Triglyceride to high-density lipoprotein cholesterol and low-density lipoprotein cholestrol to high-density lipoprotein cholesterol ratios are predictors of cardiovascular risk in Iranian adults: Evidence from a population-based cross-sectional study

Background: The superiority of TG/HDL-C and LDL-C/HDL-C ratios in predicting  CVD risk is a matter of debates. Thus, the objective of this study was to compare TG/HDL-C and LDL-C to HDL-C ratios in predicting the risk of CVD events. Methods: In a population-based cross-sectional study, 567 representative participants aged 40 years or older were entered in the study in Babol, North of Iran. The demographic data, anthropometric measures, and the cardio metabolic risk factors were measured. The individual risk of CVD events was assessed by ACC/AHA risk model. ROC analysis was applied to estimate the diagnostic accuracy and the optimal cut-off points of TG/HDL-C and LDL-C/HDL-C ratios. Results: The AUC of TG/HDL-C and LDL-C/HDL-C ratios were rather similar and both parameters significantly predicted CVD risk in men comparably, and TG/HDL-C at optimal cutoff point of 3.6 produced 75 sensitivity and 39 specificity. However,in women TG/HDL-C with AUC of 0.65( p= 0.091) at optimal cutoff value of 3.4  produced a sensitivity of 82 and specificity of 51. The LDL-C/HDL-C ratio had no discriminative ability in predicting CVD risk in women. The adjusted OR of TG/HDL-C at 2nd quartile was significant (OR=3.22, 95CI:1.25-8.29) and a greater association was found with 3rd and 4rth quartiles Conclusion: Both TG/HDL–C and LDL-C/HDL-C ratios comparably predict CVD risk in men, whereas in women only TG/ HDL-C is a significant predictor but not LDL-C/HDL-C. &#160

Metabolic syndrome and different obesity phenotypes in the elderly women population: Iran’s Health System on aging

Background: Current literature has been focused on types of obesity with normal BMI (body mass index), but metabolically unhealthy.This study evaluates the prevalence of metabolical phenotypes of obesity. We also identified the best obesity index in predicting the components of metabolic syndrome (MetS). Methods: A cross-sectional study has been conducted on 164 women over 60 years. Anthropometric parameters, body fat percentage (%BF), and biologic criteria were measured to assess the types of obesity. Unhealthy metabolic was defined by modified Adult Treatment Panel III, and obesity based on BMI≥25.ANOVA and logistic regression were utilized for the association of MetS components and obesity phenotypes, and linear regression logistic for finding the best MetS related obesity index. Results: The prevalence of metabolically unhealthy was 45.7%, out of which 33.3% was among the individuals with normal BMI.Logistic regression has shown that triglyceride (TG) (OR=3.30, p<0.001) and high density lipoprotein (HDL-C) (OR=2.15,p<0.01) was independently related to metabolically healthy and normal weight(MHNW) phenotype. Moreover, TG (OR=3.92,p<0.001), HDL-C (OR=2.18,p<0.001), fasting blood glucose(FBG) (OR=1.73,p<0.01) and waist circumference(WC) (OR=3.18,p<0.001) are correlated significantly with metabolically unhealthy and overweight/obese (MUO) and also TG (OR=2.88,p<0.001) and WC (OR=2.67,p<0.001) with metabolically unhealthy and overweight/obese(MHO).WC followed by %body fat (BF) showed to be highly correlated with the prognosis of MetS components. Conclusions: There is a high prevalence of unhealthy metabolic among the elderly women,even with normal weight.There were different associations between MetS components and various obesity phenotypes.TG was the most powerful indicator for the prognosis of unhealthy metabolic phenotypes which was independently correlated with the WC, %BF and BMI

Comparison of pathologic characteristics of breast cancer in younger and older women

Background: Breast cancer is the most common invasive cancer with high mortality in women all around the world. The present evidence shows that younger patients have poor survival. Thus, the aim of this study was to compare the pathologic characteristics of breast cancer in women younger than 40 years compared with older. Methods: This is a cross-sectional study which contains 681 patients with a confirmed diagnosis of breast cancer, who referred to Babolsar Shahid Rajaei Hospital as a referral cancer therapeutic center in the North of Iran. The data included age, residence area, occupation, location, histopathologic characteristics of the tumor, TNM classification and staging. Results: The mean age (SD) of patients was 49.7 (11.9) years, of which 19.5 were under 40. Ductal carcinoma was the most common histopathologic type (90.0) but patients at a younger age had a higher incidence of lobular and other rare carcinoma compared to the older ones (P=0.04). The younger had a greater tumor size (P=0.01), lymphatic node involvement (P=0.04) and higher staging (P=0.004). The younger age was not associated with positive estrogen/progesterone receptors. Conclusion: These findings indicated more aggressive tumor characteristics and serious breast cancer in women less than 40 years compared with older ones

Serum Irisin level in patients undergoing different Stages of Chronic Kidney Disease

