A rare presentation of the Klinefelter's syndrome

A 16 years old boy with Chronic Renal Failure (CRF) was not suspected of having Klinefelter's syndrome until he complained of painful gynecomastia. He was under haemodialysis for 2 years. At first, he was in an approximately full pubertal development (P5, G5), but he had a small and a firm testis (length 2.2cm) and some degree of facial male pattern hair. He also had a decreased upper to lower body segment ratio and despite having chronic renal failure, he was taller than his parents and siblings. His laboratory tests showed high levels of FSH and normal levels of LH and testosterone. With regards to all these findings, we suspected that there might be an occult Klinefelter's syndrome. So, we made his karyotype that showed a 47XXY pattern. Because there are only a few number of cases that have occult Klinefelter's syndrome in the basis of chronic renal failure, we decided to report this case

Relationship between serum level of interleukin-2 in patients with systemic lupus erythematosus and disease activity in comparison with control group

Background: Despite the large number of surveys, there are not any validated biomarkers for SLE disease activity till now. This study aimed to evaluate the relationship between serum level of IL-2 in patients with SLE and disease activity in comparison with control group. Materials and Methods: In this case-control study, 73 patients with lupus and 73 healthy subjects referred to the rheumatology clinic of 5 Azar Hospital in Gorgan (North of Iran).They were studied via convenience sampling during 2011-2012. Blood samples were taken from both groups and serum levels of interleukin -2 measured by Avi Bion Human IL-2 ELISA kit. Serum Level of IL-2 greater than 15 pg/ml defined positive and lesser than this amount defined negative. Disease activity evaluated with SLE disease activity index. Score greater than or equal to three or four defined as active disease. Data analysis conducted by SPSS software (version 16) and by using descriptive statistics and statistical tests. Results: Serum level of IL-2 was positive in 45.2% of sample studied and negative in 54.8% in case group, while in control group, serum level of IL-2 only in 11% of sample studied was positive and in 89% was negative. Statistical analysis indicated a significant relationship between serum level of IL-2 and the SLE disease activity index (p=0.025). Conclusion: This study showed the relationship between serum levels of IL-2 and disease activity, so this biomarker can be used as a clinical indicator for assessing disease activity in patients with SLE

S-Restricted Compositions Revisited

An S-restricted composition of a positive integer n is an ordered partition of n where each summand is drawn from a given subset S of positive integers. There are various problems regarding such compositions which have received attention in recent years. This paper is an attempt at finding a closed- form formula for the number of S-restricted compositions of n. To do so, we reduce the problem to finding solutions to corresponding so-called interpreters which are linear homogeneous recurrence relations with constant coefficients. Then, we reduce interpreters to Diophantine equations. Such equations are not in general solvable. Thus, we restrict our attention to those S-restricted composition problems whose interpreters have a small number of coefficients, thereby leading to solvable Diophantine equations. The formalism developed is then used to study the integer sequences related to some well-known cases of the S-restricted composition problem

Different features in Wegener's granulomatosis: Report of five cases

Wegener's granulomatosis (WG) is an autoimmune inflammatory condition. It is often a rapidly progressive and potentially fatal disease. The clinical presentation of WG can be so diverse that the list of its differential diagnosis is vast, ranging from infectious diseases to other vasculitis (e.g. Behcet's disease), as well as malignancies. The exact aetiology of WG remains unclear. The upper airway diseases including sinusitis, oral lesions and otitis media are the most common presenting features of WG. In this paper, we have described 5 WG cases. They had different presentations and chief complaints. Some of them presented with upper airways diseases, while the others mainly suffered from the manifestations of pulmonary involvement. Although all of them were finally diagnosed as WG cases, the processes of the work up for the diagnosis as well as the outcome of the disease were not the same. So, the diversities in the presentation should be mentioned in the management of the WG suspected patients

Evaluation of self-medication prevalence, diagnosis and prescription in migraine in Kerman, Iran

Objective: To investigate different diagnosis aspects, prescribed drugs and self-medications of migraine in Iran. Methods: We selected 210 migraineurs from high school and university students in Kerman, Iran over a period of 6 months in 2002 by multistage randomized screening based on the International Headache Society criteria. We classified them into 2 groups on the basis of whether they had consulted a physician or not. We then evaluated the physician prescriptions, and prevalence of self-medications. Results: Only 49 of migraineurs consulted a physician, and only 53 were correctly diagnosed by physicians according to the International Headache Society criteria. Our study shows that 69 of general practitioners diagnoses were wrong. In spite of indications for prophylactic treatment, it was not prescribed in 76 of the patients, and 50 of the general practitioners prescribed it without any indications. Furthermore, 91 of patients used self-medication; Acetaminophen and Codeine were the most common. Conclusion: General practitioners' misdiagnosis and mismanagement of the migraineurs, and easy access to various drugs in Iran, have led to a high rate of self-medication. Self-medication with Codeine, with regard to its side effects, such as increase of secondary headaches and dependency is the major problem. Consequently, medical education systems, physician reevaluating methods, and the concept of self-medication among patients have to be revised

