Cross-sectional Case-control Study Research Articles

Stability, Balance, and Physical Variables in Patients with Bilateral Hemophilic Arthropathy of the Ankle versus Their Healthy Peers: A Case-Control Study.

(1) Background: The recurrence of hemarthrosis in patients with hemophilia triggers a pathophysiological process of degenerative, progressive, and irreversible joint destruction. This hemophilic arthropathy is characterized by chronic pain, muscle atrophy, loss of mobility, and proprioceptive alterations. As the same joint undergoes repeated hemarthrosis, the function of the mechanical receptors deteriorates, causing a pathophysiological modulation and deterioration of the musculoskeletal system. The objective was to analyze the differences in stability and balance, as well as in ankle dorsal flexion, functionality, and muscle strength, between patients with bilateral hemophilic arthropathy and their healthy peers. (2) Methods: A cross-sectional descriptive case-control study was performed. Twenty-two participants were recruited: 10 adult patients with bilateral hemophilic arthropathy of the knee and ankle and 12 healthy subjects. The variables were balance (Rs Scan pressure platform), ankle dorsiflexion range of motion (Leg Motion), functionality (2-Minute Walk Test), and ankle dorsal strength (dynamometry). (3) Results: Statistically significant differences (p < 0.05) were found in the balance without visual support in the Max-Y variable (MD = 2.83; CI95%: 0.33;5.33; Effect size (d) = 0.67), ankle dorsiflexion (MD = 16.00; CI95%: 14.30; 20.0; d = 7.46), and strength of the ankle flexor muscles (MD = 128.50; CI95%: 92.50; 153.60; d = 2.76). (4) Conclusions: Ankle range of motion in dorsal flexion, functionality, and muscle strength in dorsal flexion is poorer in patients with bilateral lower limb hemophilic arthropathy than in their healthy peers. Patients with bilateral hemophilic ankle arthropathy have statistically poorer stability and balance without visual support than their healthy peers.

Determination of Nasal and Endotracheal (ETT) Microorganisms in Pediatric Patients with Intubated VAP Admitted to the Pediatric Intensive Care Unit (PICU)

Background: Ventilator-associated pneumonia (VAP) is one of the most common healthcare-related infections in pediatric and neonatal intensive care units. In the present study, due to the importance of prevention, early identification, and treatment of VAP, nasal and endotracheal microorganisms were determined in intubated patients admitted to the pediatric intensive care unit. Objectives: The present study aims to determine the nasal and endotracheal (ETT) microorganisms in pediatric patients with intubated VAP admitted to the pediatric intensive care unit (PICU). Methods: This cross-sectional two-group case-control study was conducted on 90 intubated patients: Sixty patients with VAP (30 nasal, 30 tracheal tubes) and 30 patients without VAP, hospitalized in the PICU department of Amir al Mominin Ali (AS) Hospital in Zabol, Iran, from March 2018 to December 2018. The criteria for diagnosing VAP was the clinical pulmonary infection score (CPIS). In both case and control groups, samples were collected from nasal tubes using nasal swabs and from tracheal tubes (ETT) as tracheal aspirates from intubated patients, and sent to the laboratory for culture. The collected samples were interpreted in the microbiology laboratory to identify microorganisms. Data collection was done using a demographic information questionnaire and the clinical pulmonary infection score CPIS. The data was entered into SPSS 20 statistical software and analyzed. Results: The results of the present study showed that gender and age of patients do not affect the incidence of VAP, but children with VAP have a significantly longer stay in the PICU. Microbiological examination showed that Klebsiella and Escherichia coli (13.3%) were the most frequent among the positive nasal samples, and Klebsiella and E. coli (36.7%) were the most frequent among the positive tracheal samples. The diversity of microbes observed in ETT samples was also higher. Conclusions: The present study showed that the duration of hospitalization in the pediatric intensive care unit, as well as the age of hospitalized patients, can increase the risk of VAP. Additionally, nasal sampling is effective in identifying and differentiating VAP patients. It is suggested to reduce the duration of hospitalization in these departments as much as possible and to pay more attention to older children to prevent the increase of VAP. The results indicate that nasal bacteria play a role in the more severe occurrence of ventilator-induced pneumonia. Therefore, it is recommended to use broad-spectrum antibiotics and implement preventive nursing measures. If possible, starting feeding earlier through a gastric tube is also suggested.

Aqueous Humor Cytokines in Idiopathic Epiretinal Membrane: Correlation with Disease Severity.

