Laboratory Investigations Research Articles

Integration of single-cell RNA sequencing of endothelial cells and proteomics to unravel the role of ICAM1-PTGS2 communication in apical periodontitis: A laboratory investigation.

Endothelial cells (EDs) play a key role in angiogenesis and are associated with granulomatous lesions in patients with chronic apical periodontitis (CAP). This study aimed to investigate the diversity of EDs using single-cell ribonucleic acid sequencing (scRNA-seq) and to evaluate the regulation of intercellular adhesion molecule 1 (ICAM1) on the ferroptosis-related protein, prostaglandin-endoperoxide synthase 2 (PTGS2), in CAP. EDs from the uploaded scRNA-seq data of five CAP samples (GSE181688 and GSE197680) were categorized using distinct marker genes. The interactions between vein EDs (veinEndo) and other cell types were analysed using CellPhoneDB. Differentially expressed proteins in the proteomics of human umbilical vein EDs (HUVECs) and THP-1-derived macrophages infected with Porphyromonas gingivalis were compared with the differentially expressed genes (DEGs) of VeinEndo in scRNA-seq of CAP versus healthy control periodontal tissues. The protein-protein interaction of ICAM1-PTGS2 in macrophages and HUVECs was validated by adding recombinant ICAM1, ICAM1 inhibitor and PTGS2 inhibitor using real-time polymerase chain reaction (PCR), western blotting, and immunofluorescence staining. EDs in patients with CAP were divided into eight subclusters: five vein ED, capillaries, arterials and EC (PLA). There were 29 mutually upregulated DEGs and two mutually downregulated DEGs in vein cells in the scRNA-seq data, as well as differentially expressed proteins in the proteomics of HUVECs. Real-time PCR and immunofluorescence staining showed that ICAM1 and PTGS2 were highly expressed in CAP, infected HUVECs, and macrophages. Recombinant protein ICAM1 may improve PTGS2 expression, reactive oxygen species (ROS), and Fe2+ levels and decrease glutathione peroxidase 4 (GPX4) and SLC7A11 protein levels. ICAM1 inhibitor may inverse the above changes. scRNA-seq revealed the diversity of EDs in CAP and identified the possible regulation of ICAM1 by the ferroptosis-related protein, PTGS2, in infected HUVECs and macrophages, thus providing a basis for therapeutic approaches that target the inflammatory microenvironment of CAP.

Characterizing the Impact of Cyanobacterial Blooms on the Photoreactivity of Surface Waters from New York Lakes: A Combined Statewide Survey and Laboratory Investigation.

Cyanobacterial blooms introduce autochthonous dissolved organic matter (DOM) into aquatic environments, but their impact on surface water photoreactivity has not been investigated through collaborative field sampling with comparative laboratory assessments. In this work, we quantified the apparent quantum yields (Φapp,RI) of reactive intermediates (RIs), including excited triplet states of dissolved organic matter (3DOM*), singlet oxygen (1O2), and hydroxyl radicals (•OH), for whole water samples collected by citizen volunteers from more than 100 New York lakes. Multiple comparisons tests and orthogonal partial least-squares analysis identified the level of cyanobacterial chlorophyll a as a key factor in explaining the enhanced photoreactivity of whole water samples sourced from bloom-impacted lakes. Laboratory recultivation of bloom samples in bloom-free lake water demonstrated that apparent increases in Φapp,RI during cyanobacterial growth were likely driven by the production of photoreactive moieties through the heterotrophic transformation of freshly produced labile bloom exudates. Cyanobacterial proliferation also altered the energy distribution of 3DOM* and contributed to the accelerated transformation of protriptyline, a model organic micropollutant susceptible to photosensitized reactions, under simulated sunlight conditions. Overall, our study provides insights into the relationship between the photoreactivity of surface waters and the limnological characteristics and trophic state of lakes and highlights the relevance of cyanobacterial abundance in predicting the photoreactivity of bloom-impacted surface waters.

