Myxomas are the most common primary cardiac tumors; the most common localization is the left atrium, and may cause mitral flow obstruction so their clinical presentation could mimic severe mitral stenosis; trans thoracic echocardiography allows the diagnosis; we report a case of left atrial myxoma revealed by atrial tachycardia concomitant with dyspnea and signs of chronic right heart failure; despite surgical resection of the tumor, our patient had developed tachycardiomyopathy with severe left ventricular dysfunction,  which recovered two months later, after intensive administration of antiarrhythmic treatment.

Corona virus disease 2019 infection exhibits a tropism for the respiratory tract, however several cardiac damages have been reported, such as coronary disease, cardiac arrhythmias and myocarditis; this latter has become more frequent after the outbreak of the COVID-19 pandemic, and may be the only manifestation of COVID 19 infection, the diagnosis is not always obvious especially for focal myocarditis and can be misdiagnosed as an acute coronary syndrome in some patients.

We reported five patients, admitted between June 2020 and January 2021, in our cardiology department for isolated acute focal myocarditis secondary to COVID 19 infection without respiratory or other damages, the diagnosis was not evident at first, but further investigations such as: electrocardiographic evolution, magnetic resonance imagery, coronary computed tomography angiography, and COVID 19 antibody testing, were in favor of the diagnosis of focal myocarditis secondary to COVID 19 infection.

Cardiac magnetic resonance imaging showed, delayed contrast enhancement in the lateral wall of the left ventricle, for all five patients, so fibrosis is preferentially located in the lateral wall, and the outcome was favorable without hemodynamic or arrhythmic complications.

Background: Blood loss occurs frequently and remains a challenge in spinal surgery. As significant intra and postoperative hemorrhage negatively affects patient outcomes by increasing coagulopathy, postoperative hematoma, and anemia. The need for allogenic blood transfusions can lead to potential transfusion reactions and infections, in addition to increasing long-term mortality rates. Although there are many randomized control trials and meta-analysis investigating the role of tranexamic acid (TXA), we could not find any study that investigated the role of TXA in patients with medical comorbidities. Therefore, tackling the role of TXA in patients with single or multiple comorbidities is of valuable outcome to our locality as most of the patients have indeed associated comorbidities.

Objectives: to investigate the role of tranexamic acid in decreasing perioperative blood loss in patients with multiple comorbidities as compared to otherwise healthy individuals.

Patients and methods: A single center randomized control trial. We included patients that were about to undergo simple decompressive surgeries for lumbar canal stenosis and fixation with decompression for spondylolisthesis. Patients were randomly categorized into cases (who received TXA) and controls who received NS. Patients then were subcategorized according to comorbidities and types of surgeries. Intraoperative blood loss was calculated using the suction drain and the gauze while the post operative bleeding was calculated using the drain output.

Results: There was 441.84 ml (49.6 %) decrease in intraoperative bleeding for patients who received TXA as compared to controls regardless the type of surgery and regardless the presence or absence of comorbidities. Hypertensive patients had 52.7 % reduction in intraoperative bleeding when received TXA, Diabetic patients showed 44.4 % reduction in bleeding, Obese patients showed 51.1% reduction and patients with multiple comorbidities showed 51% reduction in intraoperative bleeding while healthy individuals showed 38.9% reduction in intraoperative bleeding.

Conclusion: TXA was even more effective in decreasing intraoperative bleeding in patients with multiple comorbidities as compared to healthy individuals.

Fourty patients were diagnosed with Cytomegalovirus in pregnant with fever, weariness, and lymphadenitis. ELISA was recycled to check CMV IgG antibodies. A entire of 40 patients sera infested by means of lymphadenitis plus 40 regulator sera joined hip this learning be present calculated in place of IL-17 and IL-1β levels in their blood. The results point to significant transformation amongst patients and control for IL-17, while no difference between them at IL-1β.

Background: Typical Atrial Flutter in acute coronary syndrome with ST segment elevation is very rare and never reported as a separate electrocardiographic entity, but associated with atrial fibrillation.

Its incidence isn’t reported in the literature, and no data about its predictive factors or related mortality, also its epidemiological data is lacking in Algeria.

Aims: The main objective of our study is the determination of the frequency of typical atrial flutter in acute coronary syndrome with ST segment elevation, the secondary objective was the analysis of its predictive factors, and related mortality.

Methods and materials:  In this prospective study, conducted in the cardiology department of Hussein Dey hospital (Algiers-Algeria), 467 patients with acute coronary syndrome with elevated ST segment (87 women and 380 men) were enrolled between 28 February 2014 and 16 July 2015. The average age is 60 ± 13 years; at admission, a Holter recorder was attached for continuous ECG monitoring during 48 hours

Kruskal’s ANNOVA or H tests were used for comparison of quantitative variables, χ2 test or Fisher’s exact test, were used for qualitative variables, all tests were performed with 1^st species risk of 5%.

