فهرست مطالب

Red Crescent Medical Journal - Volume:21 Issue: 1, Jan 2019

Iranian Red Crescent Medical Journal
Volume:21 Issue: 1, Jan 2019

  • تاریخ انتشار: 1397/10/28
  • تعداد عناوین: 12
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  • Surena Vahabi , Bahareh Nazemisalman*, Mahsa Kalantari , Sepanta Hosseinpour Page 1
    Background
    An imbalance in the expression of matrix metalloproteinases (MMPs) and tissue inhibitor metalloproteinases initiate the destructive process in chronic periodontitis (CP). C-reactive protein (CRP) is a systemic inflammatory mediator that reflects an acute immune response.
    Objectives
    The purpose of this investigation was to analyze the association between the MMP-1 -1607 1G/2G (rs1799750) and CRP 717 A/G (rs2794521) gene polymorphisms and chronic periodontitis in Iran.
    Methods
    This analytical case-control study was performed among 141 participants including 63 CP cases and 78 matched healthy individuals. Five milliliters of peripheral blood was collected for DNA isolation. Restriction fragment length polymorphism- polymerase chain reaction (RFLP-PCR) was performed for single-nucleotide polymorphism (SNP) analysis. The frequencies were analyzed by chi-squared test (95% CI, P < 0.05). In addition, genetic data were assessed by the Hardy-Weinberg principle, linkage disequilibrium, and haplotype analysis.
    Results
    Our findings presented no significant relationship between genotype/alleles of MMP-1 -1607 1G/2G (rs1799750) (0.73: 0.27 - 1.95, P = 0.48) or CRP 717 A/G (rs2794521) (0.384: 0.104 - 1.414, P = 0.303) and the presence of CP (P = 0.47 and P = 0.30, respectively). The analysis of genetic distribution among various severities of CP and controls revealed no significant association between various severities of CP and MMP-1 -1607 1G/2G (rs1799750) (P = 0.52) and CRP 717 A/G (rs2794521) (P = 0.67).
    Conclusions
    Our results suggest no association between the occurrence or severity of chronic periodontitis and MMP-1 -1607 1G/2G (rs1799750) and CRP 717 A/G (rs2794521) polymorphisms. Further studies with larger sample sizes may provide a more generalizable evidence-based overview of the relationship between these gene polymorphisms and periodontitis.
    Keywords: Chronic Periodontitis, C-Reactive Protein, Genes, Matrix, Metalloproteinase-1, Polymorphism, Risk Factors
  • Yalçn Turhan*, Mehmet Arcan , Zekeriya Okan Karaduman , Ozan Turhal , Mehmet Gamszkan , Davut Aydn , Korhan Ozkan Page 2
    Background
    Various topical treatments are available for skin defects. Chronic and complicated wounds can affect a patient’s quality of life and cause significant economic burden and even mortality. Nigella sativa (NS) oil and silver-containing solutions are separately used to treat various skin disorders.
    Objectives
    The current study aimed at examining the healing potential of NS oil, Nano-silver (AgNPs) solution, and their combination to manage skin wounds in a rat model.
    Methods
    The current clinical experimental study was conducted in the Experimental Animal Unit of Abant Izzet Baysal University, Bolu, Turkey, in 2017. Full-thickness skin defects with a 1 cm2 surface area were created on the backs of 20 adult Wistar albino rats. The wounds were covered with 1 cm2 of absorbable oxidized regenerated cellulose (SURGICEL). The rats were numbered and assigned to four groups by simple random sampling. The agents to be compared (saline, NS oil, and AgNPs solution) were administered to the wounds twice daily for 15 days. The wounds were observed for the percentage reduction in original wound size every three days. Scars were harvested on day 15 for histological morphometric analysis.
    Results
    There were no significant differences in the mean vertical scar thickness among the saline (group 1) [1.06 ± 0.18], NS oil (group 2) [0.76 ± 0.14], AgNPs (group 3) [0.98 ± 0.44], and NS oil + AgNPs (group 4) [0.87 ± 0.38] groups (P = 0.556). However, the mean collagen density was significantly lower in groups 1 and 3 [56.50 ± 11.18 and 59.60 ± 3.16] compared with groups 2 and 4 [73.57 ± 6.30 and 80.99 ± 7.19] (P < 0.001).
    Conclusions
    Wounds treated with the combination of NS oil and Nano-silver healed significantly faster, with less scar formation, than the ones treated with NS oil or Nano-silver alone.
    Keywords: Healing, Nano-silver, Nigella sativa, Oil, Rats, Scar, Skin, Wound
  • Fatemeh Sadat Ghoreishi , Mohammadreza Davoudi , Fatemeh Assarian , Maryam Shahriyari * Page 3
    Background
    Based on animal models, the antagonists of alpha-peroxisome proliferator-activated receptors (PPAR-α) such as fibrates decrease reinforcement, brain rewards, and nicotine-related effects.
    Objectives
    The present study aimed at investigating the effect of Gemfibrozil on smoking cessation.
    Methods
    This is a double-blind, randomized clinical trial that performed on 75 adult cigarette smokers from 200 smokers. Hence, 75 adult cigarette smokers were divided into two groups after matching. The experimental group (37 peoples) and the placebo group (38 peoples). The participants received 300 mg Gemfibrozil or placebo at the same amount twice a day for 7 weeks. This study was conducted in a university affiliated hospital, Kashan, Iran. To investigate nicotine dependency, signs of deprivation syndrome and smoking cessation, the Fagerstrom test, Minnesota Scale (MNWS), and exhalation carbon monoxide markers were used.
    Results
    There was no significant difference in demographic characteristics between the two groups. At the seventh week, Fagerstrom mean score was 3.1 ± 3.1 and 5.1 ± 3.4 (P = 0.023) for the treatment and placebo groups respectively. According to the Minnesota criteria, the treatment group showed more increased weight gain and appetite, as well as more decreased desire to smoke (P < 0.001). The success rate of smoking cessation at the end of the intervention and follow-up periods indicated that there was no significant difference between the two groups in this factor (P > 0.05).
    Conclusions
    Gemfibrozil only reduced the symptoms of nicotine deprivation syndrome but did not show significant potential for smoking cessation.
    Keywords: Dependency, Deprivation, Gemfibrozil, Nicotine, Smoking Cessation
  • Maryam Sefidgar Tehrani, Malihe Amirian, Mohsen Jalali, Armin Attaranzadeh, Alireza Fazel, Alireza Ebrahimzadeh Bideskan* Page 4
    Background

