Category: Nevin Manimala

Eur Rev Med Pharmacol Sci. 2023 May;27(10):4619-4625. doi: 10.26355/eurrev_202305_32471.

ABSTRACT

OBJECTIVE: The importance of physical activities in the control of diabetes mellitus disorder is well known but its correlation with endothelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (iNOS) in diabetic patients needs to be assessed. The aim of the study is to examine inducible and endothelial nitric oxide synthase in healthy adult male patients with type 2 diabetes mellitus (T2DM) in relation to exercise.

PATIENTS AND METHODS: This is a cross-sectional study that has been performed in the Department of Physiology, King Saud University, Riyadh, Saudi Arabia. Subjects were divided into Group 1: control (n=79), and Group 2: T2DM (n=85). Each group was subdivided into three subcategories: sedentary, moderate activity, and active subjects. Serum nitric oxide (NO), iNOS, eNOS, high sensitivity C-reactive protein (hs-CRP), nitrates, and nitrites, were compared between different groups.

RESULTS: We observed significant differences in iNOS in diabetic patients compared to the control [29.1 (2.8) vs. 22.4 (1.4), p=0.050] with a significant decrease in eNOS when compared to the control group [79.5 (4.8) vs. 101.8 (5.7), p=0.003]. In the control group, eNOS showed significant differences (increase) between subgroups; sedentary, moderate, and active control subjects [77.4 (9.2), 114.7 (9.3), and 105.6 (9.5), p=0.026]. It also showed insignificant differences between subgroups in iNOS [23.4 (2.5), 24.2 (2.2), and 20.4 (2.4), p=0.520]. In addition, hsCRP showed a decrease with exercise but with no statistically significant difference between the groups [4.0 (0.5), 3.3 (0.3), and 2.9 (0.4), p=0.271]. In the diabetic patients’ group, a significant difference (decrease) between subgroups in iNOS [43.5 (4.8), 20.8 (3.9), and 19.8 (4.6), p<0.001] and hsCRP [5.7 (0.5), 3.8 (0.4), and 3.6 (0.5), p=0.006] was detected. In addition, eNOS showed a decrease with exercise but with no statistically significant difference between groups [82.9 (7.8), 74.6 (7.9), and 81.7 (10.2), p=0.741].

CONCLUSIONS: Patients with T2DM have shown significantly low eNOS and high iNOS levels. Furthermore, regular exercise can significantly decrease iNOS in patients with T2DM. Therefore, the importance of exercise for diabetic patients has to be emphasized to prevent long-term complications related to diabetes mellitus.

PMID:37259745 | DOI:10.26355/eurrev_202305_32471

Eur Rev Med Pharmacol Sci. 2023 May;27(10):4614-4618. doi: 10.26355/eurrev_202305_32470.

ABSTRACT

OBJECTIVE: Dipeptidyl peptidase-4 (DPP-4) enzyme inhibitors are used to increase the effect of incretins in the treatment of type 2 diabetes mellitus (DM). This study aimed to explore possible effects of DPP-4 enzyme inhibitors, which are widely used for blood sugar regulation in patients with type 2 DM, on hemoglobin, leukocyte (leucocyte), mean corpuscular volume (MCV) and thrombocyte levels.

PATIENTS AND METHODS: The study included 110 patients aged over 18 and diagnosed with type 2 diabetes mellitus, who applied to the Internal Medicine Polyclinic of Ankara Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital between 01.01.2019 and 31.08.2019 for routine control. Patients using metformin for DM and patients using metformin combined with DPP-4 enzyme inhibitors were divided into 2 groups. The data on patient hemogram (complete blood count) parameters were recorded retrospectively from the electronic patient file system. Patients with nutritional anemia were not included in the study. Besides, patients with known additional diseases (such as liver disease, kidney failure and malignancy) that may affect hemogram parameters, and patients with known infectious or inflammatory diseases were not included. Pregnant women were also excluded from the study. In addition, patients using angiotensin-converting enzyme (ACE) inhibitor class drugs were not included in the study.

