Long COVID-19 leading to Good's syndrome diagnosis: A clinical case-report and literature review.

Key Clinical Message: Good's syndrome (GS) in conjunction with a severe COVID-19 infection, shedding light on the complexities of managing this rare condition that combines thymoma and immunodeficiency. Abstract: This study delves into the clinical presentation and management of a 63-year-old male diagnosed with Good's syndrome (GS) amid a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. GS, an uncommon association between thymoma and immunodeficiency, remains a clinical mystery, necessitating increased awareness and understanding. Our patient's intricate clinical course, marked by recurrent COVID-19 symptoms and multiple hospitalizations, exemplifies the challenges posed by GS. Through a systematic review of GS cases globally, we highlight its worldwide distribution, with a substantial proportion reported in Europe. Notably, the diagnosis of thymoma often precedes immunodeficiency, emphasizing the importance of vigilance in clinical assessments.

Diagnosis and Treatment of Lacrimal Gland Prolapse: A Narrative Review.

BACKGROUND: Lacrimal gland prolapse (LGP) is considered to be one of the causes for upper eyelid contour abnormality that should be recognized and treated properly to yield satisfactory outcomes in blepharoplasty. To describe current findings about the prevalence, pre- and intraoperative diagnosis of LGP and its treatment options. METHODS: PubMed and Google Scholar were thoroughly searched for articles published describing the diagnosis and treatment of LGP. RESULTS: The reported prevalence of LGP by various authors varies between 10 and 60% based on their preoperative or intraoperative reports. Techniques such as dacryoadenopexy, modified dacryoadenopexy, and dacryoplasty have been described to secure the prolapsed lacrimal gland back into its original position. Additionally, creating a Whitnall's barrier has also been suggested as a method to reposition the gland. While all these surgical procedures have shown promising immediate results, there is a lack of published data on their long-term outcomes. CONCLUSION: Diagnosis and proper treatment of LGP could enhance the cosmetic results of upper eyelid blepharoplasty. LEVEL OF EVIDENCE IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Prevalence of Hepatitis B Virus Markers among the Women with Breast Cancer.

INTRODUCTION: Breast cancer represents a formidable peril to the female populace on a worldwide level. The association between breast cancer and various factors, including viral infections, has been extensively investigated. Recently, the link between HBV infection and breast cancer patients has garnered attention. The present research aims to assess the prevalence of HBV markers among women diagnosed with breast cancer in Ahvaz city, Iran. MATERIALS AND METHODS: Serum specimens were procured from 90 patients who had been clinically diagnosed with breast cancer. The age of the patients ranged from 29 to 80 years, with a mean age of 49.42±10.7. Histological examination of biopsy specimens revealed that 75 (83.33%) were ductal, 11 (8.88%) lobular, 2 (2.22%) mucinous, 1 (1.11%) medullary, and 1 (1.11%) was metastatic. The serum samples were subjected to initial HBsAg and anti-HBc testing via ELISA. Samples that tested seropositive (HBsAg + anti-HBc) were subsequently analyzed for the S region of HBV through nested PCR and DNA sequencing. Finally, a phylogenetic tree was constructed for positive HBV DNA tests. RESULTS: Among the 5/90 (5.55%) cancer patients, it was found that 3 (3.33%) cases of ductal carcinoma and one (1.11%) lobular carcinoma displayed positivity for HBV markers (HBsAg, anti-HBc, HBV PCR). Notably, one (1.11%) patient with ductal carcinoma solely demonstrated anti-HBc positivity. The phylogenetic tree analysis of the S region revealed that all HBV strains identified were categorized as genotype D. CONCLUSION: The statistical analysis did not reveal any significant findings (p= 0.315) in the distribution of cancer types across different age groups. Among patients diagnosed with breast cancer, a notable prevalence of 5.5% was observed in HBV markers. The dominant HBV genotype among breast cancer patients was identified as genotype D.

Cytomegalovirus colitis in immunocompetent hosts: A case report and literature review.

