Interventional heart catheterization to close atrial septal defect, patent ductus arteriosus, ventricular septal defect in a 3.5-year-old girl; a case report study.

The aim of this study was to introduce an interventional heart catheterization to close patent ductus arteriosus (PDA), ventricular septal defect (VSD), atrial septal defect (ASD), and pulmonary hypertension without complications from open heart surgery and a 3-day hospitalization period. PDA, VSD, and ASD are among the most common abnormalities associated with various complications. This case is a 3.5-year-old girl with frequent lung infections and Failure to thrive. Treatment in the first stage aims to close the PDA using Amplatzer ADO II type AGA, size 5-6 mm and ASD using Amplatzer Septal Occluder size 15 mm. The patient was discharged the next day. Six months later, a successful interventional closure of the VSD was performed using Lifetech Symmetric Amplatzer membranous size 12 mm and patient was discharged 2 days after. All these defects were corrected without open heart surgery and the need for long-term Intensive care unitsadmission.

Multisystem inflammatory syndrome in children (MIS-C) post-COVID-19 in Iran: clinical profile, cardiac features, and outcomes.

BACKGROUND: In April 2020, an association between multisystem inflammatory syndromes (MIS-C) was observed in children with severe acute respiratory syndrome coronavirus infection (SARS-CoV-2). Most patients had heart involvement alone, and most patients had pericardial effusion. This study aimed to express and emphasize cardiac involvement in pediatric patients with respiratory symptoms who were diagnosed with COVID-19. METHODS: This study was conducted in July 2021 in Kerman province, Southeastern Iran, during a notable surge in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. The study included 904 pediatric patients diagnosed with COVID-19. Data collection involved a comprehensive assessment of clinical symptoms and manifestations. Patients with fever lasting more than five days were admitted to the hospital. Echocardiography was utilized for cardiac involvement diagnosis, with 47 patients undergoing this diagnostic procedure. RESULTS: Of the 904 patients, most of them had high fevers (74%). Fifty-five patients had a fever for more than five days and were hospitalized. Of the 47 patients who underwent echocardiography, 45 (81%) had heart involvement. In 75% of patients, pericardial effusion was the only cardiac involvement. Patients with pericardial effusion were treated with dexamethasone up to 3 mg every 8 h for 72 h. CONCLUSIONS: MIS-C has a wide range of clinical symptoms. In cases where the fever is prolonged and there are gastrointestinal symptoms, physicians have clinical suspicion to diagnose this syndrome. Most cases of pericardial effusion are alone and improve with treatment with glucocorticosteroids.

Numerical investigation of ternary particle separation in a microchannel with a wall-mounted obstacle using dielectrophoresis.

In recent years, microfluidic-based particle/cell manipulation techniques have catalyzed significant advances in several fields of science. As an efficient, precise, and label-free particle/cell manipulation technique, dielectrophoresis (DEP) has recently attracted widespread attention. This paper presents the design and investigation of a straight sheathless 3D microchannel with a wall-mounted trapezoidal obstacle for continuous-flow separation of three different populations of polystyrene (PS) particles (5, 10 and 20 µm) using DEP. An OpenFOAM code is developed to simulate and investigate the movement of particles in the microchannel. Then, the code is validated by performing various experimental tests using a microdevice previously fabricated in our lab. By comparing the numerical simulation results with the experimental tests, it can be claimed that the newly developed solver is highly accurate, and its results agree well with experimental tests. Next, the effect of various operational and geometrical parameters such as obstacle height, applied voltage, electrode pairs angle, and flow rate on the efficient focusing and separation of particles are numerically investigated. The results showed that efficient particle separation could only be achieved for obstacle heights of more than 350 µm. Furthermore, the appropriate voltage range for efficient particle separation is increased by decreasing the electrode angle as well as increasing the flow rate. Moreover, the results showed that by employing the appropriate channel design and operational conditions, at a maximum applied voltage of 10V, a sample flow rate of 2.5µL/min could be processed. The proposed design can be beneficial for integrating with lab-on-a-chip and clinical diagnosis applications due to advantages, such as simple design, no need for sheath flow, the simultaneous ternary separation of particles, and providing precise particle separation.