Results:  The frequency of typical atrial flutter is 0.4 % (2 patients), CI 95%: [0%-1%], multivariate analysis identified right heart failure as the only predictive factor.

The risk of mortality expressed by Hazard Ration (HR) is 27 (CI95%: [3.5-207], p = 0.001); right heart failure is the only predictive factor of mortality identified in our study.

Conclusion: typical atrial flutter is very rare in acute coronary syndrome with elevated ST segment, its predictive factor according to our study is right heart failure, and its occurrence increases the risk of hospital mortality.

Hypcalcemia is a rare cause of dilated cardiomyopathy, but should be suspected in the presence of an obvious long QT interval on the surface ECG; we report a case of 46 years-old-woman, with surgical history of thyroidectomy 6 years ago, admited in our cardiology departement for mangement of congestive heart failure secondary to dilated cardiomyopathy,  her surface  ECG showed sinus rhythm with  long QT interval, his blood tests showed severe hypocalcemia and  low serum concentration of parathyroid hormone (PTH), cardiac magnetic resonance imaging was in favor of non ischemic dilated cardiomyopathy.

Concomitant with conventionel heart failure treatement, our patient had received parenteral   calcium supplementation, vitamin D, levothyrox; after four weeks, heart failure symptomes  were relieved, the intervalle QT has shortened, but persistant severe left ventricular systolic dysfuction. 

Hypoparathyroidism is frequent after thyroidectomy, and could be responsible of severe hypocalcemia which in turn may induce irreversible dilated cardiomyopathy. 

Chronic thromboembolic pulmonary hypertension occurs after one or more episodes of pulmonary embolism. A rigorous diagnostic approach makes it possible to identify this condition, to evaluate its functional and hemodynamic impact and to determine the degree of extension of the vascular damage. Surgical pulmonary endarterectomy in specialized centers remains the treatment of choice in certain cases. Other therapeutic modalities include transplantation, pulmonary angioplasty, and pharmacological treatments with pulmonary vasodilators. We report the case of OA aged 25, followed since the age of 10 for post-embolic PAH. She was hospitalized at this age in pediatrics for the first episode of pulmonary embolism. The initial etiological assessment was without abnormalities. One year after pulmonary embolism, pulmonary pressures were still elevated despite effective anticoagulation. The patient was started on sildenafil at the age of 11. The evolution was stable. At the age of 16, she was referred to us for care. Her cardiovascular assessment revealed suprasystemic PAH; the patient was then put on a combination of sintrom, sildenafil and bosentan. The thrombophilia assessment is without abnormalities. Currently, she is 25 years old, she is in NYHA functional class II on dual therapy, she has presented several right heart decompensations following non-compliance with treatment and dietary deviation. We discussed a surgical endarterectomy at her home but unfortunately the damage is distal and old. Through this case, we will review this entity of PAH by discussing the different modes of expression and the medical, surgical and interventional therapeutic management (pulmonary angiopalstia with a balloon).

Objective: By analyzing the relationship between ALP, GOT, and LDH action within the seminal plasma of fruitless men and comparing it with ripe men, this study aimed to investigate the physiological conditions that remain unexplained in most cases.

Methods: This study collected forty-four semen tests from normospermic men and 20 tests from fertile men, after a period of forbearance (3-5 days). The tests were analyzed within the Babylon Maternity and Children research facility and private research facilities, from January 2024 to April 2024.

Results: The results indicated that ALP and AST activity had a negative correlation in both fertile (r = - 0.123) and normospermic men (r = - 0.038). Similarly, ALP and LDH activity had a negative correlation in fertile men (r = -0.334), but a positive correlation that was not significant (P˃0.05) in normospermic men (r= 0.128). Moreover, the results showed that AST and LDH activity positively correlated in both normospermic (r=0.058) and fertile men (r=0.242).

Conclusion:  The study hypothesized that normal semen components and gland secretory ability may be indicated by ALP, AST, and LDH activity. The levels of ALP, AST, and LDH activity in males who were fertile and those who were not showed any discernible differences.

Background and objective: to minimize complications by proper selection of patients for surgery and to evaluate what is the impact of psychiatric co-morbidity in patients admitted to a spinal surgical unit in Basrah, Iraq.

Patients and Methods: A multi-center cross-sectional prospective cohort study was conducted on 247 patients. In Basrah province.

