Impact of Vitamin D Deficiency on the Pathogenesis of Polycystic Ovary Syndrome

There are many metabolic and hormonal factors related to polycystic ovary syndrome (PCOS) that can be affected by vitamin D3 supplementation. To find clinical trials, in vivo studies, and in vitro studies that met the review's inclusion and exclusion criteria, we searched many databases. PCOS women's ovulation and metabolic parameters were examined in relation to the effects of vitamin D3 treatment on PCOS risk variables such as seasonal changes in body mass index, and obesity. The current review included twenty-five articles. Vitamin D3(25-hydroxy vitamin D) levels were significantly lower in the PCOS group than in the control group, and lipid profile and androgen hormone levels were significantly higher in the PCOS group, resulting in increased cardiovascular events and exaggerated hirsutism. According to the majority of research, vitamin D3 plays a beneficial role in decreasing the pathophysiology of PCOS, notably in restoring ovulation, which ultimately improves fertility. Although other studies found no effect on lipid profile, there was a minor effect on reducing cardiovascular risks. The response of patients to vitamin D3 was influenced by the dose administered and the study's methodology. In conclusion, vitamin D3 had a good effect on the pathophysiology of PCOS in the majority of investigations.

Association between Lipid Profile and Glycemic Status in Iraqi patients with Acromegaly Receiving Depot Long-Acting Octreotide

Background: Treatment modalities of acromegaly and disease control impact differently on glucose homeostasis and lipid changes, and consequently on cardiometabolic risk. Aim: To investigate the possible association of lipid profile changes with the glycemic control status in acromegaly patients treated with octreotide LAR. Methods: This cross-sectional study included 52 Iraqi patients with acromegaly treated with octreotide LAR and not using statins. Demographic, anthropometric, and clinical data were collected, as well as the duration of Octreotide LAR administration. The glycemic state was assessed and classified as DM, prediabetes, or normal. Plasma levels of triglycerides, LDL cholesterol, HDL cholesterol, and non-HDL were evaluated using standard methods. Results: Most of the participants presented with low levels of triglycerides, LDL cholesterol, and HDL cholesterol. The lipid profile variables were not significantly correlated with the glycemic control status after treatment with octreotide LAR. Conclusion: Lipid profile parameters were not associated with the different glycemic control status of acromegaly patients treated with octreotide LAR.

Glycemic Status in Acromegaly Patients Receiving Depot Long-Acting Octreotide

Background: Acromegaly is an uncommon, chronic, debilitating condition characterized by hyperinsulinism, insulin resistance, diabetes and prediabetes. One possibility for managing acromegaly's questionable influence on glucose homeostasis is the somatostatin analogues. Aim: To analyze the frequency and risk factors for impaired glucose homeostasis in acromegaly patients treated with depot long-acting octreotide (octreotide LAR), as well as the relationship between risk and treatment duration. Methods: The study included 52 Iraqi adults with acromegaly receiving octreotide LAR. Demographic, anthropometric, and clinical data were collected, as well as the duration of Octreotide LAR administration. Growth hormone, IGF-1, and adenoma size were reported retrospectively from patient data. The glycemic state was assessed and classified as DM, prediabetes, or normal. Results: The prevalence of DM was 39% and prediabetes was 40%, with the exception of being male, which was substantially related with prediabetes. DM and octreotide LAR use had a non-significant correlation. However, octreotide use altered 13% of patients from normal glycemic to prediabetes, with no correlation to treatment duration. Other than hypertension and a family history of diabetes, no other variables were found to be significant. Conclusion: Acromegaly patients have abnormal glucose metabolism, which is associated with prediabetes owing to octreotide LAR medication. Hypertension and family history of diabetes are risk factors.

