Injectable platelet rich fibrin effect on laser depigmented gingiva: a clinical randomized controlled split mouth trial with histological assessment

Abstract Objective To determine whether intra-mucosal injection of injectable platelet-rich fibrin (i-PRF) can promote healing after Diode Laser Gingival Depigmentation (DLGD). Methodology A total of 20 arch sites of hyperpigmented gingiva of 10 patients underwent DLGD. For each patient, two arch sites were randomly assigned for either intra-mucosal injection of i-PRF (G1-i-PRF) (n=10 sites) or no treatment (G2-Control): (n=10 sites). Wound Healing Score (WHS), patient satisfaction, and Pigmentation Index (DOPI) were measured at 1 week and 1 and 3 months postoperatively. Histological assessment of tissue specimens was performed at baseline and 1 week. Results The percentage change in WHS at 1 week was significantly higher in G1 (58.34±15.43) compared to G2 (37.50±11.79). At day 1, 50% of patients in G1 were pain free compared with 75% in G2, who had mild pain. Mean DOPI decreased significantly at 3 months in both groups (P-value <0.001), without significant differences between groups. G1 specimens showed significantly higher epithelial thickness (P-value <0.001), as well as a higher number of blood vessels and less percentage of inflammatory cells. Conclusions i-PRF demonstrated better clinical and histological healing potential and less patient discomfort compared to sites without treatment after DLGD. Registered at https://clinicaltrials.gov/ as (NCT05283668).

A Gift of Blood: Opinions and Experience of Voluntary Blood Donors on Repeat Blood Donation

Donating blood is an essential practice that can help save lives. Effective strategies are necessary to attract and keep blood donors to meet the demand for safe blood. To evaluate the experience of voluntary blood donors in Zanzibar, a survey was conducted, and purposive sampling was used to select participants who had donated blood multiple times. The study involved interviewing 15 repeat blood donors, and the data collected was analyzed thematically. Two main themes emerged from the analysis: motivators and barriers. Despite a few negative effects, most participants had positive experiences with repeat blood donation, and only few experienced physical reactions during or after the process. The study concludesthat blood donors in Zanzibar generally have good experience towards repeat blood donation, although community participation, education, and sensitization are needed to recruit and maintain more donors.

Non-alcoholic fatty liver disease-related hepatocellular carcinoma

Non-alcoholic fatty liver disease (NAFLD), one of the most common causes of liver disease, is an increasingly common cause of hepatocellular carcinoma (HCC). Several demographic, clinical, and genetic factors contribute to HCC risk in NAFLD patients, which may inform risk stratification scores. Proven efficacious approaches to primary prevention approach in patients with non-viral liver disease remain an area of need. Semi-annual surveillance is associated with improved early tumor detection and reduced HCC-related mortality; however, patients with NAFLD have several challenges to effective surveillance, including under-recognition of at-risk patients, low surveillance utilization in clinical practice, and lower sensitivity of current tools for early-stage HCC detection. Treatment decisions are best made in a multidisciplinary fashion and are informed by several factors including tumor burden, liver dysfunction, performance status, and patient preferences. Although patients with NAFLD often have larger tumor burden and increased comorbidities compared to counterparts, they can achieve similar post-treatment survival with careful patient selection. Therefore, surgical therapies continue to provide a curative treatment option for patients diagnosed at an early stage. Although there has been debate about the efficacy of immune checkpoint inhibitors in patients with NAFLD, current data are insufficient to change treatment selection based on liver disease etiology.

Hepatocellular carcinoma surveillance in patients with non-alcoholic fatty liver disease

