European Journal of Clinical and Experimental Medicine
<p style="box-sizing: border-box; margin: 0px 0px 1em; line-height: 20px; color: #010101; font-size: 14px; font-family: Lato, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: 0.1px; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;"> <p style="box-sizing: border-box; margin: 0px 0px 1em; line-height: 20px; color: #010101; font-size: 14px; font-family: Lato, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: 0.1px; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">GENERAL INFORMATION <p style="box-sizing: border-box; margin: 0px 0px 1em; line-height: 20px; color: #010101; font-size: 14px; font-family: Lato, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: 0.1px; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">The European Journal of Clinical and Experimental Medicine (Eur J Clin Exp Med) is an internationally recognized, peer-reviewed, open-access journal published by the Rzeszów University Press. The journal is issued quarterly in an online format and publishes exclusively in English. Submissions are accepted in English only, ensuring accessibility to a global audience. <p class="rtejustify" style="box-sizing: border-box; margin: 0px 0px 1em; line-height: 20px; color: #010101; font-size: 14px; text-align: justify; font-family: Lato, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: 0.1px; orphans: 2; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Eur J Clin Exp Med is committed to promoting the dissemination of high-quality research that advances knowledge in clinical and experimental medicine. With its open-access model introduced in 2020, the journal ensures that all published articles are freely available for access, download, and sharing without any subscription barriers. <hr style="box-sizing: content-box; height: 0px; margin-top: 23px; margin-bottom: 23px; border-width: 1px 0px 0px; border-image: initial; font-family: Lato, sans-serif; font-size: 13px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: 0.1px; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; border-color: #eeeeee initial initial initial; border-style: solid initial initial initial;" /> <p style="box-sizing: border-box; margin: 0px 0px 1em; line-height: 20px; color: #010101; font-size: 14px; font-family: Lato, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: 0.1px; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">THE THEMATIC SCOPE <p class="rtejustify" style="box-sizing: border-box; margin: 0px 0px 1em; line-height: 20px; color: #010101; font-size: 14px; text-align: justify; font-family: Lato, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: 0.1px; orphans: 2; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">The European Journal of Clinical and Experimental Medicine publishes original research, reviews, and case studies that contribute to advancements in medical science and practice. The journal covers a broad range of topics within life and health sciences, clinical medicine, experimental medicine, and interdisciplinary research. <p class="rtejustify" style="box-sizing: border-box; margin: 0px 0px 1em; line-height: 20px; color: #010101; font-size: 14px; text-align: justify; font-family: Lato, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: 0.1px; orphans: 2; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">Eur J Clin Exp Med welcomes submissions that address current challenges and emerging trends in medicine, fostering collaboration and the exchange of knowledge across related disciplines. All published articles are freely accessible, promoting the unrestricted use and application of scientific discoveries worldwide. <hr style="box-sizing: content-box; height: 0px; margin-top: 23px; margin-bottom: 23px; border-width: 1px 0px 0px; border-image: initial; font-family: Lato, sans-serif; font-size: 13px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: 0.1px; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; border-color: #eeeeee initial initial initial; border-style: solid initial initial initial;" /> <p style="box-sizing: border-box; margin: 0px 0px 1em; line-height: 20px; color: #010101; font-size: 14px; font-family: Lato, sans-serif; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: 0.1px; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; background-color: #ffffff; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial;">JOURNAL METRICS (2025) <table style="box-sizing: border-box; border-collapse: collapse; border-spacing: 0px; background-color: #ffffff; color: #666666; font-family: Lato, sans-serif; font-size: 13px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: 0.1px; orphans: 2; text-align: start; text-transform: none; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; white-space: normal; text-decoration-thickness: initial; text-decoration-style: initial; text-decoration-color: initial; width: 707px;" border="0" cellspacing="1" cellpadding="1"> Rejection rate 68% The average time for initial technical and formal verification of the manuscript by the editor 2 days The average time from submission to the first decision 30 days The average time from submission to the final decision 50 days The average time in which the article is published in the online first version 80 days The average time in which the article is published in the final version (from submission to publication) 250 days
Our open access policy is in accordance with the Budapest Open Access Initiative (BOAI) definition: this means that articles have free availability on the public Internet, permitting any users to read, download, copy, distribute, print, search, or link to the full texts of these articles, crawl them for indexing, pass them as data to software, or use them for any other lawful purpose, without financial, legal, or technical barriers other than those inseparable from having access to the Internet itself. All articles are published with free open access under the CC-BY Creative Commons attribution license (the current version is CC-BY, version 4.0). If you submit your paper for publication by the Eur J Clin Exp Med, you agree to have the CC-BY license applied to your work. Under this Open Access license, you, as the author, agree that anyone may download and read the paper for free. In addition, the article may be reused and quoted provided that the original published version is cited. This facilitates freedom in re-use and also ensures that Eur J Clin Exp Med content can be mined without barriers for the research needs.
Associations between antenatal booking body mass index and postnatal placental weight: maternal health implications in HIV-positive and HIV-negative pregnant women in Uyo, Akwa Ibom state, Nigeria
Introduction and aim. Maternal body mass index (BMI) and placental weight are important indicators of maternal-fetal health, and their relationship may be influenced by HIV status. This study examined the association between antenatal booking BMI and postnatal placental weight among HIV-positive and HIV-negative pregnant women in Uyo, Nigeria. Material and methods. We conducted a retrospective comparative cross-sectional study based on medical records review of 143 women (48 HIV-positive, 95 HIV-negative) who attended antenatal care and delivered at the University of Uyo Teaching Hospital between December 2015 and May 2016. BMI was calculated from early pregnancy weight and height measured at the first antenatal visit; whole placental weight was measured post-delivery. Linear regression, adjusted for gestational age, evaluated associations between BMI, HIV status, and placental weight. Results. Among 143 participants (48 HIV-positive, 95 HIV-negative), mean placental weight was significantly lower in HIV-positive women (602.94±174.92 g) compared with HIV-negative women (684.53±139.38 g; p=0.012). Gestational age was the strongest predictor of placental weight (p=0.009), while HIV infection was independently associated with lower placental weight (p=0.016). BMI was positively but not significantly associated with placental weight. Conclusion. Antenatal BMI and postnatal placental weight are interrelated, with differing patterns by HIV status. These findings underscore the need to integrate routine nutritional assessment and targeted HIV care into antenatal programs to support healthy placental growth and improve pregnancy outcomes in high HIV-prevalence populations.
