پژوهش در علوم پزشکی
سال:1397 | دوره: | شماره: |تعداد مقالات:8

Background: We assess the potency of different Doppler indices in the differentiation of obstructive and nonobstructive hydronephrosis. Materials and Methods: In this study, infants and children who were referred for the evaluation of unilateral hydronephrosis were enrolled. Ultrasonography for the assessment of the degree of hydronephrosis and a voiding cystourethrogram for the exclusion of vesicoureteral reflux was performed. Then, Doppler ultrasonography was done for both kidneys of each patient using four classic Doppler indices as well as the difference (delta) of each index between to kidneys. Diuretic renography with 99 mTc‑ ethylene dicysteine (99 mTc‑ EC) was performed for each patient. Results: Thirty‑ nine patients met the inclusion criteria. After diuretic renography, 29 (74. 35%) patients had shown a nonobstructive pattern, and ten (25. 65%) patients had a partial (intermediate) or complete obstruction. Using receiver operating characteristic (ROC) curve, none of the classic indices of Doppler duplex (i. e., resistive index [RI], resistance index, end diastolic velocity, and peak systolic velocity) had the ability to make a difference between obstructive and nonobstructive hydronephrosis. However, by calculating the difference (delta) of these indices between two kidneys of each patient, delta RI could differentiate the nonobstructive condition, significantly (P = 0. 006). A cutoff value of 0. 055 has 60% sensitivity and 82. 8% specificity. The area under the ROC curve for delta RI is 0. 795 (standard error: 0. 086, 95% confidence interval [CI]: 0. 626, 0. 964). Furthermore, RI ratio between two kidneys of each patient could differentiate the nonobstructive condition, significantly (P = 0. 012). A cutoff point of 1. 075 has 70% sensitivity and 82. 8% specificity. The area under the ROC curve for RI ratio was 0. 769 (standard error: 0. 104, 95% CI: 0. 565, 0. 973). Conclusion: This study shows that RI ratio and delta RI with a high specificity could differentiate nonobstructive hydronephrosis and therefore it is a promising way to use especially in the follow‑ up of children with hydronephrosis.

Sir, In Iran, people with disabilities (PWDs) consist of 1. 3% of general population, but the World Health Organization’ s report cites that around 15. 6% of world population experience type of disabilities. [1, 2] Studies show that PWDs are more likely to report poorer health than their counterparts without a disability. Although disability is not a disease, it can cause more health problems among PWD than the general population. On the other hand, these people encounter with cascades of disparities and barriers to access to health‑ care services including cultural, physical, and financial barriers...

Background: Diabetes is associated with oxidative stress and considered as a major risk factor for cardiac disease. We attempted to investigate the role of oral antidiabetic (OAD) agents gliclazide and metformin in lowering the lipid peroxidation and managing the risk for cardiovascular (CV) complications in diabetic patients in comparison with nondiabetic healthy individuals. Materials and Methods: This cross‑ sectional study was comprised of 150 individuals grouped in three, namely, Group A (n = 60) healthy volunteers, Group B (n = 30) newly diagnosed diabetes, and Group C (n = 60) diabetes treated with OAD. Serum malondialdehyde (MDA), nitric oxide (NO), and Vitamin C were assessed for studying lipid peroxidation status, whereas serum triglyceride (TG) and total cholesterol were monitored as predictors for CV risk. Results: We found significantly higher concentrations of MDA and NO levels (P < 0. 001) in both groups of patients (Group B and C) in comparison to control group (Group A). Regarding antioxidants, significantly lower concentrations of Vitamin C (P = 0. 046) were found in Group B and C compared to Group A. Moreover, there was significant difference exhibited in concentration level of MDA (P = 0. 001) and NO (P = 0. 015) between Group B and C, whereas difference of Vitamin C (P = 0. 147) was not statistically significant. Conclusion: Our data confirmed that treatment with gliclazide and metformin significantly reduced the lipid peroxidation accompanied with attenuated levels of serum TGs and cholesterol and suggested that oral hypoglycemic agents have great impact to reduce the oxidative stress and increase the antioxidant status in diabetes.

