Journal of population therapeutics and clinical pharmacology = Journal de la therapeutique des populations et de la pharmacologie clinique最新文献

The modular operating theater (MOT) system is often used in operating rooms since it is incorporated into a single control panel, enabling its operation more effectively and efficiently. The MOT in the present study's operating room employs analytical techniques, and moreover has complicated space needs. Any hospital that wants to implement MOT in the operating room must adhere to the regulations of the Indonesian Ministry of Health, as everything must adhere to a specific criteria. Additionally, MOT must fulfill the primary components required to ensure that the operational process proceeds properly and without technological difficulties. The criteria also includes the use of insulated doors (swing or sliding) to control the pathogens, bacteriostatic floors with corner covings, the operating table must be set in such a way that the laminar airflow reaches it, the use of modern operating tables, the adequate filtration of the air conditioning system and the air distribution system, and use of sterile corridors. The MOT in the operating room must also include the medical gas pipeline system (MGPS), flexible arm light pendants, precise indications on surgeon control panels and electrical panels, scrub stations, comprehensive utility pendants, as well as static/dynamic clean/dirty boxes. The operating room MOT requirements are specified in PERMENKES RI No. 1204/MENKES/SK/X/2004, and any hospital that wishes to construct one must adhere to them. Several requirements are outlined in the study that must be adhered to while manufacturing MOT. For example, walls and ceilings must be insulated with PUF, EPS, or stainless steel panels.

Background: Chronic Myeloid Leukemia (CML) is initiated in the bone marrow due to the chromosomal translocation t(9;22), resulting in the fusion oncogene BCR-ABL. Tyrosine kinase inhibitors (TKIs) targeting BCR-ABL have transformed fatal CML into an almost curable disease. However, TKIs lose efficacy during disease progression, and the mechanism of CML progression remains to be fully understood. Additionally, common molecular biomarkers for CML progression are lacking. Our studies previously detected ANKRD36 (c.1183_1184 delGC and c.1187_1188 dupTT) associated exclusively with advanced phase CML. However, clinical validation of this finding was pending. Therefore, this study aimed to clinically validate mutated ANKRD36 as a novel biomarker of CML progression.

Materials and methods: The study enrolled 124 patients in all phases of CML, recruited from Mayo Hospital and Hameed Latif Hospital in Lahore, Punjab, between January 2019 and August 2021. All response criteria were adopted from the European LeukemiaNet guideline 2020. Informed consent was obtained from all study subjects. The study was approved by scientific and ethical review committees of all participating centers.Sanger sequencing was employed to detect ANKRD36 mutations in CML patients in accelerated phase (AP) (n=11) and blast crisis (BC) (n=10), with chronic-phase CML (CP-CML) patients as controls (n=103). Samples were processed using Big Dye Terminator Cycle Sequencing Ready Reaction kits and sequenced using ABI Prism 3730 Genetic Analyzer, and sequencing using forward and reverse primers for ANKRD36.

Results: During our study, 17% of CML patients progressed to advanced phases AP-CML n=11 (8.9%) and BC-CML n=10 (8.1%). The chronic- and advanced-phase patients showed significant difference with respect to male-to-female ratio, hemoglobin level, WBC count, and platelet count. Sanger sequencing detected ANKRD36 mutations c. 1183 1184 delGC and c. 1187 1185 dupTT exclusively in all AP- and BC-CML patients but in none of the CP-CML patients. Nevertheless, mutations status was not associated with male-to-female ratio, hemoglobin level, WBC count, and platelet count, which makes ANKRD32 as an independent predictor of early and terminal disease progression in CML.

Conclusions: The study confirms ANKRD36 as a novel genomic biomarker for early and late CML progression. Further prospective studies should be carried out in this regard. ANKRD36, although fully uncharacterized in humans, shows the highest expression in bone marrow, particularly myeloid cells. Functional integrated genomic studies are recommended to further explore the role of ANKRD36 in the biology and pathogenesis of CML.

Objective: This study aimed to assess the diagnostic role of perfusion weighted image (DCE-PWI) to differentiate benign from malignant breast lesions.

Patients and methods: The study comprised 32 women who had mammography and/or breast ultrasonography findings that were clinically questionable. All patients were fasting during the magnetic resonance imaging (MRI) test to avoid nausea or dynamic contrast-enhanced vomiting from the contrast medium.

Result: In this study, we observed the form of the dynamic curve (time and signal intensity curve) type I (persistent curve) was noted in 12 lesions (37.5%): 10 lesions were benign and two lesions were malignant; type II (plateau curve) was noted in eight lesions (25%): three lesions were benign and five lesions were malignant, and type III (washout curve) noted in 12 lesions (37.5%): one lesion was benign and 11 lesions were malignant.

Conclusions: The dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) perfusion technique plays an important role in differentiating benign and malignant tumors in breast cancer.

Background: Vitiligo is a disease that occurs due to dysfunction in the autoimmune system that attacks the skin pigment cells (melanocytes) leading to the appearance of light-colored spots on the skin.

Objective: The study was carried out to investigate the effect of smart devices on the children inflicted with vitiligo, and the correlation of vitiligo with other factors such as performance in the school, the marital status of their parents, type of smart devices (games, YouTube), and others.