Key Clinical Message: Rectal bleeding can manifest cytomegalovirus (CMV) colitis even in immunocompetent patients, which can be cured with ganciclovir treatment. Abstract: Cytomegalovirus (CMV) is an opportunistic virus widely affecting immunocompromised patients. Different manifestations varied from asymptomatic in immunocompetent individuals to end organ involvement, such as colitis in those with immunodeficiency. Despite the rarity of CMV colitis in immunocompetent hosts, we should consider it when the other conditions have been excluded. In this article, we have described a case of CMV colitis in an immunocompetent host and have performed a literature review on this entity. An immunocompetent 70-year-old female was admitted to the hospital with recurrent rectal bleeding. After various evaluations including laboratory analysis, stool examination, and colonoscopy, we have detected superficial lesions. Pathology and polymerase chain reaction reports favored CMV involvement. Her condition continues to improve after intravenous ganciclovir infusion. Rectal bleeding can manifest CMV colitis even in immunocompetent patients, which can be cured with ganciclovir treatment.

Articular Cartilage Injury; Current Status and Future Direction.

Today, treatments of cartilage and osteochondral lesions are routine clinical procedures. The avascular and hard-to-self-repair nature of cartilage tissue has posed a clinical challenge for the replacement and reconstruction of damaged cartilage. Treatment of large articular cartilage defects is technically difficult and complex, often accompanied by failure. Articular cartilage cannot repair itself after injury due to a lack of blood vessels, lymph, and nerves. Various treatments for cartilage regeneration have shown encouraging results, but unfortunately, none have been the perfect solution. New minimally invasive and effective techniques are being developed. The development of tissue engineering technology has created hope for articular cartilage reconstruction. This technology mainly supplies stem cells with various sources of pluripotent and mesenchymal stem cells. This article describes the treatments in detail, including types, grades of cartilage lesions, and immune mechanisms in cartilage injuries.

Atmospheric emissions estimation of polycyclic aromatic compounds from an oil sands tailings pond using passive air samplers.

A mapping study targeting emissions of polycyclic aromatic compounds (PACs) from an oil sands tailings pond was undertaken in the Athabasca Oil sands Region (AOSR). Ten passive air samplers comprising polyurethane foam (PUF) disks were deployed around the perimeter of Suncor Tailings Pond 2/3 for a five-week period to generate time-integrated concentrations in air for PACs, which included ∑unsubstituted polycyclic aromatic hydrocarbons (PAHs), ∑alkylated PAHs (alk-PAHs), and ∑dibenzothiophenes (DBTs) (both unsubstituted and alkylated). Concentrations in air ranged from 13 to 70, 220-970, and 30-210 ng/m3, respectively, and were elevated in samplers downwind of the tailings pond. PAC emissions to air from the pond were estimated using only the air-side concentration information by applying a simplified Gaussian dispersion model and found to be 896 µg/m2/day. ∑alk-PAHs and ∑DBTs had the highest contribution to the total PAC fluxes (79% and 16%, respectively). This flux estimate for PACs is equivalent to 460 kg on an annual basis and 35 000 kg/year when scaled to represent all tailings ponds in the region. The results generally agree with fluxes estimated from coupled high volume air sampling data and tailings pond water concentrations from the same field study but which are complicated due to uncertainties associated with the use of pure water Henry's Law values for tailings pond water as well as the potential for surface oily films on the tailings ponds to impact water-air exchange of PACs. Overall, these findings support the use of relatively simple and electricity-free PUF disk samplers for mapping and estimating emissions from area sources such as tailings ponds, using only air-side concentration information.

The effect of education based on health belief model on high-risk health behaviors in youth: an interventional quasi-experimental study.

