Kurdistan Institute for Strategic Studies and Scientific Research

Introduction Rapid detection and identification of pathogens and antimicrobial susceptibility is essential for guiding appropriate antimicrobial therapy and reducing morbidity and mortality associated with sepsis. Objectives The metabolic response of clinical isolates of Klebsiella oxytoca exposed to different concentrations of ciprofloxacin (the second generation of quinolones antibiotics) were studied in order to investigate underlying mechanisms associated with antimicrobial resistance (AMR). Methods Metabolomics investigations were performed using Fourier-transform infrared (FT-IR) spectroscopy as a metabolic fingerprinting approach combined with gas chromatography-mass spectrometry (GC-MS) for metabolic profiling. Results Our findings demonstrated that metabolic fingerprints provided by FT-IR analysis allowed for the differentiation of susceptible and resistant isolates. GC-MS analysis validated these findings, while also providing a deeper understanding of the metabolic alterations caused by exposure to ciprofloxacin. GC-MS metabolic profiling detected 176 metabolic features in the cellular extracts cultivated on BHI broth, and of these, 137 could be identified to Metabolomics Standards Initiative Level 2. Data analysis showed that 40 metabolites (30 Level 2 and 10 unknown) were differentiated between susceptible and resistant isolates. The identified metabolites belonging to central carbon metabolism; arginine and proline metabolism; alanine, aspartate and glutamate metabolism; and pyruvate metabolism. Univariate receiver operating characteristic (ROC) curve analyses revealed that six of these metabolites (glycerol-3-phosphate, O-phosphoethanolamine, asparagine dehydrate, maleimide, tyrosine, and alanine) have a crucial role in distinguishing susceptible from resistant isolates (AUC > 0.84) and contributing to antimicrobial resistance in K. oxtytoca. Conclusion Our study provides invaluable new insights into the mechanisms underlying development of antimicrobial resistance in K. oxytoca suggests potential therapeutic targets for prevention and identification of AMR in K. oxytoca infections.

Regulating secondary metabolite (SM) in Myxococcus xanthus bears the potential to influence the formation of important natural products with various biological activities. The authors of this study have previously found that the detectable levels of two proteins (4-hydroxyphenylpyruvate dioxygenase [HppD] and a Hsp90-like protein [HtpG]) are affected by ROK inactivation. As evidence, the current study was designed to elucidate the possible role of these two proteins in regulating the SMs’ biosynthesis in this bacterium. To begin with, inactivation of the corresponding genes was carried out, and two mutant strains (M. xanthus hppD− and htpG−) were constructed. Subsequently, high-performance liquid chromatography coupled with mass spectrometry analysis for the metabolic extracts of the mutants revealed a significant reduction in the production of several SMs, like DKxanthene, myxalamide A, and myxochromide A, in comparison to the wild type. Furthermore, electrophoretic mobility shift assays using purified ROK protein suggested a direct binding on the genes’ promoter region encoding the two proteins under study. It is therefore possible to conclude that hppD and htpG genes are implicated in the bacterium SMs’ biosynthetic regulatory cascade, which seems to be directly regulated by the ROK protein. The present study provides additional evidence to a previous investigation showing the pleiotropic regulatory role of ROK on the production of SMs in M. xanthus.

Background Because of the pathophysiological role of vitamin D in health, there is an increased interest to check the clinical status of this vitamin. Immunochemical assays are commonly employed to determine 25-hydroxyvitamin D (25 (OH) D) in clinical laboratories and its testing could be influenced by pre-analytic and analytic issues. The aim of this study was to compare the 25(OH)D results obtained from three commonly used immunoassays in pregnant women to check a possible discrepancy between tests. Material and methods A group of 50 pregnant women who were in their third trimester were included in this study. The quantification of serum vitamin D was performed utilizing three immunochemistry-based assays including Elecsys, VIDAS and Alegria. We also involved 21 non-pregnant volunteers to clinically assess the vitamin D status in this group of people. Results Our findings revealed a significant inconsistency between the obtained results from three assays for serum 25(OH)D. The 25(OH)D showed higher values when measured by the Elecsys assay while the VIDAS assay had lower values compared to the other immunoassays. More notably, the 25(OH)D testing in non-pregnant subjects showed consistent results in all three immunoassays. Conclusions The results of the 25(OH)D measurements in pregnant women should be interpreted carefully due to a great inaccuracy in immunoassay testing. There is no such disagreement in non-pregnant people. Standardization of vitamin D testing in various settings is a crucial matter for clinical laboratories.

