Predictive value of body mass index (BMI) and determination of optimum cut-off point in the diagnosis of endometrial hyperplasia in pre-menopausal women with abnormal uterine bleeding.

Background: The suitable BMI cut-off point in persons with endometrial cancer or hyperplasia with abnormal uterine bleeding was investigated in this study. Methods: This case-control research was conducted on 1470 women with abnormal uterine bleeding in Ayatollah Rouhani Hospital,Babol between 2010 and 2012, with 312 participants included in the study. In terms of uterine biopsy results, patients were split into six groups: simple hyperplasia without atypia, simple hyperplasia with atypia, complicated hyperplasia with atypia, complex hyperplasia without atypia, endometrial cancer, and normal persons. Results: The mean age and BMI of patients in these three groups were not significantly different (P equal to 0.081 and 0.435, respectively). The kind of disease exhibited a strong relationship with menstruation (P 0.001). The body mass index (BMI) values ​​did not have significant levels under the curve to determine the appropriate cut-off point in the diagnosis of hyperplasia plus endometrial cancer and endometrial cancer alone (P 0.380 and 0.124, respectively) and hyperplasia alone (P = 0.920). Based on logistic regression, age 50 years and older and irregular menstruation were significant with OR equal to 2.36 and 2.09 (P = 0.011) and HTN with OR equal to 0.44 (P = 0.026), respectively. Conclusion: BMI has little predictive value in the detection of endometrial cancer or hyperplasia, according to the findings, and other diagnostic and screening modalities should be utilized instead. The findings backed up the theory that old age and irregular menstruation are linked to an increased risk of endometrial cancer.

Aftermath histopathological findings of 2019 novel Coronavirus (COVID-19) pneumonia.

Background: There have been several studies describing clinicoradiological features of the novel coronavirus SARS-CoV-2 infection. It seems that we still should know more about pathological features in the different stages of this infection. Case presentation: A 77 year-old man with cough and respiratory distress was admitted to the intensive care unit.  Real-time PCR on nasopharyngeal swab was done for him and it was positive for SARS-CoV-2.He was treated with oxygen therapy, hydroxychloroquine and antibiotic therapy and was discharged from the hospital with brief improvement of clinical symptoms. However, due to persistent dyspnea, the patient was admitted to the hospital again and throracotomy and wedge biopsy were performed for about 3 months from the onset of symptoms. Conclusion: Pathological examination revealed diffuse alveolar damage, fibroblastic hyperplasia, infiltration of inflammatory cells and hyaline membrane formation.

Association of sonic hedgehog signaling pathway genes IHH, BOC, RAB23a and MIR195-5p, MIR509-3-5p, MIR6738-3p with gastric cancer stage.

Gastric cancer is the leading cause of cancer-related mortality worldwide. Given the importance of gastric cancer in public health, identifying biomarkers associated with disease onset is an important part of precision medicine. The hedgehog signaling pathway is considered as one of the most significant widespread pathways of intracellular signaling in the early events of embryonic development. This pathway contributes also to the maintenance of pluripotency of cancer stem cells pluripotency. In this study, we analyzed the expression levels of sonic hedgehog (Shh) signaling pathway genes IHH, BOC, RAB23a and their regulatory miRNAs including MIR-195-5p, MIR-509-3-5p, MIR-6738-3p in gastric cancer patients. In addition, the impact of infection status on the expression level of those genes and their regulatory miRNAs was investigated. One hundred samples taken from 50 gastric cancer patients (50 tumoral tissues and their adjacent non-tumoral counterparts) were included in this study. There was a significant difference in all studied genes and miRNAs in tumoral tissues in comparison with their adjacent non-tumoral counterparts. The lower expression of IHH, BOC, RAB23, miR-195-5p, and miR-6738-3p was significantly associated with more advanced cancer stage. Additionally, IHH upregulation was significantly associated with CMV infection (P < 0.001). Also, receiver operating characteristic (ROC) curve analysis indicated that mir-195 was significantly related to several clinicopathological features including tumor stage, grade, age, gender, and infection status of gastric cancer and can be considered as a potential diagnostic biomarker for gastric cancer. This study confirms the important role of Shh signaling pathway genes in gastric cancer tumorigenesis and their potential as novel molecular biomarkers and therapeutic targets.