Association between Red Cell Distribution Width to Platelet Ratio and Disease Activity among Iraqi Patients with Systemic Lupus Erythematosus

Background: The link between red blood cell distribution width-to-platelet ratio (RPR) and disease activity in systemic lupus erythematosus (SLE) is not well understood. Aim: To investigate the association between RPR levels and disease activity in SLE. Methods: This was a case-control study conducted at Baghdad Teaching Hospital, Medical City from July 2020 to March 2021. Seventy SLE patients were compared with 70 healthy controls. The diagnosis was made using the American College of Rheumatology SLE criteria. Results: SLE patients had a mean age of 35.2±12.03 years, while controls had a mean age of 36.3±9.9 years (P=0.5). Females represent 97.1% of SLE patients and 88.6% of controls. The average disease duration was 4.98±0.05 years. The disease activity index (SLEDI) was 16.4±4.8. SLE patients had a lower platelet count than controls, and the median (IQR) of RDW was larger than that of controls. SLE patients had a greater median (IQR) of RPR than controls (0.058; 0.04-0.07 vs. 0.045; 0.039-0.053). The RPR and SLEDAI showed strong positive association. The optimal cutoff point for distinguishing SLE patients from controls was 0.0455, with 79% sensitivity and 51% specificity. The RPR was not significantly affected by sociodemographic or clinical factors. Conclusion: The RPR was positively correlated with disease activity in SLE patients, and may be a valid measure to differentiate between SLE patients and healthy controls. Sociodemographic and other clinical characteristics do not significantly affect RPR.

COVID-19 variants, available treatments, and vaccinations: An overview study

SARS-CoV-2 is the recent variation of the corona virus which is infecting people around the world and has affected more than 258 million people worldwide. Upon observation, the virus is similar to the coronavirus which spread from the horseshoe bat or wild animals to human beings. Up to date, there have been three major variants of the coronavirus which have been identified in UK, South Africa, and India which are spreading to other countries. Based on the current data, it is suggested that the incidents of repeated infection with SARS-CoV-2 is related to the level of neutralizing antibodies and the retained memory response which follows infection. Moreover, recently, a critical issue arises in relation to the association of black fungus and COVID-19, and urgent investigation is required. As a treatment method of COVID-19, FDA has recently approved the feasibility of Remdesivir to treat COVID-19 as emergency use authorization (EUA). There are also various possible antivirals which are still undergoing clinical trial. After widespread of the vaccine, the results showed that EUA vaccines have been effective in controlling COVID-19 in patients. However, these licensed vaccines ought to be reviewed to ensure they are also effective in combating the rising variants of SARS-CoV-2.

The Influence of Rheumatoid Arthritis on Work Productivity among a Sample of Iraqi Patients

Background: Rheumatoid Arthritis (RA) is a chronic inflammatory disorder that impact daily life activities. The impact on work productivity is critical because of persistent work disability. Aim: To evaluate work productivity in RA patients compared to healthy controls, and to assess the impact of socio-demographic characteristics on work productivity. Methods: This was a case-control study conducted at the Rheumatology Unit of Baghdad Teaching Hospital, Medical City during the period from August 2020 to the end of March 2021. Seventy-two patients with RA were selected and compared with 72 healthy subjects as a control group. All patients were diagnosed according to ACR/EULAR 2010 RA classification criteria. The socio-demographic and clinical features, lifestyle practices, and disease activity of the patients and controls were all recorded during interviews. A standardized Arabic version of the Workplace Activity Limitation Scale (WALS) and the Job Limitations Questionnaire were used to assess the impact of RA on work productivity (WLQ-25). Results: The vast majority of patients were females (58.1%). Positive rheumatoid factor was reported in 94.4% of the patients. The patients showed a significantly lower WALS total score and higher WLQ-25 total score median (IQR) compared with controls. Conclusion: Active RA impairs the work productivity which was influenced by CDAI score and negatively associated with the use of DMARDs.