OBJECTIVES: The present study was designed to determine the effect of education based on health belief model (HBM) on high-risk health behaviors in youth. METHODS: This interventional quasi-experimental study was conducted in 2020-2021 with the participation of 62 students living in the dormitories of University of Mashhad Medical Sciences with available sampling and random allocation in two experimental and control groups. The experimental group received six training sessions. The research instruments included: demographic information, researcher-made questionnaire including HBM constructs, youth high-risk behaviors questionnaire (2019) that were used before, immediately and one month after the educations. The collected data were analyzed using t-test, Mann-Whitney, and ANOVA with SPSS 21. RESULTS: The mean scores in the field of high-risk behaviors as well as all constructs of HBM were not statistically significant in the two groups before the intervention (p>0.05), but the mean scores immediately and one month after the educational intervention in all constructs of the HBM and the range of high-risk behaviors (other than smoking behavior) in the experimental group compared to the control group was statistically significant (p<0.001). CONCLUSIONS: Education based on HBM was effective in reducing high-risk health behaviors, so this educational model can be used to reduce high-risk health behaviors in female students.

The relationship between women's sexual function and type of delivery and pelvic organ prolapse: A cross-sectional study.

ABSTRACTsThe probable relationship between type of delivery and postpartum sexual function is one of the reasons behind women's tendency to cesarean. This study was performed with 250 women participants. Female Sexual Function Index and examination form were used to determine pelvic organ prolapse and its severity and type based on POP-Q. Our results showed the difference between the mean performance score in the dimensions of desire (p = .19), lubrication (p = .08), orgasm (0.13), pain (p = .08), and satisfaction (p = .06) was not significant in the two groups of vaginal delivery and cesarean, but the difference between the mean score of sexual function in the dimension of total score (p = .002) was significant in the two groups. Regarding the relationship between sexual function and pelvic organ prolapse, the total score of sexual function in women with uterine, cystocele, and rectocele prolapse was significantly lower (p < .001). Researchers should work to provide more evidence on relationship of female sexual function and the type of delivery and pelvic organ prolapse.

Pulmonary adenocarcinoma mimicking miliary tuberculosis in a 20-year-old man: A clinical case report.

Lung adenocarcinoma (LA) is the most common subtype of lung cancer with nonsignificant manifestations. Some benign conditions can mimic LA in symptoms and even chest imaging. In this case report, we are discussing a young man without any significant medical history with metastatic LA, initially presumed military TB.

Complications of Implantable Cardioverter Defibrillator and Their Potential Risk Factors in Patients with Hypertrophic Cardiomyopathy.

Background: Hypertrophic cardiomyopathy (HCM) has different complications such as cardiac arrhythmia and sudden cardiac death (SCD). Insertion of an implantable cardioverter defibrillator (ICD) is recommended for HCM patients who are at high risk of SCD and malignant arrhythmias, despite having their own potential complications. Hypothesis. We aimed to investigate the prevalence of different complications of ICD insertion and the impact of the potential influential baseline characteristics in a one-year follow-up period. Methods: This was a retrospective study with a total of 71 HCM patients with ICD insertion. We evaluated the prevalence of different complications of ICD implantation and the impact of baseline characteristics on the occurrence of ICD complications using multivariate regression analysis in three 4-month periods. Results: In a one-year follow-up, 13 patients (18.3%) experienced at least one of the complications including pneumothorax, lead failure, ICD infection, inappropriate shocks, perforation, and upper limb deep vein thrombosis (DVT) with no mortality. Inappropriate shocks were reported as the most common (11.3%) complication during this period, with a gradual increase in the second (4.2%) and third (5.6%) follow-up sessions. Among all of the baseline characteristics that were investigated in this study, a positive history of hypertension was the only risk factor with significant impact on the occurrence of complications (P = 0.01). Conclusion: We demonstrated the occurrence of complications during a one-year follow-up as 18.3% in HCM patients with ICD insertion. A positive history of hypertension was the only baseline characteristic affecting the occurrence of complications, and inappropriate shocks were the most common complication.

The effect of education based on the theory of planned behavior on the intention of vaccination against human papillomavirus in female students: A controlled educational trial.

