rss_2.0Acta Medica Martiniana FeedSciendo RSS Feed for Acta Medica Martiniana Medica Martiniana Feed Bone as a Cause of Retropharyngeal Abscess<abstract> <title style='display:none'>Abstract</title> <p>In this work, we describe the case of a 68-year-old female patient with an injury to the back wall of the pharynx by a foreign body and its atypical placement in the retropharyngeal space, causing a retropharyngeal abscess. The foreign body was extracted during a transorally direct pharyngolaryngoscopy under general anesthesia. The symptomatology, diagnosis, and therapy of retropharyngeal abscess are the topics of discussion. We emphasize the necessity of timely and thorough localization of the foreign body and its extraction.</p> </abstract>ARTICLEtrue Absorptive Microsampling Technique in the LC-MS Determination of Direct Oral Anticoagulants<abstract> <title style='display:none'>Abstract</title> <p>Direct oral anticoagulants represent a significant group of drugs used in the prevention or treatment of venous thromboembolic events and stroke in patients with atrial fibrillation. Although routine therapy monitoring is not required, there is an increasing evidence that plasma levels may vary between individuals, suggesting the benefit of plasma levels measurement in some situations. Therapeutic drug monitoring is becoming more popular and accessible to the broader population. Introducing microsampling techniques for the quantitative collection of blood samples has arisen nowadays. The volumetric absorptive microsampling approach using a commercially available device such as a Mitra stick overcomes the hematocrit effect present in the dry blood spot technique. This review discusses the possible application of the volumetric absorptive microsampling approach in monitoring direct oral anticoagulant therapy efficacy.</p> </abstract>ARTICLEtrue for Molecular Biomarkers of Parkinson’s Disease. New Tissues and Methods<abstract> <title style='display:none'>Abstract</title> <p>Parkinson’s disease (PD) is a chronic neurodegenerative disorder that is clinically manifested by motor and non-motor symptoms. At the early stage of the disease, it can be misdiagnosed with some neurologic disorders due to overlapping or similar clinical features. In addition, the pathogenesis of this disease is initiated several years prior to the appearance of classical motor symptoms. This latent phase of neurodegeneration in PD characterised at cellular level by preservation of significant fraction of dopaminergic neurones is of particular interest with respect to the development of disease-modifying or neuroprotective therapies which would require intervention at the earliest stages of disease with an aim to slow down or reverse the disease progression. Therefore, huge effort was performed in order to find and validate a biomarker that would reliably differentiate PD from other neurologic diseases as well as a biomarker that would reveal preclinical/prodromal stage of PD. This short review summarises a recent progress in validation of molecular biomarkers of PD, distinct from genetic markers of PD, with some focus on new analysed tissues and new methods.</p> </abstract>ARTICLEtrue and Clinico-Haematological Study of Patients with Pancytopenia in Rural Area<abstract> <title style='display:none'>Abstract</title> <sec> <title style='display:none'>Background</title> <p>Pancytopenia is a manifestation of other underlying conditions, commonly associated with multiple benign and malignant conditions. Any patient presenting with pancytopenia requires a thorough evaluation to identify the underlying aetiology.</p> </sec> <sec> <title style='display:none'>Aim</title> <p>This current evaluates various hematological parameters including bone marrow aspiration (where ever feasible) in pancytopenia in adult group. Study also correlates clinico-haematological profile.</p> </sec> <sec> <title style='display:none'>Method</title> <p>Fifty patients with a hematological diagnosis of pancytopenia were studied during the period August 2020 to August 2022. The study included adult patients of both sexes having the age of 18 years and above. Tests for complete blood count, reticulocyte count, peripheral smear, bone marrow aspiration, and trephine biopsy were done.