Journal of Kerman University of Medical Sciences
Volume:29 Issue: 4, Jul-Aug 2022

Assembling an artificial ovary needs supporting the in vitro growth of cumulus cells, and finally, follicles. This study aimed to determine the appropriate cocktail for culture of cumulus cells (CCs). CCs were collected from healthy women and cultured with 9 cocktails of basal media, supplemented with 10% and 20% fetal bovine serum (FBS) and 1% and 2% human serum albumin (HSA). Ovarian cells were isolated from cortex, medulla, and hilum, and their conditioned media (CM) were collected. Expression of GDF9 in ovarian cells was evaluated. CCs were treated with various concentrations of CMs from ovarian cells and mesenchymal stem cells. Also, they were cultured with various concentrations of supplements including L-Glutamine, bovine serum albumin (BSA), HSA, insulin transferrin selenium (ITS), Follitropin alfa, and Pregnyl. Also, they were treated with various concentrations of follicular fluids (FFs), collected from patients with different infertility etiologies. Finally, CCs proliferation and culture stability were evaluated. All the ovarian cells expressed GDF9. DMEMF12 + 20% FBS was the most suitable cocktail for CCs. 20% FBS was superior to 10% FBS. HSA alone could not support the growth of CCs. The CMs of (cortical + hilar + medullar) cells and FFs from healthy women caused higher CCs proliferation. 17 mM/l L-Glutamine, 24 mg/ml BSA, 20 mg/ml HSA, 10 ng/ml ITS, 300 mIU/ml Follitropinα, and 3.5 IU/ml Pregnyl led to higher CCs proliferation. Supplementation of the basal medium with CMs, serums, FFs, hormones, ITS and L-Glutamine, can better support the culture of CCs.

Effusion in body cavities can be considered as the presentation of malignancy or inflammatory conditions. Pleural fluid cytology is a popular diagnostic tool for the differentiation of adenocarcinoma cells (AC) from reactive mesothelial cells (RMC). However, there are many sources of controversies and errors in this technique that should be addressed. This case-control study aimed to evaluate the use of immunohistochemistry markers, namely epithelial membrane antigen (EMA) and calretinin, on cell blocks to differentiate between RMC and AC in pleural effusions. Suspected malignant effusions were selected according to the clinical data and their equivocal cytological smears. A total of 80 samples corresponding to the fresh specimens sent from the Department of Internal Medicine to the Cytology Laboratory of Faghihi Hospital during Jan 2017-Feb 2018 comprised the case group. In addition, the control group entailed 80 non-malignant pleural samples with RMC. We observed that 74 (out of 80) effusion samples were strongly positive for EMA (92.5%). The sensitivity, specificity, and efficiency of the EMA marker were 92.5%, 95%, and 93.7%, respectively. The results of the calretinin assessment indicated 78 (out of 80) positive cases in the control group (97.5%). The sensitivity, specificity, and efficiency of calretinin staining were 97.5%, 98.7%, and 98.1%, respectively. According to the results of the current study, EMA and calretinin are two reliable markers with acceptable accuracy in differentiating between RMC and AC.

Among many human diet-related disorders, Diabetes mellitus (DM) stands on the top of the table, its persistent and perdurable threat/stress response to systemic functions and endocrine control makes it's more popular. The management of diabetes and related chronic diseases has focused on the use of indigenous natural compounds, derived from plant sources that possess medicinal properties. Wistar albino rats were fed with high-fat diet comprising 2% cholesterol, 1% cholic acid, 30% coconut oil, 67 % percent regular rat feed, and 25% fructose through drinking water for 60 days to induce type-2diabetic. After induction, type-2 diabetic rats were treated with β-Carophyllene (50, 100, 200, and 400mg/kg body weight once a day, orally) for 30 days, respectively. Fasting Blood glucose, liver and kidney function markers were analyzed. Diabetic animals showed elevated blood glucose level when compared to control. Treatment with 50 and 100 mg/kg b.wt β-Carophyllene did not reach control level. Whereas, 200 and 400 mg/kg b.wt doses effectively reduced the blood glucose levels in diabetic animals. Liver function markers such as ALT, AST, and ALP and kidney function markers like urea and creatinine were also found to be elevated in diabetic animals. β-Carophyllene effectively reduced it. No toxicity was found in 200 and 400 mg/kg b.wt β-Carophyllene treated animals. Since blood glucose was restored to normal range at 200 mg dose itself, the same dose was selected as optimal dose for further study to elucidate the anti-diabetic potential.

