Dysgerminoma in a 15 years old phenotypically female Swyer syndrome with 46, XY pure gonadal dysgenesis: A case report

Swyer syndrome is a 46, XY karyotype, with pure gonadal dysgenesis and primary amenorrhea. These females have primordial Mullerian structures and seek medical attention as they experience primary amenorrhea. Here, we report a 15‐year‐old girl, diagnosed as Swyer syndrome associated with left ovarian dysgerminoma.     

Histopathologic Findings of Pneumatocele in a Patient with Hyper-IgE syndrome, compatible with cystic adenomatoid malformation

Hyper-immunoglobulin E syndrome is a rare primary immunodeficiency disease characterized by recurrent abscess formation, respiratory tract infections and very high titers of serum IgE associated with peculiar face and skeletal features. We report a seven-year old girl presenting with persistent productive cough and history of chronic eczematoid facial lesions since infancy and two episodes of hospitalizations due to pneumonia and perianal abscess. Additionally, in physical examination finger tip clubbing, laxity of joints and crackles in both lungs were detected. Immunologic work up revealed markedly raised IgE level and eosinophilia. The patient was diagnosed as hyper IgE syndrome based on his clinical and laboratory findings. Chest X-ray revealed multiple large cystic lesions in left lung which were confirmed by spiral CT-scan. Pneumonectomy specimen examination showed cystic adenomatoid malformation, characterized by the presence of various cysts lined by epithelium in different sizes. There are few reports of cystic adenomatoid malformation in children. To our best known, this is the first report of cystic adenomatoid malformation in a child with hyper IgE syndrome. Early diagnosis and surgical therapy are helpful in prevention of repeated infections in these patients.     

Morning melatonin serum values do not correlate with disease activity in rheumatoid arthritis: a cross-sectional study

Rheumatoid arthritis (RA), the most prevalent autoimmune arthritis worldwide, usually presents with a circannual manner and, meanwhile, follows a circadian rhythm for symptoms like morning stiffness. Therefore, association between RA and some hormones such as melatonin (MLT) and vitamin D, whose serum values are related to body circadian rhythms or seasonal variations, has become more noticeable recently. Since some studies proposed that RA patients show altered MLT circadian rhythms, especially in concordance with symptoms, in this research, we present the correlation between MLT serum values and RA disease activity score (DAS28ESR). The current cross-sectional study was carried out on 80 volunteers (60 patients and 20 healthy controls). Fifty percent of the participants in each group were sampled in cold, and the same percentage were sampled in warm seasons at 8 a.m. Disease activity was estimated utilizing DAS28ESR. Patients with possible known confounders of MLT secretion were excluded. A commercial MLT ELISA kit was employed to measure MLT. Statistical analysis was conducted by SPSS-11 software. This study outlined higher serum values of MLT in RA patients compared with controls (P = 0.006, z = ?2.73). However, MLT did not correlate with DAS in patients (P = 0.45, r = ?0.09). GLM analysis demonstrated that DAS28ESR, age, disease duration, medications, gender, and season of sampling had no influence on serum MLT. However, newly diagnosed RA patients presented higher MLT values than established ones (P = 0.03, t = ?2.2). A cutoff point value of 23 pg/mL (63.3 % sensitivity and 90 % specificity) for MLT was computed between patients and controls. This study denoted that morning MLT serum values are higher in RA patients than in healthy volunteers. However, MLT and RA disease activity or other disease characteristics do not correlate. MLT serum values were higher in newly diagnosed RA patients than established ones.     

Gender differences in non-glycemic responses to improved insulin sensitivity by pioglitazone treatment in patients with type 2 diabetes

