ASSESSMENT OF SERUM SCLEROSTIN LEVEL AS A BIOMARKER ASSOCIATED WITH BONE DISORDERS IN Β-THALASSEMIA PATIENTS IN AL- NAJAF CITY, IRAQ

Aim of the study: To assess serum sclerostin in female patients with beta-thalassemia and compare with the healthy controls and to predict its complication associated with the bone pathophysiology, for designed improvement the lifestyle goodliness for these patients. Material and methods: Sixty-nine female beta-thalassemia (βT) patients (54 βT major and 15 βT Intermedia), aged 8-40 years who dependent on transfused blood, and 20 healthy controls were evaluated serum sclerostin, and was examined the relationship with hematological parameters RBC, Hb, PCV, WBC, PLT, BMI, splenic status, iron, and ferritin levels. The information of beta-thalassemia patients was collected and recorded by the questioner. Results: A significantly increased serum sclerostin level (mean 26.80±0.91) pg/ml was shown in βT patients compared with the healthy controls (10.03±0.68, p < 0.001) pg/ml. Furthermore, a significant decrease (p<0.05) of the sclerostin level was observed in β-thalassemia major compared to intermedia β-thalassemia patients. Serum sclerostin level revealed a significant increase in progress age; it is highest in the age group (30-40) year as compared with age group (8-18) and (19-29) year respectively. Sclerostin showed no associations with the RBC, Hb, PCV, and significantly positively correlated (p<0.05) with serum iron, ferritin levels, WBC, and PLT count. Significantly higher sclerostin levels in splenectomized and underweight groups were observed compared to unsplenectomized and normal-weight groups (p<0.05) of βT patients. Conclusion: Sclerostin plays an important role in beta-thalassemia patients and can serve as a biomarker associated with the bone pathophysiology and indicator to prevent the continuation of such serious diseases caused by iron overload in these patients.

Level of endoparasite infection in free-living wild boars in relation to carcass weight and sex

Research into the determination of intestinal parasitic levels in free-living animals can provide knowledge enabling action to be taken to improve their health status. The aim of the study was to determine the relationship between the carcass weight of wild boars and the degree of endoparasite infection. The research was performed on 165 culled wild boars, from which a representative group (n = 50) was separated and divided according to sex (males n = 24, females n = 26) and age (2-3 years). Separate weight groups were defined for males (< 70 kg, n = 6; 70-80 kg, n = 9; > 80 kg, n = 9) and females (< 45 kg, n = 10; 45-60 kg, n = 10; > 60 kg, n = 6). Oesophagostomum spp., Ascaris suum, Trichuris suis, Eimeria spp. and Strongyloides ransomi were observed and defined in the study population. A statistically significant effect of the overall infection on carcass weight was obtained (F = 9.96; P ≤ 0.01). In the case of overall infection, a more than 7 kg lower carcass weight was observed in infected males. A carcass weight over 15 kg lower was noted for overall infection of females (F = 38.47; P ≤ 0.01), for which average EPG was 2946.67 ± 6485.31 with a median of 400 (50-25 300). Correlations were proven between sex and the average number of Eimeria spp. oocysts, and carcass weight for males (r = –0.84, P ≤ 0.05). In the case of females, correlations were noted between carcass weight and infection by nematodes (r = –0.63, P ≤ 0.05). Studies have shown that there is a need to monitor the environment in order to improve the condition of free-living animals.

Objectively-measured step cadence and walking patterns in a rural African setting: a cross-sectional analysis

Objectives To investigate free-living, accelerometry-derived step cadence and walking strategy parameters in 263 adult women (19-56 years) within a rural African setting. Participants were categorised into weight groups: Under-Normal Weight (UW/NW: <25 kg.m−2), Overweight-Obese (OW/OB: ≥25 kg.m−2). From the minute-by-minute uni-axial accelerometry data, outcomes describing physical activity intensity, step volume, step cadence and step bouts were extracted. In addition, walking pattern parameters for step bout length and step cadence were determined. Results Average step volume was 13568 steps.day−1, and >85% of participants were classified as active-to-highly-active. Overall, ≈45% of daily steps was accumulated in the low-to-moderate intensity range. Peak cadence indices were higher in the UW/NW group (p≤0.0112). For both groups, 75% of steps were accumulated in bouts >15 minutes, and 95% of bouts were accumulated at 1-39 steps.minute−1. The UW/NW group employed a more varied step cadence, and higher cadences contributed more to step accumulation than the OW/OB group (p≤0.05). There were no significant group differences in bout length strategy parameters (p≥0.0861). Despite no difference between the weight groups in step volume, there were differences in some step cadence indices which reflect higher step intensities, and in cadence strategies chosen to accumulate steps.

