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20 Aug 2022
31 Aug 2022
Azerbaijan medical journal (ISSN: 0005-2523) - is a scopus indexed journal since 1961. The publisher of the journal is Izdatel'stvo Elm by WHO Office in Azerbaijan. Azerbaijan medical journal (AMJ) is also UGC approved. The journal publishes general medicine, health science, psychological, pharmaceutical journals and so on.
Aim and Scope
Azerbaijan Medical Journal
Azerbaijan Medical Journal (ISSN: 0005-2523) - is a peer-reviewed journal. The journal seeks to publish original research articles that are hypothetical and theoretical in its nature and that provide exploratory insights in the following fields but not limited to.
Azerbaijan Medical Journal
Histomorphological parameters of the gastric mucosa in patients with gastritis and helicobacteriosis
Gastritis is an inflammatory condition of the gastric mucosa that has several classifications and causes. The persistence of symptoms of the acute state can lead to the atrophic development of the disease, increasing the tissue injury and consequential the development of gastric cancer. The diagnosis is made by clinical and endoscopic information as well as histopathological analysis of samples obtained from biopsy. The purpose of this review is demonstrate the morphological aspects of gastric mucosa and gastric abnormalities found in the histopathological diagnosis of gastritis.
Features of changes in Vitamin D and carbohydrate metabolism in girls with hyperandrogenia syndrome during puberty
Vitamin D status may be associated with insulin resistance and other key features of polycystic ovary syndrome (PCOS), but data from preliminary randomized controlled trials (RCTs) are conflicting. Therefore, we aimed to investigate the effects of vitamin D supplementation on plasma glucose area under the curve (AUCgluc, primary outcome measure) and on other metabolic and endocrine parameters (secondary outcome measures). This study was a single-center, double-blind, randomized placebo-controlled trial conducted between December 2011 and July 2017 at the Medical University of Graz, Austria. One-hundred and eighty women with PCOS and 25-hydroxyvitamin D [25(OH)D] concentrations <75 nmol/L were randomized in a 2:1 ratio to either receive 20,000 IU of cholecalciferol weekly or placebo over 24 weeks. Primary outcome was the between-group difference in AUCgluc at study end while adjusting for baseline values. In total, 123 participants completed the study [age 25.9±4.7 years; BMI 27.5±7.3 kg/m2 baseline 25(OH)D 48.8±16.9 nmol/L, baseline fasting glucose 84±8 mg/dL]. Vitamin D supplementation lead to a significant increase in 25(OH)D [mean treatment effect 33.4 nmol/L 95% confidence interval (CI) 24.5 to 42.2; p<0.001] but had no significant effect on AUCgluc (mean treatment effect −9.19, 95% CI −21.40 to 3.02 p=0.139). Regarding secondary outcome measures, we observed a significant decrease in plasma glucose at 60 min during oral glucose tolerance test (mean treatment effect −10.2 mg/dL 95% CI −20.2 to −0.3 p=0.045). Vitamin D supplementation had no significant effect on metabolic and endocrine parameters in PCOS with the exception of a reduced plasma glucose during OGTT.
Respiratory tract infections (RTIs) represent one of the main health problems in children. Probiotics are viable bacteria that colonize the intestine and affect the host intestinal microbial balance. Accumulating evidence suggests that probiotic consumption may decrease the incidence of or modify RTIs. The authors systematically reviewed data from randomized controlled trials (RCTs) to investigate the effect of probiotic consumption on RTIs in children. MEDLINE/PubMed, Embase, Cochrane Library, and Web of Science were systematically searched for RCTs regarding the effect of probiotics on RTIs in children. The outcomes included number of children experienced with at least 1 RTI episode, duration of illness episodes, days of illness per subject, and school/day care absenteeism due to infection. A random-effects model was used to calculate pooled relative risks, or mean difference (MD) with the corresponding 95% confidence interval (CI). A total of 23 trials involving 6269 children were eligible for inclusion in the systematic review. None of the trials showed a high risk of bias. The quality of the evidence of outcomes was moderate. The age range of subjects was from newborn to 18 years. The results of meta-analysis showed that probiotic consumption significantly decreased the number of subjects having at least 1 RTI episode (17 RCTs, 4513 children, relative risk 0.89, 95% CI 0.82–0.96, P=0.004). Children supplemented with probiotics had fewer numbers of days of RTIs per person compared with children who had taken a placebo (6 RCTs, 2067 children, MD ─0.16, 95% CI ─0.29 to 0.02, P=0.03), and had fewer numbers of days absent from day care/school (8 RCTs, 1499 children, MD ─0.94, 95% CI ─1.72 to ─0.15, P=0.02). However, there was no statistically significant difference of illness episode duration between probiotic intervention group and placebo group (9 RCTs, 2817 children, MD ─0.60, 95% CI ─1.49 to 0.30, P=0.19). Based on the available data and taking into account the safety profile of RCTs, probiotic consumption appears to be a feasible way to decrease the incidence of RTIs in children. CI = confidence interval, IL = interleukin, LRTI = lower respiratory tract infection, MD = mean difference, RCT = randomized controlled trial, RTI = respiratory tract infection, SAE = serious adverse event, SD = standard deviation, URTI = upper respiratory tract infection.
