Assessment of Joint Hypermobility in Adult Patients with Inguinal Hernia: An Analytical Cross Sectional Study from Iraq

Background: Weakness of the supporting tissue is one of the causes of inguinal hernia. Joint hypermobility (JHM) is an excessive range of movement of the joint due to laxity of supporting connective tissue.Objective: To assess JHM in adult patients with inguinal hernia.Patients and methods: A total of 200 individuals were included in this study, 100 patients had inguinal hernia diagnosed by a surgeon based on  clinical and abdominal ultrasound examination,  and  another 100 healthy individuals matched in age and  sex were taken as a control group. Age, sex, weight, height, and body mass index (BMI) were recorded. Joint mobility was measured according to Beighton score method for all the participants in the study.Results: The mean age of patients was (35.5± 9.5) year and controls (33.2 ± 10.5) year, All the participants were males. The mean BMI was (25.3 ± 3.1) kg/m2 for patients and (25.1 ± 3.8) kg/m2 for controls. No statistical significant difference between patients and controls (P>0.05). JHM was significantly more in inguinal hernia patients than in controls (55(55%) vs 20(20%), p<0.001, OR=4.9; 95% CI = 2.6 - 9.2). A multiple logistic regression model was statistically significant and able to predict the group membership with 64% accuracy. Having an average score for joint mobility (4-6) increased the risk of having inguinal hernia by 5.2 times compared to those with negative hypermobility (score<4). Increasing the joint mobility score further to (7-9) increased the risk of having inguinal hernia by 11.3 times compared to those with negative hypermobility (score<4)Conclusions: JHM was significantly more prevalent among Iraqi patients with inguinal hernia patients than controls. A higher score for JHM was associated with a higher risk of developing inguinal hernia. Keywords: Beighton score; inguinal hernia; joint hypermobility

Analytical Solution for the Fractional Partial Differential Equations by Adomian Decomposition and Modified Decomposition Method

In this paper, analytical solution of the fractional partial differential equation has been presented. The algorithm for the analytical solution for this equation is based on Adomian's decomposition and modified decomposition method. The fractional derivative is described in Caputo's sense. The analytical method has been applied to solve a practical example and its results have been compared with exact solution

Stability and Convergence of Explicit Difference Method for Solving the 3-Dimensional Two-Sided Fractional Diffusion Equation

In this paper, a numerical solution of the 3-dimensional two-sided fractional diffusion equation has been presented. The algorithm for the numerical solution for this equation is based on explicit finite difference method. The consistency, conditional stability, and convergence of the fractional order numerical method are described. The numerical method has been applied to solve a practical numerical example and the results have been compared with exact solution. The results were presented in tables using the MathCAD 12 software package when it is needed. The explicit finite difference method appeared to be effective and reliable in solving the 3-dimensional two-sided fractional Diffusion equatio

Serum IL17 and IL6 levels in a Sample of Iraqi Patients with Rheumatoid Arthritis: A Case Control Study

Objectives: To determine serum IL17 and IL6 levels in a sample of Iraqi patients with rheumatoid arthritis (RA) and to evaluate the correlation between them if present. Methods: A case control single center study was conducted for 11 months. A total of 50 patients with RA diagnosed according to the 1987 American College of Rheumatology (ACR) and 30 individuals matched in age and sex as control group were included. Serum IL17 and IL6 levels were measured in both groups by enzyme-linked immunosorbent assay (ELISA). The cut off value was assessed by receiver operating characteristics (ROC) test and correlation by spearman's Rho linear correlation coefficient. Results: Frequency of females was more than males in patients and controls (88% and 76.7% respectively).Ages of patients range between 20-70 years with a median 43.76 years while in controls, ages range between 20-60 years with a median 37.67 years.Serum IL17 concentration was significantly higher in patients compared to controls (median 154.4 pg/ml versus 111.1 pg/ml respectively, p=0.02). Also serum IL6 concentration was higher and highly significant in patients compared to controls (median 150 versus 49 pg/ml respectively, p=0.001). There was a direct strong highly statistical significant correlation between serum IL17 and serum IL6 concentration      (r=0.771, p<0.001).The optimum cut off value for IL17 was ? 71.8 pg/ml and IL6 concentration?8.1pg/ml. Conclusions: serum IL17 and IL6 concentrations were significantly higher in Iraqi sample of RA patients compared to controls with direct strong highly significant correlation between these cytokines. This may help in diagnosis of RA and suggest potentially an effective treatment. Key words: Rheumatoid arthritis, IL17, IL6, rheumatoid arthritis and cytokines.

