فهرست مطالب

Iranian Red Crescent Medical Journal
Volume:22 Issue: 4, Apr 2020

  • تاریخ انتشار: 1399/02/02
  • تعداد عناوین: 10
|
  • Ali Ramazan Benli, Suleyman Ersoy * Page 1
    Objectives

    In this study on the steelworkers, we aimed to investigate the impact of wet cupping therapy (WCT) on heavy metal levels in the blood.

    Methods

    This single-arm clinical trial was performed at Karabuk University Training and Research Hospital from January to August 2018. All patients received three WCT sessions once every month. Venous blood specimens were drawn prior to the first WCT session (venous 1) and following the third session (venous 2). Cupping blood samples were also obtained during the first session of WCT. Heavy metal levels were assessed by inductively coupled plasma mass spectrometry (ICP-MS) device. Thirteen metals were subject to examination: aluminum (Al), antimony (Sb), arsenic (As), cadmium (Cd), chrome (Cr), cupper (Cu), iron (Fe), lead (Pb), manganese (Mn), mercury (Hg), molybdenum (Mo), nickel (Ni), and zinc (Zn). Relationships between the blood samples were examined using Wilcoxon Signed Rank test by R statistical software.

    Results

    Forty-four subjects completed the study. The levels of Al, Cd, Cr, Cu, Mn, Mo, Ni, Sb (P < 0.001 in all), Hg (P = 0.024) and Pb (P = 0.012) were significantly lower in venous 2 samples compared to venous 1, while no significant changes were observed in the levels of Fe, Zn, and As (P = 0.575, P = 0.090 and P = 0.195, respectively). When compared to venous 1 the levels of Mn, Zn, As, Sb, Hg (P < 0.001 in all), Al (P = 0.003), Cr (P = 0.004), Cu (P = 0.022) and Mo (P = 0.014) were found significantly higher in cupping blood while Cd, Pb, and Ni were not at significantly different levels (P = 0.160, P = 0.079 and P = 0.713, respectively). Fe was found significantly lower in cupping blood (P < 0.001).

    Conclusions

    This study showed that WCT has significantly reduced heavy metal levels in the blood. It might be useful in workers who work in jobs where heavy metal toxicity can be seen.

    Keywords: Complementary Therapies, Wet Cupping Therapy, Heavy Metals, Detoxification
  • Samaneh Motamed Jahromi*, Sadegh Niami Jahromi Page 2
    Background

    Pumpkin seeds are rich in phytoestrogens (estrogen precursors) and can be good alternatives to synthetic estrogen therapy, without exerting destructive effects on renal and ovarian tissues.

    Objectives

    In the present study, the effect of hydro-alcoholic extract of pumpkin seeds on estrogen levels was assessed in adult female rats and its effects on serum and tissue markers of kidney and ovaries.

    Methods

    In this experimental study, 32 adult Wistar female rats (at 60 days of age and weighing10 ± 180 g) were randomly divided into four groups of 8: three experimental groups and one control group. The three experimental groups received a hydro-alcoholic extract of pumpkin seed via intraperitoneal injection for 21 consecutive days (doses of 20, 50, and 100 mg/kg body weight, respectively). One day after the last injection, blood samples were taken from the rats to test serum levels of blood urea nitrogen (BUN), Creatinine, uric acid (UA), estrogen, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH). Moreover, their kidneys and ovaries were removed for histological studies.

    Results

    The results showed significant increases in serum levels of FSH and LH and in the number of graph follicles in the experimental group 3, in addition to significant reduction in the number of primitive and primary follicles in the three experimental groups as compared with those in the control group, in the number of secondary follicles in the experimental group 1 compared with that in the experimental groups 2 and 3, and also in renal cortical thickness, Bowman’s capsule thickness and glomerulus diameter in the experimental groups 1 and 2 compared with those in the control group (P < 0.05).
    Conclousions: It can be concluded that the estrogen found in the hydro-alcoholic extract of pumpkin seeds can play a prominent role in ovulation with the least destructive effect on renal tissue. Hence, it may be a suitable alternative to synthetic estrogen and menstrual cycle regulators.

