مجله پزشکی بالینی ابن سینا
سال سی‌ام شماره 1 (پیاپی 107، بهار 1402)

Cytokine production was shown to be changed in Type 2 diabetes mellitus (T2DM). Nonetheless, the relationship of pro-inflammatory interleukin (IL)-32α with anti-inflammatory IL-35 and transforming growth factor (TGF)-β is unclear in T2DM. The present study aimed to evaluate the IL-32α, IL-35, and TGF-β levels produced by peripheral blood mononuclear cells (PBMCs) in patients compared to healthy controls (HCs). Correlations between the IL-32α and IL-35 and TGF-β, as well as between those cytokines and paraclinical parameters [(fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c), GFR, albumin, and creatinine)] were assessed.

Blood samples were taken from 38 patients and 38 HCs. The PBMCs from each donor were isolated with the ficoll method and cultured with in vitro stimulator for four days. The production of IL-32α, IL-35, and TGF-β in culture supernatants was determined with ELISA. Paraclinical parameters were evaluated by standard laboratory methods.

High levels of IL-32α and low levels of IL-35 were found in patients compared to in HCs (P=0.006; P<0.001). A negative correlation between IL-32α and IL-35 was detected in patients (P<0.001). IL-32α was positively correlated with FPG and HbA1c (P=0.002, P=0.005), whereas IL-35 was negatively correlated with them in patients (both P<0.001). No correlations were detected between the cytokines and BMI, GFR, albumin, and creatinine, as well as between the TGF-β levels.

Increased IL-32α but diminished IL-35 production are linked with each other and with the glucose metabolism parameters in T2DM. It seems that IL-32α and IL-35 have a potential role in T2DM pathogenesis.

Laparoscopic cholecystectomy is considered a global standard procedure for the surgical treatment of gallstones. The present study aimed to compare the effect of dextromethorphan and oral placebo on postoperative analgesia in patients undergoing laparoscopic cholecystectomy.

This double-blind clinical trial study was performed on 114 ASA I and II patients who were candidates for laparoscopic cholecystectomy. Two hours before the induction of anesthesia, the intervention group was administered 30 mg of plain dextromethorphan syrup, and the control group was given 2 cc of placebo of an oral syrup. Pain intensity, systolic and diastolic blood pressure, heart rate, and SPO2 at the time of recovery, 1, 6, and 12 hours after surgery, and the amount of pethidine were recorded. Data were analyzed in SPSS software (version 24) at a significance level of 0.05.

The mean pain intensity was statistically significant in the control and intervention groups. The mean pain intensity in the intervention group was lower than that in the control group (P<0.05). Diastole blood pressure, heart rate, and SPO2 in the two groups did not have a statistically significant difference (P>0.05), while systolic blood pressure statistically differed (P<0.05). The amount of pethidine consumption in the intervention group was higher than that in the control group.

As evidenced by the obtained results, low-dose dextromethorphan (30 mg) is effective in postoperative analgesia for patients undergoing laparoscopic cholecys-tectomy and reduces opioid use.

Sirtuin1 is one of the important indicators involved in metabolic control, obesity prevention, and homeostasis control. This study aimed to investigate the effect of combined exercises and curcumin consumption on metabolic indices and serum levels of Sirtuin1 in men with metabolic syndrome.

The present study was conducted as a clinical trial in men with metabolic syndrome in three intervention groups and one control group. The people in the intervention group underwent an exercise program for 8 weeks and three sessions a week, the supplement group took 3 capsules of 500 mg daily. Blood factors were measured before and after the last training session. Data were analyzed by paired t-test, analysis of variance and covariance.

A significant difference was observed in the intra-group changes of the studied variables (Sirtuin1, HDL, LDL, TG, FBS, and TC) in all three intervention groups (P≥0.05). The results of analysis of covariance test showed a significant difference between the four groups in the indices (Sirtuin1, HDL, LDL, TG, FBS, and TC) after the test (P<0.05).

Combined exercises, curcumin consumption, and implementation of both interventions simultaneously positively affected the metabolic indices and serum levels of Sirtuin1 in people with metabolic syndrome.

There is not enough information about the long-term pulmonary complications of patients with COVID-19. This prospective study aimed to compare the findings of lung CT scan upon admission and three months after the discharge of patients with COVID-19.

This prospective study was conducted on 60 patients with COVID-19 hospitalized in Shahid Beheshti and Sina hospitals in Hamadan, Iran, in 2020-2021. The lung CT scan results of the patients upon admission and three months later were assessed and compared by an experienced radiologist quantitatively and qualitatively after obtaining and recording the demographic characteristics, risk factors, and clinical findings.

The mean score of lung involvement upon hospitalization of the patients was 3.7±1.4, and three months after discharge, it was determined at 1.1±1.2. The most frequent findings in the initial CT scan of the patients were ground-glass opacification, mixed GGO, and bands with frequencies of 60%, 36.7%, and 18.3%, respectively. After three months, CT scan results of 32 (53.3%) patients showed lung involvement and an abnormal finding in the lung, the most common of which were ground-glass opacification, mixed GGO, and bands with frequencies of 30%, 13.3%, and 10.0%, respectively. Patients who had pulmonary involvement three months after discharge had a higher average lung involvement score during hospitalization (4.4±1.5 vs. 2.9±0.7, P=0.001).