Influence of Perinatal Lesions of the Central Nervous System in Women of Reproductive Age with Hypothalamic Syndrome on the Neuroendocrine Regulation
The hypothalamo-pituitary-adrenocortical (HPA axis) is required for stress adaptation. Activation of the HPA axis causes secretion of glucocorticoids, which act on multiple organ systems to redirect energy resources to meet real or anticipated demand. The HPA stress response is driven primarily by neural mechanisms, invoking corticotrophin releasing hormone (CRH) release from hypothalamic paraventricular nucleus (PVN) neurons. Pathways activating CRH release are stressor dependent: reactive responses to homeostatic disruption frequently involve direct noradrenergic or peptidergic drive of PVN neurons by sensory relays, whereas anticipatory responses use oligosynaptic pathways originating in upstream limbic structures. Anticipatory responses are driven largely by disinhibition, mediated by trans-synaptic silencing of tonic PVN inhibition via GABAergic neurons in the amygdala. Stress responses are inhibited by negative feedback mechanisms, whereby glucocorticoids act to diminish drive (brainstem), promote transsynaptic inhibition by limbic structures (e.g, hippocampus). Glucocorticoids also act at the PVN to rapidly inhibit CRH neuronal activity via membrane glucocorticoid receptors. Chronic stressinduced activation of the HPA axis takes many forms (chronic basal hypersecretion, sensitized stress responses, even adrenal exhaustion), with manifestation dependent upon factors such as stressor chronicity, intensity, frequency and modality. Neural mechanisms driving chronic stress responses can be distinct from those controlling acute reactions, including recruitment of novel limbic, hypothalamic and brainstem circuits. Importantly, an individual’s response to acute or chronic stress is determined by numerous factors, including genetics, early life experience, environmental conditions, sex and age. The context in which stressors occur will determine whether an individual’s acute or chronic stress responses are adaptive or maladaptive (pathological).
Prader–Willi syndrome (PWS) is recognized as the first example of genomic imprinting, generally due to a de novo paternal 15q11-q13 deletion. PWS is considered the most common genetic cause of marked obesity in humans. Scoliosis, kyphosis, and kyphoscoliosis are commonly seen in children and adolescents with PWS with a prevalence of spinal deformities cited between 15% to 86%. Childhood risk is 70% or higher, until skeletal maturity, with a bimodal age distribution with one peak before 4 years of age and the other nearing adolescence. As few reports are available on treating scoliosis in PWS, we described clinical observations, risk factors, therapeutic approaches and opinions regarding orthopedic care based on 20 years of clinical experience. Treatments include diligent radiographic screening, starting once a child can sit independently, ongoing physical therapy, and options for spine casting, bracing and surgery, depending on the size of the curve, and the child’s age. Similarly, there are different surgical choices including a spinal fusion at or near skeletal maturity, versus a construct that allows continued growth while controlling the curve for younger patients. A clear understanding of the risks involved in surgically treating children with PWS is important and will be discussed.
PD-1 as a predictor of antitumor immune resistance Its detection perspectives and correction possibilites in cervical cancer
Cervical cancer is one of the most common gynecological tumors, and the majority of early-stage cervical cancer patients achieve good recovery through surgical treatment and concurrent chemo radiotherapy (CCRT). However, for patients with recurrent, persistent, metastatic cervical cancer, effective treatment is rare, except for bevacizumab combined with chemotherapy. Programmed cell death-1/programmed cell death-ligand 1 (PD-1/PD-L1) inhibitors might be a novel choice to improve the clinical outcomes of these patients. Thus far, some pivotal trials, including Keynote 028, Keynote 158 and Checkmate 358, have indicated established clinical benefit of PD-1/PD-L1 inhibitors in cervical cancer. In light of these data, the FDA has approved pembrolizumab for patients with recurrent or metastatic cervical cancer with disease progression during or after chemotherapy. There are also some ongoing studies that may provide more evidence for the PD-1/PD-L1 pathway as a therapeutic target in cervical cancer. In this review, we have summarized the status and application of PD1/PD-L1 inhibitors in clinical trials for the treatment of cervical cancer and suggested some future directions in this field.
