Zhenzhu liu; Dajun Yuan; Xiangpeng Kong; Peng Qu; Hongyan Wang
Volume 22, Issue 5 , 2020
Abstract
Introduction: ?-blockers and angiotensin receptor blocker (ARB)/angiotensin-converting enzyme inhibitors (ACEI) are well known as critical therapies for improving the prognosis in patients with acute myocardial infarction, however, their use in some case may be limited. We believe that in such cases ...
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Introduction: ?-blockers and angiotensin receptor blocker (ARB)/angiotensin-converting enzyme inhibitors (ACEI) are well known as critical therapies for improving the prognosis in patients with acute myocardial infarction, however, their use in some case may be limited. We believe that in such cases as when ?-blockers and ARB/ACEI use is limited, ivabradine plays a potential role in the improvement of individual prognoses.
Case Presentation: A 49-year-old man from Dalian, China. He was diagnosed with acute inferior myocardial infarction in Feb, 2016. And he still experienced palpitations and heart failure after drug treatment and percutaneous coronary intervention (PCI). We used metoprolol at a low dose, although the symptoms were not relieved, ?-blockers could not be used or increase dose because of his hypotension. Finally, we chose ivabradine to alleviate the symptoms of the patient related to heart rate and palpitations without affecting blood pressure so as to promote the recovery of heart function. We witnessed a gradual reduction in heart rate (HR) and a gradual increase in blood pressure. Finally, we administered an ARB and increased via titration the dose of ARB and ?-blocker.
Conclusions: When there are limitations to the use of ARB/ACEI and ?-blockers, we can use ivabradine, which reduces HR without affecting blood pressure. Ivabradine can help with the titration of the dose of ARB/ACEI or ?-blockers.
Behrouz Beiranvand; Ebrahim Hajizadeh; Aliakbar Rasekhi; Abdollah Amirfarhangi; Javad Nasseryan
Volume 22, Issue 5 , 2020
Abstract
Background: Restenosis after coronary angioplasty can have serious complications such as coronary artery bypass graft, myocardial infarction, and death.
Objectives: The present study aimed at investigating the factors affecting the recurrence of coronary artery stenosis in patients undergoing ...
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Background: Restenosis after coronary angioplasty can have serious complications such as coronary artery bypass graft, myocardial infarction, and death.
Objectives: The present study aimed at investigating the factors affecting the recurrence of coronary artery stenosis in patients undergoing angioplasty using the recurrent event data analysis.
Methods: A cohort study was performed on patients undergoing coronary angioplasty from March 23, 2009, to January 21, 2011. All patients were followed up from angioplasty to January 21, 2015. First, each of the independent variables was entered into the univariate Cox model with a frailty component. Then, variables with p-values of less than 0.2 were entered into the multivariate analysis. The statistical analysis was done using R software, version 3.6, at the significance level of 0.05.
Results: The present study was conducted on 1,000 patients who underwent coronary angioplasty. We found that 441 patients experienced restenosis at least once in the study period. The mean survival time to the first event of restenosis was 44.08 ± 1.06 months. Patients with a history of diabetes, unstable angina, and myocardial infarction had a significantly higher hazard of restenosis compared to other patients (P < 0.05).
Conclusions: The results of the recurrent event survival analysis confirmed the significant role of risk factors such as a history of diabetes, unstable angina, and myocardial infarction. Therefore, training to enhance the patients awareness and attitude seems necessary to prevent them from exposing whit known risk factors. The periodic follow-up of patients with risk factors and more ongoing care are also necessary.
Ali Akhavan Behbahani; Irvan Masoudiasl; Somayeh Hessam; Mohesn Najafikhah
Volume 22, Issue 5 , 2020
Abstract
Background: Health legislation provides a framework to implement various health policies. Participatory democracy in healthcare is inevitable. Citizens and health professionals should participate in participatory democracy, and health laws should be the result of a process in which participatory ...
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Background: Health legislation provides a framework to implement various health policies. Participatory democracy in healthcare is inevitable. Citizens and health professionals should participate in participatory democracy, and health laws should be the result of a process in which participatory instruments and techniques have a prominent role. Health democracy can be achieved through the expansion of mechanisms for citizens participation in the legislative process. The health democracy enables citizens to participate in the decision-making process and to have equal access to services provided by the public health system.
Objectives: The current study aims to assess participatory mechanisms used by selected countries to participate their citizens in legislative processes.
Methods: The current study is a comparative study of the legislative processes of selected countries. To select countries, four issues were evaluated: (a) overall legal system; (b) how laws enforce; (c) legislative backgrounds; and (d) health system basic model.
Results: The number of legislative chambers, legislative initiatives, legislative authorities and institutions, legislative commissions, and citizens participation in the legislative process were analyzed in the selected countries. An analysis of the factors affecting public participation in healthcare legislation shows that participation in the legislative process is a complex phenomenon influenced by social, legal, cultural, political, and sovereignty factors. This phenomenon cannot be analyzed isolated from these factors. However, the way should be paved for citizens' participation. The selected countries use different methods for citizens participation, depending on their legal systems.
Conclusions: Research results show that there are various public participation mechanisms. In Iran, there is a huge potential for public participation, and members of the parliament can easily interact with the interest groups and relevant individuals. These conditions provide a golden opportunity for expert health legislation.
Khanali Mohammadi; Sedigheh Sadat Tavafian
Volume 22, Issue 5 , 2020
Abstract
Background: Addiction in Afghanistan, as the largest opium producer in the world, is relatively high, and limited studies have indicated that the youth, especially students are the majority of the addicted cases in this country.
Objectives: This quasi-experimental study aimed at designing ...
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Background: Addiction in Afghanistan, as the largest opium producer in the world, is relatively high, and limited studies have indicated that the youth, especially students are the majority of the addicted cases in this country.
Objectives: This quasi-experimental study aimed at designing and evaluating the effect of educational intervention based on the Health Belief Model (HBM) on drug abuse prevention among the students of Khatam Al-Nabieen University in Afghanistan.
