Prevalence and characteristics of patent foramen ovale in a sample of Egyptian population: a computed tomography study.

BACKGROUND: The reported prevalence of patent foramen ovale (PFO) in the general population is variable. It ranges between 8.6 and 42% according to the population studied and the imaging technique used. We aim to prospectively assess the prevalence and characteristics of PFO and interatrial septum (IAS) abnormalities as well as the related clinical manifestations in a sample of Egyptian population. RESULTS: This study comprised 1000 patients who were referred for CT coronary angiography (CTCA). Mean age was 52.5 ± 10.9 years. The prevalence of PFO among the studied population was 16.3%; closed PFO (grade I) 44.2%, open PFO (grade II) 50.9%, and open PFO with jet (grade III) 4.9%. Anatomical high-risk PFO features-defined as the presence of at least 2 or more of the following (diameter ≥ 2 mm, length ≥ 10 mm, septal aneurysm "ASA", or redundant septum)-were found in 51.5% of PFOs' population. Other IAS abnormalities as redundant septum (8.6%), ASA (5.3%), Bachmann's bundle (4.5%), microaneurysm (2.6%), and atrial septal defect (ASD) (0.4%) were detected. There was a lower rate of coexistence of ASA with PFO (p = 0.031). Syncope was significantly higher in patients with PFO compared to those without PFO (6.7% vs. 1.6%, p = 0.001). Stroke, transient ischaemic attacks (TIA), and dizziness were similar in both groups. TIA, dizziness, and syncope were significantly higher in patients with IAS abnormalities including PFO compared to those without IAS abnormalities. Syncope was also significantly higher in PFO with high-risk anatomical features compared to those with non-high-risk PFO population (p = 0.02). CONCLUSION: The prevalence of PFO in our study was approximately 16.3%, almost half of them showed anatomical high-risk features for stroke. Dizziness, syncope and TIA were significantly higher in patients with IAS abnormalities including PFO.

Riverine Microplastic Quantification: A Novel Approach Integrating Satellite Images, Neural Network, and Suspended Sediment Data as a Proxy.

Rivers transport terrestrial microplastics (MP) to the marine system, demanding cost-effective and frequent monitoring, which is attainable through remote sensing. This study aims to develop and test microplastic concentration (MPC) models directly by satellite images and indirectly through suspended sediment concentration (SSC) as a proxy employing a neural network algorithm. These models relied upon high spatial (26 sites) and temporal (198 samples) SSC and MPC data in the Tisza River, along with optical and active sensor reflectance/backscattering. A feedforward MLP neural network was used to calibrate and validate the direct models employing k-fold cross-validation (five data folds) and the Optuna library for hyperparameter optimization. The spatiotemporal generalization capability of the developed models was assessed under various hydrological scenarios. The findings revealed that hydrology fundamentally influences the SSC and MPC. The indirect estimation method of MPC using SSC as a proxy demonstrated higher accuracy (R2 = 0.17-0.88) than the direct method (R2 = 0-0.2), due to the limitations of satellite sensors to directly estimate the very low MPCs in rivers. However, the estimation accuracy of the indirect method varied with lower accuracy (R2 = 0.17, RMSE = 12.9 item/m3 and MAE = 9.4 item/m3) during low stages and very high (R2 = 0.88, RMSE = 7.8 item/m3 and MAE = 10.8 item/m3) during floods. The worst estimates were achieved based on Sentinel-1. Although the accuracy of the MPC models is moderate, it still has practical applicability, especially during floods and employing proxy models. This study is one of the very initial attempts towards MPC quantification, thus more studies incorporating denser spatiotemporal data, additional water quality parameters, and surface roughness data are warranted to improve the estimation accuracy.

PROSPECTIVE SINGLE CENTER ANALYSIS OF OUTCOME STEM CELLS TRANSPLANTS IN PATIENTS WITH CEREBRAL PALSY.

