Journal of Kerman University of Medical Sciences
Volume:30 Issue: 4, Jul-Aug 2023

Background In order to detect the gestational diabetes mellitus (GDM) in pregnant women as soon as possible, the aim of this study was to investigate the role of ultrasound in predicting GDM at early pregnancy by measuring the thickness of abdominal subcutaneous adipose tissue.Methods and MaterialsThis was a longitudinal study performed on pregnant women at the weeks of 11 to 14 of pregnancy. All the women referred during this time were screened for the thickness of abdominal subcutaneous adipose tissue, which was measured by trans-abdominal ultrasound. The patients were followed up by performing the oral glucose tolerance test (OGTT) between the weeks of 24-28. Finally, abdominal subcutaneous adipose tissue thickness and other variables were compared between women with and without GDM. Oral consent was obtained from patients.Results210 pregnant women were enrolled in the study. The mean of abdominal subcutaneous adipose tissue thickness was measured by ultrasound as 1.72 ± 0.33 mm. There was a statistically significant relationship between GDM and ultrasound-derived subcutaneous adipose tissue thickness (P <0.0001). At the cut-off point of 2.01, the sensitivity, specificity, and area under curve (AUC) values were 91%, 92%, and 0.96, respectively.ConclusionMeasuring the thickness of the abdominal subcutaneous adipose tissue at early pregnancy may be useful in predicting GDM in the second trimester of pregnancy. Maternal higher age and weight gain, increased parity, and positive family histories of diabetes, preeclampsia, hypertension, and recurrent abortion may also increase the risk of GDM.

Trichomoniasis, caused by Trichomonas vaginalis protozoan, is the most common nonviral sexually transmitted infections worldwide. Although metronidazole and tinidazole are the only approved drugs for treatment, drug-resistant cases of infection are on the rise. The aim of the study was the evaluation of antitrichomonal potential of Piper nigrum and limonene. The phytochemical profile of P. nigrum oil was also investigated. The parasites were treated in vitro with essential oil and different extracts of P. nigrum seed and limonene using microtiter plate method. The oil analysis of P. nigrum was also evaluated by gas chromatography-mass spectrometry and gas chromatography-flame ionization detector. Furthermore, the cytotoxicity assay of P. nigrum oil and limonene were screened on Vero cell line by MTT method. The tested P. nigrum fractions were able to kill 100% of Trichomonas trophozoites at MLC concentration and reduce the trophozoite viability at sub-MLC and lower concentrations. After 48 hours exposure, the most potent fraction was the n-hexane extract with MLC of 78 µg/ml and followed by the essential oil and methanol extract with MLC of 156 µg/ml, limonene (MLC=1250 µg/ml), and then, aqueous extract with MLC value of 25 mg/ml. Also according to cytotoxicity assay, P. nigrum oil was less toxic to Vero cell than limonene, with a selectivity index of 13.2 and 2.04, respectively. This study clearly demonstrated the trichomonacidal potential of P. nigrum. Thus, P. nigrum fractions can be considered promising antiprotozoal agents and the basis for further development to discover new phytochemicals compounds.

A main problem in the proper management of non–muscle invasive bladder cancer (NMIBC) is the under staging of lesions after initial transurethral resection of bladder tumor (TUBRT). Under staging is much more likely in T1 tumors when the detrusor muscle is absent. So, we evaluated under-staging and residual tumor in patients with complete initial TURBT, whose initial pathological samples revealed the presence of the detrusor muscle.

In this prospective study performed in our hospital from August 2018 to April 2020, 51 patients with newly diagnosed T1 bladder tumor were enrolled according to our criteria and underwent standard Re-TURBT before eight weeks after the initial TURBT.

Of the 51 patients who underwent Re-TURBT, 12 patients (23.5%) had tumors, of whom eight patients had microscopic, and four patients had macroscopic tumors. None of them were upstaged or upgraded. There was a statistically significant relationship between the presence of tumor in Re-TURBT and the size of the primary tumor (> 3 cm) and the number of tumors (> 1). Not only no changes were observed in the stage and grade of the disease, but also the treatment plan of the patients did not change despite imposing financial burden on the patient and the health system.