Laboratory investigation of causes of bovine abortion and stillbirth in the Republic of Korea, 2014-2020.

Bovine abortion is a critical problem in the cattle industry. Identifying causes of abortion is key to establishing appropriate herd management and prevention strategies. We used pathology examinations, detection of etiologic agents, and serology to determine the cause of bovine abortions in Korea. We analyzed 360 abortion and stillbirth cases submitted to the Animal and Plant Quarantine Agency from December 2014 to January 2020. The putative cause of abortion was identified in 140 of 360 (38.9%) cases; 124 of the 140 (88.6%) cases were attributed to infections. The most common etiologic agents detected were bovine viral diarrhea virus (65 of 360; 18.1%), Coxiella burnetii (19 of 360; 5.3%), Leptospira spp. (13 of 360; 3.6%), Listeria monocytogenes (9 of 360; 2.5%), and Neospora caninum (8 of 360; 2.2%). Minor abortifacient pathogens included Brucella abortus (2 of 360; 0.6%), bovine alphaherpesvirus 1 (2 of 360; 0.6%), Akabane virus (2 of 360, 0.6%), and bovine ephemeral fever virus (1 of 360; 0.3%). Non-infectious conditions included congenital anomalies (7 of 360; 1.9%), goiter (7 of 360; 1.9%), and vitamin A deficiency (2 of 360; 0.6%). Our diagnostic rate in cases with placenta submitted (42 of 86; 48.8%) was significantly higher than in cases without placenta (98 of 274; 35.8%), which highlights the value of submitting placentas. Our results confirm the status of the large variety of causative agents associated with abortions in cattle in Korea.

Pediatric arterial ischemic stroke; Risk factors, clinical presentation and short-term outcome of patients presenting at a tertiary care hospital.

Objective: To determine the risk factors, clinical presentation and short term outcome in children presenting with arterial ischemic stroke at a tertiary care hospital. Study Design: Prospective Observational study. Setting: Medical Units of National Institute of Child Health, Karachi, Pakistan. Period: November 2022 October 2023. Methods: Children of either gender aged between 1 month to 12 years and admitted with the diagnosis of pediatric arterial ischemic stroke during the study duration were analyzed. Detailed medical and neurological examinations were performed. Routine work up and laboratory investigations were done. Modified Rankin Scale (MRS) scores at the time of enrollment, discharge and after 3 month follow-up were recorded. Results: In a total of 35 children, 21 (60.0%) were boys the mean age was 6.89±3.63 years. The most frequent presenting clinical features were focal neurological deficits noted in 29 (82.9%) children whereas fever, and fits were reported in 26 (74.3%), and 22 (62.9%) children, respectively. Right hemiplegia was observed in 15 (42.9%) children. Stroke was secondary to moyamoya 8 (22.9%), infections in 6 (17.1%) children. Mortality was reported among 3 (8.6%) children while 3 others lost during the follow ups. Comparison of mean mRS scores at the time of admission, discharge and after 3 months showed significant reduction (p<0.001). Conclusion: Focal neurological deficits were the predominant clinical features, with a significant incidence of associated fever and seizures. Moyamoya and infections emerged as primary causative factors. Despite a mortality rate of 8.6%, there was an overall improvement in outcomes, as evidenced by a significant reduction in Modified Rankin Scale scores at admission, discharge, and after three months.

Towards a model of plant awareness in education: a literature review and framework proposal

ABSTRACT The inattention to plants, known as ‘plant blindness’ or ‘plant awareness disparity’, is an established concern amongst biologists and educational practitioners alike. Many studies have called for a teaching and learning reform in botany, but there has been no thorough or critical examination of the pedagogic literature to date, an issue which this narrative review of studies (1998–2022) seeks to address. We use a framework based on theories of perceptual attention, interest, and attitude formation to derive novel insights about increasing plant awareness in education. Data were extracted using a suite of search terms, characterised using key words and subjected to a thematic content analysis, with 113 studies shortlisted for review. The dominant teaching and learning approaches were identification keys, laboratory investigations and discussion-based approaches. Educational interventions were found to increase plant awareness by providing memorable and meaningful first-hand encounters with plants and generating positive affect. We present a theoretical model based on these findings and discuss the implications for biology education.

