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The Effect of Silybinin on the Expression of Vascular Endothelial Growth Factor (VEGF) and Integrin-linked kinase (ILK) in the Olfactory Ensheathing Cells under Normal and High Glucose Conditions
No full textBackground and Aim: Diabetes is a metabolic disease with high blood sugar levels. Olfactory ensheathing cells (OECs) are able to express various growth factors and integrin-linked kinase (ILK) plays an important role in regulating various processes of cells. In this study, we investigated the effects of silybinin on the expression of vascular-endothelial growth factor (VEGF) and ILK under normal and high glucose conditions in OECs. Materials and Methods: In this study, OECs were extracted from the olfactory mucosa of neonatal rats and cultured. Low (1,5M) and high (50,75 µM) concentrations of silybinin were added to the cell culture media under normal and high glucose conditions. At the end of the study, we measured the expression of VEGF and ILK proteins using western blot technique. Data were analyzed by ANOVA test. Results: Under high glucose conditions, low concentrations of silybinin maintained expression and at high concentrations silybinin caused a dose-dependent decrease in ILK significantly. However, under high glucose conditions, low concentrations of silybinin significantly decreased expression of VEGF but high concentrations of silybinin caused a significant dose-dependent increase in VEGF expression. Conclusion: High glucose condition increased ILK and VEGF expression in the OECs, and treatment with lower concentrations of silybinin maintained ILK expression and decreased VEGF expression. Therefore, it seems that lower concentrations of silybinin can be effective in protecting cells from cytotoxicity due to diabetes hyperglycemia by stabilizing ILK and reducing VEGF levels. © 2018 the Author (s)
Development of an intelligent clinical decision support system for the early prediction of diabetic nephropathy
No full textBackground: Diabetic nephropathy (DN) is the most common microvascular complication of diabetes mellitus (DM) and is identified as a leading cause of the end-stage renal disease (ESRD). Considering the importance of early prediction of individuals at risk of this complication, the use of intelligent models through machine learning (ML) algorithms can be helpful. Therefore, this study aimed to identify the influential variables in predicting DN and fed them as inputs to develop an ML-based decision support system (DSS) for DN diagnosis. Methods: The data of 327 patients with diabetes (types 1 and 2) were retrospectively analyzed. After data preparation, the genetic algorithm (GA) feature selection method was used to identify the predictor variables affecting DN. Then, several ML algorithms, including the support vector machine (SVM), decision tree (DT), K-nearest neighbors (KNN), and artificial neural networks (ANN) were used to train predictive models based on the selected features. Afterward, the performance of the developed models was evaluated using sensitivity, specificity, and accuracy criteria in 10 independent runs. Finally, the DSS was developed based on the best fit model in the C# programming language. Results: Our findings illustrated that age, hemoglobin A1c (HbA1c) test, diastolic arterial pressure (DAP), systolic arterial pressure (SAP), fasting glycemia rate (FGR), and DM involvement time were the most important factors in predicting DN. Moreover, to predict the DN, GA combined with the DT algorithm obtained the highest performance in terms of accuracy, sensitivity, specificity, and area under the curve (AUC), equal to 98.9, 98.6, 99.2, and 98.9, respectively. Conclusions: The results revealed that GA combined with the DT classifier predicted DN with significant accuracy. Thus, the DSS developed based on DT can be considered a reliable tool to help physicians make decisions. Future studies are warranted to further validate the applicability of our model in clinical settings. © 202
Asian Pacific association for the study of liver (APASL) guidelines: hepatitis B virus in pregnancy
No full textHepatitis B virus (HBV) infection still remains a major public health issue in the Asia-Pacific region. Most of the burden of HBV-related disease results from infections acquired in infancy through perinatal or early childhood exposure to HBV in Asia-Pacific. Hepatitis B during pregnancy presents unique management issues for both the mother and fetus. These APASL guidelines provide a comprehensive review and recommendations based on available evidence in the literature, for the management of females with HBV infection through every stage of pregnancy and postpartum. These also address the concerns, management challenges, and required follow-up of children born to hepatitis B-positive mothers
Gender differences in cognitive performance and psychophysiological responses during noise exposure and different workloads
No full textBackground: Gender can affect the relationship between noise exposure and both cognitive function and comfort; however, evidence is still limited. This study aimed to examine the gender differences in cognitive performance and psychophysiological responses during exposure to noise under tasks with different workloads. Methods: Thirty-two participants (16 females and 16 males) with normal hearing and good general health were recruited. They were asked to perform the N-Back test at three levels of workload during exposure to four low-frequency noise conditions: 55, 65, 70, and 75 dB(A). The participants were also asked to judge noise-induced annoyance and subjective fatigue using visual analog scales at the end of each noise condition. The heart rate variability was also recorded using Nexus-4 device before and during each trial and the ratio of low to high frequency (LF/HF) power was analyzed. Results: The results revealed that the females rated significantly higher levels of annoyance and fatigue than the males. The mean accuracy of the women in the level of 55 dB(A) with a medium workload was higher than that of the men, while in higher noise levels the men showed better performance. The response time to the stimulus was also lower in females at different noise levels and workloads. Furthermore, the findings showed that, with increasing noise level and workload, the LF/HF of the women was higher than that of the men. Conclusion: Females and males indicated significant and different responses in exposure to different noise levels and workloads. Therefore, this study suggests that gender criteria should be taken into account particularly in the job selection, work content, and design of workplaces. © 2021 Elsevier Lt
