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Background: Breast cancer (BC) is the most prevalent neoplasm in females globally, with an increasing incidence trend almost in all regions. Previous studies have indicated that non-alcoholic fatty liver disease (NAFLD) may be an emerging risk factor for extrahepatic cancers, including BC. This systematic review and meta-analysis study aimed to determine the association between NAFLD and the development of BC.Method: Data were systematically collected without time limitation until 21 April 2022, from the following electronic databases: PubMed, Scopus, Embase, Web of Science, and Google Scholar. The association between NAFLD and BC with odds ratio (OR) was calculated with a 95% confidence interval (CI) and presented via forest plots. Hazard ratios along with incidence rate ratios in the cohort studies transformed into OR.Results: According to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) and the inclusion criteria herein, 11 eligible studies were obtained from various countries. The pooled OR of NAFLD as a risk of developing BC, using a random-effects model, was estimated at 1.61 (95% CI: 1.30-2.00) (Q-value: 51.35, I2 = 80.52%, P < 0.0001). Multivariate meta-regression analysis showed that the publication year-, country-, detection method-, study design-, and body mass index-adjusted status did not cause heterogeneity. The Egger's regression (P = 0.32) and the symmetry in the funnel plot showed no publication bias in the studies.Conclusion: The present research revealed that NAFLD had a significant association with BC, independent of traditional risk factors.

Background: Urinary tract infections (UTIs) are a widespread health concern with high recurrence rates and substantial economic impact, and they can increase the prevalence of antibiotic resistance. This study employed an integrated bioinformatics approach to identify key genes associated with UTI development, offering potential targets for interventions. Materials and Methods: For this study, the microarray dataset GSE124917 from the Gene Expression Omnibus (GEO) database was selected and reanalyzed. The differentially expressed genes (DEGs) between UTIs and healthy samples were identified using the LIMMA package in R software. In this section, Enrichr database was utilized to perform functional enrichment analysis of DEGs. Subsequently, the protein-protein interaction (PPI) network of the DEGs was constructed and visualized through Cytoscape, utilizing the STRING online database. The identification of hub genes was performed using Cytoscape’s cytoHubba plug-in employing various methods. Receiver operating characteristic (ROC) analysis was performed to assess the diagnostic accuracy of hub genes. Results: Among the outcomes of the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, the tumor necrosis factor (TNF) signaling pathway was identified as one of the notable pathways. The PPI network of the DEGs was successfully established and visualized in Cytoscape with the aid of the STRING online database. Using cytoHubba with different methods, we identified seven hub genes (STAT1, IL6, IFIT1, IFIT3, IFIH1, MX1, and IRF7). Based on the ROC analysis, all hub genes showed high diagnostic value. Conclusion: These findings provide a valuable baseline for future research aimed at unraveling the intricate molecular mechanisms behind UTI.

SARS-CoV-2 infection manifestation has great diversity and it becomes even greater while co-infection occurs or there is a serious underlying disease in an affected patient. In this case report, we present a case of a 71-year-old man who underwent a chest CT scan following the development of fever, weakness, and pulmonary symptoms. Chest CT scan showed segmental consolidation with centrilobular nodular infiltration, ground glass opacifications in the inferior segment of the left upper and lower lobes, and left lung pleural thickening which was atypical for either COVID-19 infection or pneumocystis carinii pneumonia but his SARS-CoV-2 PCR result was positive and he received COVID-19 treatment. His symptoms recurred after a few months with the same chest CT findings and subsequent bronchoalveolar lavage revealed the presence of pneumocystis carinii infection. Consequently, he received cotrimoxazole which caused improvement in symptoms, nonetheless splenomegaly and anemia remained in his clinical and laboratory investigation. Accordingly, bone marrow study and flow cytometry was done and confirmed the previously undiagnosed hairy cell leukemia. This case accentuates the fact that when we face atypical clinical or paraclinical features in a COVID-19 patient, we should explore for coinfection or unknown underlying diseases.

Objective: Although recent studies have focused on the role of genes in the pathogenesis of endometriosis, the investigation of genes and molecular pathways involved in the pathogenesis of endometriosis with a bioinformatics approach has not been addressed yet. Hence, we aimed to investigate this issue in our study. Materials and methods: The gene expression datasets GSE7305 and GSE124010 were obtained from the GEO database, consisting of endometriosis and normal endometrial tissue samples. Differential expression analysis was performed using the R software and LIMMA package, applying cutoff criteria of p-value 1 to identify differentially expressed miRNAs (DEmiRs) and genes (DEGs). The MultiMiR package was used to predict target genes for DEmiRs, considering the overlapping predictions from multiple databases. Venn diagrams were used to establish miRNA-target relationships and identify interactions with DEGs. Functional enrichment analyses were conducted using the Enrichr analysis tool to predict the molecular function, biological processes, cellular components, and pathways associated with the target genes. Protein-protein interaction networks were constructed using the STRING database and visualized in Cytoscape, and hub genes were identified based on their centrality measures. Key hub genes were selected by considering those shared among all three centrality measures. The expression levels of hub genes were validated in endometriosis samples using ROC curves to assess diagnostic accuracy. The AUC was calculated to compare the diagnostic value of the hub genes, using GraphPad Prism version 9.1.0. Result: The analysis identified six hub genes (CCNA2, ESR1, AURKA, MKI67, and VEGFA) in the protein-protein interaction network. Among the miRNAs, hsa-miR-29a-3p showed the highest number of interactions with these hub genes, making it the key miRNA in the study. These findings suggest the potential involvement of hsa-miR-29a-3p in regulating the expression of the identified hub genes in endometriosis. Conclusion: Identifying pathways related to the expression of hub genes can be useful in designing appropriate treatment strategies. On the other hand, examining the pathways activated by hub genes can be effective in preventing of endometriosis progression.

