The Relationship Between Acne Vulgaris and Insulin Resistance.

Acne vulgaris is a chronic inflammatory disease of the pilosebaceous unit that usually affects adolescents. The aetiology and severity of acne may be influenced by hyperinsulinemia and insulin resistance. A case-control study was conducted in the dermatology outpatient clinic of Al-Fayhaa Teaching Hospital in Basrah city. C-peptide and triglyceride-glucose (TyG) index levels were measured in 43 acne vulgaris patients who were age- and gender-matched with 48 controls. The results found that 81% and 67% of acne patients have insulin resistance based on their C-peptide and TyG index levels, respectively, and this is significantly higher than the control candidates (P = 0.001). Furthermore, a higher value of C-peptide was found among acne cases compared to controls (2.84 ± 1.23 vs. 1.68 ± 0.19) (P = 0.001), and a higher value of the TyG index was found among cases compared to controls (4.43 ± 0.17 vs. 3.38 ± 0.19) (P = 0.001), in addition to a significant positive and strong correlation between the level of these biomarkers and the acne severity (r = 0.760 for the C-peptide and 0.814 for the TyG index) (P = 0.001).

Which one predicts mortality better? Hemogram and ST elevation myocardial infarction.

OBJECTIVE: The aim of this study was to determine the effectiveness of hematological parameters measured at the moment of admission to the emergency room in predicting in-hospital mortality and to determine cut-off values of strongly predictive values. SUBJECTS AND METHODS: The study began with approval of the ethics committee. In total, 1,929 patients over 18 years of age, whose date could be obtained, were included in the study. From the hemogram parameters, white blood cells (WBC), red cell distribution width, mean platelet volume, and ratio of neutrophils to lymphocytes (NLR) values were determined and recorded. CK-MB and high-sensitive Troponin T values were recorded as cardiac markers. For statistical analysis, "SPSS for Windows Version 21" package program was used. FINDINGS: About 71.7% (n = 1384) of the patients were male and 28.3% (n = 545) of the patients were female. About 92.5% of the patients (n = 1785) were discharged from the hospital, whereas the remaining 144 patients (7.5%) were exitus in the hospital. When the efficacy of hematological parameters and cardiac markers in predicting mortality was examined by receiver operating charecteristics analysis, NLR was found to be the strongest predictor (area under the curve [AUC], 0.772, standard deviation [SD] = 0.022, 95% confidence interval [CI]). It was found that the WBC value came in second place after NLR as a strong predictor of mortality (AUC, 0.749, SD = 0.024, % 95 CI). CONCLUSION: The use of predictors for the prediction of mortality for ST elevation myocardial infarction patients is of great importance for faster implementation of treatment modalities. We found that WBC and especially NLR values obtained with a simple method can be used as powerful predictors.

Seroclearance of Hbsag in Chronic Hepatitis B Virus Patients on Lamivudine Therapy: A 10 Year Experience.

INTRODUCTION: The aim of this study was to determine hepatitis B surface antigen (HBsAg) seroclearance rate among patients treated with lamivudine at a specialized tertiary care referral hospital in Tehran, Iran. METHODS: All patients on lamivudine (biovudin®) therapy at a dose of 100 mg/day, who showed seroclearnace between March 2001 and September 2011 were recruited. The main evaluation parameters were duration of HBsAg seroclearance and duration of HBsAg seroconversion. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were evaluated using standard methods. HBsAg seroclearance was defined as two consecutive negative serums HBsAg at least 6 months apart, whereas HBsAg seroconversion was defined as the disappearance of serum HBsAg and the presence of anti-HBs for >6 months. RESULTS: A total of 203 chronic HBV patients treated with lamivudine at a dose of 100 mg/day were included in the study. HBsAg seroclearance and seroconversion were observed in 11 patients after the initiation of the lamivudine therapy. Overall, in lamivudine responder patients, the mean time to HBsAg seroclearance was 26.90±10.93 months (range: 12-48 months). Furthermore, the responders showed seroconversion after a mean time of 26.90±11.08 months from the initiation of lamivudine therapy. When comparing the characteristics of those who have responded to lamivudine and those who have not responded, baseline HBV-DNA levels was significantly lower in responder than non responder patients (p<0.001). Meantime, there was no difference in age, sex, baseline ALT, AST and liver biopsy score between lamivudine responder and lamivudine non-responder patients. CONCLUSION: Despite introduction of tenofovir and entecavir as first line treatment for chronic HBV infection, lamivudine remains to be a low cost, safe and effective drug for HBsAg seroclearnace.

