Clinical Biochemical Analysis Research Articles

Bone scan findings of Paget’s disease of bone in patients with VCP Multisystem Proteinopathy 1

Multisystem Proteinopathy 1 (MSP1) disease is a rare genetic disorder caused by mutations in the Valosin-Containing Protein (VCP) gene with clinical features of inclusion body myopathy (IBM), frontotemporal dementia (FTD), and Paget’s disease of bone (PDB). We performed bone scan imaging in twelve patients (6 females, 6 males) with confirmed VCP gene mutation six (50%) of which has myopathy alone, four (33%) with both PDB and myopathy, and two (15%) were presymptomatic carriers. We aim to characterize the PDB in diagnosed individuals, and potentially identify PDB in the myopathy and presymptomatic groups. Interestingly, two patients with previously undiagnosed PDB had positive diagnostic findings on the bone scan and subsequent radiograph imaging. Among the individuals with PDB, increased radiotracer uptake of the affected bones were of typical distribution as seen in conventional PDB and those reported in other MSP1 cohorts which are the thoracic spine and ribs (75%), pelvis (75%), shoulder (75%) and calvarium (15%). Overall, we show that technetium-99m bone scans done at regular intervals are a sensitive screening tool in patients with MSP1 associated VCP variants at risk for PDB. However, diagnostic confirmation should be coupled with clinical history, biochemical analysis, and skeletal radiographs to facilitate early treatment and prevention complications, acknowledging its limited specificity.

Improving diagnostic yield of pancreatic serous cystadenoma with cyst fluid ancillary testing, adjunct immunohistochemistry, and additional fine-needle biopsy sampling.

Fine-needle aspiration (FNA) diagnosis of pancreatic serous cystadenoma (SCA) remains challenging. This retrospective study aimed to evaluate the roles of cyst fluid ancillary testing and combined fine-needle biopsy (FNB) in improving the diagnostic yield. The authors retrospectively reviewed cytology cases that were histologically confirmed SCAs. Clinical features and FNA cyst fluid biochemical and molecular analysis results along FNB findings were reviewed. The study cohort included 31 cases from 13 male and 18 female patients with a mean age of 65. The original cytologic diagnoses were nondiagnostic (n=6, 19%), negative for malignant cells/cyst contents (n=7, 23%), atypical cells (n=3, 10%), nonmucinous cyst (n=11, 35%), and serous cystadenoma (n=4, 13%). Cyst fluid carcinoembryonic antigen (CEA) analysis was performed in 17 cases, all of which showed a low CEA level (<192 ng/mL). All 14 cases with molecular testing showed a wild-type KRAS. Inhibin immunohistochemistry was retrospectively performed on the FNA cell blocks, inhibin was positive in six of seven cases tested. In 15 cases with concurrent FNA and FNB biopsies, the diagnosis of SCA was seen in only one FNA case (7%) but 13 FNB cases (87%). This study suggests that FNA diagnosis of SCA remains challenging even with ancillary testing including cyst fluid CEA level and KRAS mutation analysis. Adjunct inhibin immunostaining may help improve the cytologic diagnosis of selective SCA cases. FNB appears superior to FNA for a definite diagnosis of SCA.

Biochemical profile of diabetic ketoacidosis in type 2 diabetes patients: an observational study

Background: The present study was conducted to assess the clinical profile of type 2 diabetes patients presenting with diabetic ketoacidosis and review their biochemical parameters at the time of presentation. Methods: The present study was an analytical, cross-sectional study conducted over the period of two years. All the type 2 diabetes patients with diabetic ketoacidosis admitted during the study period constituted the study population, after being subjected to prefixed selection criteria. All the participants were subjected to detailed clinical examination and biochemical analysis during hospitalization and parameters were monitored. Results: Out of the total 60 type 2 DM patients with DKA studied, 53.3% patients belonged to 51 to 60 years age group and 55% were males. One patient died and 59 survived (mortality rate-1.6%). Comparatively higher mean RBS, higher mean serum osmolality and lower pH were observed in the death case in comparison with those who survived. The patient who died had no statistically significant difference in serum sodium, potassium, calcium and magnesium but had lower serum HCO3- than alive patients on admission. Conclusions: DKA is a serious metabolic complication even in cases of type 2 diabetes and higher RBS, higher Sr Osmolality and lower pH at the time of presentation correlate directly with poorer outcomes.