To analyze the concentration of aqueous humor (AH) cytokines in eyes with idiopathic epiretinal membrane (iERM) and to investigate their potential correlation with disease severity. Retrospective cross-sectional case-control institutional study. A total of 16 eyes of 16 iERM patients and 14 eyes of 14 age-matched healthy controls were enrolled. AH samples were analyzed for various biomarkers using a glass-chip protein array. Cytokines associated with inflammation, fibrosis, angiogenesis, and glial signal transduction were quantified. Significant differences in cytokine concentration were observed between the iERM group and controls, with 19 cytokines elevated in the iERM group (among them IL-6, IL-8, PDGF-AB, PDGF-BB, TGFB-1, TGFB-2, TGFB-3, VEGF A, VEGF C, VEGF D, p < 0,05, 95% confidence interval). Correlation analysis revealed associations between cytokine levels and iERM severity. Notably, stages 2, 3, and 4 of iERM demonstrated increased levels of various biomarkers. This study provides insights into the complex molecular interactions underlying iERM pathogenesis, describing a correlation between neuroinflammation and iERM severity.

Peer Bullying and Psychiatric Diagnoses in Adolescents with Nonsuicidal Self-Injury

Objectives The aim of this study was to determine the comorbid psychiatric diagnoses, peer bullying rates and NSSI characteristics in adolescents who engage in self-injuring behavior. Materials and Methods This case-controlled cross-sectional study was conducted between 1 March 2020 and 1 May 2021 in the Child and Adolescent Psychiatry and Paediatrics outpatient clinic of a hospital in the Southeastern Anatolia region of Turkey. The data of 50 adolescents with NSSI and 60 adolescents without NSSI attending school were compared. The data in the study were obtained using sociodemographic form prepared by the researchers, the Affective Disorders and Schizophrenia Interview Schedule for School-Age Children—Present and Lifetime Version—Dsm–5, Peer Bullying Scale Adolescent Form and Self-Injurious Behaviour Assessment Inventory. Results Fifty adolescents (70% female) with a mean age of 15.4 years (S.D. = 1.4) with NSSI were included as case group and 60 adolescents (66.7% female) with a mean age of 15.5 years (S.D. = 1.3) without NSSI were included as control group. Banging/hitting self was the most common NSSI method, while affect regulation was the most common function. In the case group, verbal, isolation and damage to belongings among the victim subtypes in the last year were found to be significantly higher than in the control group. It was found that there was a positive correlation between the variety of self-injury methods and bullying exposure scores in adolescents with NSSI. Depression disorders, anxiety disorders, oppositional defiant disorder, attention deficit hyperactivity disorder, conduct disorder, and post-traumatic stress disorder diagnoses were found to be more prevalent in the group with NSSI. Conclusions Based on the finding, it was found that psychiatric diagnoses are more common in adolescents with NSSI, peer bullying subtypes are seen at a higher rate, and as bullying scores increase, the variety of NSSI methods also increases. It is thought that providing psychiatric evaluation and treatment for adolescents with NSSI, establishing cooperation with school and family for peer bullying, developing preventive mental health policies and effective intervention programmes may be beneficial.

Effect of polycyclic aromatic hydrocarbon exposure on amnestic mild cognitive impairment and Alzheimer’s disease: A matched case-control study

There is an emerging body of evidence concerning the neurological effect of air pollutants on cognitive function and increased risk of neurodegeneration. Although previous studies have suggested that polycyclic aromatic hydrocarbons (PAHs) are neurotoxic, the effect of PAHs exposure on neurodegeneration remains unclear. This study aimed to investigate the association between PAH exposure and the risk of developing amnestic mild cognitive impairment (aMCI) and Alzheimer’s disease (AD). For this matched case-control cross-sectional study, we recruited patients aged ≥50 years diagnosed with aMCI and AD from the Samsung Medical Center, Seoul, Korea, between 2014 and 2019. For each patient, we randomly selected four cognitively healthy controls through frequency matching based on sex, age group, and education level. Urinary levels of four PAH metabolites, 1-hydroxypyrene (1-OHP), 1-hydroxyphenanthrene (1-OHPhe), 2-hydroxyfluorene (2-OHFlu), and 2-naphthol (2-NAP), were measured. A conditional logistic regression model was used to evaluate the association, adjusting for potential confounders. A total of 212 patients with aMCI with 848 matched controls, and 267 patients with AD with 1068 matched controls were included in the analyses to estimate the risk of PAH exposure. We found that elevated urinary levels of PAH metabolites (specifically, 1-OHP and 2-NAP) were significantly associated with an increased risk of aMCI and AD. An increase of one unit in log-transformed level of urinary 1-OHP was associated with a 1.15- and 1.16-times higher risk of aMCI and AD, respectively. An increase of one unit in log-transformed level of urinary 2-NAP was associated with a 1.11- and 1.13-times higher risk of aMCI and AD, respectively. These findings indicate that PAH exposure may increase the risk of aMCI and AD, especially for the elderly population. Considering the widespread distribution of PAHs in the environment, reducing PAH exposure may be an effective strategy for the prevention of neurodegenerative diseases.