Excess cortisol and GH induce insulin resistance, a central feature of type 2 diabetes (T2D). To study whether the insulin sensitizer pioglitazone affects basal cortisol levels and the GH–IGF-I axis in patients with T2D. Forty-eight patients with T2D (men/women = 28:20, age 61 ± 1 years, BMI 31 ± 0.6 kg/m²) were treated for 26 weeks with pioglitazone 30–45 mg daily in addition to their preexisting therapy. Insulin, proinsulin, HbA_1c, IGF-I, IGFBP-1, and basal cortisol were analyzed before and after treatment. Pioglitazone decreased proinsulin/insulin ratio and HbA_1c decreased (HbA_1c from 7.8 ± 0.2 to 6.6 ± 0.2 % in men and from 7.6 ± 0.2 to 6.1 ± 0.2 % in women, p < 0.001 in both). There was a redistribution of fat but no change in waist circumference. IGF-I and adiponectin increased (p ≤ 0.001) in both genders. IGFBP-1 increased but significantly only for the whole group (p = 0.033). Triglycerides decreased significantly in women only (p = 0.015). Before treatment, women had lower basal cortisol (p = 0.045). Basal cortisol increased in women (from 390 ± 26 to 484 ± 32 nmol/L, p = 0.020) but not in men and did not differ between genders at week 26. ΔIGFBP-1 correlated with Δcortisol (r = 0.458; p = 0.049) and Δadiponectin (r = 0.600; p = 0.005) in women only. In addition to the known effect of improving insulin sensitivity, pioglitazone increased IGF-I regardless of gender and in women also increased basal cortisol. Increased IGF-I may contribute to improved insulin sensitivity after treatment. There seems to be gender differences in treatment responses to pioglitazone on lipid metabolism and basal cortisol, perhaps correcting different mechanisms of insulin resistance between genders.     

Mercury in Wetland Birds of Iran and Iraq: Contrasting Resident Moorhen, <Emphasis Type="Italic">Gallinula chloropus,</Emphasis> and Migratory Common Teal, <Emphasis Type="Italic">Anas crecca,</Emphasis> Life Strategies

We document mercury distribution in tissues of two waterfowls; moorhen (Gallinula chloropus; n = 6), and Common Teal (Anas crecca; n = 6) from Shadegan wetlands in Southwestern Iran. Mean value of mercury in moorhen liver was (0.36 Hg μg g⁻¹ dry weight), Common Teal had (4.34 Hg μg g⁻¹ dry weight) mercury. In all tissues, Common Teals had significantly higher mercury concentrations than moorhens (U test, p ≤ 0.05). Mercury was 12, 9, 8, and 6 times higher in liver, muscle, kidney, and feather of Common Teals. These birds have comparable diets but Common Teals are migratory and moorhens are residents of Shadegan wetlands.     

Low Postprandial Circulating Inactive Ghrelin: Role of Early Satiety in Undernourished Children

Objective

To determine difference in the levels of circulating inactive ghrelin between undernourished and healthy children.

Methods

The present cross-sectional study was conducted in undernourished children from southwestern Iran, from July 2011 through July 2012. Postprandial inactive ghrelin levels were measured in 40 undernourished children and sex- and age-matched healthy controls by enzyme immunoassay.

Results

The levels of postprandial inactive ghrelin were considerably lower in undernourished compared to the healthy children (6.4 vs. 12.9, P?vs. 7.1, P?=?0.032).

Conclusions

Thus, the levels of inactive ghrelin was found to be low in undernourished children compared to healthy children. Early loss of appetite might be a result of low circulating inactive ghrelin levels in the postprandial state in undernourished children.     

Intranasal Midazolam Compared with Intravenous Diazepam in Patients Suffering from Acute Seizure: A Randomized Clinical Trial

Objective

Acute seizure attack is a stressful experience both for health care personnel and parents. These attacks might cause morbidity and mortality among patients, so reliable methods to control the seizure preferably at home should be developed. This study was performed to measure the time needed to control seizure attacks using intranasal midazolam compared to the common treatment (intravenous diazepam) and to evaluate its probable side effects.

Methods

This study was conducted as a not blind randomized clinical trial among 60 patients coming to Imam Ali Hospital, Zahedan, Iran. The patients were 2 months to 15 years old children coming to our emergency department suffering from an acute seizure episode. Intranasal midazolam was administered 0.2 mg/kg equally dropped in both nostrils for case group and intravenous diazepam was administered 0.3mg/kg via IV line for control group. After both treatments the time needed to control the seizure was registered by the practitioner. Pulse rate and O2 saturation were recorded at patients’ entrance and in minutes 5 and 10 after drug administration.

