Expression of Long Noncoding RNA, HOTAIR, and MicroRNA-205 and Their Relation to Transforming Growth Factor ß1 in Patients with Alopecia Areata.

Introduction: Alopecia areata (AA) is a common autoimmune condition that affects anagen hair follicles. The most commonly recognized theory is that it is a T-cell-mediated autoimmune disorder in a genetically susceptible individual. MicroRNAs (miRNAs) and long noncoding RNAs (lncRNAs) were thought to play a function in the pathogenesis. The expression of lncRNA HOTAIR and miRNA-205 and their relation to transforming growth factor ß1 (TGF-ß1) in AA were not studied. Aim: The aim of the studywas to evaluate the role of miRNA-205, lncRNA, HOTAIR, and TGF-ß1 levels in AA pathogenesis, clinical course, and severity of AA. Methods: Two groups of subjects were included in this case-control study: 50 patients with AA and 50 healthy matched controls. miRNA-205 and lncRNA HOTAIR expression levels were assayed using quantitative RT-PCR, while serum levels of TGF-ß1 were assayed using ELISA techniques. Results: The serum expression of lncRNA HOTAIR was significantly downregulated in AA patients with a p value < 0.001, while the serum expression of both miRNA-205 and TGF-ß1 were significantly upregulated in patients. Discussion/Conclusion: This study highlights the potential role of high serum expression of miRNA-205 and TGF-ß1 and the low serum expression of lncRNA HOTAIR in AA pathogenesis. This could be used as a therapeutic target to treat AA.

Predictors of Malignancy in Thyroid Nodules.

Thyroid swellings are common clinical problem throughout the world and also in Bangladesh. Most of thyroid swellings are multinodular, but a good percentage is solitary thyroid nodule. There is no robust, feasible method for malignancy differentiation has not been well established. The study evaluated thyroid nodules for risk of malignancy and compared history, clinical, sonographic features and FNAC findings with histopathology. This was a cross sectional study on 160 consecutive subjects of thyroid nodules done in the department of ENT and Head Neck Surgery of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh during from July 2018 to December 2019. All patients were admitted and diagnosed by detail history, clinical examination, investigations and underwent thyroidectomy. Detailed history, clinical examination, ultrasonographic finding and FNAC variables were documented retrospectively and a mathematical model was established for malignancy prediction. In this study mean age of the patients of thyroid nodules was 37.54±11.49 years and majority of the patients were within 21-40 years of age. Frequency of thyroid nodules is more in female with male female ratio 1:7. Most of the thyroid nodules appeared in this study within 0-2 years (61.9%). In this series of thyroid nodules constituted 88.1% firm, 8.8% hard, 3.1% cystic. Among the patients 89(55.6%) cases have solitary thyroid nodule and 71(44.4%) cases have multinodular goitre Majority of the nodules were warm 57.5% followed by cold 42.5%. FNAC showed nodular goitre 72.5%, Follicular neoplasm 1.3%, Papillary carcinoma of thyroid 7.5%, colloid goitre 9.4%, suspicious papillary carcinoma 3.8% and lymphocytic thyroiditis 1.3%. In this study out of 85 solid nodule, 69(81.18%) were benign and 16(18.82%) was malignant and out of 3 cystic nodule 3(100%) were benign. In this study most of the benign and malignant nodules were predominantly solid. Study showed the malignancy is significantly (p=0.001) more in solid than cystic nodules. Final diagnosis in this study was done on the basis of histopathological reports. Out of 160 patients, histopathologically benign lesion was 120(75%) and malignant was 40(25%). Among malignant cases 36(22.5%) cases were papillary carcinoma, 1 case was medullary carcinoma and 3 cases were follicular carcinoma.

Occupational ocular health problems among marble workers at Shaq El Tho'ban industrial area in Egypt.

