Regional Myopericarditis Mimicking Inferior Myocardial Infarction Following COVID-19 Vaccination: A Rare Adverse Event.

We present the case of a 41-year-old man who developed myopericarditis after receiving the Pfizer COVID-19 vaccine. The patient experienced a sudden onset of chest and abdominal pain 16 days after vaccination. Electrocardiogram findings revealed deep T-wave inversion and minimal ST-segment elevation. Further investigation through coronary artery angiography and computed tomography identified an anomalous left main coronary artery. Magnetic resonance imaging confirmed the diagnosis of myopericarditis. This case highlights the importance of considering myopericarditis as a potential cause of chest pain and elevated cardiac biomarkers following COVID-19 vaccination, particularly in young individuals. Clinicians should be aware of this adverse event and include it in the differential diagnosis for patients presenting with similar symptoms after vaccination.

Population genetic structure of Neoschongastia gallinarum in South China based on mitochondrial DNA markers.

The genetic diversity and differentiation of four geographic populations of Neoschongastia gallinarum were evaluated using concatenated mitochondrial gene sequences (pCOI, pCOII, and pND5). Based on the results, the N. gallinarum populations had high genetic diversity and strong ecological adaptability. Genetic differentiation among paired populations calculated using concatenated mitochondrial gene sequences revealed that geographic isolation resulted in genetic differentiation among the populations of N. gallinarum, and gene flow between populations associated with human trade activities. Systematic development and molecular variance based on haplotypes revealed that genetic variation existed in different haplotypes; however, no clear rule related to geographic region was found. Further, genetic variation was mainly derived from individuals within the population. A neutral test based on concatenated mitochondrial gene sequences and nucleotide pair differences revealed that N. gallinarum did not experience an obvious population expansion in recent historical periods. Accordingly, the population size was relatively stable.

Development and validation of spectrophotometric methods for estimation of antimigraine drug eletriptan hydrobromide in pure form and pharmaceutical formulations.

OBJECTIVES: The present study aims to develop and validate four simple, sensitive, reproducible, and low-cost spectrophotometric methods for the determination of antimigraine drug (eletriptan hydrobromide) in pure form and pharmaceutical formulations. METHODS: The methods are based on the formation of yellow colored ion-pair complex between eletriptan hydrobromide and four acid dyes, namely, bromocresol purple (BCP), bromocresol green (BCG), bromophenol blue (BPB), and bromothymol blue (BTB) with absorption maxima at 410, 420, 414 and 416nm, respectively. Several parameters such as pH, buffer type and volume, reagent volume, sequence of addition and effect of extracting solvent were optimized. RESULTS: Under the optimum experimental conditions, beer's law is obeyed over the concentration ranges of 1.0-20 and 1.0-16µgmL-1 for (BCP or BCG) and (BPB or BTB), respectively with good correlation coefficients (0.9995-0.9999). The apparent molar absorptivity and Sandell's sensitivity values are reported for all methods. The limit of detection (LOD) and the limit of quantification (LOQ) values are found to be 0.27, 0.28, 0.25, and 0.30µgmL-1 and 0.90, 0.93, 0.83, and 1.0µgmL-1 for BCP, BCG, BPB and BTB, respectively. The stoichiometric ratio of the formed ion-pair complexes was found to be 1:1 (drug: reagent) for all methods. CONCLUSION: The developed methods were successfully applied for the determination of eletriptan hydrobromide in pharmaceutical formulations with good accuracy and precision. Statistical comparison of the results was performed using Student's t-test and variance ratio F-test at the 95% confidence level and there was no significant difference between the reported and proposed methods regarding accuracy and precision. Further, the validity of the proposed methods was confirmed by recovery studies via standard addition method.

Designing an Outer Membrane Protein (Omp-W) Based Vaccine for Immunization against Vibrio and Salmonella: An in silico Approach.