Calcium, Phosphorus, and Vitamin D Levels in a Series of Cystic Fibrosis Patients: A Cross-Sectional Study.

Cystic fibrosis (CF) is a monogenic disease with different types of mutations that mainly affect the respiratory-digestive system. Calcium (Ca), phosphorus (P), and vitamin D (Vit-D) are essential nutrients for maintaining adequate growth and development, as well as key components in crucial metabolic pathways. Proper diagnosis, treatment, and response are decisive components of precision medicine. Therefore, we conducted a cross-sectional study to evaluate Ca, P, and Vit-D levels along with health and nutritional indicators, regarding their non-skeletal functions, in a series of CF patients. Anthropometric and clinical evaluation, biochemical analysis, dietary survey, and respiratory and pancreatic status were performed. Even though the results showed that all patients had normal dietary and serum Ca levels, 47% of patients had deficient Vit-D intake, 53% of patients had hypovitaminosis D, 35% had insufficient Vit-D levels, 18% had hypophosphatemia, 76% had elevated alkaline phosphate levels, 29% had hypercalciuria, and 65% had hyperphosphaturia. There were no significant differences between homozygous and compound heterozygous patients. Ca, P, and Vit-D levels were associated with body mass index; body composition; physical activity; diet; growth hormones; and the immune, liver, and kidney systems. We suggest a periodically evaluation of Ca and P losses.

Biochemical Clusters as Substitutes of Bone Biopsies in Kidney Transplant Patients.

Bone and mineral metabolism abnormalities are frequent in kidney transplant recipients and have been associated with cardiovascular morbidity. The primary aim of this study was to analyse the association between routine clinically available biochemical evaluation, non-routine histomorphometric bone evaluation, and vascular disease in kidney transplanted patients. A cross-sectional analysis was performed on 69 patients, 1-year after kidney transplantation. Laboratory analysis, radiography of hands and pelvis, bone biopsy, bone densitometry, and coronary CT were performed. One-year post-transplantation, nearly one-third of the patients presented with hypercalcemia, 16% had hypophosphatemia, 39.3% had iPTH levels > 150pg/mL, 20.3% had BALP levels > 40 U/L, and 26.1% had hypovitaminosis D. Evaluation of extraosseous calcifications revealed low Adragão and Agatston scores. We divided patients into three clusters, according to laboratory results routinely used in clinical practice: hypercalcemia and hyperparathyroidism (Cluster1); hypercalcemia and high BALP levels (Cluster2); hypophosphatemia and vitamin D deficiency (Cluster 3). Patients in clusters 1 and 2 had higher cortical porosity (p = 0.001) and osteoid measurements, although there was no difference in the presence of abnormal mineralization, or low volume. Patients in cluster 2 had a higher BFR/BS (half of the patients in cluster 2 had high bone turnover), and most patients in cluster 1 had low or normal bone turnover. Cluster 3 has no differences in volume, or turnover, but 60% of the patients presented with pre-osteomalacia. All three clusters were associated with high vascular calcifications scores. Vascular calcifications scores were not related to higher bone mineral density. Instead, an association was found between a higher Adragão score and the presence of osteoporosis at the femoral neck (p = 0.008). In conclusion, inferring bone TMV by daily clinical biochemical analysis can be misleading, and bone biopsy is important for assessing both bone turnover and mineralization after kidney transplantation, although hypophosphatemia combined with vitamin D deficiency is associated with abnormal mineralization. The presence of hypercalcemia with high levels of PTH or high levels of BALP, or hypophosphatemia and vitamin D deficiency should remind us to screen vascular calcification status of patients.Clinical Research: ClinicalTrials.gov ID NCT02751099.

