A single nucleotide polymorphism within Ninjurin 2 is associated with risk of multiple sclerosis

Metabolic Brain Disease - Multiple sclerosis (MS) is a devastating inflammatory disease of the central nervous system (CNS) associated with loss of myelin sheaths. The role of Schwan cells in the...     

Perspectives towards antiviral drug discovery against Ebola virus

Ebola virus disease (EVD), caused by Ebola viruses, resulted in more than 11 500 deaths according to a recent 2018 WHO report. With mortality rates up to 90%, it is nowadays one of the most deadly infectious diseases. However, no Food and Drug Administration-approved Ebola drugs or vaccines are available yet with the mainstay of therapy being supportive care. The high fatality rate and absence of effective treatment or vaccination make Ebola virus a category-A biothreat pathogen. Fortunately, a series of investigational countermeasures have been developed to control and prevent this global threat. This review summarizes the recent therapeutic advances and ongoing research progress from research and development to clinical trials in the development of small-molecule antiviral drugs, small-interference RNA molecules, phosphorodiamidate morpholino oligomers, full-length monoclonal antibodies, and vaccines. Moreover, difficulties are highlighted in the search for effective countermeasures against EVD with additional focus on the interplay between available in silico prediction methods and their evidenced potential in antiviral drug discovery.     

Depression,anxiety and stress among medical and non-medical students in Saudi Arabia: An epidemiological comparative cross-sectional study

Objectives:To quantify the extent and variation of depression, anxiety and stress among medical and non-medical Saudi Arabian students.Methods:In this cross-sectional study, students from Umm Al-Qura University, Makkah, Saudi Arabia, were recruited. The Faculty of Education was randomly selected to represent the non-medical colleges. The depression, anxiety and stress scale-21 items (DASS-21) was used to estimate the study outcomes.Results:Of the 465 undergraduates recruited in this study, 49.68% (n=231) were medical students and 50.32% (n=234) were non-medical students. Approximately 54%, 53%, and 38% of the participants were found to be suffering from depression, anxiety, and stress, respectively. The analyses showed that the two groups did not differ significantly with respect to stress and depression (p=0.934 and 0.423, respectively). However, the non-medical students exhibited a significantly higher anxiety score compared to the medical students (p=0.002). Family conflicts was a common risk factor for the studied psychological disturbances. Female gender and travel time from home to university were significant predictors of depression and anxiety, whereas a positive history of a psychological condition increased the likelihood of depression and stress.Conclusion:There was a high prevalence of anxiety, stress, and depression among the students, with a significantly higher anxiety levels among the non-medical students.

There is a high prevalence of depression, anxiety and stress disorders (DASD) across the world. A previous report stated that around 4.4% (over 300 million) and 3.6% (264 million) of the global population suffers from depression and anxiety, respectively. Between 2005 and 2015 alone, there was a 14.9% increase in the incidence of anxiety. This report also considered depression as one of the major determinants of years lived with disability (YLD) and anxiety as a primary contributor of non-fatal health loss.^1,2 Another national-level survey reported 34.8% population to be suffering from stress, of which only 2% attained medical assistance.^3,4The amount of pressure faced by the university students might lead to a considerable psychological stress, which, in turn, leads to serious mental disorders, including anxiety, stress, and depression. Over time, the academic pressure may lead to worsening of the mental health and physical wellbeing of the students, which can only be detected at advanced stages. Certain studies on medical school graduates reported an association between the psychological stress among these students and suboptimal patient care.^5,6Several studies have evaluated and compared the anxiety, stress, and depression levels of non-medical and medical students.^7-11 A previous study in Saudi Arabia reported significantly lower depression rates among the medical students (37%) compared to non-medical students (60%).⁷ Contrarily, a meta-analysis reported no significant differences in the prevalence of depression between non-medical and medical students.⁸ A systemic review demonstrated significantly higher anxiety among medical students compared to general population.¹² Previous studies in Saudi Arabia also reported significantly high anxiety levels and low wellbeing of medical students.^13,14 Similar to anxiety and depression, the level of stress among medical students, in the same region, was as high as 59%, and was more prevalent among female and junior students.^15,16Several English scales have previously been used to assess the DASD prevalence in local population of Saudi Arabia,^7,13,17,18 and a number of local studies conducted on medical students exhibited certain methodological weaknesses, such as inadequate sampling.^19-21 Therefore, our aim was comparison of the DASD levels between medical and non-medical students with an adequate sampling method and by utilizing an Arabic validated tool that is more understandable in our culture, and to investigate risk factors for DASD among this population.     

