Journal of Research in Medical Sciences
Volume:23 Issue: 5, May 2018

People of all ages can su?er from Henoch?Schönlein purpura (HSP), but it is the most common vasculitis in childhood. Te most important involving gene is located on chromosome 6p21.3, a region coding for human leukocyte antigens (HLAs). Among HLA genes, because of the high rate of polymorphisms, HLA?DRB1 is estimated to have a strong association with HSP. In this study, we aimed to assess the association of HLA?DRB1 alleles with HSP in Iranian children.
Tis study consisted of thirty Iranian children with HSP and 35 healthy controls. Genomic DNA was extracted, and HLA typing was performed by polymerase chain reaction with sequence?specifc primers technique.
Te results have shown that HLA?DRB1*01 and HLA?DRB1*11 (P = 0.002, odds ratio [OR] = 7.579, confdence interval [CI] = 1.934–29.697 and P = 0.039, OR = 3.333, CI = 1.030–10.788), respectively, are the most frequent alleles associated with HSP in Iranian children population. Te frequency of other alleles was not signifcantly di?erent in both groups. Te results also show no correlation between HLA types and disease manifestations.
According to these results, there is an association between HLA?DRB1*01 and HLA?DRB1*11 gene polymorphisms and susceptibility to HSP in our study group.

Lower gastrointestinal (GI) bleeding is a common clinical problem in young patients. Te management of this disease in patients is challenging. Te aim of this study is to compare sigmoidoscopy with full colonoscopy in these patients.
In this cross?sectional study, 120 eligible patients under 50 years old with acute rectal bleeding were enrolled. After cleaning the colon, initially the patients underwent sigmoidoscopy. Pain, the comfort of the test by physician and patient, duration of the procedure, and pathologic fndings were recorded. Te procedure continued until the splenic ?exure passed in the ileocecal valve, and this stage was considered as proximal colonoscopy. Pain, easy performance by physician and the patient, duration of procedure, and pathologic fndings were recorded in this stage too. Te variables in the two stages were compared with each other.
Tere were 66 women (55%) and 54 men (45%) and the mean of age was 41 ± 7.9 years. Proximal colonoscopy from splenic ?exure to reach cecum was relatively easier for the physician and the patient than sigmoidoscopy (P It is advised to perform full colonoscopy than sigmoidoscopy in young patients with lower GI bleeding.

Te objective of the study was to determine whether serum levels of procollagen type 1 N propeptide (P1NP), a bone formation turnover marker, di?ers between diabetic foot ulcer with osteomyelitis (DFO) and diabetic foot ulcers without osteomyelitis serving as controls. It was also aimed to assess the usefulness of P1NP in diagnosing DFO compared to other common in?ammatory markers.
A case–control study was designed comparing the aforementioned groups. Patients were classifed as osteomyelitis and controls based on the International Working Group diagnostic criteria. Serum P1NP and three other in?ammatory markers, namely, C?reactive protein (CRP), white blood cells (WBC), and platelets were analyzed on patients with DFO and ontrols.
Te mean serum P1NP levels were signifcantly higher in the DFO group (n: 16), 10.5 ± 5.2 (ng/ml), than the control group (n: 11) 3.1 ± 2.8 (ng/ml), P = 0.001. P1NP showed the highest sensitivity/specifcity 86.7%/80% compared to 70.6%/80%, 56.2%/45.4%, and 50%/37% for CRP, WBC and platelets, respectively. Receiver operator characteristic curves showed the best value of area under the curve of 0.9 for P1NP compared to 0.85, 0.54, and 0.46 for CRP, WBC, and platelets.
We found marked elevation of serum P1NP in diabetic foot ulcer with bone infection with potential value in using it to diagnose DFO.

