Study of vacuolating cytotoxin A (vacA) genotypes of ulcerogenic and non-ulcerogenic strains of Helicobacter pylori and its association with gastric disease.

Globally, Helicobacter pylori (H. pylori), a stomach pathogen, is present in around 50 % of the population. This bacterial infection produces persistent inflammation, which significantly raises the risk of duodenal, gastric ulcer, and stomach cancer. The goal of this study is to identify the vacA genotypes in H. pylori and analyze how they relate to medical conditions brought on by the bacteria and clarithromycin resistance. PCR was used to describe 115 endoscopic stomach samples from infected patients and identify vacA gene. Of the 115 research participants, H. pylori was found in 81 (70.4 %) of them. Of the isolated cultures, only 38 (69.1 %) were resistant to clarithromycin. VacA was discovered in 55 (67.9 %) of the samples that had H. pylori in them. Patients with gastritis were more likely to have s2m2 strains of infection (66.7 %), while those with gastric and duodenal ulcers were more likely to have s1m1 strains (64.7 %). VacA-positive H. pylori strains (60 % n = 33) were more resistant to clarithromycin versus (19.2 % n = 5) for vacA-negative bacteria. Clarithromycin resistance was significantly linked to vacA s2m2 in H. pylori isolates (75.9 %). According to the study's results, the vacA variants s1m1 and s2m2 have a strong connection with the emergence of H. pylori infections that cause peptic ulcer disease in the population of Iraq. Genetic testing is essential in predicting both the course of treatment and the outcome of H. pylori disease.

Increased Dispersion of Ventricular Repolarization as an Arrhythmic Risk Marker in Drug-free Patients With Major Depressive Disorder: A Preliminary Comparative Study.

OBJECTIVE: Drug-free patients with major depressive disorder (MDD) are understudied in terms of increased risk for arrhythmias. In this study, we compared changes in corrected QT interval (QTc), QTc dispersion (QTcd), Tpeak-Tend (Tp-e), Tp-e/QT ratio, corrected JT interval (JTc), and JTc dispersion (JTcd), which are considered to be among the risk factors for the emergence of ventricular arrhythmias in patients with MDD. METHODS: The study involved 50 patients with MDD who had been free of psychotropic medications for at least 1 month and 52 age-matched and sex-matched healthy controls. Illness-related characteristics, including duration of illness and Beck Depression Inventory scores, were recorded. Electrocardiography recordings made under a standardized procedure were performed for all participants, and arrhythmia risk markers were calculated from the electrocardiograms. RESULTS: The patient group had significantly higher QTcd, JTc, and JTcd values compared with the controls. Among electrocardiogram markers, only Tp-e/QTc was significantly and inversely correlated with the duration of illness, while none of the markers was associated with Beck Depression Inventory scores. CONCLUSIONS: Alterations in electrocardiogram-derived markers of ventricular arrhythmia, which can be obtained easily and inexpensively, can be evaluated for the prediction and prevention of severe cardiac conditions in patients with MDD and considered in selecting the safest antidepressant options available.

Results on Certain Biopolymers Using M-Polynomial and NM-Polynomial of Topological Indices.

Topological indices are numerical descriptors that aid in the prediction of chemical molecules' physiochemical properties and biological actions. It is often helpful to forecast numerous physiochemical attributes and biological actions of molecules in chemometrics, bioinformatics, and biomedicine. In this paper, we establish the M-polynomial and NM-polynomial of some very familiar biopolymers, which are xanthan gum, gellan gum, and polyacrylamide. The uses of these biopolymers can increasingly take the place of traditional admixtures for the application of soil stability and enhancement. We recover the important topological degree-based indices. Also, we give diverse graphs of topological indices and their relations with the parameters of structures.

Detection of clarithromycin resistance and 23SrRNA point mutations in clinical isolates of Helicobacter pylori isolates: Phenotypic and molecular methods.

