Association between serum ferritin level and lipid profile among diabetic patients: A retrospective cohort study.

High serum ferritin (SF) levels have been linked to obesity, metabolic syndrome, atherosclerosis, diabetes, dyslipidemia, and cancer. This study aimed to investigate the association between SF and dyslipidemia in adults diagnosed with diabetes mellitus. This cross-sectional study retrospectively analyzed the electronic medical records of eligible patients from 3 primary locations in Saudi Arabia namely - Abha, Khamis Mushyt, and Jeddah - from 2010 to 2020. The study included adult patients aged 18 years or older who were diagnosed with diabetes mellitus and identified with an HbA1c level of ≥6.5. This study involved 3674 participants, with males accounting for 26.6% of the total. The mean age of the studied population was 48.0 ±â€…18.4 years. The median [interquartile range] of SF among males was higher than females, however, this difference was not statistically significant (60.0 [23.4-125.8] vs 55.4 [24.0-113.4], P = 0.204). On the other hand, age and region were significantly associated with SF (P = .032 and 0.035). SF had a significant positive correlation with cholesterol (r = 0.081, P < .001), low-density lipoprotein cholesterol (r = .087, P < .001), and triglycerides (r = 0.068, P < .001) and negative correlation with high-density lipoprotein cholesterol (r = -0.13, P < .001). Multivariate analysis revealed that age, sex, residence, and HbA1c were significantly affecting the lipid profile. Clinicians should consider including SF testing as part of the comprehensive evaluation of patients with diabetes and dyslipidemia.

Retraction: Tracheal Bronchus: A Rare Etiology of Recurrent Pneumonia in Children.

[This retracts the article DOI: 10.7759/cureus.20378.].

Lipid profiles and their relation to glycemic control in Saudi Arabia: The role of altitudes and environmental factor.

Background: The height from sea levels, environmental factors, human-environment interactions, and lifestyle significantly influence the lipid profile and glycemic control of a population. Objective: This study aims to explore the influence of altitude on lipid profiles and glycemic control among the Saudi population at sea level and high altitude. Methods: In this retrospective cross-sectional study, a large dataset of patients of both gender and over 30 years old attending internal medicine clinics from two different regions at different heights from sea level, Jeddah (sea level) and Asir region (high altitudes) and referred to commercial laboratories for glycated haemoglobin (HbA1c) and lipids profile. Results: Compared to the Asir region, the Jeddah region had significantly higher mean values for fasting blood sugar (FBG), total cholesterol (TC), low-density lipoprotein (LDL-C), and triglycerides (TG) (P < 0.05). Every 1 mg/dL increase in FBG results in a 0.662 mg/dL increase in TG from the Jeddah region. However, it was a 0.318 mg/dL increase in TG from the Asir region. HbA1c demonstrated a significant (P < 0.05) strong positive correlation with TC, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and lipid ratio. FBG levels were also associated with a high level of TC/HDL-C (ß = 0.137 95% confidence interval [CI]: 0.11-0.21; P < 0.05), LDL-C/high-density lipoprotein cholesterol (HDL-C) (ß = 0.50; 95% CI: 0.31-1.49; P < 0.05), and TG/HDL-C (ß = 0.14; 95% CI = 0.12-0.15; P < 0.05) in Jeddah region. However, significantly high blood pressure was observed in the population from high altitudes. Conclusion: Our results demonstrated a significant positive correlation between lipid profile and glycemic control with high prevalence at sea level.

Emerging advances in nanomedicine for breast cancer immunotherapy: opportunities and challenges.

Breast cancer is one of the most common causes of cancer-related morbidity and mortality in women worldwide. Early diagnosis and an appropriate therapeutic approach for all cancers are climacterics for a favorable prognosis. Targeting the immune system in breast cancer is already a clinical reality with notable successes, specifically with checkpoint blockade antibodies and chimeric antigen receptor T-cell therapy. However, there have been inevitable setbacks in the clinical application of cancer immunotherapy, including inadequate immune responses due to insufficient delivery of immunostimulants to immune cells and uncontrolled immune system modulation. Rapid advancements and new evidence have suggested that nanomedicine-based immunotherapy may be a viable option for treating breast cancer.

Cancer that begins in the breast is referred to as breast cancer. It may originate in either one or both breasts. It is one of the main causes of cancer-related death among women worldwide. Cancer immunotherapy is a game-changing treatment that improves the ability of the host defense system to spot and eliminate cancer cells with pinpoint accuracy. Cancer immunotherapy, also referred to as immuno-oncology, is a type of treatment option for breast cancer that uses the body's natural defense system to prevent, regulate and eliminate breast cancer. Immunotherapy is used to enhance or alter the functioning of the immune system so that it can locate and destroy cancer cells. Knowing how immunotherapy works and what to anticipate can often offer peace of mind to the patient who can then make informed decisions about care, especially if immunotherapy is part of the treatment plan for a particular patient.

Association between serum uric acid with diabetes and other biochemical markers.

