Morphological and Morphometric Analysis, Apoptosis and Oxidative Stress Study in Hep 2 Cells Treated by Resveratrol or Quercetine / Análisis Morfológico y Morfométrico, Estudio de Apoptosis y Estrés Oxidativo en Células Hep 2 Tratadas con Resveratrol o Quercetina

SUMMARY: Resveratrol (RES) and quercetine (QRC), is a promising agent relevant for both cancer chemoprevention and treatment via several signaling pathways, involved in their anticancer activity related to its chemotherapeutic potential, associated with the induction of ROS generation in cancer cells, leading to apoptosis. In our study, we have summarized the mechanisms of action of RES and QRC, and their pharmacological implications and potential therapeutic applications in cancer therapy. After treatment of Hep 2 cells with QRC or RES, the death pathways such as the cytochrome c release, ERK1/2 and IRS-1 pathways were upregulated, while cell survival pathway, including PI3K/AKT were downregulated. The RES and QRC caused oncosis, cells hypertrophy, hypercondensatin of chromatin, rupture of the plasma membrane and nuclear membrane, and formation of apoptotic bodies. Morphometric measurements of some cellular and nuclear parameters showed that RES and QRC induced an increase in cells and nuclear size, the nucleocytoplasmic ratio remained below 1 (N-Cyt R < 1), sign of low nuclear activity. The RES and QRC induced apoptosis of Hep2 cells by increasing of oxidative stress markers, MDA, and by modulating detoxifying enzymes, CAT and SOD. Our study results prove antiproliferative and proapoptotic properties of quercetin and resveratrol with regard to larynx cancer.

Resveratrol (RES) y quercetina (QRC), es un agente prometedor y relevante tanto para la quimioprevención como para el tratamiento del cáncer a través de varias vías de señalización, involucrado en su actividad anticancerígena relacionada con su potencial quimioterapéutico, asociado con la inducción de la generación de especies reactivas del oxígeno (ROS) en células cancerosas, lo que lleva a apoptosis. En nuestro estudio, hemos resumido los mecanismos de acción de RES y QRC, y sus implicaciones farmacológicas y posibles aplicaciones terapéuticas en la terapia del cáncer. Después del tratamiento de las células Hep 2 con QRC o RES, las vías de muerte, tal como la liberación de citocromo c, las vías ERK1/2 e IRS-1, se regulaban positivamente, mientras que la vía de supervivencia celular, incluida PI3K/AKT, se regulaba negativamente. El RES y el QRC provocaron oncosis, hipertrofia celular, hipercondensación de la cromatina, rotura de la membrana plasmática y nuclear y formación de cuerpos apoptóticos. Las mediciones morfométricas de algunos parámetros celulares y nucleares mostraron que RES y QRC indujeron un aumento en las células y el tamaño nuclear, la proporción nucleocitoplasmática se mantuvo por debajo de 1 (N- Cyt R <1), signo de baja actividad nuclear. RES y QRC indujeron la apoptosis de las células Hep2 aumentando los marcadores de estrés oxidativo, MDA, y modulando las enzimas desintoxicantes, CAT y SOD. Los resultados de nuestro estudio demuestran las propiedades antiproliferativas y proapoptóticas de la quercetina y el resveratrol con respecto al cáncer de laringe.

Community-acquired neonatal SARS-CoV-2 infection: case report / Infecção neonatal por SARS-CoV-2 adquirida na comunidade: relato de caso / Infección neonatal por SARS-CoV-2 adquirida en la comunidad: reporte de caso

Background and Objectives: Data collection on the incidence of COVID-19 is conducted less frequently in newborns (NB) than in adults. In view of the small number of described neonatal SARS-CoV-2 infections, in this study, we report a clinical case of community-acquired COVID-19 infection in a newborn. Methods: Clinical characteristics were collected from the medical records from April 2021 until the final outcome of the newborn in May 2021. Results: This article discusses the case of a full-term male newborn aged 38 weeks. On the 17th day of life, this newborn was admitted to the pediatric unit with fever and zone 4 jaundice, mild lower chest retraction and tachypnea. The mother was diagnosed with COVID-19. Late neonatal sepsis with pulmonary focus was detected. The newborn was hospitalized and the antigen test for COVID-19 came back positive. The condition of the neonate rapidly deteriorated and he was referred to the neonatal intensive care unit (NICU), where he was intubated and placed on pressure-controlled mechanical ventilation. During his second week in the NICU, he developed severe pulmonary hypertension with decreased peripheral oxygen saturation and tachycardia. The newborn required blood transfusion and was put into prone position during part of the treatment. Reductions in mechanical ventilation parameters were not tolerated by the NB's organism and he developed progressive hypoxemia. The newborn died 1 month and 3 days after hospitalization. Conclusion: Our study shows a case of community-acquired COVID-19 that progressed to the severe form of the disease.(AU)