Prevention and Management of Platinum Compounds-Induced Neurotoxicity

Oncologists considered platinum-based medicines as potent cytotoxic agents. Despite their efficacy in combination chemotherapy regimens for many solid tumors, they have many substantial side effects that limit their use. There is no known prophylactic strategy for platinum drugs-induced neurotoxicity, which limit a therapeutic dose benefit. This review highlights the etiology of platinum-drugs-induced neuropathy, and covers the preventative and therapeutic options for cancer patients. It focuses on clinical studies conducted between 2010 and 2020. Loss of functional indications such as touch, vibration and joint location, as well as diminished or missing deep tendon reflexes in the upper and lower limbs are all markers of neurotoxicity. These side effects may last for months or years after treatment, lower quality of life, and creating a substantial survivorship issue. DNA damage, oxidative stress, mitochondrial dysfunction, dysregulation of intracellular signaling, impairment of voltage gated ion channel function, and neuro-inflammation have all been proposed as mechanisms for chemotherapy-induced peripheral neuropathy (CIPN). There are no proven pharmaceutical or nutritional therapies to prevent CIPN. Several anti-CIPN medications have been investigated, but either had no effect or had an effect in a limited sample study. Supportive care medications such anti-epileptics and antidepressants are used to treat CIPN.

Diagnostic and Predictive Utility of Serum Interleukin-37 in Rheumatoid Arthritis: A Case-Control Study

Background: Rheumatoid arthritis is the most common cause of inflammatory polyarthritis. Interleukin‐37 (IL-37) has been found to play an important regulatory role in the development of inflammatory diseases. Objectives: To assess serum IL-37 level in rheumatoid arthritis (RA) patients compared to controls, to evaluate its diagnostic and predictive utility in RA patients and to investigate IL-37 level correlation with demographic and clinical characteristics of RA. Methods: Eighty subjects, 40 RA patients aged between 23-63 years and 40 healthy controls aged between 28-67 years were evaluated. An enzyme-linked immunosorbent assay (ELISA) was used to analyze the serum IL-37 levels. Results: Serum IL-37 was significantly higher in RA patients compared to healthy controls. At optimum cut off value of >58.275 pg/ml, serum IL-37 had 100% accuracy, positive predictive value, negative predictive value, sensitivity, and specificity. Serum IL‐37 level was not significantly related to Disease Activity Score of 28 joints‐erythrocyte sedimentation rate (DAS28‐ESR), also not correlated with C-reactive protein(CRP), rheumatoid factor(RF) and anti-cyclic citrullinated peptide antibody (Anti-CCP). Also there was no correlation between the level of IL-37 and treatment. Conclusions: IL-37 was significantly higher in RA patients compared to healthy controls with a high diagnostic and predictive ability, and may be a potential biomarker for diagnosis and prediction of RA.

Evaluation of EOS Gene Expression and IL-6 Serum Levels in Iraqi Patients with Psoriasis

Background: EOS (encoded by the IKZF4 gene) is a member of the zinc finger transcription factor IKaros family, and plays a critical role in Treg suppressor functions, and maintaining Treg stability. IL-6 is a soluble mediator with a pleiotropic effect on inflammation, immune response, and hematopoiesis. Aim: To estimate serum IL-6 level and EOS gene expression in Iraqi patients with psoriasis. Method: Twenty-two patients with psoriasis (8 females, 14 males) with age ranged 18-72 years, were recruited from Baghdad Teaching Hospital, Dermatology Clinic, Baghdad, and 24 healthy donors. The serum levels of IL-6 by ELISA and the gene expression of IKZF4 (EOS gene) by RT-qPCR technique. Results: The results showed a non-significant difference in the level of IL-6 in those treated with topical therapy and others treated with Etanercept compared to control. A non-significant increase in patients treated with topical therapy was reported compared to patients treated with Etanercept. There was a higher significant percentage of IKZF4 gene expression folding in psoriasis patients treated with Etanercept compared to control group, while no significant differences reported between patients treated with topical therapy, Etanercept, and the control group. Conclusion: Activation of Regulatory T cells (Tregs) with Etanercept enhances EOS expression and decreases IL-6 production more than topical treatment in patients with psoriasis.