Hormozgan Medical Journal
Volume:27 Issue: 3, Sep 2023

The age-associated dysregulated immune response may partly contribute to the greater mortality and morbidity in elderly patients undergoing cardiopulmonary bypass (CPB). The aim of the present study was to first investigate the possible relation between age and levels of interleukin (IL)-17 and IL-35 in CPB patients.

In general, 90 patients undergoing CPB from February 2018 to March 2019 in Jorjani Heart Center, Bandar Abbas, were enrolled in this cross-sectional study. IL-35 and IL-17A were measured before and 12 hours after CPB using enzyme-linked immunosorbent assay. The relation of age and the mentioned cytokines was assessed in patients < 70 and ≥ 70 years old.

IL-17A levels were slightly increased (25.7 ± 8.7 ng/mL versus 20.9 ± 6.3 ng/mL), while IL-35 levels represented a slight decrease (20.6 ± 10 ng/mL versus 23.2 ± 11.9 ng/mL) in CPB patients ≥ 70 years in comparison with those below 70 years (P > 0.05). There was a positive correlation between IL-17 and age (r = 0.4, P = 0.002) in patients older than 70 years. Eventually, IL-35 was negatively associated with age (r = -0.2, P = 0.03) in ≥ 70 years patients.

These data suggested that the age-related elevation of IL-17A levels, as well as a decline in the IL-35 serum concentration, contributing to the imbalanced pro- and anti-inflammatory response, may play a crucial role in the stronger adverse post-CPB outcomes in the elderly.

Prediabetes is associated with coronary artery disease (CAD). The current study aimed to investigate the association between impaired fasting glucose (IFG), CAD, and coronary artery stenosis severity.

This case-control study was performed on 35-70 year-old non-diabetic individuals. Patients who had coronary artery stenosis ≥ 50% at least in one coronary artery and those with stenosis < 50% on angiography were considered as case and control groups, respectively. Patients were selected from Shahid Mohammadi Educational Medical Center in Bandar Abbas in 2018-2019. Age, gender, body mass index (BMI), smoking status, history of hypertension and hyperlipidemia, family history of CAD, fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), creatinine, and lipid profiles were compared between the two groups.

There were 52 subjects in each case and control group. The mean age of participants (N = 104) was 54.83 ± 9.36, and 71.2% of them were male. The mean of FPG (P < 0.0001), low-density lipoprotein (LDL) (P = 0.02), triglyceride (P = 0.007), and the HbA1c (P = 0.011) were significantly higher in the case group than in the control group. Moreover, high-density lipoprotein (HDL) levels were significantly lower in the CAD group compared to the control group (P = 0.006). Furthermore, binary logistic regression demonstrated that the chance of IFG was (OR: 12.49), HbA1c (OR: 12.28), and LDL (OR: 1.05) in people with CAD.

IFG and elevated HbA1c levels are significantly associated with an increased risk of CAD in the Iranian adult population.

Acute otitis externa (AOE) is a common condition with multiple available treatments. This study aimed to compare gauze strips soaked in triamcinolone, neomycin, and nystatin with conventional eardrops for the treatment of AOE.

This experimental study included patients with AOE referred to the Otolaryngology Clinic of Shahid Mohammadi Hospital, Bandar Abbas, Iran, 2014-2015. Based on their signs and symptoms, patients were divided into two clinical groups of mild to moderate and moderate to severe AOE. Patients treated with polymyxin B, neomycin, and hydrocortisone (polymyxin NH), or ciprofloxacin plus betamethasone eardrops were regarded as controls (conventional eardrops), and those whose ear canal had been filled with a gauze strip soaked in triamcinolone, neomycin, and nystatin (triamcinolone NN) were regarded as cases.

A total of 76 ears were included in this study (36 and 40 cases with mild to moderate and moderate to severe AOE, respectively). After 24 hours, in both clinical groups with mild to moderate and moderate to severe AOE, response to treatment with triamcinolone NN-soaked gauze strips was significantly higher than conventional eardrops (94.4% vs. 11.1%, P < 0.001 and 80% vs. 10%, P < 0.001, respectively).

