Correlation between serum ferritin level and histopathological disease severity in non-alcoholic fatty liver disease

Background: Non-alcoholic fatty liver disease [NAFLD] is one of the most common causes of chronic liver disease worldwide. Recently several parameters, such as serum ferritin, have emerged as possible predictors for the severity of NAFLD and insulin sensitivity. We aimed to investigate the value of serum ferritin level as a useful biomarker for the prediction of histopathological disease severity in non-alcoholic steatohepatitis [NASH], the necro-inflammatory form of NAFLD

Methods: This was a prospective cross sectional study in which demographic, clinical, histological, laboratory, and anthropometric data of 30 adult patients with biopsy-proven NAFLD/NASH were analyzed

Results: In our patients population with mean age of 37.9 years and mean BMI of 26.5, statistical analysis did not show a significant difference between the three grades of steatosis in the mean ferritin levels [p=0.559]. It was also observed that ferritin level did not have a significant correlation with the stage of fibrosis [p =0.228]. The mean transferrin saturation did not show significant difference in different stages and grades of NASH [p =0.260 and 0.944, respectively], either

Conclusion: Serum ferritin level may not be useful as a single marker for the prediction of histopathological severity of disease in young patients with NASH who are not morbidly obese

Myxoma immediately above the junction of the inferior vena cava and the right atrium: a rare cause of budd-chiari syndrome

The Budd-Chiari syndrome [BCS] is a rare disorder caused by the obstruction of the hepatic veins or the inferior vena cava [IVC] at the suprahepatic level. This syndrome is developed by either hepatic vein thrombosis or mechanical venous obstruction and leads to centrilobular hepatic congestion with the subsequent development of fibrosis and cirrhosis. Intracardiac tumors have been rarely reported as a cause of the BCS. These tumors usually originate from the atrial septum. Very rarely, they arise either from the junction of the IVC and the right atrium or from the Eustachian valve. There are a few case reports in the literature where atrial tumors have caused the BCS. In these cases, the tumors were malignant, and the patients died shortly after being diagnosed. We describe a 71-year-old female patient who presented with a 3-month history of abdominal pain and protrusion. On physical examination, blood pressure and pulse rate were normal. Jugular venous pressure was about 10 cm. Cardiac examination revealed a systolic murmur, grade IV/VI, in the left sternal border without radiation. Echocardiography showed a large mass [about 6×4 cm] in the right atrium with close contact to the origin of the IVC, obstructing it. Cardiac magnetic resonance imaging, with and without gadolinium, also confirmed the diagnosis. The patient underwent surgery, and the myxoma was removed. The tumor was a large solid mass, 5×4 cm in size, which originated immediately above the entrance of the IVC. The patient is in good condition 1 year afterward. We emphasize that atrial myxomas should be considered in the differential diagnosis of tumors that cause chronic BCS

Survey on air pollution and cardiopulmonary mortality in Shiraz: an analytical-descriptive study

Expanding cities with rapid economic development has resulted in increased energy consumption leading to numerous environmental problems for their residents. The aim of this study was to investigate the correlation between air pollution and mortality rate due to cardiovascular and respiratory diseases in Shiraz. This is an analytical cross-sectional study in which the correlation between major air pollutants [including carbon monoxide [CO], sulfur dioxide [SO2], nitrogen dioxide [NO2] and particle matter with a diameter of less than 10 micro [PM10]] and climatic parameters [temperature and relative humidity] with the number of those whom expired from cardiopulmonary disease in Shiraz from March 2011 to January 2012 was investigated. Data regarding the concentration of air pollutants were determined by Shiraz Environmental Organization. Information about climatic parameters was collected from the database of Iran's Meteorological Organization. The number of those expired from cardiopulmonary disease in Shiraz were provided by the Department of Health, Shiraz University of Medical Sciences. We used non-parametric correlation test to analyze the relationship between these parameters. The results demonstrated that in all the recorded data, the average monthly pollutants standard index [PSI] values of PM10 were higher than standard limits, while the average monthly PSI value of NO2 were lower than standard. There was no significant relationship between the number of those expired from cardiopulmonary disease and the air pollutant [P > 0.05]. Air pollution can aggravate chronic cardiopulmonary disease. In the current study, one of the most important air pollutants in Shiraz was the PM10 component. Mechanical processes, such as wind blowing from neighboring countries, is the most important parameter increasing PM10 in Shiraz to alarming conditions. The average monthly variation in PSI values of air pollutants such as NO2, CO, and SO2 were lower than standard limits. Moreover, there was no significant correlation between the average monthly variation in PSI of NO2, CO, PM10, and SO2 and the number of those expired from cardiopulmonary disease in Shiraz