    Keywords: Hormone, Estrogen, Kidney, Rat, Female, Pumpkin Seeds
  • Youfu Ke *, Zemin Chen, Bo Peng Page 3
    Background

    Mainland China has adopted the most decisive and proactive measures to contain the SARS-CoV-2 epidemic, which helps control the spread of the virus across the country.

    Objectives

    Early epidemiological investigations found that the SARS-CoV-2 epidemic was more critical in Hubei province (Hubei) than in rest parts of mainland China (Rest of China). A cross-sectional study was conducted to answer this urgent question and provide implications for the world.

    Methods

    Infected cases from Mainland China were divided into two groups: Hubei and the Rest of China. Prevention, quarantine, and treatment were based on The Novel Coronavirus Infected Pneumonia Diagnosis and Treatment Standards. Total confirmed cases, daily severe cases, total deaths, and total discharged cases were collected from January 20 to March 4 for statistical analysis.

    Results

    Hubei accounted for 83.9% of China's total confirmed cases and 96.3% of China's total deaths. The percentage of severe cases and the rate of fatality in Hubei were higher than those in the Rest of China (P < 0.01). Daily severe cases in Hubei hit the peak at 11,246 cases on February 18, compared to 989 cases on February 10 in the Rest of China. The percentages of daily severe cases in both regions declined throughout the epidemic, from 23.3% to 8.6% in Hubei compared to 15.0% to 1.3% in the Rest of China. The latest fatality rate in Hubei was 4.30%, which was much higher than 0.85% in the Rest of China. Up to March 4, 64.7% of China's total confirmed cases were cured, 3.86% died, and 31.5% were under treatment.

    Conclusions

    The implications for the world are cutting off the sources of infection and transmission routes, early detection, early isolation, and early treatment that can prevent the spread of SARS-CoV-2 and reduce the severity and fatality rate.

    Keywords: 2019-nCoV, COVID-19, Cross-Sectional Study, Epidemiological Investigation, SARS-CoV-2
  • Irfan Koca, Recep Dokuyucu*, Zeynel Abidin Tas, Hasan Gokce, Oguzhan Ozcan Page 4
    Background

    Osteonecrosis (ON) is a serious health problem, which dramatically reduces the quality of life.

    Objectives

    In the present study on the rat model of glucocorticoids (GCs) -induced ON, we explored the influence of alpha-lipoic acid on serum levels of TGF-β1 and urotensin-II (U-II) and on histological alteration with respect to fatty degeneration and osteocyte necrosis.

    Methods

    A total of 32 male Wistar albino rats were equally assigned to four groups, including control, methylprednisolone acetate (MPA), alpha-lipoic acid (ALA), and MPA with ALA (MP1 + ALA). The animals in MPA group subcutaneously received 15 mg/kg/week during 2 weeks, whereas 100 mg/kg/day ALA was intraperitoneally administered to ALA group during 4 weeks. The MPA + ALA group had both treatments with the same doses. ON was confirmed and graded histologically. Lipid peroxidation and DNA damage levels were immunohistochemically assessed in rats’ bones.

    Results

    After histopathological examinations, ALA injection attenuated oxidative stress levels through reducing both 8-OHdG-and 4-HNE-positive cells in the femoral head region (P < 0.05). The U-II and TGF-β1 protein levels significantly decreased after ALA treatment in MPA injected animals (P < 0.05, P < 0.01, respectively). Moreover, there was a strong correlation between U-II and TGF-β1 protein levels (P = 0.019, r = 0.884).

    Conclusions

    This study is novel with regard to showing the therapeutic effects of ALA on GC-induced ON in rats as well as the strong correlation between the expression levels of U-II and TGF-β1 proteins. In this regard, ALA may be a therapeutic agent in the treatment of ON patients.