BACKGROUND: Human papillomavirus (HPV) is the most common sexually transmitted infection and causes more than 90% of cervical cancers. The highest rate of infection occurs between the ages of 18 and 28. This study aimed to determine the effect of education based on the theory of planned behavior (TPB) on the intention of vaccination against HPV in female students. MATERIALS AND METHODS: This controlled educational trial study was performed on 72 female students aged 18-26 years of Mashhad University of Medical Sciences by random assignment to intervention and control groups. For random assignment in the intervention and control groups, random blocking with four blocks was performed using a random number table with a ratio of 1:1. Data collection tools included demographic questionnaire, awareness about HPV vaccination, and TPB theory constructs. The control group was received the university routine training. The intervention group was received the virtual group training in four sessions, 60-90 min at weekly intervals and with educational content including TPB constructs on HPV vaccination with the method of lecture training, group discussion, questions and answers, and presentation of training package. Questionnaires were completed before, instantly, and 1 month after the educational intervention. Data were analyzed using the Chi-square test, Fisher's exact, t-test, Mann-Whitney test, and Friedman test. RESULTS: The mean age of students was 18.9 ± 1.1 years. The intervention and control groups were homogeneous in terms of demographic characteristics (P > 0.05). Before the intervention, the mean score of model constructs did not show a statistically significant difference between the two groups (P > 0.05), but after the intervention, in the intervention group, mean scores of attitude, subjective norms, perceived behavioral control, and behavioral intention in the intervention group was significantly higher than the control group (P < 0.001). In the intervention group, the difference in the mean score of HPV vaccination intention instantly (P < 0.001) and 1 month (P < 0.001) after the intervention significantly increased. CONCLUSION: TPB-based education was effective in increasing attitudes, subjective norms, and perceived behavioral control and the intention to vaccinate against HPV in the female students of Mashhad University of Medical Sciences. Therefore, it is suggested that the present educational intervention be widely used to educate female students.

Effect of Castor Oil on Cervical Ripening and Labor Induction: a systematic review and meta-analysis.

Objectives: Post-term pregnancy is a condition associated with increased maternal and fetal complications. Administration of castor oil causes cervical stimulation by increasing the production of prostaglandins. We examined the effects of castor oil on cervical ripening and labor induction through a systematic review and meta-analysis. Methods: The search process was performed to obtain relevant articles from databases including Pubmed, Cochrane library, Scopus, Science direct, SID, Iran Medex, and Google Scholar using the English keywords of cervical ripening, post-term, castor oil, labor induction, Bishop score, and pregnancy considering all possible combinations without time constraints and their Persian equivalents from national databases. Results: A total of eight related articles from the 19 primary studies were extracted and systematically reviewed. According to a cumulative chart, the difference in the post-intervention Bishop score was statistically significant (standard mean difference [SMD] 1.64, 95% confidence interval [CI] 1.67-2.11, p = 0.001), indicating an effect of castor oil on increasing the Bishop score. In addition, the difference in labor induction was statistically significant after the intervention (odds ratio 11.67, 95% CI 3.34-40.81, p = 0.001), indicating an effect of castor oil on increasing the odds ratio of labor induction (experience of vaginal delivery). Conclusion: This meta-analysis showed that oral administration of castor oil is effective for cervical ripening and labor induction. Midwives should closely monitor pregnant women with prolonged labor and collaborate with obstetricians to employ castor oil as a safe intervention to induce cervical ripening and labor to prevent undue caesarean surgery.

The Impact of Aromatherapy with Citrus Aurantium Essential Oil on Sleep Quality in Pregnant Women with Sleep Disorders: A Randomized Controlled Clinical Trial.

