Journal of Advances in Medical and Biomedical Research
Volume:30 Issue: 139, Mar-Apr 2022

Novel coronavirus causes the outbreak of COVID-19. There is still no verified treatment regimen against this novel virus; however, different drugs and compounds have been tested against it. Ample proposals have led to a good understanding of pathogenesis and drug efficacy against the novel virus disease. Excess systemic inflammation, which is described as cytokine storm, in the severe cases of COVID-19 can pass through the blood-brain barrier, enter the brain tissue, and activate the microglial cells and oligodenritcytes. Activation of the microglia cells and oligodenritcytes can increase generation of reactive oxygen species in the brain. Excess generation of reactive oxygen species can in turn increase neuro-inflammation in some cases of patients with COVID-19. Treatment of COVID-19 is far from clear. Today, some antiviral drugs such as remdisivir, favipiravir, ribavirin, kaletra, and arbidol are being tested against the disease. Besides these drugs, corticosteroids, anti-malaria drugs (such as chloroquine family), anticoagulants (such as heparin or enoxaparin) are repurposed. In this paper, first we explained the pathogenesis of COVID-19 particles, particularly in the brain. Second, we reviewed recent treatment options up to now, including interferon therapy, convalescent plasma exchange, plasmapheresis, immunoglobin therapy, and use of specified monoclonal anti-bodies in COVID-19 patients.

Bisphenol A, as a primary substance used for making many plastic devices enters the body through various routes such as skin penetration, oral ingestion, and inhalation and is among the chemicals leading to the disruption of the endocrine system. It exerts its destructive effects on the various tissues through estrogen, androgen, thyroid, pregnane X, and aryl hydrocarbon receptors. This review study was conducted to evaluate the pharmacological effects of bisphenol and its signaling pathways especially in the adipose tissue. Studies have shown that the disruption in the level of adipocytokines can contribute to the formation and progression of the chronic diseases such as cancers. Decreased level of adiponectin (as an adipokine secreted from white adipose tissue) and increased levels of IL-6, TNF-α, and leptin are among the disruptions caused by bisphenol which can develop different types of cancers. Accordingly, it seems that the use of bisphenol and contact with it should be reconsidered with regard to its destructive effects on the endocrine system.

 Perioperative myocardial ischemia remains one of the most serious complications of cardiac surgery. This study aimed to evaluate the effect of bolus esmolol versus its infusion on hemodynamic responses after laryngoscopy and intubation in patients undergoing coronary artery bypass grafting (CABG).

 This double-blind randomized clinical trial was conducted on 75 patients that were allocated into three groups. In the infusion group, 10 minutes prior to laryngoscopy 0.5 mg/kg esmolol was injected, and then, 200 µg/kg/minute esmolol was infused. In the bolus group, 2 minutes prior to the laryngoscopy 1.5 mg/kg bolus dose of esmolol was injected intravenously. In the control group, a bolus dose of normal saline was administered. Heart rate (HR), Systolic (SBP) and diastolic (DBP) blood pressures and mean arterial pressure (MAP), were recorded every one minute from 10 minutes prior to laryngoscopy to 10 minutes after intubation. Repeated measure ANOVA was applied as statistical analysis.

 SBP was at the lowest rate since laryngoscopy was started until 10 minutes after intubation in the esmolol infusion group (P= 0.029). From the initiation of laryngoscopy to 6 minutes after the intubation, DBP was at the lowest rate in the infusion group. There was a significant difference between the groups regarding DBP changes during the measurement. ANOVA model showed that interaction between time and groups on SBP, MAP, and HR (P< 0.05).

 According to our results, the exact doses of esmolol infusion significantly reduced the level of SBP during intubation, compared with bolus esmolol.

 Tuberculosis (TB) remains an ongoing major public health problem in the world. In recent years, experimental evidenc suggests a link between TB and Vitamin (Vit) D. This study was conducted to determine serum Vit D, calcium (Ca), phosphorus (P), and parathormone (PTH) levels in untreated pulmonary TB (PTB) patients.