Continuous size-based DEP separation of particles using a bi-gap electrode pair.

A novel microfluidic device containing a bi-gap electrode pair is presented in this paper, and it is capable of continuously separating three different populations of particles using dielectrophoresis. A mixture of 5, 10, and 20 µm polystyrene particles is focused by a sheath flow and then separated based on size after flowing over a bi-gap electrode pair. A new solver is developed in OpenFOAM to investigate the effects of various parameters such as the flow rate, gaps, and electrode pair angles to achieve an appropriate configuration of the bi-gap electrode pair for efficient particle separation. Based on the numerical simulation results, three different configurations of bi-gap electrode pairs are fabricated. The paths of three populations of polystyrene particles under various operating conditions are experimentally examined and compared with numerical results. Then, by examining the purity of the separated particles with three different electrode configurations at different flow rates, the performance of the device is experimentally investigated. The results showed that by employing the proposed electrode configuration, at a maximum flow rate of 100 µL h-1 (25 µL h-1 for the sample), particles are separated precisely (with more than 99% purity for all particles at desired outlets) using a 20 Vpp sinusoidal electric potential with a frequency of 100 kHz. This novel microfluidic device is thus a practical device for continuously separating three different populations of particles/cells according to size in a heterogeneous admixture.

Abnormal vitamin D and lipid profile in HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) patients.

The HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP) is a neurodegenerative disease of host-HTLV-1 interactions. In many virus-associated diseases and multiple sclerosis, the importance of vitamin-D and lipid profile has been demonstrated, thus similarly, their impacts were evaluated in HAM/TSP patients, in this study. Vitamin D and lipid profile were assessed in 120 healthy subjects (HSs), along with a proviral load (PVL) in 91 HAM/TSPs and 169 HTLV-1 carriers (ACs). The mean level of triglyceride and LDL in the HAM/TSPs were higher than HSs (P = 0.008 and 0.008, respectively), but no significant difference has been found between ACs and HSs. However, the level of HDL and vitamin-D in the HAM/TSP subjects were lower than HSs (P = 0.01 and P = 0.006, respectively). In HTLV-1 infected subjects, PVL was statistically associated with cholesterol (R = 0.24, P = 0.038), triglycerides (R = 0.26, P = 0.01) and HDL (R = 0.28, P = 0.001), and in HAM/TSPs there was a strong association between the severity of the disease, as determined by the OMDS and cholesterol (P = 0.01). Furthermore, in the HAM/TSPs, positive correlations between vitamin-D and age (R = 0.23, P = 0.028) and triglycerides (R = 0.38, P = 0.001) were found, also a significant correlation between PVL and LDL (R = 0.21, P = 0.001) and a weak correlation between PVL and OMDS (R = 0.4, P = 0.07) were noted. However, there was no correlation between PVL and urinary disturbance. Furthermore, PVL range of more than 600 copies/104 lymphocytes had a strong correlation with OMDS (P = 0.05), but not with urinary disturbance. It's more likely that HAM/TSP patients have an imbalanced lipid profile and low levels of vitamin D and may represent a potentially useful target for intervention in HTLV-1 associated diseases.

Plasma levels of CXCL1 (GRO-alpha) and CXCL10 (IP-10) are elevated in type 2 diabetic patients: evidence for the involvement of inflammation and angiogenesis/angiostasis in this disease state.

BACKGROUND: Recent evidence has demonstrated that environment and genetic factors play pivotal roles in diabetes and its related complications. The significant contributory role of cytokines in pathogenesis of type 2 diabetes is also well documented. This study was aimed to examine and compare both CXCL1 (GRO-alpha) and CXCL10 (IP-10) circulating levels in type 2 diabetic patients and healthy controls. METHODS: Peripheral blood samples were collected from 100 type 2 diabetic patients and 150 healthy controls. Circulating CXCL1 and CXCL10 levels were measured by ELISA. RESULTS: Elevated serum levels of both CXCL1 and CXCL10 were found in type 2 diabetic patients in comparison to controls. CONCLUSIONS: Elevated levels of CXCL1 and CXCL10 could possibly be used as a marker of inflammation and angiogenesis/angiostasis in type 2 diabetes.

