Immune thrombocytopenia (ITP) is one of the autoimmune diseases that presented by thrombocytopenia and increased risk of bleeding. Etiology of immune thrombocytopenia (ITP) is very complex. ...Lymphocyte function associated antigen-1 (LFA-1) plays important role in ITP. The aim of this study was evaluation of expression of CD11a on lymphocytes to explore its possible role in primary ITP patients also, regarding severity and response to immunosuppressive treatment.
This is a cross-sectional case-control study. Forty adult patients aged (18:58) years, 29 females and 11 males were enrolled as newly diagnosed primary ITP. Forty age and sex matched control subjects were randomly selected. The expression of CD11a on lymphocyte subpopulations (CD3+ T cells, CD3+CD4+ T cells and CD19+ B cells) was analyzed by flowcytometry at the start of the study and after 6 months of follow-up.
The mean fluorescence intensity (MFI) of CD11a on CD3+ T and CD19+ B lymphocytes was significantly highly increased in ITP patients compared to healthy controls while MFI of CD11a on CD3+ CD4+Tclls was non-significant. MFI of CD11a on CD3+ and CD19+ B lymphocytes showed non-significant elevation with platelet count or bleeding score. MFI of CD11a on CD3+ showed significant highly increased level in refractory ITP compared with responder cases.
CD11a had possible role in the pathogenesis of ITP. Immunosuppressive therapy in ITP did not affect the level of CD11a expression on T and B lymphocytes. Levels of CD11a do not reflect the severity of ITP neither platelet count nor bleeding score. Increased MFI of CD11a in CD3+T lymphocytes of ITP patients may cause resistance to immunosuppressive therapy.
This study examines the usefulness of computed tomography (CT) scans in evaluating patients with dizziness in the emergency department (ED).
Medical records of patients presented with complaints of ...dizziness or vertigo to the ED of a tertiary university hospital and underwent head CT scans from July 2015 to June 2018 were reviewed. The patients’ demographic information, presenting symptoms, and final head CT scan and Magnetic resonance imaging (MRI) results were collected. Stepwise logistic regressions were used to analyze data.
A total of 326 dizzy patients were included in this study. The majority of the patients (83.1%) were older than 44 years. Acute vertigo pattern of dizziness was detected among 50.6% of the patients and was more common among females than males (p < 0.001). Of these 326 patients who underwent head CT scans, 49 (15%) had abnormal findings with acute ischemic stroke was the most common one. A total of 191 patients underwent follow-up studies. MRI accounted for 70% of the follow-up studies. Of the 134 patients who received MRI of the brain, 36 (27%) had abnormal findings. A significant correlation of RBCs level, presence of other symptoms, and frequency of episodes with the presence of vertigo (p < 0.001) was found.
The study's findings indicate low effectiveness of head CT scan compared to MRI for dizziness management. Future studies are suggested to provide more insights into the cost-effectiveness and utility of head CT scans and MRI in providing valuable findings.
•The majority of the dizzy patients presented to the emergency were older than 44 years.•Acute vertigo was detected among 50.62% of the patients and more common among elderly females.•Lower effectiveness of CT scan compared to MRI in the diagnosing and management of dizziness.•Significant correlation of RBCs level, presence of other symptoms, and frequency of episodes with the presence of vertigo.
Background and Objectives: Immune thrombocytopenia (ITP) is one of the autoimmune diseases that presented by thrombocytopenia and increased risk of bleeding. Etiology of immune thrombocytopenia (ITP) ...is very complex. Lymphocyte function associated antigen-1 (LFA-1) plays important role in ITP. The aim of this study was evaluation of expression of CD11a on lymphocytes to explore its possible role in primary ITP patients also, regarding severity and response to immunosuppressive treatment. Patients and Methods: This is a cross-sectional case-control study. Forty adult patients aged (18:58) years, 29 females and 11 males were enrolled as newly diagnosed primary ITP. Forty age and sex matched control subjects were randomly selected. The expression of CD11a on lymphocyte subpopulations (CD3+ T cells, CD3+CD4+ T cells and CD19+ B cells) was analyzed by flowcytometry at the start of the study and after 6 months of follow-up. Results: The mean fluorescence intensity (MFI) of CD11a on CD3+ T and CD19+ B lymphocytes was significantly highly increased in ITP patients compared to healthy controls while MFI of CD11a on CD3+ CD4+Tclls was non-significant. MFI of CD11a on CD3+ and CD19+ B lymphocytes showed non-significant elevation with platelet count or bleeding score. MFI of CD11a on CD3+ showed significant highly increased level in refractory ITP compared with responder cases. Conclusion: CD11a had possible role in the pathogenesis of ITP. Immunosuppressive therapy in ITP did not affect the level of CD11a expression on T and B lymphocytes. Levels of CD11a do not reflect the severity of ITP neither platelet count nor bleeding score. Increased MFI of CD11a in CD3+T lymphocytes of ITP patients may cause resistance to immunosuppressive therapy. Keywords: Primary immune thrombocytopenia, immunosuppressive therapy, LFA-1, CD11a, B cells, T cells
Assessment of health workers as students and professionals has a profound impact on their learning and is an essential safety valve before certification. It is used for their training, their ...placement, their certification, and their promotion. The multiple choice question MCQ type of tests represents one of the most important examination tools that is commonly used in this assessment. The MCQs can be reliable, valid, and cost-effective in assessing medical knowledge. This paper portrays the different purposes of assessment in the medical field. The paper discusses in detail the criteria of a good assessment tool. Interpretation of MCQ test results is the final section of the paper.