OBJECTIVE: Aim: To evaluate efficacy and safety of autologous bone marrow-derived mononuclear stem cell transplantation intrathecal in children with cerebral palsy. PATIENTS AND METHODS: Materials and Methods: 35 children have levels I-V cerebral palsy aged 8-months to 8-years-old were enrolled from September (2021-2022) at Iraqi private hospital. Gross Motor Function was assessed by a pediatrician and neurologist specialist, 5 mcg/kg/day of G-CSF subcutaneous single injection daily for three consecutive days. Bone marrow harvested from posterior iliac crest under light general anesthesia. Bone marrow mononuclear cells (BMMNCs) separation was performed using density gradient centrifugation with Ficoll, the cell viability checked by propidium iodide dye in a TALI machine (Invitrogen) in average 98%. The viable BMMNCs injected intrathecal in L4-L5 over a period of 5-10 min. RESULTS: Results: Males accounted for 57.14% (20/35) while female 42.86% (15/35), and main neurological symptoms included spastic disorder spastic disorder (quadriplegia 24 (68.6), tetraplegia 2 (5.7), diplegia 5 (14.28), hemiplegia4 (11.42)). Gross Motor Function Classification System and Gross Motor Function Measure-66 (GMFM-66) showed II 10 (28.58), III 11(31.42) and IV 14 (40). On mean follow-up of 3 months post-stem cell transplant improvement was observed in 80% cases. The improvement showed in gross motor function (6/8) p=0.01, and speech (2/4) p=0.04, neck holding (5/5) p=0.0003, sitting balance (4/4) p=0.04, postural tone (5/5) p=0.0003, as well as significant reduction in seizure frequency (2/3) p=0.04 and improvement in cognition (6/7) p=0.01 were observed. CONCLUSION: Conclusion: Stem cell therapy for cerebral palsy shows a significant positive effect on the gross motor function, without long adverse effects.

High spatiotemporal resolution analysis on suspended sediment and microplastic transport of a lowland river.

The suspended sediment (SS) and microplastic (MP) transport in rivers is quite a complex process, influenced by several spatially and temporally changing factors (e.g., hydrology, sediment availability, human impact). Researchers usually investigate these factors individually and based on limited repetition in space and time. Therefore, this study aims to compare the driving factors of SS and MP transport by applying dense temporal (72 measurements) and spatial monitoring (at 26 sites). This study was performed on the medium-sized Tisza River, Central Europe. The suspended sediment concentration (SSC) was measured by water sampling and estimated based on Sentinel-2 images, while MP concentration was measured by pumping of water (1 m3). The SSC of the Tisza varied between 12.6 and 322.5 g/m3, whereas the MP concentration ranged 0-129 item/m3. Most of the transported particles were fibers (81-98 %), thus, it was assumed that MPs originated from wastewater. The results reflect that the hydrological conditions basically influence the SS and MP concentrations, as a strong positive correlation was found (ρSSC-MP = 0.6) between them during a year; however, the correlation during floods (minor floods: ρ = 0.63; medium floods: ρ = 0.41) was higher than at low stages (ρ = 0.1). It was assumed that run-off and mobilization of channel materials both contribute to increased SS and MP transport during floods. In contrary, the importance of mobilization of channel materials and wastewater input increase during low stages. The repeated measurements revealed that slope and velocity conditions, proximity of sources, tributaries, and dams influence the longitudinal changes in SS and MP concentrations. However, the effects of tributaries and dams are ambiguous (especially for MP) and require further research. The longitudinal measurements were conducted at low stages; hence, moderate negative correlations (ρ2021 = -0.35; ρ2022 = -0.41) were found between the SS and MP concentrations. Therefore, additional monitoring during (overbank) floods and denser spatial sampling are required to precisely reveal the spatiotemporal changes of SS and MP concentrations in rivers.

Risk of Oral Squamous Cell Carcinoma in One Hundred Patients with Oral Lichen Planus: A Follow-Up Study of Umberto I University Hospital of Rome.

