فهرست مطالب
Journal of Disease and Diagnosis
Volume:12 Issue: 2, Apr 2023
- تاریخ انتشار: 1402/02/02
- تعداد عناوین: 8
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Pages 57-62Background
Controlling hypertension is a key component in the management of cardiovascular risk factors and is an essential part of the prevention strategy.
Materials and MethodsThis descriptive cross-sectional study was conducted in seven integrated health centers covering most families in Bandar Abbas from July 2019 to February 2020. The sample size was estimated to include 968 individuals. Independent samples t-test and Chi-square test were used to compare groups. In addition, some factors affecting uncontrolled blood pressure were identified using logistic regression.
ResultsIn this study, 68.4% and 31.6% were women and men, respectively, of whom 136 cases were single, while 756 cases were married. With an increase in age, the prevalence of uncontrolled hypertension in both genders showed a significant increase (P < 0.001). Univariate logistic regression (crude odds ratios, ORs) demonstrated that age over 60 years, smoking, diabetes mellitus, physical inactivity, and the use of salt were the most important factors influencing the presence of uncontrolled hypertension. According to the results of the multivariable logistic regression model, smoking was the most important factor affecting the inability to control hypertension since controlling the effect of other variables triggered the chance of not controlling hypertension in smokers as 2.76 times higher than in non-smokers (adjusted OR: 2.76, 95% confidence interval: 1.05-7.26).
ConclusionSince using table salt, a sedentary lifestyle, and smoking count as risk factors for cardiovascular diseases, necessary prevention and treatment planning are strongly recommended to control modifiable risk factors in this city through public education.
Keywords: Hypertension, Community health center, Bandar Abbas, Cardiovascular risk factors -
Pages 63-69Background
Ovarian cancer ranks second among gynecological cancers worldwide. This study aimed to compare the glucose transporter-1 (GLUT-1) expression in benign, borderline, and malignant ovarian epithelial tumors and evaluate GLUT-1 expression as a diagnostic tool for distinguishing tumors in the ovary.
Materials and MethodsThis descriptive-analytical cross-sectional study analyzed 69 pathological samples of patients diagnosed with ovarian epithelial tumors who underwent oophorectomy. Immunohistochemical staining was performed using GLUT-1 antibody. The intensity of cell membrane staining and the proportion of positive neoplastic cells were graded to score immunostaining. Chi-square/Fisher’s exact test was used to analyze the data. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), and staining accuracy for GLUT-1 in distinguishing borderline from invasive tumors were calculated by standard methods (P < 0.05).
ResultsIn all benign tumors, GLUT-1 staining was negative. In addition, weak staining intensity was observed in 38.5% of borderline tumors, and 96% of invasive tumors had strong staining intensity (P < 0.001). Strong GLUT-1 staining was found in 94.7% of Papillary Serous Carcinoma, 9/1% of Borderline Serous tumors, 100% of Brenner tumors, and clear cell carcinoma. The results demonstrated a high diagnostic value of GLUT-1 expression intensity in differentiating between borderline and malignant ovarian epithelial tumors (Accuracy: 97.10, Sensitivity: 96%, Specificity: 97.73).
ConclusionOverall, GLUT-1 expression could help distinguish benign from borderline, especially borderline from malignant ovarian epithelial tumors. Thus, it seems that it provides useful prognostic information, particularly for the borderline category.
Keywords: Ovarian epithelial tumors, Immunohistochemical, GLUT-1, Benign, Borderline, Malignant -
Pages 70-76Background
In December 2019, a new virus, the coronavirus disease 2019 (COVID-19) was identified as the cause of a cluster of cases of pneumonia of unknown etiology in Wuhan, China. The COVID-19 disease increases cardiovascular events both directly and indirectly. This study aimed to investigate the laboratory diagnostic markers of cardiovascular patients with COVID-19 in Ayatollah Taleghani hospital in Abadan from March 20, 2019 to March 19, 2020.
Materials and MethodsThis study is a cross-sectional analytical study. Some demographic, laboratory, and clinical information of 200 cardiovascular patients with COVID-19 admitted to Taleghani hospital, Abadan, was received randomly by referring to the medical records section and medical records section and health information system (HIS) as well as searching in the patient records. Inclusion criteria included cardiovascular patients with COVID-19 who had been admitted to Ayatollah Taleghani hospital in Abadan with the diagnosis of a cardiologist and infectious disease specialist, and those whose information was available in HIS. The results were analyzed using SPSS software version 24.
