Novel Diagnostic Biomarkers in Colorectal Cancer

Colorectal cancer (CRC) is still a leading cause of cancer death worldwide. Less than half of cases are diagnosed when the cancer is locally advanced. CRC is a heterogenous disease associated with a number of genetic or somatic mutations. Diagnostic markers are used for risk stratification and early detection, which might prolong overall survival. Nowadays, the widespread use of semi-invasive endoscopic methods and feacal blood tests characterised by suboptimal accuracy of diagnostic results has led to the detection of cases at later stages. New molecular noninvasive tests based on the detection of CRC alterations seem to be more sensitive and specific then the current methods. Therefore, research aiming at identifying molecular markers, such as DNA, RNA and proteins, would improve survival rates and contribute to the development of personalized medicine. The identification of “ideal” diagnostic biomarkers, having high sensitivity and specificity, being safe, cheap and easy to measure, remains a challenge. The purpose of this review is to discuss recent advances in novel diagnostic biomarkers for tumor tissue, blood and stool samples in CRC patients.

Benign Intracranial Hypertension Due to Hypoparathyroidism: A Case Report

Objective: The objective of this study is to present the rare case of a young girl with idiopathic intracranial hypertension secondary to hypoparathyroidism.Background: Idiopathic intracranial hypertension is a neurological syndrome characterized by elevated intracranial pressure (> 25 cmH2O) in the absence of intracerebral abnormalities or hydrocephalus. The pathophysiology of idiopathic intracranial hypertension is unknown, and rare cases of idiopathic intracranial hypertension secondary to hypoparathyroidism have been described. It is supposed that hypocalcemia causes decrease in the absorption of cerebrospinal fluid in arachnoidal granulations.Methods: The workup of the girl with idiopathic intracranial hypertension and hypoparathyroidism included physical examination, blood tests, diagnostic imaging, and lumbar puncture.Results: We present a 9-year-old female patient who was hospitalized for headache associated with nausea and vomiting for 3 weeks. She underwent an ophthalmologic examination that revealed papilledema. Lumbar puncture revealed an opening pressure of 65 cm H2O; cerebrospinal fluid analysis and brain computed tomography scan were normal. The patient started taking acetazolamide. Blood tests revealed hypocalcemia associated with high phosphorus level and undetectable PTH hormone, which led us to suspect hypoparathyroidism. She had never had cramps, paraesthesias, or tetany. Chvostek's and Trousseau's signs were positive. In the neck ultrasonography, parathyroids were not visible. Oral supplementation with calcitriol and calcium was started. Headache, nausea, and vomiting immediately disappeared after the lumbar puncture, and the papilledema improved gradually.Conclusions: Several anecdotal cases of idiopathic intracranial hypertension secondary to hypoparathyroidism have been described. However, our case report is of particular interest, since the child did not present with typical neurological hypoparathyroidism symptoms. Therefore, we recommend that hypoparathyroidism should be included in diagnostic investigations on children with clinical findings of idiopathic intracranial hypertension, because clinical manifestations of hypoparathyroidism are variable and may involve almost all organ systems.

Diagnosing leukaemia in a primary health care setting

This article synthesises current knowledge about the presentation and diagnosis of leukaemia. It will also suggest strategies for early diagnosis of the disease in primary care. This article is to be used as a guide by GPs in their learning for when to initiate blood tests for possible cases of leukaemia and how to recognise the common and non-specific symptoms of leukaemia.

Interpreting the full blood count

The full blood count (FBC) is one of the most commonly requested blood tests in medical practice and can provide a wealth of useful information about a patient’s general state of health, as well as highlighting abnormalities which indicate systemic or sinister pathologies. This article seeks to explore the different parameters of the FBC, and how these relate to some more common clinical presentations, as well as their relation to morphological findings seen on the blood film. As with most investigations, differential diagnoses suggested by any individual laboratory tests are wide and are most valuable when combined with history and examination.