Justificativa e Objetivos: A coleta de dados sobre a ocorrência de covid-19 em recém-nascidos (RN) não é tão frequente quanto em adultos. Portanto, devido ao baixo número de infecções neonatais por SARS-CoV-2 descritas, relatamos, neste estudo, um caso clínico de infecção por covid-19 adquirida na comunidade em um recém-nascido. Métodos: As características clínicas foram coletadas dos prontuários desde abril de 2021 até o último desfecho do RN, em maio de 2021. Resultados: Este artigo abordará um RN do sexo masculino, a termo, com 38 semanas. No 17º dia de vida, o RN deu entrada na unidade pediátrica com quadro de febre e icterícia zona 4, leve retração torácica inferior e taquipneia. A mãe foi diagnosticada com covid-19. Foi detectada sepse neonatal tardia com foco pulmonar. O RN foi internado e o teste de antígeno para covid-19 foi positivo. O quadro do RN regrediu rapidamente, sendo encaminhado à unidade de terapia intensiva neonatal (UTIN), onde foi entubado e adaptado à ventilação mecânica em modo pressão controlada. Na segunda semana de internação na UTIN, desenvolveu hipertensão pulmonar grave com diminuição da saturação periférica de oxigênio e taquicardia. O RN necessitou de transfusão sanguínea e a posição prona foi realizada por períodos. Reduções nos parâmetros do ventilador mecânico não foram toleradas e o RN apresentou hipoxemia progressiva. O RN faleceu um mês e três dias após a internação. Conclusão: Nossos achados apresentam um caso de covid-19 adquirida na comunidade que evoluiu para a forma grave da doença.(AU)

Justificación y Objetivos: La recolección de datos sobre los contagios por covid-19 en recién nacidos (RN) no es tan frecuente como en adultos. En este contexto, y debido al bajo número de infecciones neonatales por SARSCoV-2 descritas, en este estudio se describe un caso clínico de infección posnatal por covid-19 en un recién nacido en la comunidad. Métodos: Se recogieron características médicas de las historias clínicas desde abril de 2021 hasta el último resultado del RN en mayo de 2021. Resultados: Este artículo reporta el caso de un RN del sexo masculino, a término de 38 semanas. Al 17.º día de vida, el RN ingresó a la unidad de pediatría con fiebre e ictericia zona 4, leve retracción torácica inferior y taquipnea. La madre dio positivo para covid-19. En el RN se detectó sepsis neonatal tardía con foco pulmonar. Lo hospitalizaron, y la prueba de antígenos para covid-19 dio como resultado positivo. El estado del RN empeoró rápidamente, lo remitieron a la unidad de cuidados intensivos neonatales (UCIN), donde requirió intubación y ventilación mecánica controlada por presión. En la segunda semana en la UCIN, desarrolló hipertensión pulmonar grave con disminución de la saturación periférica de oxígeno y taquicardia. El RN requirió transfusión sanguínea, y lo pusieron en posición prona por períodos. El paciente no soportó las reducciones en los parámetros del ventilador mecánico y presentó una hipoxemia progresiva. El RN falleció un mes y tres días después de la hospitalización. Conclusión: Los hallazgos muestran un caso del covid-19 adquirido en la comunidad que progresó a la forma grave de la enfermedad.(AU)

Impact of Pandemic COVID-19 towards Food Insecurity and Dietary Diversity Among B40 Mothers Living in Urban Areas in Selangor

@#Introduction: Food security and dietary diversity are critical in ensuring the nutritional and dietary adequacy of mothers. However, since the COVID-19 outbreak, it has become more challenging for mothers to maintain a healthy and varied diet, as more households are reported to be food insecure. Thus, this study aimed to assess food insecurity and its determinants, as well as to determine how it relates to dietary diversity. Methods: A cross-sectional study comprising 200 of B40 mothers with children under the age of two who resided in metropolitan regions of Selangor was conducted. Household Food Insecurity Access Scale (HFIAS) and Minimum Dietary Diversity for Women (MDDW) questionnaires were used to measure food insecurity and dietary diversity, respectively. Results: About 67% of mothers experienced food insecurity and 29.5% experienced dietary monotony. Less than 12 years of education (AOR=4.89, 95% CI=1.87-12.83) and living in a family with six or more people (AOR=3.48, 95% CI=1.20-11.20) were significantly associated with food insecurity. Besides, mothers with a monotonous diet were eight times more likely to be food insecure (AOR=8.03, 95% CI=2.67-24.05). Higher odds of dietary monotony were associated with less than 12 years of education (AOR=2.46, 95% CI=1.13-5.35) and household income contributor of not more than one person (AOR=3.78, 95% CI=1.66-8.60). Conclusion: Food insecurity was associated with an increased chance of dietary monotony among low-socioeconomic women residing in urban community. Therefore, identifying and addressing issues related to poor dietary diversity may allow for preventive and proactive measures to improve their nutritional status and well-being.

