Erythrodermiaichtyosisformis congenital – A case report

Non-bullous congenital ichthyosi-form erythroderma is an autosomal recessive congenital keratinization disorder. We present the only one registered case of congenital non-bullous ichthyosiformerythroderma in North Macedonia. Our patient now is a 29-year old man from Gostivar. He was born with low birth weight and a low Apgar score (5/7). After birth, the skin was so cracked, that there were bleeding in certain places. Furthermore, the entire body, especially the head, was covered with yellow-green scales of varying size, which were firmly attached to the substrate. There was no history of similar or same illness in the family. Little is known about the oral manifestations of this disorder. The prognosis is variable. The disease has a strong impact on the quality of life due to altered physical appearance, problematic symptoms and treatment restrictions

Diagnostic challenge and conservative msnsgement of cervical pregnancy with uterus presevation

Cervical pregnancy is a rare form of ectopic pregnancy in which the embryo implants in the lining of the endocervical canal. Clinical criteria and ultrasound features, supplemented by rapid assay of serum human chorionic gonadotropin (hCG), make the diagnosis easier and more accurate. Depending on the time of diagnosis and the patient’s condition, management can be conservative or operative Case: We present a rare case of cervical pregnancy with all the diagnostic challenges for making an early diagnosis and choosing the right treatment regimen, which can be life saving for the patients and can reduce the chance of severe hemorrhage necessitating hysterectomy or blood transfusion Early diagnosis, appropriate methotrexate regimen and combination of necessary adjuvant conservative procedures could contribute to successful treatment with preservation of the uterus and future reproductive ability

Application and future perspective of trichloroacetic acid in the treatment of cervical intraepithelial neoplasia after cold knife conization

Background: Factors that contribute to development of cervical intraepithelial neoplasia are: age older than 55, and infection with persistent, high risk Human papillomavirus (HPV). If the HPV remains in an episomal nonintegrated state, it results with low grade lesion and if virus becomes integrated into the human genome, high grade lesions and cancer may develop. Low grade lesion is cervical intraepithelial neoplasia and it refers to mildly atypical cellular changes in the lower third of the epithelium. High grade cervical lesions are cervical intraepithelial neoplasia II and III. CIN II refers to moderately atypical cellular changes confined at the basal two thirds of the epithelium and CIN III refers to severely atypical cellular changes encompassing greater than two thirds of the epithelial thickness. Cold knife conization usually is the treatment of choice for high grade cervical lesions. Case report: We present a case of new creative treatment with 85% trichloroacetic acid, of low grade cervical intraepithelial neoplasia, which was a residual cervical lesion after a cold knife conization preformed for high grade cervical intraepithelial neoplasia grade treatment. Conclusion: Single topical use of 85% trichloroacetic acid is an effective treatment for residual persistent cervical intraepithelial neoplasia of low grade, after cold knife conization and provides long term remission and satisfying Human papillomavirus clearance. Thus 85% trichloroacetic acid treatment can directly diminish morbidity and mortality of Human papilloma virus related to precancerous cervical lesions and cervical carcinoma

COMPARISON OF ELISA AND CHEMILUMINESCENCE IMMUNOASSAY METHODS FOR QUANTIFICATION OF HUMAN PLACENTAL GROWTH FACTOR IN SERUM

Placental growth factor (PlGF) is crucial during placental development in early pregnancy. Several studies in pregnancies with complications such as preeclampsia or small for gestational age neonates find that PlGF levels are significantly lower in the first trimester, which implies that the concentration of PlGF could be used as an early screening biomarker for these conditions. This study aimed to compare the performance of chemiluminescence immunoassay (CLIA) and enzyme-linked immunosorbent assay (ELISA) for the quantification of human PlGF in serum. This is a comparative study on 88 pregnant women in the first trimester subjected to measurement of PlGF in serum using two commercially available kits: Human PlGF Quantikine HS ELISA (R&D Systems) and PlGF CLIA (Snibe). The overall coefficient of correlation between the tests was 0.93. When the cut-off value of 40 pg/mL was applied, it dropped significantly to 0.50 towards the lower values, while remaining an excellent 0.91 in the group with higher concentrations of PlGF. While R&D Systems’s ELISA seems to have better sensitivity, it is not very convenient to use for a small number of samples. Snibe’s CLIA automated method is user-friendly, fast and powerful. Both tests show excellent performance when indicating risk-free pregnancies

