Hormozgan Medical Journal
Volume:28 Issue: 1, Jan 2024

Context:

 Regular physical activity reduces oxidative stress by increasing the capacity of antioxidant defense, reducing pro-inflammatory mediators, and increasing anti-inflammatory mediators in healthy and obese conditions with chronic diseases. The role of physical activities in oxidative stress, and inflammation is dual and depends on the mood, intensity, and duration of the activity. 

Evidence acquisition:

 One session of long-term and intense exercises can produce free radicals more than the capacity of antioxidant defense and cause oxidative stress. Medicinal plants also have anti-obesity, antioxidant, and anti-inflammatory properties due to their phytochemical compounds. 

Rice bran contains nutrients and bioactive compounds, such as phytosterols, phenolic acids, flavonoids, anthocyanins, proanthocyanins, tocopherols, tocotrienols, phytic acid, gamma-aminobutyric acid, and gamma oryzanol. These compounds have antioxidant, anti-inflammatory, anti-obesity, and anti-diabetic effects. The examination of studies with human and animal subjects show that rice bran, gamma oryzanol, and anthocyanins improve endurance and resistance performance. Evidence shows that rice bran improves endurance performance by reducing lactate accumulation, and increasing muscle glycogen content, increasing free fatty acids turnover, and increasing muscle oxidative capacity and antioxidant enzymes. 

Anthocyanins improve physical performance by affecting blood flow, metabolic pathways, and muscle fatigue. Accordingly, rice bran can improve physical performance as an ergogenic factor and promote health development by reducing oxidative stress and inflammation. However, there is a need for more studies regarding the effect of rice bran on physical performance and health.

The expression of Ki67 and p16 has been used for the diagnosis of human papillomavirus (HPV) 16 and 18; however, limited research has been conducted on the comparison with other high-risk HPVs (HR-HPVs) in this respect. Accordingly, this study compares the positivity pattern of Ki67 and p16 in HPV16/18 with other HR-HPVs. 

This descriptive study included women with positive screening test (Pap smear test) and positive HR-HPV referred to Shahid Mohammadi Hospital, Bandar Abbas, Iran, from 2018-2019 for colposcopy and cervical biopsy. Biopsy specimens were stained for Ki67 and p16. Data on age, education, and menopause status were also recorded.

Of the 80 women included in this study with a mean age of 33.16±8.55 years, 48.8% had positive HPV16/18, and 51.2% were positive for other HR-HPVs. The positivity pattern of Ki67 and the type of HR-HPV (HPV16/18 vs other HR-HPVs) were significantly correlated (P=0.006). Full-thickness positive Ki67 was only observed in HPV16/18 positive specimens. Positive Ki67 in the upper and middle thirds were also significantly more frequent with HPV16/18. The correlation between positive Ki67 and HR-HPVs remained significant in women aged >30 years, with university education, and of childbearing age. 

The positivity pattern of Ki67 is significantly correlated with HPV16/18, and age, education, and menopause status are the influential factors. Meanwhile, the strongly positive p16 pattern was more frequent in HPV16/18 compared to other HR-HPVs; however, the relationship between the positivity pattern of p16 and the type of HR-HPV was not significant.

Alterations in hematological and renal parameters have been reported with antiepileptic drugs. This study evaluates the effects of lamotrigine (LTG) and levetiracetam (LEV) on these parameters in children with epilepsy.

This randomized clinical trial included children with a first-time diagnosis of epilepsy referred to Bandar Abbas Children’s Hospital, Bandar Abbas, Iran, from 2017 to 2018. The participants’ age, gender, and family history of epilepsy were recorded. The patients in the LTG group received 0.6 mg/kg oral LTG in two divided doses for two weeks which continued with 1.2 mg/kg for another two weeks and then with a maintenance dose of 5-15 mg/kg daily. The patients in the LEV group received 10 mg/kg oral LEV twice a day. When necessary, the dosage is increased to a maximum of 30 mg/kg twice a day. The treatment continued until seizures were controlled. Hematological and renal parameters were measured at baseline and 3 months after treatment. The total duration of treatment with each drug was also noted.

From the 66 children evaluated in this study with a mean age of 8.51±2.11 years, 31 (47%) were male. Age, gender, family history of epilepsy, treatment duration, and baseline hematological and renal parameters did not differ between the LTG group (n=26) and the LEV group (n=40). The patients in both groups were comparable in terms of all the parameters after treatment. Also, no significant change was observed after treatment compared to baseline in either group. 

LTG and LEV have no significant effect on the hematological and renal parameters of children with epilepsy.

Atopic dermatitis (AD) is a risk factor for children’s onset of food allergy. This study explores the frequency of food allergies among children with AD and their relationship with the severity of the disease.

This analytical and cross-sectional study was conducted on 48 children under the age of 14 years who were diagnosed with AD. The patients were divided into three groups according to age as follows: Younger than 2 years, between 2 and 7 years, and between 7 and 14 years. Serum immunoglobulin E level of food-specified allergen was measured. Then, the children were categorized into three groups for comparison based on AD severity, food allergy type, and frequency.

The frequency of allergy to egg, peanut, and cow milk was 66.7%, 37.5%, and 18.8%, respectively, in the patients. Boys have more allergies to peanuts (46.2%) than girls (27.3%). Egg allergy is prevalent among both genders (girls 63.6% and boys 69.2%). Allergy to cow milk was higher in the age group under 2 years (23.1%). Half of the children between 7-14 years old had an allergy to peanuts (50%). Over half of the children in all age groups had egg protein allergies. The patients with mild and moderate AD had more allergies (25.0%) to cow milk compared to severe AD patients (6.2%). 

