The global prevalence of gastric cancer in Helicobacter pylori-infected individuals: a systematic review and meta-analysis

BACKGROUND

Helicobacter pylori is a gastrointestinal pathogen that infects around half of the world's population. H. pylori infection is the most severe known risk factor for gastric cancer (GC), which is the second highest cause of cancer-related deaths globally. We conducted a systematic review and meta-analysis to assess the global prevalence of GC in H. pylori-infected individuals.

METHODS

We performed a systematic search of the PubMed, Web of Science, and Embase databases for studies of the prevalence of GC in H. pylori-infected individuals published from 1 January 2011 to 20 April 2021. Metaprop package were used to calculate the pooled prevalence with 95% confidence interval. Random-effects model was applied to estimate the pooled prevalence. We also quantified it with the I2 index. Based on the Higgins classification approach, I2 values above 0.7 were determined as high heterogeneity.

RESULTS

Among 17,438 reports screened, we assessed 1053 full-text articles for eligibility; 149 were included in the final analysis, comprising data from 32 countries. The highest and lowest prevalence was observed in America (pooled prevalence: 18.06%; 95% CI: 16.48 - 19.63; I2: 98.84%) and Africa (pooled prevalence: 9.52%; 95% CI: 5.92 - 13.12; I2: 88.39%). Among individual countries, Japan had the highest pooled prevalence of GC in H. pylori positive patients (Prevalence: 90.90%:95% CI: 83.61-95.14), whereas Sweden had the lowest prevalence (Prevalence: 0.07%; 95% CI: 0.06-0.09). The highest and lowest prevalence was observed in prospective case series (pooled prevalence: 23.13%; 95% CI: 20.41 - 25.85; I2: 97.70%) and retrospective cohort (pooled prevalence: 1.17%; 95% CI: 0.55 - 1.78; I 2: 0.10%).

CONCLUSIONS

H. pylori infection in GC patients varied between regions in this systematic review and meta-analysis. We observed that large amounts of GCs in developed countries are associated with H. pylori. Using these data, regional initiatives can be taken to prevent and eradicate H. pylori worldwide, thus reducing its complications.

Prevalence, diagnosis, and manifestations of brucellosis: A systematic review and meta-analysis

Objectives

Brucellosis is one of the most prevalent zoonotic diseases common between humans and animals. Despite eradication efforts, the burden of the disease is well-known in endemic countries and in countries where brucellosis has not been an important health issue until recently. The aim of this study was to evaluate the prevalence, diagnosis, and manifestations of brucellosis.

Methods

In this study, PubMed, Web of Science, Scopus, Embase, and Google scholar databases were systematically searched to find studies published from 2011 to 2021. The search was conducted using text words and Medical Subject Headings (MeSH) Terms on the prevalence of brucellosis. Stata software 14.0 was used for all analyses.

Results

Based on the results, the pooled prevalence of brucellosis was 15.27% (95% CI: 9.68-21.86; heterogeneity I 2 index: 97.43; p < 0.001) for man and 15.33% (95% CI: 7.19-25.75; heterogeneity I 2 index: 98.19; p < 0.001) for woman. Age (coefficient: 0.240; p = 0.480), gender (coefficient: -0.017; p = 0.800), and publication year (coefficient: 0.114; p = 0.861) showed no significant effect on heterogeneity among studies. Egger's test indicated a significant publication bias for the prevalence of brucellosis (coefficient 3.894; p < 0.001). Moreover, the trim-and-fill method exhibited that the adjusted prevalence of brucellosis (18.30%, 95% CI: 14.10-22.52) was not significantly different from the original prevalence of brucellosis.

Conclusion

The pooled estimate for brucellosis prevalence was estimated as 15.53%. To better understand the epidemiology of brucellosis globally, more extensive studies are needed to be conducted throughout the world, especially in developing and low-income countries.