BACKGROUND: Cholera triggered by Vibrio cholerae remains the main reason for morbidity and mortality all over the world. In addition, salmonellosis is regarded as an infectious disease that makes it essential for the identification and detection of Salmonella. With a beta-barrel structure consisting of eight non-parallel beta strands, OmpW family is widely distributed among gram-negative bacteria. Moreover, OmpW isolated from S. typhimurium and Vibrio cholerae can be used in vaccine design. METHODS: Topology prediction was determined. T-cell and B-cell epitopes were selected from exposed areas, and sequence conservancy was evaluated. The remaining loops and inaccessible residues were removed to prepare OmpW-1. High antigenicity peptides were detected to replace inappropriate residues to obtain OmpW-2. Physicochemical properties were assessed, and antigenicity, hydrophobicity, flexibility, and accessibility were compared to the native Omp-W structure. Low score areas were removed from the designed structure for preparing the OmpW-3. To construct OmpW-4, TTFrC was used as T-CD4+ cell-stimulating factor and CTB as adjuvant to the end of the C-terminal of this sequence, which can increase the antigenicity and sequence density. The sequences were re-analyzed to delete the unfavorable residues. Besides, the solubility of the mature OmpW and the designed structure were predicted while overexpressed in E. coli. RESULTS: The designed vaccine is a stable protein that has immune cells recognizing epitopes and is considered as an antigen. The construct can be overexpressed in an E. coli. CONCLUSION: The multi-epitope vaccine is a suitable stimulator for the immune system and would be a candidate for experimental research. Recent patents describe numerous inventions related to the clinical facets of vaccine peptide against human infectious disease.

Ovariectomy does not exacerbate the negative effects of sleep deprivation on synaptic plasticity in rats.

In our previous work, we found that female rats showed more cognitive impairment than male rats following 72h sleep deprivation (SD). Here, we compared the intact female with ovariectomized (OVX) rats to assess the potential modulatory effects of endogenous female sex hormones against the 48h SD-induced cognitive and synaptic modulations. The multiple platform method was applied for SD induction and spatial performances were determined using Morris water maze (MWM) task. Early longterm potentiation (E-LTP) was evaluated in area CA1 of the hippocampus and PCR and western blotting assays were employed to assess hippocampal BDNF gene and protein expression. To reveal any influence of sleep loss on stress level, we also measured the plasma corticosterone levels of animals. Regardless of reproductive status, SD significantly impaired short-term memory and LTP, but did not significantly change the BDNF expression in the hippocampus. The corticosterone levels were decreased in both intact and OVX female rats following SD. These findings suggest that depletion of female sex steroid hormones does not lead to any heightened responsivity of female animals to the negative effects of SD on cognitive and synaptic functions.

Impact of BMI on Locoregional Control among Saudi Patients with Breast Cancer after Breast Conserving Surgery and Modified Radical Mastectomy.

UNLABELLED: Obesity and increased body mass index (BMI) are increasing among Saudi women across all age groups with an overall prevalence of 44%. Increased BMI is associated with advanced stage breast cancer and dismal survival; however impact of BMI on locoregional control (LRC) is less studied. We aimed to evaluate the impact of BMI on LRC in Saudi patients with breast cancer after breast conserving surgery (BCS) and modified radical mastectomy (MRM). MATERIALS AND METHODS: Between February 1988 and August 2008, 112 patients with breast cancer were treated with BCS and MRM followed by adjuvant chemotherapy and radiotherapy. Median age was 47.01 years (23-76). Mean BMI was 38.1 kg/m2 (15.7-52.8); BMI < 18.5 kg/m2 (underweight) in 1 (0.9%), BMI 18.5-25 kg/m2 (normal weight) in 19 (16.9%), BMI 26-30 kg/ m2 (overweight) in 32 (28.6%), BMI 31-40 kg/m2 (obese) in 48 (42.9%) and BMI > 40 kg/m2 (morbid obese) in 12 (10.7%). Median follow up period was 9 years (5-17). Cox proportional hazard analysis was done using SPSS 19.0. RESULTS: A total of ten locoregional recurrences (8.93%) were seen. The 5 and 10 years LRC were 86.4% and 86.4% respectively. Multivariate analysis showed poor LRC in BMI < 18.5 kg/m2 (HR: 4.2; 95% CI.3.8-3.6, p 0.001) and 26-30 kg/m2 (HR: 3.4; 95% CI.3.0-3.8, p 0.01). Others factors associated with poor LRC were: age less than 40 years, premenopausal status, and no adjuvant radiotherapy, and T4, N2 and N3 stages. CONCLUSION: Underweight patients with breast cancer are more prone for locoregional recurrences as compared to obese and morbid obese patients.

