Journal of Advances in Medical and Biomedical Research
Volume:30 Issue: 143, Nov-Dec 2022

 Oral cancer is one of the 10 most common cancers in the world and its global outbreak is increasing. Saliva assessment is one of the non-invasive diagnostic methods for this cancer. The aim of the study was to achieve a comprehensive conclusion about changes in salivary antioxidants in patients with squamous cell carcinoma of the mouth (OSCC).

 In the present study, as a systematic review and meta-analysis study, information extracted by searching in external databases (PubMed, Science Direct, Scopus, Web of Science, google scholar) and internal databases (IranMedex, Scientific Information Database, Magiran) between the years 1980 to 2020. Comprehensive meta-analysis version 2 software was used to analyze the data (P <0.05).

 Of 497 articles, 271 duplicate articles were deleted, and then, after reviewing the titles and abstracts of the articles, another 197 articles were removed. The full text of 26 articles were reviewed and evaluated. Finally, based on the STROB checklist, the data of 10 articles were entered into the meta-analysis. Salivary malondialdehyde (MDA) index levels were much higher in patients with OSCC than in healthy people (P=0.0001). All salivary antioxidant indexes (TAC) (P=0.003) and GSH glutathione (P=0.008) saliva was significantly lower in patients than in the healthy group and regarding the salivary superoxide dismutase (SOD) index was no significant.

 In general, antioxidant supplements may be able to help prevent, treat, and improve the prognosis of this disease, which requires further research in this area.

 Mesenchymal stem cells (MSCs) promote metastasis in colorectal cancer; however, the mechanism underlying this process is not fully understood. Epithelial to mesenchymal transition (EMT) is a key step in tumor acquisition of metastatic phenotype. We aimed to investigate the effect of MSCs on the expression of EMT markers, as well as cancer stem cell markers in HT-29 colorectal cancer cells.

 MSCs were isolated from bone marrow tissue, and their multi potency was confirmed. The HT-29 cell line was prepared and co-cultured with MSCs for 3 days using 6-well transwell co-culture plates (membrane pore size: 0.4 µm). Cell morphology was observed by inverted microscopy. The expression levels of EMT-related genes, namely E-cadherin, Vimentin, and β-catenin, were investigated by the RT-qPCR method. Also, the surface expression levels of CD44 and CD133 cancer stem cell markers were analyzed by flow cytometry.

 The co-culture of HT-29 cells with bone marrow-derived MSCs resulted in changes in cell morphology from epithelial to mesenchymal forms. The expression of mesenchymal stem cell markers, namely Vimentin and β-catenin, were significantly increased (2.25 and 1.83 folds, respectively), while the expression of the epithelial marker, E-cadherin, was reduced (0.3 folds). The expression of CD133 was also increased (51.5%).

 Tumor-resident mesenchymal stem cells can promote colorectal cancer metastasis inducing EMT as well as increasing cancer stem cell frequency in the tumor microenvironment. It seems that direct contact between MSCs and colorectal cancer cells is not required for the interaction. Our findings may help scientists to find effective strategies against cancer metastasis by targeting tumor-resident MSCs.

 Due to the severe inflammatory conditions and cytokine storm in COVID-19 disease, corticosteroids are used worldwide as adjunctive therapy for these patients due to their anti-inflammatory effects. However, due to limited and inconsistent information about the effectiveness of this drug, this study aimed to investigate the benefit of combined use of β-interferon and methylprednisolone in patients with COVID-19.

 57 patients infected with SARS coronavirus 2 underwent treatment. Laboratory parameters, hospitalization duration, and clinical outcomes in these patients were studied.

 Statistical analysis showed no correlation between combination therapy with the hospitalization duration (P=0.22) and mortality (P=0.48). Also, the findings of this study showed that the ESR level in patients receiving combination therapy with methylprednisolone and interferon beta decreased significantly at the end of the intervention (P=0.0001). At the end of the study, the levels of neutrophils (P=0.001) and lymphocytes (P- value=0.0001) in the blood in the interferon group showed a significant change.