Patients with mild to severe AOE appear to rapidly respond to gauze strips soaked in triamcinolone, neomycin, and nystatin.

Patients with hepatic cirrhosis are frequently screened for the complications of portal vein hypertension using upper endoscopy. The current study aimed to compare the efficacy and safety of midazolam and propofol for sedation in patients with cirrhosis undergoing upper endoscopy.

This single-blind randomized clinical trial included 60 cirrhotic patients aged 18-80 years referred to Shahid Mohammadi hospital, Bandar Abbas, Iran from May 22, 2019, to May 21, 2020, for upper endoscopy. The age, gender, weight, and height of the patients were recorded, and they were randomized into two groups. Patients in the midazolam group (n = 30) received 0.05 mg/kg midazolam for induction which continued with a 1 μg/kg/min dose, and those in the propofol group received 1 mg/kg propofol which continued with a 25-75 μg/kg/min dose. Blood pressure, oxygen saturation (SpO2), respiratory rate (RR), and heart rate (HR) were measured before induction, immediately, 1, and 5 minutes after induction, and in the recovery unit. Finally, the time to reach the target sedation (Ramsay sedation scale ≥ 5), sedation duration, and recovery time were noted as well.

Patients in both groups were comparable regarding age, gender, weight, and height. There were no significant differences between groups regarding hemodynamic parameters at any given time point, except for RR 1 minute after induction, which was significantly higher in the propofol group (P = 0.012). Changes in HR from baseline to recovery were significant in both groups. Moreover, changes in SpO2 from baseline to recovery were only significant in the midazolam group (P < 0.001). The time to reach the target sedation and sedation duration were significantly lower in the propofol group (P < 0.001 and P = 0.003, respectively); however, there was no significant difference between groups with regard to the recovery time. Grade II encephalopathy (West Haven criteria) developed in one patient in the midazolam group.

Based on the results of the current study, although propofol was superior to midazolam for upper endoscopy in cirrhotic patients with respect to the time to reach the target sedation and sedation duration, the two drugs were rather comparable in terms of hemodynamic stability. However, hepatic encephalopathy with midazolam remains a major concern.

The ventilatory equivalent for CO2 (VE/VCO2) is the simplest way to predict ventilatory efficiency. This study aimed to investigate the impact of treadmill and cycle ergometer exercise tests on ventilatory outcomes in healthy adolescents.

In this clinical trial with cross-over design, 52 adolescents aged 11-16 years old (age: 13.8 ± 0.17 years, height: 157.4 ± 0.95 cm, weight: 51.73 ± 1.24 kg, represented as mean ± standard error), went through treadmill and cycle ergometer exercise tests with a 6-day wash-out during July-August 2019, Tehran, Iran. Through a RAMP (raise, activate, mobilise, and potentiate) protocol, participants were asked to perform the maximal treadmill or cycle ergometer exercise and continue the test until exhaustion. Gas exchange and heart rate (HR) were obtained breath by breath during the test. Time, HR, VE/VCO2, minute ventilation) VE), end-tidal carbon dioxide pressure (PetCO2), and dead space (VD) to tidal volume (VT) ratios (VD/VT) were transferred to the computer and recorded. All data were reported at two-time points: Anaerobic threshold (AT) V-slop method and peak. Independent t-test was then performed to compare the two types of exercises using SPSS 16, and P˂0.05 was considered significant.

The results showed a significant difference in two points regarding the type of exercise for Time and VE/VCO2, but for HR (P = 0.004), VE (P = 0.0001), PetCO2 (P = 0.008), and VD/VT (P = 0.004), a significant difference was only observed in AT point.

Several physiological mechanisms that occurred during the development stage could affect individuals’ respiratory parameters; however, in general, the type of exercise test affected VE/VCO2.

Diabetes has several complications and late diagnosis of this disease leads to an increase in the complications. The present study aimed to investigate the possibility of predicting diabetes using machine learning techniques.

