Differential impact of a ghrelin receptor antagonist or inverse agonist in the electrical kindling model of epilepsy

Ghrelin is a peptide, which has been shown to affect seizures. However, there is not a consensus about its real impact on the control of seizure severity. We assessed the influence of intra-amygdala injections of a ghrelin receptor (GHSR) antagonist, as well as a GHSR inverse agonist on the electrical kindling-induced seizures. Two unipolar electrodes and a tripolar electrode twisted with a guide cannula were implanted in the skull surface or the basolateral amygdala of adult male rats, respectively. A rapid electrical kindling protocol was applied for kindling epileptogenesis. The stimulations were applied until rats showed three consecutive stage five seizures. Each rat was considered as its control. D-Lys-3-GHRP-6 (1, 12.5, and 25 μg/rat) or [D-Arg, D-phe, D-Trp, heu] substance P (D-SP) (50, 500 and 5000 ng/rat) as the GHSR antagonist or inverse agonist were injected into the basolateral amygdala. Seizure parameters including after-discharge duration (ADD), stage five duration (S5D), and seizure stage (SS) were documented thirty minutes following administration of the drugs or saline. Antagonism of the GHSR in the amygdala, significantly increased seizure induction in the kindled rats, in a dose-dependent manner, and induced spontaneous seizures leading to status epilepticus. Conversely, D-SP had a dose-dependent anticonvulsant activity, indicated by decreased ADD and S5D. The results show that GHSR inverse agonism suppressed seizure severity in the rat amygdala kindling model, whereas GHSR antagonism made seizures more severe. Therefore, when considering the ghrelin system to modulate seizures, it is crucial to note the differential impact of various GHSR ligands.

COVID-19-Associated Acute Necrotizing Encephalopathy: A Case Report

COVID-19 is a pandemic disease in which most patients have pulmonary symptoms. However, several cases of CNS involvement associated with COVID-19 have been reported. Acute necrotizing encephalopathy of childhood (ANEC) is a rare CNS complication of viral infections such as influenza, herpes virus, and COVID-19, leading to high mortality and morbidity rates. Several cases of COVID-19-associated acute necrotizing encephalopathy (ANE) have been reported since March 2020 in adults, with just a few cases in pediatrics. This article reports a 5-month-old child who presented with seizures, with the final diagnosis of ANE as a complication of COVID-19. MRI findings of ANEC, as reported in most COVID-19-associated ANEC case reports, involve bilateral, symmetric, multifocal lesions in the central thalami. Moreover, the brainstem, cerebral white matter, and cerebellum could be affected. The prognosis of COVID-19-associated ANE is poor, leading to neurologic dysfunction or mortality. COVID-19-associated ANE cases must be reported, especially in pediatrics, with detailed clinical history, laboratory data, and radiologic findings to introduce diagnostic criteria, prognosis, and a management protocol.

Diagnostic Accuracy of Ultrasonography for Identification of Elbow Fractures in Children; a Systematic Review and Meta-analysis

Introduction

In spite of the results of previous studies regarding the benefits of ultrasonography for diagnosis of elbow fractures in children, the exact accuracy of this imaging modality is still under debate. Therefore, in this diagnostic systematic review and meta-analysis, we aimed to investigate the accuracy of ultrasonography in this regard.

Methods

Two independent reviewers performed systematic search in Web of Science, Embase, PubMed, Cochrane, and Scopus for studies published from inception of these databases to May 2023. Quality assessment of the included studies was performed using Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). Meta-Disc software version 1.4 and Stata statistical software package version 17.0 were used for statistical analysis.

Results

A total of 648 studies with 1000 patients were included in the meta-analysis. The pooled sensitivity and specificity were 0.95 (95% CI: 0.93-0.97) and 0.87 (95% CI: 0.84-0.90), respectively. Pooled positive likelihood ratio (PLR) was 6.71 (95% CI: 3.86-11.67), negative likelihood ratio (NLR) was 0.09 (95% CI: 0.03-0.22), and pooled diagnostic odds ratio (DOR) of ultrasonography in detection of elbow fracture in children was 89.85 (95% CI: 31.56-255.8). The area under the summary receiver operating characteristic (ROC) curve for accuracy of ultrasonography in this regard was 0.93. Egger's and Begg's analyses showed that there is no significant publication bias (P=0.11 and P=0.29, respectively).

Conclusion

Our meta-analysis revealed that ultrasonography is a relatively promising diagnostic imaging modality for identification of elbow fractures in children. However, clinicians employing ultrasonography for diagnosis of elbow fractures should be aware that studies included in this meta-analysis had limitations regarding methodological quality and are subject to risk of bias. Future high-quality studies with standardization of ultrasonography examination protocol are required to thoroughly validate ultrasonography for elbow fractures.

Ovarian adenosarcoma in a postmenopausal woman: Case report and review of literature

INTRODUCTION AND IMPORTANCE

Mullerian adenosarcoma is a rare malignancy that generally occurs in the uterine corpus but uncommonly, it may be found extrauterine. Ovarian adenosarcoma is extremely rare and often is presented in reproductive age women. Most of them are low grade and have à good prognosis except for adenosarcoma with sarcomatous overgrowth.

CASE PRESENTATION

A 77-year-old menopausal woman presented with abdominal discomfort. She had severe ascites and elevated levels of CA-125, CA 19-9, and HE4 tumor markers. Adenosarcoma with sarcomatous overgrowth was diagnosed after the histopathological examination of the surgical biopsy.

CONCLUSION

The possibility of endometriosis transformation to malignancy even in postmenopausal women may warrant continuous follow-up for early diagnosis of ovarian cancer, this potentially fatal disease. More studies are needed to find the best therapeutic approach to adenosarcoma with sarcomatous overgrowth.

