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 (2024) <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 53% 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 70 days The average time in which the article is published in the final version (from submission to publication) 245 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.
Pharmacogenetic aspects of therapy for autoimmune hepatitis against the background of degenerative-dystrophic joint lesions
Introduction and aim. The pathogenesis of autoimmune diseases, including musculoskeletal, gastrointestinal, and endocrine manifestations, involves the interaction of genotype and environmental factors. Pathologies demonstrate comorbidity and clinical heterogeneity even within a single family. Genetic polymorphisms of one-carbon metabolism are key regulators of cellular processes that become therapeutic targets. Description of the case. The study describes personalized therapy for a patient with an autoimmune comorbid disease, with an emphasis on genetic and metabolic characteristics. The treatment regimen is adapted to the features of the one-carbon metabolism profile of a patient with chronic autoimmune hepatitis and degenerative-dystrophic joint disease. Family history includes autoimmune thyroiditis, vitiligo, Parkinson’s disease, cardiovascular diseases. The patient’s genotype for single nucleotide polymorphisms rs1801133, rs1801131, rs1801394, rs1805087, and rs3733890 of the one-carbon metabolism genes is associated with elevated plasma homocysteine levels. After treatment, changes in biochemical parameters were observed: alanine aminotransferase (72→53 U/L), aspartate aminotransferase (53→44 U/L), gamma-glutamyltransferase (129→89 U/L), alkaline phosphatase (313→125 U/L) and homocysteine (15.1→17.0 μmol/L). Conclusion. Positive dynamics after personalized therapy demonstrates the importance of an interdisciplinary approach to etiopathogenetic treatment, emphasizing the need to support hepatobiliary function along with muscular and skeletal therapy.
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Open rings of demyelination – a rare case of tumefactive multiple sclerosis
<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;">Introduction and aim. Tumefactive multiple sclerosis (MS), a rare and atypical subtype of MS, presents with large demyelinating lesions that can mimic acute stroke, leading to diagnostic uncertainty. Stroke-like symptoms in such cases require a thorough neuroimaging. We describe the case of a 35-year-old woman who presented with acute onset of right-sided hemiparesis and hemisensory loss, along with facial weakness of the left upper motor neuron facial weakness and focal seizures. Initially suspected to be a cerebrovascular event, the condition was later diagnosed as tumefactive multiple sclerosis. <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;">Description of the case. Comprehensive neurological assessment with neuroimaging and magnetic resonance peduncle, and bilateral cerebral hemispheres, raising suspicion of a demyelinating process. A differential diagnosis, including neoplastic, infectious, and inflammatory conditions was carefully evaluated before confirming tumefactive MS. The patient’s stroke-like deficits improved significantly with high-dose intravenous methylprednisolone therapy. Follow-up imaging demonstrated the resolution of the enhancing lesions, strengthening the diagnosis. The dramatic response to steroids and the absence of progressive deterioration helped differentiate tumefactive MS from gliomas or infectious abscesses. <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;">Conclusion. This case highlights the importance of considering tumefactive MS in acute neurological deficits with ring-enhancing lesions. Advanced imaging techniques are crucial for accurate differentiation that allows for timely and appropriate treatment.
A brief review of the cardiovascular complication of COVID-19 – what is the pathophysiology of arrhythmia during infection?
Introduction and aim. COVID-19, caused by SARS-CoV-2, significantly affects the cardiovascular system beyond its respiratory manifestations. This review examines the intricate relationship between COVID-19 and cardiovascular complications, focusing on cardiac arrhythmias and their underlying pathophysiology. Material and methods. A comprehensive literature search was conducted in PubMed and Google Scholar from its inception to December 2024, including peer-reviewed articles published in English. Analysis of literature. In COVID-19, a spectrum of cardiovascular complications is observed, including acute myocardial infarction, arrhythmias, myocarditis, venous thromboembolism, and heart failure/cardiac shock. The pathophysiology of cardiovascular damage in COVID-19 involves multiple mechanisms, primarily including direct viral cardiotoxicity, systemic inflammation, and hypercoagulability. Arrhythmias are a common cardiac complication in COVID-19, encompassing a range of disturbances, from bradycardia to ventricular fibrillation. The mechanisms underlying arrhythmias in COVID-19 are multifaceted, including direct viral injury to cardiomyocytes, hypoxia, systemic inflammation, hyperthermia, autonomic imbalance, electrolyte imbalances, side effects of medications, and drug-drug interactions. Conclusion. Understanding the complex interplay of these factors is crucial for the early diagnosis and appropriate management of cardiac complications in patients with COVID-19. To mitigate cardiovascular morbidity and mortality in individuals with COVID-19, cardiovascular monitoring and the development of targeted therapeutic strategies are highly recommended.
Comparative therapeutic role of ascorbic acid, α-tocopherol and riboflavin in mitigating hepatotoxicity induced by drugs and chemical toxins – a review
Introduction and aim. The liver plays a central role in the metabolism of drugs, xenobiotics, and nutrients, making it highly susceptible to exposure to toxicity due to drugs and chemical toxins (DCT). DCT-induced hepatotoxicity (DIH), remains one of the most common causes of acute liver failure, and potential therapeutic agents such as ascorbic acid, α-tocopherol and riboflavin have been explored to mitigate DIH. This review summarizes the current knowledge in the experimental model. Material and methods. This review was based in publications available on scientific databases such as PubMed, Scopus, Web of Science, and Google Scholar. After the abstract evaluation, the relevant articles were selected for further analysis. Analysis of the literature. The vital role of oxidative stress and inflammation in mediating DIH has been demonstrated. Hence, the most effective therapeutic intervention includes agents that exhibit potent antioxidant and anti-inflammatory properties such as ascorbic acid, α-tocopherol and riboflavin. Conclusion. The comparative therapeutic role of ascorbic acid, α-tocopherol and riboflavin against DIH involves the reparation of hepatic histomorphological impairments and modulation of biochemical and molecular alterations that characterized the onset and progression of DIH.