Objective: This study aimed to decipher the association between serum uric acid (UA) and glycated hemoglobin (HbA1c) in the population from the southern region of Saudi Arabia. Method: In this retrospective cross-sectional investigation, clinical data obtained from the different commercial laboratories in the Asir region of Saudi Arabia were screened over 2 years. Data were analyzed using standard statistical methods. Results: A total of 1984 laboratory investigations with 1215 females (61.2%) and 769 males (38.6%) were included in the data analysis. In our investigation, the prevalence of hyperuricemia in the study population was 53.5% (41.2% females and 12.3% males) and in the diabetic population was 12.7% (9.47% females and 3.23% males), in prediabetics was 12.65% (9.8% females and 2.85% males), respectively. Prediabetic subjects had higher UA levels than people with diabetes or healthy people. Higher UA quartiles were associated with a high level of urea, blood urea nitrogen (BUN) creatinine, HbA1c, fasting blood sugar (FBS), and total cholesterol (TC) (P < 0.05). High UA (OR = 1.33 for diabetes; OR = 2.676 for prediabetes), high BUN (OR = 3.05 for diabetes; OR = 2.293 for prediabetes), high TC (OR = 3.75 for diabetes; OR = 1.098 for prediabetes), and high TG (OR = 2.67 for diabetes; OR = 1.943 for prediabetes) parameters are the most influential risk factor in diabetic and prediabetic patients than the people who have normal UA, BUN, TC, and TG value. Conclusion: High UA levels are significantly associated with prediabetes as defined by HbA1c criteria, indicating that UA has a significant role in the disturbance of glucose metabolism. A significant positive association was observed between dyslipidemia and serum UA in the study population.

Prevalence and Characteristics of Thyroid Abnormalities and Its Association with Anemia in ASIR Region of Saudi Arabia: A Cross-Sectional Study.

The thyroid gland plays a significant role in the metabolism and proliferation of blood cells; hematological disorders are frequently observed in patients with thyroid disorders, and the most frequent problem is anemia. The main objective of this research work is to evaluate the prevalence and types of thyroid dysfunction and their association with anemia in different gender stratified by age in the Asir region of Saudi Arabia. Four years of data from July 2016 to July 2020 for 9992 study subjects were collected. Statistical analysis was performed based on thyroid disorder and anemia stratified by gender and age subgroup. The mean age of the study subject was 43.4 ± 15.8 years, and females constituted 61.7% of cases. Thyroid dysfunction was observed in 49.76% (4973), and subclinical hypothyroidism was the most prevalent type (3922/9992), followed by primary hypothyroidism (530/9992). Females have a significantly higher overall prevalence of thyroid dysfunction than males (p < 0.05). Anemia was detected in 1344 females and 465 males with a thyroid disorder, and also, the prevalence was significantly higher (p < 0.05), compared to the normal thyroid group. Thyroid disorders are a common problem in our population, more prevalent in females than males, with the peak age of above 30 years, and are associated with an increased prevalence of anemia.

Tracheal Bronchus: A Rare Etiology of Recurrent Pneumonia in Children.

Recurrent infections are a common cause for seeking medical care and they result in significant parental anxiety and concerns. Although immunodeficiency disorders are an important underlying cause of recurrent infections, the majority of children with recurrent infections do not have any dysfunction in their immune systems. We present the case of an 11-year-old boy who was brought to the outpatient department by his parents because of a complaint of productive cough for the last one week that was associated with low-grade fever. The patient had a history of frequent episodes of pneumonia. He developed three episodes of pneumonia within the last year. According to the parents, the patient was investigated previously for possible immunodeficiency disorders, but the findings did not reveal any abnormal results. His siblings are healthy and have no history of recurrent infections or immunodeficiency disorders. The vital signs were within the normal limits. The patient was treated empirically with the antibiotic course of amoxicillin. The patient was given a follow-up appointment one week later. In the follow-up visit, the patient had complete resolution of the infection. The parents expressed concern about their child having recurrent episodes of infections. The patient underwent a high-resolution CT scan of the thorax to rule out any structural abnormalities. The scan demonstrated the presence of an aberrant bronchus arising from the lateral wall of the trachea above the level of the carina and supplying the apical segment of the right upper lobe. This finding is often referred to as a "tracheal bronchus." The tracheal bronchus is a rare congenital anomaly of the respiratory tract. It should be considered in the differential diagnosis of children with recurrent pneumonia with no infections in other organ systems to suggest immunodeficiency disorder.

Secondary pituitary hormonal dysfunction patterns: tumor size and subtype matter.

PURPOSE: Patients with sellar masses (SM) frequently have secondary hormonal deficiency (SHD) at initial presentation. While larger SM are more likely to present with SHD, it is unclear whether SHD at presentation is influenced by the type of SM. METHODS: We conducted a retrospective analysis of patients with SM prospectively enrolled in our comprehensive provincial neuropituitary registry between November 2005 and December 2018. SM were subdivided based on size: < 1 cm, 1-1.9 cm, 2-2.9 cm, and > 3 cm. RESULTS: A total of 914 patients met the inclusion criteria, including: 346 nonfunctioning adenomas (NFA), 261 prolactinomas (PRLoma), 51 growth hormone adenomas, 36 adrenocorticotropic adenomas, 93 Rathke's cleft cysts, 70 craniopharyngiomas and 57 meningiomas. The overall rate of SHD at presentation was highest in PRLoma (62.8%) and craniopharyngiomas (64.3%) and lowest in meningiomas (14%). While larger SM were significantly more likely to have SHD, the rate of SHD within each group was significantly different despite similar size (p < 0.001). Of the two largest groups of SM (NFA and PRLoma), NFA had significantly higher odds ratio (3.34, CI 1.89-5.89) of having multiple SHDs when compare with PRLoma, even when corrected for age, gender and size of tumor (p < 0.001). CONCLUSION: Our study shows that the rate and distribution of SHD in SM vary dependent upon the size of the tumor and specific pathology; in particular, NFA are more likely to present with multiple SHDs. Our data will help clinicians in determining adequate hormonal testing strategy for different SM.