Circulating serum preptin levels in women with polycystic ovary syndrome: A systematic review and meta-analysis

Background: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder with complex pathogenesis and metabolic complications, such as insulin resistance. Among the new markers, preptin seems to play a significant role in metabolic disorders. Objective: This meta-analysis was conducted to determine the relationship between circulating preptin levels and PCOS. Materials and Methods: A systematic review and meta-analysis was performed to identify relevant articles in electronic databases such as PubMed, Web of Science, Scopus, Cochrane, EMBASE, and the Google Scholar search engine, using a predefined search strategy. A random-effects model was used to combine standard mean difference (SMD) and 95% CI to compare results between groups. Metaregression and subgroup analysis were also performed to reveal the sources of heterogeneity. Results: The meta-analysis encompassed a total of 8 studies and 582 participants. The results indicate a statistically significant association between PCOS and serum preptin levels, with a pooled standardized mean difference (SMD = 1.35; 95% CI: 0.63- 2.08; p < 0.001). Further analysis suggested a significant difference in serum preptin levels between women with PCOS and higher homeostatic model assessment for insulin resistance ratio (SMD = 2.40; 95% [CI]: 1.17-3.63; p < 0.001) within the subgroup. Conclusion: Our meta-analysis shows that increased serum preptin levels are associated with PCOS, suggesting that preptin may be related to the pathogenesis of PCOS and may be recognized as a novel diagnostic biomarker for PCOS. However, further studies are needed to confirm our results. Key words: Polycystic ovary syndrome, Proinsulin-like growth factor II, Preptin, Meta-analysis

Circulating nesfatin-1 levels in women with polycystic ovary syndrome: A systematic review and meta-analysis

Background: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder in females. Nesfatin-1 is a neuropeptide synthesized in the hypothalamus and other peripheral organs, and there are conflicting opinions about its correlation with PCOS. Objective: This study aims to investigate the correlation between nesfatin-1 and PCOS and evaluates the effectiveness of nesfatin-1 as a biomarker for the detection of PCOS in women. Materials and Methods: A systematic review and meta-analysis were conducted to identify pertinent articles from databases such as PubMed, Web of Science, Cochrane, EMBASE, Scopus, and Google Scholar. The standardized mean difference (SMD) and 95% confidence interval (CI) were calculated using a random effects model to compare group outcomes. Additionally, meta-regression and subgroup analysis were performed to elucidate sources of heterogeneity. Results: The meta-analysis involved 12 studies with 1222 participants, and the findings revealed a significant relationship between PCOS and nesfatin-1 levels. The pooled (SMD = 0.54; 95% CI: 0.00-1.07; p = 0.04) indicated a significant difference between the evaluated groups. Moreover, a subgroup analysis showed that there was a substantial difference in nesfatin-1 levels among women with PCOS and higher homeostatic model assessment for insulin resistance ratio (SMD = 1.46; 95% CI: 0.92-2.00; p < 0.001). Conclusion: Our meta-analysis indicates an association between high nesfatin-1 levels and PCOS. This suggests a potential role of nesfatin-1 in the development of PCOS and proposes it as a potential diagnostic biomarker for the disease. However, further research is necessary to validate these findings. Key words: Polycystic ovary syndrome, Insulin resistance, Body mass index, Meta-analysis

Spatial modeling of cutaneous leishmaniasis in Iranian army units during 2014-2017 using a hierarchical Bayesian method and the spatial scan statistic

