Control Study Research Articles

The safety and feasibility of transcranial direct current stimulation combined with conservative treatment for patients with cervicogenic headaches: A double-blinded randomized control study protocol

BackgroundCervicogenic headaches (CGH) are common following concussion and whiplash injuries and significantly reduce patient quality of life. Conservative therapies such as ET (ET) and physiotherapy combined with injection-based therapies are cornerstones of treatment for CGH but have shown limited efficacy. Transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) has shown promise in treating other chronic pain conditions. The primary aim of this trial is to evaluate the feasibility and safety of tDCS when combined with ET for the treatment of CGH. MethodsAdults (aged 18–65), blinded to treatment arm, will be randomized into one of two groups: active tDCS followed by ET or sham tDCS followed by ET. Transcranial direct current stimulation will be applied over M1 three times per week for 6-weeks and ET will be performed daily. The primary outcomes of this trial will be the feasibility and safety of the intervention. Feasibility will be defined as greater than 30 % recruitment, 70 % protocol adherence, and 80 % retention rate. Safety will be defined as no severe adverse events. Secondary exploratory outcomes will assess improvement in pain, strength, function, and quality of life. ConclusionsThis trial aims to demonstrate the safety and feasibility of tDCS in combination with ET for the treatment of CGH. Cervicogenic headaches can be difficult to treat contributing to significant impairments function and quality of life. Transcranial direct current stimulation is a potential novel treatment to improve health outcomes in these patients. RegistrationClinicalTrials.gov-NCT05582616.

Platelet indices as a predictor in patients with aplastic anemia and immune thrombocytopenic purpura: a retrospective case–control study

Background and objectivesPlatelet indices are widely available and relatively cheap platelet parameters. The critical objective of this study is to assess the reliability of platelet indices as biomarkers for diagnosis and prognosis in adult thrombocytopenic patients.MethodsA retrospective case–control study, including 81 immune thrombocytopenia (ITP) cases, 50 aplastic anemia (AA) cases, and 150 participants as a control group. This study included patients admitted from 2016 to 2021 to the Clinical Hematology Unit, Department of Internal Medicine, University Hospital. The collected data included sociodemographic information, clinical data, laboratory data, and an assessment of the therapeutic response in the studied groups.ResultsFor the diagnosis of adult thrombocytopenic patients, platelet distribution width (PDW) showed the best diagnostic accuracy (85% for ITP and 91.9% for AA) at cutoff points of 14.9% and 17.2%, respectively. This was followed by mean platelet volume (MPV) with diagnostic accuracies of 77% for ITP and 89.3% for AA at a cutoff point of 9.4 fl. Platelet large cell ratio (PLCR) demonstrated insignificant accuracy in diagnosing either ITP or AA.ConclusionPlatelet indices can play a crucial influence in the diagnosis, not the prognosis, of adult thrombocytopenia.Trial registrationNCT05116033. https://classic.clinicaltrials.gov/ct2/show/NCT05116033

MAOA uVNTR Polymorphism in a Sample of Patients Diagnosed with Papillary Thyroid Cancer

Thyroid gland carcinoma (TGC), though only 1% of all carcinomas, is the most common endocrine neoplasm with an increasing incidence since the 1990s. Of the TGC types, papillary thyroid carcinoma (PTC) is the most common and has the best overall prognosis. Although primarily studied in various neural spectrum disorders, monoamine oxidase A (MAOA) may also contribute to cancer occurrence. This case control study assessed the prevalence of MAOA uVNTR polymorphism in PTC patients, compared its frequency with a healthy control, and assessed the variant’s impact on clinical features. The research participants consisted of 30 PTC patients (20 female, 10 male) over 18 years old who underwent thyroidectomy and radioiodine therapy at a Federal District private clinic and 30 paired and unrelated healthy volunteers (18 female, 12 male). The most frequent MAOA uVNTR alleles were 3R and 4R. Although no significant difference was detected in the genotypic distribution nor the PTC patients’ thyroglobulin, thyroid-stimulating hormone, and antithyroglobulin levels; body mass indexes; administered radiopharmaceutical (131I) doses; or biological sex, the presence of at least one 3R allele was associated with a larger tumor size (T3 + T4 staging). Thus, the 3R allele seems to be associated with PTC pathogenesis severity.

