Journal of Inflammatory Diseases
Volume:25 Issue: 2, Summer 2021

There are inconsistent data about the association of smoking with the prognosis of hospitalized patients with COVID-19. This inconsistency is so huge that some investigators have suggested some protective roles for smoking against COVID-19 disease. 

This study was designed to investigate the association of smoking with mortality in hospitalized patients with COVID-19.

This cross-sectional study was conducted on 493 adult patients with COVID-19 disease. Other underlying diseases, clinical and laboratory findings, and mortality rates were compared between smoking and non-smoking patients using univariate and multivariate analyses.

 The prevalence of current smoking among hospitalized patients was 6.1%. Clinical complaints and disease severity at admission were similar between smokers and non-smokers. Leukocyte count and blood sugar were higher in smokers compared to non-smokers (P=0.003, P=0.018, respectively). The rate of ICU admission and days of hospitalization were comparable between smokers and non-smokers. However, smokers had a significantly higher mortality rate than non-smokers (36.7% vs 13.8%, respectively, P=0.001). After adjusting for significantly different variables in univariate analysis, smoking was associated with a 3.78 times higher mortality rate (OR=3.78, 95% CI: 1.48-9.67, P=0.005).

Smoking is an independent predictor of mortality in hospitalized patients with COVID-19.

Changes in patients’ Bone Mineral Density (BMD) is one of the problems in patients with rheumatoid arthritis, which can be due to the use of corticosteroid drugs to reduce patients’ symptoms or the aging process in patients. 

In this study, we decided to compare BMD in patients with psoriatic arthritis and rheumatoid arthritis.

This study as a cross-sectional descriptive-analytical study was performed to evaluate BMD in patients with psoriatic arthritis (n=59) and rheumatoid arthritis (n=41) who were referred to Rasoul Akram Hospital in Tehran between 2016 and 2020. All patients were assessed by bone density scan (Dual-Energy X-ray Absorptiometry or DEXA scan) to determine T-score at the two spine and femur sites.

 In rheumatoid arthritis and psoriatic arthritis groups, the Mean±SD spine T-score was -1.11±0.18 and -1.38±0.48, respectively, which did not show a significant difference between the two groups (P=0.556). Similarly, in the two groups with rheumatoid arthritis and psoriatic arthritis, the Mean±SD femur T-score was -1.36±0.17 and -1.78±0.61, respectively, which did not show a significant difference between the two groups (P=0.451). Considering the underlying parameters, including age, sex, and duration of the disease, the lack of differences in the values of spine and femur T-scores between the two groups was still evident.

The change in BMD was equal in both rheumatoid arthritis and psoriatic arthritis that is not affected by gender, age, or duration of disease.

In the “treating to target” strategy for Rheumatoid Arthritis (RA) management, “cognitive” beyond “physical” measures allow a more comprehensive assessment. 

This study reported a predictive analysis of patients on disease activity and the degree to which these predictions could be uniquely attributable to Illness Perception (IP), pain, and sex differences.

This cross-sectional study was conducted on 108 patients with Rheumatoid Arthritis aged 18 to 65 years old, selected via convenience sampling. Measurements were done using Disease Activity Score in 28 Joints (DAS28), patient’s Illness Perception Questionnaire (IPQ-R), and Numerical Rating Scale (NRS) for perceived pain. Data were analyzed applying Spearman and Pearson correlation coefficients and Multiple Stepwise Regression (MSR).

 In correlation analysis, the sex- Disease Activity association (0.40, P<0.01) and Pain-Disease Activity association (0.54, P<0.01) were found. Additionally, we observed stronger and significant associations between IPQ-R subscales and disease activity [Identity (r=0.53, P<0.01) personal control (r=-0.40, P<0.01) and emotional representation (r=0.36, P<0.01)]. Regression analysis showed that sex differences were a not significant predictor and perceived pain and three IPQ-R items (identity, personal control, and emotional representation) emerged as the strongest predictors (P<0.001).

Disease activity was predicted by pain and three illness perception items. By identifying the components affecting Disease Activity, the therapist can adjust complementary treatment according to patients’ needs.

Type 1 Diabetes (T1D) is an autoimmune condition, in which the pancreas produces little or no insulin. Nephropathy is a serious T1D microvascular complication that is associated with high mortality and morbidity. 

This study aimed to investigate the prevalence of diabetic nephropathy and comorbidities in children with T1D.

This cross-sectional study was conducted on 208 children (aged 1–18 years old) with T1D who were referred to the Qazvin endocrinology clinic from 2017 to 2019. Anthropometric, demographic, laboratory, and comorbidities data were collected.

 The Mean±SD age at diagnosis of diabetes was 7.59 years, and the Mean±SD HbA1c level of the study subjects was 8.68±1.42 mmol/mol. Out of 208 diabetic patients, 64 cases (30.7%) had diabetic nephropathy, of whom 53 cases (25.5%) had microalbuminuria and 11 cases (5.3%) had macroalbuminuria. Among the studied diabetic patients, 30 cases (14.45%) had hypothyroidism, 12 patients (5.8%) had celiac disease, and 14 patients (6.7%) had anemia. Retinopathy was not found in any of the patients. Moreover, variables, such as the duration of diabetes, puberty status, mean HbA1c levels, and age were significantly associated with diabetic nephropathy (P<0.05). 

Mean HbA1c levels were significantly higher in patients with macroalbuminuria, which may corroborate the role of metabolic control of diabetes in the development of albuminuria.

Oxidative stress is a leading factor in developing silver nanoparticle-induced toxicity. 

