Sensitivity, Specificity and Accuracy of Color Doppler Ultrasonography for Diagnosis of Retinal Detachment

Purpose: This study evaluated the sensitivity, specificity, and diagnostic accuracy of Color Doppler Ultrasonography (CDUS) in patients with suspected retinal detachment (RD) who underwent surgery. Methods: In this prospective, observational clinical study, 65 eyes of 65 consecutive patients with suspected RD with opaque media were included. Following a standardized protocol, CDUS of the retina of the affected eye was performed. The sensitivity, specificity, and diagnostic accuracy of CDUS were determined and compared to the findings during surgery. Results: The mean age of patients (18 men and 47 women) was 52.36 years (range: 8–77 years). The sensitivity, specificity, and overall accuracy of ocular CDUS were 91.3%, 88.1%, and 89.2%, respectively. The false-negative rate (negative CDUS images but presence of RD at operation) was 3.1% (2/65) and the false-positive rate (positive CDUS images but absence of RD at operation) was 7.7% (5/65). Conclusion: CDUS of the retina could be considered as a promising tool in the diagnosis of RD in patients with opaque media

Associations between Western and Mediterranean-type dietary patterns and depression in adults in Shiraz

Background and aims: Depression is a growing public health problem in the world. In this study we investigated the relationship between dietary patterns and depression in adults aged 20-50 years living in Shiraz, Iran. Methods: In a cross-sectional study, 416 subjects (180 men and 236 women) aged 20 to 50 years were selected by stratified multistage random sampling. Dietary intakes were assessed using a semi-quantitative food frequency questionnaire. Depression information was collected by Depression, Anxiety and Stress Scale (DASS) questionnaire. Three major dietary patterns were extracted by factor analysis: vegetable, Western, and Mediterranean-type dietary patterns. Regression analysis was used for association between dietary pattern and depression. Results: A strong positive significant association was observed between Western dietary pattern and depression. Also there was a negative significant association between Mediterranean-type dietary pattern and depression. These associations remained statistically significant even after adjustments for demographic characteristics, physical activity, smoking, body mass index, and energy intake. No association was found between vegetable dietary pattern and depression. Conclusion: The results showed that there was a relationship between dietary patterns and depression. However, clinical trials are needed to clarify whether a causal relationship between diet and mood disorders can be established

Vitamin D deficiency in patients with Behcet’s disease

BACKGROUND: Behcet’s disease is an autoimmune, recurrent and multisystem disease. Vitamin D has immunomodulator role in immune system. So that vitamin D deficiency was reported in some autoimmune diseases. Behcet’s disease as a Silk Road disease is common in Iran. The aim of this study was to detect the serum level of 25(OH) vitamin D in Behcet’s patients and control group. METHODS: In this case–control study, 112 Behcet’s patients as cases group and 112 healthy individuals as controls group were enrolled. Any subject on vitamin D supplement, steroid, and immunosuppressors during the last 6 months were excluded. The serum level of 25(OH) vitamin D was measured in the two groups by ELISA method. The findings were compared via SPSS software. RESULTS: About 57% and 17% of Behcet’s patients had vitamin D deficiency and insufficiency respectively. Vitamin D deficiency was significantly more common in controls than cases group (P < 0.001). Vitamin D levels were significantly lower in controls (P < 0.001). Age and sex did not have any confounding effect on the results. There was no significant relationship between disease duration, disease activity, Pathergy test, HLA-B5, and HLA-B51 with vitamin D level in Behcet’s patients. CONCLUSIONS: Vitamin D deficiency is common among Behcet’s patients. However, our results revealed vitamin D deficiency was significantly more common in healthy controls in comparison with Behcet’s cases

Cytochrome P450 2C19 Polymorphism in Iranian Patients with Coronary Artery Disease

