Iranian Red Crescent Medical Journal
Volume:21 Issue: 10, Oct 2019

The therapeutic effect, the optimal treatment time, and the dose of silymarin for preventing anti-tuberculosis and antipsychotic drug-induced liver injury (anti-TB/antipsychotic DILI) remains controversial. We conducted the first systematic review and meta-analysis study to evaluate the clinical efficacy of silymarin in the treatment of anti-TB/antipsychotic DILI in several subgroups based on follow-up time and dose.

We searched the keywords and free words of “silymarin (silibinin)” and “Anti-tuberculosis or antipsychotic drug-induced liver injury” in PubMed, Web of Science, Cochrane, Scopus, and clinicaltrials.gov for full text English articles and China Journal Full-text Database (CNKI) and China Medical Bio-Document Database (CBM) for full text Chinese articles. The searched papers were reserved for randomized controlled trials (RCTs). The Jadad quality scale was used to conduct quality assessments. Two observers (SY and HY) independently extracted the data. MD and OR values were calculated to evaluate the clinical efficacy of silymarin in anti-TB/antipsychotic DILI. The Q test and chi-square test were used for heterogeneity analysis.

Nine RCTs with 2,712 participants (1,351 in the silymarin group and 1,361 in the control group) satisfying the inclusion criteria were finally examined. Compared to the placebo group, silymarin at less than 300 mg/d dose significantly reduced the occurrence of anti-TB/antipsychotic DILI and serum liver enzymes AST and ALT whether for two weeks, four weeks, or eight weeks [pooled OR: 0.53, 95% CI: 0.35 - 0.78, P = 0.42, I2 = 3%; pooled MD: -4.47, 95% CI: -7.00, -1.93, P = 0.70, I2 = 0%, AST; pooled MD: -3.50, 95% CI: -6.08, -0.91, P = 0.58, I2 = 0%, ALT]. However, no significant difference was found in serum liver enzyme TBIL compared to the control group [pooled MD: -0.02, 95% CI: -0.07, -0.04, P = 0.69, I2 = 0%]. Silymarin at 315 mg/d significantly reduced the occurrence of anti-TB/antipsychotic DILI and serum liver enzymes AST, ALT, and TBIL for eight weeks [subtotal OR: 0.17, 95% CI: 0.08 - 0.39, I2 = 76%] but no significant difference was found between the over 400 mg/d silymarin group and the control group [subtotal OR: 0.93, 95% CI: 0.20 - 4.39, I2 = 76%]. No significant difference was found in the occurrence of adverse events compared to the control group [pooled OR: 0.94, 95% CI: 0.71 - 1.25, I2 = 0%]. Compared to the control group, silymarin prolonged the occurrence of anti-TB/antipsychotic DILI [pooled SMD: 1.78, 95% CI: 1.65 - 1.91, I2 = 42%].

Silymarin prolonged the occurrence of anti-TB/antipsychotic DILI and reduced the incidence of anti-TB/antipsychotic DILI without significant adverse effects. The optimal treatment time of silymarin to prevent anti-TB/antipsychotic DILI was related to its dose.

Echium amoenum (E. amoenum) is an Iranian medicinal plant with mood-enhancing effects.

This study was designed to investigate the effect of standardized E. amoenum hydroalcoholic extract on restraint stress (RS)-evoked anxiety- and- depressive-like behaviors in mice.

This experimental study was conducted at the Tabriz University of Medical Sciences, Tabriz, Iran, in 2018. Doses of the hydroalcoholic extract of E. amoenum were optimized for rosmarinic acid (> %2 w/w) concentration of the extract. Other phytochemical indices, including total phenolic and flavonoid contents and radical scavenging activity, were also measured. For behavioral studies, 65 mice were randomly assigned into five groups (n = 13) of control, RS, RS + E75, RS + E150, and RS + E300. Animals in the RS group were subjected to the RS (3 h/day for 14 days) and treated with normal saline, while treatment groups received E. amoenum extract (75, 150, and 300 mg/kg, p.o.) concomitantly with RS exposure. Anxiety-like behaviors were assessed by Elevated Plus Maze (EPM) and Open Field Test (OFT). Depression was assessed by the forced swim test (FST) and Tail Suspension Test (TST). Western blotting was performed to determine the protein levels of IL-1β, NF-κB, TNF-α, and IL-6 in the prefrontal cortex (PFC) and hippocampus (HIP). The concentrations of corticosterone, alanine aminotransferase, aspartate aminotransferase, and alanine phosphatase were also measured in serum.