    Male infertility rate has increased over the recent years across the globe. Intracytoplasmic sperm injection (ICSI) is mainly used to treat male infertility; however, in this method, sperm selection plays a critical role in improving ICSI outcome.

    Objectives

    The aim of this study was to evaluate the efficiency of three sperm selection techniques on ICSI outcomes in oligoasthenozoospermic men.

    Methods

    This randomized clinical trial study was performed on 80 oligoasthenozoospermic (OAS) couples receiving ICSI in Milad Infertility Center, Mashhad, Iran from October 2016 to June 2017. The couples were randomly assigned to the three groups of control, hypo-osmotic swelling test (HOST) and hyaluronic acid (HA) according to the sperm selection technique for ICSI. Fertilization rate, embryo development (ED), embryo quality (EQ) and implantation rate (IR) were evaluated and compared among the groups.

    Results

    Our results showed that there was no significant difference in fertilization rate between the studied groups. ED rate was increased in the HOST and HA groups compared to the control group, but this difference was not significant. EQ was increased in the HOST (P = 0.001) and HA groups (P = 0.001) compared to the control group. IR was enhanced in the HA group in comparison with the control group (P = 0.021), but there was no significant difference between the HOST and HA groups.

    Conclusions

    The results of this study showed that for achieving successful clinical outcomes and improved embryo quality and implantation rate in oligoasthenozoospermic males undergoing Intracytoplasmic sperm injection, effective sperm selection through either the HOST or HA technique is necessary.