Mesenchymal Stromal Cells from Healthy and Inflamed Human Gingiva Respond Differently to Porphyromonas gingivalis

Gingiva-Derived Mesenchymal Stromal Cells (GMSCs) have been shown to play an important role in periodontitis. However, how P. gingivalis, one of the key etiological agents of the disease, affects healthy (H)- and periodontitis (P)-GMSCs is unknown. To address this problem, we established 10 H-GMSC and 12 P-GMSC lines. No significant differences in morphology, differentiation into chondroblasts and adipocytes, expression of characteristic MSCS markers, including pericyte antigens NG2 and PDGFR, were observed between H- and P-GMSC lines. However, proliferation, cell size and osteogenic potential were higher in P-GMSCs, in contrast to their lower ability to suppress mononuclear cell proliferation. P. gingivalis up-regulated the mRNA expression of IL-6, IL-8, MCP-1, GRO-alpha, RANTES, TLR-2, HIF-1 alpha, OPG, MMP-3, SDF-1, HGF and IP-10 in P-GMSCs, whereas only IL-6, MCP-1 and GRO-alpha were up-regulated in H-GMSCs. The expression of MCP-1, RANTES, IP-10 and HGF was significantly higher in P-GMSCs compared to H-GMSCs, but IDO1 was lower. No significant changes in the expression of TLR-3, TLR-4, TGF-beta, LAP, IGFBP4 and TIMP-1 were observed in both types of GMSCs. In conclusion, our results suggest that P-GMSCs retain their pro-inflammatory properties in culture, exhibit lower immunosuppressive potential than their healthy counterparts, and impaired regeneration-associated gene induction in culture. All these functions are potentiated significantly by P. gingivalis treatment

Pomegranate Peel Extract Differently Modulates Gene Expression in Gingiva-Derived Mesenchymal Stromal Cells under Physiological and Inflammatory Conditions

Pomegranate has shown a favorable effect on gingivitis/periodontitis, but the mechanisms involved are poorly understood. The aim of this study was to test the effect of pomegranate peel extract (PoPEx) on gingiva-derived mesenchymal stromal cells (GMSCs) under physiological and inflammatory conditions. GMSC lines from healthy (H) and periodontitis (P) gingiva (n = 3 of each) were established. The lines were treated with two non-toxic concentrations of PoPEX (low—10; high—40 µg/mL), with or without additional lipopolysaccharide (LPS) stimulation. Twenty-four genes in GMSCs involved in different functions were examined using real-time polymerase chain reaction (RT-PCR). PoPEx (mostly at higher concentrations) inhibited the basal expression of IL-6, MCP-1, GRO-α, RANTES, IP-10, HIF-1α, SDF-1, and HGF but increased the expression of IL-8, TLR3, TGF-β, TGF-β/LAP ratio, IDO-1, and IGFB4 genes in H-GMSCs. PoPEx increased IL-6, RANTES, MMP3, and BMP2 but inhibited TLR2 and GRO-α gene expression in P-GMSCs. LPS upregulated genes for proinflammatory cytokines and chemokines, tissue regeneration/repair (MMP3, IGFBP4, HGF), and immunomodulation (IP-10, RANTES, IDO-1, TLR3, COX-2), more strongly in P-GMSCs. PoPEx also potentiated most genes’ expression in LPS-stimulated P-GMSCs, including upregulation of osteoblastic genes (RUNX2, BMP2, COL1A1, and OPG), simultaneously inhibiting cell proliferation. In conclusion, the modulatory effects of PoPEx on gene expression in GMSCs are complex and dependent on applied concentrations, GMSC type, and LPS stimulation. Generally, the effect is more pronounced in inflammation-simulating conditions

