Search

Introduction Panic from needle and the cost can discourage some diabetic patients from monitoring their blood glucose levels in a regular manner, so there is a critical need to find a new cost-effective, painless, and sensitive glucose-detection method. Many studies have found that α2-macroglobulin (A2MG) concentrations are increased in the blood of both type 1 and type 2 diabetic patients. Aim The aim of the article is to study the salivary A2MG value as a marker for glycemic control in patients with type 2 diabetes mellitus (DM). Patients and methods A total of 60 patients were included and divided into three groups. Group 1 included patients with type 2 DM with glycosylated hemoglobin (HbA1c) levels more than or equal to 7% (inadequate glycemic control). Group 2 included patients with type 2 DM with HbA1c levels less than 7% (adequate glycemic control). Group 3 included healthy persons (control group). All patients were subjected to the following: thorough history taking, full physical examination, and laboratory investigations, including fasting blood glucose, cholesterol, triglycerides, HbA1c, and salivary A2MG. Results There were statistical significant relations between salivary A2MG and both BMI and duration of diabetes (P0.05). There were statistically significant positive correlations between levels of salivary A2MG and HbA1c, cholesterol, triglycerides, fasting blood sugar, duration of DM, BMI, and age. The best cutoff value of salivary A2MG as a predictor of bad glycemic control, in relation to HbA1c, was more than or equal to 645 ng/ml, with area under the receiver operating characteristic curve of 0.92, sensitivity of 91.7%, specificity of 90%, and P value of less than 0.001. Conclusion and recommendation With the advantages of rapid, accessible, sensitive, cost-effective, and noninvasive method, salivary A2MG is a promising biological marker for glycemic control in patients with type 2 DM.

Background The aim of the study was to evaluate the relationship between serum Sestrin2, Insulin resistance (IR), metabolic syndrome (MetS), and diabetic nephropathy (DN) in patients with type 2 diabetes mellitus (T2DM). Patients and methods The study group consisted of 155 patients with T2DM who were recruited and evaluated for DN. IR was evaluated by the homeostasis model assessment-insulin resistance (HOMA-IR). Sestrin2 levels were determined by enzyme-linked immunosorbent assay. Results Serum Sestrin2 levels showed significant positive correlations with tumor necrosis factor-α (r=0.247, P=0.018), triglycerides (r=0.178, P=0.021), total cholesterol (r=0.33, P=0.007), fasting c-peptide (r=0.164, P=0.035), and systolic blood pressure (r=0.171, P=0.041). A significant negative correlation was found between Sestrin2 levels and serum adiponectin (r=0.247, P=0.018). Also, Sestrin2 levels were positively correlated HOMA-IR (r=0.188, P=0.026). There was a progressive significant increase of mean HOMA-IR through Sestrin2 tertiles (P=0.001). A significant increase of mean serum Sestrin2 levels was found in relation to the presence of DN or MetS. Conclusion Serum Sestrin2 levels are significantly associated with IR, MetS, and DN in patients with T2DM.

Background Spontaneous bacterial peritonitis (SBP) is a serious infection of ascitic fluid in cirrhotic patients. High mortality associated with the delay in diagnosis and treatment. There is a need for an accurate and a rapid method for SBP diagnosis. Objectives We aimed to evaluate ascitic fluid calprotectin as a diagnostic marker for SBP. Patients and methods Forty four cirrhotic patients were divided into two groups, non-SBP group: 22 patients with cirrhotic ascites without evidence of SBP and SBP group: 22 patients with cirrhotic ascites and SBP diagnosed by positive ascitic fluid bacterial culture and an increase in polymorphonuclear leukocytes (PMNLs) count in ascites (≥250 cells/mm3). Ascitic fluid calprotectin levels were measured using enzyme-linked immunosorbent assay. Results There was a significant increase of ascitic fluid calprotectin, total leukocytic count, PMNLs, lactate dehydrogenase, and total protein in SBP group when compared to non-SBP group. There were significant positive correlations between white blood cell, ascitic fluid total leukocytic count, PMNLs, total protein, and model for end-stage liver disease score values and ascitic fluid calprotectin among SBP group. Ascitic fluid calprotectin with cutoff value 620 ng/ml, showed a sensitivity of 90.91% and a specificity of 95.45%, in diagnosis of SBP with positive predictive value 95.2% and negative predictive value 91.3%. Conclusion Ascitic fluid calprotectin may be valuable in rapid diagnosis of SBP.