Phylogenetic status and diet of red fox (Vulpes vulpes griffithii) inhabiting Ayubia National Park, Pakistan

Abstract The red fox (Vulpes vulpes) is a medium-sized carnivore that occurs in different regions of Pakistan, however, still lacks scientific data on its ecology and distribution. The current study investigated the phylogenetic status and diet of the red fox (V.v. griffithii) occurring in Ayubia National Park, Pakistan. Through camera trapping and molecular analysis, we confirmed the occurrence of red fox in the study area. Based on mitochondrial cytochrome B (304 bp) and limited sampling, nearly all red foxes of Ayubia National Park and surrounding Himalayan ranges fall within Holarctic maternal lineage, whereas red foxes found in plains of Pakistan are part of the basal Palearctic maternal lineage. Using 32 scats, we found that red fox diet comprises of 80% animal-based prey species (both wild and domestic) and 19% plant matter. The wild animal prey species included Cape hare (Lepus capensis) and flying squirrel (Pteromyini sp.), which constituted 17% and 15% of diet, respectively. Red foxes infrequently consumed House mouse (Mus musculus), Himalayan Palm civet (Paguma larvata) and sheep (Ovis aries), each comprising around 6% to 9% of red fox diet. The fox species also scavenged on domestic donkey opportunistically. Based on our sampling, our study suggests that the red fox (V.v. griffithii) that occurs in Ayubia National Park and across the lesser Himalayan ranges belongs to Holarctic maternal lineage. The study also highlights consumption of plant seeds by red foxes, indicating it may play an important ecological role in seed dispersal in Ayubia National Park.

Resumo A raposa-vermelha (Vulpes vulpes) é um carnívoro de médio porte que ocorre em diferentes regiões do Paquistão, porém ainda carece de dados científicos sobre sua ecologia e distribuição. O presente estudo investigou o status filogenético e a dieta da raposa-vermelha (V.v. griffithii) que ocorre no Parque Nacional de Ayubia, Paquistão. Por meio de armadilhas fotográficas e análises moleculares, confirmamos a ocorrência de raposa-vermelha na área de estudo. Com base no citocromo B mitocondrial (304 bp) e amostragem limitada, quase todas as raposas-vermelhas do Parque Nacional de Ayubia e áreas circundantes do Himalaia se enquadram na linhagem materna holártica, enquanto as raposas-vermelhas encontradas nas planícies do Paquistão fazem parte da linhagem materna basal paleártica. Usando 32 fezes, descobrimos que a dieta da raposa-vermelha compreende 80% de espécies de presas de origem animal (selvagens e domésticas) e 19% de matéria vegetal. As espécies de presas de animais selvagens incluíram a lebre-do-cabo (Lepus capensis) e o esquilo-voador (Pteromyini sp.), que constituíram 17% e 15% da dieta, respectivamente. As raposas-vermelhas consumiam raramente ratos domésticos (Mus musculus), algas do Himalaia (Paguma larvata) e ovelhas (Ovis aries), cada um compreendendo cerca de 6% a 9% da dieta da raposa-vermelha. A espécie de raposa também se alimentava de burros domésticos de forma oportunista. Com base em nossa amostragem, nosso estudo sugere que a raposa-vermelha (V.v. griffithii) que ocorre no Parque Nacional de Ayubia e nas cordilheiras menores do Himalaia pertence à linhagem materna holártica. O estudo também destaca o consumo de sementes de plantas por raposas-vermelhas, indicando que pode desempenhar um papel ecológico importante na dispersão de sementes no Parque Nacional de Ayubia.

Incidencia del espectro de acretismo placentario en la unidad de cuidados intensivos obstétricos del Hospital de la Mujer de Sinaloa / Incidence of the placental accretism spectrum in the obstetric intensive care unit of the Hospital de la Mujer of Sinaloa

Resumen OBJETIVO: Determinar la incidencia del espectro del acretismo placentario en pacientes ingresadas a la unidad de cuidados intensivos obstétricos del Hospital de la Mujer, Culiacán, Sinaloa. MATERIALES Y MÉTODOS: Estudio retrospectivo, transversal y descriptivo fundamentado en el análisis de la base de datos del Hospital de la Mujer de pacientes internadas entre los años 2017 a 2020 con diagnóstico de espectro de placenta acreta, referidas o diagnosticadas en la institución e intervenidas para histerectomía por la complicación estudiada. RESULTADOS: Se analizaron 22 pacientes con diagnóstico de acretismo placentario que dieron una incidencia de 0.09%; de éstas, a 1 se le indicó cesárea; 19 de las 22 pacientes tenían antecedente de cicatriz uterina previa, todas con placenta previa. El promedio de edad fue de 30.86 ± 4 años. La cesárea se practicó, en promedio, a las 34 semanas de embarazo con dos técnicas quirúrgicas. El sangrado promedio estimado fue de 1.947 mL. Las complicaciones transoperatorias fueron las lesiones: ureteral (n = 2) y vesical (n = 1). La principal complicación posoperatoria fue la fístula vesicouterina (n = 1). El promedio de estancia fue de 2 días en 16 de las 22 pacientes y de 7 días en las 6 restantes. CONCLUSIONES: Lo importante del acretismo placentario es el diagnóstico oportuno que permita derivar a las pacientes a centros hospitalarios que cuenten con especialistas experimentados en la atención de estos casos.

