Attenuation of serum laminin concentrations upon treatment of chronic hepatitis

Objectives: The aim of this work was to determine the serum laminin level cutoff point for predicting liver fibrosis highlighting its diagnostic value and determining the effect of treatment on serum laminin concentrations. Methods: Serum laminin concentrations in chronic hepatitis patients (n=62) and controls (n=20) were compared by ELISA and stages of fibrosis were assessed according to the modified Knodell score system. Results: Mean serum laminin concentration in patients (91.9 ± 20.9 ng/ml) was greater than controls (46.2 ± 10.2 ng/ml; p <0.001). Serum concentrations of laminin in all stages of hepatic fibrosis were significantly higher than those of healthy controls (p <0.05). A cutoff point of 52ng laminin/ml of serum was obtained for the discrimination of various stages of liver fibrosis showing a good sensitivity (96.8%) and specificity (80%). After 6 months of treatment, a gradual decrease in serum laminin concentrations were observed, however the level was still higher than that of the healthy group (p<0.05). Conclusions: Our findings suggest that the serum laminin concentration is a useful noninvasive marker of liver fibrosis and shows a strong positive correlation with different stages of the disease

The comparison of insulin resistance frequency in patients with recurrent early pregnancy loss to normal individuals

<p>Abstract</p> <p>Background</p> <p>Patients with ≥ 3 recurrent spontaneous miscarriages are classified as having RSM. Polycystic ovary syndrome (PCOS) is associated with insulin resistance (IR). The purpose of this study is to evaluate the association of IR and RMS.</p> <p>Methods</p> <p>Present case- control prospective study was performed on 100 women in control group (with a history of at a live birth and no history of one more abortion) and study group (with a history of ≥ 3 RMS) who were not diabetes and PCOS. Two groups matched in base of age and body mass index. Blood was withdrawn from the case and control patients for the determination of the fasting blood glucose (FG), fasting insulin (FI) levels and ultrasonography was performed on all the patients.</p> <p>Results</p> <p>The observed differences between age, FG and FG to FI ratio levels in case and control groups were not significant (<it>p </it>> 0.05) but it was significant about fasting insulin (<it>p </it>= 0.0119). FI of < 20 <it>μu/ml </it>or ≥ 20 <it>μu/ml </it>in case and control group was significant (Chi-square: 4.083, p: 0.0433, odds ratio: 4.4386, CI95% = 1.1541 to 17.0701), whereas the difference between absolute and proportional frequency of patients with FG to FI ratio of < 4.5 and ≥ 4.5 in case and control groups was not significant (Chi-square: 2.374, <it>p </it>= 0.123).</p> <p>Conclusion</p> <p>Current study showed that in women with RPL, in Iranian race like Americans, frequency of insulin resistance in high, therefore there is a probability of the degree of insulin resistance in women with RPL.</p

Clinical, endoscopic, and demographic characteristics of idiopathic duodenal ulcers compared with helicobacter pylori positive ulcers

Background: Helicobacter pylori infection is the most common cause of peptic ulcer disease. However, the prevalence rates of non-helicobacter pylori idiopathic peptic ulcers have increased over the past few years. This study aims to compare the characteristics of Helicobacter pylori-positive with idiopathic duodenal ulcers. Methods: A cross-sectional cohort study was conducted on 950 patients which were excluded from the analysis process duo to the concomitant presence of gastric ulcer, malignancy, Zollinger Ellison syndrome, Crohn&#39;s disease, esophageal varices, history of taking anti-Helicobacter pylori therapy, and history of taking NSAID or aspirin. Eventually, 647 subjects were enrolled for the analysis process. In this case, these subjects were divided into two groups: (I) Helicobacter pylori-positive ulcer group and (II) Helicobacter pylori-negative and non-NSAID (idiopathic) ulcer group. Results: The findings showed that 417 patients (64.5) had duodenal ulcers induced by Helicobacter pylori, and 111 patients (17.1) had Helicobacter pylori-negative and non-NSAID ulcers. The mean ages of patients in Helicobacter pylori-positive and idiopathic ulcer groups were 39&#177;15 and 42&#177;17, respectively. In this case, 33 patients (29.7) with idiopathic ulcers and 56 patients (25.1) with Helicobacter pylori-positive ulcers had upper gastrointestinal bleeding. Also, 22 patients (21) with idiopathic ulcers and 31 patients (16.5) with Helicobacter pylori-positive ulcers had multiple duodenal ulcers Conclusion: The present study demonstrated that the idiopathic ulcers included 17.1 of duodenal ulcers. Also, it was concluded that patients with idiopathic ulcers were predominantly male with an age range older than the other group. In addition, patients in this group had more ulcers

