zahra eslamifar

 Many factors, including coagulation disorders, have an effect on mortality in patients with Covid-19 viral infection. Considering coagulation problems are so important for these patients, the goal of this study was to look into the connection between coagulation test results, such as prothrombin time (PT), partial thromboplastin time (PTT), D-dimer, and platelet count, and the death rate in Covid-19 patients who were admitted to the intensive care unit of Ganjovian Hospital (Dezful, Iran) in 2020.

This comprehensive cross-sectional study was conducted on the information of 100 patients with Covid-19 hospitalized in the intensive care unit. The data from the patient’s files were analyzed using Graph Pad Prism version 8.3 statistical software. Qualitative variables were described using frequency indices, percentages, and relative frequency. A t-test was also used to compare the study parameters between the death and discharge groups. The level of significance was considered less than 0.05.

The mean and standard deviation of the age were 58.2±14.2. The average age of the death group was significantly higher than that of discharged patients (P=0.038). The D-dimer and PT test results in patients with Covid-19 who died were significantly higher than those of discharged patients (P=0.002), but there was no significant difference in platelet count and PTT between the two groups (P=0.680).

According to the results of this study, paying attention to the results of D-dimer and PT tests may be helpful in predicting the prognosis of Covid-19 disease.

Silymarin is utilized in the treatment of liver conditions primarily because of its antioxidant properties and its ability to lower blood lipid levels. Propofol, an anesthetic and antioxidant, is harmful to patients with hyperlipidemia. The aim of this study was to investigate the beneficial effects of silymarin and propofol on liver enzymes and blood indices. We also studied the impacts of propofol and silymarin on propofol-induced hyperlipidemia in male Wistar rats.

The rats were divided into four groups: 1) controls; 2) silymarin; 3) propofol; and, 4) combined propofol and silymarin. On the 22nd day after the treatments, all rats were anesthetized, and their blood samples were collected to estimate the levels of AST, ALT, ALP, LDH, TG, TC, LDL-C, and HDL-C. After being sacrificed, the liver was removed from each rat to determine the levels of MDA, GPx, GSH, and CAT. Moreover, histopathological examinations were performed on all liver samples.

Silymarin and propofol, used either separately or in combination, had a favorable effect on the indicators of oxidative stress and the liver’s antioxidant markers. The propofol treatment alone significantly increased the blood lipid parameters. The administration of Silymarin had a modulating effect on propofol-induced hyperlipidemia in rats.

Propofol and silymarin had favorable effects on the liver; however, propofol increased the blood lipids due to its lipid structure, which is a warning for patients with hyperlipidemia. In this regard, silymarin may be considered a protective option, making it a potential treatment for patients experiencing hyperlipidemia induced by propofol.

Gastrointestinal (GI) mucositis is one of the serious side effects of methotrexate (MTX) treatment. It is known that oxidative stress plays an important role in drug-induced side effects.

The present study aimed to assess the effect of gallic acid (GA) against MTX-induced intestinal mucositis in male Wistar rats.

Twenty-eight adult male Wistar rats were randomly divided into 4 groups (n = 7), including (1) control group; (2) GA group (gallic acid: 30 mg/kg/day, orally); (3) MTX group [20 mg/kg, intra peritoneal (IP)]; and (4) (MTX + GA) group (MTX: 20 mg/kg, IP and gallic acid: 30 mg/kg/day, orally). Then amounts of malondialdehyde (MDA), nitric oxide (NO), glutathione peroxidase (GPx), glutathione (GSH), superoxide dismutase (SOD), interleukin 2 (IL-2) and interleukin 6 (IL-6) were analyzed in serum samples and then the histopathological examinations of the duodenum and jejunum of animals groups.

The results showed that treatment with GA significantly reduced the MTX-induced elevation of serumMDA(P < 0.001), NO (P < 0.001), IL-2 (P < 0.001) and IL-6 (P < 0.001) contents and increased MTX-induced reduction in GSH (P < 0.001) content, GPx (P < 0.001) and SOD (P < 0.001) activity. In addition, the histopathological results showed that MTX leads to intestinal tissue damage, and gallic acid can remarkably improve the pathological changes.

Our results indicate that gallic acid can mitigate oxidative stress and pro-inflammatory parameters and also moderately prevent histopathological damage of the small intestine of rats exposed to MTX.

Low back pain (LBP) is one of the most common complications after lower limb orthopedic surgery, which leads to many significant limitations and problems for patients and society. The aim of the present study was to investigate LBP incidence rate following general anesthesia (GA) and spinal anesthesia (SA) in lower limb orthopedic surgery.

In this randomized clinical trial study, all patients who were candidates for elective orthopedic surgery referred to Shahid Beheshti Hospital in Babol, entered the study with informed consent.
Patients were divided into two groups and LBP incidence rate following spinal anesthesia and general anesthesia was evaluated.

