Predicting the outcome in patients with unexplained syncope and suspected cardiac cause: Role of electrophysiologic studies Kalp nedenli oldu�undan ��phe edilen ve a�ıklanamayan senkoplu bir hastada sonucun kestirilmesi

Objective: Unexplained syncope is a challenge facing electrophysiologists. The prognosis varies widely depending on underlying causes, specially, cardiac ones. We sought to determine the abnormal electrophysiolgic (EP) study results as predictors of prognosis in syncope patients with suspected cardiac cause and risk factors associated with mortality. Methods: A total of 227 consecutive patients with unexplained syncope were prospectively enrolled in this study. EP study was performed in 177 patients in base of inclusion criteria. These patients, in whom a cardiac cause of syncope was suspected, underwent EP study and if negative, head-up tilts test (HUTT). Complete follow-up was obtained for 132 patients for 20.0�10.8 months. Results: A cardiac cause of syncope was established in 35, a neurally mediated syncope in 35.6, and in the rest 29.4 the cause of syncope remained unexplained despite a throughout neurologic and cardiologic evaluation. Logistic analysis revealed that the significant predictors of a cardiac cause of syncope were the absence of prodromal symptoms, left bundle branch block (LBBB), sever left ventricle (LV) dysfunction and male gender. At logistic analysis, the presence of LBBB (OR=6.63; 95 CI: 1.09-40) was significantly associated with outcome of death. Conclusion: The present study provides evidence that presence of LBBB, abnormal EP study result and structural heart disease (SHD) have prognostic value in patients with suspected cardiac cause of syncope. The patients with SHD and unexplained syncope who had a negative EP study have a good long-term prognosis even in the presence of LV dysfunction. � 2015 by Turkish Society of Cardiology

Predicting the outcome in patients with unexplained syncope and suspected cardiac cause: Role of electrophysiologic studies

Objective: Unexplained syncope is a challenge facing electrophysiologists. The prognosis varies widely depending on underlying causes, specially, cardiac ones. We sought to determine the abnormal electrophysiolgic (EP) study results as predictors of prognosis in syncope patients with suspected cardiac cause and risk factors associated with mortality. Methods: A total of 227 consecutive patients with unexplained syncope were prospectively enrolled in this study. EP study was performed in 177 patients in base of inclusion criteria. These patients, in whom a cardiac cause of syncope was suspected, underwent EP study and if negative, head-up tilts test (HUTT). Complete follow-up was obtained for 132 patients for 20.0±10.8 months. Results: A cardiac cause of syncope was established in 35, a neurally mediated syncope in 35.6, and in the rest 29.4 the cause of syncope remained unexplained despite a throughout neurologic and cardiologic evaluation. Logistic analysis revealed that the significant predictors of a cardiac cause of syncope were the absence of prodromal symptoms, left bundle branch block (LBBB), sever left ventricle (LV) dysfunction and male gender. At logistic analysis, the presence of LBBB (OR=6.63; 95 CI: 1.09-40) was significantly associated with outcome of death. Conclusion: The present study provides evidence that presence of LBBB, abnormal EP study result and structural heart disease (SHD) have prognostic value in patients with suspected cardiac cause of syncope. The patients with SHD and unexplained syncope who had a negative EP study have a good long-term prognosis even in the presence of LV dysfunction. © 2015 by Turkish Society of Cardiology

Prognostic Significance of Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography in Anal Squamous Cell Carcinoma: A Systematic Review and a Meta-Analysis.

Prognostic significance of fluorine-18 fluorodeoxyglucose positron emission tomography ( <sup>18</sup> F-FDG-PET) in anal squamous cell carcinoma (SCC) has been evaluated in several studies; however, the results seem to be controversial and no consensus exists about its predictive capability. The current meta-analysis was carried out to comprehensively investigate the prognostic significance of <sup>18</sup> F-FDG-PET parameters in patients with anal SCC. A comprehensive literature search of PubMed/MEDLINE and Scopus databases was performed to retrieve pertinent articles published until August 5th 2018, concerning the prognostic significance of <sup>18</sup> F-FDG-PET in patients with anal SCC. No language restriction was used. Several prognostic factors were reported for progression-free survival (PFS) and overall survival (OS) including pretreatment maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), inguinal nodal uptake, and metabolic response to therapy. Eleven studies (741 patients) were included. The pooled hazard ratio (HR) for the probability of PFS was 5.36 (95% confidence interval (95% CI): 3.12-9.21, p < 0.001) for metabolic response to therapy and 1.98 (95% CI: 1.26-3.12, p=0.003) for SUVmax. The pooled HR for the probability of OS was 5.87 (3.02-11.39, p < 0.0001) for metabolic response to therapy. On the other hand, the study revealed that the pooled HRs of MTV and inguinal nodal uptake for PFS were 1.56 (95% CI: 0.96-2.53, p=0.072) and 1.79 (95% CI: 1-3.21, p=0.051), respectively. Our findings propose that some <sup>18</sup> F-FDG-PET parameters could serve as prognostic indicators in anal SCC, but further larger studies are needed in this setting

