Biochemical markers as diagnostic/prognostic indicators for ischemic disease

Objective: The use of a biomarker was extremely useful in clinical emergencies such as stroke to aid in triage and early management of cases. The diagnostic accuracy of laboratory biomarkers is run to approve the identification of easy, cheap and fast tests associated with cerebral ischemia and intracranial hemorrhage. The present study was designed to screen serum enolase activity, activities of CK-BB, LDH and lipid profile in patients with ischemic or related diseases as good diagnostic/ prognostic indicator for ischemic diseases. Methods: Sixty male subjects in the age range of (45 ±2years) were divided into four groups each with 15 participants: Group (I) normal . Group (II) patients recently diagnosed as ischemic disease; Group (III) hypertensive patients and Group (IV); diabetic patients enolase activity (p<0.001) and CK-BB (p<0.01) in ischemic and hypertensive patients compared with control and diabetic groups. LDH level was significantly elevated in ischemic, hypertensive and diabetic patients compared with controls (p<0.001). The cut -off value for serum enolase was 62.5 nmol/l showing 90% sensitivity and 93% specificity for differentiation of ischemic disease. Positive correlations were observed between serum enolase (r = 0.56), and CK-BB (r = 0.53). Conclusion: Serum enolase can be considered as a more sensitive and specific marker and used as a sensitive diagnostic or prognostic marker for ischemic related diseases.Keywords: Serum enolase, ischemia, hypertension, diagnosis, prognostic

Massive Upper Gastrointestinal Bleeding Secondary to Duodenal Metastasis of Transitional Cell Carcinoma of the Urinary Bladder

Acute upper gastrointestinal (UGI) bleeding is a common problem in our clinical practice and is often due to peptic ulcer diseases. Occasionally, malignancy may be implicated in these situations. Here we report a rare case of UGI bleeding secondary to metastatic transitional cell carcinoma (TCC) of the urinary bladder. A 62-year-old man with a history of stage IIIb TCC of the urinary bladder presented with hematemesis. Endoscopy showed a large tumor in the second stage of the duodenum that occupied 40% of the duodenal circumference, over 7 cm in length. Biopsies revealed a poorly differentiated malignant neoplasm consistent with metastasis from urothelial carcinoma that was identical to the previous surgical specimen of the urinary bladder. He was treated with supportive therapy and intravenous proton pump inhibitor and was discharged home 2 weeks later. Two weeks after discharge, the patient returned to the hospital with a painful swelling of the floor of his mouth. Biopsy again showed the same cancer type. He had unremitting bleeding from his mouth requiring multiple transfusions and a course of palliative radiation therapy. He progressively deteriorated in his cardiopulmonary and neurological functions and expired with cardiopulmonary arrest one month later

Study of the effect of HFE gene mutations on iron overload in Egyptian thalassemia patients

Background: HFE gene mutations have been shown to be responsible for hereditaryhemochromatosis. Their effect on iron load in β-thalassemia patients and carriers remains controversial.Objectives: We aimed to determine the prevalence of HFE gene mutations (C282Y and H63D) in β-thalassemia patients and carriers and to investigate its effect on their serum ferritin levels.Patients and methods: A total of 100 β-thalassemia subjects; 75 patients and 25 carriers were screened for HFE gene mutations by PCR-RFLP. Serum ferritin measured by ELISA was evaluated in relation to HFE mutations.Results: Twenty-eight β-thalassemia patients (37.3%) were heterozygotes for H63D mutation (H/D), 8 (10.7%) were D/D and 39 (52%) were negative (H/H). Among carriers, 4 (16%) were D/D and 21 (84%) were H/H homozygotes. C282Y mutant allele was not detected in any of the subjects. Serum ferritin levels were significantly higher in β-thalassemia patients heterozygotes or homozygotes for H63D mutation compared to those without mutation (p= 0.000). Carriers homozygotes for H63D mutation showed significantly higher serum ferritin levels compared to those without mutation (p< 0.001).Conclusion: Homozygosity for H63D mutation tends to be associated with higher ferritin levels in beta-thalassemia patients and carriers suggesting its modulating effect on iron load in these cases