    Keywords: DNA Fragmentation, Fertilization, Injection, Intracytoplasmic, Male Infertility, Oligoasthenozoospermic, Selection, Sperm
  • Mina Eghbali , Majid Baserisalehi *, Masood Ghane Page 5
    Background
    Moraxella catarrhalis is an opportunistic bacterium that has pathogenicity in the human respiratory tract. The rates of colonization and infection of this bacterium are high in the respiratory tract of children and the elderly.
    Methods
    In this descriptive cross-sectional study conducted from April 2016 to March 2018, 400 samples were collected from patients with pharyngitis (n = 92), sinusitis (n = 85), otitis media (n = 43), respiratory failure (n = 60), and healthy individuals as the control group (n = 120) in the Northern part of Iran. The isolates were identified by phenotyping methods. Finally, the virulence genes in the isolates were detected by polymerase chain reaction (PCR) technique.
    Results
    Out of a total number of 400 samples, 32 samples (8%) were positive for M. catarrhalis. The frequency of this bacterium was found to be different in patients with pharyngitis as 5.44%, sinusitis as 8.24%, otitis media as 13.95%, respiratory failure as 15%, and in the control group as 4.16%. Since the P value from the Chi-square test was higher than 0.05, there was no relationship between the prevalence of M. catarrhalis and the type of the disease and control group. The PCR results showed that 100% of the isolates had mcaP, ompJ, and ompCD genes. However, the distribution of other virulence genes was varied.
    Conclusions
    Overall, our findings verified the existence of M. catarrhalis in patients with respiratory diseases. Therefore, the rapid identification and successful treatment can play an important role in preventing their spread. In addition, the results verified the high prevalence of virulence genes in M. catarrhalis isolates from patients compared to controls. Regarding the results of this study and by comparing with similar studies, it can be concluded that the frequency of pathogenic isolates may be different even in regions that are not geographically different.
    Keywords: Colonization, Gene, Respiratory Tract Infection, Moraxella (Branhamella) catarrhalis, Polymerase Chain Reaction, Virulence
  • Mohsen Nafar , Tahereh Sabaghian*, Alireza Khoshdel , Behrang Alipour , Shiva Samavat Page 6
    Background
    Mineral bone disorder is one of the major factors affecting mortality and morbidity in dialysis patients, which is called chronic kidney disease-mineral and bone disorder (CKD-MBD).
    Objectives
    This study aimed to evaluate the laboratory parameters of mineral bone disorder in hemodialysis patients in Iran and their relationship with malnutrition and inflammation.
    Methods
    This multicenter observational study was conducted in 2016 in 58 dialysis centers in Iran. Data of a total number of 7191 chronic hemodialysis patients aged older than 18 years with a dialysis duration of > 3 months were collected. Idiopathic hypercalcemia and history of parathyroidectomy were considered as the exclusion criteria. The serum levels of calcium (Ca), phosphorus (P), and intact parathyroid hormone (iPTH) were measured over a period of three months, and the findings were compared with the K/DOQI (National Kidney Foundation Dialysis Outcomes Quality Initiative) guidelines. Moreover, the serum level of C-reactive protein (CRP) and nutritional status based on geriatric nutritional risk index (GNRI) were assessed.
    Results
    The percentage of the patients who had a serum iPTH level of < 150 pg/mL was 46% while that of patients with iPTH of > 300 pg/mL was 29.3%. Hypercalcemia and hyperphosphatemia were observed in 20.6% and 34.2% of the patients, respectively. Moreover, 51.7%, 61.3%, 24.7%, and 84.7% of the patients, respectively, reached the K/DOQI target range of Ca, P, iPTH, and Ca × P product. The percentages of mild-to-severe malnutrition based on GNRI in patients whose iPTH level was within, below, and above the recommended range of K/DOQI guidelines were 30.7%, 34.1%, and 25.9%, respectively (P < 0.001). Furthermore, the serum level of CRP was significantly higher in low-serum PTH patients than in the other two groups. In total, only could 8.3% of the patients reach the four KDOQI target levels of CKD-MBD.