 This study showed no effect of adding methylprednisolone and interferon beta to the treatment protocol on mortality in the patients.

 Iron overload in the liver can potentially induce non-alcoholic fatty liver disease (NAFLD). In this study, we sought to evaluate the phlebotomy in NAFLD, and compare it with modifiedlife style.

 This randomized, single-blind, clinical trial was carried out to evaluate the efficacy of phlebotomy on liver enzymes and steatosis in NAFLD patients. Forty patients diagnosed with NAFLD were enrolled in the study. Patients were randomized into two groups, including twenty patients in the first group who were under daily consumption of 800 IU vitamin E with modified lifestyle, and the second group who administrated 400 ml phlebotomy at the baseline and fifth month of study alongside the modified lifestyle. Transient elastography (TE) was used to evaluate liver transaminases, hemoglobin, ferritin levels, and liver stiffness prior to and following the intervention. Chi-square and paired t-tests were used to analyze the data, using SPSS v18.

 In each group, there were 14 men and 6 women. There was no statistically significant difference in demographic features. After the intervention, the mean liver stiffness of the control group increased from 10.38±2.65 kPa before the treatment to 11.40±6.58 kPa, which was not significantly different (P=0.463). The liver stiffness was 11.29±4.71 kPa in the intervention group before the treatment, which was reduced to 8.10±2.36 kPa after the treatment; however, the difference between pre and post-treatment values was statistically significant (P=0.009). Before and after the treatment, there were no significant differences in the levels of liver enzymes between the two groups.

 Phlebotomy is a useful treatment for NAFLD patients, and decreased liver stiffness as cirrhosis complication.

 Consanguinity increases the incidence of genetic disorders. The frequency of consanguinity varies in different societies. There was no data regarding the frequency of consanguinity in Zanjan province. This study aimed to describe the prevalence of consanguineous unions in the parents of children with genetic disorders and its related factors in Zanjan, Iran.

 This cross-sectional study included children with genetic diseases referring to the medical genetics clinic in Zanjan's Musavi Hospital during 2014-2018. Data including consanguineous unions in families (up to three previous generations), types of genetic illnesses, child and parents' age, parental educational level, and occupation were collected and analyzed using descriptive statistics, independent t-test, and chi-square test.

 Of the 87 children, 41 (47.7%) were male, and 50 (59.5%) resided in urban areas. The mean age of the children was 6.5 years. The educational level of 56.6% of fathers and 50.6% of mothers were highschool diploma or higher. The parents of 44 children (51.8%) had consanguineous unions. The most common type of consanguineous union was between first cousins. The nature of the genetic disorders in 63 (72.4%) of children was molecular. The proportion of consanguinity was significantly higher in parents of children with molecular than chromosomal disorder (P<0.0001). Consanguinity had also a significant relationship with the children's age (P=0.04).

 This study's outcomes illustrate that parents of more than half of children with genetic disorders had consanguinity and the frequency of consanguinity was more common in parents of children with molecular disease than chromosomal disorder. Given that, it is necessary to avoid consanguineous marriage as much as possible, and families with a history of molecular genetic disease, should be informed of the possible consequences.

 The COVID-19 pandemic is a phenomenon that has infected and killed many people worldwide. Underlying diseases such as diabetes mellitus, heart failure, and chronic kidney disease (CKD) can affect the severity of COVID-19 and aggravate patients' condition. This study aimed to predict the severity of the COVID-19 disease in CKD patients by combining feature selection and classification methods.

 This study was conducted between March 2021 and September 2021 in Isfahan University of Medical Sciences. The data set includes 83 traits of 72 kidney transplant patients, 231 kidney failure patients, and 105 dialysis patients. The data set has 77 input attributes, including age, sex, diabetes mellitus, hypertension, ischemic heart disease, chronic lung disease, and kidney transplant.
In the proposed method, the combination of ant colony algorithm and the CHAID method has been used.