Unsuppressed HIV Viral Load and Related Factors in Patients Receiving Antiretroviral Treatment in Tanganyika Province, Democratic Republic of Congo (DRC)

Antiretroviral treatment (ART) has revolutionized the management of the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), enabling long-term viral load (VL) suppression in patients. Despite the proven effectiveness of ART, a significant proportion of patients with HIV receiving ART fail to achieve viral load suppression (VLS). This study aimed to identify factors associated with low VLS in the Tanganyika province. An unmatched case–control study was conducted from January 2022 to June 2023, including 22 care facilities with viral load data. Data were collected from patient records. For each reviewed record, the patient was invited for an interview upon providing informed consent. Data were analyzed using SPSS version 27. In a multivariable binary logistic regression model, variables with a p-value < 0.05 and a 95% confidence interval for the adjusted odds ratio were considered significantly associated with unsuppressed VL. A total of 462 individuals, including 156 cases and 306 controls, were included in the study. The mean age (standard deviation) of participants was 42.12 (±11.6) years. The following covariates were significantly associated with unsuppressed VL: poor HIV status disclosure to a confidant [adjusted OR = 2.10, 95% CI (1.33–3.31), p = 0.001], poor ART adherence [adjusted OR = 2.01, 95% CI (1.25–3.23), p = 0.004], ART interruption [adjusted OR = 3.43, 95% CI (2.00–5.88), p < 0.001], no participation in support groups [adjusted OR = 2.16, 95% CI (1.25–3.71), p = 0.005], baseline WHO clinical stage 3 and 4 [adjusted OR = 2.24, 95% CI (1.32–3.79), p = 0.003], opportunistic infections (OIs) [adjusted OR = 2.30, 95% CI (1.27–4.16), p = 0.006], and non-communicable chronic diseases (NCDs) [adjusted OR = 2.30, 95% CI (1.10–4.79), p = 0.026]. Given the clear association between several factors and unsuppressed VL, prevention should involve the implementation of innovative strategies targeting at-risk patient groups. Strengthening the monitoring of these factors among active patients at each appointment is recommended to achieve this goal.

Biochemical Evaluation and Stability Assessment of Eye Drops Manufactured at Mengo Hospital: A Quality Control Study

This comprehensive study undertook a thorough evaluation of the biochemical composition and stability of eye drops manufactured at Mengo Hospital. A range of analytical tests were conducted to assess the eye drops' pH, osmolarity, viscosity, protein content, and susceptibility to microbial contamination. Additionally, stability testing was performed under various storage conditions to simulate real-world scenarios. The results of the study revealed that the eye drops manufactured at Mengo Hospital largely conformed to regulatory standards for pH and osmolarity. However, significant variations were observed in viscosity and protein content, indicating inconsistencies in the manufacturing process. Furthermore, stability testing under accelerated conditions demonstrated degradation of the eye drops, highlighting concerns regarding their shelf life and potency. Notably, microbial contamination was detected in some samples, raising concerns about the risk of eye infections and the need for improved sterilization protocols. A comparative analysis with commercial eye drops revealed similarities in biochemical composition but distinct differences in stability profiles. This suggests that while the Mengo Hospital eye drops may possess similar characteristics to commercial products, their stability and longevity may be compromised. The findings of this study have significant implications for quality improvement initiatives at Mengo Hospital. Recommendations include optimizing the manufacturing process to minimize variations in viscosity and protein content, implementing enhanced sterilization protocols to prevent microbial contamination, and conducting regular stability testing to ensure the eye drops' potency and shelf life. By addressing these areas, Mengo Hospital can enhance the quality and safety of its eye drops, ultimately benefiting patients and maintaining trust in its products.

