Typical Symptoms Research Articles

Herbal Self-medication Practice for Coronavirus Disease 2019 in Sudan: A Public Survey, 2021

Background: the COVID19 emerged in China in late 2019 with high rate of spread and transmission. As there was no recognized therapy many people worldwide used herbs in attempt to help their body overcome the disease. This study aimed to document Sudanese patients experience in using herbs to treat the disease and decrease its severity. Methods: A cross-sectional population-based online survey was done targeting those who experienced COVID-19 among Sudanese through an online internet-based questionnaire distributed on social media platforms (mainly Facebook and WhatsApp). Descriptive statistics used to summarize data and present it as frequency tables and graphs. Multivariate logistic regression was used to quantify the association between independent variables (comorbidities and use of herbs) and the outcome variable reflecting the severity of the disease (hospitalization). Results: a total of 204 responses received from COVID-19 former and active cases. Typical symptoms of the disease were identified; fever (68.1%), cough (52.7%), shortness of breathing (59.3%), sore throat (76.5%), and loss of smelling and/or taste (67.2%). All the respondents reported using traditional herbs or plants for cure with strong statement of their usefulness. Citrus plants like lemon, orange and grape fruits, were the commonest, used by 94%, followed by the local herbs, Acacia (65%), Ginger (56%), Baobab (46%), Hibiscus (45%), Black Seed (45%) and Cinnamon (17%). Other used plants included onion (29%) and garlic (24%). An adjusted analysis found that obesity was associated with higher hospital admission, while using herbs had no effect on hospital admission. Conclusions: all participants reported the use of herbs for cure beside other treatment. The most commonly used herbs were citrus fruits followed by Acacia and Ginger and other herbs. All participants stated that herbs were useful for their recovery, however our analysis revealed no significant effect on rate of hospitalization. We recommend further deeper, well-designed study to better assess the effect of herbs.

Alterations in Neuronal Nicotinic Acetylcholine Receptors in the Pathogenesis of Various Cognitive Impairments.

Cognitive impairment is a typical symptom of both neurodegenerative and certain other diseases. In connection with these different pathologies, the etiology and neurological and metabolic changes associated with cognitive impairment must differ. Until these characteristics and differences are understood in greater detail, pharmacological treatment of the different forms of cognitive impairment remains suboptimal. Neurotransmitter receptors, including neuronal nicotinic acetylcholine receptors (nAChRs), dopamine receptors, and glutamine receptors, play key roles in the functions and metabolisms of the brain. Among these, the role of nAChRs in the development of cognitive impairment has attracted more and more attention. The present review summarizes what is presently known concerning the structure, distribution, metabolism, and function of nAChRs, as well as their involvement in major cognitive disorders such as Alzheimer's disease, Parkinson's disease, vascular dementia, schizophrenia, and diabetes mellitus. As will be discussed, the relevant scientific literature reveals clearly that the α4β2 and α7 nAChR subtypes and/or subunits of the receptors play major roles in maintaining cognitive function and in neuroprotection of the brain. Accordingly, focusing on these as targets of drug therapy can be expected to lead to breakthroughs in the treatment of cognitive disorders such as AD and schizophrenia.

Pseudoperonospora cubensis Causing Downy Mildew on Luffa aegyptiaca in Korea

In November 2021, sponge gourd (<i>Luffa aegyptiaca</i>) plants with typical downy mildew symptom were observed in Korea. Based on morphological characteristics of sporangiophores and sporangia, combined with molecular phylogenetic analysis of the internal transcribed spacer rDNA and <i>cox</i>2 mtDNA regions, the causal pathogen was identified as <i>Pseudoperonospora cubensis</i> (Oomycota). This is the first report of downy mildew caused by <i>P. cubensis</i> on <i>L. aegyptiaca</i> in Korea. Given that <i>P. cubensis</i> exhibits high disease incidence and severity on many Cucurbitaceae crops, it could pose a significant threat to sponge gourd cultivation.

