Journal of Research in Medical Sciences
Volume:24 Issue: 1, Jan 2019

Early diagnosis of herpes simplex virus‑1 (HSV‑1) meningoencephalitis is very important because antiviral therapy significantly decreases mortality and morbidity. Polymerase chain reaction (PCR) is a reliable method with high sensitivity and specificity in detection of HSV‑1. The aim of this study is to determine the prevalence of HSV‑1 in patients with diagnosis of meningoencephalitis using real‑time PCR. The cerebrospinal fluid samples were collected from 126 patients with clinical diagnosis of HSV‑1 meningoencephalitis in Alzahra Referral Hospital in Isfahan, Iran. After deoxyribonucleic acid (DNA) extraction, real‑time PCR was performed by fluorescence resonance energy transfer assay and participants underwent brain magnetic resonance imaging, as well. Among 126 patients, 68.3% were male and 31.7% were female. The mean age of the participants was 41.96 ± 22.36 years. Most of the participants were in the age group of 20–29 years. Three patients (2.4%) had positive and 123 patients (97.6%) had negative HSV‑1 DNA test. Among three positive cases, two were in the age group of 20–29 years and one in the age group of ≥80 years. No HSV‑2 DNA was detected. According to the estimated prevalence of HSV‑1 meningoencephalitis in the current study, it seems that the prevalence of HSV‑1 meningoencephalitis is not too high in our community; therefore, initial empiric acyclovir therapy is frequently overused.

The survival in Iranian HIV/AIDS patients based on data from Iran National HIV/AIDS Case Registry System has
not been evaluated. This study assessed the survival rates and associated factors among people living with HIV/AIDS in Iran. The population in this observational study included 32168 patients diagnosed with HIV/AIDS registered in Iran disease registry system between 1986 and 31 December 2015. Data until June 2016 (the cutoff date of our last data linkage) were investigated to estimate survival and related factors following HIV diagnosis. Of registered patients, 17.7% were diagnosed at AIDS stage. By June 2016, 27.2% of study population progressed to AIDS, and 8081 (25.1%) of patients died. The survival rate was 88%, 85%, 77%, and 67% for 1, 2, 5, and 10 years, respectively. Cumulative proportion surviving was significantly lower in males than in females (P = 0.0001). A higher rate of survival was seen in female patients, who diagnosed after 2010, infected in sexual route, and had CD4 cell count more than 500, nonconfected patients with tuberculosis (TB), and those who received antiretroviral therapy (ART). Based on multivariate model, the mortality risk in female patients, those with CD4 cell count more than 500, patients who received ART, and those with TB and injection drug uses (IDUs) was higher. The survival in studied patients increased in recent time periods, and ART reduced AIDS‑related mortality in these patients. The survival can be increased by focus on improvements in patient care among male patients, IDUs, and patients with TB coinfection.

Sleep bruxism (SB) in children is commonly a self‑limited problem; however, therapy of the condition may be
needed to improve sleep quality of parents and children. Benzodiazepines have some success in controlling adult bruxism. The objective of this study was to evaluate the effect and the safety of a short course of diazepam on controlling SB in healthy children. In this double‑blind, randomized placebo‑controlled clinical trial, 109 children with SB were randomly assigned to three groups, receiving low or moderate dose of diazepam or placebo for 2 weeks. For children aged 2–8 years, the dose of 2.5 and 5 mg was considered as low and moderate dose consequently. In children >8 years, the doses were doubled. The severity of SB was evaluated at the beginning and also 2, 8, and 12 weeks thereafter. Data were collected by a questionnaire completed by parents including frequency of SB per week and per night and duration of each SB, as bruxism severity score (BSS). A mixed‑model ANOVA was used to assess the differences of mean BSS between different groups and measurement times. From 109 children recruited, 90 completed the study. After 2 weeks of intervention, the mean BSS decreased significantly in all groups (P = 0.0001), but it was not significantly different between groups in any of follow‑ups (P = 0.554). Next‑day sleepiness was assessed at week 2 of the study and was significantly higher in the groups using diazepam (P = 0.026). Short course of diazepam was not more effective than placebo for long‑term control of SB in children.