Anesthesia and Intubation of 10-Day Old C57BL/6J Mouse Pups for Cardiothoracic Surgery

Murine surgical models play an important role in preclinical research. Mechanistic insights into myocardial regeneration after cardiac injury may be gained from cardiothoracic surgery models in 0-14-day-old mice, the cardiomyocytes of which, unlike those of adults, retain proliferative capacity. Mouse pups up to 7 days old are effectively immobilized by hypothermia and do not require intubation for cardiothoracic surgery. Preadolescent (8-14-day-old) mouse pups, however, do require intubation, but this is challenging and there is little information regarding anesthesia to facilitate intubation. Empirical titration of ketamine/xylazine/atropine dosage regimens to body weight indicated the response to anesthesia of 10-day-old C57BL6/J mouse pups of different weights was non-linear, whereby doses of 20/4/0.12 mg/kg, 30/4/0.12 mg/kg and 50/6/0.18 mg/kg, facilitated intubation of pups weighing between 3.15-4.49 g (n=22), 4.50-5.49 g (n=20) and 5.50-8.10 g (n=20), respectively. Lower-body-weight pups required more intubation attempts than heavier pups (p<0.001). Survival post-intubation was inversely correlated with body weight (65, 70 and 80% for low-, mid- and high-weight groups, respectively, R2=0.995). For myocardial infarction surgery after intubation, a surgical plane of anesthesia was induced with 4.5% isoflurane in 100% oxygen and maintained with 2% isoflurane in 100% oxygen. Survival post-surgery was similar for the three weight groups at 92%, 86% and 88% (p=0.91). Together with refinements in animal handling practices for intubation and surgery, and to minimize cannibalization by the dam post-surgery, overall survival for the entire procedure (intubation plus surgery) was inversely correlated with body weight (55%, 60% and 70% for low-, mid- and high-weight groups, respectively, R2=0.978). Given the difficulty encountered with intubation of 10-day old pups and the associated high mortality, we recommend cardiothoracic surgery in 10-day-old pups be restricted to those weighing at least 5.5 g.

Paediatric diagnostic reference levels for common radiological examinations using the European guidelines

Objective: The purpose of this study was to explore the feasibility to determine regional diagnostic reference levels (RDRLs) for paediatric conventional and CT examinations using the European guidelines and to compare RDRLs derived from weight and age groups, respectively. Methods: Data were collected from 31 hospitals in 4 countries, for 7 examination types for a total of 2978 patients. RDRLs were derived for each weight and age group, respectively, when the total number of patients exceeded 15. Results: It was possible to derive RDRLs for most, but not all, weight-based and age-based groups for the seven examinations. The result using weight-based and age-based groups differed substantially. The RDRLs were lower than or equal to the European and recently published national DRLs. Conclusion: It is feasible to derive RDRLs. However, a thorough review of the clinical indications and methodologies has to be performed previous to data collection. This study does not support the notion that DRLs derived using age and weight groups are exchangeable. Advances in knowledge: Paediatric DRLs should be derived using weight-based groups with access to the actual weight of the patients. DRLs developed using weight differ markedly from those developed with the use of age. There is still a need to harmonize the method to derive solid DRLs for paediatric radiological examinations.

A Study on the Association Between Subclinical Hypothyroidism and Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) and hypothyroidism are endocrine and metabolic disorders. Hypothyroidism has been found to be related to changes in blood lipids and insulin insensitivity. However, the relationship between subclinical hypothyroidism (SCH) and endocrine disorders in PCOS patients remains unclear. The incidence of SCH in PCOS patients is increasing. Metabolomics methods have been used to investigate the differences in metabolites and metabolic pathways between normal body weight and overweight (not obese) PCOS patients with SCH. Understanding the association between PCOS and SCH can guide diagnosis and treatment.Methods: We performed an untargeted serum metabolomics analysis in 62 PCOS patients. From 38 PCOS patients with SCH, 24 were selected and divided into the overweight (n = 13) and normal weight (n = 11) groups. Differential metabolites were identified using ultra-high-performance liquid chromatography–quadrupole time-of-flight mass spectrometry analysis. The significance of metabolites was evaluated by calculating the variable importance in projection score (> 1 and P < 0.01) from partial least squares discriminant analysis (PLS-DA) and orthogonal PLS-DA models. Kyoto Encyclopedia of Genes and Genomes pathway analysis was conducted to investigate the metabolomic pathways. P < 0.05 (Fisher’s exact test) was considered statistically significant.Results: In PCOS patients with SCH, significant differences in body weight, right ovary volume, homeostasis model assessment for insulin resistance value, insulin level at 2 h after a meal, and triglyceride level were observed between the overweight and normal weight groups. Twenty-six different metabolites were identified, mainly fatty acids and phosphatidylcholines, to have significantly levels in overweight patients with SCH. Moreover, 18 enriched metabolic pathways were identified, mainly biosynthesis of fatty acids and unsaturated fatty acids, digestion and absorption of proteins, aminoacyl-tRNA biosynthesis, and ATP-binding cassette (ABC) transporters.Conclusion: The interaction between body mass index and thyroid-stimulating hormone affects the metabolic status of PCOS patients. Overweight PCOS patients with SCH may have the worst metabolic status. The overweight and normal weight groups showed differences in glycerol phospholipid, sterol lipid, phosphatidylcholine, and androsterone sulphate levels. PCOS with SCH affects endocrine metabolism and ester metabolism through fatty acid biosynthesis, protein digestion and absorption, and ABC transporters.