<p><strong>BACKGROUND:</strong> The polymorphisms of cytochrome P450 2C19 (CYP2C19) gene are major prognostic factors for the response to clopidogrel therapy in patients with coronary artery diseases (CAD). The CYP2C19*2 is the most important allele responsible for resistance to clopidogrel therapy. This study examined CYP2C19 gene polymorphism (CYP2C19*1 and *2) in Iranian patients.</p> <p>&nbsp;</p> <p><strong>METHODS:</strong> This cross-sectional study was performed on 43 Iranian patients with CAD who underwent percutaneous coronary intervention (PCI) and received drug-eluted stents (DES). CYP2C19 polymorphisms were assessed using real time PCR and frequency of CYP2C19*1 and CYP2C19*2 were determined, and then homo- or heterozygous state of genes was detected by Melt Curve Analysis method.</p> <p>&nbsp;</p> <p><strong>RESULTS:</strong> Forty three patients (mean age = 58.8 &plusmn; 10.0 years, 79.1% male) participated in this study. CYP2C19*1/CYP2C19*1 genotype was observed in 31 (72.1%) of participates, CYP2C19*1/CYP2C19*2 genotype in 10 (23.3%), and CYP2C19*2/CYP2C19*2 genotype in 2 patients (4.7%). The frequency of CYP2C19*2 allele in the sample was 27.9%.</p> <p>&nbsp;</p> <p><strong>CONCLUSION:</strong> This study demonstrated a high prevalence of CYP2C19*2 gene polymorphism in Iranian patients. Further studies with larger samples or longitudinal are required to determine the effects of this polymorphism on the prognosis of CAD patients in our population.</p> <p>&nbsp;</p> <p><strong>Keywords:</strong> CYP2C19, Polymorphism, Clopidogrel, Coronary Artery Disease, Iran.</p> <p>&nbsp;</p

Morphological Description, Phylogenetic and Molecular Analysis of Dirofilaria immitis Isolated from Dogs in the Northwest of Iran

Background: Dirofilariasis is a globally distributed arthropod-borne parasitic disease of mainly canids and felids. We evaluated to extend the knowledge of morpho-molecular characteristics and outer ultrastructure of Dirofilaria immitis isolated from Northwest of Iran. Methods: Overall, 67 filarial worms including 41 females and 26 males parasites were collected from the cardiovascular system of the 43 stray dogs in Meshkinshar, Ardebil Province, Northwest of Iran in 2017, and subjected to light and scanning electron microscopy (SEM) as well as carmine alum staining for morpho-molecular and identification. Molecular methods were used for confirmation of morphological findings by sequencing of Cyto-chrome c oxidase subunit I (cox1) gene. Results: The partial DNA sequencing of cox1 gene of adult parasites showed considerable homology and close proximity to the previously isolated from Kerman and Meshkinshahr, Iran. The lowest genetic variation and the highest intra-species variability was found in D. immitis and Dirofilaria repens, respectively. No similarity was identified between D. immitis nucleotide sequence and Wolbachia species as its endosymbiont bacteria. Conclusion: The SEM technique is an excellent tool for differential recognition of the parasite surface morphology and molecular techniques could differentiate and identify Dirofilaria spp. keywords: Dirofilaria immitis, Homology, Iran, Scanning electron microscopy (SEM

Immunosuppression, eotaxin and the diagnostic changes in eosinophils that precede early acute heart allograft rejection.

Peripheral blood eosinophil counts (EOS) are undetectable in 40% blood samples sent for routine haematology at Papworth Hospital during the first 3 months after heart transplantation (HTx). Increases in EOS usually precede the development of allograft rejection by a median of 4 days. We compared the effects of cyclosporin (dose and total blood concentration), prednisolone (dose and both total and unbound plasma concentrations) and azathioprine, as well as plasma concentrations of the CCR-3 chemokines, eotaxin and RANTES, on changes in EOS in 47 consecutive HTx recipients, with a median follow-up of 90 (IQR 85-95) days. Multivariate analysis confirmed the independent association between both prednisolone dose (P<0.0001) and eotaxin (P<0.0001) and changes in EOS. The plasma eotaxin concentration was, in turn, most closely associated with the cyclosporin dose (P<0.001) and plasma prednisolone concentration (P=0.022). The blood cyclosporin concentration (P=0.028), EOS (P=0.012) and prednisolone dose (P=0.015) were all independently associated with the risk of treated acute rejection. When prednisolone pharmacokinetic parameters were substituted for the prednisolone dose in this multivariate model, only the pharmacokinetic parameter retained a significant association with the risk of rejection. Changes in EOS preceding cardiac allograft rejection are directly associated with plasma eotaxin concentrations and indirectly with prednisolone dosage. Cyclosporin may also indirectly influence these changes by inhibiting eotaxin production. EOS, prednisolone dose and blood cyclosporin concentrations were independently associated with the risk of acute rejection. The total and unbound fractions of prednisolone in plasma appear to be even more closely related to rejection but are difficult to measure. Monitoring EOS, as a surrogate measure of prednisolone immunosuppression, may be more cost-effective for controlling rejection than conventional cyclosporin monitoring in the first 6 weeks after HTx

