Caspian Journal of Internal Medicine最新文献

Background: Early colorectal cancer (CRC) detection helps reduce the mortality rate. This study aimed to investigate colon lesions in individuals with positive and negative fecal immunochemical test (FIT) results among the (PERSIAN) Guilan cohort study (PGCS) population.

Methods: This cross-sectional study was conducted on 1158 participants over 50 who were volunteers for the FIT stool test at the Endoscopy Department of Razi Hospital, Rasht, Iran, from 2021 to 2022. The FIT test was screened for all participants, and for 172 individuals (86 individuals from each group with positive and negative FIT results), a colonoscopy was performed to investigate the colon lesions. Demographic/clinical characteristics, FIT results, colonoscopy findings, and the Bristol Stool Chart were completed. All data were analyzed using SPSS Version 16, considering a significant level<0.05.

Results: Out of 1,158 participants, 86 had positive FIT results, and 172 (52.3%) were females. The colonoscopy results showed that 34.3% of the patients had colon lesions. Individuals with positive FIT exhibited a significantly higher prevalence of colon lesions (p<0.001). No statistically significant differences were observed between positive and negative FIT results, demographic and clinical characteristics, and the location of lesions in individuals with colon lesions (p>0.05). Moreover, there was a significant difference in pathological findings and the presence of adenomatous polyps regarding the FIT results (p<0.001).

Conclusion: The effectiveness of FIT in the initial stages of screening for early lesion detection is considerable, especially for individuals with upper age.

[This corrects the article on p. 690 in vol. 15, PMID: 39359446.].

Background: The Chiari network consists of movable, mesh-like structures occasionally observed in the right atrium proximate to the openings of the inferior vena cava and coronary sinus.

Case presentation: This case discusses a 75-year-old male initially suspected to have acute pulmonary thromboembolism, but we misdiagnosed the Chiari network as a thrombus in the right atrium. Subsequent echocardiography revealed a Chiari network in the right atrium. Accurate identification using transthoracic echocardiography, Doppler echocardiography, is crucial.

Conclusion: Accurate identification of the Chiari network is essential for optimal patient care. Thorough evaluation is crucial in cases suggestive of acute pulmonary thromboembolism or right atrium thrombus.

Background: This case of pancytopenia due to hypothyroidism and B12 deficiency is rare and severe as a reminder that, upon diagnosis of pancytopenia, endocrine disorders such as secondary thyroid hormone deficiency may need to be considered as a potential cause.

Case presentation: A 38-year-old male presented with progressive weakness, lethargy, and anorexia. Initial labs revealed severe pancytopenia, prompting a hematological workup. Bone marrow aspiration ruled out acute leukemia. Further investigations identified severe primary hypothyroidism (TSH: 200 mIU/L) and vitamin B12 deficiency as the underlying causes, after excluding other common etiologies. Treatment with levothyroxine and vitamin B12 was initiated. The patient showed a rapid and significant hematological response, with all cell lines improving and approaching normal ranges on follow-up, confirming the diagnosis.

Conclusion: In this patient, after the diagnosis of hypothyroidism and receiving levothyroxine, we saw a better stability of the improvement of the patient's symptoms and a further improvement in the number of any blood cell lines chiefly platelet which is one of the regulators of the coagulation pathway, and its deficiency increase the risk of bleeding.

Background: The aim of this study was developing and comparative analyzing prediction models using a Cox proportional hazards model with and without frailty, random survival forests (RSF) and survival support vector regression (SVR).

Methods: In this study, 2800 patients with STEMI have been used and two machine learning methods for survival analysis have been applied: RSF and SVR, then the Cox model with and without frailty has been employed. The main outcome was 1-year mortality after STEMI. In this study, 16 variables have missing data. After applying four multiple imputation via chained equations methods, the "Sample" algorithm was selected as the appropriate model with complete data and the modeling process was continued with this data and Hazard Ratio (HR) were calculated.

Results: Overall, 1628 (58.1%) patients received primary percutaneous coronary intervention and 737 (26.3%) received thrombolytic therapy. Based on the experimental results, between all the models, the Cox with frailty model performed the best, with the highest overall C-index (0.891) and time-dependent area under the curve (0.9134) and the least Brier score (0.0458). Ever smoking (HR= 1.46), systolic blood pressure (HR= 0.98), left ventricular ejection fraction (HR= 0.96), glomerular filtration rate (HR= 0.96), and reperfusion therapy (No reperfusion HR= 2.71) independently associated with 1-year mortality of STEMI patients.

Conclusion: The findings suggest that there are advantages in developing frailty models further than the fundamental Cox proportional hazards regression for estimating the likelihood of survival for STEMI patients to account for the unobserved heterogeneity in grouped observations.

Background: Cancers of the brain and central nervous system, with more than 250,000 deaths in 2020 and an age-adjusted mortality rate of 3.05 per 100,000, rank twelfth in mortality among various cancers. Our study aimed to investigate the crude rate, age-standardized mortality rate (ASMR) and the trends of brain and CNS malignancies over nine years in northern Iran.

Methods: This cross-sectional study conducted a thorough analysis of mortality caused by brain and CNS cancers in Babol between the years 2013 and 2021. Death registration and classification systems at Babol University of Medical Sciences were used to collect the cause-of-death data. A census sampling method was used to determine the number of brain and CNS cancers deaths. All analyses were done using SPSS Version 22 and STATA Version 14. The significance level was set at (p<0.05). The crude and age-standardized mortality rate was calculated. The Cochran-Armitage Trend Test was utilized to determine the mortality trend.

