JOURNAL OF RESEARCH IN MEDICAL SCIENCES (JRMS)
Year:2018 | Volume:23 | Issue:7|Papers Count:10

Background: The imbalance of von Willebrand factor (vWF) and a disintegrin and metalloproteinase with a thrombospondin type 1 motif member 13 (ADAMTS13) has been associated with atherosclerosis progression. A high level of vWF which regulates thrombus formation is associated with diabetes mellitus (DM), and some ADAMTS13 and vWF polymorphisms have effects on their levels. Therefore, this study aimed to evaluate the associations of ADAMTS13 and vWF polymorphisms and their levels with DM and severity of coronary stenosis. Materials and Methods: Eighty‑ seven DM and 84 control individuals were recruited. vWF and ADAMTS13 activities as well as vWF antigen were measured by collagen‑ binding assay (CBA), residual‑ CBA, and in‑ house enzyme‑ linked immunosorbent assay, respectively. ADAMTS13 and vWF polymorphisms were determined by polymerase chain reaction‑ restriction fragment length polymorphism. Results: The E and G alleles and AA genotype of ADAMTS13 Q448E, rs2073932, and rs652600, respectively, were independently associated with DM (odds ratio [OR] [95% confidence interval (CI)] = 2. 5 [1. 1, 5. 6], 2. 3 [1. 0, 5. 2], and 4. 7 [1. 2, 18. 6], respectively). Moreover, E allele and AA genotype of Q448E and rs652600 were also significantly associated with multi‑ vessel disease (OR [95% CI] = 2. 2 [1. 0, 4. 8] and 3. 2 [1. 0, 10. 0], respectively), while the E and G allele of Q448E and rs2073932 were associated with high Gensini score (OR [95% CI] = 2. 3 [1. 1, 4. 9] and 2. 3 [1. 1, 5. 1], respectively). Conclusion: Association of ADAMTS13 polymorphisms with DM, number of vessel stenosis, and Gensini score may indicate the possible contribution of ADAMTS13 polymorphisms to atherosclerosis progression and severity of coronary stenosis in DM.

Sir, Gastric intestinal decontamination (GID) remains an important issue in the management of acute poisoning. [1] Its effectiveness is dependent on the nature, form, amount of ingested toxin, and time from ingestion to admission. [2, 3] Reported adverse effects of orogastric lavage include injury to the esophagus and stomach, rupture of the stomach, inadvertent unrecognized trachea intubation as well as significant decreases in serum calcium and magnesium, severe hypernatremia, and leukocytosis. [1] We perform GID in our poisoning emergency department through the nasogastric (NG) tube insertion. Here, we report a rare complication of NG tube insertion in patients presented with acute poisoning...

Mycobacterium tuberculosis is a causative agent of tuberculosis that causes deaths across the world. The pathogen apart from causing disease manifestations can also enter into a phase of latency to re‑ emerge later. Among the various factors associated with the virulence of pathogen, the lipids composing the cell wall of the bacillus have drawn much interest among. The unique composition of the cell wall composed of mycolic acid, glycolipids such as diacyltrehaloses, polyacyltrehalose, lipomannan, lipoarabinomannan (LAM), mannose-capped-LAM, sulfolipids, and trehalose-6, 6’-dimycolate, all have been implicated in providing the pathogen an advantage in the host. The pathogen also alters its metabolism of fatty acids to survive the conditions in the host that is reflected in an altered cell wall composition in terms of lipids. In addition, the lipid profile of the cell wall has been shown to modulate the immune responses launched by the host, especially in the suppression, or production of inflammatory factors, cytokines, and phagocytic cells, such as dendritic cells and macrophages. Apart from M. tuberculosis, the paper also briefly looks at the role of Mycobacterium bovis and its role in tuberculosis in humans along with its lipid profile of its cell wall. This review aims to summarize the various lipids of the cell wall of M. tuberculosis along with their roles in enabling the pathogen to maintain its virulence to infect further humans and its persistence inside the host.