 In this case control study, 50 outdoor PTB patients were selected with 50 gender- matched controls from April 2019 to March 2020. Controls were drawn randomly from general population. Body mass index (BMI) ,serum Vit D, PTH, Ca, P, Albumin (Alb), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), total and direct bilirubin, blood urea nitrogen (BUN) and creatinine (Cr) levels were measured in the two study groups. The results were analyzed on SPSS version 25.

 Median [IQR] Vit D levels were 17.4 [14.0- 24.0] ng/ml in cases,and 23.0 [18.0- 27.0] ng/ml in controls (P=0.002). Median [IQR] serum corrected Ca value for the TB patients (8.91 [8.60- 9.15] mg/dL) was significantly lower than that of the healthy controls (9.60 [9.15- 9.89] mg/dL, P< 0.001). Median [IQR] PTH was 48 in TB patients [45- 52 pg/ml ]and 38 in controls [28- 42 pg/ml] (P<0.0001).

 BMI and uncorrected and corrected serum Ca, P, Vit D, Alb, and both two aminotransferases levels were significantly lower and serum PTH was significantly higher in patients with TB as compared to controls.

 It has been reported that low concentration of zinc in serum is associated with insulin resistance (IR), also appears to be a relationship between insulin and leptin. In this study the possibility of increased leptin concentration and zinc deficiency was evaluated; in the following, their relationship with overweight and IR was investigated in women with polycystic ovary syndrome (PCOS).

 In this case-control study, 104 PCOS involved cases and 99 healthy individuals as control were included. Blood specimens were collected from participants post overnight fasting period; zinc concentrations (spectrophotometry method), leptin (ELISA method), insulin (ECLIA method), lipid profiles and glucose were measured with enzymatic method. The homeostasis model assessment (HOMA) index determined the IR level.

 Zinc level was 87.20 ± 11.32 μg/dl in PCOS group, and 113.68 ± 8.31μg/dl in control group. Leptin  concentration was 23.06 ± 3.33 ng/mL and 19.37 ± 3.34 ng/mL, and IR was 2.37 ± 0.83 and 1.45 ± 0.74 in case and control groups, respectively (all p<0.001). Zinc had marked negative correlation with leptin, insulin, and IR (p<0.001). According to the subject, which waist circumference and body mass index (BMI) parameters were confounding factors, hyperleptinemia and zinc decrement significantly affected PCOS subjects. In contrast, only zinc decrement had an association with PCOS, after eliminating the confounding factors (OR: 0.782, p<0.001).

 Zinc reduction is more effective on PCOS than hyperleptinemia. Hyperleptinemia has association with waist circumference and BMI; it can also affect PCOS.

 Caring for children with autism is associated with parental stress and puts them at risk for depression and anxiety. Increasing resilience may help reduce the parents’ stress. The main objective of this study was to investigate the relationship between resilience and anxiety, depression, and stress in families with autistic children in 2018.

 In this cross-sectional study, 137 members of the target families were selected randomly. The cases were surveyed based on the family resilience scale and DASS-21 questionnaire with the checklist of demographics variables. The collected data were analyzed by the MS Excel and SPSS V.22 software.

 There was no significant correlation between age/gender and resilience, but depression and anxiety was related to the level of resiliency. Income and history of mental illness had significant associations with depression. The family size, educational level, income, and history of mental illness had a significant effect on anxiety. The level of education, income, history of mental illness and gender had statistically significant associations with the level of stress among individuals.

 Based on the results of this study, family resilience is the factor that directly correlates with the level of depression, anxiety and stress among the family members of the autistic children. It is therefore advisable to increase this ability of individuals in various ways, such as training, counseling and supporting groups.

 Breast cancer patients need a variety of skills and abilities to deal with the consequences of the illness. Self-management is one of the operational strategies that leads to disease acceptance, treatment adherence, and improving the quality of life. The use of smartphone applications (apps) can play a pivotal role in the support and self-management of breast cancer patients. This study aimed to identify the educational contents and technical features of a self-management smartphone app for women with breast cancer in Iran.

 This descriptive, cross-sectional study was carried out in 2020. The statistical population of the study consists of 120 women with breast cancer who were selected via simple random sampling. For data collection, a self-designed questionnaire was developed in which validity and reliability of the questionnaire was measured. The statistical analysis of the data was made using the SPSS software.