Methods: In this quasi-experimental study, 120 students of Khatam Al-Nabieen University residing in Ghazni city, Afghanistan, were randomly divided into two groups of the intervention and control (60 students per group). The HBM-based educational intervention was performed for the intervention group. The data in both groups were collected and evaluated at four time points, including before intervention, and immediately, 3, and 6 months after the intervention using a valid researcher-made questionnaire.
Results: Although there was no significant difference between the mean score of the HBM constructs (P > 0.05) before the intervention, the results of repeated measures ANOVA showed significant differences in the intervention group in HBM constructs and also intention toward substance abuse preventive behavior (P < 0.001). There were significant inter- and intra-group differences, as well as the group-time interaction in all HBM constructs mean scores (P < 0.001). Also, as the valuable finding, the preventive behavioral intention significantly (P < 0.001) improved following a 3- and 6-month follow-up in the intervention group (17.63 ± 1.34 and 17.66 ± 1.42, respectively) compared with the control group (10.95 ± 1.33 and 10.87 ± 1.22, respectively).
Conclusions: The results showed that the HBM-based educational program by preventing substance abuse can help students adopt proper behaviors.
Babak Jamshidi; Mansour Rezaei; Farid Najafi; Azad Sheikhi
Volume 22, Issue 5 , 2020
Abstract
Background: Over 150,000 confirmed cases, around 140 countries, and about 6,000 death occurred owing to coronavirus disease 2019 (COVID-19) pandemic in China, Italy, Iran, and South Korea. Iran reported its first confirmed cases of COVID-19 in Qom City on 19 February 2020 and has the third-highest ...
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Background: Over 150,000 confirmed cases, around 140 countries, and about 6,000 death occurred owing to coronavirus disease 2019 (COVID-19) pandemic in China, Italy, Iran, and South Korea. Iran reported its first confirmed cases of COVID-19 in Qom City on 19 February 2020 and has the third-highest number of COVID-19 deaths after China and Italy and the highest in Western Asia.
Methods: We applied a two-part model of time series to predict the spread of COVID-19 in Iran through addressing the daily relative increments. All of the calculations, simulations, and results in our paper were carried out by using MatLab R2015b software. The average, upper bound, and lower bound were calculated through 100 simulations of the fitted models.
Results: According to the prediction, it is expected that by 15 April 2020, the relative increment (RI) falls to the interval 1.5% to 3.6% (average equal to 2.5%). During the last three days, the RI belonged to the interval of 12% to 15%. It is expected that the reported cumulative number of confirmed cases reaches 71,000 by 15 April, 2020. Moreover, 80% confidence interval was calculated as 35K and 133K.
Conclusions: The screening of suspected people, using their electronic health files, helps isolate the patients in their earlier stage, which in turn helps decrease the period of transmissibility of the patients. Considering all issues, the best way is to apply the model with no modification to model the probable increasing or decreasing acceleration of spreading.
Seyyed Mohammad Miri; Mohammad Ajalloueyan
Volume 22, Issue 5 , 2020
Abstract
Introduction: The pandemic coronavirus disease 2019 or COVID-19 is infecting as fast as possible in more than 200 countries and creating the most horrible domino-like demolition ever seen. From its beginning in Wuhan, China, the SARS-CoV-2 infected the similar groups of 100,000 patients in 67, 11, ...
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Introduction: The pandemic coronavirus disease 2019 or COVID-19 is infecting as fast as possible in more than 200 countries and creating the most horrible domino-like demolition ever seen. From its beginning in Wuhan, China, the SARS-CoV-2 infected the similar groups of 100,000 patients in 67, 11, 4, and 2 days. Healthcare workers are in the frontline of attacking by SARS-CoV-2, especially those who are in close contact with upper respiratory mucosa like otolaryngologists.
Objectives: To describe ear pain as one of the first clinical manifestations of COVID-19, we present two cases of a family (a mother and her daughter) with a positive RT-PCR test for COVID-19 who presented earache as their first symptoms.
Case Presentation: The first case was a 32 years old female patient (stewardess of an international airline, Tehran, Iran) was labeled as at risk due to her air flight to China in Dec 2019. She was first admitted for moderate ear pain in her left ear with mild itching of the external ear to an otolaryngology outpatient clinic by a general practitioner. After 7 days, her test for RT-PCR against COVID-19 was positive. No lung involvement was reported by high-resolution computed tomography (HRCT) of the thorax. Another case was her mother who were in close contact with each other and experienced severe ear pain after 7 days. She acquired mild COVID-19 symptoms with anosmia was a positive test result for COVID-19.
Conclusions: The earache must be considered as their first clinical symptoms during the early phase of the coronavirus outbreak. It seems that local and international scientific groups of otolaryngologists must prepare their national guidelines to protect their practitioners against COVID-19 based on practical strategies. Using personal protective equipment is of utmost importance in reducing the risk of nosocomial infection among otolaryngologists.
Mohammad Taghi Taghavifard; Yohan Yousefzadeh
Volume 22, Issue 5 , 2020
Abstract
Background: After the end of an emergency period and through setting up emergency settlement camps, humanitarian agents will take action to improve livelihood and health conditions of those suffering from the disaster through sending livelihood and health packages with standard contents and based ...
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Background: After the end of an emergency period and through setting up emergency settlement camps, humanitarian agents will take action to improve livelihood and health conditions of those suffering from the disaster through sending livelihood and health packages with standard contents and based on peoples requirements. However, the problem is that the packages are prepared for normal people, and they would be no use for infants, children, and the elderly or patient family members. Cash-based Assistance (CBA) instead of in-kind donations would result in observing the human dignity of victims during the post-emergency period, as well as families and economic recovery of the affected region. There are many toolkits and process models provided by international humanitarian agencies, but because of special conditions of Iran (sanctions/economy) and a large number of natural disasters, we need a localized process model on CBA for victims of natural disasters based on Information Technology (IT), which would lead to speed, accuracy, and transparency.