Since the increase in some tubular damage biomarkers can be observed at the early stage of diabetic nephropathy, even in the absence of albuminuria, we aimed to investigate if urinary albumin is superior than tubular damage marker, such as serum retinol?binding protein 4 (RBP4), in predicting renal function decline (defned as estimated glomerular fltration rate [eGFR] A total of 106 sedentary T2D patients (mean [± standard deviation] age 64.9 [±6.6] years) were included in this cross?sectional study. Anthropometric and biochemical parameters (fasting glucose, glycated hemoglobin [HbA1c], lipid parameters, creatinine, RBP4, high sensitivity C?reactive protein [hsCRP], urinary albumin excretion [UAE]), as well as blood pressure were obtained.
HsCRP (odds ratio [OR] =0.754, 95% confdence interval [CI] (0.603–0.942), P = 0.013) and RBP4 (OR = 0.873, 95% CI [0.824–0.926], P Although serum RBP4 showed excellent clinical accuracy, just like UAE, a combination of markers of tubular damage, in?ammation, and traditional markers has the higher sensitivity and specifcity than UAE alone for prediction renal impairment in patients with T2D.

In this study, we investigated the associations of erythrocytes fatty acid composition, activities of delta?5 desaturase (D5D) and delta?6 desaturase (D6D), and other metabolic risk factors, with type 2 diabetes (T2D) risk to determine if rs174583 polymorphism of FADS2 gene had any e?ect on these associations.
Fatty acid profle of erythrocytes was determined using gas chromatography?mass spectrometry in 95 T2D patients and 95 apparently healthy participants. Te genotypes of single?nucleotide polymorphism (SNP) of FADS2 gene were determined using the polymerase chain reaction?restriction fragment length olymorphism technique. Other biochemical parameters were measured in the serum using standard analytical procedures.
D6D activity was increased (P In the population studied, there was a strong association in the erythrocytes fatty acid composition, D5D and D6D activities and other metabolic risk factors between non?T2D and T2D patients. In addition, there was a strong association in erythrocytes DGLA and AA contents and D5D activities between rs174583 genotypes in all participants. However, the distribution of rs174583 genotypes did not di?er signifcantly between T2D patient and controls, and it did not appear to be an association between rs174583 SNP and incident of T2D.

Elevated blood pressure is still one of the major risk factors for diseases and disabilities and also a public health challenge worldwide. In the present longitudinal study, we aimed to evaluate the association between risk of hypertension and dietary advanced glycation end products (AGEs) as a recently discussed potential risk factor.
Dietary assessment of 1775 participants in the third phase of Tehran lipid and glucose study to obtain dietary intake of AGEs was performed using a validated semi?quantitative food frequency questionnaire, and they were followed up for a mean duration of approximately 6 years. To determine the incidence of hypertension across quartiles of AGEs intake, logistic egression models with adjustment for potential confounding variables were used. All statistical analyses were conducted using SPSS, and P Higher hypertension occurrence risk was generally attributed to higher AGEs intake quartiles after adjusting for age in men (odds ratio [OR] = 1.48, 95% confdence interval [CI] = 1.11–1.52, P = 0.038) and additional adjustment for smoking, drugs, and physical activity in women (OR = 1.38%–95% CI = 1.09–1.42, P = 0.042). Moreover, across the increasing trend of dietary AGEs intake, the percentage of fat intake increased and that of carbohydrate signifcantly decreased (P In conclusion, it is highly recommended to limit dietary AGEs consumption to prevent and manage hypertension and its complications. Key words: Advanced glycation end products, hypertension, risk, Tehran lipid and glucose study

Signifcance of platelet distribution width (PDW) and mean platelet volume (MPV) in assessing disease activity of systemic lupus erythematosus (SLE) remains unclear. Tis study was aimed to evaluate PDW and MPV as potential disease activity markers in adult SLE patients.
A total of 204 study participants, including 91 SLE patients and 113 age? and gender?matched healthy controls, were selected in this cross?sectional study. Tey were classifed into three groups: control group (n = 113), active SLE group (n = 54), and inactive SLE group (n = 37). Demographic, clinical, and laboratory data were analyzed.
In patient group, PDW was statistically higher than that in control group (13.54 ± 2.67 vs. 12.65 ± 2.34, P = 0.012), and in active group, PDW was signifcantly increased compared to inactive group (14.31 ± 2.90 vs. 12.25 ± 1.55, P Tis study frst associates a higher PDW level with an increased SLE activity, suggesting PDW as a novel indicator to monitor the activity of SLE.