Viral vector and nucleic acid vaccines against COVID-19: A narrative review

After about 2 years since the first detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in Wuhan, China, in December 2019 that resulted in a worldwide pandemic, 6.2 million deaths have been recorded. As a result, there is an urgent need for the development of a safe and effective vaccine for coronavirus disease 2019 (COVID-19). Endeavors for the production of effective vaccines inexhaustibly are continuing. At present according to the World Health Organization (WHO) COVID-19 vaccine tracker and landscape, 153 vaccine candidates are developing in the clinical phase all over the world. Some new and exciting platforms are nucleic acid-based vaccines such as Pfizer Biontech and Moderna vaccines consisting of a messenger RNA (mRNA) encoding a viral spike protein in host cells. Another novel vaccine platform is viral vector vaccine candidates that could be replicating or nonreplicating. These types of vaccines that have a harmless viral vector like adenovirus contain a genome encoding the spike protein of SARS-CoV-2, which induces significant immune responses. This technology of vaccine manufacturing has previously been used in many human clinical trials conducted for adenoviral vector-based vaccines against different infectious agents, including Ebola virus, Zika virus, HIV, and malaria. In this paper, we have a review of nucleic acid-based vaccines that are passing their phase 3 and 4 clinical trials and discuss their efficiency and adverse effects.

A Comprehensive Review of the Protein Subunit Vaccines Against COVID-19

Two years after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), in December 2019, the first infections were identified in Wuhan city of China. SARS-CoV-2 infection caused a global pandemic and accordingly, 5.41 million deaths worldwide. Hence, developing a safe and efficient vaccine for coronavirus disease 2019 (COVID-19) seems to be an urgent need. Attempts to produce efficient vaccines inexhaustibly are ongoing. At present time, according to the COVID-19 vaccine tracker and landscape provided by World Health Organization (WHO), there are 161 vaccine candidates in different clinical phases all over the world. In between, protein subunit vaccines are types of vaccines that contain a viral protein like spike protein or its segment as the antigen assumed to elicit humoral and cellular immunity and good protective effects. Previously, this technology of vaccine manufacturing was used in a recombinant influenza vaccine (RIV4). In the present work, we review protein subunit vaccines passing their phase 3 and 4 clinical trials, population participated in these trials, vaccines manufactures, vaccines efficiency and their side effects, and other features of these vaccines.

Clinical Manifestations, Imaging Procedures and Laboratory Parameters among Hospitalized Patients with COVID-19 in Ilam Province, Western Iran

Background

COVID-19 is the last global threat which WHO confirmed it as a pandemic on March 11, 2020. In the Middle East, Iran was the first country where the SARS-Cov-2 was detected. The epidemiological and economic challenges of Iran make this country a particularly relevant subject of study. In the current study, we aimed to evaluate the clinical, radiological and laboratory findings in hospitalized COVID-19 confirmed cases in Ilam province, western of Iran.

Methods

Overall, 2204 hospitalized RT-PCR confirmed patients with COVID-19 were considered in this study. Electronic medical records, including clinical symptoms, radiological images, laboratory findings, and the comorbidities of patients with COVID-19 were collected and analyzed. In addition, the medication regimens used in these patients were evaluated. The patients were classified in discharged and died groups according to their outcomes. Then, clinical, radiological and laboratory findings as well as treatment regimens and underlying diseases were compared in these two groups.

Results

Among the patients, 1209 (54.85%) were male and 995 (45.14%) were female. Pneumonia, dyspnea and cough, were the most common clinical data in both discharged and died groups. Among the comorbidities, COPD, and cancer were significantly more common in the dead patients than in the living. The results of laboratory tests showed that blood creatinine, BUN, ESR, Na+, WBC, and neutrophil count have increased in deceased group compared to the survivors. However, the lymphocyte count decreased in deceased patients. The evaluation of radiographs demonstrated that there were significant correlations between bilateral pneumonia, ground glass opacity, bilateral patchy shadowing, and pleural effusion with death.

Conclusion

The current investigation indicated the special profile of COVID-19 in west of Iran. Discharged and dead patients with COVID-19 had distinct clinical, radiological and laboratory features, which were separated by principal component analysis. Identifying these characteristics of the disease would translate into the implementation of practical measures to improve results.