Methods: The research was performed in two phases. Through a systematic review in the first phase, we studied international models/toolkits and proposed a process model for CBA in Iran. In the second phase, the localized model was customized using Delphi based on experts opinions. The statistical population in the first phase was the international publications in addition to operational reports provided by local/international organizations/agencies from 2004 to 2019. In the second part, the statistical population included the executive managers of rescue and relief agencies and university professors in critical management from whom, 14 individuals were selected through targeted sampling and participated in Delphi rounds.
Results: In the first stage, by a systematic review, based on five well known international toolkits/models, researcher experiences, and experts, a process model was developed with five steps and 27 processes. In the first round of Delphi, four processes were rejected, and four new processes were added by experts. In the second and third rounds, the experts agreed with all of the items. The calculated Kendalls Coefficient of Concordance (KCC) value of 0.724 evidenced a good expert agreement on the obtained localized CBA model.
Conclusions: The localized process model on CBA for victims of natural disasters based on IT included 27 processes in five steps: (1) preparedness, (2) assessment, (3) response analysis, (4) implementation, and (5) monitoring, evaluation, and exit. These are localized processes agreed on by the Delphi panel expert, emphasizing hardware for e-transactions; victims, retailers, and wholesalers training in the fourth step; and program quality assurance and report to donors in the fifth step. The achieved theoretical process model would be a fundamental model to develop a process-based software application system for use in the future in Iran.
Ali Ramazan Benli; Suleyman Ersoy
Volume 22, Issue 4 , 2020
Abstract
Objectives: In this study on the steelworkers, we aimed to investigate the impact of wet cupping therapy (WCT) on heavy metal levels in the blood.
Methods: This single-arm clinical trial was performed at Karabuk University Training and Research Hospital from January to August 2018. All patients ...
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Objectives: In this study on the steelworkers, we aimed to investigate the impact of wet cupping therapy (WCT) on heavy metal levels in the blood.
Methods: This single-arm clinical trial was performed at Karabuk University Training and Research Hospital from January to August 2018. All patients received three WCT sessions once every month. Venous blood specimens were drawn prior to the first WCT session (venous 1) and following the third session (venous 2). Cupping blood samples were also obtained during the first session of WCT. Heavy metal levels were assessed by inductively coupled plasma mass spectrometry (ICP-MS) device. Thirteen metals were subject to examination: aluminum (Al), antimony (Sb), arsenic (As), cadmium (Cd), chrome (Cr), cupper (Cu), iron (Fe), lead (Pb), manganese (Mn), mercury (Hg), molybdenum (Mo), nickel (Ni), and zinc (Zn). Relationships between the blood samples were examined using Wilcoxon Signed Rank test by R statistical software.
Results: Forty-four subjects completed the study. The levels of Al, Cd, Cr, Cu, Mn, Mo, Ni, Sb (P < 0.001 in all), Hg (P = 0.024) and Pb (P = 0.012) were significantly lower in venous 2 samples compared to venous 1, while no significant changes were observed in the levels of Fe, Zn, and As (P = 0.575, P = 0.090 and P = 0.195, respectively). When compared to venous 1 the levels of Mn, Zn, As, Sb, Hg (P < 0.001 in all), Al (P = 0.003), Cr (P = 0.004), Cu (P = 0.022) and Mo (P = 0.014) were found significantly higher in cupping blood while Cd, Pb, and Ni were not at significantly different levels (P = 0.160, P = 0.079 and P = 0.713, respectively). Fe was found significantly lower in cupping blood (P < 0.001).
Conclusions: This study showed that WCT has significantly reduced heavy metal levels in the blood. It might be useful in workers who work in jobs where heavy metal toxicity can be seen.
Wang Shupeng; Yue Gu; Qingchun Guan; Ludong Tan; Ya Hui Liu
Volume 22, Issue 4 , 2020
Abstract
Background: Carcinosarcoma is a rare type of malignant tumor that can occur at various organs, such as the digestive tract, lung, and mammary glands (1-4). Carcinosarcoma of the pancreas is an extremely rare and complicated malignant neoplasm, with the characteristics of high invasiveness and rapid ...
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Background: Carcinosarcoma is a rare type of malignant tumor that can occur at various organs, such as the digestive tract, lung, and mammary glands (1-4). Carcinosarcoma of the pancreas is an extremely rare and complicated malignant neoplasm, with the characteristics of high invasiveness and rapid progression, early metastasis, and poor prognosis (4).
Case Presentation: We reported a 75-year-old male patient who was admitted with the chief complaint of intermittent pain in the right upper abdomen for more than one month. Computed tomography scans revealed a space-occupying lesion located in the tail of the pancreas considering pancreatic carcinoma. The patient underwent surgical resection of the tumor. Macroscopic observations showed a mass of approximately 6 cm x 5 cm with grayish-white cut surface. Histological analysis showed a large amount of abnormal differentiated epithelial cells and spindle cells. The immunohistochemistry results demonstrated biphasic neoplasm with both malignant epithelial and mesenchymal components. Then, the patient was diagnosed with carcinosarcoma of the pancreas. Although pancreatic carcinosarcoma was considered to have a poor outcome as previously reported, the patient was free of recurrence for 15 months after the surgery, a longer tumor-free survival recorded for this type of cancer, maybe because the patient received gemcitabine adjuvant chemotherapy after the surgery. The current literature shows that the longest postoperative survival time is 26 months (5).
Conclusions: Carcinosarcoma of the pancreas is a rare tumor. Surgery is the main way of treatment, and chemotherapy can delay tumor development to some extent.
Omolbanin Abaspour; Mohammad Akbari; Asghar Rezasoltani; Amir Ahmadi
Volume 22, Issue 4 , 2020
Abstract
Background: Cervicogenic headache (CGH) is a disabling condition associated with musculoskeletal impairment of the cervical region. There is limited evidence for the efficacy of muscle energy technique (MET) on CGH.
Objectives: The present study aimed to assess the effect of MET on CGH patients.
Methods: In ...
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Background: Cervicogenic headache (CGH) is a disabling condition associated with musculoskeletal impairment of the cervical region. There is limited evidence for the efficacy of muscle energy technique (MET) on CGH.