Correlation between systemic markers of inflammation and local synovitis in knee osteoarthritis.

BACKGROUND: In the elderly population joint swelling, effusion and pain indicate local synovitis and the presence of inflammation. At present, no serum marker has been shown linking to knee synovitis in KOA. With regard to serum high sensitive C-reactive protein (hsCRP) as a measure of inflammation, this study aimed to determine the association of systemic inflammation with local synovitis, as well as with pain and muscle strength in KOA. METHODS: The study population was selected consecutively among patients with KOA presented to Ayatollah Rouhani Hospital Rheumatology Clinic with knee joint synovitis. The diagnosis of KOA was confirmed according to the American College of Rheumatology diagnostic criteria. Data regarding radiographic, demographic and biochemical characteristics were provided and IL-17, IL-10, TGF-ß and hsCRP in serum and synovial fluid (SF) were measured in all patients. Stepwse linear regression models were used to determine the correlation between SF- hsCRP as a measure of local inflammation with other systemic or local markers of inflammation. RESULTS: A total of 40 patients (women 65%) with mean age 65.6+8.9 (49-86) years, mean BMI 27.7+3.7 (22-38) kg/m2, were analyzed. SF-hsCRP was positively correlated with serum hsCRP as well as serum and SF cytokines. Knee pain was positively associated with BMI and radiographic severity and negatively with quadriceps muscle strength (QMS) (r=-0.350, p=0.029). In stepwise linear regression analysis the SF-hsCRP was positively correlated with serum hs-CRP (r=0.769, p=0.001), SF-IL-17 (r=0.428, p=0.001) and negatvely with serum IL-10 (r=-0.316, p=0.002). CONCLUSION: These findings indicate that systemic markers of inflammation such as serum hsCRP, and IL-17 are associated with local inflamation in KOA.

Huge maxillary metastasis of an aggressive Pancoast tumor -A case report.

BACKGROUND: Metastatic carcinomas to the upper jaw region are very rare and unfortunately occur in advanced stages of malignancies. Pancoast tumor is a challenging subset of lung carcinoma commonly followed by distant metastasis. Since the metastatic lesion of our patient was very huge and unusual, we decided to report the case. CASE PRESENTATION: Our patient was a middle-aged heavy smoker male with a history of unresectable pancoast tumor. He was referred to the dental clinic with an expanded maxillary metastasis involving the bone and sinus region as well as oral soft tissues. To confirm the primary site of his malignancy, immunohistochemical staining was performed. CONCLUSION: Distant metastases of a pancoast tumor are more frequent when the primary tumor is unoperable and bone involvement is one of the early manifestations of disease.

The negative association between inflammatory bowel disease and Helicobacter pylori seropositivity.

BACKGROUND: The role of Helicobacter pylori (H. pylori) in inflammatory bowel disease is a controversial argument. The initial theory of this study was that Helicobacter is a risk factor for inflammatory bowel disease. In this study, we investigated the coincidence of H. pylori exposure and IBDs. METHODS: This case-control study has been done in Babol, teaching Hospitals; 60 newly diagnosed IBD cases without any Helicobacter eradicating treatment and 120 control patients without inflammatory bowel disease evidence in biopsy, investigated for H. pylori exposure by IgA and IgG ELISA tests. Clinical information, demographics and ELISA test results have been analyzed using SPSS.Version.18 (level of significance was less than 0.05). RESULTS: Mean age of case group was 42.27±13.64 years; in control group it was 45.52±13.83 years. There was a significant difference between the case and control groups in IgG study of the following subgroups: age under 30, females, males, urban, higher education level and BMI between 18.5 and 24.9 (p-value was respectively; 0.004, 0.014, 0.047, 0.002, 0.013, 0.003). On the basis of logistic regression; IBD was less common in females, patients with lower education and patients with positive result of IgG (p-value was respectively 0.002, 0.013, 0.010). CONCLUSION: As a result of this study, Helicobacter pylori exposure, may could play a protective role against inflammatory bowel disease.

CTNNBIP1 downregulation is associated with tumor grade and viral infections in gastric adenocarcinoma.

