Consumers are exposed to a diversity of chemicals in all areas of life. Air, water, soil and food are all unavoidable components of the human environment. Each of those elements influences the quality of human life, and each of them may be contaminated. We are exposed to toxic or potentially toxic compounds in many ways in our daily lives and toxicology is clearly a subject of great importance for society. This becomes apparent when we look at the types of poisons and the ways in which we are exposed to them. Indeed, the categories cover virtually all the chemicals one might expect to encounter in the environment. After consideration of this, one might well ask “Are all chemicals toxic?” Phrase as an answer: “There are no safe chemicals, only their safe use”. Xenobiotics are defined here as those compounds, both organic and inorganic, produced by human beings and introduced into the environment, as well as into the food chain at concentrations that cause undesirable effects. Xenobiotics in the food chain are monitored in two forms: by testing – the objective of which is to discover unsuitable foodstuffs in the consumer’s network, and by monitoring – to obtain objective information about environmental components contamination and to harmlessness health of available foodstuffs.

The main objective of the study was to find out prevalence of depression and anxiety symptoms in the population of patients with AMI with ST-segment elevation (STEMI), treated with primary PCI (pPCI). Secondary target indicators included the incidence of sleep disorders and loss of interest in sex. The project enrolled 79 consecutive patients with the first AMI, aged <80 years (median 61 years, 21.5% of women) with a follow-up period of 12 months. Symptoms of depression or anxiety were measured using the Beck Depression Inventory II tests (BDI-II, cut-off value ≥14) and Self-Rating Anxiety Scale (SAS, cut-off ≥ 45) within 24 hours of pPCI, before the discharge, and in 3, 6 and 12 months). Results with the value p<0.05 were considered as statistically significant. The BDI-II positivity was highest within 24 hours after pPCI (21.5%) with a significant decline prior to the discharge (9.2%), but with a gradual increase in 3, 6 and 12 months (10.4%; 15.4%; 13.8% respectively). The incidence of anxiety showed a relatively similar trend: 8.9% after pPCI, and 4.5%, 10.8% and 6.2% in further follow-up. Patients with STEMI treated by primary PCI have relatively low overall prevalence of symptoms of depression and anxiety. A significant decrease in mental stress was observed before discharge from the hospital, but in a period of one year after pPCI, prevalence of both symptoms was gradually increasing, which should be given medical attention.

Congenital anomaly is a partial or complete structural and/or functional defect during intrauterine life. Globally, major congenital anomalies account for 6% of all newborns among which about 94% of cases occurred in developing countries. In spite of its public health importance, very limited studies are reported in Ethiopia, and hardly any study in Arsi Zone. To determine the predictors of congenital anomalies among newborns in Arsi Zone Public Hospitals, Southeast Ethiopia. A multi-center institutional-based case-control study was conducted in 418 (105 cases and 313 controls) of newborns in Arsi Zone Public Hospitals. Descriptive analysis, binary and multivariable logistic regressions were implemented. In this study, women who have been drinking alcohol during pregnancy were 3.48 times more prone to have newborns with congenital anomalies than their counterparts (AOR = 3.48; 95% CI: 1.38, 8.74). The likelihood of having a newborn with congenital anomalies was six and four times higher for women who had a maternal illness (AOR = 6.10; 95%CI: 2.39, 15.57) and chewing khat during pregnancy (AOR = 4; 95%CI: 1.49, 10.65), respectively. Moreover, the lack of folic acid supplementation and pesticides during pregnancy were 3.25 and 4.76 times more likely to experience a newborn with congenital anomalies, respectively. Alcohol drinking, maternal illness, khat chewing, and chemical exposure during pregnancy had a significant association with the occurrence of congenital anomalies. While, taking folic acid supplements had a protective effect. Health experts and the community should take these factors into consideration and act accordingly

To investigate proliferation in disease free postmenopausal endometrium and that harbouring endometrial adenocarcinoma—is there a dynamic, yet lurking, potential for atrophic endometrium to give rise to endometrial adenocarcinoma? The study comprised 84 disease free endometria from asymptomatic postmenopausal women who had undergone hysterectomy for prolapse, and 50 endometrioid cell type endometrial adenocarcinomas with adjacent uninvolved postmenopausal endometrium. The non-neoplastic tissues were separated histologically into active, inactive, and mixed forms, although only the first two categories were studied immunohistochemically for oestrogen and progesterone receptors (ERs, PRs), epidermal growth factor receptor (EGFR), Ki-67, and angiogenic activity. All postmenopausal endometria were atrophic, but only 42 were inactive; of the remaining samples, 22 were weakly proliferative and 20 were mixed active and inactive. In contrast, the nonneoplastic component of 43 of the 50 endometrial adenocarcinomas examined was of the active form; four specimens were of the pure and 39 of the mixed form. Interestingly, high ER and PR expression was seen in active and inactive endometria, but only the former were EGFR positive and had high proliferative (Ki-67) and angiogenic activity. A similar trend was also shown by the non-neoplastic atrophic endometrium adjacent to endometrial adenocarcinoma. At least half of the disease free postmenopausal atrophic endometria show a weak proliferative pattern, either diffuse or focal, probably as a response to continuous low level oestrogenic stimulation. These tissues have a latent, although very small, carcinogenic potential, as demonstrated by the immunohistochemical profile and their frequent association with adjacent endometrial adenocarcinoma.