Study of Eye Movements Abnormalities in Epilepsy

ABSTRACT Idiopathic epilepsy (IE), is a group of epileptic syndromes with no structural brain lesion, but with microstructural changes in neuronal networks leading to neuropsychological consequences. Therefore, the assessment of saccadic eye movements can provide insight into the integrity of cerebral networks as it involves large cortical and subcortical brain areas and circuitries. Describe saccadic eye movement abnormalities in patients with IE and correlate them with disease characteristics and antiseizure medication. Case–control study including IE patients followed in the Neurology Department of Razi University Hospital and healthy controls matched. Participants underwent a recording of saccadic eye movements. Pursuit, prosaccade, and anti-saccade tasks were performed. 115 patients and 98 matched healthy controls were included. The gender ratio (male to female) was 0.6. The mean age at onset was 16.3 ± 12 years. Diagnosed epileptic syndromes were juvenile myoclonic epilepsy (JME), epilepsy with generalized tonic-clonic seizures, childhood absence epilepsy, temporal lobe epilepsy, frontal lobe epilepsy, and rolandic epilepsy. Saccadic eye movements were impaired in 52.2% of our patients and significantly more altered in those with JME (p = .021). Prolonged horizontal saccades latencies were the most frequent eye movement abnormalities (32.1%), followed by altered horizontal smooth pursuit (22.6%). A positive correlation was found between age at eye movements recording, age at onset, disease duration, global cognitive impairment, and saccadic eye movements. However, no definite relationship was identified. Saccadic eye movement illustrates extending anatomic alterations in IE including frontal and temporoparietal cortical areas and cortico-subcortical circuits. Eye movement recording is a useful and reproducible tool in the assessment of epileptic patients and provides a better understanding of neuronal mechanisms in epilepsy.

Influence of the use of a tablet-based clinical decision support algorithm by general practitioners on the consultation process: the example of FeverTravelApp

BackgroundDespite the proven positive effects of clinical decision support systems (CDSSs) on general practitioners’ (GPs’) performance and patient management, their adoption remains slow. Several factors have been proposed to explain GPs' reluctance to adopt these tools. This study hypothesizes that the influence of CDSSs on patient-physician interactions could be a determining factor. To explore this hypothesis, we utilized the FeverTravelApp, designed to assist GPs in managing patients presenting with fever after returning from the tropics. A case–control study was conducted, observing and analyzing fourteen consultations between seven physicians and three simulated patients. Each physician conducted consultations both with and without the FeverTravelApp. The consultations were video-recorded and analyzed using a custom analysis grid based on three existing tools. Simulated patients completed the Communication Assessment Tool (CAT) after each consultation, and each physician participated in a semistructured interview following the use of the app.ResultsThe use of the FeverTravelApp influenced multiple aspects of the consultation, particularly communication. Both patient and GP speaking times decreased, while active silence (no one talking while the GP actively performed a task) increased. GPs focused more on the app, which reduced direct patient interaction. However, this influence seemed to bother GPs more than simulated patients, who rated their GPs equally whether the app was used or not. This could be because patients felt better understood when GPs asked fewer but more specific questions related to travel medicine, thus effectively addressing their concerns.ConclusionsThis study supports the hypothesis that CDSSs influence consultation dynamics, which may contribute to their slow adoption. It is essential to involve clinicians early in the development of CDSSs to adapt them to clinical workflows and ensure system interoperability. Additionally, tools that allow clinicians to follow the entire clinical reasoning process, such as decision trees, are needed. Further research is necessary to confirm these findings in real patient settings and to develop CDSSs that meet both patients’ and GPs’ expectations.

