Normal Healthy Control Group Research Articles

Transverse sinus blood flow characteristics of pulsatile tinnitus with dehiscent sigmoid plate based on 4D flow MRI

Objective: To investigate the hemodynamic characteristics of transverse sinus with sigmoid sinus wall dehiscence (SSWD) of pulsatile tinnitus (PT) based on 4D flow MRI. Methods: Retrospective analysis was performed on all patients admitted to Beijing Friendship Hospital, Capital Medical University from January 2019 to January 2021 for dehiscent sigmoid plate pulsatile tinnitus. A total of 26 patients (sides) who met the criteria and underwent 4D flow MRI were included. A total of 26 subjects (46 sides), matched 1∶1 according to gender and age, were included in the normal healthy control group. Nonparametric rank sum test, Student's t test, and ANOVA were performed by SPSS 19.0 software. Binary Logistic regression was applied to the data with statistical significance. Results: There were more patients with dominant drainage on the affected side in PT group than in control group (73.1% vs. 42.3%). The incidence of transverse with a focal intraluminal filling defect and tapered stenosis was higher than that in control group (21.7% vs. 69.2%; 17.4% vs. 42.3%). Average through-plane velocity and maximum through-plane velocity in PT group were higher than those in control group [(33.75±13.88) cm/s vs. (15.84±7.21) cm/s; (93.19±33.55) cm/s vs. (40.40±14.40) cm/s]. The middle part and proximal end of Flowavg (ml/s) in PT group were larger than those in control group [4.69 (2.87; 5.62) ml/s vs. 2.76 (1.67; 4.99) ml/s; 3.41 (2.16; 5.47) ml/s vs. 2.67 (1.68; 4.41) ml/s]. In control group, the velocity of transverse sinus changed relatively gently, while in PT group, the velocity of proximal sinus increased significantly. Binary Logistic regression showed that SSWD PT was independently correlated with proximal maximum flow velocity [OR=1.086(1.029-1.146),P=0.003]. Conclusion: 4D flow MRI showed that the dominant drainage and higher velocity at the proximal end of the transverse sinus might be an important hemodynamic characteristics of dehiscent sigmoid plate pulsatile tinnitus.

Estimation of the Salivary Copper Levels in Oral Submucous Fibrosis Condition: An In Vivo Study.

The aim of the present study was to estimate the salivary copper levels in oral submucous fibrosis (OSMF) condition. A total of 60 individuals of which an equal number of 30 each in normal healthy control group as well as in clinically and histopathologically (the biopsy was done once after the clinical confirmation of OSMF in the patient) confirmed patients of OSMF were included in the study group. Total of 51 males and 9 females were considered for the present study and the age distribution of these groups ranged from a minimum of 21 years to a maximum of 74 years. Unstimulated whole saliva was collected from the patient followed by the conventional biopsy practice. The collected saliva was then subjected for the analysis of copper levels. Trace element copper was estimated by using Digital Semiautomatic Analyzer with the help of copper kit. The clinical mouth opening of OSMF was estimated. Analysis of variance (ANOVA) and Tukey HSD post hoc test was used analyze the data wherein the participants were grouped into age ranges of 20-30, 31-40, 41-50, and >60 years. The mean salivary copper level among OSMF and control groups with respect to age in 20-30 years was 55.98 ± 15.50 and 30.87 ± 7.70, in 31-40 years was 63.96 ± 21.13 and 32.95 ± 4.56, in 41-50 years was 50.11 ± 6.83 and 30.46 ± 3.28, and >60 years was 45.65 and 13.67 µg/dL, respectively. The mean salivary copper levels among OSMF and Control groups with respect to males were 55.60 ± 15.27 and 31.18 ± 6.97 and among females were 67.0 ± 24.25 and 30.06 ± 5.77 µg/dL, respectively. The mean salivary copper levels with histopathological grades in very early stage was 47.18 ± 5.73, in early stage was 49.22 ± 7.65, in moderately advanced was 73.53 ± 10.62 and in OSMF with mild dysplasia was 79.98 ± 16.27 µg/dL, respectively. The mean salivary copper levels in individuals with clinical mouth opening more than 35 mm was 45.65 ± 6.57, in 25-35 mm was 48.94 ± 21.60, in 15-25 mm was 70.54 ± 3.52 and in less than 15 mm was 81.50 ± 16.66, respectively. The present study concluded that salivary trace element levels could be used as potential diagnostic and prognostic markers in patients with OSMF. Trace elements are involved in many different physiological and metabolic processes in humans, either directly or indirectly. Copper is involved in vital biochemical activities like different redox and free radical formation and in maintaining cellular proton homeostasis. It is also associated with the processing of oxygen and a component of arecanut in all forms, which is implicated in the etiology of OSMF. How to cite this article: Gupta R, Jayanti I, Das A, et al. Estimation of the Salivary Copper Levels in Oral Submucous Fibrosis Condition: An In Vivo Study. J Contemp Dent Pract 2024;25(5):498-502.