Tuberculosis challenges: Resistance, co-infection, diagnosis, and treatment

Early diagnosis of tuberculosis (TB), followed by effective treatment, is the cornerstone of global TB control efforts. An estimated 3 million cases of TB remain undetected each year. Early detection and effective management of TB can prevent severe disease and reduce mortality and transmission. Intrinsic and acquired drug resistance of Mycobacterium tuberculosis (MTB) severely restricted the anti-TB therapeutic options, and public health policies are required to preserve the new medications to treat TB. In addition, TB and HIV frequently accelerate the progression of each other, and one disease can enhance the other effect. Overall, TB-HIV co-infections show an adverse bidirectional interaction. For HIV-infected patients, the risk of developing TB disease is approximately 22 times higher than for persons with a protective immune response. Analysis of the current TB challenges is critical to meet the goals of the end TB strategy and can go a long way in eradicating the disease. It provides opportunities for global TB control and demonstrates the efforts required to accelerate eliminating TB. This review will discuss the main challenges of the TB era, including resistance, co-infection, diagnosis, and treatment.

An ultra-sensitive optical aptasensor based on gold nanoparticles/poly vinyl alcohol hydrogel as acceptor/emitter pair for fluorometric detection of digoxin with on/off/on strategy

A novel nanobiosensor was prepared by aptamer and gold nanoparticles conjugate in poly vinyl alcohol hydrogel for sensitive detection of digoxin in human plasma samples. The developed nanobiosensor was characterized by Fourier transform infrared spectroscopy, transmission electron microscopy, and dynamic light scattering instrument. In this sensor the hydrogel acted as a fluorescent probe. The fluorescence intensity of the hydrogel was quenched by aptamer stabilized gold nanoparticles as energy acceptor. Upon addition of digoxin, the aptamer/drug complex was formed and the fluorescence of the hydrogel was restored because of destabilization and aggregation of gold nanoparticles in the presence of salt. The affecting parameters on the nanobiosensor performance were assessed and under the optimized conditions the external and in plasma calibration curves were linear in the 10-1000 ng L^-1 digoxin concentration range with detection limits of 2.9 and 3.1 ng L^-1, respectively. The relative standard deviations for 5 replicate determinations of 50, 250, and 500 ng L^-1 of digoxin, were 7.3, 5.1, and 3.8%, respectively. This nanofluoroprobe was successfully applied for determination of digoxin in spiked plasma samples without any pretreatment procedure.

A novel strategy for detection of small molecules based on aptamer/gold nanoparticles/graphitic carbon nitride nanosheets as fluorescent biosensor

Herein, a novel ultrasensitive strategy has been developed by designing a label free fluorescent nano-aptasensor for monitoring of small moecules in human plasma. In this nano-aptasensor, graphitic carbon nitride nanosheets were used as fluorescent probe. The fluorescence intensity of the probe was decreased by interaction between graphitic carbon nitride nanosheets and label-free aptamer/gold nanoparticles conjugate, via Fluorescence resonance energy transfer mechanism. Upon addition of the analyte, the fluorescence of graphitic carbon nitride nanosheets was restored due to the aptamer/analyte interaction, and the aggregation of gold nanoparticles in the presence of salt. The influence of various factors on sensing method was investigated, and under the approved conditions, the fluorescence signal showed a linear relation with Digoxin concentration in the range of 10-500 ng L^-1 with limit of detection down to 3.2 ng L^-1 relative standard deviations for 25, 100 and 500 ng L^-1 of analyte concentrations were 2.6, 4.0 and 6.5%, respectively. This strategy provided a simple, rapid, cost effective and reproducible experimental model, with successful application for determination of Digoxin in plasma samples without any pretreatment steps.

Protective effects of quercetin against oxidative stress induced by bisphenol-A in rat cardiac mitochondria

Research has shown a relationship between the exposures to a chemical agent called bisphenol-A (BPA), which is extensively used in the production of polycarbonate plastics and the incidence of cardiovascular diseases. This association is most likely caused by the BPA's ability to disrupt multiple cardiac mechanisms, including mitochondrial functions. Therefore, this study aimed to explore the ability of quercetin (QUER) to limit the cardiotoxic effect of BPA in the rat's cardiac mitochondria. The experiment was carried out on 32 male Wistar rats, which were randomly assigned to four groups. The negative control group received olive oil; the positive control group received olive oil plus BPA (250 mg/kg); the third group received olive oil, BPA, and QUER (75 mg/kg); and the fourth group received olive oil and QUER, all orally for 14 days. The rats were slaughtered 24 h after the last treatment. The measured parameters included creatine kinase-MB (CK-MB) and lactate dehydrogenase (LDH) as the biomarkers of cardiotoxicity, triglyceride (TG), total cholesterol (TC), and low-density and high-density lipoprotein cholesterol (LDL-C and HDL-C) as the measures of dyslipidemia, glutathione (GSH) content, catalase activity (CAT), reactive oxygen species (ROS), lipid peroxidation (LPO), and the level of damage to the mitochondrial membranes as the indicators of the impact of QUER on the BPA cardiotoxic effect. Finally, the rats treated with QUER showed better results in terms of serum CK-MB, serum LDH, serum lipid profile, GSH level, CAT activity, mitochondrial membrane potential (ΔΨm), LPO, and ROS. According to the results, QUER could be used as a protective agent against BPA-induced mitochondrial toxicity.