RESULTS: There were no statistically significant differences between the two groups in terms of hemoglobin levels, MCV levels, leukocyte counts and thrombocyte counts (p>0.05).

CONCLUSIONS: Abnormalities in hemogram parameters in type 2 DM patients using DPP-4 enzyme inhibitors should not be immediately related to DPP-4 enzyme inhibitors, and non-drug etiologies that may cause abnormal levels in hemogram parameters should be carefully investigated.

PMID:37259744 | DOI:10.26355/eurrev_202305_32470

Eur Rev Med Pharmacol Sci. 2023 May;27(10):4608-4613. doi: 10.26355/eurrev_202305_32468.

ABSTRACT

OBJECTIVE: In this study, we aimed to investigate whether vitiligo, an autoimmune disease, affects the ovarian reserves of women suffering from this disease.

PATIENTS AND METHODS: This case-control study included 27 vitiligo patients and 44 healthy participants with regular menstrual cycles. The total number of participants was 71. We conducted the study in a tertiary hospital between June 2022 and November 2022. We carried out the study after receiving the Ethics Committee Approval of the same institute, numbered KAEK/2022.04.88. Before the study, we obtained informed consent from all the participants included in our study. We complied with the Declaration of Helsinki at all stages of the study. We compared the study groups’ demographic information, hormonal parameters, ovarian volumes, and antral follicle numbers. We performed an independent t-test to compare group means. We used SPSS for Windows 24.0 (IBM Corp., Armonk, NY, USA) for the analyses. We considered the p-value lower than 0.05 to be statistically significant.

RESULTS: AMH values were 2.66±1.76 pmol/L in the control group and 1.61±0.86 pmol/L in the patient group. The total number of antral follicles was 10.25±2.13 (n) in the control group and 9.26±2.97 (n) in the study group. Ovarian volume was 11.57±1.37 ml in the control group and 10.63±1.96 ml in the study group. These results were statistically significantly different. We detected one premature ovarian failure (POI) in the study group. Although there was only one case, this difference between the groups was statistically significant.

CONCLUSIONS: Our study has proven that the ovaries of women of reproductive age suffering from any disease with an autoimmune etiology are affected by this autoimmune process. Therefore, ovarian reserves should be evaluated in all fertile women with autoimmune diseases. Due to the evaluation, appropriate treatment and follow-up plans should be made in patients with infertility or premature ovarian failure (POF) risk.

PMID:37259743 | DOI:10.26355/eurrev_202305_32468

Eur Rev Med Pharmacol Sci. 2023 May;27(10):4601-4607. doi: 10.26355/eurrev_202305_32467.

ABSTRACT

OBJECTIVE: This study aimed to analyze the potential correlation between chronic endometritis (CE) and intrauterine adhesions (IUA) with its associated risk factors.

PATIENTS AND METHODS: We retrospectively analyzed data from 131 patients who underwent hysteroscopic transcervical resection of adhesions (TCRA) for intrauterine adhesions at our hospital between February 2020 and February 2021. General clinical data were collected and analyzed using univariate, multifactorial, and logistic regression analyses. Patients with mild, moderate, and severe IUA were divided into two groups based on whether they coincided with CE (CE group) or not (NCE group). Logistic regression analysis of the factors associated with IUA was performed, and the recurrence rates of IUA after TCRA in the CE and NCE groups were registered.

RESULTS: The risk of severe IUA was higher in patients with a higher number of abortions, higher number of indolent abortions, and CD138 positivity. In addition, the incidence of IUA combined with chronic CE varied when comparing the different IUA stages: 10.70% (3/28) for patients with mild IUA, 25.00% (7/28) for patients with moderate IUA, and 64.30% (18/28) for patients with severe IUA. The recurrence rates of IUA after TCRA in the CE and NCE groups were 69.20% (9/26) and 30.08% (4/67), respectively, in patients with moderate to severe IUA, and the differences were statistically significant (χ2=12.782, p=0.001).