Re-TURBT is not necessary for all superficial bladder tumors, especially in the case of complete initial TURBT and also in the presence of the detrusor muscle in the pathological sample, and when the tumor is single and less than three centimeters in size.

Recent studies have shown an increase in the pro-oxidant antioxidant balance (PAB) in patients with Covid 19 and are also associated with exacerbation of clinical manifestations of the disease. What we focused on in the present study was the assessment of the status of PAB level in Covid 19 disease. rMaterials & In this cross-sectional study, 105 patients referred to Masih Hospital in Tehran in 2021, including 58 subjects with COVID 19 infection and 47 as a control group were studied. The subjects in this study were evaluated for PAB by ELISA method. The mean value of PAB in individuals with and without COVID 19 was 72.77 ± 17.66 units and 66.53 ± 14.30 units, respectively, which was significantly higher in the first group (P =0.049). In patients with COVID 19, there was a significant correlation between PAB and plasma triglyceride level (P=0.011) and there was an inverse relationship between PAB level and blood sodium level (P =0.047). In the subgroup of patients with COVID 19, there was no significant relationship between PAB level and history of hypertension, hyperlipidemia, diabetes and ischemic heart disease. The increase in PAB is quite evident in patients with COVID 19 compared to healthy individuals. There is a significant relationship between PAB and some laboratory markers in these patients such as blood triglyceride levels as well as decreased serum sodium. Therefore, it still seems that the

Obesity is a growing epidemic in developed countries. Which lead to increase the percentage of obese people in the orthopedic trauma population and concern patients postoperative period. Lower extremity long-bone fractures are among the most common fractures and are associated with significant complications, prolonged hospitalization, and a heavy financial burden on the community health network. In this cohort study, all patients with lower extremity long-bone fractures treated in Bahonar Hospital in Kerman were included using the simple sampling method and divided into two groups based on BMI (BMI greater than or equal to 30 were considered obese, and people with a BMI less than 30 as non-obese) and followed for one year after treatment. Our study was conducted on two groups, each including 65 people, of obese and non-obese people with lower extremity fractures. In statistical studies, no significant difference was found between the obese and non-obese groups in terms of underlying disease (P = 0.1), fracture site (P = 0.13), open or closed fracture (P = 0.283), type of surgery (P = 0.217), and fracture complications (P = 0.699).There is no significant relationship between the complications of lower extremity long bone fractures of obese and non-obese people; it seems that mostly systemic complications should be considered in obese people after fractures. Finally, considering the differences between the results of this and similar studies and genetic and ethnic differences in other parts of Iran, further studies in this field with larger sample sizes in different geographical locations are recommended.

Acute complications of transfusion are among leading causes of morbidity and mortality in chronically transfused patients. One of the main goals of the blood transfusion is reducing complications, improve blood safety and patient's health care worldwide. The purpose of present study was to investigate the prevalence of acute complications of transfusion in beta thalassemia major (TM) patients in Southeast Iran. In a prospective study, 23882 transfusions were evaluated in TM patients in thalassemia clinic for acute reactions during 2 years period. Data were collected by forms to record the information related to blood transfusion at the time of reaction occurence. The assessment of the data revealed that 228 TM (0.95%) had acute complications of transfusion. Of 23882 transfusions in TM patients, 211 patients (0.87%) developed allergic reactions, 11 patients (0.04%) were diagnosed with febrile non-hemolytic reaction and 1 patient (0.004%) had experienced acute hemolytic transfusion reaction. The results of current study supports preventive measures for reduction of these complications to improve patient's health. Acute complications occurred may be due to insufficient ability to perform blood bank tests, lack of standard operating instructions and lack of necessary monitoring during the transfusion process. The best way to reduce the risk of blood transfusion reactions is providing special care to the patients during the first 24 hours after transfusion. Creating a consistent and continuous education system with standard operating instructions and establishing an error reporting system leads to improve knowledge about transfusion guidelines and best practices.