Diosmin ameliorative effects on oxidative stress and fibrosis in paraquat-induced lung injury in mice

Paraquat (PQ) induces pulmonary fibrosis, a progressive lung disorder resulting in severe respiratory failure and death. Increased oxidative stress, inflammatory reactions, and multiple fibrotic lesions are major features of PQ-induced lung injury. Diosmin (Dio) is a safe drug that is available for clinical use for vascular disorders. Dio exhibits antioxidant, anti-inflammatory, and antifibrotic activities. Accordingly, the aim of this study was to evaluate the protective effect of diosmin on PQ-induced lung injury in mice and the underlying mechanisms involved. Lung injury was induced by PQ (30 mg/kg, intraperitoneally) in NMRI albino mice and Dio (50 and 100 mg/kg, gavage) was administrated 3 days before PQ and continued for 10 or 24 days. After euthanizing the mice, the biochemical and histopathological markers of lung tissue were determined. PQ significantly increased oxidative stress, inflammatory, and fibrotic markers. PQ increased the level of malonedaldehyde (MDA) and hydroxyproline (HYP) and decreased the level of glutathione (GSH) and catalase activity in the lung. Dio (50 and 100 mg/kg) significantly increased GSH levels and catalase activity and decreased HYP content and MDA levels. In addition, Dio reduced histopathological injuries in hematoxylin and eosin-stained and Masson's trichrome-stained sections. These findings suggest that Dio has protective effects against PQ-induced lung injury, which may be due to its antioxidant, anti-inflammatory, and antifibrotic effects.

Finite elastic wrinkling deformations of incompressible fiber-reinforced plates

A two-dimensional plate theory, valid for finite elastic deformations with small strains, is derived for incompressible, fiber-reinforced materials. Single-layer plates and two-layer laminates are considered. Numerical simulations illustrate the substantial effect that fiber reinforcement has on wrinkling patterns in the sheet.

Antifungal effect of the effect of Securigera securidaca L. vaginal gel on Candida species

BACKGROUND AND PURPOSE

Candida species are opportunistic fungi, capable of causing acute and chronic infections in the gastrointestinal tract, vagina, and oral mucosa, among which Candida albicans is the most important species. The Securigera securidaca L. is used as an antiseptic to treat some diseases in traditional Iranian medicine. The aim of this study was to evaluate the antimicrobial activity of S. securidaca extracts and vaginal gel against different Candida species.

MATERIALS AND METHODS

Antifungal effects of different extracts and vaginal gel of S. securidaca were investigated against Candida species. By using well diffusion test, different concentrations of the collected S. securidaca extracts and vaginal gel were examined to test their antifungal activity against C. albicans, C. parapsilosis, and C. krusei.

RESULTS

The ethanol extract and vaginal gel with the ethanol extract of S. securidaca showed the most anti-fungal activity against all three strains.

CONCLUSION

The S. securidaca extract had a significant inhibitory effect on the different species of Candida; however, the highest inhibitory effect was found against C. albicans. In order to treat candidiasis, more research is required to check the efficacy of this plant in this domain.