Meteorin-like Protein and Zonulin in Polycystic Ovary Syndrome: Exploring Associations with Obesity, Metabolic Parameters, and Inflammation.

Polycystic ovary syndrome (PCOS) is a prevalent hormonal and metabolic disorder, wherein the adipose tissue and gut microbiome have been demonstrated to contribute to its pathogenesis. This study aims to assess the concentrations of the adipokine, meteorin-like protein (Metrnl) and the protein, zonulin, related to intestine permeability, in individuals with PCOS with a particular emphasis on their relationship with obesity, clinical manifestations, hormonal profiles, and metabolic parameters. A cohort comprising 58 women with PCOS, classified according to the Rotterdam criteria, was enrolled. The study also considered age, body mass index (BMI), and ethnicity-matched controls (n = 30). Comprehensive anthropometric and clinical evaluations, hormonal assays, and biochemical analyses were conducted during the follicular phase. Subsequent subgroup analyses were executed within the PCOS cohort based on waist-to-height ratio (WHtR), insulin resistance (IR), and free androgen index (FAI). Serum concentrations of Metrnl and zonulin were quantified via the enzyme-linked immunosorbent assay (ELISA) technique. The Metrnl and zonulin levels exhibited no significant disparity between PCOS patients and controls. Nevertheless, within the entire participant cohort and the PCOS group exclusively, overweight/obese participants demonstrated higher Metrnl concentrations relative to their normal-weight counterparts (p < 0.001, p = 0.001, respectively). Furthermore, higher Metrnl concentrations were identified in subgroups characterized by high WHtR and IR in comparison to those with low WHtR (p = 0.001) and without IR (p = 0.001), respectively. A correlation emerged between Metrnl levels and various anthropometric and metabolic parameters, as well as sex-hormone-binding globulin (SHBG) and interleukin-18 (IL-18) within the PCOS group. Multiple linear regression analysis identified HOMA-IR as the sole independent predictor of Metrnl levels. While Metrnl and zonulin levels do not serve as diagnostic indicators of PCOS, elevated Metrnl concentrations exhibited robust associations with proinflammatory and metabolic irregularities within the PCOS population.

Insulinoma em Ferret (Mustela putorius furo) - relato de caso

ABSTRACT Insulinoma is a tumor of pancreatic beta cells that occurs in ferrets and can lead to symptoms such as hypoglycemia, lethargy, and seizures. Prognosis varies depending on the extent of the tumor and response to treatment. This study describes the follow-up, diagnosis, and therapeutic management of two cases of insulinoma in ferrets. Clinical signs of reported animals varied according to the severity and duration of hypoglycemia. Presumptive diagnosis was based on clinical signs, hematological monitoring (evidenced by hypochromic anemia), biochemical analysis (increased alanine aminotransferase enzyme and hypoglycemia), and imaging exams (hepatomegaly and splenomegaly in one case of this study). Treatment varied according to the intensity of clinical signs, but both cases resulted in death. Regular veterinary follow-up and early detection are important to improve animal quality of life.

Evaluation of serum taurine level as a biomarker for early diagnosis and follow up of chronic myeloid leukemia

Evaluation of serum taurine level as a biomarker for early diagnosis and follow up of chronic myeloid leukemia

Modification-free pumpless laser-induced graphene multichannel open microfluidic electrode chip for simultaneous quantification of dual targets