    Keywords: Osteonecrosis, Alpha-Lipoic Acid, Urotensin-II, TGF- 1
  • Omolbanin Abaspour, Mohammad Akbari *, Asghar Rezasoltani, Amir Ahmadi Page 5
    Background

    Cervicogenic headache (CGH) is a disabling condition associated with musculoskeletal impairment of the cervical region. There is limited evidence for the efficacy of muscle energy technique (MET) on CGH.

    Objectives

    The present study aimed to assess the effect of MET on CGH patients.

    Methods

    In this single-blinded, randomized, controlled study, thirty subjects with CGH aged 18 - 55years were randomly assigned into two groups, intervention group (MET in cervical muscles + infrared (IR) radiation) and control group (IR). Both groups received these interventions for 6 sessions, 3 times a week for two weeks. Outcome measures included headache index, upper cervical rotation range of motion (ROM), and deep upper cervical muscles thickness.

    Results

    In the intragroup analysis, the headache index and upper cervical rotation ROM were significantly different in the two groups (P < 0.05), but in the intergroup analysis, only left upper cervical rotation ROM was significantly different (P < 0.05). Additionally, all muscles thickness had no significant difference in intragroup and intergroup analyses (P > 0.05). The effect size was large in the MET group than that in the control group for ROM and headache index (d > 0.7), but this was less than medium for muscle thickness in the two groups (d < 0.5).

    Conclusions

    MET + IR is a suitable and durable approach for CGH treatment and increase of upper cervical rotation ROM rather than IR alone, but this approach cannot change the muscles thickness significantly in 2 weeks.

    Keywords: Cervicogenic Headache, Muscle Energy Technique, Headache Index, Deep Muscle, Thickness
  • Seyedeh Shaghayegh Mirabdollah Elahi, Reza Mirnejad, Reza Kazempoor*, Fattah Sotoodehnejadnematalahi Page 6
    Background

    Over the past three decades, the use of probiotics has increased as growth promoters and effective supplements to reduce the pathogenicity of pathogens. In this regard, Lactobacillus bacteria are among the most common probiotics used, as they can help strengthening the digestive system and therefore reducing intestinal hystopathological damage when encountering pathogens.

    Objectives

    This study aimed to evaluate the histopathologic effects of Lactobacillus acidophilus as a dietary supplement in zebrafish ration, as an appropriate laboratory model, and in the exposure to Escherichia coli O157: H7.

    Methods

    In this project, 48 fish were grouped in 4 aquariums and monitored for 30 days; control group (C1A1) received basic ration; B1A1 group received control group ration and were exposed to E. coli O157: H7; Treatment 1 (T1A1) received basic ration containing L. acidophilus with no exposure to E. coliO157: H7, and Treatment 2 (T2A2) received basic ration containing L. acidophilus with exposure to E. coli O157: H7. During 30 days of the experiment, the samples were taken from the intestinal tissue in the days 15, 27, and 30 for the histopathological examinations.

    Results

    The results of the findings showed a significant increase in the length of the intestinal villi and the number of goblet cells in the studied tissue in the group treated with a ration containing probiotic supplements compared to the control group (P < 0.001, P < 0.01, P < 0.05). Also, in the group exposed to E. coli O157: H7, histopathological changes including mild edema, inflammatory cell accumulation in the intestinal mucosal tissue, severe necrosis and epithelium loss in the intestinal tissue were evident. These symptoms were much lower in the group fed with probiotic.

    Conclusions

    According to the obtained data, it can be concluded that feeding fish using L. acidophilus supplement can produce very beneficial effects in reducing tissue damage caused by E. coli O157: H7 infection in zebrafish intestines as a laboratory model.