OBJECTIVES This study aimed to map the incidence of cutaneous leishmaniasis (CL) in Iranian army units (IAUs) and to identify possible spatial clusters. METHODS This ecological study investigated incident cases of CL between 2014 and 2017. CL data were extracted from the CL registry maintained by the deputy of health of AJA University of Medical Sciences. The standardized incidence ratio (SIR) of CL was computed with a Besag, York, and Mollié model. The purely spatial scan statistic was employed to detect the most likely high-and low-rate clusters and to obtain the observed-to-expected (O/E) ratio for each detected cluster. The statistical significance of the clusters was assessed using the log likelihood ratio (LLR) test and Monte Carlo hypothesis testing. RESULTS A total of 1,144 new CL cases occurred in IAUs from 2014 to 2017, with an incidence rate of 260 per 100,000. Isfahan and Khuzestan Provinces were found to have more CL cases than expected in all studied years (SIR>1), while Kermanshah, Kerman, and Fars Provinces were observed to have been high-risk areas in only some years of the study period. The most significant CL cluster was in Kermanshah Province (O/E, 67.88; LLR, 1,200.62; p<0.001), followed by clusters in Isfahan Province (O/E, 6.02; LLR, 513.24; p<0.001) and Khuzestan Province (O/E, 2.35; LLR, 73.71; p<0.001), while low-rate clusters were located in the northeast areas, including Razavi Khorasan, North Khorasan, Semnan, and Golestan Provinces (O/E, 0.03; LLR, 95.11; p<0.001). CONCLUSIONS This study identified high-risk areas for CL. These findings have public health implications and should be considered when planning control interventions among IAUs

Human Umbilical Cord Mesenchymal Stem Cells-Derived Exosomes Can Alleviate the Proctitis Model Through TLR4/NF-Κb Pathway

Background: Proctitis is a significant concern of inflammatory bowel diseases, especially ulcerative colitis. Exosomes are a new method for treating many diseases by their immunosuppressive and tissue-repairing potential. Here, we tried Mesenchymal stem cells (MSCs)-derived Exosomes for treating the proctitis model of rats. Materials and Methods: Rats were assigned into four groups: sham, control group, rectal, and intraperitoneal exosome injection. The proctitis model was induced by rectal administration of 4% acetic acid. The exosome was derived from human MSCs isolated from human umbilical cords. After seven days, rectum samples were assessed for histopathological, IHC, and PCR analysis. Results: The histopathologic scores, collagen deposition, and the expression of NF-κB, TLR4, TNFα, IL-6, and TGFβ were decreased in intraperitoneal exosome compared to controls. The result was not promising for the rectal administration of exosomes. Conclusion: Exosomes can suppress the inflammatory response in the proctitis model and improve the rectum's healing process. Exosomes can inhabit the NF-κB/TLR4 pathway and downstream pro-inflammatory cytokines. This study implicates the therapeutic benefits of exomes in treating proctitis

Gastrointestinal bleeding in a newborn infant with congenital factor X deficiency and COVID-19—A common clinical feature between a rare disorder and a new, common infection