Background: Sleep disorders are so prevalent during pregnancy. The present study was conducted to investigate the impact of aromatherapy with Citrus aurantium essential oil on sleep quality in pregnant women with sleep disorders. Methods: This randomized clinical trial study was conducted on 68 pregnant women in their 28-34 weeks of pregnancy who sufferred sleep disorders and referred to Jiroft health centers in 2021 (January-June). Those meeting the inclusion criteria were divided into the intervention and placebo groups, using random sequence generated through the randomization website. They were given five drops of Citrus aurantium essential oil and the placebo twice a day, every day for one month in the form of facemasks which they inhaled through normal breathing for 20 minutes. Sleep quality was assessed before the intervention and one month after the start of the intervention. The demographic questionnaire and Pittsburgh Sleep Quality Index (PSQI) were used for collecting the data. Data analysis was performed using SPSS 24 software. The Mann-Whitney-U, Wilcoxon and fisher exact tests were carried out. P-value<0.05 was considered statistically significant. Results: Before the intervention, the mean and standard deviation scores of pregnant women's sleep quality in the intervention (9.89±3.00) and placebo (8.12±2.53) groups were not significantly different (P=0.10). One month after the intervention, the score was significantly lower in the intervention group (4.37±1.85) than the placebo group (8.48±2.62) (P<0.001). Conclusion: Based on the results of the present study, it seems that aromatherapy with Citrus aurantium essential oil enhances the sleep quality in pregnant women with sleep disorders, so it can be used to diminish sleep disorders in these women.Trial Registration Number: IRCT20200512047414N1.

The effect of evening primrose oil on labor induction and cervical ripening: A systematic review and meta-analysis.

The evening primrose oil has prostaglandin effects and is applied to soften the cervix. This systematic review and meta-analysis aimed to establish the results of clinical trials performed on the effect of evening primrose oil on labor induction and cervical ripening in pregnant women. Research studies were searched from 1990 to September 2019 in Pubmed, Science Direct, Embase, and Cochrane Library using the keywords: cervical ripening, Bishop score, labor induction, post-term pregnancy, evening primrose, and any possible combination of these keywords (Farsi, English). Data analysis was conducted using STATA (version 14.1), and I2 index and random effect forest plots to assess the heterogeneity between the studies and perform the meta-analysis, respectively. Six articles that met the inclusion criteria were extracted in which four were entered into quantitative meta-analysis. The results' high heterogeneity was 91.4% based on I2 index (p ≤ .001) and the random model was applied for meta-analysis. The result demonstrated no significant difference between the intervention and control groups in terms of mean difference of the Bishop score before and after intervention (SMD: 0.27, 95%CI: -0.41, 0.96, p = .43). Based on current meta-analysis on four studies, effectiveness of oral consumption of evening primrose on cervical ripening was not approved.

Fugitive emissions of polycyclic aromatic compounds from an oil sands tailings pond based on fugacity and inverse dispersion flux calculations.

Alberta's oil sands tailings ponds are suspected to be a source of fugitive emissions of polycyclic aromatic compounds (PACs) to the atmosphere. Here we report, for the first time, fluxes of 6 parent and 21 alkylated PACs based on the measured co-located air and water concentrations using a two-film fugacity-based model (FUG), an inverse dispersion model (DISP) and a simple box model (BOX). Air samples were collected at the Suncor Tailings Pond 2/3 using a high volume air sampler from the "pond" and towards the pond ("non-pond") directions separately. Mean ∑27PACs in air from the "pond" direction was greater than the "non-pond" direction by a factor of 17. Water-air fugacity ratio of 20 PACs quantifiable in water indicated net volatilization from water. Dispersion and box model results also indicated upward fluxes of 22 PACs. Correlation between the estimated flux results of BOX and DISP model was statistically significant (r = 0.99 and p < 0.05), and correlation between FUG and DISP results ranged from 0.54 to 0.85. In this first-ever assessment of PAC fluxes from tailings pond, the three models confirmed volatilization fluxes of PACs indicating Suncor Tailings Pond 2/3 is a source of PAC emissions to the atmosphere. This study addressed a key data gap identified in the Joint Oil Sands Monitoring Emissions Inventory Compilation Report (Government of Alberta and Canada, 2016) which is the lack of consistent real-world tailings pond fugitive emission monitoring of organic chemicals. Our findings highlight the need for measurements from other tailings ponds to determine their overall contribution in releasing PACs to the atmosphere. This paper presents a practical method for estimating PAC emissions from other tailings ponds, which can provide a better understanding of these fugitive emissions, and thereby help to improve the overall characterization of emissions in the oil sands region.