Assessment of Knowledge and Attitude of Allied Health Sciences Students Regarding Depression Among Patients

ABSTRACT: A prevalent and dangerous medical condition that hurts a person's feelings, thoughts, and behavior is depression. As stated by WHO, “A typical symptom of depression is a loss of interest in activities that one usually enjoys and a persistent sadness that lasts for at least two weeks, making it difficult to carry out daily activities”. Additional symptoms include low energy, altered appetite, increased or decreased sleep, anxiety, difficulty concentrating, difficulty making decisions, restlessness, feelings of guilt, hopelessness, or unworthiness, and suicidal thoughts. In 2015, it was projected that there were over 300 million cases of depression worldwide or 4.3% of the world's population. As per the 2015-2016 National Mental Health Survey (NMHS), one in every 20 Indians has depression, and approximately 15% of adult Indians require active care for one or more mental health conditions. According to statistics, depression accounts for 7.5% of all years survived with an infirmity in 2015, making it the leading cause of disability worldwide. When depression reaches its worst, it can result in suicide, which claims the lives of over 800,000 individuals annually. For those aged 15 to 29, it is the second most common cause of death1. Allied Health Sciences Students as primary health care workers/professionals will play an important part in identifying the symptoms of depression if any in a patient even when they come for a different health issue.

First report of Cotton leaf curl Multan virus of Spinach in China.

Cotton leaf curl Multan virus(CLCuMuV; Begomovirus gossypimultanese, family Geminiviridea) is a single-stranded circular DNA virus, with a genome size of about 2.7 kb, CLCuMuV, which is commonly associated with its satellite DNA, Cotton leaf curl Multan betasatellite (CLCuMuB) (Mansoor et al., 2003), is a serious threat in cotton production causing cotton leaf curl disease (CLCuD) (Briddon et al., 2000). The spread of CLCuMuV is closely linked to its insect vector, whitefly (Bemisia tabaci), which is the exclusive vector species for CLCuMuV transmission (Pan et al., 2018). In May 2019, two spinach (Spinacia oleracea L) samples (XJBC01, XJBC02) showing upward curling of the leaf margins, vein thickening, and enation, symptoms were collected in Shihezi City, Xinjiang, China (Fig. 1B). A 570 bp fragment was amplified from the two symptomatic spinach samples using Begomovirus universal primer pair AV494 (5'-GCCYATRTAYAGRAAGCCMAG-3') and COPR (5'-GANGSATGHTRCADGCCAT ATA-3'), Sequences generated from these amplicons shared 99% nucleotide sequence identities with CLCuMuV DNA-A sequences, suggesting CLCuMuV infection in spinach. To our knowledge CLCuMuV has not been reported in spinach previously. The complete sequences of CLCuMuV and CLCuMuB were then sequenced using CLCuMuV-specific primers GD37-F (5'-GGATCCATTGTTAAACGAATTTCC-3') and GD37-R (5'-GGATCCCACATGTTTGAATTTGA-3') (Gu et al., 2015), as well as betasatellite universal primers β01 (5'-GGTACCACTACGCTACGCAGCAGCC-3') and β02 (5'-GGTACCTACCCTCCCAGGGGTACAC-3') (Zhou et al.,2003). The full length CLCuMuV DNA-A in spinach spans 2737 nt (GenBank accession number: MW561346), while CLCuMuB in spinach covers 1343 nt (GenBank accession number: MW561347). The 2737 nt full length CLCuMuV DNA-A and the associated 1343 nt CLCuMuB genome sequences generated from spinach samples were deposited in the GenBank with accession numbers MW561346 and MW561347. The MW561346 shared 99.5% sequence identity with CLCuMV GD37 from Hibiscus rosasinensis. Whereas the MW561347 shared 98.4% sequence identity with CLCuMuB GD37β. Therefore, we used infectious clones of CLCuMuV (GD37) and CLCuMuB (GD37β), provided by Xueping Zhou (Gu et al., 2015), to inoculate healthy spinach via Agrobacterium. Infected plants showed typical symptoms 14 days post-inoculation, including leaf edge curling, shrinkage, and vein enlargement, which is consistent with symptoms observed in infected spinach plants in the field (Fig. 1C). The expected 570 bp fragments were amplified in the uninoculated upper leaves of spinach showing symptoms, while not detected in the control spinach, indicating that the symptoms on spinach plants were caused by CLCuMuV associated with CLCuMuB. The transmission efficiency of CLCuMuV to spinach was assessed using two whitefly species, MEAM1 and MED, which were fed on h. rosasinensis infected with CLCuMuV. To compare the transmission efficiency between the two species, 14 spinach plants were inoculated with MEAM1, and 11 spinach plants were inoculated with MED. Each spinach plant was inoculated by releasing 10 whiteflies. After 30 days, MEAM1 transmitted CLCuMuV to spinach inducing typical symptoms (Fig. 1D), with a 78.57% (11/14) transmission efficiency. Similarly, MED also transmitted CLCuMuV to spinach but with a lower efficiency of 54.54% (6/11). These results suggested both MEAM1 and MED could transmit CLCuMuV to spinach, with MEAM1 demonstrating higher efficiency than MED. To the best of our knowledge, this study marks the first report of CLCuMuV infecting spinach, indicating an expanded host range for the virus.