Relationship between β-Thalassemia minor and Helicobacter pylori infection

Background: Until now, no study has been reported investigating the association between β-thalassemia minor and Helicobacter pylori (H. pylori) infection. This study was designed to compare H. pylori infection rate between β-thalassemia minor patients and healthy controls. Methods: A number of 100 β-thalassemia minor patients (50 males, 50 females) and 100 gender-matched healthy controls were prospectively recruited in this study in a period of 3 months. The study population consisted of the people who referred to a health center in Babol, North of Iran, for premarital counseling. H. pylori status was assessed by measuring the anti-H. pylori IgG antibodies using enzyme-linked immunosorbent assay. Demographic information and informed consent were collected from all participants. Results: The overall H. pylori infection rate was 43%. The infection was significantly more prevalent in thalassemia patients (53%) than in the controls (33%) in both univariate (OR=2.29, 95% CI: 1.3-4.06) and multivariable analyses (OR=2.05, 95% CI: 1.12-3.76). Age was the only significant factor which was positively correlated with the infection in β-thalassemia minor cases (OR=1.11, 95% CI: 1.02-1.2). Gender, blood groups, residency, and education level were not related to the infection. Conclusions: According to the results, it can be concluded that β-thalassemia minor patients are possibly more susceptible to H. pylori infection than healthy people. Further studies are needed to discover more about the exact mechanisms of increased susceptibility to H. pylori infection in β-thalassemia minor patients

Assessment of Effective Factors In Recurrent Implantation Failure (RIF) Following Assisted Reproductive Technology (ART)

BACKGROUND AND OBJECTIVE: Despite many advances have been made in the assisted reproduction techniques (ART), implantation rate after embryo transfer has not increased significantly. Therefore, this study aims to determine the factors involved in recurrent implantation failure (RIF) following ART. METHODS: In this retrospective study, 80 infertile patients with a history of at least 3 recurrent implantation failure (RIF) following assisted reproductive technology (ART) were referred to Fatemezahra Infertility Center in Babol from March 2006 to March 2013 were selected. The control group also included 80 women who became pregnant following the first IVF. Associated factors of infertility, endocrine disorder and endometriosis were recorded and their effect on RIF was assessed in both groups. FINDINGS: The mean BMI was 26.39±3.63 in the case group and 26.77±4.49 in the control group. Body mass index (BMI) >30 increased the risk of RIF significantly (p=0.001). After adjusting for the effects of other possible confounding factors, the odds ratio of obesity on RIF was 1.09(0.91-1.19) 95% CI which was not significant (p=0.06). There were no significant differences among type and cause of infertility, endocrine abnormalities, uterine malformations, endometriosis and polycystic ovary with RIF. CONCLUSION: According to our findings, BMI, type and cause of infertility, endocrine disorders, uterine abnormalities, endometriosis, and polycystic ovary were not effective on recurrent implantation failure

Interventions for treating hyperemesis gravidarum.