Factor VII Padua in Iran: clinical and laboratory findings of three unrelated patients

The congenital factor VII (FVII) deficiency with an estimated incidence of one per 300 000 is the most common rare congenital bleeding disorder. The heterogeneous clinical pictures, including asymptomatic to life-threatening manifestations, are seen in patients with FVII deficiency. A variety of gene variants throughout the FVII ( F7 ) gene have been reported so far. In this setting, very rare FVII Padua polymorphism provokes an interesting condition in which results of prothrombin time and FVII activity are different based on the thromboplastin sources used in these tests. The current study aimed to report the phenotype and genotyping of patients with Padua variant. During the workup of the laboratory for FVII deficiency for diagnosis of FVII Padua, all patients with FVII deficiency who had prolonged prothrombin time, normal activated partial thromboplastin time, and variable FVII activity results using different sources of thromboplastin were included. Demographic data and clinical findings were recorded. For the molecular study, the F7 gene sequencing was performed using the Sanger sequencing technique. Five patients with FVII Padua and a history of mild-to-moderate bleeding, including easy bruising, epistaxis, gingivorrhagia, and bleeding after surgical challenges (including dental extraction and tonsillectomy), were detected during the study. DNA sequencing revealed a heterozygote CGG to CAG (Arg364Gln) variant in exon 9 at nucleotide position 1091, consistent with the genetic variant of FVII Padua. Timely diagnosis of FVII Padua is vital to avoid unnecessary exposure of patients to replacement therapy.

Rare presentation of retroperitoneal leiomyosarcoma mimicking a myoma in a 46-year-old woman: A case report

Retroperitoneal sarcoma is relatively uncommon. We share our experience in encountering retroperitoneal sarcoma with vascular and urethral adhesion in a 46-year-old woman. Given the rarity of these tumors, evaluation and management should ideally be performed in a center equipped with multidisciplinary expertise in treating sarcomas.

Struma ovarii: A case report and review the literature

INTRODUCTION AND IMPORTANCE

Struma ovarii is a monodermal teratoma which characterized by the presence of thyroid tissue. The symptoms of this tumor are nonspecific and thus misdiagnosis and indifference to other ovarian lesions are very common.

CASE PRESENTATION

Herein, we described a case of struma ovarii that was successfully diagnosed and managed. The tumor is mimicking a malignant tumor based on ascites and tumor marker assessments. Although, thyroid function indices are normal.

CLINICAL DISCUSSION

The initial footprint of the tumor is mostly based on incidental imaging, but definitive diagnosis is possible based on pathological studies. Surgical resection of the tumor can be led to successful treatment and prognosis.

CONCLUSION

Struma ovarii is a rare tumor and also misdiagnosis is common. Regarding rarity of Struma Ovarii, the treatment option is debated. However, in postmenopausal cases with the aim of completely removing the symptoms, total abdominal hysterectomy with bilateral salpingo-oophorectomy can be occasionally indicative.

Infected urchus cyst in a teenage girl

We report the case of a 16-year-old girl who complained of stomach discomfort. She's been on medical therapy for roughly 6 months after being diagnosed with Crohn's disease. Magnetic resonance enterography confirmed the diagnosis of an infected urachal cyst, and she eventually had surgery. The removed material had a significant chronic inflammatory and foreign body type granulomatous response, according to histology. Because urachal cyst is an uncommon disease, early identification requires a high level of suspicion, and urachal cyst should be included in the differential diagnosis.

Comparison of risk assessment tools for cardiovascular diseases: results of an Iranian cohort study

OBJECTIVES

Several popular cardiovascular risk assessment tools have been developed in Western countries; however, the predictive abilities of these tools have not been evaluated in Middle Eastern countries. The present study aimed to determine the abilities of cardiovascular risk assessment tools in a population-based study in Northern Iran.

STUDY DESIGN

Population-based cohort study in Northern Iran.

METHODS

In total, 2883 individuals (1629 men and 1254 women), aged 40-74 years, were included in the study. We determined the predictive abilities of the American College of Cardiology/American Heart Association (ACC/AHA) risk prediction tool, the Framingham general cardiovascular risk profile in primary care settings, and the Systematic Coronary Risk Evaluation (SCORE) equations for low- and high-risk European countries. Receiver operating characteristic (ROC) analysis was used to determine the predictive abilities of these four risk assessment tools.

RESULTS

Based on areas under curve (AUC) values and related 95% confidence intervals (95% CIs), the discriminative abilities of the ACC/AHA tool, the Framingham approach, and the SCORE for low- and high-risk European countries to estimate non-fatal cardiovascular disease (CVD) events were 0.6625, 0.6517, 0.6476 and 0.6458, respectively, in men, and 0.7722, 0.7525, 0.7330 and 0.7331, respectively, in women. Moreover, the abilities of these four tools to estimate fatal CVD events were found to be 0.8614, 0.8329, 0.7996 and 0.7988 in men, and 0.8779, 0.8372, 0.8535 and 0.8518 in women, respectively.

CONCLUSIONS

The cardiovascular risk assessment tools investigated in this study showed acceptable predictive abilities in women. The ACC/AHA approach showed slightly better performance compared with the SCORE tool; however, the SCORE tool benefited from the lowest cost compared with all the other tools.

Comparison of the diagnostic accuracy of contrast-enhanced/DWI MRI and ultrasonography in the differentiation between benign and malignant myometrial tumors

Background

Various modalities including ultrasonography and magnetic resonance imaging (MRI) have been developed as imaging technique for screening malignant myometrial tumors, but a few studies assessed the diagnostic value of these two techniques in differentiation of benign from malignant myometrial tumors that had been the main purpose of this study.

Materials and methods

This cross-sectional study was performed on 63 women underwent surgery for intrauterine masses that were initially assessed using MRI and ultrasound before surgery at a tertiary hospital in Tehran from 2016 to 2020. Their MRI was reviewed by a reputable radiologist in the field. The findings of histopathological assessment were considered as the gold diagnostic standard.

Results

The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of MRI to detect sarcoma were revealed to be 94.6%, 92.3%, 94.6%, 92.3%, and 93.7% respectively. Ultrasonography had not preferable applicability to differentiate sarcoma from benign tumors with sensitivity, specificity, PPV, NPV and accuracy of 35.1%, 88.4%, 81.2%, 48.9%, and 57.1% respectively. The diagnostic performance of both modalities was not affected by baseline clinical conditions including pain, abnormal uterine bleeding and menopausal status.

Conclusion

MRI but not ultrasonography can effectively differentiate benign from malignant myometrial tumors.

•

Pretreatment Diagnosis of malignant myometrial tumors may be challenging.

•

MRI with DWI can be considered as a diagnostic tool in leiomyosarcoma.

•

Pretreatment distinction between benign and malignant myometrial tumors is necessary.