Sepsis is a life-threatening condition arising from a dysregulated host immune response to infection, leading to a substantial global health burden. The accurate identification of bacterial pathogens in sepsis is essential for guiding effective antimicrobial therapy and optimising patient outcomes. Traditional culture-based bacterial typing methods present inherent limitations, necessitating the exploration of alternative diagnostic approaches. This study reports the successful application of Fourier-transform infrared (FT-IR) spectroscopy in combination with chemometrics as a potent tool for the classification and discrimination of microbial species and strains, primarily sourced from individuals with invasive infections. These samples were obtained from various children with suspected sepsis infections with bacteria and fungi originating at different sites. We conducted a comprehensive analysis utilising 212 isolates from 14 distinct genera, comprising 202 bacterial and 10 fungal isolates. With the spectral analysis taking several weeks, we present the incorporation of quality control samples to mitigate potential variations that may arise between different sample plates, especially when dealing with a large sample size. The results demonstrated a remarkable consistency in clustering patterns among 14 genera when subjected to principal component analysis (PCA). Particularly, Candida, a fungal genus, was distinctly recovered away from bacterial samples. Principal component discriminant function analysis (PC-DFA) allowed for distinct discrimination between different bacterial groups, particularly Gram-negative and Gram-positive bacteria. Clear differentiation was also observed between coagulase-negative staphylococci (CNS) and Staphylococcus aureus isolates, while methicillin-resistant S. aureus (MRSA) was also separated from methicillin-susceptible S. aureus (MSSA) isolates. Furthermore, highly accurate discrimination was achieved between Enterococcus and vancomycin-resistant enterococci isolates with 98.4% accuracy using partial least squares-discriminant analysis. The study also demonstrates the specificity of FT-IR, as it effectively discriminates between individual isolates of Streptococcus and Candida at their respective species levels. The findings of this study establish a strong groundwork for the broader implementation of FT-IR and chemometrics in clinical and microbiological applications. The potential of these techniques for enhanced microbial classification holds significant promise in the diagnosis and management of invasive bacterial infections, thereby contributing to improved patient outcomes.

This study aimed to investigate the concentrations of some heavy metals HMs in the bottom sediments of Darbandikhan Reservoir in North of Iraq. This study evaluated the contamination of sediments with heavy metals HMs and their ecological risk levels as well as their potential effects on human health. Among the examined metals: Ni, Cr and Zn exceeded the background values in most of the sampling stations. The Enrichment factor EF for the examined HMs in the sediment of the study area showed an order of Ni > Cr > Zn > Pb > Cu. Also, the Potential ecological risk Er mean values of Ni, Cu, Cr, Pb and Zn were 13.64, 2.75, 2.17, 2.02 and 1.01 respectively. Moreover, the mean value of contamination factor CF for Ni was 2.73, which shows that the sediment in Darbandikhan Reservior is in the status of reasonable to significant degree of contamination. The values of hazard quotient HQ for Cr, Zn, and Ni ranged from 1.7x10 − 7 to 8.7x10 − 4 , and 8.1x10 − 7 to 2.1x10 − 1 for adults and children, respectively, which indicates that the examined HMs would not cause non-carcinogenic risk for children and adults. While, the values of CR for Cr, Ni and Zn on children via accidental ingestion were 2.6x10 − 5 , 8.3x10 − 5 and 4.34x10 − 7 , respectively; and those of adult were 5.58x10 − 5 , 1.78x10 − 4 and 9.3x10 − 7 , respectively. This indicated that the CR levels caused by Ni and Cr were not acceptable and may pose risks of cancer in case of accidental ingestion.