</p> </sec> <sec> <title style='display:none'>Results</title> <p>Various etiological factors were identified in which majority were of megaloblastic anaemia (48.9%), followed by mixed nutritional anaemia (22.2%), hypersplenism (13.3%), aplastic anaemia (8.9%), malignant conditions (6.7%), myelodysplastic syndromes (2%), and others (4%) respectively. Megaloblastic anaemia cases observed in the age group of 31–50 years with male preponderance. Hemoglobin, TLC, Platelet count, and Reticulocyte count ranged from 2 g% - 10g%, 500–4000 cells/cumm, 24,000–1.5 lakh cells/cumm, and 0.1% – 2%. MCV was higher than 100 fl in 57.5% of cases. Majority of the patients had macrocytic and dimorphic anaemia. Hypersegmented neutrophils were present in all the patients. Bone marrow of Megaloblastic anaemia was hypercellular. Megaloblastic erythropoiesis with giant meta- myelocytes and band forms were seen. Nutritional anaemia seen in the age group of 51-60 years. Haemoglobin, TLC, Platelet count, and Reticulocyte count ranges from 2.3 g%–7.8 g%, 1000–4000 cells/cumm, 5000–1.4 lakh cells/cumm, and 0.1–8%. Two cases had microcytic hypochromic anaemia in Nutritional anaemia. Bone marrow was hypercellular with a reversal of M:E ratio in 93.8% of cases. In hypersplenism seen in the age group of 51–60 years. Haemoglobin, TLC, Platelet count, and Reticulocyte count ranges from 3.8 g% – 10 g%, 1700–3800 cells/cumm, 26000-1.4 lakh cells/cumm, and 0.6–2% respectilvey in hypersplenism. 40% of hypersplenism patients had microcytic hypochromic anaemia. Bone marrow was hypercellular with a reversal of M:E ratio in 70% of hypersplenism cases. Aplastic anaemia seen in the age group of 41–50 years. Haemoglobin, TLC, Platelet count, and Reticulocyte count ranges from 3.1–10 g%, 1100–4000 cells/cumm, 51000–1.5lakh cells/cumm, and 0.2%–1.8%. Aplastic anaemia (35.8%) cases showed macrocytosis. Bone marrow was hypocellular with an increase in marrow fat and Lymphocytes and plasma cells were prominent in Aplastic anaemia cases. Leukaemia commonly seen in the age group of 31–40 years with male predominance. Hemoglobin, TLC, and Reticulocyte count ranges from 5.1–9.8%, 1100–4000 cells/cumm, and 0.6–2% respectively. Bone marrow was hypercellular with a reversal of M:E ratio in 80%.</p> </sec> <sec> <title style='display:none'>Conclusion</title> <p>Megaloblastic anaemia was the commonest cause of pancytopenia. Most other studies have reported aplastic anaemia as the commonest cause. This seems to reflect the higher prevalence of nutritional anaemia in the Indian subjects. The haematological parameters and bone marrow morphological features in patients with megaloblastic anaemia, aplastic anaemia, and malignant diseases including MDS in the present study were comparable to the findings by other authors. Uncommon etiological factors like dengue fever and hemolytic anaemia were identified in this study. A comprehensive clinical, haematological, and bone marrow study of patients with pancytopenia usually helps in identification of the underlying cause. However, in view of a wide array of etiological factors, pancytopenia continues to be a challenge for hematologists.</p> </sec> </abstract>ARTICLEtrue Nasal Nitric Oxide Measurement an Useful Diagnostic Tool in Respiratory Diseases?<abstract> <title style='display:none'>Abstract</title> <p>Nasal nitric oxide (nNO), discovered in exhaled air in 1991, is produced in the nose and paranasal sinuses. This small gaseous molecule plays various roles in the organism, e.g. the first line defense through its antiviral and antimicrobial activity, stimulation of ciliary motility, regulation of pulmonary function. The measurement of nNO has become a diagnostic tool in various diagnoses, such as primary ciliary dyskinesia, allergic rhinitis, chronic rhinosinusitis, and others. In this article, we discuss the potential benefit of nNO measurement in diagnosis and monitoring of various respiratory diseases.</p> </abstract>ARTICLEtrue of Objectifying Cough<abstract> <title style='display:none'>Abstract</title> <p>Cough is one of the most common symptoms encountered by clinicians. Attempts to measure cough date back to early 1950s and since then, significant progress has been made in understanding cough and many methods have been developed. Methods for cough measurement can be divided into subjective and objective methods and further according to the aspect of cough they assess. Subjective methods for cough assessment provide us with information about patient’s personal experiences of cough and about psychosocial aspect of cough. Most widely used subjective methods include cough severity visual analogue scale, cough severity diaries, and various quality of life questionnaires. Objective methods for cough assessment focus mainly on cough frequency and on cough reflex sensitivity. Most widely used methods from this group include cough monitors and cough inhalation challenges. This review focuses on the most widely used cough measurement methods and points out their advantages and limitations for use in research and clinical practice. The ability to measure cough in clinical and research conditions could be used to determine treatment outcomes, to test new therapies, and to further study pathophysiology and physiology of cough.