samer mohsen

Job’s syndrome or hyper-immunoglobulin E (IgE) syndrome (HIES) is an extremely rare primary immunodeficiency disease with an approximate annual incidence of less than 1/1000000. It is characterized by recurrent cold staphylococcal infections, unusual eczematous dermatitis, severe lung infections, and extensively high concentrations of the serum antibody IgE.

A typical case of Job’s syndrome with a family history of Kawasaki disease is presented in this study aiming at identifying the clinical features, investigational procedures, and management strategy, as well as evaluating the role of the ear, nose, and throat specialist and highlighting the probable relation between Job’s syndrome and Kawasaki disease.

In general, early detection with proper care can prevent the progression of Job syndrome. In addition, the initiated treatment at the first signs of infection is mandatory for preventing long-term complications. There is a probable relation between Job and Kawasaki which requires more consideration.

A recent ongoing pandemic of coronavirus disease named coronavirus disease 2019 (COVID-19) has spread in Syria from March 2020 with a pattern of a slow case increase. So far, the government has put the country under lock-down orders as a preventive measure. However, there is a considerable belief in the medical community of our country supposes that the virus has previously passed through the country depending on the high numbers of diagnosed severe respiratory infections early in 2020. Thus, this study was designed to determine the number of people with detectable antibodies to SARS-CoV-2 from two samples of healthy adults with and without a previous history of severe respiratory infection in the last 6 months of the study.

To this end, samples were collected from 123 and 198 subjects with a previous severe respiratory infection and healthy controls, respectively. Then, immunoglobulin M (IgM) and IgG anti-SARS-CoV-2 antibodies were tested as well.

None of the samples from both groups tested IgG positive in the assay while four tested IgM samples were positive. Accordingly, these positive samples were re-analyzed and remained IgM positive in the second test although the reverse transcriptase-polymerase chain reaction for the SARS-CoV-2 virus was negative.

Based on our findings, there is no evidence concerning the previous COVID-19 infection in Syria thus it is suggested that all isolation and lock-down orders should be respected as an effective preventive tool in this regard

Tinnitus is a common disorder with a considerable amount of distress that affects the patient`s daily life. No objective tools were approved for measuring tinnitus distress. It can be estimated only by subjective scales and questionnaires, albeit, the Electroencephalography (EEG) studies have reported some alterations regarding tinnitus distress network. This study aimed to investigate the correlation between Tinnitus Handicap Inventory (THI) and the recorded EEG data. 

A total of 33 chronic tinnitus cases (9 females) with the mean age of 42.67 years were recruited. Their THI scores were collected, and a 3-minute EEG recorded with eye closed at resting-state. The correlation analysis was performed on THI scores and the current density in the selected Region of Interests (ROIs) concerning the distress network for the eight frequency bands. The patients grouped depending on the THI cutoff point of 56 into low and high THI groups, and then the groups were compared for source analysis and functional connectivity between ROIs using standardized low-resolution brain electromagnetic tomography.

A significant positive correlation was seen between THI scores and the electrical activity in the Anterior Cingulate Cortex (ACC), the prefrontal cortex, and the parahippocampus for an alpha band (P<0.05) and in the ACC for beta (P<0.01). Source analysis showed significant differences with increased activity in the high THI group for alpha, beta and gamma bands. Functional connectivity was also elevated in the high THI group between the ROIs in alpha and beta bands.

THI can be a useful tool for measuring tinnitus distress, and it has a high correlation with EEG data.

Tinnitus, the phantom perception of sound, in which many cortical and subcortical areas are involved has become one of the popular subjects of neuroscience research. Neuroimaging studies have introduced the tinnitus network model to explain the involvement of auditory and non-auditory areas in this perception. In such a model, the cognitive and emotional aspects of tinnitus can be interpreted conveniently. Therefore, this paper aimed to review the neural basis of tinnitus networks, including data from neuroimaging studies, and discuss the clinical implication of this concept, as well. The data from neuroimaging studies were reviewed and discussed in order to complete the overall image of tinnitus network and its correlates such as the distress network, attentional network and other cognitive mechanisms. In addition to the auditory system, the anterior cingulate cortex (ACC) and dorsolateral prefrontal cortex (DLPFC) were considered to be important hubs in tinnitus distress network, especially for having important connectivity with the other networks like attention and salience networks. Moreover, the top-down control of DLPFC over the other brain areas was regarded as the most important brain area to be targeted using the non-invasive interventions and the results were compelling. Understanding the network model has helped in optimizing the neuromodulation protocols like electrical stimulation techniques. Thus, the clinical implications of this model can be generalized to the other types of treatments and the outcomes might be satisfying

Tinnitus is an auditory phantom percept in the absence of any objective physical sound source. Although advances have been made in its treatment, there is very low percent of patients that report an elimination of their tinnitus. A novel approach using noninv­asive neuromodulation has emerged as an inter­esting and promising modality for tinnitus relief. Our aim in this review is to investigate the efficacy and the specific parameters of some types of noninvasive neuromodulation using transcranial electrical stimulation (TES) namely transcranial direct current stimulation (tDCS), transcranial alternative current stimulation (tACS), transcranial random noise stimulation (tRNS). Then we will correlate the outcomes with the findings of the most newly neurobiol­ogic and neuroimaging researches.
Up to now, the optimal use of tDCS was to apply a current of 2 mA for 20 minute over both auditory cortex or dorsolateral prefrontal cortex. The results were somewhat good but still need more optimization. While there is no effects of tACS; tRNS is shown to have the more suppressive effects among the three types of TES, so it would be a promising therapeutic tool for modulating tinnitus. In addi­tion, recently many researches on tinnitus have shed light on the tinnitus generating network and it’s correlation to another functional brain networks. This article show how can the neuro­modulation be optimized by using these new concepts.
Although the different techniques introduced revealed promising results, further research is needed to better understand how they work and how the brain responds to neuro­modulation.