 The combination of the ant colony algorithm and CHAID method leads to better performance than CHAID alone. A total of 22 rules were extracted, of which 6 rules with a confidence of more than 60% were introduced as selected rules. The most reliable rule states that if a person has CKD stage 5, is not undergoing dialysis (5ND), and is short of breath, in 81% of cases the type of COVID-19 disease will be severe.

 In this study the severity of COVID-19 disease in kidney patients was measured using variables including age, diabetes mellitus, blood pressure, CKD stage, etc. The results showed that high levels of kidney disease can lead to severe COVID-19.

 Type 2 Diabetes Mellitus (T2DM) is among the epidemic metabolic chronic diseases that attenuates physiological functions, including hematopoiesis and immune responses, developing a higher risk of COVID-19 incidence. This study purposed to study the association of physical activity level (PAL) with the COVID-19 incidence in patients with T2DM.

 All patients with T2DM from Kermanshah (Iran) were among the statistical population of this study. Using Cochran's formula, 424 patients with T2DM (220 women, 224 men) were chosen. The International Physical Activity Questionnaire (IPAQ) assessed the PAL. To compare the variables between men and women the independent t-test was used. Also, to evaluate the relationship between variables the Pearson correlation coefficient test was used (SPSS software version 24) at a significant level of (P≤0.05).

 Based on the results, no significant difference was observed in PAL and COVID-19 incidence between women and men (P=0.342). Also, a significant positive relationship was observed between low and high PAL with COVID-19 incidence in men (r=0.638, P=0.039; r=0.231, P=0.048) and women (r=0.728, P=0.011; r=0.331, P=0.018), respectively. However, there was a significant inverse relationship between the moderate PAL and the incidence of COVID-19 among women (r=-0.791, P=0.021) and men (r=-0.731, P=0.029).

 Most of the patients with T2DM had an inadequate PAL. Compared with low and high PALs, moderate PAL might have lowered the incidence of COVID-19 more effectively. Finally, a moderate PAL is recommended to patients with T2DM to boost the immune system and prevent COVID-19 infection than high or low PAL.

 COVID-19 has enforced high burden on health systems universally. To better allocate limited health equipment, we aimed to investigate the prognostic impacts of laboratory parameters.

 All SARS-CoV-2 patients admitted to Imam-Reza University Hospital, Mashhad, Iran, during three COVID19 peak periods in Iran (March to April 2020, July to August, and October to November 2020) were enrolled the study. Demographic and laboratory data were extracted and compared between survivors and non-survivors. Regression analyses and receiver operating characteristic (ROC curve) were used to identify risk factors and assess the ability of laboratory tests in predicting in-hospital mortality.

 A total of 2156 COVID19 patients were included in the analysis, with a mean age of 60.20 (±18.8) years. Most patients were male (57%). Multiple regression analysis identified older age (OR=1.01), male sex (OR=2.34), lymphopenia (OR=2.12), LDH >500U/L (OR=2.17), hypernatremia (OR=9.7), urea >45mg/dL (OR=3.6), and BS >200mg/dl (OR=1.93) as significant risk factors for in-hospital death. Using ROC curve analysis, D-dimer (>1000ng/ml) as well as CK-Mb (>28U/L) both with sensitivities and specificities of more than 80% and PPV of about 90% were able to identify patients with higher possibility of in-hospital death.

 Male sex, older age, lymphopenia, hypernatremia, increased Urea, increased LDH, and hyperglycemia may serve as potential risk factors for in-hospital death. D-dimer and CK-MB may be used in identifying patients with high probability of in-hospital death. These tests may be used in clinical decision-making in order to improve outcomes of patients with COVID-19.