Non-alcoholic fatty liver disease (NAFLD) may progress to cirrhotic or non-cirrhotic hepatocellular carcinoma (HCC), and is currently recognized as the fastest growing cause of HCC worldwide. Accordingly, professional society guidelines recommend HCC surveillance in patients with cirrhosis from any etiology, and some may consider it beneficial in subgroups with non-cirrhotic NAFLD at higher risk for HCC. Notably, patients with NAFLD-related HCC are more likely to have HCC diagnosed at more advanced stages and have poorer outcomes when compared to other etiologies, and suboptimal effectiveness of HCC surveillance programs is a major culprit. In this review, we summarize the current guidelines for HCC surveillance and discuss its benefits versus potential harms for NAFLD patients. We also address the unique challenges of HCC surveillance in NAFLD, including higher proportion of NAFLD-related HCC without cirrhosis, poor recognition of at-risk patients, lack of consensus regarding the value of surveillance in non-cirrhotic NAFLD, subpar effectiveness of surveillance tools related to NAFLD phenotype, and preponderant surveillance underuse among NAFLD patients. Finally, we examine the effectiveness of currently used surveillance tools (i.e., ultrasound and alpha fetoprotein) and outline future perspectives including emerging risk stratification tools, imaging surveillance strategies (e.g., abbreviated magnetic resonance imaging protocols), blood-based biomarkers (e.g., GALAD and circulating tumor DNA panels), and interventions to improve surveillance adherence.

Safety and efficacy of omecamtiv mecarbil for heart failure: A systematic review and meta-analysis

Aim: To assess the safety and efficacy of omecamtiv mecarbil compared with placebo in heart failure (HF) patients. Methods: We searched PubMed, Web of Science, Cochrane Library, and SCOPUS until August 15th, 2021. We included all randomized controlled studies comparing omecamtiv mecarbil with placebo in heart failure patients. The meta-analysis was carried out using Rev Man software V5.4. Results: A total of eight studies were included in our systematic review. Pooled analysis showed that omecamtiv mecarbil is not associated with increased incidence of death, any adverse events, hypotension, heart failure, ventricular tachyarrhythmia, dyspnea, dizziness, and serious adverse events. Regarding the efficacy, omecamtiv mecarbil significantly reduced heart rate with some studies demonstrating its significant improvement in left ventricular ejection fraction and systolic function. Conclusion: Omecamtiv mecarbil is a well-tolerated drug in heart failure patients. The limited data regarding the efficacy suggested that it may improve ejection fraction and systolic function

Country-specific lockdown measures in response to the COVID-19 pandemic and its impact on tuberculosis control: a global study / Medidas de confinamento específicas de cada país em resposta à pandemia de COVID-19 e seu impacto no controle da tuberculose: um estudo global

ABSTRACT The objective of this study was to describe country-specific lockdown measures and tuberculosis indicators collected during the first year of the COVID-19 pandemic. Data on lockdown/social restrictions (compulsory face masks and hand hygiene; international and local travel restrictions; restrictions to family visits, and school closures) were collected from 24 countries spanning five continents. The majority of the countries implemented multiple lockdowns with partial or full reopening. There was an overall decrease in active tuberculosis, drug-resistant tuberculosis, and latent tuberculosis cases. Although national lockdowns were effective in containing COVID-19 cases, several indicators of tuberculosis were affected during the pandemic.

RESUMO O objetivo deste estudo foi descrever as medidas de confinamento específicas de cada país e os indicadores de tuberculose coletados durante o primeiro ano da pandemia de COVID-19. Dados referentes a confinamento/restrições sociais (uso obrigatório de máscaras faciais e higiene obrigatória das mãos; restrições a viagens internacionais e locais; restrições a visitas familiares e fechamento das escolas) foram coletados de 24 países em cinco continentes. A maioria dos países implantou múltiplos confinamentos, com reabertura parcial ou total. Houve uma redução geral dos casos de tuberculose ativa, tuberculose resistente e tuberculose latente. Embora os confinamentos nacionais tenham sido eficazes na contenção dos casos de COVID-19, vários indicadores de tuberculose foram afetados durante a pandemia.

Antidiabetic effect of Pterocarpus marsupium seed extract in gabapentin induced diabetic rats