Pumpless surface fluid transport technology has attracted concerns in the field of electroanalysis. However, the combination of surface wettability-controlled multichannel fluid transport and flexible three-electrode systems has been rarely reported for electrochemical detection. Here, we have developed a modification-free pumpless laser-induced graphene multichannel open microfluidic electrode chip (LIG-MOMEC) for simultaneous quantification of dual targets. The LIG-MOMEC enables rapid sample distribution to four addressable locations for multiple parallel tests on a single chip and simultaneous detection of dopamine (DA) and uric acid (UA) using differential pulsed voltammetry. The flexible polyimide templated by laser parameters supports a programmable electrochemical sensing surface with desired conductivity and optimal surface wettability without post-chemical modification, effectively avoiding the tedious multi-step processing and time-consuming surface modification of conventional modified electrodes. The LIG-MOMEC has a linear detection range of 0.91 ∼ 171.15 μM for DA and 0.83 ∼ 250.04 μM for UA with the LODs of 72 nM and 48 nM. Due to the advantages of superior selectivity, anti-interference and reliable stability, the LIG-MOMEC could be reversibly used 30 times with high reproducibility and attain satisfactory recovery in human serum samples. The LIG-MOMEC provides great potential for the rapid detection of biomolecules in clinical diagnostics and biochemical analysis.

EVALUATION OF LOCAL THERAPEUTIC AGENTS IN ANIMALS WITH EXPERIMENTAL PERIODONTITIS

Main etiological factor in the development of generalized periodontitis is considered to be the presence of periodontopathogens of the red complex, namely Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Bacteroides forsythus in the oral cavity. Among the widely used local therapeutic agents for periodontal diseases, researchers highlight chlorhexidine. Chlorhexidine is available in the form of toothpaste, mouthwashes, gels, sprays, and inserts (PerioChip). In dentistry, the antiseptic is commonly applied in concentrations of 0.2%, 0.12%, and 0.06%. The aim of this study was to propose and evaluate new local therapeutic agents in experimental animals with modeled chronic periodontitis. The study included 36 experimental animals. We suggested using an insert with subgingival application, soaked with chlorhexidinebased official products – Dentaid Perio-Aid Gel and Perio-Aid Protect Gel. The animals were divided into groups as follows: Group I intact rats, Group II modeled periodontal pathology without treatment on the 7th day of modeling, Group III rats with experimental periodontitis without treatment on the 12th day of modeled pathology, Group IV rats with experimental periodontitis treated with an insert soaked in 0.12% chlorhexidine gel (Dentaid Perio-Aid Gel), and Group V rats with experimental periodontitis treated with an insert soaked in 0.2% chlorhexidine gel + hyaluronic acid (PERIO-AID Protect Gel).&#x0D; The experimental periodontitis was induced using an ultrasonic device. On the 7th and 12th days of the experiment, the rats from Groups IV and V were treated according to the specified scheme, preceded by removal of dental deposits using manual instruments. Group IV was treated with an insert with subgingival application soaked in Dentaid Perio-Aid Gel, and Group V was treated with an insert soaked in Perio-Aid Protect Gel. Euthanasia of the rats and sampling of blood and periodontal tissues (gingiva, alveolar process) were performed on the 7th and 12th days in the animals with modeled periodontitis. The assessment of the modeled pathological process was based on clinical examination and biochemical analysis. After the experiment, it was observed that the probable reduction in antioxidant defense during the treatment of experimental animals with Dentaid Perio-Aid Gel and Perio-Aid Protect Gel, applied on the insert, was associated with a decrease in lipid peroxidation. At the same time, alkaline phosphatase activity increased, both in serum and in the homogenate, which may indicate activation of bone formation processes.

Green synthesis of silver nanoparticles using durian rind extract and optical characteristics of surface plasmon resonance-based optical sensor for the detection of hydrogen peroxide