Background: Irisin is a myokine that regulates energy metabolism by inducing browning of adipose tissue. The aim of this study was to evaluate the relationship between irisin level and biochemical parameters of chronic kidney disease (CKD) patients in stage 2 and stage 4. Methods: The research was a cross-sectional study; the study population included patients with CKD who were over 18 years of age, included 90 individuals with CKD, of these participants, 45 were in the second stage of the CKD while the other 45 subjects were in the fourth stage. Serum irisin concentration plus the level of glucose (Glu), urea, creatinine (Cr) and hemoglobin (Hb) were measured. Results: In the present study, the serum irisin level of patients in stage 4 was significantly reduced (13.00 ng / ml) compared with patients in stage 2(21.41 ng / ml). Conclusion: With the progression of CKD from stage 2 to stage 4, parameters such as serum Cr, TG, LDL, FBS, BUN and urea levels significantly increased. Inversely, factors such as irisin, GFR, Alb, HDL and Hb levels significantly decreased. These findings suggest that irisin may be involved in the regulation of biochemical factor levels in CKD patients through the progression from stage 2 to stage 4

Comparison of bladder ultrasonographic and rigid cystoscopic findings in patients with hematuria

Background: Bladder cancer ranks ninth in world-wide cancer incidence and is 2.5-4 times more common in men, and painless gross hematuria is its typical clinical symptom. Cystoscopy is used to evaluate the cause of hematuria in bladder while the use and reliability of ultrasonography is questionable for this purpose. Therefore, the aim of this study was to compare abdominal ultrasonography and rigid cystoscopy in the diagnosis of bladder tumors in Babol Shahid Beheshti Hospital. Methods: In this cross-sectional study, 60 patients who were candidate for cystoscopy referred to Babol Shahid Beheshti Hospital in Iran in 2017-2018. In this study, rigid cystoscope was used to view the bladder after doing sonography. The numbers, demographic information (age, gender and residence) and clinical characteristics (indication of cystoscopy, history of chronic disease, sonographic and cystoscopic results) of patients were recorded in the checklist. Results: The mean age of patients (37 (61.7)=males) was 58.65&#177;14.26 (19-85) years and 48 (80) of them were &#62;50 years old. The sensitivity and specificity of sonography was 71.43 (95 CI: 29.4, 96.33) and 96.23 (95 CI: 87.02, 99.54) in detecting bladder tumors, respectively. The negative predictive and positive predictive values in sonography were 96.23 (95 CI: 88.76, 98.8) and 71.43 (95 CI: 37.25, 91.33) respectively. Conclusion: The results of this study indicate that since sonography has high negative predictive values in evaluating hematuria; therefore it can be replaced with rigid cystoscopy for patients with lower risk of malignancy. &#160

The negative association between inflammatory bowel disease and Helicobacter pylori seropositivity

Background: The role of Helicobacter pylori (H. pylori) in inflammatory bowel disease is a controversial argument. The initial theory of this study was that Helicobacter is a risk factor for inflammatory bowel disease. In this study, we investigated the coincidence of H. pylori exposure and IBDs. Methods: This case-control study has been done in Babol, teaching Hospitals; 60 newly diagnosed IBD cases without any Helicobacter eradicating treatment and 120 control patients without inflammatory bowel disease evidence in biopsy, investigated for H. pylori exposure by IgA and IgG ELISA tests. Clinical information, demographics and ELISA test results have been analyzed using SPSS.Version.18 (level of significance was less than 0.05). Results: Mean age of case group was 42.27&#177;13.64 years; in control group it was 45.52&#177;13.83 years. There was a significant difference between the case and control groups in IgG study of the following subgroups: age under 30, females, males, urban, higher education level and BMI between 18.5 and 24.9 (p-value was respectively; 0.004, 0.014, 0.047, 0.002, 0.013, 0.003). On the basis of logistic regression; IBD was less common in females, patients with lower education and patients with positive result of IgG (p-value was respectively 0.002, 0.013, 0.010). Conclusion: As a result of this study, Helicobacter pylori exposure, may could play a protective role against inflammatory bowel disease

Analgesic effects of lidocaine-ketorolac compared to lidocaine alone for intravenous regional anesthesia

Background: Intravenous regional anesthesia is a simple and reliable method for upper extremity surgery. In order to increase the quality of blocks and reduce the amount of pain, many drugs are used with lidocaine. In this study, the effect of ketorolac-lidocaine in intravenous regional anesthesia was investigated. Methods: 40 patients undergoing elective upper limb with America Society of Anesthesiologists class I and II were selected and randomly divided into two groups. The first group of 20 patients received 200 mg of lidocaine, and the second group, 200 mg of lidocaine with 20 mg of ketorolac. In both groups, the drug was diluted to 40 ml. In both groups, the onset of sensory block, onset of tourniquet pain, the onset of pain after opening the tourniquet, score of postoperative pain and analgesic prescription in the first 24 hours, during 1, 6, 12 and 24 hours were studied. A measure of the quality of analgesia was evaluated by VAS. Results: The mean onset of tourniquet pain in the two groups was not significantly different (P=0.443). In the ketorolac group, the onset of pain after opening the tourniquet was significantly longer than lidocaine group (p<0.001). The mean postoperative pain score during the first 24 hours after surgery in the ketorolac group was significantly lower than lidocaine group (p<0.001). The average number of analgesia prescription during the 24 hours after operation was significantly lower in ketorolac group than lidocaine group (p<0.001). Conclusions: Adding ketorolac to lidocaine for regional anesthesia can reduce the postoperative pain for up to 24 hours after opening the tourniquet