Change in bone mineral density in post menopausal women with rheumatoid arthritis

Introduction: Low bone mass is a serious complication of post menopausal women with rheumatoid arthritis. We determined the Change in Bone Mineral Density in postmenopausal women with rheumatoid arthritis. Methods: This retrospective cohort study was carried out on consecutive postmenopausal women with rheumatoid arthritis who were referred to the Azar 5th teaching hospital affiliated to Golestan University of Medical Sciences, North of Iran in 2009. The required data were gathered from the patients' medical records. The data were analyzed using SPSS software and statistical tests. Results: We studied 98 postmenopausal women with rheumatoid arthritis. Mean number of years since menopause and mean duration of disease were 9.39 and 5.13 respectively. T Score mean in femoral neck and lumbar spines was -1.45±1.26 and -2.45±1.44 respectively. The overall prevalence of osteoporosis at both the lumbar spine and femoral neck was 13.3. We have found a significant correlation between age, duration of disease, duration of menopause and bone mineral density (P-Value<0.01). Conlusion: Our results indicate a negative effect of age, number of years since menopause and duration of disease on bone mineral density. So, BMD should be measured in high risk women prior to the implementation of any treatment or prevention program

Reversal effect of <em>Achillea millefolium </em>extract on ileum contractions

Introduction: Traditionally Achillea millefolium L. has been used to treat gastrointestinal disorders. In this study the hydroalcoholic extract of A. millefolium was evaluated on ileum contractions of Wistar rats. Materials and Methods: In this experimental study 32 male Wistar rats were designated into 4 equal groups, including: acetyl choline, KCl, extract plus acetyl choline and the group which received extract plus KCl. The isotonic contractions of ileum (induced by 60 mM KCl or 1 &mu;M acetyl choline) in tyrode solution were recorded, under 1 gr tension. Then, the effects of normal saline or extract (1) were evaluated. The percentage changes were calculated and compared in different groups using ANOWA and Tukey tests. Results: The mean of ileum contractions in acetyl choline and KCl groups were 18.83&plusmn;4.91 and 18.31&plusmn;11.12 (p=0.5). The percentage of contraction relieve in extract plus acetyl choline group was 53.16&plusmn;12.06 and in extract plus KCl group was 62.96&plusmn;11.08 (p=0.4). The contractions in extract groups were significantly less than acetyl choline or KCl groups (p&lt;0.05). Conclusion: The results indicate that Achillea millefolium extract inhibits ileum contractions. Therefore, it might be used in patients to reduce ileum spasms.</p

Epigenetic Chromatin Silencing: Bistability and Front Propagation

The role of post-translational modification of histones in eukaryotic gene regulation is well recognized. Epigenetic silencing of genes via heritable chromatin modifications plays a major role in cell fate specification in higher organisms. We formulate a coarse-grained model of chromatin silencing in yeast and study the conditions under which the system becomes bistable, allowing for different epigenetic states. We also study the dynamics of the boundary between the two locally stable states of chromatin: silenced and unsilenced. The model could be of use in guiding the discussion on chromatin silencing in general. In the context of silencing in budding yeast, it helps us understand the phenotype of various mutants, some of which may be non-trivial to see without the help of a mathematical model. One such example is a mutation that reduces the rate of background acetylation of particular histone side-chains that competes with the deacetylation by Sir2p. The resulting negative feedback due to a Sir protein depletion effect gives rise to interesting counter-intuitive consequences. Our mathematical analysis brings forth the different dynamical behaviors possible within the same molecular model and guides the formulation of more refined hypotheses that could be addressed experimentally.Comment: 19 pages, 5 figure

An Optimized Approach to Determine Alternative Cluster Head in Wireless Sensor Network Clustering Structure

Wireless sensor networks consist of hundreds or thousands tiny nodes that work together to do some special tasks. Generally, to reduce energy consumption in the network, just some of the nodes send the data to the sink. This structure is called clustering and the nodes linked to the sink are called cluster head. The other nodes send their data to the nearest cluster head. Choosing a node as alternative cluster head can improve the network efficiency because clustering formation is a costly approach. When the cluster head stops working it is necessary to do the clustering formation but when we have alternative for the cluster head no clustering formation is needed, just the alternative introduces itself as the new cluster head and informs the other nodes in the cluster about this matter. In this paper we propose a novel approach to determine alternative node for cluster head. The existing methods impose high overhead on the network and some of them has very low accuracy while the proposed method has high accuracy also imposes almost no overhead to the network by using in-network data and eliminating the array data structur