Pulmonary Sequestration Infant with Unusual Presentation: A Case Report

Background: Pulmonary sequestration (PS) is characterized by a separate segment of the lung that receives anomalous vascular supply separate from the pulmonary arteries. Here we report the case of a 4-year-old girl with dyspnea and recurrent pneumonia who was finally diagnosed as a case of PS. Case presentation: A 4-year-old girl was admitted to Imam-Reza hospital, Mashhad city, Iran, with a history of coughing and dyspnea from two years ago. On the CXR, consolidation can be seen in the left lower lobe. As there was a high likelihood of aspiration or pneumonia following her past medical history, the patient underwent bronchoscopy. More investigation with HRCT revealed vascular anomaly. CMRI (Cardiac Magnetic Resonance Imaging) showed no cardiac abnormality. More findings showed a large collateral artery originated from left lateral side of abdominal aorta. This collateral artery went upward to the LLLL (the Lower Lobe of Left Lung) and anastomosed directly with two large posterior segmental tributary of the left lung pulmonary veins. Hyper-vascular pattern of both lungs was also observed in the MRI. Conclusion: To avoid misdiagnosis, PS should be considered in differential diagnosis in infants with chronic cough and dyspnea. These patients should be referred to a tertiary center to receive appropriate treatment

Association of NFKB1 gene polymorphism (rs28362491) with cardiometabolic risk factor in patients undergoing coronary angiography

Introduction: Genetic and environmental factors are involved in the pathogenesis of cardiovascular diseases (CVDs). The aim of the study was to investigate between the genotype of the NFKB1 gene and the cardiometabolic risk factor in patients undergoing coronary angiography. Methods: This cross-sectional study was conducted on 462 adults (male and women) aged between 35 and 75 years who referred to Afshar Hospital for coronary angiography in 2021- 2022. The polymerase chain reaction restriction fragment length polymorphism method was used to detect the genotype of rs28362491. Biochemical parameters were measured using commercial kits. Gensini and Syntax scores were calculated using the angiography result to assess the extent of coronary artery stenosis. We used multivariate logistic regression analysis to examine the relationship between genotype variants and cardiometabolic risk factors. Results: There was no association between variant genotypes and abnormally levels of serum alanine aminotransferase (ALT) (P value=0.51), aspartate aminotransferase (AST) (P value=0.99), triglyceride (TG) (P value=0.48), total cholesterol (P value=0.79), low density lipoprotein-cholestero (LDL-C) (P value=0.31), high-density lipoprotein-cholesterol (HDL-C) (P value=0.53), fast blood sugar (FBS) (P value=0.39), systolic blood pressure (P value=0.14), diastolic blood pressure (P value=0.64), Gensini score (P value=0.48) and syntax score (P value=0.74) in the crude model even after adjustment for confounding factors. Conclusion: We found no association between the ATTG polymorphism and cardiometabolic risk factors in patients who had coronary angiography. Further investigations are needed to assess the association between variants of 28362491 and cardiometabolic markers

Evaluation of risk factors and diseases associated with metabolic and atherosclerotic disorders in different abdominal fat distribution patterns assessed by CT-scan

Introduction: Obesity is defined as an increase in body fat composition. Aim: The purpose of our study was to evaluate metabolic risk factors and diseases in different patterns of abdominal fat distribution. Materials and methods: This is a cross-sectional study. Among patients aged 15 to 65 years who have had no significant weight loss in the past year and were referred to the Radiology Department to perform an abdominal CT-scan, the visceral and subcutaneous fat area (VFA and SFA) with Hounsfield units -30 to -190 (±2 SD) was calculated at the umbilical level. Based on the VFA and SFA, patients were stratified into four groups, group 1: V(+)S(+); group 2: V(+)S(-); group 3: V(−)S(+); group 4: V(−)S(−). The following parameters were assessed in the groups: anthropometric parameters including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist to hip ratio (WH); laboratory parameters, including fasting blood glucose (FBG), lipids profile (TG, LDH, LDL, and total cholesterol), creatinine, and liver enzymes (AST, ALT). Additionally, sensitivity, specificity, positive predictive value (PPV), and negative predictive value of study variables were assessed in predicting group 1. Results: The study included 180 individuals (mean age 50±14 years, range 15-65 years). Group 1 was the most, and group 2 was the least prevalent pattern of abdominal fat distribution. Most females (75%) had high percentage of subcutaneous fat tissue. There was a significant association between the abdominal fat distribution pattern and BMI, WC, WHtR, TG, LDL, HDL, total cholesterol, FBG, diabetes, and metabolic syndrome (p<0.05). Conclusions: Most of the metabolic factors, including BMI, WC, lipid profile, and FBG, as well as metabolic syndrome, diabetes, and impaired glucose tolerance, were highly correlated with group 1. However, most of the individuals in group 1 were normal according to the factors mentioned above. Therefore, there is a gap between the main definition of obesity (increasing body fat mass) and parameters that calculated obesity and metabolic disorders