Jejunal web as the cause of bowel obstruction in a toddler: Case report and brief literature review

Introduction and importance

Intestinal webs which are categorized under type-1 intestinal atresia rarely occur in the jejunum. These webs are occasionally diagnosed late because their central fenestration allows the passage of food.

Case presentation

We report a toddler who presented with atypical symptoms of bowel obstruction and non-specific plain radiograph and ultrasound findings. The diagnosis of jejunal obstruction was made possible with contrast-enhanced computed tomography and obstruction was found to be the result of a jejunal web at the surgery.

Clinical discussion

Few cases of jejunal webs are reported in the literature. The jejunum is the site of only 8% of webs and 33% of jejunal webs are associated with other congenital anomalies and/or prematurity.

Conclusion

Jejunal web needs a high degree of suspicion to be diagnosed and should be kept in mind as a differential diagnosis in the setting of unexplained persistent non-bilious emesis in otherwise normal toddlers.

•

Jejunum is the site of 8% of webs and 33% of jejunal webs are associated with other congenital anomalies and/or prematurity.

•

Jejunal webs may become only intermittently symptomatic because their central fenestration allows passage of food.

•

Vascular, Re-canalization, disrupted endodermal development and hyper-proliferation theories are proposed as their etiology

•

Intra-operative endoscopy for localizing and resection of jejunal webs is a new approach in the treatment of this entity.

Expression and Characterization of Two DNA Constructs Derived from HIV-1-vif in Escherichia coli and Mammalian Cells

Background

Acquired immunodeficiency syndrome (HIV/AIDS) is still a major global concern and no effective therapeutic vaccine has been produced to prevent the problem. Among HIV-1 proteins, vif as a basic cytoplasmic protein of HIV-1 is involved in late stages of viral generation and plays important role in HIV-1 virion replication. It also increases the stability of virion cores, which probably inhibits early degradation of viral entry. Therefore, it seems rational to apply this protein as a vaccine based on its impact on HIV-1 life cycle. This study aimed at cloning, expression and production of vif protein as an HIV-1 vaccine candidate.

Methods

In this study, vif sequence was amplified from pLN4-3 plasmid including HIV-1 vif gene and then cloned in pET23a to generate the recombinant plasmids of pET23a/vif with hexahistidine tags. BL21 competent cells were transformed to obtain the protein of interest. Ni-NTA column was used to purify the protein of interest and western blotting confirmed vif protein using anti-His tag antibody. In order to express the gene of interest in eukaryotic cells, vif was sub-cloned into pEGFP plasmids and HEK 293-T cells were transfected. Flow cytometry was then applied to evaluate GFP expression.

Results

vif protein was expressed in BL21(DE3) strain and identified as a23 kDa band in SDS-PAGE and confirmed by anti-His antibody in western blotting. The purified protein concentration was 173.3 μg/ml using Bradford assay. HEK-293T cells were successfully transfected by recombinant pEGFP plasmids and flow cytometry confirmed the cell transfection.

Conclusion

vif protein can be expressed in mammalian cells and may be a proper protein subunit vaccine candidate against HIV-1.

Clinical and imaging outcomes after intrathecal injection of umbilical cord tissue mesenchymal stem cells in cerebral palsy: a randomized double-blind sham-controlled clinical trial

BACKGROUND

This study assessed the safety and efficacy of intrathecal injection of umbilical cord tissue mesenchymal stem cells (UCT-MSC) in individuals with cerebral palsy (CP). The diffusion tensor imaging (DTI) was performed to evaluate the alterations in white-matter integrity.

METHODS

Participants (4-14 years old) with spastic CP were assigned in 1:1 ratio to receive either UCT-MSC or sham procedure. Single-dose (2 × 107) cells were administered in the experimental group. Small needle pricks to the lower back were performed in the sham-control arm. All individuals were sedated to prevent awareness. The primary endpoints were the mean changes in gross motor function measure (GMFM)-66 from baseline to 12 months after procedures. The mean changes in the modified Ashworth scale (MAS), pediatric evaluation of disability inventory (PEDI), and CP quality of life (CP-QoL) were also assessed. Secondary endpoints were the mean changes in fractional anisotropy (FA) and mean diffusivity (MD) of corticospinal tract (CST) and posterior thalamic radiation (PTR).

RESULTS

There were 36 participants in each group. The mean GMFM-66 scores after 12 months of intervention were significantly higher in the UCT-MSC group compared to baseline (10.65; 95%CI 5.39, 15.91) and control (β 8.07; 95%CI 1.62, 14.52; Cohen's d 0.92). The increase was also seen in total PEDI scores (vs baseline 8.53; 95%CI 4.98, 12.08; vs control: β 6.87; 95%CI 1.52, 12.21; Cohen's d 0.70). The mean change in MAS scores after 12 months of cell injection reduced compared to baseline (-1.0; 95%CI -1.31, -0.69) and control (β -0.72; 95%CI -1.18, -0.26; Cohen's d 0.76). Regarding CP-QoL, mean changes in domains including friends and family, participation in activities, and communication were higher than the control group with a large effect size. The DTI analysis in the experimental group showed that mean FA increased (CST 0.032; 95%CI 0.02, 0.03. PTR 0.024; 95%CI 0.020, 0.028) and MD decreased (CST -0.035 × 10-3; 95%CI -0.04 × 10-3, -0.02 × 10-3. PTR -0.045 × 10-3; 95%CI -0.05 × 10-3, -0.03 × 10-3); compared to baseline. The mean changes were significantly higher than the control group.

CONCLUSIONS

The UCT-MSC transplantation was safe and may improve the clinical and imaging outcomes.

TRIAL REGISTRATION

The study was registered with ClinicalTrials.gov ( NCT03795974 ).

Fabrication of PCL nanofibrous scaffold with tuned porosity for neural cell culture

In tissue engineering, the structure of nanofibrous scaffolds and optimization of their properties play important role in the enhancement of cell growth and proliferation. Therefore, the basic idea of the current study is to find a proper method for tuning the extent of porosity of the scaffold, study the effect of porosity on the cell growth, and optimize the extent of porosity with the aim of achieving the maximum cell growth. To tune the scaffold's porosity, four types of metal mesh with different mesh sizes were employed as collectors. For this purpose, the structural properties of polycaprolactone nanofibrous layers which were electrospun on collectors, and the level of neural A-172 cell growth on layers were investigated, and the results were compared with the results attained for the fabricated nanofibrous layer on a flat aluminum collector. It was found that upon changing the porosity of the metal mesh as collector, the fibers' diameter would be inevitably changed, albeit insignificantly, and following no specific trends. However, changing the mesh size has shown a significant effect on the thickness and porosity of nanofibrous layer. According to the MTT assay results, the optimum neural cell growth was observed for the electrospun nanofibrous scaffold with the porosity of 96% and pore size of (0.42-23 µm) which has been fabricated on the type-4 collector having a mesh size of 10. The fabricated scaffold using this mesh with the optimum extent of porosity (58%) resulted in 44% enhancement in the cell growth as compared with the fabricated layer on the flat collector.

