRH (cases) and 115 Uzbek patients with non-TRH (controls) (Group 2). Our results indicate a significantly greater accumulation of the C allele and CC genotype of the AGT T704C (M235T) rs699 SNP among TRH patients than among patients with non-TRH. We found a significant association between the AGT T704C (M235T) rs699 SNP and the risk of TRH under the multiplicative genetic model (C vs. T : OR=1.85, 95% CI: 1.17-2.92, P=0.006), additive model (CC vs.TT vs. TC; OR=3.00, 95% CI: 1.56-5.75, P=0.009), and recessive model (CC vs. TC+TT; OR=3.00, 95% CI: 1.56-5.75, P=0.0008). For the NOS3 G894T (Glu298Asp) rs1799983 SNP, the multiplicative model showed a significant risk of TRH with the carriage of the T allele (OR=1.99, 95% CI: 1.20-3.28, P=0.007), and the additive model showed a significant risk of TRH with the carriage of the heterozygous GT genotype (OR=2.25, 95% CI: 1.17-4.33, P=0.01). At the same time, the carriage of the G allele (OR=0.5, 95% CI: 0.30-0.83, P=0.007) and GG genotype (OR=0.40, 95% CI: 0.21-0.76, P=0.01) may be protective against the development of TRH. Conclusion: Further genetic studies of TRH may help achieve better individual outcomes by optimizing drug therapy based on genetic variation.
{"title":"Association of AGT (T704C) and NOS3 (G894T) Gene Polymorphisms with Treatment-Resistant Hypertension in the Uzbek Population","authors":"Shukhrat Masharipov, G. Abdullaeva, G. Khamidullaeva, D. Zakirova, A. Abdullaev","doi":"10.21103/article13(2)_oa1","DOIUrl":"https://doi.org/10.21103/article13(2)_oa1","url":null,"abstract":"The aim of our study was to assess the effect of polymorphic markers of the AGT T704C (M235T) rs699 and NOS3 G894T (Glu298Asp) rs1799983 SNPs on the risk of the development of treatment-resistant hypertension (TRH). Methods and Results: The study included 178 patients (mean age of 56.67±11.12 years) with AH Grades 1-3 (ESC/ESH, 2018), who were on outpatient treatment at the Republican Specialized Scientific and Practical Medical Center for Cardiology. Genomic DNA samples were isolated from the peripheral blood leukocytes by using the DiatomТМ DNA Prep 200 Kit (Isogen Laboratory LLC, Moscow, Russia) according to manufacturer`s protocol. A multiplex RT-PCR assay was used to detect the AGT T704C (M235T) rs699 SNP and NOS3 G894T (Glu298Asp) rs1799983 SNP. We studied the distribution of the AGT T704C (M235T) rs699 polymorphism in 61 Uzbek patients with TRH (cases) and 117 Uzbek patients with non-TRH (controls) (Group 1) and the distribution of the NOS3 G894T (Glu298Asp) rs1799983 polymorphism in 61 Uzbek patients with TRH (cases) and 115 Uzbek patients with non-TRH (controls) (Group 2). Our results indicate a significantly greater accumulation of the C allele and CC genotype of the AGT T704C (M235T) rs699 SNP among TRH patients than among patients with non-TRH. We found a significant association between the AGT T704C (M235T) rs699 SNP and the risk of TRH under the multiplicative genetic model (C vs. T : OR=1.85, 95% CI: 1.17-2.92, P=0.006), additive model (CC vs.TT vs. TC; OR=3.00, 95% CI: 1.56-5.75, P=0.009), and recessive model (CC vs. TC+TT; OR=3.00, 95% CI: 1.56-5.75, P=0.0008). For the NOS3 G894T (Glu298Asp) rs1799983 SNP, the multiplicative model showed a significant risk of TRH with the carriage of the T allele (OR=1.99, 95% CI: 1.20-3.28, P=0.007), and the additive model showed a significant risk of TRH with the carriage of the heterozygous GT genotype (OR=2.25, 95% CI: 1.17-4.33, P=0.01). At the same time, the carriage of the G allele (OR=0.5, 95% CI: 0.30-0.83, P=0.007) and GG genotype (OR=0.40, 95% CI: 0.21-0.76, P=0.01) may be protective against the development of TRH. Conclusion: Further genetic studies of TRH may help achieve better individual outcomes by optimizing drug therapy based on genetic variation.","PeriodicalId":53991,"journal":{"name":"International Journal of Biomedicine","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47573465","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}
Pub Date : 2023-06-05DOI: 10.21103/article13(2)_oa14
M. Darenskaya, S. Tokmakova, E. Kirienkova, O. Bondarenko, Y. Lunitsyna, Y. Gurevich, V.A. Kuzikova, E. Mokrenko, I. Goncharov, Tatyana A. Gaidarova, Oleg V. Klyushnikov, M. Suslikova, L. Kolesnikova, S. G. Aleksandrov, M. Gubina