Connectome-based prediction of decreased trust propensity in older adults with mild cognitive impairment: A resting-state functional magnetic resonance imaging study

Trust propensity (TP) relies more on social than economic rationality to transform the perceived probability of betrayal into positive reciprocity expectations in older adults with normal cognition. While deficits in social rationality have been observed in older adults with mild cognitive impairment (MCI), there is limited research on TP and its associated resting-state functional connectivity (RSFC) mechanisms in this population. To measure TP and related psychological functions (affect, motivation, executive cognition, and social cognition), MCI (n = 42) and normal healthy control (NHC, n = 115) groups completed a one-shot trust game and additional assessments of related psychological functions. RSFC associated with TP was analyzed using connectome-based predictive modeling (CPM) and lesion simulations. Our behavioral results showed that the MCI group trusted less (i.e., had lower TP) than the NHC group, with lower TP associated with higher sensitivity to the probability of betrayal in the MCI group. In the MCI group, only negative CPM models (RSFC negatively correlated with TP) significantly predicted TP, with a high salience network (SN) contribution. In contrast, in the NHC group, positive CPM models (RSFC positively correlated with TP) significantly predicted TP, with a high contribution from the default mode network (DMN). In addition, the total network strength of the NHC-specific positive network was lower in the MCI group than in the NHC group. Our findings demonstrated a decrease in TP in the MCI group compared to the NHC group, which is associated with deficits in social rationality (social cognition, associated with DMN) and increased sensitivity to betrayal (affect, associated with SN) in a trust dilemma. In conclusion, our study contributes to understanding MCI-related alterations in trust and their underlying neural mechanisms.

Effects of prebiotic (lactoferrin) and diclazuril on broiler chickens experimentally infected with Eimeria tenella.

Avian coccidiosis presents a significant challenge to the poultry industry in Egypt, highlighting the urgent need for validating new drug targets offering promising prospects for the development of advanced anticoccidials. Although numerous reports highlight the activity of lactoferrin (LF) against various microorganisms, its potential against Eimeria has not been explored. The present study evaluated the potential anticoccidial effect of LF and diclazuril in broiler chickens experimentally infected with Eimeria tenella. A total of 100 one-day-old broiler chicks were divided into five equal groups (20 each) as follows: Group 1 (G1) served as the normal healthy control group, Group 2 (G2) consisted of chickens infected with 1 × 105 sporulated E. tenella oocysts at 14 days of age, Group 3 (G3) comprised infected chickens treated with diclazuril (0.5 mL/L in drinking water) for 3 days successively, Group 4 (G4) included infected chickens treated with LF (at a dose of 250 mg/kg of diet) from one day of age until the end of the study, and Group 5 (G5) comprised infected chickens treated with both LF and diclazuril. The positive control group (G2) experienced significant reductions in body weight (BW), BW gain, serum glucose, lipase, amylase, total antioxidant capacity, several hematological indices, and total proteins, along with alterations in various antioxidant enzymes. Conversely, serum levels of aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Alkaline phosphatases (ALP), urea, creatinine, nitric oxide, mean corpuscular volume (MCV), White blood cells (WBCs), heterophils, alpha 2, beta 1, and liver contents of malondialdehyde were elevated in this group. Moreover, higher oocyst counts and lesion scores, along with histopathological alterations, were observed in G2. Remarkably, treatment with diclazuril and/or LF demonstrated potent antioxidant and anticoccidial effects, resulting in reduced shedding of oocysts, lesion scores, and lymphocytic infiltrates in the cecum. Additionally, these treatments improved the antioxidant and immune systems in chickens and restored all histopathological changes reported in the infected non-treated group (G2). This study offers novel perspectives on the potential anticoccidial effects of the combination of LF and diclazuril in broiler chickens infected with E. tenella, highlighting the potential synergistic actions of LF in treating poultry coccidiosis.