Evaluation of Correlation between Serum Free Light-Chain Assay and Bone Marrow Study in Multiple Myeloma Patients

Background: Multiple myeloma is a hematologic malignancy manifested by the secretion of abnormal immunoglobulin. Different methods have been described for diagnosis and patient response to management. Serum free light-chain assay is recently approved in the diagnosis of multiple myeloma patients. This study aimed to evaluate the diagnostic accuracy of serum free light-chain assay and its agreement to bone marrow findings. Materials and Methods: Forty-six patients with the diagnosis of multiple myeloma were enrolled in the study. The patients were grouped into newly diagnosed cases (22 patients,47.8%) and known cases who were under treatment (24 patients,52.2%). Bone marrow study was done and percentage and clonal status of plasma cells were evaluated by a combination of immunohistochemistry and flow cytometry. Free light-chain assay was done in all patients and sensitivity, specificity, positive predictive value, and negative predictive value were analyzed. Results: Thirty of 46 patients showed monoclonal plasma cell infiltration and 16 patients showed polyclonal plasma cell infiltration based on bone marrow findings. An abnormal κ/λ ratio was seen in 15(68.18%) of new cases and 16(66.6%) of known cases. Sensitivity, specificity, PPV and NPV for κ⁄λ ratio were 72.73%, 46.15%, 71%, and 50%, respectively. Conclusion: In conclusion, due to high false positive and false negative results, the presence of an abnormal serum FLC ratio was not equal to the presence of monoclonal gammopathy, and observation of a normal ratio does not exclude the presence of monoclonal gammopathy.

Diagnostic Accuracy of Ultrasonography Method of Graf in the detection of Developmental Dysplasia of the Hip: A Meta-Analysis and Systematic Review

BACKGROUND

The present study aimed to perform a meta-analysis on the performance of Graf's ultrasonography method in the detection of developmental dysplasia of the hip (DDH).

METHODS

A query was conducted on electronic bibliographic databases until the end of October 2020. The inclusion criteria entailed: 1. the use of Graf method in less than 12 weeks of age, 2. the use of follow-up as reference test, and 3. provision of crude data. Pooled diagnostic performance measures were calculated. Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) checklist was utilized to assess the quality of the included studies. The hierarchical summary receiver-operating characteristic (HROC) curves were also drawn.

RESULTS

Six articles (including seven populations, 11,012 patients) were considered eligible. The pooled sensitivity and specificity were obtained at 93% (95% CI: 0.57-0.99) and 97% (95% CI:0.86-0.99), respectively (area under curve= 0.99). The pooled positive and negative likelihood ratio, as well as diagnostic odds ratio, was reported as 28.4, 0.07, and 396, respectively.

CONCLUSION

As evidenced by the obtained results, Graf's method is a useful ultrasonography technique with acceptable accuracy for screening DDH in neonates. However, there are uncertainties about the best population and age for screening. Furthermore, more attention should be paid to the proper training of this method to reduce the number of operator errors.

Apigenin ameliorates oxidative stress and mitochondrial damage induced by multiwall carbon nanotubes in rat kidney mitochondria

The toxicity of carbon nanotubes (CNTs) toward the mitochondria of the kidney is not fully recognized and still needs further research. Apigenin (APG) is known as a flavonoid compound and natural antioxidant. The purpose of this study was to assess the ameliorative role of APG against multiwall CNT (MWCNT)-induced kidney toxicity in rats. The animals were administrated with APG (10 mg/kg) for 2 weeks and then were exposed to MWCNTs (5 mg/m³ ) in pure and impure forms (10 and 100 nm) for 5 h/day and 5 days/week. Then, mitochondria were isolated from the kidney tissue and mitochondrial toxicity parameters were measured. Decreases in succinate dehydrogenase activity have been reported in all groups exposed to MWCNTs. Results indicated that MWCNTs in both forms and sizes were able to increase the generation of reactive oxygen species, decline mitochondrial membrane potential, induce mitochondrial swelling, and release cytochrome c in isolated kidney mitochondria. The pretreatment of APG decreased all the abovementioned mitochondrial damage and oxidative stress parameters induced by both pure and impure MWCNTs. Our results showed that MWCNTs have the ability to enter the body, subsequently, cross cellular barriers, and reach the kidney as a sensitive organ, which can result in mitochondrial damage in kidney cells including renal tubular cells. In addition, APG can be an effective nutritional antioxidant regimen against MWCNT-induced kidney damage.

Promotion of nerve regeneration by biodegradable nanofibrous scaffold following sciatic nerve transection in rats

Peripheral nerve injuries (PNIs) are one of the common causes of morbidity and disability worldwide. Autograft is considered the gold standard treatment for PNIs. However, due to the complications associated with autografts, other sources are considered as alternatives. Recently, electrospun nanofibrous scaffolds have received wide attention in the field of tissue engineering. Exogenous tubular constructs with uniaxially aligned topographical cues to enhance the axonal re-growth are needed to bridge large nerve gaps between proximal and distal ends. Although several studies have used PLGA/PCL, but few studies have been conducted on developing a two-layer scaffold with aligned fibers properly orientated along the axis direction of the sciatic nerve to meet the physical properties required for suturing, transplantation, and nerve regeneration. In this study, we sought to design and develop PLGA-PCL-aligned nanofibers. Following the conventional examinations, we implanted the scaffolds into 7-mm sciatic nerve gaps in a rat model of nerve injury. Our in vivo evaluations did not show any adverse effects, and after eight weeks, an acceptable improvement was noted in the electrophysiological, functional, and histological analyses. Thus, it can be concluded that nanofiber scaffolds can be used as a reliable approach for repairing PNIs. However, further research is warranted.