Gastric cancer is a life-threatening disease; resulting from interaction among genetic, epigenetic, and environmental factors. Aberrant dysregulation and methylation changes in Wnt/ß-catenin signaling downstream elements are a prevalent phenomenon encountered in gastric tumorigenesis. Also, viral infections play a role in gastric cancer development. CTNNBIP1 (ß-catenin interacting protein 1) gene is an antagonist of Wnt signaling which binds to the ß-catenin molecules. The CTNNBIP1 function as tumor suppressor gene or oncogene in different types of cancer is controversial. Moreover, its function and regulatory mechanisms in gastric cancer progression is unknown. In the present study, we examined CTNNBIP1 gene expression, the methylation status of the regulatory region of the gene, and their association with Epstein-Barr virus (EBV), and cytomegalovirus (CMV) and Helicobacter pylori infections in human gastric adenocarcinoma tissues in comparison with their adjacent nontumoral tissues. Our data revealed a significant downregulation of CTNNBIP1 in gastric tumors. Female patients showed lower level of CTNNBIP1 than males (p < 0.05). Also, decreased expression of CTNNBIP1 was markedly associated with well-differentiated tumor grades (p < 0.05). No methylation change was observed between tumoral and nontumoral tissues. Additionally, CTNNBIP1 down regulation was significantly associated with CMV infection (p < 0.05). In the absence of EBV infection, lower expression of CTNNBIP1 was observed. There was no association between H. pylori infection and CTNNBIP1 expression. Our findings revealed the tumor suppressor role for CTNNBIP1 in gastric adenocarcinoma. Interestingly, EBV and CMV infections modulate CTNNBIP1 expression.

Association of Helicobacter pylori Infection With Colon Cancer and Adenomatous Polyps.

BACKGROUND AND OBJECTIVE: Helicobacter pylori infection is one of the most common chronic bacterial infections in the world, especially in the developing countries. This bacterium is the cause of many diseases such as lymphoma, gastritis, peptic ulcers, and stomach cancer. According to recent reports, H. pylori infection can potentially increase the risk of colon cancer. The current study aimed at investigating the association of H. pylori infection and the risk of colorectal cancer and adenomatous polyps. METHODS: The current study was conducted on 50 patients with colon cancer and adenomatous polyps as the case group and 100 subjects with no specific pathologies (i e, polyps, neoplasms, or inflammatory diseases) as the control group. Blood samples were collected from the patients in order to assess the presence of anti-Helicobacter pylori infection antibodies, and the serum titer levels of anti-Helicobacter pylori IgG and IgA antibodies were measured using indirect enzyme-linked immunosorbent assay (ELISA) and a kit procured by Pishtaz Teb Company (Iran). RESULTS: A total of 33 patients in the current study had adenomatous polyps and 17 had colon cancer. H. pylori infection (IgA >20 U/mL and IgG >10 U/mL) was significantly more prevalent in the patients with colon cancer and adenomatous polyps compared with the healthy controls (P= 0.003, P= 0.039, respectively). CONCLUSION: The obtained results suggested that H. pylori infection can be considered as a risk factor for colon cancer and adenomatous polyps.

Relationship between hepatitis B DNA viral load in the liver and its histology in patients with chronic hepatitis B.

BACKGROUND: Serial measurement of hepatitis B virus (HBV) DNA levels in the liver and its relation with liver damage and serum HBV DNA levels are guide to begin and/or end a treatment course. This study evaluated the relationship between liver hepatitis B DNA viral load with liver histology in patients with chronic hepatitis B (HBV). METHODS: Thirty patients with chronic anti-Hbe positive hepatitis B, with liver enzymes ≥ 2 times of the upper limit of normal and positive HBV DNA of any amount were entered in the study. They underwent percutaneous liver biopsy. Liver and serum viral load were determined using real time polymerase chain reaction method (RT-PCR). Liver function tests and liver histology for all cases were recorded. The amount of viral load in the liver and histological grading and staging were recorded. Data were collected and analyzed. RESULTS: The mean age of the patients was 32.8±10 years and 24 (80%) patients were males. Ten (33.3%) patients had HBV viral load levels less than 20000 IU/mL. There was a significant correlation between liver viral load levels with staging or grading of liver damage. CONCLUSION: The results of the present study showed a strong correlation between liver viral load and liver damage in patients with chronic hepatitis B.