Impact of Obesity and Its Associated Comorbid Conditions on COVID-19 Presentation.

BACKGROUND: There is great variability in clinical presentation of COVID-19 worldwide. The current study evaluated the impact of obesity and its related complications on the course of COVID-19 in Egyptian patients. METHODS: We included 230 COVID-19 Egyptian patients from Tanta City. According to their body-mass index (BMI), patient were divided into three groups: normal weight (BMI <25 kg/m2), overweight (BMI >25-<30 kg/m2), and obese (BMI ≥30 kg/m2). Patients' glycemic status, lipid profile, and serum levels of acute-phase reactants were assessed. The number of patients receiving intensive care and the number of deaths in each group were counted. RESULTS: Mean values of random blood sugar, serum cholesterol, triglycerides, serum ferritin, erythrocyte-sedimentation rate, LDH, CRP, D-dimer levels, and blood pressure were significantly higher in obese patients (165.6, 129.5, 105, 1,873, 26, 403, 56.45, 977.16 and 142/87, respectively) than in normal-weight (97.2, 103.5, 70.4, 479, 17.4, 252, 23.2, 612.4, and 118.6/76.8, respectively) and overweight patients (111.4, 106.3, 78.13, 491.3, 19.8, 269.27, 25.42, 618.4, and 120.3/79.3, respectively). Lymphopenia was also significantly predominant in the obese group. Multivariate logistic regression analysis revealed that elevated serum triglycerides, total cholesterol, low density-lipoprotein cholesterol, blood pressure, ferritin, CRP, and low relative lymphocyte count were significant risk factors in obese COVID-19 patients. CONCLUSION: Obesity and its related complications increase the risk of presenting a more severe form of COVID-19 in Egyptian patients.

The Potential Protective Effects of Diosmin on Streptozotocin-Induced Diabetic Cardiomyopathy in Rats.

BACKGROUND: Diabetic cardiomyopathy (DCM) is a nonischemic myocardial disorder characterized by metabolic disturbances and oxidative stress in diabetic patients. The present paper aims to determine the protective effect of the phlebotrophic drug, diosmin, on DCM in a model of high-fat diet-fed and streptozotocin-induced type 2 diabetes in the rat. MATERIALS AND METHODS: The animals were divided into 4 groups (8 rats/group) as follows: vehicle-treated nondiabetic control group, vehicle-treated diabetic group, diosmin (50 mg/kg)-treated diabetic group and diosmin (100 mg/kg)-treated diabetic group. Treatment was given once daily orally by gavage for 6 weeks. Oxidant and antioxidant stress markers, inflammatory markers and proapoptotic and antiapoptotic gene expression using quantified real-time polymerase chain reaction were investigated. RESULTS: Diosmin treatment in diabetic rats lowered elevated blood glucose levels, homeostatic model assessment for insulin resistance, cardiac creatine kinase and lactate dehydrogenase enzymes, cardiac malondialdehyde and nitric oxide. Moreover, diosmin increased plasma insulin and c-peptide levels, cardiac glutathione content, superoxide dismutase, catalase and glutathione S-transferase activities. Also, diosmin treatment significantly (P < 0.05) lowered the levels of interleukin-1ß (IL-1ß), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α), down-regulated cardiac Bcl-2-associated X protein and caspase 3 and 9 and up-regulated B-cell lymphoma 2 mRNA expression levels. CONCLUSIONS: Diosmin may have a sizeable therapeutic potential in the treatment of DCM due to antidiabetic, antioxidative stress, anti-inflammatory and antiapoptotic effects. Detailed studies are needed to disclose the precise mechanisms motivating the protective effect of diosmin .

Clinicopathological Criteria Defining Mucinous Appendiceal Tumors from 2476 Appendectomies: a Single-Center Retrospective Study.

OBJECTIVES: Mucinous appendiceal tumors (MATs) constitute 0.2-0.3% of appendectomies. This retrospective chart review study determines the incidence of MATs among appendectomies at King Abdul-Aziz Specialist Hospital, Taif City, Saudi Arabia, from January 2009 to December 2014. The clinicopathological features, histopathological criteria, management, outcomes of patients, and the impact of histopathological classification on the follow-up period and recurrence are evaluated. METHODS: Demographic and clinicopathological data were collected from medical records. Microscopic slides from 2476 appendectomies were re-examined to diagnose and classify MATs into low-grade mucinous neoplasms (LAMNs) and mucinous adenocarcinomas (MACAs). CK20, CK7, and cdx2 immunohistochemistry was applied for evaluating pseudomyxoma peritonei. Data were expressed as numbers, percentages, and mean ± standard deviation. RESULTS: Nine MATs were diagnosed with an incidence of 0.36% of appendectomies, a male:female ratio of 1.25:1 and a mean age of 57.2 years. Acute appendicitis was the commonest clinical presentation. About 66.7% were LAMNs and 33.3% MACAs. Beside appendectomy, MACAs were managed with right hemicolectomy and chemotherapy. The median follow-up was 34 months with recurrence and liver metastases in two MACAs. No recurrences for LAMNs. CONCLUSIONS: MATs constitute 0.36% of all appendectomies. Classifying MATs into LAMNs and MACAs is more applicable for both clinical and pathology practices as compared to the three- or four-tiered classification schemes.

