Anatomic evaluation of the posterior superior alveolar artery using cone-beam computed tomography: A systematic review and meta-analysis

Purpose@#This systematic review examined the detection of the posterior superior alveolar artery, along with various anatomic characteristics, on cone-beam computed tomography images. @*Materials and Methods@#Studies were identified electronically through the Web of Science, MEDLINE, Scopus, and Embase databases. The quality of the included studies was evaluated using a 5-item binary scale. The detection rate, location, and classified diameter of the posterior superior alveolar artery were estimated as prevalence values. The diameter of this artery, as well as the distances from the artery to the alveolar crest and sinus floor, were estimated as means with associated 95% confidence intervals. @*Results@#Thirty-seven studies were enrolled, with 34 of these included in the meta-analysis. The mean detection rate was 79% (range: 72%-84%), and the mean diameter was 1.06±0.05 mm (range: 0.96-1.16 mm). The posterior superior alveolar artery was located intraosseously in 64% of cases. The mean distance of the artery from the alveolar crest was 16.71±0.49 mm (range: 15.75-17.68 mm), while the mean distance from the artery to the sinus floor was 8.85±0.4 mm (range: 8.05-9.64 mm). @*Conclusion@#According to the findings of this meta-analysis regarding various anatomic characteristics of the posterior superior alveolar artery, severe hemorrhage after damage to this artery during sinus augmentation procedures is not a substantial clinical problem.

Pattern and Severity of Anaemia in Predialysis Chronic Kidney Disease Patients in Bangladesh: A Tertiary Care Hospital Study

Background: Anemia is a common complication in chronic kidney disease (CKD), and is associated with a reduced quality of life, and increased morbidity and mortality. The mechanisms involved in ananaemiassociated with CKD are diverse and complex. They include a decrease in endogenous erythropoietin (EPO) production, absolute and/or functional iron deficiency, and inflammation with increased hepcidin levels, among others. Objective: The objective of our study was to investigate the prevalence and severity of anaemia in pre-dialysis patients, and chronic kidney disease patients in Bangladesh.Material & Methods:This was a case-control prospective study conducted with over 300 Bangladeshi non-patients as the control group A and 87 with different stages of chronic kidney disease (CKD) patients as the case group B in the department of Nephrology BSMMU from April’2004 to June 2006. The normal people who had no history of diabetes mellitus, hypertension, or CKD and were not on any medication were controlled and different stages of the CKD patients who had no history of blood transfusion, erythropoietin and parental iron infusion were cases.Results:Out of 300 normal populations male was 158(52.7%) and the female was 142(47.3%) and the mean haemoglobin level of the male was 13.94 g/dl and the female was 12.29 g/dl. Among males 24(15.2%) and females 55(38.7%) were anaemic and the overall prevalence of anaemia was noted at 26.3%. Of the total anaemic people, 25% was microcytic anemia. Out of 87 CKD patients, 56 (64%) were male and 31 (36%) were female. The overall prevalence of anaemia in CKD patients was 95.4%. The haemoglobin level was <11g/dl in 57.14% patients with CCr 30-59 ml/min/1.73m2 which increases to 87.5 % in patients with CCr 15-29 ml/min/1.73m2, which also increases to 94.2 % in patients with CCr<15 ml/min/1.73m2. Mean haemoglobin was observed at 8.6 g/dl, 9.54 g/dl and 11.25 g/dl in stage V, stage IV and stage III CKD patients respectively. Anaemia appeared at 43.53 ml/min/1.73 m2 of CCR.Conclusions:The results demonstrate that patient with reduced renal function is more likely to have anaemia and the prevalence and severity of anaemia increase with declining kidney function. CCr and TSAT is the important predictor of anaemia. In a significant number of the CKD, patient anaemia was associated with iron deficiency.