Detection of gastrointestinal cancers using salivary biomarkers – a systematic review
Introduction and aim. Cancers of the gastrointestinal tract are highly prevalent worldwide, with usually symptomless presentations making diagnosis at an early stage challenging. At the same time, salivary biomarkers are a promising method of early diagnosis in different malignancies. To this end, the present systematic review was carried out to investigate if salivary biomarkers can help with the early detection of gastrointestinal cancer and ascertain their diagnostic value. Material and methods. Major electronic databases were searched using a combination of keywords and Boolean operators to retrieve all existing literature on the topic from April 2024 until inception. Clinical studies with relevant information were included in the quantitative synthesis. Analysis of the literature. A total of 48 studies exploring the use of potential salivary biomarkers in esophageal, gastric, colorectal, pancreatic, hepatocellular and biomarkers were included in the present review. All studies retrieved statistically significant correlations between the presence of certain markers in the saliva and development of gastrointestinal cancers. Conclusion. Salivary biomarkers can help detect different gastrointestinal cancers. However, more studies are required to determine their diagnostic value. The use of artificial intelligence might help clinicians in exploiting these biomarkers.
Characterization of anti-steatogenic long noncoding RNAs and their epigenetic influence on the development of metabolic fatty liver disease – a systematic review
Introduction and aim. Numerous transcriptomic studies have demonstrated that the development of metabolically associated fatty liver disease is accompanied by changes in the expression level of long noncoding RNAs (lncRs). The aim: to present a brief description of the role of anti-steatogenic lncRs in the epigenetic influence on the development of metabolically associated fatty liver disease, analyzing the data of modern scientific literature. Material and methods. An analysis of 64 reports over the past 10 years was conducted from the databases PubMed; MEDLINE; EMBASE; Cochrane Systematic Reviews Database; BIOSIS which were selected using the indicated keywords. Quality aspects were assessed using the adapted Newcastle–Ottawa Scale, PROSPERO CRD420250652980. Analysis of the literature. Hypoexpression of AC012668 – increased representation of miR-380-5p, activation of LRP2; B4GALT1- AS1/lncSHGL, MEG3 – activation of lipogenesis, gluconeogenesis in hepatocytes; FLRL2 – inhibition of BMAL1 and SIRT1; Gm16551 – increased expression of ACC1, SCD1; HR1 – activation of SREBP1c. LncLSTR – activation of cytochrome Cyp8b1 transcription; MRAK052686 reduction of FABP7 expression. Conclusion. The formation of hepatosteatosis is supported by a decrease in the expression level of anti-steatogenic lncRs, such as AC012668, B4GALT1-AS1/lncSHGL, MEG3, FLRL2, Gm16551, lncHR1, lncLSTR, MRAK052686. LncRs overexpression is compensatory in escalating inflammation, hyperglycemia.
Genetic determinant of metabolic syndrome – a review
Introduction and aim. Metabolic syndrome is a pathological condition that is a combination of insulin resistance, hypertension, dyslipidemia, and abdominal obesity. Every metabolic syndrome trait has an estimated hereditary factor greater than fifty percent. Many mutations related to distinct traits have been successfully identified through genetic studies. With respect to the advancements in our knowledge of the genetics of obesity, it is a major contributor to metabolic syndrome. Metabolic syndrome is associated with many diseases and is closely related to overweight / obesity and lack of activity. Genetic predisposition also plays an important role in it. Therefore, lifestyle modification is the initial and main intervention that can be implemented for such a population. This review pinpoints the literature on the definition of metabolic syndrome, epidemiology, pathogenesis, and its gene polymorphism and treatment approach comprising metabolic syndrome. Material and methods. The literature review was carried out using databases such as PubMed, Scopus, Google Scholar and the Web of Science for studies looking into metabolic syndrome and its complications. This review provides a comprehensive analysis of the role of genetic and lifestyle changes in the development of metabolic syndrome. Analysis of the literature. Metabolic syndrome is a collection of diseases that include lower levels of high-density lipoprotein (HDL), increased triglyceride levels (TG), high blood pressure, more waist circumference, and elevated fasting blood glucose. It is closely related to overweight / obesity and lack of activity. Genetic predisposition also plays an important role in it. So lifestyle modification is the initial and main intervention that can be implemented for this population. Conclusion. Genetic, lifestyle changes, and other environmental changes contribute to the development of metabolic syndrome. Metabolic syndrome leads to many health issues; for a better healthy outcome, lifestyle modifications such as healthy dietary habits, following regular physical activity, quitting smoking and alcohol, balanced weight, stress management are required.
Effects of Ganoderma lucidum (“lingzhi”) supplementation on blood lipids – a systematic review of clinical trials
Introduction and aim. Impaired blood lipid profile is a major risk factor for cardiovascular disease, the leading cause of mortality worldwide. Supplementation of Ganoderma lucidum (“lingzhi”) has been postulated to have a positive impact on blood lipids. This review aims to evaluate the evidence on this topic. Material and methods. A systematic search of Google Scholar, PubMed and clinicaltrials.gov databases was performed to identify randomized clinical trials and cross-over trials which assessed the effects of lingzhi supplementation on blood lipids. The gathered data were reviewed and analyzed in accordance with PRISMA guidelines. Analysis of the literature. Of the 805 records identified in the initial search, a total of 7 studies met all the inclusion criteria and were qualified for the review. None of them reported a statistically significant change in triglycerides, high-density lipoprotein, or low-density lipoprotein during lingzhi supplementation. Only 2 out of 7 trials showed a moderate decrease in total cholesterol level. Conclusion. There is no evidence to support any effect of G. lucidum supplementation on triglycerides, high-density lipoprotein or low-density lipoprotein. Its influence on total cholesterol also remains highly doubtful based on the present systematic review.