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Dysregulation of iron metabolism in chronic kidney disease – hepcidin as a diagnostic biomarker in Iraqi adults – a case-control study
Introduction and aim. Chronic kidney disease (CKD) is a global health burden, with iron deficiency (ID) being a prevalent but under-diagnosed comorbidity. Traditional biomarkers, such as serum ferritin and transferrin saturation, are confounded by inflammation, which limits diagnostic accuracy. Hepcidin, a key regulator of iron homeostasis, offers potential as a reliable biomarker; however, data from low- and middle-income countries (LMICs), including Iraq, remain scarce. This study assessed the diagnostic utility of hepcidin for CKD and its association with iron dysregulation in Iraqi adults, addressing regional gaps in biomarker validation and clinical application. Material and methods. This case-control study (September 2024–February 2025) recruited 60 patients with CKD (stages 2–4) and 40 age-and sex-matched healthy controls. The exclusion criteria were recent transfusions, infections, or iron therapy. Serum hepcidin, ferritin, iron, Total Iron-Binding Capacity (TIBC), transferrin, and renal function indices were analyzed via enzyme-linked immunosorbent assay and standardized assays. Results. CKD patients exhibited significantly elevated hepcidin (39.8±23.1 vs. 13.7±4.8 pg/mL, p<0.001) and ferritin (246±128 vs. 160±61 ng/mL, p<0.001) but lower serum iron (12.38±3.1 vs. 118±33.5 μg/dL, p<0.001), TIBC (347±109 vs. 385±62 μg/dL, p=0.004), and transferrin levels (224±74 vs. 258±39 mg/dL, p=0.005) than controls. Hepcidin levels increased progressively with CKD stage (p<0.001) and correlated strongly with eGFR (r=-0.800, p<0.001) and serum creatinine (r=0.702, p<0.001). At a cut-off of >25 pg/mL, hepcidin demonstrated 80% sensitivity and 100% specificity for CKD diagnosis, with an AUC of 0.86 (95% CI: 0.78–0.92, p<0.001). Conclusion. Hepcidin demonstrated high diagnostic accuracy for CKD and was a superior indicator of iron metabolism dysregulation compared to traditional biomarkers. Its utility in resource-limited settings, such as Iraq, could enhance early CKD detection and guide management strategies, thereby addressing critical gaps in LMIC healthcare.
Molecular analysis of BCR-ABL1 fusion transcripts in acute leukemia patients in Southern Odisha, India
Introduction and aim. The occurrence of BCR-ABL1 fusion transcript in acute-leukemia cases are limited and is characterized with various subtypes. This study was based on investigation of the BCR-ABL1 fusion transcript in acute-leukemia cases in a tertiary care hospital. Material and methods. This cross-sectional study was carried out in suspected cases of acute leukemia. Cases were analyzed for complete blood counts, peripheral smear, bone marrow and flow-cytometry for the diagnosis of acute-leukemia. Additionally, diagnosed cases were investigated for BCR-ABL1 fusion transcript by PCR amplification using reverse transcriptase enzyme followed by documentation. Results. Approximately 55 acute leukemia cases included, diagnosed by flow cytometric analysis. Analysis of the BCR-ABL1 fusion-transcript in 55 cases showed its occurrence in only 2 cases, where one case with the B-ALL was characterized with e1a2 subtype and a other case with AML was characterized with the e13a2 subtype. Conclusion. The BCR-ABL1 fusion transcript in acute-leukemia cases was found in 3.64% (2/55) of cases. The diagnosis of BCR-ABL1 fusion transcript in acute-leukemia cases is important for its poor prognosis, as well as calls for the use of ABL tyrosine kinase inhibitors. The diagnosis of BCR-ABL1 fusion-transcript in acute leukemia cases in a tertiary health care facility will be helpful for better treatment of patients in the study area.
Clinical impact of a personalized hypertension care approach on blood pressure and quality of life in older adults
Introduction and aim. Hypertension is highly prevalent among older adults and contributes significantly to poor health outcomes and a reduced quality of life, especially in rural populations. Although pharmacological treatment is essential, individualized nonpharmacological strategies are increasingly recognized for their role in optimizing chronic disease management. The present study investigated the effects of an individualized hypertension care strategy on blood pressure control and the quality of life of older patients who reside in rural areas. Material and methods. A quasiexperimental pre-post-test study with control group design was conducted involving 112 elderly participants with hypertension in Central Java, Indonesia. The intervention group (n=56) received a personalized care approach that included customized nursing education, self-care support, and family involvement over a one-month period. The control group (n=56) received standard care. The measured were systolic and diastolic blood pressure (using a digital sphygmomanometer) and quality of life (using the OPQOL-Brief questionnaire). Data were analyzed using paired and independent t-tests. Results. After the intervention, the intervention group showed significant reductions in systolic blood pressure (from 157.6±11.9 to 138.2±10.4 mmHg, p<0.001) and diastolic blood pressure (from 94.5±8.7 to 83.3±7.9 mmHg, p<0.001). Quality of life scores also improved significantly in all domains, including physical health, psychological well-being, and social relationships (p<0.001). In contrast, the control group showed no significant changes in either outcome. Conclusion. The personalized approach to hypertension care was effective in lowering blood pressure and improving quality of life among older adults with hypertension. These findings suggest that individualized, low-cost strategies can enhance chronic disease management, particularly in rural or resource-limited settings.