BACKGROUND: Hyperemesis gravidarum is a severe form of nausea and vomiting in pregnancy affecting 0.3% to 1.0% of pregnancies, and is one of the most common indications for hospitalization during pregnancy. While a previous Cochrane review examined interventions for nausea and vomiting in pregnancy, there has not yet been a review examining the interventions for the more severe condition of hyperemesis gravidarum. OBJECTIVES: To assess the effectiveness and safety, of all interventions for hyperemesis gravidarum in pregnancy up to 20 weeks\u27 gestation. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group\u27s Trials Register and the Cochrane Complementary Medicine Field\u27s Trials Register (20 December 2015) and reference lists of retrieved studies. SELECTION CRITERIA: Randomized controlled trials of any intervention for hyperemesis gravidarum. Quasi-randomized trials and trials using a cross-over design were not eligible for inclusion.We excluded trials on nausea and vomiting of pregnancy that were not specifically studying the more severe condition of hyperemesis gravidarum. DATA COLLECTION AND ANALYSIS: Two review authors independently reviewed the eligibility of trials, extracted data and evaluated the risk of bias. Data were checked for accuracy. MAIN RESULTS: Twenty-five trials (involving 2052 women) met the inclusion criteria but the majority of 18 different comparisons described in the review include data from single studies with small numbers of participants. The comparisons covered a range of interventions including acupressure/acupuncture, outpatient care, intravenous fluids, and various pharmaceutical interventions. The methodological quality of included studies was mixed. For selected important comparisons and outcomes, we graded the quality of the evidence and created \u27Summary of findings\u27 tables. For most outcomes the evidence was graded as low or very low quality mainly due to the imprecision of effect estimates. Comparisons included in the \u27Summary of findings\u27 tables are described below, the remaining comparisons are described in detail in the main text.No primary outcome data were available when acupuncture was compared with placebo, There was no clear evidence of differences between groups for anxiodepressive symptoms (risk ratio (RR) 1.01, 95% confidence interval (CI) 0.73 to 1.40; one study, 36 women, very low-quality evidence), spontaneous abortion (RR 0.48, 95% CI 0.05 to 5.03; one study, 57 women, low-quality evidence), preterm birth (RR 0.12, 95% CI 0.01 to 2.26; one study, 36 women, low-quality evidence), or perinatal death (RR 0.57, 95% CI 0.04 to 8.30; one study, 36 women, low-quality evidence).There was insufficient evidence to identify clear differences between acupuncture and metoclopramide in a study with 81 participants regarding reduction/cessation in nausea or vomiting (RR 1.40, 95% CI 0.79 to 2.49 and RR 1.51, 95% CI 0.92 to 2.48, respectively; very low-quality evidence).In a study with 92 participants, women taking vitamin B6 had a slightly longer hospital stay compared with placebo (mean difference (MD) 0.80 days, 95% CI 0.08 to 1.52, moderate-quality evidence). There was insufficient evidence to demonstrate a difference in other outcomes including mean number of episodes of emesis (MD 0.50, 95% CI -0.40 to 1.40, low-quality evidence) or side effects.A comparison between metoclopramide and ondansetron identified no clear difference in the severity of nausea or vomiting (MD 1.70, 95% CI -0.15 to 3.55, and MD -0.10, 95% CI -1.63 to 1.43; one study, 83 women, respectively, very low-quality evidence). However, more women taking metoclopramide complained of drowsiness and dry mouth (RR 2.40, 95% CI 1.23 to 4.69, and RR 2.38, 95% CI 1.10 to 5.11, respectively; moderate-quality evidence). There were no clear differences between groups for other side effects.In a single study with 146 participants comparing metoclopramide with promethazine, more women taking promethazine reported drowsiness, dizziness, and dystonia (RR 0.70, 95% CI 0.56 to 0.87, RR 0.48, 95% CI 0.34 to 0.69, and RR 0.31, 95% CI 0.11 to 0.90, respectively, moderate-quality evidence). There were no clear differences between groups for other important outcomes including quality of life and other side effects.In a single trial with 30 women, those receiving ondansetron had no difference in duration of hospital admission compared to those receiving promethazine (MD 0.00, 95% CI -1.39 to 1.39, very low-quality evidence), although there was increased sedation with promethazine (RR 0.06, 95% CI 0.00 to 0.94, low-quality evidence) .Regarding corticosteroids, in a study with 110 participants there was no difference in days of hospital admission compared to placebo (MD -0.30, 95% CI -0.70 to 0.10; very low-quality evidence), but there was a decreased readmission rate (RR 0.69, 95% CI 0.50 to 0.94; four studies, 269 women). For other important outcomes including pregnancy complications, spontaneous abortion, stillbirth and congenital abnormalities, there was insufficient evidence to identify differences between groups (very low-quality evidence for all outcomes). In other single studies there were no clear differences between groups for preterm birth or side effects (very low-quality evidence).For hydrocortisone compared with metoclopramide, no data were available for primary outcomes and there was no difference in the readmission rate (RR 0.08, 95% CI 0.00 to 1.28;one study, 40 women).In a study with 80 women, compared to promethazine, those receiving prednisolone had increased nausea at 48 hours (RR 2.00, 95% CI 1.08 to 3.72; low-quality evidence), but not at 17 days (RR 0.81, 95% CI 0.58 to 1.15, very low-quality evidence). There was no clear difference in the number of episodes of emesis or subjective improvement in nausea/vomiting. There was insufficient evidence to identify differences between groups for stillbirth and neonatal death and preterm birth. AUTHORS\u27 CONCLUSIONS: On the basis of this review, there is little high-quality and consistent evidence supporting any one intervention, which should be taken into account when making management decisions. There was also very limited reporting on the economic impact of hyperemesis gravidarum and the impact that interventions may have.The limitations in interpreting the results of the included studies highlights the importance of consistency in the definition of hyperemesis gravidarum, the use of validated outcome measures, and the need for larger placebo-controlled trials