The effect of exercises on the quality of life in individuals undergoing hip arthroplasty following hip fractures – a systematic review and meta-analysis
Introduction and aim. The increasing burden of hip fractures and hip arthroplasties (HA) requires a deeper understanding of physiotherapy rehabilitation, facilitating the development of evidence-based strategies to enhance patient recovery. The aim of this study is to evaluate the effectiveness of exercises in improving quality of life after HA. Material and methods. A systematic search of PubMed, Scopus, Web of Science, CINAHL, Pedro, Embase, and the Cochrane Central Register of Controlled Studies (CENTRAL) was conducted from inception until April 2023. Randomized controlled trials (RCTs) were recovered that compare exercises with any comparator to improve quality of life were retrieved. The quality was evaluated using PeDro. Data were pooled using random-effects models. Analysis of the literature. Analysis of eight RCTs, comprising 1,560 individuals, revealed that comprehensive exercise programs produced superior outcomes in quality of life compared to standard treatment, with a notable effect size (SMD, 0.68; 95% CI, -0.01 to 1.37; I2=89%) and progressive resistance exercises have a statistically significant positive impact on quality of life. Conclusion. This review underscores the importance of comprehensive exercise programs, including progressive resistance training to improve quality of life in patients undergoing hip arthroplasty, and recommends further investigation to determine the most effective exercise parameters for the development of personalized rehabilitation programs.
Evaluation of the Glasgow-Blatchford score in predicting clinical outcomes in upper gastrointestinal bleeding
Introduction and aim. Acute upper gastrointestinal bleeding is a common cause of emergency admissions with potentially serious outcomes. Early evaluation of patients is crucial to predict morbidity, recurrence of bleeding, and mortality. The Glasgow Blatchford score (GBS) is a validated scoring system used to predict the need for medical interventions such as blood transfusion, endoscopy, and surgery. This study aimed to explore the correlation of GBS with prognostic markers in patients with upper gastrointestinal bleeding. Material and methods. This retrospective study included patients >18 years old admitted to Hitit University Corum Erol Olcok Training and Research Hospital due to upper gastrointestinal bleeding between December 2022 and May 2023. Exclusion criteria were insufficient endoscopy or data or pregnancy. GBS scores were calculated at the initial presentation for each patient and their association with prognostic markers and mortality was analyzed. Comparison of numerical measurements between independent groups was evaluated using the Mann-Whitney U test and categorical variables were evaluated using the Chisquare test. Spearman coefficients were used for correlations. ROC analysis was used to determine the sensitivity and specificity of GBS to predict endpoints. The predictive factors for the endpoints were investigated using logistic regression analysis. Results. A total of 140 patients were enrolled in the study. GBS was significant in predicting the need for blood transfusion (OR: 1.493, 95% CI: 1.297–1.719, p<0.001), need for endoscopic intervention (OR: 1.248, 95% CI: 1.089–1.430, p=0.001), and preference for ward/intensive care unit (OR: 0.869, 95% CI: 0.790–0.953, p=0.003). For predicting mortality, Charlson Comorbidity Index (OR: 1.023, CI=1.008–1.437, p=0.046) was significant. GBS was not significant for predicting mortality (p=0.582). The area under the curve (AUC) of GBS with a cut-off of 9.5 for mortality was 0.64 (95% CI 0.513–0.775, p=0.032) with a sensitivity of 68.2% and specificity of 52.5%, AUC 0.752 (95% CI 0.653–0.851, p<0.001) for the need for endoscopic intervention with a sensitivity of 90% and specificity of 50.8%, AUC 0.729 (95% CI 0.646–0.812, p<0.001) for admission to intensive care with a sensitivity of 70.1% and specificity of 58.9% and AUC 0.853 (95% CI 0.782–0.924, p<0.001) for the need for blood transfusion with a cut-off of 8.5 with a sensitivity of 84.9% and specificity of 75.5% for the selected. Conclusion. The GBS did not predict mortality, but effectively predicted the need for blood transfusion, endoscopic intervention, and intensive care unit admission. The Charlson comorbidity index was predictive for mortality in this study group.
Optimizing rehabilitation strategies for elderly patients with femoral fracture – a prognostic perspective
Introduction and aim. Femoral fractures in elderly people significantly impact their functional recovery and independence. Identifying reliable prognostic markers upon admission can facilitate optimal resource allocation and improve rehabilitation outcomes. This study aims to evaluate the predictive significance of pre-injury functional status, comorbid conditions, and cognitive function in determining independent living one year after injury. Material and methods. This retrospective observational study involved 132 consecutive patients over the age of 60 years who had suffered femoral fractures and were admitted to a specialized geriatric orthopedic unit. Prior to hospitalization, all patients were capable of independent living. Upon admission, three key prognostic indicators were evaluated: (1) the level of pre-injury performance in activities of daily living (ADL); (2) the absence of comorbidities that could hinder recovery; and (3) cognitive function, measured by a Pfeiffer mental questionnaire score above 7. The relationship between these prognostic factors and the ability to live independently one year after injury was examined using odds ratios (OR) with 95% confidence intervals (CI). Results. Among patients who possessed all three positive prognostic factors, 92% maintained independent living status after one year. In contrast, individuals with one, two, or three unfavorable predictors exhibited progressively lower rates of independent living, recorded at 96%, 82%, and 55%, respectively. The median duration of hospitalization within the first year varied across these groups, averaging 23, 74, 91, and 96 days, respectively. Furthermore, one-year mortality rates were found to be associated with the presence of comorbid conditions: 0% among those with only a femoral fracture, 14% in patients with one or two additional conditions, and 24% for those with three or more comorbidities. Conclusion. Simple and robust admission predictors including pre-injury ADL performance, absence of significant comorbidities, and preserved cognitive function can effectively estimate long-term functional outcomes in patients with femoral fracture in elderly people. These findings support the optimization of rehabilitation resources to improve recovery and promote independent living.
