Phenotypical Aspects of a Familial Syndromic Retinitis Pigmentosa

Aim: To report a familial case of syndromic retinitis pigmentosa identified at Aristide Le Dantec Hospital in Dakar and to describe their clinical characteristics ophthalmic. Observation: We report a sibling group of nine children, four died at a young age from unknown causes. Three children were affected by retinitis pigmentosa, two cases were syndromic. A history of nyctalopia was found in all three affected children. The mean age of onset of decreased visual acuity was 6.6 years. Patient 1 affected by syndromic retinitis pigmentosa had an extraocular sign of cystic dilation of the main bile duct. Patient 2 had myoclonic epilepsy, psychomotor retardation, and the molar tooth sign on cerebral MRI (highly suggestive of Joubert syndrome). The third child had isolated retinitis pigmentosa. Ophthalmological examinations (fundus examination, electroretinogram, and visual evoked potentials) and pediatric examinations in the remaining two children were normal. Discussion and Conclusion: Retinitis pigmentosa is a rare degenerative disease that can be associated with several other malformations, highlighting the importance of screening for associated conditions. It presents a grim functional prognosis and a life prognosis dependent on extraocular manifestations. Molecular biology (karyotyping, next-generation sequencing) could have identified the implicated genes and allowed for a formal diagnosis and genetic counseling.

A Clinical Study to Assess the Effectiveness of Oral Combination Kit Therapy in Syndromic Management of Abnormal Vaginal Discharge (FEMINE Study) in Kinshasa, Democratic Republic of Congo

Background: Vaginal discharge is one of most common and nagging problems that women face. About 20% - 25% of women who visit gynecology department complain of vaginal discharge and leucorrhoea. An orally administered combination kit, containing 2 g secnidazole, 1 g azithromycin and 150 mg fluconazole (Azimyn FS Kit), has been successfully evaluated in clinical trials and used in several countries for management syndromic vaginal discharge due to infections. Methods: This is a longitudinal study which aimed to verify the clinical efficacy of the combined oral kit containing secnidazole, azithromycin and fluconazole (Azimyn FS Kit®) in the syndromic treatment of abnormal vaginal discharge in patients received in outpatient consultations in Kinshasa/DR Congo from March to September 2023. Results: Majority of patients had whitish vaginal discharge (51.6%) of average abundance (56.2%), accompanied by pruritus in 72.1% of cases, and dyspareunia in 23.5% of cases and hypogastralgia in 40.2% of cases. One week after treatment with the Azimyn FS® combined kit, at the greatest majority of patients (97.3%), abnormal vaginal discharge had decreased by more than 50% (84.1%). Two weeks after treatment with the Azimyn FS® combined kit, almost all patients (97.3%) no longer had abnormal vaginal discharge which had completely disappeared. Conclusion: A single dose of secnidazole, azithromycin and fluconazole in the form of an oral combi-kit (Azimyn FS Kit) has shown excellent therapeutic effectiveness in the syndromic treatment of abnormal vaginal discharge wherein patients were treated without diagnostic confirmation.

Social network analysis and modeling of cellphone-based syndromic surveillance data for ebola in Sierra Leone

Objective:To explore and visualize the connectivity of suspected Ebola cases and surveillance callers who used cellphone technology in Moyamba District in Sierra Leone for Ebola surveillance,and to examine the demographic differences and characteristics of Ebola surveillance callers who make more calls as well as those callers who are more likely to make at least one positive Ebola call.Methods:Surveillance data for 393 suspected Ebola cases(192 males,201 females) were collected from October 23,2014 to June 28,2015 using cellphone technology.UCINET and Net Draw software were used to explore and visualize the social connectivity between callers and suspected Ebola cases.Poisson and logistic regression analyses were used to do multivariable analysis.Results:The entire social network was comprised of 393 ties and 745 nodes.Women(AOR=0.33,95% CI [0.14,0.81]) were associated with decreased odds of making at least one positive Ebola surveillance call compared to men.Women(IR= 0.63,95% CI [0.49,0.82]) were also associated with making fewer Ebola surveillance calls compared to men.Conclusion:Social network visualization can analyze syndromic surveillance data for Ebola collected by cellphone technology with unique insights.

