hamid reza niazkar

Identifying subjects that are at risk of type 2 diabetes mellitus (T2DM) and predicting the associated risk factors are highly important. Thus, this study aimed to explore the risk factors and find the prediction model for T2DM using decision trees (DTs) and random forest (RF) models.

This cross-sectional study is a part of the Kharameh Cohort Study. Kharameh Cohort is a part of the Fars Cohort, which started in 2014 with 10663 people aged 40–70. In this study, the risk factors of T2DM were explored using two data mining methods. Accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were applied to evaluate the models. The data were statistically analyzed using R software.

The DT modeling showed that age, triglycerides (TG), physical activity, systolic blood pressure, low-density lipoproteins (LDL), and body mass index (BMI) were the most associated factors in D2MT, while applying RF revealed that fasting blood sugar, cholesterol, creatinine, TG, gamma-glutamyl transferase physical activity, BMI, and LDL were the most effective on T2DM. The RF model was superior to the DT based on the applied criteria. Sensitivity, specificity, accuracy, and AUC for the RF were 73.4, 70.10, 73.5, and 79.1. These findings for the DT were 63.8, 69.7, 62.8, and 66.8, respectively.

Based on the inferences, a strong association was found between several risk factors and the risk of T2DM. Therefore, predictive analytics using the RF model can be applied to identify the risk factors of other chronic diseases.

platelet count errors such as PU flag, could cause misdiagnosis.

Case report:

 a 36-year-old thalassemia minor male with fever and myalgia presented. Petechiae and purpura in the lower extremities of patients were observed in physical examination. The platelet count was assessed by Nihon Kohden’s Celltac G cell and Sysmex XP-300 cell counter and the platelet count was reported 10,000/μL and 129,000/μL respectively. But peripheral blood smear assessment confirms that the result of the Sysmex XP-300 cell counter was wrong and a platelet flag was seen. This situation can be corrected by the CBC histogram and peripheral blood smear evaluation.

Sysmex XP-300 cell counter inability to differentiate severely microcytic cells from platelets can cause the PU error, which means the severe microcytic RBCs were counted as platelets that cause the platelet count falsely higher than the actual number in this patient. The PU flag means the platelet histogram intersects the PU line and does not touch the zero baseline, that occur in conditions such as platelet clumps, giant platelet, microcytic and fragmented or dysplastic RBCs in hemolytic anemia. In Nihon Kohden’s Celltac G cell counter, due to the change in the PU line this error was prevented and the actual platelet count of the patient was reported. By the way, to avoid such errors, abnormal platelet counts should always be confirmed with the findings of PBS. ConclusionPoikilocytosis such as microcytic RBCs can cause the PU flag, so platelet and erythrocytes histograms and PBS evaluation should be assessed.

The current study was conducted on adult male models to assess the impact of the Syzygium aromaticum (clove) extract on male fertility factors and oxidative stress after torsion/detorsion using the intrauterine insemination (IUI) method.

This experimental study was performed on 56 adult male Wistar rats including 28 males and 28 females. The male subjects were randomly assigned to four groups of sham (G1), 4 hours of testicular torsion following a surgical torsion/detorsion (TD/G2), TD treated with the clove extract (4 mg/kg, orally/G3) 30 minutes before detorsion, and healthy subjects treated with the clove extract (4 mg/kg/G4). The levels of blood testosterone and some oxidative stress indices were investigated in the testis tissue. In addition, some sperm parameters were evaluated, including the concentration, motility, and morphology of the sperm. Finally, the fertilization potential of adult female rats was assessed through the IUI method.

The histological evaluation revealed considerable adverse changes in the G2 in comparison with the sham group. The serum levels of testosterone, and glutathione peroxidase, and superoxide dismutase meaningfully reduced in the testis of rats in the G2. In addition, the malondialdehyde level was significantly higher during the ischemia although all the mentioned changes improved in the treated groups. Nonetheless, the sperm quality and fertility power considerably reduced in the G2 compared to the sham group.

The results of the current experimental study demonstrated that the testicular torsion/detorsion has an adverse impact on the testis function and decreases the fertilization potential, and finally, treatment with the clove extract can improve these adverse changes.

The Coronavirus disease 2019 (COVID-19), which was declared to be pandemic on March 12, 2020, is the latest health concern worldwide. COVID-19 patients may develop cerebrovascular complications either during the course of COVID-19 or even as an initial presentation of the disease. Herein, a case of myocarditis in a COVID-19 patient without any respiratory signs and symptoms is presented.

Maternal immunity to Toxoplasma gondii is critical during pregnancy. Non-immunized women may be at the risk of toxoplasmosis during pregnancy. This parasite can pass through the placenta to the fetus and causes severe complications in the fetus. This study aimed to investigate the seroepidemiology of Toxoplasma infection in pregnant women of Gonabad.

Three hundred blood samples were collected from pregnant women and abortive women of 18-40 years old who referred to the health centers and hospitals of Gonabad. The immunoglobulin G (IgG) and immunoglobulin M (IgM) antibody titers were measured by the enzyme-linked immunosorbent assay.

