Thyroid Function in Molar Pregnancies

Introduction: Molar pregnancies represent a significant burden of disease on the spectrum of gestational trophoblastic diseases. Vaginal bleeding being the most common occasionally, molar pregnancy is complicated by hyperthyroidism, which may require treatment. Aims: To determine thyroid function test and association of hyperthyroidism among the cases of molar pregnancy. Methods: This is a hospital-based cross-sectional study conducted in the department of Obstetrics and Gynecology, Nepalgunj Medical College and Teaching Hospital, Kohalpur. Sixty cases of molar pregnancy were included during the study period from February 2020 to January 2021.Patients having history of known thyroid disorders were excluded. Results: Prevalence of molar pregnancy in our study was 5.4 per thousand pregnancies in our hospital. Molar pregnancy and hyperthyroidism, both were common in the age group of 21-35 years. Hyperthyroidism was present in 10% patients. Enlarged thyroid was seen in 3.3%, tremor was present in 3.3%, and palpitation in 21.5%. Five (8.3%) patients with hyperthyroidism were underweight. Majority of patients with hyperthyroidism, beta humanchorionic gonadotrophhin level was more than three lakhs and it was mostly associated with complete hydatidiform mole compared to partial hydatidiform mole. Thyroid storm was not experienced in any of the patients. Conclusion: The rate of molar pregnancy is high. Hyperthyroidism in molar pregnancy is not uncommon. High levels of human chorionic gonadotropin, complete hydatiform mole are directly associated with hyperthyroidism. Awareness of this condition is important for diagnosis and treatment to prevent life threatening complications.

Evaluation of Disease Burden by (Separate) Patient-reported, Clinical, and Laboratory Factor Scores in Patients With Established Rheumatoid Arthritis: A Factor Analysis Replication

Rheumatoid arthritis (RA) can cause significant burden to patients. Some of these aspects are directly related to disease activity and are manageable with antirheumatic drugs, whereas others require nonpharmacological interventions.

Incidence and risk factors for surgical site infection post-gynecological operations in a tertiary hospital in Egypt: a retrospective study

Background: Surgical site infection (SSI) is the most common complication of surgical procedures in gynecology and it poses a significant burden for both patients and healthcare systems. Our objective was determining the incidence and risk factors for SSI post-gynecological operations during the period of five years.Methods: A matched case-control study at Minia maternity university, Egypt where A total of 18772 cases had undergone different gynecological procedures. The 876 cases were complicated with SSI (SSI cases group) and 2 matched controls per case were chosen from the rest of the cases and served as the control group (n=1752 cases).Results: The overall incidence of SSI post-gynecological operations was 4.67% and post-hysterectomy was 7.57%. SSI group had a significantly higher number of cases with diabetes, obesity, high parity (>4), increased blood loss and those had prolonged duration of surgery compared to the control group (all p<0.01).Conclusions: The identified risk factors are crucial for risk stratification of SSI and prioritizing interventions to improve the outcome. These results could give a picture for SSI post-gynecological operations in our country and identifying these risk factors is crucial for risk stratification of SSI and prioritizing interventions to improve the outcome.

Local-scale virome depiction supports significant differences between Aedes aegypti and Aedes albopictus