Objectives: The present study aimed to assess the effect of MET on CGH patients.
Methods: In this single-blinded, randomized, controlled study, thirty subjects with CGH aged 18 - 55years were randomly assigned into two groups, intervention group (MET in cervical muscles + infrared (IR) radiation) and control group (IR). Both groups received these interventions for 6 sessions, 3 times a week for two weeks. Outcome measures included headache index, upper cervical rotation range of motion (ROM), and deep upper cervical muscles thickness.
Results: In the intragroup analysis, the headache index and upper cervical rotation ROM were significantly different in the two groups (P < 0.05), but in the intergroup analysis, only left upper cervical rotation ROM was significantly different (P < 0.05). Additionally, all muscles thickness had no significant difference in intragroup and intergroup analyses (P > 0.05). The effect size was large in the MET group than that in the control group for ROM and headache index (d > 0.7), but this was less than medium for muscle thickness in the two groups (d < 0.5).
Conclusions: MET + IR is a suitable and durable approach for CGH treatment and increase of upper cervical rotation ROM rather than IR alone, but this approach cannot change the muscles thickness significantly in 2 weeks.
Irfan Koca; Recep Dokuyucu; Zeynel Abidin Tas; Hasan Gokce; Oguzhan Ozcan
Volume 22, Issue 4 , 2020
Abstract
Background: Osteonecrosis (ON) is a serious health problem, which dramatically reduces the quality of life.
Objectives: In the present study on the rat model of glucocorticoids (GCs) -induced ON, we explored the influence of alpha-lipoic acid on serum levels of TGF-?1 and urotensin-II (U-II) ...
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Background: Osteonecrosis (ON) is a serious health problem, which dramatically reduces the quality of life.
Objectives: In the present study on the rat model of glucocorticoids (GCs) -induced ON, we explored the influence of alpha-lipoic acid on serum levels of TGF-?1 and urotensin-II (U-II) and on histological alteration with respect to fatty degeneration and osteocyte necrosis.
Methods: A total of 32 male Wistar albino rats were equally assigned to four groups, including control, methylprednisolone acetate (MPA), alpha-lipoic acid (ALA), and MPA with ALA (MP1 + ALA). The animals in MPA group subcutaneously received 15 mg/kg/week during 2 weeks, whereas 100 mg/kg/day ALA was intraperitoneally administered to ALA group during 4 weeks. The MPA + ALA group had both treatments with the same doses. ON was confirmed and graded histologically. Lipid peroxidation and DNA damage levels were immunohistochemically assessed in rats bones.
Results: After histopathological examinations, ALA injection attenuated oxidative stress levels through reducing both 8-OHdG-and 4-HNE-positive cells in the femoral head region (P < 0.05). The U-II and TGF-?1 protein levels significantly decreased after ALA treatment in MPA injected animals (P < 0.05, P < 0.01, respectively). Moreover, there was a strong correlation between U-II and TGF-?1 protein levels (P = 0.019, r = 0.884).
Conclusions: This study is novel with regard to showing the therapeutic effects of ALA on GC-induced ON in rats as well as the strong correlation between the expression levels of U-II and TGF-?1 proteins. In this regard, ALA may be a therapeutic agent in the treatment of ON patients.
Fereshteh Mohammadizadeh; Somayeh Heydari
Volume 22, Issue 4 , 2020
Abstract
Background: Fibronectin plays a key role in the extracellular matrix. The expression of fibronectin and its impact on tumor behavior have been studied in several tumors such as breast carcinoma.
Objectives: We aimed at investigating the immunohistochemical expression of intracellular fibronectin ...
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Background: Fibronectin plays a key role in the extracellular matrix. The expression of fibronectin and its impact on tumor behavior have been studied in several tumors such as breast carcinoma.
Objectives: We aimed at investigating the immunohistochemical expression of intracellular fibronectin in breast carcinoma and its relationship with significant clinicopathological factors.
Methods: This case-control study was conducted on 125 formalin-fixed and paraffin-embedded tissue blocks, including 50 invasive breast carcinomas (tumor group) and their adjacent normal tissue (tumor control group), and 25 normal control samples from mammoplasty (normal control group). The samples were obtained from the pathology archive of Alzahra Hospital, Isfahan, Iran, from 2016 to 2018. All the 125 samples were stained immunohistochemically by the fibronectin antibody. Intracellular fibronectin expression was then compared between the three groups. Moreover, the relationship between fibronectin expression and some clinicopathological factors was evaluated in the tumor group.
Results: Fibronectin staining intensity and extent showed no significant difference between the normal control and tumor control groups (P-Value = 0.65 and 0.065, respectively), while the tumor group showed a significant difference from both normal control and tumor control groups in fibronectin staining intensity (P-Value = 0.002 and < 0.001, respectively) and fibronectin staining extent (P-Value < 0.001). In addition, a significant relationship between fibronectin expression in tumor samples and fibronectin staining intensity and tumor grade was observed (P-Value = 0.01). However, fibronectin expression did not show any significant relationship with age, tumor size, tumor subtype, and lymph node status.
Conclusions: Intracellular fibronectin expression seems to be a tendency observed in some breast carcinomas. Normal breast tissue, whether adjacent to carcinoma or normal control, does not show such a tendency. Despite the significant relationship between fibronectin expression and carcinoma grade, fibronectin expression did not show any significant relationship with tumor size and lymph node status.
Samaneh Motamed Jahromi; Sadegh Niami Jahromi
Volume 22, Issue 4 , 2020
Abstract
Background: Pumpkin seeds are rich in phytoestrogens (estrogen precursors) and can be good alternatives to synthetic estrogen therapy, without exerting destructive effects on renal and ovarian tissues.
Objectives: In the present study, the effect of hydro-alcoholic extract of pumpkin seeds ...
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Background: Pumpkin seeds are rich in phytoestrogens (estrogen precursors) and can be good alternatives to synthetic estrogen therapy, without exerting destructive effects on renal and ovarian tissues.
Objectives: In the present study, the effect of hydro-alcoholic extract of pumpkin seeds on estrogen levels was assessed in adult female rats and its effects on serum and tissue markers of kidney and ovaries.