CONCLUSIONS: A correlation was observed between CE and IUA. Patients presenting both conditions had more severe IUA stage and higher recurrence rates after TCRA.

PMID:37259742 | DOI:10.26355/eurrev_202305_32467

Eur Rev Med Pharmacol Sci. 2023 May;27(10):4504-4509. doi: 10.26355/eurrev_202305_32456.

ABSTRACT

OBJECTIVE: We aimed to investigate whether there is a relationship between blood fibrinogen levels during hospitalization of patients hospitalized for conservative treatment due to acute cholecystitis (AC) in our clinic. Patients underwent surgery and were discharged with medical treatment.

PATIENTS AND METHODS: The files of 118 patients who were hospitalized due to the diagnosis of AC and planned for conservative medical treatment in our clinic between January 2018 and February 2020 were recorded, prospectively. The patients were divided into two groups as those who responded to conservative treatment (Group 1), and those who were operated urgently despite conservative treatment (Group 2). Increase in gallbladder wall thickness, presence of pericholecystic fluid and hydrops sac on ultrasound and computed tomography (CT) were considered significant for the diagnosis of acute cholecystitis. Blood fibrinogen levels were measured in all patients during hospitalization.

RESULTS: The mean age of 118 patients included in the study was 58.32 (19-96) years. There were 77 patients in Group 1 and 41 patients in Group 2. Serum fibrinogen level was found to be 298.34±111.7 mg/dl in Group 1 and 637±124.5 mg/dl in Group 2, and a statistically significant difference was found (p<0.001). When the cut-off value for the fibrinogen level was taken as 564.50 mg/dl, the sensitivity and specificity of the test were found to be 75.6% and 61%, respectively in showing surgical treatment.

CONCLUSIONS: As a result of our study, we concluded that when the data obtained are evaluated, it should be kept in mind that despite medical treatment, there is an urgent need for an operation in patients with acute cholecystitis, and in patients with high plasma fibrinogen level (cut-off) at first admission.

PMID:37259731 | DOI:10.26355/eurrev_202305_32456

Eur Rev Med Pharmacol Sci. 2023 May;27(10):4481-4491. doi: 10.26355/eurrev_202305_32454.

ABSTRACT

OBJECTIVE: Our aims were to determine whether the levels of plasma monocyte chemotactic protein-1 (MCP-1), fetuin-A, serum total antioxidant status (TAS), and serum total oxidant status (TOS) are cardiac biomarkers and to clarify their relationship with each other in acute myocardial infarction (AMI).

PATIENTS AND METHODS: The study included 90 participants: 60 patients with AMI [30 with and 30 without ST-segment elevation myocardial infarction (STEMI)] and 30 cardiac patients without AMI. The diagnostic values of serum Hs-cTnT, MCP-1, fetuin-A, TAS, and TOS levels in predicting AMI were evaluated statistically.

RESULTS: Median levels of MCP-1 [120.10 ng/L (interquartile range: 76.94-230.54 ng/L)] and TOS [2.89 U/MI (IQR: 2.31-3.94 U/Ml)] were statistically higher, and median levels of fetuin-A [433.52 mg/L (IQR: 387.89-584.49 mg/L)] and TAS (3.10 ± 0.86 U/mL) were lower in patients with AMI than in controls. The parameter with the area under the curve (0.815), sensitivity (73.3%), and specificity (66.7%) closest to those of Hs-cTnT was fetuin-A, followed by MCP-1, TOS, and TAS, respectively. A one-unit increase in MCP-1 levels increased the probability of AMI by 1.023 times (p = 0.002). A one-unit increase in fetuin-A levels decreased the probability of AMI by 0.995 times (p = 0.003). A one-unit increase in serum TOS levels was 1.29 times more characteristic of STEMI than of NSTEMI (p = 0.044).