Potential utility of hemogram indices in hepatitis C virus-related vasculitis: a case–control study

BackgroundHemogram indices are simple, economic indicators of the systemic inflammation characteristic of autoimmune diseases including vasculitides. The clinical utility of hemogram indices in hepatitis C virus-related vasculitis (HCV-V) has not been established. This study aimed to evaluate neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), neutrophil/hemoglobin ratio (NHR), platelet/hemoglobin ratio (PHR), and systemic immune-inflammation index (SII) as potential biomarkers of HCV-V, and their relationship with disease activity. This cross-sectional case–control study was conducted in the departments of Rheumatology and Rehabilitation and Hepatogastroenterology, at Cairo University Hospital. Patients with HCV-V, patients with HCV infection free from extrahepatic manifestations (HCV sine vasculitis), and healthy control subjects were recruited. HCV-V activity was assessed using the Birmingham Vasculitis Activity Score (BVAS).ResultsTwenty-four HCV-V patients, 21 HCV sine vasculitis patients, and 40 healthy controls were recruited. Age and sex distribution was similar across groups. In HCV-V patients, NLR, PLR, NHR, and SII were higher than healthy controls, with NLR (area under curve (AUC) 0.94, p = 0.002), PLR (AUC 0.72, p = 0.007), NHR (AUC 0.89, p < 0.001) and SII (AUC 0.92, p < 0.001) discriminating both groups. PHR correlated with BVAS (r = 0.53, p = 0.007) while NHR correlated with ESR (r = 0.55, p = 0.007). NLR, NHR, and SII were higher in HCV-V than HCV sine vasculitis patients, with NHR (AUC 0.74, p = 0.022) and SII (AUC 0.75, p = 0.038) discriminating in both groups.ConclusionHemogram indices are useful biomarkers of HCV-V. Longitudinal studies are recommended to explore the predictive power of HCV-infected patients developing vasculitis and their potential relationship with therapeutic response and disease relapse.

Bariatric Surgery Is Associated with Lower Concentrations of Fecal Secondary Bile Acids and Their Metabolizing Microbial Enzymes: A Pilot Study.

Excess body fat elevates colorectal cancer risk. While bariatric surgery (BRS) induces significant weight loss, its effects on the fecal stream and colon biology are poorly understood. Specifically, limited data exist on the impact of bariatric surgery (BRS) on fecal secondary bile acids (BA), including lithocholic acid (LCA), a putative promotor of colorectal carcinogenesis. This cross-sectional case-control study included 44 patients with obesity; 15 pre-BRS (controls) vs. 29 at a median of 24.1months post-BRS.We examined the fecal concentrations of 11 BA by liquid chromatography and gene abundance of BA-metabolizing bacterial enzymes through fecal metagenomic sequencing. Differences were quantified using non-parametric tests for BA levels and linear discriminant analysis (LDA) effect size (LEfSe) for genes encoding BA-metabolizing enzymes. Total fecal secondary BA concentrations trended towards lower levels post- vs. pre-BRS controls (p = 0.07). Individually, fecal LCA concentrations were significantly lower post- vs. pre-BRS (8477.0 vs. 11,914.0 uM/mg, p < 0.008). Consistent with this finding, fecal bacterial genes encoding BA-metabolizing enzymes, specifically 3-betahydroxycholanate-3-dehydrogenase (EC 1.1.1.391) and 3-alpha-hydroxycholanate dehydrogenase (EC 1.1.1.52), were also lower post- vs. pre-BRS controls (LDA of - 3.32 and - 2.64, respectively, adjusted p < 0.0001). Post-BRS fecal BA concentrations showed significant inverse correlations with weight loss, a healthy diet quality, and increased physical activity. Concentrations of LCA, a secondary BA, and bacterial genes needed for BA metabolism are lower post-BRS. These changes can impact health and modulate the colorectal cancer cascade. Further research is warranted to examine how surgical alterations and the associated dietary changes impact bile acid metabolism.

Investigating cortical hypoxia in multiple sclerosis via time-domain near-infrared spectroscopy.

Hypoperfusion and tissue hypoxia have been implicated as contributory mechanisms in the neuropathology of multiple sclerosis (MS). Our objective has been to study cortical oxygenation in vivo in patients with MS and age-matched controls. A custom, multiwavelength time-domain near-infrared spectroscopy system was developed for assessing tissue hypoxia from the prefrontal cortex. A cross-sectional case-control study was undertaken assessing patients with secondary progressive MS (SPMS) and age-matched controls. Co-registered magnetic resonance imaging was used to verify the location from which near-infrared spectroscopy data were obtained through Monte Carlo simulations of photon propagation. Additional clinical assessments of MS disease severity were carried out by trained neurologists. Linear mixed effect models were used to compare cortical oxygenation between cases and controls, and against measures of MS severity. Thirty-three patients with secondary progressive MS (median expanded disability status scale 6 [IQR: 5-6.5]; median age 53.0 [IQR: 49-58]) and 20 age-matched controls were recruited. Modeling of photon propagation confirmed spectroscopy data were obtained from the prefrontal cortex. Patients with SPMS had significantly lower cortical hemoglobin oxygenation compared with controls (-6.0% [95% CI: -10.0 to -1.9], P = 0.004). There were no significant associations between cortical oxygenation and MS severity. Using an advanced, multiwavelength time-domain near-infrared spectroscopy system, we demonstrate that patients with SPMS have lower cortical oxygenation compared with controls.