Streptococcus constellatus appendicitis in children: A case series

AbstractBackgroundStreptococcus constellatus (SC) is a pathogen well‐known for its involvement in pyogenic infections, with a notable preference for manifesting within the oral cavity, head and neck, and abdomen. This bacterium, belonging to the Streptococcus milleri group, has garnered attention for its propensity to incite inflammatory processes, especially in the abdominal region.ObjectivesThis study aims to present and characterise nine cases of paediatric patients with SC appendicitis.MethodsWe conducted a report on nine cases of SC appendicitis, all of whom presented to the emergency room with typical symptoms of appendicitis.ResultsPatients diagnosed with SC appendicitis exhibited a severe clinical course, necessitating appendectomy at presentation and requiring prolonged parenteral antimicrobial therapy. Furthermore, a higher readmission rate was observed among these patients, even several months after their initial discharge.ConclusionsSurgeons should be vigilant regarding SC appendicitis and its severe clinical course. Prolonged treatment with antimicrobial agents may be necessary for these patients to achieve better outcomes.

Polycystic ovary syndrome and type 1 diabetes - the current state of knowledge.

Type 1 diabetes mellitus (T1DM) is characterized by an increased prevalence of polycystic ovary syndrome (PCOS) with its negative metabolic consequences, including increased cardiovascular risk. Both diseases affect patients, significantly deteriorating the quality of life. During the treatment of patients with T1DM and PCOS, lifestyle modification and increased physical activity resulting in weight reduction should always be recommended. Pharmacological treatment should be applied in accordance with the current standards. In most of these patients metformin alone or with combined oral contraceptive pills could be considered for cycle regulation. In obese patients with T1DM and PCOS glucagon-like peptide-1 receptor agonists (GLP-1 Ras) (liraglutide, semaglutide) and dual glucose-dependent insulinotropic polypeptides (GIP)/GLP-1 RAs (tirzepatide) are regarded as a safe approach. Anti-androgens could also be considered especially to treat hirsutism and hyperandrogenism in women with PCOS. There are relatively limited evidence on anti-androgens in PCOS and we should consider use them in only selected cases. Some other substances may have a positive effect on patients with T1DM and PCOS include inositol, alpha-lipoic acid, folic acid, vitamins (B1, B6, B12, D, K, E, A), chromium and selenium compounds, as well as omega-3 fatty acids. The gut microbiome is also considered as a critical modulator of the predisposition to PCOS and T1DM and may be the future goal of the treatment. The proper treatment of PCOS will translate into a reduction in the severity of typical symptoms and also into the improvement in the metabolic control of diabetes and the patients' quality of life.

Normalizing flow sampling with Langevin dynamics in the latent space

AbstractNormalizing flows (NF) use a continuous generator to map a simple latent (e.g. Gaussian) distribution, towards an empirical target distribution associated with a training data set. Once trained by minimizing a variational objective, the learnt map provides an approximate generative model of the target distribution. Since standard NF implement differentiable maps, they may suffer from pathological behaviors when targeting complex distributions. For instance, such problems may appear for distributions on multi-component topologies or characterized by multiple modes with high probability regions separated by very unlikely areas. A typical symptom is the explosion of the Jacobian norm of the transformation in very low probability areas. This paper proposes to overcome this issue thanks to a new Markov chain Monte Carlo algorithm to sample from the target distribution in the latent domain before transporting it back to the target domain. The approach relies on a Metropolis adjusted Langevin algorithm whose dynamics explicitly exploits the Jacobian of the transformation. Contrary to alternative approaches, the proposed strategy preserves the tractability of the likelihood and it does not require a specific training. Notably, it can be straightforwardly used with any pre-trained NF network, regardless of the architecture. Experiments conducted on synthetic and high-dimensional real data sets illustrate the efficiency of the method.

Identification of fungal species associated with gall oak (Quercus infectoria Oliv.) decline in Iran.