ResultsThe mean age of cardiovascular patients with COVID-19 was reported to be 66.98 ± 18.14. The results revealed that the mean of fasting blood sugar (FBS), serum glutamic oxaloacetic transaminase (SGOT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), creatinine (Cr), blood urea nitrogen (BUN), and erythrocyte sedimentation rate (ESR) was higher than the normal level in these patients. In addition, the mean oxygen saturation (SpO2) was observed to be lower than normal. Reducing the level of SpO2 to less than 90% was significantly related to increasing age, death, patients with a history of lung disease, the duration of hospitalization in ICU, and intubation. This reduction also led to an increase in respiratory rate (RR), LDH, ESR, and C-reactive protein (CRP + 1) in cardiovascular patients with COVID-19.
ConclusionIn cardiovascular patients with COVID-19, FBS, some kidney markers, liver markers, and inflammatory markers were observed to be higher than normal, and a significant relationship was observed between the reduction of SpO2 and some laboratory diagnostic markers, which requires extensive studies with larger sample size.
Keywords: SpO2, COVID-19, Cardiovascular diseases -
Pages 77-83Background
The assessment of the individual magnetic resonance imaging (MRI) features provides vital clues about the diagnosis of neurological complications during the postpartum period assists in the determination of the common neurological complications, differentiates these neurological disorders on basis of the MRI features, and helps with the early treatment planning. This study aimed to describe various complications that occur during the postpartum period to describe the MRI features of these neurological complications and the differentiating features from each other.
Materials and MethodsThe study was a retrospective hospital-based analysis study conducted in the Department of Radiodiagnosis and modern imaging, Maharana Bhopal government hospital and RNT Medical College Udaipur, Rajasthan, India, from October 2017 to September 2018 (All the patients presented during this time frame were included in the study). A total of 58 postpartum cases of neurological disorders who were referred to the department for radiological evaluation and who had positive MRI imaging findings were included in the study.
ResultsMost common neurological symptoms were seizures followed by headache and focal neurological deficit (FND). Moreover, the most typical neurological complication was cerebral vein thrombosis, followed by posterior reversible encephalopathy syndrome (PRES). Other common complications were intracranial hemorrhage, ischemic infarcts, infections, acute hypoxic-ischemic encephalopathy, and metabolic encephalopathy. Rare but important findings included postpartum hypernatremic encephalopathy with extra pontine myelinolysis and rhabdomyolysis and postpartum reversible cerebral vasoconstriction syndrome (PRCVS).
ConclusionMRI, along with angiography and venography, is the modality of choice to evaluate postpartum neurological symptoms and plays a crucial role in the early diagnosis of neurological complications. Furthermore, MRI helps establish this diagnosis early to avoid further complications.
Keywords: MRI, Extra pontine myelinolysis, Postpartum reversible cerebral vasoconstriction, Pontine hemorrhage -
Pages 84-88Background
Chemotherapy-induced peripheral neuropathy is one of the most common side effects of chemotherapy. This study aimed to determine the effectiveness of venlafaxine and duloxetine in improving chronic neurotoxicity induced by chemotherapy in cancer patients.
Materials and MethodsThe study was performed on cancer patients undergoing outpatient chemotherapy or hospitalization in Rasoul Akram hospital. The admitted patients were blindly divided into two groups. The first group was treated with venlafaxine, and the second group was treated with duloxetine. The treatment lasted up until the patients’ full recovery up to 10 weeks. Different intensities of the patients’ neuropathy were measured on all days of treatment based on NCI Common Terminology Criteria for Adverse Events (CTCAE) v 3.0 criteria. At the end of the treatment, the side effects of venlafaxine and duloxetine were identified.
ResultsA total of 30 patients in two groups (n = 15 for each group) were treated with venlafaxine and duloxetine. There was no significant difference between the two groups in terms of age and gender. The severity of neuropathy was significantly reduced in the venlafaxine compared to the duloxetine group from 7 to 10 weeks. The results indicated that 75% and 85.7% fall asleep in the venlafaxine group and the duloxetine group, respectively. Further, there was no significant difference between the two groups in terms of drug side effects.
