Blepharophimosis ptosis epicanthus inversus (BPES) is a relatively rare congenital disorder, which usually presents with classical eye manifestations. In some cases, it is associated with premature ovarian failure (POF). BPES is of two types, type I and type II. Type I is associated with POF along with eyelid malformations, while Type 2 has only eyelid malformations.Here, we report a family of BPES, in whom two sisters presented with secondary amenorrhea. On eye examination, they have blepharophimosis, ptosis, epicanthus inversus and telecanthus. Investigations revealed hypergonadotropic hypogonadism. Their father also has similar eye manifestations. Diagnosis of BPES type I was made and both were started on hormone replacement therapy.
Blockchain is a disruptive technology and has attracted significant attention with prominent applications across finance, medical and many other systems. Electronic voting or e-voting is one of the emerging applications of blockchain leveraging benefits such as integrity, and non-repudiation of data. Whilst existing research has focused on using blockchain for e-voting applications to achieve transparent and verifiable solutions, there exists a gap in study with respect to an in-depth investigation for the challenges surrounding the trade-off for scalability versus security in the context of transaction malleability attack when mining capability is compromised for the blockchain network. In order to present our research, we have used e-voting as an example application to demonstrate our investigations regarding the mentioned gap. The paper does not focus on building a blockchain based e-voting system. The study carries out empirical analysis by establishing blockchain networks with varying mining strength under an extreme load of incoming transactions to achieve a real world scenario of large blockchain based system. The developed system has then been exposed to transaction malleability attack while scaling throughput up to thousands of transactions. The findings reveal that blockchain networks upon scaling, are more vulnerable to transaction malleability attack while operating under lower mining strength as compared to the networks having higher mining power under same conditions. These research outcomes would help researchers and application architect to build highly secured and large scaled applications. To the best of our knowledge, there has not been any published empirical investigation present in the given context.
Chordoid glioma of third ventricle is relatively rare and characterized by unique histomorphology and varied clinical presentation. Chordoid glioma has high morbidity and high mortality rates despite being low grade tumor because of insidious presentation and difficulty in complete resection. Here, we report a new case of chordoid glioma occurring in a 32-year-old male, who presented with polyuria, polydipsia and behavioral problems, and on the water deprivation test diagnosis of primary polydipsia was made. MRI revealed tumor of third ventricle, which was resected subtotally. Diagnosis of chordoid glioma was confirmed by histology and immunohistochemical analysis of resected tumor. Recurrence of chordoid glioma was reported on MRI after 2.5 months. Based on this case report, we suggest chordoid glioma should be kept in differential diagnosis of primary polydipsia.
Objective: To determine the serum immunoglobulin E and serotonin levels of patients with chronic suppurative otitis media (CSOM) with and without treatment.
Methods: This is a case-control study carried out in ENT ward of Jinnah Postgraduate Medical Centre Karachi Pakistan from May to September 2018.. Sample (n=160) was divided into four groups (40 individuals per group) as G1: control negative (group-1 without any disease), G2: positive control (patients didn’t received medicines), G3: group (patients treated with co-amoxicillin 1000mg per day) and G4: group (patients treated with ciprofloxacin1000mg per day). After treatment period of One week serum immunoglobulin E and serotonin concentrations were evaluated by Elisa method at 450nm. Statistical evaluation was carried out using one-way ANOVA (p<0.05) followed by post hoc (tukey test) for further group comparison. In order to find out correlation between IgE and serotonin with CSOM Pearson’s correlation was applied.
Results: There was no significant (p>0.05) association found between genders with serotonin as well as with IgE levels in CSOM patients. One way ANOVA showed significant difference (p<0.05) for IgE and serotonin levels and post hoc (tukey test) showed significant higher of IgE levels in CSOM patients of G2 positive control (diseased patients) was observed when compared to the control negative group (healthy individuals) and also from treated groups of G3 and G4. This also showed that serotonin levels were significantly low in G2 (positive control) as well as in treated groups of G3 and G4 in contrast with healthy individuals of group G1.
Conclusion: Antibiotics may revert the higher levels of IgE but cannot attenuate the decreased levels of neurotransmitter (serotonin) like healthy individuals, therefore, depression levels of CSOM patients should be monitored, scored and attenuated with proper intervention of antidepressants or counseling.
doi: https://doi.org/10.12669/pjms.37.5.2414
How to cite this:Mehboob S, Rafi SMT, Mehjabeen, Khan H. Serum Immunoglobulin E and Serotonin levels in Chronic Supporative Otitis Media Patients with and without treatment. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.2414
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