The gall oak (Quercus infectoria Oliv.) tree is one of the most important and valuable forestry species in the Northern Zagros forests in the west of Iran. Gall oak decline is considered to be one of the most important diseases currently affecting the oak Zagros forests in Iran. The main objective of the present study, conducted in the years 2021-2023, was to investigate the possible role of fungi as causative agents of gall oak dieback in the Zagros forests of Iran. Wood samples were taken from gall oak trees showing canker, dieback, and internal wood discoloration symptoms. Fungal isolates recovered from gall oak trees were identified based on cultural and morphological characteristics, as well as phylogenetic analyses using DNA sequencing of the internal transcribed spacer region of rDNA (ITS) and partial beta-tubulin (tub2). Achaetomium aegilopis, Alternaria tenuissima, Apiospora intestine, Botrytis cinerea, Coniochaeta sp., Coniothyrium palmarum, Coniothyrium sp., Cytospora rhodophila, Dialonectria episphaeria, Diatrype sp., Diatrypella macrospora, Endoconidioma populi, Fonsecazyma sp., Fusarium ipomoeae, Jattaea discrete, Kalmusia variispora, Microsphaeropsis olivacea, Neoscytalidium dimidiatum, Paecilomyces lecytidis, Paramicrosphaeropsis eriobotryae, Paramicrosphaeropsis ellipsoidea, and Seimatosporium pezizoides were identified from diseased trees. Pathogenicity tests were performed by artificial inoculation of excised branches of healthy gall oak trees under controlled conditions and evaluated after 35 days by measuring the discolored lesion length at the inoculation site. N. dimidiatum was the most virulent species and caused the longest wood necrosis within 35 days of inoculation. In the greenhouse test, only some species induced typical symptoms of canker. All isolated fungi are reported for the first time on gall oak trees in the world.

Identification and molecular analysis of watermelon chlorotic stunt virus infecting snake gourd in Saudi Arabia

Snake gourd (Trichosanthes cucumerina) plants exhibiting typical begomovirus-like symptoms of stunted growth, leaf yellowing and mottling were observed at an open field in the Eastern region of Saudi Arabia. Sequencing analysis of the amplified complete DNA molecules revealed that the plants were infected with watermelon chlorotic stunt virus (WmCSV), which is a bipartite begomovirus prevalent mostly in the Old World and a serious threat to cucurbit production in the Arabian Peninsula, Middle East and Africa. The two WmCSV DNA-A isolates (SG31A and SG52A) were 98.9% identical and showed their highest nucleotide (nt) sequence identities (98.7%) with the isolates from Iran and Saudi Arabia. The DNA-B isolates (SG31B and SG52B), on the other hand, were 97.4% identical and exhibited their highest nt sequence identities (99.5 and 97%) with isolates reported from Iran and Oman. In the phylogenetic dendrograms the identified isolates clustered closely with previously reported WmCSV isolates from Iran and Saudi Arabia. Infectivity assays revealed that the DNA-A components alone could not induce infection in Nicotiana benthamiana plants however, together with DNA-B these isolates successfully caused typical begomovirus symptoms and both components were detected successfully using Southern blot hybridization. This study highlights the importance of conducting extensive future begomovirus surveillance to detect spillover events that could threaten native vegetable production in Saudi Arabia. This is crucial as begomoviruses pose a serious threat to vegetable cultivation throughout the Middle East.

Maslinic acid prevented lipopolysaccharide‐induced injury of IPEC‐J2 cells through regulating PTEN‐FAK signaling pathway

AbstractIntestinal epithelial injury is one of the typical symptoms associated with intestinal inflammation and diarrhea, and the repair of the intestinal epithelium intricately linked to cell migration. Here, we test the hypothesis that maslinic acid (MA) regulates porcine intestinal epithelial cell migration by inhibiting focal adhesion kinase (FAK)/AKT signaling pathway. In this experiment, the optimal concentration of MA (0.5 μg/mL) on IPEC‐J2 cell viability was selected to investigate the effect under low‐dose lipopolysaccharide (LPS) (1 μg/mL) conditions. Transcriptome sequencing and polymerase chain reaction array results revealed that MA could alleviate LPS‐induced the gene expressions decreasing in focal adhesion signaling pathway. From the pathway map analysis and western blot analysis results, MA alleviated the LPS‐induced decrease in FAK protein expression mainly by promoting FAK protein phosphorylation, which in turn alleviated the decrease in cell migration and formation of cytoskeleton protein Vinculin and F‐actin, the above results were verified by FAK phosphorylation inhibitors Defactinib. The molecular docking and immunoprecipitation further verified that MA could bind to PTEN protein and significantly inhibit its interaction with FAK protein, blocking the function of PTEN to inhibit FAK phosphorylation finally shown to promote the level of FAK phosphorylation, meanwhile LPS inhibited FAK protein expression and its binding to PKC and PTEN proteins. Our study revealed the role of MA and LPS in FAK protein, and increased understanding of MA anti‐inflammatory mechanism.