Eye health of the working population is an essential condition for productivity. Marble industry is processed at large scale at Shaq El Tho'ban area where much dust, crushed pieces of stone, and fluctuating temperatures are endangering employees' health generally and eye health specifically. The objectives of this study were assessing the prevalence of the most common ocular health problems associated with marble industry and investigating the impact of the working environment and occupational risk factors on the oculo-visual status of marble workers. A cross-sectional study was conducted among 250 workers, working at Shaq El Tho'ban area in Egypt during the period from August 2020 to September 2021, using a semi-structured questionnaire and eye examination comprised of full ocular history, visual acuity testing (unaided/aided), slit lamp examination, ophthalmoscopy, and Schirmer's type I and tear break up time tests. The current study showed that gritty sensation (65.2%) and eye dryness (51.2%) were the commonest symptoms complained. By examination, conjunctival hyperemia (59.6%) was the most prevalent finding. By performing dry eye tests, dry eye was diagnosed in 60.4% and 51.2% of workers by Schirmer's test and tear break up time test respectively. The study's results indicated that age, working category, smoking, and diabetes had significant impact on development of ocular symptoms, while working duration, diabetes, smoking, ocular symptoms, and ocular foreign body had significant impact on development of dry eye disease. Implementation of engineering control measures, proper designing, and supply of eye PPE together with adequate health education to all workers about occupational health risks and preventive measures are recommended.

MicroRNA-22 Level in Patients with Multiple Sclerosis and Its Relationship with Vitamin D and Vitamin D Receptor Levels.

INTRODUCTION: Multiple sclerosis (MS) is known to be a multifactorial disorder. Numerous observational studies have suggested the implication of multiple genetic and environmental factors in the pathogenesis of MS. The aim of this work was to evaluate expression of the microRNA-22 (miRNA-22) level, in relation to vitamin D (VD) and VD receptor (VDR) levels in patients with MS during remission state. METHODS: This case-control study was conducted in 50 patients with clinically definite MS and 50 age- and sex-matched healthy controls. miRNA-22 expression was assessed in both MS patients and controls using quantitative RT-PCR. The serum level of VD and VDR was assessed in both MS patients and controls using ELISA techniques. RESULTS: The miRNA-22 level was significantly downregulated in MS patients in comparison to controls (p value <0.001). MS patients had also significantly lower VD and VDR levels in comparison to controls (p value <0.001 and <0.001, respectively). Patients with secondary progressive MS (SPMS) have a significantly higher miRNA-22 level than patients with relapsing remitting MS (RRMS) (p value = 0.042). There was a statistically significant positive correlation between the miRNA-22 level and EDSS (p value = 0.033). There was also a statistically significant positive correlation between the miRNA-22 level and VDR level (p value = 0.002). CONCLUSION: The miRNA-22 level was significantly downregulated in MS patients, but it had a positive correlation with disability status. Patients with SPMS have a significantly higher miRNA-22 level than patients with RRMS. VD and VDR levels were significantly lower in MS patients than controls. The miRNA-22 level was positively correlated with the VDR level.

Efficacy of Clotrimazole 1% Solution Compared to Econazole Nitrate 1% + Triamcinolone Acetonide 0.1% Cream in Patient with Otomycosis.

Fungal infection of the ear canal is called Otomycosis. It is more common in hot and humid condition. There are many modalities of treatment or therapeutic agent for treatment of otomycosis. Econazole Nitrate 1% + Triamcinolone Acetonide 0.1% cream is a topical antifungal agent described to be effective in the treatment of otomycosis. This study was performed to compare the efficacy of topical application clotrimazole 1% solution and Econazole Nitrate 1% + Triamcinolone Acetonide 0.1% cream in the treatment of otomycosis. A controlled, randomized and open clinical trial was carried out in ENT department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2020 to July 2020. Patients diagnosed with fungal otitis externa who were treated with topical antifungals were included in this study. They were randomized into two treatment groups: i) Clotrimazole 1% solution, 2) Econazole Nitrate 1% + Triamcinolone Acetonide 0.1% cream. Patients were microscopically evaluated at two weeks of treatment to determine resolution of disease. Recurrence and complications were recorded. Demographic and clinical variables were collected and analyzed, follow up and final outcomes (absence of infection) were compared between two groups. One hundred & two (102) patients were included, 51 in the clotrimazole 1% solution group and 51 in the Econazole Nitrate 1% + Triamcinolone Acetonide 0.1% cream group. Predominant symptoms are pain, pruritus, aural fullness and hearing loss. Aspergillus organism was isolated most frequently (63.73%). Treatment with clotrimazole 1% solution groups resulted in 88.23% resolution vs. 80.39% resolution with Econazole Nitrate 1% + Triamcinolone Acetonide 0.1% cream at 2 weeks of treatment. Econazole Nitrate 1% + Triamcinolone Acetonide 0.1% cream group demonstrated higher treatment failure 11.76 and 19.60 respectively. Clotrimazole 1% solution is more effective than Econazole Nitrate 1% + Triamcinolone Acetonide 0.1% cream for uncomplicated otomycosis. More study is needed to corroborate our results.