Assessment of Advanced Remediation Techniques for Enhanced CO2 Injectivity: Laboratory Investigations and Implications for Improved CO2 Flow in Saline Aquifers

Assessment of Advanced Remediation Techniques for Enhanced CO₂ Injectivity: Laboratory Investigations and Implications for Improved CO₂ Flow in Saline Aquifers

All That Wheezes Is Not Asthma.

Wheezing is a high pitched, whistling sound generated when air flows through narrowed airways and is often equated with asthma. However, wheezing may be a presenting symptom of various other conditions including structural lesions of the airways, foreign body aspiration, pulmonary infections as well as cardiac causes. Underlying etiology of wheezing may also vary with age. Detailed history, physical examination, and laboratory investigations are often required to identify the underlying etiology of wheezing. Additional studies may sometimes be needed to accurately identify the underlying etiology such as pulmonary function test or spirometry, chest radiography (chest X-ray), and bronchoscopy. This review article discusses the common causes of wheezing encountered in clinical practice. [Pediatr Ann. 2024;53(5):e189-e194.].

Photoprotection and dermatological profile of persons with albinism in Plateau state, Nigeria: findings from a collaborative awareness and screening outreach program

Introduction As a result of genetically being deficient of melanin, albinos are particularly susceptible to skin damage from ultraviolet rays leading to photodermatoses such as sunburns, dermatoheliosis, and cutaneous cancers. These negatively affects quality of life and cause premature death. Little is known of the photoprotective measures available to and dermatological profile of persons with albinism in Plateau state, North Central Nigeria. Objective To describe the dermatological profile of albinos in Plateau state, Nigeria, photo exposure levels, photoprotection strategies, and factors associated with presence of photodermatoses. Patients and methods Consenting individuals with albinism attending the sensitization event hosted by the Centre for Albinism Right and Empowerment Network were recruited. Demographic information, occupational history, solar exposure, photoprotective practices, and perceived sun exposure were all documented using semistructured questionnaires. Physical and dermatological examination, dermoscopy, and laboratory investigations were used to make diagnosis. Statistical package for social sciences, version 26, was used to carry out univariate and bivariate analysis. Results While a wide spectrum of skin diseases was observed among the 59 albinos that participated. Photodermatoses were three times more than nonphotodermatoses. The commonest photodermatoses were solar elastosis (55.9%), solar lentigines (44.1%), actinic keratosis (27.1%), and sunburn (25.4%). Skin cancers affected 10.2% of all patients and 16.6% of persons more than or equal to 20 years. Generally, the presence of photodermatoses was associated with age and occupation while actinic keratotic changes specifically was associated with living in rural areas (P=0.035). Despite this, only seven (11.9%) owned sunscreen at the time of study with more than a third (35.2%) being ignorant of existence of sunscreen lotions. Conclusion Continuous multifaceted programs that involve tracking, education, prevention, early detection, and treatment of photodermatoses will be planned to be targeted towards persons with albinism living in Plateau state.