Lecithin-cholesterol acyltransferase and paraoxonase-1 levels in atherosclerotic cardiovascular disease patients in Nigeria.

Recent evidence has linked changes in plasma lecithin-cholesterol acyltransferase (LCAT) and paraoxonase-1 (PON-1) levels with increased risk for development of premature atherosclerotic cardiovascular disease (ASCVD) in different populations. However, studies on this in Nigeria and sub-Saharan Africa are scarce. This study assessed the association between reduced plasma LCAT and PON-1 levels and an increased risk of ASCVD, and their potential as biomarkers for ASCVD. Atherosclerotic cardiovascular disease patients and healthy controls were randomly selected for this cross-sectional case-control study from the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria, between March 2022 and March 2023. Plasma LCAT and PON-1 were determined by sandwich enzyme-linked immunosorbent assay, while the lipid profile was measured by spectrophotometry. A total of 153 ASCVD patients (mean age: 52.92 ± 10.24 years) and 50 healthy controls (mean age: 46.96 ± 11.05 years) were included in the analyses. Stastistically significant increases were observed in the mean body weight, hip circumference, waist circumference, waist-to-hip ratio, body mass index, diastolic and systolic blood pressure (all p ≤ 0.001), and pulse rate (p = 0.003) compared to the control values. Statistically significant increases were also observed in the mean plasma total cholesterol, triglycerides, low-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol (all p ≤ 0.001). In contrast, the mean plasma high-density lipoprotein cholesterol, LCAT, and PON-1 (p ≤ 0.001) were notably reduced compared to the control values. The present study provides supportive evidence that changes in plasma LCAT and PON-1 could predispose individuals to risk of premature ASCVD. Plasma LCAT and PON-1 may serve as independent markers or complement other established cardiovascular disease markers to discriminate the risk of ASCVD when it is unclear.

Combined corneal biomechanical and tomographical indices in subclinical and forme fruste keratoconus.

Evaluation of combined corneal tomographic and biomechanical parameters in subclinical/forme fruste keratoconus (ScKC/FFKC). Cross-sectional observational case-control study. Thirty-one eyes with ScKC (fellow eye of KC with any one sign keratometry >47 diopters, cylinder >1.5 D, central corneal thickness <500 μm, with/without abnormal topography) or FFKC (fellow eye of KC with normal topography and slit lamp examination) >13 years (cases) and 44 eyes of age-matched 22 healthy subjects (controls). Clinically diagnosed KC, presence of corneal scars, and prior ocular surgery eyes. Sixteen Pentacam, 15 Corvis ST, and five Sirius parameters were analyzed using paired sample t-test, and a subsample found to be significantly different was used in receiver operating characteristic curve analysis. The Youden index was calculated, and Pearson's correlation analysis was done. Five Pentacam, three Corvis ST, and two Sirius parameters had an area under curve (AUC) >0.75. Tomographic and biomechanical index (TBI) (cutoff 0.59, 95% specificity, 77% sensitivity), Belin Ambrosio enhanced ecstasia display (cutoff 1.8, 81% specificity, 80% sensitivity), and symmetry index of posterior corneal curvature (cutoff 0.16, 97% specificity, 67% sensitivity) best identified early KC. TBI strongly correlated with maximum Pentacam parameters in both cases and controls. Corvis biomechanical index strongly correlated only in cases, and SP-A1-SD weakly correlated in cases. Upon combined analysis, the average sensitivity and specificity, respectively, of top three parameters (according to AUC) from Pentacam and Corvis ST were 74.1% and 95.4% for posterior elevation and TBI. A trial was registered in Clinical Trial Registry of India on January 28, 2022. The Trial Registration Number is REF/2022/01/050638.

Serum lipid level as a biomarker in depressive disorder: A cross-sectional case control study