Per- and polyfluoroalkyl substances in soil and sediments: Occurrence, fate, remediation and future outlook.

Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are contaminants of great concern due to their wide-spread occurrence and persistence in the environments (i.e., in water, soil and sediment) and potential toxicology even at very low concentration. The main focus of this review is on the PFASs in soil and sediments. More specifically, this review systematically examines the occurrence and toxicological effects with associated risks, fate (i.e., PFASs adsorption by soil and sediment, transportation and transformation, and bioaccumulation), and remediation practices of PFASs in soil and sediment. Various models and equations such as fugacity-based multimedia fate and hydrodynamic models are used to study the fate, transport, and transformation of PFASs. Among different remediation practices, sorption is the dominant process for the removal of PFASs from soil and sediments. Results also indicate that PFASs adsorption onto activated carbon decrease with the increase of carbon chain length in the PFASs. The longer-chain PFASs have larger partition coefficient values than shorter-chained PFASs. Sorption of PFASs to soil and sediments are mainly governed by different electrostatic interactions, hydrogen bonds formation, hydrophobic interactions, organic content in soil and sediments, and ligand exchange. Other technology such as thermal treatment might be potential in the removal of PAFSs, but need further study to elucidate a conclusion. Finally, the associated challenges and future outlook have been included.

Evaluation of antifungal activity of six children's toothpaste on Candida albicans isolated from early childhood caries patients.

BACKGROUND: Early childhood caries (ECC) is an aggressive, destructive form of dental caries that affects the children younger than 6 years of age. Candida is known to increase the adherence of Streptococcus mutans to the oral biofilm and produce acids that cause tooth demineralization. AIM OF THE STUDY: To evaluate the efficacy of six commercially available children's toothpaste on clinical isolates of Candida albicans obtained from ECC patients. MATERIALS AND METHODS: The study population comprised 60 children aged 3-6 years having ECC. Samples were divided into six groups comprising ten children in each group. Samples were collected using sterile cotton swabs, inoculated on Sabouraud dextrose agar, and incubated at 37°C for 24 h. Species identification was done by germ tube test and growth on corn meal agar. After the confirmed growth of C. albicans, the six commercially available children's toothpaste namely Organic Children's Coconut Oil Toothpaste®, Aloe Dent Children's Toothpaste®, Patanjali Dant Kanti Junior Toothpaste®, Colgate Kids Toothpaste®, Pediflor Kids Toothpaste®, and Crest Pro-Health Stages Kids Toothpaste® and distilled water as control group were subjected for antifungal activity of C. albicans. Agar plates were incubated at 37°C for 48 h, and the diameter of the zones of inhibition was measured and recorded. Data were tabulated and statistical analysis was done using Statistical Package for the Social Science (16.0) version. RESULTS: Pediflor kids toothpaste® showed maximum antifungal activity and Aloe Dent children's toothpaste® showed minimum antifungal activity. CONCLUSION: All brands of children's toothpaste show antifungal activity against Candida albicans.

Effect of Sphenoid Sinus Pneumatization on the Surgical Windows for Extended Endoscopic Endonasal Transsphenoidal Surgery.