Vaccine-associated thrombotic thrombocytopenic purpura (TTP) is a rare type of acquired TTP recently reported after COVID-19 vaccination. Merely four cases are ascribed to the ChAdOx1 nCoV-19 vaccine in the medical literature till the preparation of this study. In this case report, we describe a 43-year-old man who developed symptoms of TTP four days after receiving the second dose of the ChAdOx1 nCoV-19 vaccine. Peripheral blood smear demonstrated multiple schistocytes. Given a high plasmic score, he received plasma exchange, corticosteroids, and rituximab, and later, low ADAMTS 13 activity and high-titer ADAMTS inhibition antibody confirmed the diagnosis of COVID-19 vaccine-associated TTP. COVID-19 vaccine-associated TTP is an infrequent consequence of SARS-CoV-2 vaccination but with a substantial mortality rate which must be considered as one of the crucial differential diagnoses of post-COVID-19 vaccine thrombocytopenia besides vaccine-induced immune thrombotic thrombocytopenia and Immune thrombocytopenic purpura.

35-year-old woman presented to the dermatology clinic complaining of lax skin and atrophic and pendulous plaques in axillary, inguinal folds, and deltoid region. Initially, lesions were indurated plaques, which slowly became wrinkled.Histopathologic evaluation showed Pandermal and subcutaneous infiltrate of atypical lymphocytes admixed with evenly distributed epithelioid and multinucleated giant cells, many of which contain numerous nuclei. Histopathology and clinical findings were consistent with the diagnosis of Granulomatous slack skin.

Background: The most prominent part of the cellular response of the immune system is driven by neutrophils. These cells tend to decline following chemotherapy in patients with leukemia. Neutropenia is an influential factor in the prognosis of cancer patients. Stress reduces white blood cells (WBC) and neutrophils are linked to an increased risk of infectious diseases after chemotherapy. We investigated the association between neutropenia and perceived stress following chemotherapy. Materials and Methods: We performed a cross-sectional study on 60 patients with leukemia in a university hospital. Participants completed self-report measures including the demographic data and perceived stress scale (PSS) questionnaire. We compared rates of neutropenia, as a measure of chemotherapy prognosis, 10 days after chemotherapy in different stress levels. Moreover, the number of patients with polymorphonuclear (PMN) under 1000/microl was compared at different stress levels. Results: We found that neutropenia is directly correlated with negative stress perception and inversely correlated with positive stress perception. These effects appear more prominent in patients with PMN under 1000/microl as the number of these patients was significantly more in groups with higher negative stress and less in groups with higher positive stress scores. Conclusion: It can be concluded that stress is correlated with neutropenia and stress management in patients with leukemia will be accompanied by better recovery outcomes and reduced risk of infectious disease.

Primary Malignant Melanoma of the Esophagus (PMME) is an aggressive tumor with a median survival of about 13 months. Surgical extirpation is the only treatment for PMME. The most common clinical presentation is the onset of progressive dysphagia. Endoscopy presents a polypoid lesion occasionally in the middle and lower third of the esophagus. Definitive diagnoses are based on pathology and immunohistochemical examination with positive results for S-100, Human Melanoma Black (HMB)-45, and Melanoma-specific Antigen (Melan-A) proteins. We presented a 46-year-old man complaining of dysphagia and melena from the past two months. Gasteroesophagoscopy demonstrated a large polypoid in the lower third of the esophagus extending to the cardia. Histopathology of the biopsy specimen from the esophagus revealed positive staining for S-100, Human Melanoma Black (HMB)-45, and Melanoma-specific Antigen (Melan A) proteins that were all compatible with malignant melanoma of the esophagus. The patient underwent surgery followed by radiotherapy and Immunotherapy. The postoperative period was uneventful. No metastasis and recurrence was observed after more than 6 months of initial treatment. PMME is a rare but highly aggressive tumor. The diagnosis of PMME should be made by clinical symptoms, auxiliary examination, pathological examination, and immunohistochemistry markers. The problem of exact diagnosis at the early stages of the disease and effective treatment is still a challenge.

Background: Multiple Endocrine Neoplasia type 2B (MEN2B) is an autosomal dominant disorder characterized by Medullary Thyroid Carcinoma (MTC) and pheochromocytoma. MTC occurs in almost all MEN2B patients. The tumor develops at an earlier age and is aggressive. Surgery is often not curative for this condition. Death from MTC occurred in 50% of patients with MEN2B. Thus, early diagnosis and prevention are crucial in this regard. Thyroidectomy, as early as the neonatal period, may be indicated in patients with MEN2B identified by genetic screening. Case Presentation: We reported a 24-year-old male presented to the emergency department with dyspnea for the past 3 months. There was a nodule 3*3 cm in the Right Lower Lobe (RLL) of the thyroid gland. Non-contrast Computer Tomography (CT) scan of the lung revealed multiple nodular lesions compatible with metastasis. The Fine Needle Aspiration (FNA) cytology of the thyroid nodule indicated that the features of medullary thyroid carcinoma were positive stains in Immunohistochemistry (IHC) for calcitonin. A diagnosis of pulmonary metastatic medullary thyroid carcinoma, as a presenting feature of MEN2B, was made. The patient was treated with Vandetanib. Conclusion: In the reported MEN2B patient, MTC occurred in the early stages of life and was multifocal. Thus, it is crucial to diagnose medullary thyroid cancer at the early stages of the disease.