X-chromosome short tandem repeat (X-STR) tools are crucial in forensic genetics and human population fields. This study presents the development and validation of a multiplex STR system consisting of thirteen X-STR loci and amelogenin specific to the human X chromosome. The system was optimized and tested for species specificity, sensitivity, stability, and DNA mixture using 9947A female and 9948 male control genomic DNA. The amplified products of nine loci were sequenced to determine the correct amplicon length. Allele frequencies, forensic parameters, mean exclusion chance (MEC), linkage disequilibrium (LD), and allelic patterns were investigated using DNA samples from 225 (159 male, 66 female) unrelated Kurdish individuals who live in Sulaymaniyah province in the Kurdistan region of Iraq. The most informative locus in the Kurdish population was GATA172D05, while the least informative locus was DXS10164. The results demonstrated that the 13 X-STR system is highly polymorphic and sensitive for forensic DNA identification. Genetic distance-based clustering, metric multidimensional scaling (MDS), and correlation matrix were analyzed for 19 ethnic groups and populations. The phylogenetic tree showed that populations clustered according to their ethnogeographic relationships. The findings revealed genetic links between the Iraqi Kurds, Caucasians, Iraqi Arabs, United States (U.S.) ethnic groups, and Chinese populations.

A common challenge for urban areas in developed countries is increasing the amount of solid waste. The Sulaimaniyah Governorate, located in the north of Iraq, characterized by a semi-arid climate region. Currently, there is no landfill site in the study area, and inappropriate solid waste dumping is causing adverse environmental impacts. This study reveals the present state of poor waste management that disposed of through open dumpsite; the core aspects are to evaluate the amount of solid waste leachate, which caused environmental pollution through water and soil. The HELP model was developed to evaluate the hydrological performance of the disposal site and analyze the water balance. The hydrological evaluation of the solid waste quantity from 2005 to 2018 resulted in an average yearly about 964.5 mm of final water storage in the study area. This study is a typical approach for evaluating solid waste leachate at disposal sites in semi-arid locations, and it will contribute in the planning of successful solid waste policy implementation for solid waste leachate treatment and reuse in agriculture.

Introduction Wireless communication connects billions of people worldwide, relying on radiofrequency electromagnetic fields (RF-EMF). Generally, fifth-generation (5G) networks shift RF carriers to higher frequencies. Although radio, cell phones, and television have benefitted humans for decades, higher carrier frequencies can present potential health risks. Insects closely associated with humans (such as mosquitoes) can undergo increased RF absorption and dielectric heating. This process inadvertently impacts the insects’ behaviour, morphology, and physiology, which can influence their spread. Therefore, this study examined the impact of RF exposure on Ae. aegypti mosquitoes, which are prevalent in indoor environments with higher RF exposure risk. The morphologies of Ae. aegypti eggs and their developments into Ae. aegypti mosquitoes were investigated. Methods A total of 30 eggs were exposed to RF radiation at three frequencies: baseline, 900 MHz, and 18 GHz. Each frequency was tested in triplicate. Several parameters were assessed through daily observations in an insectarium, including hatching responses, development times, larval numbers, and pupation periods until the emergence of adult insects. Results This study revealed that the hatching rate for the 900 MHz group was the highest (79 ± 10.54%) compared to other exposures (p = 0.87). The adult emergence rate for the 900 MHz group was also the lowest at 33 ± 2.77%. A significant difference between the groups was demonstrated in the statistical analysis (p = 0.03). Conclusion This work highlighted the morphology sensitivity of Ae. aegypti eggs and their developments in the aquatic phase to RF radiation, potentially altering their life cycle.