</p> </abstract>ARTICLEtrue nocturnal hemoglobinuria: A rare case of recurrent episodes of icterus<abstract><title style='display:none'>Abstract</title><p>In this work we describe a rare case of a patient with paroxysmal nocturnal hemoglobinuria (PNH) developed on the background of specific medical history of morbus Gilbert with chronically elevated bilirubin and recurrent attacks of macroscopic haematuria. We focus on a differential diagnosis of the disease, its obstacles, and treatment options.</p></abstract>ARTICLEtrue correlative interaction between thyroid dysfunction and semen parameters in male infertility: A prospective case control study<abstract><title style='display:none'>Abstract</title><p>The role of thyroid function on sperm quality has not been well studied from a pathological aspect. This study aimed to report the degree of association between the status of thyroid hormones, sperm quality and aetiology in infertile men compared to healthy subjects. A prospective case control investigative study was conducted on 100 infertile males and age matched healthy controls. Semen samples were collected for sperm quality examination, and the serum levels of tetraiodothyronine (T4), triiodothyronine (T3), and thyroid stimulation hormone (TSH) were measured. Out of 100 infertile men, oligozoospermia (32%), asthenozoospermia (48%), and oligo-asthenozoospermia (20%) were found. There was a statistical difference between the group I and group II groups related to sperm count (28.32 ± 14.60 vs 66.50 ± 10.50 x 106/ml), sperm motility (40.1 ± 13.8 vs 64.8 ± 7.85%), and sperm morphology (55.92 ± 5.27 vs 83.50 ± 5.25%, p&lt;0.05). There was a statistical difference among the oligozoospermia, asthenozoospermia, and oligo-asthenozoospermia groups related to T3 (115 + 0.40 vs 1.29 ± 0.59 vs 1.25 ± 0.32 ng/ml), T4 (7.35 ± 1.42 vs 9.15 ± 1.85 vs 7.85 ± 1.65 μg/dl), and TSH (1.69 ± 0.55 vs 2.12 ± 1.45 vs 1.98 ± 0.4 μIU/ml) (P&lt;0.05). There was a significant inverse correlation of TSH levels with sperm volume (r = -0.12, p= 0.02), sperm motility (r = -0.26, p= 0.02), and sperm morphology (r = -0.304, p = 0.02) observed. T4 levels were significantly correlated with sperm count (r = -0.278, p = 0.02), and sperm motility (r = -0.249, p = 0.032). T4 levels were very highly associated with asthenozoospermia. Relative operating curve analysis shows that Sperm motility of &gt;40.1%, T3 levels of &lt;1.29 ng/ml, total T4 levels of &lt;8.42 μg/dl, TSH levels of &lt;1.98 μIU/ml inferred the male infertility.</p> <p>Although thyroid function screening is not currently recommended as a part of the diagnostic workup of the infertile male, it may be reconsidered in light of the physiopathological background. Studies will be necessary to initiate the trial of a small dose of anti-thyroid drug in asthenozoospermic patients.</p></abstract>ARTICLEtrue and classification of hereditary fibrinogen disorders<abstract><title style='display:none'>Abstract</title><p>Hereditary fibrinogen disorders (HFDs) are rare bleeding disorders with a wide spectrum of biological and clinical features. While most patients with HFDs are at risk to suffer from mild to severe, sometimes life-threatening bleeding, thrombotic events are also common. Therefore, an appropriate diagnosis is needed to offer the optimal treatment. Diagnosis of HFDs can be challenging and plenty of pitfalls. The sensitivity and specificity of hemostasis routine test are depending on the reagents, the methods, and the fibrinogen variants. To distinguish subtypes of HFDs additional tests are often required. Historically based on the assessment of fibrinogen levels, a recent classification also considers the clinical phenotype and the genotype. In this short review, diagnosis strategies and HFDs classification are reviewed.