During admission complete history was taken in form of identity, complaint, past medical and surgical history, drug history, type of previous and the coming surgery and lastly special emphasis on the questioner to assess patient psychological status using the Patient Health Questioner. Somatic Anxiety Depressive Symptoms (PHQ.SADS)

After one week and one-month the same questions were addressed to the patient to check the general condition,and any complications or readmission.

Results: Out of the 247 patients: Eight patients refuse to be part of this study, thirty-one patients lost follow up, three patients excluded from the study due to exclusion criteria, five patients their surgery postponded because they were psychologically unstable and advised for psychiatrist consultation.

111 patients (55.5%) of the sample size were male patients.

A 90 (45%) patients were at age of 38-57 years, 111 (55.5%) of the sample were male 82 patients (41%) were of moderate degree using the PHQ.SADS. 62 patients (31%) were within the severe scale PHQ.SADS.132 patients (66%) complained from radiculopathy with or without backache,192 (96%) patients discharged safely postoperatively.

41(39.4%) patients were diagnosed with lumber canal stenosis belongs to the severe group.

Psychological break down occurs in 10 (5%) patients, 9 (90%) of those patients belong to severe grade category of PHQ.SADS.

Conclusion: There was a strong association between pre-operative psychological conditions and post-operative complications in form of repeated visit after surgery and persistence of pain and disability.

The present studies aim at reducing the planktonic bacterial load in drinking water using non-activated charcoal. The evaluation is dependent on the incubation time and the different physiological states of the bacterial cells. Three bacteria (Vibrio cholerae, Escherichia coli and Staphylococcus aureus) and two charcoal substrates (Okan and Tali) were used for the experimentation. The Bacteria adhered to charcoal fragments in varying degrees. Overall, the concentrations of fixed Vibrio cholerae reached 53.4x10⁷ CFU/cm² and 39.6x10⁷ CFU/cm² after 9 hours of contact in exponential phase on the Okan and Tali respectively. Those of fixed Staphylococcus aureus reached 5.8x10⁶ CFU/cm² after 3 hours of contact in exponential phase and 3.4x10⁶ CFU/cm² after 3 and 6 hours of contact in the same phase, on the Okan and the Tali, respectively. The highest abundances of Escherichia coli adhered to the charcoal fragments were 50.4x10⁷ CFU/cm² on Okan and 53.2x10⁷ CFU/cm² on Tali after 9 hours of contact in the exponential phase. The highest adsorption coefficient (639.06 adhered cells/cm²) was noted on Okan in the exponential phase with Vibrio cholerae cells; and the lowest (1.02 adhered cells/cm²) on Tali in stationary phase with Staphylococcus aureus. The incubation time significantly (P<0.01) influenced the adhesion of bacterial cells to charcoal substrates. Although the adsorption capacity and intensity of Okan were relatively higher, the comparison of the adsorption potential of the two substrates considered did not reveal any significant difference (P>0.05), reflecting the absence of the influence of the physical properties of these substrates on cell retention.

Unintended but common consequences of pace maker placement or insertion include shoulder dysfunction and pain. This is not something that cardiologist or electrophysiology specialist will be familiar with terms of treatment once these problems become manifest. Cross discipline collaboration as reported in this case resulted in the relief of discomfort caused by pace maker insertion induced shoulder dysfunction.  This procedure was safe and rapidly affective.

Purpose: The study investigates the role of Sprouty2 (SPRY2) in colorectal cancer (CRC) cell function. It found that SPRY2 inhibits the RAS/MAPK/ERK pathway and promotes cancer invasion in KRAS-WT CRC. However, it did not significantly alter p-ERK levels, cell proliferation, or invasion in KRAS-mutant CRCs. High SPRY2 expression was associated with shorter cancer-specific survival in both KRAS-WT and KRAS-mutant CRC patients. The study suggests that SPRY2 may promote invasion and progression in both types of CRC.

Methods: The gene expression data were retrieved from Gene Expression Omnibus (GEO). Fold change, p.value t-test and David Functional analysis, hierarchical clustering was performed.

Results: In this study, we identified altered genes involved in SPRY2 mutation in the colon and the relevant pathways to understand whether the SPRY2 mutation changes cancer progression. 4 genes of 5 genes were downregulated following the mutation in colon cancer cells. We identified a network between these genes and pathways they belong to. Pathway analysis showed that these genes are mostly associated with cancer cell proliferation.

Conclusion: MAL2, ESRP1, CDH3, CXCL14 and CDH1 genes were found to be associated with in SPRY2 mutation in colon cancer pathogenesis. Almost all these genes are effective in the proliferation of cancer cells, especially during the SPRY2 mutation process. Therefore, it is hypothesized that downregulation or upregulation of these genes may affect colon cancer pathogenesis by reducing cell proliferation. And it is predicted that SPRY2 mutation may be an important factor for colon cancer.