Amoebic liver abscess in an adult Nigerian: A case report

Background: Amoebic liver abscess (ALA) is a parasitic infection caused by Entamoeba histolytica. ALA is a significant health concern, particularly in regions with poor sanitation and hygiene practices. Radiological imaging plays a crucial role in the diagnosis and management of ALA. Methods: We present a case report of a 40-year-old male patient with ALA. The patient presented to a radio diagnostic centre in Umuahia with right upper quadrant abdominal pain, fever,diarrhea and weight loss. Radiological evaluation was performed using abdominal ultrasound and contrast-enhanced CT scan. The imaging findings were correlated with clinical presentation and laboratory investigations. Results: The radiological findings revealed a focal hypoechoic lesion in the right hepatic lobe with ill-defined margins and internal echoes suggestive of liquefaction. The contrast-enhanced CT scan confirmed the presence of a well-defined, hypodense lesion with peripheral enhancement and central hypoattenuation. No evidence of biliary ductal dilatation or vascular invasion was observed. Based on the findings, a diagnosis of ALA was made, and the patient was initiated on intravenous metronidazole therapy. Follow-up imaging demonstrated a decrease in abscess size and resolution of internal echoes, indicating a positive response to treatment. Conclusion: Radiological imaging, including ultrasound and CT scan, plays a pivotal role in the diagnosis and management of ALA. The characteristic imaging findings, such as hypoechoic lesions with internal echoes and peripheral enhancement with central hypoattenuation, aid in differentiating ALA from other hepatic lesions. Early diagnosis and prompt initiation of appropriate therapy are crucial for favorable patient outcomes. Radiological follow-up allows monitoring of treatment response and guides further management decisions.

Long-term characteristics of a stabilized expansive clay exposed to environmental-driven processes

Understanding the impact of climatic conditions on the long-term performances of soils stabilized with lime and cement is of crucial importance. Most of the available studies on durability solely rely on laboratory investigations to assess the effects of exposure to environmental-driven processes such as wetting and drying, leaching, etc. In this context, a research embankment built in 2010 with an expansive soil stabilized with 4% quicklime and a mix of 2% quicklime and 3% cement was sampled in 2021. A comprehensive experimental campaign was conducted using these samples to evaluate the performance of materials 11 years after the construction of the structure. The studies were completed by microstructural and physico-chemical investigations to understand the mechanisms that might explain changes in performance over time.The analysis of the hydro-mechanical properties of the soil sampled between the edge and the interior of the embankment was first performed. The results indicated that the material taken near the surface had a mechanical behavior equivalent to the untreated soil, demonstrating a total loss of the benefit brought by lime/cement addition. Towards the internal part of the embankment, the mechanical performance progressively increased. Physico-chemical investigations showed that on the edge of the backfill significant part of the calcium was leached 11 years after the construction. This was associated to a drop of pH, and to the formation of calcite. The microstructure was also significantly altered on the edge of the embankment compared to the internal part of the structure. Based on these results, a new mechanism of soil deterioration driven by climatic conditions was proposed. Water circulation and carbonation, associated to a significant reorganization of the microstructure were identified as the main phenomena responsible for the degradation of the treatment effects. This study showed that embankment slopes built with lime and cement stabilized expansive clay must be protected from weather-driven processes to limit any associated degradation.

Evaluation of Sabkha Soil Bearing Capacity by Plate Load Test in Al Muthanna Province

For projects such as airports and road paving, an appropriate foundation must be developed in Sabkha soil, which requires a trustworthy assessment of soil-bearing capacity. When heavy traffic is expected to result in substantial wheel loads throughout pavement construction and maintenance, the plate load test helps solve these issues with subgrade and sub-base layer design. This work aims to investigate and assess the geotechnical behavior regarding soil strata from one area in southern Iraq: Sabkha. Conversely, a comparison is made between subgrade response modulus and soil-bearing capacity determined by field plate load tests and traditional laboratory investigations. The data demonstrated that the values related to Ks in the consolidation test rose as a ratio of pre-consolidation pressure of 45% and dramatically dropped with an increase in applied stress that is vertically applied below pre-consolidation stress. Furthermore, PLT data demonstrated that when pressure was applied, the modulus of the subgrade reaction did not follow a regular pattern. At the beginning of the loaded stage, after the pre-consolidation stress, Ks values at testing points 2 and 3 were high. After that, Ks abruptly decreased, particularly when the applied pressure surpassed the pre-consolidation stress before being constant again. A detailed discussion is given on the effects of stress distribution and test conditions on the elasticity stress curve's shape and the subgrade reaction modulus.