The ameliorative effect of quercetin on bisphenol A-induced toxicity in mitochondria isolated from rats

Recent studies have demonstrated that bisphenol A (BPA) has an adverse or toxic effect on the kidney. This study was designed to evaluate the ability of quercetin (QUER) to prevent BPA-induced mitochondrial dysfunction. Thirty-two healthy adult male Wistar rats were randomly divided into four groups, as follows: control group (olive oil), BPA group (250 mg/kg), BPA þ QUER group (250 mg/kg + 75 mg/kg), and QUER group (75 mg/kg). All treatments were orally administered for 14 days. Kidney mitochondria were isolated by administration of the different centrifugation method. Uric acid and creatinine were considered to be biomarkers of nephrotoxicity. The ameliorative effects of QUER on BPA toxicity were evaluated by determining the glutathione (GSH) content, CAT, the damage to the mitochondrial membrane, the reactive oxygen species (ROS), and lipid peroxidation (LPO). Administration of BPA significantly decreased kidney weight. In the kidney, BPA can deplete GSH content and CAT activity, increase the mitochondrial ROS formation, and enhances LPO and mitochondrial membrane damage. The pretreatment of mitochondria with QUER has the ability to reduce the toxic effects of BPA in isolated mitochondria. These findings suggest a potential role for QUER in protecting mitochondria from oxidative damage in kidney tissue.

Patient satisfaction with occlusal scheme of conventional complete dentures: A randomised clinical trial (Part II)

The occlusion of choice is a controversial topic in conventional complete denture (CCD) treatment. This study aimed to compare patient satisfaction with CCD with partially group-function occlusion (PGFO), fully bilateral balanced occlusion (FBBO), buccalised occlusion (BO), lingualised occlusion (LO) and the entire balanced group. Participants received new CCDs with PGFO. All steps of patient enrolment, denture fabrication, assessments during the follow-up period and data collection were carried out exactly the same as part 1 of this research project. All patients were recalled at 1 and 3 months after delivery for data collection using the shortened version of oral health impact profile for edentulous patients (OHIP-EDENT) questionnaire and 7 visual analog scales (VASs) for the quality of CCD based on general patient satisfaction, masticatory function, ability to speak, comfort, stability, retention and aesthetics. Data were analysed using the Wilcoxon signed-rank test, the Kruskal-Wallis test and Mann-Whitney test via SPSS version 18.0 (α = 0.05). Thirty participants completed the follow-up period for PGFO group. The mean age ± standard deviation of the new participants was 57.97 ± 6.93 years. Participants reported significantly less satisfaction in terms of comfort, stability and retention of denture with PGFO compared to balanced groups. Also, using OHIP-EDENT questionnaire, significantly higher physical pain score was noted for PGFO group compared to BO and LO. Higher physical disability score was noted in PGFO compared to LO. Participants receiving CCDs with PGFO reported lower satisfaction in terms of comfort, stability and retention of denture and higher physical pain and physical disability than the balanced occlusal schemes.

Effects of Quercetin on Tubular Cell Apoptosis and Kidney Damage in Rats Induced by Titanium Dioxide Nanoparticles

Background

Recent studies have demonstrated that many nanoparticles have an adverse or toxic effect on the kidney.

Objective

To investigate the nephroprotective effect of quercetin (QT) against renal injury induced by titanium dioxide nanoparticles (NTiO2) in rats.

Methods

NTiO₂-intoxicated rats received 50 mg/kg of NTiO₂ for seven days. The QT + NTiO₂ group was pretreated with QT for seven days before being administered NTiO₂. Uric acid, creatinine, and blood urea nitrogen were considered to be biomarkers of nephrotoxicity. Catalase (CAT) and superoxide dismutase (SOD) activities and renal levels of malondialdehyde (MDA) were measured to assess the oxidative stress caused by NTiO₂.

Results

NTiO₂ significantly increased the plasma level of the biomarkers. It also significantly decreased the activities of CAT (P = 0.008) and SOD (P = 0.004), and significantly increased the MDA levels (P = 0.007). NTiO₂ caused proximal tubule damage, the accumulation of red blood cells, the infiltration of inflammatory cells, and reduced the glomerular diameters, as well as induced apoptosis in the proximal tubules. Pre-treatment with QT attenuated the histological changes, normalised the plasma biomarkers, suppressed oxidative stress, ameliorated the activities of CAT (P = 0.007) and SOD (P = 0.006), and reduced apoptosis (P < 0.001).

Conclusion

QT was found to have a potent protective effect against nephrotoxicity induced by NTiO₂ in rats. It also reduced apoptosis caused by NTiO₂.