Methods: In this experimental study, 32 adult Wistar female rats (at 60 days of age and weighing10 ± 180 g) were randomly divided into four groups of 8: three experimental groups and one control group. The three experimental groups received a hydro-alcoholic extract of pumpkin seed via intraperitoneal injection for 21 consecutive days (doses of 20, 50, and 100 mg/kg body weight, respectively). One day after the last injection, blood samples were taken from the rats to test serum levels of blood urea nitrogen (BUN), Creatinine, uric acid (UA), estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). Moreover, their kidneys and ovaries were removed for histological studies.
Results: The results showed significant increases in serum levels of FSH and LH and in the number of graph follicles in the experimental group 3, in addition to significant reduction in the number of primitive and primary follicles in the three experimental groups as compared with those in the control group, in the number of secondary follicles in the experimental group 1 compared with that in the experimental groups 2 and 3, and also in renal cortical thickness, Bowmans capsule thickness and glomerulus diameter in the experimental groups 1 and 2 compared with those in the control group (P < 0.05).
Conclousions: It can be concluded that the estrogen found in the hydro-alcoholic extract of pumpkin seeds can play a prominent role in ovulation with the least destructive effect on renal tissue. Hence, it may be a suitable alternative to synthetic estrogen and menstrual cycle regulators
Omid Salimi; Aliasghar Mohammadvand; Abbas Ebrahimi Kalan; Mohammad Charkhpour; Javad Mahmoudi; Bohlool Habibi Asl
Volume 22, Issue 4 , 2020
Abstract
Background: Spinal Cord Injury (SCI) is one of the leading causes of severe neurological deficits worldwide. The pathophysiology of SCI includes a primary injury followed by a cascade of secondary biochemical and cellular changes. Current pharmacological options are limited for significant recovery ...
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Background: Spinal Cord Injury (SCI) is one of the leading causes of severe neurological deficits worldwide. The pathophysiology of SCI includes a primary injury followed by a cascade of secondary biochemical and cellular changes. Current pharmacological options are limited for significant recovery from SCI. The ?-lactam antibiotic ceftriaxone (CEF) and N-acetylcysteine (NAC) have shown to induce neuroprotection in animal models of neurodegenerative disorders.
Objectives: This study aimed to evaluate the effects of CEF, NAC, and their combination on the functional recovery and histological damage in experimental SCI.
Methods: Rats were randomly divided into four groups (n = 7): Saline, CEF, NAC, and CEF + NAC. Then, SCI was performed on rats under general anesthesia using the Neurosciences Research Center (NSRC) impactor. Locomotor recovery following SCI was monitored using the locomotor rating scale of Basso, Beattie, and Bresnahan (BBB). At the end of the study, all rats were sacrificed, and spinal cord cross-sections were stained with hematoxylin and eosin for histopathological evaluation.
Results: The CEF and NAC administration, either alone or in combination (CEF + NAC), significantly improved locomotor recovery following SCI in rats when compared to the saline group. The histological analysis showed that the severity of histopathological lesion in the spinal cord of rats was significantly lower in the CEF, NAC, and CEF + NAC groups than in the saline group.
Conclusions: Treatment with CEF and NAC, either separately or in combination, promotes locomotor recovery following SCI, which is associated with the effective reduction of the histopathological lesion.
Seyedeh Shaghayegh Mirabdollah Elahi; Reza Mirnejad; Reza Kazempoor Reza Kazempoor; Fattah Sotoodehnejadnematalahi
Volume 22, Issue 4 , 2020
Abstract
Background: Over the past three decades, the use of probiotics has increased as growth promoters and effective supplements to reduce the pathogenicity of pathogens. In this regard, Lactobacillus bacteria are among the most common probiotics used, as they can help strengthening the digestive system ...
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Background: Over the past three decades, the use of probiotics has increased as growth promoters and effective supplements to reduce the pathogenicity of pathogens. In this regard, Lactobacillus bacteria are among the most common probiotics used, as they can help strengthening the digestive system and therefore reducing intestinal hystopathological damage when encountering pathogens.
Objectives: This study aimed to evaluate the histopathologic effects of Lactobacillus acidophilus as a dietary supplement in zebrafish ration, as an appropriate laboratory model, and in the exposure to Escherichia coli O157: H7.
Methods: In this project, 48 fish were grouped in 4 aquariums and monitored for 30 days; control group (C1A1) received basic ration; B1A1 group received control group ration and were exposed to E. coli O157: H7; Treatment 1 (T1A1) received basic ration containing L. acidophilus with no exposure to E. coliO157: H7, and Treatment 2 (T2A2) received basic ration containing L. acidophilus with exposure to E. coli O157: H7. During 30 days of the experiment, the samples were taken from the intestinal tissue in the days 15, 27, and 30 for the histopathological examinations.
Results: The results of the findings showed a significant increase in the length of the intestinal villi and the number of goblet cells in the studied tissue in the group treated with a ration containing probiotic supplements compared to the control group (P < 0.001, P < 0.01, P < 0.05). Also, in the group exposed to E. coli O157: H7, histopathological changes including mild edema, inflammatory cell accumulation in the intestinal mucosal tissue, severe necrosis and epithelium loss in the intestinal tissue were evident. These symptoms were much lower in the group fed with probiotic.
Conclusions: According to the obtained data, it can be concluded that feeding fish using L. acidophilus supplement can produce very beneficial effects in reducing tissue damage caused by E. coli O157: H7 infection in zebrafish intestines as a laboratory model.
Youfu Ke; Zemin Chen; Bo Peng
Volume 22, Issue 4 , 2020
Abstract
Background: Mainland China has adopted the most decisive and proactive measures to contain the SARS-CoV-2 epidemic, which helps control the spread of the virus across the country.
Objectives: Early epidemiological investigations found that the SARS-CoV-2 epidemic was more critical in Hubei ...
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Background: Mainland China has adopted the most decisive and proactive measures to contain the SARS-CoV-2 epidemic, which helps control the spread of the virus across the country.