Investigation of the expression of long non-coding RNA in Parkinson’s disease

BackgroundParkinson’s disease is the second most common age-related neurodegenerative disease after Alzheimer’s. Pathogenic factors in Parkinson’s include inflammation and oxidative stress, which lead to dopaminergic cell apoptosis. The case–control study aims to determine the expression level of long non-coding RNAs (lncRNAs) of the apoptosis pathway in Parkinson’s patients compared to healthy individuals. In the case–control study, 50 patients with Parkinson’s disease were examined, along with 50 healthy individuals matched in age and sex. In both groups, the expression of long non-coding RNAs, including taurine upregulated 1 (TUG1), metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), nuclear-enriched abundant transcript 1 (NEAT1), and growth arrest-specific 5 (GAS5), was compared using real-time polymerase chain reaction (PCR).ResultsThe ratio of MALAT1, NEAT1, and TUG1 gene expression in the case group was statistically significantly higher than in healthy individuals. The ratio of GAS5 gene expression in people with Parkinson’s disease was lower, with a statistically significant difference. The ratio of HULC gene expression was higher in the case group, but it did not show a statistically significant difference with the control group.ConclusionThe involvement of long lncRNAs that increase apoptosis may play a role in the pathogenesis of the disease, which may be used for identification and therapeutic purposes.

Relationship between maternal serum sFlt-1 level and placenta accreta spectrum disorders in the third trimester

PurposeThis study aims to evaluate whether the third-trimester soluble fms-like tyrosine kinase-1 (sFlt-1) serum levels could be related to placenta accreta spectrum (PAS) disorders and the severity of postpartum blood loss.MethodsThis was a nested case–control study which compared serum sFlt-1 level between gravid women with or without PAS disorders. Spearman correlation analysis was conducted to explore the relationship between sFlt-1 level and the volume of postpartum blood loss. Confounding factors were adjusted to avoid the impact on the results.ResultsSixty gravid women were enrolled: 36 women in the PAS group and 24 women in the non-PAS group. Women in the PAS group had a median sFlt-1 level of 9407.1 [2745.9–21,691.5] pg/ml, whereas women in the non-PAS group had a median sFlt-1 level of 25,779.2 [14317.1–35,626.7] pg/ml, (p < 0.001). The sFlt-1 level was negatively related to the volume of postpartum blood loss (r = − 0.358, p = 0.041). After adjusting for maternal age and gestational age at blood taking, sFlt-1 level showed no significant relationship with PAS disorders (p = 0.245) and postpartum blood loss (p = 0.526).ConclusionThird-trimester sFlt-1 serum level is not independently associated with PAS disorders or postpartum blood loss after adjusting for confounding factors.

A study protocol for a randomized controlled trial on the effect of Surya Nadi Pranayama practice on cognitive abilities in school children

Abstract Background Surya Nadi Pranayama is a yogic breathing technique that involves controlled breathing through the right nostril. The study aims to evaluate the effects of the 20-min practice of Surya Nadi pranayama (4 weeks) on cognition among schoolchildren, comparing it to observing a normal breathing pattern. Methods A randomized control study design will be adopted for this study with 100 school children with 12–16 years of age, will be recruited. Subjects will be randomly divided into the study and control groups. The study group will be advised to practice Surya Nadi Pranayama (n = 50), whereas the control group (n = 50) will be asked to relax in a sitting posture between 9 am and 10 am, Monday to Friday, for 20 min daily over 30 days. Results A baseline and post-intervention assessment will be performed for all the subjects a day before and after the intervention. The primary outcome measures are visual reaction time and auditory reaction time. The secondary outcome is critical flicker fusion frequency. Conclusion The potential benefits of this yogic breathing technique and the findings of this research may contribute to the development of interventions aimed at improving cognitive functioning in school-aged children. The study is prospectively registered in the Clinical Trial Registry of India (CTRI/2024/05/067441).