 From the breast cancer patients’ point of view, the most important educational contents of the smartphone app.  include information acquisition (4.73), lifestyle management (4.65), symptom management (4.43), psychological management (4.01), and compatibility with changes (3.98) respectively. In terms of technical features the most important characteristics were ease of the app. use (4.83), simple visual interface (4.75), security and privacy of information (4.63), reminders (4.55) and the ability to communicate (4.42).

 For more effective smartphone apps, educational contents and technical features of apps should be designed based on the needs and preferences of patients. To ensure the use and acceptance of the app., developers should design apps that have technical requirements.

 Retinopathy is a common difficulty in diabetic subjects. Hyperglycemia damages the tissues through stimulation of oxidative stress and inflammation. Since the antioxidant function of garlic has been proven, in the current report the activity of aqueous garlic extract (AGE) upon the oxidative stress and inflammation in the retinal substances of rats with diabetes was investigated.

 24 male Wistar rats were distributed in 4 groups: the healthy rats,  the rats with diabetes (DM2),the garlic- treated rats with diabetes (DM2+AGE), and the garlic- treated healthy rats (AGE). After the treatment was finished, oxidative stress, total antioxidant capacity (TAC), total oxidant status (TOS), oxidative stress index (OSI), thiol group (SH), and lipid peroxidation (LPO) were assayed. For the evaluation of inflammation, mRNA and protein levels of transforming growth factor beta-2 (TGF-β2) and interleukin-1 beta (IL-1β) were measured in retinal homogenates using real-time PCR and ELISA, correspondingly.

 In  the DM2 rats, TAC and thiol group diminished (p<0.05 and p<0.001, respectively), whereas TOS and LPO increased (p<0.01 and p<0.001, correspondingly) compared to the control rats. In the DM2+AGE rats TAC and thiol group increased (p<0.01 and p<0.05, correspondingly), whereas TOS and LPO diminished (p<0.05 and p<0.001, correspondingly) compared with DM2 rats. The gene expression and protein concentrations of TGF-β2 and IL-1β increased in  the DM2 rats compared to the healthy group, whereas these parameters decreased in the DM2+AGE rats compared to the untreated rats with diabetes (p<0.001).

 The findings revealed the antioxidant and anti-inflammatory results of garlic extract. Thus, garlic extract could be beneficial for lessening diabetes-induced retinopathy.

 Lead entry into the body causes considerable damages to the brain in the long term. We aimed to investigate the effects of exercise (treadmill running) and flaxseed oil on lead acetate-induced behavioral deficits in male rats. 

 60 rats were divided into 6 groups: Control (C), Exercise (Ex), Flaxseed oil (FO), Lead (L), Lead- Exercise (L-Ex), and Lead- Flaxseed oil (L-FO). Groups L, L-Ex, and L-FO obtained 100 mg/kg of lead acetate, and groups FO and L-FO received 4 ml/kg (by gavage) of flaxseed oil for 28 consecutive days and Ex, and L-Ex groups ran on the treadmill. At the end of the session, spatial memory, depression, and anxiety behaviors were examined utilizing Morris water maze, forced swimming test, and elevated plus maze respectively. 

 Lead acetate impaired learning and memory and led to depression and anxiety in rats. Treadmill running and flaxseed oil, both, improved learning and memory and decreased anxiety, but unlike treadmill running, flaxseed oil could not prevent depression resulted from lead consumption.

 Exercising (treadmill running) and flaxseed oil prevent lead-induced behavioral deficits.

 Phage therapy could be used as an alternative method to antibiotic treatments. The purpose of this study was to evaluate the antibacterial activities of isolated lytic bacteriophage against ciprofloxacin-resistant strain of Salmonella infanits in vitro conditions.

 The standard strain of Salmonella infantis  and its specific bacteriophage was isolated by soft agar method. Phage susceptibility to heat and pH was evaluated by the Double-Layer Agar method.  In vitro assay was carried out on human epithelial type 2 (HEp-2) cells to investigate the effect of bacteriophage on the cytotoxic and invasion of Salmonella infantis to human epithelial cells.