</p></abstract>ARTICLEtrue of early dexamethasone treatment on several markers of inflammation and fibrosis in an animal model of lung silicosis in rats – A pilot study<abstract><title style='display:none'>Abstract</title><p>Lung silicosis is primarily caused by inhalation of particles of silicon oxide (silica). Despite a huge progress in understanding the interactions among the pathomechanisms of lung silicosis in the last years, there is a lack of effective therapy. With respect to a wide therapeutic action of corticosteroids, the purpose of this pilot study was to evaluate early effects of dexamethasone on several markers of inflammation and lung fibrosis in a rat model of silicosis. The silicosis model was induced by a single transoral intratracheal instillation of silica (50 mg/ml/animal), while the controls received an equivalent volume of sterile saline. The treatment with intraperitoneal dexamethasone initiated the next day after the silica instillation and was given 2-times a week at a dose of 1 mg/kg, while the controls received an equivalent volume of saline. The animals were euthanized 14 or 28 days after the treatment onset. Total and differential counts of leukocytes in the blood and bronchoalveolar lavage (BAL) fluid were determined. The presence of collagen in the bronchioles and lung vessels was detected by Sirius red staining and a smooth muscle mass was detected by smooth muscle actin. In comparison to saline, the instillation of silica increased the total count of circulating leukocytes after 14 and 28 days of the experiment (both <italic>p</italic>&lt;0.05), which was associated with higher counts of lymphocytes (<italic>p</italic>&lt;0.05 after 14 days, <italic>p</italic>&gt;0.05 after 28 days) and slight but non-significant increases in neutrophils and eosinophils (both <italic>p</italic>&gt;0.05). Although the total cell count in the BAL fluid did not change significantly, the percentages and absolute counts of neutrophils, eosinophils, and lymphocytes (<italic>p</italic>&lt;0.05, <italic>p</italic>&lt;0.01 or <italic>p</italic>&lt;0.001) elevated after 14 and 28 days of the experiment. Silica induced an accumulation of collagen in the bronchioles (<italic>p</italic>&lt;0.001 after both 14 and 28 days) and pulmonary vessels (<italic>p</italic>&lt;0.01 after both 14 and 28 days) and elevated a formation of smooth muscle mass (<italic>p</italic>&lt;0.05 after 14 days, <italic>p</italic>&lt;0.01 or <italic>p</italic>&lt;0.001 after 28 days). Treatment with dexamethasone decreased circulating leukocytes (<italic>p</italic>&lt;0.01) and lymphocytes (<italic>p</italic>&lt;0.001) and increased neutrophils (<italic>p</italic>&lt;0.05), which was associated with a slightly decreased total cell count in BAL (<italic>p</italic>&gt;0.05), decline in lymphocytes (<italic>p</italic>&lt;0.01), and slight decreases in neutrophils and eosinophils after 28 days of the treatment. Moreover, dexamethasone reduced the accumulation of collagen (<italic>p</italic>&lt;0.01 after 14 days and <italic>p</italic>&lt;0.001 after 28 days) and the formation of smooth muscle mass (<italic>p</italic>&lt;0.01 for bronchioles and <italic>p</italic>&gt;0.05 for vessels after 24 days, <italic>p</italic>&lt;0.001 for both bronchioles and vessels after 28 days). In conclusion, early dexamethasone treatment mitigated silica-induced granulocytic-lymphocytic inflammation and decreased a formation of collagen and smooth muscle mass in the bronchiolar and vascular walls, demonstrating a therapeutic potential of dexamethasone in the lung silicosis.</p></abstract>ARTICLEtrue of acute pancreatitis based on BISAP scoring system: A cohort study of 50 cases<abstract><title style='display:none'>Abstract</title> <sec id="j_acm-2022-0016_s_005"><title style='display:none'>Background/Aim</title> <p>Acute pancreatitis is encountered in both medical and surgical specialty. Assessment of severity and grading is done using radiological investigations mostly like ultrasonography or CECT. We present a study to assess the severity of Acute Pancreatitis based on Bedside Index for Severity in Acute Pancreatitis (BISAP) scoring system.</p> </sec> <sec id="j_acm-2022-0016_s_006"><title style='display:none'>Material &amp; Methods</title> <p>The study was conducted on 50 patients presenting with acute pancreatitis who were included as per inclusion criteria and a detailed history, clinical examination and blood investigation performed. Data like serum amylase, serum lipase, serum calcium, blood urea nitrogen (BUN), pleural effusion and systemic inflammatory response syndrome (SIRS) was collected from the patients. Based on data collected in 24 hours of hospitalization, BISAP score was calculated.