BACKGROUND AND OBJECTIVES: Peptic ulcer disease, chronic gastritis, and stomach cancer are all caused by H. pylori. The most notable drug for the treatment is the antibiotic clarithromycin, which is currently the drug of choice. H. pylori clarithromycin resistance has been associated with point mutations in 23srRNA, the most prominent of which are A2143 and A2144G. In H. pylori bacteria, methylase synthesis, macrolide-inactivating enzyme activity, and active efflux have all been found to be resistance mechanisms. The goal of the study is to determine how resistant H. pylori is to clarithromycin and what the minimum inhibitory concentration is for various antimicrobials. Furthermore, gastro-endoscopy will be performed on Iraqi patients to detect the presence of A2143G and A2144G point mutations in Helicobacter pylori infections, as diagnosed from the pyloric region and other anatomical regions. METHODS: One hundred fifteen samples were collected from patients strongly suspected of H. pylori infection presented for upper gastrointestinal endoscopy at Ramadi Teaching Hospitals and Private Clinics for the period from January 2020 until February 2021. Specimens were cultured on brain heart infusion agar containing various antibiotics and were incubated at 37 °C under microaerophilic conditions. For identification of H. pylori, isolates of the biochemical tests and RT-PCR assay were applied. The Epsilometer test was used in the antibiotic susceptibility testing as dependent on the CLSI standard. The Restriction Fragment Length Polymorphism technique was used to determine point mutations. RESULTS: In total, 55 (47.8%) Helicobacter pylori isolates were cultured from the 115 biopsy specimens, among which 16 (29.1%), 38 (69.1%), 20 (36.4%), and 40 (72.7%) revealed some degree of resistance to levofloxacin, clarithromycin, ciprofloxacin, and metronidazole, respectively. The frequency of A2144G and A2143 point mutations were 23 (60.5%) and 19 (50%), respectively. CONCLUSIONS: According to our results, Helicobacter pylori showed high resistance to clarithromycin. Our results demonstrate the requirement for antibiotic susceptibility testing and molecular methods in selecting drug regimens.

Effect of Age and Gender on Acoustic Voice Quality Index Across Lifespan: A Cross-sectional Study in Indian Population.

BACKGROUND: The human voice is dynamic and changes throughout the life span. The effects of age and gender on acoustical measures of voice quality have been well established. Assessment of voice quality using multiparametric measures has been recommended over singleton measures. Acoustic Voice Quality Index (AVQI), which is a multiparametric measure of voice quality, has gained popularity in the recent past. Studies investigating the effect of age on AVQI are very limited especially across the life span. The majority of the studies involving AVQI have been carried out in the European and East Asian populations. There is a dearth of studies involving AVQI in the Indian population. OBJECTIVES: The present study was taken up to investigate the effects of age, gender on the AVQI version 02.02 in the Indian population. The present study also aimed to establish reference data for AVQI in the Indian population. METHOD: AVQI and its constituent parameters were obtained from a total of 200 participants (50 pediatrics, 100 adults and 50 older adults) with an equal number of males and females. Multivariate Analysis of Variance was carried out to check the significant differences across age group and gender for AVQI and its constituent parameters along with interaction effects. RESULTS: AVQI values obtained from the Indian population were slightly higher than those reported in the earlier literature for the European and East Asian populations. AVQI obtained by pediatric and older adult groups was found to be significantly higher when compared to that of adults. Significant age effects were also demonstrated by AVQI. The values of AVQI were found to be more stable in adults than in pediatric and older adult groups. AVQI values did not differ significantly across older adult and pediatric groups. Gender effects were not observed in AVQI. CONCLUSION: This is the first study to report changes in AVQI across the lifespan in the Indian population. The present study adds on to the literature the reference measures of AVQI for the Indian population. Findings of the present study suggest that age can have an impact on AVQI v.02.02 values; even though it is independent of gender.

Detection of Helicobacter Pylori infection by invasive and non-invasive techniques in patients with gastrointestinal diseases from Iraq: A validation study.