Background: Type 2 diabetes mellitus is the most common type of diabetes. Diabetes mellitus is a leading cause of morbidity and mortality among Indian population and all over the world with more than hundreds of millions of patients worldwide. Pterocarpus marsupium is a medicinal plant used in Ayurvedic system of medicine to control blood sugar and strong antidiabetic. The purpose of this study was to assess the hypoglycemic effect of the ethanolic extract of Pterocarpus marsupium seeds in diabetic rats.Methods: The present work was designed to evaluate the anti-hyperglycaemic activity of Pterocarpus marsupium seed extract (100 mg/kg and 200 mg/kg) on gabapentin induced hyperglycaemia in wistar albino rats. Blood glucose level, serum triglycerides, total cholesterol, HDL cholesterol and LDL cholesterol were evaluated in gabapentin induced diabetic rats. The results of the test drug were compared with the standard drug.Results: Ethanolic seed extract of Pterocarpus marsupium at 100 mg/kg and 200 mg/kg had significantly reduced the blood glucose level compared to disease control rats on day 1, 7, 14 and 21. Pterocarpus marsupium shows significant decrease in triglycerides levels, serum cholesterol levels, LDL levels and increased HDL levels, total protein levels compared to the disease control group.Conclusions: In conclusion, the present study shows that the ethanolic seed extract of Pterocarpus marsupium has potential antidiabetic action in gabapentin induced diabetic rats and the effect was found to be more similar to the standard drug metformin.

Comparison of Photon-electron and Photon Radiotherapyfor Supraclavicular Lymph Nodes of Mastectomy Patientswith Left-sided Breast Cancer

The aim of radiotherapy is to deliver the highest possible radiation dose to the tumor and the lowest radiation to normal tissues surroundingthe tumor. In the present study, lymph nodes of the supraclavicular region were treated using two therapeutic techniques,namely photon technique (PT) and combinatory photon-electron technique (CPET). We recruited 50 patients with local lymph nodemetastasis. The photon energies were 6-15 MV. Furthermore, the electron beam energy was 18 MeV in CPET. The study findingsrevealed that the mean delivered dose to target volume was 41.12 ± 2.98Gy for PT and 44.56 ± 1.90Gy for CPET. The percentage ofthe target volume irradiated to 90% of the prescribed dose (V90) was calculated as 74.61% ± 9.30% and 82.06% ± 9.70% for PT andCPET, respectively. The mean dose delivered to the heart and lungs was not significantly different between the two groups. Furthermore,the maximum doses delivered to the spinal cord were 12.55Gy in PT and 8.89Gy in CPET. The mean doses delivered to thethyroid gland were 39.26 and 34.89Gy in PT and CPET. According to the study results, the maximum doses delivered to the spinalcord, head of the humerus bone, and thyroid were reduced significantly as measured the CPET technique. In contrast, no significantdifference was observed regarding the dose delivered to the heart and lung. The dose delivered to the supraclavicular region determinedby the CPET was significantly augmented. Furthermore, the coverage of the tumor mass was optimized using the new method.

Influence of some methylated hepatocarcinogenesis-related genes on the response to antiviral therapy and development of fibrosis in chronic hepatitis C patients

Epigenetics involved in multiple normal cellular processes. Previous research have revealed the role of hepatitis C virus infection in accelerating methylation process and affecting response to treatment in chronic hepatitis patients. This work aimed to elucidate the role of promoter methylation (PM) in response to antiviral therapy, and its contribution to the development of fibrosis through hepatocarcinogenesis-related genes. A total of 159 chronic hepatitis Egyptian patients versus 100 healthy control group were included. The methylation profile of a panel 9 genes (SFRP1, p14, p73, APC, DAPK, RASSF1A, LINE1, O6MGMT, and p16) was detected in patients’ plasma using methylation-specific polymerase chain reaction (MSP). Clinical and laboratory findings were gathered for patients with combined pegylated interferon and ribavirin antiviral therapy. Regarding the patients’ response to antiviral therapy, the percentage of non-responders for APC, O6MGMT, RASSF1A, SFRP1, and p16 methylated genes were significantly higher versus responders (P<0.05). Of the 159 included patients, the most frequent methylated genes were SFRP1 (102/159), followed by p16 (100/159), RASSF1A (98/159), then LINE1 (81/159), P73 (81/159), APC (78/159), DAPK (66/159), O6MGMT (66/159), and p14 (54/159). A total of 67/98 (68.4%) cases of RASSF1A methylated gene (P=0.0.024), and 62/100 (62%) cases of P16 methylated gene (P=0.03) were associated with mild-degree fibrosis. To recapitulate, the PM of SFRP1, APC, RASSF1A, O6MGMT, and p16 genes increases in chronic hepatitis C patients, and can affect patients’ response to antiviral therapy. The RASSF1A and P16 genes might have a role in the distinction between mild and marked fibrosis.