This study aims to retrospectively assess the potential risk of malignant transformation in patients with diagnosed oral lichen planus (OLP) between 2015 and 2022, and to evaluate the influence of different risk factors. The department's database and medical records from 2015 to 2022 were searched for patients with a confirmed diagnosis of OLP based on both clinical and histological parameters. A total of 100 patients (59 females and 41 males) were found with a mean age of 64.03 years. In the considered period, the percentage of diagnosed OLP patients was 1.6%, while the percentage of diagnosed OLP patients with transformation to oral squamous cell carcinoma (OSCC) was 0.18%. A statistically significant difference was found with age (p = 0.038), tobacco status (p = 0.022), and radiotherapy (p = 0.041). The analysis revealed the presence of significant risk in ex-smokers (>20 pack-years), with an odds ratio (OR) of 10.0000 (95% confidence interval (95% CI) 1.5793-63.3186); in alcohol-drinker patients, with an OR of 4.0519 (95% CI 1.0182-16.1253); in ex-smoker and alcohol-drinker patients, with OR of 17.6250 (95% CI 2.2464-138.2808); and in patients who had undergone radiotherapy, with OR of 6.3000 (95% CI 1.2661-31.3484). The malignant transformation of oral lichen planus was slightly higher than thought, and the results revealed a possible association with age, tobacco and alcohol status, and history of radiotherapy. An elevated risk of malignant transformation was observed in heavy ex-smoker patients, alcohol-drinker patients, and alcohol-drinker patients with a history of smoking (ex-smokers). Persuading the patient to quit tobacco and alcohol consumption and periodic follow-ups are recommended in general, but particularly in the presence of these risk factors.

Machine learning-based detection and mapping of riverine litter utilizing Sentinel-2 imagery.

Despite the substantial impact of rivers on the global marine litter problem, riverine litter has been accorded inadequate consideration. Therefore, our objective was to detect riverine litter by utilizing middle-scale multispectral satellite images and machine learning (ML), with the Tisza River (Hungary) as a study area. The Very High Resolution (VHR) images obtained from the Google Earth database were employed to recognize some riverine litter spots (a blend of anthropogenic and natural substances). These litter spots served as the basis for training and validating five supervised machine-learning algorithms based on Sentinel-2 images [Artificial Neural Network (ANN), Support Vector Classifier (SVC), Random Forest (RF), Naïve Bays (NB) and Decision Tree (DT)]. To evaluate the generalization capability of the developed models, they were tested on larger unseen data under varying hydrological conditions and with different litter sizes. Besides the best-performing model was used to investigate the spatio-temporal variations of riverine litter in the Middel Tisza. According to the results, almost all the developed models showed favorable metrics based on the validation dataset (e.g., F1-score; SVC: 0.94, ANN: 0.93, RF: 0.91, DT: 0.90, and NB: 0.83); however, during the testing process, they showed medium (e.g., F1-score; RF:0.69, SVC: 0.62; ANN: 0.62) to poor performance (e.g., F1-score; NB: 0.48; DT: 0.45). The capability of all models to detect litter was bounded to the pixel size of the Sentinel-2 images. Based on the spatio-temporal investigation, hydraulic structures (e.g., Kisköre Dam) are the greatest litter accumulation spots. Although the highest transport rate of litter occurs during floods, the largest litter spot area upstream of the Kisköre Dam was observed at low stages in summer. This study represents a preliminary step in the automatic detection of riverine litter; therefore, additional research incorporating a larger dataset with more representative small litter spots, as well as finer spatial resolution images is necessary.

Mathematical Modeling and Analysis of the Dynamics of RNA Viruses in Presence of Immunity and Treatment: A Case Study of SARS-CoV-2.

The emergence of novel RNA viruses like SARS-CoV-2 poses a greater threat to human health. Thus, the main objective of this article is to develop a new mathematical model with a view to better understand the evolutionary behavior of such viruses inside the human body and to determine control strategies to deal with this type of threat. The developed model takes into account two modes of transmission and both classes of infected cells that are latently infected cells and actively infected cells that produce virus particles. The cure of infected cells in latent period as well as the lytic and non-lytic immune response are considered into the model. We first show that the developed model is well-posed from the biological point of view by proving the non-negativity and boundedness of model's solutions. Our analytical results show that the dynamical behavior of the model is fully determined by two threshold parameters one for viral infection and the other for humoral immunity. The effect of antiviral treatment is also investigated. Furthermore, numerical simulations are presented in order to illustrate our analytical results.

The Impact of Laser Thermal Effect on Histological Evaluation of Oral Soft Tissue Biopsy: Systematic Review.