Safety zone for surgical procedures for the prevention of neurovascular injury in minimally invasive total hip arthroplasty
Introduction and aim. With the development of minimally invasive surgery (MIS), decreased incision size produces limited visualization leading to an increased risk of adjacent neurovascular structures during the procedure.The aim was to identify the safest zones of surgical procedures for the prevention of major neurovascular structures around the acetabulum. Material and methods. 84 cadaver pelvic specimens with 168 hips were used to analyze the anatomic relationship between the sciatic nerve and the piriformis muscle in the normal Korean population according to sex and height. We performed a qualitative and quantitative analysis of the anatomic relationship between the acetabulum and the sciatic nerve, based on the clockwise direction method, to identify the safety zones of the surgical procedure’s proximity to the acetabulum. Results. The prevalence of type I (normal type) was more than 79% and 88% in males and females, respectively. Distances A, B and E were 7.1±0.78 mm between the 3 and 4 o’clock position, 14.2±0.67 mm between the 8 and 9 o’clock position, 17.0±1.22 mm in the 9 o’clock position, respectively, on the left side, whereas 6.0±0.69 mm between the 8 and 9 o’clock position, 14.8±0.59 mm in the 7 o’clock position, 17.9±1.08 mm in the 3 o’clock position on the right side. The proximity of the retractors to acetabulum should be placed with careful and proper retraction between the 3 and 5 o’clock position on the left side and between the 7 and 9 o’clock position on the right side, in which the placement in the 9 and 3 o’clock position should be cautious on the right and left side, respectively. The cautious use of electrocautery between the 3 and 5 o’clock position on the left side, and between the 7 and 9 o’clock position on the right side, is recommended. However, performing the electrocauterization in the 9 o’clock and 3 o’clock position respectively on the left and right side should be avoided. It is forbidden between the 10 and 12 on the left side and between 12 and 2 o’clock position on the right side. The absolute safety zones for the placement of the transacetabular screw were between 1 and 3, and between the position 5 and the 6 o’clock position on the left side and between the position 9 and 11, and between the 6 and 7 on the right side. Relative safe zones were between 12 and 1, and between the 6 and 7 o’clock position on the left and between the 11 and 12, and between the 5 and 6 o’clock positions on the right side. Screws with a length of <24mm could be safely inserted between the 3 and 5 o’clock position on the left side and between the 7 and 9 o’clock position on the right side. The risk zones were between 7 and 9, and between the 9 and 12 hours on the left side, and between 3 and 5, and between the 12 and 3 o’clock position on the right side. In cases with highly elevated trochanter major, the distances between the acetabulum and adjacent neurovascular structures changed and the risk of the SN increased. Conclusion. These data could be helpful for arthroplasty surgeons in avoiding neurovascular injuries in MIS THA.
The detection of internal tandem duplication in the FMS-like tyrosine kinase 3 gene in a sample of Iraqi patients with acute myeloid leukemia
Introduction and aim. Acute myeloid leukemia (AML) is a genetically heterogeneous malignancy significantly influenced by FMS-like tyrosine kinase 3 mutations. This study investigated the prevalence and clinical implications of internal tandem duplication (ITD) mutations in FLT3 in patients with AML in Iraq. Material and methods. The study involved blood samples collected from 50 newly diagnosed AML and 50 healthy subjects between April 2023 and January 2024 and used for conventional PCR. PCR products positive for the ITD mutation were subjected to fragment analysis using capillary electrophoresis (CF) to confirm ITD mutations. Results. FLT3-ITD mutations were identified in 20% of patients with AML (10/50), with striking female predominance (90% of mutation-positive cases). Based on the FAB classification, M5 was the most prevalent FAB subtype among mutation carriers (40%), with no mutations detected in M7. Conclusion. This study provides critical information on the prevalence and clinical implications of FLT3-ITD mutations in patients with AML in Iraqi, emphasizing the need for precise molecular diagnostic approaches. This finding revealed a distinct subset of patients with AML that harbor FLT3-ITD mutations, with a significant proportion exhibiting elevated allelic ratios, which reinforces their prognostic relevance.
Diuretic efficacy and phytochemical profiling of the 80% methanol extract of Sida schimperiana Hochst. ex A. Rich
Introduction and aim. Diuretics are used for edema, heart failure, and hypertension, but may cause side effects and resistance. Sida schimperiana is used for urinary retention in Ethiopian folk medicine, although its diuretic effects are unverified. This study aims to evaluate the diuretic potential and phytochemical content of the 80% methanol extract of S. schimperiana. Material and methods. Male rats were administered distilled water (2 mL/100 g), furosemide (10 mg/kg), or 80% methanol extract (100, 200, or 400 mg/kg). Diuretic effects were assessed by monitoring urination onset, urine volume, electrolyte levels, and pH. Phytochemical analysis was performed to explore underlying diuretic mechanisms. Results. The 80% methanol extract demonstrated significant diuretic and natriuretic effects in a dose- and time-dependent manner, surpassing the negative control. At doses of 200 and 400 mg/kg, diuresis (p<0.001) and sodium and chloride excretion (p<0.001) were notably increased at all time points. The treated group also showed significant changes in urine pH. Phytochemical analysis identified alkaloids, flavonoids, polyphenols, and tannins, with high concentrations of flavonoids (187.3 mg quercetin equivalent/g) and polyphenols (128.4 mg quercetin equivalent/g). Conclusion. This study affirmed the methanolic extract’s diuretic potency, comparable to furosemide, emphasizing its prospective therapeutic value.
An overview of the diagnostic and prognostic values of biochemical markers in patients with COVID-19
Introduction and aim. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic that disrupts both public health operations and financial structures throughout the world. This article aims to evaluate the relationship between the severity of coronavirus disease 2019 (COVID-19) and its alterations in specific biomarkers such as D-dimer and C-reactive protein (CRP) together with alanine transaminase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH). Material and methods. Participants in this study were split into two groups consisting of 200 COVID-19 patients and 200 healthy controls ranging from 18 to 80 years old. Polymerase chain reaction and chest radiograph examinations were used to officially verify the participant’s diagnosis. This study used Mann-Whitney U tests combined with logistic regression and receiver operating characteristic (ROC) curves to identify and determine their value as diagnostic tools and prognostic indicators. Results. D-dimer and CRP along with ALT, AST, and LDH demonstrated significant and elevated levels in COVID-19 infected participants when analyzed against control participants (p<0.0001). D-dimer emerged as a diagnostic biomarker according to ROC analysis with an AUC value of 0.96 and a p-value<0.001 which signified its quality for the evaluation of the severity of the disease. The additional biomarkers AST and LDH received AUC scores of 0.79 and 0.76, respectively,,with ALT reaching an AUC value of 0.74. Conclusion. The combination of the biochemical markers D-dimer, AST, and LDH significantly improves risk assessment while enhancing predictions about disease outcomes. These biomarkers provide vital data for early disease detection in combination with disease progression through tracking patient outcomes and therapeutic planning assessments.