</p> </sec> <sec id="j_acm-2022-0016_s_007"><title style='display:none'>Results</title> <p>Results showed that no significant temperature rise, pancreatic necrosis, SIRS or impaired mental status in patients with BISAP severity of &lt;=3. However, patients having BISAP score &gt;3, factors like BUN, age, pleural effusion, and organ failure show significant correlation. Also on comparative analysis of patients showed that the hospital stay, respiratory rate, pulse and laboratory markers (blood urea, serum creatinine, serum amylase, serum lipase) were significantly higher in patients with BISAP score ≥3.</p> </sec> <sec id="j_acm-2022-0016_s_008"><title style='display:none'>Conclusion</title> <p>BISAP score is an easy, quick and bedside method to assess the severity of acute pancreatitis and predict its mortality. It is easy bedside procedure that can be done in every setup.</p> </sec> </abstract>ARTICLEtrue training in aneurysm clipping<abstract><title style='display:none'>Abstract</title><p>Due to an increased number of patients with aneurysms treated endovascularly, a resident does not have enough opportunities to come across such a complex procedure as surgical clipping. There have been many types of training methods designed for traditional surgical aneurysm treatment so far. A brief report regarding the helpfulness of vascular simulator AneurysmBox at our Neurosurgical Department is presented.</p></abstract>ARTICLEtrue SARS-CoV-2 variant: An observational study from a hospital in Southern India<abstract> <title style='display:none'>Abstract</title> <sec id="j_acm-2022-0010_s_007"><title style='display:none'>Introduction</title> <p>The Omicron variant rapidly outpaced Delta with documented community transmission in most countries and has led to an upsurge in cases in most regions. Since its initial detection from a specimen collected on November 8th 2021, Omicron amounted to 74.0% of the genome sequenced in South Africa and more than 99.0% in rest of the world.</p> </sec> <sec id="j_acm-2022-0010_s_008"><title style='display:none'>Objectives</title> <p>1. To describe the socio-demographic and clinical profile of Omicron cases treated at our tertiary care institution. 2. To assess the factors associated with the vaccination status of such Omicron cases.</p></sec> <sec id="j_acm-2022-0010_s_009"><title style='display:none'>Methods</title> <p>This observational study was conducted at a 500 bedded hospital in southern India from 15th of December 2021 to 5th of February 2022. Of the 333 COVID-19 patients who were registered with Reverse Transcription-Polymerase Chain Reaction (RT-PCR) positive result along with S Gene Target Failure (SGTF), 203 patients were included and were interviewed using a pre-designed semi-structured questionnaire. With prior approval from the Institutional Ethics Committee (IEC) data was collected and statistically analyzed with descriptive statistics and inferential statistics using SPSS software trial version 28.0 and OpenEpi software. At 95% confidence level, a P value of &lt; 0.05 was considered as statistically significant.</p></sec> <sec id="j_acm-2022-0010_s_010"><title style='display:none'>Results</title> <p>Of the 203 cases studied, majority 149 (73.4%) were symptomatic, of which almost 114 (76.5%) had fever, 72 (48.3%) had cough and 29 (19.5%) had myalgia. 193 (95.1%) cases were categorized as mild, 8 (3.9%) as moderate and 2 (1.0%) as severe cases of COVID-19 with SGTF. Only 10 (4.9%) patients received supplementary oxygen support. Almost 158 patients (77.8%) were vaccinated against COVID-19 of which 106 (67%) were vaccinated with Covishield vaccine followed by 50 (31.7%) of them with Covaxin. 126 (79.7%) patients were completely vaccinated with two doses of any COVID-19 vaccine and 32 (20.3%) were partially vaccinated with a single dose of any COVID-19 vaccine. Among those who required supplemental oxygen (n = 10), the proportion of those vaccinated (40.0%) was lower com pared to those who were unvaccinated (60.0%). This association was statistically significant (P = 0.003, OR = 0.169, 95% CI of OR = 0.045, 0.628). Among the completely vaccinated subjects (n = 125), there was a statistically significant difference in mean (95% CI) interval between the last dose of vaccine taken and date of RT-PCR positivity with SGTF (P &lt; 0.001). It was 186 (162, 210) days for Covaxin and was 131 (114, 148) days for Covishield vaccine.