The aim of the study is to review the literature to observe studies that evaluate the extent of the thermal effect of different laser wavelengths on the histological evaluation of oral soft tissue biopsies. An electronic search for published studies was performed on the PubMed and Scopus databases between July 2020 and November 2022. After the selection process, all the included studies were subjected to quality assessment and data extraction processes. A total of 28 studies met the eligibility criteria. The most studied laser was the carbon dioxide (CO2) laser, followed by the diode laser 940 nm-980 nm. Six studies were focused on each of the Erbium-doped Yttrium Aluminium Garnet (Er:YAG), Neodymium-doped Yttrium Aluminum Garnet (Nd:YAG) lasers, and diode lasers of 808 nm and 445 nm. Three studies were for the Potassium Titanyl Phosphate (KTP) laser, and four studies were for the Erbium, Chromium-doped Yttrium, Scandium, Gallium, and Garnet (Er,Cr:YSGG) laser. The quality and bias assessment revealed that almost all the animal studies were at a low risk of bias (RoB) in the considered domains of the used assessment tool except the allocation concealment domain in the selection bias and the blinding domain in the performance bias, where these domains were awarded an unclear or high score in almost all the included animal studies. For clinical studies, the range of the total RoB score in the comparative studies was 14 to 23, while in the non-comparative studies, it was 11 to 15. Almost all the studies concluded that the thermal effect of different laser wavelengths did not hinder the histological diagnosis. This literature review showed some observations. The thermal effect occurred with different wavelengths and parameters and what should be done is to minimize it by better adjusting the laser parameters. The extension of margins during the collection of laser oral biopsies and the use of laser only in non-suspicious lesions are recommended because of the difficulty of the histopathologist to assess the extension and grade of dysplasia at the surgical margins. The comparison of the thermal effect between different studies was impossible due to the presence of methodological heterogeneity.

Three-dimensional evaluation of the mandibular condyle in adults with various skeletal patterns.

Objective: Morphometric and morphological evaluation of the mandibular condyle in adults and to identify its correlation with skeletal malocclusion patterns. Methods: Cone-beam computed tomography scans of 135 adult patients were used in this study and classified into groups according to four criteria: (1) sex (male and female); (2) sagittal skeletal discrepancy (Class I, Class II, and Class III); (3) vertical skeletal discrepancy (hyperdivergent, normodivergent, and hypodivergent); and age (group 1 ≤ 20 years, 21 ≤ group 2 < 30, and group 3 ≥ 30 years). The morphometrical variables were mandibular condyle height and width, and the morphological variable was the mandibular condyle shape in coronal and sagittal sections. Three-dimensional standard tessellation language files were created using itk-snap (open-source software), and measurements were performed using Meshmixer (open-source software). Results: The mandibular condyle height was significantly greater (p < 0.05) in patients with class III malocclusion than in those with class I or II malocclusion; the mandibular condyle width was not significantly different among different sexes, age groups, and sagittal and vertical malocclusions. There were no statistical associations between various mandibular condyle shapes and the sexes, age groups, and skeletal malocclusions. Conclusions: The condylar height was greatest in patients with class III malocclusion. The condylar height and width were greater among males than in females. The mandibular condyle shapes observed in sagittal and coronal sections did not affect the skeletal malocclusion patterns.

Spirulina platensis extract improves the production and defenses of the common bean grown in a heavy metals-contaminated saline soil.

Plants have to cope with several abiotic stresses, including salinity and heavy metals (HMs). Under these stresses, several extracts have been used as effective natural biostimulants, however, the use of Spirulina platensis (SP) extract (SPE) remains elusive. The effects of SPE were evaluated as soil addition (SA) and/or foliar spraying (FS) on antioxidant defenses and HMs content of common bean grown in saline soil contaminated with HMs. Individual (40 or 80 mg SPE/hill added as SA or 20 or 40 mg SPE/plant added as FS) or integrative (SA+FS) applications of SPE showed significant improvements in the following order: SA-80+FS-40 > SA-80+FS-20 > SA-40+FS-40 > SA-40+FS-20 > SA-80 > SA-40 > FS-40 > FS-20 > control. Therefore, the integrative SA+FS with 40 mg SP/plant was the most effective treatment in increasing plant growth and production, overcoming stress effects and minimizing contamination of the edible part. It significantly increased plant growth (74%-185%) and yield (107%-227%) by enhancing net photosynthetic rate (78.5%), stomatal conductance (104%), transpiration rate (124%), and contents of carotenoids (60.0%), chlorophylls (49%-51%), and NPK (271%-366%). These results were concurrent with the marked reductions in malondialdehyde (61.6%), hydrogen peroxide (42.2%), nickel (91%-94%), lead (80%-9%), and cadmium (74%-91%) contents due to the improved contents of glutathione (87.1%), ascorbate (37.0%), and α-tocopherol (77.2%), and the activities of catalase (18.1%), ascorbate peroxidase (18.3%), superoxide dismutase (192%), and glutathione reductase (52.2%) as reinforcing mechanisms. Therefore, this most effective treatment is recommended to mitigate the stress effects of salinity and HMs on common bean production while minimizing HMs in the edible part.