Five years treatment outcomes of postoperative radiotherapy in saudi women with uterine cancers: single institutional experience.

UNLABELLED: We aimed to evaluate long-term treatment outcomes and toxicity profile of postoperative radiotherapy (PORT) in Saudi women with uterine cancers. METHODS AND MATERIALS: Medical records of patients with histopathologically proven uterine cancers were reviewed and identified those who received PORT (45-50.4 Gy in 25-28 fractions) followed by vaginal brachytherapy (15-20 Gy in 3 to 4 sessions) after total abdominal hystrectomy and bilateral salpingo-oophorectomy (TAHBSO) in our center between August 2007 and April 2012. Data regarding the safety profile, locoregional control (LRC) or distant metastases control (DMC) and overall survival (OS) rates were analyzed. RESULTS: Median follow-up period was 60 months (range, 12-70) for 89 patients. Predominant histological type was endometrial (59 patients), followed by carcinosarcoma (17 patients) and leiomyosarcoma (13 patients). Median age at time of diagnosis was 57.6, 56 and 51.1 years for endometrial, carcinosarcoma and leiomyosarcoma respectively. LRC rates were 80.9%, 87.1% and 100% for leiomyosarcoma, carcinosarcoma and endometrial carcinoma respectively (p 0.4). DMC rates were 69.3%, 45% and 16.3% for endometrial, leiomyosarcoma and carcinosarcoma respectively (p 0.0001). Five-year OS rates were 71.1%, 60% and 16.3% for endometrial, leiomyosarcoma and carcinosarcoma respectively (p 0.001). Coxproportional hazard ratio model showed body mass index, FIGO stage, lymphovascular invasion in endometrial carcinoma, tumor size in leiomyosarcoma and histology in carcinosarcoma important prognostic factors for LRC. Acute grade 3 and 4 proctitis/enteritis seen only in 4 patients (4.5%) and late toxicities were minimal. CONCLUSION: PORT in Saudi women with uterine cancers showed better LRC, DMC and OS rates with minimal toxicity.

Patterns of meningococcal infection in Sudan with emergence of Neisseria meningitidis serogroup W135.

This study was conducted during the 2004-2006 epidemic of meningitis in Sudan to follow-up the frequency of disease outbreak or endemic waves and to evaluate the new quadrivalent vaccine for actual application. Samples were collected from Darfur, El Gedaref, Kassala and Khartoum States and transported to the National Health Central Laboratory in Khartoum. Of 196 patients with clinical symptoms and signs of meningitis, conventional culture identified Neisseria meningitidis in 37 (189%), confirmed by polymerase chain reaction. N. meningitidis type A was identified in 29 (78.4%) patients, type C in 3 (8.1%) and N. meningitidis W135 in 5 (15.5%). The serotyping and molecular diagnosis patterns of N. meningitidis showed the emergence of the new strain, W135, in 5 (15.5%). The patients from the borders of Sudan, 3 from the West Darfur, and 1 each from El Gedaref and Kassala. These could be related to the movement of pilgrims through the borders to Saudi Arabia in the Hajj season. Serious consideration may be needed for quadrivalent vaccination to prevent seasonal and Hajj season outbreaks.

Kinetic study of fission product activity released inside containment under loss of coolant transients in a typical MTR system.

Based on continuous release of fission product (FP) activity from fuel to the coolant and then to the containment, a kinetic model is developed for source term after a LOCA in a typical MTR type system. The time dependent source, re-suspension rate, decay of fission products, leakage, deposition on surfaces, and re-circulation of air through filters are employed with a partial prompt source plus a time varying source. Releases of different FP activities are simulated for various release rates.

Obstructed labor in a teaching hospital in Sudan.