Abstract Silver nanoparticles (AgNPs) have been efficaciously synthesized from AgNO3 via an easy and green method, also called green synthesis, using Mon Thong durian (Durio zibethinus L.) rind extract. The inner shell of durian rind extract was used as an intermediary for the synthesis of AgNPs because the absorption spectra of the AgNP colloid extracted from the inner shell had a higher absorption than that of the outer shell. Additionally, we have found more fructose and glucose – which act as a reducing agent – and protein and carbohydrates – which act as the stabilizer – in a higher amount in the inner shell than the extract from the outer shell. The synthesized AgNPs were mainly spherical in shape and exhibited a relatively narrow size distribution with an average particle diameter of 10.2 ± 0.2 nm. In the reduction of hydrogen peroxide (H2O2), these nanoparticles demonstrate catalytic activity. The degradation of AgNPs, including the catalytic decomposition of H2O2, causes a considerable change in the absorbance strength of the surface plasmon resonance band depending on the H2O2 concentration. Over a broad concentration range of 10−1–10−6 mol·L−1 H2O2, a good sensitivity and a linear response are achieved. This sensor’s quantification limit is found to be 0.9 µmol·L−1 H2O2. Therefore, this optical sensor for the detection of H2O2 can be potentially applied in the determination of color indicators in medical or clinical diagnosis, biochemical analysis, and environmental applications.

Analysis of the Serie of Cases of Neuroleptic Malignant Syndrome (Cross-Sectional Observational Study)

Background: neuroleptic malignant syndrome (NMS) is the most dangerous complication of therapy with neuroleptics with high mortality. The publications on MNS are the reviews articles or case reports.The aim of study: an identification of the frequency of occurrence of NMS harm in patients of the city psychiatric hospital over a 4-year period, a clarification of the clinical manifestations of this complication, an analysis of the effectiveness of the treatment and rate of deaths.Patients and methods: 19 cases with a confirmed diagnosis of NMS who were treated for 4 years in one of the clinical psychiatric hospitals in Moscow with 1158 beds. All patients met the criteria for the diagnosis of NMS according to DSM-5 (333.92). The severity of extrapyramidal disorders was assessed on the Simpson–Angus Rating Scale (SAS). The Bush–Francis Catatonia Rating Scale (BFCRS) was used to assess the features and severity of catatonic symptoms. All patients underwent a study of the general clinical analysis and biochemical analysis of blood with the determination of the number of leukocytes and the activity of the enzyme creatine phosphokinase (CPK).Results: the incidence of NMS was 0.035% of all treated patients, mortality— 10.5%. Most often, NMS develops during treatment with haloperidol and much less frequently with the appointment of atypical antipsychotics risperidone and clozapine in patients with schizophrenia, acute polymorphic mental disorder, organic mental disorders, including dementia. The influence of such factors as gender, age, type of disease on the development of NMS has not been established. The age of patients with a fatal outcome was higher than the average for the group. The clinical picture of NMS was characterized by a combination of catatonic, extrapyramidal and somato-vegetative disorders with hyperthermia, leukocytosis and increased activity of CPK.Conclusion: today NMS remains a relatively rare, but extremely dangerous complication of antipsychotic therapy, with a high risk of death and can develop both in the treatment with first and second generation antipsychotics in patients with schizophrenia and acute polymorphic mental disorder and in organic mental disorders, including dementia.

Multimetallic nanoparticles decorated metal-organic framework for boosting peroxidase-like catalytic activity and its application in point-of-care testing

Metal-organic frameworks (MOFs) are a sort of promising peroxidase-like nanozyme but face the challenge that the inorganic nodes in most of the MOF structures are generally blocked by the organic linkers. Further enhancement or activation of their peroxidase-like activity plays an important role in developing MOF-based nanozymes. Herein, a multimetallic nanoparticle (NP) decorated-MOF, Cu/Au/Pt NP decorated-Cu-TCPP(Fe) nanozyme (CuAuPt/Cu-TCPP(Fe)) was synthesized in situ and served as a peroxidase-like nanozyme. The peroxidase-like activity of this stable CuAuPt/Cu-TCPP(Fe) nanozyme was enhanced due to the decreased potential barriers for *OH generation in the catalytic process. Owing to the remarkable peroxidase-like activity, a CuAuPt/Cu-TCPP(Fe)-based colorimetric assay was established for the sensitive determination of H2O2 and glucose with the limit of detection (LOD) of 9.3 µM and 4.0 µM, respectively. In addition, a visual point-of-care testing (POCT) device was developed by integrating the CuAuPt/Cu-TCPP(Fe)-based test strips with a smartphone and was employed for a portable test of 20 clinical serum glucose samples. The results determined by this method agree well with the values deduced by clinical automatic biochemical analysis. This work not only represents an inspiration for the usage of MNP/MOF composite as a novel nanozyme for POCT diagnosis, but also provides a deeper insight and understanding into the enhanced enzyme-mimic effect of MNP-hybrid MOF composites, which in turn will guide the engineering of MOF-based functional nanomaterials.Graphical

