Non-Infectious Dermatological Manifestations among Patients with Diabetes Mellitus in Basrah, Iraq.

Diabetes mellitus (DM) is a clinical illness usually linked to a wide range of skin manifestations; however, skin, as the greatest organ in the body, has received little attention. As a result, this study aimed to detect the prevalence and pattern of non-infectious skin disorders among patients with diabetes. This study was carried out at the Faiha Specialized Diabetes, Endocrine, and Metabolism Center, Basrah Province, Iraq, from September 2020 to September 2021. The data were collected from 347 patients with Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM). The exclusion criteria were patients with skin changes due to some medications, pregnancy, iatrogenic factors, skin infections, established hypo- or hyper-thyroidism, Cushing or adrenal insufficiency, pituitary disorders, end-stage renal impairment, malignancy, and established rheumatological disease and those who were on chemotherapy. Full dermatological examinations and screenings were performed under the supervision of a dermatologist expert and all clinically definable cutaneous lesions were recorded. The prevalence of skin lesions was estimated at 71.5% in patients. Pruritus, xerosis, acrochordon, diabetic dermopathy, acanthosis nigricans, and insulin-related lipohypertrophy were the commonest skin lesions reported among the patients. The occurrence of skin lesions in diabetic patients was proportional to the female gender, duration of disease, obesity, insulin therapy, and worse glycemic control. There was a broad spectrum of skin lesions in both T1DM and T2DM with corresponding prevalence.

Total Testosterone to Estradiol Ratio as a Predictor Marker of Metabolic Syndrome in Males.

Nowadays, metabolic syndrome (MetS) represents a global health challenge in developed and developing countries. The sex hormones disorders in males are related to many clinical co-morbidities. This study aimed to evaluate the total testosterone (TT) to estradiol (E2) ratio as a predictor marker of MetS. This case-control study included 88 MetS patients and 88 healthy individuals (control), in the age range of 18-69 years who were selected among patients who were referring to an outpatient clinic, using a convenience sampling method. The study participants were selected based on their medical history and physical examination, which included waist circumference, blood pressure, serum E2, TT, fasting blood glucose (FBG), triglyceride (TG), and high-density lipoprotein-cholesterol (HDL-C). Diagnosis of MetS was confirmed according to the National Cholesterol Education Program Adult Treatment Panel III guidelines. The findings revealed that the mean TT level was significantly lower among patients with MetS (P<0.001), while the mean E2 level was significantly higher among patients with MetS (P<0.001). The mean TT to E2 ratio was significantly lower among patients with MetS (OR=9.6, P<0.001). There was a significant correlation between MetS components and TT to E2 ratio and waist circumference (WC) (r = - 0.49, P<0.0001). The means of weight, WC, blood pressure, and FBG levels were significantly higher in patients with MetS (P<0.001, P<0.001, P<0.001, P=0.04, respectively), and the lipid profile of patients with MetS was abnormal (TG, P<0.001, HDL-C, P<0.001). Eventually, it can be concluded that the TT to E2 ratio can be regarded as a significant predictor of MetS in males.

Serum Level of Heat Shock Protein 70 in Patients with Type 2 Diabetes Mellitus in Basrah, Iraq.

Diabetes mellitus is a chronic metabolic disease with an increasing prevalence, caused by a defect in insulin production, insulin action, or both, and can increase the risk for the development of microvascular as well as macrovascular complications. Heat shock protein70 is considered a family of a larger group of proteins known as heat shock proteins, which their expression is induced when the cells are subjected to environmental stress. They are believed to keep the native folding of proteins in cells under stressful conditions and their therapeutic role. Therefore, this study aimed to investigate the serum level of HSP70 in patients with type 2 diabetes mellitus (T2DM) to assess if there is an association of HSP70 with T2DM and to evaluate the effect of age and duration of disease on the serum level of HSP70. Ninety-one patients with T2DM were recruited, and 85 individuals with the same age range and sex as healthy controls. Serum HSP70, fasting blood sugar, and HbA1c were measured. The results revealed that the level of HSP70 was significantly higher in the diabetic group compared to the control group (P value<0.05). The level of HSP70 showed a significant positive correlation with age and duration of disease as well as with fasting blood sugar and HbA1c. The study suggested that HSP70 may have the potential to be used as an indicator of metabolic derangement and a prognostic biomarker in diabetes.

Unique presentation of intra-abdominal testis: small bowel obstruction.

We describe here a two-year-old male who required urgent laparotomy to relieve a strangulated small bowel caused by internal herniation around an intra-abdominal testis. This clinical presentation has not been reported previously.