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Abstract : Highly contagious hepatitis B virus (HBV) might result in both chronic and acute hepatitis. The purpose of this work was to look into the level of anamnestic and vaccination response to a booster dosage of recombinant-Hepatitis B vaccine among healthcare professionals. In a cross-sectional study involving 232 healthcare professionals, sera were tested using an enzyme-linked immunosorbent assay for the presence of hepatitis B surface antibodies. The anti-HBs antibody titer was measured before and following a booster dose of recombinant hepatitis B vaccination to evaluate the anamnestic response. The study had shown that protective level regarding anti-HBs antibody (≥10mIU/ml) was observed in 170(73.3%) HCWs while 62(26.7%) of them had titer of (<10 mIU/ml). Statistically significant differences were demonstrated among different profession groups with highest Anti-HBs titer ≥100 IU/mL observed among the vaccination staff 8(100%). On contrary highest percentage of ˂10mIU/mL anti-HBs titer was observed among cleaners 28(47.5%). A significant correlation was demonstrated between the protective titer and the number of vaccine doses received and the time elapsed after the last dose of vaccine. Forty-one participants 41/62(66.1%) with AntiHBs titer<10 mIU/ml agreed to receive a booster dose of vaccination, and six weeks later, all gained titer >10mIU/ml. Vaccination coverage rate among HCWs is still low; those who did not respond well to the primary vaccination course need to receive booster doses. The infection control and prevention department (ICP) in hospitals and health facilities must concentrate its efforts on raising awareness among all HCWs.

Abstract : Hypertensive diseases of pregnancy (HDP), including preeclampsia and gestational hypertension, profoundly affect mother and fetal health. Increased serum uric acid levels have been associated with negative pregnancy outcomes. This study is to examine the correlation between blood uric acid levels and maternal and perinatal outcomes in women with hypertensive disorders of pregnancy (HDP). To study the association of serum uric acid levels on maternal and perinatal outcome in women with hypertensive disorders of pregnancy. A total of 70 pregnant women diagnosed with hypertensive disorders were enrolled in this cross-sectional study. Serum uric acid levels were measured, and participants were categorized into normal and abnormal uric acid groups. Maternal characteristics, delivery methods, neonatal APGAR scores, and gestational ages were recorded. Statistical analyses were performed to assess the associations between uric acid levels and various outcomes. The abnormal uric acid group had a mean age of 25.0 ± 3.27 years, while the normal group averaged 23.3 ± 3.26 years. Gestational age was significantly shorter in the abnormal group (35.37 ± 2.79 weeks) compared to the normal group (36.76 ± 1.76 weeks, p=0.038). APGAR scores at 1 minute (6.69 ± 1.19 vs. 7.38 ± 1.02, p=0.025) and at 5 minutes (6.59 ± 1.22 vs. 7.24 ± 0.94, p=0.034) were also significantly lower in the abnormal group. This study underscores a notable correlation between increased serum uric acid levels and negative maternal and fetal outcomes in women with hypertensive disorders of pregnancy, stressing the necessity for regular monitoring of uric acid levels to optimize clinical management and improve health outcomes for mothers and infants.

Abstract : The establishment of an optimal level of intra-abdominal pressure during laparoscopic surgery represents a considerable challenge for surgeons, with the most commonly used range being 12 to 15 mmHg, which allows for a sufficient working space. The aim of this work was to study the morphological features of the lumbar, costal and tendon parts of the diaphragm under low-pressure pneumoperitoneum modelling and long-term structure recovery. The experiment was performed on sexually mature rats of the reproductive period (6-7 months), weighing (230.0±20.0) grams, in the amount of 30 animals. The animals were divided into two experimental groups. The difference in the groups was in the timing of diaphragm sampling. In the first group, the diaphragm was sampled immediately after five hours of pneumoperitoneum, and in the second group 14 days after the simulated pneumoperitoneum. Histological examination of the microsections after five hours revealed destructive changes in all structural components of the diaphragm. Muscle fibres exhibited a compact arrangement, frequently with blurred boundaries, and a loss of differentiation from the stroma. Myofibrils undergo a transformation, becoming undulated, whilst transverse striations are fragmented or absent. The stroma exhibits thickening perivascularly, with adipose tissue representing this structure. The veins and capillaries are full of blood, and there is a distributed leukocytosis. In the arterioles, there is evidence of wall oedema, endothelial desquamation and moderate blood filling. The tendon part loses its compactness. The collagen fibres of the tendons were severely disintegrated, disintegrated and underwent lysis, and there was often detection of haemorrhages and reactive inflammation. After 14 days, the muscle fibres of the diaphragm exhibited an equidirectional, parallel and compact arrangement, and their thickness varied slightly. The nuclei were oval-round in shape, with a characteristic sublemmal arrangement. The endomysium was found to be thin, and was composed of a limited number of collagen fibres, among which hemocapillaries, filled with blood to a moderate degree, were visualised. The perimysium is more pronounced, especially around veins and arterioles, and a greater proportion of collagen fibres in the tendons are parallel to each other and retain their integrity. Low-pressure pneumoperitoneum for 5 hours leads to structural changes in the diaphragm. These changes are reversible, as demonstrated by the complete recovery of all diaphragm parts 14 days after the application of 5 mmHg pneumoperitoneum.

Abstract : In this article, we will present a case study of the somatic manifestations of stress in a 15-year-old teenager. In particular, under psychological stress, the teenager developed multiple stretch marks in the lumbar region. Despite the fact that the literature describes the presence of multiple striae in adolescents, we decided to study the case using a multidisciplinary approach, namely, we assessed both the stress level and cognitive functions (we used the Adolescent Stress Questionnaire ASQ-14 - a short version and a Mini-Mental State Examination -MMSE scale), as well as the endocrine system. The results of the study show that the stress index according to the ASQ-14 is 52; The results of laboratory studies showed that the concentrations of TSH and 25 (OH) D in the blood are outside the normal range. No adrenal pathology was detected. The study of such cases allows us to once again remind doctors of the rather complex and multifaceted interdependence of psychosomatic connections. The term "stress stretch marks" is rarely found in scientific literature, but, in our opinion, it is quite justified to apply it to our case.

Abstract : In the last ten years, immune checkpoint inhibitors (ICI) have transformed the cancer treatment landscape. Due to their immunomodulating properties, the ICIs have a distinctive toxicity profile, resulting in autoimmune-like manifestations termed immune-related adverse events (irAEs). This irAE can range from a mild asymptomatic state to severe life-threatening conditions involving various organs, including endocrinopathies, which need clinical attention. The present case series, case one, represents the development of hypophysitis, though rare, with nivolumab, which is yet a crucial diagnosis. Cases two, three, four, and five highlight the varied spectrum of development of hypothyroidism, thereby underscoring the need for regular biochemical monitoring in patients on immunotherapy. Given the rapidly expanding indication for the use of ICIs, future research must assess the long-term effects of ICIs on thyroid function to understand thyroid irAEs better. Further research is mandated to analyze the disease causation mechanism and determine the reversibility once the drug is stopped.