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   Table of Contents - Current issue
Coverpage
October-December 2022
Volume 7 | Issue 4
Page Nos. 83-105

Online since Tuesday, December 27, 2022

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REVIEW ARTICLE  

Mini review: Hyperglycemia in ischemic stroke p. 83
Honglian Duan, Wesley Kohls, Roxanne Ilagan, Xiaokun Geng, Yuchuan Ding
DOI:10.4103/ed.ed_26_22  
The impact of stroke, currently the second leading cause of death worldwide, continues to worsen, and even those that survive can have persistent neurological deficits. A potentially significant implication may be due to hyperglycemia, found in one-third of all acute ischemic stroke (AIS) patients. However, prior studies reported conflicting information about the impact of hyperglycemia on poststroke prognosis, likely due to different measurements of stress-induced hyperglycemia. The glucose-to-glycated hemoglobin ratio is an index of stress-induced hyperglycemia after AIS that better quantifies acute changes in blood glucose, as opposed to absolute variations in glucose levels. Moderate blood glucose reductions might counteract the negative effects of hyperglycemia and glycemic control medications can also play a role in neuroprotection. The liver is the main organ that functions to maintain energy and glucose metabolism and the effects of AIS can reach far peripheral organs, including the liver. In this review, we highlighted the mechanism responsible for acute poststroke hyperglycemia, a hepatic inflammatory pathway that results in hepatic gluconeogenesis and reduced hepatic insulin sensitivity. Hepatitis cascades lead to hepatic gluconeogenesis, and targeted therapy with antihyperglycemic drugs has the potential to improve stroke prognosis and recovery.
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ORIGINAL ARTICLES Top

The clinical significance of serum complement component 1q tumor necrosis factor-related protein 3 and complement component 1q tumor necrosis factor-related protein 9 levels in patients with rheumatoid arthritis p. 89
Xin Li, Yuan Wang, Xiaoxia Jia, Jing Ke, Baoyu Zhang, Yan Wang
DOI:10.4103/ed.ed_19_22  
Objective: The objective of this study was to assess the expression of serum complement component 1q tumor necrosis factor-related protein 3 (CTRP3) and CTRP9 in rheumatoid arthritis (RA) patients, and further explore their correlation with disease activity and the predictive value of RA. Methods: RA group (n = 60) and healthy group (n = 60) were enrolled in Beijing Luhe Hospital, Capital Medical University. We collected the clinical data, including the basic information, laboratory parameters as well as the Disease Activity Score using 28 joint counts (DAS28) scores, and measured the expression of serum CTRP3 and CTRP9 in two groups by enzyme-linked immunosorbent assay. To analyze the correlation between serum CTRP3 and CTRP9 and RA. We explored the predictive value of the serum CTRP3 and CTRP9 for RA. Results: Compared to the healthy group, the expression of serum CTRP3 and CTRP9 was higher in the RA group (P < 0.05). Except rheumatoid factor (serum CTRP9: r = −0.310, P = 0.018), and immunoglobulin (serum CTRP9: r = 0.338, P = 0.010), platelet, erythrocyte sedimentation rate, C-reactive protein, DAS28, anti-cyclic citrullinated peptide antibody, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein, etc., of RA patients were not related to the levels of serum CTRP3 and CTRP9. The best cutoff value of serum CTRP3 and CTRP9 was 31.66 and 34.39 ng/ml, respectively. In terms of sensitivity, negative predictive value, and accuracy, compared with single detection of serum CTRP3 or CTRP9, combined detection has more predictive value for RA. Conclusion: CTRP3 and CTRP9 may become two candidate biomarkers for RA. The serum CTRP3 and CTRP9 may have certain predictive values for RA.
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Association between the concentrations of some toxic metals and the risk of uterine fibroids among Nigerian women p. 96
Fatimoh Bukola Kareem, Mathias Abiodun Emokpae
DOI:10.4103/ed.ed_18_22  
Background: Uterine fibroids are a major health challenge to some women in the world, especially women of African descendants. The etiology of uterine fibroids and the mechanisms of their growth are not fully understood, and those factors that make women to be susceptible to fibroid development are subjects of investigation. Environmental toxicants such as toxic metals exposure have been implicated, but the results have not been consistent. This study seeks to determine the association between blood cadmium (Cd), arsenic (As), and lead (Pb) levels and the risk of uterine fibroids among women of reproductive age. Materials and Methods: This case–control study comprised 100 women of reproductive age (age range, 20–50 years) with uterine fibroid and 50 age-matched women without uterine fibroids. Fibroids were diagnosed using abdominal scan by attending physicians. Furthermore, the control subjects were screened for fibroids using abnormal scan. Blood Cd, As, and Pb were determined using an atomic absorption spectrophotometer, and the risk of association was calculated. Results: The mean blood Cd, As, and Pb were significantly higher (P < 0.001) among women with fibroid than those without fibroid (controls). The odds ratio for Cd 2.62 (confidence interval [CI]: 0.02–0.05), As 1.02 (CI: 0.02–0.030), and Pb 1.42 (CI: 0.04–0.129) was greater among women with uterine fibroids than controls. Conclusions: Exposure to cadmium and lead might be a risk factor for developing uterine fibroids among Nigerian women.
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CASE REPORT Top

A case of fatal liver failure due to chronic environmental exposure of copper in a child p. 102
Utpal Sutaria, Rohan Modi, Aarti Solanki, Nehal Patel
DOI:10.4103/ed.ed_21_22  
Chronic liver damage followed by copper toxicity is very rare in pediatric population. This case report describes a 9-year-old child with acute liver failure as the presentation of copper toxicity due to chronic environmental exposure as a part of an occupational hazard. If not intervened in the early stage, the outcome is always lethal. Therefore, it is recommended to rule out heavy metal toxicity like copper as a cause of liver damage for any case of acute or chronic liver failure after ruling out the common infectious and inflammatory causes.
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