Retinal image quality through an operating microscope with wavefront shaping extended depth of focus intraocular lens in model eye

PURPOSETo compare the quality of images of gratings placed in a model eye viewed through an extended depth of focus (EDoF) intraocular lens (IOL) to that of diffractive bifocal IOL or monofocal IOL. DESIGNExperimental laboratory investigation. METHODSNon-diffractive wavefront shaping EDoF (CNAET0, Alcon laboratories), echelette-designed EDoF (ZXR00V, Johnson & Johnson Vision), diffractive bifocal IOL with low power addition (SV25T, Alcon Laboratories), or monofocal IOL (CNA0T0, Alcon laboratories) was placed in a fluid-filled model eye. A USAF Resolution Grating Target was glued to the posterior surface of the model eye and viewed through a flat or a wide-angle contact lens. The contrast of the gratings viewed through the EDoF or multifocal IOLs was compared to that through the monofocal IOL. A wavefront analyzer was used to measure the spherical power of the central 4.5 mm optics of the EDoF, multifocal, and monofocal IOLs. The distribution of the dioptric power and the dioptric power map were compared. RESULTSThe gratings observed through the flat contact lens with the CNAET0, ZXR00V, or SV25T were slightly blurred when viewed through the multifocal optics. The blurred area was in the circumferential area of the CNAET0, the central area of SV25T, and the peripheral area of ZXR00V. The mean contrast was 0.258±0.020 for CNAET0, 0.227±0.025 for ZXR00V, and 0.221±0.020 for SV25T for the 16.0 cyc/mm grating. The contrast was significantly lower for ZXR00V (P=0.004) and SV25T (P=0.004) than the 0.303±0.015 for CNA0T0 but the differences were not significant. For the wide-angle contact lens, the contrast for CNAET0 was 0.182±0.009, for ZXR00V was 0.162±0.011, and for SV25T was 0.163±0.007 for the 16.0 cyc/mm grating, and none was significantly different from the 0.188±0.012 for CNA0T0. The dioptric variations of the CNAET0 indicated a ring-shaped area of higher power corresponding to the circumferential blurred zone observed through the flat contact lens. CONCLUSIONThe wavefront shaping and echelette-designed EDoF-IOLs reduce the contrast of the grating more than the monofocal IOL when viewed through the flat contact lens. The degree of reduction depended on the design of the extended-focus optics. The difference was less through the wide-angle contact lens.

Comparative Effectiveness of Panchamrut Parpati and Placebo in Management of Grahani W.S.R. to Irritable Bowel Syndrome - Study Protocol for a Single Blind, Randomized Controlled Trial

Abstract: Background: Ayurveda has described several treatment modalities regarding the treatment of Grahani Roga including the usage of herbs and formulations, yoga and lifestyle modifications. On the other hand, systematic data regarding their efficacy relative to placebo are not currently available. The purpose of this study is to compare the efficacy of the Ayurvedic formulation Panchamrut Parpati with a placebo, which contains an inert component called starch, in the treatment of Grahani Roga patients. Methods and design: In a prospective, single- centered, randomized controlled trial,60 patients, between 19 and 60 years, diagnosed with Grahani Roga, presenting with cardinal features of Grahani Roga as presented in Ayurvedic texts, two groups will be randomly assigned. In Group one, the patients will receive Panchamrut Parpati and in Group two, patients will receive Placebo filled with starch. Guidelines regarding Pathya-apathya will be given to both the groups. The course of treatment will last for 28 days for both groups. Outcomes will be evaluated on 14th&28th (During treatment) & 56th day (post-treatment). Result:The primary result will be assessed by checking the grading of the cardinal symptoms of Grahani Roga mentioned in Ayurvedic texts. Secondary outcome will check for improvement in laboratory investigations and quality of life of the patient. Conclusion: This trial compares the efficacy of Panchamrut Parpati with Placebo in the patients of Grahani roga. Panchamrut Parpati is envisioned to improve the symptoms of Grahani Roga, thus proving to be effective in management of patients of Grahani Roga. Trial registration: CTRI/2023/07/055048