Clinical outcomes of an integrated wound care protocol for diabetic foot ulcers ‒ a prospective study
Introduction and aim. Diabetic foot ulcers (DFUs) are serious complications of diabetes, often leading to infection and amputation. This study evaluated the clinical outcomes of an integrated wound care protocol in patients with DFUs. Material and methods. A prospective cohort study was conducted among 225 patients with type 2 diabetes and Wagner grade 1–3 DFUs at PKU Muhammadiyah Hospital, Indonesia, between February and September 2024. All patients received a standardized integrated wound care protocol, including wound bed preparation, debridement, infection control, moisture balance, nutritional counseling, patient education, and ulcer offloading. The primary outcome was complete wound healing at 12 weeks; secondary outcomes were wound area reduction, BWAT score improvement, pain reduction, and infection control. Results. By week 12, 157 patients (69.8%) achieved complete healing. Mean wound area decreased from 6.8±3.2 cm² to 1.2±1.5 cm² (p<0.001), BWAT scores improved from 28.4±4.1 to 13.6±3.8 (p<0.001), and pain scores declined from 5.8±1.6 to 2.1±1.1 (p<0.001). Infection prevalence dropped from 45.3% to 12.4% (p<0.001). Healing was highest in Wagner grade 1 (83.1%), compared with grade 2 (69.7%) and grade 3 (47.1%). Conclusion. The integrated wound care protocol significantly improved healing, reduced wound size and pain, and controlled infection in DFU patients. These findings support its incorporation into routine multidisciplinary DFU management.
The effects of breathing and coughing exercises on respiratory parameters in COVID-19 patients
Introduction and aim. COVID-19 primarily affects the respiratory system, often resulting in pneumonia and dyspnea that may persist after recovery. This study aimed to evaluate the effect of deep breathing and coughing exercises using a Triflow device on respiratory parameters in patients with COVID-19 pneumonia. Material and methods. This single-blinded randomized controlled study was conducted with 326 patients diagnosed with COVID-19 pneumonia. Participants were randomly assigned to an experimental group (n=163) or a control group (n=163). The experimental group performed exercises for 10 consecutive days. The control group received routine hospital care, which included routine nurse-led monitoring of vital signs, peripheral oxygen saturation (SpO₂) assessment, medical treatment per clinical guidelines, and supportive care, but no structured breathing-exercise education. Data were analyzed using descriptive statistics, ANOVA, chi-square, and post hoc tests. Results. After 10 days of intervention, Dyspnea-12 scores decreased more markedly in the experimental group than in the control group (mean change −15 vs. −8 points; p<0.001). Arterial oxygen and SpO₂ levels also improved significantly in the experimental group compared to controls (p<0.001), while respiratory rate decreased to a greater extent (p<0.001). No adverse effects were observed. Conclusion. Deep breathing and coughing exercises with the Trilow device significantly reduced the severity of dyspnea and improved oxygenation in COVID-19 pneumonia patients. These findings suggest that incorporating structured respiratory exercises into standard care may enhance clinical outcomes and support recovery in this population.
A comparative study of C-reactive protein levels in patients with major depressive disorder with and without suicidal attempts
Introduction and aim. Major depressive disorder (MDD) is closely linked to suicidal behavior, and systemic inflammation ‒ particularly elevated C-reactive protein (CRP) ‒ has been proposed as a contributing factor. However, evidence comparing CRP patterns separately in suicide attempters and non-attempters remains limited, especially in underrepresented populations. The aim of this study was to compare serum CRP levels in patients with MDD with and without a history of suicide attempts. Material and methods. This cross-sectional analytical study included 60 adults diagnosed with MDD according to ICD-10 criteria. Participants were divided into two groups: those with a history of suicide attempts (n=30) and those without such a history (n=30). Depression severity was assessed using the Hamilton Depression Rating Scale (HAM-D). Serum CRP levels were measured using a turbidimetric method. Statistical analyses included Student’s t-test, Mann-Whitney U-test, and Pearson’s correlation. Results. CRP levels were significantly higher among suicide attempters compared with non-attempters (4.47±3.53 mg/L vs 2.50±3.59 mg/L; p=0.03). A significant positive correlation between HAM-D scores and CRP levels was observed in the suicide-attempt group (R=0.52; p=0.003), whereas no such correlation was found in non-attempters (R=0.12; p=0.52). Severe depression was more common among suicide attempters (30/44 cases). Conclusion. This study provides novel evidence that the association between inflammation and depressive symptom severity is present only in patients with a history of suicidal behavior. Elevated CRP may therefore represent a potential marker for identifying MDD patients at increased risk of suicide.
Association of the GPX1 rs1050450 single nucleotide variant and identification of the novel variant rs771425412 in patients with primary osteoporosis from Baghdad, Iraq
Introduction and aim. Osteoporosis is a multifactorial bone disorder driven by genetic and environmental factors, with oxidative stress implicated in its pathogenesis. Glutathione peroxidase 1 (GPX1), a key antioxidant enzyme, modulates bone homeostasis by regulating reactive oxygen species. To our knowledge, this is the first study to report the rs771425412 variant of the GPX1 gene in association with primary osteoporosis. This study investigated the association between the single nucleotide variant (rs1050450 C>T and rs771425412 C>A) and the risk of primary osteoporosis in Iraqi patients. Material and methods. A case-control study was conducted involving 105 patients with primary osteoporosis and 105 age-/sex-matched healthy controls recruited from Baghdad Hospital. Peripheral blood genomic DNA was genotyped by PCR and direct sequencing. Results. The rs1050450-T allele was significantly more frequent in patients than in controls (25.7% vs. 10.95%; OR=2.68, 95% CI: 1.58–4.55, p<0.001), with the CT genotype increasing the risk (dominant model: OR=3.77, 95% CI: 2.08–6.86). Similarly, the rs771425412-A allele was enriched in patients compared to controls (17.1% vs. 2.9%; OR=7.03, 95% CI: 2.93–16.92, p<0.001), and the CA genotype increased risk (OR=8.61, 95% CI: 3.47–21.3). Haplotype analysis revealed a protective C-C haplotype (OR=0.31, 95% CI: 0.19–0.51), while the T-A (OR=23.2, 95% CI: 3.09–174.3) and C-A (OR=3.15, 95% CI=1.12–8.8) haplotypes were associated with increased susceptibility. Conclusion. The CT genotype of rs1050450 and the CA genotype of rs771425412 in the GPX1 gene are significantly associated with an increased susceptibility to primary osteoporosis in the Iraqi population, likely through mechanisms involving impaired oxidative stress regulation.
