Designing a Logistic Regression Model for a Dataset to Predict Diabetic Foot Ulcer in Diabetic Patients: High-Density Lipoprotein (HDL) Cholesterol Was the Negative Predictor.

OBJECTIVES: Although the risk factors for diabetic neuropathy and diabetic foot ulcer have been detected, there was no practical modeling for their prediction. We aimed to design a logistic regression model on an Iranian dataset to predict the probability of experiencing diabetic foot ulcers up to a considered age in diabetic patients. METHODS: The present study was a statistical modeling on a previously published dataset. The covariates were sex, age, body mass index (BMI), fasting blood sugar (FBS), hemoglobin A1C (HbA1C), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), insulin dependency, and statin use. The final model of logistic regression was designed through a manual stepwise method. To study the performance of the model, an area under receiver operating characteristic (AUC) curve was reported. A scoring system was defined according to the beta coefficients to be used in logistic function for calculation of the probability. RESULTS: The pretest probability for the outcome was 30.83%. The final model consisted of age (ß1 = 0.133), BMI (ß2 = 0.194), FBS (ß3 = 0.011), HDL (ß4 = -0.118), and insulin dependency (ß5 = 0.986) (P < 0.1). The performance of the model was definitely acceptable (AUC = 0.914). CONCLUSION: This model can be used clinically for consulting the patients. The only negative predictor of the risk is HDL cholesterol. Keeping the HDL level more than 50 (mg/dl) is strongly suggested. Logistic regression modeling is a simple and practical method to be used in the clinic.

Evaluation of colonoscopy data for colorectal polyps and associated histopathological findings.

BACKGROUND: Adenomas of colon and rectal are frequent colonoscopically found benign lesions. The aim of this study is to evaluate the incidence of polyps among patients referred for colonoscopy and associated histopathological findings. METHODS: In this retrospective study, patients referred for colonoscopy at Shahid Madani Hospital from were enrolled. The records of the patients were evaluated for demographic data, polyp status along with size and location and type and histopathological findings of the polyps. The data obtained were statistically analyzed using SPSSv22. RESULTS: Among 1600 patients who underwent colonoscopy, 260 were positive with polyps. The main symptom among these patients was lower gastrointestinal bleeding 44.2%. The average size of the polyps was 5.68 ± 2.66 and the incidence was significantly greatest among the age group of 51-65 years, p < 0.01. The commonest sites polyps were sigmoid and descending colon, 28.6% and 23.2%, respectively. Adenomatous polyps were the most frequent type, 58.3%. The morphology and pathology of the polyps were significantly associated with each other, p < 0.01. CONCLUSION: Our study evaluates the retrospective data for polyp findings among colonoscopy patients. Early diagnosis of polyps can provide better therapeutic outcomes.

Role of growth factors and biomaterials in wound healing.

Wound healing is a biological complex process that involves several cell types under the control and regulation of several growth factors and cytokines. There have been efforts to study the therapeutic effects of granulocyte-macrophage colony-stimulating factor, platelet-derived growth factor, transforming growth factor-ß, vascular endothelial growth factor and basic fibroblast growth factor on chronic wounds. In addition, the effects of biomaterials such as nano-fibrous chitin and chitosan have been proven to be effective on wound healing. Furthermore, stem cell therapy using adipose-derived stem cells (ASCs) has been developed as a new therapeutic method for wound repair and healing. In this review, we will summarize the role of stem cells; growth factors and biomaterials in wound healing and repair.

Echocardiographic Evaluation in Neonates with Heart Murmurs.

Auscultation of the heart is one of the most important tools of physical examination in neonates, which is very helpful in the diagnosis or rejection of congenital heart diseases (CHDs). The aim of this study is to investigate the causes of heart murmur in neonates hospitalized in neonatal unit in Imam Reza Hospital, Kermanshah, Iran. This cross-sectional study was conducted within the period of 18 months on neonates hospitalized in neonatal unit whose heart murmur, diagnosed through examination, and echocardiography was conducted to investigate the existence of CHD. In 62.1% of the cases, murmuring was auscultated within the first week after birth. Among 172 neonates with heart murmur, 25 subjects (14.5%) had normal echocardiogram, and others had abnormal echocardiogram in which ventricular septal defect (31.4%) was the most common CHD. Patent ductus arteriosus (23.3%) was the second common CHD found. Other defects were atrial septal defect, persistent foramen ovale, pulmonary stenosis, and tricuspid regurgitation. Among the neonates with CHD, 55 subjects were females and 92 cases were males. There was CHD history in previous siblings in 10 cases. In 73 neonates with CHD, the mother had not taken folic acid in the first trimester of pregnancy. A total of 14.5% of the hospitalized neonates suffered from innocent murmur, and the rest with heart murmur had abnormal echocardiography and suffered from CHD (85.5%). Heart murmur in neonates could be a symptom of CHD, and timely echocardiography is very important in diagnosing the type of disease.

A brief review on the application of nanoparticle enclosed herbal medicine for the treatment of infective endocarditis.

Herbal medicines have been routinely employed all over the world dated back from the ancient time and have been identified by patients and physicians for their excellent therapeutic value as they have lower adverse effects when compared with the modern medicines. Phytotherapeutics requires a scientific technique to deliver the active herbal extract in a controlled manner to avoid repeated administration and increase patient compliance. This can be reached by fabricating a novel drug delivery systems (NDDS) for herbal components. NDDSs does not only decrease the repeated dose to overcome ineffectiveness, but also help to increase potency by decreasing toxicity and elevating drug bioavailability. Nano-sized DDS of herbal drugs have a potential application for improving the activity and countering the problems related to herbal medicines. Hence, application of nanocarriers as an NDDS in the traditional herbal medicine system is important to treat more chronic diseases like infectious endocarditis.

Protective effects of oleuropein against renal injury oxidative damage in alloxan-induced diabetic rats; a histological and biochemical study.

BACKGROUND: Oleuropein is a potent antioxidant and free-radical scavenger with antiinflammatory properties. OBJECTIVES: In the present study, we evaluated the protective effects of oleuropein on myeloperoxidase (MPO) activity, nitrite, urea, creatinine and glomerulosclerosis in alloxan-induced type 1 diabetic rats. MATERIALS AND METHODS: Thirty Sprague-Dawley male rats were randomly divided into 3 groups: group 1 as control; group 2 as untreated diabetic; and group 3 as treated with oleuropein 15 mg/kg i.p daily. Diabetes was induced in the second and third groups by subcutaneous alloxan injection. After 48 days, the animals were anaesthetized and then the livers and kidneys were removed immediately and used fresh or kept frozen until MPO activity analysis. Blood samples were also collected before sacrificing to measure nitrite, urea, and creatinine. Kidney paraffin sections were prepared to estimate glomerular volume, leukocyte infiltration, and glomerulosclerosis. RESULTS: Oleuropein significantly decreased leukocyte infiltration and glomerulosclerosis in the treated group compared with the diabetic untreated group. Oleuropein significantly decreased the levels of urea, nitrite, and creatinine in the treated group compared with the diabetic untreated group. Moreover, oleuropein significantly decreased MPO activity in the treated group compared with the diabetic untreated group. CONCLUSIONS: Oleuropein has antioxidative and antiatherogenic activities and exerts beneficial effects on inflammation and kidney function test and decreases diabetic complication in diabetic rats.