There is still no agreement on the gold standard technique for diagnosing of H. Pylori in Iraq, as well as a paucity of data on the validity of different diagnostic techniques. This study aimed to investigate the prevalence of this bacterium with different methods and compare them to the quantitative polymerase chain reaction (qPCR) as a golden standard technique among Iraqi patients. In total, 115 Iraqi patients strongly suspected of H. pylori infection were enrolled in the current study. Invasive techniques including rapid urease testing (RUT) and gastric tissue culture in addition to non-invasive techniques including 14C-Urea breath test (14C-UBT), stool antigen test (SAT), CagA-IgG serology, and qPCR were performed to confirm the H. pylori infection. The qPCR was used as the gold standard to estimate the sensitivity, specificity, positive and negative predictive values for the studied diagnostic tests. Overall, the prevalence rate of H. pylori in Iraqi patients was ranged from 47.8 to 70.4% using different methods. The positive results for each test were as follows: qPCR 81, (70.4%) UBT 79 (68.7%), SAT 77 (67%), RUT 76 (66.1%), Cag-IgG 61 (53%), and culture 55 (47.8%). The 14C-UBT showed the highest overall performance with 97.5% sensitivity, 97% specificity, and total accuracy of 97.3% followed by SAT, RUT, Cag-IgG, and culture method. Based on the accuracy of the studied methods for H. pylori detection, they can be arranged in order as follows: qPCR > UBT > SAT > RUT> CagA IgG > culture. Since a universal gold standard assay for the diagnosis of H. pylori has not yet been established in Iraq, the UBT may be recommended as first choice due to its higher performance compared to other methods.

A Preliminary Exploration of Vocal Usage in Prospective Professional Voice Users (PPVUs): Students of the Alimah Course.

BACKGROUND: Students of the Alimah degree are Prospective Professional Voice Users whose career involves teaching, preaching, and conducting religious activities. For them, a cultured and efficient voice is an important prerequisite for a successful career. This study aimed to explore vocal usage and knowledge of voice care among students pursuing the Alimah course. OBJECTIVES: To check the period prevalence of voice problems among the students during the Alimah course, understand communication, and voice usage in daily situations, understand their lifestyle, assess their knowledge about voice and voice care through a self-reporting questionnaire. METHOD: The data were obtained from 150 undergraduate students pursuing the Alimah degree in and around Nagapattinam and Thanjavur districts of Tamil Nadu, India, through a self-reporting questionnaire. RESULTS: The students pursuing the course were at a high risk for developing voice problems, with a period prevalence of 70%. Excessive vocal load, inappropriate diet, phonotraumatic behaviours and limited knowledge of voice care were found to be the threats to voice problems among the population. CONCLUSION: This population with a high prevalence rate of voice problems should be studied further. The authors suggest including lessons on vocal enhancement methods and voice care in the course curriculum of the Alimah degree.

SEN virus genotype H distribution in ß-thalassemic patients and in healthy donors in Iraq: Molecular and physiological study.

The SEN virus (SENV) has been linked to transfusion-associated non-A-E hepatitis; however, information regarding SENV infections in patients with thalassemia, particularly in those with hepatitis virus co-infections, remains limited. This study investigated the frequency of SENV (genotypes D and H) infections in Iraqi patients with thalassemic patients infected and not infected with hepatitis C virus. The study involved 150 ß-thalassemia patients (75 with HCV infections and 75 without) and 75 healthy blood donors. Patient levels of vitamins C and E, liver function markers, and glutathione peroxidase (GPX) were determined. Recovered viral nucleic acids were amplified using the conventional polymerase chain reaction (SENV DNA) or the real-time polymerase chain reaction (HCV RNA) techniques. Only 10% of healthy donors had evidence of SENV infection. Among patients with thalassemia, 80% and 77% of patients with and without concurrent HCV infections, respectively, had SENV infections. DNA sequencing analyses were performed on blood samples obtained from 29 patients. Patients with thalassemia, particularly those with SENV infections, had higher levels of several enzymatic liver function markers and total serum bilirubin (P < 0.05) than did healthy blood donors. Among the examined liver function markers, only gamma-glutamyl transferase demonstrated significantly higher levels in HCV-negative patients infected with SENV-H than in those infected with SENV-D (P = 0.01). There were significantly lower vitamin C, vitamin E, and glutathione peroxidase levels in patients than in healthy donors (P < 0.05), but only glutathione peroxidase levels were significantly lower in HCV-negative thalassemia patients infected with SENV than in those without SENV infections (P = 0.04). The SENV-H genotype sequences were similar to the global standard genes in GenBank. These results broaden our understanding the nature of the SENV-H genotype and the differential role of SENV-H infections, compared to SENV-D infections, in patients with thalassemia, in Iraq.