Objectives: This study investigates the potential of serum lipids as markers for depression, specifically focusing on symptoms such as suicidal ideation and anhedonia. In the context of advancing psychiatric biomarker research, this study aims to identify lipid-related markers and their underlying biological connections to depression, offering valuable insights for clinical practice and patient outcomes. Material and Methods: This case-control observational study was conducted over 18 months at a tertiary care center. The study enrolled patients aged 18–60 years diagnosed with depression attending outpatient and inpatient departments, totaling 100 subjects, including 100 cases and 100 controls, with gender and body mass index (BMI)-matched controls. Inclusion criteria for cases required depression diagnosis using the International Classification of Diseases-10-Diagnostic Criteria for Research criteria, while controls comprised healthy individuals within the same age range. Exclusion criteria encompassed comorbid psychiatric illnesses, substance use disorders (except tobacco), unstable medical conditions, lipid-lowering agent use, and a BMI over 30. Clinical assessments, including the Hamilton Depression Rating Scale-17 item scale, Modified Scale for Suicidal Ideation, and Snaith-Hamilton Pleasure Scale-Clinician administered, were administered. Serum lipid parameters, including triglycerides (TG), total cholesterol (TC), and high-density lipoprotein (HDL)-cholesterol, were measured. Results: In a cross-sectional case-control study (n = 200), we examined serum lipids as potential depression biomarkers. Cases (n = 100) matched controls in age, BMI, and gender. Cases had lower TC (153.27 mg/dL vs. 171.34 mg/dL, P &lt; 0.01*). Serum TG and low-density lipoprotein also varied significantly with depression severity (P &lt; 0.01*). However, HDL levels remained consistent. No significant associations were found between suicidal ideation and anhedonia, and post hoc analyses revealed significant differences (P ≤ 0.05) in lipid parameters across various depression severity levels. Conclusion: These findings suggest a complex relationship between serum lipids and depression, with potential implications for understanding the biological underpinnings of depression and its severity. However, there was no such relationship that was observed between serum lipids and anhedonia or suicidal ideation. These insights could inform clinical practices and improve patient outcomes in depression management.

Study of Serum Complement 3 Split Product iC3b /C3 Ratio in a Cohort of Systemic Lupus Erythematosus Patients

Abstract Background Systemic lupus erythematosus (SLE) is a chronic autoimmune systemic disease that causes widespread multi organ inflammation. The exact cause of SLE remains unclear; however, genetic, hormonal, and environmental factors contribute to the development of the disease. Aim of the Work The aim of this study is to measure the ratio of complement split product iC3b to C3 and its relation to disease activity and lupus nephritis in a cohort of SLE patients. Patients and Methods This study is a Cross sectional case control study conducted in internal medicine and Rheumatology unit, Ain Shams university hospital and Rheumatology unit, Maadi military hospital. Our study included. Results The present study shows that female were (76%) in active group of SLE patients and (60%) in inactive group while male were (24%) and (40%) respectively. with no significant difference. The mean of Disease Duration was (5.66 ± 1.97) with a range from 3 and 10 years in active group of SLE patients and (5.08 ± 1.54) with a range from 3 and 9 years in inactive group. with no significant difference. Regarding clinical manifestations of SLE the present study shows that active group of SLE patients had statistically highly significant increase in incidence of lupus nephritis, arthritis, serositis, oral ulcers, malar rash (p &amp;lt; 0.001) with significant increase in incidence of alopecia and neurological manifestations (p &amp;lt; 0.05). The current study shows that active group of SLE patients had statistically significantly higher mean ESR, anti-DNA titre, 24hr urinary proteins, serum creatinine, serum urea, and GFR levels (p = 0.000) than inactive group, Also active group had significant leucopenia, anemia (p = 0.000, 0.005 respectively) and C3 was significantly more consumed than inactive group (p &amp;lt; 0.05) Conclusion The ratio of complement split product iC3b to C3 concentrations correlates with the extent of SLE disease activity more than C3 alone. Furthermore, the iC3b:C3 ratio may discriminate between patients with lupus nephritis and patients without lupus nephritis. Detection of SLE disease activity and lupus nephritis by iC3b/C3 ratio help to make a proper decision in management to induce remission.

Detection of Subclinical Cardiomyopathy in Patients with Hashimoto Thyroiditis

Abstract Background Hashimoto thyroiditis (HT) is the most common cause of thyroid diseases in children and adolescents. Ventricular myocardial dysfunction associated with HT has been suggested to be related to the chronic inflammatory state associated with autoimmunity as well as to the endocrine effects. Objective To evaluate using speckle tracking echocardiography (STE) and estimation of carotid intima-media thickness (CIMT) in early detection of myocardial dysfunction in children with Hashimoto thyroiditis. Patients and Methods A cross-sectional case-control study was performed that included 15 patients with HT recruited from the pediatric endocrinology clinic, at Ain Shams University Hospital from October 2020 to July 2021. The patients were compared to 15 age and sex-matched healthy controls. Data were collected from patients’ files including age at initial diagnosis, initial level of thyroid hormones, antithyroglobulin antibodies, and antithyroid peroxidase antibodies. Results Mean age of enrolled patients was 13.20 ± 3.05 years. Cardiac functions in HT patients by using conventional Echocardiography and STE, both were correlated to thyroid hormones, auto- antibodies, lipid profile, and duration of disease (P &amp;lt; 0.05 for all). There were no statistically significant differences in conventional Echocardiographic parameters between patients and controls(P &amp;gt; 0.05 for all). Left ventricular global longitudinal strain (LVGLS) was within the normal range for both groups and showed no statistically significant differences between them (P &amp;gt; 0.05). Known HT patients had lower LVGLS mean (19.72 ± 1.22 %) than newly diagnosed patients (21.52 ± 0.99%, P = 0.014). There was no correlation between cardiac functions and the level of thyroid auto-antibodies (P &amp;gt; 0.05 for all). There was no statistically significant difference between patients and controls in CIMT (0.33 ± 0.05 vs 0.35± 0.05, P = 0.473). There was a positive correlation between the duration of disease and CIMT among patients (P-value= 0.025) Conclusion Patients with HT may have subclinical myocardial dysfunction which could be attributed to the chronic inflammatory state even with normal thyroid functions. STE can early detect the myocardial dysfunction on initial examination and follow up.