Anamnesis in Alzheimer's Disease: A Review and Proposal

In general, mental illnesses take the patient away from the family, making his quality of life lower, and in particular, Alzheimer's disease (AD) is amental morbidity increasing faster in the world. The diagnosis of AD is predominantly clinical with the test of imaging as adjuvant; however, these tests could be difficult to obtain in developing countries. Therefore, anamnesis is the main tool in the diagnosis of AD and must be used efficiently. The propose of this critical review is to indicate a logical and scientific path for clinical procedures in the diagnosis of brain disorders, specifically for AD. Then, a literary search was made, and the subjects of the articles were directed to the descriptors clinical procedures, biochemical analysis and diagnosis. Twenty-three articles were selected, in addition was used a WHO text and two books for the ground of theory, and from that, a discussion was carried out, based on the deductive analysis of the general criteria of the psychiatric diagnosis for the specific ones, and, finally, a heuristic reasoning was associated linking the scientific method to the studied methods. Finally, the psychiatrist's preparation to carry out the anamnesis of the patient with dementia can be added to the current scientific method to make the procedure more accurate in order to avoid possible errors.

The therapeutic effect of PEI-Fe3O4/pYr-ads-8-5HRE-cfosp-IFNG albumin nanospheres combined with magnetic fluid hyperthermia on hepatoma.

Hepatocellular carcinoma (HCC) is one of the most prevalent and deadly malignant tumors with serious clinical and socioeconomic consequences. Although gene therapy holds great promise in the treatment of hepatoma, its clinical applications are hindered by uncontrolled gene transmission and transcription. The pY-ads-8-5HRE-cfosp-IFNG plasmid was constructed and identified by double enzyme digestion and gene sequencing. The expression of pYr-ads-8-5HRE-cfosp-IFNG in HepG2 cells was detected by quantitative PCR. PEI-Fe3O4/pYr-ads-8-5HRE-cfosp-IFNG albumin nanospheres were prepared and characterized. In vitro heating test of magnetic albumin nanospheres in an alternating magnetic field (AMF) was carried out. The therapeutic effect of PEI-Fe3O4/pYr-ads-8-5HRE-cfosp-IFNG albumin nanospheres on hepatocellular carcinoma was investigated by cell and animal experiments. After treatment, mice blood was collected for clinical biochemical analysis and histopathological evaluation of major organs was performed to assess potential adverse effects of treatment. Double enzyme digestion and gene sequencing showed that the pY-ads-8-5HRE-cfosp-IFNG plasmid was constructed successfully. QPCR results showed that the IFNγ transcript level in the PEI-Fe3O4/pYr-ads-8-5HRE-cfosp-IFNG group was higher than that in the PEI-Fe3O4/pYr-ads-8-cfosp-IFNG group after being treated with hypoxia (P<0.05). TEM revealed that the self-prepared PEI-Fe3O4/pYr-ads-8-5HRE-cfosp-IFNG albumin nanospheres exhibit an approximately spherical or elliptical shape. The hydrodynamic size of the albumin nanospheres was 139.7 nm. The maximum temperature of 0.25 mg/mL solution is stable at about 44°C, which is suitable for tumor thermal therapy without damaging normal tissues. The relative cell inhibition rate of the radiation-gene therapy and MFH combination group was higher than that of other control groups in CCK8 experiment. (P<0.05) Flow cytometry showed that the apoptosis rate and necrosis rate of the combined treatment group were 42.32% and 35.73%, respectively, higher than those of the other groups. (P<0.05) In animal experiments, the mass and volume inhibition rates of the combined treatment group were 66.67% and 72.53%, respectively, higher than those of other control groups. (P<0.05) Clinical biochemical analysis and histopathological evaluation showed no abnormality. The results indicated the successful construction of the radiation-induced plasmid and demonstrated that the hypoxia enhancer could augment the expression of INFγ in a hypoxia environment. Gene therapy combined with magnetic fluid hyperthermia (MFH) has exhibited excellent outcomes in both cell and animal studies. Our experiments demonstrated that the PEI-Fe3O4/pYr-ads-8-5HRE-cfosp-IFNG albumin nanospheres system is a comprehensive treatment method for hepatoma, which can effectively combine immune genre therapy with hyperthermia.

