Diagnostic Performance of Ultrasonography for Identification of Small Bowel Obstruction: A Systematic Review and Meta-analysis

Introduction: Small bowel obstruction (SBO) is known as a common cause of acute abdominal complaints in the emergency department (ED). The modality of choice for the diagnosis of SBO has not yet been established. This systematic review and meta-analysis aimed to investigate the accuracy of ultrasonography for the diagnosis of SBO. Methods: Systematic search was performed on five electronic databases including Medline, Scopus, Web of Sciences, Embase, and Cochrane Library, and the retrieval period was from the inception of each database to November 2023. The quality of the included studies were investigated using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). The pooled values of diagnostic characteristics for ultrasonography were estimated using meta-Disc and Stata statistical software. Results: Twenty-one studies with a total of 1977 patients were included in the meta-analysis. The pooled estimate for sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary ROC curve of ultrasonography for diagnosing SBO were 0.93 (95% CI: 0.91–0.95), 0.8 (95% CI: 0.77–0.83), 5.69 (95% CI: 3.64–8.89), 0.1 (95% CI: 0.07–0.16), 83.51 (95% CI: 18.12–182.91) and 0.96, respectively. Conclusion: The findings of this meta-analysis showed that the utilization of ultrasonography holds promise as a diagnostic imaging for SBO with high accuracy. However, additional worldwide studies are essential to get more evidence on the value of ultrasonography for the diagnosis of SBO

Prevalence of benign tumors among patients with multiple sclerosis

Multiple sclerosis (MS), an inflammatory autoimmune disease, affects almost 1% of world’s population in which myelin sheaths of neurons are targeted by immune cells. Association of different factors and diseases with MS provides new insights into possible pathogenesis and treatment for this disease. In this regard, we investigated the association of benign tumors with MS disease by studying total Isfehan multiple sclerosis (TIMS) records for MS patients registered in Isfahan Multiple Sclerosis Society (IMSS) who had developed any kind of benign tumors whether before MS diagnosis or after it. This study was performed in Isfahan province, third large province of Iran, with 4,815,863 populations located 1590 meters above sea level between latitudes 30 and 34 degrees north of the equator, and longitude 49-55 east. Among 4950 registered patients, 28 patients were discovered to have three types of benign tumors; pituitary adenoma in 22, meningioma in 5 and lipoma in 1 patient. The incidence rate of developing pituitary adenoma and meningioma were higher than in general population (OR 95%CI: 1.110; range: 0.731-1.685 and 1.035; range: 0.431-2.487 respectively) but these findings were not statistically significant (p= 0.624 for pituitary adenoma and p= 0.939 for meningioma). But the incidence rate for lipoma was lower among MS patients (OR 95%CI: 0.020; range: 0.003-0.143) which was statistically significant (p &lt;0.001).</span

Spatial prediction of the urban inter-annual land surface temperature variability: An integrated modeling approach in a rapidly urbanizing semi-arid region

The inter-annual land surface temperature (LST) is a meteorological indicator of urban environments, affecting energy consumption and quality of life. In this study, the annual LST variability (ALSTV) of a rapidly urbanizing region in Iran including Karaj, Shahriar and Mohammad-Shahr cities and their surrounding suburbs was esti- mated using Landsat-8 images. Pixel-based image classification and object-based segmentation techniques were employed to extract built-up patches and spectrally homogeneous regions. Using the multiple regression analysis, the ALSTV of built-up patches was modeled as a function of their structure and the spatial characteristics of other land-use patches located in their respective segments (as neighborhood factors). A Cellular Automata model was utilized to simulate the expansion of built-up area up to 5% and, therefore, estimate their future ALSTV. The mean ALSTV was highest in urban areas (33.25± 7.41 ◦C), while the lowest mean value of 24.12± 3.24 ◦C was in green covers. The ALSTV of built-up patches were positively associated with their area and the percentage and size of neighborhood built-up patches, while negatively with the percentage of neighborhood green patches. To create a thermally comfortable landscape, additional green patch allocation and preventing excessive urban patch growth are required in all large built-up segments

Polymorphisms in CD14 Gene May Modify Soluble CD14 Levels and Represent Risk Factors for Multiple Sclerosis

Background: Besides the central role of the adaptive immune system, a disturbance of innate immune system is also suggested to be involved in the pathogenesis of multiple sclerosis (MS). CD14, a receptor upregulated in activated microglia, is known to be an essential mediator of inflammation in innate immune responses. Therefore, in this study we aimed to assess possible roles of CD14-159 and -260 gene polymorphisms in MS susceptibility and the effects of those polymorphisms to its protein producing capacity in Iranian population. Methods: In this case control study, CD14-159 and -260 polymorphisms were genotyped using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) in 200 MS patients and 200 healthy controls matched in age and gender. Serum levels of soluble CD14 (sCD14) was determined by enzyme-linked immunosorbent assay (ELISA). Results: There were significant differences in genotype distribution of CD14-159 and -260 polymorphisms between patients and controls (P = 0.01, for-both). Mean serum level of sCD14 was significantly higher in MS patients than in control subjects (3340.30 ± 612.50 ng/ml vs 2353.73 ± 539.07 ng/ml; P < 0.01). Conclusion: In summary, we conclude that CD14-159 and -260 polymorphisms are associated with the risk of MS in Iranian population and affects CD14 promoter activity, thereby regulating CD14 expression. Furthermore, our study provides preliminary evidence for the activation of innate immunity in the pathogenesis of MS. In addition, the findings of the present study suggest serum level of sCD14 as candidate biomarker of MS severity