Chemical composition and antifungal effect of hydroalcoholic extract of Allium tripedale (Tvautv.) against Candida species

Background and Purpose

Treatment of life-threatening fungal infections caused by Candida species has become a major problem. Candida spp. are the most important causative agents of candidiasis. Allium tripedale is a medicinal plant that has been traditionally used to treat infections. In the present study, we aimed to determine the chemical compounds and antimicrobial activity of hydroalcoholic extract of A. tripedale against different species of Candida.

Materials and Methods

Phytochemical analysis was performed to identify the possible bioactive components of this extract by using gas chromatography and mass spectroscopy (GC-MS). The hydroalcoholic extract of A. tripedale were collected. Different concentrations of A. tripedale (50, 25, 12.5, and 6.25 mg/ml) were used to evaluate its antifungal activity against Candida species (C. albicans, C. parapsilosis, and C. krusei) using disk diffusion assay.

Results

The GC-MS analysis revealed the presence of 40 different phytoconstituents with peak area; the major compounds were tetracosane, hexadecanoic acid, 1-eicosanol, 1,2-dihydro-pyrido[3,2,1-kl]phenothiazin-3-one, 2-hexadecen-1-ol, and 3,7,11,15-tetramethyl. Hydroalcoholic extract showed strong antimicrobial activity (inhibition zone ⩾ 20 mm), moderate antimicrobial activity (inhibition zone < 12-20 mm), and no inhibition (zone < 12 mm). In addition, the hydroalcoholic extract exhibited the highest antimicrobial properties against C. albicans strains.

Conclusion

A. tripedale extract had a considerable inhibitory effect against various Candida species, but its highest inhibitory effect was against Candid albicans. Further investigations are required to detect the performance of this plant in the treatment of Candida infection.

Patient satisfaction with occlusal scheme of conventional complete dentures: A randomised clinical trial (part I)

BACKGROUND

Occlusal scheme can affect denture retention, stability, occlusal force distribution, aesthetics, masticatory function, patient comfort and general patient satisfaction with dentures.

OBJECTIVES

This study aimed to compare the patient satisfaction with 3 types of complete denture occlusion including fully bilateral balanced occlusion (FBBO), newly presented buccalised occlusion (BO) and lingualised occlusion (LO).

METHODS

In this parallel randomised clinical trial, new conventional complete dentures were fabricated for 86 volunteers. Participants were randomly allocated to 3 groups with 3 different occlusal schemes. All patients were recalled at 1 and 3 months after delivery for data collection. The 19-item version of Oral Health Impact Profile for Edentulous Patients questionnaire was used in this study. The visual analogue scale (VAS) was used for assessment of the prosthodontist's attitude towards denture quality, patient's attitude towards different occlusal schemes and evaluation of patient satisfaction. Data were analysed using the Wilcoxon signed rank test, the Kruskal-Wallis test and the post hoc Dunn test via SPSS version 18.0 (P ≤ .05).

RESULTS

Eighty-six patients completed the study, and their data were analysed (mean age ± standard deviation = 57.78 ± 9.98 years). The only significant difference when comparing the 3 groups was physical pain, which was significantly higher in FBBO group. No significant differences were found for the VAS scores of patient and prosthodontist satisfaction or the domain scores among the 3 occlusal schemes either at 1 or at 3 months post-delivery. The VAS score of patient satisfaction and prosthodontist satisfaction increased at third compared to first month after delivery.

CONCLUSION

The results of this randomised clinical trial provided evidence that BO is as effective as LO for the fabrication of complete dentures.

The relationship between tooth loss and psychological factors

OBJECTIVES

Limited evidence is available regarding mutual interactions between psychological factors and tooth loss. This study aimed to investigate the association between these two issues.

METHOD

In this 2011 cross-sectional study we obtained data from 4,585 adults who had completed information in 20 counties across Isfahan province, Iran, regarding tooth loss and psychological factors (depression, anxiety and stress level). To analyse the data ANOVA and multiple ordinal regression were applied.

RESULTS

After adjusting socio demographic factors, the association between depression (OR 1.23; 95% CI = 1.01,1.49), anxiety (OR 1.19; 95% CI = 1.03,1.38), and high stress level (OR 95% CI = 1.19; 1.01,1.39) remained significant.

CONCLUSION

We confirm the interaction between psychological factors and tooth loss, but recommend further studies on a national Iranian population.