Despite traditional beliefs about the beneficial effects of opium use, current evidence suggests an adverse effect of this substance on cardiovascular disease (CVD) risk factors. The present study aimed to investigate the association between opium-addiction status and lipid profile, the severity of atherosclerosis (measured by Gensini score), inflammatory cytokines, and renal function among non-diabetic patients subjected to angiography. This cross-sectional study was conducted on 95 post-angiography patients. Routine tests including lipid profile, blood urea, creatinine, and hematocrit were collected at the time of admission. Also, serum levels of IL-6 and IL-8 were measured using ELISA. Independent sample t-test, Mann-Whitney U test, and chi-square were used to compare variables according to opium addiction. Multivariate regression was conducted to adjust the effect of potential confounding variables. Opium-addict subjects had a higher IL-6 (P=0.049) level and PLT number (P=0.005). In contrast, there was a lower level of TG (P=0.015) and GFR (P=0.039) in the opium-addict group. There was no association between opium addiction and other variables (P>0.05). Although no significant association was observed between addiction and atherosclerosis and even there was a lower level of TG in addict subjects, there was a direct association between the serum IL-6 levels (an important inflammatory cytokine with adverse effects on coronary artery disease) and opium addiction. It has been revealed that confounding variables affect the relationship between opium use and CVD outcomes. Therefore, well-designed prospective studies controlling a vast range of general variables seem to be necessary.

Diabetic nephropathy (DN) is the most common cause of the end-stage renal disease (ESRD) globally. This study aimed to evaluate the effect of Crocin and Losartan on DN in diabetic rats. A single dose of Streptozotocin (50 mg/kg IP) was administered to 40 male Wistar rats to induce diabetes. Crocin and Losartan (50 and 25 mg/kg, respectively) were given orally for four weeks. The study groups were untreated control, Diabetes, Crocin, Losartan, and Losartan-Crocin. At the end of the intervention, blood was tested for FBS, urea, UA, Cr, albumin, TG, TC, LDL-C, HDL-C, TAC, and MDA. Serum levels of FBS, urea, UA, TG, TC, and LDL-C increased significantly in the diabetic group compared to the untreated control group (P = 0.001), while albumin and HDL-C decreased significantly (P = 0.001). In the Crocin group, serum FBS, urea, TG, TC, and LDL-C levels were significantly lower than the diabetic group (P = 0.001), while serum albumin levels were significantly higher (P = 0.02). Serum levels of TAC and MDA in the Losartan group increased (P=0.04) and decreased significantly (P = 0.001) compared to the diabetic group, respectively. The findings of the present study showed that Crocin could control hyperglycemia and prevent DN progression. It appears that combining Losartan with sufficient doses of Crocin improves its efficacy. However, understanding the exact mechanism of these changes requires further studies.

The COVID-19 pandemic is a red alarm for global health, so researchers around the world are working on it to design an effective vaccine against it. Protein is one of the candidates for vaccine development which plays an important role in virus pathogenesis. Accordingly, this study was done to evaluate the critical characteristic of this protein as a vaccine candidate using in-silico analysis. The sequence of SARS-CoV-2-associated E protein was recruited from NCBI and subjected to the IEDB software to evaluate the most potent epitopes. The capacity of the interactions of HLA-I and HLA-II molecules with selective peptides was studied using IEBD tool kit. The E protein sequence was subjected to B cell and T cell tests to realize the most promising peptides that could act as COVID-19 vaccine. Among the tested peptides for the T cell-test, this study found two interesting epitopes: VSEETGTLI and LTALRLCAY that exhibit high binding affinity as a strong indicator to HLA-I and HLA-II alleles together. The results of the analysis demonstrated that some epitopes in the E protein have a relatively higher immunogenicity score based on interaction with HLA-II, such as SEETGTLIVNSVLLF, TLIVNSVLLFLAFVV, LAFVVFLLVTLAILT, LAILTALRLCAYCCN, and SVLLFLAFVVFLLVT. Furthermore, two sequences (FVSEET and PSFYVYSRVKNLNSSRVP) were reported as the selective linear epitopes for B cell, on the surface of SARS-CoV-2 E protein and being Immunogenic. Since E protein can stimulate favorable immune responses, T and B- cell responses, its evaluation in patients with COVID-19 is of a great importance.

