BACKGROUND: Renal cell carcinoma (RCC) is the most common and malignant tumor of kidney tissue, with unknown molecular mechanism and pathogenesis. Recent studies have demonstrated that micro ribonucleic acids (miRNAs) may have potential role in initiation and progression of RCC. In this study we evaluated expression patterns of two RNA molecules, miR-625 and miR-302a in tumor and non-tumor portions of RCC samples.

METHODS: The relative expression levels of miR-625 and miR-302a were delineated by real-time PCR in 20 formalin-fixed paraffin-embedded (FFPE) RCC samples and compared with 20 non-tumor matched samples obtained from margins of the same samples.

RESULTS: We found approximately 15-fold increase in miR-625 expression in tumor samples compared to non-tumor samples of each patient, but it was not a significant difference (P Value: 0.097). On the other hand, miR-302a expression was similar between tumor and non-tumor sections of the sample (P Value > 0.05). Additionally, we did not find an association between age, gender, grade and stage of tumors, and expression level of either of the two miRNAs.

CONCLUSION: Our data demonstrated that there is no significant difference of miR-625 and miR-302a expression in tumor samples of RCC when compared to non-tumor samples. We further found no relationship between clinico-pathological characteristics and expression levels of miR-625 or miR-302a.

BACKGROUND: Weight gain among patients with schizophrenia is challenging. To evaluate the effects of topiramate on treatment of schizophrenia and weight gain management.

METHODS: For this double-blind randomized placebo-controlled clinical trial; 59 patients at Arak University Hospital were recruited. In the control group (n=29) atypical antipsychotic agent equivalent to 20 mg of olanzapine was given while the intervention group (n=30) was treated with atypical antipsychotic equivalent to 20 mg of olanzapine and topiramate at dose of up to 200 mg for 12 weeks. The Positive And Negative Syndrome Scale (PANSS) and Body Mass Index (BMI) of patients were measured at baseline and during the study.

RESULTS: 59 patients, 31 males (52.5%) and 28 females (47.5%) with mean age of 29.9±7.67 years (ranged 16.7-47.3 years) were randomized. In the two groups, total PANSS significantly decreased after 12-week therapy (P=0.001). BMI in the control group decreased by only 0.25% from baseline to week 12 and was not significant (p=0.69). In topiramate group, the reduction of BMI from baseline to week 12 was 8.3% and was statistically significant (26.67±3.51 to 24.47±3.55, P=0.001). The difference between the treatment and control groups regarding BMI in weeks 8 and 12 and PANSS in weeks 4, 8 and 12 was significant (P<0.05).

CONCLUSION: Our results indicated that topiramate at a dose of 200 mg/day is a safe agent and induces weight loss and significantly decreases PANSS score in patients with schizophrenia.

 Cornelia de Lange Syndrome (CdLS) is a genetic disorder, with approximately one per 10,000-30,000 prevalence. The most frequent clinical abnormalities include typical face dysmorphia, anomalies of the hands and feet, multiple malformations, microcephaly and other characteristics include feeding difficulties in the newborn period and mental delay. The reported genes associated with CdLS include NIPBL, SMC1A, SMC3, RAD21 and HDAC8. We report a 20-day-old Iranian Turkmen girl with this syndrome.

A lipoma is a common benign soft tissue tumor which is composed of fat. It can be of variable sizes and may present at any location where fat cells are present. The posterior neck space is the most common site for head and neck lipomas [1]. However, when present in the anterior neck space, excision of the lipoma may result in injuries to the structures within anterior neck, namely the marginal mandibular nerve, which may have an impact on the patient’s appearance and function of the lower lip. We report a case of a 28 years old woman who presented with a lipoma of the anterior neck and developed left marginal mandibular nerve palsy following excision.

Globus pharyngeus is a common symptom referred to theotorhinolaryngology department. This is a diagnosis of exclusion and is most often psychosomatic. However, organic causes should be ruled out withdetailed history, physical examinations, office procedures such as endoscopy, and imaging procedures. Herein, we report an unusual case of globuspharyngeus associated with kinking ofinternal carotid artery in the pharyngeal region. A 55-year old woman who underwent surgery and radiotherapy for high-grademucoepidermoid carcinoma of the right parotid gland presented with complaints ofglobus sensation during her routine clinic follow up. Clinical examination found an anterior neck mass. Endoscopy showed a pulsatile mass bulging out from the left posterior pharyngeal wall. Computed tomography angiogram showed kinking of the left internal carotid artery. Diagnosis dilemma for globus sensation in patients with a history of radiation therapy includes external compression from a post-radiation thyroid disorder and secondary malignancies. Rare complication could be weakening of major vasculature walls.

Trichosporon mycotoxinivorans is an emerging fungus which causes pulmonary infections in humans, with a predilection for patients with cystic fibrosis. In recent years, several case reports have described the role of Trichosporon mycotoxinivorans in disseminated infections, particularly in patients undergoing dialysis and those with various malignancies. However, this is the first case presentation of Trichosporon mycotoxinivorans dissemination to brain. We present our findings in a 42-year-old female undergoing treatment for acute liver failure and acute tubular necrosis, who had positive blood and stool cultures for Trichosporon mycotoxinivorans and a rapidly developing hypodense lesion in right basal ganglia during hospitalization.

BACKGROUND: Diabetic neuropathy affects more than 50% patients with diabetes mellitus of more than 25 years’ duration. Up to 16.2% of diabetic patients have painful neuropathy which can profoundly undermine the quality of life. Both Pregabalin and Amitriptyline are commonly used to relieve symptoms of painful diabetic peripheral neuropathy (DPN).The objectives were to compare efficacy of Pregabalin and Amitriptyline in relieving pain associated with DPN and to compare their adverse effect profiles.

METHODS: We conducted a non-blinded, randomized controlled trial at the Diabetic Clinic, Department of Medicine at Benazir Bhutto Hospital, Rawalpindi, Pakistan from January 2015 to August 2015 on a total of 320 patients who met the inclusion and exclusion criteria. 160 patients each were randomly allocated to either Pregabalin group or Amitriptyline group for up to 6 weeks. Likert Numeric Rating Scale (NRS) was used to assess the severity of pain at the start and six weeks later. Patient-reported adverse outcomes were recorded. Chi-square test was applied to compare the pain relief amongst the two groups.

RESULTS: Of the 320 patients, 180 (56.3%) had pain relief (Likert NRS improvement > 50% from the baseline). Of the 160 patients assigned to Pregabalin group, 104(65%) achieved good pain relief as compared to just 76 (47.5%) of the 160 patients assigned to Amitriptyline group (p-value= 0.002).

CONCLUSION: Pregabalin is more effective and safer than Amitriptyline for control of symptoms of painful DPN.