Background: The aim of this research was to determine the functional state of regional blood flow in young people with varying degrees of anatomical and functional disorders of periodontal tissues. Methods and Results: One hundred and thirty-five young patients with varying degrees of anatomical and functional disorders of periodontal tissues (AFDP) and 52 controls with intact periodontium were examined. All patients with AFDP were divided into three groups: Group 1 included 33 patients in the compensation stage (low degree of periodontal risk, intact periodontium, no clinical symptoms, pale pink gums, no bleeding on probing, dentogingival attachment is not disturbed); Group 2 included 38 patients in the sub-compensation stage (average degree of periodontal risk, disorders of the mucogingival complex, without clinical symptoms); and 64 patients in the decompensation stage (high degree of periodontal risk, disorders of the mucogingival complex, the presence of clinical symptoms, individual or combined signs of periodontal pathology, gingival recession (Class I and II according to Miller's classification). We studied the regional blood flow of periodontal tissues, which was assessed by an ultrasound Doppler graph in a non-invasive way. The parameters of linear (PSV, peak systolic velocity) and volumetric (Qs, maximum systolic volume velocity) velocities of blood flow, as well as the parameters of the wall vascularization (PI, pulsation index; RI, resistance index). Results: The PSV increased statistically significantly with a load compared to rest in the control and sub-compensation groups and decreased in the decompensation group with a load, compared to the rest condition. The PSV increased relative to the control in the subcompensation and decompensation groups in rest and under load. The Qs indicator showed a similar trend in the groups. Qs significantly increased under load, compared to the rest condition in the control, compensation, and subcompensation groups, and decreased in the decompensation group. The Qs values, in comparison with the control, increased in the subcompensation and decompensation groups in the rest condition and under load. The PI increased with the load relative to the rest condition in the control, compensation, and decompensation group. At the same time, PI decreased under the load, compared to the rest condition, in the subcompensation group. In comparison with the control, the PI values decreased in the subcompensation and decompensation groups in the rest condition and under load. The RI significantly changed only in the subcompensation group under load, compared to the rest condition. Only RI values decreased significantly in the subcompensation group under load, compared to the control. Conclusion: The use of Doppler ultrasonography in assessing the state of regional blood flow of periodontal tissues is a highly informative and non-invasive method. The velocity characteristics (linear and volumetric velocities) of
{"title":"State of Regional Blood Flow in Patients with Varying Degrees of Anatomical and Functional Disorders of Periodontal Tissues","authors":"M. Darenskaya, S. Tokmakova, E. Kirienkova, O. Bondarenko, Y. Lunitsyna, Y. Gurevich, V.A. Kuzikova, E. Mokrenko, I. Goncharov, Tatyana A. Gaidarova, Oleg V. Klyushnikov, M. Suslikova, L. Kolesnikova, S. G. Aleksandrov, M. Gubina","doi":"10.21103/article13(2)_oa14","DOIUrl":"https://doi.org/10.21103/article13(2)_oa14","url":null,"abstract":"Background: The aim of this research was to determine the functional state of regional blood flow in young people with varying degrees of anatomical and functional disorders of periodontal tissues. Methods and Results: One hundred and thirty-five young patients with varying degrees of anatomical and functional disorders of periodontal tissues (AFDP) and 52 controls with intact periodontium were examined. All patients with AFDP were divided into three groups: Group 1 included 33 patients in the compensation stage (low degree of periodontal risk, intact periodontium, no clinical symptoms, pale pink gums, no bleeding on probing, dentogingival attachment is not disturbed); Group 2 included 38 patients in the sub-compensation stage (average degree of periodontal risk, disorders of the mucogingival complex, without clinical symptoms); and 64 patients in the decompensation stage (high degree of periodontal risk, disorders of the mucogingival complex, the presence of clinical symptoms, individual or combined signs of periodontal pathology, gingival recession (Class I and II according to Miller's classification). We studied the regional blood flow of periodontal tissues, which was assessed by an ultrasound Doppler graph in a non-invasive way. The parameters of linear (PSV, peak systolic velocity) and volumetric (Qs, maximum systolic volume velocity) velocities of blood flow, as well as the parameters of the wall vascularization (PI, pulsation index; RI, resistance index). Results: The PSV increased statistically significantly with a load compared to rest in the control and sub-compensation groups and decreased in the decompensation group with a load, compared to the rest condition. The PSV increased relative to the control in the subcompensation and decompensation groups in rest