Neonatal hypoxic-ischemic encephalopathy (HIE) is one of the most common causes of long-term neurological disabilities among children. Various types of cellular stress stimuli, including oxidative stress, inflammation, and hypoxia, induce heme oxygenase-1 (HO-1) enzyme for different kinds of tissues. The purpose of this study was to evaluate the plasma level of HO-1 enzyme in neonatal HIE patients and to determine the relationship between HO-1 enzyme level and clinical severity of HIE. In this case-control study, the plasma level of HO-1 enzyme was measured through sandwich ELISA in 28 newborns with a proven diagnosis of HIE and 31 healthy full-term newborns admitted to Bentolhoda Hospital, Bojnourd, Iran. Newborns with HIE were classified according to the Sarnat staging to mild, moderate, and severe HIE. Maternal and neonatal data were recorded in checklists and compared between the two groups. The mean plasma level of HO-1 enzyme in HIE patients was significantly higher than that in the control group (104.0 ± 4.01 and 91.63± 2.67 pg/ml, respectively, P=0.011). We also found that plasma HO-1 levels were significantly higher in severe neonatal HIE patients compared to mild and moderate neonatal HIE patients (121.0 ± 8.48Vs. 91.23 ± 3.35 and 105.5 ± 5.76, P ˂ 0.001). Our findings suggested that HO-1enzyme may be associated with the pathophysiology and clinical severity of neonatal HIE. We suggest further research on the correlation of plasma level of HO-1 enzyme at birth with the multi-organ dysfunction and abnormal neurodevelopmental outcomes in full-term newborns with HIE.

Nurses are front-line health-care workers for patients with severe Coronavirus disease (COVID-19) symptoms. The aim of this study was to determine the resiliency of nurses and its relationship with secondary traumatic stress (STS) in pandemic conditions. This cross-sectional study was performed on 233 nurses working in a medical center providing services to patients with COVID-19 in southeast Iran from May to August 2020. Data were collected using demographic questionnaire, Connor-Davidson Resilience Scale (CD-RISC) and The Secondary Traumatic Stress Scale (STSS). Pearson correlation coefficient was used to determine the relationship between variables and data were analyzed through SPSS22. The mean STS score of nurses was 40.82 ± 11.7. The results showed a significant relationship between STS score and Job satisfaction. The mean score of resilience was 60.91± 17.1 in nurses. The resiliency score showed significant difference based on work experience and exposure to COVID-19 disease. The results of correlation test showed that the overall stress score was significantly related to all aspects of resilience except trust (p < 0.05).  Also, based on the multiple regression model, positive acceptance (one of the dimensions of resilience) and exposure to COVID-19 disease were the predictors of STS.  The results showed that there is a significant and inverse relationship between resiliency score and STS. Therefore, according to the present conditions, it is recommended to design programs to improve resilience and reduce stress of nurses during COVID-19 pandemic.

Cleidocranial dysplasia (CCD) is an inherited autosomal dominant disorder affecting the skeletal and craniofacial structures, exhibiting distinct maxillofacial abnormalities. A case of CCD in an adolescent girl who presented with significant maxillofacial abnormalities is reported in this study. She had a total of 58 teeth including the retained deciduous, impacted, and unerupted teeth. The role of radiography in the diagnosis and treatment planning of CCD is inevitable. In our case, the application of cone-beam computed tomography aided in effective treatment planning which included surgical and orthodontic interventions for the management of the maxillofacial abnormalities. Gene testing was done for the patient and the diagnosis of CCD was confirmed. A dental surgeon can be the first person to diagnose the disease because of its striking craniofacial features and associated dental problems. Hence, adequate knowledge about the maxillofacial abnormalities of CCD among dental and maxillofacial surgeons is necessary to aid in an early diagnosis and better aesthetic outcome.