Materials and methods: The study was carried out on 49 children diagnosed with vitiligo in Nassiriah City, Iraq. The data of all the variable factors were collected and classified according to the types of smart applications (YouTube and/or games), the status of their parents, and hours spent on using these applications.

Results: The collected data were analyzed into five figures; according to the children's performance in the school and the highest percentage were in the no failure category, or in the high achiever category constituting 38.77% to each one. The percentage of children who lives with both parents is 79.5%. Most of the affected children are the 2nd in order in their families representing 40.8% of children under study. The number of diseased children who use YouTube are 23, their percentage is the highest constituting 46.94%.

Conclusions: Seven conclusions were drawn in this novel study, among them are; that most of the affected children are 2nd in order in their families, and the highest percent of the affected children with vitiligo are those who use YouTube.

Objective: Stress urinary incontinence (SUI) causes a significant physical and psychological burden on women. The laparoscopic vaginal suspension (LC), used in the treatment of women with SUI, is known for its advantages such as smaller incisions, short hospital stays, and better aesthetic results. This article throws light upon the advantages and disadvantages of LC and open Burch vaginal (OC) incontinence along with its associated complications.

Patients and methods: Between December 1, 2017 and February 10, 2019, 26 women with SUI with physical, social, and psychological consequences from two hospitals were enrolled in this study. The sample was divided into two equal groups of 13 women each. Data were collected and statistically analyzed. P ≤ 0.05 is statistically significant.

Results: The study showed that the operational time was significantly shorter in the OC method compared to the LC approach (59.2 ± 5.3 min and 91 ± 4.5 min, respectively). Mean blood loss was higher in the OC approach than in the LC approach (152.2 ± 30.3 and 143.3 ± 38.6, respectively). The LC approach has minimal pain and a shorter hospital stay compared to the OC approach. Patients with the LC approach required less analgesia (8.9 ± 1.3 mg vs 2.5 ± 1.8 mg) and less hospital stay (110.3 ± 11.4 h vs 70.2 ± 8.9 h) after surgery. Resumption of normal activity was faster in the LC approach [25.1 ± (12.6) days, 18.9 ± (12.5) days] than in the OC approach. There was no significant difference between the OC and LC approaches in terms of complications.

Conclusions: Although LC is a superior and less invasive approach than the OC approach in terms of hospital stay, blood loss, pain, and recovery time, the operation time is longer.

Cutaneous cautery is a form of traditional medicine practiced in many countries. It was mentioned in the books of many ancient, pre-, and post-Islamic scholars. Patients may resort to traditional medicine (cauterization in particular) for many reasons. This study aims is to acquire more knowledge about the cautery practices and the reasons for practicing cautery in children together with other implications from adverse events of the cautery. This is a cross-sectional study in which 133 children were enrolled (77 males and 56 females with age ranged from 0.5 to 108 months) who had been admitted to Bint Al-Huda Maternity and Childhood Teaching Hospital in Nasiriya city, Thi-Qar Governorate, Southern Iraq, from December 1, 2019 to end of July 2020). The study found that >80% of cauterized children were below 1 year, (53.4%) of rural residency. Parents of the cauterized children were mainly of illiterate and primary education constituting the highest percentage (91.6%) of cauterized children were of low per capita monthly income. The grandmothers were advisors in more than half of the cauterized children, a vast majority of the advisors were either illiterate or had primary education, The person performing the cautery was a traditional healer (95.5%). Cauterization was done mostly in the head and abdomen, and a vast majority of it was done by a lighted cotton-tipped application (97%). The number of cauterization points ranged from 2 to 25 with a mean of 8.8 cautery marks. Approximately 59% of patients did not improve or worsened, whereas 30% showed partial improvement, and 11% improved. Complications were seen in 9% of the cases. There is a necessity to spread awareness regarding the dangers and complications of traditional cauterization in health care centers by health care providers. Improving the delivery of medical services to areas far from the city centers as well as spreading health awareness by use of multimedia together with eradicating illiteracy is needed.

Psoriasis is a medical condition in which the skin of the body is affected at a multisytemic level. Patients with moderate to severe psoriasis have a considerably reduced quality of life as a result of their disease. For morphological indicators, the Psoriasis Area Severity Index (PASI) test is one of the methods for indicating the severity of the illness. An imbalance between pro-oxidants and antioxidants in our bodies causes oxidative stress and plays a crucial role in the pathophysiology of chronic inflammatory diseases like psoriasis(1). It has been considered that antioxidant treatment can be an effective therapeutic option. The goal of this clinical investigation was to see if there was a link between the percentage change in quality of life and the clinical severity of psoriasis during a 12-week period among Iraqi psoriatic patients. Over the course of 3 months, 24 psoriatic patients (9 females and 15 males) ranging in age from 17 to 72 years participated in a prospective double-blinded clinical experiment. Two groups of participants were formed. A biological medicine (adalimumab) and a placebo was given to group A (n = 11), whereas group B (n = 13) received 100 mg CoQ10 adjuvant therapy in addition to the biological medication already provided. The Psoriasis Area and Severity Index (PASI) and the Dermatology Life Quality Index (DLQI) were used to examine patients (DLQI). Treatment with both biological and adjuvant CoQ10 therapy showed a substantial association between the PASI and the DLQI (p = 0.000132). After 3 months of therapy, the mean (SD) of the PASI score for all patients was 20.88 7.15, with a 67.48% ± 22.25% improvement change. The mean SD of the DLQI score at baseline was 12.5 ± 4.71, with a change of 56.13% ± 20.15% following treatment. After therapy with a biological medication, there was a favorable association between the PASI and the DLQI (p > 0.05). This indicates that therapy with a biological medication with daily administration of 100 mg CoQ10 supplements to psoriatic patients for 12 weeks improved the correlation between PASI and DLQI.

