فهرست مطالب
Journal of Research in Medical Sciences
Volume:27 Issue: 9, Sep 2022
- تاریخ انتشار: 1401/07/10
- تعداد عناوین: 10
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Page 67Background
Interleukin?6 (IL?6) is an important mediator in the acute phase of inflammatory diseases such as neuromyelitis optica (NMO) and multiple sclerosis (MS). The level of IL?6 is higher in cerebrospinal fluid and serum of NMO patients compare to MS. Vitamin D has a regulatory effect on IL?6, so it may have a negative correlation with IL?6 in the acute phase of these diseases. This study was performed to evaluate the serum levels of IL?6 and Vitamin D in NMO and MS patients at the onset of disease to find differences that may help in early diagnosis.
Materials and MethodsThis case–control study was done on patients with the first episode of optic neuritis, transverse myelitis, and area postrema syndrome who were referred to Kashani MS Center in Isfahan, Iran, between January 2018 and January 2020. The serum levels of Vitamin D and IL?6 were assessed using enzyme?linked immunosorbent assay in blood sample taken at the time of first presentation in patients who had a definitive diagnosis of NMO and MS during subsequent workup.
ResultsDuring a 2?year follow?up, definitive diagnosis of NMO was given in 25 cases, and they were compared with 25 cases that were randomly selected from patients with definite MS. Nineteen patients in the NMO group and 21 patients in the MS group were female. The mean age of patients in the NMO and MS groups was 29.64 ± 1.47 and 30.20 ± 1.42,respectively (P = 0.46). The mean of serum level of Vitamin D was 24.88 ± 15.2 in NMO patients and 21.56 ± 18.7 in MS patients without significant difference (P = 0.48). The mean of IL?6 was 30.1 ± 22.62 in the NMO group and 23.35 ± 18.8 in the MS group without significant difference (P = 0.28). The serum levels of Vitamin D were insufficient in both groups. No correlation between Vitamin D and IL?6 levels was found in our study (P > 0.05).
ConclusionOur results showed that serum IL?6 levels were higher at the onset of NMO disease compared with MS. The serum levels of Vitamin D were low in both groups and there was no association between serum levels of Vitamin D and IL?6 in either group. Future studies with large sample size are needed to confirm these findings.
Keywords: Interleukin‑6, multiple sclerosis, Vitamin D -
Page 68
Quinazolinone and quinazoline have been shown different pharmacological activities, namely anticancer, anti?inflammatory, anti?hyperlipidemia, analgesic, antihypertensive, and antibacterial. On the other hand, molecular hybridization is a structural modification technique in the design of new ligands which consist of two or more pharmacologically active molecules in one structure. Therefore, due to the importance of the biological activities of quinazolinones for the development of new therapeutic agents, this review emphasizes current findings on various quinazolinone?based hybrids in medicinal chemistry. Moreover, it highlights the biological activities and structure?activity relationship of these hybrids.
Keywords: Biological activities, hybrid, quinazoline, quinazolinone, synthesis -
Page 69Background
Atrial fibrillation (AF) with fast ventricular response over an overt accessory pathway (AP) (preexcited AF) with a short anterograde refractory period is a potentially malignant arrhythmia. This study aimed to evaluate the safety and efficacy of amiodarone for preexcited AF management.
Materials and MethodsThis study enrolled 103 patients with evidence of AP in electrocardiography. Patients with preexcited AF were included in the study. Intravenous amiodarone (300 mg) was nfused for 30 min for all patients in the AF rhythm. Electrophysiological parameters were evaluated before amiodarone injection and 2 h after pharmacological or electrical cardioversion.
ResultsAntegrade and retrograde refractory periods of the atrioventricular node (AVN) and AP, as well as antegrade and retrograde Wenckebach points of AVN, were increased significantly after amiodarone infusion. Furthermore, the meanof the shortest preexcited RR interval was increased during the onitoring period. Comparing the preexcited index at the beginning of the study and before cardioversion (2 h later) revealed that the QRS complexes anged to a wider pattern as the preexcitation index changed from 80.61 to 92.26 (P < 0.001). Nineteen (18.4%) patients converted to the sinus rhythm with amiodarone infusion. No ventricular arrhythmia was detected during monitoring.
ConclusionAmiodarone could be considered a safe drug in patients with preexcited AF for rate control despite its relatively low efficacy in conversion to the sinus rhythm.
Keywords: Accessory pathway, amiodarone, atrial fibrillation, electrophysiology -
Page 70Background
Complications after primary total hip arthroplasty (THA) are the most common reason for revision. Due to the high prevalence of revision surgery, we investigated the frequency of postprimary THA complications and related risk factor revision surgery.