Dear Editors, Congenital factor X (FX) deficiency is an extremely rare, bleeding disorder with an estimated incidence of one per 1 million. Patients with severe FX deficiency (FX:C < 1%) demonstrate a wide spectrum of serious clinical presentations, including hemarthrosis, hematoma, gastrointestinal (GI) bleeding, intracranial hemorrhage (ICH), and umbilical cord bleeding.1 In fact, severe FX deficiency, with a high rate of life‐threatening bleeding, is the second‐most severe, rare coagulation factor deficiency (RCFD) after FXIII deficiency.1, 2 Although homozygotes are at risk of severe bleeding, heterozygotes usually are asymptomatic, but postsurgical bleeding or bleeding after childbirth may occur.1, 2 Other risk factors can increase the risk of bleeding in FX deficiency, and coronavirus disease 2019 (COVID‐19), a new medical challenge, could affect the patient's bleeding or thrombotic tendency.3 COVID‐19, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) presents an enormous challenge for everyone, especially for those with underlying risk factors such as cardiovascular disease, diabetes, obesity, and renal failure. Age and male sex are other risk factors.4 Limited data are available regarding the effect of COVID‐19 on patients with congenital bleeding disorders (CBDs), particularly RCFDs.5 It has been shown that hypercoagulability‐related adverse consequences are less common among patients with CBDs, at least in those with moderate‐to‐severe deficiency, but further studies, including our ongoing work on a large number of patients, are required.5 Although there are several reports of newborns among infected pregnant mothers, this is the first report of such a case in an RCFD. This case report may help medical professionals to better manage similar cases. A 19‐year‐old pregnant woman was infected with SARS‐CoV‐2 early in the 9th month of pregnancy. Reverse transcriptase‐polymerase chain reaction (RT‐PCR) confirmed the infection. The patient had been in close contact with family members with confirmed COVID‐19. The patient had cough and fever. Due to the mild presentation, she was given Azithromycin and advised to isolate herself at home. The symptoms resolved within 14 days. At end of her 9th month, three days prior to the planned cesarean section, she was rechecked for SARS‐CoV‐2 infection; her RT‐PCR was negative. She successfully underwent cesarean section without complications and delivered a healthy full‐term baby. Therefore, mother and newborn discharged the following morning. In the evening, the baby experienced bloody vomiting and was hospitalized for further assessment, which showed GI bleeding. At admission, laboratory tests showed a positive C‐reactive protein (CRP) (qualitative), a low hemoglobin level, and prolonged prothrombin time (PT), and activated partial thromboplastin time (APTT) (Table 1). He was hospitalized in the neonate intensive care unit (NICU) for 10 days. Due to the risk of SARS‐CoV‐2 infection, on the third day after admission he was tested by RT‐PCR, which was positive. The neonate received 30 mL frozen plasma (FFP) six times over 10 days, which resolved the GI bleeding. Tranexamic acid (TXA) was administered at a dose of 10 mg/kg every 8 hours. Due to lack of COVID‐19 symptoms, he did not receive any special treatment for the disorder. After 10‐day hospitalization in the NICU, the neonate was sent to an isolation room for 5 days, during which his condition stabilized, after which he was discharged in stable condition. He has had no complications during the past two months after discharge. Since the child's father and two other first‐degree family members have severe FX deficiency, and the parents of the baby are closely related, the mother and the baby were checked for FX deficiency. Routine coagulation tests, and FX:C assay performed by STA Compact automatic coagulometer (Stago, Paris, France), revealed a severe deficiency in the baby, and a mild deficiency, compatible with heterozygote FX deficiency, in the mother (Table 1). Table 1. Laboratory characteristics of mother and baby with factor X deficiency and COVID‐19 Test Proband (2nd day after birth) Proband (7th day after birth) Proband (2 months after hospital discharge) Mother (about 3 1/2 months after SARS‐CoV‐2 infection) WBC × 109/L 14.2 (8‐24)b 9.43 (5‐21) 10.79 (6‐18) 8.7 (3.6‐10.6) RBC × 109/L 2.5 (4.36‐5.96) 2.78 (4.2‐5.8) 3.50 (3.4‐5) 4.41 (3.8‐5.2) Hb (g/dL) 8.2 (16.4‐20.8) 9.2 (15.2‐20.4) 10.2 (10.6‐16.4) 13.6 (12‐15) HCT (%) 24.6 (48‐68) 27 (50‐64) 29.2 (32‐50) 41.4 (35‐49) Lymphocyte × 109/L 6.4 (1.3‐11) 4.3 (1.2‐11.3) 8.21 (2.5‐13) 2.22 (1‐3.2) Neutrophil × 109/L 4.9 (2.6‐17) 2.9 (1.5‐12.6) 1.85 (1.2‐8.1) 5.75 (1.7‐7.5) Platelet × 109/L 370 (150‐450) 331 (150‐450) 334 (150‐450) 276 (150‐450) PT (sec) >60 (PTC: 12.6) 90 (PTC: 12.6) >60 (PTC: 10) 13 (PTC: 10) APTT (sec) >120 (APTTC: 31) 100 (APTTC: 30) >120 (APTTC: 32) 37 (APTTC: 32) CRP (Quantitative) Trace Negative NC NC FX:C level NC NC <1% (50%‐150%) 40% (50%‐150%) Abbreviations: APTT, activated partial thromboplastin time; APTTC, APTT control; CRP, C‐reactive