In hypothermia, the core temperature of the body decreases below 35°C. In this situation, the body initiates some thermal regulatory process. Thermal regulation is the balance between heat production (thermogenesis) and heat loss (thermolysis) during thermal changes. Thermoregulation in skin blood flow can maintain body temperature and so homeostasis. A large body of literature has shown that in cold exposure, the hypothalamus contributes to thermoregulation by affecting skin blood flow. Moreover, some peripheral factors contribute to thermoregulation through modification of skin blood flow. Furthermore, the sympathetic nervous system can regulate the body temperature through a noradrenergic vasoconstrictor and a vasodilator system. As orexin receptors are also found in several peripheral mammal tissues, the activation of the orexin may stimulate the autonomic nervous system to increase blood pressure leading to control of heat balance. The present study aimed to evaluate the activity level and involvement of thermal regulators in cold stress. Generally, more experiments should be accomplished to find the regulatory pathways in these situations. Furthermore, this study was focused on the effect of orexin on thermoregulatory functions. This brief review intended to report the studies revealing the prime effects of orexin on the body temperature through influences exerted on the sympathetic nervous system.

This study was conducted to evaluate the status of eye and intraocular pressure (IOP), two-six hours, one day, and one week after cataract surgery and implantation of the intraocular lens.

In a longitudinal study, 159 patients with senile cataracts were evaluated. Phacoemulsification surgery and intraocular lens (IOL) implantation in the capsular bag was done. The examinations including visual acuity measurement, slit-lamp examination, and measurement of IOP were done preoperatively, and three times after the surgery.

The mean±standard deviation (range) age of the patients was 65.8 ± 10.5 (40-90) years. Preoperatively the IOP was 12.8 ± 3.5 mmHg, it increased to 20.8 ± 10.7, 2-6 hours after surgery (P < 0.0001), and then reached 13.7 ± 4.4 mmHg on the first postoperative day (P < 0.0001), then it decreased to 12.4 ± 2.9 mmHg one week after the surgery (P=0.02). The IOP was 28.6 ± 12.2 mmHg in eyes with epithelial edema which was significantly higher than those with stromal edema (17.3 ± 7.5 mmHg), and those without edema (16.5 ± 7.1 mmHg) 2-6 hours after surgery.

Since the IOP spike can damage the structure and function of the eye and cause pain, discomfort, and corneal edema that in turn prolongs recovery of vision, especially in those previously damaged, early postoperative examination on the same day after cataract surgery is strongly advised. IOP spikes can be managed safely by aqueous paracentesis without oral, parenteral, or topical drugs. Elevated IOP is more prevalent in eyes with postoperative epithelial corneal edema and in individuals whose cornea is totally edematous.

COVID-19 is a novel disease that infected many people around the world. It is essential to find the potential high-risk locations and provide suitable healthcare interventions to control COVID-19 distribution. Using a geographic information system, this study aimed to investigate the distribution trends of patients with COVID-19 in Kerman, Iran.

The information of registered patients of Afzalipour hospital in Kerman city who were admitted before July 22, 2020, was collected and used in this paper. The patients’ addresses were converted into geocodes. The trend of disease prevalence in connection with population density in different parts of Kerman was investigated. After that, the average nearest neighbor analysis was performed to check the random distribution of disease cases. Data were checked for randomness by High/Low clustering analysis.

: The spread of the COVID-19 disease started in Kerman city’s north, south, and west and then distributed to the center. The southern and western regions were in high-high clusters, and the central and northern regions were in low-low clusters in terms of COVID-19 outbreak risk. Regression showed a significant correlation between underlying diseases and patients' age with the incidence of Covid-19 disease.

The prevalence of COVID-19 had been higher in densely populated areas and also in areas with poorer economic conditions. Therefore, paying attention to these areas as well as applying strict rules can help control the spread of COVID-19. The result of this study could be useful for public health experts and healthcare managers to manage better this pandemic.