Socio-Demographic, Clinical, and Hygiene Profile of Syndromically Managed Sexually Transmitted Diseases: A Cross Sectional Study in a Tertiary Care Center in India

Background: Sexually transmitted diseases are one of the several major public health concerns, the burden of which is borne by low- and middle-income countries like India. Purpose: The purpose is to evaluate the relationship between menstrual and sanitary hygiene and sexually transmitted diseases (STD) based on syndromic diagnosis Methods: An out-patient department (OPD) based cross sectional survey to determine these associations, if any exist, which would help critically analyze syndromic management. STD was reported by the presence of vaginal/cervical/urethral discharge with or without irritation and itching, lower abdominal pain and ulcer. Results: The prevalence of STD was 66.84% with the most commonly reported symptoms being discharged (31.18%), followed by abdominal pain (17.92%) and itching/irritation (12.90%), with ulcer (4.83%) being the least reported symptom. Perimenopausal age ((AOR: 0.420 [CI: 0.189 - 0.915];p = 0.030), higher grades of education ((AOR: 0.228 [CI: 0.119 - 0.424];p < 0.001) for secondary), urban residency (AOR: 0.435 [CI: 0.686 - 2.733];p < 0.001), and contraception use (AOR: 0.531 [CI: 0.308 - 0.887];p = 0.018) were associated with lesser odds of presenting with an STD symptom. Belonging to a minority religious community (AOR: 7.20 [CI: 1.866 - 48.251];p < 0.012) or backward castes (AOR: 3.753 [CI: 1.587 - 10.144];p < 0.001), having similar illness (AOR: 4.205 [CI: 2.795 - 6.439];p < 0.001) or having an invasive gynecological procedure done in the past one year (AOR: 1.953 [CI: 1.184 - 3.295];p = 0.010) and washing the reusable sanitary material only with water (AOR: 4.900 [CI: 2.701 - 9.116];p < 0.001) as compared to washing it with water and soap, had a higher association with presenting with STD symptoms. Stratified analysis also showed that women presenting discharge (AOR: 2.049 [CI: 1.343 - 3.146] for vaginal and cervical;AOR: 1.426 [CI: 0.826 - 2.482] for urethral) were more likely to not have a toilet facility in an accessible condition. Women with sanitary napkin use had lesser odds (AOR: 0.780 [CI: 0.516 - 1.180];p = 0.293) of presentation for STD in OPD than women who used other material. Conclusion: To better manage the group of diseases that may present with symptoms of STD under syndromic approach, we propose interventions such as menstrual hygiene education and promotion of the use of sanitary napkins among women especially those belonging to lower socio-economic sections of the society.

Advances on Syndromic Management of Sexually Transmitted Diseases

Research data showed that syndromic approach could successfully manage gonococcal and chlamydial infections in males and syphilis and chancroid in males and females. However, low sensitivity, specificity and positive predictive value were found in the syndromic management of vaginal discharge. It is recommended that the syndromic algorithm for management of vaginal discharge used when serving high-risk and symptomatic women.

Rationale of Cross-Sectional Descriptive Study on Clinical Effectiveness of Oral Combination Therapy Based on Secnidazole, Azithromycin and Fluconazole in Syndromic Treatment of Abnormal Vaginal Discharge in Kinshasa/DR Congo

Background: Vaginal discharge is one of the most common troubles faced by childbearing age women. About 20% - 25% of women who visit service of gynecology complain of vaginal discharge and leucorrhoea. Management of vaginal discharge in low-income countries generally depends on syndromic approach, which limits the understanding of specific responsible agents. Thus targeted management is based on the identification of causal organism and targeting of therapy against it, while syndromic management is based on presence of high risk factors. Thus the oral combination kit (Azimyn FS Kit®) offers convenience of a one-day treatment compared to other multidose treatments, which will also ensure high patient adherence to treatment, thus increasing chances of desired results. Due to its widespread use, it is proposed to evaluate the effectiveness of this oral association kit therapy in management of vaginal discharge in the population of our milieu in the Democratic Republic of Congo (DRC) particularly those received in outpatient consultation in some medical facilities in city of Kinshasa. Expensive laboratory tests and the associated waiting period for result mean that patient remains without treatment while waiting for test results. Therefore, by adopting a syndromic management approach, patient’s eligibility for treatment will be decided based on abnormal vaginal discharge, their characteristics, severity and other presentations symptomatic. This approach will also avoid losing sight of patients during follow-up and will help to reduce financial burden for patients. Objectives: To determine the efficacy and safety of oral combination kit therapy containing secnidazole, azithromycin and fluconazole (Azimyn FS Kit®) in syndromic treatment of abnormal vaginal discharge in patients received in outpatient consultation in some medical facilities in the city of Kinshasa;to measure rate of recurrence of abnormal vaginal discharge in these patients. And to identify the adverse effects observed in these patients who received treatment with the combined oral kit containing secnidazole, azithromycin and fluconazole (Azimyn FS Kit®) in outpatient consultation in some medical facilities in the city of Kinshasa. Methods: It will be a cross-sectional descriptive study. Sample size will be 319 women of childbearing age who consult the gynecology department with complaint of abnormal vaginal discharge and suspicion of vaginal infection, who agree to abstain from sex during treatment and who have given their written consent to use their personal and/or health data in the study. Conclusion: A study on clinical efficacy of oral combination therapy based on secnidazole, azithromycin and fluconazole is beneficial.