The samples were taken from 252 (84.0%) pregnant women and 48 (16.0%) women with abortion. The average age of these women was 29.23 ± 6.24 years. Among these subjects, 56 (22.2%) pregnant women and 15 (31.3%) women with a history of abortion had anti-Toxoplasma IgG antibodies while 196 (77.8%) pregnant women and 33 (68.7%) women with abortion history did not have this specific antibody. Based on the results, 3 (1.2%) pregnant women had IgM antibodies while this antibody was not observed in any woman with a history of abortion. Finally, the prevalence of toxoplasmosis was 23.6%.

According to the results, 76.33% of pregnant and abortive women in Gonabad have no history of Toxoplasma infection. Therefore, they are prone to toxoplasmosis infection during their pregnancies. In this regard, it is necessary to establish public health and preventive actions, as well as a rapid diagnosis to eliminate risk factors during pregnancy

Chemical drugs and herbal medicine play a significant role in the management of diabetes mellitus complications. The aim of this study was to investigate the effects of Fumaria parviflora as an herbal source and glibenclamide as a chemical drug, on the liver tissue of diabetic rats.

Male Wistar rats (n=32) were classified randomly into four groups (8/group), including control, diabetic (induced by 50mg/kg streptozocin), 250mg/kg hydroalcoholic extract of Fumaria parviflora (DFP) and 5mg/kg glibenclamide groups. After 21 days of treatment, liver tissues and blood samples were stored at -80°C to test lipid profile, liver enzymes and some oxidative stress markers.

In the diabetic group compared to the control group, the activities of SOD and GPx and also the serum levels of alkaline phosphatase were significantly decreased, while the levels of malondialdehyde, alanine aminotransferase and aspartate transaminase enhanced. Treatment with DFP and glibenclamide could manage the levels of all mentioned-parameters. Furthermore, in both treated groups, the rate of damages in the liver of rats reduced compared to the diabetic group.

According to the obtained results, the administration of DFP or glibenclamide could ameliorate the deleterious effects of diabetes mellitus on some investigated-parameters. As there were no difference between DFP and glibenclamide effects, Fumaria parviflora could be considered as an alternative drug, at least for the diabetic complications examined in this study. However, further investigation is needed.

The Rh blood group system is a complex blood group which includes different antigen specificities such as c antigen. Anti-c antibody is associated with both acute and delayed hemolytic transfusion reactions as well as hemolytic disease of the newborn (HDN). Rh mediated hemolytic transfusion reactions (HTR) are mostly immunoglobulin G (IgG) mediated and results in extravascular hemolysis and delayed HTR (DHTR). However, we are presenting a case of acute intravascular hemolytic transfusion reaction due to anti-c in a patient with acute subdural hematoma. A 77-year-old woman was referred to our hospital with a loss of conscious and left-sided hemiparesis. After an emergency MRI, she was diagnosed with Acute Subdural hematoma, and an emergency craniotomy was performed. Since Acute Subdural hematoma is a neurosurgery emergency, laboratory technician performed an Immediate-spincrossmatchedd for blood bag to preserve time. During the transfusion of the first packed cell, the patient developed severe hypotension and tachycardia. Thus, the transfusion was stopped. Laboratory results raised the suspicion of an Acute Intravascular Hemolysis. Antibody identification revealed that the patient had an irregular blood phenotype (C2+/c-/E-/e3+/K-), and the presence of alloantigen-c Rh antibody confirmed the suspicion of HTR. In patients with multi transfusion history and pregnant women, pre-transfusion screening of irregular antibodies must be performed. The immediate spincrossmatchh must be prevented in patients with a history of multi transfusions, even in emergency situations.

Diabetes mellitus (DM) is a metabolic disorder with a high prevalence, which affects approximately 25% of the world’s population. This systematic review aimed to assess the Iranian research regarding the effects of medicinal plants on pancreatic beta cells in diabetes.

This systematic review was conducted via searching in databases such as Medline, PubMed, Google Scholar, and ScienceDirect until April 2018. The studied that were published in Iran, peer-reviewed, and designed as a randomized control trial on type I diabetes were retrieved and screened.

The initial search results of the electronic databases yielded 822 relevant articles. After two stages of screening, checking the references, and removing the duplicate articles in various databases, 18 articles were finally selected for the review.

According to the results, medicinal plants have a positive impact on the performance of pancreatic beta cells in animal models through various mechanisms, such as increasing the number, size, regeneration, and reduction of the inflammation of beta cells.

Parasitology is a course filled with many complicated terminologies. In this study, a guide was designed to facilitate the learning of parasitology. More precisely, an annual educational calendar of medical parasitology was designed based on the weeks of education and its effectiveness was assessed in university students of medical sciences.

This cross-sectional study included 174 students who were randomly divided into two intervention and control groups. At the baseline, the students were tested with a questionnaire at the beginning of each teaching session and the end of the intervention. In addition, another questionnaire was used to compare the attitude and satisfaction of students in two groups. Finally, the scores of the students were entered in SPSS 16 for analysis.