Aim: This study aimed to find the effect of hypothyroidism in men on metabolism and bone mineral density.

Method: The study included a patients group of 90 men suffering from hypothyroidism and 120 healthy subjects as a control group. The study comprised the estimation of the concentration of Blood free triiodothyronine (FT3), free thyroid hormone (FT4), thyroid stimulating hormone (TSH), bone resorption index type I collagen C-terminal peptide (CTX-1), the serum calcium (Ca2+), serum phosphorus (Pi3+), the bone mineral density of the lumbar spine and femoral neck.

Results: In the hypothyroidism men group: (1) the bone mass was lower than the control group with significant differences, (2) the bone resorption index CTX-1 was significantly higher than that in the control group and calcium and phosphorus were not different from those in healthy control subjects, and (3) TSH was positively correlated with CTX-1. Male TSH and CTX-1 levels were positively correlated.

Conclusions: There is bone loss in men with hypothyroidism, which may be related to increased bone resorption.

Toxoplasmosis is one of the most globally prevalent zoonotic infection caused by an obligate, intracellular parasite called Toxoplasma gondii. Toxoplasmosis actively triggers an acute immune response and inflammatory reactions, which causes serious pathological changes in various tissues in the human body, and more evidently localizes in different nervous tissues of various body organs. The YKL-40 is a glycoprotein secreted by numerous cell types in different patterns associated with various pathological processes such as inflammatory reactions, tissue remodeling, and fibrosis, and is a disease-specific biomarker of neuroinflammation. Therefore, this study aimed to determine whether the YKL-40 is markedly increased in toxoplasmosis or not and whether its level is different between the acute and chronic phases of the infection to determine if it can be used as a clinically useful biomarker in the diagnosis, and determination of disease severity and follow-up of toxoplasmosis. Accordingly, a total of 80 serum samples were collected from previously diagnosed female patients of different ages with toxoplasmosis. In addition, serum samples of 10 healthy females were used as the control. Patients were first divided into two groups (30 patients with acute infection, and 50 patients with chronic infection) depending on the results of detection of specific anti-Toxoplasma IgM and IgG by enzyme-linked immunosorbent assay (ELISA). The level of YKL-40 was then measured in the patients' serum by ELISA. The statistical analysis of data clearly disclosed very highly significant differences (P < 0.001) between the level of YKL-40 in the acute infection group and healthy controls, chronic infection group and healthy controls, and between the groups with acute and chronic infections. These findings led to conclude that YKL-40 classify as a unique and sophisticated biomarker in the diagnosis of toxoplasmosis where it can vitally be used to detect the stage of the disease, whether acute or chronic, besides its ability to detect the infection.

Background: Acute otitis externa (AOE) is a common disease encountered in otolaryngology practice, it is mainly bacterial in origin. AOE can cause severe otalgia and can interrupt the daily activities; however, bed rest is required in about 20% of the patients.

Aim: To evaluate the usefulness of adding an oral antibiotic with the topical antibiotic steroid in the treatment of uncomplicated AOE which is limited to the ear canal in immunocompetent patients.

Patients and methods: A prospective comparative clinical study was conducted in the department of otolaryngology at Al-Jerrahat Teaching Hospital and Private Clinic, Baghdad, Iraq, during the period from April 2020 to October 2021. A total of 68 immunocompetent patients (39 females and 29 males), diagnosed as cases of uncomplicated AOE which is limited to the ear canal, were included in this study. The patients were categorized into two groups. Patients in group A were treated with topical tobramycin 0.3%-dexamethasone 0.1% drops, while patients in group B received the same treatment as group A patients plus oral Ciprofloxacin tablets 500 mg twice daily. The patients were followed up on day-to-day basis until complete resolution of pain and edema. The severity of pain was assessed by visual analogue scale (VAS) scores, while edema was graded by dividing the ear canal by imaginary horizontal and vertical lines into four quarters. The post-treatment pain VAS scores and edema grades of both groups were compared. Statistical analysis using t-test was done to calculate P-value in order to find if there is a significant difference regarding the resolution of pain and edema between group A and group B.

Results: During the whole follow-up period there was no significant difference between group A and group B patients regarding the resolution of pain and edema (P-value was more than 0.05).

Conclusions: There is no significant benefit of adding an oral antibiotic with the topical antibiotic steroid in the treatment of uncomplicated AOE limited to the ear canal in immunocompetent patients.