Toward a non-invasive diagnostic tool for Helicobacter pylori ‒ insights from ELISA-based biomarker profiling
Introduction and aim. This study aimed to evaluate the diagnostic performance of a novel ELISA-based panel of virulence-associated antibodies (anti-CagA, anti-UreB, and anti-HpNAP IgG) for early detection of Helicobacter pylori infection. Material and methods. In this cross-sectional study of 40 dyspeptic patients, ELISA results were compared with histopathology and stool antigen testing as reference standards. Diagnostic accuracy was assessed using receiver operating characteristic (ROC) curve analysis, and predictors were evaluated through logistic regression. Results. Anti-CagA IgG achieved the highest diagnostic performance (AUC=0.95; sensitivity=90.9%; specificity=94.4%), followed by anti-UreB (AUC=0.92) and anti-HpNAP (AUC=0.89). The combined biomarker model reached an AUC of 0.97, demonstrating strong correlation with both infection status and symptom severity. Agreement between stool antigen testing and histopathology was high (κ=0.80). Conclusion. This study provides the first regional validation of a standardized three-marker ELISA panel that demonstrated high accuracy as a non-invasive diagnostic approach for early H. pylori detection, offering a cost-effective tool for use in resource-limited settings.
Identification of hepatotoxicity of untreated and UV-irradiated GdYVO₄:Eu³⁺ nanoparticles
Introduction and aim. Gadolinium–yttrium orthovanadate GdYVO4:Eu3+ nanoparticles (NPs) display dual redox activity, acting as pro-oxidants or antioxidants depending on the surrounding environment, concentration, and pretreatment conditions, a property that can be harnessed for potential oncological therapies. This study aims to evaluate the effect of untreated and UV-irradiated NPs administered orally on blood biochemical parameters, liver tissue, and histological condition of liver tissue in an experiment on laboratory rats. Material and methods. Male rats of the WAG population received oral colloidal NPs solutions (in untreated and UV-irradiated forms) at different doses: (50, 100, 200) μg/kg of body weight for 14 days. The content of medium-weight molecules, alanine aminotransferase activity, direct and indirect bilirubin content, and von Willebrand factor content were determined in blood serum. The content of reduced glutathione, superoxide dismutase, diene conjugates, and TBK-active products was determined in liver homogenates. Liver tissue samples were examined using morphological and morphometric methods. Results. The formation of oxidative stress, intoxication, damage to endothelial cells, impaired membrane permeability, destruction of hepatocytes, and destruction of sinusoidal endothelial cells were detected. Conclusion. It has been established that the introduction of GdYVO4: Eu3+ NP, both in untreated and UV-irradiated forms, induces dose-dependent effects, including oxidative stress, endothelial dysfunction, intoxication, damage to hepatocyte membranes, functional and histological damage to the liver, with more pronounced effects observed for UV-irradiated NPs.
Evaluation of autonomic imbalance in irritable bowel syndrome and functional dyspepsia
Introduction and Aim. Irritable bowel syndrome (IBS) and functional dyspepsia (FD) are functional gastrointestinal disorders that may involve autonomic imbalance. This study assessed autonomic nervous system activity using short-term heart rate variability (HRV). To our knowledge, this is the first study in an Indian population to directly compare autonomic modulation across IBS subtypes and FD using a unified HRV protocol, demonstrating subtype-specific alterations ‒ particularly reduced LF/HF in IBS-diarrhea (IBS-D). Material and methods. Thirty IBS patients and thirty FD patients diagnosed using the Rome IV criteria, along with thirty healthy controls, were enrolled. Short-term HRV analysis was performed following ECG acquisition using the LABCHART platform. Results. Mean low-frequency/high-frequency (LF/HF) ratio was 1.26±0.83 in IBS, 1.40±1.171 in FD, and 1.60±1.196 in controls. High-frequency (HF) power values (ms²) were 733.9±1661.16 (IBS), 534.18±778.28 (FD), and 674.87±1187.16 (controls), with no significant differences among the three groups (p>0.05). Subgroup analysis revealed significantly lower LF/HF values in IBS-D compared to controls (0.98±0.69 vs. 1.60±1.196; p=0.038), while HF values did not differ (p>0.05). No significant differences were found between IBS-constipation (IBS-C) patients and controls. Conclusion. IBS-D patients exhibited decreased LF/HF and increased HF values, indicating enhanced parasympathetic modulation, which may contribute to diarrhea-predominant symptoms. IBS-C patients showed a trend toward higher LF/HF and lower HF values, compatible with increased sympathetic modulation, although results were not statistically significant. FD patients showed no autonomic differences relative to controls. These findings highlight subtype-specific autonomic patterns in IBS and provide novel HRV-based insights from an Indian cohort.
Histochemical evaluation of ethanol extracts of Senecio biafrae leaves in mercury chloride-induced hepatic injury in adult male Wistar rats
Introduction and aim. Mercury chloride is a potent hepatotoxin that disrupts liver architecture, glucose metabolism, and nuclear integrity. To our knowledge, no previous study has evaluated the histochemical effects of the ethanol extract of Senecio biafrae leaves (EESBL) on mercury chloride-induced hepatic injury. This study presents new evidence for the glycogen stabilizing and genoprotective properties of its compounds. Material and methods. Forty-nine adult Wistar rats were randomly assigned to seven groups (n=7 per group). Except for the control, all received 4 mg/kg mercury chloride orally for 21 days. Group II rats were sacrificed immediately after exposure, while group III underwent a 21-day recovery. Group IV received 2 mg/kg silymarin, and also Groups V–VII received 200, 400, and 600 mg/kg EESBL, respectively, for 21 days. Liver tissues were harvested for histochemical evaluation using periodic acid-Schiff (PAS) and Feulgen staining. Results. Mercury chloride significantly depleted liver glycogen stores (PAS-positive area: control 75.00±0.56% vs toxic 20.00±1.09%). EESBL restored glycogen storage in a dose-dependent manner (200 mg/kg: 52.02±0.56%; 400 mg/kg: 60.00±0.57%; 600 mg/kg: 72.06±0.57%), approaching silymarin (68.00±0.57%). Nuclear DNA integrity was markedly affected by HgCl2 (Feulgen-positive area: control 16.20±0.19% vs toxic 9.00±0.33%). EESBL improved nuclear morphology and DNA intensity (200 mg/kg: 11.11±0.12%; 400 mg/kg: 13.20±0.44%; 600 mg/kg: 14.06±0.33%), comparable to silymarin (14.00±0.25%) (all p<0.001). Conclusion. EESBL demonstrated protective effects against mercury chloride-induced hepatotoxicity by stabilizing hepatic glycogen metabolism and nuclear structure, underscoring its therapeutic potential in mitigating heavy metal-induced liver injury.