Materials and MethodsThis is a cohort study that was performed in 2011–2019 on all patients who underwent primary THA surgery re?admitted to the Kashani and Saadi Hospital affiliated to Isfahan University of Medical Science, Iran, due to some complications after THA. Demographic and basic data were collected from patient’s medical documents. Harris hip score (HHS) was calculated for all patients 6 months after the last surgery. The obtained data were analyzed using SPSS software version 21. Appropriate statistical tests were conducted to compare the results between the study groups.
ResultsAmong 1260 patients who underwentprimary THA, 1006 of them entered the study after applying the exclusion criteria. Thirty nine patients were under revision, 53.8% had prosthesis infection, 56.4% had instability, 6% had aseptic loosening, and 30.8% had periprosthetic fracture. Odds ratio for the above complications were 45.5, 45, 6.4, and 15.5, respectively. HHS postoperatively was also significantly (P < 0.001) higher in patients without revision. No correlation between gender or surgeon experience and revision was detected; however wound discharge (P < 0.001), body mass index (BMI) (P = 0.003), and Infection during hospitalization (P < 0.001) affect revision rate significantly. All four postsurgery complications, i.e., instability, postoperative prothesis infections, periprosthetic fractures, and aseptic loosening, significantly increased the risk of revision (P < 0.001, for all).
ConclusionInstability, prosthetic infections, periprosthetic fractures, and aseptic loosening were the most common causes for increasing revision rates after THA, respectively. Higher BMI, persistent wound discharge, and nosocomial infections during the first hospitalization also increased the rate of revision after primary THA.
Keywords: Mehdi Teimouri, Mehdi Motififard, Sahar Sadat Lalehzar, Saeed Hatami, Sina Raeisi -
Page 71Background
Long noncoding RNAs (lncRNAs) have been recognized as the main modulatory molecules in various cancers and perform as competing endogenous RNAs (ceRNAs). The nuclear hormone receptor superfamily of ligand?activated transcription factors (NR3C1) regulates numerous proliferative and metabolic processes such as tumorigenesis and metabolic diseases. Furthermore, X?linked inhibitor of apoptosis protein (XIAP) belongs to a family of the inhibitors of apoptosis proteins, is located downstream of the glucocorticoid receptor (GR or NR3C1) pathway, and cooperates with GR to suppress apoptosis. However, the underlying mechanisms of NR3C1 and XIAP in colorectal cancer (CRC) remain mainly unclear. This research aims to clarify the potential RNAbiomarkers and to construct a novel ceRNA network in CRC.
Materials and MethodsMultistep bioinformatics methods such as Lnc2cancer and miRDB databases were applied to identify candidate lncRNAs and miRNAs. The interaction energy between lncRNAs, NR3C1, and XIAP genes was analyzed by the LncRRIsearch database. Plus, microRNAs and lncRNA were evaluated via the Diana tools database to select microRNAs with the most binding scores. Quantitative reverse transcription– olymerase chain reaction (QRT?PCR) was applied to verify RNA molecules’ expression levels and their association with the clinicopathological factors in 30 CRC tissues compared to 30 adjacent tissues.
ResultsQRT?PCR showed upregulation of KCNQ1OT1, NR3C1, and XIAP and downregulation of miR?421. The ceRNA network was constructed with 17 lncRNAs, 2 mRNAs, and 42 miRNAs. Thus, we explained the potential interactions between KCNQ1OT1 and miR?421 with NR3C1 and XIAP genes.
ConclusionOur study represents potential prognostic biomarkers and a new ceRNA network for further study in CRC.
Keywords: Colorectal cancer, competing endogenous RNA, KCNQ1OT1, miR‑421, X‑linked inhibitor of apoptosis protein, NR3C1 -
Page 72Background
Hip dysplasia is one of the most widespread hip disorders. Total hip arthroplasty (THA) is the preferred treatment in patients with cup placement choices in true or false acetabulum. The objective of this research was to compare the effectiveness of the two mentioned procedures.
Materials and MethodsThis study was a randomized, open?label, parallel?group clinical trial, in which 46 patients/51 hips with Crowe type 3 dysplastic hip having THA were assigned to two groups: roup 1 – patients who had cup placement in the true acetabulum and Group 2 – patients who underwent cup placement in the false acetabulum. The variables that were evaluated and analyzed included severity of pain using the visual analog scale (VAS), range of motion (ROM), gait ability, the need for repeated joint replacement, and the Harris Hip Score (HHS).
ResultsForty?six patients/51 hips were included in the present study. The patients who were evaluated included 30 (65.2%) males and 16 (34.8%) females. The mean age in the population under study was 71.0 ± 10.22, and the mean body mass index of participants was 26.34 ± 2.22 kg/m2. The basic parameters in the two research groups were similar (P > 0.05). There were no significant differences between the two groups in terms of the mean values of VAS and ROM (P > 0.05); however, the mean HHS was significantly higher in the true acetabulum group, 57.90 ± 18.47 versus 48.29 ± 13.80 (P = 0.04).
