World Journal of Clinical Medicine Research <p>World Journal of Clinical Medicine Research(WJCMR) is a peer reviewed journal dedicated to the latest advancement of clinical medicine. The goal of this journal is to serve as a resource for dissemination of state-of-the-art research and educational material within the field of clinical medicine. CMR aims to promote rapid communication and dialogue among researchers, scientists, and engineers working in the areas of clinical medicine. It is hoped that this journal will prove to be an important factor in raising the standards of discussion, analyses, and evaluations relating to clinical medicine programs.</p> en-US World Journal of Clinical Medicine Research CLINICAL PATHOPHYSIOLOGY OF PAIN IN HIV-RELATED SMALL FIBRE NEUROPATHY <p><strong>Background : </strong>Small fiber neuropathy HIV &nbsp;is a type of neuropathy often underdiagnosed due to insignificant clinical manifestations and easily conveyed by the patient. Pain, as one of the manifestations of small fiber neuropathy, is also often ignored so that it is not adequately diagnosed and received the proper therapy. This narrative article aims to determine the pathophysiology of pain as a manifestation of small fiber neuropathy in HIV infection.</p> <p><strong>Source</strong>: Relevant&nbsp;articles&nbsp;relating&nbsp;pathophysiology of small fiber neuropathy search with the keywords small fiber neuropathy, pain and pathophysiology were sourced via Medline and Pubmed databases. From this search, 25 articles and journals were published between 2009-2020.</p> <p><strong>Results: </strong>The peripheral immune system plays an important role in developing hypersensitivity during an HIV infection. Activation through proinflammatory pathways in peripheral immune cells to HIV infection causes changes in nociceptive afferent signals that develop hypersensitivity and pain syndrome. Another pathophysiology is related to ARV-induced neuropathy, which is thought to be associated with direct damage to the mitochondrial. &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</p> <p><strong>Conclusion: </strong>Mechanisms underlying pain are multifactorial, including host immunity, viral activity, medical history, and comorbidities in people living with HIV</p> <p><strong>Keywords:</strong> pathophysiology, HIV, pain, small fiber neuropathy</p> Yusak Mangara Tua Siahaan Copyright (c) 2023 World Journal of Clinical Medicine Research 2023-08-01 2023-08-01 Correlation of Thyroid Gland Functions with Menstrual Patterns amongst Infertile and Fertile Women Attending a Tertiary Care Hospital in North-Central Nigeria <p>A regular menstrual cycle is important to maintain a woman’s fertility. This cycle has been linked to optimal function of the thyroid gland in the production of its hormones. Disturbance of thyroid gland functions could result to female infertility due to changes in menstrual patterns. Aim of this research was to determine the correlation between thyroid gland functions and menstrual patterns amongst infertile and fertile women attending a tertiary care hospital in North-Central Nigeria. This comparative, cross-sectional study recruited 106 women who visited the hospital's Gynecology Clinic and Family Planning Clinic. 53 of the 106 patients were women with a history suggestive of either primary or secondary infertility and the remaining 53 women with no history of infertility served as the control. A well-structured questionnaire was used to obtain data on the patients’ menstrual patterns. Anthropometric data were measured and obtained. Collected blood samples were analyzed using Enzyme-Linked Immunosorbent Assay (ELISA) technique to determine the serum levels of thyroid hormones. All obtained data was analyzed, and the level of significance was set at <em>p</em>&lt;0.05, at a 95% confidence interval. 33 patients had menstrual anomalies (78.8% infertile women; 21.2% fertile women who served as control, <em>p</em>=0.012). The incidence of menstrual anomalies in the infertile women group and control group was 7.5% versus 0.0% for amenorrhea; 20.8% versus 5.7% for menorrhagia; 9.4% versus 7.5% for oligomenorrhea; 7.5% versus 0.0% for hypomenorrhea; nil polymenorrhea for both groups; and 50.9% versus 86.8% for normal menstrual patterns. Ten (9.43%) patients were diagnosed with thyroid dysfunctions (80% in infertile group; 20% in control group, <em>p</em>=0.046). Six (18.2%) out of 33 women with menstrual anomalies were diagnosed with thyroid dysfunction. Five (83.3%) out of these 6 women with both menstrual anomalies and diagnosed thyroid dysfunction were infertile while only one (16.7%) was fertile. Thyroid gland dysfunction correlates strongly with abnormal menstrual patterns, which implies that it is vital to evaluate thyroid hormone levels in blood serum in the course of treating menstrual irregularities and female infertility. Early detection of thyroid dysfunction is important in achieving a positive treatment outcome for female infertility.</p> Halima Inya Aliu-Ayo Kikelomo Temilola Adesina Abiodun Akanbi Gafar Jimoh Aloysius Obinna Ikwuka Francis Chigozie Udeh Sikiru Abayomi Biliaminu Olayinka Waheed Ayo Copyright (c) 2023 World Journal of Clinical Medicine Research 2023-10-08 2023-10-08 13 26 Retinal Detachment: A Mini Review <p>Retinal detachments comprised of serious ocular conditions and can lead to permanent vision loss. When the retina, the neurosensory layer, detaches from the back of the eye, it loses its oxygen and nutrient supply leading to the death of the tissue. Immediate diagnosis and treatment are essential to avoid significant morbidity associated with this condition. In this mini review, we outline the evaluation and management of retinal detachments and highlights the role of the interprofessional team in evaluating and treating patients with this condition.</p> Noha Soliman Tanya Gopal Janet Asare Copyright (c) 2023 World Journal of Clinical Medicine Research 2023-01-06 2023-01-06 1 12 Ensitrelvir improved SARS-CoV-2 viral titers of COVID-19 patients refractory to remdesivir <p><strong>Background</strong>: The titers of SARS-COV-2 antigens are frequently used as markers of viral activity and threshold for release from quarantine and treatment. COVID-19 patients were treated with several antiviral agents, including remdesivir (RDV) and ensitrelvir (ESV), which is a novel anti-SARS-CoV-2 agent recently suggested to have strong antiviral activity. <strong>Cases</strong>: We present the cases of two patients whose SARS-CoV-2 antigens were successfully decreased by oral administration of ESV after they could not be decreased by RDV drip infusion. Case 1 was a 74-year-old man who was admitted with SARS-CoV-2 infection and had been infected by the virus a month earlier and relapsed twice. He had been treated with rituximab for diffuse B cell lymphoma and not received vaccination for SARS-CoV-2. RDV was administered intravenously two weeks earlier and again 4 days earlier, but it failed to control the infection, and he was transferred to our hospital (day 1). Intravenous RDV was restarted on day 1, but viral antigens remained high until day 5. The RDV was then switched to oral ESV, and viral antigen titers were successfully decreased on days 8, 10, and 12. Case 2 was an 81-year-old man who was admitted with SARS-CoV-2 infection on day 0. He had heart failure and diabetes mellitus, and had not received vaccination for SARS-CoV-2. Intravenous RDV was started on day 1, but viral antigens were still high until day 8. He was then switched from RDV to oral ESV, and viral antigen titers were successfully decreased on day 11. <strong>Conclusions:</strong> These cases suggest that ESV might be more effective than RDV for reducing viral activity, and it is easy to administer orally.</p> Masafumi Seki Kotaro Mitsutake Atsuko Shimizu Daisuke Honda Ken Ishigami Mitsuko Yamanaka Yasuhiro Kuwata Genji Ueda Kazunori Enami Copyright (c) 2023 World Journal of Clinical Medicine Research 2023-11-20 2023-11-20 27 31