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Frequency of unconventional treatment use in psychiatric patients
No full textBackground: This study was conducted to determine the frequency of unconventional treatment use by psychiatric patients in Tehran. Methods: In this cross-sectional study, 404 patients diagnosed with psychiatric disorders were studied. The participants responded to a checklist and filled a questionnaire about their demographic characteristics. Results: Simultaneous use of conventional and unconventional treatment was seen in 39.4 of patients, and among them, herbal therapy was the most common type (20.5). No relationship was observed between patient satisfaction and the use of such treatment (p=0.347). Conclusion: There is a high frequency of unconventional treatment use in psychiatric patients. However, the exact reasons for patients' tendency towards such approach and also advantages and disadvantages of its application need more investigation. © 2021, Journal of Iranian Medical Council
Should oncoplastic breast conserving surgery be used for the treatment of early stage breast cancer? Using the GRADE approach for development of clinical recommendations
Get PDFIntroduction: The potential advantages of oncoplastic breast conserving surgery (BCS) have not been validated in robust studies that constitute high levels of evidence, despite oncoplastic techniques being widely adopted around the globe. There is hence the need to define the precise role of oncoplastic BCS in the treatment of early breast cancer, with consensual recommendations for clinical practice. Methods: A panel of world-renowned breast specialists was convened to evaluate evidence, express personal viewpoints and establish recommendations for the use of oncoplastic BCS as primary treatment of unifocal early stage breast cancers using the GRADE approach. Results: According to the results of the systematic review of literature, the panelists were asked to comment on the recommendation for use of oncoplastic BCS for treatment of operable breast cancer that is suitable for breast conserving surgery, with the GRADE approach. Based on the voting outcome, the following recommendation emerged as a consensus statement: Oncoplastic breast conserving surgery should be recommended versus standard breast conserving surgery for the treatment of operable breast cancer in adult women who are suitable candidates for breast conserving surgery (with very low certainty of evidence). Discussion: This review has revealed a low level of evidence for most of the important outcomes in oncoplastic surgery with lack of any randomized data and absence of standard tools for evaluation of clinical outcomes and especially patients� values. Despite areas of controversy, about one-third (36) of panel members expressed a strong recommendation in support of oncoplastic BCS. Presumably, this reflects a synthesis of views on the relative complexity of these techniques, associated complications, impact on quality of life and costs. © 2021 The Author
DITAS: An Integrated Gateway to E-health Communications
Get PDFToday, the demand for health-oriented systems to facilitate and improve treatment processes is growing. For different information systems with different structures and technologies to be able to communicate with each other, a single gateway is required. The gateway acts as an interface between information systems and unifies protocols, rules, and standards related to communication processes. Health-related systems need a unique regulator that explains data models, coding, and data exchange structures. Moreover, the gateway has control over information systems and the data transmitted between them. In this paper, we explain an integrated gateway of health information exchange named DITAS which is a bridging point between health-related systems
The application of G2013 (α-L-Guluronic acid) as an anti-inflammatory drug candidate in treatment of disease
No full textNon-steroidal anti-inflammatory drugs (NSAIDs) are commonly used for the treatment of different inflammatory disorders, and shown to have many side effects for patients. G2013 or α-L-guluronic acid is a new NSAID candidate made from alginate in the pathobiology department of Tehran University of Medical Sciences, Iran, and it has been proven to be safe. G2013 anti-inflammatory, immunosuppressive, and immunomodulatory effects have been reported in previous studies. In many studies, it has been shown that this drug candidate has good potential for treatment of different diseases, and is going through clinical phases. In this review article, first, toxicity and anti-inflammatory effects of G2013 is mentioned, and then its effects on the treatment of oxidative stress, and diseases including rheumatoid arthritis, multiple sclerosis, ankylosing spondylitis, and breast cancer is also reviewed. © 2021 Isfahan University of Medical Sciences(IUMS). All rights reserved
A cardiac approach to wilms tumor with tumor thrombus extension to the right atrium without cardiopulmonary bypass: A 5-year follow-up