 Breast milk contains nutrients such as carbohydrates, essential fatty acids, proteins, vitamins, minerals, and a source of communal bacteria with probiotic potential that is very effective in the prevention and treatment of neonatal infections. The aim of this study was the evaluation of probiotic properties of lactobacilli in breast milk and their inhibitory effect on pathogenic bacteria of the gastrointestinal tracts.

 In a cross-sectional descriptive study, during 10 months from January to October 2018, 100 breast milk samples were collected by referring to health centers after isolation. Lactobacilli strains were evaluated based on morphological characteristics, catalase, and hot staining tests, survival tests in acidic conditions, and bile salt tolerance to evaluate probiotic properties. Antibiotic resistance of probiotic strains and ability to inhibit pathogenic bacteria was evaluated by well method and growth inhibition zone.

 122 lactobacilli belonging to 12 species were identified from 100 samples of breast milk by phototypical methods. The predominant species belonging to casei and other lactobacilli were Fermentum, Plantarum, and Gasseri, respectively.The highest antibiotic resistance was related to vancomycin (63.15%). The 3 isolates L4, L14 and L16 were able to strongly inhibit all the studied gastrointestinal pathogens.

 Breast milk is a rich source of beneficial probiotic lactobacilli, which can be useful in breast milk for infants who are not breastfed to prevent neonatal infections.

 As a significant cause of nosocomial infections, Acinetobacter baumannii has been linked to opportunistic infections. The assessment of clonal relatedness of A. baumannii isolates using typing methods like ERIC-PCR is beneficial for controlling conditions due to these resistant isolates. This research aims to study Acinetobacter baumannii resistant isolates to multidrug using typing methods like ERIC-PCR in clinics of Zanjan city.

 In all, one hundred immunocompromised patients in ICU were included in the study and isolates of A. baumannii were extracted from their samples, and molecular typing using ERIC-PCR was performed on patients who were positive for aminoglycoside resistance-related genes (aph(2'')-Id, ant(4'')-Ia, ant(3'')-I, aac(6'')-Ib, aac(3)-I, aph(3'')-I, aph(2'')-Ib and aph (2'')-Ic). 67% of isolates had gentamicin resistance, and 63% had tobramycin resistance.

 The isolates tested positive for multidrug resistance (MDR) were all labeled as MDR strains. Furthermore, all antibiotics tested were ineffective against 32% of the isolates, while 91% could be deemed extensively drug-resistant (XDR). The aminoglycoside resistance gene aac(6′)-Ib accounted for 79% of the cases, followed by ant(3'')-I and aph(2'')-Id (47%). Sixty-four percent of the isolates carried three or more aminoglycoside resistance genes simultaneously. A total of six types and 20 subtypes of patterns were obtained from ERIC-PCR.

 In this study, aminoglycoside-resistant A. baumannii was found in a high percentage of ICU patients, mainly with the enzyme-modified aminoglycosides like aac(6′)-Ib, aph(2'')-Id and ant(3'')-I. ERIC-PCR has also shown an increased level of diversity in A. baumannii isolates. Therefore, genetic diversity or clonal relatedness of A. baumannii isolates in clinical settings can be assessed using ERIC-PCR.

 Rheum turkestanicum (R. turkestanicum) has been known to reduce inflammation and has antioxidant properties such as protective effect in neurons. This study aimed to determine the effects of R. turkestanicum on neuronal toxicity induced by the pro-parkinsonian neurotoxin 6-hydroxydopamine (6-OHDA) in neuroblastoma SH-SY5Y cells.

 MTT and DNA fragmentation by PI staining (sub-G1 peak) assays were used to determine cell viability and induction of apoptosis, respectively. Fluorimetry methods measured lipid peroxidation malondialdehyde (MDA) and reactive oxygen species (ROS) levels. The amount of glutathione (GSH) and the activity of superoxide dismutase (SOD) were measured by DTNB (5, 5′-Dithiobis(2-nitrobenzoic acid)  and pyrogallol respectively.

