Serum levels of interleukin-23 and 35 in patients with and without type 2 diabetes mellitus and chronic periodontitis

Background: Type 2 diabetes mellitus (DM) and chronic periodontitis (CP) show common pathophysiological features. We investigated the serum levels of IL-23 and IL-35 in people with type 2 DM and CP. Methods: In a cross-sectional study, 72 patients were divided into four equal groups: group A, participants without type 2 DM and CP; group B, patients with type 2 DM without CP; group C, patients with CP and without type 2 DM; and group D, patients with type 2 DM and CP. Demographic data were obtained and periodontal conditions including clinical attachment loss, bleeding on probing, plaque index, gingival index, and probing depth was evaluated on all existing teeth. Fasting blood sugar (FBS) levels, hemoglobin (Hb) A1c, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were assessed. In addition, serum levels of IL-23 and 35 were measured using enzyme-linked immunosorbent assay. Results: The serum levels of IL-23 and 35 showed no significant differences between all groups (P>0.05). A significant positive correlation between the serum concentration of IL-23 and clinical attachment loss in the control group (r: 0.548, P=0.019) was detected. A significant negative correlation between IL-35 and the plaque index in group B (r: -0.578, P=0.012), plus significant negative correlations between IL-23 with ESR (r: -0.487, P=0.040) and CRP (r: -0.498, P=0.035) in groups C and D were also detected. Conclusion: Despite significant associations of serum concentration of IL-23 and 35 with certain periodontal and inflammatory indices, neither type 2 DM nor CP differentially affects serum levels of these two cytokines

Adult-type granulosa cell tumor of the ovary : a FOXL2-centric disease

Adult-type granulosa cell tumors (aGCTs) account for 90% of malignant ovarian sex cord-stromal tumors and 2-5% of all ovarian cancers. These tumors are usually diagnosed at an early stage and are treated with surgery. However, one-third of patients relapse between 4 and 8 years after initial diagnosis, and there are currently no effective treatments other than surgery for these relapsed patients. As the majority of aGCTs (>95%) harbor a somatic mutation in FOXL2 (c.C402G; p.C134W), the aim of this study was to identify genetic mutations besides FOXL2 C402G in aGCTs that could explain the clinical diversity of this disease. Whole-genome sequencing of 10 aGCTs and their matched normal blood was performed to identify somatic mutations. From this analysis, a custom amplicon-based panel was designed to sequence 39 genes of interest in a validation cohort of 83 aGCTs collected internationally. KMT2D inactivating mutations were present in 10 of 93 aGCTs (10.8%), and the frequency of these mutations was similar between primary and recurrent aGCTs. Inactivating mutations, including a splice site mutation in candidate tumor suppressor WNK2 and nonsense mutations in PIK3R1 and NLRC5, were identified at a low frequency in our cohort. Missense mutations were identified in cell cycle-related genes TP53, CDKN2D, and CDK1. From these data, we conclude that aGCTs are comparatively a homogeneous group of tumors that arise from a limited set of genetic events and are characterized by the FOXL2 C402G mutation. Secondary mutations occur in a subset of patients but do not explain the diverse clinical behavior of this disease. As the FOXL2 C402G mutation remains the main driver of this disease, progress in the development of therapeutics for aGCT would likely come from understanding the functional consequences of the FOXL2 C402G mutation.Peer reviewe

SARS-CoV-2 Omicron-B.1.1.529 leads to widespread escape from neutralizing antibody responses

On 24th November 2021, the sequence of a new SARS-CoV-2 viral isolate Omicron-B.1.1.529 was announced, containing far more mutations in Spike (S) than previously reported variants. Neutralization titers of Omicron by sera from vaccinees and convalescent subjects infected with early pandemic Alpha, Beta, Gamma, or Delta are substantially reduced, or the sera failed to neutralize. Titers against Omicron are boosted by third vaccine doses and are high in both vaccinated individuals and those infected by Delta. Mutations in Omicron knock out or substantially reduce neutralization by most of the large panel of potent monoclonal antibodies and antibodies under commercial development. Omicron S has structural changes from earlier viruses and uses mutations that confer tight binding to ACE2 to unleash evolution driven by immune escape. This leads to a large number of mutations in the ACE2 binding site and rebalances receptor affinity to that of earlier pandemic viruses

A successful pregnancy for a young hypothyroid woman with Gitelman Syndrome: A rare case study report