Abstract OBJECTIVE: To determine the incidence of placental accretism spectrum in pregnant women admitted to the obstetric intensive care unit of the Hospital de la Mujer, Culiacán, Sinaloa. MATERIALS AND METHODS: Retrospective, cross-sectional, descriptive study based on the analysis of the database of the Hospital de la Mujer of patients admitted between 2017 and 2020 with a diagnosis of placenta accreta spectrum, referred or diagnosed at the institution and underwent hysterectomy for the complication studied. RESULTS: Twenty-two patients with a diagnosis of placenta accreta were analysed, giving a prevalence of 0.09%; of these, caesarean section was indicated in 0.2%. 19 of the 22 patients had a history of previous uterine scarring, all with placenta praevia. Mean age was 30.86 ± 4 years. Caesarean section was performed at a mean gestational age of 34 weeks using two surgical techniques. The mean estimated blood loss was 1,947 mL. The most common operative complications were ureteral (n = 2) and bladder (n = 1) injuries. The most common postoperative complication was vesico-uterine fistula (n = 1). The mean length of stay was 2 days in 16 of the 22 patients and 7 days in the remaining 6 patients. CONCLUSIONS: The most important aspect of placenta accreta is early diagnosis, which allows referral to hospital centres with specialists experienced in the management of these cases.

Insulin-like growth factor binding protein 3 promoter variant (rs2854744) is associated with nonalcoholic fatty liver disease

ABSTRACT Objective: Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease and a growing global epidemic. In NAFLD, liver fat surpasses 5% of hepatocytes without the secondary causes of lipid accumulation or excessive alcohol consumption. Given the link between NAFLD and insulin resistance, the possible association between the rs2854744 (−202 G>T) promoter polymorphism of insulin-like growth factor binding protein 3 (IGFBP3) gene and NAFLD was investigated in this study. Materials and methods: In this genetic case-control association study, the IGFBP3 rs2854744 genotypes of 315 unrelated individuals, including 156 patients with biopsy-proven NAFLD and 159 controls, were determined using polymerase chain reaction/restriction fragment length polymorphism analyses. Results: The "GT+TT" genotype of the IGFBP3 rs2854744 polymorphism, compared with the "GG" genotype, was associated with a 2.7-fold increased risk of NAFLD after adjustment for confounding factors (P = 0.009; odds ratio [OR] = 2.71; 95% confidence interval [CI] = 1.19-3.18). Additionally, the IGFBP3 rs2854744 "T" allele, in comparison with the "G" allele, was significantly overrepresented in NAFLD patients than the controls (P = 0.008; OR = 1.85; 95%CI = 1.23-2.94). Conclusion: Our findings first indicated that the IGFBP3 rs2854744 "GT+TT" genotype is a marker of increased NAFLD susceptibility; however, it needs to be supported by further investigations in other populations.

The rs1862513 promoter variant of resistin gene influences susceptibility to nonalcoholic fatty liver disease

SUMMARY OBJECTIVES: Nonalcoholic fatty liver disease is the term used for a range of conditions in which fat builds up in the liver and exceeds 5% of hepatocytes without inordinate alcohol intake or other causes of lipid accumulation. Regarding the fact that insulin resistance and obesity play key roles in the pathogenesis of nonalcoholic fatty liver disease, as well as the connection between resistin and these metabolic diseases, the association between nonalcoholic fatty liver disease and a resistin gene (RETN) polymorphism was examined. METHODS: In this genetic case-control association study, 150 biopsy-proven nonalcoholic fatty liver disease patients and 154 controls were enrolled and genotyped for the RETN rs1862513 (-420C>G) gene polymorphism using PCR-RFLP method. RESULTS: The −420C>G genotype frequency distributions in both groups were consistent with Hardy-Weinberg equilibrium (HWE; p>0.05). The carriers of the RETN −420C>G "CC" genotype compared with the "GG" genotype occurred less frequently in the cases with nonalcoholic fatty liver disease than in the controls, and the difference remained significant even after adjustment for confounding factors (p=0.030; OR=0.47, 95%CI=0.36-0.93). Interestingly, the RETN −420C>G "C" allele was also associated with a decreased risk for nonalcoholic fatty liver disease too (p=0.042; OR=0.72, 95%CI=0.53-0.95). CONCLUSION: We found for the first time an association between biopsy-proven nonalcoholic fatty liver disease and RETN −420C>G promoter polymorphism. The carriers of the RETN −420C>G "CC" genotype had a 53% decreased risk for nonalcoholic fatty liver disease. Our findings, however, need to be corroborated by further studies.

Evaluation of core decompression outcome in systemic lupus erythematosus with hip osteonecrosis: a retrospective cohort study

Abstract Background Osteonecrosis is a major cause of morbidity for patients with systemic lupus erythematosus (SLE). Although core decompression is an approved and trusted technique to prevent further joint deterioration, this surgical method seems to be less beneficial for SLE patients. We aimed to evaluate the outcomes of core decompression in SLE patients with primary stages of femoral head osteonecrosis. Methods In this study, 23 patients (39 affected hip joints) with osteonecrosis of the femoral head with stage II of the disease, based on the Ficat-Arlet classification system, underwent core decompression. Also, patients demographic characteristics, clinical data, medication history, comorbidities, immunological findings, hip plain radiographs, history of total hip arthroplasty after core decompression, and patients satisfaction with joint function according to the Oxford hip score questionnaire were obtained. Results In the study, 53.8% of affected joints showed signs of radiographic deterioration in follow-up imaging. Sixty-one and a half percent (61.5%) of patients had unsatisfactory joint performance. A third (33.3%) of affected hip joints underwent total hip arthroplasty up to 5 years from core decompression. SLE patients with a history of receiving bisphosphonate were 83.2% less dissatisfied with their joint function than patients without a history of bisphospho-nate use (P < 0.02). Of the 23 studied cases, the mean cumulative dose of prednisolone before and after core decompression surgery was 46.41 mg and 14.74 mg respectively. Besides, one case (2.6%) that had a high anti-phospholipid antibodies level during follow-up did not have any radiographic deterioration, and 9 cases (23.1%) had some degrees of radiographic deterioration. Conclusions The patients group that used bis-phosphonate, had a higher level of satisfaction with joint function after core decompression. Patients with high-level anti-phospholipid antibodies are related to a poor prognosis after core decompression.