Evaluation of serum vitamin D3 and total serum calcium in patients with posterior canal benign paroxysmal positional vertigo

BackgroundBenign paroxysmal positional vertigo is the most common neurootologic disorder, characterized by brief attacks of vertigo aggravated by certain head positions. During the last two decades, several studies were performed in different countries trying to find a relationship between benign paroxysmal positional vertigo and vitamin D3 (25 hydroxyvitamin D) deficiency.ObjectivesThis study aimed to find the relationship between vitamin D3 deficiency and total serum calcium with benign paroxysmal positional vertigo.Patients and methodsA case–control study conducted from January 2021 to December 2021, consisted of 62 participants; 30 patients with posterior canal benign paroxysmal positional vertigo and 32 healthy persons considered as a control group. The age and sex of both groups were matched, and diagnosis was made by history and examination (Dix-Hallpike’s maneuver). A blood sample was taken to evaluate serum vitamin D level and total serum calcium. The results were compared between both groups.ResultsThe mean levels of vitamin D3 in patients and control groups were 18.57 ± 9.88 ng/ml and 64.12 ± 24.64 ng/ml, respectively, with a statistically significant difference at p ≤ 0.0001. Moreover, regarding vitamin D3 deficiency below 20 ng/ml between patients and control groups, there was a statistically significant difference p = 0.001. Furthermore, there was no significant difference regarding total serum calcium between the two groups, the mean of both groups was 8.57 ± 0.68 mg/dl and 8.93 ± 0.92 mg/dl for patients and control, respectively, at p = 0.084.ConclusionThere might be an association between benign paroxysmal positional vertigo and vitamin D3 deficiency. Moreover, there was no significant difference concerning total serum calcium levels between the patient and control groups.

Cu2WS4 with high-exposure {0 0 1} surfaces promotes efficient charge separation in ZnIn2S4

The spatial segmentation of photogenerated carriers is crucial for achieving efficient photocatalytic H2 production (PHP) rates in photocatalyst. Design studies of crystalline catalyst facets and selective morphology control can facilitate the development of catalysts that expose more advantageous active facets. Herein, Cu2WS4/ZnIn2S4 composites are constructed by growing ZnIn2S4 nanosheets in situ on Cu2WS4 with largely exposed {001} surface. Experiments and density functional theory calculations demonstrate that the electrons of ZnIn2S4 flowed to the {001} surface of Cu2WS4, and the holes vectorially migrated to the {101} surface, during the reaction process, resulting in efficient spatial separation of the photogenerated carriers. The Cu2WS4/ZnIn2S4 achieves a PHP rate of 23.67 mmol g−1 h−1, 13.44-fold increase compared with pure ZnIn2S4. This report combines the advantages of the high-energy activity of the Cu2WS4 {001} surface to morphologically control the ratio of the {001}/{101} surfaces so that ZnIn2S4 can contact a larger area of the {001} surface. Furthermore, under the influence of crystallographic effects on the {001} and {101} surfaces, electrons and holes of ZnIn2S4 are transferred to different crystalline facets, promoting the redox reaction. This paper provides effective ideas for the rational design of photocatalysts with efficient carrier space separation.

A structural MRI marker predicts individual differences in impulsivity and classifies patients with behavioral-variant frontotemporal dementia from matched controls.

Impulsivity and higher preference for sooner over later rewards (i.e., delay discounting) are transdiagnostic markers of many psychiatric and neurodegenerative disorders. Yet, their neurobiological basis is still debated. Here, we aimed at 1) identifying a structural MRI signature of delay discounting in healthy adults, and 2) validating it in patients with behavioral variant frontotemporal dementia (bvFTD)-a neurodegenerative disease characterized by high impulsivity. We used a machine-learning algorithm to predict individual differences in delay discounting rates based on whole-brain grey matter density maps in healthy male adults (Study 1, N=117). This resulted in a cross-validated prediction-outcome correlation of r=0.35 (p=0.0028). We tested the validity of this brain signature in an independent sample of 166 healthy adults (Study 2) and its clinical relevance in 24 bvFTD patients and 18 matched controls (Study 3). In Study 2, responses of the brain signature did not correlate significantly with discounting rates, but in both Studies 1 and 2, they correlated with psychometric measures of trait urgency-a measure of impulsivity. In Study 3, brain-based predictions correlated with discounting rates, separated bvFTD patients from controls with 81% accuracy, and were associated with the severity of disinhibition among patients. Our results suggest a new structural brain pattern-the Structural Impulsivity Signature (SIS)-which predicts individual differences in impulsivity from whole-brain structure, albeit with small-to-moderate effect sizes. It provides a new brain target that can be tested in future studies to assess its diagnostic value in bvFTD and other neurodegenerative and psychiatric conditions characterized by high impulsivity.