A Comparative Effectiveness of Kokilakshadi Kashayam & Kaishore Guggulu in the Management of Vatarakta W.S.R. Gout – Study Protocol For A Randomized Controlled Trial

Abstract: Background: Vatarakta can be managed in a number of ways, including with the use of herbs and formulations, as indicated by Ayurvedic texts. However, no systematic data are available on the comparative efficacy of Kokilakshadi Kashayam and Kaishore Guggulu. The purpose of this study is to compare the efficacy of Kaishore Guggulu and Kokilakshadi kashayam in the treatment of Vatarakta patients. Method and design: In a prospective, single-centered, randomized controlled trial, 60 patients, between 19 and 60 years, diagnosed with Vatarakta, presenting with cardinal features of Vatarakta as per Ayurvedic texts, and the Patients having serum uric acid levels of more than 6mg/dl in females & more than 7mg/dl in males will be split into two groups at random. Patients will receive Kaishore Guggulu in one group and Kokilakshadi kashayam in the other. Guidelines regarding Pathya-apathya will be given. 30 days of treatment will be given to each group. Outcomes will be evaluated on the 15th & 30th (During treatment) & 60th day (post-treatment). The primary outcome will be assessed by looking up the Vatarakta cardinal symptoms' grading. Secondary outcomes will check for improvement in laboratory investigations like changes in Serum uric acid levels and the patient's quality of life.

Comparative Effectiveness of Varunadi Ghan Vati and Kanchnar Guggulu in Management of Subclinical Hypothyroidism- Study Protocol for a Randomized Controlled Trial

Abstract: Background: Hypothyroidism is an emerging disease nowadays. India has a high prevalence of Hypothyroidism, which is about 10%. Hormone replacement therapy is advised in the treatment of hypothyroidism. However, in subclinical hypothyroidism, no treatment is advised. Ayurveda describes a number of treatment modalities for the treatment of disease on the basis of their dosha-dushya. The aim of this study is to evaluate the effectiveness of Varunadi Ghan Vati in comparison with Kanchnar Guggulu in the management of subclinical hypothyroidism. Methods and Design: This study will be a prospective, single-centered, randomized controlled trial. A total of 60 patients of age between 19 and 60 years, diagnosed with subclinical hypothyroidism, and presented with cardinal features of the disease will be randomized into two groups. In Group A, patients will be given Varunadi Ghan Vati and in Group B patients will be given Kanchnar Guggulu. Pathya-Apathya regarding the disease will be guided to both groups. Both groups will receive treatment for 45 days. Outcomes will be evaluated on the 15th, 30th and 45th days (during treatment) and 75 th day(post-treatment). The primary outcome will be evaluated on the basis of cardinal symptoms of subclinical hypothyroidism. Improvement in laboratory investigations will be evaluated for secondary outcomes. Conclusion: This trial is the first to compare the effectiveness of Varunadi Ghan Vati with Kanchnar Guggulu in the management of subclinical hypothyroidism. Varunadi Ghan Vati is expected to improve the symptoms of subclinical hypothyroidism, thus proving to be effective in the management of patients with subclinical hypothyroidism. Trial registration: CTRI/2023/07/055295

Search for Chirality in Hydrogenated Magnesium Nanosilicates: A DFT and TD-DFT Investigation.