Knowledge, attitude, and practice regarding COVID-19 skin manifestations among doctors working at Khartoum dermatology and venereology teaching Hospital, 2021

Background: COVID-19 is a global pandemic caused by SARS_COV2. The symptoms of covid-19 include: fever, dyspnea, fatigue, a recent loss of smell and taste, sore throat, cough, and cutaneous lesions. In addition, some skin manifestations were reported to be associated with COVID-19. Methods: The study design is a descriptive cross-sectional hospital-based study. The study aimed to evaluate the level of knowledge and practice about skin manifestations of COVID-19 among doctors working at Khartoum dermatology and venereology teaching hospital. A self-administrated questionnaire was used for data collection after an informed consent was taken. Results: Among 140 doctors working in the dermatology and venereology teaching hospital, 75.7% of the doctors had knowledge that COVID-19 can present with skin manifestations. The study results showed that about half of the participants have poor knowledge about COVID-19 skin manifestations while 25% have no knowledge, and that 35 (25%) doctors have good knowledge. From a total of 140 doctors; 46.4% reported that when patients present with COVID-19 skin lesions, they will isolate them in separate rooms and call the epidemiology center, whereas, 61 doctors (43.6%) did not know if they have a protocol for COVID-19 suspected cases. This study reported a significant association between job category and level of knowledge toward COVID-19 skin manifestations measured by Chi-square test, the P-value was 0.003 (significant at 0.05), and the same significant association was found between the year of rotation and knowledge. Conclusion: Half of the doctors covered by this study had poor knowledge about COVID-19 skin manifestations, and therefore, educating doctors in dermatology hospitals about skin manifestations of COVID-19 is recommended, besides clear and precise guidelines and protocols for diagnosis and management.

A health mobile application for self-care of colostomy patients

Introduction and Objective: In most cases, due to the failure of nonsurgical methods in the treatment of diseases related to the colon, it is necessary to perform colostomy as the main treatment method. However, this surgery can cause a wide range of physical, social, and psychological problems in patients. Therefore, in order to prevent and treat the complications of colostomy, it is necessary to adopt measures in the field of self-care and continuous education for patients to control the complications of the disease, seek treatment, and experience improvements in their quality of life. Additionally, considering the role of mobile health (mHealth) applications in facilitating continuous and effective training, and improving self-care for these patients, the aim of the present study was to design and evaluate an mHealth application for self-care of colostomy patients. Materials and Methods: In the present applied research, first the functional requirements of the software were determined considering the self-care requirements of colostomy patients. Then, the software was designed based on object-oriented analysis, and according to it, the application was coded in Java and developed in the Android Studio environment. Finally, to evaluate the software, the opinions and comments of 5 gastroenterologists and 10 adult colostomy patients in the age range between 27 and 64 years who had at least a high school diploma were used as the basis of judgment at this stage. The instruments used in the evaluation included a checklist, derived from three standard questionnaires (the System Usability Scale [SUS], the mHealth App Usability Questionnaire [MAUQ], and the User Version of the Mobile Application Rating Scale [uMARS]) to measure the user-friendliness indicator, and a researcher-made checklist to measure the performance indicator of the various services provided. Results The services of the software developed include the provision of medical information and self-care instructions regarding colostomy surgery, as well as alerts for the user to schedule an appointment with a doctor and the time to take medications. Based on the results of the evaluation stage, the users were generally satisfied with the interface, services, and general features of the software. In general, the software was evaluated at the "acceptable" level, with a rate of 85%. Discussion and Conclusion Based on the findings of the current research, thesoftware developed can be significantly effective in facilitating the education of colostomy patients and improving their self-care. Proper and continuous self-care and education for colostomy patients is necessary to prevent and control complications resulting from surgery and to improve their quality of life. Therefore, in addition to patients, all health care staff, organizations, and associations which support colostomy patients can also use this software to educate patients and improve the care provided to them. (AU)

Maternal and Perinatal Complications in Eclampsia Patients: Study in a Private Medical College, Dhaka, Bangladesh