T11TS immunotherapy augments microglial and lymphocyte protective immune responses against Cryptococcus neoformans in the brain

Cryptococcus neoformans, the encapsulated yeast acquired through inhalation, remains localized in lungs, but harbours the CNS in immunocompromised individuals. Several treatment regimes have failed combating this disease totally, but long‐term usage of drugs leads to organ damage. As T11‐target structure (T11TS) has documented profound immune potentiation, we aimed to investigate the role of microglia, pivotal immune cells of brain in ameliorating cryptococcosis, with T11TS immunotherapy. Murine model with C neoformans infection was prepared by intraperitoneal injection and the brains of rats examined 7 days post‐infections for histopathology by PAS and Alcian blue staining corroborated with organ fungal burden evidencing restorative T11TS action on Cryptococcal meningitis. Immunotherapy with three doses of T11TS, a CD2 ligand, in C neoformans infected rats, upregulates toll‐like receptors 2, ?4 and ?9 of microglia, indicating increased phagocytosis of the fungus. Flowcytometric analysis revealed increased numbers of T11TS treated brain infiltrating CD4⁺ and CD8⁺ T‐lymphocytes along with increased MHC I and MHC II on microglia, activating the infiltrating lymphocytes aiding the killing mechanism. Present study also indicated that T11TS increased production of Th1 inflammatory cytokines conducive to fungal elimination while the inhibitory Th2 cytokines were dampened. This preclinical study is first of its kind to show that T11TS effected profound immune stimulation of microglial activity of C neoformans infected rats eradicating residual fungal burden from the brain and can be a useful therapeutic strategy in fighting against this deadly disease.     

Coronary sinus diverticulum: Importance,function, and treatment

The importance of venous structure in the heart is usually overshadowed by that of the arterial system. Coronary sinus (CS) is a part of cardiac venous apparatus and connects left atria to the right atria. Other than having role in physiological contractions of both atria, it contributes substantially to cardiac electrical conduction system. Due to unique placement and connections of the CS, it has become growing interest in clinical cardiology. It is used in cardiac resynchronization therapy with biventricular pacing, left-sided catheter ablation of arrhythmias, and administration of retrograde cardioplegia in cardiac surgery. In some individuals, CS is presented with anatomical variants. CS diverticulum is a congenital outpouching that provides muscular connection between atria and ventricle. This connection provides a suitable substrate for occurrence of arrhythmias, which even results in life-threatening events such as sudden cardiac death. Early diagnosis leads to treatment with ablation techniques, which ultimately eliminates origins of arrhythmias.     

Correction to: Behçet’s disease in Egypt: a multicenter nationwide study on 1526 adult patients and review of the literature

Clinical Rheumatology - The author wishes to correct the record and clarify that in the original version of this article in the Discussion section under “Prevalence over the country...     

Pharmacists in humanitarian crisis settings: Assessing the impact of pharmacist-delivered home medication management review service to Syrian refugees in Jordan

Background

Refugees all over the world are facing several health-related problems. Chronic diseases among Syrian refugees in Jordan are high. The Home Medication Management Review (HMMR) service could be ideal to optimize refugees' health management.

Accuracy of three-dimensional photogrammetry and cone beam computed tomography based on linear measurements in patients with facial deformities

Objectives:This study was aimed to investigate the accuracy of soft-tissue measurements obtained by two imaging modalities, three-dimensional (3D) photogrammetry and cone beam CT (CBCT) when confounded by influence factors (facial deformities and partitions).Methods:60 wax facial models from facially deformed patients were captured by 3D photogrammetry and CBCT. 19 linear distances on each image were measured and juxtaposed to reference values attained via a coordinate-measuring machine (CMM) as the gold-standard. Paired t-tests were used to compare linear accuracy of the test and reference systems. The influence of deformities and partitions (created by dividing the face with three vertical and five horizontal lines) on the measurement errors were analyzed by independent sample t-test and one-way ANOVA.Results:Statistically significant differences were found between linear accuracy of the test and reference systems. The test values obtained by 3D photogrammetry were closer to the reference values than CBCT’s. 3D photogrammetry’s measurement errors were significantly higher in deformed areas, unlike CBCT’s. Both systems reported significantly lower errors within partitions 8 and 13 compared to other partitions; for CBCT, aside from partitions 8 and 13, the differences in the errors for partitions 6 and 10 were significant compared to partitions 8, 12, 13, 14.Conclusion:3D photogrammetry showed a higher linear accuracy than CBCT in patients with facial deformities due to protuberances. Facial reconstruction by both test modalities was significantly influenced in different facial partitions, but facial deformities extensively affected the results from 3D photogrammetry.