Sodium Glucose Transporter-2 Inhibitors (SGLT2Is)-TLRs Axis Modulates Diabetes.

Diabetes affects millions of people worldwide and is mainly associated with impaired insulin function. To date, various oral anti-diabetic drugs have been developed, of which, the sodium glucose transporter-2 inhibitors (SGLT2Is) are of the most recent classes that have been introduced. They differ from other classes in terms of their novel mechanism of actions and unique beneficial effects rather than just lowering glucose levels. SGLT2Is can protect body against cardiovascular events and kidney diseases even in non-diabetic individuals. SGLT2Is participate in immune cell activation, oxidative stress reduction, and inflammation mediation, thereby, moderating diabetic complications. In addition, toll like receptors (TLRs) are the intermediators of the immune system and inflammatory process, thus it's believed to play crucial roles in diabetic complications, particularly the ones that are related to inflammatory reactions. SGLT2Is are also effective against diabetic complications via their anti-inflammatory and oxidative properties. Given the anti-inflammatory properties of TLRs and SGLT2Is, this review investigates how SGLT2Is can affect the TLR pathway, and whether this could be favorable toward diabetes.

Multi-organ system involvement in coronavirus disease 2019 (COVID-19): A mega review.

Since the pandemic of the coronavirus disease 2019 (COVID-19) infection, many people have been affected in different ways. The majority of infected people experience mild to moderate symptoms and recover without the need for hospitalization. However, in some affected people, it may lead to catastrophic disease. The severity of COVID-19 infection is widely influenced by co-morbidities, immune system functions, and extra-pulmonary organ injuries. Since the emergence of COVID-19, multi-organ involvement has been documented. In order to implement preventative and protective measures, full attention to potential organ injuries is required. Most existing articles and review papers are focused on a specific organ system, and their numbers are growing. In this review paper, attempts were made to collect review papers and articles published on seven organ system involvements in COVID-19 infection published till 15 July and highlight conclusions and managements of all affected organs. We tried to add to the medical knowledge on COVID-19, pointing out its multi-organ system impact. Finally, we tried to facilitate access to organized information and optimum conclusion by representing review tables for each organ system. Besides, this review article can clarify and magnify the empty research space easily for future investigations.

Lipoid proteinosis: A systematic presentation of an unusual disease.

BACKGROUND: Lipoid proteinosis (LP) or Hyalinosis Cutis et Mucosae or Urbach-Wiethe disease is a rare autosomal recessive genodermatosis characterized by an amorphous hyaline material deposition in the skin mucosa and viscera. The clinical symptoms of this disease often begin in childhood, which persist throughout life. Skin manifestations include inflammation, scaling, acne, and eventually ulceration, and hyaline amorphous deposits in these areas of the wound cause a waxy and thick appearance on the skin. In addition, wounds leave atrophic scars like chickenpox. AIM: Herein, we present the first case of LP in the north of Iran; although LP is a sporadic disease, it occurs all around the world, with about 400 cases worldwide having been reported thus far. PATIENT: We report the case of a 28-year-old female patient with a history of skin lesions on her face, scalp, extremities, and buttock, as well as hoarse cry, respiratory problems, dysphagia, and migraine since childhood. There was no evidence of other clinical presentations. A biopsy was taken from the lesions, and the patient was diagnosed with LP. A laryngeal laser was performed for the patient, and peeling creams were used for her skin lesions. RESULT: According to previous findings, there has been no case report of LP with systemic symptoms in the north of Iran.

Comparison of Formulas for Low-Density Lipoprotein (LDL) Calculation for Predicting the Risk of Metabolic Syndrome.

BACKGROUND: The correlation between serum cholesterol level and the risk of developing atherosclerosis and metabolic syndrome has been well established in previous studies. Serum low-density lipoprotein (LDL-C) measurement is conducted using different methods which are generally divided into two groups, namely direct and indirect. Using indirect methods or calculations such as the Friedewald or Iranian formula for measuring LDL, particularly in developing countries, is quite common. The present study has stepped in to compare the robustness of the extant formulas in prognosticating and determining the incidence of metabolic syndrome. MATERIALS AND METHODS: In this cross-sectional study, the target population was the community of Fasa cohort study. According to the views of the statistical advisor, 9530 people were included in the study and clinical laboratory examinations were done for each person. Their serum LDL level was measured using the existing formulas. Then, the results of the serum LDL level that was computed with different formulas, were compared with both the status of metabolic syndrome and laboratory tests of individuals. RESULTS: The Iranian formula has the highest area under curve, the sensitivity of 0.73, and specificity of 0.77, higher positive and negative predictive values among other formulas. In Friedewald formula, for example, sensitivity and specificity equal 0.28 and 0.80, respectively. After further analysis, two new models proposed for predicting metabolic syndrome. The results revealed that these two models even outperform the Iranian formula. CONCLUSION: The Iranian formula for plasma LDL calculation has higher precision and application for predicting and measuring the metabolic syndrome in the Iranian population due to its considerable features. It is required to develop a new formula for each population and even for each sex, if possible.