OBJECTIVE: This study was aimed to deal with a serious obstetrical problem in Wad Medani Teaching Hospital, Medani, Sudan. The study reviewed the incidence of obstructed labor, its clinical presentation and methods of diagnosis. The study also includes the methods of treatment and its complications. METHODS: A prospective and descriptive study was carried out in Wad Medani Teaching Hospital, Medani, Sudan. Case notes were studied for all cases with obstructed labor received during the period 1 January 1997 to 31 December 1999. The data was analyzed. The literature was reviewed for similar studies. RESULTS: During the period 207 cases of obstructed labor were diagnosed. The total number of deliveries during the same period was 16221, giving an incidence of 1.27%. The most striking symptoms are tachycardia and low blood pressure, while the common sign is the non-engagement of the presenting part. The most common complication is septicemia. CONCLUSION: Obstructed labor remains a major obstetrical problem. Adequate antenatal care and proper care at delivery could prevent it. The obstructed labor should always be anticipated and the attendant should not wait for the advanced classical signs to make the diagnosis. Early intervention is associated with an excellent outcome.

Clinical presentation and CAT scan findings in mycetoma of the head.

Nine cases comprising seven males and two females with mycetoma of the cranium were studied between January 1990 and June 1997. Streptomyces somaliensis was the most common causative organism. The source of the infection was thought to be known in only three cases. The common mode of presentation was headache and scalp swelling. The next common presentation was epilepsy. Other focal neurological disorders also occur. CT scan findings of the cranium showed osteosclerotic rather than osteolytic changes.

Prevalence and infection pattern of Trypanosoma evansi in camels in mid-eastern Sudan.

The antigen detection enzyme immunoassay (AgELISA) in conjunction with parasitological examination of blood were used to study the enzootic situation of cameline trypanosomiasis in mid-Eastern Sudan. A one year survey showed that the infection is endemic among pastoral camels with a prevalence of 5.4% based on parasitological examination and 31.3% based on AgELISA. The infection rate was higher during the dry period (November to May) than the wet season. Young camels had a much lower infection rate as detected by parasitological techniques, but not with AgELISA. A lower prevalence of infection was detected by buffy coat technique (BCT) in herds of camels raised by nomads compared with those kept by agropastoralists and in camels located in the southern districts of mid-Eastern Sudan.

Nephrotic syndrome and pulmonary artery thrombosis.

Nephrotic syndrome is associated with various thromboembolic phenomena. Thrombosis in both the arterial and venous sides of circulation has been reported. We report a case of a 42-year-old man who suffered a right lower lobe pulmonary artery thrombus followed by thrombosis of the middle cerebral artery.

Detection of mycobacterial antigens in sputum by an enzyme immunoassay.

An enzyme immunoassay (EIA) for the detection of mycobacterial antigens in sputum was evaluated. The system utilises commercially available anti-BCG immunoglobulin. BCG protein standard was used as positive control. Thirty-nine patients with culture-proven pulmonary tuberculosis were tested. The EIA was positive in 24 of 29 patients with positive smears and cultures, giving a sensitivity of 86.2%. It was also positive in six of ten patients with smear-negative culture-positive disease, resulting in a sensitivity of 60% in this group. In another 176 patients with different nontuberculous pulmonary infections, only nine were positive by EIA, giving a specificity of 94.9%. The high sensitivity and specificity of the assay make it a useful tool for the early diagnosis of pulmonary tuberculosis.

Failure of ciprofloxacin to eradicate brucellosis in experimental animals.

Ciprofloxacin is a quinolone that penetrates well intracellularly. It was shown to be active against Brucella melitensis in vitro. In this study, ciprofloxacin and tetracycline were used to treat B. melitensis and B. abortus infections in mice. The drugs were given for 7, 14, 21 and 28 days. Tetracycline reduced spleen and liver weight and splenic bacterial counts and eliminated the infection in 70% of mice treated for 3 or 4 weeks. Ciprofloxacin, on the other hand, did not affect liver or spleen weight or bacterial counts after 3-4 weeks of therapy. It failed to eradicate the organism from any of the mice treated. It is concluded that ciprofloxacin is probably not suitable for the treatment of brucellosis.

Nosocomial bacteraemia in a teaching hospital in Saudi Arabia.

During a period of one year, 117 episodes of nosocomial bacteraemia were documented at King Khalid University Hospital, an incidence of 5 per 1000 admissions. Sixty-two percent were gram-negative organisms with Escherichia coli, Klebsiella spp., Serratia spp. and Pseudomonas spp. being the most frequent. Staphylococcus aureus was the most common gram-positive organism isolated. The source of infection was identified in 75% of patients. Intravenous lines accounted for a high proportion of cases (22%). Most deaths occurred in infants and patients with serious underlying disease.