Risk factors for clinically significant macular edema in a multi-ethnics population with type 2 diabetes

AIM: To determine the risk factors of clinically significant macular edema (CSME) in patients with non-proliferative diabetic retinopathy (NPDR) in a multi-ethnics Malaysian population. METHODS: We performed a case control study in which 150 patients with bilateral NPDR and CSME in either eye were compared to 150 patients with bilateral NPDR and no CSME in both eyes. CSME and NPDR were graded according to Early Treatment of Diabetic Retinopathy Study criteria. Student’s t-test, odds ratio and multiple logistic regression analysis were performed to analyze the duration of diabetes, body mass index (BMI), blood pressure(BP), total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (TG), fasting blood glucose (FBG), HbA1c, full blood count, serum creatinine and proteinuria between the two groups. RESULTS: Both groups were matched in terms of age, gender and ethnicity. Duration of diabetes, total serum cholesterol, serum LDL, FBG, HbA1c and serum creatinine were significantly higher in the CSME group (P<0.05). The hemoglobin, packed cell volume were significantly lower in the CSME group (p<0.05). There was no significant difference for serum HDL, TG, BMI, systolic and diastolic BP. Multiple logistic regression analysis showed that total serum cholesterol and HbA1c had significantly high odds of developing CSME. CONCLUSION: HbA1c and total cholesterol are the two most important risk factors associated with CSME in patients with NPDR.     

Bioaccumulation and Distribution of Metals in Sediments and Avicenna marina Tissues in the Hara Biosphere Reserve, Iran

The metal pollution in Sediments and Avicenna marina tissues in the Hara Biosphere Reserve was monitored for Lead (Pb), Cadmium (Cd), and Nickel (Ni) with atomic absorption spectrometer. The results showed that the mean concentration of Pb, Cd, and Ni in the water and sediments were much higher than the recommended threshold limits in the most stations, also the highest means of Pb, Cd, and Ni were observed in Avicenna roots and it were 25.26?±?4.86, 2.17?±?0.74, and 26.72?±?6.17 (μg?g(-1)) respectively. Calculating BCF (bioconcentration factor) index illustrates that A. marina accumulates Pb, Cd, and Ni 1.62, 1.52 and 0.73 times greater than sediment levels respectively, So it can show that A. marina may be employed as a biological indicator exposure of Cd, Pb, and Ni with temporal monitoring, also the factories were main sources of metals contamination in the Hara Biosphere Reserve.     

Management of sexual disorders in spinal cord injured patients

Spinal cord injured (SCI) patients have sexual disorders including erectile dysfunction (ED), impotence, priapism, ejaculatory dysfunction and infertility. Treatments for erectile dysfunction include four steps. Step 1 involves smoking cessation, weight loss, and increasing physical activity. Step 2 is phosphodiesterase type 5 inhibitors (PDE5I) such as Sildenafil (Viagra), intracavernous injections of Papaverine or prostaglandins, and vacuum constriction devices. Step 3 is a penile prosthesis, and Step 4 is sacral neuromodulation (SNM). Priapism can be resolved spontaneously if there is no ischemia found on blood gas measurement or by Phenylephrine. For anejaculatory dysfunction, massage, vibrator, electrical stimulation and direct surgical biopsy can be used to obtain sperm which can then be used for intra-uterine or in-vitro fertilization. Infertility treatment in male SCI patients involves a combination of the above treatments for erectile and anejaculatory dysfunctions. The basic approach to and management of sexual dysfunction in female SCI patients are similar as for men but do not require treatment for erectile or ejaculatory problems.     

Situation of medical sciences in 50 top countries from 1996 to 2010--based on quality and quantity of publications

In research outputs both quality and quantity are of critical value and evaluation of both aspects is required for best evaluation. Several studies have worked on single or two-dimensional methods that provide the assessment of quality, quantity or both simultaneously in different branches of sciences, but none of them have played a role in a particular area of medicine. This study has been conducted to compare countries worldwide in the field of medical researches. Measuring both quality and quantity of researches is performed separately. In order to evaluate countries from both aspects of quantity and quality of research outputs, a modified form of the citation per publication (CPPm) and publication per population (PPPm) were used to make these indices comparable through different years and nations by normalizing the values according to the world average standards. When countries are ranked by CPPm, Iceland ranks the 1st with the score of 1.98, Faroe Islands and Gambia rank the 2nd and the 3rd with scores of 1.84 and 1.63, respectively. In PPPm Switzerland, Sweden and Denmark ranked the top three with scores of 13.34, 11.67 and 10.32, respectively. Iran ranked 71 in CPPm and 141 in PPPm. Ranking countries makes it possible to identify countries which have performed better in research outcomes by means of quality and quantity; thus, reforming policies can be taken into action to lower the waste of money, higher quality and quantity of outputs while providing helpful tip(s) for institutions to improve.     

Renal mass: a confusing feature of sarcoidosis

Sarcoidosis is a systemic disorder with a wide spectrum of clinical involvements. Renal mass is a very rare condition in sarcoidosis. Here, we report a 34-year-old female with renal masses and advanced renal failure. The condition created a lot of diagnosis difficulties. Finally, after histologic diagnosis and corticosteroid therapy, renal masses were resolved and she became free from dialysis.     

Omentin-1, visfatin and adiponectin levels in relation to bone mineral density in Iranian postmenopausal women

The bone and fat interface is implicated in the pathogenesis of postmenopausal osteoporosis. The association between circulating omentin-1 levels and bone mineral density (BMD) in postmenopausal women has never been assessed. A total of 382 healthy postmenopausal women were randomly selected. Omentin-1, visfatin, adiponectin, the receptor activator of nuclear factor-κB ligand (RANKL), osteoprotegerin, high sensitivity C-reactive protein, degradation products of C-terminal telopeptides of type I collagen, and osteocalcin were measured by highly specific enzyme-linked immunosorbent assay methods. BMD was determined for the lumbar spine (L2-L4) and the proximal femur using dual-energy X-ray absorptiometry. In multivariable-adjusted linear regression, serum omentin-1 levels were inversely correlated with BMD at the lumbar spine (β=-0.11, p=0.020). In multiple regression analyses, serum visfatin and adiponectin levels were not significantly correlated with BMD at different skeletal sites after controlling for age, body mass index, and bone-related markers. However, the highest quartile of adiponectin compared to the lowest quartile, after adjusting for potential confounders, revealed an inverse association with BMD in the lumbar spine (β=-0.19, p=0.010). In conclusion, circulating omentin-1 levels had an inverse correlation with BMD at the lumbar spine in Iranian postmenopausal women. To further understand the role of omentin-1 in bone and mineral metabolism, large-scale longitudinal studies focusing on BMD and osteoporotic fractures are warranted.     

Merkel cell carcinoma on the right calf in association with chronic lymphocytic leukemia: A case report

This study showed a rare case of Merkel cell carcinoma (MCC) with atypical manifestations accompanied by chronic lymphocytic leukemia of B‐cell type that underwent chemotherapy and had poor prognosis. The findings suggest that the physicians should consider MCC when performing diagnosis and assess all possible associated risk factors like neoplasms to achieve good prognosis.