Objective The aim of the study was to evaluate the value of the N-terminal prohormone of brain natriuretic peptide (NT-proBNP) as an early diagnostic marker for chronic heart failure (CHF) in hypothyroid patients with ischemic heart disease (IHD). Materials and methods A total of 120 patients with an age range between 42 and 64 years participated in the study. All patients were classified into four groups: the master first group includes 30 patients with IHD, CHF functional class II–III and hyperthyroidism; the second group includes 30 patients with IHD and CHF functional class II–III, but with normal thyroid function; the third group includes 30 hyperthyroid patients without CHF or IHD; and the fourth group includes 30 hyperthyroid patients with IHD, without CHF. All patients were subjected to the following: full clinical and functional assessment, measurement of NT-proBNP, echocardiography, and the 6-min walk test. Results NT-proBNP levels were high in all studied groups. NT-proBNP levels showed no significant difference between patients of second and fourth group. The master first group had the highest significant NT-proBNP concentrations than other studied groups. Thyroid hyperfunction in patients with IHD appears to stimulate the natriuretic peptides secretion at a level exceeding what is recommended for the initial diagnosis of CHF. Conclusion The highest NT-proBNP level in hyperthyroid patients with IHD apparently is caused by stimulation of natriuretic peptide secretion by both thyroid hyperfunction and myocardial ischemic changes, which determine the need to check out the cut-off value of NT-proBNP level as a serological marker for the initial diagnosis of heart failure of such patients’ category.

Breastfeeding improves maternal and child health. The American Academy of Pediatrics recommends exclusive breastfeeding for six months, with continued breastfeeding for at least one year. However, in the US, only 18.8% of infants are exclusively breastfed until six months of age. For mothers who initiate breastfeeding, the early postpartum period sets the stage for sustained breastfeeding. Mothers who experience breastfeeding problems in the early postpartum period are more likely to discontinue breastfeeding within two weeks. A major risk factor for shorter breastfeeding duration is delayed lactogenesis II (i.e. onset of milk coming in more than 72 h postpartum). Recent studies report a metabolic-hormonal link to delayed lactogenesis II. This is not surprising because around the time of birth the mother’s entire metabolism changes to direct nutrients to mammary glands. Circadian and metabolic systems are closely linked, and our rodent studies suggest circadian clocks coordinate hormonal and metabolic changes to support lactation. Molecular and environmental disruption of the circadian system decreases a dam’s ability to initiate lactation and negatively impacts milk production. Circadian and metabolic systems evolved to be functional and adaptive when lifestyles and environmental exposures were quite different from modern times. We now have artificial lights, longer work days, and increases in shift work. Disruption in the circadian system due to shift work, jet lag, sleep disorders and other modern life style choices are associated with metabolic disorders, obesity, and impaired reproduction. We hypothesize delayed lactogenesis II is related to disruption of the mother’s circadian system. Here we review literature that supports this hypothesis, and describe interventions that may help to increase breastfeeding success.

