Pyogenic Granuloma of Lower Lip: An Unusual Presentation

Pyogenic granuloma is a benign inflammatory hyperplasia of connective tissue. It depicts an overzealous tissue response to a known stimulus or injury and is commonly found in the gingiva, especially in the anterior maxilla, and rarely on lips, oral mucosa, and tongue. It is commonly seen during the second, third, and fourth decade in females, with predilection in the third decade. This case report depicts the unusual presentation of pyogenic granuloma of the lower lip in an 11-year-old male child following a positive history of trauma and lip biting, which was successfully managed by excision under local anesthesia.

Comparison of Serum and Dietary Selenium Levels in Participants with a Positive History of Recurrent Herpes Lesions and Healthy Individuals

Aim. In this study, we aimed to compare the level of serum and dietary selenium in participants with a positive history of recurrent herpes labial lesions and healthy controls. Materials and Methods. This cross-sectional study, conducted during 2020-2021, evaluated the selenium serum level of 40 participants with a positive history of recurrent herpes labial lesions who had referred to Motahhari Laboratory in Shiraz, compared with 38 healthy controls. The selenium level of the serum was assessed by an absorption device, Atomic Graphite Furnace Model FS-240-AAS, made by a US Company. Independent T -test was used to compare the selenium level of males and females. In order to assess the mean age value and gender distribution between the two evaluated groups, the independent T -test and chi-square test were used, respectively. The serum selenium level was compered between both control and test groups. Results. The level of serum selenium was not statistically correlated with its dietary level in group 1 (participants with recurrent herpes labialis, P value = 0.18) and group 2 (healthy controls, P value = 0.6). The serum selenium level was compared between groups 1 and 2, which was significantly higher in healthy controls ( P value < 0.0001). In contrast, dietary selenium level was not significantly different between patients with a history of herpes labialis and healthy controls ( P value = 0.48). The level of serum selenium was not statistically correlated with its dietary level in group 1 ( P value = 0.18) and group 2 ( P value = 0.6). Conclusion. Patients with recurrent herpes labialis had lower serum selenium level as compared to the healthy controls.

Low weight at birth can be an indicative in childhood as a marker of metabolic syndrome and hypertension

As low weight at birth can be a marker for future risk factors for cardiovascular diseases, public school children who had this positive history were studied S to nutritional status, lipids, glucose, uric acid, blood pressure and socioeconomic conditions. The main interest of the investigation is to find statistically significant correlations among data collected from young public school children from a city outside of the capital of Sao Paulo in Brazil. Results: risk factors for metabolic syndrome presented higher impact considering blood pressure and socioeconomic conditions, calling for better prenatal care and surveillance plus intervention in the low weight at birth children.

Predictive value of chest HRCT for survival in idiopathic pulmonary arterial hypertension

Background Little attention has been paid to chest high resolution computed tomography (HRCT) findings in idiopathic pulmonary arterial hypertension (IPAH) patients so far, while a couple of small studies suggested that presence of centrilobular ground-glass opacifications (GGO) on lung scans could have a significant negative prognostic value. Therefore, the aims of the present study were: to assess frequency and clinical significance of GGO in IPAH, and to verify if it carries an add-on prognostic value in reference to multidimensional risk assessment tool recommended by the 2015 European pulmonary hypertension guidelines. Methods Chest HRCT scans of 110 IPAH patients were retrospectively analysed. Patients were divided into three groups: with panlobular (p)GGO, centrilobular (c)GGO, and normal lung pattern. Association of different GGO patterns with demographic, functional, haemodynamic, and biochemical parameters was tested. Survival analysis was also performed. Results GGO were found in 46% of the IPAH patients: pGGO in 24% and cGGO in 22%. Independent predictors of pGGO were: positive history of haemoptysis, higher number of low-risk factors, and lower cardiac output. Independent predictors of cGGO were: positive history of haemoptysis, younger age, higher right atrial pressure, and higher mixed venous blood oxygen saturation. CGGO had a negative prognostic value for outcome in a 2-year perspective. This effect was not seen in the longer term, probably due to short survival of cGGO patients. Conclusions Lung HRCT carries a significant independent prognostic information in IPAH, and in patients with cGGO present on the scans an early referral to lung transplantation centres should be considered.

Neonatal Multi-System Inflammatory Syndrome Associated With Covid-19 Exposure in Two Cases From Iran

Introduction:Immune dysregulation following exposure to Covid-19 results in MIS-N (Multi-system Inflammatory Syndrome in Neonates). MIS-N affects various systems in the body and is diagnosed with a positive history of PCR test, positive serologic test, and a history of contact with those vectors of COVID-19 infection. This case series aimed to differentiate from possible misdiagnosis about MIS-N.Case Presentation:Both cases are term neonates with positive serology of COVID -19 and the 2nd case with a mother's positive history of Covid-19 PCR at 30 weeks of pregnancy. The first case was admitted with diarrhea, dehydration, fever for three days, and rash on the 3rd day of hospitalization. We admitted the 2nd case on the 22nd day of birth with a cough, rashes on the head, palms, and soles for two days. Both cases responded to corticosteroid treatment that confirmed MIS-N. Finally, we discharged them with a stable and normal condition in follow-ups.Conclusions:In inflammatory syndromes, especially in delayed phases of COVID cytokine storms, the mortality and morbidity caused by infections diminish with proper interventions and inhibited cytokine cascade inflammations.