Background: Ulcerative colitis (UC) is a chronic inflammatory bowel disease. Recent studies have shown that dietary factors play an important role in the development of UC. Index of Nutritional Quality (INQ) is a suitable method that analyzes quantitatively and qualitatively single foods, meals, and diets. The aim of this study was to determine the association between INQ and UC. Materials and Methods: Overall, 62 newly diagnosed cases with UC and 124 healthy age‑ and sex‑ matched controls were studied in a referral hospital in Tabriz, Iran. INQ scores were calculated based on information on the usual diet that was measured by a valid and reliable Food Frequency Questionnaire consisting of 168 food items. Logistic regression analysis adjusting for age, gender, body mass index, education, smoking, Helicobacter pylori, family history of UC, appendectomy, alcohol, and total energy intake was used to estimate multivariable odds ratios (ORs). Results: After controlling for several covariates, we found inverse associations between UC risk and INQs of Vitamin C (OR = 0. 34 [0. 16– 0. 73]) and folate (OR = 0. 11 [0. 01– 0. 99]). In crude model of analysis, cases had a higher intake of total energy, protein, carbohydrate, total fat, saturated fatty acid, monounsaturated fatty acid, polyunsaturated fatty acid, niacin, Vitamin B6, Vitamin B12, magnesium, zinc, copper, selenium, and iron compared to controls, whereas controls had higher intakes of Vitamin C, Vitamin D, folate, and biotin compared to cases. Conclusion: Our results indicate that enough consumption of Vitamin C and folate was associated with lower risk of UC.

Background: The purpose of this study was to assess the diagnostic role of preoperative hematological parameters, especially neutrophil‑ to‑ lymphocyte ratio (NLR), platelet‑ to‑ lymphocyte ratio (PLR), and mean platelet volume (MPV) in germ cell testicular malignancies and their prediagnostic role in staging of testicular cancer. Materials and Methods: In this cross‑ sectional retrospective study, we analyzed 39 patients who underwent radical orchiectomy due to a testicular cancer (Group 1) and 82 patients on whom varicocelectomy procedure was performed as control group (Group 2) between January 2006 and January 2016 in our clinic. Evaluation of the preoperative hematological parameters in both groups and also the subgroups in malignancy group according to histopathological stages was conducted in this study. Results: When the hematological parameters were compared, a statistically significant difference was found between the two groups in terms of neutrophil counts, NLR, PLR, and MPV. NLR and PLR were significantly higher and MPV was significantly lower in testicular cancer group compared to the control group. NLR was 3. 1 ± 1. 4 and 2. 0 ± 1. 5, PLR was 141. 3 ± 53. 2 and 115. 7 ± 44. 8, and MPV was 8. 9 ± 1. 0 and 9. 3 ± 1. 1 for testicular cancer and control groups, respectively (P < 0. 05). Furthermore, differences were observed between only mean corpuscular volume, mean corpuscular hemoglobin, and MPV (P < 0. 05) in different stages of malignancy. Conclusion: In accordance with these findings, NLR, PLR, and MPV may be helpful for prediagnosis of testicular malignancies. Hematological parameters will become important in the preoperative assessment for those patients.

Background: In this study, we aimed to retrospectively evaluate treatment outcomes and treatment methods in acromegaly patients. Materials and Methods: The study included 65 acromegaly patients followed in Sakarya University Faculty of Medicine Department of Endocrinology in Turkey between 2004 and 2013. Clinical, biochemical, and radiological data were obtained retrospectively from the medical files of the patients. All cases have been discussed in the endocrinology and pituitary surgery council, and a multidisciplinary treatment approach had been chosen in management. Results: Sixty‑ five patients were included in the study. Of the patients, 57% were female. Mean age was 45. 3 ± 9. 2 years old. Of the cases, 12. 3% were microadenomas (n = 8, tumor diameter <10 mm) and 87. 6% were macroadenomas (n = 57, tumor diameter ≥ 10 mm). In our study, 70% remission was achieved with the first operation and medical treatment. Patients with invasive acromegaly without remission after the first operation underwent reoperation, medical treatment, and conventional or stereotactic radiotherapy and achieved 45% remission rate. Conclusion: Pituitary surgery is the first treatment option for acromegaly. In patients who could not be remissioned after the first operation, remission can be achieved by combined therapy consist of reoperation, medical treatment, and conventional or stereotactic radiotherapy.

Kidney diseases are categorized as the highest prevalent ones with worldwide noticeable incidence. They cause accelerated cardiovascular diseases and noticeable mortalities. Adipose tissue and its messengers, adipokines, are reported to have the highest relationship with end‑ stage renal diseases or chronic kidney diseases. Over recent years, with shifting of scientists’ mindset from a simple overview of adipose tissue as a fat store to the complex paradigm of this issue as a multipotential secretory organ, the importance of studies on this tissue has emerged.