Facilitating the Implementation of Sexually Transmitted Infection Syndromic Management in China

Objerctive: To introduce the current status of implementing sexually transmitted infection (STIs)syndromic management in China. Methods: Data werecollected and analyzed from the literature. Possiblesolutions were suggested for the obstacles encountered inthe implementation process. Results: Validation of revised flowcharts for themanagement of three syndromes (urethritis, vaginaldischarge, and genital ulcers) has been conducted in China.The feasibility, effectiveness and acceptance of using asyndromic STI approach were investigated in a large studyin Hainan, Zhejiang and Hubei Provinces. Chief obstaclesto implementation included the following: lack of supportfrom government authorities; negative reaction by hospitals;lack of critical thinking and innovation; perceivedover-emphasis on treatment at the expense of prevention;and lack of coverage for several important pathogens withintreatment algorithms. Possible solutions may include policyadvocacy, adopting syndromic management into a Chinesecontext, ssemination and promotion, training of providers, encouraging use of syndromic approach, and conductingoperational rescarch. Conclusions: Syndromic STI management provides afeasible approach for the diagnosis and treatment of STIs inChina. Further efforts should be made for scaling up itsapplication in clinical settings.

CLINICAL SIMULATED EXPERIMENT ON SYNDROMIC STANDARDS OF PULMONARY SYSTEM DISEASES

Clinical simulated experiment (CSE) is an intermediate experiment in clinic withmodern functional simulation.Traditional Chinese Medicine (TCM) has a long histo-ry with an unique system of medical theory which has not been standardized and cannot be fully explained by modern natural sciences.CSE on the syndromic standardsof pulmonary system diseases (SSOPSD) was carried out by following TCM’s theo-

Syndromic Management of Sexually Transmitted Diseases inAntenatal and Family Planning Clinic Attendees

For the purpose of control of STDs and AIDS, WHO has recommended the syn-dromic approach to prompt and complete diagnosis and treatment of diseases. In ante-natal and family planning clinic attendees (a low STD prevalence population), theuse of signs and symptoms and the risk assessment can be evaluated as a screening toolto manage infections factors (RTIS ) in women. However, for the asymptomatic indi-viduals more sensitive and specific laboratory tests should be used to find out more STDpatlents.The syndromic management of genital ulceration and lower abdominal pain inwomen appears to be feasible. On the otherh and, the management of abnormal vagi-nal discharge can relleve symptoms of vaginal infections, but prevention of transmis-sion and complications of cervical infections, even adding risk factor assessment andcersical examination, it ofen results in significant amount of overtrealment. However,using the syndromic approach as a screening tool, the diagnosis of cervical infecti0ns inindividuals with a positive screening result can be further confrmed.

Identification of Known and Novel PTCH Mutations in Both Syndromic and Non-syndromic Keratocystic Odontogenic Tumors

Aim To clarify the role of PTCH in patients with NBCCS- related and non-sydromic keratocystic odontogenic tumors. Methodology Mutation analysis was undertaken in 8 sporadic and 4 NBCCS-associated KCOTs. Results Four novel and two known mutations were identifled in 2 sporadic and 3 syndromic cases, two of which being germline mutations （c.2179delT, c.2824delC） and 4 somatic mutations （c.3162dupG, c.1362-1374dup, c.1012 C〉T, c.403C〉T）. Conclusion Our findings suggest that defects of PTCH are associated with the pathogenesis of syndromic as well as a subset of non-syndromic KCOTs.