Equation of State Effects in Core-Collapse Supernovae.

We investigate the impact of different properties of the nuclear equation of state in core-collapse supernovae, with a focus on the proto-neutron-star contraction and its impact on the shock evolution. To this end, we introduce a range of equations of state that vary the nucleon effective mass, incompressibility, symmetry energy, and nuclear saturation point. This allows us to point to the different effects in changing these properties from the Lattimer and Swesty to the Shen et al. equations of state, the two most commonly used equations of state in simulations. In particular, we trace the contraction behavior to the effective mass, which determines the thermal nucleonic contributions to the equation of state. Larger effective masses lead to lower pressures at nuclear densities and a lower thermal index. This results in a more rapid contraction of the proto-neutron star and consequently higher neutrino energies, which aids the shock evolution to a faster explosion.

Clinical characteristics of antidepressant use and related manic switch in bipolar disorder.

OBJECTIVE: To examine the association between clinical and treatment characteristics and antidepressants (AD)-induced manic switch in bipolar disorder (BD). METHODS: Total of 238 euthymic BD patients, who had been followed-up for at least 6 months at the outpatient clinic of Haseki Training and Research Hospital in istanbul, Turkey, were enrolled in this cross-sectional study in 2016. Semi-structured data form, the mood chart, and the mirror-designated assessment were applied to all subjects. The files of the patients were retrospectively reviewed and the patients using ADs were compared as AD-monotherapy (AD-m) and AD-combination (AD-c) groups, then divided into 2 subgroups according to the presence/absence of manic switch under AD treatment. RESULTS: Fifty eight (47.15%) patients out of 123 who received ADs at least once had experienced a manic switch under AD treatment. The rate of manic switch in AD-m patients was significantly higher than the AD-c group. Independent from being monotherapy or combined treatment, AD use longer than 12 months was negatively associated with the occurrence of manic switch. CONCLUSION: Our study suggests that the risk of manic switch is especially prominent in the first months of AD use. Antidepressants use in combining it with a mood stabilizers (MS) may not be adequate in preventing switches in shorter terms. However, in longer term uses addition of MS to ADs may decrease the risk of switches.

Dissociative features of fibromyalgia syndrome.

OBJECTIVE: To assess the relationships between the dissociative features of FMS and the pain, psychological status, and functional status. METHODS: Twenty-seven women with fibromyalgia syndrome (FMS) and 24 controls from the Istanbul Physical Medicine and Rehabilitation Hospital (2013-2015) were included in this cross-sectional study. The Diagnostic and Statistical Manual of Mental Disorders Structured Clinical Interview for Axis I Disorders was used to evaluate the participants. A visual analogous scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), Beck Depression Inventory (BDI), and Beck Anxiety Inventory (BAI) were used to assess the levels of pain, quality of sleep and functional and psychological statuses. The Dissociative Experiences Scale (DES) was used to evaluate the dissociative features. RESULTS: The BDI, BAI and DES scores were statistically significantly higher in the cases of FMS. There were remarkable associations between all but 2 of the DES and FIQ scores, while positive correlations were found between the DES and, VAS pain and sleep quality scores. The prevalences of current and lifelong dysthymia, and major depressive disorder; not otherwise specified, common anxiety and somatoform disorders were higher in the cases of FMS. CONCLUSION: Pain, physical function and emotional status appear to be associated with dissociative features in FMS. Further studies are required to define these relationships and improve treatment.

