The potential role of micro-RNA 125b-5p level in predicting outcome from thrombolytic therapy in patients with acute ischemic stroke.

Several studies highlighted a significant role of specific miRNA as diagnostic and prognostic biomarkers for acute ischemic stroke. The aim of this work was to study micro-RNA 125b-5p level in patients with acute ischemic stroke in relation to stroke etiology, risk factors, severity and outcome. This case-control study was conducted on 40 patients with acute ischemic stroke eligible for receiving rt-PA and 40 age and sex matched healthy controls, Patients were submitted to neurological and radiological assessment. Functional outcome after 3 months was assessed using the modified Rankin Scale (mRS). Plasma micro-RNA 125b-5p levels were measured for both patients and control groups by quantitative real time PCR. MiRNA-125b-5p was extracted from the plasma samples then Real-time quantitative reversed transcription PCR (RT-qPCR) analysis was done. To analyze miRNA-125b-5p expression in plasma, the ∆Cq value of miRNA-125b-5p was calculated by subtracting Cq of miRNA-125b-5p from the average Cq of MiRNA RNU6B. Stroke patients had significantly higher circulating micro-RNA 125b-5p levels in comparison to healthy controls (P value = 0.01). The circulating levels of micro-RNA 125b-5p were positively correlated with stroke severity assessed by National Institutes of Health Stroke Scale (NIHSS) and infarction size. Stroke patients with poor outcome had significantly higher circulating levels of micro-RNA 125b-5p in comparison to those with good outcome (P value ≤ 0.001). The circulating levels of micro-RNA 125b-5p were significantly higher in patients who developed complications after receiving rt-PA (P value ≤ 0.001). Logistic regression model revealed that each unit increase in micro-RNA125b-5p decreased the odds of good outcome by 0.095 (95% CI 0.016-0.58, P value = 0.011). Plasma micro-RNA 125b-5p is significantly elevated is ischemic stroke patients. It is positively correlated with stroke severity and strongly associated with poor outcome and complications after thrombolytic therapy.

The potential use of urinary transferrin, urinary adiponectin, urinary Retinol Binding Protein, and serum zinc alpha 2 glycoprotein levels as novel biomarkers for early diagnosis of diabetic nephropathy: A case-control study.

BACKGROUND AND AIMS: The level of albuminuria is used to evaluate diabetic nephropathy (DN). However, to detect or predict the early stages of DN, better biomarkers are needed. METHODS: This study is a case-control observational study. 80 Egyptians participated in the study: 60 patients with type 2 diabetes mellitus (T2DM) were divided into three groups (20 patients each), and 20 healthy subjects with matched age and gender were used as controls. Demographic and laboratory data were analyzed. An enzyme-linked immunosorbent assay was used to determine the levels of four biomarkers of DN; urinary adiponectin (ADP), urinary transferrin, serum Zinc Alpha 2 Glycoprotein (ZAG), and urinary Retinol Binding Protein (RBP). RESULTS: The levels of DN biomarkers urinary ADP, transferrin, RBP, and serum, ZAG were significantly higher in patients with T2DM than in controls. The ROC curve of the validity of the simultaneous use of all four biomarkers in predicting albuminuria indicates a sensitivity of 90% and a specificity of 90%. The Area Under the Curve (AUC) was 0.948, the 95% confidence interval was 0.998-0.897, and the p-value was 0.001. CONCLUSIONS: In patients with T2DM, urine adiponectin, transferrin, RBP, and serum ZAG concentration may be useful biomarkers in the early diagnosis of DN. A further longitudinal prospective study is required to explore the potential utility of these biomarkers.

WITHDRAWN:Randomized controlled trial of effect of N-acetylcysteine as an antioxidant on iron overload in children with thalassemia major.

Ahead of Print article withdrawn by publisher.

Could intraoperative magnesium sulphate protect against postoperative cognitive dysfunction?

BACKGROUND: Although there is much concern about the pathogenesis of postoperative cognitive dysfunction (POCD); no effective prevention strategies are currently described. The aim of this work was to study whether intraoperative magnesium sulphate could have a protective effect against developing POCD and to study its impact on serum level of S100B, a marker of neuronal degeneration. METHODS: This is a prospective randomized controlled trial carried out on 80 participants undergoing elective laparoscopic cholecystectomy, 40 participants received conventional general anesthesia (conventional anesthesia group) and 40 participants received conventional general anesthesia with extra administration of intraoperative magnesium sulphate (Mg sulphate group). Cognitive assessment for both groups was done preoperatively and 1 week postoperatively using Paired Associate Learning test (PALT) and Benton Visual Retention Test (BVRT). Quantitative determination of serum S100B was done for both groups preoperatively and one week postoperatively by using an enzyme- linked immunoabsorbent assay technique. RESULTS: Postoperative PALT and BVRT were significantly lower than preoperative PALT and BVRT in the conventional anesthesia group (P value =0.043, P value =0.015 respectively), but not in the Mg sulphate group (P value =0.134, P value =0.151 respectively). Postoperative S100B was significantly higher than preoperative S100B in the conventional anesthesia group (P value =0.006), but not in the Mg sulphate group (P value =0.293). CONCLUSIONS: Administration of intravenous infusion of magnesium sulphate during conventional general anesthesia can protect against POCD and attenuate the post operative elevation of serum S100B.

The potential role of serum vitamin D level in migraine headache: a case-control study.

PURPOSE: Much concern was directed toward exploring the relationship between vitamin D and migraine. There is strong evidence that vitamin D supplementation can decrease frequency, severity, and duration of migraine headache attacks. The aim of this work was to investigate the difference in serum levels of 25 (OH)-vitamin D between patients with migraine and healthy controls, to determine the differences in headache characteristics according to vitamin D status, and to correlate serum 25 (OH)-vitamin D level with duration, frequency, and severity of migraine headache attacks. PATIENTS AND METHODS: This is a case-control study conducted on 40 patients diagnosed with migraine and 40 healthy controls. History was taken from patients with migraine regarding headache characteristics. Migraine severity scale (MIGSEV) and Headache Impact Test-6 (HIT-6) were used for migraine assessment. Serum 25(OH)-vitamin D was measured for all patients and controls using enzyme-linked immunosorbent assay (ELISA). RESULTS: Patients with migraine had significantly lower 25(OH)-vitamin D serum level in comparison to controls (P-value=0.019). The incidence of aura, phonophobia/photophobia, autonomic manifestations, allodynia, and resistance to medications were significantly higher in migraineurs with vitamin D deficiency than those with normal vitamin D. There was a statistically significant negative correlation between 25(OH)-vitamin D serum level and attack duration in hours (P-value˂0.001), frequency of the attacks/month (P-value˂0.001), MIGSEV scale (P-value=0.001), and HIT-6 scale (P-value=0.001). CONCLUSION: Patients with migraine had significant vitamin D deficiency compared to healthy controls. Such deficiency significantly affects headache characteristics, duration, frequency, and severity of headache attacks.