Gender and Ocular Manifestations of Connective Tissue Diseases and Systemic Vasculitides

Ocular manifestations are present in many connective tissue diseases which are characterized by an immune system that is directed against self. In this paper, we review the ocular findings in various connective tissue diseases and systemic vasculitides and highlight gender differences in each disease. In rheumatoid arthritis, we find that dry eyes affect women nine times more than men. The other extra-articular manifestations of rheumatoid arthritis affect women three times more commonly than men. Systemic lupus erythematosus can involve all ocular structures and women are nine times more affected than men. Systemic sclerosis is a rare disease but, again, it is more common in women with a female to male ratio of 8 : 1. Polymyositis and dermatomyositis also affect women more commonly than men but no gender differences have been found in the incidence or disease course in the systemic vasculitides associated with antineutrophil cytoplasmic antibody such as granulomatosis with polyangiitis (GPA, formerly known as Wegener’s granulomatosis). Finally, Behcet’s disease is more common in males, and male gender is a risk factor for Behcet’s disease. There is a slight female preponderance in sarcoidosis with female gender carrying a worse prognosis in the outcome of ocular disease

IN VITRO ANTI-LEISHMANIAL ACTIVITY AGAINST CUTANEOUS LEISHMANIA PARASITES AND PRELIMINARY PHYTOCHEMICAL ANALYSIS OF FOUR YEMENI MEDICINAL PLANTS

Objective: Cutaneous leishmaniasis is one form of leishmaniasis that chiefly infected the poor sections of the society. The prototypical therapeutic interventions in vogue are handicapped due to toxicity and an alarming increase in drug resistance. Furthermore, the absence of vaccines has raised the quest for alternative therapies. So, the aim of our study was to assess the anti-leishmanial activity of Euphorbia cactus Ehrenb, Euphorbia ammak Forssk, Euphorbia inarticulate Schweinf, and Pergularia tomentosa L. Methods: The extracts of plants were prepared by maceration method and by Soxhlet extractor. The extracts were dried and re-dissolved in 2% dimethyl sulfoxide (DMSO) 1% solvent.  Leishmania spp. cells were then tested with serial concentrations (15.6 μgml-1 to 500 μg ml-1 ) of the extracts, using the 3-(4,5-dimethylthazolk-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay. All experiments were performed in triplicate and analyzed by ANOVA test. The optical density values as measured by Enzyme-Linked Immunosorbent Assay (ELISA) were used to calculate the IC50 values.  Results: The results indicated that the methanolic latex extract of Euphorbia cactus Ehrenb, Euphorbia ammak Forssk had potent anti-leishmanial activity against the promastigotes of Leishmania spp. based on a dose-dependent response analysis. The IC50 values for Euphorbia cactus Ehrenb and Euphorbia ammak Forssk after 24h incubation against Leishmania spp. promastigotes were less than <15.6 μgml-1. Furthermore, the phytochemical analysis of methanolic extracts showed the presence of alkaloids, phytosterols, phenols, saponins, and flavonoids in which these components have been proven previously to be the active compounds against Leishmania parasite. Conclusion: In conclusion, the present study reveals that latex extract of Euphorbia cactus Ehrenb and Euphorbia ammak Forssk contain active compounds that have anti-leishmanial activity, which could serve as an alternative agent in the treatment of Cutaneous leishmaniasis, but further studies would, therefore, be needed to assess the activity of these materials of this plants in vivo clinical response and study their toxicity on cell lines. Peer Review History: Received 26 July 2018;   Revised 19 August; Accepted 5 September, Available online 15 September 2018 Received file:        Reviewer's Comments: Average Peer review marks at initial stage: 5/10 Average Peer review marks at publication stage: 8.5/10 Reviewer(s) detail: Dr. Lucky Llegbosi Nwidu, University of Port Harcourt, Nigeria, [email protected] Dr. George Zhu, Tehran University of Medical Sciences, Tehran, Iran, [email protected] Similar Articles: COUMARIN ANALOGUES AS A POTENTIAL INHIBITOR OF LEISHMANIASIS: A MULTI-TARGETING PROTEIN INHIBITION APPROACH BY MOLECULAR DOCKIN