Dexmedetomidine as an additive to local anesthetics compared with intravenous dexmedetomidine in peribulbar block for cataract surgery.

BACKGROUND: No studies compared parenteral dexmedetomidine with its use as an adjuvant to ophthalmic block. We compared between adding dexmedetomidine to bupivacaine in peribulbar block and intravenous (IV) dexmedetomidine during peribulbar block for cataract surgery. MATERIALS AND METHODS: A prospective, randomized, double-blind study on 90 patients for cataract surgery under peribulbar anesthesia. Study included three groups; all patients received 10 ml of peribulbar anesthesia and IV infusion of drugs as follows: Group I: Received a mixture of bupivacaine 0.5% (4.5 ml) + lidocaine 2% (4.5 ml) + normal saline (1 ml) + 150 IU hyaluronidase + IV infusion of normal saline, Group II: Received mixture of bupivacaine 0.5% (4.5 ml) + lidocaine 2% (4.5 ml) + dexmedetomidine 50 µg (1 ml) +150 IU hyaluronidase + IV infusion of normal saline and Group III: Received mixture of bupivacaine 0.5% (4.5 ml) + lidocaine 2% (4.5 ml) + normal saline (1 ml) +150 IU hyaluronidase + IV dexmedetomidine 1 µg/kg over 10 min; followed by 0.4 µg/kg/h IV infusion. We recorded onset, duration of block, Ramsay Sedation Score, intra-ocular pressure (IOP), hemodynamics, and adverse effects. RESULTS: There was a significant decrease in the onset of action and increase in the duration of block in Group II as compared with the Group I and Group III. Mean Ramsay Sedation Score was higher in Group III. The IOP showed a significant decrease in Group II and Group III 10 min after injection (P < 0.01). Heart rate showed a significant decrease in Group III in comparison with the two other groups (P < 0.05). Only two patients in Group III developed bradycardia. CONCLUSION: Dexmedetomidine as an additive shortens onset time, prolong block durations and significantly decreases the IOP with minimal side effects. IV dexmedetomidine, in addition, produces intra-operative sedation with hemodynamic stability.

Experience of initiating collaboration of traditional healers in managing HIV and AIDS in Tanzania.

Collaboration between traditional healers and biomedical practitioners is now being accepted by many African countries south of the Sahara because of the increasing problem of HIV/AIDS. The key problem, however, is how to initiate collaboration between two health systems which differ in theory of disease causation and management. This paper presents findings on experience learned by initiation of collaboration between traditional healers and the Institute of Traditional Medicine in Arusha and Dar-es-Salaam Municipalities, Tanzania where 132 and 60 traditional healers respectively were interviewed. Of these 110 traditional healers claimed to be treating HIV/AIDS. The objective of the study was to initiate sustainable collaboration with traditional healers in managing HIV/AIDS. Consultative meetings with leaders of traditional healers' associations and government officials were held, followed by surveys at respective traditional healers' "vilinge" (traditional clinics). The findings were analysed using both qualitative and quantitative methods. The findings showed that influential people and leaders of traditional healers' association appeared to be gatekeepers to access potential good healers in the two study areas. After consultative meetings these leaders showed to be willing to collaborate; and opened doors to other traditional healers, who too were willing to collaborate with the Institute of Traditional Medicine in managing HIV/AIDS patients. Seventy five percent of traditional healers who claimed to be treating HIV/AIDS knew some HIV/AIDS symptoms; and some traditional healers attempted to manage these symptoms. Even though, they were willing to collaborate with the Institute of Traditional Medicine there were nevertheless some reservations based on questions surrounding sharing from collaboration. The reality of past experiences of mistreatment of traditional healers in the colonial period informed these reservations. General findings suggest that initiating collaboration is not as easy as it appears to be from the literature, if it is to be meaningful; and thus we are calling for appropriate strategies to access potential healers targeted for any study designed with sustainability in mind.