The formation of silicate grains in the interstellar medium (ISM), especially those containing chiral surfaces such as clinopyroxenes, is poorly understood. Moreover, silicate interactions with various forms of hydrogen-proton (H+), neutral H (HI), and molecular hydrogen (H2) are of high importance as hydrogen comprises >90% of the ISM gas budget, and these species play important roles in the formation of new molecules in space. Furthermore, silicate surfaces catalyze the formation of H2 in the interstellar medium formed on dust grain surfaces by H-H association. The technical difficulty of in situ laboratory investigations of nanosilicate nucleation using astrophysically relevant environmental conditions makes computational chemistry a useful tool for studying potential nanosilicate structures. Furthermore, chiral surfaces interacting with chiral organic molecules could serve as templates that lead to the enantiomeric excess of l-amino acids and d-polyols detected in carbonaceous meteorites. However, in order for this effect to take place, an excess of one chiral form of a mineral is required to break the symmetry. This symmetry-breaking event could have been due to the asymmetric absorption of circularly polarized light by the nanosilicate as it traverses star-forming regions. We investigate this possibility using a metastable chiral form of an enstatite dimer as an input for density functional theory (DFT) and time-dependent (TD)-DFT calculations to obtain various properties and circular dichroism spectra. All in all, twenty-six magnesium nanosilicate structures were studied using varying degrees of hydrogenation: none, with HI, with H+, and with H2. The HSE06/aug-cc-pVQZ level of theory was used for the DFT calculations. TD-DFT calculations utilized the CAM-B3LYP/cc-pVQZ and ωB97X-D3/cc-pVQZ functional and basic set pairings. Results show that (1) all twenty-six structures have absorption bands that fall within the 0.6-28.3 μm range available with the newly launched James Webb Space Telescope and (2) there is a small enantioselective effect by UV-CPL on the eight chiral enstatite dimers (predicted g-values of up to 0.007). While the observed effect is small, it opens up the possibility that it is the inorganic material that becomes enantiomerically biased by UV-CPL, driving chiral enhancements in meteoric organic molecules.

Comparison of platelet count by automated hematology analyzer and peripheral blood smear in thrombocytopenic patient

Platelet count estimation is one of the common as well as important laboratory investigations to diagnose many diseases like dengue, malaria etc. Different methods for platelet estimations are automated haematology analyzer, peripheral blood smear examination method etc. Most common causes of inaccurate platelet count by automated analyser are the presence of giant platelets, platelet clumps etc. leading to erroneous result like false low platelet count etc. We aimed to compare platelet count estimation by automated haematology analyzer and the peripheral blood smear examination in thrombocytopenic patients. A comparative cross-sectional study was conducted on 100 blood samples of patients which came thrombocytopenic on automated haematology analyzer. Each case was also analyzed by peripheral blood smear examination and compared with its corresponding automated haematology platelet count value. Our study included 63% males and 37% females, with the mean age of 38.8 years. Most of the patients belonged to the age group of 30-40 years (34%). The mean platelet count on automated analyzers was 85.46 ± 38.81 x 103/uL whereas on peripheral smear was 92.13 ± 38.30×103/uL with a significant difference between the two groups (p-value <0.0001).Pseudo-thrombocytopenia was observed in 10% of patients, with giant platelets observed in 29% of the cases on blood smear. In view of false low platelet count by automated analyser, we concluded that manual examination by peripheral blood smear examination should always be considered whose platelet count is low by automation.

Understanding Bardet-Biedl Syndrome: Unveiling the Complexities of this Rare Genetic Disorder and its Systematic Review to Identify its Various Variants with Genetic Analysis.