The Human papillomaviruses (HPV) main capsid protein L1 is naturally capable to self-assemble as virus-like particles (VLPs). There are different recombinant protein expression systems such as bacteria, yeast, insect, plant, and mammalian cells for generation of VLP-based candidate vaccines targeting various pathogens. In this study, we produced HPV-L1 protein by BL21/pET32a expression system and VLP production was confirmed.

The recombinant plasmid pET32/L1 was transformed into Escherichia. coli BL21 and selected with ampicillin. The positive clones containing the recombinant plasmid pET32/L1 were assessed by restriction endonucleases HindIII and XhoI and sequence analysis. The expression of HPV16-L1 fusion protein in E. coli BL21was identified by SDS-PAGE and Western blotting. VLPs were evaluated using electron microscopy.

A codon-optimized L1 gene was expressed in BL21 under the control of the T7/lac promoter. Purification of L1 protein was achieved after Ni NTA chromatography. The 60kDa protein was detected in the lysates of BL21, recognized as HPV16- L1 protein by Western blotting. VLPs were confirmed using electron microscopy.

In this study, we established a high-efficient recombinant E. coli expression system for the production of HPV 16- L1 protein. The generated L1 protein was correctly self-assembled into VLPs. Therefore, BL21/pET32a as a prokaryotic expression system is a potent tool for HPV16-L1 VLP production.

Hypoxia exists in some malignancies and is a prognostic risk factor contributing to tumor growth and metastasis. Anti-hypoxic compounds may improve this situation and be considered anti-cancer agents. In previous reports, Cydonia oblonga, Portulaca oleracea, and Artemisia dracunculus showed anti-cancer activity. So, we investigated the anti-hypoxic activities of C. oblonga, P. oleracea, and A. dracunculus to evaluate the possible mechanism of the plant's effectiveness in treating cancer.

Total phenolic and flavonoid contents and HPLC analysis were performed on C. oblonga leaves, P. oleracea, and A. dracunculus aerial parts extract. Anti-hypoxic activities were evaluated in asphyctic, haemic, and circulatory hypoxia models.

A. dracunculus extract (at 250 mg/kg) significantly improved the survival time compared to the normal saline (P < 0.0001) in asphyctic hypoxia, even its effect was significantly better than phenytoin in this dose (P = 0.0005). Although the extracts increased the survival time in other doses, their effects were not significant (P > 0.05). In haemic hypoxia, the extracts were ineffective at any dose (P > 0.05). At 250 mg/kg, P. oleracea and A. dracunculus significantly increased the survival time (P < 0.001 and P < 0.05, respectively) in circulatory hypoxia. Their effects were similar to propranolol (P > 0.05).

The anti-cancer effects of C. oblonga are not dependent on the anti-hypoxic effects. P. oleracea and A. dracunculus have anti-hypoxic effects only in high doses, indicating their extracts' weak anti-hypoxic ability or the presence of potent anti-hypoxic compounds with low concentrations in them.

Mandibular condyles constitute a major part of the temporomandibular joint. Bifid Mandibular Condyle (BMC) is a rare morphological variant of the condyle that is asymptomatic in most cases and can be diagnosed incidentally on a Orthopantomogram during routine radiographic examination. But Orthopantomography is a 2-Dimensional imaging modality with various structures superimposed over the temporomandibular region causing practical difficulty in the diagnosis of BMC. The exact morphological architecture of the condyles can be more accurately visualized in advanced imaging techniques like Computed tomography and Cone beam computed tomography, helping in the diagnosis of the bifid condyles. The radiological appearance of BMC varies depending on direction and depth of the separating groove. The typical radiographic presentation in most cases is a complete or incomplete split of the condylar heads, separated by a groove This paper presents a case of a unilateral Bifid mandibular condyle on the right side which was diagnosed Cone Beam Computed tomography.