Salivary enzymatic antioxidant activity and dental caries: A cross-sectional study

BACKGROUND

Oxidative stress has been identified as a predisposing factor for dental caries. Saliva, as a rich source of antioxidants, plays an essential role in the protection against dental caries. Salivary enzymatic antioxidants include superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx).

OBJECTIVES

The aim of this study was to evaluate the correlation of salivary enzymatic antioxidant activity with different levels of dental caries in children.

MATERIAL AND METHODS

In this cross-sectional study, 90 healthy children aged 7-12 years (36 girls, 54 boys) were investigated. Demographic information was gathered and dental examinations were provided for all participants. Then, unstimulated whole saliva samples were collected in the morning. The salivary SOD, CAT and GPx activity was measured spectrophotometrically. For statistical analysis, Spearman's correlation test, the Mann-Whitney U test and the Kruskal-Wallis test were used with the SPSS for Windows software, v. 16.

RESULTS

Our results showed no significant correlation between SOD, CAT and GPx and the decayed, missing, filled teeth index for permanent/primary dentition (DMFT/dmft). The CAT activity was elevated in proportion to the number of decayed teeth. The SOD activity showed a positive correlation with the frequency of tooth brushing. The activity of SOD, CAT and GPx was higher in boys than in girls. An inverse relationship between enzymatic antioxidant activity and age was also observed.

CONCLUSIONS

Although enzymatic antioxidants had no positive correlation with DMFT/dmft, they were positively correlated with the number of decayed teeth and the improvement of oral hygiene.

NCMHap: a novel method for haplotype reconstruction based on Neutrosophic c-means clustering

BACKGROUND

Single individual haplotype problem refers to reconstructing haplotypes of an individual based on several input fragments sequenced from a specified chromosome. Solving this problem is an important task in computational biology and has many applications in the pharmaceutical industry, clinical decision-making, and genetic diseases. It is known that solving the problem is NP-hard. Although several methods have been proposed to solve the problem, it is found that most of them have low performances in dealing with noisy input fragments. Therefore, proposing a method which is accurate and scalable, is a challenging task.

RESULTS

In this paper, we introduced a method, named NCMHap, which utilizes the Neutrosophic c-means (NCM) clustering algorithm. The NCM algorithm can effectively detect the noise and outliers in the input data. In addition, it can reduce their effects in the clustering process. The proposed method has been evaluated by several benchmark datasets. Comparing with existing methods indicates when NCM is tuned by suitable parameters, the results are encouraging. In particular, when the amount of noise increases, it outperforms the comparing methods.

CONCLUSION

The proposed method is validated using simulated and real datasets. The achieved results recommend the application of NCMHap on the datasets which involve the fragments with a huge amount of gaps and noise.

Atypical and novel presentations of Coronavirus Disease 2019: a case series of three children

Typical presentations of Coronavirus Disease 2019 (Covid-19) including respiratory symptoms (cough, respiratory distress and hypoxia), fever and dyspnoea are considered main symptoms in adults, but atypical presentation in children could be a diagnostic challenge. We report three children whose initial presentation was gastrointestinal, and in whom Covid-19 infection was found, concluding that cases of acute appendicitis, mesenteric adenitis and flank tenderness may mask an infection with this virus, and should therefore be investigated.

Aerobic training and hydroalcoholic extracts of green tea improve pro-oxidant-antioxidant balance and histopathological score in the N-methyl-N-nitrosourea-induced prostate cancer model of rat

Green tea is a main resource for catechins. Catechins as antioxidant compounds reduce the production of reactive oxygen species and they have a protective role in the development of cancer. As well as, aerobic exercise change free radicals with two contradictory mechanisms. Aerobic training promotes excessive production of free radicals resulting in oxidative stress. In contrast, it increases the total antioxidant capacity. In this study, effect of aerobic training and hydroalcoholic extract of green tea (HEGT) on the pro-oxidant-antioxidant balance (PAB), prostate-specific antigen (PSA) and histopathological score of cancerous tissue in the N-methyl-N-nitrosourea-induced prostate cancer was investigated. A rat model of prostate cancer was induced by hormonal change and N-Nitroso-N-methylurea (NMU). HEGT 0.1 % and 45 min of aerobic exercise in 5 days a week for eight weeks were scheduled. The presence of major catechins was approved using GC-MS. Histological study, PAB and PSA levels were used to monitor the preventive role of treatments. The prostate weights of cancerous rats were significantly higher than healthy controls (P<0.05). The PAB was only significantly higher in cancerous rats and cancerous rats receiving aerobic exercise (P<0.05). The mean of histological score of cancerous tissue was reduced in rat receiving HEGT and both HEGT and aerobic exercise. The amounts of PSA level did not significantly differ between the groups of this study (P>0.05). Our results provided laboratory and histological documentation for the preventive role of green tea extract in developing prostate cancer via its potential to re-establish the pro-oxidant-antioxidant balance.

ITPA, TPMT, and NUDT15 Genetic Polymorphisms Predict 6-Mercaptopurine Toxicity in Middle Eastern Children With Acute Lymphoblastic Leukemia

Background: Acute lymphoblastic leukemia (ALL) is the most common cancer seen in children worldwide and in the Middle East. Although there have been major advances in treatment approaches for childhood ALL, serious toxicities do occur but with significant inter-individual variability. The aim of this study is to measure the frequency of polymorphisms in candidate genes involved in 6-Mercaptopurine (6-MP) disposition in a combined cohort of Middle Eastern Children with ALL, and evaluate whether these polymorphisms predict 6-MP intolerance and toxicity during ALL maintenance therapy.

Methods: The study includes children treated for ALL on two treatment protocols from two cohorts; one from Lebanon (N = 136) and another from Kurdistan province of Iran (N = 74). Genotyping for the following six candidate genetic polymorphisms: ITPA 94C > A (rs1127354) and IVS2+21A > C (rs7270101), TPMT*2 238G > C (rs1800462), TPMT*3B 460G > A (rs1800460) and *3C 719A > G (rs1142345), and NUDT15 415C > T (rs116855232) was performed and analyzed in association with 6-MP dose intensity and toxicity.