Association between Serum Uric Acid Levels and Primary Open-angle Glaucoma: A Cross-sectional Study

Introduction: There is an intricate association between serum Uric Acid (UA) levels and Primary Open Angle Glaucoma (POAG). UA levels in the blood are known to be a good indicator of antioxidant function, and a decrease in UA plays a key role in the pathogenesis of POAG. However, the association of serum UA and Uric Acid Creatinine Ratio (UACR) in POAG cases in the Indian population remains unexplored. Aim: To investigate the association of serum UA levels and serum UACR with POAG. Materials and Methods: This cross-sectional study was conducted among patients who attended the Outpatient Department (OPD) of Opthalmology at Maharajah’s Institute of Medical Sciences, Vizianagaram, Andhra Pradesh, India. The duration of the study was one year and six months, from January 15, 2021 to July 15, 2022. The study included 200 recently diagnosed patients with POAG, who were divided into three groups based on Intraocular Pressure (IOP): Group 1 (mild) with an IOP of 21-30 mmHg, group 2 (moderate) with an IOP of 31-50 mmHg, and group 3 (severe) with an IOP greater than 51 mmHg. Age and gender-matched 199 healthy subjects were included as the control group. Blood samples were collected from the study subjects after obtaining informed consent and were tested for serum UA (using the modified Trinder method) and serum creatinine (using Jaffe’s method) in a semiautomatic analyser (Erba chem 7). The data were analysed using Statistical Package for Social Sciences (SPSS) version 21.0 software and MS Excel 2007. Results: The mean age of the study participants of all three groups was found to be 51.19±5.06 years with 46.7% male and 53.3% female subjects. The serum UA levels were 5.55±0.74 mg/dL in the mild POAG group, 4.1±0.5 mg/dL in the moderate POAG group, and 2.67±0.6 mg/dL in the severe POAG group (p-value <0.001). The present study also found that among the three study groups of POAG, UA levels were the lowest in the severe POAG group, followed by the moderate POAG group, and then the mild POAG group. This pattern was observed in both the males and females population. Conclusion: The present study found that serum UA levels were decreased in POAG patients compared to the normal healthy control group. Furthermore, the study revealed a significant negative association between serum UA levels and serum UACR levels with the severity of POAG.

Association of high blood pressure with raised homocysteine level among urban population- A case control study

Abstract Introduction: Hypertension is a major risk factor for cardiovascular diseases. Raised homocysteine level is also an important independent risk factor for CVD. This study sought to determine whether there is any relationship between plasma homocysteine and blood pressure levels. Method: A case control study was conducted among 200 hypertensive cases and 200 normal healthy control groups. Cases were from the Department of medicine and hypertensive clinics at GMC, Baramati and similar controls were selected from patients’ neighborhood. Detailed clinical assessment as well as plasma homocysteine level were assessed and compared in both. Results: Hypertensive cases had higher mean homocysteine level (21.3 ± 4.6 μmol/L) from controls (13.0 ± 6.0 μmol/L), p<0.001. Homocysteine is positively correlated with both systolic and diastolic blood pressure among both hypertensive patients and healthy controls. In both hypertensive subjects and healthy control, homocysteine level has weak positive correlation with DBP and moderate to strong positive correlation with SBP. The hypertensive cases had very high chance (OR=52.4) of developing hyperhomocysteinemia (>15 μmol/L), p<0.001. Conclusion: This study showed higher mean plasma homocysteine levels in hypertensive subjects than controls. Serum homocysteine concentrations were positively associated with both systolic and diastolic blood pressure levels in a general adult population.

Extracellular vesicles from focal segmental glomerulosclerosis pediatric patients induce STAT3 activation and mesangial cell proliferation.

Primary focal segmental glomerulosclerosis (FSGS), a major cause of end-stage kidney disease (ESKD) in adolescents and young adults, is attributable to recognized genetic mutations in a minority of cases. For the majority with idiopathic primary FSGS, the cause of the disease is unknown. We hypothesize that extracellular vesicle (EVs), that carry information between podocytes and mesangial cells, may play a key role in disease progression. A total of 30 participants (20 primary nephrotic syndrome/ 10 healthy controls) were enrolled in this study. Primary nephrotic syndrome subjects were grouped based on pathologic diagnosis. The FSGS group was compared to healthy control subjects based on demographic and clinical findings. EVs were isolated from the urine of each group before being characterized by Western blotting, transmission electron microscopy, and nanoparticle tracking analysis. The effects of the EVs from each group on normal human mesangial cells and activation of certain pathways were then investigated. Based on demographic and clinical findings, mean serum creatinine was significantly higher in the FSGS group than the normal healthy control group. The mean size of the EVs in the FSGS group was significantly higher than the healthy control group. The mesangial cells that were challenged with EVs isolated from FSGS patients showed significant upregulation of STAT-3, PCNA, Ki67, and cell proliferation. Our data demonstrate that EVs from FSGS patients stimulate mesangial cell proliferation in association with upregulation of the phospho-STAT-3 pathway. Additional studies are planned to identify the molecular cargo within the EVs from FSGS patients that contribute to the pathogenesis of FSGS.