    Keywords: Escherichia coli O157: H7, Lactobacillus acidophilus, Zebrafish
  • Fereshteh Mohammadizadeh, Somayeh Heydari* Page 7
    Background

    Fibronectin plays a key role in the extracellular matrix. The expression of fibronectin and its impact on tumor behavior have been studied in several tumors such as breast carcinoma.

    Objectives

    We aimed at investigating the immunohistochemical expression of intracellular fibronectin in breast carcinoma and its relationship with significant clinicopathological factors.

    Methods

    This case-control study was conducted on 125 formalin-fixed and paraffin-embedded tissue blocks, including 50 invasive breast carcinomas (tumor group) and their adjacent normal tissue (tumor control group), and 25 normal control samples from mammoplasty (normal control group). The samples were obtained from the pathology archive of Alzahra Hospital, Isfahan, Iran, from 2016 to 2018. All the 125 samples were stained immunohistochemically by the fibronectin antibody. Intracellular fibronectin expression was then compared between the three groups. Moreover, the relationship between fibronectin expression and some clinicopathological factors was evaluated in the tumor group.

    Results

    Fibronectin staining intensity and extent showed no significant difference between the normal control and tumor control groups (P-Value = 0.65 and 0.065, respectively), while the tumor group showed a significant difference from both normal control and tumor control groups in fibronectin staining intensity (P-Value = 0.002 and < 0.001, respectively) and fibronectin staining extent (P-Value < 0.001). In addition, a significant relationship between fibronectin expression in tumor samples and fibronectin staining intensity and tumor grade was observed (P-Value = 0.01). However, fibronectin expression did not show any significant relationship with age, tumor size, tumor subtype, and lymph node status.

    Conclusions

    Intracellular fibronectin expression seems to be a tendency observed in some breast carcinomas. Normal breast tissue, whether adjacent to carcinoma or normal control, does not show such a tendency. Despite the significant relationship between fibronectin expression and carcinoma grade, fibronectin expression did not show any significant relationship with tumor size and lymph node status.

    Keywords: Breast Cancer, Fibronectin, Immunohistochemistry, Prognostic Factors
  • Omid Salimi, Aliasghar Mohammadvand, Abbas Ebrahimi Kalan, Mohammad Charkhpour, Javad Mahmoudi, Bohlool Habibi Asl* Page 8
    Background

    Spinal Cord Injury (SCI) is one of the leading causes of severe neurological deficits worldwide. The pathophysiology of SCI includes a primary injury followed by a cascade of secondary biochemical and cellular changes. Current pharmacological options are limited for significant recovery from SCI. The β-lactam antibiotic ceftriaxone (CEF) and N-acetylcysteine (NAC) have shown to induce neuroprotection in animal models of neurodegenerative disorders.

    Objectives

    This study aimed to evaluate the effects of CEF, NAC, and their combination on the functional recovery and histological damage in experimental SCI.

    Methods

    Rats were randomly divided into four groups (n = 7): Saline, CEF, NAC, and CEF + NAC. Then, SCI was performed on rats under general anesthesia using the Neurosciences Research Center (NSRC) impactor. Locomotor recovery following SCI was monitored using the locomotor rating scale of Basso, Beattie, and Bresnahan (BBB). At the end of the study, all rats were sacrificed, and spinal cord cross-sections were stained with hematoxylin and eosin for histopathological evaluation.

    Results

    The CEF and NAC administration, either alone or in combination (CEF + NAC), significantly improved locomotor recovery following SCI in rats when compared to the saline group. The histological analysis showed that the severity of histopathological lesion in the spinal cord of rats was significantly lower in the CEF, NAC, and CEF + NAC groups than in the saline group.

    Conclusions

    Treatment with CEF and NAC, either separately or in combination, promotes locomotor recovery following SCI, which is associated with the effective reduction of the histopathological lesion.