Acute and sub-acute toxicity evaluation of Merremia tridentata (L.) stem extract on mice

The acute and sub-acute toxicity studies were performed in male and female Swiss albino mice as per the guidelines mentioned in OECD. The oral administration of M. tridentata stem extract (MSE) showed no treatment-related mortality and body weight change in mice up to the single dose of 30,000 mg/kg body weight in the acute toxicity study and up to a dose of 30,000 mg/kg/day body weight in the sub-acute toxicity study. Moreover, the clinical signs, body weight, gross pathology, organ weight, hematology (except for platelet count), biochemical analysis, and histopathology did not show significant variation at a medium dose of 15,000 mg/kg/day body weight compared to the control group. However, toxicological signs in behavior, very mild interstitial nephritis, as well as significant variation in platelet count and total protein parameters were observed at a dose of 30,000 mg/kg/day in the 28-day oral toxicity study. Thus, the no-observed-adverse-effect level was determined at a dose of 15,000 mg/kg/day body weight. Based on study results, it is concluded that MSE showed LD50 of greater than 5000 mg/kg/day body weight. Hence, this could be a potential candidature as a future safe pharmaceutical product.

Post-COVID-19 Syndrome Comprehensive Assessment: From Clinical Diagnosis to Imaging and Biochemical-Guided Diagnosis and Management.

The COVID-19 outbreak was first reported in 2019, causing massive morbidity and mortality. The majority of the COVID-19 patients survived and developed Post-COVID-19 Syndrome (PC19S) of varying severity. Currently, the diagnosis of PC19S is achieved through history and symptomatology that cannot be explained by an alternative diagnosis. However, the heavy reliance on subjective reporting is prone to reporting errors. Besides, there is no unified diagnostic assessment tool to classify the clinical severity of patients. This leads to significant difficulties when managing patients in terms of public resource utilization, clinical progression monitorization and rehabilitation plan formulation. This narrative review aims to review current evidence of diagnosis based on triple assessment: clinical symptomatology, biochemical analysis and imaging evidence. Further assessment tools can be developed based on triple assessment to monitor patient's clinical progression, prognosis and intervals of monitoring. It also highlights the high-risk features of patients for closer and earlier monitoring. Rehabilitation programs and related clinical trials are evaluated; however, most of them focus on cardiorespiratory fitness and psychiatric presentations such as anxiety and depression. Further research is required to establish an objective and comprehensive assessment tool to facilitate clinical management and rehabilitation plans.