The importance of size of cervical ectopy to predict postcoital bleeding: is there any cut-off value?

OBJECTIVE: To investigate the relationship between size of cervical ectopy and existence of postcoital bleeding (PCB) in non-symptomatic women. MATERIALS AND METHODS: Study population were recruited from women ages 18-65 years, sexually active who applied to the present outpatient department. They were asked whether they had had postcoital bleeding in the last three months. After ful visualization of the cervix, the existence of ectopy was noted and measured. The smears were taken from all patients with endobrushes. RESULTS: The authors found a relationship between the size of ectopy and PCB. In the prediction of PCB, the lesion's size (of both antero-posterior and transverse diameters) of 3.5 mm as the cut off level, sensitivity, and specificity were found to be 70% and 76%, respectively. CONCLUSION: The full visualization of the cervix is important because of the relationship between the existence of ectopy and PCB.

Effects of natural progesterone on endometriosis in an experimental rat model: is it effective?

UNLABELLED: To assess the effects of the natural progesterone on the endometriosis in a rat model. MATERIALS AND METHODS: Endometriosis was surgically induced in 20 rats by transplanting an autologous fragment of endometrial tissue onto the inner surface of the abdominal wall. Rats in control group had no medication but 2.5 mg/kg/weekly natural progesterone was administered to rats in study group for four weeks. After that, all rats were sacrificed and dimensions of endometriosis were measured and they were evaluated morphologically and histologically. Scoring systems were used to evaluate preservation of epithelia. RESULTS: Two rats in the study group and one rat in the control group died of complications related to surgery. At the end of the treatment, there was a reduction in the size of the endometriotic lesions in the study group (p < 0.01). According to histological evaluation, the study group had lower score than control goup which was statistically significant (p = 0.014). CONCLUSIONS: Natural progesterone is effective against endometriosis in rat model.

Complications of gynecological laparoscopy: experience of a single center.

BACKGROUND: The purpose of this study was to describe the prevalence and type of laparoscopic complications seen in a teaching hospital. MATERIALS AND METHODS: Four hundred and forty-one diagnostic and operative laparoscopic procedures were performed by the same senior resident/resident surgical team. Direct entry technique was used for all procedures. RESULTS: The procedures included 74 (16.8%) diagnostic and 367 (83.2%) operative laparoscopies. The overall complication rate was 7.7% (34 cases). Conversion to laparotomy occurred in 16 cases (3.6%). CONCLUSIONS: The complication rate was found to be slightly higher than the rates quoted in the literature. This rate of 7.7% is still an acceptable one.

Coexistence of blaOXA-48 and aac(6')-Ib-cr genes in Klebsiella pneumoniae isolates from Istanbul, Turkey.

This study evaluated the presence of carbapenem hydrolysing ß-lactamase genes and plasmid-mediated quinolone resistance (PMQR) determinants in 22 Klebsiella pneumoniae isolates collected from the Istanbul Medical Faculty, Turkey, which reduced the susceptibility or resistance to carbapenem. The VITEK(®) 2 system and E-tests were used to determine the minimum inhibitory concentrations needed to inhibit bacterial growth. Genes were screened by polymerase chain reaction, and gene transferability was evaluated by transconjugation. Strain clonality was investigated by pulsed-field gel electrophoresis (PFGE). All strains were OXA-48 ß-lactamase producers and three (13.6%) were also positive for the aac(6')-Ib-cr gene. Most of the strains harboured other ß-lactamase (bla) genes such as bla(TEM), bla(SHV), bla(CTX-M) and bla(VEB-1). The transconjugants mostly harboured bla(OXA-48) and other ß-lactamases separately. PFGE revealed eight pulsotypes among the isolates. The coexistence of bla(OXA-48) and PMQR in K. pneumoniae isolates may present a significant threat to health, especially in the nosocomial setting.