    Keywords: Spinal Cord Injury, N-acetylcysteine, Ceftriaxone, Methylprednisolone, Rat
  • Xianwu Xia, Liang Sheng, Tiejun Yang, Guobing Zhang, Li Ding, Jianmin Shen*, Jihong Feng Page 9
    Background

    Regarding the outbreak of highly contagious the 2019 Novel Coronavirus (2019-nCoV) in various countries and regions, data have been needed on the early chest CT images and clinical characteristics of the affected patients.

    Objectives

    To explore the early clinical and computed tomography (CT) characteristics of the 2019 Novel Coronavirus Disease (COVID-19) patients to improve the diagnostic level of this contagious respiratory disease.

    Methods

    An analysis retrospectively was implemented on the radiological features and clinical characteristics of 12 patients with COVID-19 who had undergone chest CT scanning in the designated hospital from Jan 23, 2020, to Feb 18, 2020. The clinical data on general information, epidemiological, cardinal symptoms, blood test, and CT imaging characteristics were obtained.

    Results

    According to the relevant diagnostic criteria, the patients were divided into two groups: mild (2 cases), and ordinary type (10 cases). The main symptoms of 2019-nCoV pneumonia were fever (9/12) and cough (8/12) with or without respiratory and other systemic symptoms. The blood test of the patients showed that most of the white blood cell count was normal (10/12), decreased lymphocyte count (6/12), and increased hypersensitive C reactive protein (hs-CRP) (5/12). In the early stage of COVID-19, the chest CT images showed patchy mixed ground-glass opacity (GGO) (8/12), mainly distributed in the periphery and posterior part of both lungs. The internal density of image lesion area was uneven, and lesions primarily manifested as “crazy-paving pattern” (8/12), with grid-like, interlobular septal thickening, thickened bronchovascular bundle and air bronchus sign andmultiple fibrosis. A few cases showed pulmonary atelectasis (1/12), bilateral pleural effusion (1/12), no mediastinal or bilateral hilar lymph node enlargement.

    Conclusions

    The clinical characteristics of 2019-nCoV pneumonia are similar to those of common viral pneumonia. The chest CT images may be helpful for the early detection of novel coronavirus pneumonia.

    Keywords: COVID-19, Pneumonia, Tomography, X-Ray Computed
  • Wang Shupeng, Yue Gu, Qingchun Guan, Ludong Tan, Ya Hui Liu* Page 10
    Background

    Carcinosarcoma is a rare type of malignant tumor that can occur at various organs, such as the digestive tract, lung, and mammary glands (1-4). Carcinosarcoma of the pancreas is an extremely rare and complicated malignant neoplasm, with the characteristics of high invasiveness and rapid progression, early metastasis, and poor prognosis (4).

    Case Presentation

    We reported a 75-year-old male patient who was admitted with the chief complaint of intermittent pain in the right upper abdomen for more than one month. Computed tomography scans revealed a space-occupying lesion located in the tail of the pancreas considering pancreatic carcinoma. The patient underwent surgical resection of the tumor. Macroscopic observations showed a mass of approximately 6 cm × 5 cm with grayish-white cut surface. Histological analysis showed a large amount of abnormal differentiated epithelial cells and spindle cells. The immunohistochemistry results demonstrated biphasic neoplasm with both malignant epithelial and mesenchymal components. Then, the patient was diagnosed with carcinosarcoma of the pancreas. Although pancreatic carcinosarcoma was considered to have a poor outcome as previously reported, the patient was free of recurrence for 15 months after the surgery, a longer tumor-free survival recorded for this type of cancer, maybe because the patient received gemcitabine adjuvant chemotherapy after the surgery. The current literature shows that the longest postoperative survival time is 26 months (5).

    Conclusions

    Carcinosarcoma of the pancreas is a rare tumor. Surgery is the main way of treatment, and chemotherapy can delay tumor development to some extent.

    Keywords: Carcinosarcoma, Epithelial Cell, Pancreas, Spindle Cell, Survival