Aedes spp. comprise the primary group of mosquitoes that transmit arboviruses such as dengue, Zika, and chikungunya viruses to humans, and thus these insects pose a significant burden on public health worldwide. Advancements in next-generation sequencing and metagenomics have expanded our knowledge on the richness of RNA viruses harbored by arthropods such as Ae. aegypti and Ae. albopictus ; increasing evidence suggests that vectorial competence can be modified by the microbiome (comprising both bacteriome and virome) of mosquitoes present in endemic zones. Using an RNA-seq-based metataxonomic approach, this study determined the virome structure of field-caught Ae. aegypti and Ae. albopictus mosquitoes in Medellín, Colombia, a municipality with a high incidence of mosquito-transmitted arboviruses. The two species are sympatric, but their core viromes differed considerably in richness, diversity, and abundance; the viromes were dominated by a few viruses. BLAST searches of assembled contigs suggested that at least 17 virus species (16 of which are insect-specific viruses [ISVs]) infect the Ae. aegypti population. Dengue virus 3 was detected in one sample. In Ae. albopictus , up to 11 ISVs and one plant virus were detected. Therefore, the virome composition was species-specific. The bacterial endosymbiont Wolbachia was identified in all Ae. albopictus samples and in some Ae. aegypti samples collected after 2017. The presence of Wolbachi a sp. in Ae. aegypti was not related to significant changes in the richness, diversity, or abundance of this mosquito’s virome, although it was related to an increase in the abundance of Aedes aegypti To virus 2 (unclassified). The mitochondrial diversity of these mosquitoes suggested that the Ae. aegypti population underwent a change that started in the second half of 2017, which coincides with the release of Wolbachia -infected mosquitoes in Medellín, indicating that the population of w Mel-infected mosquitoes has expanded. However, additional studies are required on the dispersal speed and intergenerational stability of w Mel in Medellín and nearby areas as well as on the introgression of genetic variants in the native mosquito population.

Italian cultural policy: conclusions for Russia

The article analyses current public management and funding practices of cultural organisations in Italy by using comparative and statistical analysis. The structure of the sector’s governing bodies and approaches to budgeting for culture at national level have been explored. Trends in decreasing funding from provincial, regional and local budgets have been identified. The status, legislative and institutional conditions for the emergence of Italy’s unique multichannel cultural financing system have been described. An analysis of the Italian museum system’s reform has been presented. The activities of private opera foundations have been discussed in detail. The main similarities between Russian and Italian cultural policies have been described. These are the drive to expand the boundaries and activities associated with the cultural sector, the significant burden on local and regional authorities in the field of cultural heritage preservation, the “quantitative approach” and the application of financial performance indicators to assess cultural organisations performance.The article’s scientific novelty lies in the complex approach to the study of Italian cultural policy using the criteria proposed by D. Montias and A. I. Glagolev, and in the study of the activities of Italian opera foundations and museums, which had not previously been sufficiently covered in the Russian and foreign literature. The prospect of the topic, the practical significance and relevance of the research are due to the need to implement regulations in Russia which set a course for the creation of a multi-channel system of funding and a broad understanding of the cultural sector, and ensuring inter-agency and inter-regional cooperation between the authorities in the implementation of cultural policy.The article analyses a wide range of financial support mechanisms for culture, most of which are named in the “Strategy of State Cultural Policy of Russia as Targets by 2030”, while Italy has accumulated considerable experience in this area for several decades.

2-Sulfonylpyrimidines as Privileged Warheads for the Development of S. aureus Sortase A Inhibitors

Staphylococcus aureus is one of the most frequent causes of nosocomial and community-acquired infections, with emerging multiresistant isolates causing a significant burden to public health systems. We identified 2-sulfonylpyrimidines as a new class of potent inhibitors against S. aureus sortase A acting by covalent modification of the active site cysteine 184. Series of derivatives were synthesized to derive structure-activity relationship (SAR) with the most potent compounds displaying low micromolar KI values. Studies on the inhibition selectivity of homologous cysteine proteases showed that 2-sulfonylpyrimidines reacted efficiently with protonated cysteine residues as found in sortase A, though surprisingly, no reaction occurred with the more nucleophilic cysteine residue from imidazolinium-thiolate dyads of cathepsin-like proteases. By means of enzymatic and chemical kinetics as well as quantum chemical calculations, it could be rationalized that the SNAr reaction between protonated cysteine residues and 2-sulfonylpyrimidines proceeds in a concerted fashion, and the mechanism involves a ternary transition state with a conjugated base. Molecular docking and enzyme inhibition at variable pH values allowed us to hypothesize that in sortase A this base is represented by the catalytic histidine 120, which could be substantiated by QM model calculation with 4-methylimidazole as histidine analog.

