Transcatheter Atrial Septal Defect Closure under Transthorasic Echocardiography in Children

Objective

Atrial septal defect (ASD) device closure is routinely done under the guide of transesophageal or intracardiac echocardiography which are expensive techniques and not easily affordable in developing countries.

Methods

Using metallic devices, we attempted 32 ASD device closures under transthoracic echocardiography.

Findings

Of those, 30 procedures were successful (94 %). In two patients with relatively large ASD we encountered difficulty in positioning the device. These patients were referred for surgical closure.

Conclusion

ASD device closure can be carried out successfully in most patients under transthoracic echocardiography in situations where transesophageal or intravenous echocardiographies are not available or affordable.     

Non-syndromic hypodontia in an Iranian orthodontic population

To investigate the prevalence, characteristics (ie, malocclusion, location, type), and sex distribution of hypodontia in an Iranian orthodontic population. A retrospective study was conducted using periapical and panoramic radiographs and study models of 1,751 subjects attending university orthodontic clinics (870 females, 881 males, age 9-27 years). The Chi-square test was used to analyze differences in the distribution of hypodontia, after stratification by sex and malocclusion type. A total of 197 congenitally missing teeth were observed in 160 patients (9.1%; 74 boys and 86 girls); there were no statistically significant differences between sexes (Chi-square = 0.832, P = 0.36). Hypodontia was more common in patients with Class III malocclusion (45.2%), and was more prevalent in the maxilla (71%) than in the mandible (29%). Maxillary lateral incisors (35.6%) and maxillary second premolars (13.0%) were the most commonly missing teeth, followed by mandibular lateral incisors (9.6%) and mandibular second premolars (8.2%). The prevalence of missing teeth was higher in the anterior segment (incisors and canines) than in the posterior segment (premolars and molars). The prevalence of oligodontia was 0.34%. The prevalence and characteristics of the most frequently missing teeth accorded with the findings of most studies conducted in other countries.     

Evaluation of the protective effect of pentoxifylline on carrageenan-induced chronic non-bacterial prostatitis in rats

Chronic non-bacterial prostatitis (CNP) is the most common type of prostatitis and oxidative stress (OS) was shown to be highly elevated in prostatitis patients. This study aimed to investigate the protective effect of pentoxifylline (PTX) on CNP induced by carrageenan in rats. Male adult Wistar rats (n = 30) were divided into control, CNP and three treatment groups (n = 6) including CNP + cernilton and CNP + PTX groups. CNP was induced by single intraprostatic injection of 1% carrageenan (100 µl). Rats in treatment groups received orally cernilton 100 mg/kg and PTX at 50 and 100 mg/kg 1 week after CNP induction for 21 days. Prostatic index (PI), prostatic specific antigen (PSA), tumor-necrosis factor alpha (TNF-α), serum lipid peroxidation (MDA), blood urea nitrogen, creatinine and histopathological changes were compared between groups. There were significant increase of PI, serum levels of PSA, TNF-α and MDA in CNP group at 29 day. In treatment groups, significant reduction in PI, serum levels of PSA, TNF-α, MDA and creatinine was observed especially in rats treated with dose of 50 mg/kg of PTX. In CNP group, histopathological changes of the prostate such as leucocyte infiltration, large involutions and projection into the lumen and reducing the volume of the lumen were observed as well. Whereas PTX, especially at dose of 50 mg/kg, could improve the above-mentioned changes remarkably in CNP treated rats. For the first time, our findings indicated that PTX improved CNP induced by carrageenan in rats.     

Association of the DNA repair SMUG1 rs3087404 polymorphism and its interaction with high sensitivity C-reactive protein for age-related macular degeneration in Iranian patients

Background: Age-related macular degeneration (AMD) is a complex disease and recently the role of DNA repairing genes in its susceptibility has been studied. It has been hypothesized that polymorphism in DNA repair system genes reduce the capacity to repair DNA damages which may lead to a greater susceptibility to AMD. C-reactive protein (CRP) production is shown to enhance inflammatory processes by increasing oxidative stress and inducing DNA damage. We planned to evaluate the possible association of SMUG1 variants and their possible interaction with high sensitivity CRP levels in AMD.

Materials and methods: We included 500 case-control samples consisting of 279 advanced type AMD patients and 221 genetically unrelated healthy controls enrolled for evaluation. Extracted-DNA samples were amplified to obtain fragments including the polymorphic region SMUG1 rs3087404. We calculated relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy index (S) to clarify possible interaction of different genotypes and CRP levels for AMD.

Results: The distribution of the genotypes were not significantly different in the AMD patients compared to that of controls (p = 0.849). The allele frequency for SMUG1 was not different between study groups. No difference of SMUG1 polymorphism between case and control groups was evident in higher CRP levels (CRP>3mg/dl) compared with lower CRP levels. SMUG1/CRP synergy indices calculated as RERI = ?0.12 and AP = ?0.18 while S was not calculable.

Conclusions: Our study showed that c.-31A/G-SMUG1 genotypes/alleles do not have any association with the occurrence or severity of advanced type AMD. There was no interaction of CRP levels and SMUG1 genotypes in AMD susceptibility.     