Increased circulating levels of SDF-1 (CXCL12) in type 2 diabetic patients are correlated to disease state but are unrelated to polymorphism of the SDF-1ß gene in the Iranian population.

Several environmental and genetic factors are believed to influence the onset of diabetes and its complications. It has also been established that cytokines play a key role in the pathogenesis of type 2 diabetes. Previous studies have revealed that the polymorphism at the stromal-derived factor 1ß (SDF-1ß) 3'A regulates the expression of SDF-1 (CXCL12). This study was aimed to explore this polymorphism in parallel with SDF-1 serum levels in type 2 diabetic patients. In this assessment, peripheral blood samples were collected from 200 type 2 diabetic patients and 200 healthy controls. DNA was extracted, and a PCR-RFLP screening was applied to examine the SDF-1ß 3'A polymorphism. We also applied the ELISA technique to measure serum levels of SDF-1. Our results showed that there were no significant correlations between SDF-1ß 3'Α polymorphism in type 2 diabetic patients when compared to controls. However, our results showed that the serum levels of SDF-1 were significantly increased in the patients when compared to controls. Based on the results of this study, we concluded that SDF-1ß 3'Α polymorphism does not play a role in the pathogenesis of type 2 diabetes but that elevated serum levels of SDF-1 may be important for the etiology of type 2 diabetes but are unrelated to the SDF-1ß 3'Α polymorphism.

Interleukin (IL)-10 gene polymorphisms are associated with type 2 diabetes with and without nephropathy: a study of patients from the southeast region of Iran.

The impact of several environmental and genetic factors on diabetes and its complications is well documented. It has also been established that cytokines play a key role in the regulation of immune responses which have been shown to be important in the pathogenesis of diabetes. Studies showed that single-nucleotide polymorphisms within the -592 region of interleukin-10 (IL-10) are associated with the regulation of its expression. In this study, we aimed to find polymorphisms of this region that may be associated to type 2 diabetic (T2D) patients with and without nephropathy. In this study, peripheral blood samples were collected from 100 T2D patients without nephropathy, 100 T2D patients with nephropathy, and 100 healthy controls. DNA was extracted, and a polymerase chain reaction-restriction fragment length polymorphism technique was performed to examine the polymorphisms within the -592 region of the IL-10 gene. Our results showed a significant difference between the genotypes and alleles of the -592 region of IL-10 in nephropathic and non-nephropathic patients in comparison to the healthy controls. The differences between the two patient groups in relation to genotypes and alleles were not significant. Results of this study suggest that the functional gene polymorphism of IL-10 reported here may play an important role in the pathogenesis of diabetes, but it seems that these polymorphisms do not have an effect on the nephropathic complications of the disease.

Lack of association between chemokine receptor 5 (CCR5) δ32 mutation and pathogenesis of asthma in Iranian patients.

BACKGROUND: Chemokines and their receptors are clinically important mediators, as the chemokine receptors are expressed on almost all immune cells. They play pivotal roles in pathogenesis of almost all clinical situations including asthma. Correspondingly, MIP-1α (CCL3), MIP-1ß (CCL4), and RANTES (CCL5) are among the important chemokines involved in the pathogenesis of asthma. These chemokines bind to the CCR5 (their related receptor) on the cell surfaces. Attachment of related chemokine ligands to CCR5 plays an important role in the pathogenesis of asthma; hence, this study aimed to analyze δ32 mutations in CCR5 in asthmatic patients. MATERIAL AND METHODS: This experimental study was undertaken on 162 asthmatic patients and 200 healthy controls during February to June 2008 at Rafsanjan University of Medical Sciences. The Gap-PCR method was applied to analyze the δ32 mutation in the CCR5 gene, and demographic data (eg, age, sex, occupation, socio-economic status) were collected using a questionnaire. RESULTS: The findings of this study indicated that none of the asthmatic patients exhibited δ32 mutation in CCR5 chemokine receptor while only 3 (1.5%) of controls had the heterozygotic form of this mutation. DISCUSSION: Several research groups analyzed δ32 mutations in CCR5 in different diseases, including asthma. Some investigations reported a significant relation between asthma and δ32 mutations in CCR5, but there are also many reports which failed to find a relation between asthma and this mutation. Based on the results of this study and others, it seems that the δ32 mutation does not affect the pathogenesis of asthma.