</p></sec> <sec id="j_acm-2022-0010_s_011"><title style='display:none'>Conclusion</title> <p>Omicron (SGTF) cases manifests mostly as mild cases with symptoms like fever, cough, myalgia and majority were independent of oxygen supplementation and had good prognosis. Omicron infection was delayed over six months among completely vaccinated subjects especially those who were vaccinated with Covaxin.</p></sec> </abstract>ARTICLEtrue of the airway reactivity in patients with rhinosinusitis<abstract><title style='display:none'>Abstract</title><p>Rhinosinusitis is one of the most common conditions in primary and secondary care all over the world. Rhinosinusitis together with asthma and gastroesophageal reflux disease represent the most common causes of chronic cough. The relationship between rhinosinusitis and cough is still not completely understood, however, direct stimulation of nasal mucosa, upper airway cough syndrome, inflammation of the airways, and cough reflex sensitisation play the crucial role in the pathogenesis of chronic cough.</p></abstract>ARTICLEtrue morphofunctional rearrangements in the adult rats adenohypophysis after long-term exposure of heavy metal salts<abstract> <title style='display:none'>Abstract</title> <p>Important environmental problem of some northern regions of Ukraine is the accumulation of heavy metal salts in the soil, water and air, which is observed in various combinations depending on the region and causes adverse effects on population’s health. The central link, in particular the pituitary gland, is involved in triggering a stress response, limiting its further development preventing adverse effects on the body. The study of morphofunctional rearrangements in the pituitary gland of adult male rats under the influence of heavy metal salts complex on the body remains a relevant aspect of modern morphology. The experiment was performed on 12 white mature male rats weighing 200-250g at the age of 7-8 months, which were divided into 2 groups (control and experimental). The experimental group included rats, which after 90 days of use of a heavy metals salts complex (zinc, copper, iron, manganese, lead and chromium) for 30 days used ordinary drinking water. General morphological (histological, morphometric), mmunohistochemical, biochemical and statistical research methods were used. Results showed a decrease in the linear parameters of the adenohypophysis, there was a significant increase in the value of fibrous connective tissue component in the stroma, increased collagenization of large vessels, significant diffuse stromal edema and edematous processes in the gland parenchyma persisted. Measurements revealed an increase in the number of chromophobes and at the same time a decrease in the number of chromophilic basophils compared to control animals, the presence of cysts in the parenchyma was found out. number of morphological features still indicated the development of adaptive and compensatory processes in the adenohypophysis (vascular plethora decreased, significantly improved the rheological properties of blood, an increase in the number of adenocytes with increasing expression of hsp90 in their cytoplasm). However, despite the positive dynamics of adaptive processes, it should be noted that the 30-day period of adaptation is insufficient for complete recovery of the organ.</p></abstract>ARTICLEtrue of coliform bacteria infection on intestinal goblet cells secretory activity of germ-free piglets<abstract><title style='display:none'>Abstract</title><p>Recently, influence of bacteria colonization on development and maturation of gut wall is getting more into the focus of gastrointestinal research. For years, the main interest and research were aimed to the development and maturation of gut wall and its functional properties in normal conditions, less attention has been paid on the germ-free animals. Germ-free (GF) piglets have clear microbiological background and are reared in sterile environment. GF piglets are regarded as clinically relevant models for studying of human diseases, as these piglets’ manifest similar clinical symptoms to humans. In this study we briefly summarised the main characteristics in the distribution of goblet cells in the wall of jejunum and colon of GF piglets as healthy control (HC) group and piglets, which were experimentally infected by <italic>E. coli</italic> O149:K88 as ECK group. Neutral mucins were stained with periodic acid-Shiff (PAS) whereas acidic mucins are stained with Alcian blue. Numbers of goblet cells containing total acidic mucins in both, the jejunum and colon, differed significantly between HC and ECK piglets and in the colon, a similar trend was also observed. In the ECK piglets, jejunal goblet cells exhibited decrease in neutral mucins. This change in mucin profile in response to bacterial colonization suggests a potential role as a protective mechanism against pathogenic invasion of the intestinal mucosa during of gut mucosa development in piglets.