The M235T polymorphism in the angiotensinogen gene is not a major risk factor for diabetic nephropathy; a meta-analysis

Introduction: Diabetic nephropathy (DN) is the leading cause of chronic kidney disease in diabetes patients. The angiotensin AGT M235T gene polymorphism, which is linked to the renin-angiotensin-aldosterone system (RAAS), has been extensively studied in DN patients, but the results are still conflicting. The current study’s goal is to conduct a meta-analysis to assess the relationship between AGT M235T gene polymorphism and DN susceptibility. Methods: Fourteen case-control studies related to AGT M235T polymorphism and DN were searched using PubMed, Web of Science and Google Scholar databases. Genotype data from the T2DM and T2DN groups were collected from all papers. The pooled odds ratio (OR) and 95 percent confidence interval (95% CI) were calculated employing a random-effects model to assess the relationship. Results: There were no statistically significant link between AGT M235T and DN risk in dominant (P=0.801, OR: 0.95; 95% CI: 0.66-1.38), allelic (P=0.933, OR: 1.01; 95% CI: 0.75-1.37) and recessive (P=0.374, OR: 1.21; 95% CI: 0.80-1.83) genetic models. Further, the stratified analysis based on ethnicity did not reveal significant link between AGT M235T and DN risk in Asian (Dom OR: 1.07; 95% CI: 0.63-1.82) and the Caucasian populations (Dom OR: 0.77; 95% CI: 0.49-1.21). In all three models, there was a high degree of heterogeneity between studies. Publication bias was not seen. Conclusion: Our findings suggest that the AGT gene M235T polymorphism does not contribute to DN risk. However, validation of this association will require multi-center and large population-based studies.

The survival rate of Iranian breast cancer patients with focus on prognostic factors

Introduction: Breast cancer is the most prevalent cancer in women. Several studies showed that TNM stage, grade cancer, lymph node involvement, and the status of hormone receptors are the most important factor of breast cancer prognosis. Objectives: To evaluate the clinical characteristics, prognostic factors, and survival rate in patients with breast cancer who underwent surgery in Ahvaz, Southwest of Iran. Patients and Methods: This historical cohort study was conducted on 561 patients who underwent surgery for breast cancer between May 1997 and June 2016. Clinical characteristics, pathological profile, stage, and treatments of the patients were recorded. The prognostic factor, two and five-year overall survival (OS) rates, disease-free survival (DFS) were evaluated by the Cox proportional hazards model and the Kaplan-Meier test, respectively. Results: The two and five-year OS rates were 92.1% and 81.7%, respectively. The most important prognostic factors in breast cancer survival were age, the size of the tumor, regional lymph node involvement, metastasis, stage, relapse, estrogen receptor (ER), progesterone receptor (PR), and hormone therapy. There was no significant relationship between tumor type, tumor site, metastasis, surgery kind, chemotherapy, radiation therapy, and the status of human epidermal growth factor receptor 2 (HER2) and the five-year survival rate. Conclusion: This study showed that the most important factors affecting the high survival rate of patients with breast cancer are hormonal receptors, non-involvement of the lymph nodes, early-stage cancer, no recurrence, and no metastasis.

Asprosin; effects and associations

Asprosin is a hormone that is released by the white adipose tissue. It stimulates the release of glucose, which is produced in the liver, into the blood. Asprosin targets many organs including the skeletal muscle, pancreas, liver, and cardiac system. In addition, asprosin stimulates appetite leading to weight gain. It also influences glucose metabolism, cell apoptosis, and insulin resistance. Furthermore, it has been implicated in some medical conditions such as obesity and diabetes.

The effect of exercise during hemodialysis on serum levels of albumin, calcium, phosphorus and parathyroid hormone: a randomized clinical trial

Introduction: Disorders in the levels of blood electrolytes are often considered as complications of kidney illnesses which are responsible for various systemic problems experienced by patients. Objectives: The aim of this study was to investigate the efficiency of an exercise program during hemodialysis on serum levels of biochemical factors such as albumin, calcium, phosphorus and intact parathyroid hormone (iPTH). Patients and Methods: Sixty patients undergoing hemodialysis were evaluated in the clinical trial. The patients in the intervention group pedaled on a stationary bicycle for one hour in every hemodialysis session for eight weeks. At the beginning of the study and at the end of it, the patients’ blood samples were sent to hospital’s laboratory to measure the levels of biochemical factors in blood. Data were analyzed by SPSS software. Results: The serum levels of electrolytes showed no significant improvement between the study groups before and after the exercise program (P>0.05). A significant improvement was observed after the program in serum phosphorus and iPTH (P=0.04). In contrast, serum albumin (P=0.3) and calcium (P=0.5) did not alter significantly after the exercise program. Conclusion: Exercise improved some biochemical factors of blood in the patients undergoing hemodialysis. Exercise is therefore a complementary procedure for these patients. Trial Registration: The trial protocol was approved in the Iranian Registry of Clinical Trial (#IRCT20150116020675N4; https://en.irct.ir/trial/50492, ethical code# IR.MUI.MED.REC.1399.212).