Hormonal profiles and metabolic changes in women diagnosed with concomitant Hashimoto’s thyroiditis and polycystic ovary syndrome via sonography
Introduction and aim. Women with both Hashimoto’s thyroiditis (HT) and polycystic ovary syndrome (PCOS) often experience hormonal imbalances and metabolic changes. We investigated the correlation between sonographic changes and hormonal abnormalities in women with Hashimoto’s thyroiditis and PCOS. Material and methods. A case-control study including 150 women with PCOS and Hashimoto’s thyroiditis, and 50 healthy women as a control group, was conducted at Al-Habobbi Teaching Hospital from 7/1/2023 to 7/10/2024. Lipid, blood sugar, luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, testosterone, and thyroid hormones were assessed, the groups had similar mean ages and smoking rates. Results. When the case group was compared with the control group, significant hormonal and metabolic differences were observed. Specifically, levels of LH were significantly higher in the case group (14.68±1.21 vs. 3.31±1.03 mIU/mL, p=0.001), as were levels of FSH (14.85±1.07 vs. 5.26±0.51 mIU/mL, p<0.001), prolactin (28.90±1.34 vs. 7.02±1.16 ng/dL, p<0.001), and testosterone (57.71±2.61 vs. 12.41±2.27 ng/dL, p<0.001). In terms of lipid profile, the case group showed elevated total cholesterol (229.93±14.61 vs. 134.51±9.38 mg/dL, p<0.001), triglycerides (287.78±41.43 vs. 128.04±10.20 mg/dL, p<0.001), low-density lipoprotein (LDL) (136.98±20.02 vs. 58.67±11.45 mg/dL, p<0.001), and very low-density lipoprotein (VLDL) (57.55±8.28 vs. 25.60±2.04 mg/dL, p<0.001), while levels of high-density lipoprotein (HDL) were significantly lower (35.39±3.54 vs. 50.23±4.55 mg/dL, p<0.001). Regarding thyroid function, thyroxine (T4) levels were significantly reduced in the case group (9.80±0.77 vs. 15.02±1.25, p<0.001), while thyroid-stimulating hormone levels were elevated (6.25±1.10 vs. 2.17±0.74 μIU/mL, p<0.001). Conclusion. These findings suggest a potential complex interaction between the thyroid and reproductive glands, which may influence the pathogenesis and metabolic effects of these endocrine disorders. However, the individual and combined effects require further detailed investigation.
A cross-sectional study of psychosocial variables associated with medication burden among type 2 diabetes mellitus with multiple comorbidities in geriatric patients
Introduction and aim. As the population ages, the management of type 2 diabetes mellitus in older adults with multiple comorbidities becomes more complex. Geriatric patients often face a medication burden, impacting their quality of life and adherence. Psychosocial variables such as depression, anxiety, social support, and health literacy may influence how patients cope with their medications. This study explores the relationship between these variables and the burden in geriatric patients with type 2 diabetes and comorbidities, offering insight into improving care and outcomes. Material and methods. The cross-sectional survey was carried out from April to September 2024. 250 patients were included. The demographics of the participants, the burden of the disease, polypharmacy, the burden of the medication, and the psychosocial variables were evaluated. Univariate and multivariate linear regression analyzes assessed the variables associated with the burden of medications. Results. There was a positive correlation between the belief in medication, depression, disease burden, number of medications, number of comorbidities, and medication burden (p<0.05). Knowledge about medications was not significantly correlated with the burden (p>0.05). Conclusion. Low self-efficacy, depression, polypharmacy, high disease burden, and decreased medication satisfaction can all contribute to medication burden. Comprehending these factors helps identify patients with geriatric diabetes and enables personalized treatment to ease their burden.
Determinants of time to first birth among women of childbearing age in Somalia – a survival analysis model
Introduction and aim. The study evaluated factors and the significant indicators of time to first birth for reproductive aged women (aged 15–49 years) in Somalia. Material and methods. The study considered SDHS, 2020. The log-rank test was used to assess the statistical significance of the observed difference between waiting time for first birth and various socioeconomic and demographic factors. The Cox proportional hazard model was applied to identify the influential factors for the waiting time to the first birth. Results. The study established that about 71.19% of the respondents got married before the age of 20, while 28.81% did marry after the 20 years of age. Survival analysis revealed that the place of residence, region, age at first marriage, respondent’s education, employment status, and Wealth quintile were statistically significant determinants of waiting time to first birth. The majority of the respondents (64.56%) of the total had their first birth between the ages of 15 and 24. Among these age groups, the highest number of first births occurs at the age of 19 years, with 11.98% of respondents falling into this category. The study also found that the different age groups revealed significantly lower hazards for first births as the age increased. Regarding regional differences, the study found significant variations in the probability of survival of the first birth. In particular, the Togdheer region exhibited a higher hazard ratio (HR=1.132979, p=0.030), indicating an increased risk of experiencing the first birth compared to the reference category. Other regions, such as Galgaduud (HR=1.140067, p=0.029) and Bay (HR=1.199272, p=0.018), also showed higher hazards. On the contrary, Woqooyi Galbeed did not show significant difference in survival probabilities (HR=0.972095, p=0.604) compared to the reference category. Conclusion. Raising the minimum age for the first childbirth and promoting women’s education are crucial for reducing child marriage rates in Somalia.