TGF-β1 role in uterine leiomyoma and endometrial polyp: an insight to drug-based treatment instead of surgical techniques

Objective@#Considering the high prevalence of leiomyoma and endometrial polyps, investigating the contributing factors and determining the pathophysiology of these lesions are essential. Target therapy is now an acceptable method for the treatment of some diseases. We aimed to determine the expression of transforming growth factor (TGF)-β1 in endometrial polyps and leiomyomas to discover a drug-based method to overcome surgical treatments. @*Methods@#In this cross-sectional study, 55 patients with leiomyoma and 55 patients with polyps were included. Prepared slides from leiomyoma and adjacent myometrium or polyp lesions and adjacent endometrium were obtained and investigated for TGF-β1. Then, data were collected and analyzed using SPSS version 22. @*Results@#The mean age of participants was 40.6±5.8 years. Based on their reports, 88.2% (n=97) of patients in the study population had abnormal uterine bleeding with similar distributions among both groups. In contrast, 63.5% of the leiomyoma group did not express TGF-β1. However, in normal myometrium, 23.6% had the highest degree of TGF-β1 expression. Polyp tissue did not show staining for TGF-β1 in any patients. Additionally, 89.1% of non-polypoid endometrium did not express TGF-β1. Normal tissue had a significantly greater amount of TGF-β1 compared to leiomyoma and endometrial polyps. @*Conclusion@#TGF-β1 is expressed more prominently in normal myometrium with mostly high-intensity features compared to leiomyoma. Additionally, polyps showed no staining for TGF-β1, while normal endometrium showed a low-density staining pattern.

Validity and Reliability of the World Health Organization Disability Assessment Schedule 2.0 36-Item Persian Version for Persons with Multiple Sclerosis / 가정의학회지

Background@#No previous studies have assessed the psychometric properties of the 36-item version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) in the Persian language of Iran. This study was designed and conducted to evaluate the validity and reliability of the Persian version using a sample of persons with multiple sclerosis in Ahvaz, Iran. @*Methods@#The methodological study was conducted in two stages: First, the 36 items of the original WHODAS 2.0 were translated to create a Persian version, after which the translation validity and psychometric properties were tested. The factor structure of the instrument was also tested using exploratory and confirmatory factor analyses. @*Results@#The intraclass correlation coefficients were very good to excellent, varying between 0.82 and 0.99 for the six domains, and all domains had Cronbach’s α reliability values of above 0.70. For construct validity, results showed negative and strong correlation between the total score of WHODAS 2.0 and the Multiple Sclerosis Quality of Life-54. Exploratory factor analysis divided the Persian version of WHODAS 2.0 into seven factors for multiple sclerosis patients. @*Conclusion@#The results of this study indicate that the Persian version of WHODAS 2.0 is a valid and reliable instrument to study the disabilities of people with multiple sclerosis.

Evaluation of circulating miR-21 and miR-222 as diagnostic biomarkers for gastric cancer

Introduction: Gastric cancer is responsible for a large number of death worldwide and its high death rate is associated with a lack of noninvasive tools in GC diagnosis. MicroRNAs (miRNAs), as gene regulators, were shown to dysregulate in different types of cancer. Moreover, it is proven that miRNAs are stable in serum/plasma, so they can be used as a potential noninvasive marker in GC diagnosis. The objective of this study is to investigate the plasma miRNA expression in GC samples compared to controls as a potential biomarker in cancer diagnosis. Materials and Methods: Expression levels of miR-21 and miR-222 were assessed using quantitative real-time polymerase chain reaction in plasma of 30 GC patients and 30 healthy controls. Diagnostic value of selected miRNAs was evaluated using receiver operating characteristic curve. Target prediction was done using bioinformatics tools to investigate the signaling pathways and function of the selected miRNAs. Results: Our results demonstrated that the expression levels of miR-21 and miR-222 were significantly higher in GC plasma than in the controls (P < 0.0001, P = 0.043). The sensitivity and specificity for miR-21 and in plasma were 86.7% and 72.2% and for miR-222 were 62.5% and 56.2%, respectively. Bioinformatics analysis revealed that most target genes of miR-21 and miR-222 are involved in cancer-related signaling pathway such as tumor initiation and progression. Conclusion: Our results indicated that miR-21 and miR-222 in plasma samples can be served as a potential noninvasive tool in GC detection. Furthermore, the miRNA target prediction manifested that miR-21 and miR-222 involve in key processes associated with GC initiation and development