Abstract Background Stapedotomy is being performed endoscopically for otosclerosis in Sudan since 2011 with increasing number of patients. This prospective hospital-based study from Nov 2016 to Nov 2020 states the clinic-demographic features of otosclerosis; it describes this surgical technique and hearing outcome following endoscopic stapedotomy. Results Total number included in the study was 91 patients. Females were 48, and males were 43 with a female to male ratio of 1.1:1. Age ranged from 19 years to 52 with a mean age of 30.6± 7 SD years. The main symptom was decreased hearing in all patients (100%); in 82 patients (90%), it was bilateral, followed by tinnitus in 80 patients (88%) while two patients (2.2%) had vertigo. Family history was stated by 2 patients (2.2%) only. Audiological assessment by pure tone audiogram (PTA) for each ear (total of 182) revealed that conductive hearing loss (CHL) is the commonest type of hearing loss in 148 ears (81.3%), mixed type in 30 ears (16.5%), while 4 ears (2.2%) were normal. Endoscopic stapedotomy was performed for 74 patients; this technique was safe; few complications were managed successfully: one gusher and one revision, with no facial nerve injury. Majority of complications happened during the first year. Mean air bone gap (ABG) gain was 23.3± 7.2 dB, air conduction (AC) gain was 18.3 ± 8 dB, and Carhart notch disappeared in 79.5%. Conclusions Endoscopic stapedotomy is a safe and effective procedure with a steep learning curve and a satisfactory hearing outcome. The air bone gap (ABG) gain was comparable to international studies.

Objective: Long non-coding RNAs (lncRNAs) and their target microRNAs were documented in multiple studies to have a significant role in different joint disorders such as rheumatoid arthritis (RA) and osteoarthritis (OA). The current work aimed to determine the potential role of lnc-PVT1 and miR-146a as promising biomarkers to distinguish between RA, OA patients, and healthy individuals. Methods: The expression levels of lnc-PVT1 and its target miR-146a in the serum were measured for three different groups, including patients with RA (40), OA patients (40), and healthy controls (HCs) (40). Participating individuals were subjected to a full history investigation and clinical examination. Blood samples were tested for ESR, RF, CBC, as well as liver and renal functions. Serum was used to detect the relative expression levels of lnc-PVT1 and miR-146a and we correlated the levels with RA and OA activity and severity signs. Results: Lnc-PVT1 expression level was greater among patients with RA compared to that of OA patients, with a fold change median of 2.62 and 0.22, respectively (p = 0.001). The miR-146a fold change was significantly demonstrated between the RA, OA, and HCs groups. There was no correlation between both biomarkers with the disease activity scales (DAS28) of RA, the Knee injury Osteoarthritis Outcome Score (KOOS), or any sign of detection of the disease severity of OA. Conclusions: lnc-PVT1 and miR-146a could be considered as promising biomarkers for the diagnosis of RA and OA and may have an important role as therapeutic targets in the future.

Abstract About 5% of the population suffers from fibromyalgia (FM), a chronic multi-symptom pain illness whose pathophysiology is still unknown. We aimed to be the first to investigate the possible association of sera levels of miR-217 and miR-532 in patients with fibromyalgia and correlate their expression levels to different clinical and biochemical disease criteria. This study included 80 participants who splitted into two groups: 40 fibromyalgia sufferers (12 male and 28 female), and 40 healthy volunteers (10 male and 30 female) who served as the control group. Venous blood samples were collected from all subjects. The miR-217 and miR-532 serum expressions were detected using quantitative real-time PCR (qRT-PCR). According to our data, the fold changes of miR-217 and miR-532 in fibromyalgia patients were significantly lower than in controls, for miR-217 (median = 0.1359, IQR: 0.038–0.287, P

Objective: To assess the relationship between serum endostatin (ES) and coronary artery calcification (CAC) in type 2 diabetic (T2DM) patients. Methods: The study included 110 participants with coronary artery disease (CAD); 55 with T2DM, for serum ES levels by enzyme-linked immunosorbent assay and CAC by contrast-enhanced spiral computed tomography (CT). Results: Mean serum ES value was 66.54 ng/mL [95% confidence interval (CI), 61.77–71.32 ng/mL]. Serum ES levels positively correlated with Agatston score index [ASI; r = 0.701, p