Background: Eclampsia is a serious pregnancy complication that can lead to seizures and potentially fatal outcomes for both mother and baby. It is most common in developing countries but improved antenatal care and early intervention have significantly decreased its incidence in developed countries. Risk factors for eclampsia include pre-eclampsia, hypertension, obesity, and renal disease, and early detection and management are crucial for preventing adverse outcomes. Magnesium sulfate is the preferred treatment for seizures, and delivery timing depends on disease severity, gestational age, and fetal well-being. Maternal and perinatal mortality rates vary by country, highlighting the need for continued efforts to improve outcomes for those affected by eclampsia. The study aimed to observe the maternal and perinatal complications in eclampsia patients. Material & Methods: This observational study was conducted at the Department of Gynecology, Gonoshasthaya Nagar Hospital, Dhaka, Bangladesh during the period of January 2020 to June 2020. We included a total of 270 patients with eclampsia who were admitted to a tertiary care hospital. A Purposive consecutive sampling method was followed for the selection of the participants. Results: This study analyzed the demographic and clinical characteristics, maternal and perinatal complications, and risk factors of 270 patients with eclampsia. The majority of patients were aged between 20-34 years (77.8%), and 61.1% were multiparous. Over half of the cases (55.6%) presented with eclampsia between 28-36 weeks of gestation, and 38.9% had a history of preeclampsia in a previous pregnancy. The most common symptoms reported were headaches (88.9%). All cases involved hypertensive disorders, and maternal death was reported in 1.9% of cases. Perinatal complications included low birth weight (44.4%), preterm delivery (36.3%), NICU admission (34.8%), stillbirth (4.4%), and early neonatal death (3.0%). Maternal mortality rates were highest among women aged 20-34 years (56.5%), while perinatal mortality rates were highest among women aged under 20 years (20.0%). The highest maternal mortality rate was observed among women with severe eclampsia (91.4%), and time to treatment was a crucial factor in maternal mortality rates. These findings underscore the need for timely and appropriate care to improve maternal and perinatal outcomes, particularly in high-risk populations. Conclusion: Eclampsia is a serious complication of pregnancy that can result in significant maternal and perinatal morbidity and mortality. Early detection, prompt management, and close monitoring of high-risk pregnancies are crucial in preventing adverse outcomes. Further research is needed to identify effective interventions for preventing and managing eclampsia.

Vitamin D in Clinical Practice: Current Perspectives

India is a heliophobic country; despite ample sunshine, almost 490 million people are vitamin D deficient in the country. Additionally, the Indian diet has not been successful in providing the daily need for vitamin D, leading to a vitamin D deficiency. The need to fortifying food with vitamin D has been raised several times. Besides, there have been discussions about whether vitamin D is a hormone or a vitamin? In this review, the authors have reviewed vitamin D deficiency and its status in India, assessment and screening, the role of vitamin D in various disease conditions, dosage recommendation and regimen.

Hearing and Visual Impairment in Children with Cerebral Palsy, A Study in Tertiary Level Hospital in Bangladesh

Background: Cerebral palsy (CP) is a diagnostic term used to describe a group of motor syndromes resulting from disorders of early brain development. CP remains unexplained in most cases and is typically diagnosed outside the neonatal period. Visual impairment decreases the quality of life and hearing impairment hampers linguistic development. This study aimed to observe the visual and hearing impairment of children with cerebral palsy associated with developmental disabilities. Material & Methods: This is a cross-sectional observational descriptive study carried out in the department of Paediatric Neurology CMH Dhaka from March 2018 to February 2022. The participants (N=120) were from birth to 12 years of age. Detailed information was obtained in each case according to protocol. The pediatric neurologist based on the study definition crosschecked the diagnosis. The hearing assessment was done with the help of an Otolaryngologist in the department of Otolaryngology and the ophthalmological evaluation was done with the help of an ophthalmologist of the department of ophthalmology of CMH Dhaka. Hearing impairment, Ophthalmological motor disturbance, and developmental disabilities were correlated. A convenience sampling technique was used in this study. Relevant data were collected from hospital records. All the information was recorded in the fixed protocol. Collected data were classified, edited, coded, and entered into the computer for statistical analysis by using SPSS 2021. Results: In this study, among the 120 children with CP, the mean age of the study was 5.57(SD±3.89) age range of 2-12 years Males were 82(68%) and females were 38(32%), male-female ratio (sex M: F 2.15: 1). Spastic quadriplegia constitutes the predominant group 59(49%), followed by Spastic diplegia 21(18%), Spastic hemiplegia 20(17.5%), dyskinetic CP 09(8%), 7(6%) were mixed CP and 4(3%) were hypotonic CP. Hearing impairment was found in 87 (72%) cases and visual impairment was detected in 92(76%). Among them, the child with Spastic Quadriplegic (83%) and diplegic CP (62%) children had a hearing impairment. Regarding vision, no fix and follow were observed in 69(57%) cases. Among the studied CP child (n=120) 16 children (13.33%) had normal eye finding and 104 (86%) had abnormal eye findings. Refractive error (32.5%) and Squint (19%) were the most common ocular defect among studied patients. Other ocular defect were nystagmus(10%), optic atrophy(12.5%), microphthalmia(10%), corneal opacity(3%), optic hypoplasia(4.1%), cataract(2.5%), pigmentary retinopathy(5%), retro-lental fibroplasias(3.3%) and ptosis(2.5%). In children with hypotonic (athetoid) and mixed CP, almost all (11 of 11) children had visual impairment. Spastic quadriplegic CP children (80%) and Spastic diplegic CP children (90%) had one or more domains of visual impairment. Conclusion: Cerebral Palsy is a non-progressive various form of neurological disorder in children. Early visual screening and hearing assessment can help CP children to minimize mental retardation, learning difficulties, and speech delay.