The results of parametric tests showed that the mean scores of laboratory and medical students during several tests in different sessions were significantly different in the two groups.

The educational calendar is a new method in medical education, especially in the field of medical parasitology. This calendar as an educational supplement, emphasizes on students’ active learning and contributes to improving the quality of teaching the parasitology course in addition to meeting their educational needs.

Eosinophilic gastroenteritis is a rare disease with unknown etiology. It is characterized by the eosinophilic infiltration of one or more layers of the gastrointestinal tract. Recently, the authors visited a rare case of eosinophilic gastroenteritis. A 30-year-old woman was admitted to our hospital complaining of acute-onset excessive abdominal pain in the periumbilical region and chronic diarrhea. Physical examination revealed a distended abdomen with tenderness. Complete blood count showed moderate eosinophilia with elevated IgA serum levels. Computed tomography of the abdomen and pelvis was normal. Upper endoscopy (with taking biopsy samples from the stomach and duodenum) and total colonoscopy (with taking biopsy sample from the rectum and ascending colon) were performed. The pathological examination showed a non-destructive colitis with increased mucosal eosinophilia throughout the entire thickness of the ascending colon and duodenum. Rectal and gastric biopsy samples did not show any signs of eosinophilic infiltration. After ruling out of other causes of eosinophilia, eosinophilic gastroenteritis was diagnosed. The patient recovered well after treatment with prednisone (40 mg/day) over two weeks and was free from gastrointestinal symptoms at the time we reported her disease.

Factor V Leiden, Prothrombin gene (G20210A) and MTHFR (C677T) polymorphism are the main biomarkers for evaluation of tendency for venous thromboembolism. We aimed to investigate the frequency of mutations in factor V Leiden, Prothrombin G20210A and MTHFR C677T and identify the genetic status for these mutations in patients with venous thrombosis.

This study was carried out in 312 patients with venous thrombosis who were referred to “Thrombosis Clinical center”, Imam Khomeini Hospital, Tehran, Iran and “Sarvar Clinic”, Mashhad, Iran. Identification of gene mutations was performed using PCR-restriction fragment length polymorphism (RFLP)-based method.

The prevalence of Factor V Leiden mutation was 35.8%, while 8.9% of them were homozygous for AA allele and 26.9% had the GA allele in heterozygous state. The prevalence of MTHFR (C677T) mutation was 17.9% of which 7.1% had the TT mutant allele in homozygous and 10.8% had CT allele in heterozygous state. The prevalence of mutation in prothrombin gene G20210A was 8.9% with all cases heterozygous for GA mutant allele.

In our study from two referral centers for thrombotic disorders, the prevalence of mutations in gene encoding factor V Leiden was higher than Prothrombin 20210A and MTHFR C677T polymorphisms. Therefore, assay for factor V Leiden mutation has the first priority in the evaluation of patients with hereditary thrombophilia in these geographical regions.

This study aimed to evaluate the anti-oxidative potential of Galega officinalis extract on oxidative damages in the testes and sperm parameters of diabetic rats. In this experimental study, 32 male Wistar rats were segregated in 4 groups: Control, Diabetic control, Diabetic treated with G. officinalis extract and healthy group that received G. officinalis extract. An instillation of distilled water was performed in the control and diabetic groups. Also, treatment groups received Galega extract (50 mg/kg body weight) for 8 weeks. After treatment period all of subjects were anesthetized, their blood samples were taken, the serum level of insulin and glucose were measured then the testicles and epididymis were removed and sperm parameters and oxidative stress markers were assessed. Treatment of diabetic rats with G. officinalis extract significantly increased the Johnson score and diameter of seminiferous tubule as well as reduced the glucose plasma levels (P = 0.001) and increased the insulin levels (P = 0.001). Furthermore, during diabetes an upsurge in the level of malondialdehyde (MDA) and a decrease in the levels of superoxide dismutase (SOD) and catalase (CAT) enzymes activity were observed in the testes. Administration of G. officinalis extract (50 mg/kg BW) significantly rectified these parameters (P < 0.05). Moreover, the sperm parameters decreased in the diabetic group, while the use of G. officinalis significantly improved the mentioned disorders in the treatment groups (P < 0.05). The results of this study confirm the antioxidant role of hydroalcoholic extract of G. officinalis in the improvement of the testicular oxidative damage caused by diabetes.

Idiopathic thrombocytopenia purpura (ITP) is an autoimmune disorder characterized by isolated thrombocytopenia and mucocutaneous bleeding. The former has a primary role in the diagnosis and treatment of ITP. One of the leading causes of miscounted platelets in patients who suffer from ITP is giant platelets which may indicate factitiously a severe false thrombocytopenia. Here, a case of macrothrombocytopenia is presented in an ITP patient. Giant platelets of this patient not only resulted in miscounting platelets but also falsely increased reading of RBC counts. By counting platelets through peripheral blood smear and hemocytometer, the patient was saved from an unnecessary splenectomy.