Epidemiology of dental caries in permanent dentition: evidence from a population-based survey in Egypt.

BACKGROUND: In recognition of the risk factors common between oral diseases and various chronic conditions and the intersection between oral health and some sustainable development goals, the current cross-sectional study was designed to quantify the burden of dental caries and identify factors associated with its occurrence in permanent teeth. METHODS: Using data from Egypt's population-based survey (2013-2014), two individual-level outcomes; past caries experience (DMFT > 0) and presence of untreated carious lesions (DT > 0) were assessed using the WHO basic methods for oral health surveys. Information on potential explanatory variables including sociodemographic characteristics, exposure to fluoridated water, dental attendance, and dental anxiety was gathered using a structured questionnaire. Stratified multistage cluster random sampling was used to recruit survey participants. Multivariable logistic regression was performed to identify significant potential risk factors for caries in the permanent dentition of Egyptians. FINDINGS: A total of 9,457 participants were included of which 70.3% had at least one untreated carious lesion. After adjusting for all covariates, analphabetic Egyptians were found to have significantly higher odds of caries experience in permanent dentition DMFT > 0 (OR 1.54, 95% CI [1.20-1.98]), DT > 0 (OR 1.62, 95% CI [1.32-2.00]). Males, however, had significantly lower caries risk DMFT > 0 (OR 0.75, 95% CI [0.67-0.85]), DT > 0 (OR 0.81, 95% CI [0.73-0.89]) when compared to females. Regarding age, mean DMFT scores were significantly lower in age groups (6-15 years) (OR 0.03, 95% CI [0.014; 0.082]), (16- 20 years) (OR 0.09, 95% CI [0.037; 0.23]), and (21-35 years) (OR 0.22, 95% CI [0.09; 0.53]) than among people ≥ 60 years. CONCLUSION: Addressing individual-level caries risk factors should be complemented by addressing upstream factors to reduce burden of untreated dental caries among Egyptians.

Liquid biopsy in the assessment of microRNAs in oral squamous cell carcinoma: A systematic review.

Background: The identification of non-invasive biomarkers from biological fluids collected by liquid biopsy provides new horizons for individualized therapeutic strategies and improves clinical decision-making in OSCC patients. Circulating microRNAs have emerged as biomarkers that may reflect not only the existence of cancer, but also the dynamic, malignant potential, and drug resistance of tumors. The aim of the systematic review is to evaluate and summarize the results of the published studies regarding the use of microRNAs as biomarkers for OSCC. Material and Methods: A literature search was conducted on PubMed, Scopus, Web of Science, and Cochrane databases till November 2020. A total of 34 studies met the inclusion criteria and were therefore subjected to quality assessment. Each study was subjected to data extraction including; patient characteristics, type of fluid sample (whole blood, plasma, serum, or saliva), molecular analysis method, specific dysregulated microRNA, and microRNA expression pattern. Results: The analysis showed that 57 microRNAs of liquid biopsy samples of four different fluids (whole blood, serum, plasma, and saliva) were analyzed. The prognostic and therapeutic significance of these microRNAs were suggested by several studies; where 41 microRNAs were upregulated while 16 were downregulated. Conclusions: Scientific evidence supports the interest in the use of microRNAs in the diagnosis and prognosis in OSCC patients; however, further studies in a larger cohort of patients are mandatory to introduce liquid biopsy in the routine clinical practice for the OSCC management. Key words:Biomarkers, liquid biopsy, microRNA, oral squamous cell carcinoma, systematic review.