Results: As expected, TPMT and NUDT15 variants were uncommon. As for ITPA, both polymorphisms were more common in the Lebanese as compared to the Kurdish cohort with a minor allele frequency of 0.05 for 94C > A and 0.14 for IVS2+21A > C in the Lebanese only (N = 121), and of 0.01 for either ITPA polymorphism in Kurds. The most significant toxic effects were depicted with the NUDT15 polymorphism with a median 6-MP dose intensity of 33.33%, followed by 46.65% for TPMT*3A polymorphism, followed by 65.33% for two ITPA risk allele carriers and 74% for one ITPA risk allele carriers, in comparison to a median of 100% for the homozygous wild type in the combined cohort (P < 0.001). In addition, the onset of febrile neutropenia was significantly higher in variant allele carriers in the combined cohorts.

Conclusions: These data confirm the predictive role of TPMT, NUDT15, and ITPA in 6-MP intolerance in Middle Eastern children with ALL. Given the relatively high frequency of ITPA variants in our study and their significant association with 6-MP dose intensity, we recommend that physicians consider genotyping for ITPA variants in conjunction with TPMT and NUDT15 prior to 6-MP therapy in these children.

The Accreditation of Human Resources and Physical Space of the Iranian Heart Centre: Comparison to the national and international standards

Objective: Standardization of hospital resources and physical space can be an important strategy to increase productivity and effectiveness of services. The study was conducted with the aim of comparative accreditation of human resources and physical space in Mazandaran heart centre compared with the standards. Method: This comparative descriptive study was carried out in Sari city (centre of Mazandaran province) during 2016-2017. The data collection tool consists of two checklists for investigating the physical space and human resources of the hospital. To evaluate the quality of the content, a checklist was distributed to 5 experts from Mazandaran University of Medical Sciences. After corrections the checklist was applied. Data were analyzed by SPSS software version 16 and descriptive statistics. Findings: The total number of nurses in this hospital was 288 and the total number of beds was 171. The human resources in the nursing, nutrition, operating room, anaesthesia departments were not standard. The ratio of total human resource to the number of beds was also estimated as 4.04. Results showed that the physical conditions in the hospital were moderately standard. The physical conditions of the hospital in most dimensions based on checklist, except the physical location of hospital and the features of its doors, were in accordance with the standard requirements. Conclusion: Considering the inappropriate distribution of human resource in the hospital and the non-standard design of physical space for providing services with better quality and increasing patients' satisfaction, it is recommended that experts control more carefully standard requirements.

Fermi Volume Evolution and Crystal-Field Excitations in Heavy-Fermion Compounds Probed by Time-Domain Terahertz Spectroscopy

We measure the quasiparticle weight in the heavy-fermion compound CeCu_{6-x}Au_{x} (x=0, 0.1) by time-resolved terahertz spectroscopy for temperatures from 2 up to 300 K. This method distinguishes contributions from the heavy Kondo band and from the crystal-electric-field satellite bands by different terahertz response delay times. We find that the formation of heavy bands is controlled by an exponentially enhanced, high-energy Kondo scale once the crystal-electric-field states become thermally occupied. We corroborate these observations by temperature-dependent dynamical mean-field calculations for the multiorbital Anderson lattice model and discuss consequences for quantum-critical scenarios.

Self-Care in Iranian Cancer Patients: The Role of Religious Coping

Religious and spiritual practices are related to physical and mental health. Social support is an important source to aid coping, but this is not without its difficulties. This study was conducted to investigate the relationship between religious coping and self-care in a sample of Iranian cancer patients. In this cross-sectional study (October-December, 2015), 380 cancer patients were entered into the study using non random sampling (accessible sampling). Data were collected using socio-demographic, religious coping (R-COPE), and self-care questionnaires. Male patients (48.39 ± 13.39; 95% CI 46.41-50.38) were older than the females patients (45.33 ± 18.44; 95% CI 42.79-47.87). The findings indicated that there was a significant correlation between self-care and positive religious coping (r = .188, p = .009). Also there was a significant relationship between self-care and a history of smoking (p < .05). It seems that improving the level of positive religious affiliation can have beneficial effect on the self-care of cancer patients. Therefore, it is necessary to conduct these studies with greater scale and more different societies to achieve more reliable results about the effects of religious coping on self-care behaviors in cancer patients.

Relationship between Depression and Self-care in Iranian Patients with Cancer

Background:

The current cross-sectional study was carried out to determine relationships between self-care and depression in patients with cancer.

Materials and Methods:

From October to December, 2015, 380 patients with cancer admitted to the associated university’s medical sciences hospitals (Sari, Iran), were entered into the study using non random sampling (accessible sampling). Data were collected by demographic questionnaire, Center for Epidemiological Studies Depression Scale (CES-D) and a Self-care Questionnaire.

Results:

Males (48.4±13±39; CI95: 46.4-50.4) were older than females (45.3±18.4; CI95:42.8-47.9). Spearman correlation analysis results showed that there was a significant negative correlation between self-care and depression (r= -0.134, P<0.05) and also a significant inverse relationship between physical (r= -0.166, P=0.001), psychological (r= -0.207, P<0.001) and emotional self-care (r= -0.179, P<0.001) with depression.

Conclusions:

It appears that self-care measures such as training of physical exercises, promotion of physical self-care, holding counseling sessions and psychotherapy can reduce depression levels.

Caustic Agent Ingestion by a 1.5-Year-Old Boy

We present a case of caustic ingestion by a 1.5-year-old boy. The caustic agent was drain opener which is a strong alkaline substance. Children in Iran and many other countries are still exposed to not "child proof" (child resistant packaging) toxic substance containers. Ingestion of caustic agents may lead to necrosis, perforation, and strictures. Substances that are ingested more frequently are liquid alkali material which causes severe, deep liquefaction necrosis. Common signs and symptoms of caustic agents are vomiting, drooling, refusal to drink, oral burns, stridor, hematemesis, dyspnea, dysphagia and abdominal pain. Even if no oropharyngeal lesion is seen, a significant esophageal injury which can lead to perforation and stricture cannot be ruled out. If abdominal pain or rigidity, substernal, chest or back pain exists, visceral perforation should be considered. The first thing to be checked is airway assessment. A lot of patients should be admitted to intensive care unit, and endoscopic evaluation, surgical intervention, long-term hospitalization, and worsening quality of life or among the complications. Preventive measures especially at the country level and approving proper legislation for obligating the related industries to produce child proof containers for house hold toxic products are the urgent measures to be followed by all of us.