Brain Activation Site of Laryngeal Elevation During Swallowing: An fMRI Study.

The object of this study is to investigate dysphagia caused by reduced laryngeal elevation in patients poststroke. The central mechanism of laryngeal elevation during swallowing was explored by comparing the brain activation area before and after treatment with that of healthy subjects. The treatment group included patients diagnosed with dysphagia poststroke that showed reduced laryngeal elevation. They were treated with electrical stimulation at the motor points of the muscles related to laryngeal elevation. Functional magnetic resonance imaging (fMRI) using the blood oxygenation level-dependent (BOLD) was used to observe brain activation of the normal healthy control group and treatment group during voluntary swallowing. Independent sample t test and paired sample t test were used to analyze the differences in brain activation between and within the groups. Compared with the control group, no activation was observed in the brainstem and putamen regions of the experimental group before treatment. Statistics showed that the experimental group had a wider range of brain activation than the control group pretreatment, including the left supplementary motor area, the cingulate gyrus, the inferior frontal gyrus, the right thalamus, and the right putamen. After the electrical stimulation, the brain stem subregion, the left cerebellar lobule IV and V, and parts of the cerebral cortex were more active, while the left supplementary motor area, paracentral lobule, and occipital lobule were less active post-treatment. (1) The brainstem and putamen are the specific brain regions that control laryngeal movement. (2) The enhanced activation of the cortical-basal ganglia-thalamic circuit after stroke is a compensatory mechanism. (3) The improvement of hyoid bone elevation was related to the enhanced activation of the IV and V lobes of the cerebellar hemisphere. The over-activation of the supplementary motor area poststroke would subside once the motor function improved.

Study of association of C-reactive protein and alkaline phosphatase in type 2 diabetes mellitus patients

The prevalence and incidence of type 2 diabetes are rising rapidly worldwide, especially in Asia. Diabetes has been linked to a shorter life expectancy mainly because of its complications, including heart disease, strokes, eye disease, inflammation and bone disease. The aim of the study was to examine the relationship between high sensitive C reactive protein (hsCRP) and alkaline phosphatase (ALP) in type 2 diabetes patients. Furthermore, we investigated correlation between serum hsCRP and ALP level with glycaemic triad (FBS, PPBS, HbA1c) in case and control group. A cross sectional study consists of 200 patients out of which 100 normal healthy control (Group I), case - 100 patients having type 2 DM (Group II). FBS, PPBS, HbA1c, hsCRP and ALP were measured. Mean serum hsCRP and ALP level were statistically significantly higher in case group compared to control group. Moreover, significant positive correlation was observed between hsCRP and ALP level as well as both with FBS, PPBS and HbA1c. Oxidative stress and inflammation appears to be a key component and also associated with poor glycaemic control and further pathogenesis of diabetes and its complications.

Adiponectin: A novel prognostic marker for rheumatoid arthritis: A case control study in a tertiary care hospital in central India