Concomitant administration of atorvastatin with N-acetylcysteine mitigates liver injury and steatosis in experimental non-alcoholic fatty liver disease

Although numerous efforts have been directed toward searching for new treatments against non-alcoholic fatty liverdisease (NAFLD), there are no approved pharmacologic agents up to date. This study evaluates the therapeutic effectof concomitant administration of atorvastatin (ATO) and N-Acetylcysteine (NAC) with/without diet control. Ninegroups of rats were divided into: normal, rats fed on high-fat diet for 12 weeks (NAFLD-HFD model), HFD-ratsswitched to regular diet (NAFLD-RD model), NAFLD-HFD or -RD rats treated with either ATO or NAC orally with30 or 500 mg/kg/day, respectively, or both for 8 weeks. NAFLD-HFD rats exhibited remarkable steatosis with lobularinflammation, hepatocytes vacuolation, and fibrosis, as well as significant changes in lipid profile, oxidative stress,and adipocytokines and these manifestations were less prominent in the HFD-RD group. ATO and NAC combinationwith diet control has the added benefits on ameliorating lipid levels, liver enzymes, oxidative stress, hepatic steatosis(9.01% ± 1.66% vs. 13.21% ± 2.20% for ATO and 25.60% ± 2.11% for NAC), inflammation, hepatocyte vacuolation,and fibrosis versus each drug separately. Conclusion: ATO and NAC concomitant therapy has a greater effect onNAFLD as compared to monotherapy and is recommended for further investigation in clinical trials.

Knowledge, attitude and practice of travel medicine among primary care physicians in Oman: the need for intervention

Background: Oman is witnessing an increase in outbound and inbound travelers.

Aims: This study was undertaken to assess the current knowledge, attitude, and practice of travel medicine among primary care physicians (PCPs) working in the Muscat Governorate.

Methods: We conducted a cross-sectional survey of 108 primary healthcare physicians in primary healthcare institutions in the Muscat Governorate in December 2014 using a self-administered questionnaire.

Results: We had a response rate of 81%, 78% (n = 84) were females, 56.5% (n= 61) were Omani nationals. More than 50% (n= 54) of study participants had been in practice for more than 8 years. Sixty-eight (58.3%) reported having pre-travel consultations during the previous 1-month period and 86 (79.6%) had post-travel consultations. Most of the PCPs were aware of the issues that needed to be addressed in pre-travel consultation.

Conclusions: This study showed that travel health is in an early stage of development in Oman and supports the need for the establishment of travel medicine services

Cap-Assisted Technique versus Conventional Methods for Esophageal Food Bolus Extraction: A Comparative Study

BACKGROUND/AIMS: Food bolus impaction is the most common form of esophageal foreign body impaction observed in adults. Clinical guidelines recommend using the push technique or retrieval methods in such cases. The push technique can cause injuries in certain clinical situations. Notably, conventional retrieval methods are time and effort consuming. Cap-assisted endoscopic extraction of an impacted food bolus is an easy and effective technique; however, more data are needed for its validation. This study compared the capassisted extraction technique with conventional methods. METHODS: This prospective observational multicenter study compared the success and en bloc removal rates, total procedure time, and adverse events in both techniques.. RESULTS: The study included 303 patients who underwent food bolus extraction. The push technique was used in 87 patients (28.7%) and a retrieval procedure in 216 patients (71.3%). Cap-assisted extraction was performed in 106 patients and retrieval using conventional methods in 110 patients. The cap-assisted technique was associated with a higher rate of en bloc removal (80.2% vs. 15%, p<0.01), shorter procedure time (6.9±3.5 min vs. 15.7±4.1 min, p<0.001), and fewer adverse events (0/106 vs. 9/110, p<0.001). CONCLUSIONS: Cap-assisted extraction showed no adverse events, higher efficacy, and a shorter procedure time compared with conventional retrieval procedures.