Background: The objective of the present study was to determine the association between chemotherapy and infectious complications in patients diagnosed with Hematologic malignancies (HMs). Materials and Methods: The study included 463 patients diagnosed with HMs multiple myeloma (MM), Hodgkin’ s lymphoma (HL), non‑ HL (NHL), acute myeloid leukemia (AML), acute lymphocytic leukemia, chronic lymphocytic leukemia, and chronic myeloid leukemia, between January 2014 and June 2015. The patients were followed for 1 year after inclusion, to record the infectious complications. The collected data included age, sex, type of chemotherapy regimen, and several blood tests at admission. All patients received prophylactic treatment with antibiotics and antifungal agents. For each infection, we recorded the microbiological diagnosis and the day of occurrence since HMs diagnosis. Results: In patients with MM, we found that the treatment with growth factors (hazard ratio [HR] 2. 2; confidence interval [CI] 95%: 1– 4. 6; P = 0. 03) was associated with a higher chance of infectious complications. In patients with non-Hodgkin lymhoma (LNH), the following drugs were associated with a higher infectious incidence: cytarabine (HR: 2. 3; CI 95%: 1– 5; P = 0. 03), methotrexate (HR: 2. 1; CI 95%: 1. 8– 4; P = 0. 01), dexamethasone (HR: 1. 7; CI 95%: 0. 9– 3; P = 0. 06), growth factors (HR: 1. 7; CI 95%: 0. 9– 3. 2; P = 0. 001), and etoposide (HR: 2. 5; CI 95%: 1. 5– 4. 2; P = 0. 002). Cytarabine (induction) (HR: 2; CI 95%: 1. 1– 3. 7; P = 0. 01), cytarabine (consolidation) (HR: 2. 1; CI 95%: 1. 3– 3. 5; P = 0. 01), and growth factors (HR: 2. 1; CI 95%: 1. 3– 3. 5; P = 0. 002) were often on the therapeutic plan of patients with AML, which developed infections. Conclusion: Regarding the chemotherapy regimen, the highest incidences of infectious complications were observed for growth factors and cytarabine.

Background: Lamnin has important effects on human immunity system. The current study aimed to assess the role of L‑ leucine‑ 7‑ amido‑ 4‑ methyl coumarin 1 gene polymorphisms on hepatitis B virus (HBV) susceptibility. Materials and Methods: The rs20558, rs20563, rs10911193, rs10911251, and rs1413390 polymorphisms were analyzed using polymerase chain reaction (PCR) and PCR‑ reaction– restriction fragment‑ length polymorphism and amplification‑ refractory mutation system‑ PCR using three different groups including chronic HBV‑ infected patients, HBV patients who were resolved their infection spontaneously and healthy volunteers. Laminin concentrations were also measured in the blood of these individuals. Results: People with rs20558C, rs20563G, and rs10911193T alleles have an increased risk of HBV infection. Moreover, we found that CGTAT haplotype was more frequent in chronically infected people who could affect the mechanism of disease. Furthermore, there was a significant relationship between laminin concentration and rs20558, rs20563, and rs10911193 genotypes in patients. Conclusion: According to the statistical analysis, rs20558, rs20563, rs10911193 polymorphisms probably, related to the chronic HBV infection. In addition, no association of the rs10911251, rs1413390 single nucleotide polymorphisms with the disease was found.

Background: Diagnosing of obstructive sleep apnea (OSA) is an important subject in medicine. This study aimed to compare the performance of two data mining techniques, support vector machine (SVM), and logistic regression (LR), in diagnosing OSA. The best‑ fit model was used as a substitute for polysomnography (PSG), which is the gold standard for diagnosing this disease. Materials and Methods: A total of 250 patients with sleep problems complaints and whose disease had been diagnosed by PSG and referred to the Sleep Disorders Research Center of Farabi Hospital, Kermanshah, between 2012 and 2015 were recruited in this study. To fit the best LR model, a model was first fitted with all variables and then compared with a model made from the significant variables using Akaike’ s information criterion (AIC). The SVM model and radial basis function (RBF) kernel, whose parameters had been optimized by genetic algorithm, were used to diagnose OSA. Results: Based on AIC, the best LR model obtained from this study was a model fitted with all variables. The performance of final LR model was compared with SVM model, revealing the accuracy 0. 797 versus 0. 729, sensitivity 0. 714 versus 0. 777, and specificity 0. 847 vs. 0. 702, respectively. Conclusion: Both models were found to have an appropriate performance. However, considering accuracy as an important criterion for comparing the performance of models in this domain, it can be argued that SVM could have a better efficiency than LR in diagnosing OSA in patients.