Exploring the effect of adding low dose human chorionic gonadotropin on oocyte maturation in women undergoing intracytoplasmic sperm injection: A randomized control trial

Background: The aim of this study was to examine the effect of adding low dose human chorionic gonadotropin (hCG) on oocyte maturity and hyper-stimulation syndrome in women undergoing Intra-cytoplasmic Sperm Injection (ICSI). Methods: In a randomaized clinical trail, 150 eligible patients undergoing a long GnRH agonist protocol were randomly divided into three groups of 50 women. The women in the first group received recombinant FSH alone (rFSH). The women in the second group received rFSH by 100 IU hCG daily. All participants in the three groups received rFSH by 200 IU hCG daily. The mean numbers of mature oocytes retrieved (MII oocytes) for normal responders as the primary outcome, and the occurrence ovarian hyperstimulation syndrome (OHSS) as the secondary outcome were measured for each group. A P-value of less than 0.05 was considered as statistically significant. Results: There was no significant difference in the comparison of the incidence of mature oocytes formation among the three groups. The number of OHSS was significantly lower in third group compared with those of the other groups (6% vs 14% and 18%, respectively; P = 0.03). Conclusion: The addition of 200 hCG to recFSH throughout the stimulation in a long GnRH agonist protocol only benefited a lower number of OHSS

Investigation of chronic diseases in patients with inflammatory bowel disease: A hospital-based case-control study

Background: Inflammatory bowel disease (IBD) is a broad term that refers to a group of chronic inflammatory disorders that have an unknown origin and might be associated with other diseases. The aim of this study was to determine the frequency of chronic diseases in patients with IBD. Methods: In this case-control study, 280 patients with IBD were compared with 280 healthy individuals, frequency-matched by age, sex, place of residence and marital status. Random sampling was performed in patients that referred to the internal medicine and gastroenterology wards of hospitals affiliated to Babol University of Medical Sciences. Data collection tools included a demographic questionnaire and a checklist for chronic diseases, which were completed through interviews with the case and control groups. Results: Two hundred and twenty-nine (81.78) patients with IBD had at least one chronic disease. Patients with IBD were at increased risks of rheumatoid arthritis (OR= 4.48, 95CI: 1.48, 13.54, P= 0.008), eye diseases (OR= 3.49, 95CI: 1.68, 7.28, P= 0.001), liver diseases (OR= 2.74, 95CI: 1.40, 5.34, P= 0.003), anemia (OR = 2.53, 95CI: 1.56, 4.13, P= 0.000), depression (OR= 2.43, 95CI: 1.58, 3.74, P= 0.000), skin diseases (OR= 2.36, 95CI: 1.18, 4.74, P= 0.015) and hypertension (OR= 1.77, 95CI: 1.06, 2.95, P= 0.028). Conclusion: The frequency of chronic diseases associated with IBD has been high, therefore, physicians and health care professionals should consider the possibility of other chronic diseases when dealing with IBD patients. © The Author(s)