PREVALENCE OF CYTOMEGALOVIRUS IGG ANTIBODIES, POTENTIAL RISK FACTORS AND AWARENESS OF CONGENITAL CYTOMEGALOVIRUS AMONG FEMALE DOCTORS

Objective:  Female staff in children-Mother care hospitals may run an increased risk of cytomegalovirus (CMV) contact infection leading to a congenital CMV feto-pathy during pregnancy. Also, because of limited treatment options for congenital cytomegalovirus infection, preventive strategies are important so knowledge and awareness among doctors are essential for the success of preventive strategies. Thus this study was carried out to determine the positive rate of IgG among female doctors at age bearing who care for children and mothers in Sana'a hospitals. Also, to investigate the knowledge of congenital CMV among doctors involved in the study. Methods: This cross sectional study was carried out for one year (June 2017- June 2018); 178 Yemeni female doctors were included in this study. 23 (12.9%) of the total female doctors were pediatrics, 32(18%) gynecology and obstetrics, 9 (5.1%) Oto-rhinolaryngology and 114 (64%) were general practices. Blood samples were collected from all participants and tested for IgG antibodies of HCMV by ELISA. The individual's data were collected in a pre-designed questionnaire including; demographic data, risk factors. Also, a questionnaire on CMV infection was answered by doctors on the knowledge concerning epidemiology, transmission, symptoms and signs of CMV infection in adults and children; and treatment options. Results: 13.4% of female doctors were negative (HCMV IgG <9 SU), while the rest (86.6%) were positive (HCMV IgG ≥ 11 SU). There was escalate trend of positive HCMV IgG antibodies rate with increasing age, significance association between sero-positive HCMV IgG antibodies and parity (OR=3.1, p=0.01), 1-3 pregnancy rate (OR=2.2, p=0.05), and history of surgery (OR=3.8, p=0.01). Most of the doctors were aware that most healthy adults and pregnant women do not experience any symptoms of a CMV infection (66.8%); and only one-fifth of the respondents were aware that kissing, and changing diapers, are risk factors for the transmission of CMV. Also, only half of the total respondents were aware that microcephaly (59%), and hearing loss (56.7%) could be symptoms of congenital CMV. Conclusion: This study revealed that the HCMV is highly endemic in our population where the prevalence of IgG among the medical female doctors was 86.5%, thus HCMV should be considered as a possible cause of morbidity and mortality in fetus and might in mothers in Yemen. Increasing knowledge and awareness is expected to enhance the prevention of transmission, to improve recognition, and to stimulate diagnostic investigations and follow-up programs.                    Peer Review History: Received 8 October 2018;   Revised 22 October; Accepted 5 November, Available online 15 November 2018 Academic Editor:  Dr. Iman Muhammad Higazy, National Research Center, Egypt, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file:        Reviewer's Comments: Average Peer review marks at initial stage: 5.0/10 Average Peer review marks at publication stage: 8.0/10 Reviewer(s) detail: Dr. Omonkhelin J Owolabi, University of Benin, Nigeria, [email protected]  Dr. Ali Abdullah A. Al-Mehdar, University of Basrah, Iraq, [email protected] Similar Articles: THE ASSOCIATION OF EPSTEIN-BARR VIRUS ANTIBODIES WITH RHEUMATOID ARTHRITIS AMONG YEMENI PATIENTS IN SANA’A CITY PREVALENCE OF RUBELLA IGG ANTIBODIES AMONG PRODUCTIVE-AGE ‎WOMEN IN AL-MAHWEET GOVERNORATE, YEME