Maternal–fetal tolerance plays a fundamental role in the maintenance of pregnancy. However, this immunological
tolerance can be influenced by intrauterine infections. Human amniotic epithelial cells (hAECs) have immunomodulatory effects and respond to invading pathogens through expressing various toll‑like receptors (TLRs). We hypothesize that bacteria or bacterial products affect the immunosuppressive effects of hAECs through TLR stimulation. Here, we investigated how a successful pregnancy can be threatened by TLR4 activation on hAECs on lipopolysaccharide (LPS) engagement. hAECs were isolated from the amniotic membrane received from six healthy pregnant women. The immunophenotyping of hAECs was studied by flow cytometry. The isolated hAECs (4 × 105 cells/ml) were cultured in 24‑well plates in the presence or absence of LPS (5 μg/ml).
After 24, 48, and 72 h of incubation, the culture supernatants of hAECs were collected, and the levels of interleukin‑5 (IL‑5), IL‑6,
IL‑1β, tumor necrosis factor‑alpha (TNF‑α), transforming growth factor‑beta 1 (TGF‑β1), and prostaglandin E2 (PGE2) were measured by enzyme‑linked immunosorbent assay. TLR4 activation showed a stimulatory effect on TGF‑β1 production of hAECs (P < 0.001–0.05). PGE2 production of LPS‑stimulated hAECs was significantly increased (P < 0.01–0.05). Moreover, TLR4 could
induce TNF‑α and IL‑1β production of hAECs (P < 0.0001–0.01), while this effect was not observed on IL‑6 production of hAECs. The IL‑5 was produced at a very low level in two culture supernatants of hAECs, in which its production was independent of LPS effect. TLR4 activation by bacterial components on hAECs may be a potential risk factor for pregnancy complications.

Intra‑aortic balloon pump (IABP) has been the most commonly used mechanical assist circulatory device in many postcardiotomy low output disorders for decades. Mechanism of IABP is based on its inflation in time of the diastolic pressure in the aortic root resulting increase in the blood and oxygen amount of the coronary artery and its deflation in left ventricular afterload during the systolic period. Prophylactic and postoperative application of IABP has been suggested by researchers, which has been commonly used in high‑risk patients undertaking coronary artery bypass grafting surgery or percutaneous coronary intervention. Other researchers put forward the idea of the percutaneous IABP insertion throughout the left axillary artery as a reliable and relatively well‑tolerated approach and also as a recovery tool to bridge patients with end‑stage heart failure to heart transplantation. The current review was aimed to give further insight into routine IABP application by presenting the basic principles and trends in the incidence, management, role of IABP recovery, and long‑lasting mortality outcomes in patients with cardiovascular disorders and discussing previous and current evidence.

Paraquat (PQ) poisoning is a serious public health problem in many countries. In spite of different treatments, the
mortality is still high. We performed a meta‑analysis to see whether hemoperfusion (HP) in combination with other treatments reduces the mortality more than HP alone in patients with PQ poisoning. We searched EMBASE, PubMed, Google Scholar, ISI Web of Knowledge, Cochrane Central Register of Controlled Trials, Scopus, Springer, TRIP, ProQuest, and references of the included studies from January 2000 to August 2017. Two reviewers independently searched and extracted data. We measured I2 to determine variance contributed by heterogeneity. To investigate the publication bias, Begg’s and Egger’s tests were used along with funnel plot analysis. Ultimately 12 articles were included in the meta‑analysis. Five articles compared HP with conventional therapy with a total of 1311 patients, and seven articles compared mortality of patients received HP versus those received HP in combination with an additional treatment. HP alone reduced the odds of death (odds ratio [OR] = 0.20; 95% confidence interval [CI]: 0.11–0.40, P < 0.0001) compared to conventional therapy. Furthermore, the odds of death was higher in HP group compared to those received HP in combination of additional treatments (OR = 1.24; 95% CI: 1.05–1.46, P = 0.01). The mortality was less in HP‑treated group compared to those received only conventional therapy. Addition of other treatments with HP reduced the mortality more than HP alone.

According to an Anglo‑Saxon study, in breast cancer survivors, there is a high prevalence of impaired fasting glucose. Our aim was to assess the impaired fasting glucose occurring in Mexican woman survivors of breast cancer. At a general hospital in Mexico City, women with breast cancer with a surviving ≥2 years, without type 2 diabetes mellitus, were studied.
The analysis included demographic and anthropometric features, time of surviving, and blood levels of lipids and glucose. The sample was 119 women. Impaired fasting glucose happened in 53 (44.5%). In those with normal weight (n = 28),
impaired fasting glucose occurred in 9 (32.1%); however, in overweight participants (n = 48), it developed in 22 (45.8%) and in obese participants (n = 43) in 22 (51.1%). Impaired fasting glucose is usual in Mexican breast cancer survivors. It is more in obese and overweight women compared to normal weight.