accessible and pragmatic experimental model of nonalcoholic fatty

Background: There is no convenient cheap pragmatic experimental model for Nonalcoholic Fatty Liver Disease [NAFLD]/Nonalcoholic Steatohepatitis [NASH]. We aimed to create a pragmatic model of NAFLD/NASH

Method: Sprague-Dawley rats were fed a high-fat, high sugar homemade diet ad libitum for seven weeks. The high-fat, high sugar diet included 59% of energy derived from fat, 30% from carbohydrates, and 11% from protein. Serum levels of fasting glucose, triglyceride, cholesterol, liver enzymes, insulin, and hepatic tumor necrosis factor-alpha [TNF-alpha] gene expression were determined. Hepatic histology was examined by H and E stain

Results: Rats fed the high-fat, high sugar diet developed hepatic steatosis, and a moderate inflammation, which was associated with increased serum levels of liver enzymes, glucose, insulin, triglyceride, cholesterol, and hepatic TNF-alpha gene expression

Conclusion: This rat model resembles the key features of human NAFLD/NASH and provides a simple pragmatic experimental model for elucidating the disease prevention and treatment

Outcome of subsequent pregnancies in familial molar pregnancy

Familial recurrent molar pregnancy is an exceedingly rare condition, in which complete hydatidiform moles are mostly diploid but biparental in origin and the outcome of subsequent pregnancies is likely to be a hydatidiform mole or other type of reproductive loss. We previously reported a case of familial molar pregnancy [family K] comprising five affected members [four sisters and one of their cousins] each with at least one hydatidiform mole [HM]. In addition to the molar pregnancies, these patients have a total of three miscarriages and 8 normal pregnancies leading to healthy children; but the youngest member of this family has given birth to a boy with Down syndrome. Our second family [case S] includes two sisters with diploid biparental complete moles. They have a total of six molar pregnancies with no living child. Recently the younger sister had a partial molar pregnancy with apparently normal XX fetus accompanying diffuse molar changes of the placenta that led to preeclampsia and preterm delivery. Overall, these families have had 26 pregnancies including 12 molar pregnancies [complete or partial] and three abortions. We concluded that these families are predisposed to various genetic mutations, chromosomal abnormalities and clinical manifestations, which affect their offspring. Further studies of patients are needed to determine any relationship between a history of familial molar pregnancy and trisomy or other chromosomal abnormalities in offspring and genetic mutations in the products of conception to complete the puzzle and manage familial molar pregnancy

High prevalence of sleep problems in school- and preschool-aged children in Tehran: a population based study

Sleep problems are experienced by 25-30 percent of children and adolescents, regardless of age. The purpose of this study was to investigate if there is any relationship between gender or school entrance and sleep complaints. From June 2008 to May 2009 children aged 2 to 12 years were selected by clustered randomization of families. The Persian version of the BEARS questionnaire [Bedtime problems, Excessive sleepiness, Awakenings during the night, Regularity of sleep, Snoring] with five domains was filled out by general pediatricians. Prevalence of sleep complaints in each B-E-A-R-S category was calculated and compared for pre-school and school-age groups. BEARS questionnaire was completed for a total of 746 children [2-12 years old]; 325 in pre-school-age group [2-6 years old] [142 females [43.7%] and 183 males [56.3%]] and 421 in primary school-age group [7-12 years old] with the average age of 3.93 [ +/- 0.16] years and 9.63 [ +/- 0.16] years respectively. The most common screening problem in both groups was excessive daytime sleepiness [64.9% and 62.9% respectively]. Bedtime problems and also regularity and duration of sleep were significantly more prevalent in pre-school-age group [P<0.0002; odds ratio [OR] =1.98; 95% confidence interval [95%CI]: 1.98-4.20; and OR=2.00; 95%CI: 1.41- 2.84 respectively]. The difference between mean sleep duration between pre-school age and school-age groups was statistically significant [P<0.0001]. The current survey shows that different types of sleep problems are relatively high especially in the form of excessive daytime sleeping domain in preschool- and school-aged children. Bedtime problems and regularity problems were significantly more prevalent in pre-school-age group. School entrance seems to play a positive role for bedtime problems, and sleep-disordered breathing

Pathologic findings of Whipple pancreaticoduodenectomy: a 5-year review on 51 cases at Taleghani general hospital

The aim of this study was to comprehensively analyze histopathologic parameters of Whipple pancreaticoduodenectomy specimens at Taleghani general hospital pathology department. The Whipple procedure is performed for variety of tumors involving the head of the pancreas, ampulla of Vater, common bile duct, or duodenum. Records of all cases of Whipple pancreaticoduodenectomy between 2007 and 2011were retrospectively reviewed and pathological details of diagnosis and staging were extracted. A total of 51 patients underwent Whipple procedure during a 5-year period, including 37 males and 14 females. The average age was 57 years [18-82 years]. The most frequent presenting symptoms were jaundice and weight loss. Forty-four patients [86.3%] had malignant and 7 [13.7%] had benign lesions. Among malignant lesions, 27 [61.4%] were ampullary carcinomas, 12 [27.3%] were pancreatic carcinomas and 5 [11.4%] were cholangiocarcinomas. The pathological stage of most of the tumors was T3 [50%]; followed by T2 [29.5%], and T1 [15.9%]; only 4.5% were T4. Mean tumor size was 2.8 cm [0.2-7 cm]. Duodenal and common bile duct margins were tumor-free in most cases [95.5%]. The pancreatic margin was free in 81.8% of patients; this margin had not been evaluated in 5 patients. Nearly 38.6% of all tumors showed vascular invasion while 68.2% showed perineural invasion. The average number of dissected lymph nodes was 4 [range 1-15]; although in 25% of specimens, no lymph nodes had been found. Twelve specimens [35.3%] had lymph node metastases. The present study demonstrates that most of our patients are diagnosed with malignancy, at advanced stage, and further research is needed to develop practical methods for earlier diagnosis. The fact that 25% of specimens had no lymph nodes needs more consideration