Epidemic Characteristics and Spatio-Temporal Patterns of HFRS in Qingdao City, China, 2010–2022

ObjectiveThis study investigated the epidemic characteristics and spatio-temporal dynamics of hemorrhagic fever with renal syndrome (HFRS) in Qingdao City, China. MethodsInformation was collected on HFRS cases in Qingdao City from 2010 to 2022. Descriptive epidemiologic, seasonal decomposition, spatial autocorrelation, and spatio-temporal cluster analyses were performed. ResultsA total of 2,220 patients with HFRS were reported over the study period, with an average annual incidence of 1.89/100,000 and a case fatality rate of 2.52%. The male:female ratio was 2.8:1. 75.3% of patients were aged between 16 and 60 years old, 75.3% of patients were farmers, and 11.6% had both “three red” and “three pain” symptoms. The HFRS epidemic showed two-peak seasonality: the primary fall-winter peak and the minor spring peak. The HFRS epidemic presented highly spatially heterogeneous, street/township-level hot spots that were mostly distributed in Huangdao, Pingdu, and Jiaozhou. The spatio-temporal cluster analysis revealed three cluster areas in Qingdao City that were located in the south of Huangdao District during the fall-winter peak. ConclusionThe distribution of HFRS in Qingdao exhibited periodic, seasonal, and regional characteristics, with high spatial clustering heterogeneity. The typical symptoms of “three red” and “three pain” in patients with HFRS were not obvious.

Effectiveness of results of complex treatment of pathological wear of hard tissues of teeth

Background:Tooth wear is a multifactorial condition that results in the loss of hard dental tissue. Physiological wear does not usually result in any subjective symptoms. Pathological abrasion of hard dental tissues is accompanied by both morphological and functional disorders of the dental system Objective: To evaluate the functional and aesthetic results of complex treatment of pathological abrasion of dental hard tissues. Materials and methods: This is a prospective controlled study that included 82 patients with a clinically confirmed diagnosis of Increased tooth wear of the first and second degree of severity (from 2020 to 2024). The age of the patients ranged from 34 to 68 years (48 men, 34 women). The examination of patients included: collecting complaints and identifying concomitant somatic diseases, X-ray examination, photographs of the patient's face, bite height, and nasolabial folds. Distribution of the group: Group 1 included patients with the first degree of hard tissue loss 47 (29 men, 18 women) Group 2 included patients with the second degree of hard tissue damage 35 (21 men, 14 women). During examination, patients complained of aesthetic defects caused by tooth wear and discoloration, discomfort when closing, chewing and phonetic disorders, typical symptoms of TMJ dysfunction, such as pain and crunching in the joints, fatigue of the masticatory muscles and muscle pain, displacement of the lower jaw to the side during vertical movements, a feeling of distension in the ears, headaches and bruxism. In patients of group 1: tooth wear was restored with orthopedic structures. In patients of group 2: temporary prosthetic structures and occlusal splints were used to normalize occlusal relationships in case of TMJ and masticatory muscle dysfunction. Gradual raising of the bite was carried out by means of a set of kappa-splints for 14 days, 1 month and 3 months from 1.0 to 5.0 mm until complete restoration of the occlusal height depending on the severity of pathological abrasion of teeth, abrasion of teeth restored by orthopedic structures. Dynamic observation of the clinical condition of the prosthesis structure was carried out in the following periods: 1 week, 1, 6, 12, 24 months,assessment of the condition of the performed restorations were recorded in the medical record of the dental patient. Results:Clinical radiological results showed satisfactory results and are encouraging in patients of groups 1 and 2. After treatment in patients of groups 2, according to the analysis of the lateral teleroentgenogram of the head, an increase in the height of the lower third of the face is noted, in 28 patients the nasolabial folds were smoothed out. Patients were satisfied with the aesthetic and functional results of the treatment Conclusions: The results of the study showed that treatment using occlusal splints at the preparatory stage in patients of group 2 with occlusion disorders due to pathological abrasion of hard dental tissues and restoration with orthopedic structures is relevant for normalizing the occlusal relationships of the jaws and this complex treatment method provides a good aesthetic and functional result.