Lipid accumulation product and metabolic syndrome: a population-based study in northern Iran, Amol

PURPOSE

Lipid accumulation product (LAP) demonstrated a strong predictive accuracy for metabolic syndrome (MetS) in previous studies. This study was conducted to determine the predictive performance of LAP compared to obesity indexes. Moreover, the optimal cutoff point of LAP based on the study population waist circumference threshold was estimated in both men and women.

METHODS

5797 subjects with an average age of 44.77 ± 16.77 years for men and 43.78 ± 15.43 years for women were included in the present study. The ROC analysis was performed to assess the predictive accuracy of LAP in the diagnosis of MetS. The optimal cutoff point of LAP was determined according to maximal Youden index in both men and women.

RESULTS

The optimal cutoff points determined for LAP were 49.71 (sensitivity = 85.2 %, specificity = 82.3 %) for women and 39.89 (sensitivity = 86 %, specificity = 79.6 %) for men. Based on the assigned cutoff points, the prevalence of high LAP was obtained 44.1 % in men and 45.1 % in women. LAP also showed a significantly higher predictive performance for MetS compared to obesity measures and also TG.

CONCLUSION

LAP has a strong and reliable diagnostic accuracy for MetS in Iranian population in the north of Iran. LAP showed a better predictability than other obesity indexes assessed in the present study.

New Approaches to the Immunotherapy of Type 1 Diabetes Mellitus Using Interleukin-27

Type 1 diabetes (T1D) is a pancreatic beta cell specific autoimmune disease. One of the most significant current discussions in T1D studies is therapy. Since the conventional therapy, islet transplantation and external insulin, e.g., cannot prevent the destructive autoimmune process against original beta cells and persistent hyperglycemia remains, so recent developments in the field of T1D therapy paved the way to a renewed interest in immunotherapy based on the disease process, especially monoclonal antibody therapy. Due to encouraging laboratory results, cytokine antibody-based drugs could be effective in the clinical direction of the T1D disease process. Hence, implementation of this approach can be useful to improve clinical and laboratory manifestations of T1D.

Steady-State Dynamics and Effective Temperature for a Model of Quantum Criticality in an Open System

We study the thermal and nonthermal steady-state scaling functions and the steady-state dynamics of a model of local quantum criticality. The model we consider, i.e., the pseudogap Kondo model, allows us to study the concept of effective temperatures near fully interacting as well as weak-coupling fixed points. In the vicinity of each fixed point we establish the existence of an effective temperature-different at each fixed point-such that the equilibrium fluctuation-dissipation theorem is recovered. Most notably, steady-state scaling functions in terms of the effective temperatures coincide with the equilibrium scaling functions. This result extends to higher correlation functions as is explicitly demonstrated for the Kondo singlet strength. The nonlinear charge transport is also studied and analyzed in terms of the effective temperature.

Silver- and fluoride-containing mesoporous bioactive glasses versus commonly used antibiotics: Activity against multidrug-resistant bacterial strains isolated from patients with burns

The wound healing process is frequently associated with a number of major clinical challenges, due to the failure of commonly used antibiotics as a remedy for wounds. There have always been fascinating questions about the novel applications of bioactive glasses (BGs) and it is expected that in the next few years these types of materials may play an important role in many aspects of soft tissue regeneration. This research focuses on the feasibility of using silver- and fluoride-containing BGs against multidrug-resistant bacterial strains isolated from patients with burns. According to the results obtained, fluoride did not exhibit antibacterial activity against the tested bacteria, while both 1% and 2% silver-containing BGs inhibited the bacterial growth. It is an important finding that 1% silver-containing BGs showed a potential antibacterial activity without any toxicity against fibroblasts, suggesting that this class of BGs could play a key role in the prevention of infection, reduction of pain, and removal of excessive exudates.

Evaluating the Possibility of Defining Cut-Off Points for ΔFA% in Order to Differentiate Four Major Types of Peri-Tumoral White Matter Tract Involvement

BACKGROUND

Diffusion tensor imaging (DTI) and its different scalar values such as fractional anisotropy (FA) have recently been used for evaluation of peri-tumoral white matter (WM) involvement to help define safer surgical excision margins.

OBJECTIVES

The purpose of this study is to evaluate the possibility of defining diagnostic cut-off points for differentiating four major types of peri-tumoral WM involvement using FA.

PATIENTS AND METHODS

DTI was performed in 12 patients with high presumption of having brain tumors, on a 1.5 T MRI scanner. DTI data was processed by MedINRIA software. Two-hundred region of interests (ROI) were evaluated: 100 in the lesion zone and the rest in the normal WM in the contralateral hemisphere. FA value related to each ROI was measured, and the percentage of FA decrement (ΔFAs%) was calculated.

RESULTS

Of the 100 ROIs on the lesion side, 74 were related to high-grade lesions, 23 to low-grade ones, and three to "gliosis". There were 54 "infiltrated", 22 "displaced", 15 "disrupted", and 9 "edematous" tracts. The major type of fiber involvement, both in low-grade and high-grade tumors was "infiltrated, whereas "edematous" fibers comprised the minority. ΔFA% was more than -35 for "displaced" and "edematous" fibers, and less than -35 for the majority of "disrupted" ones, but "infiltrated" fibers had scattered distribution. Mean ΔFA% was the least for "disrupted", followed by "infiltrated", "edematous" and "displaced" parts.

CONCLUSION

Introducing definite diagnostic cut-points was not possible, due to overlap. Based on the fact that "disruption" is the most aggressive process, a sensitivity analysis was carried out for "disrupted" fibers for several presumptive cut-off points.

Tumor angiogenesis and anti-angiogenic therapies

Angiogenesis, the development and growth of blood vessels, is a major topic of research which began in 1971 with Folkman's original hypothesis. Different mechanisms of blood vessel growth are sprouting and intussusceptive angiogenesis, vascular mimicry, and blood vessel cooption. Dis-regulated angiogenesis may result in numerous angiogenic diseases and is responsible for solid tumor growth and metastasis. Vascular endothelial cells are generally dormant in adult but in pathological conditions when tumors reach a size of about 0.2-2.0 mm in diameter, they become hypoxic and hindered in tumor growth in the lack of angiogenesis. During angiogenic switch pro-angiogenic factors predominate and result in angiogenesis and tumor progression. Angiogenesis switch leads to the increased production of vascular endothelial growth factor (VEGF) following up-regulation of the hypoxia-inducible transcription factor. The VEGF family comprises from VEGF (VEGF-A), VEGF-B, VEGF-C, VEGF-D, and placental growth factor (PlGF). The VEGF family of receptors consists of three protein-tyrosine kinases. Now, the most conventional approach for controlling tumor angiogenesis is blockade of the vascular endothelial growth factor (VEGF) pathway. The results of preclinical studies, substantial therapeutic effects of VEGF blockers have been stated in various types of human cancers, even in progressive or recurrent cancer cases.