Association between human leucocyte antigen alleles and risk of stroke in Iranian population

Previous studies have demonstrated associations between human leucocyte antigen (HLA) and some types of ischaemic stroke. In the present study, we genotyped HLA‐A,‐B and ‐DRB1 alleles in 140 Iranian patients with history of ischaemic stroke and 140 age‐/sex‐matched healthy subjects. No significant difference has been found in the distribution of HLA‐A and B alleles between cases and controls. The DRB1*16 allele was significantly over‐represented in patient group compared with control group (Adjusted p value = 0.048). Other HLA‐DRB1 alleles were not associated with stroke risk. The HLA‐B*35,B*52 genotype was significantly more prevalent among patients compared with controls (Adjusted p value = 0.03, OR [95% CI] = 9.3 [1.3, 407.2]). Several HLA haplotypes were associated with risk of stroke in the assessed population. The current study provides further evidences for participation of HLA in conferring risk of ischaemic stroke.     

A Bibliometric Review of Published Abstracts Presented at the Dysphagia Research Society: 2001–2011

The purpose of this investigation was to perform a comprehensive bibliometric review of published abstracts presented at the Dysphagia Research Society between 2001 and 2011 in order to delineate research trends, identify knowledge gaps, and recommend areas for future dysphagia research. All 972 research abstracts, both oral and poster presentations, were included. Study designs included cross-sectional (n = 333, 34.4 %), cohort (n = 279, 28.8 %), and case series (n = 210, 21.7 %), while randomized controlled trials constituted only 3.3 % (n = 32) of all research presentations. Levels of evidence were assigned based on analysis of abstract details, as level 1 (n = 29, 3.0 %), level 2 (n = 639, 65.7 %), level 3 (n = 53, 5.5 %), level 4 (n = 243, 25.0 %), and level 5 (n = 8, 0.8 %). Research topics included normal swallowing pathophysiology (n = 279, 28.7 %), swallowing physiology (n = 266, 27.4 %), swallowing diagnosis (n = 192, 19.7 %), swallowing treatment (n = 165, 17.0 %), clinical policy and practice (n = 36, 3.7 %), and basic science (n = 34, 3.5 %). Research occurred in adults (n = 861, 88.6 %), pediatrics (n = 76, 7.8 %), animals (n = 29, 3.0 %), cadavers (n = 3, 0.3 %), and mechanical models (n = 3, 0.3 %). Presenting authors represented 14 different disciplines, with the majority in speech-language pathology, dentistry, basic science, and otolaryngology. Research was performed in 14 different countries with increased geographical diversity during the decade of analysis. Research recommendations derived from our findings call for increased (1) randomized controlled clinical trials consistent with level 1 evidence, (2) focus on pediatric feeding and swallowing, (3) use of animal models to study swallowing dysfunction and novel treatments, and (4) investigations from additional medical specialties. In addition, we applaud current trends and encourage continued support of interdisciplinary, international, and trainee representation.     

IUD perforation and embedment within omentum: A rare and perplexing incidence

Intrauterine devices rarely fail, which results in pregnancy. Meanwhile, these devices can perforate uterine and migrate through abdomen. Our case experienced IUD failure and perforation simultaneously, and the device was embedded in omentum and shifted rapidly, which made it hard to localize and could only be removed using ultrasonography guidance.     

A review of neuroradiological abnormalities in patients with coronavirus disease 2019 (COVID-19)

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to various neurological manifestations. There is an urgent need for a summary of neuroimaging findings to accelerate diagnosis and treatment plans. We reviewed prospective and retrospective studies to classify neurological abnormalities observed in patients with the SARS-CoV-2 infection.MethodsThe relevant studies published in Scopus, PubMed and Clarivate Analytics databases were analysed. The search was performed for full-text articles published from 23 January 2020 to 23 February 2021.ResultsIn 23 studies the number of patients with SARS-CoV-2 infection was 20,850 and the number of patients with neurological manifestations was 1996 (9.5%). The total number of patients with neuroradiological abnormalities was 602 (2.8%). SARS-CoV-2 has led to various neuroimaging abnormalities which can be categorised by neuroanatomical localisation of lesions and their main probable underlying pathogenesis. Cranial nerve and spinal root abnormalities were cranial neuritis and polyradiculitis. Parenchymal abnormalities fell into four groups of: (a) thrombosis disorders, namely ischaemic stroke and sinus venous thrombosis; (b) endothelial dysfunction and damage disorders manifested as various types of intracranial haemorrhage and posterior reversible encephalopathy syndrome; (c) hypoxia/hypoperfusion disorders of leukoencephalopathy and watershed infarction; and (d) inflammatory disorders encompassing demyelinating disorders, encephalitis, vasculitis-like disorders, vasculopathy and cytotoxic lesions of the corpus callosum. Leptomeninges disorders included meningitis. Ischaemic stroke was the most frequent abnormality in these studies.ConclusionThe review study suggests that an anatomical approach to the classification of heterogeneous neuroimaging findings in patients with SARS-CoV-2 and neurological manifestations would lend itself well for use by practitioners in diagnosis and treatment planning.