This investigation looks at the Late Triassic Baluti Formation's organic geochemical, mineralogical, and petrographical characteristics from a single exploration well (TT-22) near the Taq Taq oilfield in northern Iraq. The Baluti Formation shale samples that were studied in the studied well have high total organic carbon (TOC%) values up to 4.92 wt.% and mostly hydrogen-rich Types types I and II kerogen with a minor gradient to Types types II/III and III kerogen, indicating a good oil-source rock. The hydrogen-rich kerogen was also confirmed by the various organic matter (OM) origin and depositional environment-related biomarkers. The biomarker indicators demonstrate that the Baluti shale was deposited under anoxic conditions and contains a variety of organic matter generated mostly from algae marine and other aqueous organic materials, with some terrigenous land plants. The geochemical and optical maturity indicators show that most of examined Baluti shale samples from the studied well, with a deep burial depth of more than 4000 m, are thermally mature, thus is defining peak-mature to late mature stages of the oil generation window. According to the basin models, from the late Miocene to the present, between 10% and 59% of the kerogen in the Baluti shale source rock has been transformed into oil, which is consistent with the VR values between 0.77 and 1.08%. The presence of the oil crossover in these shale rocks with an oil saturation index (OSI) of more than 100 mg HC/ g rock supports the maximal oil generation from the Baluti source rock system. Additionally, there was a little amount of oil expulsion from the Baluti source rock system at the end of the late Miocene, with TR values below 60% (59%). Considering the In this case, more significant oil generation and little expulsion a leads to high pressures was generated and that forced the brittle minerals of the Baluti shales (mainly quartz), creating and then created a natural fracture system as recognized and observed in the thin section. This natural fracture system enhances the porosity system can be developed the porosity of tight shale rocks of the Baluti Formation giving rise to with high probability of oil production using hydraulic fracturing stimulation.

Plain concrete is strong in compression but brittle in tension, having a low tensile strain capacity that can significantly degrade the long-term performance of concrete structures, even when steel reinforcing is present. In order to address these challenges, short polymer fibers are randomly dispersed in a cement-based matrix to form a highly ductile engineered cementitious composite (ECC). This material exhibits high ductility under tensile forces, with its tensile strain being several hundred times greater than conventional concrete. Since concrete is inherently weak in tension, the tensile strain capacity (TSC) has become one of the most extensively researched properties. As a result, developing a model to predict the TSC of the ECC and to optimize the mixture proportions becomes challenging. Meanwhile, the effort required for laboratory trial batches to determine the TSC is reduced. To achieve the research objectives, five distinct models, artificial neural network (ANN), nonlinear model (NLR), linear relationship model (LR), multi-logistic model (MLR), and M5P-tree model (M5P), are investigated and employed to predict the TSC of ECC mixtures containing fly ash. Data from 115 mixtures are gathered and analyzed to develop a new model. The input variables include mixture proportions, fiber length and diameter, and the time required for curing the various mixtures. The model’s effectiveness is evaluated and verified based on statistical parameters such as R², mean absolute error (MAE), scatter index (SI), root mean squared error (RMSE), and objective function (OBJ) value. Consequently, the ANN model outperforms the others in predicting the TSC of the ECC, with RMSE, MAE, OBJ, SI, and R² values of 0.42%, 0.3%, 0.33%, 0.135%, and 0.98, respectively.

Sentiment analysis is a technique for determining whether data is positive, negative, or neutral using Natural Language Processing (NLP). The particular challenge in classifying huge amounts of data is that it takes a long time and requires the employment of specialist human resources. Various deep learning techniques have been employed by different researchers to train and classify different datasets with varying outcomes. However, the results are not satisfactory. To address this challenge, this paper proposes a novel Sentiment Analysis approach based on Hybrid Neural Network Techniques. The preprocessing step is first applied to the Amazon Fine Food Reviews dataset in our architecture, which includes a number of data cleaning and text normalization techniques. The word embedding technique is then used to capture the semantics of the input by clustering semantically related inputs in the embedding space on the cleaned dataset. Finally, generated features were classified using three different deep learning techniques, including Recurrent Neural Network (RNN), Convolutional Neural Network (CNN), and Hybrid CNN-RNN models, in two different ways, with each technique as follows: classification on the original feature set and classification on the reduced feature set based on Binary Coordinate Ascent (BCA) and Optimal Coordinate Ascent (OCA). The experimental results show that a hybrid CNN-RNN with the BCA and OCA algorithms outperforms state-of-the-art methods with 97.91% accuracy.