First Report of Powdery mildew Caused by Golovinomyces ambrosiae on Verbena × hybrida in the U.S.

Verbena × hybrida, also known as common garden verbena, has an important ornamental value for their wide range of flower colors and for attracting hummingbirds and butterflies. During the winter of 2021-2022 (December through February), more than 50% pot-grown verbena plants showed symptoms of powdery mildew in a field trial at a Syngenta Crop Protection research facility in Vero Beach, FL. Symptoms were characterized by the development of white, superficial mycelium on the adaxial side of leaves which, eventually, progressed to covering the whole surface of leaves, causing leaf discoloration, shoot distortion, and eventual plant death. Morphological characterization was carried out by observing powdery mildew colonies under the microscope. This powdery mildew forms dense patches of white mycelia, mainly on the adaxial leaf surfaces. The mycelium was a mat of hyphae with septa. Conidiophores were erect. The foot cells were straight, followed by one to three short cells bearing short chains of up to four conidia. The conidia were hyaline and ellipsoidal to doliiform in shape. Conidial germination is of the Eudoidium type. The conidia ranged from 25 to 32 μm long by 12 to 16 μm wide. The length to width ratio ranged between 1.6 and 2.3, but most were between 2.0 and 2.2. This is further verification of its identity as Golovinomyces ambrosiae and not Golovinomyces latisporus, because the length to width ratio of the latter species is consistently less than 2.0 (Qiu et al. 2020). Chasmothecia were not observed. Additionally, the ITS, GAPDH, and IGS regions were sequenced using the primer pairs ITS4/ITS5 (White et al. 1990), PMGAPDH1/PMGAPDH3R (Bradshaw et al. 2022a), and IGS-12a/NS1R (Carbone and Kohn 1999), respectively. The ITS region (GenBank number=PP924119) cannot distinguish between G. latisporus and G. ambrosiae and as such aligned 100% with both species on GenBank. However, the GAPDH and IGS regions can be used to distinguish G. ambrosiae from G. latisporus (Bradshaw et al. 2022b). The GAPDH (GenBank number=PP931995) and IGS (GenBank number=PP931996) regions aligned 100% with multiple G. ambrosiae sequences from GenBank including ON360708 and MK452567, respectively. The specimen was deposited in the Larry F. Grand Mycological Herbarium (NCSLG 24479). To confirm pathogenicity, 'Tuscany® Pink Picotee' and 'Quartz XP Violet with Eye' plugs were transplanted to 10-cm diameter pots containing ProMix potting mix and maintained in a greenhouse (± 26 °C). Inoculation was carried out 21 days after transplanting by touching infected leaves onto healthy leaves of 15 disease-free plants of each variety. Fifteen non-inoculated plants of each variety were used as controls. Typical powdery mildew symptoms and signs were first observed ten days after inoculation and the pathogen was more aggressive on 'Tuscany® Pink Picotee'. Symptoms were not observed on non-inoculated plants. The fungus was morphologically identical to the one originally recovered from infected plants in the field. There have been many reports of Golovinomyces spp. affecting Verbena spp. worldwide; however, this is the first report of G. ambrosiae causing powdery mildew on Verbena × hybrida in the U.S. (Braun and Cook, 2012, Choi et al., 2021; Bradshaw et al. 2024). Powdery mildews reduce plant quality and decreases the aesthetics value of infected plants, causing great losses to the ornamental industry. Correct identification of the causal agent is crucial to recommend appropriate control methods, as they may differ according to the pathogen species.

The Lyon Score: A Novel Reflux Scoring System Based on the Lyon Consensus 2.0 That Associates With Treatment Outcome From Antireflux Therapy.