Assessment of the lipid profile correction in patients with arterial hypertension and type 2 diabetes mellitus
Previous studies have shown that diabetes mellitus (DM) increases the risk of cardiovascular diseases in females to a greater extent than in males. In this cross-sectional study, we evaluated the lipid profiles of type 2 diabetic males and females. Materials and Methods: The study included 107 type 2 diabetic patients (41 males and 66 females), and 122 hypertensive type 2 diabetic patients (39 males and 83 females), aged 15 years and older. Total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C), very low density lipoprotein-cholesterol (VLDL-C) and high density lipoprotein-cholesterol (HDL-C) concentrations were assayed for each group using standard biochemical methods. Results: The mean TC, TG, VLDL-C, HDL-C and LDL-C concentrations, TG/HDL and LDL/HDL ratios were higher in type 2 diabetic and hypertensive type 2 diabetic patients compared with non-diabetic, and hypertensive non-diabetic control subjects, although these were not significant (P > 0.05). Hypertensive type 2 diabetic females had significantly higher serum TC (7.42 ± 1.63 mmol/L) than hypertensive non-diabetic males (5.76±1.57 mmol/L; P < 0.05). All the other lipid and lipoprotein parameters except HDL-C were non-significantly higher in females with type 2 DM and those with hypertension and type 2 DM, compared with type 2 diabetic and hypertensive type 2 diabetic males, respectively (P > 0.05). Conclusion: This study demonstrated that dyslipidemia exists in our type 2 diabetic population with greater TC in hypertensive type 2 diabetic females compared with hypertensive type 2 diabetic males. This suggests that hypertensive type 2 diabetic females are exposed more profoundly to risk factors including atherogenic dyslipidemia compared with males.
The role of the Vitamin D / parathormone system in the pathogenesis of bone metabolism disorders in rheumatoid arthritis
Osteoporosis is a well-established extra-articular feature of rheumatoid arthritis (RA). Systemic inflammation seems to play a crucial role in causing an alteration of multiple homeostatic systems implied in bone health, such as the RANK/RANKL/Osteoprotegerin and Wnt/ catenin pathways several other causal factors have been called into question, including the chronic use of corticosteroids. Since vitamin D exerts important immune-regulatory roles, it has been claimed that derangement of the vitamin D/parathyroid hormone (PTH) system, a well-known determinant of bone health, may play a pathogenic role in autoimmunity; animal models and clinical data support this hypothesis. Furthermore, RA patients seem to be relatively refractory to vitamin D-induced PTH suppression. Therefore, the link between RA and osteoporosis might in part be due to alterations in the vitamin D/PTH system. A better understanding of the pathophysiology of this system may be crucial to prevent and cure osteoporosis in patients with inflammatory/autoimmune diseases. A major clinical correlate of the strict cooperation and interdependence between vitamin D and PTH is that correction of the vitamin D deficiency, at least in autoimmune diseases, should be targeted to PTH suppression.
The aim of this study was to investigate the level of serum cytokines in different periods of pregnancy associated with anemia. 85 pregnant patients with anemia were examined. 46 of them were in their first pregnancy (1st group), and 39 (2nd group) patients were in their second or further pregnancy period. The comparison group consisted of 19 pregnant women without anemia. The level of hemoglobin and serum iron were determined by using colorimetric method, as well as the level of cytokines IL-2, IL-6, IL-8 and IL-10 were determined using an enzyme-linked immunosorbent assay method. The results showed a significant decrease in hemoglobin and serum iron level in the blood of pregnant women with anemia, significant increase in proinflammatory ytokines, such as IL-2 and IL-8, and a significant decrease in IL-10 compared with pregnant women without anemia were also detected. The most pronounced changes in the cytokine profile were observed in the third trimester and during second or futher pregnancy, which is caused by the progression of anemia.
FCGR2C gene was investigated at first time in Hashimoto disease. The aim of this study is to show with genotype-phenotype correlation analysis of the clinical phenotypic role in autoimmune disease of Hashimoto's thyroiditis of nucleotide polymorphisms or variations in the nature of mutations in FcGR2C gene, responsible for the production of proteins which have an extremely active role in immune system. The study group comprised by 48 patients admitted to Department of Endokrinology of Ege Univercity Faculty of Medicine, Department of Internal Medicine and corresponding to Hoshimoto disease criteries. Also, 25 healthy individuals not diagnosed with Hashimoto thyroid and family history of this disease aggred to participate in the study was included in this study. Looking to the results of this study after analysis of the entire coding region of FCGR2C there was found 12 new mutations. This is 7 mises mutations, 5 sininim aminoacit and also in intron 6 pieces nucleotide was seen. Looking to regions where was found mutations and polymorphisms in this study: Pro83Gln, Pro83Pro, Gln57Gln, Gln63Gln FCGR2C proteins are correspond to the first domain. Mutations and polymorphisms are correspending to second domaine of FCGR2C are Ile183Met, Ser189Thr, Tyr205Phe, Gln57Gln, Gln63Gln, Leu150Leu, Thr203Thr ve Leu204Leu. Furthermore, the frequency of mutant alleles of FCGR2C gene were; %90 in patients group and %70 in healthy control group. After applied for the statistical analysis FCGR2C gene mutations increased significantly (χ2: 10.559 - p: 0.001) in Hashimoto disease patients.