Serial high-sensitivity troponin I monitoring as a prognostic marker in acute ischemic stroke
Introduction and aim. Acute ischemic stroke (AIS) is a complex disease with multifactorial etiologies, often masking underlying cardiovascular morbidities that contribute to clinical outcomes. This study explored the role of serial high-sensitivity troponin I (hs-TnI) monitoring in AIS patients as a prognostic marker of cardiovascular morbidity and mortality. The results offer substantial information on the relationship between hs-TnI elevations and clinical, electrocardiographic (ECG), echocardiographic (ECHO), and angiographic parameters in patients with AIS. Material and methods. A prospective observational study was conducted on 60 patients with AIS in a tertiary care center, Tamil Nadu. Hs-TnI levels were measured at the time of admission and after 48 h together with ECG, ECHO. Angiographic evaluations were done in patients with elevated hs-TnI at 48 h after admission. Results. Among the study population, hs-TnI levels increased significantly from 11.7% at admission to 20% after 48 h (p=0.02).Logistic regression showed hs-TnI at 48 h predicted mortality (odds ratio [OR]=28.5, 95% confidence interval [CI]: 5.9‒137.1, p<0.001) and coronary artery disease (CAD) (OR=48.2, 95% CI: 9.8‒236.5, p<0.001). Conclusion. Serial monitoring of hs-TnI in AIS patients revealed its potential role in the identification of culprit lesions on coronary angiogram, which is correlated with the presence of CAD and mortality.
Association of the DeRitis ratio with insulin resistance in non-obese adults ‒ a cross-sectional study from South India
Introduction and aim. Beyond overt obesity, insulin resistance (IR) is increasingly recognized in non-obese individuals, particularly South Asians. Liver enzymes, especially aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and their ratio (DeRitis) have emerged as potential surrogate markers of metabolic dysfunction. To the best of our knowledge, this is the first study to evaluate the DeRitis ratio as a surrogate marker of IR specifically in non-obese South Indian adults, addressing an important evidence gap. With this background, the aim was to estimate the IR prevalence in non-obese adults by homeostasis model assessment of IR (HOMA-IR) and to assess the correlation and diagnostic performance of the DeRitis ratio. Material and methods. This cross-sectional study included 100 non-obese adults (body mass index (BMI) <25kg/m²) selected using a convenience sampling technique attending a tertiary care hospital in Pondicherry, India. Data collected by structured proforma and biochemical assays of fasting plasma glucose, fasting insulin, and liver enzymes. HOMA-IR ≥2.5 as confirmed IR. The correlation and diagnostic accuracy of the DeRitis ratio for predicting IR was analyzed using SPSS software (V_25.0); p<0.05 considered statistically significant. Results. IR (HOMA-IR 2.5) was present in 13% of participants. Overweight individuals showed significantly higher fasting insulin levels and HOMA-IR values compared to adults with normal BMI. The DeRitis ratio was positively correlated with HOMA-IR (r=0.516, p<0.001). Using the cut-off AST/ALT >1.0, the ratio demonstrated good discriminatory ability for IR (AUC=0.778), with 82.5% sensitivity and 83.3% specificity. Conclusion. The DeRitis ratio shows moderate discrimination for IR and may aid in screening where insulin assays are limited. Validation in larger, multicenter cohorts is warranted.
Correlation of thyroid hormones with levels of iron and selenium in women with hypothyroidism in Basrah, Iraq
Introduction and aim. Trace elements play a critical role in thyroid hormone synthesis and metabolism; however, data on their combined alterations in hypothyroid women from the Middle East remain limited. This study aimed to evaluate the relationship between serum selenium (Se) and iron (Fe) levels and thyroid function in women with overt and subclinical hypothyroidism compared with euthyroid controls. Material and methods. In this case-control study, 312 women were enrolled, including 194 patients with hypothyroidism and 118 age- and body mass index-matched euthyroid controls recruited in Basra, Iraq. Serum thyroid-stimulating hormone (TSH), free thyroxine (FT4), iron (Fe), and Se were measured using standardized automated assays. Results. Hypothyroid women had significantly higher median thyroid-stimulating hormone levels than controls (4.51 [1.9–7.5] vs. 1.45 [0.98–2.1] mU/L; p<0.0001) and lower median free thyroxine concentrations (12.48 [9.0–16.47] vs. 16.73 [14.16–20.59] pmol/L; p<0.0001). Serum iron levels were significantly reduced in hypothyroid patients (11.52 [7.79–15.83] vs. 15.90 [10.47–19.42] µmol/L; p<0.0001), as were selenium levels (0.81 [0.55–1.12] vs. 1.45 [1.18–1.92] µmol/L; p<0.0001). Age correlated positively with thyroid-stimulating hormone (Spearman’s ρ=0.449, p<0.001) and negatively with free thyroxine (ρ=-0.301, p=0.007), while no significant correlations were observed for iron or selenium. Conclusion. Women with hypothyroidism exhibited combined selenium and iron deficiencies alongside marked hormonal disturbances. To our knowledge, this is one of the first large case-control studies in women from southern Iraq to simultaneously assess selenium and iron status in relation to thyroid function. These findings support the potential clinical relevance of routine micronutrient assessment in hypothyroid patients, particularly in regions with known dietary deficiencies.