Corticosteroid therapy for liver abscesses in a neonate with Chronic granulomatous disease

Chronic granulomatous disease (CGD) is a rare inherited immunodeficiency disorder, characterized by susceptibility to recurrent infections, including hepatic abscess. These abscesses are typically resistant to antibiotics and surgical procedures.Here, we describe an infant with CGD and liver abscesses that was successfully treated with corticosteroids and antibiotics. A 19-day-old neonate was admitted after presenting with malaise, fever, poor feeding, abdominal distension, and hepatomegaly. Routine laboratory evaluation for sepsis and polymerase chain reaction (PCR) testing for SARS-CoV-2 was done. The PCR test results was negative in two different samples 15 days apart. Ultrasound image showed numerous focal hypoechoic masses in the liver suspected to liver abscess. Nitroblue tetrazolium (NBT) test was sent which showed less than 5% positive leukocytes. The neonate recovered completely, and the liver abscesses were removed once oral prednisolone was started in combination with antibiotic therapy.Corticosteroid therapy and prolonged antibiotic courses can be effective for the management of CGD-related hepatic abscesses

Effects of LI-4 and SP-6 Acupuncture on Labor Pain, Cortisol Level and Duration of Labor

AbstractNowadays, acupuncture is widely used to manage pain, and childbirth is a condition requiring appropriate pain management interventions. The efficacy of acupuncture in the management of labor pain has recently been studied, but the results are not satisfactory and conflicts exist. In this study, we investigated the effects of acupuncture on labor pain, serum cortisol level, and duration of labor. We conducted a randomized, single-blind, controlled trial that included 63 nulliparous women: 32 in the study group and 31 in the control group. Acupuncture was performed at the SP-6 and the LI-4 points in the study group, and sham acupuncture was performed at the same points in the control group. Pain scores and serum cortisol levels were measured before and after the intervention. Changes in these measures and in the duration of labor were compared between the groups. No significant variations in pain scores or serum cortisol levels were observed between the two control groups. However, the duration of labor was significantly lower (p < 0.001) in the group receiving real acupuncture. Our results show that acupuncture is significantly associated with a decreased duration of labor, even though it was no better than a placebo for the treatment of labor pain

Interaction of dietary patterns with rs28362491 on severity of coronary artery stenosis in patients undergoing coronary angiography

Abstract Coronary artery disease (CAD) is one of the most important cardiovascular diseases. Lifestyle and genetic factors play important roles in the development of CAD. The aim of the study is to examine the interaction of dietary patterns and genes on the likelihood of abnormal lipid profile and coronary artery stenosis in Iranians undergoing coronary angiography. This cross-sectional study was performed on 440 patients who underwent coronary angiography. The factor analysis method was used to extract dietary patterns. Commercial kits have been used to assess biochemical parameters. The detection of the rs28362491 genotype was carried out by the method of restriction fragment length polymorphism. Traditional (TDP) and western dietary pattern (WDP) were extracted. We observed an interaction of adherence to TDP and rs28362491 on the odds of having a high Gensini score. These interactions indicated that higher adherence to TDP was associated with higher odds of having a high Gensini score for patients with DD genotype than for those with II genotype. (OR 2.33, 95%CI 1.00–5.44; P = 0.05). These interactions remained statistically significant even after confounder variables. We observed an interaction between higher adherence to TDP and rs28362491 variants on the odds of high low-density lipoprotein cholesterol levels (P = 0.04) in the unadjusted model. We found a significant interaction of this polymorphism and higher adherence to WDP on the odds of having a high Gensini score in the unadjusted model (P = 0.04). This study provides a basis for future research on NF-KB1 gene and diet interaction. More large-scale longitudinal studies are needed to validate these findings