International Medical Journal

The present study aims to evaluate the relevance of IFNλ4rs73555604 SNP and ERAP1rs26618 SNPs and response to direct anti-viral drugs among HCV infected Egyptian patients. 100 participants were included in the study (40 HCV infected patients responded to DAA therapy, 40 HCV infected patients who did not respond to DAA and 20 healthy volunteers). Allelic discriminations of IFNλ-4 rs73555604SNP and ERAPrs26618SNP were carried out using step One real-time PCR. Allelic discrimination of IFNλ4rs73555604 and ERAP1rs26618 exhibited significant differences among the studied groups where 75% of non-responders carry IFNλ4rs73555604T allele while 75% of responders carry ERAPrs26618C allele. Calculations of odds ratio revealed that persons carrying T allele of INFλ4rs555604 and ERAPrs26618 have 2.5 and 3.3 folds more odd to be non-responder to DAA therapy, respectively. IFN-λ-4rs73555604 and ERAP-1rs26618 polymorphism could affect HCV response to DAA treatment among HCV infected Egyptian patients. There was a significant association between INFλ4rs555604CC genotype and response to treatment. However, ERAP1rs26618T-allele was associated with resistance to treatment. Odds ratio calculation revealed that persons carrying ERAPrs26618T allele have 3.3 folds more odd to be non-responder to DAA therapy. Both SNP can be used as surrogate markers to assess response to DAA treatment.

The present paper aimed at discussing the advances of pharmacological treatment of COVID-19 and highlighting the recent findings reported by either international medical bodies or specialized pharmacological research groups. The study adopted the narrative review approach through exploring and analyzing the findings reported in literature during the period of COVID-19 pandemic, in addition to providing commentary notes regarding the released statements of pharmacological research groups. The findings of the study revealed that there is a significant advancement in COVID-19 therapy. However, still there is a significant lack of a single research-based evidence that the released or suggested drugs are effectively eradicating the COVID-19 viral infection. The study concluded that commitment to the announced precautionary measures at the meantime remains the most appropriate action to be taken until a reliable research-based evidence is released regarding the effectiveness of the pharmacological treatments of COVID-19 infection.

A common technique employed in medical research is to answer questions using statistical inference and to calculate an appropriate test statistic and confidence interval that will determine whether some hypothesis should be rejected or otherwise. There are many issues to consider, including the controversial matter of whether a one- or two-sided alternative is appropriate. The objective of this paper is to provide a precise interpretation of a confidence interval as well examining how conditional probability should be interpreted. A novel approach is undertaken for explaining the p-value in relation to a confidence interval that has been used to test a medical hypothesis. It is also apparent that even skilled medical researchers have not been sufficiently trained in statistical analysis do not have the ability to interpret statistical results. Examples to illustrate the techniques are provided. The results in this paper will enable the medial researcher to better understand the nature of confidence intervals and to use them more effectively in reaching conclusions. It is known that there are a number of medical research articles appearing in refereed journals that contain erroneous conclusions through the misinterpretation of data analysis. This paper uses a case study to illustrate that their findings can often be misleading or just plain wrong.

Autonomic nervous dysfunction is a well-recognized symptom in chronic kidney disease (CKD). We have reported that slow breathing exercise (SBE) enhances parasympathetic nervous activity in healthy males. This study aimed to evaluate the effects of SBE in CKD patients. Six male outpatients with severe CKD participated. SBE (six abdominal breaths per minute for each 15-minute session) were performed twice a day for around four weeks. Before and after the SBE trials, electrocardiogram, blood pressure, respiratory rate, skin temperature and skin blood flow were obtained at rest. Autonomic nervous activity was evaluated with power spectral analysis of heart rate variability. High frequency (HF) and low frequency (LF) powers corresponded to the para- sympathetic nervous activity and sympathetic-parasympathetic nervous activity, respectively, and LF/HF ratio corresponded to sympatho-vagal balance. After SBE, respiratory rate and LF/HF ratio decreased, diastolic blood pressure tended to decrease, and HF and skin temperature tended to increase. Sympatho-vagal balance is shifted to sympathetic dominance in CKD patients compared to healthy adults. Our results showed that SBE can shift autonomic balance to parasympathetic nerve dominance even in severe CKD patients. SBE has the potential to improve autonomic nervous imbalance in CKD patients.

Goat-assisted therapy is widely used and recognized for the medical benefits. An experimental study. Tokara, Alpine, Saanen, Shiba and Korean therapy goats (age under 11 year-old) were used. We cooperated with 6 therapy goat farms. We intercrossed Tokara male goat with Tokara, Alpine, Saanen, Shiba and Korean goats. White daughter F1 hybrid backcross with Tokara father goat (white) bore white grandson and black granddaughter BC1 hybrids just 8 months after her birth. Tokara goat kept peculiar characteristics, namely colored coat, horns, supernumerary teats, no wattles. Some Tokara goats are supposing Saanen breed crossing and the genetic variation differed from the native Tokara goats. Nevertheless, just about any breed of goat can be a therapy goat.