COCCIDIAN INTESTINAL PARASITES AMONG CHILDREN IN AL-TORBAH CITY IN YEMEN: IN COUNTRY WITH HIGH INCIDENCE OF MALNUTRITION

Objective: Diarrhoea is an important cause of malnutrition, morbidity and mortality among children in Yemen. Coccidian parasitic infections are an important cause of diarrhea in children particularly malnutrition and immune-compromised patients, but their investigations are rarely required by the treating physicians in apparently immunocompetent children. This study was aimed to find the prevalence of intestinal coccidian parasites in country with high incidence rate of malnutrition. Methods:  Between May 2016 and October 2016, 228 faecal samples from 228 selected school children in Al Turbah city, Taiz governorate, Yemen, aged between 6 and 15 years were examined using wet-mount preparations and formal concentration method then films stained by modified acid-fast staining. Also data of children were collected including demographic data, and sources of water. Findings of positive intestinal coccidian parasites were analyzed in relation with demographic data, and sources of water.   Results: The prevalence of Cryptosporidium species, Cyclospora species and Isospora belli were 75.9%, 45.6% and 1.75% respectively. There was significant association between positive of Cryptosporidium species and females (OR=2.1 times, P=0.01), and spring water source (OR=4 times, P=0.04), while there was no significant association between positive of Cryptosporidium species and others factors studied. Also there was no significant association between positive of Cyclospora species and Isospora belli and children sex, age groups, or different sources of water. Conclusion: In conclusion the study highlights the high prevalence of coccidian parasites among immunocompetent school children in Yemen. The clinicians in Yemen need to be aware that coccidian parasites are a potential cause of childhood diarrhea even in immunocompetent children.                    Peer Review History: Received 13 August 2019;   Revised 23 August; Accepted 7 September, Available online 15 September 2019 Academic Editor: Ahmad Najib, Universitas Muslim Indonesia,  Indonesia, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 7/10 Average Peer review marks at publication stage: 9.5/10 Reviewer(s) detail: Asmaa Ahmed Mohamed Ahmed Khalifa, Pharos University, Alexandria, Egypt, [email protected] Dr. Hayriye Eda Şatana Kara, Gazi University, Turkey, [email protected] Similar Articles: PREVALENCE OF INTESTINAL HELMINTHIASIS AND THEIR ASSOCIATION WITH EOSINOPHILIA AMONG SCHOOLCHILDREN IN WADIDHAHAR DISTRICT AT SANA’A GOVERNORATE, YEMEN FREQUENCY OF INTESTINAL PARASITIC INFECTIONS AMONG SCHOOLCHILDREN IN IBB CITY-YEME

Utility of EUS following endoscopic polypectomy of high-risk rectosigmoid lesions

BACKGROUND: The utility of endoscopic ultrasound (EUS) compared with standard white light endoscopy (WLE) following recent polypectomy of high-risk colorectal polyps is unknown. OBJECTIVE: To assess the incremental yield of EUS after endoscopic polypectomy of a high-risk rectal lesion. DESIGN: Retrospective cohort. SETTING: Tertiary referral center. MATERIALS AND METHODS: Patients referred for EUS following attempted endoscopic resection of a high-risk rectal neoplasm, defined as a tubulovillous adenoma, tubular adenoma with high-grade dysplasia, carcinoid, carcinoma in-situ or adenocarcinoma (CA). INTERVENTIONS: Sigmoidoscopy ± mucosal biopsy and EUS ± fine-needle aspiration (FNA) to evaluate for: (1) Residual polyp/tumor in the rectal wall or (2) peritumoral adenopathy. MAIN OUTCOME: Sensitivity and specificity for detection of residual neoplasia for WLE ± biopsy (WLE/BX) and EUS ± FNA for cancer (CA group) or benign disease (non-CA group). The incremental yield of EUS defined as: (1) Residual intramural neoplasia not present on WLE ± BX and; (2) abnormal peritumoral adenopathy. RESULTS: A total of 70 patients (mean age 64 ± 11 years, 61% male) with a final diagnosis of CA (n = 38) and non-CA (n = 32) were identified. There was no difference between the sensitivity and specificity of WLE alone (65% and 84%), WLE with biopsy (71% and 95%), and EUS (59% and 84%), for the detection of residual neoplasia (P > 0.05 for all). EUS identified 3 masses missed by WLE, all in the CA group. A malignant (n = 2) or benign (n = 3) node was identified in 5 (13%) CA patients; EUS-FNA in two showed residual malignancy in one and a reactive lymph node (LN) in one. No LNs were identified in the non-CA patients. LIMITATIONS: Retrospective design, incomplete follow-up in some patients. CONCLUSION: Following endoscopic polypectomy of high-risk rectal neoplasia, the incremental yield of EUS compared with WLE/BX for evaluation of residual disease appears limited, especially in patients with benign disease