Radiological Assessment of Hand and Wrist Bones in Malnourished Children

Abstract Background Protein energy malnutrition (PEM) is still an important health problem that is responsible for childhood morbidity and mortality leading to permanent impairment of physical and mental growth. Objective This study is designed to assess the appearance of ossification centers of lower end of radius and ulna, carpals, metacarpals and phalanges in normal children and malnourished children then comparing between them, to detect early changes in bone growth in malnourished children. Subjects and Methods This case-control cross-sectional study included 45 malnourished children and 45 age and sex matched controls whose ages ranged between 6 months and 5 years. The patients were recruited from Pediatric Nutrition Clinic of Ain Shams University. All children (malnourished and control) were examined for anthropometric parameters (weight, height, body mass index (BMI) and mid upper arm circumference (MUAC)), investigated for serum calcium, phosphorus, alkaline phosphates and had a plain X-ray done on left hand and wrist (posteroanterior (P-A) view), the X-ray was analyzed by using A Digital Atlas of Skeletal Maturity. Results The plain X-ray hand and wrist showed delayed appearance of ossification centers in malnourished infants and children (97.8% had delayed bone age) when compared to controls (25.5% had delayed bone age) which was statistically highly significant with P-value &amp;lt; 0.01. Signs of vitamin D deficiency rickets together with serum calcium, phosphorus and alkaline phosphatase were statistically significantly lower in the cases when compared to the controls with P-value &amp;lt; 0.01. The statistical measurements of mean ± SD regarding weight of case group and control group was (9.05 ± 2.48, 13.54 ± 3.81) with P-value &amp;lt; 0.01 which is highly significant, regarding length or height was (79.51 ± 12.78, 88.94 ± 15.02) with P-value &amp;lt; 0.01 which is highly significant, regarding MUAC was (11.38 ± 1.91, 16.02 ± 1.26) with P-value &amp;lt; 0.01 which is highly significant. Conclusion X-ray hand and wrist for malnourished infants and children showed delayed appearance of ossification centers when compared to matched controls.

Anti-carbamylated Protein Antibodies Positivity in Rheumatoid Arthritis and Its Association With Rheumatoid Factor and Anti-cyclic Citrullinated Protein Antibodies.

Background Rheumatoid arthritis (RA) is a widespread autoimmune disease affecting millions of people worldwide. The current markers include anti-cyclic citrullinated peptide (anti-CCP) antibodiesand rheumatoid factor (RF), which are nonspecific and elevated in variousconditions and do not have a prognostic value. They are also elevated in the later stages of the disease. Anti-carbamylated protein (anti-CarP) antibodies have been reported to be associated with joint damage in RA. Therefore, this study aimed to evaluate the sensitivity and specificity of anti-CarP antibodies in individuals with RA and their relationship with inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Methods This was a cross-sectional case-control study conducted from April 2020 to March 2021 at the Saveetha Medical College, Chennai, India. The age makeup of the three groups was evaluated: Group 1 comprised anti-CCP and RF-positive patients; Group 2 comprised anti-CCP and RF-negative patients; and Group 3 was the control group, which comprised healthy volunteers. Patient samples, including blood and serum, have been utilized to conduct various assessments aimed at evaluating biomarkers such as CRP, ESR, RF, and autoantibodies like anti-CCP and anti-CarP. Results This study examined the role of various autoantibodies and biomarkers in RA across three distinct groups. Group 1 predominantly consisted of middle-aged individuals, and women constituted the majority in both Group 1 and Group 2, consistent with higher RA prevalence among females. In Group 1, 65.7% of patients tested positive for anti-CarP, while in Group 2, 48.6% tested positiveeven when RF and anti-CCP antibodies were absent. This suggests a potential diagnostic role for anti-CarP antibodies in identifying RA patients early. CRP and ESR levels were significantly elevated in RA patients (Groups 1 and 2) compared to healthy controls (Group 3), indicating higher inflammatory activity in affected individuals. We also observed that anti-CarPantibodies had a specificity of 69.1% and a sensitivity of 78.2%. Positive correlations between the diagnosis of RA and anti-CarP antibody positivity were observed across the groups and correlated well with the inflammatory markers and signs such as joint damage. The data were found to be statistically significant. Conclusions Our study showed a significant correlation between joint damage and CRP levels and a positive correlation between anti-CarP antibodies and ESR and CRP values. These findings suggest that anti-CarP antibodies can offer certain advantages over RF and anti-CCP antibodies in RA diagnosis due to their early detection potential, higher specificity, complementary diagnostic role, and predictive value for disease severity.