ConclusionThe effectiveness of cup placements both in the true and false acetabula was similar in all of the evaluated variables in terms of clinical outcomes except for HHS which was higher in the true acetabulum group. To further support the results of this research, it is recommended that more research be done on a greater population.
Keywords: Acetabulum, general surgery, hip dislocation -
Page 73Background
Cancer patients, as a highly vulnerable population, are receiving a great deal of attention in the current crisis of coronavirus 2019 (COVID?19). To date, shreds of evidence are not sufficient to the description of COVID?19 outcomes in patients with cancer. This study was performed to evaluate the demographic and clinical characteristics and subsequent outcomes of COVID?19 in cancer patients.
Materials and MethodsA hospital?based study was conducted involving 66 cancer patients with a confirmed diagnosis of COVID?19 from January 15, 2020, to December 21, 2020, in Isfahan, Iran. The clinical information was collected by interview and medical records. The statistical analyses were performed to describe categorical variables as well as mean, standarddeviation, median, and the interquartile range for quantitative variables.
ResultsIn our study, 66 cancer patients with confirmed COVID?19 (age: 17–97 years; 50% female) were included. Leukemia and bone marrow cancer with a frequency of 25.7% were the most common types of cancer among them. Cancer patients mostly complained of fever, cough and fatigue, and shortness of breath. Among 76.9% of patients discharged from the hospital with relative recovery, 23% died; the most common cause of death was acute respiratory distress syndrome. Age, gender, and type of cancer did not affect cancer mortality. COVID?19 had no potential effect to increase the risk of side effects of anticancer therapies.
ConclusionThe results of our studies revealed that cancer is an important risk factor for the higher rate of mortality in patients with COVID?19. These findings could help physicians for the management,treatment, and supportive care of COVID?19 cancer patients.
Keywords: Coronavirus, COVID‑19, neoplasms, retrospective case study, severe clinical events -
Page 74Background
Paraquat (PQ) poisoning is a serious public health concern, especially in developing countries, due to its easy access and lack of awareness of potential harms. No effective treatment has been reported yet. Conventional hemodialysis (HD) is still used in many centers for excreting PQ or reducing acute kidney injury, but there is no consensus on its efficacy. Therefore, we aimed to review the HD efficacy in PQ poisoning mortality.
Materials and MethodsWe searched Web of Science, PubMed, Excerpta Medical Database, Google Scholar, Scopus, Cochrane, Web of Knowledge, Pro?Quest, ScienceDirect, Springer, Clinical Key, cientific Information Database, Magiran, and Iran?doc, in publications before January 1, 2020. We compared patients who underwent HD (Group 1) with those who did not (Group 2). The outcome was considered mortality/survival. The data were analyzed by Comprehensive Meta?analysis Software.
ResultsThis systematic review and meta?analysis included five studies with a combined total of 203 patients. The patients in the Group 1 had higher mortality than Group 2 (odds ratio, 2.84; 95% confidence interval: 1.22–6.64; P = 0.02). There was no evidence of publication bias (P value for Egger’s test = 0.833).
ConclusionAlthough HD did not affect the survival of patients, other variables such as the amount of ingested PQ, poisoning severity, the time between PQ ingestion and the start of HD, duration, and times of HD sessions may influence the results regarding mortality.
Keywords: Meta‑analysis, mortality, paraquat, poisoning, survival, systematic review -
Page 75Background
The first confirmed case of COVID?19 in Iran was reported in February 2019. The current study aimed to investigate the epidemiological aspects of COVID?19 disease in Isfahan province and evaluate the chances of infection and death in the population.
Materials and MethodsIn this cross?sectional study, 21,203 confirmed cases of COVID?19, based on the polymerase chain reaction test, referred to outpatient facilities from February 2019 to July 2020 in Isfahan province are studied. Disease incidence, mortality, and case fatality rate, as well as odds ratio (OR) of infection and death, were calculated and analyzed using SPSS version 20.
ResultsThe highest incidence of the disease was within the age group of 30–39 years 4911 (23.9%) and males 11,561 (54.5%). Mortality in people over 80 years (207 [32.9%]), men (370 cases [58.7%]), diabetics (182 cases [28.9%]), and people with ardiovascular disease (165 people [26.2%]) was more. In multivariateanalysis, patients with a cancer diagnosis had the highest OR of death (OR = 4.03 confidence interval [CI]: 2.56–6.35) (P < 0.001), followedby those with immune deficiency disease (OR = 2.46 CI: 1.07–5.63) (P = 0.03). As the number of comorbidities increased, the risk of death increased in the total population, so that in patients with more than 4 nderlying diseases, compared to the group without disease, the chance of death increased 6.33 times.
ConclusionThis study showed that people ith cancer and chronic respiratory disease had a higher chance of COVID?19 infection. People over the age of 60, people with cancer, and immunodeficiency also had a higher chance of COVID?19 mortalityW.
Keywords: Coronavirus, COVID‑9, disease incidence, epidemiology, mortality