Effects of the health transformation plan on caesarean section rate in the Islamic Republic of Iran: an interrupted time series

Background: in recent decades, the rate of caesarian section [C-section] has increased in the Islamic Republic of Iran. A reform in the Iranian health system - the Health Transformation Plan [HTP] - was launched in 2014 in which one of the objectives of HTP is decreasing the rate of C-section

Aims: this study aimed to assess the effects of the Health Transformation Plan [HTP] on the C-section rate in the Islamic Republic of Iran

Methods: this study was an interrupted time series analysis that used segmented regression analysis to assess the im-mediate and long-term effects of the HTP on C-section rate in two groups of hospitals affiliated and not affiliated to the Ministry of Health and Medical Education [MoHME] in Kurdistan province. Study samples were selected using the data on monthly C-section rate collected over a period of four years

Results: we observed significant decreases in C-section rate immediately after the HTP in both groups of hospitals by 0.0629 and 0.0013, respectively [P < 0.05]. In the long run, we observed no significant decrease in the regression slope of C-section rate in both groups

Conclusions: the implementation of HTP decreased the C-section rate. However, the reduction does not meet expectations

effects of lactobacillus casei on glycemic response, serum sirtuin1 and fetuin-A levels in patients with type 2 diabetes mellitus: a randomized controlled trial

Background: Type 2 diabetes mellitus [T2DM] is related to the gut microbiota with numerous molecular mechanisms. Modulating the gut microbiota by probiotics could be effective in management of T2DM. The aim of the present trial was to evaluate the effect of Lactobacillus casei on glycemic control and serum sirtuin1 [SIRT1] and fetuin-A in patients with T2DM

Methods: Forty patients with T2DM [n = 20 for each group] were divided into intervention [probiotic] and placebo groups. The intervention group received a daily capsule containing 108 cfu of L. casei for eight weeks. The patients in placebo group took capsules containing maltodextrin for the same time duration. Anthropometric measurements, dietary intake questionnaires, and blood samples were collected, and the patients were assessed by an endocrinologist at the beginning and at the end of the trial

Results: Fasting blood sugar, insulin concentration, and insulin resistance significantly decreased in probiotic group compared with placebo group [-28.32 [-50.23 to -6.41], 0.013; -3.12 [-5.90 to -0.35], 0.028; -32.31 [-55.09 to -9.54], 0.007, respectively]. Moreover, HbA1c reduced after intervention, but the reduction was not significant [-0.45 [-0.96 to 0.05], 0.077]. In comparison with placebo, the L. casei supplementation significantly increased SIRT1 and decreased fetuin-A levels at the end of the trial [0.52 [0.026 to 1.02], 0.040; -17.56 [-32.54 to -2.58], 0.023, respectively]

Conclusion:L. casei supplementation affected SIRT1 and fetuin-A levels in a way that improved glycemic response in subjects with T2DM. Affecting the SIRT1 and fetuin-A levels introduces a new known mechanism of probiotic action in diabetes management

Asymmetric Flankers in Comodulation Masking Release

BACKGROUND AND OBJECTIVES: Detection of auditory signals may be improved when maskers far from the frequency of the target signal are coherently amplitude-modulated. This improvement of signal detection is called comodulation masking release (CMR). In the CMR experiments, flankers have been usually arranged symmetrically. In practice, we will be confronted with a problem by using symmetric flankers due to the limited output of clinical audiometers, especially at high-frequency. We aimed to check whether flanker arrangement has any effect on the amount of CMR, especially when there is no flankers with a frequency higher than the signal. SUBJECTS AND METHODS: Eighteen normal hearing listeners ranging in age from 20 to 46 years old participated. Symmetric (2-2) and asymmetric (3-1 and 4-0) flankers were used and then the amount of CMR compared among them. RESULTS: Our results showed in the same numbers of flankers, there were no statistically CMR differences between symmetric and asymmetric arrangement. Also when we did not have a flanker at a frequency higher than the signal and all flankers were placed below the signal, there was no statistically difference with the symmetric arrangement. CONCLUSIONS: The asymmetry of the flankers and also omitting the flankers with a frequency higher than the signal, have no effect on CMR results. We concluded that CMR can be considered by using clinical audiometer.