protein; Hb, hemoglobin; HCT, hematocrit; NC, Not checked; PT, prothrombin time; PTC, PT control; RBC, red blood cell; WBC, white blood cell. a Hematological test normal ranges are extracted from Rodak's Hematology: Clinical Principles and Applications, 5th Ed (2016). b Normal values are placed in parentheses. COVID‐19 is an emerging medical challenge that can present more difficulties for those with special conditions, such as pregnant women and newborns. Due to alterations in cellular immunity, pregnant women are more prone to infection by intracellular pathogens like viruses.6 The fetus is also highly susceptible to infection due to immaturity of the immune system.7 Furthermore, the mother's (heterozygote) congenital coagulopathy and that of her newborn (homozygote) were additional potential risk factors, because a disrupted coagulation system is a prominent feature of SARS‐CoV‐2 infection.8 To date, FX deficiency in a newborn has not been cited anywhere as a special condition requiring close attention in the case of SARS‐CoV‐2 infection. According to the few reports to date, SARS‐CoV‐2 infection is a risk factor for severe maternal morbidity. It is worth noting that most of those mothers were discharged without complications.9 From a clinical aspect, fever was the most common symptom (68%) at the time of admission.9 This was also observed in the affected woman of this study. SARS‐CoV‐2 infection can even affect the type of delivery. A systematic review of these women showed that about 92% of deliveries were by cesarean section, less than 10% being the usual vaginal delivery (7 of 85). Fetal distress was mentioned as the most common indication for cesarean section. Our patient underwent a planned cesarean section, due to her previous history. The delivery itself was uneventful, and a healthy baby was delivered, while among other reported cases, a number of complications have been noted.9 As with most other reports, the infant did not have any symptoms at the time of delivery and was discharged the day after birth.9 In a case series of 10 patients, various first clinical presentations were observed, including shortness of breath (n = 6), fever (n = 2), vomiting (n = 1), and rapid heart rate (n = 1).10 In the case at hand, bloody vomiting was the first clinical presentation. In the same case series, one died due to refractory shock, multiple organ failure (MOF), and disseminated intravascular coagulation (DIC). Another patient with severe presentation was managed by intravenous infusions of gamma globulin, platelets, and plasma, which was suggestive of the effectiveness of gamma globulin in severe cases. The author recommended early use of intravenous gamma globulin for passive immunization.10 GI bleeding in our case was successfully managed by administration of FFP and TXA. In addition to thrombotic complication, bleeding is not infrequent in patients affected by COVID‐19, with GI bleeding seemingly the most common hemorrhagic manifestation among adults. GI bleeding, with a frequency of 40%, was observed among neonates from affected mothers.3 On the other hand, GI bleeding is also a relatively common presentation among severely FX deficient patients.1, 2 In fact, GI bleeding can occur in children with severe FX deficiency within the first months of life. It seems that such patients are prone to experience severe bleeding, such as ICH, later in life, in the absence of an appropriate therapeutic strategy, most likely preventative regular secondary prophylaxis.1, 2 In one study of 102 patients with congenital FX deficiency, GI bleeding has been reported in 12% of symptomatic cases.1 In this case, with GI bleeding being a common presentation of SARS‐CoV‐2 infection and congenital FX deficiency, it cannot definitively be attributed to one or the other. Close monitoring of such cases is necessary to decrease related adverse consequences. Although it seems that COVID‐19 is less severe in adults with CBDs, it is a less‐known issue among children and newborns with CBDs. Further reports and studies could provide clarity. Due to their severe bleeding tendency, close monitoring of patients with severe congenital FX deficiency is mandatory, even without potential SARS‐CoV‐2 infection. And close monitoring of neonates with infected mothers is mandatory to prevent severe consequences. Patients with concomitant infection with SARS‐CoV‐2 require even more rigorous preventative and supportive care. ACKNOWLEDGEMENTS We highly appreciate Daisy Morant's valuable aid in improving the English Language of this manuscript. The study was supported and approved by Shahid Beheshti University of Medical Sciences. CONFLICT OF INTEREST The authors have no competing interests. AUTHOR CONTRIBUTIONS A. Dorgalaleh designed the work, performed laboratory analysis, and wrote the manuscript. F Ghazizadeh, M. Baghaipour, A. Dabbagh, Gh. Bahoush, and N Baghaipour performed clinical studies. Sh. Tabibian, M. Jazebi, N. Baghaipour, M. Bahraini, A. Fazeli, and F. Yousefi performed laboratory analysis. All the authors approved the submission