and under load. The Qs indicator showed a similar trend in the groups. Qs significantly increased under load, compared to the rest condition in the control, compensation, and subcompensation groups, and decreased in the decompensation group. The Qs values, in comparison with the control, increased in the subcompensation and decompensation groups in the rest condition and under load. The PI increased with the load relative to the rest condition in the control, compensation, and decompensation group. At the same time, PI decreased under the load, compared to the rest condition, in the subcompensation group. In comparison with the control, the PI values decreased in the subcompensation and decompensation groups in the rest condition and under load. The RI significantly changed only in the subcompensation group under load, compared to the rest condition. Only RI values decreased significantly in the subcompensation group under load, compared to the control. Conclusion: The use of Doppler ultrasonography in assessing the state of regional blood flow of periodontal tissues is a highly informative and non-invasive method. The velocity characteristics (linear and volumetric velocities) of","PeriodicalId":53991,"journal":{"name":"International Journal of Biomedicine","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43459443","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}
Pub Date : 2023-06-05DOI: 10.21103/article13(2)_oa13
Aida Kumnova, L. Shahini, Bujar Tabaku, Koshi Arberore, Cena Valon, Kabashi Klodete
Background: Chronic endometritis (CE) is highly prevalent in patients with unexplained infertility. This study aimed to determine the associations between CE and infertility. Methods and Results: We performed a prospective study of 197 women with implantation failure and pregnancy loss after undergoing in vitro fertilization (IVF). The endometrium was examined with a hysteroscope, and a sample was taken for biopsy in areas suspected of having inflammation. Immunohistochemistry was performed for CD138 antibodies. Diagnostic criterion was more than 5 plasma cells per 10 high-power fields. Patients who were positive for CE were treated with antibiotics. Among the 197 patients in our study, 115(58.4%) were positive for CE. Regarding the success of CE treatment and pregnancy after treatment, among the 115 CD138-positive patients, 32 became pregnant without IVF after treatment, while another 43 had successful pregnancies and childbirth with IVF. Thus, with treated CE, a successful pregnancy and childbirth was detected in 65.2% of cases, including spontaneous pregnancies and IVF. Conclusion: Patients with infertility and those who have pregnancies lost in IVF have a high rate of CE. Failure to treat CE results in infertility and IVF failure. An efficient diagnosis and treatment of CE are important for a successful pregnancy.
{"title":"Chronic Endometritis in Patients with Failure of IVF","authors":"Aida Kumnova, L. Shahini, Bujar Tabaku, Koshi Arberore, Cena Valon, Kabashi Klodete","doi":"10.21103/article13(2)_oa13","DOIUrl":"https://doi.org/10.21103/article13(2)_oa13","url":null,"abstract":"Background: Chronic endometritis (CE) is highly prevalent in patients with unexplained infertility. This study aimed to determine the associations between CE and infertility. Methods and Results: We performed a prospective study of 197 women with implantation failure and pregnancy loss after undergoing in vitro fertilization (IVF). The endometrium was examined with a hysteroscope, and a sample was taken for biopsy in areas suspected of having inflammation. Immunohistochemistry was performed for CD138 antibodies. Diagnostic criterion was more than 5 plasma cells per 10 high-power fields. Patients who were positive for CE were treated with antibiotics. Among the 197 patients in our study, 115(58.4%) were positive for CE. Regarding the success of CE treatment and pregnancy after treatment, among the 115 CD138-positive patients, 32 became pregnant without IVF after treatment, while another 43 had successful pregnancies and childbirth with IVF. Thus, with treated CE, a successful pregnancy and childbirth was detected in 65.2% of cases, including spontaneous pregnancies and IVF. Conclusion: Patients with infertility and those who have pregnancies lost in IVF have a high rate of CE. Failure to treat CE results in infertility and IVF failure. An efficient diagnosis and treatment of CE are important for a successful pregnancy.","PeriodicalId":53991,"journal":{"name":"International Journal of Biomedicine","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2023-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41948491","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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