Abnormal CT scan results of the lung three months after discharge is common in COVID-19 patients, among whom patients with more pulmonary involvement during hospitalization have more abnormal findings

Condyloma acuminata is treated in different ways, each of which may have advantages and disadvantages. The present study aimed to evaluate the effective factors in response to cryotherapy treatment in women with condyloma acuminata.

This case-control study was conducted on 200 women with condyloma acuminata who were candidates for cryotherapy and were referred to Farshchian Hospital (Sinai) in 2021-2022. Before starting cryotherapy, a biopsy sample was taken from the lesions to perform a polymerase chain reaction (PCR) and determine the genotype of the human papillomavirus. Based on the extracted subtype, the lesions were classified into three high-risk, medium- and low-risk groups. Cryotherapy was performed for each lesion once every two weeks and up to six sessions at most. Patients were examined one month after the last cryotherapy session in terms of recovery with no recovery. Non-response to treatment was considered the case group, and response was regarded as the control group.

In terms of genotype, 43% were high risk, 24.5% were intermediate, and 32.5% were low risk. The frequency of response to treatment was 37%. A response to cryotherapy of condyloma acuminata in the anogenital area of participating showed a significant correlation with age (P=0.008), lesion size (P=0.001), duration of disease (P=0.001), genotype (P=0.001), and lesion location (P =0.014).

Response to cryotherapy treatment in anogenital condyloma acuminata warts is relatively low. Lesions in the vaginal area, younger age, the smaller size of lesions, and shorter duration of infection had a better prognosis after cryotherapy

Determining the exact position of the impacted maxillary canine during its orthodontic treatment using cone beam computed tomography (CBCT) can help select the most appropriate treatment plan. The present study aimed to compare the proposed treatment plan for impacted maxillary canines based on the factors affecting the degree of treatment difficulty in impacted maxillary canines with their definitive treatment plan using CBCT.

In this retrospective cross-sectional study, 120 CBCT images were assessed. These images were taken from patients with impacted maxillary canines whose treatments were terminated. To investigate the severity of maxillary canine impaction factors, including the type of impaction, position of canine, distance to the occlusal plane, distance to the midline, and width of follicular space, were measured using CBCT. Ten orthodontists were asked to determine the type of treatment plan proposed for the patient. Then, they determined the degree of difficulty of each measured factors using numbers 1 to 10. Then, the relationship between the specified difficulty number for each factor and the proposed treatment plan was evaluated, and at the end, the relationship between the type of proposed treatment plan and the patient's actual treatment plan was measured.

A total of 26 men and 94 women with a mean age of 18.85 ± 6.5 participated in the present study. A significant relationship was observed between the variables of age, transverse to midline, and the type of impaction, with the type of treatment.

Although the findings of this study showed a low inter-observer agreement on severity degree concerning the width of follicular space, the inter-observer agreement on severity degree with the other factors was high.

Considering the high prevalence of thyroid nodules and the increased incidence of malignancy of this gland, the present study aimed to assess the clinical characteristics and pathology results following surgery in patients with nodular goiter and referred to the endocrinology clinic in Hamadan, Iran.

This study was conducted as case series from 2011 to 2021. All patients diagnosed with thyroid nodules who underwent thyroidectomy according to the indication and whose pathology was benign or malignant were included in the study. The patients' information was collected by reviewing the files, which included demographic, clinical, and pathology results. The data was analyzed in SPSS software (version 26), and the significance level was considered less than 0.05.

Among the 507 patients studied, 88.2% were female, and 11.8% were male. The mean age of the patients was 41.93 years. Pathology result was malignant in 57% of cases and benign in 43% of subjects. Most patients with malignant pathology were under 35 years of age, and those with benign pathology were older (P<0.001). Most patients were in stage I of the disease; nonetheless, males compared to females were significantly in more advanced stages of the disease (P<0.001).

Thyroid nodules are very common, and their incidence is increasing. Considering the nature of malignancy, the good prognosis of these nodules, and effective treatment, early diagnosis of malignancy assumes critical importance.

Arrhythmias are the most dangerous cause of death in cardiac patients, the purpose of this study is to investigate cardiac arrhythmias in non-cardiac surgeries with a focus on the type of arrhythmia and the type of surgery in Imam Khomeini (RA) hospital in Ilam city in 2021.

In a retrospective study, 150 patients were selected as the sample size. A questionnaire containing demographic information and type of underlying disease, type of arrhythmia and clinical outcome of arrhythmia, type of surgery and type of anesthesia. The studied data were analyzed by SPSS software. To analyze the data, T-test and chi-square were used.

The most arrhythmia caused in general anesthesia was related to AF arrhythmia and tachycardia, significantly 100% (P<0.04). The results show that craniotomy had the highest (72.5%) clinical outcome of arrhythmia in the form of death, and there was a significant relationship between the type of surgery and the clinical outcome of arrhythmia.

The results of this study generally showed that bradycardia is the most common arrhythmia and PVC arrhythmia is the least, general anesthesia has played an important role in causing cardiac arrhythmias, and the incidence of AF arrhythmia is evident at older ages and the greatest recovery is in the age range of 30-60 years and it was more in men than women, and more incidence of AF was reported in patients who underwent laparotomy. Postoperative AF is a frequent and serious complication in older patients