Acta Medica Iranica
Volume:58 Issue: 2, Feb 2020

Diabetic neuropathy can cause disorders in axon transmission, changes in the extracellular matrix, and peripheral nerve damages. However, its mechanism, along with the beneficial effects of exercise on these disorders is not entirely clear. The aim of the current study was to assess changes in fibronectin mRNA gene expression level of the sciatic nerve in rats with streptozotocin-induced diabetes after endurance training. Eighteen male Wistar rats (10 weeks old with 250±20 gr weight) were randomly assigned to three groups, including healthy, induced diabetes and induced diabetes plus endurance training. Induction of diabetes was conducted using an intraperitoneal injection of a single dose of streptozotocin (STZ). Neuropathy was confirmed using the behavioral tests. Rats in induced diabetes plus training group had 8 weeks of moderate and increasing intensity endurance training on the treadmill. The Fibronectin mRNA gene expression level of the sciatic nerve was assessed using Real-time-PCR. Changes in fibronectin protein and myelin thickness were measured by immunohistochemistry and luxol fast blue staining. The mean and standard deviation was used to report descriptive data. Data were entered into SPSS 22. Fibronectin mRNA gene expression level (1.90) of sciatic nerve fibronectin protein and myelin thickness reduced significantly due to diabetes (P<0.05). Eight weeks of endurance training increased fibronectin gene expression of sciatic nerve fibronectin protein and prevented further destruction of myelin, which was statistically significant. The results showed that diabetes leads to changes in the extracellular matrix and the reduction of the sciatic nerve myelin thickness. Endurance training as a non-drug strategy is effective in preventing these damages.

The aims of this study are to determine the prevalence of sexual dysfunction and to examine the relationships of sexual function and psychological factors of depression and anxiety and diabetes-related factors in Jordanian women with type 2 diabetes mellitus. This study employed a cross-sectional, descriptive, correlational design. All eligible participants with type 2 diabetes mellitus were consequently recruited from primary care centers. All enrolled participants were asked to complete questionnaires: Arabic version of the Female Sexual Function Index, Beck Depression Inventory-II, Beck Anxiety Inventory, and demographic questionnaires. Physical and biological measures were collected from the patient's medical records. 107 women with type 2 diabetes mellitus were recruited with a mean of age of 52.46±8.38 years. The prevalence of female sexual dysfunction was 94.4%. Regarding the mean scores of the Arabic version of the Female Sexual Function Index domains, the highest mean score was for pain (5.09±1.51), and the lowest mean score was for sexual arousal (2.44±1.28). This study found significant inverse relationships between female sexual function and age (r= -0.340, P<0.01), duration of diabetes (r= -0.211, P=0.029), fasting blood sugar (r= -0.234, P=0.015), anxiety (r= -0.375, P<0.01), and depression (r= -0.480, P<0.01). Our study found female sexual dysfunction is widely prevalent in Jordanian women with type 2 diabetes mellitus (94.4%). There were significant correlations between anxiety, depression, and female sexual function among women with type 2 diabetes mellitus.

Obesity is one of the major health issues in developed and developing countries, which has been increasing in recent decades. Obesity is one of the important risk factors for type 2 diabetes by developing insulin resistance. The purpose of this study was to investigate the effect of vitamin D on insulin resistance in overweight and obese children and adolescents with vitamin D deficiency. In this interventional study, 53 overweight and obese children and adolescents with vitamin D deficiency referred to the Endocrinology Clinic of Shahrekord University of Medical Sciences were included. The height and weight of participants were measured, and their Body Mass Index (BMI) calculated. To participants, 50,000 units of vitamin D were administered weekly for 8 weeks, and then 1000 units were orally administered daily for 3 months. Before and after the intervention, levels of vitamin D, insulin, and fasting blood sugar were measured. The HOMA-IR was also calculated as an indicator of insulin resistance. After the intervention, serum vitamin D significantly increased, and BMI and fasting blood sugar significantly decreased (P<0.05). The insulin resistance index did not change significantly during the intervention (P>0.05). After the intervention, HOMA-IR had a significant direct correlation with body mass index, insulin, and fasting blood sugar and a significant inverse correlation with vitamin D (P<0.05). Vitamin D had a significant inverse correlation with BMI, insulin, and fasting blood sugar after the intervention (P<0.05). Oral treatment with vitamin D significantly increased serum vitamin D levels and significantly decreased BMI and fasting blood sugar in obese and overweight children.