Induction and aggravation of atrioventricular valve regurgitation in the course of chronic right ventricular apical pacing

Aims Valvular regurgitation, especially on the right side of the heart, is a common finding even in patients without endocardial pacing leads. The severity of valvular regurgitation can change after permanent pacemaker (PPM) implantation. Ventricular pacing has been shown to cause ventricular dysfunction. The purpose of this study was to evaluate the mid-term effects of right ventricular (RV) apical pacing on atrioventricular (AV) valvular regurgitation in patients with a normal left ventricular function before PPM implantation. Methods and results Patients who required dual-chamber pacemakers due to a high-degree AV block were enrolled in the study. Initial echocardiography was performed before PPM implantation and re-evaluation by echocardiography was performed every 24 months thereafter. A total of 125 patients (61 male; mean age: 66.57 ± 6.45 years) were included in the study, and 115 pacemaker-dependent patients were followed up (mean ± SD; 4.08 ± 0.8 years). Echocardiography demonstrated mild tricuspid regurgitation (TR) and mitral regurgitation (MR) in 70 (60.1) and 34 (29.6) patients before PPM implantation, respectively. Moderate TR and MR were detected in 10 (8.7) and 1 (0.9) patients, respectively. Thirty-six (31.6) patients showed moderate-to-severe TR at long-term follow-up, compared with the 10 (8.7) patients, who had the same degree of TR before RV apical pacing (P< 0.001). Mild and moderate MR were detected in 54 (47) and 8 (7) patients after PPM implantation on the last echocardiography(P< 0.001). Baseline systolic pulmonary artery pressure (PAP) was 29.24 ± 8.45 mmHg, which increased to 36 ± 11 mmHg on the last echocardiography (P< 0.001). Conclusion Considering the haemodynamic effects at mid-term follow-up, left ventricular dysfunction is rare in patients with RV apical pacing and normal baseline left ventricular function. Right ventricular apical pacing is associated with a significant increase in the prevalence and severity of TR and MR. © The Author 2011

Autosomal recessive and sporadic non syndromic hearing loss and the incidence of Cx26 mutations in a province of Iran

Despite the enormous heterogeneity of genetic hearing loss, mutations in the GJB2 (connexin 26) gene located on "DFNB1" locus (13q12) account for up to 50 of cases of autosomal recessive non-syndromic hearing loss (ARNSHL) in some populations. This study describes the analysis of 100 autosomal recessive and sporadic nonsyndromic hearing loss individuals from 79 families each having at least one deaf child in Chehar Mahal va Bakhtiari province in west of Iran. We have investigated the prevalence of the connexin 26 gene mutations using nested PCR strategy to screen the predominant 35delG mutation and subsequent direct sequencing to detect other Cx26 mutations. Seven different genetic variants were detected from which one novel variant was including 363delC. The 35delG was the most common mutation found in 5 of 79 families (6.3). Cx26 related deafness mutations (35delG,V27I; E114G) and R127H) were found in 12 of 158 chromosomes studied (7.8%). We conclude that the association of Cx26 mutations with deafness in Chehar Mahal va Bakhtiari province is low and looks like most other populations of Iran

Design and psychometric evaluation of epilepsy-related apathy scale (E-RAS) in adults with epilepsy: a sequential exploratory mixed methods design

