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A challenging case of COVID-19: a COVID-19 positive adolescent presented with severe diabetic ketoacidosis, resistant hypertension
No full textBackground Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a virus which causes COVID-19. It binds to the angiotensin-converting enzyme 2 (ACE2) receptors, expressed in key metabolic organs and tissues, including pancreatic beta cells, adipose tissue, the small intestine, and kidneys. This condition has been linked to a variety of additional symptoms, including acute encephalopathy, changes in consciousness, and even gastrointestinal bleeding. Case presentation In this study, we have reported a 13-year-old boy, 69 kg, with SARS-COV-2 infection. In this case, multiple systems, including the endocrine, renal, pulmonary, gastrointestinal, and nervous systems, were affected. Conclusions It is speculated that different manifestations of COVID-19 can be seen in clinical settings, and practitioners should be more cautious not to miss the chimeric characteristics of COVID-19 infection
Global distribution of Echinococcus granulosus genotypes in domestic and wild canids: a systematic review and meta-analysis
No full textThe current systematic review and meta-analysis demonstrate the genotypic distribution of canine echinococcosis worldwide. Studies published from the inception until 21 May 2021 were screened, relevant articles were selected and the random-effect model was used to draw forest plots with 95 confidence intervals (CIs). Totally, 44 articles were included, mostly examined dogs (37 records), followed by wolf (8 records), jackal (7 records), fox (3 records), pump fox (3 records) and coyote (1 record). Echinococcus granulosus sensu stricto (G1-G3) and G6/7 cluster of Echinococcus canadensis were the most common genotypes among canids. Most studies were conducted in Asia and Europe with 17 and 15 datasets, respectively. Exclusively, Iran possessed the highest number of studies (10 records). Meta-analysis showed that the pooled molecular prevalence of echinococcosis was 33.82 (95 CI 24.50-43.83). Also, the highest and lowest prevalence of canine echinococcosis was calculated for South America (66.03; 95 CI 25.67-95.85) and Europe (19.01; 95 CI 9.95-30.16). Additionally, there were statistically significant differences between the global prevalence of echinococcosis in canines and publication year, continent, country, sample type, host and molecular test. These findings will elevate our knowledge on the poorly known canine echinococcosis worldwide
Abuse in Patients with Spinal Cord Injury During the COVID-19 Pandemic
No full textBackground: One of the chronic diseases with various challenges for patients and caregivers is spinal cord injury (SCI). The spread and prevalence of coronavirus disease 2019 (COVID-19) have been an influential risk factor for abuse. Objectives: The aim of this study was to assess the rate of abuse in patients with SCI during the COVID-19 pandemic. Methods: This cross-sectional descriptive study population was all SCI cases in Ilam, Iran. Researcher-made forms and questionnaires with confirmed validity and reliability, including the demographic characteristics, form and perceived abuse researcher-made questionnaire for people with SCI, were used. The perceived abuse questionnaire for patients with SCI was a researcher-made questionnaire designed based on library studies, interviews with patients, and determination of abuse instances. This instrument consists of 20 questions answered as yes (score 1) or no (score 0). After data collection, statistical analyzes were performed using the SPSS software version 16. Results: According to our results, the mean +/- SD of the perceived abuse score by caregivers and patients was 8.48 +/- 2.31 and 42.45 during the COVID-19 pandemic, respectively. Moreover, the mean +/- SD of the age of patients was 62.86 +/- 19.15 years, and the patient abuse increased with elevation in age (P = 0, F = 27.42). The possible abuse score was 0 - 20 divided into three categories of low (20, 20.4), moderate (76, 76.5), and high (2, 2). The perceived abuse score was significantly higher among women and patients with a history of more than 10 years of SCI. Abuse prevalence did not have a significant relationship with income and marital status. Regarding age and abuse, our results showed a rise in perceived abuse scores with an increase in age. Conclusions: The present study showed that it is necessary to take measures to prevent abuse in patients with SCI. Moreover, the prevalence of abuse related to COVID-19 in patients with SCI was high. Therefore, preventive actions need to be proposed in this field
Investigating the effect of methylprednisolone pulse on the treatment of back pain