BACKGROUND: Little is known on the impact of the pattern and extent of pneumatization of the sphenoid sinus (SS) on the dimensions of the surgical windows used in extended endoscopic endonasal transsphenoidal approaches. We therefore investigated whether the distances between the 2 optic canals and between the paired paraclival carotid arteries are influenced by the pattern and extent of pneumatization of the SS. METHODS: One hundred high-resolution computed tomography scans from 47 adult female and 53 adult male patients were analyzed. The pattern of SS pneumatization was classified into conchal, presellar, and sellar types. Sellar-type sinuses were then classified according to a newer detailed classification system. Maximal anteroposterior (AP), transverse (TR), and craniocaudal diameters of the SS, interoptic distance at the limbus sphenoidale (IODL) and at the entrance of the optic canal (IODE) and the intercarotid distance between the paraclival carotids (ICD) were measured. A 2-tailed Mann-Whitney U test and Pearson correlation coefficient (R) were used for statistical analysis. A P value <0.05 was considered statistically significant. RESULTS: Positive correlation was found between IODL and both AP and TR diameters of the SS; between IODE and both AP and TR diameters of the SS; and between ICD and all diameters of the SS. The highest correlation for each of the IODL, IODE, and ICD was noted with the TR diameter of the SS. CONCLUSIONS: During the development of the SS, pneumatization progress likely exerts quantitative and direction-specific forces, which gradually increase the interoptic and intercarotid distances.

Secondary Intraocular Lens Implantation After Simultaneous Penetrating Keratoplasty and Cataract Extraction for Coexisting Corneal and Lens Opacities.

PURPOSE: To report the results of a new approach to the 2-stage surgical management of coexisting visually significant corneal opacities and cataract. METHODS: A retrospective analysis of eyes with corneal opacities and cataract that were surgically treated with simultaneous penetrating keratoplasty and cataract surgery, followed by secondary intraocular lens (IOL) implantation after removal of corneal sutures, was conducted. The parameters used for assessment were the following: mean percentage of graft endothelial cell loss after IOL implantation, deviation of the postoperative mean spherical equivalent from the target refraction, and mean uncorrected distance visual acuity (UDVA). RESULTS: Twenty-nine eyes were included in the study. The mean baseline UDVA was 1.94 ± 0.46, and the mean baseline best-corrected distance visual acuity was 1.56 ± 0.42. The mean interval between the 2 surgical interventions was 13.3 ± 2.2 months. Just before secondary IOL implantation, the mean endothelial cell density was 2198 ± 311 cells. The mean percentage of corneal endothelial cell loss was 7.3% at 6 months after IOL implantation (P = 0.16). Before IOL implantation, the mean spherical equivalent was +11.75 ± 3.38 D. After IOL implantation, the mean spherical equivalent improved to -0.19 ± 0.93 D (P = 0.003) at 6 months. The mean UDVA improved to 0.34 ± 0.18 (P = 0.017), whereas the mean corrected distance visual acuity improved to 0.18 ± 0.29 at 6 months (P = 0.016). All grafted corneas maintained their clarity until the final follow-up visit. CONCLUSIONS: Postponing IOL implantation some months after simultaneous penetrating keratoplasty and cataract extraction has a negligible effect on the corneal graft endothelium and achieves near postoperative target refraction with significant improvement in UDVA.

Intravitreal Clindamycin and Dexamethasone Combined with Systemic Oral Antitoxoplasma Therapy versus Intravitreal Therapy Alone in the Management of Toxoplasma Retinochoroiditis: A Retrospective Study.

PURPOSE: To compare clinical outcome of IVCD combined with oral therapy with IVCD alone in patients with toxoplasmic retinochoroiditis. PATIENTS AND METHODS: Thirty eyes were reviewed. Two equal groups were identified (15 eyes each). Clinical outcome measures were resolution of active inflammation, changes in BCVA and CMT, adverse drug reactions, and rate of recurrence. RESULTS: Mean baseline of BCVA 1.08 ± 0.17 and 1.03 ± 0.15 improved to 0.64 ± 0.18 and 0.69 ± 0.17 at the end of follow-up in group I and II, respectively. No statistically significant difference was observed. CMT was 392.6 ± 33.16 µm and 397.3 ± 14.6 µm significantly decreased to 314.7 ± 4.43 µm and 319.6 ± 7.8 µm. Resolution of acute inflammation was achieved in all cases in both groups. There were no recurrent cases in group I, and only one out of 15 (6.7%) in group II. No ocular or systemic adverse events were recorded. CONCLUSION: IVCD is an effective route of treatment for active toxoplasmic retinochoroiditis that can be used solely without the need to use systemic medications..

Effect of human umbilical cord blood mesenchymal stem cells administered by intravenous or intravitreal routes on cryo-induced retinal injury.

