Journal of Kerman University of Medical Sciences
Volume:28 Issue: 6, Nov-Dec 2021

Normal exercise can improve human physical abilities, but strenuous exercise can damage human cells. Strenuous exercise causes oxidative stress to the body. In order to determine the level of oxidative stress, it is important to check the levels of Superoxide Dismutase (SOD) and Malondialdehyde (MDA) in the body. SOD is the first line of defence in fighting against the oxidative stress, whereas MDA is the result of oxidative stress cell damage in the body. The sperm cell is the one that is affected by oxidative stress. This research aimed to investigate the differences in the effects of acute and chronic strenuous exercise on SOD production, MDA, and sperm quality. The research was based on experimental design with post-test only control group design with Wistar rats. Eighteen male Wistar rats were randomly divided into 3 groups (n = 6). Group I: Normal control, Group II: Rats were treated to swim for about 25-40 minutes until they were drowning for 1 day (acute strenuous physical exercise), and Group III: Rats were treated to swim for about 25-40 minutes until they were drowning for almost every day for 2 weeks (chronic strenuous physical exercise). Examination of SOD and MDA levels was done using spectrophotometry, examination of sperm quality was done by looking at the morphology, motility, and sperm quantity through the light microscope at x1000 with haemocytometer. Chronic strenuous exercise significantly affects the decreasing SOD levels, increasing MDA levels, and decreasing sperm quality compared to the control group and acute strenuous exercise (P < 0.05). According to the results of this study, the chronic strenuous exercise effects increase oxidative stress and sperm damage.

Medications can increase the incidence rate of metabolic syndrome (MetS) and insulin resistance (IR). This study aimed to evaluate the effects of Carbamazepine (CBZ) or Valproate (VPA) as monotherapy on the development of MetS and IR in adult Iranian epileptic patients.

In this observational analytic case-control study, 80 epileptic patients were treated with VPA (40 patients) or CBZ (40 patients) monotherapies for more than 6 months, and 45 age- and sex-matched controls were included.

Subjects with MetS or with IR had higher age, weight, waist, FBS, cholesterol, systolic and diastolic pressure, TG, LDL, insulin, BMI, and lower HDL. In MetS and IR, the frequency of VPA or CBZ use was significantly higher than the control group. The multiple regression analysis showed that in VPA-treated epileptic patients, the risk of MetS was increased 19 times higher than controls (OR= 19.20; 95% CI= 2.62-140.23, P=0. 004) and risk of IR was increased 15 and 9 times more than controls (OR=14.83; 95% CI=3.03-72.56, P=0.001) and (OR=9.13; 95% CI=2.55-32.65, P= 0.001), respectively. An increase in the waist, DBP, and insulin level were also shown as important factors in the risk of MetS. In patients under CBZ therapy, the risk of MetS reduced by 17% less than controls and the risk of IR increased 7 times more than controls.

Treatment with VPA may increase the likelihood of developing MetS and IR more than the CBZ therapy in epileptic patients in Iran.

Drug resistant Acinetobacter baumannii have emerged as a major problem in many hospitals and intensive care units. The aim of this study was to determine the antibiotic resistance pattern and the prevalence of metallo-beta-lactamase genes among nosocomial A. baumannii isolates from Qom/ Iran. For this study, a total of 108 A. baumannii isolates were collected from hospitalized patients in four teaching hospitals of Qom/ Iran. Antibiotic susceptibility profile of isolates was tested by Kirby-Bauer disc diffusion method and distribution of MBL genes among carbapenem-resistant isolates was determined by polymerase chain reaction (PCR) method. According to the results, 97 (89.81%) isolates of 108 A. baumannii isolates were resistant to carbapenem. All isolates carried bla oxa-51like gene. Among carbapenem resistant isolates, 79.38% carried bla VIM and 1.03% had bla IMP genes. Among the MBL- producing isolates, 7 isolates were MDR, 73 ones were XDR and 5 isolates were PDR. This study also revealed that suceptibility to carbapenems in the population of A. baumannii isolates reduced and the bla VIM gene was the most prevalent metallo-beta-lactamase genotype among carbapenem resistant A. baumannii isolates in this area. MBL-producing A. baumannii in recent years has become a serious concern. Rapid identification and good infection control are requiered to reduce their impact.