Primary angiitis of the central nervous system presenting with subacute and fatal course of disease: a case report

BACKGROUND: Primary angiitis of the central nervous system is an idiopathic disorder characterized by vasculitis within the dural confines. The clinical presentation shows a wide variation and the course and the duration of disease are heterogeneous. This rare but treatable disease provides a diagnostic challenge owing to the lack of pathognomonic tests and the necessity of a histological confirmation. CASE PRESENTATION: A 28-year-old patient presenting with headache and fluctuating signs of encephalopathy was treated on the assumption of viral meningoencephalitis. The course of the disease led to his death 10 days after hospital admission. Postmortem examination revealed primary angiitis of the central nervous system. CONCLUSION: Primary angiitis of the central nervous system should always be taken into consideration when suspected infectious inflammation of the central nervous system does not respond to treatment adequately. In order to confirm the diagnosis with the consequence of a modified therapy angiography and combined leptomeningeal and brain biopsy should be considered immediately

The role of clathrin in post-golgi trafficking in toxoplasma gondii

Apicomplexan parasites are single eukaryotic cells with a highly polarised secretory system that contains unique secretory organelles (micronemes and rhoptries) that are required for host cell invasion. In contrast, the role of the endosomal system is poorly understood in these parasites. With many typical endocytic factors missing, we speculated that endocytosis depends exclusively on a clathrin-mediated mechanism. Intriguingly, in Toxoplasma gondii we were only able to observe the endogenous clathrin heavy chain 1 (CHC1) at the Golgi, but not at the parasite surface. For the functional characterisation of Toxoplasma gondii CHC1 we generated parasite mutants conditionally expressing the dominant negative clathrin Hub fragment and demonstrate that CHC1 is essential for vesicle formation at the trans-Golgi network. Consequently, the functional ablation of CHC1 results in Golgi aberrations, a block in the biogenesis of the unique secretory microneme and rhoptry organelles, and of the pellicle. However, we found no morphological evidence for clathrin mediating endocytosis in these parasites and speculate that they remodelled their vesicular trafficking system to adapt to an intracellular lifestyle

PREVALENCE AND POTENTIAL RISK FACTORS OF HEPATITIS B VIRUS IN A SAMPLE OF CHILDREN IN TWO SELECTED AREAS IN YEMEN

Objective: The global epidemic of hepatitis B is a significant public health problem. The endemicity of HBV infection used to be believed high in Yemen. Data for the prevalence of HBsAg among children in rural and urban areas in Yemen is scarce and incompetent. The study was made to determine prevalence of HB surface antigen among children in 2 selected areas in Yemen. Methods: Eight hundred forty and 212 children were randomly chosen from Sana'a city and Shabowah governorate, respectively. Sera were tested for HBs antigen by ELISA technique, and HB genome was tested for positive HB surface antigen specimens to confirm positivity using polymerase chain reaction (PCR)-based test. Each data collected in a pre-designed questionnaire including sex, age, and risk factors of HBV and prior vaccine of HBV. Results: The prevalence of HB surface antigen among children in Sana'a city was only 1.8%, and in Shabowah governorate was 3.8%. There was a significant association of non-vaccinated children, birth by cesarean, and with a history of parental exposure with contracting HBV infection.Conclusion: Evidence from these studies in Yemen suggests that there is a steady increase in exposure to HBV over a lifetime. Hospital-acquired HBV infection is common in Yemen, and high vaccination coverage rate should be achieved, particularly in rural areas, in parallel with health education.                      Peer Review History: Received 21 June 2019;   Revised 6 July; Accepted 10 July, Available online 15 July 2019 Academic Editor: Dr. Amany Mohamed Alboghdadly, Princess Nourah bint abdulrahman university, Riyadh, [email protected] UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. Received file:                Reviewer's Comments: Average Peer review marks at initial stage: 6.5/10 Average Peer review marks at publication stage: 8.5/10 Reviewer(s) detail: Aya Mohammed Mohammed Essawy, MTI University- Mokattam, Egypt, [email protected] Dr. Dalia Kamal Zaffar Ali, Modern University for technology and information, Egypt, [email protected] Similar Articles: SERO-EPIDEMIOLOGICAL STUDY OF HEPATITIS B, C, HIV AND TREPONEMA PALLIDUM AMONG BLOOD DONORS IN HODEIDA CITY- YEMEN EXPLOSION OF HEPATITIS B AND C VIRUSES AMONG HEMODIALYSIS PATIENTS AS A RESULT OF HEMODIALYSIS CRISIS IN YEME