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

First record of a sclerodactylid sea cucumber, <i>Ohshimella ehrenbergii</i>(Selenka, 1868) from Iranian waters (Echinodermata: Holothuroidea: Sclerodactylidae)

117-120One specimen of a sclerodactylid sea cucumber was collected by snorkelling diving at depth 2.5 m from Farur Island in 2008 in Iranian waters of the Persian Gulf. This paper shows a morphological description of the specimen and the habitat characteristics

Prevalence of autoimmune thyroiditis in women with polycystic ovary syndrome: a systematic review and meta-analysis

Introduction: Polycystic ovary syndrome (PCOS) is one of the women's most common endocrine disorders, which may be is associated with some autoimmune diseases such as autoimmune thyroiditis disorders (AIT). This study was performed with aim to evaluate the prevalence of autoimmune thyroiditis in women with PCOS by a systematic review and meta-analysis.  Methods: This review study was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. The research documents were collected by searching Persian-language databases such as Magiran, Sid, Iranmedex, and English-language databases such as Web of Science, Pubmed Scopus, and Google Scholar from January 1 until August 1, 2022. All studies were evaluated by the Newcastle-Ottawa scale at the four levels of selection, comparison, exposure, and outcome. Data analysis was performed with comprehensive meta-analysis (CMA) software (version 3.1).  Results: A total of 9 studies with 2290 participants were included in the meta-analysis. The prevalence of AIT in patients with polycystic ovary syndrome was 26.4% (95% CI: 21.3-32.2) and in healthy women was 11.7% (95% CI: 8.1-16.7). Subgroup studies demonstrated a higher prevalence of AIT in younger patients. Meta-regression analysis also showed a significant association between the study area and the prevalence of AIT.  Conclusion: There is a significant association between the increased prevalence of AIT in patients with PCOS. This shows the importance of evaluating and monitoring thyroid function in patients with PCOS

Tissues, Cells and Biomarkers in ARDS

&nbsp;The utility of biomarkers for the action of endothelium and epithelium of the pulmonary microvasculars is unknown and their action of being barrier for edema and dysfunction of them cause ARDS and its mortality rate with no specific drugs efficiency is high (1). Recently, there are many important information about biomarkers in ARDS (2). These biomarkers in ARDS can effect either cellular activation or cell injury. Currently, biomarkers are the most important research tool. The biomarkers have an important role in ARDS treatment in the function. There is an executive phase with some damage like edema and necroses. Then, fibro-proliferative phase will be happen. To understand the mechanism of repair, we focus on the function of alveolar type I (3). &nbsp

Effect of straw mulch application on agronomic traits and grain yield of common bean (Phaseolus vulgaris L.) cultivars under drought stress

Abstract In order to investigate the agronomic traits and grain yield of common bean (Phaseolus vulgaris L.) cultivars under irrigation and straw mulch treatments, an experiment was conducted as factorial based on randomized complete block design with three replications at the research farm of the Faculty of agriculture, University of Tabriz, Iran in 2012. Treatments were two irrigation levels (60 and 120 mm evaporation from class A pan), two cultivars with different growth habits (akhtar and naz as determinate and indeterminate respectively) and two mulch levels (0 and 2 ton/ha of wheat straw). Results showed that effect of irrigation levels, straw mulch and cultivars were significant on plant height, number of leaf per plant, relative water content (RWC) and grain yield of common been. Normal irrigation and application of straw mulch produced the highest measured traits. Also in normal irrigation, leaf area index (LAI) and chlorophyll contents were significantly increased. Akhtar cultivar had higher LAI than that of Naz. Straw mulch in both irrigation treatments improved agronomic traits and grain yield of common bean cultivars