Pseudoeosinophilia with Abnormal WBC Scattergram: an Important Diagnostic Clue on Hematology Analyzer

Malaria is one of the most common parasitic diseases causing a significant burden on health care, especially in India. Light microscopy, the gold standard for malaria diagnosis is time-consuming especially in a setup where the caseload is high and parasite index is low. Knowledge of abnormal scattergrams by the malarial parasite is very essential to suspect malaria and screen those cases thoroughly on a peripheral smear for accurate diagnosis. A timely and accurate diagnosis is crucial to the prognosis of this disease. Herein, we report a case of a 40-year-old male from Punjab who presented to the emergency with fever and an altered sensorium. Analyzer showed characteristic pseudo eosinophilia with greying of neutrophil eosinophil zone with double eosinophil cluster. According to flagging rules because of eosinophilia, peripheral blood film (PBF) was made and examined, which revealed Plasmodium falciparum gametocytes.

Glycosides for Peripheral Neuropathic Pain: A Potential Medicinal Components

Neuropathic pain is a refractory disease that occurs across the world and pharmacotherapy has limited efficacy and/or safety. This disease imposes a significant burden on both the somatic and mental health of patients; indeed, some patients have referred to neuropathic pain as being ‘worse than death’. The pharmacological agents that are used to treat neuropathic pain at present can produce mild effects in certain patients, and induce many adverse reactions, such as sedation, dizziness, vomiting, and peripheral oedema. Therefore, there is an urgent need to discover novel drugs that are safer and more effective. Natural compounds from medical plants have become potential sources of analgesics, and evidence has shown that glycosides alleviated neuropathic pain via regulating oxidative stress, transcriptional regulation, ion channels, membrane receptors and so on. In this review, we summarize the epidemiology of neuropathic pain and the existing therapeutic drugs used for disease prevention and treatment. We also demonstrate how glycosides exhibit an antinociceptive effect on neuropathic pain in laboratory research and describe the antinociceptive mechanisms involved to facilitate the discovery of new drugs to improve the quality of life of patients experiencing neuropathic pain.

Fecal Calprotectin Is Increased in Stroke

Background: While there have been major advances in unveiling the mechanisms comprising the ischemic cascade of CNS, stroke continues to be a significant burden. There is a need to extend the focus toward peripheral changes, and the brain–gut axis has recently gained much attention. Our study aimed to evaluate gut inflammation and its association with blood variables in stroke using fecal calprotectin (FC). Methods: Fecal samples were obtained from 27 stroke patients and 27 control subjects. FC was quantitatively measured using a commercial ELISA. Laboratory data on the fecal sample collection were also collected, including CBC, ESR, glucose, creatinine, total protein, albumin, transaminases, and CRP. Results: There was a significant increase in FC levels in stroke patients compared to the controls. Furthermore, FC in stroke patients was negatively correlated with the Glasgow Coma Scale. Moreover, FC in stroke patients was positively correlated with CRP and negatively correlated with lymphocyte count and albumin. Conclusions: Our findings show that increased FC is associated with consciousness and systemic response in stroke and warrants further studies to elucidate the usefulness of FC in the management of stroke.

Clear Aligners in Patients with Amelogenesis and Dentinogenesis Imperfecta

Dentinogenesis imperfecta (DI) and amelogenesis imperfecta (AI) are hereditary abnormalities of dental hard tissues. Dental abnormalities may also be accompanied by symptoms of disorders such as osteogenesis imperfecta. AI and DI have a significant burden on socializing, function, and comfort; therefore, frequent screening and accurate diagnosis is the cornerstone of managing such conditions. Both AI and DI could be treated with many strategies, including restorative, prosthetic, periodontal, surgical, and orthodontics treatment. The interdisciplinary combination of orthodontic, prosthodontic, and periodontic treatment has been proven to improve the prognosis of AI and DI. Regarding orthodontic treatment, the most difficult element of orthodontic therapy may be maintaining a high level of motivation for what might be a prolonged form of treatment spanning several years. There are many forms of orthodontic management for AI and DI, including removable appliances, functional appliances, and fixed appliances. Clear aligner therapy (CAT) contains a broad range of equipment that works in different ways, has different construction processes, and is compatible with different malocclusion procedures. The application of CAT in patients with AI and DI is favorable over the fixed applicants. However, the available evidence regarding the application of CAT in AI is weak and heterogeneous. In this review, we discussed the current evidence regarding the application of clear CAT in patients with AI and DI.