This study indicated that food allergy is common in patients with AD, and nearly two-thirds of the patients were allergic to one foodstuff. Meanwhile, allergy to eggs was more common among the patients compared to other foodstuffs.

Coronary artery disease (CAD) is an atherosclerotic disease that is a major cause of mortality worldwide. Bilirubin has been considered an antioxidant that protects patients against atherosclerosis. Therefore, the present study examines the relationship between serum bilirubin levels with CAD.

In this cross-sectional, analytical study, the patients with suspected CAD were electively scheduled for angiography. Their blood samples were measured for total, direct, and indirect bilirubin levels. Following angiography, comparisons were made between the two groups of CAD and non-CAD subjects. 

Of 140 studied patients, 73(52.1%) were male and 67(47.9%) were female. The mean age of subjects was 55.32±10.71 years which was statistically significantly significant (P˂0.001). The mean total, direct, and indirect bilirubin levels between the groups were 0.74±0.57 (P=0.79), 0.22±0.07 (P=0.77), and 0.48±0.45 (P=0.77) mg/dL, respectively, which were not significant. The mean total (0.77±0.57 vs 0.71±0.57) and indirect bilirubin levels (0.53±0.53 vs 0.44±0.35) were higher in men than women and mean direct bilirubin was similar between men and women (0.23±0.07 vs 0.22±0.07). There was a statistically significant relationship between male and female groups in total and indirect bilirubin (P=0.05).

No significant relationship was found between bilirubin levels and CAD either in terms of protective or aggravating role.

Given the spread of azole resistance in Candida albicans (C. albicans), searching for new potent compounds, such as spirocyclopropane-oxindole derivatives is important. This study evaluates the antifungal susceptibility of spirocyclopropane-oxindole derivatives on clinical isolates of C. albicans. 

Antifungal susceptibility of 50 clinical isolates of C. albicans to spirocyclopropane-oxindole derivatives (4a, 4b, and 4c), nystatin, and fluconazole were evaluated according to Clinical Laboratory Standards Institute (M27-S4) guidelines. The medicinal dilution range of the compounds, fluconazole, and nystatin was 0.256 to 128, 0.128 to 64, and 0.032 to 16 μg/mL, respectively. The minimum inhibitory concentration (MIC) was defined as the concentration that caused at least 50% growth inhibition compared to the positive control. Statistical analysis was performed using the SPSS software, version 20. The significance level was set at P≤0.05.

There was a significant difference between the MIC values of spirocyclopropane-oxindole derivatives (4a, 4b, and 4c), nystatin, and fluconazole against C. albicans. The comparison of the MICs of the spirocyclopropane-oxindole derivatives (4a, 4b, and 4c) against C. albicans showed that derivative 4a had a lower MIC50 (8 μg/mL), MIC90 (16 μg/mL), and Geometric (G) Mean (10.126) than derivatives 4b (MIC50=64, MIC90=128, G Mean=76.638), and 4c (MIC50=64, MIC90=128, G Mean=60.547).

Antifungal effects of spirocyclopropane-oxindole derivatives (4a, 4b, and 4c) on C. albicans isolates were significantly less than nystatin and fluconazole. Therefore, with structural changes, the antifungal effects of these compounds will increase.

This study compares patients’ satisfaction with patient-controlled analgesia versus intrathecal opioid injection after cesarean section in Shariati and Khalij Fars hospitals in Bandar Abbas City, Iran, from 2016 to 2017. 

This double-blind, randomized clinical trial included 60 women with term pregnancies scheduled for elective cesarean section in Shariati and Khalij Fars hospitals in Bandar Abbas City, Iran, from 2017 to 2018. The patients were randomized into two groups: One group received patient-controlled analgesia (PCA), and the other group received intrathecal opioid injection. A numerical rating scale was used to assess pain and patient satisfaction. The patients also reported nausea, vomiting, and pruritus. The data were analyzed using the SPSS software, version 25. 

Nausea and or vomiting did not differ significantly between the groups (P=0.46). The highest frequency of pruritus was observed in the PCA group at 1 (P=0.44), 4 (P=1.00), and 24 (P=0.24) h after surgery. Patient satisfaction was higher in the intrathecal opioid group (9.23±1.22) compared to the PCA group (8.84±1.22); however, the difference between groups was not statistically significant (P=0.08). 

The results of the current study showed that despite the novelty of PCA, this method is not superior to conventional methods such as intrathecal opioid injection for pain relief. Also, patient satisfaction was lower with PCA compared to intrathecal opioids.

Ectopic pregnancy is the most common cause of maternal mortality in the first trimester of pregnancy. The use of progesterone-containing contraceptives is a risk factor for ectopic pregnancy. This study reports a rare case of ectopic pregnancy following a depot medroxyprogesterone acetate (DMPA) injection that was managed conservatively. 

A 36-year-old woman (gravida 2) was referred to the Gynecology Clinic of the Persian Gulf Hospital, Bandar Abbas, Iran with a history of amenorrhea, vague pelvic pain, and no past medical history, except for DMPA injection, three months before the symptoms. Ectopic pregnancy was determined based on ultrasonography and beta-human chorionic gonadotropin (BHCG) evaluation. The patient was managed conservatively with serial ultrasonography and BHCG titration due to normal laboratory tests, stable clinical status, and a decline in BHCG titration. 

Amenorrhea and pelvic pain in all women of childbearing age should be considered an alarming sign of ectopic pregnancy. In case of stable hemodynamic status, the patient can be conservatively managed with serial trans-vaginal ultrasonography and evaluation of serum BHCG till the resolution of symptoms.