Therapeutic effect of naringenin on ethanol-induced liver fibrosis in rats
Introduction and aim. Liver fibrosis, a progressive disorder marked by the surplus buildup of extracellular matrix proteins, frequently results from long-term ethanol intake. Our aim of study is to investigate how naringenin’s antifibrotic properties impact ethanol induced liver fibrosis in rats. Material and methods. Rats were divided into four groups: groups 1 and 2 received carboxymethylcellulose (CMC) containing 0.5% glucose, while groups 3 and 4 received 20% ethanol (6 g/kg of body weight) over a 60-day period. In the last 30 days, naringenin (50 mg/kg) was administered each day to groups 2 and 4. Results. Rats treated with ethanol exhibited liver damage and fibrosis, leading to elevated serum concentrations of aspartate and alanine transaminases. Expression levels of matrix metalloproteinases (MMPs), tissue inhibitors of metalloproteinases (TIMPs), alpha-smooth muscle actin (α-SMA) and related proteins were compared with the control group. Conclusion. Ethanol-fed rats showed an increase in serum matrix metalloproteinases, TIMPs, α-SMA, transaminases, and other proteins compared to the control group. The administration of ethanol led to liver damage and fibrosis. During the final 30 days of the trial, the inclusion of naringenin in the diets of rats notably reduced the levels of α-SMA, MMP2, MMP9, TIMP1, along with serum levels of aspartate and alanine transaminase levels and significant differences were observed compared to control group.
Interleukin 6 as a key inflammatory predictor of gestational diabetes – clinical and biochemical evidence
Introduction and aim. Gestational diabetes mellitus (GDM) is a prevalent metabolic disorder in pregnancy associated with significant maternal and fetal complications. Chronic low-grade inflammation is increasingly recognized as a key contributor to GDM pathophysiology, with interleukin 6 (IL-6) emerging as an important mediator of insulin resistance. The aim was to investigate the relationship between IL-6 levels and metabolic parameters in pregnant women with and without GDM, and to evaluate the diagnostic performance of IL-6 for distinguishing GDM. Material and methods. A total of 45 pregnant women with GDM and 45 normoglycemic controls between 24 and 28 weeks of gestation were enrolled. Clinical data age, body mass index (BMI), gestational age, fasting insulin, oral glucose tolerance test (OGTT), and lipid profile were assessed. IL-6 was quantified by high-sensitivity enzyme-linked immunosorbent assay. Correlation analysis, multiple linear regression, and receiver operating characteristic (ROC) curve analysis were performed using SPSS. Results. Women with GDM exhibited significantly higher IL-6 levels (25.35±11.76 ng/L) than controls (11.02±3.59 ng/L, p<0.001). IL-6 showed strong positive correlations with fasting insulin (r=0.900, p<0.001) and OGTT (r=0.684, p<0.001). Multiple regression indicated that gestational age, BMI, and total cholesterol were significant predictors of IL-6 in GDM (p<0.05). ROC analysis revealed an area under the curve of 0.923 (p<0.001) for IL-6, with a sensitivity of 88.9% and specificity of 78.3% at the cutoff of 13.243 ng/L. Conclusion. Elevated IL-6 is strongly associated with insulin resistance and dyslipidemia in GDM, suggesting a potential role as an inflammatory biomarker for early risk stratification. Incorporating IL-6 measurement into GDM screening protocols may enhance diagnostic accuracy and facilitate timely interventions to improve pregnancy outcomes.
Significance of C-reactive protein to albumin ratio and thrombus burden in acute coronary syndrome
Introduction and aim. Thrombus burden (TB) is a critical factor in the pathogenesis of acute coronary syndrome (ACS) pathogenesis with biomarkers such as C-reactive protein (CRP) and serum albumin that reflect systemic inflammatory and nutritional states. The CRP and albumin ratio (CAR) has emerged as a new composite marker, offering enhanced prognostic value. The aim of this study was to evaluate the association between CAR and TB in patients with ACS and to assess the predictive utility of CAR compared to CRP and albumin individually. Material and methods. A hospital cross-sectional analytical study was conducted among 93 patients ages 18–60 years with ACS who underwent coronary angiography (CAG). CAR was calculated and its association with TB was analyzed. Results. Of the participants, 9.7% had high tuberculosis. CAR, CRP, and albumin were significantly associated with TB (p<0.001). CAR showed the highest correlation (r=0.728) and perfect diagnostic accuracy (AUC=1), outperforming CRP (AUC=0.987) and albumin (AUC=0.030). High TB was significantly associated with the presentation of grade 1 TIMI and ST-elevated myocardial infarction (STEMI) presentation (p<0.05). Conclusion. CAR is a reliable, accessible and independent biomarker for predicting TB in ACS, and its incorporation into standard clinical protocols could improve early risk stratification, therapeutic decision-making, and patient outcomes. More multicentric study are warranted to validate its broader clinical applicability.
Impact of melatonin on platelets during oxidative stress – an in vitro approach
Introduction and aim. Platelets are susceptible to oxidative damage due to metabolic pathways and oxygen-rich environments. Antioxidants combat oxidative stress (OS) and are currently employed in therapeutics. Melatonin has potent antioxidant properties; however, it has not been explored in platelet OS models. This study investigates the effect of melatonin on platelets during 2,2’-azobis(2-amidinopropane) dihydrochloride (AAPH)-induced OS. Material and methods. Platelets from Wistar rats (n=5) were grouped into controls (untreated), free radical-inducer (FRI: AAPH-treated), melatonin-treated (AO), and preincubated with melatonin and AAPH-treated (FRI+AO). OS and platelet markers were analyzed. Results. Antioxidant defenses decreased in FRI, whereas increased in AO and FRI+AO. Lipid peroxidation (LPO) increased in FRI, whereas advanced oxidation protein products (AOPP) and metabolism increased in AO compared to controls. Superoxides, AOPP, and ATP secretion increased, whereas LPO decreased in FRI+AO compared to FRI. However, aggregation increased in FRI and AO compared to Controls, whereas decreased in FRI+AO compared to FRI. Conclusion. OS models can give insights into the underlying redox status of the cells and modulations of antioxidants in platelets. The findings indicate that melatonin can modulate antioxidant defenses and alleviate OS in platelets. This study lays the foundation for further in vivo studies on platelet pathophysiology.