Traumatic optic neuropathy is an important cause of severe vision loss. So, many attempts were performed to transplant stem cells systemically or locally to regenerate the injured retina. In this study, we investigated the effect of human umbilical cord blood mesenchymal stem cells (hUBMSCs) on histological structure, apoptotic, antiapoptotic, oxidant and antioxidant markers in an experimental model of cryo-induced retinal damage in mice. Forty-eight mice were included with 4 major groups; group I contained 18 mice as controls. The others included 30 mice exposed to cryo-induced retinal injury and were subdivided into three equal groups: group II received no treatment after injury. Group III was intravenously injected with hUCBMSCs after injury and group IV received an intravitreal injection with hUCBMSCs into both eyes. Retinal tissues were used for histopathological, immunological and gene expression studies. Real time-PCR was performed to assess B-cell lymphoma 2 (bcl2), Bcl2-associated X protein (bax), heme oxygenase-1 (hmox-1) and thioredoxin-2 (tnx-2) expression and to assess the differentiation of the stem cells into the retinal tissue. Immunohistochemical analysis was performed to assess caspase-3, 3-nitrotyrosine (3-NT) and basic fibroblast growth factor (bFGF). Disturbed retinal structure was seen in cryo-injured mice while hUCBMSCs treated groups showed nearly normal structure. By real time-PCR, significantly reduced mRNA expressions of Bax and notably enhanced mRNA expression of Bcl-2, hmox-1 and txn-2 were demonstrated in retinal injured mice with hUCBMSCs treatment compared to those without. In addition, immunohistochemical analysis confirmed downregulation of 3-NT and caspase-3 and upregulation of bFGF after hUCBMSCs injection in injured retina. Furthermore, there was no differentiation of transplanted stem cells into the retinal tissue. In conclusions, hUCBMSCs could improve the morphological retinal structure in cryo-induced retinal damage model by modulation of the oxidant-apoptotic status and by increased the expression of bFGF. © 2017 IUBMB Life, 69(3):188-201, 2017.

Nanosuspension as an ophthalmic delivery system for certain glucocorticoid drugs.

Poorly-water-soluble compounds are difficult to develop as drug products using conventional formulation techniques. The use of nanotechnology to formulate poorly-water-soluble drugs as nanosuspensions offers the opportunity to address many of the deficiencies associated with this class of molecules. In the present study, the high pressure homogenization method used to prepare nanosuspensions of three practically insoluble glucocorticoid drugs; hydrocortisone, prednisolone and dexamethasone. The effect of particle size in the micron and nano-size ranges as well as the effect of viscosity of the nanosuspension on the ocular bioavailability was studied by measuring the intraocular pressure of normotensive Albino rabbits using shiØetz tonometer. The results show that compared to solution and micro-crystalline suspensions it is a common feature of the three drugs that the nanosuspensions always enhance the rate and extent of ophthalmic drug absorption as well as the intensity of drug action. In the majority of cases nanosuspensions extend the duration of drug effect to a significant extent. The data presented confirms that nanosuspensions differ from micro-crystalline suspensions and solution as ophthalmic drug delivery systems and that the differences are statistically, highly to very highly significant. The results confirm also the importance of viscosity of nanosuspension especially in increasing the duration of drug action.

Changing the prescribing patterns of sexually transmitted infections in the White Nile Region of Sudan.

BACKGROUND: The number of inappropriate prescriptions for sexually transmitted infections (STIs) in Sudan is suspected to be high. Simple multifaceted interventions directed at prescribers may improve prescribing patterns in the Sudan. OBJECTIVE: To evaluate the effect of multifaceted interventions on prescribing for STIs in the White Nile State, Sudan. METHODS: The study involved 20 health centres randomly assigned to four different multifaceted interventions to improve prescribing. RESULTS: Prescriber targeted interventions involving audit and feedback together with academic detailing and practice guidelines reduced the number of inappropriate prescriptions by 50% (p < 0.001). Audit and feedback together with seminars and practice guidelines reduced inappropriate prescriptions by 43% (p < 0.001). Audit and feedback alone reduced inappropriate prescriptions by 16% (p = 0.127). CONCLUSION: Prescribing for STIs in the White Nile State of Sudan needs improving. Multifaceted interventions appear effective in improving prescribing.