Objectives: Early epidemiological investigations found that the SARS-CoV-2 epidemic was more critical in Hubei province (Hubei) than in rest parts of mainland China (Rest of China). A cross-sectional study was conducted to answer this urgent question and provide implications for the world.
Methods: Infected cases from Mainland China were divided into two groups: Hubei and the Rest of China. Prevention, quarantine, and treatment were based on The Novel Coronavirus Infected Pneumonia Diagnosis and Treatment Standards. Total confirmed cases, daily severe cases, total deaths, and total discharged cases were collected from January 20 to March 4 for statistical analysis.
Results: Hubei accounted for 83.9% of China's total confirmed cases and 96.3% of China's total deaths. The percentage of severe cases and the rate of fatality in Hubei were higher than those in the Rest of China (P < 0.01). Daily severe cases in Hubei hit the peak at 11,246 cases on February 18, compared to 989 cases on February 10 in the Rest of China. The percentages of daily severe cases in both regions declined throughout the epidemic, from 23.3% to 8.6% in Hubei compared to 15.0% to 1.3% in the Rest of China. The latest fatality rate in Hubei was 4.30%, which was much higher than 0.85% in the Rest of China. Up to March 4, 64.7% of China's total confirmed cases were cured, 3.86% died, and 31.5% were under treatment.
Conclusions: The implications for the world are cutting off the sources of infection and transmission routes, early detection, early isolation, and early treatment that can prevent the spread of SARS-CoV-2 and reduce the severity and fatality rate.
Xianwu Xia; Liang Sheng; Tiejun Yang; Guobing Zhang; Li Ding; Jianmin Shen; Jihong Feng
Volume 22, Issue 4 , 2020
Abstract
Background: Regarding the outbreak of highly contagious the 2019 Novel Coronavirus (2019-nCoV) in various countries and regions, data have been needed on the early chest CT images and clinical characteristics of the affected patients.
Objectives: To explore the early clinical and computed ...
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Background: Regarding the outbreak of highly contagious the 2019 Novel Coronavirus (2019-nCoV) in various countries and regions, data have been needed on the early chest CT images and clinical characteristics of the affected patients.
Objectives: To explore the early clinical and computed tomography (CT) characteristics of the 2019 Novel Coronavirus Disease (COVID-19) patients to improve the diagnostic level of this contagious respiratory disease.
Methods: An analysis retrospectively was implemented on the radiological features and clinical characteristics of 12 patients with COVID-19 who had undergone chest CT scanning in the designated hospital from Jan 23, 2020, to Feb 18, 2020. The clinical data on general information, epidemiological, cardinal symptoms, blood test, and CT imaging characteristics were obtained.
Results: According to the relevant diagnostic criteria, the patients were divided into two groups: mild (2 cases), and ordinary type (10 cases). The main symptoms of 2019-nCoV pneumonia were fever (9/12) and cough (8/12) with or without respiratory and other systemic symptoms. The blood test of the patients showed that most of the white blood cell count was normal (10/12), decreased lymphocyte count (6/12), and increased hypersensitive C reactive protein (hs-CRP) (5/12). In the early stage of COVID-19, the chest CT images showed patchy mixed ground-glass opacity (GGO) (8/12), mainly distributed in the periphery and posterior part of both lungs. The internal density of image lesion area was uneven, and lesions primarily manifested as "crazy-paving pattern" (8/12), with grid-like, interlobular septal thickening, thickened bronchovascular bundle and air bronchus sign and multiple fibrosis. A few cases showed pulmonary atelectasis (1/12), bilateral pleural effusion (1/12), no mediastinal or bilateral hilar lymph node enlargement.
Conclusions: The clinical characteristics of 2019-nCoV pneumonia are similar to those of common viral pneumonia. The chest CT images may be helpful for the early detection of novel coronavirus pneumonia.
Jinfeng Xiao; Hongyuan Zhou; Yuanyuan Guo
Volume 22, Issue 3 , 2020
Abstract
Background: The changes before and after fluid resuscitation in patients with septic shock and their relationship with prognosis have rarely been reported.
Objectives: We aimed to observe the correlation between pulmonary vascular permeability index (PVPI), shock index (SI), and severity of ...
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Background: The changes before and after fluid resuscitation in patients with septic shock and their relationship with prognosis have rarely been reported.
Objectives: We aimed to observe the correlation between pulmonary vascular permeability index (PVPI), shock index (SI), and severity of septic shock.
Methods: This case-control study retrospectively analyzed the clinical data of 154 patients with septic shock treated at our hospital (Weifang, China) from October 2016 to October 2018. They were divided into a survival group or a death group according to the 28-day prognosis. Univariate analysis was performed for vital signs, the acute physiology and chronic health evaluation II (APACHE-II) score, the sequential organ failure assessment (SOFA) score at admission, SI at admission (SI1), SI at 3 h after fluid resuscitation (SI2), PVPI at admission (PVPI1), PVPI at 3 h after fluid resuscitation (PVPI2), and lactate clearance rate (LCR). The correlations of PVPI and SI with the APACHE-II score, SOFA score, and LCR were analyzed by plotting the receiver operating characteristic curves.
Results: Among the 154 cases, 70 survived after 28 days and 84 died. We observed that SI1, SI2, PVPI1, PVPI2, APACHE-II score, and SOFA score were significantly lower in the survival group than in the death group, while LCR was significantly higher (P < 0.05). Also, SI1, SI2, PVPI1, and PVPI2 were positively correlated with APSCHE-II and SOFA scores of patients with septic shock, but negatively correlated with LCR (P < 0.05). Moreover, SI2 predicted the prognosis of patients with septic shock significantly better than SI1, PVPI1, and PVPI2 did. When SI2 was 1.22, the Youden index was 0.822, the sensitivity was 91.23%, the specificity was 89.47%, the positive predictive value was 0.912, and the negative predictive value was 0.924. The positive and negative likelihood ratios were 0.897 and 0.375, respectively.