This study was a cross-sectional descriptive-analytical study. The population included the people referred to Falavarjan Social Security Center in Isfahan province in Iran in 2020 for diabetes screening. Blood samples were collected from 250 diabetic patients and 100 healthy non-diabetic samples. Then, glucose, cholesterol, triglyceride, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and very low-density lipoprotein (VLDL) were measured and some characteristics such as height, weight, age and gender were collected from patients’ records. Finally, the data were analyzed and compared using the k-nearest neighbor (KNN) algorithm, artificial neural networks (ANNs), support vector machine (SVM), Naive Bayes, and decision tree (DT). All analyses and modeling were performed in Python programming environment.

In all criteria, the best results were obtained by SVM with an accuracy of 0.98, followed by ANNs with an accuracy of 0.96, respectively. Then, the K-NN algorithm with an accuracy of 0.87, Naive Bayes with an accuracy of 0.87, and DT with an accuracy of 0.76 were considered.

Both ANNs and linear SVMs are recommended as superior final models for the diagnosis of diabetes due to their higher performance (accuracy) in final decision-making.

Myocardial infarction (MI) is the death of the heart muscle tissue that causes damage and inflammation. Quercetin consumption and interval training can probably prevent the progression of this condition in the active parts of the myocardium by activating angiogenesis pathways and stimulating hypoxia factor-1a (HIF-1a) at the onset of infarction. This study investigated the effect of high-intensity interval training (HIIT) and quercetin nanoliposome consumption on angiogenesis indexes in the heart tissue of MI rats.

In this experimental study, 30 male rats weighing 250 ± 20 grams were randomly divided into five groups: 1) MI + training, 2) MI + supplement, 3) MI + training + supplement, 4) healthy control, and 5) MI. MI was induced by subcutaneous injection of isoprenaline hydrochloride at a dose of 80 mg/kg. Groups 2 and 3 received quercetin daily at a dose of 0.25 mg/kg by gavage. Groups 1 and 3 performed five sessions of training protocol per week. Then, the Smirnov-Kolmogorov, one-way analysis of variance, and Tukey’s post hoc test were used to analyze the data (P < 0.05).

Interval training and quercetin had a significant effect on increasing vascular endothelial growth factor (VEGF) and HIF-1a gene expression (P < 0.001).

The combined effect of interval training and quercetin consumption may prevent the progression of MI by activating VEGF and HIF-1a in the early stages and play an effective role in preventing this disease.

Both exercise and vitamin D can affect oxidative stress indicators. However, their interaction at the level of kidney tissue has been less investigated. Hence, the main objective of the present study was to determine the effect of vitamin D supplementation and aerobic training on oxidative stress markers in the kidney tissue of middle-aged male rats.

To conduct this study, 20 Wistar male rats )14–12 months and 350–400 grams (were randomly divided into four groups: control (CON), aerobic training (EXE), vitamin D (VD), and aerobic training + vitamin D (EXE + VD). The exercise consisted of 8 weeks of aerobic training (5 days/week). The VD and EXE + VD groups received vitamin D (500 units/kg) daily. Olive oil was also used as a placebo, and 48 hours after the last intervention session, animal tissues were removed. The gene expression of oxidative stress biomarkers, including catalase (CAT), manganese superoxide dismutase (Mn-SOD), glutathione peroxidase (GPx), and xanthine oxidase (XO) was measured by the real-time polymerase chain reaction (PCR) method. Data analysis was performed by one-way analysis of variance test at the significance level of P < 0.05.

The results showed that the EXE + VD increased the gene expression of Mn-SOD, CAT, and GPx (P < 0.05) and decreased the expression of XO (P < 0.05). Furthermore, VD alone had no effect on the expression of antioxidant enzymes or XO (P > 0.05). Moreover, EXE increased CAT and Mn-SOD expression compared to the CON (P < 0.05) and decreased XO expression (P < 0.05). Additionally, CAT values in EXE were significantly higher than those in VD (P < 0.05).

According to the results of the present study, it seems that the VD + EXE can increase antioxidant defense and reduce oxidative stress in kidney tissue.

Unexplained neonatal hyperbilirubinemia may be the sole clinical presentation of urinary tract infection (UTI) in newborns. We aimed to determine the potential factors affecting the type of pathogens responsible for UTI in neonatal hyperbilirubinemia.