Congenital combined atresia of the left main coronary with supravalvar aortic stenosis

Congenital atresia of the left main coronary artery (LMCA) is an exceedingly rare phenomenon, and in the most of them, coronary artery bypass graft is required. We here describe a rare case of this anomaly that concomitantly was associated with supravalvar aortic stenosis and coronary–pulmonary fistula without the presence of conventional collateral circulation in a 16-year-old boy. The patient was admitted to our center with chest pain and dyspnea. Echocardiographic examinations showed supravalvar aortic stenosis with normal function of the aortic valve. Coronary angiography revealed atresia of LMCA with poorly developed left anterior descending coronary artery and well-developed circumflex coronary artery and diagonal artery that perfused by dominant and lengthy right coronary artery. The patient underwent coronary artery bypass grafting with repair of supravalvar aortic stenosis. The postoperative course was uneventful. The 6-month follow-up revealed normal diameter of the ascending aorta with symptomatic relief of preoperative chest complaint.

Is emotional functioning related to academic achievement among university students? Results from a cross-sectional Iranian sample

Objective: Whereas several studies have predicted academic achievement (AA) as a function of favorable cognitive factors and low negative emotional functioning (such as depression and anxiety), little is known about its associations with cognitive-emotional states of positive emotional functioning, such as social satisfaction. The present study sought to evaluate associations of AA with dimensions of negative and positive emotional functioning. Method: This cross-sectional study enrolled 275 students (mean age, 21.24 years; 66.1% females), who completed questionnaires covering sociodemographic parameters and AA scores, as well as measures of loneliness and depression (representing negative emotional functioning) and social satisfaction (representing positive emotional functioning). Results: Lower scores for negative and higher scores for positive emotional functioning were associated with higher AA scores. Multiple regression analysis showed that AA was predicted independently by both low negative and high positive emotional functioning. No gender differences were observed. Conclusions: The pattern of results observed in this study suggests that opposing dimensions of emotional functioning are independently related to AA. Students, educators, and health professionals dealing with students should focus both on increasing social satisfaction and on decreasing feelings of loneliness and depression.

Titanium Dioxide Nanoparticles and Sodium Nitroprusside Alleviate the Adverse Effects of Cadmium Stress on Germination and Seedling Growth of Wheat (Triticum aestivum L) / Nanopartículas de dióxido de titanio y nitroprusiato de sodio alivian los efectos adversos del estrés por cadmio en la germinación y el crecimiento de as plántulas de trigo (Triticum aestivum L) / Nanopartículas de dióxido de titânio e nitroprussiato de sódio aliviam os efeitos adversos do estresse por cádmio na germinação e no crescimento do trigo (Triticum aestivum L)

Abstract Effect of titanium dioxide nanoparticles (TiO2 NPs) (0, 500, 1 000 and 2 000 mg/L) and sodium nitroprusside (SNP) (0 and 100 μM) as nitric oxide (NO) donor, on wheat seed germination and seedling growth were investigated under cadmium (Cd) stress (0, 50 and 100 mM CdCl2). Concentration-dependent declining trends were observed in wheat germination indices upon seed exposure to CdCl2 suspensions which were more obvious under higher Cd stress. Exogenous sodium nitroprusside (SNP) and TiO2 nanoparticles (NPs) positively affected most germination indices under normal and stress conditions. In most cases, combined application of TiO2 NPs and SNP suspensions boosted stimulatory function of both compounds and moderated adverse effects of Cd treatments on wheat seed germination and seedling growth. 2 000 mg/L TiO2 + SNP (100 μM) treatment recorded the best results regarding most germination indices under lower and higher (50 and 100 mM CdCl2) Cd stress. Overall, it could be concluded that application of TiO2 NPs in combination with SNP might be a promising approach in counteracting the adverse effects of Cd stress on wheat seed germination and early growth.