This study evaluated the effects of oral prescription of different doses of silver nanoparticles and propolis on lipid peroxidation in male Wistar rats.

The male Wistar rats were randomly divided into four groups. Control group and three different treatment groups with oral prescription of 30 ppm, 60 ppm, and 60 ppm of silver nanoparticles with 200 mg/kg of propolis. The serum level of Malondialdehyde (MDA) was measured by Thiobarbituric Acid Reactive Substances (TBARS) assay using Thiobarbituric Acid (TBA). 

 The serum level of MDA as a marker of lipid peroxidation in the control group was 1.92 mM/mL, and in other groups that received silver nanoparticles (30 ppm, 60 ppm, 60 ppm with 200 mg/kg propolis) were respectively 2.82, 3.83 and 2.62 mM/mL. MDA level also increased at the doses of 30 ppm and 60 ppm compared to the control group and decreased when propolis was prescribed with silver nanoparticles in the third group; however, its value did not reach the level of the control group. Minimal levels of serum lipid peroxidation were observed when silver and propolis nanoparticles were administered to male rats.

The mixture of silver nanoparticles and propolis reduces the toxic effects of silver nanoparticles; it preserves and increases the efficiency of this compound in medical applications.

Human Serum Albumin (HSA) is one of the most prominent proteins in human blood. Trimethoprim (TMP) is an efficient antibiotic drug for treating pneumocystis pneumonia. Patients with HIV/AIDS and cancer are highly affected by this disease due to immune system deficiency. 

This study aims to evaluate the Molecular Dynamics (MD) simulation of HSA with TMP for drug delivery systems. 

In the first step, the 3D structure of HSA and TMP were determined by PDB (Protein Data Bank) and PubChem, respectively. Then, the molecular docking was done via AutoDock Vina software, and the best complex was selected based on the lowest binding energy. Finally, the structural characteristics of the above complex were evaluated. 

 The results showed that TMP binds to the HSA molecule with a binding energy of -7.3 kcal/mol, and this binding causes changes in the third and second structures of the HSA. Thus, Root-Mean-Square Deviation (RMSD) and radius of gyration results proved the third structural change, and the results obtained from DSSP (Database of Secondary Structure assignment for all Protein entries) confirmed the second structural modification. The TMP-HSA complex formation is accompanied by hydrophobic interaction between residues of Tyr150, Ala291, His288, Leu238, Leu219, Lys199, Lys195, Glu153, and TMP. The TMP molecule had two hydrogen bonds with Arg222 residue and three with Ser192. Furthermore, the final PDB file of the MD simulation process showed that the TMP molecule reacted with HSA (IIA chain). 

Because of the extensive application of TMP in infectious diseases and appropriate interaction with HSA, the complex could be used for the purposeful transport of nanoparticles in the future.

Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) that causes COVID-19 disease could progress to Acute Respiratory Distress Syndrome (ARDS). The immune cells’ migration in response to the virus leads to cell death by releasing oxidizing free radicals. These oxidizing free radicals mediate NF-κB (Nuclear Factor ‘kappa-light-chain-enhancer’ of activated B-cells) activation and induce transcription of cytokine-producing genes that eventually causes cytokine storm and septic shock. The over-expression of oxidative stress and enhancing Reactive Oxygen Species (ROS) and Reactive Nitrogen Species (RNS) production activate transcription factors like NF-κB. So repeating this cycle intensifies the host’s inflammatory responses. In this way, antioxidants as compounds that inhibit oxidation by terminating chain reactions are suggested to alleviate COVID-19 symptoms. In the present review study, the pathogenesis of the virus, the virus immunopathology, and the balance between immune responses and oxidative stress are discussed. Also, in this review, due to the importance of oxidative stress in the pathogenesis of the disease, some of the most important antioxidant agents whose therapeutic effects have been shown in improving many viral infections, ARDS, and acute lung injury, are recommended to improve the patient’s condition infected with SARS-CoV-2. Besides, the recent COVID-19 clinical studies in this field are summarized in this review article. In the present review study, the pathogenesis of the virus, the virus immunopathology, and the balance between immune responses and oxidative stress are discussed. Also, in this review, due to the importance of oxidative stress in the pathogenesis of the disease, some of the most important antioxidant agents whose therapeutic effects have been shown in improving many viral infections, ARDS, and acute lung injury, are recommended to improve the patient’s condition infected with SARS-CoV-2. Besides, the recent COVID-19 clinical studies in this field are summarized in this review article. According to these studies, melatonin through promoting sleep quality, decreasing vascular permeability, reducing anxiety, and regulating blood pressure; vitamin C through decreasing the mortality rates and the requirement for mechanical ventilation; glutathione through decreasing respiratory distress in the pneumonia of COVID-19 patients; and high selenium levels could improve the COVID-19 patients’ clinical outcomes.

Diabetic Foot Ulcer (DFU) is a common complication of diabetes mellitus. Among the various non-invasive treatment modalities used for the improvement of DFUs healing, topical herbal therapies are regaining an increasing body of interest. In this report, the authors review the literature and discuss wound healing with a focus on DFUs with Semelil. In this Structured review, we searched for articles published between 2008 and 2021, in the international and national databases with keywords “Melilotus officinalis”, “Semelil”, “Angipars”, and “diabetic foot ulcer”, “wound management”. Eligible articles (n=26) were identified according to inclusion and exclusion criteria. This review showed no complications with the application of Semelil and consensus on the positive effects of the found medication. In summary, our review showed that Semelil may be a valuable non-invasive treatment for wound healing in DFUs patients and reduces the wound size for four weeks without major adverse side effects.