Factitious Disorders ; diagnosis ; etiology ; Female ; Humans ; Language ; Middle Aged ; Parkinsonian Disorders ; complications ; Syndrome

Aims: Variation in the traditional growth medium conditions to enhance the production of lipids, carbohydrates, protein and the free amino acids content of three cyanobacterial species. Methodology and Results: Three species of cyanobacteria (Anabaena laxa, Anabaena fertilissima and Nostoc muscorum) were collected from the culture collection of Soils, Water and Environment Research Institute, Agriculture Research Center, Giza, Egypt, to investigate their biochemical composition under different growth conditions, using BG110 (nitrogen free) as growth medium. These conditions were represented by control medium, static glucose medium with (1%, w/v), aerated medium (aerated by bubbling technique depending on CO2 normally existed in air with a concentration of 0.03%), molasses medium (0.7%, v/v) and aerated medium enriched with glucose (1%, w/v). Lipid content, total carbohydrates, soluble proteins and free amino acids were determined at the previous conditions. Glucose at 0.7% (w/v) was the most favorable for lipid production in A. laxa, where it exhibited the highest lipid content (427 μg/g fresh wt.). Increasing molasses concentration up to 0.7% (v/v) produced an increase in lipid contents of the tested cyanobacterial strains. The highest lipid content of both N. muscorum (366.2 μg/g fresh wt.) and A. laxa (357.4 μg/g fresh wt.) were recorded at molasses concentrations of 0.1 and 0.7% (v/v), respectively. A. laxa expressed high significant values for both proteins (31.6 μg/mL) and free amino acids (40.5 mg/g dry wt.) after 6 days of incubation period under aerated enriched glucose condition (1%, w/v). Also, at the same growth conditions, A. fertilissima exhibited high significant values for carbohydrates at 4th day (876.8 mg/g dry wt.). Conclusion, significance and impact of study: Aerated enriched glucose medium (1%, w/v) was the best growth medium condition used in the present study.

Cutaneous sins tract of dental origin are often misdiagnosed and inappropriately treated because of their uncommon occurrence and absence of symptoms in about half of the patients. A case report describing the diagnosis and treatment of an extra oral cutaneous sinus tract of odontogenic origin in relation to mandibular left first molar with surgical treatment and proper antibiotic coverage is presented.

The mucocele is a salivary gland pathology that results from rupture of salivary gland duct and spillage of mucin into the surrounding tissues. The term mucous extravacation is also used to describe this lesion. The rupture of the gland or duct may be due to local trauma. The most common site of mucocele is lower lip. The treatment of mucocele includes cryosurgery , intra-lesional corticosteroid injection, micro-marsupialization, marsupialization of the mucocele, conventional surgical removal of the lesion , and laser ablation. The advantages of laser ablation over other methods include less treatment time, avoidance of suturing, minimal complications and relapse. Here we report a case of mucocele on lower lip treated using diode laser.

Dentinogenesis imperfecta is an autosomal dominant disorder of tooth development characterized by the presence of opalescent dentine, resulting in a dusky blue to brownish discoloration of the teeth. It is the most common dental genetic disease. This condition is genetically and clinically heterogeneous, it may affect only the teeth or it may be associated with the osteogenesis imperfecta. Diagnosis is based on history, clinical examination and radiographic features. This report describes an 18 year old male patient who showed the characteristic dental features of dentinogenesis imperfecta.

Graft-versus-host Disease (GVHD) is the main cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (alloHSCT). In spite of immune-suppressive prophylaxis, most survivors suffer from acute and chronic GVHD (aGVHD and cGVHD). The outcome of alloHSCT may be affected by the presence of single nucleotide polymorphism (SNP) in non-HLA genes including those involved in innate immune responses. This study aimed to evaluate the impact of cytotoxic T-lymphocyte antigen-4 (CTLA-4) and caspase recruitment domain 15 (NOD2/CARD15) gene polymorphisms on the incidence and severity of aGVHD and cGVHD following alloHSCT. A structured literature review was carried out using various keywords and MESH terms such as stem cell transplantation, allogenic haematopoietic stem cell transplantation, GVHD, and non-HLA gene polymorphism, in PubMed, Google Scholar and Cochrane Database. A total of 8 studies that met inclusion criteria (English publications from 2006 to 2017) were included. Ten SNPs in CTLA-4 gene and three SNPs in NOD2/CARD15 gene were tested in patients with underlying haematological malignancies. Four studies tested the SNPs of CTLA-4 gene and two were found to have an association with CTLA-4 SNPs (rs3087243, rs231775) and increased incidence of aGVHD. The other four studies tested the SNPs of NOD2/CARD15 gene and one found an association between SNP13 and increased incidence of aGVHD. None of these eight studies found any effect on severity of GVHD. In conclusion, two SNPs in CTLA-4 and one SNP in NOD2/CARD15 increased the incidence of aGVHD but not its severity. The higher incidence of aGVHD in studies with larger sample size could support the impact of SNPs in the outcome of alloHSCT. However, due to the heterogeneity of studies in regard to the age of patients and donor, and conditioning regimen, it is difficult to draw a definite conclusion