Assesment of serum taurine level as a potential biomarker for early diagnosis of diabetic nephropathy

Objective: Measuring of serum taurine as an early marker to detect and prevent complications of Diabetic nephropathy. Method: Ninty diabetic patients (male and female) were chosen from Ahmed Maher hospital after their approval, eighty patients classified into four groups (diabetic control group, early stage group, before dialysis group, after dialysis group) according to its Complete clinical examination, investigation and biochemical analysis, twenty diabetic controlled patients not suffered from kidney impairment considered as diabetic control group. ten frank healthy non diabetic persons enrolled as volunteers. Complete clinical examination, investigation and biochemical analysis (liver and kidney functions, lipid profile), add to measuring Blood sugar, HbA1c, and the recent biomarker taurine, was measured for all patient and volunteers. Results: The data showed non-significant change in lipid profile, creatinine in urine, and serum Albumine in all patients regarding to control group (P&gt;0.05). that Liver function in all groups demonstrated non significance between groups,but values recorded significant changes in all groups of patients related to frank control group (p&lt;0.05). Kidney function (urea – creatinine) values recorded very highly significant changes in all groups of patients related to frank control group (p&lt;0.00), except controlled diabetic group and Early stage of diabetic nephropathy. also, there is a highly significant changes in blood glucose and HbA1c (P&gt;0.001). On the other hand, the data showed extremely significant decrease in serum taurine in all diabetic patients according to the severity of diabetic nephropathy compared to that recorded in healthy control (P&lt;0.000). Conclusion: Serum taurine is reduced in diabetic patients with advanced conditions of diabetic nephropathy. Taurine Level is considered as an early marker (prognostic) to detect and prevent the diabetic nephropathy complications.

Overview of Periodontal Disease, Etiology, Pathogenesis, Diagnosis and Treatment Therapy

Periodontal Disease is the most common chronic inflammatory bacterial disease that dramatically affects tooth loss and consequent adverse effects not only on the patient's aesthetics and self-confidence but also on the general condition of the body. Because of the high expectation of aggressive behaviour of periodontal disease, the ability to diagnosis and treat early may decrease the risk of tooth loss. So a complete understanding of its silent characteristic is the key. Aim: to thoroughly light on the significance of the early diagnosis and treatment of periodontal diseases which will take part in good prognosis and better outcomes on oral and general health. Methodology: A systematic literature review depends on collecting data from an evidence based studies. Searches were made of twenty electronic databases: the Cochrane Oral Health Group’s Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, PsycINFO, Scopus and Web of science, MEDLINE (PubMed). Results: There is a statistically significant clinical improvement in all clinical parameter and biochemical analysis following the periodontal therapy treatment which effect on tooth shelf life. Conclusion: The results proved the benefit of periodontal therapy as a promising treatment therapy in improving periodontal parameters. Understanding the etiology of the progression of periodontal diseases is a very essential step to stopping the disease.

Phosphatidylethanol as a prognostic indicator in patients with alcoholic liver cirrhosis

Purpose. To assess the risk of readmission and death in patients with alcoholic liver cirrhosis who continue to drink alcohol based on the phosphatidylethanol level. Materials and methods: A study involved 112 patients with alcoholic liver cirrhosis. On the first day of hospitalization, patients underwent a clinical examination, general and biochemical blood analysis, coagulation profile, blood sampling was performed to determine the level of phosphatidylethanol and assessment of the severity of liver cirrhosis on the Child-Pugh scale. A year after the date of hospitalization, a survey was conducted among patients to identify the presence of repeated hospitalizations or a fatal outcome, depending on the results of which patients were divided into groups with favorable and unfavorable course of liver cirrhosis. A ROC analysis of the relationship between the level of phosphatidylethanol and the course of liver cirrhosis was performed. Result: A total of 112 men were included in the study, with an average age of 50.5 years. Of these, 74 patients had a favorable course of liver cirrhosis and 38 unfavorable (36 had readmissions, 18 had a fatal outcome). The average level of phosphatidylethanol was higher in patients with fatal outcome and readmissions compared with patients with a favorable course of liver cirrhosis. In patients who continue to drink alcohol, the risk of readmissions and death during the year increases by almost 5 (p= 0.0005) and 4 (p= 0.04) times, respectively. Conclusion: In patients with alcoholic cirrhosis of the liver, alcohol abuse according to the results of the phosphatidylethanol test is associated with a higher risk of repeated hospitalizations and death within 1 year.