Resumen Se investigó el efecto de nanopartículas de dióxido de titanio (TiO2 NPs) (0, 500, 1 000 and 2 000 mg/L) y nitroprusiato de sodio (SNP) (0 and 100 μM) como donador de óxido nítrico (NO), en la germinación de las semillas y el crecimiento de las plántulas de trigo bajo estrés por Cadmio (Cd) (0, 50 and 100 mM CdCl2). Se observaron tendencias decrecientes en los índices de germinación de las semillas de trigo expuestas a suspensiones de CdCl2. Estas tendencias fueron dependientes de la concentración, y más obvias ante alto estrés por Cd. El Nitroprusiato de Sodio exógeno (SNP) y las nanopartículas de TiO2 (NPs) afectaron positivamente la mayoría de los índices de germinación bajo condiciones normales y de estrés. En la mayoría de los casos, la aplicación combinada de suspensiones de TiO2 NPs y SNP incrementó la función estimulante de ambos componentes y moderó los efectos adversos de los tratamientos de Cd en la geminación de las semillas de trigo y el crecimiento de las plántulas. Con el tratamiento de 2000 mg/L TiO2 + SNP (100 μM) se registraron los mejores resultados en cuanto a los índices de germinación sometidos a bajo y alto estrés por Cd (50 and 100 mM CdCl2). En general, podría concluirse que la aplicación de TiO2 NPs en combinación con SNP podría ser una aproximación promisoria para contrarrestar los efectos adversos del estrés por Cd en la germinación de las semillas de trigo y en su crecimiento temprano.

Resumo Foram investigados os efeitos de nanopartículas de dióxido de titânio (TiO2 NPs) (0, 500, 1000 e 2000 mg/L) e nitroprussiato de sódio (SNP) (0 e 100 pM) como donadoras de óxido nítrico (NO) na germinação de sementes e no crescimento de plántulas de trigo sob estresse por cádmio (Cd) (0, 50 e 100 mM CdCl2). Se observaram tendências decrescentes nos índices de germinação de sementes de trigo expostas a suspensões de CdCl2. Essas tendências foram dependentes da concentração, sendo mais evidentes frente ao alto estresse por Cd. O nitroprussiato de sódio (SNP) e as nanopartículas de TiO2 (NPs) afetaram positivamente a maioria dos índices de germinação sob condições normais e de estresse. Na maioria dos casos, a aplicação combinada de suspensões de TiO2 NPs e SNP aumentou a função estimulante de ambos componentes e moderou os efeitos adversos dos tratamentos de Cd na germinação de semestres de trigo e no crescimento das plántulas. Com o tratamento de 2 000 mg/L TiO2 + SNP (100 μM) se registraram os melhores resultados em quanto aos índices de germinação submetidos a baixo e alto estresse por Cd (50 e 100 mM CdCl2). De modo geral, se pode concluir que a aplicação de TiO2 NPs em combinação com SNP poderia ser uma aproximação promissora para combater os efeitos adversos do estresse por Cd na germinação de sementes de trigo e no seu crescimento inicial.

Impact of metformin on the severity and outcomes of ischemic stroke

Background: Stroke is the third most common cause of death in the United States and the most commonly diagnosed neurological disorder. About 750,000 strokes occur annually in the United States and about 150,000 people die as a result of stroke. The aim of this study was evaluation of the effect of Metformin on complication of ischemic strokes.Methods: In this randomized, double-blind clinical trial study, 100 patients with ischemic stroke will be assigned randomly into two groups A and B. The National Institutes of Health Stroke Scale (NIHSS) will be used to evaluate the clinical manifestations of ischemic stroke. The two groups will be followed up for 3 months. Metformin 500mg twice in a day will be administered for seven days for group (A) and placebo will be administered for seven days for group (B). Blood glucose will be checked every 6 hours and will be recorded on the blood glucose (BS) chart. Before the intervention, the NIHSS questionnaire will be recorded in one day, three days, seven days and one month, two months, and three months after the intervention will be followed up respectively.Results: In the present study, according to the neuro-protective effects of metformin, there is a significant difference in metformin taking in the reduction of NIHSS Score in non-diabetic stroke patients. There was a significant association in metformin taking and decrease in NIHSS scores in patients with cortical ischemic stroke.Conclusions: According to the results, in patients with cortical stroke, there weren抰 a significant difference in NIHSS between the two groups in the first, third and seventh days but in the first, second and third months after intervention the difference was significant. Also, the results showed that metformin reduced the severity and stroke symptoms and accelerated recovery and functional output in patients with cortical stroke after the first, second and third months.