Comparative diagnostic utility of leptin and resistin as inflammatory biomarkers in acute myocardial infarction
Introduction and aim. Acute myocardial infarction (AMI) is a leading cause of mortality. Although traditional risk factors are known, adipokines, such as leptin (LEP) and resistin (RETN), are emerging as potential biomarkers involved in the inflammatory and metabolic processes underlying AMI. This study aimed to evaluate serum LEP and RETN levels in patients with AMI. Material and methods. This case-control study included 60 patients diagnosed with AMI and 60 healthy controls recruited from the Nasiriyah Heart Hospital, Thi-Qar Province. Serum levels of LEP and RETN were measured using an enzyme-linked immunosorbent assay. Results. AMI patients exhibited significantly elevated LEP (3.79±2.0 vs. 1.43±0.7 ng/mL, p<0.001) and RETN (606±325 vs. 289±160 ng/L, p<0.001) compared to controls. Both adipokines were positively correlated with high-sensitive troponin I (Hs-TnI), low-density lipoprotein (LDL-C), and triglycerides (p<0.05). ROC analysis demonstrated a high diagnostic accuracy for LEP (AUC=0.964; cutoff >2.23 ng/mL, derived from internal study data) and moderate accuracy for RETN (AUC=0.878; cutoff >305.9 ng/L). The sensitivity and specificity of the LEP were 93% and 92%, respectively. Conclusion. LEP demonstrated high diagnostic accuracy in our cohort, and its clinical application requires validation in larger prospective studies. The association between RETN and AMI likely reflects inflammatory sequelae rather than predictive utility.
Association of interleukin-1β gene polymorphisms in the occurrence of gastric ulcer in Southern Odisha, India
Introduction and aim. The occurrence of gastric ulcer (GU) is influenced by many factors including interleukin 1β (IL-1β) gene polymorphisms. In this study, the association of GU with IL-1β gene polymorphisms was investigated in patients with gastric disorders. Material and methods. The patients were categorized into two groups, group 1: patients with normal impression in the upper-GI-endoscopy (n=135); group 2: patients with GU (n=135). Three single nucleotide variants (SNVs) of IL-1β gene [rs16944 (–511 C/T), rs1143627 (–31 C/T) and rs1143634 (+3954 C/T)] were investigated by PCR-RFLP method. Results. The association of IL-1β gene polymorphisms and occurrence of GU along with other factors (socio-demographic and habits) showed patients with smoking, alcohol intake and NSAID use was high in group 2. For SNVs and occurrence of GU, rs1143627 (–31 ‘TT’) genotype was significantly high in group 2 (21.48%) compared to group 1 (9.63%), while the other two genotypes were comparable. Further, there was no association of any genotypes with smoking, alcohol intake and NSAID use, except NSAID use with rs1143627 (–31 C/T) in group 1. Conclusion. The findings revealed, the habits like smoking, alcohol intake and recurrent NSAID use may influence the occurrence of GU while, the IL-1β gene polymorphisms have minimal impact on the occurrence of GU.
The knowledge of society regarding health-promoting behaviors in oncology
Introduction and aim. Enhancing awareness, early detection, and fostering health-seeking behavior is imperative to address the growing problem of cancer, advocating for basic health education from an early age to reduce morbidity and mortality. Material and methods. The survey was carried out in two forms: paper and online. The research tool was a questionnaire, consisting of 25 closed-ended questions. Results. While 95.5% denied the presence of personal cancer, 63% reported family history. Despite awareness of the impact (83% women; 81% men), 44% consume fast food monthly. Self-examination rates are low: only 37% perform it regularly; 45% of men lack knowledge of testicular examination. Conclusions. Health campaigns across all age groups are necessary to promote cancer prevention and early detection, with a focus on educating both men and women on self-examination due to inadequate knowledge levels.
Ultrasonography of the salivary glands in the diagnosis of Sjögren’s syndrome secondary to rheumatoid arthritis – a probabilistic approach
Introduction and aim. To evaluate the role of salivary gland ultrasound (SGUS) in differentiating rheumatoid arthritis (RA) patients with or without Sjogren’s syndrome (SS) using a probability method and to study the relation between secondary SS (sSS) and RA disease characteristics. Material and methods. One hundred RA patients with disease duration ≥5 years underwent detailed history taking, examination, routine laboratory testing, Schirmer’s test, unstimulated salivary flow rate and SGUS of the 4 major salivary glands using Salaffi and Outcome Measures In Rheumatoid Arthritis Clinical Trials (OMERACT) scores. Results. Patients sum with probabilities for sSS ≤20% and ≥80% were (39/100) before and (90/100) after SGUS with a highly significant difference (p<0.001).There was significantly more frequent carpal tunnel syndrome (CTS), longer RA disease duration and higher anti-cyclic citrullinated peptide antibodies (anti-CCP) in RA patients with sSS compared to those without (p<0.05). There was highly significant agreement between Salaffi and OMERACT scores in gland evaluation by kappa test. The highest ultrasound OMERACT score of SG showed significant positive correlation with both Disease Activity Score-28-Erythrocyte Sedimentation Rate (DAS-28 ESR score) and ESR in RA patients. Conclusion. Secondary SS is frequent in RA patients especially in association with longer disease duration, higher anti-CCP antibody titer and CTS. SGUS is a useful tool that helps diagnosing and grading the severity of SS in RA. SS severity correlates with RA disease activity.
Evaluation of corin and copeptin as novel biomarkers for polycystic ovary syndrome – diagnostic accuracy and associations with cardiometabolics
Introduction and aim. Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects 5–18% of women of reproductive age and is intricately linked to metabolic dysfunction and cardiovascular risks. This study aimed to evaluate the diagnostic utility of copeptin and corin as potential biomarkers in PCOS and their association with cardiometabolic risk factors. Material and methods. This case-control study included 60 women diagnosed with PCOS (Rotterdam criteria) and 30 healthy controls. Serum levels of copeptin and corin and metabolic parameters were measured using enzyme-linked immunosorbent assay kits. Statistical analyses included receiver operating characteristic (ROC) curves, logistic regression, and correlation tests. Results. The results revealed significantly elevated corin (1450.23±264.91 vs. 619.17±159.19 pg/mL, p<0.001) and copeptin levels (5.81±1.66 vs. 2.46±0.64 ng/mL, p<0.001) in patients with PCOS compared to controls. Both biomarkers were strongly correlated with insulin resistance (HOMA-IR: r=0.648 for corin and r=0.750 for copeptin) and dyslipidemia. ROC analysis demonstrated exceptional associative biomarker precisions for corin (AUC=1.00) and copeptin (AUC=0.89). Univariate regression identified corin (odds ratio [OR]=1.018) and copeptin (OR=1.344) as independent predictors of PCOS. Conclusion. This study identified plasma corin and copeptin levels as potential biomarkers for PCOS diagnosis and risk stratification. Elevated corin levels predict infertility, while copeptin levels correlate with metabolic dysfunction, particularly in obese, insulin resistant phenotypes.