Pleural effusion (PE) is common in children with acute illness that are admitted to the intensive care unit (ICU). The present study aimed to investigate the efficacy of albumin add-on therapy to furosemide in contrast to furosemide treatment only for treating transudative PE. The present randomized clinical trial was conducted on fifty 1-12-year-old children (under mechanical ventilation admitted at ICU randomly allocated to treatment with daily furosemide only (2 mg/kg) or albumin (1 gr/kg) add-on therapy to furosemide (2 mg/kg) for three days. The vital signs, venous blood gas, the pleural effusion volume, serum potassium level, potassium, and dopamine requirement were measured daily and compared between the groups. Comparison of the two groups showed a significant decrease in the pleural fluid volume (P<0.001), base excess (P<0.001), diastolic blood pressure (P=0.004), heart rate (P=0.009), and potassium (P=0.005) in the intervention group than the control group. The mean of dopamine and potassium doses requirement were 2.25±0.95 and 2.60±0.89 for the intervention group, and 1.00±0.00 and 2.00±1.41 for the control group, respectively. The comparison of the two groups showed an insignificant difference between them (P=0.26 for the dopamine injection and P=0.57 for the potassium prescription). As the first study worldwide, considerable benefits were observed in the use of albumin and furosemide combination among PICU-admitted children under mechanical ventilation who required negative fluid balance. In addition, no hemodynamic instability or death was reported. During this short-term follow-up period, a satisfactory percentage of children were separated from the ventilator and transferred to the ward.

The literature indicates a link between schizophrenia and a disturbance in innate and adaptive immunity. However, the results about allergic rhinitis have been inconsistent so far. The aim of this population-based study was to investigate the prevalence and clinical features of allergic rhinitis in patients with schizophrenia.

This cross-sectional study was performed on 998 patients and 1000 age- and sex-matched control subjects from March 2013 to August 2014. All participants were assessed by the Score for Allergic Rhinitis (SFAR) questionnaire and nasal smear (for eosinophilia) investigation. Symptoms were assessed using the Brief Psychiatric Rating Scale (BPRS). Univariable and multivariable logistic regression models were fitted to estimate adjusted odds ratios.

The mean age of subjects was 45.0 years, and 61.0% of subjects of either group were male. About 26.5% of subjects in the case group and 21.0% in the control group had allergic rhinitis. The patients with schizophrenia were found to be at an increased risk for allergic rhinitis (adjusted OR 1.41, 95% CI 1.08-1.83) compared to control subjects. Furthermore, multivariable logistic regression identified the affect subscale on the BPRS as a risk factor of allergic rhinitis (P=0.004).

Our results suggest that the prevalence of allergic rhinitis is higher in patients with schizophrenia. However, the impact of type and severity of allergic rhinitis on the course of schizophrenia must be investigated in further trials.

Microencapsulation of probiotics can be used to increase their viability during the process and delivery to target areas in the gut and intestinal tract. The aim of this study was to investigate the effect of microencapsulation on viability of probiotics bacteria (Lactobacillus acidophilus and Bifidobactrium animalis subs lactis) in bile salt solution and simulated gastrointestinal juice conditions. First, 1 gram of probiotic bacteria was mixed in 100 ml of MRS broth and incubated at 37°C for 24 h until bacteria were activated. Microencapsulation of probiotics with sodium alginate/resistant starch and sodium alginate/chitosan were done by extrusion method. The number of viable bacteria was evaluated in bile salt solution (0.6%, w/v) and simulated gastric juice (0.08 mol/L HCl solution contained 0.2% NaCL and pH: 1.55 without pepsin), followed by incubation in simulated intestinal juice (0.05 mol/L KH2PO4 solution with 0.6 % bile salts and pH: 7.43). The microencapsulation could successfully and significantly protect probiotic bacteria against adverse condition of simulated human gastro-intestinal condition. Microcapsules containing sodium alginate/resistant starch had the highest survival rate at the end of the incubation time in bile salt solution (6.3±0.2 × 106 and 4.6±0.3 × 107 for Lactobacillus acidophilus and Bifidobacterium animalis, respectively) and simulated gastrointestinal condition (4.5±0.4 × 107 and 1.7±0.2 × 106 for Lactobacillus acidophilus and Bifidobacterium animalis, respectively). Generally, the microencapsulation process improved the survival of probiotic bacteria under simulated gastrointestinal conditions and bile salts solution and in this case, sodium alginate / resistant starch coating was more effective than sodium alginate/ chitosan.