Cytomorphologic patterns of Pap and PAS-stained oral exfoliative cytology smears in adult Saudi diabetic patients as compared to healthy controls.

INTRODUCTION: Diabetes mellitus (DM) is one of the most common metabolic disorders worldwide and 425 million people were estimated to have diabetes by 2017. Oral manifestations reflect the metabolic control of diabetes. Exfoliative cytology using Papanicolaou (Pap) and periodic acid Schiff (PAS) stains is a practical technique to evaluate oral epithelial cytomorphologic changes in diabetes. AIM: This study analyzes the cytomorphologic changes and the glycogen content in exfoliated oral epithelial cells among diabetic patients as compared to healthy controls using Pap and PAS stains to verify the utility of exfoliative cytology as adjunct to diagnosis, follow up or screening of diabetes. SUBJECTS AND METHODS: Eighty-nine participants; 38 adult diabetic patients (case group) and 51 age-matching nondiabetics (control group) were enrolled in the study after fulfilling appropriate inclusion and exclusion criteria. Sampling and staining procedures were performed using routine protocols. Slides were observed by two pathologists and categorized as inflammatory, dyskaryotic and negative. Glycogen content was expressed as PAS negative or +, ++, and +++ positive. RESULTS: The difference between the diabetics and the controls was statistically significant regarding inflammatory, dyskaryotic/nuclear changes and glycogen content and staining intensity. Other observed finding in diabetic patient smears included binucleation, polychromic, and/or vacuolated cytoplasm. CONCLUSIONS: Cytomorphologic changes of oral epithelial cells reflect the complex pathological mechanisms by which DM affects cellular metabolism and function. Cytomorphologic patterns of Pap and PAS-stained oral exfoliative cytology smears can be helpful for diagnosis, follow up as well as for screening for diabetes in high prevalence communities.

Effect of phosphodiesterase inhibitors on renal functions and oxidant/antioxidant parameters in streptozocin-induced diabetic rats.

The goal of this study was to investigate the effect of different phosphodiesterase inhibitors (PDEIs), on renal oxidant/antioxidant balance in diabetic rats. Our study was conducted on 125 rats, diabetes was induced in 100 rats by a single administration of streptozocin (STZ). Diabetic rats were divided into four equal groups. The first group was assigned as diabetic control, the remaining three groups were treated with pentoxifylline, sildenafil and milrinone via drinking water for 15 successive days, another group of 25 normal rats was assigned as non-diabetic control. Significant increase in plasma levels of glucose, urea, creatinine, malondialdehyde (MDA), and nitric oxide (NO) with a concomitant decrease in the levels of insulin, reduced glutathione (GSH), glutathione peroxidase (Gpx), superoxide dismutase (SOD), catalase (CAT), and total antioxidant capacity (TAC) were observed in diabetic rats. These alterations were reverted back to near normal level after treatment with PDEIs. Our data seem to suggest a potential role of PDEIs in maintaining health in diabetes by reducing the progression of diabetic nephropathy.

Alteration of the Total Nuclear DNA Ploidy in Different Histopathological Liver Tissues Negative and Positive for HCV RNA.

BACKGROUND: Hepatitis C virus (HCV) infection is associated with the development of hepatocellular carcinoma (HCC). The molecular mechanisms of HCV-associated carcinogenesis are unknown. We aim to investigate the alteration of the total nuclear DNA content (ploidy) in different histopathological liver tissues infected with HCV and their relation to the seropositivity of HCV RNA. METHODS: Blood and liver tissues were collected from 26 patients. Diagnosis was carried out according to clinical and pathological examinations by specialized physicians. HCV RNA was detected in patients' sera and tissue samples by RT-PCR. To examine nuclear DNA ploidy, liver tissues were stained with blue Fulgen using the image analysis techniques. Finally, the patients' DNA content was examined by histochemical analysis depending on the optical density of DNA from liver biopsies using the grey image menu in each specimen. RESULTS: The HCV RT-PCR results demonstrated that 13/26 (50%) patients had detectable HCV RNA in their sera samples while 18/26 (69%) had detectable HCV RNA in liver tissues. The DNA content from those patients measured by image cytometry showed a high level of alteration of nuclear DNA ploidy and proliferation in liver tissues with HCC, less alteration of nuclear DNA ploidy in cirrhotic patients, and least proliferation nearly normal in liver fibrosis patients. Moreover, the results of histochemical analysis confirmed the DNA image cytometry results and showed that positive HCV RNA liver tissues had more DNA ploidy than negative HCV RNA liver tissues with statistical significance (p-value < 0.05). CONCLUSIONS: HCV positive liver tissue had alterations in DNA content (ploidy) which may lead to liver disease progression, malignant transformation of the liver cells and development of hepatocellular carcinoma.