Conclusions: Based on the study, SI after fluid resuscitation was more valuable for evaluating the prognosis of patients with septic shock than SI at admission, as well as PVPI values at admission and after fluid resuscitation.
Narges Karimi; Athena Sharifi Razavi; Nima Rouhani
Volume 22, Issue 3 , 2020
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) is a novel coronavirus that was extracted from patients with respiratory tract infections. The most common symptoms of patients are fever and respiratory tract involvement. In this report, we describe one patient with frequent seizures probably due ...
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Introduction: Coronavirus disease 2019 (COVID-19) is a novel coronavirus that was extracted from patients with respiratory tract infections. The most common symptoms of patients are fever and respiratory tract involvement. In this report, we describe one patient with frequent seizures probably due to COVID-19 infection for the first time.
Case Presentation: A 30-year-old previously healthy female was admitted with generalized tonic-clonic seizure in the neurology emergency room. The patient complained of dry cough five days before the admission. She had seizures (five times) approximately every 8 hours. Brain MRI was normal and chest CT revealed focal ground-glass opacities. The respiratory specimen was positive for COVID-19 using real-time PCR assay. The symptoms of the patient improved with anticonvulsive and antiviral medications.
Conclusions: To the best of our knowledge, this is the first case study to report an association between frequent seizures and COVID-19. In our opinion, there is a hypothesis about this subject that the etiology of seizure may be due to encephalitis and invasion virus to the brain or toxic effect of inflammatory cytokines.
Hamzeh Baharlouei; Ebrahim Sadeghi-demneh; Mohammad Mehravar; Parisa Manzari; Mohammad Jafar Shaterzadeh Yazdi; Mohammad Taghi Joghataei; Shapour Jaberzadeh
Volume 22, Issue 3 , 2020
Abstract
Background: Falling is a major problem in older adults. Transcranial direct current stimulation (tDCS) is a neuromodulation technique to improve balance in the elderly. The majority of previous studies have assessed the effects of cerebellar and primary motor cortex (M1) tDCS, while less attention ...
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Background: Falling is a major problem in older adults. Transcranial direct current stimulation (tDCS) is a neuromodulation technique to improve balance in the elderly. The majority of previous studies have assessed the effects of cerebellar and primary motor cortex (M1) tDCS, while less attention has been paid to the comparison of the effects of tDCS in these two regions.
Objectives: The goal of this study was to compare the effectiveness of cerebellum and M1 tDCS on the balance in older adults.
Methods: In this double-blind sham-controlled crossover study, a total of 32 healthy older adults were randomly assigned to two groups of M1 and cerebellum tDCS. Each group received active and sham stimulation with a crossover design within a one-week interval. The intensity and duration of tDCS were 2 mA and 20 minutes, respectively. Before and after each session, the total path length (TPL) and mean velocity (MV) of the center of pressure were determined using a force plate in both mediolateral and anteroposterior directions under single-task and dual-task conditions.
Results: The results of mixed ANOVA test showed that the main effect of time on TPL and MV was significant in both mediolateral (P < 0.01) and anteroposterior (P = 0.01) directions. The interaction between time and stimulation was also significant on TPL and MV in both mediolateral (P < 0.001) and anteroposterior (P < 0.001) directions. The between-group analysis showed no significant difference in the efficacy of cerebellar and M1 tDCS in the mediolateral (P = 0.79) and anteroposterior (P = 0.60) directions.
Conclusions: Anodal tDCS of the cerebellum and M1 could improve the postural balance indices in healthy older adults. These two techniques exerted similar effects on static balance.
Xiao-Jing Zhao; Qun-Xi Li; Ying Liu; Li-Sha Chang; Rui-Ying Chen; Hai-Yan Fan; Fu-Xia Zheng
Volume 22, Issue 3 , 2020
Abstract
Background: Acute cerebral infarction (ACI) is a common cerebrovascular disease that seriously endangers human health. It is very important to carry out disease assessments to rescue patients who may suffer from preventable death.
Objectives: This study aimed to explore the predictive value ...
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Background: Acute cerebral infarction (ACI) is a common cerebrovascular disease that seriously endangers human health. It is very important to carry out disease assessments to rescue patients who may suffer from preventable death.
Objectives: This study aimed to explore the predictive value of concomitant disease scoring for the prognosis of patients with ACI.
Methods: This is a respective observational study. A total of 399 patients with ACI from the Affiliated Hospital of North China University of Science and Technology, who met the inclusion criteria, were enrolled in the present study. The concomitant disease score was assessed within 24 hours after admission, and the risk degree of death was analyzed. Then, the goodness of fit test and validity analysis were carried out, and the best survival/death cut-off value was determined.
Results: The area under the receiver operating characteristic (ROC) curve for the concomitant disease score was 0.700, the distinctiveness was relatively good, and the prediction cut-off value was 10 points. Furthermore, the mortality rate of patients with a higher score was significantly higher compared to patients with a lower score.
Conclusions: The concomitant disease score has good predictive value for the prognosis of ACI patients, and is an ideal system for evaluating the condition of cerebral infarction.
Samaneh Roohi; Javad Salehi; Habibollah Mahmoodzadeh; Zekrolah Morovati
Volume 22, Issue 3 , 2020
Abstract
Background: Psychological factors play important roles in mental and physical outcomes of cancer, like disability and positive growth after exposure to cancer trauma.
Objectives: This study aimed to investigate the mediating role of health literacy in the relationship of social support and ...
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Background: Psychological factors play important roles in mental and physical outcomes of cancer, like disability and positive growth after exposure to cancer trauma.
Objectives: This study aimed to investigate the mediating role of health literacy in the relationship of social support and coping strategies with post-traumatic growth and functional disability among patients with cancer.
Methods: The present descriptive, cross-sectional study included 265 patients (142 women and 123 men) with various types of cancer selected by a convenience sampling method among patients referring to the Cancer Clinics of Imam Khomeini Hospital in Tehran, Iran. Data were collected by the "WHO Disability Assessment schedule", "post-traumatic growth inventory", "Functional, Communicative, and Critical Health Literacy scale", "Social Support scale", and "Brief Cope scale". Data were analyzed by structural equation modeling (SEM) using AMOS-24 and SPSS-20 software.