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disorder characterized by symmetrical synovitis, progressive damage to the articular cartilage and the subchondral bone, pain, fatigue, and disabilityRecognition of RA as early as possible is important, because a significant proportion of the patients develop irreversible joint damage shortly after disease onset & risks associated with its treatment. The adiponectin is an active participant in the regulation of physiological and pathological processes, inflammatory process as mediator. This study was done to compare the progression of rheumatoid arthritis in conjunction with changes in levels of adiponectin and to evaluate its role as a prognostic marker. Analyse serum adiponectin level to evaluate its potential role to assess disease severity in patients of rheumatoid arthritis & compare its level in normal healthy control subjects. This study was conducted in MY Hospital, Indore. We enrolled 50 cases of confirmed rheumatoid arthritis patients of 20-70 years age group and 50 age and sex matched apparently healthy controls. Both cases (n=50) and controls (n=50) were assessed for haematological tests and biochemical tests, lipid profile, uric acid, CRP & adiponectin. The data were expressed as mean ± SD and analysed by using SPSS version 20. P-value of < 0.05 was accepted as statistically significant. The mean age of the cases was 44.74 ± 13.10 and that of controls was 42.26 ± 8.09. Maximum number of study patients were in the age group of 31-40 years & women. The rheumatoid arthritis group was divided into subgroup according to DAS28 Score. Out of 50 cases, 2 patients (4.0%) had remission, 2 patients (4.0%) had low disease activity, 30 patients (60.0%) had moderate disease activity and 16 patients(32.0%) had high disease activity. The mean CRP in the rheumatoid arthritis group was 21.56 ± 25.46 mg/dL while in the control group was 11.09 ± 7.95 mg/L. The difference was found to be statistically significant (p<0.05).The mean ESR in the rheumatoid arthritis group was 21.26 ± 8.88 mm/hour while in the control group was 15.70 ± 5.40 mm/hour. The difference was found to be statistically significant (p<0.05).The mean adiponectin level in the rheumatoid arthritis group was 30.13 ± 13.04 µg/ml while in the control group was 17.08 ± 8.69 µg/ml. The difference was found to be statistically significant (p<0.05).The mean adiponectin level was highest in the high disease activity subgroup and lowest in the low disease activity subgroup.In our study we concluded that patients of rheumatoid arthritis have raised level of adiponectin & CRP as compared to normal healthy control group. Adiponectin might be better marker for RA compare to CRP & ESR. Also higher levels of adiponectin were observed in patients with severe disease. Therefore, adiponectin might be used for screening which will help in predicting disease progression.

Acceleration of wound healing by quercetin in diabetic rats requires mitigation of oxidative stress and stimulation of the proliferative phase

ABSTRACT Increased oxidative stress in diabetic wound areas impairs wound healing. Quercetin exhibits significant antioxidant properties. We investigated the effects of topical quercetin on antioxidant status in diabetic wound areas and its effect on wound healing in rats. A 2 cm2 cutaneous wound was produced on the back of streptozotocin induced diabetic and normal rats. Rats were divided into three groups of 20: normal healthy control group, diabetic group and quercetin treated diabetic group. The control and diabetic groups were treated topically with ointment base once daily for 21 days. The quercetin treated diabetic rats were treated similarly with ointment containing quercetin. The quercetin treated diabetic group exhibited increased levels of catalase, glutathione peroxidase, superoxide dismutase and total thiols compared to the diabetic group. Nitrite levels in the diabetic group were decreased significantly on day 3 compared to the healthy control group. Malondialdehyde levels were decreased in the quercetin treated diabetic group compared to the diabetic group. The expression of proliferating cell nuclear antigen) (PCNA) was greater in the quercetin treated diabetic group on day 7 compared to healthy control and diabetic groups. Formation of granulation tissue and the quality of healed tissue was improved in the quercetin treated diabetic group compared to the diabetic group. Quercetin improves antioxidant status in wounds of diabetic rats and stimulates the proliferation phase, which accelerates wound healing.

High Sensitive C Reactive Protein (hsCRP) and Alkaline Phosphatase (ALP) in Type 2 Diabetes Patients

Background: Diabetes is a group of metabolic disorders, characterized by hyperglycemia which results from defects in insulin secretion, insulin action, or both. The prevalence and incidence of type 2 diabetes are rising rapidly worldwide. Diabetes has been linked to a shorter life expectancy mainly because of its complications, including heart disease, strokes, retinopathy, and chronic kidney disease and bone disease. Objective: To examine the relationship between high sensitive C reactive protein (hsCRP) and alkaline phosphatase (ALP) in type 2 diabetic patients. Methods: This study was a hospital based cross sectional study conducted at Dept. of Biochemistry, Ashiyan Medical College Hospital from January to June 2020. The study consists of 180 patients out of which 90 were normal healthy controls (Group I) and 90 patients having type 2 DM were included in case (Group II). FBS, PPBS, HbA1c, hsCRP and ALP of all subjects were measured. Results: Mean serum hsCRP and ALP level were statistically significant higher in case group compared to control group. Moreover, significant positive correlation was observed between hsCRP and ALP level as well as both with FBS, PPBS and HbA1c. Conclusions: Oxidative stress and inflammation appears to be a key component and also associated with poor glycaemic control and further pathogenesis of diabetes and its complications. All our finding suggest a link between oxidative stress, inflammation and glycaemic control in patient with type 2 diabetes mellitus.