Post-transfusion-transmitted hepatitis C virus infection: a study on thalassemia and hemodialysis patients in southeastern Iran.

Thalassemia and hemodialysis patients are at risk of blood-transmitted infections due to their long-term need for blood transfusion. Nowadays, control of viral infections, including HCV infections, is one of the main tasks of blood transfusion services worldwide. Therefore, the aim of this research was to investigate the prevalence of HCV infection in thalassemia and hemodialysis patients in Kerman, in southeastern Iran. In this cross-sectional experimental study, 384 (203 hemodialysis and 181 thalassemia) patients were examined for HCV infection. Demographic data were also collected by questionnaire, and HCV infection was screened by enzyme-linked immunosorbent assay (ELISA) and confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR). Data were analyzed by chi-square and t-test. Our results showed that 81 (44.7%) thalassemia and 64 (31.5%) hemodialysis patients were infected with HCV. There was a significant relationship between HCV positivity and the frequency of blood transfusion and the duration of dialysis in thalassemia and hemodialysis patients, respectively. Based on our results, the prevalence of HCV infection in thalassemia and hemodialysis patients in the southeastern part of Iran is higher than the other parts. Therefore, it is suggested that clinical and health authorities in southeastern Iran should pay more attention to preventing the transmission of HCV through blood and blood components.

Gender-specific differences in the association of adiponectin gene polymorphisms with body mass index.

OBJECTIVE: Adiponectin gene polymorphisms are associated with obesity, metabolic syndrome and type 2 diabetes (T2D). The study evaluated possible associations of +45T/G and -11391G/A adiponectin gene polymorphisms with body mass index (BMI), waist circumferences (WC), and blood pressure in diabetic and non-diabetic Iranians. METHODS: This cross-sectional study involved two groups of subjects: 243 diabetic patients and 173 non-diabetic subjects recruited from Rafsanjan city in the south-east of Iran. RESULTS: No significant association was found between +45T/G and -11391G/A adiponectin gene polymorphisms and systolic or diastolic blood pressure. However, male carriers of the TT genotype of +45T/G had a significantly higher mean BMI than male GG homozygotes (p = 0.018). Also, male carriers of the GG genotype of -11391G/A had significantly higher mean BMI than male GA or AA homozygotes (p = 0.041). Female carriers of the GG genotype of -11391G/A had significantly higher mean WC than female GA or AA homozygotes (p = 0.038). CONCLUSIONS: We observed a significantly higher BMI in women, and GA or AA carriers of -11391G/A polymorphism. Also, there was a significantly lower WC in females and GG carriers of +45T/G. These results point to a gender-specific impact of the studied genotypes on BMI and WC.

Nephropathic complication of type-2 diabetes is following pattern of autoimmune diseases?

The impact of several environmental and genetic factors on diabetes and its complications is well documented. The present study was aimed to examine the serum levels of IL-17A and IFN-gamma as antagonistic cytokines in nephropathic and non-nephropathic type-2 diabetic patients. In this experimental study, serum samples were obtained from 180 type-2 diabetic patients, 100 nephropathic type-2 diabetic patients and 100 healthy controls. Serum levels of IL-17A and IFN-gamma was detected by ELISA. Results of this study showed that the serum level of IFN-gamma was higher in both diabetic patients (nephropathic and non-nephropathic) in comparison to the controls. In terms of IL-17A, while non-nephropathic type-2 diabetic patients showed an increased serum level of it, the other patients group had a lower serum level. Based on these findings, it can be concluded that the lower serum level of IL-17A is possibly associated with nephropathic complications of type-2 diabetes.