We explored if a score derived from parameters from esophageal testing could increase confidence in diagnosing conclusive gastroesophageal reflux disease and in predicting outcome. A prediction score was developed using metrics based on Lyon Consensus 2.0 thresholds extracted from endoscopy and pH-impedance monitoring. The Lyon score was the sum of weighted scores derived from a logistic regression model. The outcome was response to antireflux therapy, defined as 50% reduction in global symptoms on validated questionnaires. An existing database of endoscopy-negative patients with typical reflux symptoms undergoing esophageal testing from 2 centers (Europe and the United States) constituted the developmental cohort, while 2 separate cohorts (Europe and Asia) served as validation cohorts. Receiver operating characteristics analysis determined performance of the Lyon score in predicting treatment response. In 281 developmental cohort patients (median age 53 years, 57.7% female), the Lyon score demonstrated an area under the curve (AUC) of 0.819 in predicting 50% symptom improvement ( P < 0.001) on receiver operating characteristics, with an optimal threshold of 6.25 (sensitivity 81.2%, specificity 73.4%). Of the individual components, only acid exposure time (AUC 0.799, P < 0.001), mean nocturnal baseline impedance (AUC 0.785, P < 0.001), and reflux episodes (AUC 0.764, P < 0.001) approached the Lyon score performance. The Lyon score segregated treatment response in both the European (AUC 0.908, P < 0.001) and Asian validation cohorts (AUC 0.637, P < 0.001) and outperformed the DeMeester score in sensitivity for predicting outcome in the developmental and Asian validation cohorts. The novel Lyon score segregates reflux phenotypes and identifies likelihood of symptom response from antireflux therapy.

Prevalence of thoracic outlet syndrome among patients visiting physical therapy outpatient department of public sector Tertiary Care Hospitals, Peshawar

The indications and symptoms in the upper extremity brought on by compression of the brachial plexus, subclavian vein, and/or subclavian artery at the thoracic outlet were originally referred to as thoracic outlet syndrome (TOS). The symptoms of neurogenic thoracic outlet syndrome (NTOS) are caused by compression of the brachial plexus roots as they travel through the thoracic outlet. The most typical symptom of thoracic outlet syndrome is neurogenic thoracic outlet syndrome (NTOS). The brachial plexus is compressed and irritated, which causes its symptoms.A cross-sectional study was conducted from March 2023 to June 2023 among patients visiting Physical therapy outpatient department of public sector tertiary care hospitals Peshawar. The DASH questionnaire was distributed to all patients according to inclusion criteria from different hospitals to collect data on the prevalence of thoracic outlet syndrome.The study found that the prevalence of thoracic outlet syndrome was higher in female. The prevalence was higher among female housewives (77.77%) compared to male (63%). Risk factors associated with this pain included improper posture in same position while working, long work durations, repetitive tasks, and restricted neck movements.

Clinical, myopathological, and genetic features of two Chinese families with Andersen-Tawil syndrome.

To explore the clinical, muscle pathological, and pathogenic gene mutation characteristics of Andersen-Tawil Syndrome (ATS) and enhance the understanding of ATS among clinical practitioners. Retrospective analysis of clinical data and muscle pathology of two ATS families, along with genetic testing for probands and some family members. In Family 1, spanning four generations, four individuals were affected, while Family 2 had two affected individuals across four generations. All six patients in both families experienced onset in childhood, presenting with periodic paralysis, arrhythmias, and craniofacial skeletal abnormalities. In Family 1, the proband's periodic paralysis was more triggered by low temperature and exercise, occurring several times a year, lasting 4-7 days. All three adult patients in Family 1 had a history of hypokalemia, and the frequency and severity of attacks were reduced after regular oral potassium supplement therapy. Two adult females in Family 1 experienced limb weakness triggered by stress, exertion, and premenstrual period, with milder symptoms than the proband. In Family 2, the proband's periodic paralysis typically occurred the day after excessive exertion, with a frequency of approximately 2-3 months. Two years prior, the proband developed arrhythmias without palpitations or chest tightness. The proband's brother experienced intermittent limb weakness during adolescence, remained untreated, and had sudden death at age 40. Physical examination revealed characteristic features in Family 1 and both probands: small mandible, wide eye spacing, and fifth-digit clinodactyly. Four adult patients were shorter in stature, while the growth status of a pediatric patient was indeterminate. Supplementary tests showed a history of hypokalemia during muscle weakness episodes in Family 1, while Family 2 patients had normal potassium levels during episodes. The long exercise tests were positive in both probands. Muscle MRI showed no significant abnormalities, but muscle pathology revealed rimmed vacuoles and tubular aggregates. Genetic testing identified KCNJ2 gene mutations in two probands and some of their family members, with c.407C > T (p.S136F) heterozygous mutation in Family 1 and c.652C > T (p.R218W) heterozygous mutation in Family 2. Among the clinical symptoms of the patients with Andersen-Tawil Syndrome in this study, not everyone exhibits the full triad of signs: periodic paralysis is the most common initial symptom, craniofacial and digit skeletal abnormalities are characteristic signs, and ventricular arrhythmias pose the most serious potential risk. Given that these typical symptoms were observed in 5 out of 6 patients, clinicians should pay special attention to these typical symptoms, and patients with these symptoms should be followed up over time. Muscle biopsy May reveal pathological changes such as tubular aggregates, but genetic testing for KCNJ gene mutations remains a crucial diagnostic criterion for this syndrome.