The application of the loop-mediated isothermal amplification method for rapid detection of methicillin-resistant Staphylococcus aureus
No full textMethicillin-resistant Staphylococcus aureus (MRSA) is an important problem associated with significant mortality and morbidity and well known as a predominant bacterial pathogen. The aim of this study was to identify MRSA strains. In this study (June 2018 to June 2019) isolates of S. aureus were obtained from patients referred to teaching hospitals of Ahvaz, Iran. All isolates were confirmed by conventional microbiological methods. In following, antimicrobial susceptibility testing (AST), MRSA screening, PCR detection of MRSA and LAMP assay were performed. Out of a total of 156 staphylococcal isolates, 126 isolates were identified as MRSA. Seventy-two (57.1) MRSA isolates were recovered from wound. All MRSA isolates were sensitive to vancomycin, linezolid, teicoplanin, quinupristin-dalfopristin, and tigecycline. The results of LAMP showed 100 agreement with PCR. Sensitivity and specificity of the LAMP assays for the mecA genes were 100 and 100, respectively. The LAMP assay is a rapid and simple method for the identifications of MRSA. Because of its performance without the need for specific instrumentation, this method can be easily employed in medical centers for the detection of mecA. © 2022 The Author
Post-pandemic stress of COVID-19 among high-risk groups: A systematic review and meta-analysis
No full textBACKGROUND: Post-Traumatic Stress Disorder (PTSD) is considered as a prevalent outcome of the COVID-19 pandemic. This study aimed to present a global picture of the prevalence of PTSD in high-risk groups for COVID-19 (HRGs-COVID19) and determine its risk factors. METHODS: Cross-sectional studies published between March 11, 2020, and October 11, 2021, in English, were searched in seven databases on the prevalence of PTSD in HRGs-COVID19. After screening the retrieved records, their quality was assessed, and the required data were extracted. R-4.1.3 software and random effect model with 95 confidence interval (CI) were used to synthesize and analyze the data. RESULTS: The pooled prevalence of PTSD in HRGs-COVID19 was 30 (95 CI: 21-39 ). The pooled prevalence of PTSD was significantly different in terms of the variables of data collection during the lockdown, gender, and data collection season (P < 0.05). Subgroup analyses could not identify sources of heterogeneity. LIMITATIONS: The included studies did not cover all HRGs-COVID19 such as smokers and the elderly. CONCLUSION: Considering the higher pooled prevalence of PTSD in HRGs-COVID19 than the general population, COVID-19 patients, and health care workers, prioritizing this subgroup for prevention and treatment of psychological outcomes is highly recommended. Predicting and implementing psychological interventions early in the pandemic is more critical when applying restrictive measures and among HRGs-COVID19 women
The effects of nutrition bio-shield superfood powder on immune system function: A clinical trial study among patients with COVID-19
No full textThe present study aimed to evaluate the effects of Nutrition Bio-shield Superfood (NBS) powder on the immune system function and clinical manifestations in patients with COVID-19. We compare the effects of NBS powder on the immune system function and clinical manifestations among two different groups: 1) intervention group receiving standard treatment scheduled according to treatment guidelines plus NBS powder, and 2) control group receiving only the same standard treatment. The serum levels of IL-2, IL-6, IL-17, IFNgamma, and TNFalpha were determined after four weeks of treatment by specific ELISA kits according to the manufacturer's instructions. Finally, the level of immune system stimulation and inflammatory markers were compared at baseline and after intervention in both groups. Data were analyzed using SPSS (version 22). A p-value of </= 0.05 was set as significant. A total of 47 patients with COVID-19 (24 patients in the intervention group and 23 patients in the control group) were included in this study. Results showed that the differences in the mean decrease of IL-2, IL-6, and TNF-alpha in the intervention group in comparison to the control group were 0.93, 10.28, and 8.11 pg/ml, respectively (P<0.001). On the other hand, there was no difference in IL-17, IFNgamma, monocytes, eosinophil, and other inflammatory indices between the intervention and control groups. Although NBS powder was able to significantly decrease the levels of some proinflammatory cytokines in patients with COVID-19, however, it is noteworthy that the course of the disease was to large part unaffected by NBS power and there was a reduction independent of treatment. The present study indicates that NBS powder could provide a beneficial anti-inflammatory effect in patients with COVID-19. Hence, NBS in treating patients with COVID-19 shows promise as an adjuvant to the current standard antiviral treatment of such patients. Clinical Trial Registration: https://www.irct.ir, identifier IRCT20200426047206N1
Determine the consequences of delay in referring to the hospital in patients with COVID-19 in Shahid Mostafa Khomeini Hospital of Ilam Province
