Acta Medica Iranica
Volume:59 Issue: 9, Sep 2021

Inflammation and remodeling in airways are the two crucial characteristics of asthma, a common respiratory disease. In asthma pathophysiology, the recruitment of granulocytes finally results in inflammation, leading to lung damage. In this regard, failure to clear inflammatory cells by programed cell death, apoptosis, will cause the prolongation of inflammation. On the other hand, in bronchial epithelial cells, apoptosis may occur, resulting in airway remodeling. Hence, dysregulation of apoptosis has been suggested to contribute to the development of asthma. Importantly, knowledge of the factors related to apoptotic cascade seems vital to explore various pharmacological interventions for the treatment of asthma. In this review, we highlight several important apoptotic and anti-apoptotic factors contributing either to inflammatory cells or bronchial epithelial cells involved in the asthma pathogenesis.

This study was attempted to investigate the prevalence of BRAF gene mutation (V600E) in aspiration cytology of patients with suspected papillary thyroid carcinoma (PTC).

Seventy six Patients suspected of having PTC who referred for fine needle aspiration (FNA) biopsy were included in this cross-sectional study. Ultrasound-guided FNA was taken from the thyroid masses and samples were sent for cytologic evaluation. Simultaneously, the samples were sent to a genetic laboratory to check the status of BRAFV600E mutation. Patients with FNA positive for PTC were assigned in one group and those with FNA negative for PTC were assigned in other group. Cytological and molecular results were compared with those of histopathology and sonography.

The results showed that the prevalence of the BRAF gene (V600E) mutation in our study was 21.1% (16 out of 76 patients). In addition the results showed a significant relation between gene mutation and pathologic findings so that the highest gene mutation was significantly detected in patients with FNA positive for PTC (p.value=0.001). Also, our results showed a significant relation between gene mutation and some sonographic findings (calcification, p.value=0.004) and no significant relation in the other sonographic findings (hypo echoic changes, p.value=1.12 and regular changes, p.value=0.194).

According to the results of the present study, BRAF mutation (V600E) can be an effective indicator for definitive diagnosis and primary treatment of PTC in suspected cases.

Despite a low prevalence, salivary gland tumors (SGTs) represent a diverse set of tumors with a broad range of biologic behaviors. Implementation of early detection programs has significantly improved the outcome of treatment and patients' survival. High mobility group box 1 protein (HMGB1) may likely be a candidate for the detection of SGTs due to its background in other human tumors. This study, for the first time, aimed to investigate the clinical value of HMGB1 in patients with benign and malignant SGTs and analyze its correlation with clinicopathologic outcomes.

Using an enzyme-linked immunosorbent assay (ELISA), the serum level of HMGB1 was measured in 85 patients with SGTs (30 benign and 55 malignant cases) and 85 age- and sex-matched healthy individuals.

HMGB1 levels had a significant difference between patients with SGTs and healthy controls (2041.4±787.1 pg/ml versus 536.3±374.6 pg/ml, p<0.0001) as well as those with benign and malignant tumors (1680.1±429.7 pg/ml versus 2238.6±867.2 pg/ml, p<0.0001). The serum level of HMGB1 was associated with some clinicopathologic factors, such as the size of the main tumor, clinical stage and the lymph node metastasis, but not with patients' gender, age as well as the site of the lesions.

These results suggest that the serum level of HMGB1 has the potential to be a supportive diagnostic marker for SGTs and can provide a precise assessment of the tumor status. There is no published report regarding the serum level of HMGB1 in SGTs; therefore, further studies are warranted.

Hypertensive disorders of pregnancy are one of the leading causes of fetal and maternal mortality worldwide. Aside from the immediate risk they pose for the pregnant woman, there is significant evidence that women after such a pregnancy have a long-term risk for the development of cardiovascular diseases. On the other hand Galectin-3 is a biomarker that has proven its role in cardiac remodeling, fibrosis and heart failure.

To determine the levels of Galectin-3 in women with gestational hypertension, preeclampsia and in healthy pregnant women and test for association with premature birth.

A prospective single-centre clinical epidemiological study was performed and data was analyzed for 123 pregnant women – 36 with gestational hypertension, 37 with preeclampsia and 50 controls. ELISA method was used to determine the serum levels of Galectin-3.

Mean Galectin-3 level was 6,53 ng/ml in the controls, 7.30 ng/ml in the gestational hypertension group and 7,59 ng/ml in the preeclampsia group. There was a significant difference in the levels between the controls and each of the of the pathological groups (p<0,05), while the two pathological groups were not statistically different from each other.

Gestational hypertension and preeclampsia are associated with significantly higher levels of Galectin-3 which could be indicative of cardiovascular dysfunction in those women. Additionally, higher Galectin-3 levels were associated with an OR ~2.5 for preterm even birth after adjustment for the presence of the two hypertensive disorders of pregnancy.

lupus nephritis (LN) is a severe form of systemic lupus erythematosus (SLE) with renal involvement. It affects the kidneys in about 50% of SLE patients.  The aim of this study was to assess the evaluation of proteinuria recovery time and its related factors associated with lupus nephritis patients in Urmia- Northwest of Iran.