 Pretreatment with 12.5 to 100 μg/mL of R. turkestanicum extract for 24 hours attenuated 6-OHDA (final concentration 42.5 μg/mL)-induced cytotoxicity. Also, the pretreatment of SH-SY5Y cells with R. turkestanicum inhibited 6-OHDA-stimulated apoptosis in a dose-dependent manner. Additionally, R. turkestanicum extract repressed 6-OHDA-induced oxidative stress as measured by the MDA, ROS, GSH, and SOD levels.

 The findings suggest that R. turkestanicum extract has neuroprotective activity on 6-OHDA-induced neuronal toxicity of neuroblastoma cells.

 Datura stramonium L. is a medicinal herb from the family of Solanaceae. It has been used in herbal remedies for promoting health and treating several diseases. The current study was set up to compare the effects of Datura stramonium L. extract on the naloxone-precipitated opiate-withdrawal in mice.

 Male BALB/c mice (30–35 g, n = 40) were arbitrarily separated into 4 groups. The control group received morphine and normal saline and other groups received three doses of D. stramonium extract (10, 20, or 30 mg/kg, intraperitoneally, i.p.). Physically dependent was made by the administration of morphine in increasing doses (50-75 mg/kg, i.p.). The withdrawal signs were elicited by intraperitoneal injections of naloxone (5 mg/kg) 2 h after the last injection of morphine.

 Administration of D. stramonium extract in doses of 20 and 30 mg/kg markedly diminished the jumping numbers compared to the control group (P<0.05). All three doses of D. stramonium extract could significantly suppress the increase in climbing (P<0.05, P<0.001, and P<0.001, respectively) and diarrhea (P<0.001). D. stramonium in higher doses (20 or 30 mg/kg) significantly decreased rearing and itching (P<0.001).

 The study findings suggest that D. stramonium extract is effective in alleviating the signs of morphine withdrawal. Additional research is needed to determine the exact mechanisms underlying D. stramonium for inhibiting morphine withdrawal syndrome.

Reconstructing scalp defects can be challenging for a plastic surgeon. For this purpose, different procedures such as primary repair and coverage with skin grafts or flaps can be considered. Sometimes, the external table of the skull can be removed completely to the diploic space. At the same time or after the formation of granulation tissue, the diploic space can be covered with split-thickness skin grafting.
In this article, we have reported the reconstruction of a traumatic scalp defect in a one-year-old baby. There was a large defect in the left temporoparietal area of the scalp. The wound was debrided and irrigated with normal saline frequently. After the wound infection was controlled, instead of covering it with a flap or excising the external table of the skull and skin grafting, we managed this defect by the fenestration of the external table of the skull followed by the formation of the granulation tissue and coverage of the defect with split-thickness skin grafting. The post-op course was uneventful, and the wound was covered completely with the skin graft. We believe that this method of treatment in a child allows us to provide better coverage for the defect when the patient is older and after tissue expansion. We also showed that the punctate fenestration of the skull can provide a granulated tissue bed for skin grafting, as well as the excision of the external table of the skull.

We herein describe a 34-year-old woman with a persistent left superior vena cava (PLSVC) impinging on the posterior wall of the left atrium, subdivided by a membrane at the distal part of the impingement. In this patient, a much dilated coronary sinus due to the PLSVC resulted in a membrane-like structure in the posterior wall of the left atrium with the appearance of the cor triatriatum in transthoracic echocardiography (ie, a pseudo cor triatriatum). Although the PLSVC is a common malformation of the superior systemic vein, its aforementioned presentation is rare.

SARS-CoV-2 is a novel strain of the coronaviruses posing great challenges to the human immune system. Hence, human innate immunity determines how our body responses to the early infection (1-3). According to the studies, coronavirus can cause a range of symptoms by affecting various organs in the body (4, 5). Currently, our hospital is one of the referral centers of COVID-19 in Iran. We would like to share our findings regarding complete bed rest in management of moderate COVID-19 cases.