Get PDFIntroduction: Wilms tumor is the most common kidney cancer in children, but Wilms�s tumors that extend by direct intravascular spread into the right side of the heart are rare and at this stage, they require the cardiac surgeons� intervention. Case Presentation: The patient was a 2-year-old girl who was hospitalized due to fever and abdominal pain that had started 2 weeks before admission. Patient�s full abdominal exams revealed a large mass in the right kidney with a thrombus tumor in the entire inferior vena cava which was extended into the right atrium. Patient completed 8 weeks of neoadjuvant chemotherapy. After chemotherapy no changes was noted in renal mass and tumor thrombus. As, the thrombosis in the atrium was loose and there was a high risk of pulmonary embolism, emergency surgery was needed. Two pediatric and cardiac teams, simultaneously performed the surgery without cardiopulmonary bypass and cardiac arrest. Both kidney mass and the thrombus tumor were completely removed. Patient followed up for 5 years after surgery and no surgical complications, tumor recurrence, or metastasis were observed during that period. Conclusions: Although surgical intervention and tumor resection leads to good prognosis, multimodality management and mul-tidisciplinary approach gives the best results. © 2021, Author(s)
Comparison of the cardiovascular presentations, complications and outcomes following different coronaviruses' infection: A systematic review
Get PDFManifestations caused by coronavirus family have presented it in many ways during the previous years. The aim of this systematic review was to gather all possible cardiovascular manifestations of the coronavirus family in the literature. Adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched PubMed, Scopus, Web of Science, Cochrane and ProQuest which were updated on May 1, 2020 for the last time. Regarding to the novelty and speed of publications on COVID-19, we searched Google Scholar and also references of included studies and review articles in the systematic search results were searched manually. The searched keywords were the combination of the following MeSH terms: "COVID-19", "SARS", "MERS"and "cardiovascular presentation". The systematic review was registered with ID CRD42020180736 in International Prospective Register of Systematic Reviews (PROSPERO). After screening, 28 original articles and ten case studies (five case reports and five case series) were included. Most of the studies were focused on COVID-19 (20 original articles and five case studies) while the only studies about Middle East Respiratory Syndrome (MERS) was a case report. Almost all the cardiovascular presentations and complications including acute cardiac injury, arrhythmias and the thrombotic complications were more prevalent in COVID-19 than severe acute respiratory syndrome (SARS) and MERS. The cardiac injury was the most common cardiovascular presentation and complication in COVID-19 whereas thrombotic complications were commonly reported in SARS. The cardiac injury was the predictor of disease severity and mortality in both COVID-19 and SARS. Coronavirus 2019 may present with cardiovascular manifestations and complications in signs and symptoms, laboratory data and other paraclinical findings. Also, cardiovascular complications in the course of COVID-19 may result in worse outcomes. © 2021 The Author(s)
The influence of combined low-strength ultrasonics and micro-aerobic pretreatment process on methane generation and sludge digestion: Lipase enzyme, microbial activation, and energy yield
Get PDFLow-frequency ultrasonics is a potential technology to reduce the hydrolysis phase period in anaerobic digestion process. In this study, the influence of combined low frequency ultrasonics and micro-aerobic (MA) pretreatment on sewage sludge solubilization, enzyme activity and anaerobic digestion were assessed. Initially, the effect of ultrasonic density (0.012, 0.014, 0.016, 0.018, 0.1, 0.12 and 0.14 W/mL) and irradiation time (1, 3, 5, 8, 9, 10 and 12 min) of 20 kHz frequency waves were investigated. Accordingly, the effect of micro-aerobic pretreatment (Air flow rate (AFR) = 0.1, 0.2, 0.3 and 0.5 VVM) within 20, 30, 40.48 and 60 h were examined. In addition, the effect of combined pretreatment on COD solubilization, lipase enzyme activation, ATP, percentage of live bacteria and methane gas production during the anaerobic process were examined. The results showed that the highest lipase activity (14.9 Umol/mL) was obtained under the effect of ultrasonic density of 0.1 W/ml within 9 min. The highest solubilization (65) was observed under optimal micro-aerobic conditions: AFR = 0.2 (VVM) and micro-aerobic time: 40 h. Combined ultrasonic and micro-aerobic (US + MA) pretreatment increases the solubilization (70), microbial activity (2080) and lipase enzymatic activity (129) compared to individual pretreatment. The Biogas production during anaerobic digestion pretreated with combined methods increased by 193 compared to the control, while the elevated values of biogas production in reactors pretreated by ultrasonic and micro-aerobic pretreatment alone were observed to be 101 and 165, respectively. The net energy in reactor with the combined pre-treatment methods was calculated to be 1.26 kWh, while this value for control, pretreated ultrasonic and micro-aerobic reactors were obtained to be 0.56, 0.67 and 1.2 kWh, respectively. © 2021 The Author