Pulmonoprotective effect of carnosol on LPS-induced cytokine storm model in mice
Introduction and aim. The cytokine storm represents a severe hyperinflammatory response that can lead to acute lung injury and organ failure. Carnosol, a phenolic diterpene derived from Rosmarinus officinalis, exhibits documented antioxidant and anti-inflammatory properties. The aim was to evaluate the effects of carnosol, alone and in combination with methylprednisolone acetate (MPA), in a lipopolysaccharide (LPS)-induced cytokine storm model in mice. Material and methods. Sixty male mice were randomly assigned to six groups: control, lipopolysaccharide (LPS), vehicle, carnosol (120 mg/kg), methylprednisolone acetate (50 mg/kg), and combined carnosol plus methylprednisolone acetate (half doses). Treatments were administered for seven days following LPS induction. Pulmonary concentrations of interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNF-α) were quantified using enzyme-linked immunosorbent assay, and lung histopathology was evaluated. Results. Lipopolysaccharide administration significantly increased pulmonary cytokine levels compared with controls (IL-1β: 85.8±13.5 vs. 11.5±3.8 pg/g; IL-6: 93.0±8.5 vs.16.6±4.8 pg/g; TNF-α: 144.4±10.1 vs.18.6±0.01 pg/g; all p<0.05). Treatment with carnosol significantly reduced IL-1β, IL-6, and TNF-α levels compared with the LPS group (p<0.05). The combined carnosol and methylprednisolone acetate therapy produced the greatest cytokine attenuation (e.g. IL-6: 24.6±1.8 pg/g vs. LPS; p<0.05) and was associated with the most pronounced improvement in lung histopathological scores (p<0.05). Conclusion. Carnosol attenuates lipopolysaccharide-induced pulmonary inflammation and cytokine overproduction in a murine model. Its combination with methylprednisolone acetate may enhance anti-inflammatory efficacy and allow for glucocorticoid dose reduction. These findings provide preclinical evidence supporting further mechanistic and translational studies.
Effect of retatrutide on body weight, lipid profile, liver function, oxidative stress, and inflammation in experimental obesity in male rats
Introduction and aim. Obesity is a global health concern associated with an increased risk of diabetes, cardiovascular disease, hypertension, and non-alcoholic fatty liver disease, often driven by chronic low-grade inflammation. Recent evidence suggests that retatrutide, a novel GIPR/GLP-1R/GCGR tri-agonist, possesses anti-inflammatory properties in addition to its known effects on glucose metabolism, lipid profiles, and weight reduction. However, comprehensive preclinical data on retatrutide’s direct impact on hepatic inflammation, oxidative stress, and FGF21 regulation in diet-induced obesity models remain limited. This study aims to investigate the potential protective effect of retatrutide on inflammatory and oxidative stress status in diet-induced obesity in male rats, thereby providing mechanistic insight into its hepatoprotective actions. Material and methods. Twenty-eight adult male Sprague-Dawley rats were randomly assigned to four groups: normal controls (standard chow for 12 weeks), obese controls (HF/sucrose diet for 12 weeks), vehicle-treated (HF/sucrose for 8 weeks, then normal saline S.C. for 4 weeks with HF/sucrose), and retatrutide-treated (HF/sucrose for 8 weeks, then retatrutide 25 nmol/kg S.C. for 4 weeks with HF/sucrose). Serum insulin, lipid profile, liver enzymes, blood glucose, and FGF21 were measured from blood samples. Crucially, tumor necrosis factor- α (TNF-α), malondialdehyde (MDA), and glutathione (GSH) levels were measured in liver tissue samples. Results. Modeling obesity using HF/sucrose diet significantly increased insulin levels, blood glucose, liver enzymes, lipid profile, serum FGF21, and body weight. It also considerably elevated hepatic MDA and TNF-α while reducing GSH levels. Retatrutide treatment resulted in significant improvements across most parameters compared to both the obesity and vehicle-treated groups (p<0.0001). Specifically, retatrutide-treated rats showed significant reductions in body weight (e.g., approximately 25% reduction compared to obese controls), blood glucose (e.g., from 107±5.944 mg/dL to 85.714±4.785 mg/dL), and liver enzymes AST (e.g., from 89.843±4.533 U/L to 48.959±4.816U/L) and ALP (e.g., from 168.451±28.384 U/L to 97.526±13.446 U/L). Lipid profile parameters, including cholesterol (e.g., from 232.325±23.058mg/dL to 105.881±26.225 mg/dL), triglycerides (e.g., from 112.140±11.450 mg/dL to 30.355±9.479 mg/dL), and LDL (e.g., from 171.557±17.678 mg/dL to 51.341±21.858 mg/dL), were significantly improved, while HDL (e.g., from 38.339±9.670 mg/dL to 65.759±13.828 mg/dL) was significantly increased. Hepatic inflammatory (TNF-α, e.g., from 115.621±5.682 pg/mL to 92.715±5.647 pg/mL) and oxidative stress markers (MDA, e.g., from 5.409±1.078 nmol/ml to 3.120±0.401 nmol/mL) were significantly reduced, and hepatic GSH levels (e.g., from 1.220±0.545 ng/mL to 2.895±0.475 ng/mL) were significantly increased, serum FGF21 (e.g. from 115.367±6.921 pg/mL to 87.445±4.279 pg/mL) . These parameters were largely restored to near-control levels in the retatrutide-treated group. Conclusion. This study assessed the hepatoprotective effect of retatrutide in a diet-induced obesity model. While the metabolic benefits of incretin-based therapies are well documented, data on retatrutide’s direct impact on liver-specific inflammatory and oxidative stress pathways remain limited. This study is among the first to simultaneously evaluate hepatic TNF-α, oxidative stress markers (MDA and GSH), and circulating FGF21 following retatrutide treatment in obese rats, thereby providing mechanistic insight into its hepatoprotective actions beyond weight loss and glycemic control.