Doppler ultrasonography (Doppler US) plays an important role in evaluating patients with liver cirrhosis. Tis study aims to investigate the hemodynamic alterations of hepatic artery and portal vein among children with liver cirrhosis and portal hypertension (esophageal varices).
We conducted an analytical cross?sectional study in Imam Hossein Children’s Hospital, Isfahan, Iran, in 2016. A number of 33 cirrhotic children with or without esophageal varices were selected through convenience sampling method to be compared with 19 healthy children as controls using color and spectral Doppler US.
Portal vein mean velocities were 15.03 ± 7.3 cm/s in cirrhotics, 16.47 ± 6.4 cm/s in controls (P = 0.51), 11.6 ± 4.7 cm/s in patients with varices, and 17.9 ± 7.3 cm/s in patients without varices (P = 0.015). Mean diameters of caudate lobe, portal vein, and splenic vein, as well as the mean values of liver and spleen span, were signifcantly higher in cirrhotic children. Te frequency of ?ow reversal (hepatofugal ?ow) was not detected signifcantly di?erent in cirrhotics. Peak systolic velocity, end diastolic velocity, pulsatility index, and resistive index for hepatic artery as well as liver vascular index were not signifcantly di?erent in cirrhotics in comparison with controls.
Alterations in Doppler parameters of portal vein including diameter and velocity may be the helpful indicators of liver cirrhosis and esophageal varices in children, respectively. Parameters of hepatic artery may not di?erentiate children with liver cirrhosis.

Hashemi et al recently published an article with title: Hyperimmunoglobulin E syndrome: Genetics, immunopathogenesis, clinical findings, and treatment modalities in your journal that it is a good paper. Despite without limitation for searching, there are not a few of related papers in their working.
Incidence of Hyperimmunoglobulin E syndrome (HIGE) is 1/100000 to 1/200000. This syndrome divided in two groups including; autosomal dominant with mutation in signal transducer and activator of transcription-3 (STAT 3) (chromosome 17, MIM=147060) type one and autosomal recessive with mutation in Dedicator of Cytokinesis 8 (Dock-8) (chromosome 9, MIM=243700) (type2) (1).
Mutations of autosomal recessive HIES-like disorders following;
1. Tyrosine kinase 2 gene (TYK2), encoded on chromosome 19p13.2 (MIM #611521).
2. Phosphoglucomutase 3 gene (PGM3), which encodes an enzyme in the biosynthesis of N-glucans (MIM #615816) (2).
About skin manifestations of HIGE syndrome, we reported a boy (16-year-old) of HIGE presented with skin psoriasis disease from one year ago. His history was recurrent infections including otitis media, pneumonia, diarrhea and skin infection. Histologic finding was hyperkeratosis; parakeratosis of acanthotic epidermis with regular elongation of rete ridges.
This is the first report of association or relation between hyperactive IgE immunoglobulinemia and psoriasis disorder.
We reported another case of HIGE whit recurrent infections and pneumatocle in the left and right of lung. Because there were multiple large pneumaocles, there was no possible surgery.
The role of Bone Marrow Transplant (BMT) has different results. Hematopoietic stem cell transplantation (HSCT) was done for different kinds of HIES, but information and experience about the long term results of this therapy is little (1).
Recently studies suggest that HSCT can improve immunologic parameters and reduce frequency and severity of infections although Nonhematologic organ failers are not corrected (5).