A database for the Iraqi Sorani Kurds, specifically focused on the 12 X-short tandem repeat (STR) loci, has been developed to fascilitate forensic and population genetics investigations. The present study involved genotyping 117 unrelated individuals from the Sorani Kurds ethnic group using the Investigator Argus X-12 QS kit. The analysis revealed that the DXS10135 locus exhibited the highest degree of polymorphism, as indicated by a polymorphism information content (PIC) value of 0.94565 and a gene diversity (GD) value of 0.95623. Conversely, the DXS8378 locus displayed the lowest level of polymorphism, with a PIC value of 0.61026 and a GD value of 0.68170. Notably, two individuals were found to possess a rare allele (allele = 6) at the DXS8378 locus, which was not included in the allelic ladder of the kit. Furthermore, a significant linkage disequilibrium (LD) (p < 0.05/117) was observed between the DXS10103 and DXS10101 loci on linkage group 3 (LG3). The ancestral composition of the five primary geographic regions, namely Africa, Middle East, East Asia, Europe, and South America, was determined through the utilization of the FST/FSTmax ratio. The findings of this analysis revealed that the Middle Eastern populations exhibited the lowest FST/FSTmax ratio, measuring at 0.23243, indicating a relatively lower ancestral diversity. Conversely, the European populations showcased the highest FST/FSTmax ratio, measuring at 0.27122, indicative of a greater ancestral diversity within this region. Additionally, the allelic richness indicators, namely distinctive and private alleles, indicated that Africa and the Middle East displayed the highest levels, while Far East Asia exhibited the lowest. This analysis supports the hypothesis of repeated founder effects during outward migrations, as evidenced by both the ancestry variability and the allelic richness. Consequently, the findings of this study have important implications for forensic genetics and population genetics research, particularly in relation to the consideration of genetic predispositions within specific ethnic groups.

Background: Recently studies reported that miRNAs play vital roles in pathogenesis of many human diseases including cancer, which may serve as diagnostic, prognostic markers and may provide means for cancer treatment. The study aimed to investigate the feasibility of using miRNAs as molecular markers for colorectal cancer detection. Methods: Paired tumour/normal tissues of 81 CRC patients were investigated to measure the expression level of six miRNAs (miR-20a, 21, 29a, 31, 92a and 224), evaluate mRNA and protein expressions in a further six genes (SMAD4, PTEN, TGFBRII, BCL2, KLF4 and RASA1) genes using RT-qPCR and immunohistochemistry analysis respectively. Results: In relative to the normal tissue mucosa, statistical analysis revealed a significant increase in the tumour expression level of (miR-20a (p=0.007), miR-21 (p=0.0003), miR-29a (p=0.001) and miR-31 (p=0.0003) with a decrease in the mRNA expression level of TGFBRII. Spearman’s rank order correlation demonstrated that high miR-20a expression was inversely correlated with PTEN-mRNA level (r= -0.238, p=0.033) and PTEN-protein level (r= -0.253, p= 0.023). High miR-21 and miR-224 expression were associated with low expression of TGFBRII-mRNA [(r= -0.358, p=0.001), (r= -0.276, p=0.013)] and TGFBRII-protein [(r= -0.328, p= 0.003), (r= -0.319, p=0.004)] respectively. In addition, over expression of both miR-29a and miR-31 inversely correlated with RASA1-mRNA level [(r= -0.217, p=0.014), (r= -0.276, p=0.013)] and RASA1-protein level [(r= -0.222, p=0.046), (r= -0.209, p=0.010)] respectively. Conclusions: The presence of a high degree of correlation between upregulated miRNAs and downregulation of some of target genes involved in different signalling pathways, indicated that miRNAs may have roles in CRC carcinogenesis. Additionally, upregulation of (miR-20a, 21, 29a and 31) may be suitable to differentiate CRC with a high degree of accuracy from a normal mucosa of CRC patients and can play a critical role on screening CRC in general population.