Over-expression of β-catenin is associated with high grade of prostatic cancer in Libyan patients

Objectives: At present, sufficient prognostic markers for prostate cancer (PCa) progression are still lacking, in spite of thorough investigation. The aim of this study was to evaluate abnormalities of β-catenin protein expression, subcellular localization and determine its relation to different clinicopathological features anddisease free survival in prostate cancer patients.Patients and methods: Forty prostate cancer specimens, obtained from patients with different stages of prostate cancer (83% stage IV) who underwent a radical prostatectomy or TURP flanked by 2006 and 2011, β-catenin was determined by immuno-histochemistry (IHC). The membranous expression was semi- quantitatively evaluated in four scores (0, 1+, 2+, 3+). Clinical records of these patients were studied for follow up data.Results: β-Catenin immune staining results show over-expression of β-catenin in PCa Libyan patients. There was no statistically significant difference in β-catenin immune expression as regards histopathological type, perineural invasion, tumor stage, biological recurrence. However, β-catenin over-expression showed significant correlation with old age (p < 0.014).Conclusions: We concluded that changes in expression and cell distribution of β-catenin correlated with the progression degree of prostate adenocarcinoma, signifying a role of this molecule as a marker of progression and prognosis. Further investigations, on a larger and more heterogeneous population, should be carried out to validate and extend our results.Keywords: Prostate cancer; β-Catenin expression; Immuno-histochemistry; Gleason score; Prognosi

Examining the impact of artificial intelligence and social and computer anxiety in e-learning settings: students’ perceptions at the university level

The learning environment usually raises various types of anxiety based on the student’s abilities to use technology and their abilities to overcome the negative feelings of an individual being watched all the time and criticized. Hence, learners still feel anxious while using computers and socializing in an e-learning environment. Learners who are faced with computer and AI tools are confused and frustrated. The uneasiness stems from anxiety or uneasiness, which is highly evident in daily interaction with computers and artificial intelligence tools or devices in e-learning contexts. The uneasiness stems from anxiety or uneasiness, which is highly evident in the daily interaction with computers and artificial intelligence tools or devices in e-learning contexts. To investigate this phenomenon empirically, a questionnaire was distributed among a group of undergraduate students who are studying different majors. This study aims to investigate the role of social anxiety and computer anxiety in an e-learning environment at the university level. Universities in the Gulf area are among those implementing e-learning systems. In spite of this, recent studies have shown that most students at Gulf universities are still resistant to using online systems; hence, it is necessary to determine the type of anxiety that creates such resistance and their relationship with other external variables such as motivation, satisfaction and self-efficacy. Students would be more likely to use e-learning tools and participate more effectively in their courses using the accessible electronic channels when the degree of anxiety is low. In this study, we have proposed a theoretical framework to investigate the role of social anxiety and computer anxiety in e-learning environments in the Gulf region. We examined how different variables such as satisfaction, motivation and self-efficacy can negatively or positively affect these two types of anxiety

Ameliorative effect of biosynthesized titanium dioxide nanoparticles using garlic extract on the body weight and developmental toxicity of liver in albino rats compared with chemically synthesized nanoparticles