Background: There are a variety of clinical features associated with Bardet-Biedl Syndrome (BBS), a rare genetic disorder affecting several organ systems. First identified in the early 20th century, BBS has since been the subject of extensive research to understand its underlying genetics, clinical presentation, and management. This article provides a comprehensive background on BBS, highlighting its clinical manifestations, genetic basis, and current research efforts. Introduction: BBS is a multisystem, genetic, autosomal recessive heterogeneous cilia structural and functional disorder (occurs when one gene influences two or more seemingly unrelated phenotypic traits) characterized by structural and functional abnormalities of organ and tissues with diverse embryonic derivation. It was first described by Laurence and Moon in 1866. It is caused by loss of proteins coding by the BBS gene. It is characterized by retinal degeneration, post-axial polydactyly, obesity, cognitive deficit, hypogonadism, and cognitive dysfunction. Associated features are diabetes mellitus, hypertension, congenital heart disease, speech defects, dental anomalies, and hepatic fibrosis. In order to diagnose the BBS, molecular genetic tests, such as whole-exome sequencing or whole-genome sequencing is considered useful. Case: A 16 year old girl presented to us in the general medicine ward through the Emergency department with the complaints of dyspnea for six months, fever for three days, and dysuria for three days. Her fever was associated with rigors and chills. On further questioning, her urine was reported to have a bad smell. Past medical history was positive for otitis media and falls. She needed walking support as she was unable to see at night time. On physical examination a young lady was laying in the supine position. She was pale, obese and had high respiratory rate. There was no lymphadenopathy. Extra digits were noted in her upper and lower limbs. Rest of the physical examination was normal. The patient was started on 2 liters of oxygen and blood samples were taken for laboratory investigations. Conclusion: As this was diagnosed on time, so it helped both the family and physcians to check on her weight, respiratory functions, skeletal abnormalities, sexual development, visual acquity, cardiac functioning, hepatic functioning and hematologic stability such as hemoglobin. Being a very rare disease a therefore this disease awareness is necessary among physicians to diagnose the disease early and treat the complications of the disease so that the complications do not progress to the stage where it is irreversible. Early detection of renal problem, visual problems, obesity, and learning disabilities is necessary to be treated on time by involving multidisciplinary approaches.

Prognostic Value of Hyperglycemia and Insulin Resistance Among Patients with Confirmed COVID-19 Infections at Admission to the Alexandria Fever Hospital, Egypt.

Background: The interaction between COVID-19 infection, hyperglycemia, and insulin resistance (IR) may lead to poor outcome. Methods: This prospective study included 100 adult participants without diabetes attending Alexandria Fever Hospital with confirmed COVID-19 infections. They were classified into four groups according to disease severity using World Health Organization (WHO) criteria. Demographic and clinical parameters were collected. Laboratory investigations were obtained. Another follow-up fasting plasma glucose (FPG) value was measured after 3 months in cured patients. Results: Admission FPG, follow-up FPG, lipid profile, markers of IR, and inflammation were significantly higher in severe and critical cases than in mild and moderate cases with increasing values with increased severity. Furthermore, these parameters were significantly higher in died cases compared with cured cases. Admission FPG, TyG index, and homeostatic model assessment (HOMA)-IR showed significant positive correlations with follow-up FPG. Admission FPG was the only independent mortality predictor in multivariate analysis (P = 0.027) with 1.7-folds increased mortality risk with each 10 mg/dL increments. Values exceeding 117 mg/dL, 2.2, and 6.33 for admission FPG, HOMA-IR, and Fasting Insulin Resistance Index, respectively, were able to predict mortality in the studied sample. Conclusions: These results will help in identifying patients at high risk of severe infection and death at admission and take early actions to improve outcome.

Clinical insights into liver abscess: a comprehensive analysis of presentation, etiology and management in Northeastern India, Silchar, Assam

Hepatic abscess is a prevalent disease in Northeastern India with a myriad clinical feature. The present study is aimed to understand the clinical profile, microbiological aetiologies, and management outcomes in patients with hepatic abscesses in Northeastern India, Silchar. In the surgery department of Silchar medical college and hospital, 20 cases of hepatic abscess were studied from January 2022 to October 2023. Records were kept for history, examination, and laboratory investigations. Ultrasound-guided aspiration of the abscess was done, and samples were subject to relevant investigation. The mean age of patients was 33 years, 2/3rd of the patients were from lower socioeconomic status. Alcoholic history was elicited from 45% of the patients. The abscesses were predominantly in the right lobe (70%) and solitary (65%). Etiology of the cases, 55% amoebic, 40% pyogenic, and 5% were tubercular in origin. Pigtail catheterization was done in 70% of the patients; percutaneous needle aspiration was done in 25% of the cases. No cases of mortality were noted. Amoebic and tubercular abscess were solitary in nature whereas pyogenic abscesses were multiple. The amoebic and pyogenic abscess had right lobe predominantly affected whereas in tubercular abscesses left lobe involvement was more common. The most common presentation was young male of low socioeconomic status having solitary amoebic abscess usually in the right lobe of liver