Cancer stem cell markers in breast cancer: pathological, clinical and prognostic significance

INTRODUCTION: The cancer stem cell (CSC) hypothesis states that tumours consist of a cellular hierarchy with CSCs at the apex driving tumour recurrence and metastasis. Hence, CSCs are potentially of profound clinical importance. We set out to establish the clinical relevance of breast CSC markers by profiling a large cohort of breast tumours in tissue microarrays (TMAs) using immunohistochemistry (IHC). METHODS: We included 4, 125 patients enrolled in the SEARCH population-based study with tumours represented in TMAs and classified into molecular subtype according to a validated IHC-based five-marker scheme. IHC was used to detect CD44/CD24, ALDH1A1, aldehyde dehydrogenase family 1 member A3 (ALDH1A3) and integrin alpha-6 (ITGA6). A 'Total CSC' score representing expression of all four CSC markers was also investigated. Association with breast cancer specific survival (BCSS) at 10 years was assessed using a Cox proportional-hazards model. This study was complied with REMARK criteria. RESULTS: In ER negative cases, multivariate analysis showed that ITGA6 was an independent prognostic factor with a time-dependent effect restricted to the first two years of follow-up (hazard ratio (HR) for 0 to 2 years follow-up, 2.4; 95% confidence interval (95% CI), 1.2 to 4.8; P = 0.009). The composite 'Total CSC' score carried independent prognostic significance in ER negative cases for the first four years of follow-up (HR for 0 to 4 years follow-up, 1.3; 95% CI, 1.1 to 1.6; P = 0.006). CONCLUSIONS: Breast CSC markers do not identify identical subpopulations in primary tumours. Both ITGA6 and a composite Total CSC score show independent prognostic significance in ER negative disease. The use of multiple markers to identify tumours enriched for CSCs has the greatest prognostic value. In the absence of more specific markers, we propose that the effective translation of the CSC hypothesis into patient benefit will necessitate the use of a panel of markers to robustly identify tumours enriched for CSCs

Understanding the impact of the Hajj: explaining experiences of self-change at a religious mass gathering

Previous research has shown that participation in the Hajj pilgrimage to Mecca can lead to both more positive outgroup attitudes and increased commitment to Muslim identity. We describe a survey of pilgrims (N = 1176) carried out at Mecca, during the Hajj, which tested explanations for these experiences of self‐change at the time of their occurrence. In line with contact theory, perceived cooperation among pilgrims indirectly predicted more positive outgroup attitudes (as well as enhanced Muslim identification), via identification with the crowd. In line with social identity and identity congruence explanations, positive emotional experience and the perception that the crowd embodied the Muslim value of unity predicted self‐change variables through identification with the crowd. The finding that participation in an all‐Muslim gathering increases positive views of other groups (including non‐Muslims) through identification with the crowd offers an alternative perspective to suggestions that such gatherings might encourage intolerance