    Conclusions
    The findings showed a significant percentage of patients had a low serum PTH level, which might be attributed to inflammatory and nutritional factors. Only had a small percentage of patients reached all the K/DOQI targets. Therefore, the effects of inflammatory and nutritional factors should also be considered, particularly in developing countries.
    Keywords: Mineral, Bone, Calcium, Disorder, Hemodialysis, K-DOQI Guideline Phosphorus, PTH
  • Nina Brki, Jovanovi , Sanela Slavkovi*, Mila Beljanski , Ivana Mihi , Milica Lazi Page 7
    Background
    Multiple Sclerosis (MS) affects everyday functioning of individuals with MS, and their family dynamics. Furthermore, MS is a chronic disease with unpredictable course imposing a stressful experience on the entire family. Changes in family functioning patterns are necessary so that they can appropriately respond to complex demands imposed by the disease.
    Objectives
    This study aimed to evaluate predictive values of family resources in the encounter with stressful life events and family adaptation. These data are required to provide adequate family support systems.
    Methods
    The sample consisted of 62 people with MS. The following instruments were used: Family Adaptation Scale, Family Social Support Index, Financial Well-Being Scale, and Family Problem Solving Communication Scale.
    Results
    The results of this research indicate that subjective assessment of the quality of family relationships, measures of the quality of family communication (β = 0.353, P < 0.001), and measures of perceived family social support (β = 0.272, P < 0.05) are the only predictors of successful family adaptation.
    Conclusions
    The results infer that the processes essential for successful adaptation of people with MS occurs within their nuclear family. Therefore, adaptation to accidental crisis created by MS onset can be promoted by strengthening support and communication within the nuclear family.
    Keywords: Adaptation, Family, Multiple Sclerosis, Psychological, Quality of Life, Relationship, Social Support, Stress
  • Soheila Sedaghat , Abbas Ebadi*, Shahnaz Rostami , Malek Fereidooni, Moghadam Page 8
    Background
    Open-heart surgery is a stressful, life-threatening experience inducing fear and anxiety in many patients and their families.
    Objectives
    The present study was conducted to design an inventory assessing the stressors in open-heart surgery patients and evaluate its psychometric properties.
    Methods
    This study was accomplished in two phases. The first phase involved a qualitative study during which in-depth interviews were carried out with 21 therapists and patients with a history of heart surgery. In addition, the primary items of the inventory were extracted by reviewing the literature and available questionnaires through a qualitative approach. In the second phase, the face, content, and construct validities of the inventory were investigated using the exploratory factor analysis with 360 participants. In addition, the reliability of the developed instrument was examined using Cronbach’s alpha and intraclass correlation coefficient (ICC).
    Results
    Based on the findings obtained in the first phase, a pool of items was prepared. The findings of the exploratory factor analysis revealed a five-factor structure that explained 50.45% of the structural variance with a Kaiser-Meyer-Olkin value of 0.921 (P < 0.001). The first (12 items), second (13 items), third (seven items), fourth (eight items), and fifth (10 items) factors were named as “stressors in the intensive care unit”, “stressors related to the fear of uncertain future”, “internal stressors”, “stressors related to treatment team and facilities”, and “preoperative stressors”, respectively. The Cronbach’s alpha coefficient of the final version of the inventory, entailing 50 items, was obtained as 0.87. In addition, the ICC between the test and retest scores was estimated at 0.94.
    Conclusions
