Anatomical landmarks for localisation of the anterior ethmoidal artery: a combined radiological and cadaveric (endoscopic) study.

PURPOSE: The anterior ethmoidal artery is a major surgical landmark that is susceptible to iatrogenic injury during surgery of the anterior ethmoidal sinus, frontal sinus, and skull base. The present study aimed to define the location of the anterior ethmoidal artery in relation to specific anatomical landmarks using radiological imaging and endoscopic dissection. METHODS: Eighty-six anterior ethmoidal arteries were assessed using computed tomography scans (bilateral analyses) and forty anterior ethmoidal arteries were assessed using cadaveric specimens (bilateral analyses). The skull base, anterior nasal spine, anterior axilla of the middle turbinate, and nasal axilla were morphometrically analysed to determine their reliability as anterior ethmoidal artery landmarks. RESULTS: Distances to the skull base, anterior nasal spine, and nasal axilla displayed statistically significant differences between sexes and sides (p < 0.05). All landmarks demonstrated excellent reliability as anatomical landmarks for the localisation of the anterior ethmoidal artery, radiologically and endoscopically (ICC values ranged from 0.94 to 0.99). CONCLUSION: The middle turbinate axilla was the most reliable landmark, due to the lack of statistically significant differences according to sex and laterality, and the high inter-rater agreement between measurements. Anatomical knowledge of variations and relationships observed in the present study can be applied to surgeries of the anterior ethmoidal sinus, frontal sinus, and skull base to improve localisation of the anterior ethmoidal artery, preoperatively and intraoperatively, and avoid iatrogenic injury of the vessel.

Human growth hormone, a marker for HIV infection among adult Igbo Nigerians: relationship between human growth hormone and CD4+ count with viral load.

Routine viral load and CD4+ testing is key to monitoring the extent of danger caused by HIV and response to antiretroviral therapy (ART) for HIV individuals, but its availability has been limited in low and middle-income countries. The study sort to ascertain relationship between serum Human Growth Hormone (HGH) gold standard with CD4 cells and viral load in HIV-infected patients. CD4+ T-cells, HIV viral load, and HGH were assayed in HIV- infected patients from May to December 2020. 460 subjects were engaged and separated into two groups: the HIV-infected untreated (Pre-ART) and the control groups. An interventional study was conducted for the Pre-Art group after six months. Serum HGH was assayed by the ELISA method, CD4 cell count was examined by BD-FACScan flow cytometer, and HIV viral load was assessed using RT-PCR. The CD4 count and serum HGH of Pre-ART HIV-infected subjects were significantly low (p<0.05), while the viral load was significantly high compared to those treated with ART for 6months (p<0.05). CD4 count and serum HGH were significantly higher (p<0.05) in females than in males. It also reveals that CD4 count correlates positively with HGH level (r= 0.191**). Serum HGH could serve as a surrogate marker and valuable index in monitoring HIV patients.

Studies on testicular ultrastructural and hormonal changes in type-2 diabetic rats treated with highly active antiretroviral therapy conjugated silver nanoparticles.

AIM: This study investigated the impact of highly active antiretroviral therapy (HAART) loaded silver nanoparticles (AgNPs) as HAART-AgNPs on the sperm count, viability, serum hormonal profile, insulin-like growth factor I (IGF-1), and testicular ultrastructure. METHODS: Thirty-six adult male Sprague-Dawley rats were allocated into diabetic and non-diabetic groups (n = 18). The rats in the diabetic group were induced experimental type 2 diabetes using fructose and streptozotocin (frt-STZ). Animals in both groups were subdivided into three groups each, A-C and DF (n = 6), and received distilled water, HAART, and HAART-AgNP, respectively. FINDINGS: Treatment with HAART-AgNP displayed a significant increase (p < 0.05) in serum gonadotropin-releasing hormone (GnRH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testicular IGF-1 in diabetic rats. Also, electron microscopy revealed ameliorated testicular ultrastructure upon administration of HAART-AgNP in diabetic rats that were previously marked with architectural and cellular alterations. In addition, treatment with HAART-AgNP significantly reduced (p < 0.05) the blood glucose levels of diabetic rats. In contrast, the treatment of non-diabetic rats with HAART caused a significant decrease (p < 0.05) in the sperm count, serum GnRH, and testicular IGF-1, however, this treatment induced ultrastructural changes and a significant increase (p < 0.05) in serum testosterone levels in diabetic and non-diabetic rats. SIGNIFICANCE: This study has demonstrated the beneficial impact of HAART-AgNP on the hypothalamic-pituitary-gonadal axis, IGF-1, and testicular architecture in male frt-STZ induced diabetic rats. This nanoconjugate could be a potential nano-drug candidate to cater for testicular dysfunction and metabolic derangements while managing HIV-infected male individuals.