Out of 110 patients, 46 (41.8%) complained of LBP as a postoperative complication and 64 cases (58.2%) did not report it. The mean pain decreased over time in patients with LBP. Results also showed that LBP intensity was higher in spinal anesthesia group one day and one week after surgery. One month after surgery, the general anesthesia group did not report LBP, but the spinal anesthesia group still complained of LBP. There was no significant relationship between sex, age, BMI, duration of surgery, type of surgery and cause of fracture with LBP incidence.

According to the present study, the mean LBP intensity in the general anesthesia group is significantly less than spinal anesthesia group one day, one week and one month after surgery. patients should receive necessary explanations about the complications of both types of anesthesia preoperatively so that they consciously choose the method of anesthesia.

Areas with a higher prevalence of vitaminDdeficiency have reported a higher frequency of severe coronavirus disease 2019 (COVID-19) infections.

This study aimed to assess the possible association between vitamin D and COVID-19.

This study examined the vitamin D status, hepatic, serologic, and hematologic parameters of COVID-19 patients who tested positive upon admission to a major referral center in southwest Iran. A total of 50 cases and 50 controls were enrolled in the study after obtaining informed consent. The patients did not receive a vitamin D supplement during their hospitalization.

Patients with insufficiency and deficiency of vitamin D3 had a longer hospitalization time, a higher likelihood of ICU admission, and a greater risk of death compared to cases with sufficient levels of vitamin D.

The results of this study showed that vitamin D deficiency is associated with increased severity and mortality rates. Therefore, using a vitamin D supplement may help reduce the severity of COVID-19.

Gentamicin leads to kidney failure by producing free radicals and inflammation in renal tissue. Cineole as a terpenoid has antioxidant properties. Antioxidants can play an effective role in preserving the oxidant-antioxidant balance. Hence, this study investigated the effects of cineole on acute kidney injury (AKI) and renal function recovery following gentamicin administration in rats.

36 male Wistar rats were randomly divided into 6 equal groups; healthy control, gentamicin, DMSO carriers, cineole 50, cineole 100, and vitamin E. After 12 days of treatment, the animals were anesthetized with ketamine and xylazine. Serum and kidney samples were taken for biochemical and gene expression experiments.

Cineole 50 and 100 groups increased the levels of serum glutathione (GSH) (<0.05), kidney and serum glutathione peroxidase (GPX) (<0.001), kidney catalase (CAT) (<0.001), serum nitric oxide (NO) (<0.001), and the GPX gene (<0.05) compared with the gentamicin group. These treatment groups had decreased levels of kidney malondialdehyde (MDA) (<0.001), serum creatinine (<0.001), urine protein, and the Interleukin 6 (IL-6) gene (<0.05) compared with the gentamicin group. Cineole 50 increased the serum MDA (<0.001), urea, and CAT gene (>0.05) and decreased the kidney GSH (<0.05) and the tumor necrosis factor-alpha (TNF-α) gene (<0.05). Cineole 100 increased the kidney GSH (<0.05) and decreased the serum MDA (<0.001), urea, CAT gene (>0.05), and TNF-α gene (>0.05) compared with the gentamicin group. Improvement in histological alterations was displayed in cineole groups compared with the gentamicin group.

Cineole can reduce kidney damage caused by nephrotoxicity following gentamicin consumption through its antioxidant and anti-inflammatory properties.

Methotrexate (MTX) is a cytotoxic drug that is prescribed for some diseases and tumors that its use is limited due to some side effects. Propofol, a drug with antioxidant properties, is one of the most desirable sedatives and anesthetics. The aim of this study was to evaluate the effect of propofol against MTX-induced hepatotoxicity.

24 rats were divided into 4 groups: control group (distilled water gavage), propofol group (10 mg / kg three times a week), methotrexate group (20 mg/kg on days 17 and 18) and propofol-methotrexate group. There were intraperitoneal injections and the duration of the study was 21 days. Animals were anesthetized and plasma was collected to estimate AST, ALT, LDH, and total bilirubin. Liver tissue was isolated for histopathological study.

There was observed that propofol significantly reduced the levels of AST and ALT (P<0.0001), but its effect on reducing ALP and LDH was not significant. Changes in total bilirubin were not significant in any group. In the histopathological study, in "MTX group" were seen cell necrosis, cell degeneration, leukocyte infiltration, congestion of central vein and sinusoid dilation. Injury was significantly reduced in the "pro-MTX group" compared to the "MTX group"(P<0.0001).

The results of the present study showed that propofol has protective effects against methotrexate-induced hepatotoxicity, but for clinical application, there are needed further studies.