Role of scaling combination of risk factors in clinical and imaging findings during pregnancy in predicting placenta accreta spectrum

Background: Placenta accreta is one of the known causes of maternal mortality and morbidity. If diagnosed before delivery, appropriate actions can be taken. The aim of this study was to investigate the role of scaling combination of risk factors in predicting placenta accreta spectrum (PAS). Methods: In this cross-sectional study, 120 pregnant women with two criteria and more of placenta previa in their ultrasound, underwent MRI. Clinical scores (history of surgery, cesarean section, previa, etc.) and paraclinical scores (ultrasound and MRI) were recorded and combined. In cases of hysterectomy, pathological examination was performed. The results were compared and analyzed using SPSS Version 22. The significance level was less than 0.05. Results: Of the120 studied patients, 90 (75) women were diagnosed with placenta previa in which, 32(36) patients had placenta accreta and 12 patients had placenta accreta without placenta previa. The mean ultrasound score in women without and with placenta accreta were 0.05&#177;0.32 and 2.43&#177;1.83 (p&#60;0.001). The mean MRI score in women without and with placenta accreta were 0.05&#177;0.27 and 2.07&#177;2.02, respectively. The cut-off point, sensitivity and specificity were 0.50, 100 and 93.4, respectively. The mean clinical score without and with placenta accreta were 1.97&#177;1.32 and 4.89&#177;3.21, respectively. The cut-off point, sensitivity and specificity were 2.50, 70 and 80, respectively. The cut-off point of combination score, sensitivity and specificity were 3.50, 89, 83. Conclusion: The results of the present study showed that the most specific test to confirm the definitive diagnosis of placenta accreta is paraclinical score, alone

Comparative evaluation of the frequency of myofibroblasts between oral and cutaneous squamous cell carcinomas

Introduction: Differentiation of fibroblasts to myofibroblasts is an initial and very important event in tumor genesis. Myofibroblasts produce proteinases that stimulate invasion in cancers. Due to the more malignant potential of oral squamous cell carcinoma (OSCC) compared to cutaneous squamous cell carcinoma (CSCC) , the aim of the present study was to compare myofibroblasts between OSCC and CSCC to understand whether myofibroblasts can help more malignant potential of OSCC compared to CSCC or not. Materials &Methods: This cross-sectional study included 40 cases of OSCC and CSCC and 20 cases of normal skin and normal oral mucosa. Then, 4-micron sections of paraffin-embedded tissue blocks of studied groups were stained immunohistochemically with α-SMA antibody. Mean percentage of myofibroblasts was calculated in invasive fronts of OSCCs with CSCCs and also in normal samples and staining intensity of cells for α-SMA marker and distribution pattern of myofibroblasts were determined. Results: The differences of average percentage of myofibroblasts in OSCC and CSCC compared to normal groups were significant (Pvalue= 0.007 and Pvalue=0.003 respectively), but when we compared OSCCs and CSCCs, the difference was not significant. Also, there were no significant differences between OSCC and CSCC with regard to staining intensity and pattern. Conclusion: Different biologic behavior of OSCC compared to CSCC doesn’t depend on myofibroblasts and other factors can be involved

Effect of long-term low dose prednisolone administration on bone mineral density: Relating to non-compliant women with rheumatoid arthritis

Background: Long-term treatment of rheumatoid arthritis (RA) with prednisolone (PRED) is associated with bone mineral density (BMD) loss. This study aimed to determine the status of BMD in non-compliant women who used PRED alone for RA. Methods: Non-adherent RA taking 6 months, and RA patients taking methotrexate +PRED (RA control) were compared with age-matched non-RA controls. BMD was measured by dual energy x-ray absorptiometry (DXA) method and osteoporosis (OP) was diagnosed by WHO criteria. Influence of PRED on RA bone mass, and the risk of OP in RA was assessed by comparing PRED users RA and RA control,versus non-RA controls. Results: Sixty-four PRED user RA, 39 RA controls and 111 non RA-controls, with respective mean (±SD) age of 52±11; 8, 51±11; and 52±7.5 years (P=0.91) were studied. Median duration of treatment in PRED users and RA control was 2.5 and 4 years, respectively. BMD g/cm2 at the femoral neck (FN-BMD) and lumber spine (LS-BMD) in PRED users and RA control was significantly lower than non-RA control (P=0.001). The prevalence of OP at either FN or LS in both RA groups was significantly higher than controls (P=0.001). In PRED users, the risk of OP increased by OR=4.9, P=0.001) and in RA controls by OR=1.7 (P=0.20). The risk of OP in PRED user RA was 2.89 times (P=0.014) greater than RA controls. Conclusions: These findings indicate significantly lower BMD, and higher prevalence of osteoporosis in non-compliant women with RA taking low-dose PRED alone for a median period of 2.5 years, as compared with patients taking standard treatment comprising methotrexate +PRED