Characterization of two novel knock-in mouse models of syndromic retinal ciliopathy carrying hypomorphic Sdccag8 mutations

Mutations in serologically defined colon cancer autoantigen protein 8(SDCCAG8)were first identified in retinal ciliopathy families a decade ago with unknown function.To investigate the pathogenesis of SDCCAG8-associated retinal ciliopathies in vivo,we employed CRISPR/Cas9-mediated homology-directed recombination(HDR)to generate two knock-in mouse models,Sdccag8^(Y236X/Y236X) and Sdccag8^(E451GfsX467/E451GfsX467),which carry truncating mutations of the mouse Sdccag8,corresponding to mutations that cause Bardet-Biedl syndrome(BBS)and Senior-L?ken syndrome(SLS)(c.696T>G p.Y232X and c.1339-1340ins G p.E447GfsX463)in humans,respectively.The two mutant Sdccag8 knock-in mice faithfully recapitulated human SDCCAG8-associated BBS phenotypes such as rod-cone dystrophy,cystic renal disorder,polydactyly,infertility,and growth retardation,with varied age of onset and severity depending on the hypomorphic strength of the Sdccag8 mutations.To the best of our knowledge,these knock-in mouse lines are the first BBS mouse models to present with the polydactyly phenotype.Major phototransduction protein mislocalization was also observed outside the outer segment after initiation of photoreceptor degeneration.Impaired cilia were observed in the mutant photoreceptors,renal epithelial cells,and mouse embryonic fibroblasts derived from the knock-in mouse embryos,suggesting that SDCCAG8 plays an essential role in ciliogenesis,and cilium defects are a primary driving force of SDCCAG8-associated retinal ciliopathies.

Ocular findings in syndromic gingival fibromatosis: a case study and electronic microscopic investigation of lens

We report a case of syndromic gingival fibromatosis with notable ocular lesions,bilateral congenital cataracts,esotropia,and high myopia of a 21-year-old male patient from China.The patient was diagnosed with gingival fibromatosis based on his massive gingival overgrowth and histological findings that were consistent with gingival fibromatosis through a gingival biopsy.Lens opacity features were presented and phacoemulsificaion with intraocular lens(IOL)implantation was performed to manage the cataracts in both eyes.Transmission electronic microscopy was used to investigate the ultrastructure of the removed lens tissue.We also review the literature on gingival fibromatosis and briefly summarize the ocular manifestations of this rare disease.

Whole-exome sequencing identifies ECPAS as a novel potentially pathogenic gene in multiple hereditary families with nonsyndromic orofacial cleft

Dear Editor,Orofacial cleft(OFC),which includes cleft lip and/or palate(CL/P)and cleft palate(CP),is the most common congenital craniofacial structural disorder,with a prevalence of 1.416%。among live infants worldwide(Massenburg et al.,2021).Nonsyndromic OFC(NSOFC),which does not contain other malformations as syndromic OFC(SOFC),accounts for 70%of cases and is believed to have complex etiologies.Notably,it has been established that genetic factors play a crucial role in the occurrence of NSOFC(Dixon et al.,2011).

Acquired immunity and asymptomatic reservoir impact on frontline and airport ebola outbreak syndromic surveillance and response

The number of surveillance networks for infectious disease diagnosis and response has been growing.In 2000,the World Health Organization(WHO)established the Global Outbreak Alert and Response Network,which has been endorsed by each of the 46 WHO African members since then.Yet,taming the dynamics and plague of the vicious Ebola virus disease(EVD)in African countries has been patchy and erratic due to inadequate surveillance and contact tracing,community defiance and resistance,a lack of detection and response systems,meager/weak knowledge and information on the disease,inadequacies in protective materials protocols,contact tracing nightmare and differing priorities at various levels of the public health system.Despite the widespread acceptance of syndromic surveillance(SS)systems,their ability to provide early warning alerts and notifications of outbreaks is still unverified.Information is often too limited for any outbreak,or emerging or otherwise unexpected disease,to be recognized at either the community or the national level.Indeed,little is known about the role and the interactions between the Ebola infection and exposure to other syndemics and the development of acquired immunity,asymptomatic reservoir,and Ebola seroconversion.Can lessons be learnt from smallpox,polio,and influenza immunity,and can immunization against these serve as a guide?In most endemic countries,community health centers and disease control and prevention at airports solely relies on passive routine immunization control and reactive syndromic response.The frontline and airport Ebola SS systems in West Africa have shown deficiencies in terms of responding with an alarming number of case fatalities,and suggest that more detailed insights into Ebola,and proactive actions,are needed.The quest for effective early indicators(EEE)in shifting the public and global health paradigm requires the development and implementation of a comprehensive and effective community or regional integrated pandemic preparedness and surveillance response systems tailored to local contexts.These systems must have mechanisms for early identification,rapid contact tracing and tracking,confirmation,and communication with the local population and the global community,and must endeavor to respond in a timely manner.

