Treatments for Cocaine Use Disorder (CUD) are variably effective, and there are no FDA-approved medications. One approach to developing new treatments for CUD may be to investigate and target poor prognostic signs. One such sign is anhedonia (i.e. a loss of pleasure or interest in non-drug rewards), which predicts worse outcomes in existing CUD treatments. Inflammation is thought to underlie anhedonia in many other disorders, but the relationship between anhedonia and inflammation has not been investigated in CUD. Therefore, we assessed peripheral genome-wide gene expression in n = 48 individuals with CUD with high (n = 24) vs. low (n = 24) levels of anhedonia, defined by a median split of self-reported anhedonia. Our hypothesis was that individuals with high anhedonia would show differential gene expression in inflammatory pathways. No individual genes were significantly different between the low and high anhedonia groups when using t-tests with a stringent false discovery rate correction (FDR-corrected p < 0.05). However, an exploratory analysis identified 166 loci where t-tests suggested group differences at a nominal p < 0.05. We used DAVID, a bioinformatics tool that provides functional interpretations of complex lists of genes, to examine representation of this gene list in known pathways. It confirmed that mechanisms related to immunity were the top significant associations with anhedonia in the sample. Further, the two top differentially expressed genes in our sample, IRF1 and GBP5, both have primary inflammation and immune functions, and were significantly negatively correlated with total scores on our self-report of anhedonia across all 48 subjects. These results suggest that prioritizing development of anti-inflammatory medications for CUD may pay dividends, particularly in combination with treatment-matching strategies using either phenotypic measures of anhedonia or biomarkers of inflammatory gene expression to individualize treatment.
Male patient 46 years of age presented with history of Laparoscopic A-H pyeloplasty with DJ stenting for left side hydronephrosis due to PUJ obstruction. After stent removed he experienced intermittent flank pain, discomfort with fullness sensation. On examination there was mild left renal angle tenderness. Urinalysis showed RBC. USG revealed moderate left hydronephrosis. CT urogram showed left side gross HDN with 5 mm PUJ stone. Tc-99m DTPA renal scan revealed partial obstruction. After counseled and exploration founded an impacted PUJ stone. During removal of PUJ stone, identified a suture material embedded by the stone. After removed the stone,PUJ still narrowed. Then A- H pyeloplasty done with placed a D-J stent in situ. The patient had a good post-operative recovery.
Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.164-165
Conclusion:With the help of neutrophil lymphocyte ratio we can take preventive measure and precaution to reduce the progression of atherosclerosis in type 2 diabetic patients with coronary artery disease.
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