AIM: To evaluate the aldose reductase (ALR2, rs759853), receptor for advanced glycation end products (RAGE, rs2070600), and vascular endothelial growth factor (VEGF, rs833061) association with diabetic retinopathy in type 2 diabetic patients in Khyber Pakhtunkhwa population.Methods: A Case control study was conducted on a total of 550 subjects consisting of 186 with diabetic retinopathy (DR) having type 2 diabetes, 180 had type 2 diabetes (T2DM), and 184 healthy controls (HC). All the samples were subjected to DNA isolation using salting-out method followed by SNP genotyping through Tetra-ARMS PCR. Chi square and Exact Fischer tests were used for allele and genotype distribution. Odd ratio and con dence interval values were found out by online software Medcalc Odd ratio Calculator.Results: Multiple parameters such as random blood sugar (RBS) (p<0.001), fasting blood sugar (FBS) (p<0.001), HbA1c (p<0.001), total cholesterol (p<0.001), LDL (p<0.001), HDL (p<0.001), BMI (p<0.001) and hypertension (p=0.018) showed strong association with DR as compared to DM and HC. Our results showed that VEGF rs833061 (p<.001) and RAGE rs2070600 (p<.001) polymorphism was strongly associated with an increased risk of DR. The odd ratio of CC genotype in VEGF (0.262, 95% CI=0.129-0.531) and AA genotype in RAGE (0.59, 95% CI=0.032-0.110) was noted. However, the signi cance in ALR2 rs759853 gene polymorphism was observed at (p=0.001).Conclusion: There is a statistically signi cant association of VEGF rs833061 and RAGE rs2070600 with diabetic retinopathy in type 2 diabetic patients. Also, this is the rst study to report the association of RAGE with diabetic retinopathy in type 2 diabetes in Khyber Pakhtunkhwa population.
Objective: The goal of this study was to see how transpedicular fixation for degenerative spondylolisthesis affected lumbago. Methodology: A retrospective observational study was conducted at the Department of Neurosurgery in Hayatabad Medical Complex, Peshawar between May 2018 and February 2020. Degenerative spondylolisthesis was diagnosed using static and dynamic spinal X-rays. The research excluded the patients with grade 5 spondylolisthesis, congenital anomalies, or prior spinal surgery. The visual rating scale was used to assess pain alleviation (GRS). Dynamic or static lumbosacral X-rays and 3D CT scans were used to assess union. Results: In total 70 patients, 38 (54.3%) were male and 32 (45.7%) were female. L5–S1 was impacted in most of the cases (68%). 40% of patients were having Meyerding grade II. All patients had pedicle screw fixation. Following surgery, 44 (63%) patients reported no pain, and 12 (17%) patients reported mild discomfort. 8 (11%) patients reported moderate pain and 6(9%) patients experienced severe pain. There existed a significant difference between pre/postoperative moderate-severe GRS scores (p-value: 0.000336). After surgery, we were able to negotiate surgical unions with 91.4% of the patients. Conclusion: For individuals with spondylolisthesis who need pain relief, transpedicular fixation is a safe, straightforward, and effective treatment. It also aids with the surgical union and the improvement of the neurological condition. Keywords: Spondylolisthesis, Meyerding grading, Transpedicular fixation.
: Despite gigantic advances in medical research and development, chemotherapeutic resistance remains a major challenge for CNS tumors. The failure of complete eradication of CNS tumors has been correlated with the existence of several factors including over expression of transporter proteins. To date, 49 ABC-transporter proteins (ABC-TPs) are reported in humans, and the evidence of their strong association with chemotherapeutics’ influx, dissemination, and efflux in CNS tumors, is growing. Research studies in CNS tumor are implicating ABC-TPs as diagnostic, prognostic and therapeutic biomarkers that may be utilised in preclinical and clinical studies. With the current advancements in cell biology, molecular analysis of genomic and transcriptomic interplay, and protein homology-based drug-transporters’ interaction, our research approaches are streamlining the ABC-TPs’ roles in cancers and multidrug resistance. Potential ABC-TPs’ inhibitors for better clinical outcomes in CNS tumors have emerged. These include members of EZH2 inhibitors, which exhibit disparate level of selectivity for being a substrate for ABCB1 and ABCG2. Elacridar was shown to enhance chemo-sensitivity of Dasatanib and Imatinib in various glioma models. Tariquidar has improved Temozolomide’s effectiveness in CNS tumors. Although these inhibitors were shown to be effective in preclinical settings, their significant clinical outcomes have not been promising in clinical trials. Molecular evaluations of ABC-TPs and their drug-interactions are being pursued in various research labs, including ours, in an effort to better comprehend their biological mechanisms that are utilised for drug resistance, and to develop novel strategies to upsurge the clinical effectiveness of anticancer chemotherapeutics, which will ultimately improve the clinical outcomes.
OBJECTIVES: To determine the frequency of cerebellopontine angle tumors in patients presented with trigeminal neuralgia. METHODOLOGY: This descriptive study was conducted in Neurosurgery Department, Hayatabad Medical Complex, Peshawar from 01-01-2016 to 31-12-2019. Patients with either gender and above 18 years of age diagnosed to be having trigeminal neuralgia and being symptomatic from a minimum duration of 03 months were included in the study. All the patients were subjected to a detailed history, thorough physical and neurological examinations and magnetic resonance imaging for the diagnosis of cerebellopontine angle tumors. RESULTS: The mean age group was 43 ± 2.37 years of which 37% were male and 62% were female patients, respectively. Cerebellopontine angle tumors were present in 3% of the patients. CONCLUSION: This study concluded that the frequency of cerebellopontine angle tumors was 3% among patients with trigeminal neuralgia.
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