A novel SPINT2 missense mutation causes syndromic congenital sodium diarrhea

Congenital sodium diarrhea(CSD)is a monogenic disordercausedby specific geneticdefects that increase sodium content in the stool,resulting in intractable diarrhea.The disease was first reported by Holmberg in 1985[1].Fewerthan50cases havebeen reportedworldwide todate,mainly in Europe(Germany and Sweden)and Oceania(Australia),while no cases have been reported in China.Therearetwocategories of CSDdependingonwhetherit involves other congenital malformations:non-syndromic congenital sodium diarrhea(non-sCSD)and syndromic congenital sodium diarrhea(sCSD).Fornon-sCSD,the identified causative genes include SLC9A3 and GUCY2C,whereas sCSD is primarily caused bySPINT2mutations[2].

Comparative analysis of syndromic and PCR-based diagnostic assay reveals misdiagnosis/ overtreatment for trichomoniasis based on subjective judgment in symptomatic patients

Background:Trichomoniasis,a sexually transmitted disease(STD),is caused by Trichomonas vaginalis in both men and women.Screening of trichomoniasis is problematic in resource challenged settings as currently available,inexpensive diagnostic methods are of low sensitivity and/or specificity.In India,National AIDS Control organization(NACO)recommended syndromic case management(SCM)for treatment.The objective of the present study was to compare the utility of the NACO-NACP III Algorithms for STI/RTI treatment used by clinicians with PCR based diagnosis.Methods:Patients visiting Department of Obstetrics&Gynecology,Vardhman Mahavir Medical College and Safdarjung Hospital,New Delhi from January 2011 to June 2014 were enrolled in the study to compare the diagnostic efficiency of PCR-based assays against SCM.Based on SCM,patients(n=820)were treated with antibiotics using pre-packed STI/RTI kits(sexually transmitted infection/reproductive tract infection;procured by National AIDS Control/State AIDS Control Society(NACO/SACS),Ministry of Health and Family Welfare,Govt of India.)under National AIDS Control Programme(NACP III)for syndromic case management(SCM).Ectocervical dry swab samples were also obtained from these patients and out of that 634 samples were tested by PCR.Total genomic DNA was extracted from these samples and used as template for PCR amplification using pfoB,gyrA and orf1 gene specific primers for diagnosis of T.vaginalis(TV),Chlamydia trachomatis(CT)and Neisseria gonorrhoeae(NG)respectively.Results:Out of 6000 patients who visited OPD,820(14%)female patients reported vaginal discharge and were recommended antibiotic treatment for one or more pathogens namely,TV,CT,NG and Candida or for co-infection.On the basis of signs&symptoms and NACO guidelines,the following distribution of various infections was observed:TV(46%),CT(20%),coinfection with TV and CT(12%),coinfection with CT and NG(11%),coinfection with TV,CT and Candida(7%)and coinfection with TV and NG(2%).Others were infected with NG alone(1%),coinfected with TV and Candida(0.4%)and 0.3%were coinfected with CT,NG and Candida.Based on PCR method,110(17%)women tested positive for one or more of these three pathogens while 524(83%)women were negative for any of these three pathogens but could be positive for other STIs not tested in this study.Since all the patients(634)were given antibiotics,we estimate that the over-treatment was 85%while 524(83%)patients were also misdiagnosed by SCM.Conclusions:The over-treatment and inaccurate diagnosis of pathogens due to subjective judgment based on syndromic approach in symptomatic women is a large economic wastage and may also contribute towards increased resistance.The misdiagnosed patients will also serve as a reservoir for transmission of pathogens to their sexual partner.