Imipenem Resistance in Gram-Negative Bacteria in the Central Pediatric Teaching Hospital in Baghdad, Iraq.

Antimicrobial resistance (AMR) is a serious challenge for infectious disease prevention and treatment, according to the World Health Organization. It is a worldwide problem caused primarily by inappropriate and insufficient therapy, misuse of antimicrobials without physician supervision, unnecessary hospital readmissions, and other factors. AMR has several consequences, including increased medical costs and mortality. The present study aimed to evaluate imipenem resistance in gram-negative bacteria in Central Pediatric Teaching Hospital in Baghdad, Iraq, and determine this bacteria resistance in different samples. Initially, a total of 100 different samples were collected from child patients from October 1, 2020, to August 31, 2021. Each isolate was identified using VITEK 2 automated microbiology system. The recorded data showed that the isolated organisms resistant to imipenem included Klebsiella pneumonia (n=21), Pseudomonas aeruginosa (n=19), and Acinetobacter baumannii (n=16). In the current study, Klebsiella pneumonia was the most common pathogen in males (n=57) compared to female (n=43), followed by Pseudomonas aeruginosa and Acinetobacter baumannii, particularly in the age range of 1 day- 3 years. Depending on the sample type, Klebsiella pneumonia, the most imipenem-resistant bacteria, was found more in the urine of patients with urinary tract infections. Pseudomonas aeruginosa was equally found in blood, urine, wound swab, and sputum samples. In comparison to other samples, Acinetobacter baumannii was found in greater numbers in the blood and in an equal number in urine and cerebrospinal.

Surveillance of Pathogenicity of Rhizoctonia solani Japanese Isolates with Varied Anastomosis Groups and Subgroups on Arabidopsis thaliana.

Rhizoctonia solani is a necrotrophic plant pathogen with a wide host range. R. solani is a species complex consisting of thirteen anastomosis groups (AGs) defined by compatibility of hyphal fusion reaction and subgroups based on cultural morphology. The relationship between such classifications and host specificity remains elusive. Here, we investigated the pathogenicity of seventeen R. solani isolates (AG-1 to 7) in Japan towards Arabidopsis thaliana using leaf and soil inoculations. The tested AGs, except AG-3 and AG-6, induced symptoms in both methods with variations in pathogenicity. The virulence levels differed even within the same AG and subgroup. Some isolates showed tissue-specific infection behavior. Thus, the AGs and their subgroups are suggested to be not enough to define the virulence (host and tissue specificity) of R. solani. We also evaluated the virulence of the isolates on Arabidopsis plants pretreated with salicylic acid, jasmonic acid, and ethylene. No obvious effects were detected on the symptom formation by the virulence isolates, but ethylene and salicylic acid slightly enhanced the susceptibility to the weak and nonvirulent isolates. R. solani seems to be able to overcome the induced defense by these phytohormones in the infection to Arabidopsis.

Response Surface Optimization of Extraction Conditions and In Vitro Antioxidant and Antidiabetic Evaluation of an Under-Valued Medicinal Weed, Mimosa pudica.

Mimosa pudica Linn is a well-known perennial herb and is traditionally used in ayurvedic medicine for the treatment of various illnesses. Despite its abundance in nature, the therapeutic potential of this invasive weed is deemed to be underappreciated in Malaysia. Previous studies have found an abundance of bioactive compounds associated with potent antioxidant properties in all parts of the plant. However, the optimum parameters required for the extraction of antioxidant compounds are still unknown. Therefore, the present study aimed to optimize the solvent extraction parameters of M. pudica using response surface methodology to enrich the accumulation of antioxidant compounds in the extracts. The effects of the optimized M. pudica extracts were then evaluated on the cell viability and glucose uptake ability in a 3T3-L1 adipocyte cell line. The highest total phenolic (91.98 mg of gallic acid equivalent per g of the dry extract) and total flavonoid content (606.31 mg of quercetin equivalent per g of the dry extract) were recorded when using 100% ethanol that was five-fold and three-fold higher, respectively, as compared to using 50% ethanol. The extract concentration required to achieve 50% of antioxidant activity (IC50 value) was 42.0 µg/mL using 100% ethanol as compared to 975.03 µg/mL using 50% ethanol. The results indicated that the use of 100% ethanol solvent had the greatest impact on the accumulation of antioxidant compounds in the extract (p < 0.05). Cell viability assay revealed that all extract concentration treatments recorded a viability level of above 50%. Glucose uptake assay using 2-NBDG analog showed that the cells treated with 50 µg/mL extract combined with insulin were five-fold higher than the control group. Given the high antioxidant and antidiabetic properties of this plant, M. pudica can be easily highlighted as a plant subject of interest, which warrants further investigation for nutraceutical prospects.