Moderate and high doses of the extract ameliorated RS-induced anxiety- (P < 0.05 in OFT and EPM) and depressive-like (P < 0.05 and P < 0.01 in FST; P < 0.01 and P < 0.001 in TST) behaviors. These results were approved by decreased serum corticosterone levels (P < 0.05 and P < 0.001). Furthermore, E. amoenum reduced the protein expression of neuroinflammatory markers in the HIP and PFC subregions (significant at least at P < 0.05 for IL-1β, NF-κB, and TNF-α). Although RS slightly increased the serum levels of liver enzymes, no histopathological changes were seen in the liver of the RS or E. amoenum-treated groups.

E. amoenum can be an effective and safe complementary strategy for the treatment of stress-associated inflammation and behavioral changes.

In recent years, various poultry diseases have posed risks to this industry. Respiratory and infectious diseases are the most common diseases. According to previous findings, influenza disease is recognized as a significant life-threatening disease in the industry of poultry worldwide. Influenza virus type A, which belongs to the family Orthomyxoviridae, is responsible for a serious infectious disease. H9N2 AVI subtype circulates in the poultry worldwide, causing significant economic losses and infections in humans, also domestic and wild animals.

The purpose of the present experimental research was monoclonal antibodies (MAbs) production in contradiction of the NP of avian influenza virus (AIV) H9N2 subtype to detect AIV antigens and antibodies in the Department of Proteomics and Biochemistry, Razi Vaccine and Serum Research Institute, Agricultural Research Education and Extension Organization (AREEO), Karaj, Iran. in 2017.

The conserved protein of NP from H9N2A/Chicken/Iran/259/2014 virus, with 60 kDa molecular weight, was isolated using the electroelution method. The purified protein was applied for Australian BALB/c mice immunization. After evaluating immunization by ELISA assay, the spleen of immunized mice was isolated and hybridized with SP2/0 myeloma cell. Next, the hybridized cell was cultured, and clone soups were collected after 15 days to examine antibodies via ELISA assay. The produced antibodies using Western blotting and antibody isotype kits were characterized.

Thirty antibody-producing clones were examined for reactivity against Nucleoprotein (NP), the antigen, at 1 µg/mL concentration. According to the ELISA assay of antibody titers, two (3/F10 and 2/D7) out of 30 antibodies were bound to the antigen with titer 0.863 and 1.641, respectively. Two hybrid clones, 2D7 and 3F10, which produced anti-NP antibodies, were isolated and cultured. Characterizing of the produced antibodies using Western blotting was performed using H9N2 virus; finally, two clone soups (3/F10 and 2/D7) reacted with the NP virus protein. According to the isotyping of antibodies produced by 3F10 and 2D7 clones, 3F10 clone produced IgG1 with a κ chain, and IgG1 concentration was 1.997, based on ELISA assay. Also, 2D7 clone produced IgG2a with a κ chain, and IgG2a concentration was obtained 1.951.

According to the findings of our study, the produced antibody might be used in the diagnosis of influenza.

Avian influenza virus (AIV) belongs to the family of Orthomyxoviruses type A and causes avian influenza (AI) infectious disease. Currently, serological diagnostic techniques such as agar gel propagation (AGP), hemagglutination inhibition, and enzyme-linked immunosorbent assay (ELISA) are considered as important tools for the antibodies detection against viral antigens. Due to antigenic variation in the surface of AIV glycoproteins (hemagglutinin and neuraminidase), these proteins cannot be used in serological tests. Development of assays to detect AI surface glycoproteins is problematic because a great variety of combinations of these subtypes are found in nature. The internal antigen determinants on the nucleoprotein (NP) are highly conserved within influenza viruses, making this protein more appropriate for a serological test.

In the experimental present study, an effectual method was expanded to purify NP of H9N2 AIV based on Electroelution method.

AIV strain A/flash chicken/Iran/772/1998 (H9N2) was acquired from the Department of Avian Influenza Reference Laboratory, Razi Vaccine and Serum Research Institute, Iran, about 2 cc, in 2017. Nucleoprotein of AIV (H9N2) was purified by an efficient and simple modified method directly from native polyacrylamide gel electrophoresis (PAGE) according to the Electroelution method. The purified protein concentration was defined by the Lowry method, and the purified NP protein (60 KDa) was examined by Tricine-SDS-PAGE.

The protein concentration of the virus solution was 4.62 mg/mL by the Lowry method. The purified Nucleoprotein concentration was 0.296 mg/mL by Lowry method and the Tricine-sodium dodecyl sulfate-polyacrylamide gel electrophoresis results showed only a 60-KDa protein band in the gel.