Results: The results showed that social support had a significant positive correlation with post-traumatic growth (P ? 0.001) and health literacy (P ? 0.001) and a significant negative correlation with functional disability (P ? 0.001). There was a significant positive correlation between avoidance-coping strategies and post-traumatic growth (P ? 0.001) and functional disability (P ? 0.051). Problem-focused coping strategies had a significant positive correlation with health literacy (P ? 0.051) and there was a significant negative correlation between health literacy and functional disability (P ? 0.001). Additionally, health literacy had a mediating role in the relationship between social support and functional disability (P ? 0.001) and between problem-focused coping strategies and functional disability (P ? 0.001).
Conclusions: Social support and coping strategies directly or through the mediating role of health literacy are important predictors of post-traumatic growth and functional disability among patients with cancer, suggesting the need for intervening and educating in these areas to improve patients' physical and mental status.
Hadi Ahmadi Amoli; Abbas Naeej; Neda Nilforoushan; Hossein Zabihi Mahmoudabadi; Ehsan Rahimpour; Amir Ashraf-Ganjouei
Volume 22, Issue 3 , 2020
Abstract
Background: Acute appendicitis is one the most common and sometimes life threatening conditions in the Emergency Department referrals. Since suspected cases of acute appendicitis require immediate diagnosis and proper intervention, the computed tomography (CT) scan becomes the most frequently used modality ...
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Background: Acute appendicitis is one the most common and sometimes life threatening conditions in the Emergency Department referrals. Since suspected cases of acute appendicitis require immediate diagnosis and proper intervention, the computed tomography (CT) scan becomes the most frequently used modality for such conditions. However, due to the nature of emergency wards, gastrointestinal (GI) expert radiologists may not be always available.
Objectives: The current study aimed at comparing the interobserver variability of GI expert radiologists, general radiologists, and radiology residents in in CT-scan interpretation of cases suspected of acute appendicitis.
Methods: Seventy patients suspected of acute appendicitis admitted to the Emergency Department of our university hospital were included in the study. CT-scan with intravenous contrast was performed on patients that their Alvarado score ranged 5 to 8. Decision for surgical or non-surgical management of patients was made by the routine treatment team of hospital and retrospectively, CTscan
images of all 70 patients were reported blindly by three groups of radiologists.
Results: Out of the 70 cases, 48 had positive confirmatory pathology for appendicitis (69%) and 22 had negative pathology report (31%). The sensitivity of the reports for radiology residents, general radiologists, and GI expert radiologists was 81.3%, 93.8% and 95.8%, respectively. The specificity of the diagnosis in the three groups was 72.7%, 86.4% and 81.8%, respectively.
Conclusions: The study results showed that although the interpretation was not perfect, radiology residents and general radiologists can provide reports with acceptable sensitivity and specificity in the emergency ward.
Mahyar Riahi; Kazem Parivar; Javad Baharara; Reza Zandi
Volume 22, Issue 3 , 2020
Abstract
Background: The major function of the bone in the skeletal system is to provide structural support to the body and its vital organs. Many patients suffer from the disability to restore bone lesions following bone fractures during crashes or accidents. The use of mesenchymal stem cells such as adipose-derived ...
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Background: The major function of the bone in the skeletal system is to provide structural support to the body and its vital organs. Many patients suffer from the disability to restore bone lesions following bone fractures during crashes or accidents. The use of mesenchymal stem cells such as adipose-derived mesenchymal stem cells (ADMSCs), along with collagen scaffolds, and its transfer to the lesion site can be valued as one of the available treatment options.
Objectives: In the current paper, a study was conducted on the level of mesenchymal stem cell repair from the rat adipocytes, where it was evaluated in bone defects.
Methods: In this study, mesenchymal stem cells were isolated from the rat adipocytes and their stem cell lines were determined with the standard cell tests. The isolated cells were differentiated in the next step and transferred to the two main groups: nicotine modeled and non-modeled (non-nicotine) along with collagens. The repair of the defect caused by a 2 mm drill in the diaphyseal region of the rat bone was evaluated after four weeks using radiographic examination and histopathologic staining.
Results: Radiographic data analysis indicated that bone density was much higher in the non-nicotine group than in the nicotine group. Histopathologic staining showed that bone formation was higher in the non-nicotine group than in the nicotine group. The new bone formation was about 80% and 60% in the non-nicotine and nicotine groups with differentiated osteocytes of ADMSCs, respectively.
Conclusions: Adipose-derived mesenchymal stem cell transplantation is effective in bone defect repair and nicotine plays an important role in the bone repair process as an inhibitory agent.
Ahmad Hormati; Faezeh Alemi; Seyed Hasan Adeli; Mohaddeseh Zojaji
Volume 22, Issue 3 , 2020
Abstract
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is an uncommon systemic allergic reaction, which usually occurs due to a specific medication. The most common presentation is fever, skin eruption, and lymphadenopathy that presents two to eight weeks after exposure to the culprit ...
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Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is an uncommon systemic allergic reaction, which usually occurs due to a specific medication. The most common presentation is fever, skin eruption, and lymphadenopathy that presents two to eight weeks after exposure to the culprit drug. In some cases, evidence of internal organ involvement including renal failure, respiratory symptoms, or liver involvement may present. These symptoms may present weeks to months after the exposure or even discontinuing the drug, which makes the diagnosis challenging. This report presents a young man with first presentation of icter and elevated liver enzymes, whose laboratory and imaging studies failed to diagnose the disease. A liver biopsy was performed and the pathologist reported hepatocellular carcinoma (HCC). A high level of serum alpha-fetoprotein was consistent with the histologic findings, but concerning the uncommon clinical setting, the pathologic specimen was reviewed by another pathologist, which reported hepatocyte regeneration following hepatitis. This finding was consistent with elevated serum alpha-fetoprotein. A retrospective review revealed the history of using ceftriaxone nine months before the presentation and his final diagnosis was the DRESS syndrome with a dramatic response to corticosteroid treatment.