Impact of diabetes on dengue – a comparative study of clinical and inflammatory variables in patients with and without diabetes
Introduction and aim. Dengue fever is a mosquito-borne viral disease and its severity may be influenced by comorbid conditions such as diabetes mellitus, which can alter the inflammatory and clinical response. This study aimed to evaluate and compare clinical characteristics, laboratory findings, and inflammatory markers between patients with and without diabetes who were diagnosed with dengue infection. Material and methods. The retrospective observational study included 100 patients with confirmed dengue infection, divided equally into 50 with diabetes and 50 without. It examined the distribution of age, HbA1C levels, clinical symptoms, bleeding events, liver enzymes, and inflammatory markers. Correlation analyzes were conducted to assess the relationship between HbA1C levels and inflammatory markers within each group. In addition, inflammatory markers were compared in different age categories (<50 years and ≥50 years) and by diabetic status. Results. Laboratory findings, including liver enzymes and inflammatory markers, were markedly elevated in the diabetic cohort (p<0.001). The correlation analysis revealed a strong positive relationship between HbA1c and inflammatory markers in the diabetic group (r>0.8, p<0.001), while weaker correlations were observed in the non-diabetic group (r=0.4–0.6, p<0.001). Inflammatory markers were significantly higher in diabetic patients, particularly those 50 and older. Conclusion. Diabetes may contribute to a more intense inflammatory response in dengue, highlighting it as an independent risk factor for severe clinical outcomes in dengue infection.
Phytochemical composition, antioxidant, antihyperlipidemic, and hepatoprotective effects of phenolic components of Iraqi sumac (Rhus coriaria)
Introduction and aim. Hyperlipidemia is a pathogenic disease associated with significant cardiovascular complications. Rhus coriaria, traditionally recognized as sumac, is abundant in numerous phenolic constituents that enhance its antioxidant, antibacterial, and anti-inflammatory characteristics. The aim was to investigate the phytochemical and pharmacological attributes of phenolic constituents of R. coriaria. Material and methods. 32 male albino mice were assigned at random into 4 groups (n=8). Group 1 (control), group 2 (induced), group 3 (atorvastatin) and group 4 (phenolic). All groups received a diet that was rich in fat for a duration of 28 days, except the control group, which instead consumed a standard diet. Group 2 received no treatment, while group 3 and group 4 received atorvastatin 10 mg/kg and phenolic fractions of R. coriaria 500 mg/kg, respectively, for a further 28 days. Lipid profiles, oxidative indicators, biochemical parameters, and liver histopathological examination were estimated. Results. Phenolic fractions substantially improved total cholesterol (167.5±2.4 vs. 280.4±17.6 mg/dL), triglycerides (181.1±12.5 vs. 238.6±11.05 mg/dL), low-density lipoprotein (109.0±1.6 vs. 209.2±16.8 mg/dL), and very low-density lipoprotein (36.2±2.5 vs. 47.7±2.21), while raising high-density lipoprotein levels (42.3±1.8 vs. 23.5±2.3 mg/dL) as opposed to the induced group (p<0.05). Furthermore, the phenolic constituents significantly reduced liver enzyme activities like alanine transaminase (27.4±1.8 vs. 45.2±2.8 U/L), aspartate aminotransferase (31.7±2.1 vs. 44.9±2.0 U/L), and alkaline phosphatase (28.0±2.1 vs.50.9±1.9 U/L), and decreased total blood bilirubin (0.6±0.08 vs. 1.7±0.1 mg/dL) and albumin (4.7±0.7 vs. 6.6±0.3 g/dL) when compared to the induced nontreated group (p<0.05). Phenolic treatment also alleviated tissue malondialdehyde (221.09±3.2 vs. 475.98±44.02 nmol/mL) and increased reduced glutathione (35.48±1.86 vs. 11.65±0.78 μg/mL) as compared to the group without induced non-treated group (p<0.05) and restored liver histopathological changes. Conclusion. Phenolic compounds have the potential to treat hyperlipidemia due to their anti-oxidative and anti-inflammatory properties.
Evaluation of nutritional knowledge in relation to primary prevention of doctors and nurses in Morocco
Introduction and aim. Currently, Morocco suffers the burden of non-communicable diseases. Healthcare professionals play a crucial role in guiding the population toward healthy dietary choices, which can reduce the risk of these types of diseases. This study aims to assess nutritional knowledge in relation to primary prevention of doctors and nurses working in the hospital network and primary health care facilities in Morocco. Material and methods. The study population consists of 472 nurses and 185 physicians. A self-administered questionnaire composed of four main sections (nutrition by the Mediterranean diet; nutrition for children; nutrition for pregnant and breastfeeding women; and nutrition for the elderly) was used for data collection. Results. The Mediterranean diet obtained the highest score of 0.46 (IQR [0.30, 0.53]) for physicians. But for nurses, the highest score was for child nutrition 0.33 (IQR [0, 0.333]). Our results reveal a statistically significant association of the median total score of answers of health professionals with basic training (p<0.001), receiving information on nutrition (p<0.001), their degree (doctors or nurses) (p<0.001) and the workplace (p<0.001). Conclusion. The training programs of the medical faculties and nursing training institutes in Morocco should be revised in favor of a more in-depth training in nutrition.
Corrigendum: The effect of different blood groups on visual evoked potentials
<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;">A Corrigendum on <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 effect of different blood groups on visual evoked potentials by Eski MT, Yabalak A, Şahan H, Ayaslı AAH, Sezer T. Eur J Clin Exp Med. 2023;21(3):576–581. doi: 10.15584/ejcem.2023.3.25.