Usefulness of sudomotor function assessment in individuals with type-2 diabetes: A case–control study

Usefulness of sudomotor function assessment in individuals with type-2 diabetes: A case–control study

Economic evaluation of the prevention of falls resulting from missed care in polish hospitals.

Falls are associated with increased morbidity, mortality, prolonged hospitalization and an increase in the cost of treatment in hospitals. They contribute to the deterioration of fitness and quality of life, especially among older patients, thus posing a serious social and economic problem. They increase the risk of premature death. Falls are adverse, costly, and potentially preventable. The aim of the study was to analyze the cost-effectiveness of avoiding one fall by nurse care provided by the nurses with higher education, from the perspective of the health service provider. The economic analysis included and compared only the cost of nurse intervention measured by the hours of care provided with higher education in non-surgical departments (40.5%) with higher time spend by nurses with higher education level an increase in the number of hours by 10% (50.5%) to avoid one fall. The time horizon for the study is 1 year (2021). Cost-effectiveness and Cost-benefit analysis were performed. All registered falls of all hospitalized patients were included in the study. In the analyzed was based on the case control study where, 7,305 patients were hospitalized, which amounted to 41,762 patient care days. Care was provided by 100 nurses, including 40 nurses with bachelor's degrees and nurses with Master of Science in Nursing. Increasing the hours number of high-educated nurses care by 10% in non-surgical departments decreased the chance for falls by 9%; however, this dependence was statistically insignificant (OR = 1.09; 95% CI: 0.72-1.65; p = 0.65). After the intervention (a 10% increase in Bachelor's Degrees/Master of Science in Nursing hours), the number of additional Bachelor's Degrees/Master of Science hours was 6100.5, and the cost was USD 7630.4. The intervention eliminated four falls. The cost of preventing one fall is CER = USD 1697.1. The results of these studies broaden the understanding of the relationship among nursing education, falls, and the economic outcomes of hospital care. According to the authors, the proposed intervention has an economic justification.

Performance of Computer-Aided Detection and Quality of Bowel Preparation: A Comprehensive Analysis of Colonoscopy Outcomes

BackgroundArtificial intelligence (AI) has emerged as a promising tool for detecting and characterizing colorectal polyps during colonoscopy, offering potential enhancements in traditional colonoscopy procedures to improve outcomes in patients with inadequate bowel preparation.AimsThis study aimed to assess the impact of an AI tool on computer-aided detection (CADe) assistance during colonoscopy in this population.MethodsThis case–control study utilized propensity score matching (PSM) for age, sex, race, and colonoscopy indication to analyze a database of patients who underwent colonoscopy at a single tertiary referral center between 2017 and 2023. Patients were excluded if the procedure was incomplete or aborted owing to poor preparation. The patients were categorized based on the use of AI during colonoscopy. Data on patient demographics and colonoscopy performance metrics were collected. Univariate and multivariate logistic regression models were used to compare the groups.ResultsAfter PSM patients with adequately prepped colonoscopies (n = 1466), the likelihood of detecting hyperplastic polyps (OR = 2.0, 95%CI 1.7–2.5, p < 0.001), adenomas (OR = 1.47, 95%CI 1.19–1.81, p < 0.001), and sessile serrated polyps (OR = 1.90, 95%CI 1.20–3.03, p = 0.007) significantly increased with the inclusion of CADe. In inadequately prepped patients (n = 160), CADe exhibited a more pronounced impact on the polyp detection rate (OR = 4.34, 95%CI 1.6–6.16, p = 0.049) and adenomas (OR = 2.9, 95%CI 2.20–8.57, p < 0.001), with a marginal increase in withdrawal and procedure times.ConclusionThis study highlights the significant improvement in detecting diminutive polyps (< 5 mm) and sessile polyps using CADe, although notably, this benefit was only seen in patients with adequate bowel preparation. In conclusion, the integration of AI in colonoscopy, driven by artificial intelligence, promises to significantly enhance lesion detection and diagnosis, revolutionize the procedure’s effectiveness, and improve patient outcomes.