Differential role of gpaB and sidA gene expressions in relation to virulence in Aspergillus species from patients with invasive aspergillosis

Abstract The virulence genes in invasive aspergillosis (IA) have not been analyzed adequately. The present study was designed to evaluate the expression of gpaB and sidA genes, which are important virulence genes in Aspergillus spp. from bronchoalveolar lavage (BAL) samples. Direct examination and culture on Czapek Agar and Sabouraud Dextrose Agar media were performed for 600 BAL specimens isolated from patients with possible aspergillosis. A Galactomannan ELISA assay was also carried out. The expression levels of the gpaB and sidA genes in isolates were analyzed using quantitative real-time PCR (qRT-PCR). We identified 2 species, including Aspergillus flavus (A. flavus) and Aspergillus fumigatus (A. fumigatus) in 25 positive samples for invasive aspergillosis as validated using GM-ELISA. A. flavus is the main pathogen threatening transplant recipients and cancer patients worldwide. In this study, A. flavus had low levels of the gpaB gene expression compared to A. fumigatus (p = 0.006). The highest sidA expression was detected in transplant recipients (p = 0.05). There was no significant correlation between sidA expression and underlying disease (p = 0.15). The sidA and gpaB gene expression patterns may provide evidence that these virulence genes play important roles in the pathogenicity of Aspergillus isolates; however, there are several regulatory genes responsible for the unexpressed sidA and gpaB genes in the isolates.

Surveillance of adverse events following immunization in Oman, 2006-2015

Background: In 1996, Oman launched its surveillance programme for adverse events following immunization [AEFI] to address vaccine safety concerns. In 2010, an analysis of surveillance activities for AEFI was done for 10 years [1996-2005]. Objectives: The main objective of the study was to describe the trend of AEFI over the 10-year period, 2006-2015, and compare the findings with a previous report in Oman and reports from other countries. Methods: A descriptive record-based review of AEFI was carried out using the national AEFI surveillance database for the study period, 2006-2015. Results: A total of 890 adverse event reports were received, giving an annual rate during the review period of 21.4 per 100 000 population or 8.3 per 100 000 doses administered. The most frequently reported AEFI were BCG adenitis and local reactions - 31.1 and 4.1 per 100 000 doses respectively. There were no reported deaths. Pentavalent vaccine was responsible for the greatest proportion of adverse events [30%]. Local reaction was the most common adverse event among all vaccines administered. The Hexa vaccine caused fewer adverse events compared with the pentavalent vaccine, probably due to the acellular pertussis component – 0.8 versus 1.5 per 100 000 doses administered respectively. Conclusion: The overall rate of AEFI [8.3 per 100 000 doses administered] is comparable to the rate [10.8/100 000 doses] in the previous decade [1996-2005] in Oman. The reported rates for individual vaccines are similar to or below international rates

Diagnostic value of plasma m2-pyruvate kinase in egyptian patients with colorectal cancer

Background: M2-pyruvate kinase [M2-PK] is a tumor growth key regulator and plays a crucial role in tumor metabolism and can dynamically regulate aerobic glycolsis. Notwithstanding, the colonoscopy is the gold standard for early detection of colorectal cancer [CRC], the acceptance of this invasive technique is low

Aim of the work: to assess the diagnostic value of plasma M2-PK in Egyptian patients with CRC

Methods: we measured the plasma M2-PK using Enzyme-linked immunosorbent assay in CRC patients and comparing these levels with those obtained from patients with functional bowel disorders [FBD], inflammatory bowel disease [IBD],colorectal polyp and apparently healthy individuals and to detect its sensitivity and specificity

Results: the value of plasma M2-PK level was higher in CRC patients, 15.22 U/ml than other groups. Average plasma M2-PK was 6.78, 5.28, 2.25 and 2.1 U/ml among colorectal polyp, IBD, FBD patients and normal individuals respectively. The plasma M2-PK can be used in differentiating between CRC and normal individual with 83.33% sensitivity, 100% specificity at area under the curve [AUC] 0.949 with cut-off >6U/ml. Also, it can be used to discriminate between colorectal polyp and CRC patients at cut-off level of >10.6 U/mL with 75.5% sensitivity and 87.5% specificity and to differentiate between FBD and organic colonic lesions at cut-off level >3 U/ml with 81.94% sensitivity and 83.3% specificity

Conclusion: plasma M2-PK was considerably elevated in CRC patients and may be used as non-invasive biomarker for CRC. Recommendation: future researches including a large and long-term follow-up studies are recommended