The application of metallic nanoparticles poses risks to human and animal health. Titanium dioxide nanoparticles (TiO2NPs) are the most commonly synthesized metallic oxides in the world. Exposure to TiO2NPs can cause toxicity in the target organisms. This study aimed to evaluate the effects of green and chemical TiO2NPs on maternal and embryo-fetal livers. Green TiO2NPs using garlic extract (GTiO2NPs) and chemical TiO2NPs (CHTiO2NPs) were synthesized and characterized by x-ray powder diffraction and high-resolution transmission electron microscopy. The cytotoxicity of both chemical and green TiO2NPs was determined against HepG2 cell lines. Fifty pregnant female Albino rats were equally and randomly divided into five groups. Group 1 was kept as a control. Groups 2 and 3 were orally treated with 100 and 300 mg/kg body weight of CHTiO2NPs, respectively. Groups 4 and 5 were orally treated with 100 and 300 mg/kg of GTiO2NPs, respectively, from day 6 to 19 of gestation. All dams were euthanized on gestation day 20. All live fetuses were weighed and euthanized. Blood and tissue samples were collected for biochemical, histopathological, and Bax-immunohistochemical expression analyses. Our results indicated that garlic could be used as a reducing agent for the synthesis of TiO2NPs, and the produced NPs have no toxic effect against HepG2 cells compared with CHTiO2NPs. The maternal and fetal bodyweights were greatly reduced among the chemically TiO2NPs induced animals. The mean serum level of AST and ALT activities and the total protein level significantly increased when TiO2NPs were administered at high doses. Histologically, the CHTiO2NPs-treated groups revealed vacuolated and necrotized hepatocytes with congested and dilated blood vessels in the fetal and maternal livers. The immunohistochemistry revealed distinct positive staining of Bax expressed in the hepatocytes. Nevertheless, the biosynthesis of TiO2NPs using garlic extract had a minimal effect on the normal architecture of the liver. It could be concluded that the bioactivity of TiO2NPs can be modified by green synthesis using garlic extract. Compared to the CHTiO2NPs, the exposure to GTiO2NPs showed reduced liver damage in maternal and embryo-fetal rats

Sensory Electrical Stimulation Improves Foot Placement during Targeted Stepping Post-Stroke

Proper foot placement is vital for maintaining balance during walking, requiring the integration of multiple sensory signals with motor commands. Disruption of brain structures post-stroke likely alters the processing of sensory information by motor centers, interfering with precision control of foot placement and walking function for stroke survivors. In this study, we examined whether somatosensory stimulation, which improves functional movements of the paretic hand, could be used to improve foot placement of the paretic limb. Foot placement was evaluated before, during, and after application of somatosensory electrical stimulation to the paretic foot during a targeted stepping task. Starting from standing, twelve chronic stroke participants initiated movement with the non-paretic limb and stepped to one of five target locations projected onto the floor with distances normalized to the paretic stride length. Targeting error and lower extremity kinematics were used to assess changes in foot placement and limb control due to somatosensory stimulation. Significant reductions in placement error in the medial–lateral direction (p = 0.008) were observed during the stimulation and post-stimulation blocks. Seven participants, presenting with a hip circumduction walking pattern, had reductions (p = 0.008) in the magnitude and duration of hip abduction during swing with somatosensory stimulation. Reductions in circumduction correlated with both functional and clinical measures, with larger improvements observed in participants with greater impairment. The results of this study suggest that somatosensory stimulation of the paretic foot applied during movement can improve the precision control of foot placement

Middle East respiratory syndrome coronavirus in dromedary camels: An outbreak investigation

Background: Middle East respiratory syndrome coronavirus (MERS-CoV) causes severe lower respiratory tract infection in people. Previous studies suggested dromedary camels were a reservoir for this virus. We tested for the presence of MERS-CoV in dromedary camels from a farm in Qatar linked to two human cases of the infection in October, 2013. Methods: We took nose swabs, rectal swabs, and blood samples from all camels on the Qatari farm. We tested swabs with RT-PCR, with amplification targeting the E gene (upE), nucleocapsid (N) gene, and open reading frame (ORF) 1a. PCR positive samples were tested by different MERS-CoV specific PCRs and obtained sequences were used for phylogentic analysis together with sequences from the linked human cases and other human cases. We tested serum samples from the camels for IgG immunofluorescence assay, protein microarray, and virus neutralisation assay. Findings: We obtained samples from 14 camels on Oct 17, 2013. We detected MERS-CoV in nose swabs from three camels by three independent RT-PCRs and sequencing. The nucleotide sequence of an ORF1a fragment (940 nucleotides) and a 4·2 kb concatenated fragment were very similar to the MERS-CoV from two human cases on the same farm and a MERS-CoV isolate from Hafr-Al-Batin. Eight additional camel nose swabs were positive on one or more RT-PCRs, but could not be confirmed by sequencing. All camels had MERS-CoV spike-binding antibodies that correlated well with the presence of neutralising antibodies to MERS-CoV. Interpretation: Our study provides virological confirmation of MERS-CoV in camels and suggests a recent outbreak affecting both human beings and camels. We cannot conclude whether the people on the farm were infected by the camels or vice versa, or if a third source was responsible. Funding: European Union projects EMPERIE (contract number 223498), ANTIGONE (contract number 278976), and the VIRGO consortium