Background & Aims The dilemma of early diagnosis of biliary Atresia (BA), particularly distinguishing it from other causes of neonatal cholestasis is challenging. The aim was to design and validate a ...scoring system for early discrimination of BA from other causes of neonatal cholestasis. Methods A twelve-point scoring system was proposed according to clinical, laboratory, ultrasonographic, and histopathological parameters. A total of 135 patients with neonatal cholestasis in two sets were recruited to design (n = 60) and validate (n = 75) a scoring system. Parameters with significant statistical difference between BA (n = 30) and non-BA (n = 30) patients in the design set were analyzed by logistic regression to predict the presence or absence of BA then a scoring system was designed and validated. Results The total score ranged from 0 to 37.18 and a cut-off value of >23.927 could discriminate BA from other causes of neonatal cholestasis with sensitivity and specificity of 100% each. By applying this score in the validation set, the accuracy was 98.83% in predicting BA. The diagnosis of BA was proposed correctly in 100% and the diagnosis of non-BA was proposed correctly in 97.67% of patients. By applying this model, unnecessary intraoperative cholangiography would be avoided in non-BA patients. Conclusions This scoring system accurately separates infants with BA and those with non-BA, rendering intraoperative cholangiography for confirming or excluding BA unnecessary in a substantial proportion of patients.
•Ecofriendly synthesis of Ag decorated ZnO nanoparticles was carried out.•Carya illinoinensis leaves extract was used as reducing and capping agent.•Decoration of Ag increased the photocatalytic ...activity due to trapping of electrons.•The effect of various factors were examined, degradation kinetic of dye (Rhodamine B) obeyed pseudo first order model.
In the present work, ZnO and Ag@ZnO nanoparticles based photocatalyst were synthesized via green route by using the leaves extract of pecan nuts (Carya illinoinensis) for the first time. The phytochemicals present in leaf of extract pecan nuts (Carya illinoinensis) such as methyl gallate and kaempferol act as capping and reducing agents. The obtained photocatalyst were analyzed via various techniques such as XRD (X-ray diffraction), TEM (transmission electron microscopy), SEM (scanning electron microscopy), FTIR (Fourier transform infrared spectroscopy), PL (Photoluminescence spectroscopy), XPS (X-ray photoelectron spectroscopy) and UV (UV–visible spectroscopy). The activity of biogenic photocatalyst were investigated against RhB (Rhodamine B) dye and the results demonstrated that the catalytic properties become enhanced significantly after Ag doping as compared to bare ZnO. The effect of various parameters were also investigated such as pH, catalyst dose, initial concentration of dye. The obtained results showed highest efficacy of catalyst at pH 10, further the photo-degradation of Rhodamine B (RhB) dye followed pseudo first order kinetic model. The reusability test of biogenic photocatalyst revealed that the catalyst was an excellent option for practical use with high stability even after 5 cycles. The mechanism for, ZnO and Ag@ZnO synthesis and degradation pathway of RhB dye was proposed.
Background
Tranexamic acid (TXA) in oral, topical, and intra‐dermal injection routes showed efficacy in melasma treatment. Micro‐needling and fractional carbon dioxide (CO2) laser were reported to ...enhance the drug delivery of TXA.
Aims
This study aimed at comparing the use of micro‐needling and fractional CO2 laser for drug delivery of TXA in the treatment of facial melasma.
Patients/Methods
Thirty female patients with bilateral symmetrical facial melasma were subjected to micro‐needling, for one side of the face, and fractional CO2 laser, for the other, followed by an immediate topical application of TXA solution 4 mg/mL. Patients received six biweekly sessions.
Results
Two weeks after the last session, a significant reduction in baseline modified melasma area and severity index (mMASI) score was observed on both sides. The mean ± SD baseline mMASI dropped from 3.43 ± 1.84 to 1.59 ± 1.51 (mean reduction 57.73%, P < .001) and from 3.51 ± 1.84 to 1.78 ± 1.51 (mean reduction 55.82%, P < .001) in the micro‐needling–treated side and in the fractional CO2 laser–treated side, respectively. However, no statistically significant differences were found between the two sides (P = .81).
Conclusions
Micro‐needling and fractional CO2 laser are equally safe and effective for the delivery of TXA in the treatment of facial melasma.
Water availability is considered as the main limiting factor of wheat growth illuminating the need of cultivars best adapted to drought situations for better wheat production and yield. Among these, ...the stay-green trait is thought to be related to the ability of wheat plants to maintain photosynthesis and CO
assimilation, and a detailed molecular understanding of this trait may help in the selection of high-yielding, drought-tolerant wheats. The current study, therefore, evaluated the physiological responses of the selected wheat genotypes under pot-induced water stress conditions through different field capacities. The study also focused on exploring the molecular mechanisms involved in drought tolerance conferred due to the stay-green trait by studying the expression pattern of the selected PSI-associated light-harvesting complex I (LHC1) and PSII-associated LHCII gene families related to pigment-binding proteins. The results revealed that the studied traits, including relative water content, membrane stability index and chlorophyll, were variably and negatively affected, while the proline content was positively enhanced in the studied wheats under water stress treatments. Molecular diagnosis of the selected wheat genotypes using the expression profile of 06 genes, viz.
,
,
,
,
and
that encodes for the LHCI and LHCII proteins, indicated variable responses to different levels of drought stress. The results obtained showed the relation between the genotypes and the severity of the drought stress condition. Among the studied genotypes, Chirya-1 and SD-28 performed well with a higher level of gene expression under drought stress conditions and may be used in genetic crosses to enrich the genetic background of common wheat against drought stress.
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