Protein tyrosine phosphatase non-receptor type 22 gene polymorphism C1858T is not associated with leprosy in Azerbaijan, Northwest Iran

BACKGROUND

Leprosy (Hansen's disease) is a human chronic granulomatous infectious disease caused by Mycobacterium leprae. Several types of study support a role for host genetics in susceptibility to leprosy. The protein tyrosine phosphatase non-receptor type 22 (PTPN22) gene encodes an intracellular lymphoid protein tyrosine phosphatase that has been shown to play a negative regulatory role in T-cell activation.

AIMS

The aim of the present study was to find out associating the PTPN22 C1858T (R620W) polymorphism and leprosy in the Azeri population from Northwest Iran.

MATERIALS AND METHODS

A total of 153 treated leprosy patients and 197 healthy and ethnic matched controls entered this study. We used restriction fragment length polymorphism method to type PTPN22 C1858T polymorphism.

RESULTS

There was no significant difference in distribution of genotype and allele frequencies of PTPN22 C1858T polymorphism between leprosy patients and controls (P = 0.641 and 0.645; respectively). Moreover, there was no significant association between different clinical findings (karnofsky performance status score, clinical forms and manifestations of leprosy) and PTPN22 C1858T polymorphism. Data showed a low frequency of the minor (T) allele by 2.3% in leprosy and 1.5% in healthy individuals.

CONCLUSIONS

The PTPN22 C1858T (R620W) is not relevant in susceptibility to leprosy in the Azeri population of Northwest Iran.

Erythrocyte membrane fatty acids in multiple sclerosis patients and hot-nature dietary intervention with co-supplemented hemp-seed and evening-primrose oils

The risk of developing multiple sclerosis (MS) is associated with increased dietary intake of saturated fatty acids. For many years it has been suspected that this disease might be associated with an imbalance between unsaturated and saturated fatty acids. We determined erythrocyte membrane fatty acids levels in Hot nature dietary intervention with co-supplemented hemp seed and evening primrose oils in multiple sclerosis patients. To determine the erythrocyte membrane fatty acids levels and correlate it with expanded disability status scale (EDSS) at baseline after 6 months intervention in MS patients by gas chromatography, in this double blind, randomized trial, 100 RRMS patients with EDSS<6 were allocated into three groups: "Group A" that received co-supplemented hemp seed and evening primrose oils with advised Hot nature diet. "Group B" received olive oil and "Group C" received the co-supplemented oils. The results showed that the mean follow-up was 180 ± 2.9SD days (N=65, 23 M and 42 F aged 34.25 ± 8.07 years with disease duration of 6.80 ± 4.33 years). There was no significant difference in the study parameters at baseline. After 6 months, EDSS, Immunological parameters and the erythrocyte cell membrane with regard to specific fatty acids showed improvement in the group A and C, whereas there was worsening condition for the group B after the intervention. We concluded that Hot-nature dietary intervention with co-supplemented hemp seed and evening primrose oils caused an increase PUFAs in MS patients and improvement in the erythrocyte membrane fatty acids composition. This could be an indication of restored plasma stores, and a reflection of disease severity reduction.

In vitro Cytotoxic Activity of Four Plants Used in Persian Traditional Medicine

PURPOSE

The aim of this study was to investigate in vitro cytotoxic activity of four methanolic crude plant extracts against panel cell lines.

METHODS

Methanolic extracts were tested for their possible antitumor activity and cytotoxicity using the 3-(4,5-dimetylthiazol-2-yl)-2,5- diphenyltetrazolium bromide (MTT) assay on six cancer cell lines; non-Hodgkin's B-cell lymphoma (Raji), human leukemic monocyte lymphoma (U937), human acute myelocytic leukemia (KG-1A), human breast carcinoma (MCF-7 cells), human Prostate Cancer (PC3) and mouse fibrosarcoma (WEHI-164) cell lines and one normal cell line; Human Umbilical Vein Endothelial Cells (HUVEC).

RESULTS

All species showed dose dependent inhibition of cell proliferation. IC50 values ranging from 25.66±1.2 to 205.11±1.3 μg/ml. The highest cytotoxic activity Chelidonium majus L> Ferulago Angulata DC> Echinophora platyloba DC> Salvia officinalis L, respectively.

CONCLUSION

all extracts demonstrate promising cytotoxicity activity as a natural resource for future bio-guided fractionation and isolation of potential antitumor agents.

Induction of CD14 Expression and Differentiation to Monocytes or Mature Macrophages in Promyelocytic Cell Lines: New Approach

PURPOSE

CD14, one of the main differentiation markers on the surface of myeloid lineage cells, acts as a key role in activation of LPS-induced monocytes. LPS (lipopolysaccharide) binds to LPS-binding protein in plasma and are delivered to the cell surface receptor CD14. In this study, Various stimuli [Dimethyl Sulfoxide (DMSO), active 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] and LPS], either alone or in combination, have been recognized that have an effect on the level of CD14 expression in the human HL-60 and U937 promonocytic cell lines and therefore induce their terminal differentiation into monocytes or mature macrophages.

METHODS

U937 and HL-60 cells were cultured in RPMI 1640 supplemented with 10% FBS. For each cell line, 1Ã106 cells were seeded for 72 hours with DMSO, 14 days with LPS and 18 days with 1, 25-D3 in each well plate; then ELISA method was used to study their responses to the factors by means of anti-CD14.

RESULTS

ELISA assay demonstrated that U937 and HL-60 cells were induced by both [1,25(OH)2D3] and DMSO to obtain characteristics of adherent cells and express CD14 protein; moreover, LPS at a low dose increased CD14 expression on surface of this cells.

CONCLUSION

According to the our results, it is speculated that CD14 gene expression may be induced in human U937 and HL-60 cell lines by different factors including 1,25-D3, DMSO and LPS.