Prospective case-control study on pain intensity after the use of promethazine in patients undergoing videothoracoscopy.

Effective and secure pain management following video-assisted thoracoscopic surgery (VATS) is crucial for rapid postoperative recovery. This study evaluated analgesic and sedative effects of sufentanil and promethazine in patient-controlled intravenous analgesia (PCIA) post-thoracic surgery, along with potential adverse reactions. In this prospective, randomized, controlled, double-blind, clinical study, 60 patients (American Society of Anesthesiologists status I-III) undergoing VATS were enrolled. The patients were randomized into experimental (Group P) or control (Group C) groups. PCIA was administered post-general anesthesia using a double-blind method. Group P received sufentanil (3 μg/kg) + promethazine (1 mg/kg) + 0.9% sodium chloride solution (100 mL total), while Group C received sufentanil (3 μg/kg) + 0.9% sodium chloride solution (100 mL total). PCIA settings included a 1-mL bolus and 15-min locking time. The primary outcomes were the visual analog scale (VAS) at rest and during coughing and sedation (Ramsay) scores at 6, 12, 24, and 48 h. The secondary outcomes were rescue drug use rate, hemodynamic parameters (mean arterial pressure and heart rate), percutaneous oxygen saturation, respiratory rate, and occurrence of adverse reactions. Group P exhibited lower resting and coughing VAS scores at 6, 12, 24, and 48 h, plus decreased incidence of nausea and vomiting within 48 h post-surgery compared with Group C (p < 0.05). No significant differences were observed in pruritus, sedation (Ramsay) scores, mean arterial pressure, heart rate, oxygen saturation, or respiratory rate between the two groups (p > 0.05). The combination of sufentanil and promethazine for postoperative intravenous analgesia could effectively reduce adverse effects such as nausea and vomiting, contributing to postoperative pain relief.

Dorsal root ganglion inflammation by oxaliplatin toxicity: DPEP1 as possible target for peripheral neuropathy prevention

BackgroundPeripheral neuropathy (PN) constitutes a dose-limiting side effect of oxaliplatin chemotherapy that often compromises the efficacy of antineoplastic treatments. Sensory neurons damage in dorsal root ganglia (DRG) are the cellular substrate of PN complex molecular origin. Dehydropeptidase-1 (DPEP1) inhibitors have shown to avoid platin-induced nephrotoxicity without compromising its anticancer efficiency. The objective of this study was to describe DPEP1 expression in rat DRG in health and in early stages of oxaliplatin toxicity. To this end, we produced and characterized anti-DPEP1 polyclonal antibodies and used them to define the expression, and cellular and subcellular localization of DPEP1 by immunohistochemical confocal microscopy studies in healthy controls and short term (six days) oxaliplatin treated rats.ResultsDPEP1 is expressed mostly in neurons and in glia, and to a lesser extent in endothelial cells. Rats undergoing oxaliplatin treatment developed allodynia. TNF-\U0001d6fc expression in DRG revealed a pattern of focal and at different intensity levels of neural cell inflammatory damage, accompanied by slight variations in DPEP1 expression in endothelial cells and in nuclei of neurons.ConclusionsDPEP1 is expressed in neurons, glia and endothelial cells of DRG. Oxaliplatin caused allodynia in rats and increased TNF-α expression in DRG neurons. The expression of DPEP1 in neurons and other cells of DRG suggest this protein as a novel strategic molecular target in the prevention of oxaliplatin-induced acute neurotoxicity.