This cross-sectional study retrospectively evaluated newborns admitted to the neonatal ward of Bandar Abbas Children’s Hospital between 2016 and 2018. Newborns with hyperbilirubinemia and culture-confirmed UTIs were included in the study. The following data were extracted from patients’ medical records: demographics and anthropometrics, type of delivery, newborn feeding, clinical manifestations, urine sampling method, and laboratory test results, including total bilirubin and urine culture.

Of the 96 neonates with hyperbilirubinemia and positive urine culture in this study, 63 (65.6%) were male. Their mean age was 13.60 ± 6.00 days. Escherichia coli was the most common pathogen isolated from the urine cultures (33.3%), followed by Klebsiella (24%). Age, gender, gestational age, birth weight, type of delivery, newborn feeding, clinical manifestations, total bilirubin level, and urine sampling method were not associated with the type of pathogens isolated from urine culture (P > 0.05).

Most urine cultures from newborns with hyperbilirubinemia were positive for E. coli. None of the potential factors evaluated in this study were correlated with the type of pathogens responsible for UTI in neonates with hyperbilirubinemia.

SARS-CoV-2 disease is a highly contagious infection causing a large number of deaths in susceptible individuals throughout the world. In this study, a low-cost, sensitive, and easy-to-perform conventional polymerase chain reaction (PCR)-based RNA detection method was evaluated to diagnose the infection, which was feasible at a laboratory with minimal molecular infrastructure.

From 4 July to 31 August 2020, a total of 277 nasopharyngeal/oropharyngeal swab samples consisting of 72 samples from hospitalized patients with a severe respiratory infection and 205 suspected patients in Isfahan, Iran, were tested using probe-based rtRT-PCR and conventional PCR assays.

A total of 160 clinical samples were tested by rtRT-PCR using the E gene. The sensitivity and specificity of the conventional PCR method were determined to be 100%. Furthermore, out of 117 clinical samples evaluated by the probe-based RT-PCR using the N gene, 74.4% of the samples were positive. Moreover, the duplex PCR method using the N gene and RNase P as an internal control reference gene showed that 68.4% of the samples were positive. Therefore, the tested PCRs could detect positive samples with a sensitivity of 92.55% and a specificity of 100%.

According to the results, this method is a simple, inexpensive, and valuable alternative as well as a suitable procedure for the laboratory diagnosis of SARS-CoV-2 infection.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first identified in December 2019 in Wuhan, China. Although the respiratory system is infected by this disease, other tissues are prone to coronavirus attack so that the male reproductive system can be another target for the virus, causing sexual transmission of coronavirus. The extant research systematically reviewed the studies conducted on COVID-19 and the sexual transmission possibility.

In this systematic review study, the articles and papers were collected by using some keywords such as COVID-19, Semen, Novel Coronavirus, SARS-CoV-2, Angiotensin-converting enzyme 2 (ACE2), and Male Infertility searching through PubMed, Web of Science, Scopus, and Google Scholar databases using OR and AND operators from December 2019 to November 2020. There was not any constraint on publication language when searching through electronic data sources directly or in reviewing the reference list of studies. Thirteen papers as eligible articles were studied finally. The original research studies examining the expression of SARS-CoV-2 in semen fluid or sexual transmission of this virus in men were chosen, while other studies were removed from the investigation. The full text of the articles was reviewed and discussed by two authors to reach a consensus; disagreements were resolved by consensus. We extracted information on study characteristics from each of the considered studies.

According to current studies, ACE2, which is found abundantly in testicles, can perform as a cellular receptor for SARS-CoV-2. This finding is the foundation of this hypothesis that human testis and semen can be infected by SARS-CoV-2. In particular, a study showed that SARS-CoV-2 might be detected in the semen of patients with COVID-19, while other studies found no viral RNA in testicular biopsy tissue. Furthermore, some studies concluded that this virus, even in the acute phase, could not infect the testicles or the male genital system. Accordingly, no evidence confirms that this virus can be transmitted through male genital organs.

Although this virus has not been detected in semen fluid and it has not been sexually transmitted, one study reported this virus in the semen of coronavirus-infected patients and introduced its possible sexual transmission. Therefore, there is a low probability of sexual transmission of coronavirus.