Gluten sensitive enteropathy in patients with iron deficiency anemia of unknown origin

AIM： To determine the prevalence of gluten sensitive enteropathy （GSE） in a large group of patients with iron deficiency anemia （IDA） of obscure origin.METHODS： ：In this cross-sectional study, patients with IDA of obscure origin were screened for GSE. Anti- endomysial antibody （EMA） and tissue transglutaminase antibody （tTG） levels were evaluated and duodenal biopsies were taken and scored according to the Marsh classification. The diagnosis of GSE was based on a positive serological test and abnormal duodenal histology. Gluten free diet （GFD） was advised for all the GSE patients.RESULTS： Of the 4120 IDA patients referred to our Hematology departments, 206 （95 male） patients were found to have IDA of obscure origin. Thirty out of 206 patients （14.6%） had GSE. The mean age of GSE patients was 34.6± 17.03 （range 10-72 years）. The female to male ratio was 1.3：1. Sixteen patients had Marsh 3,12 had Marsh 2, and 2 had Marsh 1 lesions. The severity of anemia was in parallel with the severity of duodenal lesions. Twenty-two GSE patients （73.3%） had no gastrointestinal symptoms. Fourteen GSE patients who adhered to GFD without receiving iron supplementation agreed to undergo follow up visits. After 6 mo of GFD, their mean hemoglobin levels （Hb） increased from 9.9 ±1.6 to 12.8 ±1.0 g/dL （P 〈 0.01）. Interestingly, in 6 out of 14 patients who had Marsh 1/2 lesions （e.g. no villous atrophy） on duodenal biopsy, mean Hb increased from 11.0 ±1.1 to 13.1 ±1.0 g/dL （P 〈 0.01） while they did not receive any iron supplementation. CONCLUSION： There is a high prevalence （e.g. 14.6%） of GSE in patients with IDA of obscure origin. Gluten free diet can improve anemia in GSE patients who have mild duodenal lesions without villous atrophy.     

Increased levels of 5HT2A receptor mRNA expression in peripheral blood mononuclear cells of patients with major depression: correlations with severity and duration of illness

Background: Neuroimaging, immunologic, and pharmacologic studies have emphasized the role of 5-HT2A and 5-HT3A serotonin receptors in the pathophysiology of major depression.

Aim: The aim of this study was to measure the relative expression of 5-HT2A and 5-HT3A receptor mRNA in peripheral blood mononuclear cells (PBMCs) of patients with major depressive disorder (MDD).

Method: 5-HT2A and 5-HT3A receptor mRNA expressions were examined in PBMCs of 25 medication-naïve-patients with MDD, 25 medication-free MDD patients, and 25 healthy controls. 5-HT2A and 5-HT3A receptor mRNA expressions were measured using real-time quantitative PCR. This study evaluated patients’ clinical symptoms using the Hamilton Depression Rating Scale-17 items (HDRS) and the Beck Depression Inventory (BDI).

Results: Relative 5-HTR2A mRNA expression was significantly higher in PBMCs of all MDD patients when compared with healthy controls (Z = ?3.875, p?Z = ?1.328, p?>?0.05). MDD patients showed significant correlations between 5-HTR2A mRNA expression and HDRS scores (rs?=?0.902, p?rs?=?0.878, p?Conclusion: This study showed that depressed patients, irrespective of treatment, have higher 5-HTR2A mRNA levels in PBMCs than healthy subjects. It also provided evidence that 5-HTR2A mRNA levels in PBMCs of MDD patients could be associated with the severity of depression and the duration of the illness.     

A novel CoFe2O4@Cr-MIL-101/Y zeolite ternary nanocomposite as a magnetically separable sonocatalyst for efficient sonodegradation of organic dye contaminants from water

In this research, a novel magnetic sonocatalyst nanocomposite, CoFe₂O₄@Cr-MIL-101/Y zeolite, has been successfully fabricated employing a simple hydrothermal method. The as-prepared catalyst was thoroughly identified using Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), energy dispersive X-ray spectroscopy (EDS), EDS elemental dot-mapping, transmission electron microscopy (TEM), atomic force microscopy (AFM), vibrating sample magnetometer (VSM), and nitrogen Brunauer–Emmett–Teller (N₂-BET) analyses. The procured CoFe₂O₄@Cr-MIL-101/Y nanocomposite was then assessed for the decomposition of three types of organic dyes namely methylene blue (MB), rhodamine B (RhB) and methyl orange (MO) from water solution using ultrasound irradiation and subsequently monitored via UV-Vis absorption technique. The sonodecomposition reactions of organic dyes were accomplished in the presence of the H₂O₂ solution as a green oxidizing agent. Furthermore, the influence of various experimental independent factors such as irradiation time, process type, initial dye concentration, catalyst dosage, H₂O₂ concentration, scavenger type, and catalyst regeneration on the decomposition of MB, RhB and MO were surveyed. Additionally, a first order kinetic model was applied to investigate the sonodecomposition reactions of dye contaminants. The rate constant (k) and half-life (t_1/2) data were gained as 0.0675 min⁻¹ and 10.2666 min, respectively, for the decomposition of MB in the US/H₂O₂/CoFe₂O₄@Cr-MIL-101/Y system. Besides, evaluating the attained results, the distinctive performance of ˙OH as the radical scavenger originating from H₂O₂ throughout the sonodecomposition process is vividly approved.

A novel magnetically separable CoFe₂O₄@Cr-MIL-101/Y zeolite ternary nanocomposite was prepared and applied as a sonocatalyst for efficient degradation of organic contaminants.     

Comparing Efficacy of Three Methods of Tranexamic Acid Administration in Reducing Hemoglobin Drop Following Total Knee Arthroplasty

The ideal method of providing tranexamic acid (TXA) for decreasing hemoglobin drop after TKA is still controversial. In this clinical trial, 200 patients were randomly allocated to four groups. In group 1, 500 mg TXA was administered intravenously. In group 2, the joint irrigated with 3 g of TXA in 100 cc of saline. In group 3, 1.5 g of TXA was injected through the drain. Group 4 did not take TXA. Albeit all methods had a statistical effect on hemoglobin drop, drainage and number of transfused units when compared to controls, but intravenous injection of TXA seems to be much more effective in terms of reducing hemoglobin drop and transfused units; and what's more TXA injection by drain is more effective regarding to reducing postoperative drainage.     

Intraoral transnasal approach for surgical extraction of bilateral deeply impacted mesiodens: A case report

We describe a novel modified intranasal approach to minimize the complications of the impacted mesiodens surgical extraction. Also, it can be performed under local anesthesia with proper preoperative workup.