Vitamin D has an important role in bone metabolism but recently has been recognized as an immunoregulator, and this has led to investigations on the effect of Vitamin D supplementation in various autoimmune diseases and its anti‑ inflammatory effects. There is some evidence that Vitamin D can regulate gastrointestinal inflammation. In addition, previous studies have shown that Vitamin D can affect the gut microbiome. The aim of this review is to evaluate the effect of Vitamin D on inflammatory processes, especially its relation to the inflammatory bowel disease (IBD) and gut microbiome. There is some evidence that Vitamin D can regulate gastrointestinal inflammation, with epidemiological studies showing that individuals with higher serum Vitamin D have a lower incidence of IBD, particularly Crohn’ s disease. Vitamin D changes transcription of cathelicidin and DEFB4 (defensin, beta 4) that can affect the gut microbiome. Several cell types of the immune system express Vitamin D receptor, and hence the use of Vitamin D in immune regulation has some potential. Furthermore, Vitamin D deficiency leads to dysbiosis of gut microbiome and reported to cause severe colitis. Vitamin D supplementation is low cost and available and can be a therapeutic option.

Background: This study aimed to assess the serum serotonin levels in the newly diagnosed fibromyalgia (FM) and to relate these levels to the presenting signs and symptoms. Materials and Methods: This case– control study included 35 healthy women (Group I) served as controls and 130 women with newly diagnosed FM (Group II). The diagnosis of FM was confirmed by the diagnostic criteria of the American College of Rheumatology‑ 10. The assessment of pain using a revised fibromyalgia impact questionnaire and tender points scoring, blood platelet indices, and serum serotonin levels were determined. Results: Group II patients had significantly (P < 0. 001) higher values of mean platelet volume (MPV) (10. 60 ± 1. 57fL) and platelet width distribution (16. 25 ± 1. 45%) than the corresponding values in Group I (8. 73 ± 0. 81fL and 15. 0 ± 1. 15%). Significant low‑ serum serotonin levels observed in Group II patients compared with Group I healthy individuals (187. 3 ± 50. 3 ng/ml vs. 219. 5 ± 78. 3 ng/ml, P = 0. 026). Multiple linear regression analysis showed the nonsignificant correlations between serum serotonin levels and platelet indices in Group II patients. Conclusion: Newly diagnosed FM women have significantly low‑ serum serotonin levels, which does not correlate with a significant increment of the platelet activity expressed as increase MPV and platelet width distribution percentage. Therefore, this study highlighted that the correction of serum serotonin level by medicines could help the patients.

Background: Myelosuppression is one of the frequent side effects of chemotherapy in breast cancer patients. Granulocyte‑ colony stimulating factor (G‑ CSF) and pegylated G‑ CSF are used for the prevention of neutropenia after chemotherapy. Pegylated G‑ CSF has longer half‑ life of action and can be used as a single dose in comparison to G‑ CSF. The aim of this study is to compare the grade of cytopenia and side effects between G‑ CSF and biosimilar pegylated G‑ CSF in breast cancer patients treated with dose‑ dense chemotherapy. Materials and Methods: In the cross‑ over clinical trial study, 24 women with breast cancer were randomly divided into two groups and treated with dose‑ dense chemotherapy. The first group was treated with single dose of 6 mg biosimilar pegylated G‑ CSF 24 h after the first course of chemotherapy and the second course was followed by 300 μ g daily injection of G‑ CSF for 6 days. The chemotherapy regimen was combination of doxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2. The second group was treated with G‑ CSF after the first course and pegylated G‑ CSF after the second course. Cell blood count (CBC) and side effects were evaluated 1 and 2 weeks after both courses of chemotherapy. Results: In this study, no significant carryover effect and treatment effect about the CBC parameters was found between pegylated G‑ CSF and G‑ CSF. Patients who were treated with biosimilar pegylated G‑ CSF had significantly higher side effects such as bone pain (P = 0. 09) and gastrointestinal effects (P = 0. 005) in comparison to G‑ CSF. Conclusion: G‑ CSF and biosimilar pegylated G‑ CSF are effective in reducing cytopenia in breast cancer patients treated with dose‑ dense chemotherapy, but side effects induced by pegylated G‑ CSF (Pegagen) are higher.