Obesity phenotypes and their relationships with atrial fibrillation

Background This study assessed the associations of metabolic obesity phenotypes with the risk of atrial fibrillation (Afib). Methods This prospective cohort study categorized Taiwanese adults according to their body mass index (BMI) and metabolic health status at baseline. We assigned the participants to the underweight (BMI < 18.5 kg/m2), normal weight (BMI = 18.5–23.9 kg/m2), and overweight/obesity groups (BMI ≥ 24 kg/m2). Metabolically healthy was defined as absence of hypertension, diabetes, and hyperlipidemia and the presence of healthy metabolic profiles. Results In total, 5,742 adults were included. During a median follow-up of 13.7 years, 148 patients developed Afib. Compared to the metabolically healthy normal weight group, the risk of Afib was significantly higher than those in the metabolically unhealthy overweight/obesity (hazard ratio = 2.20, 95% confidence interval [1.12–4.33]) and metabolically unhealthy normal weight groups (HR = 2.64, 95% CI [1.34–5.17]). Additionally, the point estimate suggested a 1.97-fold greater risk among the metabolically healthy overweight/obesity group, although this difference was not significant given the wide confidence interval (HR = 1.97, 95% CI [0.80–4.86]). Conclusion Our results demonstrated the relationships of metabolic health and weight regarding the risk of Afib in Taiwanese adults. The Afib risk among metabolic and obesity phenotypes is associated with a metabolically unhealthy status. A trend toward a higher Afib risk with obesity among metabolically healthy subjects was observed. However, the result was not robust and it still suggested further study.

Estimation of Fetal Weight by Clinical Methods and Ultrasonography and Comparing With Actual Birth Weight

Introduction: Assessment of fetal weight is a vital factor in antenatal care, not only in the management of labor and delivery but also in identifying fetal weight disorders. Objective: This study compares the accuracy of clinical methods and ultrasonography in Estimating Fetal Weight (EFW) with Actual Birth Weight (ABW) in term pregnant women. Materials and Methods: This diagnostic test evaluation study was performed on 247 single-term pregnant women admitted to an educational, therapeutic hospital in Rasht City, Iran. In this study, abdominal palpation, Johnson’s formula, Insler’s formula, and ultrasonography were used to estimate fetal weight. One-sample t-test, the Chi-square, and the Bland-Altman plot were used to compare the diagnostic value of fetal weight estimation methods. The accuracy of tests was estimated based on sensitivity and specificity in fetal weight groups (below 2500 g, 2500- 4000 g, and above 4000 g) by the Bland-Altman plot. Results: The participating pregnant women had a Mean±SD age of 28.86±4.24 years, body mass index of 32.98±6.0 kg/m2, and gestational age of 39±1.04 wk. Their Mean±SD actual birth weight was 3343.352±432.799 gr, Also, the Mean±SD birth weight found by abdominal palpation was 3371.053±345.561 gr, Mean±SD birth weight by Johnson’s formula 3041.206 ±411 gr, by Insler’s formula 3556.316±531.567 gr, and by ultrasonography 3294.28±380.09 gr, Based on the one-sample t-test, the abdominal palpation had the lowest (P=0.261), and the Insler’s formula (P=0.001) had the highest difference with the actual birth weight. Regarding the fetal weight groups, Insler’s formula (96.33%) was highly accurate in Low Birth Weight (LBW), but abdominal palpation (91.09%) was more accurate in normal weight and macrosomia (94.72%) groups. There was a significant difference between clinical methods with ABW (P=0.026). Conclusion: Clinical methods are accessible, affordable, and available and can estimate fetal weight in developing countries, especially in our country.