The Effects of Body Acupuncture on Obesity: Anthropometric Parameters, Lipid Profile, and Inflammatory and Immunologic Markers

A randomized controlled clinical trial in 196 obese subjects was performed to examine the effectiveness of body acupuncture on body weight loss, lipid profile and immunogenic and inflammatory markers. Subjects received authentic (cases) or sham (controls) acupuncture for 6 weeks in combination with a low-calorie diet. In the following 6 weeks, they received the low-calorie diet alone. Subjects were assessed at the beginning, 6 and 12 weeks later. Heat shock protein (Hsps)-27, 60, 65, 70 antibody titers and high sensitivity C-reactive protein (hs-CRP) levels were also assessed. A significant reduction in measures of adiposity and improvement in lipid profile were observed in both groups, but the levels of anti-Hsp-antibodies decreased in cases only. A reduction in anthropometric and lipid profile in cases were sustained in the second period, however, only changes in lipid profile were observed in the control group. Anti-Hsp-antibodies and hs-CRP levels continued to be reduced in cases but in controls only the reduction in hs-CRP remained. Changes in anthropometric parameters, lipid profile, and anti-Hsp-antibodies were more evident in cases. Body acupuncture in combination with diet restriction was effective in enhancing weight loss and improving dyslipidemia

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

Both Low and Upper Normal Levels of 25-Hydroxy Vitamin D Relates to Risk Factors of Metabolic Syndrome and Cardiovascular Diseases

Background: Vitamin D deficiency is implicated in a wide range of pathological situations including cardiovascular diseases. This study aimed to investigate the association between serum 25-hydroxy vitamin D (25(OH)D) and risk factors of metabolic syndrome and cardiovascular diseases. Methods: The cross-sectional study was conducted on 169 adults (88 males, 81 females) aged 19-52 years living in Shiraz, Iran. Anthropometric characteristics and blood pressure were measured using standard methods. Blood samples were collected in fasting state for determination of blood glucose, lipids, and 25(OH)D. Data were analyzed with one-way analysis of variance and linear regression using SPSS software. Results: Serum 25(OH)D concentrations were considerably higher in males. One third of females had vitamin D deficiency (25(OH)D <10 ng/ml) while one third of males exhibited 25(OH)D levels >50 ng/ml. In males, systolic and diastolic blood pressure, triglycerides, and metabolic syndrome score increased and high-density lipoprotein (HDL) cholesterol decreased across tertiles of serum 25(OH)D. On the contrary, in females body mass index (BMI) and metabolic syndrome score decreased and HDL cholesterol increased across tertiles of 25(OH)D. Linear regression, after controlling for confounding factors, showed that diastolic blood pressure (B=0.07; 95% CI: 0.02, 0.11; P=0.006), triglycerides (B=0.54; 95% CI: 0.22, 0.85; P=0.001), and metabolic syndrome score (B=0.01; 95% CI: 0.001, 0.01; P=0.02) positively and HDL cholesterol (B=-0.05; 95% CI: -0.09, -0.01; P=0.02) inversely associated with tertiles of 25(OH) D concentrations in males. In contrast, BMI (B=-0.06; 95% CI: -0.11, -0.02; P=0.01), waist circumference (B= -0.12; 95% CI:- 0.23, -0.01; p=0.04), and metabolic syndrome score (B=-0.02; 95% CI:-0.03, -0.01; P=0.01) were inversely and HDL-C (B=0.16; 95% CI: 0.02, 0.31; P=0.02) positively associated with 25(OH) D tertiles in females. Conclusion: The results suggest that both low and upper normal levels of 25(OH)D are associated with increased risk of cardiovascular diseases and metabolic syndrom