Clinical utility of PCA3 assay in patients with suspicious prostate cancer

Background: this study evaluated the clinical utility of the PCA3 assay in guiding initial biopsy decisions in prostate cancer

Subjects and Methods: this study was conducted on fifty patients selected from the Urology Department at Ain Shams University Hospitals and scheduled for prostate biopsy after digital rectal examination first catch urine was collected. PCA3 scores were determined using RT-PCR and compared to biopsy outcome. The diagnostic accuracy of PCA3 was compared to total prostate specific antigen and %free prostate specific antigen

Results: the best cutoff for PCA3 was 4.6 folds [RQ]. This cutoff had a diagnostic sensitivity of 94.7%, specificity 95% and area under the curve [AUC] was 0.978. Total PSA at the cutoff 10 ng/mL had a diagnostic sensitivity 68%, specificity 70% and AUC was 0.766. At cut off 19%, f/t PSA ratio had a diagnostic sensitivity 38%, diagnostic specificity 90 %, and AUC was 0.529

Conclusions: the PCA3 assay can aid in guiding biopsy decisions. It is superior to total prostate specific antigen and %free prostate specific antigen in predicting initial biopsy outcome, and may be indicative of prostate cancer aggressiveness

Non-invasive assessment of liver fibrosis in patients with hepatitis C: shear wave elastography and colour Doppler velocity profile technique versus liver biopsy

Background and study aims: Determination of the presence and degree of liver fibrosis is essential for the prognosis and treatment of patients with chronic hepatitis C. Non-invasive methods of assessing fibrosis have been developed to reduce the need for biopsy. We determined the efficacy of shear wave elastography [SWE] and colour Doppler velocity as non-invasive methods for the assessment of liver fibrosis compared to liver biopsy among patients with chronic hepatitis C virus [HCV] infection

Patients and methods: In total, 117 patients with chronic HCV infection and 50 healthy age- and sexmatched control subjects were included. For each patient and control, abdominal ultrasonography, Doppler ultrasonography of the right portal vein [PV], and SWE were performed, whereas liver biopsy was performed for patients

Results: The mean value of the right PV maximum velocity was lower in patients with different stages of fibrosis than in controls [p < 0.001]. The mean value of liver stiffness determined by SWE was significantly higher in patients with different stages of fibrosis than in controls. Cutoff values for liver stiffness determined by SWE for assessing fibrosis stages were F2 >/= 4.815, F3 >/= 6.335, and F4 = 7.540 with a sensitivity of 84.6%, 96.2%, and 100.0%; specificity of 88.5%, 93.8%, and 100.0%; positive predictive value [PPV] of 93.6%, 98.0%, and 100.0%; negative predictive value [NPV] of 74.2%, 88.2%, and 100.0%; and overall accuracy of 85.9%, 95.6%, and 100.0% [area under the ROC curve [AUC]: 0.89, 0.96, and 1.0], respectively. Cutoff values for the right PV maximum velocity for assessing fibrosis stages were F2 < 23.4, F3 < 21, and F4 < 20 with a sensitivity of 65.0%, 57.4%, and 57.1%; specificity of 59.8%, 76.4%, and 75.5%; PPV of 33.8%, 58.3%, and 32.0%; NPV of 84.4%, 75.7%, and 89.7%; and overall accuracy of 61.1%, 69.5%, and 72.5% [AUC: 0.614, 0.696, and 0.625], respectively

Conclusion: SWE is effective for the non-invasive assessment of liver fibrosis in patients with HCV infection. SWE provides a more accurate correlation with liver fibrosis stage than colour Doppler velocity profile for the assessment of liver fibrosis, especially in advanced stages [F3 and F4]