It is widely assumed that Gitelman syndrome is a rare genetic disorder with such electrolyte imbalance as hypokalemia and hypomagnesaemia. The impact of hypothyroidism on Gitelman syndrome and its management is not clear. In this case study, a hypothyroid young woman referred to our endocrine clinic for muscle cramp after the hypothyroidism management. Based on Laboratory and clinical findings, the woman was diagnosed to have been suffering from Gitelman syndrome and the treatment with magnesium, potassium and oral Spironolactone began immediately. After two years of treatment, the woman experienced a successful planned pregnancy

Major Depressive Disorder as the First Presentation of Panhypopituitarism: A Case Report

Pan-hypopituitarism is a rare but life threatening disorder that occurs due to reduction of anterior pituitary hormones. In this condition, major depressive disorders are presented by depressed mood and markedly diminished interest in many activities during a day. Some disorders are associated with psychiatric symptoms at presentation, therefore, the diagnosis of mood disorder due to a medical condition should also be considered. This study presents a middle aged man admitted with symptoms of major depressive disorder involving suicidal ideation whose condition did not improve despite treatment with different antidepressant agents. He had past history of brain tumor surgery, chemotherapy, and radiotherapy. Due to the possibility of pituitary axis deficits since the time that radiotherapy was initiated, the patient was evaluated for these axes and the decrease in adrenal, thyroid, gonad and growth hormone axis function was confirmed by lab tests.In patients with persistent and severe depression, underlying medical causes such as endocrine disorders especially hypo-pituitarism should also be considered

Sexual Dysfunction in Women with Type 2 Diabetes Mellitus

Background: Sexual dysfunction (SD) is one of the important problems in diabetic patients. The present study aimed to determine the prevalence of sexual problems in Iranian women with type 2 diabetes mellitus. Methods: A cross-sectional study was conducted among type 2 diabetic women who visited two outpatient endocrine clinics, namely Imam Hospital and Tuba clinic (Sari, Iran) in 2012. Patients were asked to complete two validated questionnaires: Female Sexual Function Index (FSFI) and The Hospital Anxiety and Depression Scale (HADS) as well as a demographic questionnaire. Analysis was performed using descriptive and analytical tests. P<0.05 was considered to be significant. Results: One hundred and fifty women with type 2 diabetes were investigated. Most of the cases aged 40-44 years old. The mean of the total score of the FSFI questionnaire was 22. The prevalence of sexual dysfunction was 78.7% (CI: 71.4-84.4); among these, 58% (CI: 50.0-65.6) reported problems in lubrication, 50% (CI: 42.1-57.9) complained of decreased sexual desire, 50% (CI: 42.1-57.9) had problems with arousal, 47.3% (CI: 39.5-55.3) had dyspareunia, 32.7% (CI: 25.7-40.5) complained of orgasmic dysfunction and 42.7% (CI: 35.0-50.7) reported problems in sexual satisfaction. With regard to the results of the HADS questionnaire, 58.7% (CI: 50.7-66.2) of the patients had depression and 96.7% (CI: 92.4-98.6) had anxiety. Conclusion: This study showed the high prevalence of sexual dysfunction in diabetic women, especially among those complaining of depression. Health care professionals dealing with diabetic patients should be aware of possible presence of sexual dysfunction in female patients

Therapeutic Outcomes of Hyperthyroidism: A Ten-year Investigation in an Endocrine Clinic in North of Iran

Materials and methods: This descriptive study included all hyperthyroid patients. All therapeutic results were recorded and analyzed. Results: In this study, 329 records were studied and 104 patients met the study inclusion criteria. Graves' disease (GD) and toxic adenoma were reported in 94% and 6%, respectively. Among the patients with GD, 30.5% (21.7-40.3%) did not respond to initial ATD treatment and 20% had recurrent GD despite appropriate initial response. Overall, antithyroid drugs failure occurred in 50.5% (40.45-60.55%) of the patients. Lower age, lower body mass index (BMI), high thyroid weight, and higher baseline thyroid hormone levels were associated with ATD failure (P <0.05). Patients with toxic adenomas and patients who did not respond to ATD or those who experienced relapse of hyperthyroidism received radioactive iodine or underwent surgery. Hypothyroidism occurred in 13.1% of patients with ATD alone, in 66.7% of those with surgery, and in 79.4% of the patients who received radioactive iodine (P= 0.0001). Conclusion: A significant proportion of hyperthyroid patients experience drug failure. Age, BMI, thyroid weight, and basal levels of thyroid hormones are associated with drug treatment failure. Prevalence of hypothyroidism after treatment with radioactive iodine is higher than the drug treatment alone or surgery groups

Metabolic and endocrine changes induced by cinnamon in women with polycystic ovarian syndrome: A pilot study