 Head and tail morphology of bacteriophages against Salmonella infantis were identified by transmission electron microscopy and assigned to the Myoviridae family. The results of the double-layer agar assay showed that the titer of bacteriophages was 1.8×107 PFU/ml. bacteriophage was stable at 4 C and the best quantification of bacteriophage was determined at pH=8. The isolated bacteriophage was specific for Salmonella infantis and had no lytic activity against other pathogenic bacteria. In the evaluation of the binding and invasion of Salmonella infantis to the HEp-2 cell line, as expected, the lytic activity of specific bacteriophage was observed following inoculation.

 Additional studies are needed for better understanding of the interaction between phage, microorganisms and human host before applying phage therapy on a large scale.

 Hospitals niche as a source and repository for microbial infections are playing a significant role in the health of hospitalized patients. Bacteria are playing an essential role in human and animal blood infections and meningitis. The prevalence of bacterial agents and their susceptibility patterns are fundamental goals of current research.

 Sampling was carried out in two main educational hospitals, Sari City, Iran, from April 2016 to March 2017. After traditional biochemical tests, susceptibility testing of isolates was performed taking advantage of Kerby-Bauer. Subsequently, the frequency of related bacterial agents to meningitis and bacteremia and their susceptibility patterns were analyzed.

 Frequencies of bacterial isolates in Bouali and Imam Hospitals for meningitis (1.9%, 3.5%), bacteremia (31.9%, 26.3%), and urinary tract infection (UTI) were screened (66.2%, 70.1%). Staphylococcus aureus (41.7%) and Streptococcus pneumoniae (45%) were the highest isolates of meningitis in the mentioned hospital. These values to bacteremia were as follows: Gram-negative Staphylococci (30.7%), Escherichia coli (30%). Coagulase- negative Staphylococci isolates recovered from meningitis were completely sensitive to ciprofloxacin and Gentamycin. In addition, P. aeruginosa, Klebsiella and Acinetobacter spp showed higher than 90% resistance against ampicillin. E. coli, Klebsiella spp and S. aureus showed 100% resistance to amoxiclav; while Klebsiella spp were completely sensitive to amoxiclav.

 Given the bacterial isolates detected from hospital wards and following the findings prompt diagnosis method is essential to control infections and the proper use of effective antibiotics.

 Acrylamide is a highly soluble, widely- produced industrial and cytotoxic material. Some substances with antioxidant properties can ameliorate the deleterious effect of acrylamide. Vitamin C is necessary for the normal functioning of all cells and scavenging the free radicals due to the antioxidant properties. The present study was aimed to evaluate the effect of vitamin C on the biochemical parameters and histological changes in the kidney tissue damage induced by acrylamide in rats.

 Forty rats were randomly divided into four groups (n=10): 1) the control group, 2) acrylamide group, 3) vitamin C group, and 4) acrylamide + vitamin C group. Histopathologic assessment (by Hematoxylin and Eosin (H& E) staining of the kidney tissue) was performed and biochemical parameters (serum malondialdehyde, total antioxidant capacity (TAC), urea, and creatinine) were measured.

 There was a significant enhancement in the serum urea, creatinine, and malondialdehyde levels in the acrylamide group compared to the other groups (P < 0.001). Serum TAC increased in the vitamin C group compared to the acrylamide + vitamin C and acrylamide groups (P ≤ 0.001).

 The present study showed that chronic consumption of acrylamide can lead to pathological changes in the kidney tissue as well as unfavorable alteration in serum urea, creatinine, TAC, and MDA levels. Concurrent vitamin C consumption had a significant preventive effect on the aforementioned parameters. Therefore, vitamin C can play a protective and antioxidant role in decreasing the toxic effects of acrylamide in rat kidneys.

 Screening and timely diagnosis of positive individuals is one of the important issues in controlling pandemic of Covid-19. Early and timely diagnosis of asymptomatic individuals, contact tracking, disconnection of Covid-19 transmission chain through early detection of patients and decreasing R0 were the main objectives of the current study.