The present method comparison study was carried out in the Radiology and Imaging Department of Dhaka Medical College & Hospital, Dhaka during the period of January 2012 to December 2013 to evaluate the role of Magnetic Resonance Imaging in the diagnosis of cervical disc herniation. A total of 40 patients having clinical features of cervical disc herniation with neck pain referred to the Department of Radiology & Imaging for MRI of their cervical spine were included in the study. At first all the patients were evaluated by detail history and clinical examination with special emphasis on clinical features. Then subsequently MRI of cervical spine was performed in all cases. The MRI report was checked by a competent radiologist of the department of Radiology and imaging DMCH. Among these 40 patients 11 were operated in department of neurosurgery, DMCH and 29 were operated in spine surgery unit, Department of Orthopaedic, BSMMU, Dhaka. The MRI and peroperative findings of these 40 patients were analyzed for the study. MRI findings correlated well in most of the cases with preoperative findings. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MRI in the diagnosis of cervical disc herniation were 94.12%, 83.33%, 96.97%, 71.43% and 92.5% respectively. Therefore it can be concluded that MRI may be used as a reliable tool with which we can assess the level, type and position of cervical disc herniation and can plan the subsequent appropriate management in majority of cases.

Coronavirus related respiratory illness usually manifests clinically as pneumonia with predominant imaging findings of an atypical or organizing pneumonia. Plain radiography is very helpful for COVID-19 disease assessment and follow-up. It gives an accurate insight into the disease course. We aimed to determine the COVID-19 disease course and severity using chest X-ray (CXR) scoring system and correlate these with patients’ age, sex, and outcome. In our study, there were 350 patients proven with positive COVID-19 disease; 220 patients (62.9%) had abnormal baseline CXR and 130 patients (37.1%) had normal baseline CXR. During follow-up chest X-ray studies, 48 patients (13.7%) of the normal baseline CXR showed CXR abnormalities. In abnormal chest X-ray, consolidation opacities were the most common finding seen in 218 patients (81.3%), followed by reticular interstitial thickening seen in 107 patients (39.9%) and GGO seen in 87 patients (32.5%). Pulmonary nodules were found 25 patients (9.3%) and pleural effusion was seen in 20 patients (7.5%). Most of the patients showed bilateral lung affection (181 patients, 67.5%) with peripheral distribution (156 patients, 58.2%) and lower zone affection (196 patients, 73.1%). The total severity score was estimated in the baseline and followup CXR and it was ranged from 0 to 8. The outcome of COVID-19 disease was significantly related to the age, sex, and TSS of the patients. Male patients showed significantly higher mortality rate as compared to the female patients (P value 0.025). Also, the mortality rate was higher in patients older than 40 years especially with higher TSS. Radiographic findings are very good predictors for assessing the course of COVID-19 disease and it could be used as long-term consequences monitoring

Arterio-venous anastomoses (AVAs) are direct connections between small arteries and small veins. In humans they are numerous in the glabrous skin of the hands and feet. The AVAs are short vessel segments with a large inner diameter and a very thick muscular wall. They are densely innervated by adrenergic axons. When they are open, they provide a low-resistance connection between arteries and veins, shunting blood directly into the venous plexuses of the limbs. The AVAs play an important role in temperature regulation in humans in their thermoneutral zone, which for a naked resting human is about 26C to 36C, but lower when active and clothed. From the temperature control center in the hypothalamus, bursts of nerve impulses are sent simultaneously to all AVAs. The AVAs are all closed near the lower end and all open near the upper end of the thermoneutral zone. The small veins in the skin of the arms and legs are also contracted near the lower end of the thermoneutral zone and relax to a wider cross section as the ambient temperature rises. At the cold end of the thermoneutral range, the blood returns to the heart through the deep veins and cools the arterial blood through a countercurrent mechanism. As the ambient temperature rises, more blood is returned through the superficial venous plexuses and veins and heats the skin surface of the full length of the 4 limbs. This skin surface is responsible for a large part of the loss of heat from the body toward the upper end of the thermoneutral zone