Molecular characterization of gliotoxin-producing Aspergillus fumigatus in dairy cattle feed

Background and Aim: Several strains of Aspergillus fumigatus produce mycotoxins that affect the health and productivity of dairy cattle, and their presence in dairy cattle feed is a serious concern. This study aimed to determine the densities of A. fumigatus and gliotoxin in commercial dairy feed. Materials and Methods: More than 60 dairy feed samples were examined for fungal contamination, specifically for A. fumigatus, using phenotypic approaches and DNA sequencing of the internal transcribed spacer (ITS) and β-tubulin regions. Thin-layer chromatography and high-performance liquid chromatography (HPLC) were used to assess gliotoxin production in A. fumigatus. Real-time polymerase chain reaction (RT-PCR) was used to investigate the expression of gliZ, which was responsible for gliotoxin production. High-performance liquid chromatography was used to detect gliotoxin in feed samples. Results: Aspergillus was the most commonly identified genus (68.3%). Aspergillus fumigatus was isolated from 18.3% of dairy feed samples. Only four of the 11 A. fumigatus isolates yielded detectable gliotoxins by HPLC. In total, 7/11 (43.7%) feed samples tested had gliotoxin contamination above the threshold known to induce immunosuppressive and apoptotic effects in vitro. The HPLC-based classification of isolates as high, moderate, or non-producers of gliotoxin was confirmed by RT-PCR, and the evaluation of gliZ expression levels corroborated this classification. Conclusion: The identification of A. fumigatus from animal feed greatly depended on ITS and β-tubulin sequencing. Significant concentrations of gliotoxin were found in dairy cattle feed, and its presence may affect dairy cow productivity and health. Furthermore, workers face contamination risks when handling and storing animal feed

The sample of choice for detecting Middle East respiratory syndrome coronavirus in asymptomatic dromedary camels using real-time reverse-transcription polymerase chain reaction

The newly identified Middle East respiratory syndrome coronavirus (MERS-CoV), which causes severe respiratory disease, particularly in people with comorbidities, requires further investigation. Studies in Qatar and elsewhere have provided evidence that dromedary camels are a reservoir for the virus, but the exact modes of transmission of MERS-CoV to humans remain unclear. In February 2014, an assessment was made of the suitability and sensitivity of different types of sample for the detection of MERS-CoV by real-time reverse-transcription polymerase chain reaction (RT-PCR) for three gene targets: UpE (upstream of the E gene), the N (nucleocapsid) gene and open reading frame (ORF) 1a. Fifty-three animals presented for slaughter were sampled. A high percentage of the sampled camels (79% [95% confidence interval 66.9-91.5%, standard error 0.0625]; 42 out of 53) were shown to be shedding MERS-CoV at the time of slaughter, yet all the animals were apparently healthy. Among the virus-positive animals, nasal swabs were most often positive (97.6%). Oral swabs were the second most frequently positive (35.7%), followed by rectal swabs (28.5%). In addition, the highest viral load, expressed as a cycle threshold (Ct) value of 11.27, was obtained from a nasal swab. These findings lead to the conclusion that nasal swabs are the candidate sample of choice for detecting MERS-CoV using RT-PCR technology in apparently healthy camels