A Comparative Study of Bone-Health and Associated Factors in Healthy Indian Adolescents and Young Women

Abstract Introduction: Adolescence is a critical period for the accrual of bone mass. However, few studies have assessed the bone geometry in slum-dwelling girls/young women. We thus conducted this study: (1) to assess bone health in Indian adolescent girls and young women residing in slum vs nonslum (NS) areas and (2) to identify factors associated with poor bone health. Methods: This cross-sectional case–control study was performed on 110 apparently healthy unmarried, nonpregnant, nonlactating, postmenarchal adolescent girls and young women aged 11 to 24 years residing in urban slums with the same number of age-matched controls from NS areas. Anthropometric, dietary, physical-activity and bone-health parameters (using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography—DXA and pQCT—respectively) were evaluated using standard protocols. A P value of &lt; 0.05 was considered statistically significant. Results: Slum girls were significantly shorter and lighter and had lower dietary intakes of calcium and protein after adjusting for total daily calorie intake than NS girls (P &lt; 0.05). Areal bone-mineral density (BMD) at lumber spine (0.940 ± 0.13 vs1.042 ± 0.15 g/cm2), femur and total body (less-head), bone-mineral apparent density adjusted for volume at the lumbar spine (0.295 ± 0.04 vs 0.319 ± 0.04 g/cm3) and height-adjusted bone density at femur (0.862 ± 0.011 vs 0.905 ± 0.011 g/cm2) were significantly lower in slum dwelling participants as compared to their NS counterparts (P &lt; 0.05). After adjusting for confounders like sunlight exposure, anthropometric parameters and dietary calcium intake, area of dwelling was still a significant factor for the difference in BMD. Conclusions: The potential determinants of poor bone density and geometry in girls and young women residing in slums include residential location, dietary habits, and physical activity levels. Despite adjustments for confounding factors, differences in bone health between those in slum and nonslum areas suggest adaptations developed over generations of deprivation in these individuals, necessitating urgent intervention.

In-vivo confocal microscopy predicts cytomegalovirus as the cause of chronic or recurrent anterior uveitis among Chinese.

To evaluate and compare endothelial features by in-vivo confocal microscopy (IVCM) in Chinese eyes with chronic or recurrent anterior uveitis (AU) with and without cytomegalovirus (CMV). A double-masked, cross-sectional case-control study at a tertiary eye clinic. Thirty eyes of 30 subjects were analyzed. Fifteen eyes (50%) were CMV positive, while fifteen eyes were negative for herpes simplex virus, varicella zoster virus and CMV. Absence of pseudoguttata was the strongest, independent risk factor for CMV (OR 34.53, 95% CI: 1.84-648.02, p = 0.018), followed by severe iris depigmentation (OR 31.45, 1.02-965.81, p = 0.048) and low corneal endothelial cell density (ECD) (OR 14.79, 1.14-191.30, p = 0.039) on univariable regression. All three remained statistically significant after adjustment. The combination of absence of pseudoguttata and low ECD on IVCM achieved a similar predictive value as iris depigmentation examination. Absence of pseudoguttata on IVCM was an independent predictor of positive CMV detection after adjusting for iris depigmentation and corneal endothelial cell density. The addition of this feature to severe iris depigmentation and low corneal ECD can increase the positive predictive value of detecting CMV. IVCM was a useful non-invasive tool to predict CMV in patients with chronic or recurrent AU.