RELATION OF ECHO DOPPLER UTERIN IN THE FIRST TRIMESTER TO FETAL SGA OR IUGR

The ECHO Doppler of the uterine artery is used to predict adverse pregnancy outcomes such as. preeclampsia and in the fetal SGA. Objectives. Evaluation of the impact of ECHO Doppler uterine parameters in the first trimester, with the fetal SGA / IUGR. Materials and method. The study is a prospective study conducted at the Special Gynecology Hospital "Mother Teresa", Skopje, and the Clinical-Biochemical Laboratory, Institute of Immunology at the University Clinical Center Skopje R, North Macedonia, and February 2018-September 2019. 698 pregnant women were included in the study. Outcomes. Out of all controlled patients in the period February 2019-June 2010, a total of 698 pregnant women were studied. Increase in ECHO Doppler of uterine arteries. Discussion. Assessment of placental development during pregnancy is one of the most important predictors of fetal development and pre-eclampsia. In modern acupuncture protocols, new diagnostic methods are of particular importance. Conclusion. In our study, ECHO Doppler of uterine arteries resulted in: sensitivity 50%, specificity 50%, PPV 50%, NPV 50%. P = 0.5 R = 0.5. Confirming high reliability of ECHO Doppler uterine arteries in early detection of preeclampsia and its impact on the newborn with SGA / IUGR, further research is needed in relation to these two pregnancy predictors. Recommendations. ECHO Doppler uterine methods have their own difficulties due to the high cost of, and the realization of ECHO Doppler benefits are great and practical. Opportunities for further study are opened, because a new database has been formed in this area of obstetrics from clinically validated and diagnosed patients

RELATION OF PLGF IN THE FIRST TRIMESTER TO FETAL SGA OR IUGR

PlGF determination today is of particular clinical importance in determining fetal-placental development. Placental growth factor PlGF is a human, genetically encoded protein. Objectives. Evaluation of the impact of PlGF in the first trimester, with the fetal SGA / IUGR. Material and method. The study is a prospective study conducted at the Special Gynecology Hospital "Mother Teresa", Skopje, and the Clinical-Biochemical Laboratory, Institute of Immunology at the University Clinical Center Skopje R, North Macedonia, from February 2019 - September 2010. 698 pregnant women were included in the study. Outcomes. Out of all controlled patients in the period February 2019-June 2010, a total of 698 pregnant women were studied. increase in PlGF values, in 1 or 25 (25%) cases with SGA we have increased values of PlGF. PlGF level > 40 pg/ml cut-off resulted in 337 or (48.28%) cases, and in 361 or (51.71)% cases have an increase in PlGF < cut-off 40 pg/ml. Newborns with SGA / IUGR resulted in 4 or (0.57%) newborns, according to gestation evaluation criteria. Results. In our study PlGF resulted in: sensitivity 75%, specificity 50%, PPV 75%, NPV 50%, P = 0.25 and R = 0.5. Discussions. Assessment of placental development during pregnancy is one of the most important predictors of fetal development and pre-eclampsia. In modern acupuncture protocols, new diagnostic methods are of particular importance. Conclusions. PlGF methods have their own difficulties due to the high cost of PlGF reagents, Opportunities for further study are opened, because a new database has been formed in this area of obstetrics from clinically validated and diagnosed patients. Ohet A computerized database of these problems is formed

Erythrodermia Ichtyosis Formis Congenital - Case Report

Non-bullous congenital ichthyosi-form erythroderma is an autosomal recessive congenital keratinization disorder. Materials and Methods: We present the only one registered case of congenital non-bullous ichthyosiform erythroderma in North Macedonia. Our patient now is a 29-year old man from Gostivar. He was born with low birth weight and a low Apgar score (5/7). After birth, the skin was so cracked, that there were bleeding in certain places. Furthermore, the entire body, especially the head, was covered with yellow-green scales of varying size, which were firmly attached to the substrate. He does not provide information about a similar or same illness in the family. The ophthalmologist detected ectropion on the eyes, congenital chronic dacryocystitis, and conjunctivitis. His nails are very fragile. Often, pruritus occurs due to dryness of the skin. Meanwhile, flexion contractures on the 4th and 5th fingers of the right arm are noticed. In addition, they are with reduced function. Little is known about the oral manifestations of this disorder. Conclusion: The prognosis is variable. The disease has a strong impact on the quality of life due to altered physical appearance, problematic symptoms and treatment restrictions Key words: Congenital; Recessive; Non-Bullous Congenital Ichthyosiform Erythroderma; Oral Manifestations of Itchthyosi