No full textBackground: Pain is a common problem afflicting humanity. Back pain is a musculoskeletal disorder with a high prevalence; this pain may occur to anyone at least once during their lifetime. Aim: the present study was performed to investigate the effect of the use of methylprednisolone pulse on the pain status of patients suffering from back pain in Ilam city. Methods: This study is a clinical trial conducted as double-blind in 2021 in Ilam city with pretest and post-test groups plus a control group. The patients referred with vertebral disc herniation diagnosis suffering from diffuse pain in the right leg were assigned into test and control groups. A methylprednisolone 500 mg IV would be administered to the patient as pulse inside DW 500cc serum. The extent of pain was compared before and after the intervention at one, two, three, and seven days later. Placebo was applied for the control group patients. The data were analyzed by SPSS 16 as well as based on descriptive and analytical tests. Results: According to the findings, no statistically significant difference was observed between the demographic characteristics of patients receiving methylprednisolone and patients in the control group (p0.05). Conclusions: Considering the effect of methylprednisolone on mitigating the pain of patients suffering from back pain, it is suggested to use injective methylprednisolone for reducing the pain of patients suffering from back pain
Mutations in Thalassemia Carrier Couples: The Importance of Prenatal Diagnostic Tests
No full textBackground: Thalassemia carrier couples play an important role in increasing thalassemia patients. The study of thalassemia genotypes in carrier couples is also effective in improving genetic counseling for them. The aim of this study was to investigate the prevalence of thalassemia mutations and genotypes in couples. Methods: This cross-sectional study was performed on 241 couples who were suspected of thalassemia from April 2018 to March 2020 in Lorestan province. Statistical analysis of data was performed using SPSS software 16.0 (SPSS Inc., Chicago, IL, USA). Online tools such as www.ithanet.eu/db/ithagenes and http://globin.bx.psu.edu/hbvar/menu.html were also used to match patients' mutations with known cases. Results: IVSII-1 (G>A), CD36-37 (-T), IVSI-110 (G>A), —Med, and alpha(3.7 )were the most common mutations in the beta and alpha genes, respectively. IVSII-1 (G>A) 130/13 (26.1), CD36-37 (-T) beta 0/beta (21.1), and IVSI-110 (G>A) beta 0/beta (10.3) genotypes were the most common in women. The frequency of these genotypes in men were 24.8, 28.6, and 12.8, respectively. Among alpha thalassemia carriers, the alpha(3.7)alpha/alpha alpha genotype had the highest frequency among women (3.7) and men (5.3). Alpha and beta-thalassemia were 15 and 13 times higher in related women and 18 and 9 times higher in related men than non-related ones, respectively. This difference was statistically significant (p < 0.001). In addition, 12.8 of fetuses were thalassemia major, 31.9 beta thalassemia minor, and 10.3 normal. Conclusions: Thalassemia screening in related couples plays an important role in reducing thalassemia major infants
The novel putative target to the eradication of Acinetobacter baumannii persister cells
No full textBackground: Bacterial persister cells are dormant, slow-growing or growth-arrested phenotypic variants of normal cells in bacterial populations and are suggested that occurrence of the persisters leads to the recalcitrance and relapse of different chronic infections. Acinetobacter baumannii associated-infections are often correlated with high rates of drug-tolerant persisters, triggering a leading human health concern. Methods: In our study, mqsR (as the toxin) and mqsA (as antitoxin) were considered as novel antimicrobial targets and silencing with antisense peptide nucleic acid (PNA) assay to eradicate the A. baumannii persister cells. Firstly, mqsR/A genes were molecularly evaluated. The functionality was assessed by normal and stress conditions in A. baumannii persister cells. Results: Expression of mqsR significantly increased the under stress. A high expression of mqsR TA type II system was detected in A. baumannii persister cells. The mqsR gene fully silenced by PNA and A. baumannii persisters is eradicated. Conclusions: Antisense mqsR-PNA in 15 and 20 mu M concentrations could eradicate A. baumannii persister cells. Moreover, it is proposed that other TA loci in A. baumannii are surveyed by antisense PNA to detect their functionality. However, conferring to importance of persisters in human infections, ex vivo, in vivo, preclinical and clinical settings could be highlighted
Bacteria-derived chimeric toxins as potential anticancer agents
No full textCancer is one of the major causes of death globally, requiring everlasting efforts to develop novel, specific, effective, and safe treatment strategies. Despite advances in recent years, chemotherapy, as the primary treatment for cancer, still faces limitations such as the lack of specificity, drug resistance, and treatment failure. Bacterial toxins have great potential to be used as anticancer agents and can boost the effectiveness of cancer chemotherapeutics. Bacterial toxins exert anticancer effects by affecting the cell cycle and apoptotic pathways and regulating tumorigenesis. Chimeric toxins, which are recombinant derivatives of bacterial toxins, have been developed to address the low specificity of their conventional peers. Through their targeting moieties, chimeric toxins can specifically and effectively detect and kill cancer cells. This review takes a comprehensive look at the anticancer properties of bacteria-derived toxins and discusses their potential applications as therapeutic options for integrative cancer treatment