Targeting TrkB–PSD-95 coupling to mitigate neurological disorders

Tropomyosin receptor kinase B(TrkB)signaling plays a pivotal role in dendritic growth and dendritic spine formation to promote learning and memory.The activity-dependent release of brain-derived neurotrophic factor at synapses binds to pre-or postsynaptic TrkB resulting in the strengthening of synapses,reflected by long-term potentiation.Postsynaptically,the association of postsynaptic density protein-95 with TrkB enhances phospholipase Cγ-Ca^(2+)/calmodulin-dependent protein kinaseⅡand phosphatidylinositol 3-kinase-mechanistic target of rapamycin signaling required for long-term potentiation.In this review,we discuss TrkB-postsynaptic density protein-95 coupling as a promising strategy to magnify brain-derived neurotrophic factor signaling towards the development of novel therapeutics for specific neurological disorders.A reduction of TrkB signaling has been observed in neurodegenerative disorders,such as Alzheimer's disease and Huntington's disease,and enhancement of postsynaptic density protein-95 association with TrkB signaling could mitigate the observed deficiency of neuronal connectivity in schizophrenia and depression.Treatment with brain-derived neurotrophic factor is problematic,due to poor pharmacokinetics,low brain penetration,and side effects resulting from activation of the p75 neurotrophin receptor or the truncated TrkB.T1 isoform.Although TrkB agonists and antibodies that activate TrkB are being intensively investigated,they cannot distinguish the multiple human TrkB splicing isoforms or cell type-specific functions.Targeting TrkB–postsynaptic density protein-95 coupling provides an alternative approach to specifically boost TrkB signaling at localized synaptic sites versus global stimulation that risks many adverse side effects.

Saccharomyces boulardii as a single trigger of food protein-induced enterocolitis syndrome: Seven case reports

BACKGROUND Food protein-induced enterocolitis syndrome(FPIES)is the most serious type of non-immunoglobulin E(IgE)-mediated food allergic reaction manifesting as sepsis-like symptom,which can lead to shock.Saccharomyces boulardii(S.boulardii),a probiotic prescribed frequently in clinical settings,has been reported to trigger FPIES in an infant with soy-triggered FPIES.In this report,we describe a new clinical FPIES in which S.boulardii was the sole triggering factor of acute FPIES adverse reaction in seven healthy infants.CASE SUMMARY Seven FPIES cases triggered by only S.boulardii were gathered from 2011 to the present.None of the patients had previously experienced any allergic reaction to cow’s milk,soy,or complementary food.The age of the patients was 4-10-months old,and the symptoms of FPIES developed after ingestion of S.boulardii,which is mostly prescribed for the treatment of gastroenteritis or antibiotic-associated diarrhea.All patients experienced severe repetitive vomiting 1-3 hours after S.boulardii ingestion.Extreme lethargy,marked pallor,and cyanosis were also observed.No IgE-mediated hypersensitivity developed in any patient.Diarrhea was followed by initial intense vomiting in approximately 5-10 hours after S.boulardii ingestion,and only one case showed bloody,purulent,and foul-smelling diarrhea.The patients stabilized quickly,mostly within 6 hours.Symptoms got all improved within 24 hours after discontinuation of S.boulardii.CONCLUSION S.boulardii can be the sole trigger of acute FPIES and be prescribed cautiously even in healthy children without FPIES.

Unusual ovarian hyperstimulation syndrome presentation:Pleural effusion without ascites.A case report

BACKGROUND Ovarian hyperstimulation syndrome(OHSS)is a life-threatening complication that can occur in the luteal phase or early pregnancy after controlled ovarian stimulation.This case report highlights a unique manifestation of OHSS involving pleural effusion(PE)in a patient without identifiable risk factors.CASE SUMMARY A 39-year-old woman who underwent controlled ovarian hyperstimulation for an in vitro fertilization(IVF)cycle experienced dyspnea on the eleventh day of post oocyte retrieval.The diagnosis was severe OHSS with a unique manifestation of PE without ascites.Clinical management involved fluid balance and treatment with albumin,furosemide,thromboembolic prophylaxis,and thoracentesis.A continued drainage of the pleural cavity was performed.The patient had a favo-rable outcome,and a dichorionic diamniotic gestation passed without incident.CONCLUSION OHSS and its potential complications can include respiratory distress and PE,as well as thromboembolic disorders.

Association of interleukin-6 with acute lung injury risk and disease severity in sepsis

Sepsis is a life-threatening condition caused by a dysregulated response of the body in response to an infection that harms its tissues and organs.Interleukin-6(IL-6)is a significant component of the inflammatory response as part of the pa-thogenesis of sepsis.It aids in the development of Acute lung injury and,subse-quently,multiple organ dysfunction syndrome.This letter probes into the corre-lation between plasma IL-6 levels and the risk of developing acute lung injury and multiple organ dysfunction syndrome in critically ill patients with sepsis.While it shows promising results,limitations like its observational study design,a limited sample size,a single center involvement,single-time-point measurement,and a lack of a control group restrain its cogency.The study is a big step in identifying IL-6 as a biomarker to improve patient care.