Role of elastography strain ratio and TIRADS score in predicting malignant thyroid nodule.

OBJECTIVE: Ultrasonography (US) is the most accurate and cost-effective imaging method in diagnosis of thyroid nodules. A practical thyroid imaging reporting and data system (TIRADS) for thyroid nodules has been proposed to classify nodules of the thyroid gland to solve the problem of nodule selection for fine needle aspiration cytology (FNAC). Real-time elastography and strain ratio (SR) is a method used to assess the stiffness and predict the malignancy of thyroid nodules. The objective of this study was to assess the role of elastography and SR and the TIRADS scoring system in discriminating malignant from benign thyroid nodules. METHODS: From 2015 to 2018 at Cairo University Hospital, a series of 409 patients with thyroid nodules was referred to undergo thyroid ultrasound. Categorization of each nodule according to the TIRADS ranged from 1 to 5. The qualitative elastography score and semiquantitative SR of the nodules were evaluated. Final diagnosis was done by either post-thyroidectomy histopathological examination or US-guided FNAC. RESULTS: Our study included 409 patients with thyroid nodules. Their mean age was 39 ± 10 SD; 36 were males and 373 were females. There were 22 malignant nodules and 387 benign nodules. There were statistical differences between benign and malignant nodules regarding TIRADS classification, SR, anteroposterior/transverse ratio, degree of echogenicity, border, presence of calcification, and absence of halo sign (P < 0.001). The elastic properties of thyroid nodules proved to be a good discriminator between malignant and benign nodules (P- < 0.001) at a cut off value of > 2.32 with 95.2% sensitivity and 86.5% specificity. For every unit increase in SR, the risk of malignancy increased by nearly 2 times. Patients with irregular borders had nearly 17 times increased risk of malignancy than those with regular borders. CONCLUSION: Elastography and SR proved to be of high significant value in discriminating benign from malignant nodules, so we recommend adding it to the TIRADS classification.

Abdominal Computed Tomography Angiography and Venography in Evaluation of Hemorrhagic and Thrombotic lesions in Hospitalized COVID-19 patients.

PURPOSE: To report imaging findings at computed tomography angiography (CTA) and venography (CTV) of the abdomen and pelvis in evaluation of hemorrhagic and thrombotic lesions in hospitalized patients with COVID-19. METHODS: In this retrospective observational study, patients admitted to a single tertiary care center from April 1 to July 20, 2020, who tested positive for SARS-CoV-2 and developed acute abdominal pain or decreasing hemoglobin levels over the course of hospitalization were included. Abdominal CTA/CTV imaging studies performed in these patients were reviewed, and acute hemorrhagic or thromboembolic findings were recorded. RESULTS: A total of 40 patients (mean age, 59.7 years; 20 men, 20 women) were evaluated. Twenty-five patients (62.5%) required intensive care unit (ICU) admission and 15 patients (37.5%) were treated in the medical ward. Hemorrhagic complications were detected in 19 patients (47.5%), the most common was intramuscular hematoma diagnosed in 17 patients; It involved the iliopsoas compartment unilaterally in 10 patients, bilaterally in 2 patients and the rectus sheath in 5 cases. Pelvic extraperitoneal hemorrhage was found in 3 patients, and mesenteric hematoma in one patient. Thromboembolic events were diagnosed in 8 patients (20%) including; arterial thrombosis (n = 2), venous thrombosis (n = 2), splenic infarct (n = 1), bowel ischemia (n = 1) and multiple sites of thromboembolism (n = 2). CONCLUSION: Our study highlights that both hemorrhagic and thromboembolic complications can be seen in hospitalized patients with COVID-19. It is important that radiologists maintain a high index of suspicion for early diagnosis of these complications.