 Dengue fever is caused by any one of four types of dengue viruses (DEN1-DEN4), spread mainly by Aedes aegypti. India had the largest number of dengue cases, with about 33 million apparent and another 100 million asymptomatic infections occurring annually. The patients typically present with the sudden onset of fever, frontal headache, retroorbital pain. The laboratory diagnosis can be made by IgM ELISA or by NS1 antigen-detection ELISA during the acute phase. This research was conducted from January 2018 to December 2018 at Sir T. hospital and Government Medical College in Bhavnagar, Gujarat. The patients having complaints of fever, headache, myalgia, arthralgia or rash, were clinically examined, and laboratory investigated for dengue with NS1 and/or IgM dengue antibody. A total of 536 patients was screened, of which 112 patients were diagnosed as dengue fever at 21% dengue positivity rate, based on detection of NS1 (46/304, 15%), and anti-dengue IgM (66/232, 28%) in their sera. The majority of the patients were males (77/112, 69%). The majority of patients were in 11–30 years’ age group (66/316, 21%). Fever (100%) was the chief presenting complaint, followed by headache (83, 93%), and myalgia (79, 89%). The highest number (28) of dengue patients was observed in the month of October 2018. According to this study results, the physicians in the dengue-endemic area should be aware of dengue in acute febrile illnesses and use the appropriate laboratory tests such as NS1 antigen and IgM antibodies for early dengue diagnosis. This can help clinicians to prevent morbidity and mortality associated with dengue.

The aim of this study was to determine the prevalence of overweight and obesity and their associated factors in the female population of Shiraz, South of Iran. This population-based cross-sectional study is based on a screening program on 11850 women referring to a gynecological clinic between 2004 and 2012. Overweight and obesity were defined as a body mass index (BMI) of 25-29.9 kg/m2 and a BMI ≥30 kg/m2, respectively. The mean age of participants was 41.1±10.6 yrs. Mean BMI were 27 kg/m2 (95% CI: 26.90-27.10). The total prevalence of overweight and obesity was 41.4% (95% CI: 40.5-42.3) and 24.10% (95% CI: 23.3-24.9), respectively. In addition, 50-54-year-old women were more likely to have a BMI ≥25 than Youngers. The high prevalence of obesity and overweight in the present study indicates the need for planning preventive programs for the health system in this population.

The Oxygenation Index (OI= [MAP×FiO2]/PaO2×100), an invasive diagnostic criterion, is routinely used as a marker of severity of acute respiratory distress syndrome (ARDS). In order to determine of OI, arterial blood gas (ABG) through an invasive procedure is indispensably used to obtain PaO2. The Oxygenation saturation Index (OSI= [MAP×FiO2]/ SPO2 ×100), as an alternative method, can be implemented using pulse oximetry to assess SpO2. For this epidemiologic-analytic study, 74 intubated patients admitted in a pediatric intensive care unit of Abouzar hospital of Ahvaz during the first 3-day admission were selected equally in pulmonary and non-pulmonary groups within a six months period, from January 1, 2019, to May 31, 2019. Two indexes of OI and OSI in both patients were evaluated, and eventually, the results were analyzed by linear regression using Spss. A comparison of the two OI and OSI indexes showed a meaningful relationship was found (P<0.001), which has a higher correlation coefficient of 0.726 in patients with the pulmonary disease than non-pulmonary patients with 0.394. The present study demonstrates that the index of oxygen saturation (OSI) with a sensitivity of 78% and specificity of 83% in the patients without acute pulmonary distress syndrome is a suitable indicator instead of the invasive index of OI. Also, in patients with pulmonary disease that meet the medium range of Berlin criteria, with a sensitivity of 100% and specificity of 76%, the OSI index can be used to predict the status of patients.

Erector Spine Block is a simple and effective block in controlling chest wall and upper abdominal pain. It is also possible to increase painless period for a few days by placing a catheter. We used this block in a high-risk traumatic patient to reduce the pain of rib fractures.

In this study, we compared regional recurrence in patients who had a dissection of levels I-III or levels I-IV. Patients with tongue SCC who were node-negative both clinically and radiologically, and underwent elective supraomohyoid neck dissection (SOHND) or extended supraomohyoid neck dissection (ESOHND) between March 2012, and March 2015 were retrospectively reviewed. The two therapeutic groups were analyzed for the incidence of tumor recurrence and survival. The two groups had statistically similar demographic qualities. Surgery duration and complications were the same in both groups. Complications mainly included internal jugular vein and thoracic duct injury. Tumour size was 46.2% T1, 40.4 % T2, and 13.3% Tx, being statistically similar in both groups. Tumour size had no meaningful correlation with the occurrence of occult neck metastasis in both groups. Local recurrence was more in ESOHND patients, but regional recurrence was similar in both groups. The survival rate was alike in both groups. No significant differences in tumor recurrence and mortality rate were found between patients treated with SOHND versus ESOHND. Thus, SOHND could be considered as a sufficient treatment for early-stage tongue SCC.

Poland syndrome is a rare congenital anomaly with various presentations. The most consistent findings of this syndrome are hypoplasia or aplasia of the sternocostal part of the pectoralis major muscle and upper limb malformations. Here, we are reporting a case of Poland syndrome with renal stone, a new finding that has not been reported in previous literature.

This is the presentation of a 19-month-old female admitted for recurrent lower urinary tract infection. Renal ultrasound and computed tomography showed a round bladder stone with no associated abnormality. Open cystolithotomy was performed, and a large bladder stone, measured 3.2 x 2 x 3.2 cm, and composed of magnesium ammonium phosphate (struvite) was removed. To the best of our research, this is the youngest patient, involved with a large struvite bladder stone.