Study of Tumor Necrosis Factor-Alpha-Induced Protein 3 Gene Single-Nucleotide Variants in JAK2 V617F-Positive Myeloproliferative Disorders: A Case–Control Study

Background and Objectives: Myeloproliferative neoplasms (MPNs) are Philadelphia negative disorders involving polycythemia vera (PV), essential thrombocythemia (ET), primary myelofibrosis (PMF). Although JAK2 mutation is almost involved, other several mutations are linked to MPNs risk and prognosis. TNFAIP3 genetic mutations are related to several cancers and autoimmune diseases. Our study aimed to demonstrate the effects of rs2230926_T/G & rs5029939_C/G SNVs of TNFAIP3 gene on the risk and prognosis of JAK2 V617F positive MPNs.
 Methods: Matched 2 groups in age, sex and race were enrolled in our research; 80 MPNs cases group and 130 normal healthy controls group with follow up of MPNs cases for 3 years. Taqman assay probes involved in real time polymerase chain reaction (PCR) were utilized for variants analysis.
 Results: The rs2230926 & rs5029939 SNVs were in modest linkage disequilibrium (LD) in MPNs cases. The observed frequencies of G allele and its genotypes of both variants were more prevalent in MPNs patients than normal controls. The bleeding symptoms and the presence of splenomegaly were more existent in the heterozygous genotype and the combined G involved genotypes respectively. The overall survival (OS) was lower in G containing genotypes of both variants but the progression free survival (PFS) was affected only in rs5029939 SNV.
 Conclusion: Our study revealed the association of G containing genotypes of both rs2230926 & rs5029939 SNVs to the increased MPNs incidence as well to poor clinical course and prognosis of JAK2 V617F positive MPNs disorders in Egyptian ethnic.

Hyperfibrinogenemia and Reduced Plasma Protein C Levels in HIV-Infected Patients

Background: Heamatological problems have been associated with human immunodeficiency virus infection. Hypercoagulability, in particular, thrombosis is becoming more common in HIV-positive patients. Aim: The goals of this study were to determine levels of plasma fibrinogen, protein C, Hemoglobin, and ESR among Sudanese HIV-positive patients. Materials and Methods: This is a case-control study, for this investigation, a total of 100 participants were recruited for this study. Fifty people were diagnosed with HIV, 25 of whom were males (50 percent) and 25 of whom were females (50 percent), with an average age of 35.5 years. Further fifty healthy people, 26 (52%) of whom were men and 24 (48%) of whom were women, with a mean age of 37.1 years, matched the case group. Fresh Poor Plasma was obtained by centrifuging citrated venous blood samples at 3000 rpm for 15 minutes. The fibrinogen level was determined using an automated coagulation analyzer. Total protein C level was measured by a fully-automated blood coagulation analyzer (SYSMEX CA-500’JAPAN). The haemoglobin parameter was measured from EDTA anticoagulant samples using the Sysmex KX 21-N automated haematological analyzer. In one hour, the ESR was done using a Westergren tube. Data was collected using a structured direct questionnaire. SPSS version 21 was used to analyse the data. Results: The current study discovered that in Sudanese HIV infection, the mean and standard deviation of plasma fibrinogen levels were statistically substantially higher than in the normal control group (370.5 ± 67 vs 214.7 ± 21 with P value 0.001). Protein C levels were statistically significantly lower in HIV positive patients compared with control group (0.6 ± 0.1 vs 1.3 ± 0.2 with P value 0.001). In HIV positive patients, haemoglobin was statistically substantially lower than in healthy people (10.8 ± 1.8 vs 13.7 ± 1.9, P value 0.01). The erythrocyte sedimentation rate was statistically significantly higher in HIV positive patients than in the control group, with (58.00 ± 27 vs 7.68 ± 3 with P value 0.00). Conclusions: HIV infected patients had higher plasma fibrinogen levels and lower haemoglobin levels than normal healthy control groups. In 16 percent of HIV positive patients, protein C deficiency was discovered. HIV-positive patients had significantly greater ESR.