ConclusionThis study showed that venlafaxine is a suitable drug for the treatment of chronic neurotoxicity in patients with relatively fewer side effects compared to other used drugs. Although these results require further prospective studies due to the small sample size, future drug regimens may preferably contain venlafaxine.
Keywords: Chronic neurotoxicity, Venlafaxine, Duloxetine, Chemotherapy, Cancer -
Pages 89-94Background
Sepsis is an important risk factor for the development of acute renal injury (ARI) among patients admitted to the intensive care unit (ICU). There are limited studies showing that increased uric acid level is an important risk factor for the development of ARI. The present study was carried out to find out whether increased basal uric acid levels play an important role in predicting the development of ARI and whether it could be used as a biomarker for this.
Materials and MethodsThis retrospective study included patients aged ≥ 18 years who were admitted to the ICU of Yüzüncü Yıl University Medical Faculty Hospital from September 2018 to December 2020. Group 1 comprised 100 patients developing ARI and group 2 comprised 110 patients who did not develop ARI. Laboratory test values and Simplified Acute Physiologic Score II (SAPS II) data on the first day of ICU admission were obtained from archive records.
ResultsDuring the 10-day follow-up of patients included in the study, the ARI development rate was 57.3%. Basal serum uric acid levels were higher in group 1 compared to group 2 (P = 0.001). Based on the results of the multivariate logistic regression analysis, basal serum uric acid values and albumin and SAPS II values had independent correlations with ARI (P < 0.001).
ConclusionWe believe that increased basal uric acid levels examined in patients admitted to the ICU with sepsis diagnosis may be an important biomarker for the prediction of ARI.
Keywords: Uric acid, Acute renal injury, Sepsis, Intensive care unit -
Pages 95-100Background
The global public health and economic systems have been severely damaged by the coronavirus disease 2019 (COVID-19) pandemic. Olfactory dysfunction (OD) is one of the most prevalent symptoms experienced by COVID-19 patients, documented in clinical practice. In some individuals, OD is the first or the sole clinical symptom. In this review, the clinical characteristics, causes, evaluation procedures, prognosis, and available treatments of COVID-19-induced OD were examined.
MethodsThe PubMed, Scopus, Web of Sciences, and Google Scholar databases were searched for the related articles from inception until August 2022.
ResultsOD appears to be common in COVID-19, particularly in younger individuals and women and those with milder disease. Even though the issue is still unresolved, current research suggests that COVID-19-related OD is not caused by direct injury to olfactory sensory neurons but instead is a result of indirect injury to these cells. Moreover, effective therapeutic methods are inadequate despite the high prevalence of COVID-19-related OD.
ConclusionThe focus of medical practice regarding COVID-19-related OD should be on identifying individuals with a poor prognosis who may benefit from early management to prevent complications, e.g., depression and anxiety, because COVID-19 OD generally has a good prognosis and quick recovery time.
Keywords: COVID-19, Olfactory dysfunction, Anosmia, Dysosmia, Hyposmia -
Pages 101-105Background
Pheochromocytomas (PCCs) are catecholamine-producing neuroendocrine tumors that originate from the adrenal medulla. Their clinical presentations most commonly include hypertension, headache, palpitations, and sweating; however, PCCs are sometimes normotensive and clinically silent.
Case PresentationA female patient with abdominal pain as well as persistent and crushing left flank pain for the past six months was examined. The imaging studies revealed a mass in the upper pole of the left kidney indicative of a potential adrenal gland tumor; however, she had normal blood pressure (BP). Histopathologic examination of the mass from exploratory laparotomy showed that it was a PCC. Findings from sonography and computed tomography (CT) scan of the left adrenal tumor, along with elevated urinary normetanephrine level and positive iodine-123 metaiodobenzylguanidine (MIBG) scan led to preoperative diagnosis of PCC in our case.
ConclusionThis study highlighted the importance of imaging and biochemical testing in diagnosing PCCs in patients with adrenal incidentalomas (AIs), even though they were normotensive and entirely asymptomatic.
Keywords: Pheochromocytoma, Incidentaloma, Normotensive