</p></abstract>ARTICLEtrue randomized controlled trial of intravenous magnesium sulphate as an adjunct to standard therapy in atrial fibrillation<abstract> <title style='display:none'>Abstract</title> <sec id="j_acm-2022-0011_s_006"><title style='display:none'>Background</title> <p>Magnesium sulphate (MgSO<sub>4</sub>) has been proven as an analgesic, neuromuscular blocker agent, and treatment of acute asthma.</p> </sec> <sec id="j_acm-2022-0011_s_007"><title style='display:none'>Objective</title> <p>The study aimed to assess the safety and efficacy of magnesium sulphate infusion for the treatment of patients with atrial fibrillation.</p> </sec> <sec id="j_acm-2022-0011_s_008"><title style='display:none'>Methods</title> <p>A prospective, randomized, double-blind, placebo-controlled study was conducted on 55 atrial fibrillation patients at the Emergency Department. The treatment group consisting of 41 patients received 20 mEq (2.5 g, 10 mmol) magnesium sulphate over a 20-minute period, followed by 20 mEq (2.5 g, 10 mmol) over a 2-hour period intravenously in addition to the standard treatment, and the control group consisting of 14 patients received placebo with a standard treatment. ECG was repeated and monitored upto 24 hours after the infusion.</p> </sec> <sec id="j_acm-2022-0011_s_009"><title style='display:none'>Results</title> <p>41 patients received magnesium sulphate and 14 patients received a placebo. The heart rate was 127 bpm – 210 bpm at the presentation to the emergency department and it was reached &lt;100bpm in 70%(n=31) patients after 150 minutes of MgSO<sub>4</sub> infusion. Two patients attained a heart rate of &lt;100bpm in Placebo infusion. In the treatment group, 65% of subjects attained normal sinus rhythm at the end of 24 hours of infusion. Magnesium sulphate was more likely than placebo to achieve a heart rate of &lt;100bpm and more likely to convert to sinus rhythm. ECG report reverted to normal in 74.5% in the treatment group and 25.5 % in the Placebo group within 24 hours. The patients in the treatment group stay a mean of 2.25 days in ICU, while the patients in the Placebo group stayed 4.25 days in ICU. Seven patients in the treatment group had minor side effects like flushing, headache, and nausea, which came to normal after 48hrs.</p> </sec> <sec id="j_acm-2022-0011_s_010"><title style='display:none'>Conclusions</title> <p>Magnesium sulphate has been shown a better efficacy to control the heart rate and conversion to sinus rhythm when used along with the standard management of Atrial fibrillation.</p></sec> </abstract>ARTICLEtrue Spot Count Optimization of Automated Fluorescent Slide Scanning System<abstract> <title style='display:none'>Abstract</title> <p><bold>Purpose</bold>: Ionizing radiation induced foci (IRIF) known also as DNA repair foci represent the most sensitive endpoint for assessing DNA double strand breaks (DSB). IRIF are usually visualized and enumerated with the aid of fluorescence microscopy using antibodies to γH2AX and 53BP1. Although several approaches and software packages were developed for the quantification of IRIF, not one of them was commonly accepted and inter-laboratory variability in the outputs was reported. In this study, the sensitization of Metafer software to counting also small appearing IRIF was validated.</p> <p><bold>Materials and Methods</bold>: Human lymphocytes were γ-irradiated at a dose of 2 Gy. The cells were fixed at 0.5, 1, 2, and 18 hours post-irradiation, permeabilized and IRIF were immunostained using appropriate antibodies. Cell images were acquired with the automatic Metafer system. Radiation-induced γH2AX and 53BP1 foci were enumerated using either manual counting (JCountPro program) or the Metafer software (after its classifier optimization has been done) and compared. The statistical analysis was performed using One-way ANOVA.</p> <p><bold>Results</bold>: The enumeration of 53BP1, γH2AX foci manually by JCountPro did not statistically significantly differ from the automatic one performed with the optimized Metafer classifier. A detailed step-by-step protocol of this successful optimization is described in this study.