Comparison between Anneroth’s & Broder’s Grading Systems in Oral Squamous Cell Carcinoma in Relation to Histopathological Prognostic Factors

Background: Oral squamous cell carcinoma (OSCC) is a commonly occurring head and neck cancer. It has a high prevalence, and is associated with a high mortality rate. OSCC occurs due to many etiological factors, but smoking and alcohol remain the most common risk factors. The histological grading of tumors has been used to predict the clinical behaviour of OSCC. Broder’s initiated quantitative grading in cancer. Anneroth’s and Hansen developed another grading system for grading of OSCC’s. With this background, a study was undertaken to compare between Anneroth’s & Broder’s grading systems in oral squamous cell carcinoma in relation to histopathological prognostic factors. Material & Methods: A retrospective study was carried out on 50 formalin fixed paraffin embedded tissue blocks of the confirmed cases of Oral squamous cell carcinoma in the archives of department of oral pathology, Govt. Dental College & Hospital, Srinagar. The cases were evaluated on the basis of Broder’s & Anneroth’s grading systems for OSCC & the comparison of the systems was made pertaining to histopathological prognostic parameters. Results: In our study according to Anneroth’s system maximum cases comes under grade III while in Broder’s system maximum cases are in grade I & II. Conclusion: Anneroth’s classification provides us a detailed analysis of grading the cases according to scoring of each parameter. Thus, it is more informative than Broder’s grading system.

To Assess the Interobserver Variability in Mitotic Figure Counting in Various Grades of Oral Squamous Cell Carcinoma

Background: Oral squamous cell carcinoma (OSCC) is the most common oral malignancy, representing up to 80–90% of all malignant neoplasms of the oral cavity. The increasing cases of oral cancer are the most important concern for community health. Defects of mitosis result in various nuclear abnormalities namely micronuclei, binucleation, broken egg appearance, pyknotic nuclei, and increased numbers of mitotic figures. The rationale for mitotic counting is that it is frequently used for classification and grading of tumors, prediction of prognosis of tumors and even advocated as a decision point for treatment. Reproducibility of the mitotic counting is paramount for the assessment of malignancy on a histologic scale. Considering this, we decided to assess the inter-observer variability in mitotic figure counting in various grades of oral squamous cell carcinoma. Material & Methods: A retrospective study was carried out on 48 formalin fixed paraffin embedded tissue blocks of the confirmed cases of Oral squamous cell carcinoma in the archives of department of oral pathology, Govt. Dental College & Hospital, Srinagar. Mitotic figure counting was done by two independent, mutually blind observers. The data was assessed for inter-observer variability in counting of figures. Results: Least difference was seen in cases of WDSCC up to the maximum difference of 3 mitoses. MDSCC showed modest differences in observations, with a maximum difference of 4 mitoses. PDSCC cases had the highest inter-observer variability, with a maximum difference of 5 mitoses. Conclusion: Mitosis counting has been shown most convincingly to provide independent prognostic value and is the most well established component of the histological grading systems of OSCC. Reproducibility of the mitotic counting is paramount for the assessment of malignancy on a histologic scale.

Inborn Errors of Metabolism Associated With Autism Among Children: A Multicenter Study from Iran

Objective: This study aimed to find the common inborn errors of metabolism in Iranian patients with autism spectrum disorder. Methods: In this cross-sectional multicenter study, 105 children and adolescents with autism spectrum disorder from six centers in different cities of Iran were enrolled between August, 2019 and October, 2020. Metabolic screening, including measuring plasma levels of amino acids, acylcarnitines, creatine, and guanidinoacetate, and urinary levels of organic acids, purines, and pyrimidines was performed. Other data, including age, parental consanguinity, history of seizure, developmental mile-stones, and physical examination, were also recorded. Results: An inborn error of metabolism was found in 13 (12.4%) patients. Five patients (4.8%) had cerebral creatine deficiency syndrome, 4 (3.8%) had arginine succinate aciduria, 2- methylbutyryl glycinuria, short-chain acyl-CoA dehydrogenase deficiency, and combined methylmalonic aciduria/malonic aciduria. There was a strong association between positive metabolic evaluation and parental consanguinity, history of seizures, microcephaly, and delayed development. Conclusions: Our results suggest that metabolic screening should be performed in the cases of autism associated with parental consanguinity, developmental delay, and a history of seizures. The assays to be considered as a screening panel include plasma or blood amino acids, acylcarnitines, creatine and guanidinoacetate, and urinary levels of organic acids.

Vitamin D in Clinical Practice: Current Perspectives

India is a heliophobic country; despite ample sunshine, almost 490 million people are vitamin D deficient in the country. Additionally, the Indian diet has not been successful in providing the daily need for vitamin D, leading to a vitamin D deficiency. The need to fortifying food with vitamin D has been raised several times. Besides, there have been discussions about whether vitamin D is a hormone or a vitamin? In this review, the authors have reviewed vitamin D deficiency and its status in India, assessment and screening, the role of vitamin D in various disease conditions, dosage recommendation and regimen.