    Given the fact that the meaning, concept, and factors associated with any phenomenon are influenced by sociocultural context and they vary from country to country, it is necessary to use a questionnaire designed based on the experiences and concepts expressed by the individuals living in the same context. According to the findings, the developed 50-item Cardiac Surgery Stressor Inventory is a simple, valid, and reliable tool for the measurement of stressors in open-heart surgery patients.
    Keywords: Cardiac, Inventory, Psychometrics, Reliability, Stressors, Surgery, Validity
  • Cheng, Wei Lu , Zhi, Hua Cui , Xiao, Feng Qi , Om Prakash Pant , Cheng, Bo Lu , Ji, Long Hao , Dan, Dan Zhou * Page 9
    Introduction
    Keratitis induced by type I hypersensitivity to metronidazole is rarely reported. In vivo confocal microscopy (IVCM) is a promising method for the investigation of corneal morphology under pathological conditions. The purpose of the present study was to investigate the IVCM features of keratitis associated with anaphylaxis to metronidazole and review the literature regarding IVCM application to study drug-related changes in the cornea.
    Case Presentation
    A 50-year-old woman with acute bilateral keratitis induced by anaphylaxis to intravenous metronidazole presented to the Department of Ophthalmology, the first affiliated hospital of Jilin University, Changchun, China in Jan 2018. She initially experienced photophobia, moderate conjunctival injection, and watery discharge after infusion of intravenous metronidazole. These symptoms gradually resolved one month after she was administered anti-allergic drugs. Corneal morphology related to anaphylaxis to metronidazole was investigated by IVCM before and after treatment. To our knowledge, this is the first reported case of IVCM images of keratitis associated with anaphylaxis to metronidazole.
    Conclusions
    In vivo confocal microscopy can allow objective evaluation of treatment response through cellular changes in the cornea and could provide good-quantity images of ocular surface tissues for follow-up.
    Keywords: Anaphylaxis, Confocal, Keratitis, Langerhans Cells, Metronidazole, Microscopy
  • Massimo De Martinis*, Maria Maddalena Sirufo, Lia Ginaldi Page 10
    Introduction
    One of the most common forms of physical urticaria is the cold urticaria. It can be a medical emergency, since it can induce anaphylaxis and edema of the glottis, and in any case, it is a condition that reduces the quality of life of the affected subjects forced to significantly limit their normal activities. Moreover, since the symptoms are triggered by exposure to cold, which is difficult (if not impossible) to avoid in everyday life, a safe and effective therapy appears to be essential. Unfortunately, traditional therapies often cannot provide adequate and safe answers.
    Case Presentation
    The current study reported the case of a 52-year-old female patient manifesting the first symptoms after going to the stadium to watch football games while sitting in the stands. On such occasions, her buttocks would begin to itch, and started swelling and reddening. These manifestations then occurred on other occasions of exposure to the cold, and in other body areas. The patient visited the outpatient clinic of Allergy and Clinical Immunology Unit, Teramo General Hospital (Teramo, Italy), and was treated with sedating and non-sedating H1-blocking antihistamines (Rupatadine, Cetirizine), a leukotriene antagonist, and oral steroids with no success; therefore, it was decided to treat her with Omalizumab, an anti-IgE antibody.
    Conclusions
    The satisfactory response to Omalizumab in the patient, after the failure of previous standard therapeutic strategies, confirmed the effectiveness of this molecule to treat cold urticaria, which despite what reported in several studies, is not yet recognized and authorized by the competent health authorities in the treatment of this condition.
    Keywords: Allergy, Anaphylaxis, Antihistamines, Anti-IgE Antibody, Cold, Immunology, Leukotriene Antagonist, Omalizumab, Oral Steroids, Physical Urticaria, Urticaria
  • Azadeh Kiani , Seyed Mohd Abbas Zaidi , Mojtaba Heydari * Page 12