This paper investigates the impact of a roundabout's central island geometry on operational performance. A case study roundabout with an elliptical central island, characterized by major and minor axes of 63 and 44 meters respectively, is examined. Using SIDRA intersection software, two simulation models were developed, one with an elliptical shape and the other circular. The investigation commenced by assigning peak traffic volumes to both models, followed by the generation of twelve diverse scenarios. These scenarios encompassed gradual increases in lane volumes, spanning from levels of service A to F. Each approach received 100% of the assigned volume for one run and 75% for the other, with this allocation alternating in successive runs. The results demonstrated that at high degrees of saturation, the elliptical roundabout outperformed the circular roundabout in terms of delay and capacity. The performance index of the elliptical roundabout was 16.9% lower than that of the circular roundabout, confirming its superior performance. Moreover, recognizing the importance of accommodating heavy vehicles in urban settings, a parametric study was conducted. Eight additional simulation scenarios, encompassing varying heavy vehicle percentage (HV%) were executed. Results indicated at higher HV% levels, particularly around 8% and 12%, control delay increases by 28.9% and 35.2% for elliptical and circular roundabouts, respectively. These results confirm

Introduction Approximately 50% of patients with primary colorectal carcinoma develop liver metastases. This study investigates the possible molecular discrepancies between primary colorectal cancer (pCRC) and their respective metastases. Methods A total of 22 pairs of pCRC and metastases were tested. Mutation profiling of 26 cancer-associated genes was undertaken in 22/22primary-metastasis tumour pairs using next-generation sequencing, whilst the expression of a panel of six microRNAs (miRNAs) was investigated using qPCRin 21/22 pairs and 22 protein biomarkers was tested using Reverse Phase Protein Array (RPPA)in 20/22 patients’ tumour pairs. Results Among the primary and metastatic tumours the mutation rates for the individual genes are as follows:TP53 (86%), APC (44%), KRAS (36%), PIK3CA (9%), SMAD4 (9%), NRAS (9%) and 4% for FBXW7, BRAF, GNAS and CDH1. The primary-metastasis tumour mutation status was identical in 54/60 (90%) loci. However, there was discordance in heterogeneity status in 40/58 genetic loci (z-score = 6.246, difference = 0.3793, P < 0.0001). Furthermore, there was loss of concordance in miRNA expression status between primary and metastatic tumours, and 57.14–80.95% of the primary-metastases tumour pairs showed altered primary-metastasis relative expression in all the miRNAs tested. Moreover, 16 of 20 (80%) tumour pairs showed alteration in at least 3 of 6 (50%) of the protein biomarker pathways analysed. Conclusion The molecular alterations of primary colorectal tumours differ significantly from those of their matched metastases. These differences have profound implications for patients’ prognoses and response to therapy.