Managua Salsa City de Franz Galich

La presente es una investigación literaria que esboza un breve recorrido histórico y sociopolítico desde principios del siglo XX con la injerencia extranjera en Nicaragua, la instauración y las pugnas entre somocistas y sandinistas, hasta el fin de la guerra en 1990. El eje temático principal es la posguerra. Un entramado de problemáticas sociales como la violencia, el crimen organizado, el desempleo y la pobreza, que desenfundan en los individuos un sentimiento de desencanto generalizado hacia los proyectos revolucionarios que habían prometido velar por la seguridad, la igualdad y el cambio hacia una sociedad más prospera. El análisis narratológico retoma los aportes de autores como Beatriz Cortéz, José Luis Escamilla, Werner Mackenbach, José María Pozuelo Yvancos y otros. El cual se organiza según las instancias narrativas, del relato, la narración y la historia, incorporando los elementos concernientes a cada una de ellas siguiendo la línea del tradicionalismo narratológico de Tzvetan Todorov y A.J. Greimas. Finalmente, el análisis semántico se enfoca en los signos y símbolos. Palabras clave: Franz Galich, Novela de posguerra ; Estética del Cinismo ; Contexto de posguerra centroamericana ; Posmodernidad

A Novel Unusual Manifestation of CH-Alpha as Acute Metabolic Disturbances: Case Report and Big Data Analytics

Background: The pharmaceutical “marketplace” is booming with a plethora of over-the-counter products known as supplements, including regulated and unregulated chemicals that can be purchased from pharmacies, the black market, or via the internet, including the infamous deep web and the darknet. Some supplements can boost specific physiological functions, including physical endurance, sexual performance, and musculoskeletal-articular rejuvenation. Case Report: We are reporting a case of acute metabolic disturbances that materialized following the ingestion of CH-alpha. An otherwise healthy 35 years old male from Iraq, manifested with bilateral periorbital and dependent leg edema. Biochemical profiling revealed hypoproteinemia [6.5 g/dl], hypogammaglobulinemia [1.58 g/dl], hypercholesterolemia [218 mg/dl], and a borderline serum creatinine [1.2 mg/dl]. Following CH-Alpha's withdrawal, the patient’s condition resolved spontaneously. Although the reported case is anecdotal, we implemented the Bradford Hill’s criteria to analyze its credibility and the implied level-of-evidence in connection with causality. We also carried out collateral analytics of big data, using Google Trends, to infer data on the spatiotemporal variations of the interest of the public in CH-Alpha and related products. Conclusion: Future externally-valid studies, including controlled trials and metanalytic studies, can satisfy the full Hill’s criteria on the potential causality for the observed acute dysmetabolism in humans

Diagnostic and Predictive Values of IL-6 in a Group of Iraqi Patients with Rheumatoid Arthritis

Background: Researchers have found that interleukin 6 (IL-6) plays a crucial regulatory function in the onset and progression of a wide range of inflammatory disorders. One of the more prevalent inflammatory illnesses affecting people today is rheumatoid arthritis. Aim of the study: The purpose of this study was to compare the IL-6 levels of rheumatoid arthritis (RA) patients to those of healthy controls and to examine the relationship between IL-6 and RA-related demographic and clinical factors.                                                                                                                                                          Materials and Method A total of 80 participants: 40 rheumatoid arthritis (RA) sufferers and 40 healthy controls, all of whom ranged in age from 23 to 61. The serum concentrations of (IL-6) were analyzed using an enzyme-linked immunosorbent assay (ELISA). Results: Increased IL-6 blood levels were associated with rheumatoid arthritis, suggesting that this biomarker may be useful for diagnosing the disease at an early stage. There was no statistically significant correlation between disease severity and the DAS28 score and IL-6 levels in the serum. Conclusion: The cytokine interleukin 6 (IL-6) has been proposed as a biomarker and possible player in the etiology of rheumatoid arthritis