 The Covid-19 outpatient sampling detection project started in Zanjan province on March 26, 2020 and samples were taken from people suspected of having Corona Virus and people in contact with these patients.

 All 31,937 cases (48% male, 52% female) who had referred to Comprehensive Health Care Centers until May 16, 2020, were selected. A considerable percentage of incidences were observed in Zanjan and Khodabandeh cities. 20% of the examined samples had positive results. A substantial incidence was found in the age group of over 70 -year- old. Following implementation of the outpatient screening project, R0 fell below 1 in the province.

 Prior to the implementation of Covid-19 laboratorial outpatient screening project, the value of R0 was 1.4 in Zanjan province. However, this value fell below 1, after implementation of the laboratorial outpatient screening indicating that the principal way to effectively control Covid -19 is to detect positive cases and manage them.

Bartter syndrome (BS) is a group of uncommon genetic disorders of reabsorption of salt in the cortical thick ascending limb (TAL) of the Henle's loop, typically distinguished by metabolic alkalosis, salt loss, hypokalemia, hyperreninemic hyperaldosteronism and normal blood pressure. Bartter syndrome type 3, recognized as a classic BS (CBS), occurs because of mutations in CLCNKB gene.We enrolled one consanguineous Iranian family with one patient in our study. Targeted genomic capture and massively parallel sequencing (MPS) of all recognized genes responsible for BS subtypes 1–5 were carried out to recognize the genetic reasons of BS.Here, we report the recognition of a novel homozygous frameshift mutation in the CLCNKB gene in an Iranian pedigree. The subjects were homozygous for a frameshift mutation (p.Gly662GlyfsX12) within CLCNKB gene that encodes the basolateral chloride voltage-gated channel Kb.The identification of other causative mutations in CLCNKB gene additionally supports the important function of this gene in causing BS. To the best of our knowledge, this is a novel CLCNKB gene mutation in BS children.The accurate function of the CLCNKB Gly662GlyfsX12 mutation in the CBS pathogenesis  is still unknown.

Autoimmune myelofibrosis (AIMF) is considered as an infrequent cause of bone marrow fibrosis (BMF) and a rare complication of systemic lupus erythematosus (SLE). Due to its rarity, it is mistakenly diagnosed as primary myelofibrosis (MF).We describe the clinicopathologic features of a secondary form of AIMF in a 33- year- old female patient with an undiagnosed SLE which presented with acute bicytopenia. Absence of splenomegaly, leukopenia, anemia, BMF (grade MF-1), and presence of autoantibodies were some of noticeable features. Treatment with corticosteroid led to complete regeneration of the bone marrow and subsequently to an improved hematological status. Six- month follow-up showed that the patient was in good clinical condition.Identification of AIMF is a diagnostic challenge and pitfall and it is actually a diagnosis of exclusion. It could be the first and only presenting feature of SLE and results in hematologic disturbances. So, we should consider SLE-associated AIMF in the differential diagnosis of pancytopenia.

COVID-19 spread rapidly worldwide and became a pandemic disease in April 2020. During this period, various medical complications of this disease have been reported, but less attention has been paid to the cognitive aspects caused by the pandemic. In this review article, an attempt has been made to address the cognitive aspects of COVID-19 disease. Importantly, this disease has caused people to use their hands lesser than before the pandemic. It also forces the people to escape from the contaminated regions. In addition, mental fatigue resulting from long-term quarantine and staying at home, social jet lag due to changes in the hours of use of artificial light, economic problems, and poverty resulting from a long-lasting lockdown, are also the consequences of the pandemic. All of these consequences can be led to chronic psychological stress, which may induce several metabolic, immunological, cardiovascular, and psychological impairments and/or disorders. These outcomes indicate that the COVID-19 pandemic is a complicated issue that would not be resolved by considering the epidemiologic rules. There is an urgent need for a new branch of science which could be called “Pandemiology”, which could be categorized as a sub-branch of cognitive science. Pandemiology seems to be an interdisciplinary science and uses the social sciences, psychology, neuroscience, art, economy, politics, medicine, biology, media, and other sciences to better deal with the complications of such emerging pandemics.