Right atrial fibroma in an adult patient

Left atrial fibroma as a benign tumor is an exceedingly rare left atrial mass. It has various clinical signs and symptoms and sometimes leads to serious complications such as lethal arrhythmia and death. We report a case of right atrial fibroma in a 40-year-old male who presented with dyspnea and atrial fibrillation. Transthoracic echocardiography revealed a large sessile mass attached to interatrial septum near the coronary sinus valve in the right atrium. The patient underwent surgical resection of tumor through the right atrium. The postoperative course was unremarkable. Histopathological examination showed that it was a fibroma. The 6-month follow-up revealed that the patient was in well condition with no evidence of tumor recurrence.

Rural-urban differences in stroke types, risk factors, severity and prognosis in Babol, Northern Iran

Introduction: Stroke recognized as the third most common cause of death. Stroke survivors often suffer a large amount of physical and mental disability. Due to assess difference between stroke types, progression and distribution of risk factors according residential status, to get correct information for prevention planning and management, this study was conducted

Methods: This descriptive cross-sectional study on stroke patient from 2016 to 2017 that admitted to Ayatollah Rohani Hospital of Babol was conducted. Type of stroke, their severity, risk factors, and urban or rural area of residence of patients were recorded in the checklist. The chi-square test was used to compare frequencies of gender, and stroke risk assessment between the urban and rural residents. Binary logistic regression modeling was used to estimate the association of risk factors with living in urban and rural areas. The results were expressed as multivariable-adjusted odds ratios [ORs] and 95 % confidence intervals [95 % CIs]. A two-sided p < 0.05 was considered statistically significant. All data analyses were performed, using SPSS statistical analysis software

Results: Of 241 stroke patients, 133 patients [55 %] were female and 213 patients [88.4 %] were ischemic. Also, 140 cases were [58 %] rural. Embolic strokes more in urban population and thrombotic strokes were more in rural populations. Hyperlipidemia was more in urban than rural p = 0.01. Severity of stroke in admission time [p = 0.03] and at discharge [p = 0.005] was more in rural than urban. The mortality was higher in rural 12 [8.6] vs. 2 [2] urban resident,[ p = 0.03]

Conclusion: Rural patients had more severity, thrombotic type and mortality than urban. Suitable policy regard to residential parameter is suggested

[ study of psychological factors associated with quality of life in patients with irritable bowel syndrome]

Background: The aim of this study was to evaluate the psychological characteristics of negative affect, social inhibition, and ambiguity tolerance in prediction of quality of life in patients suffering from irritable bowel syndrome [IBS]

Materials and Methods: In this cross-sectional study, 62 patients suffering from IBS who were referred to the Digestion Clinic of Shadid Beheshti Hospital in Qom city were selected with available sampling method. For data gathering, quality of life questionnaire in irritable bowel syndrome [IBS QOL], D personality type scale [DS - 14], and ambiguity tolerance questionnaire were used Lin. Research data were analyzed using Pearson correlation and regression tests

Results: This study showed that psychological characteristics of negative affect, social inhibition and ambiguity tolerance are factors prediction of quality of life in IBS suffering

Conclusion: For the recovery of the quality of life in patients suffering from IBS, appropriate interventions, training, counseling, and referral to psychologist to make positive changes in the mentioned psychological factors are recommended

[Effect of 12-week aerobics training on metabolic control in type-2 diabetic men with peripheral neuropathy]