Pelatihan Skrining Penyakit Tidak Menular dan Pencegahannya Bagi Kader Kesehatan

Non-communicable disease (NCD) screening training aims to provide skills in determining a person's health condition based on body mass index (BMI) and simple blood tests. Health cadres who have been equipped with the skills to determine BMI and simple blood tests can then detect NCD in the community independently. Nutrition training aims to provide skills in calculating nutritional adequacy from a daily menu. Educational videos on simple blood tests were made to replace hands-on training due to limitations of the covid19 protocol. Before and after training, pre and posttest were carried out. The training was attended by 15 health cadres in Gamping Kidul Village, Ambarketawang, Gamping, Sleman, Yogyakarta. The average score before training was 67.14, increasing to 73.57 thereafter. Paired T-test analysis showed no significant difference in pre and posttest scores (p = 0.076). After receiving the training, it is hoped that health cadres can carry out screening independently around their respective homes, so that early detection of NCD in the community can take place, then prevention can be carried out so that it does not become a fatal complication. It was concluded that the training could improve health cadres' understanding of PTM screening, prevention and calculating a balanced nutritious diet but not significant.

Medical diagnosis of COVID-19 using blood tests and machine learning

Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2), colloquially known as Coronavirus surfaced in late 2019 and is an extremely dangerous disease. RT-PCR (Reverse transcription Polymerase Chain Reaction) tests are extensively used in COVID-19 diagnosis. However, they are prone to a lot of false negatives and erroneous results. Hence, alternate methods are being researched and discovered for the detection of this infectious disease. We diagnose and forecast COVID-19 with the help of routine blood tests and Artificial Intelligence in this paper. The COVID-19 patient dataset was obtained from Israelita Albert Einstein Hospital, Brazil. Logistic regression, random forest, k nearest neighbours and Xgboost were the classifiers used for prediction. Since the dataset was extremely unbalanced, a technique called SMOTE was used to perform oversampling. Random forest obtained optimal results with an accuracy of 92%. The most important parameters according to the study were leukocytes, eosinophils, platelets and monocytes. This preliminary COVID-19 detection can be utilised in conjunction with RT-PCR testing to improve sensitivity, as well as in further pandemic outbreaks.

Poisoning due to consumption of horse chestnut seed

Horse chestnut (Aesculus hippocastanum) is a common tree found on roads and parks. The shape of the fruit is very similar to that of the edible Korean chestnut (Castanea crenata); thus, people can eat it by mistake. However, reports of the side effects and toxicity from ingestion are very rare. A 46-year-old male who had no unusual findings in the past had eaten horse chestnut seed which he had mistaken to be Korean chestnut. He visited the emergency department (ED) with complaints of epigastric pain, nausea, and sweating. Blood tests showed a slight increase in the levels of liver enzymes, serum amylase, and pancreatic amylase. During the monitoring, he complained of palpitations, and electrocardiogram showed atrial fibrillation. On the following day after conservative treatment, blood testing and electrocardiogram showed normal findings. He was discharged from the ED as he did not complain of any further symptoms. When a patient who has eaten horse chestnut visits the ED, blood examination and electrocardiogram monitoring are needed, and conservative treatment is required.

A case of spontaneous hypoglycemia

We describe a case of systemic lupus erythematosus with POEMS syndrome presenting as spontaneous hypoglycemia. A 58-year-old female suffered repeated episodes of hypoglycemia. During thesehypoglycemic episodes, her postprandial insulin level was inappropriately high. Further blood tests revealed the presence of antinuclear antibodies, anti-double-stranded DNA antibodies,low C4level.Altered albumin-globulin ratio,monoclonal gammopathy (IgG LAMBDA), polyneuropathy and organomegaly lead to suspicion of concurrent presence of POEMS syndrome.Bone marrow examination revealed plasma cell dyscrasia and plasmacytoma in trephine biopsy confirmed the diagnosis.Here, we emphasize on autoimmune cause of hypoglycemia. BIRDEM Med J 2022; 12(1): 70-73

Assessment of changes in the main homeostasis indicators in mammals after hyperthermic exposure