This study aimed to assess efficacy and safety data from pilot trials of the radial extracorporeal shock wave therapy (rESWT) to treat benign prostatic hyperplasia (BPH) refractory to current medical therapy. A total of 29 men with lower urinary tract symptoms (LUTS) suggestive of BPH who had responded poorly to medical therapy for at least 6 months and were poor surgical candidates were enrolled. Each participant was treated with rESWT once a week for 8 weeks, each by 2000 impulses at 2.0 bar and 10 hertz of frequency. International Prostate Symptom Score (IPSS), quality of life (QoL), and International Index of Erectile Function-5 (IIEF-5) were evaluated before treatment, after the fourth and eighth rESWT, and 3 months after the end of treatment. Peak urinary flow (Qmax) and postvoid residual (PVR) were assessed. Safety was also documented. Statistically significant clinical improvements were reported for IPSS, QoL, and IIEF-5 after treatment, and those were sustained until 3 months follow-up. Qmax and PVR improved evidently at 8 weeks with a 63% and 70% improvement, respectively. The only adverse event was the occasional perineum pain or discomfort, which usually disappeared within 3 days. The rESWT may be an effective, safe, and noninvasive treatment for symptomatic BPH in selected patients whose medical treatment has faced failure and are poor surgical candidates.

The risk of hypoglycemia with anti-hyperglycemic agents is an important limiting factor in the management of type 1 (T1DM) and type 2 (T2DM) diabetes mellitus. While hypoglycemia is more common in T1DM, the incidence is high in T2DM patients who use insulin or secretagogues, particularly patients with longer duration of diabetes. The underlying cause of hypoglycemia in diabetes is a complex interaction between hyperinsulinemia and compromised physiologic and behavioral responses to falling glucose levels. Pancreatic dysfunction also causes loss of normal therapeutic response to hypoglycemia—a reduction in circulating insulin (in T2DM only) and an increase in glucagon secretion. In T1DM and advanced T2DM, the third defense against hypoglycemia is increase in adrenomedullary sympathoadrenal epinephrine secretion, which is also compromised, causing the syndrome of defective glucose counterregulation. Diminished increase in epinephrine, also called hypoglycemia-associated autonomic failure (HAAF), is largely responsible for defective glucose counterregulation. HAAF can result in recurrent hypoglycemia and lowering of glycemic threshold that typically triggers sympathoadrenal response to hypoglycemia. This results in hypoglycemia without warning symptoms, or “hypoglycemia unawareness,” which increases the risk of severe hypoglycemia associated with substantial morbidity and mortality. Long-term effects of severe hypoglycemia, aside from causing accidents, may include adverse cardiovascular outcomes and cognitive impairment. To reduce the impact of hypoglycemia, it is important to identify patients at risk and use careful consideration when choosing antidiabetes medications. Newer insulin analogs that more accurately replicate endogenous insulin secretion and incretin therapies that cause glucose-sensitive insulin secretion may ultimately reduce the risk of hypoglycemia.

Migraine is a common disabling brain disorder. Approximately 1% of the world’s population may have chronic migraine. Cerebral hemodynamics during different phases of the migraine attack demonstrate alterations in cerebral blood flow and perfusion, vessel caliber, cortical and sub-cortical function, underscoring that migraine pathophysiology is highly complex. Transcranial dopplerography assessment of blood flow parameters in patients with migraine. A retrospective analysis of the results of TransCranial Dopplerography (TCD) of the middle cerebral artery and main cerebral veins was performed in 117 patients with migraine-54 with aura and 63 without aura. The age of the subjects was 18-43 years, among them 53 (45.3%) men and 64 (54.7%) women. The maximum Systolic Velocity (Vs), the Resistance and Pulsativity Indexes (RI, PI) in Middle Cerebral Artery (MCA) the maximum systolic velocity in Basal Vein of Rosenthal (BVR) and in the Direct Sinus (DS) were determined. According to MRI data, structural changes in white matter of the brain were detected in 19 (30.2%) patients with migraine without aura (1st group) and 28 (51.9%) patients with migraine with aura (2nd group). The Vs in MCA among patients of 1st group averaged 127.9±6.8cm/c, in the patients of 2nd group - 61.7±5.7cm/c, in the control group - 108.4±6.1cm/c respectively. The Vs in a patient of 1st group were significantly higher than in patients of 2nd group and control group (P1-2<0.001, P1-2<0.001). The value of Vs was significantly lower than in the control group (P2-3 <0.001). In the first group, the value of RI was significantly (P1-2<0.05) less than in the second group. The value of PI in patients with migraine with aura was significantly higher (P<0.05) than in the group with migraine without an aura and a control group. The highest systolic blood flow velocity and asymmetry in the basal vein of Rosenthal was noted in patients of 1st group and amounted to 46.4±5.7cm/s, in the 2nd group - 27.8±4.6cm/s, in the control group - 21.4±3.8cm/c, respectively. The value of Vs among patients of 2nd group with high reliability (P 2-1<0.01, P 2-3<0.001) exceeded the rate in patients of 1st group and control group. In patients with migraine without an aura in the fetal period, the systolic blood flow velocity in the middle cerebral artery increases, the resistance index decreases. In patients with migraine with aura, the greatest increase in systolic blood flow velocity in the direct sinus is observed.