The current technique was simple and rapid and made it possible to isolate NP from the H9N2 virus. The Nucleoprotein antigen is an appropriate candidate potential to detect antibodies against all subtypes of AIV and used as the main target antigen for the diagnosis of influenza virus due to its very high scale of sequence preserved among exist strains.

Coronary artery bypass graft (CABG) surgery with cardiopulmonary bypass (CPB) triggers an inflammatory reaction, leading to the development of myocardial damage and dysfunction. Selenium is the main cofactor for many antioxidant enzymes. Selenium level is decreased during heart surgeries affecting the cardiopulmonary pump, which in turn can aggravate the organ and heart dysfunction and mortality.

The aim of this study was to evaluate the cardiac protective effects of adding selenium to cardioplegia solution in these surgeries.

In this randomized, double-blind, clinical trial study that was conducted in the department of cardiac surgery of Shiraz University of Medical Sciences (SUMS) in Shiraz, Iran, 67 elected CABG patients were allocated to the two control or selenium groups. In the intervention group, 1000 μg sodium selenite was added to cardioplegia solution. The same amount of normal saline was added to the cardioplegia solution in the control group. Arterial blood samples were withdrawn before anesthesia induction (T1), immediately after the surgery (T2), as well as, 6 and 24 hours after the surgery (T3 and T4 respectively), to determine the CK-MB and Troponin I levels.

According to our findings, the CK-MB and Troponin I cardiac enzyme levels were significantly different, considering different time points (P < 0.05). Despite lower enzyme levels in the selenium group, the differences were not statistically significant between the two groups (P > 0.05). There were also no significant differences between the two groups regarding systolic and diastolic blood pressures.

The administration of 1000 µg sodium selenite via cardioplegia solution had no significant cardioprotective effect during coronary bypass surgery in CABG patients

The airplane crash is one of the most catastrophic events that may lead to extensive damage. The Tehran - Yasuj airplane crash was one of these disasters that took place on 18 February 2018 in Dena mountains in the south of Iran and resulted in the death of all 66 passengers and staff.

This study aimed to investigate the prevalence of Post-Traumatic Stress Disorders (PTSD) among rescuers participating in the Tehran - Yasuj airplane crash operation.

This study was conducted on 210 rescuers who participated in the rescue and collection operation of the Tehran - Yasuj airplane crash. A snowball method was used for sampling. Data collection was done using the PTSD Checklist for DSM-5 (PCL-5) and structured interviews. Correlation coefficients, linear regression, and Z-test were used for data analysis.

The prevalence rate of PTSd t according to PCL-5 and interview was 25%. The severity of the criteria was significantly different between different groups of education levels and duration of participation.

The results showed a high rate of PTSD among Iranian Red Crescent volunteers, who had participated in the rescue and collection operation. The most severe symptoms were super-alert”, watchful or on guard and this severity was different according to different duration of participation in the operation and education levels

Gastrointestinal Stromal Tumor (GIST) is an uncommon mesenchymal tumor of the gastrointestinal tract. It is rarely presented as Multiple Primary Malignancy Syndrome (MPMS) without an association with the familial syndromes.

A 63-year-old Iranian Azeri man admitted to a government hospital, affiliated to the Tabriz University of Medical Sciences, Tabriz, Iran, in 2012. The illness presented with complicated gastrointestinal problems with the diagnosis of GIST of the stomach, treated with imatinib. They family history and the screening tests of malignancies were negative, but the patient diagnosed with Squamous Cell Carcinoma (SCC) of the lower lip, leading to 28 courses of radiotherapy, followed by the recurrence of gastrointestinal symptoms, the GIST and SCC of the esophagus, that was also detected accidentally.

Management of the multiple primary malignancy syndrome needs multidisciplinary teamwork. The study of MPMs, its etiology, and epidemiology can provide us proper ways of management.

 Acute parotitis is known as an uncommon disease in children and a rare condition in infancy. Dehydration, prematurity, immune deficiency, congenital anomalies of the parotid gland or ducts, and oral trauma are some of its important risk factors. The most common bacteria contributing to this condition is Staphylococcus aureus. Acute parotitis is managed with intravenous antibiotic therapy and surgery in complicated cases. Favorable prognosis is reported in early diagnosis and proper antibiotic therapy.

 The present report presents the case of a 60-day-old breastfed female infant with a chief complaint of agitation referred to the Department of Pediatrics in a university-affiliated hospital in Tehran, Iran, in 2018. She underwent treatment for the infantile colic diagnosis.

 Timely diagnosis and treatment of acute bacterial parotitis prevented suppurative parotitis and formation of abscess.