Introduction. The occupation of firefighters is characterized by the impact of both hazardous fire factors and a complex of harmful and dangerous characteristics of various natures, often exceeding the expected values. High air temperature is typical for almost all types of fire and is one of the main adverse physical factors affecting the body of firefighters. Experimental models on animals are of leading importance in studying extreme fire factors, including hyperthermic exposure. Material and methods. The study was carried out on 124 outbred white male rats of 3 months of age weighing 250-300 g, divided randomly into two groups. The first group (62 rats) was subjected to a single hyperthermic load. The second group (62 rats) was subjected to daily hyperthermic load during 14 days. The study of the leading indicators of the acid-base state and water-electrolyte balance, biochemical and clinical blood tests, cellular and humoral immunity was carried out before and after hyperthermic exposure. Results. The obtained data indicate high ambient temperatures cause changes in homeostasis indices in laboratory animals. At the same time, there are alterations in the indicators of water-electrolyte balance, acid-base state, clinical and biochemical blood tests and the immune system. Conclusion. An experimental model of extreme heat exposure on animals showed the emergence and persistence of changes in the leading indicators of homeostasis. In the group of single hyperthermia, these parameters were restored to the background levels in a day. In the group of multiple hyperthermia, they remained altered.

Situasi Filariasis Limfatik di Daerah Pasca Pemberian Obat Pencegahan Massal (POPM) dan Pasca Eliminasi di Kabupaten Tanjung Jabung Timur dan Belitung

East Tanjung Jabung Regency, Jambi did not pass in the Pre-Transmission Assessment Survey (Pre-TAS) in 2017, while Belitung, Bangka Belitung has a microfilaria rate (Mf rate) >1% even though it has passed TAS 1,2, and 3. The purpose of this study is to identify the program implementation control of lymphatic filariasis in East Tanjung Jabung Regency and Belitung Regency. The research was conducted in four villages, namely of Rantau Rasau 2, Nibung Putih (East Tanjung Jabung), Lasar, and Suak Gual (Belitung). Blood sampling was conducted on 1,919 people aged 5-70 years, while interviews were conducted on 900 people aged >16 years. The results of blood tests in East Tanjung Jabung were not found positive for mf, while in Belitung, 33 people were found positive for mf. The results of the risk estimate analysis of the respondent's knowledge, attitude and behavior factors indicate that respondents who live in East Tanjung Jabung Regency have a better level of knowledge, attitudes, and behaviour towards lymphatic filariasis t han respondents who live in Belitung Regency. Keywords: lymphatic filariasis, elimination, risk factor Abstrak Kabupaten Tanjung Jabung Timur, Jambi tidak lulus dalam Survei Penilaian Pra Transmisi (Pre-TAS) tahun 2017, sedangkan Belitung, Bangka Belitung memiliki angka mikrofilaria (Mf rate) >1% padahal sudah lolos TAS 1,2, dan 3. Tujuan penelitian ini adalah untuk mengidentifikasi pelaksanaan program pengendalian penyakit filariasis limfatik di Kabupaten Tanjung Jabung Timur dan Kabupaten Belitung. Penelitian dilakukan di empat desa, yaitu Rantau Rasau, Nibung Putih (Tanjung Jabung Timur), Lasar dan Suak Gual (Belitung). Pengambilan sampel darah dilakukan pada 1.919 orang berusia 5-70 tahun, sedangkan wawancara dilakukan pada 900 orang berusia >16 tahun. Hasil tes darah di Tanjung Jabung Timur tidak ditemukan positif mf, sedangkan di Belitung, 33 orang ditemukan positif mf. Hasil analisis estimasi risiko faktor pengetahuan, sikap dan perilaku responden menunjukkan bahwa responden yang berdomisili di Kabupaten Tanjung Jabung Timur memiliki tingkat pengetahuan, sikap, dan perilaku yang lebih baik terhadap filariasis limfatik dibandingkan responden yang berdomisili di Kabupaten Belitung. Kata kunci: filariasis limfatik, eliminasi, faktor risiko