Drug-induced nephrotoxicity – a review of therapeutic activity of selenium and zinc in preclinical studies
Introduction and aim. Certain drugs cause nephrotoxicity and renal dysfunction through induction of oxidative stress and activation of inflammatory and apoptotic signaling pathways within the renal tissue. To mitigate drug nephrotoxicity, the therapeutic potential of trace elements such as selenium (Se) and zinc (Zn) has been experimentally explored. The current knowledge and mechanisms are hereby summarized in this review. Material and methods. This narrative review was carried out through a critical assessment of relevant articles published in scientific databases like Google Scholar, PubMed, Scopus, and Web of Science. Analysis of the literature. The antioxidant, antiapoptotic and anti-inflammatory properties of Se and Zn culminate in their therapeutic activity against drugs nephrotoxicity. The nephroprotective effect of Se and Zn has been characterized with suppression of renal oxidative stress (reduced malondialdehyde, protein cabonyl and elevated levels of superoxide dismutase, glutathione, glutathione peroxidase, catalase, total antioxidant capacity levels); upregulation of anti-apoptotic and anti-inflammatory markers (Bcl-2, heme oxygenase-1, factor related to nuclear factor erythroid 2; downregulation of pro-apoptotic and pro-inflammatory like inducible nitric oxide synthase, nitric oxide, tumor necrosis factor-α, interleukin-6, nuclear factor kappa light chain enhancer of activated B cells NF-κB, and Bax, leading to reparation of renal histomorphology and improved renal function (indicated by reduced serum creatinine, urea, BUN levels). Conclusion. The therapeutic activity of Se and Zn against drugs nephrotoxicity underscores their potential role in the management of nephrotoxicity due to pharmacotherapy.
Mapping the use of virtual reality in health promotion and weight management among overweight and obese individuals ‒ a scoping review
Introduction and aim. Obesity and overweight, defined by excess body fat, are major global public health challenges. Virtual reality (VR) is emerging as a novel tool for health promotion and weight management. This scoping review aimed to map existing research on VR applications in overweight and obese populations. Material and methods. Following PRISMA-ScR guidelines, systematic searches were conducted in PubMed, SCOPUS, EBSCO, Pedro, Embase, Web of Science, and Google Scholar up to March 2025. Keywords included ‘obese’, ‘overweight’ and “virtual reality.” Eligible studies were cross-sectional, experimental or randomized controlled trials involving overweight or obese individuals exposed to VR-based interventions targeting physical health, behavior change, or weight control. Two reviewers independently screened and extracted the data. Results. Ten studies published between 2012 and 2025 were included. Most involved adolescents and women, with limited representation of men and older adults. VR interventions varied in immersion, platform, and focus, targeting physical activity, behavioral change, and nutrition. Outcomes commonly included body composition, physical activity, emotional well-being, and diet. Heterogeneity prevented meta-analysis. Conclusion. VR holds promise as a multidimensional tool for the management of obesity. However, more inclusive, culturally adapted, and long-term studies are needed to validate its effectiveness and applicability in diverse populations.
Humanized NSG mice ‒ a modern approach to modelling systemic lupus erythematosus in preclinical research
Introduction and aim. Systemic lupus erythematosus (SLE) is a complex autoimmune illness characterized by widespread immune dysregulation and involvement of several organ systems. Conventional mouse models, although crucial for understanding basic immunopathogenic pathways, inadequately mimic human-specific immunological responses, hence constraining translational relevance. This review offers a comprehensive understanding of humanized NSG mice in systemic lupus erythematosus research, outlining techniques for engraftment, model-specific immune reconstitution characteristics, and their respective applications in simulating acute and chronic disease phenotypes. Material and methods. A comprehensive analysis of studies published between 2017 to 2025 was conducted in PubMed, Scopus, Web of Science and Google Scholar database. After removing the duplicates, a total of 87 articles were employed to finalize this study. Analysis of literature. Humanized NSG mice successfully recapitulate major immunopathological features of systemic lupus erythematosus. Among numerous approaches, CD 34+ hemopoietic stem cell models best mimic chronic phenotype, while PBMC and pristane-based systems mimic acute and environmentally triggered forms. Recent advances include cytokine knock-in and HLA transgenic derivatives improving immune reconstitution and translational dependability. Conclusion. This review provides the first integrative synthesis of humanized NSG mouse models applied to systemic lupus erythematosus, highlighting their translational potential and methodological advancements from 2017–2025. Collectively, these innovations establish humanized NSG mice as essential preclinical tools bridging experimental immunology with precision medicine in lupus research and therapy development.
Ocular and systemic adverse effects of topical non-steroidal anti-inflammatory drugs ‒ a narrative review with quantitative synthesis
Introduction and aim. The impacts of topical ophthalmic non-steroidal anti-inflammatory drugs (NSAIDs) have been studied, with instances of an unprecedented quantitative assessment of adverse drug reaction prevalence among several NSAID classes. This study aimed to systematically observe and synthesize the relevant information on the pharmacodynamic mechanism of adverse drug reactions (ADR) corresponding to topical NSAID administration. Material and methods. A preliminary search on PubMed Central, Google Scholar, and ScienceDirect databases yielded 83 articles. Analysis of literature. Conditions such as corneal perforation, ulceration, infiltration, keratitis, melt, corneal issues involving epithelial defects, tissue loss, stromal thinning, and delayed wound healing accentuate a comprehensive range of consequences on corneal integrity and physiology. The topical NSAID group also conveys more diversified systemic adverse reactions involving dilated ventricle, tricuspid regurgitation, pulmonary insufficiency, closure of the ductus arteriosus, and prenatal ductal constriction, which constitute a concern for their impact on cardiac activity and developing embryos. Conclusion. Burning sensation is reported to be the most commonly reported frequency after photophobia. Notably, preferential COX-2 inhibitors had a significantly greater prevalence of ADRs than both nonselective COX inhibitors (mean difference=1.05, p=0.023) and selective COX-2 inhibitors. Longitudinal studies with frequent follow-ups are essential to fully characterize the incidence, severity, and long-term effects of adverse consequences.