The extent of the economic burden of malaria and its imposed mechanisms are both relevant to public policy. This paper investigates the economic burden of malaria and household behaviour in relation to the treatment and prevention of the illness in Pakistan. In this regard, data were collected from a randomly selected sample of 360 households using structured questionnaires. The survey results indicate that 23.4% of household members contracted malaria during the three-month reference period. The average per person cost of malaria is estimated at 3116 Pakistani rupees (PKR) (USD 32). The estimated cost of the illness was found to be equivalent to, on average, 6.7% of monthly household income. Although high-income households face a higher financial burden due to better preventive and mitigation measures, the negative consequences hit low-income households harder due to liquidity constraints and poor access to effective treatment. We recommend that malaria control policies be integrated into development and poverty reduction programs.

Introduction: The Gallbladder stone (GBS) disease is most commonly asymptomatic that may lead to several complications such as ascending cholangitis and obstructive jaundice. In this study the frequency of gallbladder stones among patients referred for abdominal ultrasound at the University of Science and Technology hospital (USTH), Sana’a – Yemen, have been estimated during the period between January and June 2013. Methods: This study is a record-based and conducted at the radiology department in USTH, on cases underwent abdominal ultrasound during the period from January – June 2013. Information were collected from abdominal ultrasonography reports. Results: In this study 4935 patients’ records are included. Of them, 2541 were males and 2394 were females. The frequency of patients with GBS was 5.53%. Multiple stones were observed in 3.57% of patients and 4.34% patients had large stones with size ≥ 5 mm. Females had significantly higher frequency of GBS (8.0%: 191/2394) than males (3.2%: 82/2541) (P < 0.001). It was found that, no significant difference between males and females in harboring small stones (< 5mm) (P = 0.251). However, significantly higher frequency of large GBS (≥ 5 mm) was found among females compared to males (P < 0.001). The frequencies of GBS, small size of GBS and large size of GBS have significantly increased with increasing age (P < 0.001). Conclusion: In this study it was found that females had significantly higher frequency of GBS than males. No significant difference between males and females in harboring small stones. There was a significantly higher frequency of large GBS was found among females compared to males. The frequencies of GBS, small size of GBS and large size of GBS have significantly increased with increasing age.

Introduction: Estimation of gestational age (GA) is clinically crucial for managing pregnancy and assessing the foetal anatomy, growth and development. Transverse cerebellar diameter (TCD) has been reported as an accurate tool for dating the pregnancy. This study aimed to determine the accuracy of foetal TCD for dating the pregnancy and to construct a reference chart for GA of Yemeni foetuses. Methods: We conducted this prospective cross-sectional study among 400 Yemeni pregnant women between 18 and 40 weeks of gestation provided that they were with known last menstrual period and singleton normal pregnancies. Sonographic TCDs were measured for each foetus. The mean TCD was measured for gestational weeks separately, and a polynomial regression model was then used to predict the GA by TCD. Results: There was a robust correlation between GA and TCD (r = 0.995, p <0.001). The coefficient of determination was 0.989, which indicates that the TCD explains 98.9% of GA change. Conclusion: TCD is an accurate tool to estimate the GA in second and third trimesters, including final weeks, among Yemeni pregnant women as in developed countries. The narrow range between the 5% and 95% percentiles is a significant indication of the accuracy of the TCD in estimating the GA. Therefore, clinicians are recommended to use TCD for estimating the GA and should be trained on measuring it accurately.