Background: Depression is a common medical condition with a high prevalence leading to emotional abnormality. Despite some drawbacks, depression currently diagnosed using a combination of patient interviews and self‑ report questionnaires. Recently, there is emerging emphasis to establish biomarkers to diagnosis and clinical management of depression. This case– control study was designed to develop microRNA (miRNA)‑ based serum biomarker for depression. Materials and Methods: In this study, 39 patients with depression and 36 healthy controls were enrolled. Serum miRNAs gene expression was measured using real‑ time polymerase chain reaction (PCR) analysis; finally, the data represent as the 2– Δ Ct followed by further statistical analysis. Results: The serum level of miR‑ 16 was significantly (P < 0. 001) down‑ regulated (mean: 0. 9123 and standard deviation [SD]: 0. 06) in compared to normal individuals (mean: 1. 6848 and SD: 0. 09). The concentration of miR‑ 135a was also catastrophically decreased (P < 0. 001) in the patients (mean: 1. 160 and SD: 0. 07) in compared to control (mean: 1. 819 and SD: 0. 09). The relative miR‑ 1202 expression levels were significantly lower (P < 0. 001) in the patients (mean: 0. 1755 and SD: 0. 01) than in the healthy individuals (mean: 0. 2939 and SD: 0. 01). The receiver operating characteristic curve analysis indicated the obvious separation between patient and healthy control, with an AUC of 0. 75 (95% confidence interval [CI] = 0. 642– 0. 858, P < 0. 001), 0. 72 (95% CI = 0. 607– 0. 834, P < 0. 001), and 0. 74 (95% CI = 0. 630– 0. 861, P < 0. 001) for miR‑ 16, miR‑ 135a, and miR‑ 1202, respectively. The data suggest that these miRNAs have a potential to be used as a biomarker of depression with sensitivity 77. 8% and specificity of 61. 5% for miR‑ 16, 94. 4% and 41. 0% for miR‑ 135a as well as 86. 1% and 61. 5% for miR‑ 1202, respectively (P < 0. 001). Conclusion: Our findings showed that these miRNA can be used as a biomarker of depression diagnosis. MiR‑ 135a and miR‑ 1202 exhibited better sensitivity and specificity, respectively.

Background: First‑ degree relatives (FDRs) of hypertensive (HT) are predisposed to hypertension (HTN) which accelerates cardiovascular aging. Same can be studied noninvasively by pulse wave analysis (PWA), encompassing central hemodynamics such as central blood pressure (cBP), cardiac output, and stroke work (SW) and vascular stiffness parameters such as pulse wave velocity (PWV) and augmentation index at HR 75 (AIx@75). We studied PWA‑ derived cardiovascular parameters in FDRs of HT compared to controls. Materials and Methods: We conducted a case– control study in 119 FDRs of HT and 119 matched controls. Oscillometric PWA was performed by Mobil‑ o‑ Graph (IEM, Germany) and cardiovascular parameters were compared. P < 0. 05 was considered statistically significant. Results: Groups were comparable with gender, age, height, weight, body mass index, and physical activity. FDRs of HT had significantly higher brachial and cBPs, SW (101. 41 ± 25. 44 vs. 88. 31 ± 20. 25, P = 0. 001), rate pressure product‑ 119. 40 ± 25. 34 vs. 108. 34 ± 18. 17, P < 0. 0001), PWV (5. 22 ± 0. 46, P < 0. 0001), and AIx@75 (31. 48 ± 9. 01 vs. 27. 95 ± 9. 4, P = 0. 002) than control. Dependent study variables correlated with brachial blood pressure more in magnitude and significance level than age or anthropometric variables. PWA results of FDR with maternal inheritance did not differ significantly from those with paternal inheritance. Conclusion: PWA reveals early cardiovascular aging in young FDRs of HTs. It clues to future cardiovascular disease including HTN itself, need for primary prevention, and further study for consolidation of these results.