Assessment of YME1L and mitofusin2 as a possible diagnostic and/or therapeutic target in hepatocellular carcinoma

Mitochondrial dynamics are a contraversal issue in hepatocellular carcinoma. The present study tries to illustrate the role of mitochondrial dynamics proteins (mitofusin-2 (Mfn2) and YME1L) in hepatocarcinogenesis. Five groups were used: the control group and three HCC groups (after 8, 16, and 24 weeks from DENA induction). The last group was treated with Sorafenib (SP) (10 mg/kg), via oral gavage for 4 weeks after cancer induction. This study revealed that Mfn-2 was downregulated and YME1l was overexpressed in different HCC groups. This dysregulation of mitochondrial dynamics proteins was associated with high hepatic levels of cyclin D1, MMP-9, and MDA and overexpression of ki67 as well as decreasing the hepatic expression of tissue inhibitor of matrix metalloproteinase-3 (Timp-3) and Bax. To confirm the possible role of Mfn2 and YME1L in HCC, we assessed the effect of sorafenib on these parameters and its related HCC characteristics. Sorafenib corrected the level of Mfn2 and YME1L and decreased tumor cell proliferation as well. We also elucidated that mitochondrial dynamics proteins (Mfn2 and YME1L) could be a good therapeutic target for HCC.

Comparison of trabecular bone in impacted and normal erupted unilateral maxillary canine teeth using cone-beam computed tomography in patients scheduled for orthodontic treatment at the Universitas Airlangga Dental and Oral Hospital

Background@#Cone-beam computed tomography is being utilized in more clinical contexts and determining bone density with this method is becoming more important. Dentists, particularly dentomaxillofacial radiologists, orthodontists, and oral surgeons, must have a solid understanding of gray value. The gray values acquired from conebeam computed tomography images are used to assess dental implant bone density, diagnose dental ankylosis, and diagnose and differentiate pathological lesions.@*Objective@#To determine the difference in the gray value of the trabecular bone in the impacted and normal erupted maxillary canine teeth using cone computed tomography.@*Methods@#We retrospectively evaluated the cone-beam computed tomography images of patients scheduled for orthodontic treatment at the Universitas Airlangga Dental and Oral Hospital. On cross-sectional cone-beam computed tomography images, the region of interest determination of 5 mm2 in the area was placed in the trabecular bone and the gray value measurements were collected using Digital Imaging and Communications in Medicine (OnDemand3D™) dental software. The images were categorized by type of impacted canine teeth after assessing the gray values of all the teeth. Using images on the mesial, distal, buccal, and palatal areas, gray values of impacted and non-impacted teeth were compared. We used the SPSS 24 software.@*Results@#From a total of 13 patient radiographs, we found types I (6/13), II (6/13), and VII (1/13). The mean pixel values of impacted maxillary unilateral canine teeth were 1972.92 (mesial), 2016.55 (distal), 1990.66 (buccal), and 1904.39 (palatal). The mean pixel values of normal erupted maxillary canines were 1754.93 (mesial), 1710.53 (distal), 1852.94 (buccal), and 1674.49 (palatal). There were significant differences between impacted and normal erupted maxillary canines: mesial (P = 0.018), distal (P = 0.000), buccal (P = 0.003), and palatal (P = 0.036).@*Conclusion@#There were statistically significant differences between affected and unaffected gray values in the canines in FOV size 51 × 55 mm. However, no statistically significant differences were found in the gray values in trabecular bone of unilateral maxillary impacted canines and normal erupted canines on the mesial, distal, buccal, and palatal sides.

Perception of Malaysian Dental Practitioner on the provisional COVID-19 Guidelines in the Dental Practice: A Cross-Sectional Study (Persepsi Pengamal Pergigian Malaysia terhadap Garis Panduan COVID-19 sementara dalam Amalan Pergigian: Kajian Keratan Rentas) / Jurnal Sains Kesihatan Malaysia

@#Following the COVID-19 outbreak, the World Health Organization issued provisional guidelines to address considerations for essential oral health services in the pandemic situation. Compliance with the guidelines is essential to curb the potential spread of infection within a dental practice. This study aimed to assess the perception of Malaysian dental practitioners towards exercising the provisional COVID-19 dental practice guideline during the early phase of the pandemic. A self-administered questionnaire of a structured type consisting of demographic information and dentist perceptions of the provisional guidelines of dental care during the COVID-19 outbreak was distributed online from May 2021 until August 2021 through various social networking platforms among dental practitioners working at different healthcare sectors in all states in Malaysia. A total of 468 dental practitioners responded to this study. More than threequarters of the respondents were working in public dental care facilities (76.3%, n=357). The majority of respondents adhered to the provisional guidelines issued during the pandemic outbreak and exhibited a change in standard clinical practice (p<0.001). Dental practitioners working in public sectors perceive that swab tests prior to dental appointments should be mandatory, the reopening of dental clinics increases the risk of spread and the provisional guidelines of COVID-19 in dental practice will be changed in the future compared to private dental practitioners (p<0.001). The majority of dental practitioners in Malaysia have complied with the provisional guidelines imposed by the health bodies. As the COVID-19 virus will persist and become endemic in our communities, it is important to balance the safety issue and patient oral health needs.