A retrospective cohort study was carried out, in which medical records of 80 patients with systemic lupus nephritis referred to Imam Khomeini university hospital were reviewed. According to these records biopsy-proven renal disease has been progressed from September 2009 to September 2013. Proteinuria less than 0.5 g/24h was defined as proteinuria recovery. The time elapsed from the diagnosis of proteinuria to its recovery is considered as the duration of proteinuria recovery (month). The findings were analyzed by STATA11 statistical software.

Mean age at diagnosis of lupus nephritis was 26.50±8.10 years (14-51 years). Mean creatinine level at the start of treatment was 1.20±0.61 mg/dl (0.5- 2.80).  Proteinuria recovery time was 4 months for 25% of patients, 6 months for 50% of patients (median time) and 12 months for 75% of them. Higher class of LN had a trend toward 31 % lower risk of proteinuria recovery (HR: 0.73, 95% CI 0.56 -0.96; P= 0.02), the expected risk is 1.94 times greater in women as compared with men (HR: 1.94, 95% CI 1.1-3.48; P=0.02).

The patients in this study population respond to treatment in less time and in comparison with other studies, their proteinuria recovers earlier. Class of lupus nephritis (negative) and gender (positive) were predictive factors proteinuria recovery among LN patients.

Gestational diabetes is a metabolic disease that can have multiple maternal and fetal complications. Therapeutic adherence can help controlling blood sugar and reducing its complications. This study investigates the medication adherence among pregnant women and effective factors on it.

This cross-sectional study was conducted on 104 pregnant women with gestational diabetes who referred to endocrinology clinic of Shahid Beheshti hospital in Hamadan, Iran, in 2018. Input criteria were those over 18 years of age and output criteria included heart, kidney and thyroid disorders. Medication adherence was evaluated using the Morisky's 6-question questionnaire (MMAS-6). Analyzes were conducted using SPSS version 21 at the significance level of less than 0.05.

Based on the results, 77.9% of the women lived in the city, 65.4% had a college education and 73.1% were housewives. 58.7% of them had good medication adherence. There was the significance relationship between adherence and glycemic control. Address and level of education had a significant relationship with medication adherence. People with higher levels of health literacy had significantly higher medication adherence.

Low education level, rural residence and low health literacy level are determinants of poor medication adherence in pregnant women with gestational diabetes, which indicate the need for more training to these people.

The aim of this study is to evaluate the response to endoscopic treatment and treatment outcomes in patients with rhino-orbito-sinusal mucormycosis.

In this descriptive cross-sectional study 19 patients with rhino-orbito-sinusal mucormycosis were involved. Data such as age, gender, 6-month survival rate of the patients, type of underlying disease, site of involvement, number of endoscopic procedures, history of exenterating of the eye, type of received systemic treatments and the time interval between the onset of symptoms and the start of treatment were recorded and analyzed.

The 6-month outcome analysis showed that 10 out of 19 patients (58.8%) survived. The results also revealed no significant difference in 6-month survival rate according to parameters such as gender, underlying disease (57.9% of the patients had diabetes and 42.1% had cancer), age, delay in surgery, site of involvement, and number of surgeries (p> 0.05). However, there was a significant difference in 6-month survival rates of patients with respect to exenterating of the eye (P <0.05).

According to our results, uncontrolled diabetes is the most common underlying cause of rhino-orbito-sinusal mucormycosis. It also seems that exenterating of the eye affects the survival rate of patients. This study suggests that timely and early diagnosis as well as correct treatment, endoscopic procedure if possible, play an important role in the prognosis of the disease and can greatly reduce the mortality rate.

Strongyloides Stercoralis is a common cause of gastrointestinal (GI) infection. Symptoms are usually mild, but in the setting of impaired host immunity, severe and disseminated illness may occur.

The present report describes a male patient with history of asthma and corticosteroid therapy, now presented with dyspnea and abdominal pain. In examinations show Strongyloides Stercoralis larvae in BAL fluid specimen.

The patients who undergone immunosuppressive therapy, are highly indicated for Strongyloides Stercoralis screening which prevent hyperinfection in endemic areas.

Uterine prolapse and bladder exstrophy (BE) during pregnancy is a rare condition. The aim of this study was to present a rare case of pregnancy which complicated by both the bladder exstrophy and uterine prolapse.

A 39 year old pregnant woman (gravid 2, para 1) presented to the maternity department at 39 weeks of gestation with labor pain. Physical examination showed regular uterine contractions; the cervix was completely out of the vaginal opening with dilatation 3 cm and effacement 30%. She had the history of multiple surgeries for correction of bladder exstrophy and also suffered from uterine prolapse .In active labor, abnormal fetal heart rate tracing happened, so emergent cesarean section was planned and a healthy neonate with the normal Apgar score was born. At regular follow-up until 4 months after delivery, there was no sign or symptom of uterine proplase.

Multidisciplinary management of patients with BE and uterine prolapse may result in the optimal perinatal outcomes. Uterine prolapse may disappear after delivery even in the complicated case of bladder exstrophy.