Breast cancer is a major health problem in Iran with increasing incidence in the recent years. Breast density is one of the most important risk factors for developing breast cancer. Metabolic syndrome that is defined by the presence of multiple clinical and lab data findings has also been shown to be related with breast cancer. A sample of 246 cases who referred to Mahdiyeh hospital in Tehran were selected according to the inclusion criteria and a form was prepared including breast density in the screening mammogram done in our center and recent lab tests including FBS, HDL and TG. We also measured the waist circumference, height, weight and blood pressure of all subjects. Data analysis was done through SPSS23 and using fishers exact and ordinal regression tests. The incidence of metabolic syndrome was 44% among the cases in this study. Mean age ± standard deviation (SD) was 48.08 ± 7.6 years. There was a significant association between lower breast densities and ages greater than 50 years (p = 0.0). There was no significant association between metabolic syndrome or its components and breast density among the patients above 50 years of age but in ages lower than 50 years, there was a significant association between increased breast density and lower abdominal circumference (p=0.017), lower triglyceride levels (p=0.02), higher HDL levels (p=0.018), lower FBS levels and lower frequency of metabolic syndrome. There was no significant association between metabolic syndrome or its components and mammographic breast density after adjustment for age and BMI.

Neurological disability associated with multiple sclerosis and immunosuppressive or immunomodulatory therapy which is administered for it may increase the risk of SARS-CoV-2 infection and its morbidity/mortality.In this study, we evaluated the severity of SARS-CoV-2 infection in patients with multiple sclerosis based on their demographic and disease data. A total of 1361 multiple sclerosis patients from Fars province were interviewed by phone from April 3 to June 20, 2020. Basic demographic data, information about their disease and any symptoms or laboratory results relevant to COVID-19 were gathered. Among the studied patients, 68 ones (5%) were COVID-19 suspected cases and 8 ones (0.58%) were in the confirmed group. Five cases in the confirmed group needed hospitalization. Two patients died while both of them were taking rituximab. The frequency rate of suspected cases with RRMS was 57 (87.7%), followed by 5 (7.7%) PPMS and 2 (3.1%) CIS. In the confirmed group, 25% used corticosteroid drug and 50% were on rituximab; moreover, 62.5% of the confirmed cases had a high disability level and needed assistance to walk. In whole, 36.8% of the suspected and 25% of the confirmed cases were on IFN-β1; eventually, all of them recovered well from COVID-19 infection. In the present study, the rate of developing COVID-19 in multiple sclerosis patients was similar to the general population and most of patients with multiple sclerosis recovered from COVID-19 without referral to a medical specialist.

 Dentinogenesis imperfecta (DI) is an autosomal dominant (AD) hereditary dentin disorder, which occurs in the absence of any systemic disorder. The patients with DI presented rapid and severe attrition in primary teeth, which causes functional disorders and unusual discomforting appearance.

The purpose of this case report was to describe the clinical, radiographical, Familial, histopathological, and genotype characteristics of a 2.5-year-old boy with early diagnosis of dentinogenesis imperfecta type II. In this case, it was also presented an uncommon and novel treatment method to promote function and esthetic of dentinogenesis imperfecta patients with 18-month follow up. The treatment plan included two major phases: 1) Restoring badly destroyed teeth by stainless steel crowns to reconstructed ideal function and 2) Using Wiedenfeld’s method for making the appearance of anterior teeth better and acceptable.

Combination of “restoring destroyed teeth by steel crowns” and “using Wiedenfeld’s method for anterior teeth” provided function and esthetic successfully for patients with dentinogenesis imperfecta.

Gingival SCC is the malignancy of gingival epithelium. Prevalence of gingival and alveolar process SCC is 2% to 12% of diagnosed cases. However, it occurs much more frequently in the mandible than in the maxilla. The purpose of this case report is to introduce a case of gingival SCC in the anterior maxilla with no diagnosed risk factor.