Is High Preprocedural Renal Resistive Index Sensitive Enough to Predict Iodine Contrast-Induced Nephropathy in Patients Receiving Intra-Arterial Iodinate Contrast?

PURPOSE: Renal Resistive Index (RRI) is a newly introduced sonographic index in predicting contrast-induced nephropathy (CIN) development. It has been suggested that RRI > 0.69 should be considered as a risk factor for CIN development. The present study aimed to calculate the predictive value of RRI using a cutoff point of 0.69. METHODS: A total of 90 patients who were a candidate for coronary vessels angiography were enrolled in this study. Color Doppler ultrasonography was performed and RRI was measured. Patients were followed up for 48 hours after contrast media exposure for the CIN development. The diagnosis of CIN was based on a 25% relative rise or 0.5 mg/dL absolute rise in creatinine level. The predictive values of RRI were measured using 0.69 as a cutoff point. RESULTS: Out of 90 patients, CIN developed in 3 patients and 17 patients had preprocedural RRI > 0.69. Of 3 patients with CIN, 1 had RRI > 0.69. Using 0.69 as the cutoff point, the measured sensitivity and specificity of RRI were 33.3% and 83.9%, respectively. CONCLUSIONS: RRI > 0.69 is not a sensitive index in predicting the CIN development and cannot be used as an independent factor.

Prevalence of Cytomegalovirus (CMV) and Epstein-Barr Virus (EBV) Subclinical Infection in Patients with Acute Immune Thrombocytopenic Purpura (ITP).

Background: Immune thrombocytopenic purpura (ITP) defined as a bleeding disorder in which the number and production of platelets reduced by the immune system; however, the destruction of peripheral blood platelets also occurs. Although its exact etiology and pathogenesis not already know, several studies have shown that Epstein-Barr virus (EBV) and cytomegalovirus (CMV) known as possible causative agents of ITP. This investigation aims to evaluate the presence of CMV and EBV in two groups of case and control by polymerase chain reaction (PCR). Materials and Methods: we considered the presence of CMV and EBV in 48 acute ITP patients and 48 healthy people. Study participants were recruited from Ahvaz Shafa Hospital between 2017 and 2018 and the presence of two viruses was investigated by (PCR). Results: Out of 48 acute ITP patients, the CMV DNA was detected from the blood of 12 (25%) patients and the EBV DNA from the blood of 2 (4.2%) other patients. In addition, only one patient was (2.1%) co-infected with CMV and EBV. In contrast, in 48 healthy subjects, 3 (6.6%) had CMV and none of the control group was infected with EBV. Conclusion: Due to the presence of both EBV and CMV in the acute ITP patients in Ahvaz, they can be considered as factors in the progression of this disease. Therefore, consideration of the methods of elimination and treatment of these two viruses in these patients may be used as a treatment strategy in ITP patients in the future.

Is there any association between aortic root rotation angle and aortic dissection?