Results: The crude rates and ASMRs for brain and CNS cancers increased, from 3.3 and 3.2 per 100,000 people in 2013 to 7.0 and 6.3 per 100,000 in 2021, respectively (p < 0.001). Additionally, over the nine years, an increasing trend was explicitly observed for brain cancer (p < 0.001), while the trends for other cancers remained stable.

Conclusion: The ASMR and the trend of brain and CNS cancers are on the rise. This study's findings could be beneficial for designing monitoring programs and investigating cancer risk factors.

Background: Chronic tonsillitis can lead to various complications in childhood. Various treatment methods, including pharmaceutical treatments, surgery, and complementary medicine, have been used to treat it. Iranian traditional medicine has mentioned the effects of black mulberry on tonsillitis. Hence, this study aimed to investigate the effects of black mulberry syrup on tonsil hypertrophy.

Methods: This controlled clinical trial study involved 5- to 15-year-old children referred to Bu-Ali Hospital, Sari. First, 76 patients were allocated equally to the intervention or control groups using randomized blocks of four. In a three-week period, the intervention group received black mulberry syrup, whereas the control group received the placebo. Data analysis was done in SPSS Version 20, using Mann-Whitney U and McNemar tests.

Results: The study results revealed significant differences between the intervention and control groups regarding the primary outcomes of the intervention, including the size of the tonsils, oral breathing during sleep, nocturnal snoring, and hypernasal speech (P=0.001). The intervention group showed significant improvement in these symptoms compared to the control group.

Conclusion: The findings of this study suggest that black mulberry syrup effectively alleviated tonsillitis symptoms in the intervention group compared to the control group. In addition, no side effects or drug complications were reported in any study participants.

Background: Postmenopausal women with symptomatic knee osteoarthritis (KOA) may be at increased risk of bone loss due to reduced physical activity. However, findings on the association between KOA and osteoporosis have been inconsistent. This study aimed to assess the relationship between symptomatic KOA and bone mineral density (BMD) in postmenopausal women.

Methods: Postmenopausal women with symptomatic KOA were recruited from a rheumatology clinic. KOA was diagnosed according to the American College of Rheumatology (ACR) criteria. Age-matched postmenopausal women without clinical KOA served as controls. BMD at the femoral neck (FN) and lumbar spine (LS) was measured using dual-energy X-ray absorptiometry (DXA). Osteoporosis was defined as a T-score < -2.5 at either site. Statistical analyses included Student's t-test, chi-square test, and multiple regression analysis. Data were analyzed using SPSS software.

Results: Seventy participants (35 KOA patients and 35 controls) with mean ages of 61.9±8.7 and 58.8±6.8 years, respectively (P = 0.67), were included. No significant differences in BMD were found between the groups. However, multiple regression analysis revealed that obesity was significantly associated with a reduced risk of osteoporosis (OR = 0.23; 95% CI: 0.058-0.945).

Conclusion: This study found no significant association between symptomatic KOA and osteoporosis in postmenopausal women. Interestingly, obesity appeared to have a protective effect against osteoporosis. Further large-scale, long-term studies are needed to confirm these findings and explore underlying mechanisms.

Background: Zinc oxide (ZnO) nanoparticles are particularly notable in the biomedical field, especially for antimicrobial applications, due to their beneficial properties. This study aimed to investigate the antimicrobial activity of ZnO nanoparticles against Pseudomonas aeruginosa (P. aeruginosa) isolated from clinical samples.

Methods: A microdilution test was conducted to assess the effectiveness of the synthesized against P. aeruginosa. Additionally, the impact of the zinc oxide nanocomposite on the expression of biofilm-related genes, including algD, lecA, and lecB, was measured using the Real-Time PCR method.

Results: The minimum inhibitory concentration (MIC) of the ZnO nanocomposite against P. aeruginosa was found to be 625 µg/ml. At half the MIC concentration, ZnO nanoparticles demonstrated a 54% inhibition of biofilm formation. The expression levels of the algD, lecA, and lecB genes were reduced by 3.3 (p < 0.001), 1.8 (p < 0.05), and 3.1 folds (p < 0.05), respectively.

Conclusion: Overall, ZnO nanoparticles, by reducing the expression levels of the algD, LecA, and LecB genes in P. aeruginosa, can be utilized as a novel therapeutic approach to improve and treat infection-related biofilms.

Background: The relationship between epicardial fat and coronary stenosis has been a topic of recent discussion. This study aimed to determine the correlation between epicardial fat volume and coronary artery stenosis in patients undergoing CT angiography.

Methods: In this descriptive/cross-sectional study, 240 patients with low to moderate risk of CAD, referred to the CT angiography unit of Farshchian Hospital in Hamadan in 2023, were selected via the Census method. Coronary artery stenosis was assessed using a 128-slice multi-detector CT scan, while epicardial fat volume was measured using CT scan analysis. Statistical analyses were performed using SPSS software Version 21, with a significance level set at 0.05.

Results: The mean age of the patients was 54.69 years, with 52.5% being males. The mean epicardial fat volume was 76.64 ml, and 58.3% of the patients had coronary artery stenosis. The mean epicardial fat volume in patients with coronary stenosis was 82.82±31.41 ml, compared to 65.66±25.79 ml in those without stenosis (p<0.001). There was a significant positive correlation between epicardial fat volume and patients' age, calcium score, vessel score, and LDL levels. Additionally, the mean epicardial fat volume in patients with both obstructive and non-obstructive stenosis in the LAD and LCX was significantly higher than in vessels without stenosis (P < 0.05).

Conclusion: Epicardial fat volume is significantly associated with coronary artery stenosis and calcium score. Therefore, it can be utilized to determine and predict the presence and severity of coronary artery stenosis.