Association between abnormal maternal serum levels of Vitamin B12and preeclampsia: A systematic review and meta-analysis
No full textContext: Some evidence has shown an association between maternal Vitamin B12 levels and the development of preeclampsia in pregnant women, but the relationship between preeclampsia and Vitamin B12 is not clear. Objective: The aim of this systematic review was to compare serum Vitamin B12 levels in women with preeclampsia with those in normotensive pregnant women. Data Sources: The PubMed/MEDLINE, Scopus, and Web of Science databases were searched up to August 2019, along with the reference lists of included articles. Study Selection: The literature was searched for observational studies that investigated Vitamin B12 levels in women with preeclampsia. Data Extraction: Data were extracted independently by 2 authors. Data were pooled using a random-effects model. Results: Vitamin B12 levels in women with preeclampsia were significantly lower than those in healthy women (mean,-15.24 pg/mL; 95CI,-27.52 to-2.954; P < 0.015), but heterogeneity between studies was high (I2â=â97.8; P = 0.0103). Subgroup analyses based on folic acid supplementation, homocysteine concentrations, and gestational age at the time of sampling for Vitamin B12 assessment did not identify the sources of heterogeneity. Conclusions: Women with preeclampsia had significantly lower Vitamin B12 concentrations than normotensive pregnant women. © 2020 The Author(s) 2020. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved
Antidepressant-like effect of ethanol in mice forced swimming test is mediated via inhibition of NMDA/nitric oxide/cGMP signaling pathway
No full textThere is evidence for a dramatic relationship between depression and alcohol consumption. Depressed patients may abuse ethanol because this agent reduces the symptoms of depression. In the current study, we aimed to investigate the NMDA/nitric oxide/cGMP pathway in the antidepressant-like effect of ethanol in an animal model of behavioral despair. Animals were subjected to locomotor activity in an open-field test separately, followed by a forced swimming test. During the forced swimming test (FST), ethanol (2 and 2.5 g/kg) significantly decreased the immobility time without altering the locomotor activity of animals. The antidepressant-like effect of ethanol (2.5 g/kg) was reversed by co-administration of N-methyl-D-aspartate (NMDA, 75 mg/kg), L-arginine (750 mg/kg), or sildenafil (5 mg/kg). In contrast, co-administration of MK-801 (0.05 mg/kg), ketamine (1 mg/kg), and ifenprodil (0.5 mg/kg) as antagonists of NMDAR, and NG-nitro-L-arginine methyl ester (L-NAME, 10 mg/kg), 7-nitroindazole (7-NI, 30 mg/kg), and methylene blue (10 mg/kg) as inhibitors of nitric oxide synthase (NOS), or 1H-1,2,4oxadiazole4,3-aquinoxalin-1-one (ODQ) (20 mg/kg), a nitric oxide/cyclic-guanosine monophosphate (NO-cGMP) inhibitor, with a subeffective dose of ethanol (1.5 g/kg), significantly decreased the immobility time in the FST. Furthermore, injection of ethanol 2.5 g/kg alone or 1.5 g/kg with a 7-NI subeffective dose, significantly decreased the nitrite levels in the hippocampus and prefrontal cortex. Hence, it is concluded that blockade of NMDA receptors and the nitric oxide/cyclic-guanosine monophosphate (NO-cGMP) pathway might be involved in the antidepressant-like effect of ethanol in mice. © 2021 Elsevier Inc
Two rivals or colleagues in the liver? Hepatit B virus and Schistosoma mansoni co-infections: A systematic review and meta-analysis
No full textBackground: Globally, hepatitis B and schistosomiasis (Mansoni) together affect about 300 million people; which cause hepatic disorders worldwide. Given that little is known about co-infections with hepatitis B and schistosoma mansoni, the present study investigates these two health problems alone and together and their possible correlation. Methods: A search was conducted for reports published between January 1990 and October 2020 by using Embase, Scopus, PubMed, Web of Science databases; Out of a total of 20 studies, 14 cross-sectional studies (6329 people) and 6 case-control studies (2138 individual) were reviewed. The pooled prevalence of hepatitis B virus (HBV), S.mansoni infections, and their co-infections; heterogeneity and the Odds Ratio (OR) were evaluated by Stata 11.2. Findings: Among the included studies in the inclusion criteria, the pooled prevalence of hepatitis B, S. mansoni was 34 (95 CI, 0.23�0.46), 41 (95 CI, 0.24�0.59) and their co-infections was 18 (95 CI, 0.11�0.25) by regions. The hepatitis B and S. mansoni correlation was significant in populations with schistosoma compared to control group (OR, 2.12; 95 CI, 1.36�3.30). Commentary: Our results showed that in addition to the high global prevalence of hepatitis B- S. mansoni (co) infections in the included studies, there is a significant association between them, especially in people suffering from schistosoma. These results highlight the importance of integrated interventions measurements against coexistence of parasitic and viral diseases. We know that more research studies need to be done in this field and global monitoring should be considered for the co-infection of these two important complications. © 202