CONCLUSIONS: MCP-1, oxidative stress parameters, and fetuin-A might support Hs-cTnT levels in the early diagnosis of AMI. Fetuin-A and MCP-1 levels may be independent risk factors for AMI, whereas TOS could be used to distinguish STEMI from NSTEMI.

PMID:37259729 | DOI:10.26355/eurrev_202305_32454

Eur Rev Med Pharmacol Sci. 2023 May;27(10):4442-4449. doi: 10.26355/eurrev_202305_32450.

ABSTRACT

OBJECTIVE: We aimed at comparing the curative effect of proximal femoral nail antirotation (PFNA) and dynamic hip screw (DHS) in the treatment of Seinsheimer type V (type V) subtrochanteric fractures with sarcopenia.

PATIENTS AND METHODS: A retrospective analysis was performed on 59 patients with type V subtrochanteric fractures complicated with sarcopenia admitted to the Department of Orthopedics of the affiliated Jiangning Hospital with Nanjing Medical University from January 2016 to December 2021. Sarcopenia was diagnosed based on grip strength and skeletal muscle index (SMI). According to different surgical methods, they were divided into PFNA group (32 cases) and DHS group (27 cases). The age, gender, time from injury to operation, SMI value, incision length, operation time, intraoperative blood loss, fluoroscopy times, perioperative blood transfusion, lower limb full weight-bearing time, visual analogue scale (VAS) for pain at 3 months after operation and at the last follow-up, Harris score as well as postoperative complications were compared between the two groups.

RESULTS: There were no significant differences in age, gender, time from injury to operation, and SMI between the two groups. The length of surgical incision, blood loss and blood transfusion in the PFNA group were less than those in the DHS group; however, the number of intraoperative fluoroscopies was more than that in the DHS group. The PFNA group had earlier full weight-bearing time, lower VAS score and higher Harris score at 3 months after operation, while there was no statistically significant difference in VAS score and Harris score between the two groups at the last follow-up. The incidence of complications in the PFNA group was lower than that in the DHS group, and the difference was statistically significant.

CONCLUSIONS: Both PFNA and DHS are effective methods for the treatment of type V subtrochanteric fractures complicated with sarcopenia. Strikingly, PFNA is preferred because of its short surgical incision, less blood loss, faster recovery, and lower incidence of complications.

PMID:37259725 | DOI:10.26355/eurrev_202305_32450

Eur Rev Med Pharmacol Sci. 2023 May;27(10):4406-4420. doi: 10.26355/eurrev_202305_32446.

ABSTRACT

OBJECTIVE: The purpose of this study was to retrospectively assess the efficacy and safety of percutaneous nephrolithotomy (PCNL) for upper urinary stones using upper pole access (UPA) and other (low or middle) pole access (OPA).

MATERIALS AND METHODS: A comprehensive literature review of articles investigating the clinical efficacy and safety of UPA and OPA was performed. The relevant literature was obtained from PubMed, EMBASE, Science Direct, Google Scholar and the Cochrane Library. The primary outcomes, including the stone-free rate, were evaluated using Review Manager 5.4 software. The secondary outcomes (peri- and postoperative complications and operative date) were also compared and analyzed.

RESULTS: Ten comparative studies involving 5,290 patients were included in the analysis. The pooled data showed that the UPA group had a stone-free rate (SFR) similar to that of the OPA group [odds ratio (OR) 1.38, 95% confidence interval (CI): 0.94 to 2.03; p=0.22] but a higher incidence of blood transfusion [OR: 1.50; 95% CI: (1.03, 2.19), p=0.04]. There was no statistically significant difference in operative time [mean difference (MD): -7.27; 95% CI: (-25.18, 10.65), p=0.43] or hospital stay [MD: -0.13; 95% CI: (-0.64, 0.37), p=0.60] between the two groups. In addition, the results support that UPA causes fewer complications than OPA.