Findings

The time needed to control seizure using intranasal midazolam (3.16±1.24) was statistically shorter than intravenous diazepam (6.42±2.59) if the time needed to establish IV line in patients treated by intravenous diazepam is taken into account (P<0.001). The readings for O2 saturation or heart rate did not indicate a statistically significant difference between two groups of patients either at entrance or 5 and 10 minutes after drug administration.

Conclusion

Considering the shorter time needed to control acute seizure episodes compared to intravenous diazepam and its safety record, intranasal midazolam seems to be a good candidate to replace diazepam, as the drug of choice, in controlling this condition.     

Comparing the effects of Calendula officinalis and clotrimazole on vaginal Candidiasis: A randomized controlled trial

This triple-blind trial examined the effects of Calendula officinalis vaginal cream on the treatment of vaginal Candidiasis (primary outcome) and sexual function (secondary outcome). Married women aged 18–45 years with vaginal Candidiasis (n = 150) were recruited from April to October 2014 and randomized into Calendula and clotrimazole groups, using 5-g vaginal cream every night for seven nights. Clinical and laboratory assessments were conducted at 10–15 and 30–35 days after intervention and the female sexual function index was assessed at 30–35 days. Six women were lost to follow-up. The frequency of testing negative for Candidiasis in the Calendula group was significantly lower at the first (49% vs. 74%; odds ratio (OR) 0.32; 95% confidence interval (CI) 0.16–0.67) but higher at the second (77% vs. 34%; OR 3.1; 95% CI 1.5–6.2) follow-up compared to the clotrimazole group. The frequency of most signs and symptoms were almost equal in the two groups at the first follow-up, but were significantly lower in the Calendula group at the second follow-up. Sexual function had almost equal significant improvement in both groups. Calendula vaginal cream appears to have been effective in the treatment of vaginal Candidiasis and to have a delayed but greater long-term effect compared to clotrimazole.     

p53 Binds to <Emphasis Type="Italic">Estrogen Receptor 1</Emphasis> Promoter in Human Breast Cancer Cells

p53 is a tumor suppressor protein that regulates estrogen receptor 1 (ESR1) expression. To investigate the mechanism of ESR1 gene regulation by p53, chromatin immunoprecipitation was applied to assess the binding of p53, DNMT1, HDAC1 and MeCP2 to both silenced ESR1 promoter in MDA-MB-468 cells and active ESR1 promoter in MCF-7 breast cancer cells. The results of chromatin immunoprecipitation experiments showed that p53 protein binds to both unmethylated CpG island of the ESR1 promoter in the ER-positive MCF-7 and the hypermethylated ESR1 promoter in the ER-negative MDA-MB-468 cells. However, repression complex including DNMT1, HDAC1 and MeCP2 is only associated with silenced ESR1 in ER-negative MDA-MB-468 human breast cancer cells. In addition, ectopically expressed wild type p53 failed to reactivate the ESR1 gene in these cells. These results suggest that specific p53 mutations may contribute to loss of estrogen receptor α expression in breast tumors and also support the hypothesis that mutant p53 is likely to impact DNA methylation.     

Efficient protocol for rapid Aloe vera micropropagation

Context: Aloe vera Linn. (Liliaceae) is a medicinal plant and has a number of curative properties. Vegetative propagation has not enough potential for supplying market demand. However, via in vitro propagation makes possible the mass production of Aloe plants.

Objective: The current study was conducted to investigate growth regulators’ effects on proliferation of A. vera.

Materials and methods: In this study, for comparison of plant growth regulators’ effects on proliferation, the shoot tips and auxiliary buds of A. vera were cultured in the Murashige and Skoog (MS) medium. Rooted plantlets were transferred to garden soil, compost, and sand in the proportion of 1:1:1, respectively, after hardening.

Results: The maximum number of shoots was obtained on the medium supplemented with 1?mg/L IAA?+?4?mg/L BAP and 0.2?mg/L IAA?+?0.8?BAP mg/L. Rooting was also achieved in the same media composition proliferation of shoot. The acclimatized plants showed 100% of survival. The regenerated plants looked healthy, and they were morphologically similar to that of stock plants.

Conclusion: These results suggest that in vitro culture may be used as a technique for rapid propagation of A. vera.