No full textBackground: COVID-19 is a systemic infection with a significant impact on the hematopoietic system and hemostasis. Infected subjects are at high risk for coagulation diseases such as venous thromboembolism. Therefore, the present study was conducted to investigate the consequences of delayed referral of patients with Quaid-19 in Ilam. Methods: In this study, a present prospective study was performed in 2020 on the registry data of patients with COVID-19 disease in the infectious ward of Shahid Mostafa Khomeini Hospital in Ilam.. In this study, the effect of delay in hospitalization from the onset of the first symptom of the disease on death and intubation of patients in special and general wards in 2350 patients with COVID-19 was investigated. Delays in referrals were recorded by day and based on the biographies recorded in the patients' files. In this registry, only 96 of patients reported a delay of 1 to 60 days. The effect of the delay on mortality as well as the intubation rate were analyzed using logistic regression models in Stata software 12. Results: The average number of days of delay in referral according to different variables for deceased patients, requiring intubation and requiring hospitalization in the ICU is listed in Table 1. The results of univariate logistic regression analysis for the main causes of death due to COVID-19 disease according to hospitalization in ICU and general ward showed that the variables of age, sex, marital status, heart disease, blood pressure, diabetes, chronic lung disease, chronic disease Kidney, neurological disease, cancer and delayed referral were statistically significantly associated with death at the 5 error level. The chance of death for delayed referral in ICU patients is equal (OR ICU ADMISSION = 1.06; 95 CI, 1.01 - 1.12; P value = 0.01) and in normal ward patients (OR = 0.88; 95 CI, 0.79 - 0.97; P value = 0.01 was obtained. Conclusions: According to the results of the final regression model which were adjusted to other variables, in hospitalized patients, each day of delay in hospitalization meant a 0.08 increase in the odds of mortality rate and a 0.05 increase in the odds of intubation
Immunogenicity of COVID-19 mRNA vaccines in hemodialysis patients: Systematic review and meta-analysis
No full textBackground and Aims Vaccine response is a concern in hemodialysis patients. Given that hemodialysis patients were not included in clinical trials, we aimed to synthesize the available evidence on the immunogenicity of coronavirus disease 2019 (COVID-19) mRNA vaccines in hemodialysis patients. Methods We searched Scopus, PubMed, Sciencedirect, and finally google scholar databases for studies on COVID-19 mRNA-vaccines immunogenicity in hemodialysis patients up to December 1, 2021. Eligible articles measured antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike or Receptor-Binding Domain Antibody (S/RBD) postimmunization with COVID-19 mRNA vaccines. The immunogenicity of the vaccine was evaluated using seroconversion rates measured between 21 and 30 days after the first immunization and between 14 and 36 days post the second dose. We included studies including participants without a history of COVID-19 before vaccination. Healthy controls or health-care workers served as the control groups. After selecting eligible articles, the data were finally extracted from included articles. We used a random effects model to estimate the pooled seroconversion rate after COVID-19 mRNA vaccine administration. We assessed the heterogeneity between studies with the I-2 statistical index. Result We selected 39 eligible citations comprising 806 cases and 336 controls for the first dose and 6314 cases and 927 controls for the second dose for statistical analysis. After the first dose of mRNA vaccines, the seroconversion rate was 36 (95 confidence interval CI: 0.24-0.47) and 68% (95% CI: 0.45-0.91) in hemodialysis patients and the control group, respectively. While seroconversion rate after the second dose of mRNA vaccines was 86% (95% CI: 0.81-0.91) and 100% (95% CI: 1.00-1.00) in hemodialysis patients and the control group, respectively. Conclusion Although the immune response of hemodialysis patients to the second dose of the SARS-CoV-2 mRNA vaccine is very promising, the seroconversion rate of dialysis patients is lower than healthy controls. Periodically assessment of antibody levels of hemodialysis patients at short intervals is recommended
The expression of type II TA system genes following persister cell formation in Pseudomonas aeruginosa isolates in the exponential and stationary phases
No full textFailure of infection therapy in the presence of antibiotics has become a major problem which has been mostly attributed to the ability of bacterial persister cell formation. Bacteria use various mechanisms to form persister cells in different phases, among which is the toxin-antitoxin (TA) systems. This study aimed at investigating the expression of type II TA system genes under the stress of ciprofloxacin and colistin antibiotics in the exponential and stationary phases. To determine the effects of ciprofloxacin and colistin on persister cell formation in the exponential and stationary phases of Pseudomonas aeruginosa strains, colony counting was performed at different time intervals in the presence of fivefold MIC of ciprofloxacin and colistin. In addition, the expression of relBE, Xre-COG5654, vapBC, and Xre-GNAT genes in P. aeruginosa isolates was assessed 3.5 h after antibiotic treatment in the exponential and stationary phases using qRT-PCR. Our results indicated the presence of persister phenotype of P. aeruginosa strains in the presence of fivefold MIC of ciprofloxacin and colistin compared to the control after 3.5 h of incubation in the exponential and stationary phases. Also, the number of persister cells in the stationary phase was higher than that of the exponential phase. According to the results of qRT-PCR, ciprofloxacin and colistin may induce persister cells by increasing the expression of type II TA systems in stationary and exponential phases. Ciprofloxacin and colistin may increase the formation of persister cells by affecting the expression of type II TA systems