Investigation of the effect of Duloxetine on pain status of patients with spinal cord injuries: A systematic review of drug therapy
No full textDuloxetine is a series of tricyclic antidepressants that have the potential inhibitory properties of histamine H1 and H2 receptors. The present study aimed at evaluating the effect of a Systematic Review of Investigating the Effect of Duloxetine on the pain status of patients with SCIs. The present systematic review was conducted observing principles of publication ethics and guidelines of systematic reviews and meta-analyzes (PARISMA) aimed to investigate the effect of duloxetine on the pain status of patients with SCIs during 2010-2021. Two researchers who were proficient in SCIs and reviewed review articles performed the search. A checklist including the author's name, publication date, Outcomes, Control, Intervention, Population, and Study design was used for data collection. Using Excel 2007 Software, the collected data were classified and the final report. The result showed that 202 articles were included in the study in the first stage. In the first stage, 154 articles were deleted due to the irrelevance of the title and method of the article. Also, 34 articles were done due to duplication of articles, and 8 articles were done due to non-human studies. Finally, 6 articles entered the systematic review stage. In all reviewed articles, it was shown that doxepin effectively reduces pain and can reduce pain. While in the placebo group, patients' pain did not decrease. Due to the effect of duloxetine on reducing pain in patients with SCIs, it is suggested that duloxetine can reduce pain in patients
Dietary total antioxidant capacity and its association with renal function and kidney stones: Results of a RaNCD cohort study
No full textThere is evidence to support the hypothesis that dietary antioxidants have shown protective effects against chronic kidney disease (CKD). The purpose of this study was to determine the association between the dietary total antioxidant capacity (DTAC), renal function, and development of CKD and kidney stones in Ravansar Non-Communicable Diseases (RaNCD) cohort study, Kermanshah, Iran. This cross-sectional study was conducted using the recruitment baseline data of the RaNCD cohort study on 9,777 individuals aged 35-65 years. Food frequency questionnaire (FFQ) was performed to assess diet. DTAC scores were calculated using the ferric reducing antioxidant power (FRAP) of selected foods. Renal function was assessed by the estimated glomerular filtration rate (eGFR), blood urea nitrogen, and serum creatinine concentration. Prevalent CKD was based on an eGFR less than <60 ml/min per 1.73 m(2). Incidence of kidney stones was also assessed by self-reporting. Out of 9,777 participants, 1,747 subjects (eGFR: 18.50 ml/min per 1.73 m(2); 95 confidence interval (CI): 17.72-19.30) had CKD. The mean DTAC score in this study was 0.24 +/- 0.16 mu mol TE/100 g (micromole of Trolox Equivalents). We showed a significant trend for eGFR across quartiles of DTAC, i.e., participants in the fourth quartile had a higher glomerular filtration rate (GFR) than those in the first one (DTAC (Q4 vs Q1) = 82.20 versus 72.20 ml/min per 1.73 m(2), p < .001). Another finding is that high DTAC scores were not associated with having kidney stones after adjusting for confounders. We revealed that higher DTAC scores have positive effects on the renal function. Interestingly, our findings showed that a high DTAC score had nonsignificant correlation with odds of kidney stones
Primary Tooth Decay Prevention Program in Children: Application of Intervention Mapping Approach
No full textBackground. As the most common diseases globally, oral and dental diseases are closely related to people's behavior. The present study is aimed at developing a program to prevent primary teeth decay in children using the intervention mapping approach. Methods. This study protocol is aimed at using the intervention mapping approach as the planning framework. The study consists of six steps of intervention mapping, including needs assessment based on the relevant literature review, development of an objectives matrix for changing people's behaviors and environmental factors, program preparation, program implementation, and program evaluation to develop a family-centered program. Results. The use of the intervention mapping approach helped us identify the outcomes and functional objectives, develop an appropriate intervention program, and evaluate the program. Conclusions. The intervention mapping approach is an appropriate guide to developing a systematic and evidence-based program