Background: Apathy in patients with epilepsy is associated with a wide range of consequences that reduce the patient�s ability to perform social functions and participate in self-care and rehabilitation programs. Therefore, apathy is one of the important diagnoses of the healthcare team in the process of caring for epileptic patients and its dimensions need to be examined and recognized. Therefore, appropriate instruments with the sociocultural milieu of each community should be provided to health care providers. The aim of the present study was to design and measure epilepsy�related apathy scale (E-RAS) in adults with epilepsy. Methods: This study of sequential exploratory mixed methods design was conducted in Iran from April 2019 to December 2019. In the Item generation stage, two inductive (face-to-face and semi-structured interviews with 17 adult epileptic patients) and deductive (literature review) were used. In item reduction, integration of qualitative and literature reviews and scale evaluation were accomplished. For Scale Evaluation, face, content, construct exploratory factor analysis (EFA) (n = 360) and confirmatory factor analysis (CFA) (n = 200), convergent and divergent Validity and reliability (internal consistency and stability) were investigated. Results: The results of EFA showed that E-RAS has four factors, namely, motivation; self-regulatory; cognition and emotional-effective. These four latent factors accounted for a total of 48.351% of the total variance in the E-RAS construct. The results of CFA showed that the 4-factor model of E-RAS has the highest fit with the data. The results of convergent and divergent validity showed that the values of composite reliability (CR) and average variance extracted (AVE) for the four factors were greater than 0.7 and 0.5, respectively, and the value of AVE for each factor was greater than CR. The Cronbach�s alpha coefficient for the whole scale was obtained 0.815. The results of the test-retest showed that there was a significant agreement between the test and retest scores (P < 0.001). Conclusion: E-RAS is a multidimensional construct consisting of 24 items, and has acceptable validity and reliability for the study of epilepsy-related apathy in adult epileptic patients. © 2021, The Author(s)

Novel loss-of-function variants in CDC14A are associated with recessive sensorineural hearing loss in Iranian and Pakistani patients

CDC14A encodes the Cell Division Cycle 14A protein and has been associated with autosomal recessive non-syndromic hearing loss (DFNB32), as well as hearing impairment and infertile male syndrome (HIIMS) since 2016. To date, only nine variants have been associated in patients whose initial symptoms included moderate-to-profound hearing impairment. Exome analysis of Iranian and Pakistani probands who both showed bilateral, sensorineural hearing loss revealed a novel splice site variant (c.1421+2T>C, p.?) that disrupts the splice donor site and a novel frameshift variant (c.1041dup, p.Ser348Glnfs*2) in the gene CDC14A, respectively. To evaluate the pathogenicity of both loss-of-function variants, we analyzed the effects of both variants on the RNA-level. The splice variant was characterized using a minigene assay. Altered expression levels due to the c.1041dup variant were assessed using RT-qPCR. In summary, cDNA analysis confirmed that the c.1421+2T>C variant activates a cryptic splice site, resulting in a truncated transcript (c.1414_1421del, p.Val472Leufs*20) and the c.1041dup variant results in a defective transcript that is likely degraded by nonsense-mediated mRNA decay. The present study functionally characterizes two variants and provides further confirmatory evidence that CDC14A is associated with a rare form of hereditary hearing loss

Determining of DNA-barcoding of 6 – 8 species by partial sequencing of mtDNA (CO1) using molecular method (PCR-Sequencing)

Barcodes are short segments of DNA that can be used to uniquely identify an unknown specimen to species, particularly when diagnostic morphological features are absent. These sequences could offer a new forensic tool in plant and animal Conservation-especially for endangered species. It was proved that a small fragment of mitochondrial DNA from the 5′-end of cytochrome c oxidase subunit 1 (COI) gene as a reliable, quick and costeffective identification system for most Crustacea like shrimp. Take a look in DNA barcoding website show that there is a little data about Iranian shrimps which live in Persian Gulf and Oman Sea. In this Study six species of shrimp: Fenoro penaeus indicus, Fenoro penaeus merguensis, penaeus semisulcatus, Metapenaeus affinis, Marsupenaeus japonicas, Fenoro penaeus penicillatus were collected from different stations in Persian Gulf and Oman Sea. All materials were preserved in 70% ethanol and were shipped to the laboratory for taxonomic studies. After identification, the total DNA was extracted; COI gene was first amplified and then sequenced for each species. Finally the collected data were analyzed with the specific phylogenetic software. The results were amazing and the interesting part was that analytical methods for showing species relationship suggested that Fenoro penaeus penicillatus is closer to Marsupenaeus gnus than penaeus gnus. This finding needs more investigation to be proved. We suggest a workflow for DNA barcoding, including database generation and management, which will ultimately be necessary if we are to succeed to join universal DNA barcode for Crustacea