A Cross Sectional Study on Hypokalemia in Patients with Acute Myocardial Infarction

Introduction: Hypokalemia was found to be more common in women, those with hypertension, and those on chronic diuretic therapy.
 Objectives of the Study: The main objective of the study is to analyse the hypokalemia in patients with acute myocardial infarction.
 Materials and Methods: This cross sectional study was conducted in District Head Quarter Teaching Hospital Faisalabad during 2019 to 2020. The data was collected from 100 male and female patients with myocardial infarction. The effect of plasma potassium concentration on patient survival after a myocardial infarction is investigated. 
 Results: The data was collected from 100 patients of MI. Mean age of male patients was found to be 64.12±12.34 and female patients was 46.21±10.24. There was statistically significant decrease in serum sodium and potassium levels in study group among both the ages compared to normal healthy control group. Serum sodium, potassium, chloride, calcium levels were significantly lower in the AMI patients and magnesium levels were slightly raised among cases than controls.
 Conclusion: It is concluded that reduction in sodium level was assessed only in patients with AMI as compared to healthy persons. Estimation of serum electrolyte is of utmost importance for diagnosis and prognosis of AMI.

Vestibular‐Evoked Myogenic Potential Outcomes Associated with Pediatric Sports‐Related Concussion

To 1) characterize vestibular-evoked myogenic potential responses in children and young adults with sports-related concussion (SRC) histories as compared with a normal healthy control group, and 2) correlate VEMP characteristics to SRC/sport history outcomes. Prospective cohort study. Seventy-six children and young adults with and without a history of SRC received cervical and ocular VEMP testing using a 500 Hz tone burst air conduction stimuli. VEMP response parameters (response rates, peak latencies, and peak-to-peak amplitudes) were assessed. Other clinical vestibular measures were performed. In the SRC group, sport history outcomes including number of SRC sustained over a lifetime, years of playing contact sports, and length of time playing contact sports were collected via in-person questionnaire. Children and young adults with SRC had significantly reduced oVEMP responses and peak-to-peak amplitudes and greater amplitude response asymmetries between left and right ear. There was no effect of group on cVEMP findings. A greater frequency of SRCs sustained throughout a lifetime, a greater number of contact sports played, and a longer duration of playing a contact sport correlated with significantly poorer VEMP response characteristics. Our results suggest that SRC and repeated subclinical head impact events have an effect on oVEMP outcomes. SRC may affect the utricle, superior vestibular nerve, and/or brainstem-mediated vestibular-ocular-reflex pathway. The prevalence of post-concussion-related dizziness is becoming increasingly common in a pediatric-otology clinic, thus performing VEMP testing in youth post-SRC provides an objective, noninvasive, and cost-effective method for monitoring the effects of sports-related impact on the vestibular system and related neural pathways. 3 Laryngoscope, 132:436-442, 2022.

The relation of 12 lead ECG to the cardiac anatomy: The normal CineECG

BackgroundThe interpretation of the 12‑lead ECG is notoriously difficult and requires experts to distinguish normal from abnormal ECG waveforms. ECG waveforms depend on body build and electrode positions, both often different in males and females. To relate the ECG waveforms to cardiac anatomical structures is even more difficult. The novel CineECG algorithm enables a direct projection of the 12‑lead ECG to the cardiac anatomy by computing the mean location of cardiac activity over time. The aim of this study is to investigate the cardiac locations of the CineECG derived from standard 12‑lead ECGs of normal subjects. MethodsIn this study we used 6525 12‑lead ECG tracings labelled as normal obtained from the certified Physionet PTB XL Diagnostic ECG Database to construct the CineECG. All 12 lead ECGs were analyzed, and then divided by age groups (18–29,30-39,40-49,50-59,60-69,70–100 years) and by gender (male/female). For each ECG, we computed the CineECG within a generic 3D heart/torso model. Based on these CineECG's, the average normal cardiac location and direction for QRS, STpeak, and TpeakTend segments were determined. ResultsThe CineECG direction for the QRS segment showed large variation towards the left free wall, whereas the STT segments were homogeneously directed towards the septal/apical region. The differences in the CineECG location for the QRS, STpeak, and TpeakTend between the age and gender groups were relatively small (maximally 10 mm at end T-wave), although between the gender groups minor differences were found in the 4 chamber direction angles (QRS 4°, STpeak 5°, and TpeakTend 8°) and LAO (QRS 1°, STpeak 13°, and TpeakTend 30°). ConclusionCineECG demonstrated to be a feasible and pragmatic solution for ECG waveform interpretation, relating the ECG directly to the cardiac anatomy. The variations in depolarization and repolarization CineECG were small within this group of normal healthy controls, both in cardiac location as well as in direction. CineECG may enable an easier discrimination between normal and abnormal QRS and T-wave morphologies, reducing the amount of expert training. Further studies are needed to prove whether novel CineECG can significantly contribute to the discrimination of normal versus abnormal ECG tracings.