Prevalenceof hypertension in south-western Saudi Arabia

Prevalence of hypertension was surveyed in south-western Saudi Arabia. Hypertension was ascertained by measuring blood pressure under standard conditions and by interview for positive history. The overall prevalence was 11.1%, and the age-adjusted prevalence was 10.6% in men and 11.4% in women. Prevalence increased significantly by age. Among previously known cases, 76% were receiving treatment, but only 20% were found controlled. It is concluded that hypertension affects a sizeable proportion of Saudi communities. Further efforts are needed to improve control of the disease

Extra-skeletal manifestations in axial spondyloarthritis are associated with worse clinical outcome despite the use of TNF blocking therapy

Objective To investigate the prevalence and 4-year incidence of acute anterior uveitis (AAU), inflammatory bowel disease (IBD) and psoriasis, and to explore associations of newly developed extra-skeletal manifestations (ESMs) with clinical disease outcome in a large cohort of axial spondyloarthritis (SpA) patients. Methods All consecutive patients included in the Groningen Leeuwarden Axial SpA (GLAS) cohort between 2004 and 2011 were analysed. History of ESMs at baseline and newly developed ESMs during 4-year follow-up were only recorded when diagnosis by an ophthalmologist, gastroenterologist or dermatologist was present. Results Of the 414 included axial SpA patients, 31.5% had a positive history of one or more ESMs: 24.9% AAU, 9.4% IBD, and 4.4% psoriasis. History of psoriasis was significantly associated with more radiographic damage, especially of the cervical spine. Of the 362 patients with 4-year follow-up data, 15.7% patients developed an ESM: 13.3% patients with AAU, of which 3.6% had a first episode and 9.7% had recurrent AAU, 1.9% developed IBD, and 0.8% developed psoriasis. Patients who newly developed ESMs (without history of ESMs) had worse ASQoL score (mean 10.0 vs. 5.9, p=0.001), larger occiput to wall distance (median 6.3 vs. 2.0, p=0.021) and more limited modified Schober test (mean 12.6 vs. 13.6, p=0.014) after 4 years of follow-up. The majority of patients developing an ESM used anti-TNF therapy. Conclusion History of ESMs was present at baseline in one-third of axial SpA patients. The 4-year incidence of ESMs was relatively low, but patients who developed a new ESM reported worse quality of life.

Risk factors of early and late preterm birth

Preterm birth (PTB) is one of the major causes of morbidity in newborn. The aim of this study was to estimate the prevalence and to compare the associated risk factors of early and late PTB. This was a hospital-based cross sectional study conducted in 2016/2017. Women, 271, having PTB at 28-33+6 weeks period of gestation was taken as early PTB and 34-36+6 were taken as late PTB. Data was collected using semi-structured questionnaire, patients’ record book, adopting face- to - face interview technique and clinical examination. The annual prevalence of PTB was 7.25% of which 11% were <28+0 weeks, early PTB was 32% and late PTB was 57%. Mother with school education were 2.0 times more likely to have early preterm births than those having higher education (P-value: 0.005, COR: 2.061,95% CI:1.234-3.441). Mothers with positive history of PTB in any of previous pregnancy was 10.7 times more likely to have early PTB in current pregnancy (P-value: <0.001, COR: 10.677, 95% CI: 2.792 – 40.746). Both variables were found to have independent risk on early PTB in logistic regression analysis (education: P-value: 0.027, aOR: 2.973, 95% CI: 1.132- 3.047; previous history of PTB: P-value: 0.002, aOR: 9.191, 95% CI: 2.308 - 36.596). Early and late PTB have differential risk factors. Mothers with positive history of PTB and having lower level of education were more likely to have early PTB.

Association between Patients with Metabolic Syndrome and Other Various Factors Defining Metabolic Syndrome: A Cross-Sectional Study

Background: Risk factors can lead to clinical conditions, like metabolic syndrome, that predisposes the development of cardiovascular diseases. Objective: The goal of this population-based, prospective and non-randomised cohort study was to study the association between patients with metabolic syndrome and other various factors defining metabolic syndrome. Methods: All the patients referred to the department of Medicine, Al-Ameen Medical college hospital and District Hospital, Vijayapur, Karnataka, India over a period of twenty-two months extending from December 2013 to September 2015 were considered in this study. Results: In the current study, out of 100 patients, 62.9% patients had metabolic syndrome with positive family history of hypertension, diabetes mellitus. 70.8% patients had metabolic syndrome with positive history of smoking. 64.3% patients had metabolic syndrome with positive history of alcohol .73.9% patients had metabolic syndrome with positive history of IHD. 87% of the patients with metabolic syndrome had SBP> 130 mmHg, and 78.85% patients had DBP>85 mmHg. And metabolic syndrome was observed in 71.8% patients on anti hypertensive drugs. The mean level of total cholesterol, LDL cholesterol, triglyceride is increased whereas the mean level of anti-atherogenic HDL cholesterol is low in subjects with MS. At least one lipid abnormality was present in > 95 % of cases. Around 81% subjects with BMI <25 (out of 38) had metabolic syndrome and 58% subjects with BMI>25(out of 62) had metabolic syndrome. Conclusion: All the components defining the metabolic syndrome correlated positively with the abdominal obesity. Systolic blood pressure values were significantly higher than diastolic blood pressure in subjects with abdominal obesity. Metabolic syndrome has multiple risk factors determined by various aspects like the race, the life style, geographical factors larger study is needed to understand the correlation between various components defining it. A healthy lifestyle, that includes avoiding tobacco exposure and proper weight control, must be encouraged in this high-risk population. Keywords: Cardiovascular diseases; Overweight; Risk factors; Smoking.