A 49-year- old male with the chief complaint of a growing mass in anterior maxillary gingiva with the differential diagnosis of reactive lesions for three months. Panoramic and periapical examination showed no evidence of generalized alveolar bone resorption. After the excisional biopsy, in the follow-up session, the recurrence of the lesion was seen. Considering rapidly growth of the lesion, suspension to SCC was reinforced and the next excisional biopsy was done. Histopathologic analysis established the diagnosis of squamous cell carcinoma.

SCC is a great imitator; for lesions with a benign appearance on the gingiva and it should be considered in the differential diagnosis. This case report revealed the importance of early diagnosis of gingival SCC. Considering the low survival rate of gingival SCC and its high morbidity, early diagnosis help improves the survival of the patient

Pulmonary carcinoma is a burdensome malignancy that has the third rank in prevalence among other cancers and is the leading cause of death in patients with cancer diagnosis. Signet ring morphology is encountered commonly in many sites like stomach, bladder, gallbladder and etc. Primary signet ring adenocarcinoma of the lung is a rare phenomenon, including about 5% of all surgically removed pulmonary adenocarcinoma. It should be distinguished from metastatic tumors.

a 34-year-old nonsmoker man who referred to Babol Rohani Hospital with a one-month history of nonproductive cough. Biopsy with CT scan guidance from ground-glass opacities of the left lung revealed neoplastic cells with signet ring appearance infiltrating lung parenchyma. Immunohistochemistry (IHC) study revealed positivity of neoplastic cells for AE1/AE3, CK7, TTF-1 and negativity for CK20, CDX2, and CD68.

The signet ring feature of pulmonary adenocarcinoma has shorter survival, therefore, it is associated with poor prognosis. Immunohistochemistry (IHC) techniques provide the ability to originate tumor cells in these conditions.

Scimitar syndrome is characterized by partial or total anomalous pulmonary venous return from the right lung along with pulmonary hypoplasia. Scimitar syndrome is associated with a partial anomalous pulmonary venous connection of the right lung to the inferior vena cava, right lung hypoplasia, heart dextroposition, and anomalous systemic arterial supply to the right lung. Patients are diagnosed either early with severe symptoms (infantile type) including tachypnea, chest infection, heart failure and failure to thrive or late with minimal symptoms (childhood/adult type) as a result of accidental findings. The most common anomalies associated with this syndrome are intracardiac defects with a prevalence of about 40%. Here.

 we present a case of a male infant with respiratory distress and manifestation of large ASD2 and pulmonary hypertension, who was diagnosed with scimitar syndrome after more evaluation.

This diagnosis should be considered when ASD2 with PH are diagnosed in infantile period.

Several types of cancer have mutations in the tumor suppressor gene p53. Environmental mutagens such as heavy metals play an undeniable role in p53 mutations and leave the mutational fingerprint on the TP53 gene. Therefore, the study of p53 mutation spectra can reflect the past heavy metals exposure.

The current study was found interesting results by reviewing the previous data published in the databases. These results were obtained by comparing the common mutational profile between Iran, India, and Pakistan, and the association of these mutations with metals. The mutations in codons 146 (TGG→ TGA, Trp→ Stop), 214 (CAT→CGT, His→ Arg), and 249 (AGG→AGT, Arg→ Ser) were common in both India and Iran, due to the contamination by zinc and arsenic; arsenic and copper; cadmium, arsenic, nickel, and copper poisoning, respectively. Moreover, the mutations in codons 248 (CGG→ CAG, Arg→ Gln), 220 (TAT→ TGT, Tyr→ Cys), 248 (CGG→ TGG, Arg→ Trr), and 273 (CGT→ CAT, Arg→ His) were common among these three countries that could be related to poisoning with arsenic and zinc; arsenic; copper and arsenic; zinc and arsenic, respectively. These results can give a possible explanation for the cause of mutational similarities in these three areas, which can help identify the cause of high rates of p53 mutation and cancer control in these areas.

However, concerning the effects of other environmental factors, we definitely cannot explain the cause of these mutations among the heavy metals mentioned, since it requires more detailed studies.