Sirtuin3 and Sirtuin7 are promising biomarkers in systemic sclerosis

BackgroundSystemic sclerosis (SSc) is an autoimmune disease that results in micro-vasculopathy, leading to organ dysfunction. Sirtuins are known for their role in cellular processes such as the cell cycle, aging, and inflammation, Sirtuins also play an important role in regulating fibrotic responses, inhibiting collagen production and myofibroblast differentiation, implying that its dysregulation is involved in the pathogenesis of systemic sclerosis. The aim of this study was to determine the circulating Sirtuin3 and Sirtuin7 levels in patients suffering from systemic sclerosis with a focus on how they might be associated with the different clinical features and subsets of the disease.MethodsThis prospective cross-sectional case–control study included 56 participants 41 SSc patients and 15 healthy controls. Demographics, clinical, and laboratory data were analyzed. Quantitative determination of human Sirtuin3 and Sirtuin7 concentrations was done.ResultsAmong systemic sclerosis patients, the age of SSc patients was 42.27 ± 10.46 years. The mean serum levels of Sirtuin3 and Sirtuin7 were significantly lower in SSc patients than in healthy controls (p < 0.001). SIRT3 and SIRT7 levels among SSc patients showed a statistically significant positive correlation (p < 0.001). SIRT7 level was insignificantly decreased in dcSSc (14.16 ± 5.93) than in lcSSc (20.01 ± 8.34). Regarding the SIRT3 level, there was an insignificant difference between dcSSc and lcSSc. Modified Rodnan’s skin score correlated negatively with Sirtuin3 and Sirtuin7 levels. In systemic sclerosis patients with interstitial lung disease (56.1%), there was an insignificant difference in SIRT3 and SIRT7 levels (0.12 ± 0.01and 21.23 ± 8.23) compared with systemic sclerosis patients without interstitial lung disease (0.10 ± 0.01 and 17.47 ± 8.57), with p = 0.408 and 0.258, respectively. The receiver operating characteristic curve for SSc prediction with Sirtuin3 has an accuracy of 83.0%, sensitivity of 85.4%, and specificity of 80.0% and p < 0.001. Regarding Sirtuin7, it has an accuracy of 89.5%, sensitivity of 85.4%, and specificity of 93.3% and p < 0.001.ConclusionSirtuin3 and Sirtuin7 levels were found to have a significant positive correlation in SSc patients. Sirtuin3 and Sirtuin7 levels are both good diagnostic biomarkers for detecting and diagnosing SSc, with Sirtuin7 being more accurate, specific, and predictive of the disease than Sirtuin3. Sirtuin7 is thought to be a new biomarker for SSc disease.

The ABCA1 gene polymorphisms rs1800977 and rs2230806 are differentially associated with the risk for myocardial infarction in Slovenian subjects with type 2 diabetes mellitus

BackgroundThe adenosine triphosphate-binding cassette transporter A1 (ABCA1) is closely linked to various aspects of the regulation of whole-body cholesterol metabolism and atherosclerosis formation. The object of the study was to investigate the association between rs1800977 and rs2230806 polymorphisms in the ABCA1 gene and myocardial infarction (MI) in Slovenian subjects with type 2 diabetes mellitus (T2DM). Methods1590 T2DM patients (484 subjects with MI and 1106 controls) were included in this retrospective cross-sectional case–control study. After genotyping, Pearson χ2 test was used to compare the distribution of genotypes and alleles among the two groups. Logistic regression analysis adjusted for several risk factors for MI was performed. ResultsGenotype distribution showed significant association with MI in T2DM subjects for both selected polymorphisms in ABCA1 gene (p = 0.009 for rs2230806 and p = 0.042 for rs1800977). After applying corrections for confounding variables like age, waist circumference, diastolic blood pressure, serum high-density lipoprotein levels, gender and smoking several genetic models still showed significant associations with MI (dominant model for rs2230806 and dominant, overdominant and co-dominant for rs1800977). ConclusionOur study showed that presence of the T allele of the rs2230806 ABCA1 gene is associated with higher risk of MI, while the A allele of the rs1800977 conferred protection against MI in Slovenian T2DM subjects.

The relationship of peripheral blood cell inflammatory biomarkers and psychological stress in unmedicated major depressive disorder

BackgroundRecent research has explored the linkage between major depressive disorder (MDD) and inflammation, especially via altered peripheral blood immune markers. However, the relationship between several novel leukocyte-derived ratios (LDR) and psychological stress in MDD remains uncertain. This study aimed to explore the relationship between LDR, clinical characteristics, recent life events, and childhood maltreatment in MDD patients. MethodsA cross-sectional case-control study was conducted involving 59 healthy controls (HC) and 50 unmedicated MDD patients. Subjects underwent psychological assessments and peripheral blood measurements. LDR assessed in this study included neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), white blood cell-to-mean platelet volume ratio (WMR), systemic immune inflammation index (SII), multiplication of neutrophil and monocyte counts (MNM), and systemic inflammation response index (SIRI). ResultsMDD patients displayed significant alterations in WMR, PLR, and MNM compared to HC, as well as correlations between several LDR and various clinical features (duration of untreated psychosis and dNLR, the nine-item Patient Health Questionnaire and PLR, the 7-item Generalized Anxiety Disorder Questionnaire and SIRI (NLR and dNLR). There was a significant difference in the comparison of WMR in first-episode patients than in recurrent patients. Analyses further revealed an association between Life Event Scale total scores and NLR (dNLR). No correlation was found between Childhood Trauma Questionnaire total (or subscale) scores and LDR. Additionally, WMR and dNLR presented potential predictive value for distinguishing between MDD and HC. ConclusionThe study concludes that MDD and some clinical features are associated with alterations in some peripheral blood LDR. These findings emphasize the potential role of peripheral blood LDR in the pathogenesis and clinical heterogeneity of MDD.