The de-structuration of eating models in East Asia under compressed food modernity: An empirical synthesis

The de-structuration of eating models refers to a multitude of contemporary dietary changes, such as meal skipping and eating out, that diverge from ‘proper’ eating models in given societies. This phenomenon has been studied primarily in Western societies and diagnosed as a more modest change than previously assumed by alarming social discourse. However, this view must be relativised from non-Western perspectives. De-structuration involves the weakening of dietary normative systems and the increased food anxiety, the typical symptoms of reflexive modernity. This concept is theoretically based on the paradigm of ‘plural’ modernities, but it has been scarcely tested empirically in non-Western regions. Web-based questionnaire surveys were conducted from 2021 to 2024 in four East Asian societies that have experienced compressed modernisation. The two studies in Japan (n = 973) and Taiwan (n = 920) have already been reported elsewhere. In this article, discussion on this Japan-Taiwan comparison is further extended with new datasets in South Korea (n = 1039) and China (n = 1035), providing an empirical synthesis of eating models and their de-structuration in four East Asian societies. In contrast to Western societies, de-structuration in East Asia has been more intense than a modest change. Similarly, in Taiwan and South Korea, the degree of change has been so large that de-structuration has extended to dietary norms. In Japan, the norm–practice discrepancy has been intensified by the country's gendered dietary norms. Finally, in China, there has been a time lag between dietary changes and the drastic socioeconomic reforms since the 1980s, manifesting an embryonic form of de-structuration. These phenomena are diverse aspects of compressed food modernity, and our article contributes by providing empirical support for plural views of food modernisation.

Atrial Myxoma – A Rare Cause of Heart Failure

Abstract Atrial myxomas are rare cardiac tumors that usually present with diverse, unrelated symptoms. Conversely, heart failure (HF) is a common cardiac disorder that is mostly caused by uncontrolled systemic hypertension. It is a progressive cardiac disease that is managed with guideline directed medical therapy (GDMT). We present the case of a farmer who presented with typical symptoms of HF. Echocardiography however revealed an unusual cause of his symptoms—a huge mass in his left atrium (LA) prolapsing through the mitral valve, causing functional mitral stenosis. The mass is suspected to be an atrial myxoma. Surgical excision of this mass is proposed as the cure, which will obviate the need for continuous use of GDMT. This case report and literature review bring to fore the mechanisms by which atrial myxoma can cause HF and the other varied clinical presentations of atrial myxomas.

Clonostachys rosea, a Pathogen of Brown Rot in Gastrodia elata in China.

Gastrodia elata, commonly known as Tian Ma, is a perennial mycoheterotrophic orchid. Qianyang Tian Ma (QTM), a geographical indication agricultural product from Hongjiang City, Hunan Province, China, is primarily characterized by the red variety, G. elata f. elata. A severe outbreak of tuber brown rot disease was documented in QTM during the harvesting season in Hunan. The fungal pathogen associated with the disease was isolated on potato saccharose agar (PSA) and identified through morphological and phylogenetic analyses. Pathogenicity tests were performed on healthy tubers of G. elata f. elata. The results showed that the representative isolate, named TMB, produced white hyphal colonies with a ring structure, broom-like phialides, partially curved ellipsoidal conidia, and orange-yellow spherical ascocarps on PSA. Phylogenetic analysis of the ITS, LSU, rpb2 and tub2 sequences using Bayesian and maximum-likelihood methods identified the isolate TMB as Clonostachys rosea, based on morphological and phylogenetic data. Pathogenicity tests revealed typical disease symptoms on healthy G. elata tubers 15 days post-inoculation with the isolate TMB. C. rosea is known to cause diseases in economically important crops, but there are no reports of its occurrence on G. elata f. elata in China. This study provides valuable insights into the occurrence, prevention, and control of brown rot disease in G. elata f. elata.