Objective: Most polycystic ovary syndrome (PCOS) patients have metabolic abnormalities in which insulin resistance (IR) plays a pivotal role. Cinnamon is a herbal medicine with insulinotropic properties. This pilot study aimed to evaluate the effects of cinnamon on ovarian volume, androgenic profile, and metabolic and anthropometric parameters in women with PCOS.Materials and Methods: A single-center, double-blind, randomized, placebo-controlled trial was carried out on 39 overweight / obese women with PCOS. For six months, subjects in the cinnamon (500 mg) (n=19) and placebo (n=20) groups were given three capsules daily. Before and after the intervention, the variables were assessed. The data was analyzed using the GraphPad Prism software.Results: After the intervention, the two intervention and control groups had significant differences in abdominal subcutaneous fat and ovarian volume, but they did not differ significantly in terms of body mass index (BMI). Also, after the intervention, no significant difference was observed between the two groups in terms of lipid profile and the concentration of androgenic biomarkers of insulin resistance.Conclusion: Cinnamon supplementation improves ovarian volume and subcutaneous abdominal fat but has no effect on anthropometric parameters, lipid profile, insulin resistance, or androgen hormones

Relationship between type 2 diabetic retinopathy and periodontal disease in Iranian Adults

Background: Periodontal disease in diabetic patients can compromise a patient′s ability to maintain a proper metabolic control and may be associated with diabetic complication. Aims: This study was designed to evaluate the frequency of periodontal disease in patients with type 2 diabetes mellitus (DM) and how this was related with the presence of diabetic retinopathy (DR). Materials and Methods: A comparison was made of periodontal parameters (plaque index (PI), community periodontal index of treatment needs (CPITN), periodontal disease severity measured in quartiles of probing depth (PD), and clinical attachment loss (CAL)) in a group of diabetic patients with retinopathy (n = 84) versus a group of diabetic patients without retinopathy (n = 129). In addition, 73 age- and sex-matched individuals were selected to serve as the control group. Analysis was performed to evaluate the relationships between periodontal disease and DR. Results: In terms of PI, no statistically significant differences were observed, so, oral hygiene was similar in both groups. Diabetic patients with retinopathy had greater CPITN (P < 0.001) and more severe periodontal disease (P < 0.001) than no retinopathy. Also, our results indicated a relationship between type 2 DM and periodontal disease. Conclusions: The patients with diabetes retinopathy appear to show increased periodontal disease susceptibility

The Impact of Fasting on Metabolic and Anthropometric Parameters in Type II Diabetic Patients: A Prospective Observational Study

Introduction: Fasting has certain effects on metabolic and anthropometric parameters in diabetic patients. It is therefore, necessary for patients to receive proper instructions about their physical activities, eating habits, blood glucose monitoring and medications. Aim: To investigate the effects of fasting on metabolic and anthropometric indices in type II diabetic patients. Materials and Methods: This prospective observational study was performed during Ramadan 2018. The study population consisted of 40 type II diabetic patients (33 females and 7 males) who wished to fast. They started to follow given instructions on their physical activity, eating habits, blood glucose monitoring, and medications before Ramadan. Anthropometric variables were measured pre and post-Ramadan. Fasting Blood/Plasma Glucose (FBG/FPG), Glucose 2 Hour Postprandial (2h PPG), glycosylated haemoglobin (HbA1c), and the lipids profile were assessed before and after Ramadan. FPG and 2h PPG were also evaluated on the fifteenth day of Ramadan. Data were presented as mean±SD. Paired t-test was employed and a p-value of <0.05 was considered statistically significant. Results: After completion of the study, anthropometric variables of patients, including weight (74.9±12.7 vs. 73.0±13.1 kg, p<0.001), BMI (29.9±5.2 vs. 29.0±5.1 kg/m2 , p=0.042), waist circumference (106.2±11.8 vs. 105.3±11.6 cm, p<0.001), conicity index (9.94±0.96 vs 9.80±0.99, p=0.085), systolic blood pressure (118.5±10.6 vs. 113.8±9.4 mmHg, p=0.018), Diastolic blood pressure (72.0±7.9 vs. 68.3±7.0 mmHg, p=0.02) and FPG (125.1±27.4 vs. 105.2±21.4 mg/dL, p<0.001) decreased significantly. However, serum triglyceride increased significantly (127.5±45.5 vs. 166.5±53.5 mg/dL, p<0.001) after fasting compared to pre-Ramadan measurements. Changes in other variables were not statistically significant. Conclusion: The results of this study indicate that fasting had beneficial effect on fasting blood glucose level and anthropometric parameters in type II diabetic patients