Evaluation of the protective potential of Ambrosia maritima extract on acetaminophen-induced liver damage.

The hepatoprotective activity of the aqueous-methanolic extract of Ambrosia maritima was investigated against acetaminophen (paracetamol, 4-hydroxy acetanilide) induced hepatic damage. Acetaminophen at the dose of 640 mg/kg produced liver damage in rats as manifested by the significant (P < 0.001) rise in serum levels of glutamate oxaloacetate transaminase (AST), glutamate pyruvate transaminase (ALT) and alkaline phosphatase (ALP) to 1178.5 +/-118.05; 607.5 +/- 32.6 and 274.16 +/- 8.89 IU/l (n = 10), respectively, compared with respective control values of 97.83+/-3.23; 46.0 +/- 3.92 and 168.67 +/- 7.86 IU/l. Pretreatment of rats with the plant extract (100 and 200 mg/kg) lowered significantly (P < 0.001) the respective serum AST to 203.3+/-5.74 and 157.1 +/- 8.78 IU/l, ALT to 138.67 +/- 7.7 and 87.5 +/- 3.6 IU/l and ALP levels to 238.0 +/- 5.89 and 206.5 +/- 7.5 IU/l, respectively. Treatment of rats with acetaminophen led to a marked increase in lipid peroxidation as measured by malondialdehyde (MDA) (42%). This was associated with a significant reduction of the hepatic antioxidant system e.g. reduced glutathione (GSH) (65%), glutathione reductase (GSH-R) (35%), total glutathione peroxidase (GSH-Px) (32%) and glutathione-S-transferase (GST) (16%). These biochemical alterations resulting from acetaminophen administration were inhibited by pretreatment with A. maritima L. extract. These data suggest that the plant A. maritima L. may act as a hepatoprotective and antioxidant agent.

Alzheimer's disease: recent advances in etiology, diagnosis, and management.

Alzheimer's disease is a chronic and progressive neurodegenerative disorder characterized by cognitive and functional deficit and by behavior disturbance. This disease presents a major clinical and social challenge. Increasing evidence suggests that early intervention can delay the progression of the disease and improve symptoms and cognitive functioning. Recent research focuses on genetic susceptibility. Genetic testing may eventually prove to be useful in identifying persons at risk before the onset of symptoms, but at this stage, this testing plays a limited role in identifying and confirming the diagnosis and in genetic counseling. The diagnostic work in all suspected cases of dementia should be started by family physicians; confirmed cases should be treated as soon as possible by the family physician or referred to a psychiatrist or neurologist for appropriate treatment. Donepezil, new cholinesterase inhibitors, and vitamin E have proved effective in delaying progression of Alzheimer's disease.

Psychological and legal aspects of mental incompetence.

The elderly population in the United States is increasing gradually. Estimates project that during the next 50 years 21% of the population, or approximately 70 million people, will be older than 65 years. Various medical and psychiatric disorders produce cognitive disturbances that result in temporary or permanent incompetence. That incompetence will affect an individual's decision-making capacity and ability to give informed consent. Problems exist related to obtaining informed consent from the elderly and distinguishing between incapacitated versus incompetent individuals. Physicians are responsible for providing information to their patients about a durable power of attorney for health care, a living will, and "do not resuscitate" orders, before they lose their capacity to make decisions related to their health care. Informed consent, living wills, durable power of attorney for health care, and guardianship are discussed.

Biochemical effects of Catha edulis, cathine and cathinone on adrenocortical functions.

Catha edulis is a plant that grows in certain areas of East Africa and the Arab Peninsula. The stimulating properties of fresh material were described more than seven centuries ago and today the habit of inducing a state of euphoria and subjective well-being by chewing Catha edulis prevails among the inhabitants of these regions. Oral administration of this plant and its active constituents (cathine and cathione) on experimental animals might have stimulating effects on adrenocortical function. This was indicated by the significant decrease in adrenal cholesterol, ascorbic acid, glycogen, and the increase in adrenal phosphorylase activity. In addition, the level of urinary 17-hydroxycorticosteroids and plasma free fatty acids were increased.