RELATION BETWEEN SERUM URIC ACID LEVELS AND ESSENTIAL HYPERTENSION

Hypertension is due to increased oxidative stress.As urate is natural anti-oxidant,increase in level of hypertension is a case or effect of raised uric acid level.Aim:Aim of the present study was to evaluate serum uric acid levels in cases of Essential Hypertension and comparison with normal controls in different grades of hypertension. Material and Methods: 100 subjects were taken out of which 50 were normal healthy control groups and 50 were of Essential Hypertension. Hypertensive subjects were further subdivided into 2 groups based on the level of Blood Pressure(JNC7). Results: Mean serum Uric Acid levels is found to be 4.8 mg/dl in 50 controls and 5.7 mg/dl in 50 cases of Essential Hypertension, 5.5 mg/dl in stage 1 hypertension(BP=140-159mmHg) and 5.8759 in stage 2 hypertension (BP>160mmHg).Conclusion:It is seen that hypertension is related to rise in mean serum uric acid levels and this rise is directly related to severity of hypertension.Randomized control trials need to be done to see whether lowering serum uric acid level will ameliorate the level of blood pressure.

Optical coherence tomography angiography in patients with type 2 diabetes without clinical diabetic retinopathy

Background and objectives To investigate changes in retinal vascular plexuses, choriocapillaris, along with microcirculation of optic nerve head (ONH), in patients with type 2 diabetes mellitus without clinically evident retinopathy and healthy controls using optical coherence tomography angiography (OCTA). Patients and methods This is a prospective, cross-sectional observational study that included 20 eyes of normal healthy controls (group 1) and 20 eyes of diabetic patients without clinically evident retinopathy (group 2). All participants underwent OCTA examination (RTVue-XR Avanti; Optovue). Average and parafoveal vessel density in superficial capillary plexus (SCP), deep capillary plexus, choriocapillaris vessel density, foveal avascular zone area and perimeter, and vessel density inside ONH and in peripapillary region were compared between groups. Microaneurysms and capillary nonperfusion were taken into analysis. glycated hemoglobin and serum creatinine were assessed for diabetic patients. Results Group 2 showed statistically significant lower average vessel densities of SCP and deep capillary plexus (P<0.01) and parafoveal vessel density of SCP (P<0.01) compared with group 1. Moreover, there was statistically significant and highly significant difference between group 2 and group 1 regarding tempo-inferior and tempo-superior sectors of peripapillary area (P=0.016 and 0.001, respectively). A statistically significant increase in foveal avascular zone area and perimeter was found in group 2 compared with group 1 (P<0.01). Average vessel density of choriocapillaris had a negative correlation with serum creatinine in group 2 (P<0.05). Microaneurysms and capillary nonperfusion were detected by OCTA in diabetic patients. Conclusion OCTA can identify preclinical diabetic retinopathy before the clinical manifestations appear. It is a promising noninvasive tool for assessing retinal vascular plexuses, choriocapillaris, and ONH microcirculation.

ASSESSMENT OF VIRULENCE FACTORS OF CANDIDIAL SPECIES AND ITS BIOTYPING IN ORAL POTENTIALLY MALIGNANT DISORDERS

The aim of the study was to evaluate the virulence factors of candidal species and its biotypes associated with Oral Potentially Malignant Disorders. Materials and methods included that the present study comprised of red and white lesions (40) and normal healthy control group (5) individuals. Oral swabs were taken from representative area of the lesion to be used for both cytological, microbiological and biochemical tests. Samples were inoculated for fungal growth in Sabouraud Dextrose Agar and culture-positive samples had undergone for the germ tube test, chlymadospore formation and chrome agar test. The virulence factors were conrmed by Lipolytic, proteolytic, protinease and phospholipase tests. Anova test, Kruskall Wallis test and Post Hoc test were the statistical analysis used. The result showed that in this study group no candidial growth was found in control group, study group showed positive germ tube test formation, chlymadospore formation and chrom agar test. All positive isolates produced the four virulence factors with higher levels in candida albican isolates. The hemolytic activity in leukoplakia was found to be more virulent followed by Protienase activity amongst the group and within the study groups. Phospholipase activity amongst the study groups was found more virulent in Oral squamous cell carcinoma. Lipolytic activity was found more aggressive in Denture induced stomatitis amongst all the study group. It can be concluded that in this study there is a close association of Candida species with Oral potentially malignant disorders. The correlation of virulence properties of Candida with potentially malignant disorders has led to its role in its invasive potential.