Clinical utility of PCA3 assay in patients with suspicious prostate cancer

Background: this study evaluated the clinical utility of the PCA3 assay in guiding initial biopsy decisions in prostate cancer. Subjects and Methods: this study was conducted on fifty patients selected from the Urology Department at Ain Shams University Hospitals and scheduled for prostate biopsy after digital rectal examination first catch urine was collected. PCA3 scores were determined using RT-PCR and compared to biopsy outcome. The diagnostic accuracy of PCA3 was compared to total prostate specific antigen and %free prostate specific antigen. Results: the best cutoff for PCA3 was 4.6 folds (RQ). This cutoff had a diagnostic sensitivity of 94.7%, specificity 95% and area under the curve (AUC) was 0.978. Total PSA at the cutoff 10 ng/mL had a diagnostic sensitivity 68%, specificity 70% and AUC was 0.766. At cut off 19%, f/t PSA ratio had a diagnostic sensitivity 38%, diagnostic specificity 90 %, and AUC was 0.529. Conclusions: the PCA3 assay can aid in guiding biopsy decisions. It is superior to total prostate specific antigen and %free prostate specific antigen in predicting initial biopsy outcome, and may be indicative of prostate cancer aggressiveness

Evaluation of the response of fractional carbon dioxide [CO2] laser and punch elevation technique in treatment of acne scars: a split-face comparative clinical, histopathological, and immune histochemical study

Background: Acne is the most common skin disease affecting adolescents and young adults, with associated scarring and its sequelae. Treatment options are either lifting procedures raising scar base closer to normal skin surface, or resurfacing ones injuring epidermis and superficial dermis with neocollagenesis and epidermal repair. Punch elevation [PE] method is better for improving deep atrophic acne scars, that can be combined with depth resurfacing. CO2 laser stimulates new collagen formation, tightens skin and raises scar to surface

Aim of the Work: to assess efficacy and safety of combination of PE technique and fractional co2 laser [Fr co2 L] compared to fr co2 L alone

Subjects and Methods: 20 atrophic post acne scars patients were subjected to history taking, general and dermatological examinations, identifying scars types and grades. Treatment response at start, before each fr. co2 L session and 4 weeks after last laser session was clinically evaluated by Goodman and Baron scale, and recording patients' photographs, satisfaction, and complications. Histopathological examination of scar skin biopsies before and 4 weeks after the last fr. co2 L session was done using H and E, Mallory trichome, sliver stain and immunohistochemical VEGF

Results: combined treatment with fr co2 L and PE was more effective in improving post acne scars than fr. co2 L resurfacing alone. Histopathological examination before combined fr. co2 L and PE treatment and 1 month after the last fr. co2 L session showed high significant increase in epidermal thickness [H and E], increase in collagen fiber type III [Mallory trichrome stain], decrease in collagen fiber type I [sliver stain] and increase in fibroblasts' activity [VEGF]

Conclusion: both PE technique and fr. co2 L resurfacing show promising efficacy and safety in treating atrophic post acne scars, complementing each other to improve skin texture and appearance, with excellent cosmetic outcomes

relationship between anthropometric factors and iron deficiency anemia factors

Background: Iron deficiency is often observed in obese individuals. The prevalence of obesity has increased at an epidemic rate. A few small studies have noted a possible association between iron deficiency and obesity. The purpose of the study has been determined relationship between anthropometric including body mass index and the size of abdomen and iron-shortage anemia

Materials and Methods: Descriptive, analytical, and cross sectional methods of research have been applied in the study. The instruments used to collect the data were a set of organized items in the questionnaire and a checklist contained the measurement of abdominal obesity, height, weight, BMI, the results of ferritin levels, hemoglobin, hematocrit, and TIBC and MCV. The tools were validated via content validity and test-retest. The participants were the staff [n=300] of Hamadan branch, Islamic Azad university, Iran, who were selected via census sampling technique. To analyze the data, descriptive statistics and inferential statistics, that is, chi-square, Pearson correlation coefficient, and ANOVA were run using SPSS software

Results: 48.4% had overweight and 43.9% had various degrees of general obesity. 45.7% of women and 1.9% of men suffered from abdominal obesity. 3.2% of men had ferritin levels less than 20ng/dl and 79.2% of them had high levels of TIBC, while 31.5% of women had ferritin serum less than 12ng per dl and 73.9% of them had high TIBC. There was a significant relationship between abdominal obesity and TIBC, HB, HCT, and ferritin serum [p<0.0005]

Conclusion: The results of this study indicate the high prevalence of overweight, obesity, and abdominal obesity and their relationship with iron deficiency anemia. These are non-communicable disease, which are directly related to the lifestyle