A study on the relationship between morphological lesions of lupus nephritis with demographic and biochemical findings

Introduction: Lupus nephritis is one of the important aspects of systemic lupus erythematosus (SLE). Objectives: This study aimed to investigate possible relationship between pathological lesions of lupus nephritis classes and demographic and biochemical findings among patients. Patients and Methods: This is a cross-sectional study that was conducted on a group of renal biopsy proven lupus nephritis patients using lupus nephritis classification of ISN/RPS 2003. We collected demographic data of all patients including age, gender serum creatinine and 24h proteinuria. Results: Data of 101 patients, of whom 78 (77.23%) were females and mean age of 33.54±13.15 years. The mean serum creatinine and proteinuria were 1.54±0.88 mg/dL 2502.5±1495.05 mg/d. Based on our data, IV-G (class IV, diffuse lupus nephritis-global) lupus nephritis class was the most common (39.6%) followed by class III (23.8%). The mean crescent and sclerotic glomeruli were 1.66±3.32 and 2.27±5.32, respectively. In this study, 24 hours proteinuria, serum creatinine, activity percent, chronicity percent, crescent and glomerular sclerosis between genders showed no significant differences (P>0.05). The correlation between plasma creatinine and activity was directly positive and significant (r=0.381, P=0.001). In addition, a significant correlation between C1q deposits and glomerular sclerosis (P=0.031) was detected. Accordingly, a significant correlation between IgG deposits and lupus nephritis classification (P=0.025) was seen. Conclusion: Lupus nephritis of IV-G and III classes of lupus nephritis were most common among patients and higher IgG deposits were observed in patients with IV-G classification. We found a significant correlation between glomerular sclerosis and C1q deposits that could be an indicator of lupus nephritis activity and severity. However, we recommend further studies in this regard.

Comparative study of surgical site infection with or without post cesarean prophylactic oral antibiotics; a single-blinded randomized clinical trial

Introduction: Surgical site infection (SSI) is caused by cesarean section in the hospital and its prevalence in the studies is up to 16%. Objectives: This study aimed to compare the rate of infection in women undergoing cesarean section. Oral clindamycin and cefalexin were administered for 48 hours as prophylactic antibiotics. Patients and Methods: In this clinical trial study, women with emergency cesarean section were divided into two groups. Intervention was oral administration of cefalexin 500mg every 6 hours and clindamycin 300 mg every 6 hours for 48 hours. All participants were referred to the gynecology center on day 7–10, at the time of removal of the sutures, and within 30 days after cesarean section, to assess the presence or absence of wound infection after surgery during 30 days. Results: In this clinical trial study, 462 pregnant women undergoing cesarean section were enrolled in the intervention and control groups. Of 231 patients in the intervention group, 15 women (6.5%) had cesarean section infection (13 cases with superficial, and 2 cases with deep infection). In the control group, 45 cases (19.5%) had cesarean section infection (31 cases with superficial, 10 cases with deep, and 4 cases with developed pelvic infection) (P = 0.001). Age, pre-cesarean length of stay, pre-term incision, type of incision, discharge longer than 18 hours after cesarean section, and maternal diabetes were significantly different regarding cesarean section infection in both groups. The frequency of cesarean section infection was less in the intervention group (P <0.001). Conclusion: Administration of prophylactic antibiotic can have a significant role in reducing cesarean section infection. Trial Registration: Registration of trial protocol has been approved in Thailand registry of clinical trials (identifier: TCTR20201204002, http://www.clinicaltrials.in.th/index.php?tp=regtrials & menu=trialsearch & s-menu=fulltext & task=search & task2=view1 & id=7120, ethical code; IR.UMSU.REC.1397.323).

A review of the reasons for high prevalence and rapid progression of COVID-19 in men

Previous studies have demonstrated a relationship between gender and COVID-19 outcomes. In addition, this is confirmed that men have more danger of progressing an acute type of the illness than women, specifies the significance of miscellaneous data related to male and female patients with COVID-19. In other words, some factors like hormonal levels and immune function may interact with each other. A perception of the fundamental reasons for gender diversities in COVID-19 patients can beget a chance for disease prevention and faster treatment. The present study evaluates the role of gender in the incidence and progression of the COVID-19 disease. It has been explained that how gender affects angiotensin-converting enzyme 2 (ACE2), which is a basic factor for the COVID-19 pathogenesis introducing the sex diversities in platelet function, immune reactions and how sex hormones affect immune functions, also the effect of androgens on transmembrane protein serine protease 2 (TMPRSS2) receptor in COVID-19 patients was investigated.