</p> <p><bold>Conclusions</bold>: We concluded that the Metafer software after the optimization was efficient in objectively enumerating IRIF, having a potential for usage in clinics and molecular epidemiology.</p> </abstract>ARTICLEtrue Modeling of D, L – Homocysteic Acid Microinjection into the Bötzinger Complex Area<abstract> <title style='display:none'>Abstract</title> <p>The impact of D,L – homocysteic acid (DLH) microinjection (non-specific glutamate receptor agonist that causes excitation of neurons) into the Bötzinger complex area (BOT) was simulated using computer model of quiet breathing and cough reflex. Integrated signals from simulated neuronal populations innervating inspiratory phrenic and expiratory lumbar motoneurons were obtained. We analysed durations and amplitudes of these “pre-phrenic and pre-lumbar” activities during quiet breathing and cough reflex and the number of coughs elicited by a fictive 10-second-long stimulation. Model fibre population provides virtual DLH related excitation to expiratory neuronal populations with augmenting discharge pattern (BOT neurons). The excitation was modelled by a higher number of fibres and terminals (simulated a higher number of excitatory inputs) or by a higher synaptic strength (simulated a higher effect of excitatory inputs).</p> <p>Our simulations have demonstrated a high analogy of cough and breathing changes to those observed in animal experiments. The simulated neuronal excitations in the BOT led to cough depression represented by a lower cough number and a cough neuronal activity of the lumbar nerve. Despite the shortening of the phrenic activity during cough (compared to quiet breathing), which was not observed in animal experiments, our simulations confirm the ability of the computer model to simulate motor processes in the respiratory system. The computer model of functional respiratory / cough neural network is capable to confirm and / or predict the results obtained on animals.</p> </abstract>ARTICLEtrue Students’ Perception of Patient Safety Culture During the Covid-19 Pandemic – Results of a Pilot Study<abstract> <title style='display:none'>Abstract</title> <p><bold>Introduction</bold>: The COVID-19 pandemic posed health and social threats and directly affected the quality and safe care. Many nursing students had mandatory practical training in hospitals to help the national system respond to the crisis. The investigation of nursing students’ perceptions of patient safety culture (PSC) might be beneficial in identifying safety areas that need improvement.</p> <p><bold>Aim</bold>: The pilot study aimed to investigate nursing students’ perception of PSC during the second wave of the COVID-19 pandemic.</p> <p><bold>Methods</bold>: The data were collected using the Hospital Survey on Patient Safety Culture - Nursing Students (HSOPS-NS). The HSOPS-NS tool was distributed online via the Google Forms platform between February and April 2021. The respondents studied in the 3<sup>rd</sup> year of the bachelor’s degree in nursing (n = 66). Three nursing faculties from 3 regions in Slovakia were addressed. Descriptive statistics (mean, SD, frequency) was used for the sample characteristics and the HSOPS-NS tool. The Mann-Whitney U test and the Kruskal Wallis test analysed associations between sociodemographic data. The predictors of outcome dimensions of the HSOPS-NS were analysed by a multiple regression analysis.</p> <p><bold>Results</bold>: The nursing students evaluated the overall patient safety grade as very acceptable. Concerning PSC dimensions, the best-rated dimensions were “Feedback &amp; communication about the error” (55.04%) and “Communication openness” (53.53%). The worst-rated dimensions were “Frequency of events reported” (33.32%) and “Staffing” (35.22%). A significant relationship was found between the perception of PSC and age, current area/unit, awareness of reporting systems, and supervision. The overall patient safety grade, the number of reported events, the number of reported events by nursing students were significantly predicted by several PSC dimensions (p ≤ 0.05).</p> <p><bold>Conclusions</bold>: The nursing students’ perspective on PSC revealed a weak perception of reporting adverse events. The awareness of reporting adverse events requires an increase in theoretical knowledge and the support of nursing students during their clinical training. A regular and comprehensive evaluation of PSC may strengthen patient safety and the overall awareness of patient safety among nursing students.</p> </abstract>ARTICLEtrue