Background: Diabetes is one of the main causes of neuropathy. Metabolic control is essential to hinder its process. The present study was designed to investigate the effect of aerobics training on metabolic control in type-2 diabetic men with peripheral neuropathy

Methods: Twenty-four male subjects with Type 2 Diabetes were randomly assigned into two groups [each group comprised of 12 subjects]: 1- Aerobics training [43+/-6.4 yrs, 86.5+/-15.3 kg] 2- control [42+/-4.6 yrs, 89.3+/-11.9 kg]. Aerobics training consisted of 20 to 45 minutes walking and running with 50 to 75 percent of heart rate reserve, three sessions per week for 3 months. Before and 48h after last training session, body composition measurements were performed and then fasting and aftermeal blood samples were taken

Results: We observed no significant changes in weight, fat percentage and body mass index following intervention [P>0.05]. Furthermore, fasting and OGTT glucose and HbA1C levels significantly decreased and lipid profile improved significantly [P<0.05]. We also observed significant inter-group difference only for HbA1C and HDL-C [P<0.05]

Conclusion: Based on the findings of the present study, it could be concluded that aerobic exercise regimen could be a safe non-pharmacological strategy to achieve an optimal metabolic control in type-2 patients with peripheral neuropathy

The Role of Risk-sharing Mechanisms in Finance Health Care and Towards Universal Health Coverage in Low-and Middle-income Countries of World Health Organization Regions / 예방의학회지

No abstract available.

Pineal and Suprasellar Germinoma Cooccurence with Vertebra Plana: A Case Report

Germinoma is the most common type of intracranial germ cell tumors (GCTs). Pineal gland and suprasellar region are the most frequent sites of central nervous system (CNS) involvement. Intracranial masses caused by Langerhans cell histiocytosis (LCH) mimics features of CNS GCTs. LCH frequently involve spine and is the most common cause of vertebra plana in children. A 15-year-old boy presented with progressing symptoms of polydipsia, polyuria, general headache, nausea and severe back pain. Brain MRI showed brain tumor with simultaneous involvement of suprasellar region and pineal gland. An excisional biopsy of suprasellar mass was done. The pathologic assessment confirmed the diagnosis of germinoma. Patient's treatment continued accordingly. A spine MRI, done due to persistent backache, showed a vertebra plana. We reevaluated the primary diagnosis suspecting LCH. Germinoma of CNS was confirmed and a biopsy of vertebral lesion resulted in hemangioma. Thus we report a case of CNS germinoma with co-occurrence of vertebra plana. We emphasized the importance of histopathologic diagnosis of pineal/suprasellar masses and primary investigation of other CNS regions including spine for possible metastasis or comorbidities.

Dietary Intake of Thiamine in Migraine Patients and Healthy Subjects: a Case-Control Study

The migraine headache is a disease related to the neurovascular system, which affects 10%–20% of people, worldwide. Recent evidences suggested a relation between thiamine status and migraine headaches. The current study was undertaken to assess dietary intake of the thiamine in migraine patients and to evaluate its association with the frequency of migraine attacks. In a case-control design, the current study was performed on 50 migraine patients and 50 healthy people, 20–60 years old in Isfahan, Iran, in 2017. Information about dietary intake was collected by Food frequency questionnaire and analyzed using the Nutritionist version 4 (N4) software (Tinuviel Software). Information about the history of disease was collected by demographic questionnaire. Analysis of covariance and independent t-test were used for data analysis and p value less than 0.05 was considered significant. Mean age, weight, height, and body mass index of participants were 35.1 ± 9.8 years, 65.3 ± 10.4 kg, 162.5 ± 8.4 cm, and 24.7 ± 4.0 kg/m², respectively. Dietary intake of thiamine among the migraine patients was lower than that in the healthy participants (p < 0.001). Migraine patients with the high frequency attacks had significantly lower intake of thiamine compared with moderate frequency attacks group (p = 0.010), however, it was not significant after adjusting for energy intake (p = 0.410, p = 0.240). Dietary intake of thiamine in migraine patients was not significantly different in comparing with healthy subjects. In addition, no significant correlation between thiamine intake and the frequency of migraine attacks was observed.