Background: Numerous factors can influence decisions regarding the type of delivery of human babies. There is an increasing demand for non-medically indicated cesarean sections (CS) (non-miCS) or CS on request (CSor). Therefore, this survey study aimed to identify the factors that may foster the decision of CS among obstetricians. Methods: After the sample size calculation returned with 132 needed participants, confidence surveys were sent electronically or disseminated in paper form to nearly all obstetricians (around 200) in the province between mid-August 2021 and mid-February 2022. After signing the consent form, obstetricians were able to provide responses to the four sections of the questionnaire. Data from the copies of the paper were entered into Excel by a local data collector. The data analysis was done using Statistical Product and Service Solutions (SPSS) (IBM SPSS Statistics for Windows, Armonk, NY) and followed the following sequence: summary statistics were done first; then the groups (for and against non-miCS) were compared using analysis of variance (ANOVA); and, finally, regression models were conducted to determine the factors that may affect the favorability of doing non-miCS. Results: A total of 104 obstetricians responded to the survey. Approximately 62.5% of them performed CSor for women who requested it. In addition, more than half (57.7%) agreed that all women had the right and autonomy to choose their mode of delivery. Most providers (65.4) agreed that fear of vaginal delivery (VD) and a bad experience with it are rational reasons for performing a CSor. Unfortunately, some obstetricians (18.3%) faced lawsuits when they refused to perform CSor. As for the factors that may influence the acceptance of obstetricians to non-miCS, it was found that obstetricians who are unsure or refuse to answer (OR=4.30, 95%-CI 1.25-16.29, p=0.025), along with people who do not always perform CSor (OR=4.33, 95%-CI 1.59-12.50, p=0.005) or even refuse it (3.54, 95%-CI 1.05-12.96, p=0.046), are more likely to agree that women have the right to request CSor. Conclusion: The surge in CSor rates was mostly correlated with an attempt to escape the fear of VD. However, given the wide discrepancies in obstetricians’ opinions in this survey, we cannot draw firm conclusions about the reasons behind this phenomenon. It is also important to explore possible ways to address the problem, such as through litigation with providers who refuse to perform a CSor and through economic reform to protect women from money-grubbing obstetricians.

Unlabelled: The stylohyoid ligament begins when the styloid process extends from the petrous temporal bone in a thin bony protrusion. Eagle's syndrome (ES) is a condition related to either calcification of the calcifying the stylohyoid ligament or elongating styloid process The incidence of symptomatic ES is 0.16%, and it is more common in women. The reported study diagnosed ES and treated it surgically through transoral approach styloidectomy. Case presentation: A 39-year-old man who is a farmer and a driver was presented with complaints of ongoing, excruciating discomfort in the back of his left ear. Before the exam, he took a variety of drugs, various drugs 2 years without receiving a definitive diagnosis. Axial, coronal, and sagittal computed tomography scans of both petrous bones were analyzed, and the results showed aberrant styloid process elongation and calcification of the stylohyoid ligament. Discussion: ES, shares many symptoms with other regional illnesses. Physicians frequently misdiagnose cases of ES and treat them without providing a conclusive diagnosis or treatment. Conclusion: ES diagnosis can be difficult for otolaryngologists and primary care providers due to its similarity with other regional illnesses. However, surgical intervention can result in consistent and significant symptomatic improvement when correctly diagnosed. The case presented in the report was successfully diagnosed as ES and treated surgically through transoral approach styloidectomy.

Unlabelled: Despite being very infectious and fatal, the coronavirus disease 2019 (COVID-19) lacks a reliable and practical biomarker to assess how serious it will be. Aim: The current study aims to conclude the possibility of C-reactive protein (CRP) level serving as a biomarker for early prediction of COVID-19 infections. Methods: In this retrospective cross-sectional study, 88 people participated who were infected with COVID-19, aged from 25 to 79 years old. Compare the CRP test range of all samples from patients who visited the hospital between January and April 2022. Results: All participants were confirmed to have COVID-19 through nasopharyngeal swab analysis and real-time polymerase chain reaction real-time polymerase chain reaction testing. Results showed that the majority of infected individuals had elevated CRP levels. A P-value of less than 0.05 indicated a significant difference in CRP levels between alive and dead patients. No significant difference in CRP levels was found between male and female patients. The average CRP level of deceased patients was 137.79 mg/l, while the average CRP level of survivors was 14.37 mg/l. The median interquartile range of deceased patients was also found to be significantly higher compared to survivors. Conclusion: In conclusion, serum CRP levels potentially predict the severity and development of sickness in patients with COVID-19 infections.