From diagnosis to therapy ‒ mixed hyperkinetic-hypokinetic dysarthria ‒ a comprehensive case study
Introduction and aim. Progressive dysarthria and dysphagia pose substantial diagnostic and therapeutic challenges. This case report aims to describe the assessment and intensive structured management of a patient with chronic, functionally limiting dysarthria and dysphagia. Description of the case. The patient was a 38-year-old male with neuroacanthocytosis syndrome. Dysarthria diagnosis was established through auditory-perceptual profiling and acoustic analysis, confirming a mixed hyperkinetic-hypokinetic pattern. Clinical bedside evaluation of swallowing was done, which revealed severe oral dysphagia. Speech therapy was conducted using the hierarchy of motor speech treatment, targeting various motor speech bases. Additionally, severe oral phase dysphagia was managed using rehabilitative, compensatory, and modified diet approaches. Results. Improvements were noted across all motor speech bases, supported by subjective reports and objective data. The patient's self-reported measures, as well as the improvement in voice quality (AVQI score decreased from 4 to 2.95), improved intelligibility (from 30 to 75%), and decreased speech rate (4.36 to 2.53 syllables/second) showed substantial improvement in dysarthria. Similarly, safe swallowing was achieved at IDDSI Levels 4–6 with compensatory strategies. Conclusion. This case illustrates that even rare and chronic forms of dysarthria can respond positively to structured, intensive speech-language therapy, underscoring the importance of individualized, comprehensive intervention approaches.
Occipital necrotizing fasciitis ‒ a case report of diagnostic and surgical challenges from an atypical anatomical presentation
Introduction and aim. Necrotizing fasciitis (NF) is a rapidly progressive soft tissue infection with high mortality. While most cases involve the extremities or perineum, isolated occipital scalp NF is exceptionally rare, often leading to delayed recognition. We present a case describing its unusual site, diagnostic pitfalls, and surgical challenges. Description of the case. A 48-year-old man presented with one week of progressive swelling and pain following rupture of a boil-like lesion on the occipital region. Examination revealed a 20×20 cm erythematous, tender, and swelling. The primary survey was unremarkable. Laboratory results showed hyperglycemia (490.6 mg/dL), hyponatremia (122.0 mEq/L), and leukocytosis (26.72×10⁹/L). Imaging suggested a localized abscess, initially managed with incision and drainage. Rapid necrosis progression necessitated emergent wide debridement, confirming NF. Intraoperative bleeding complicated tissue assessment. Negative pressure wound therapy was attempted but discontinued due to anatomical limitations. The patient improved with repeated debridements, antibiotics, and reconstructive surgery. Conclusion. This case highlights the rarity of occipital NF and the risk of low clinical suspicion in atypical locations, emphasizing the importance of early recognition and tailored surgical management.
Carcinosarcoma of the uterus and its monoclonal behavior ‒ a case report with review of literature from rural India
Introduction and aim. Carcinosarcoma of the uterus is a rare and aggressive monoclonal tumor composed of both epithelial and mesenchymal components. It is associated with poor prognosis and shows a marked tendency for early metastasis and recurrence, posing a significant challenge in gynecological oncology. This study aimed to identify the precise clinicopathological features of uterine carcinosarcoma that may facilitate accurate diagnosis and, ultimately, timely patient management. Description of the case. A 53-year-old nulliparous woman presented with vaginal bleeding and an abdominal mass. Clinically, the case was initially diagnosed as leiomyoma uteri. The patient underwent hysterectomy, and the specimen was submitted for histopathological examination. Histopathology suggested a malignant mixed Müllerian tumor (homologous type). Immunohistochemistry was performed to confirm the diagnosis and to exclude differentials such as endometrial carcinoma. The tumor was positive for cytokeratin, vimentin, cyclin D1, and CD10, while negative for p53 in both components. The coexistence of epithelial and mesenchymal elements of common embryonic origin, together with the absence of p53 expression, confirmed the monoclonal nature of the tumor. Conclusion. Accurate diagnosis of uterine carcinosarcoma requires the combined use of clinical evaluation, histopathology, and immunohistochemistry, which are essential for guiding optimal therapeutic interventions and determining prognosis.
Simultaneous cardiac and cerebral infarction ‒ a case report
Introduction and aim. Concurrent cardiocerebral infarction (CCI) is a rare condition defined by the simultaneous presentation of acute myocardial infarction (AMI) and acute ischemic stroke (AIS). This case report aims to illustrate the clinical presentation, diagnostic challenges, and treatment considerations in a patient with CCI. Description of the case. We describe the case of a 61-year-old Asian patient with symptoms of AMI, which was successfully treated with primary percutaneous coronary intervention (PCI). Six hours after the initial presentation, the patient developed symptoms of AIS. Imaging revealed an acute infarct in the left globus pallidus and small lacunar infarcts in the left thalamus region. Due to the location of the cerebral infarct, the patient was managed conservatively for AIS. The patient showed a positive response to the treatment, with no recurrence of chest pain or neurological symptoms observed at the six-month follow- up. Conclusion. This case emphasizes the importance of prompt brain imaging to distinguish between different types of stroke and highlights the challenges in managing CCI, a condition linked to high mortality and morbidity. Early recognition and tailored therapy are crucial for improving prognosis.
Floating-Harbor syndrome ‒ case report with literature review
Introduction and aim. Floating-Harbor syndrome (FHS) is a very rare disease, whose typical characteristics include short stature, facial dysmorphic features and significant speech delay. We aim to present the first reported case of FHS with discordant growth hormone tests and confirmed hypoplasia of the pituitary gland. Description of the case. We report a case of a boy aged 8 years and 3 months with a height constantly below the 3rd percentile, delayed bone age in comparison to chronological age, typical dysmorphic triangular face and a high-pitched voice. Whole-exome sequencing (WES) detected a heterozygous pathogenic variant in SRCAP gene – a confirmation of the diagnosis Floating-Harbor syndrome (FHS). Recombinant human growth hormone (rhGH) therapy at a dose of 0.033 mg/kg/day (0.65 mg/day) was initiated at the age of 7 years and 10 months. Because of the insufficient growth velocity at the time of manuscript preparation a dose increase was made to 0.035 mg/kg/day (0.80 mg/day). Conclusion. In children presenting with short stature (especially when GH deficiency is confirmed), facial dysmorphism and developmental delay, Floating-Harbor syndrome should be considered as a possible diagnosis. A multidisciplinary approach involving pediatric endocrinologists, geneticists and developmental specialists is essential for timely etiological diagnosis and optimal management.
Commentary on the use of D-dimer as a biomarker in chronic obstructive pulmonary disease