Novel Candidate Single Nucleotide Polymorphisms of ERCC2 Gene that Influence Colorectal Cancer Susceptibility

Colorectal cancer (CRC) is the most common gastrointestinal malignancy and one of the top ten common cancers worldwide with approximately 2 million cases. There are multiple risk factors that could lead to CRC emergence; of which are genetic polymorphisms. Excision repair cross-complementing group 2 (ERCC2) gene encodes for ERCC2 enzyme which plays a crucial role in maintaining genomic integrity by removing DNA adducts. Several studies suggested that there could be a link between genetic polymorphisms of ERCC2 gene and the risk of CRC development. Hence the present study aims to validate the relationship between the following ERCC2 single nucleotide polymorphisms (rs13181, rs149943175, rs530662943, and rs1799790) and CRC susceptibility. A total of 121 participants were enrolled in this case control study; 72 CRC patients and 49 apparently healthy individuals. Genotyping was performed using polymerase chain reaction (PCR) followed by sequencing then the association between genetic polymorphisms and CRC susceptibility was examined. GA genotype and A allele of rs149943175 were associated with lower risk of CRC development. However, GA genotype and A allele carriers of rs530662943 had significantly increased risk compared to GG genotype. Additional stratified analyses showed that carriers of heterozygous genotype of rs149943175 who non-smokers, females or BMI figures less than 25 are less likely to develop CRC compared to wild genotype carriers. Taken together, genetic polymorphisms of ERCC2 modulate the susceptibility of CRC malignancy.

Association between pseudoexfoliation syndrome and dyslipidemia: A case control study

: Pseudoexfoliation syndrome, also known as PEX 1, is a systemic micro fibrillopathy associated with ageing that is brought on by the gradual buildup of extracellular white and grey matter on various ocular and extra ocular structures. It is deposited in extra-ocular tissues such the heart, blood vessels, meninges, liver, and lungs. Numerous investigations have shown a connection between PEX and glaucoma. A person with PEX is typically thought to be at risk for acquiring glaucoma, and vice versa.Atherosclerosis is facilitated by dyslipidemia, which is an increase in plasma cholesterol, triglycerides (TGs), or both, or a low HDL level. A potential risk factor for the progression of cardiovascular disease is dyslipidemia. Numerous investigations have discovered abnormal lipid profiles in pseudoexfoliation syndrome patients, including elevated levels of triglycerides, cholesterol, and LDL. Due to the straight association between lipid levels, atherosclerosis, and cardiovascular risk, patients with PEX are shown to be at an elevated risk of cardiovascular and cerebrovascular events.To study the correlation between dyslipidemia and pseudoexfoliation syndrome in patients above 50 years of age and compare it with age matched controls.This case control study was conducted from November 2020 to November 2022 at SKIMS Medical College and Hospital, Srinagar and included 150 patients with PEX above 50 years of age and compared with age matched controls. In this study mean total cholesterol among cases was 176.88±34.76 mg/dl versus 172.94±51.51 mg/dl in controls. P-value for total cholesterol was statistically insignificant (0.438). Mean triglyceride level among cases was 180.11±54.70 mg/dl while as mean triglyceride level among controls was 163.14±46.21 mg/dl and P-value was found to be statistically significant. Mean LDL level among cases was 104.57±32.80 mg/dl while as in controls mean was 82.70±27.60 mg/dl. P-value for LDL levels was found to be statistically significant. Mean HDL levels among cases was found to be 41.93±8.94 mg/dl while as in controls mean was 39.67±13.73 mg/dl. P-value for HDL levels was statistically insignificant (0.09). Mean VLDL levels among cases was found to be 25.34±19.52 mg/dl while as in controls mean was 27.66±14.36mg/dl. P-value for VLDL levels was statistically insignificant (0.242).There is significant correlation between dyslipidemia and pseudoexfoliation syndrome in patients above 50 years of age.