INTRODUCTION: Thoracic aortic dissection is a probable fatal condition that requires early diagnosis and management. The underlying etiology of this disorder is an important issue that has not been completely responded yet. In the current study, the association between aortic root rotation and ascending aortic dissection has been assessed. METHODS: This is a non-randomized retrospective case-control study conducted on twenty-five cases referring with ascending aortic dissection and seventy-five controls that underwent computed tomography (CT) angiography for reasons other than aortic dissection. Aortic root rotation angle and aortic diameter for both cases and controls were measured and then compared. RESULTS: There was no significant difference regarding age and gender distribution (P value = 0.22 and 0.38 respectively) between patients in case and control groups. The mean values of aortic root rotation angle and aortic diameter in cases were 22.5 ± 10.5° and 43.1 ± 12.5 mm versus 15.7 ± 10.7° and 30.7 ± 5.3 mm in controls (P value = 0.007 and 0.001 respectively). Direct relation was found between aortic root rotation angle and aortic diameter (P value = 0.007, r = 0.276). Mean of aortic root rotation angle was significantly higher in females (P value = 0.02). No association between cases' age with either aortic root rotation angle or aortic diameter was found (P value = 0.33, r = 0.098, and P value = 0.085, r = 0.173 respectively). CONCLUSION: Based on the findings of the current study, aortic root rotation angle was independently in direct association with thoracic aortic dissection. In addition, females had higher aortic root rotation angles.

Variations of Ethmoid Roof in the Iranian Population- A Cross Sectional Study.

INTRODUCTION: This study aimed to investigate the distribution of ethmoid roof variation and symmetry according to Keros classification. MATERIALS AND METHODS: This cross-sectional study assessed the paranasal CT scans of 600 patients over 18 years of age with no history of surgery, trauma, or localized fracture in the ethmoid, nose, and anterior skull base. The lateral lamella of the cribriform plate (LLCP) sizes were measured and classified as Keros type I (1-3 mm), II (4-7mm), and III (8-16mm). Moreover, the symmetry was surveyed in accordance with the LLCP measurements on both sides of the ethmoid roof. These variations were analyzed regarding gender and age. RESULTS: In total, 600 patients participated in this study out of whom 311 cases were male. According to the results, the mean age of the participants was 37.50±16.63 years. Furthermore, the mean values of the LLCP height for the right and left sides were 4.17±1.69 and 4.93±1.97 mm, respectively. Moreover, the asymmetry was observed in 38.3% of the cases, and they were classified as 36.7% Keros type I, 50.5% Keros type II, and 12.8% Keros type III. CONCLUSION: Keros type II and symmetry were the most common variations in this study. In addition, these variations were independent of age and gender.

Assessment of Key Elements in the Innate Immunity System Among Patients with HIV, HCV, and Coinfections of HIV/HCV.

BACKGROUND: Coinfection of Hepatitis C virus (HCV) with human immunodeficiency virus (HIV) has a higher risk of mortality than HCV or HIV monoinfection. HCV and HIV infections are specified by systemic inflammation, but the inflammation process in HCV/HIV coinfection is much complicated and is not well characterized. OBJECTIVE: The aim of this study was to analyze the expression of TLR-3, TLR-7, IL-10, IFN-1 (IFN-α, IFN-ß), and TNF-α in HIV, HCV and HIV/HCV co-infected patients. METHODS: Forty-five patients including HIV group (n=15), HCV group (n=15), HIV/HCV coinfection group (n=15) and healthy control group (n=15) participated. Peripheral blood mononuclear cells (PBMCs) were obtained. PBMC-RNA, HCV and HIV RNA were extracted from all subjects and cDNA was synthesized. The viral load analyzed by reverse transcription-quantitative PCR (RT-qPCR), and the expression levels of IFN-α, IFN-ß, TLR-3, TLR-7, TNF, and IL-10 mRNA were quantified in PBMCs. RESULTS: The levels of IFN-I, IL-10, and TNF-α were overexpressed in all patients' groups (p<0.05), TLR-7 was upregulated in all groups, but this upregulation was not statistically significant (p>0.05). TLR-3 showed a decrease in all patient groups (p<0.05). The statistical analysis demonstrated that TLR-3 has a negative correlation with HIV load, whereas other genes positively correlated with HIV load. In addition, TLR-3, TNF-α, and IFN-I were negatively correlated with HCV load, whereas TLR-7 and IL-10 s were positively correlated with HCV load. CONCLUSION: Our results showed a significant relationship between the expression level of innate immunity genes and inflammation in HCV, HIV, and HIV/HCV coinfected patients.