CONCLUSIONS: Our findings suggest that UPA and OPA are both effective treatments for the management of upper urinary stones. Compared to OPA, UPA is associated with less need for blood transfusion and fewer complications. Nevertheless, the findings should be further confirmed by well-designed prospective randomized controlled trials (RCTs) with large samples and strict standards.

PMID:37259721 | DOI:10.26355/eurrev_202305_32446

Eur Rev Med Pharmacol Sci. 2023 May;27(10):4399-4405. doi: 10.26355/eurrev_202305_32445.

ABSTRACT

OBJECTIVE: The aim of our study was to investigate the role of tissue Doppler and Myocardial Performance Index (MPI) in evaluating cardiac involvement in patients with rheumatoid arthritis (RA) with no cardiac symptoms, to determine whether these measurements differ between healthy controls and RA patients, and whether they can be used to determine the risk of cardiovascular disease and predict prognosis.

PATIENTS AND METHODS: 50 RA patients fulfilling the 2010 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RA criteria and 50 healthy volunteering controls were included in the study. All patients and controls were assessed using electrocardiography (ECG), echocardiography, conventional Doppler echocardiography and tissue Doppler echocardiography. MPI values were calculated. In addition, RA patients were compared after being divided into two subgroups: seropositive and seronegative RA. Disease activity levels of the patients were determined based on Disease Activity Score in 28 Joints (DAS28).

RESULTS: The control group and RA group were compared in terms of PR interval, left atrial diameter, E/A, E/e’, and MPI values. Comparisons between the groups yielded statistically significant differences in left atrial diameter, E/A, E/e’, and MPI values and no significant difference in PR intervals. These parameters were also compared between seropositive and seronegative patients. Left atrial diameter was significantly higher in seronegative patients than in seropositive patients. There was no significant difference in the other values. DAS28 scores had no correlation with cardiac parameters.

CONCLUSIONS: Early detection of ventricular dysfunction in RA may be useful in clinical practice when predicting prognosis and optimizing treatment. The present study found that RA patients had impaired tissue Doppler measurements and MPI results compared to controls. MPI and tissue Doppler may be useful in early detection of ventricular dysfunction.

PMID:37259720 | DOI:10.26355/eurrev_202305_32445

J Asthma. 2023 May 31:1-16. doi: 10.1080/02770903.2023.2220791. Online ahead of print.

ABSTRACT

OBJECTIVE: This study aimed to analyze the prevalence of chronic allergic diseases before and after the COVID-19 pandemic using data from the Korea National Health and Nutrition Examination Survey in 2019 and 2021.

DATA SOURCES: A representative sample of Korean adults (n = 10,346) aged 19-85 years who completed the survey in 2019 and 2021 was analyzed.

STUDY SELECTION: General and health-related characteristics, as well as the prevalence and diagnosis of asthma, atopic dermatitis, and allergic rhinitis, were compared between the two years. Sub-analyses by gender and age were also conducted.

RESULTS: Statistically significant differences were found in marital status, subjective health perception, sleep quality, and walking status between 2019 and 2021. However, there were no statistically significant differences in the prevalence and diagnosis of asthma, atopic dermatitis, and allergic rhinitis. In a sub-analysis by gender and age, the prevalence of asthma in teenagers showed a statistically significant increase in 2021 compared to 2019, while it decreased significantly in the 30s group.

CONCLUSION: This study found no significant changes in the prevalence and diagnosis of chronic allergic diseases before and after the COVID-19 pandemic in Korea. However, changes in lifestyle factors, such as physical activity and sleep quality, were observed. The increase in asthma prevalence in teenagers after COVID-19 can be attributed to age-specific differences in asthma treatment. Further research on the relationship between COVID-19 and chronic allergic diseases is necessary, and healthcare providers should consider lifestyle changes in their treatment of chronic allergic disease patients during the pandemic.

PMID:37259180 | DOI:10.1080/02770903.2023.2220791