Iranian Red Crescent Medical Journal
Volume:21 Issue: 11, Nov 2019

Gestational diabetes is the most common antenatal medical complication that is associated with adverse short- and long-term maternal, fetal, and neonatal outcomes. Reducing maternal and fetal complications requires the early diagnosis of gestational diabetes. Unconjugated Estriol (UE) has led to insulin resistance under in vitro conditions.

This study aimed to determine the predictive power of unconjugated estriol in the diagnosis of gestational diabetes in Tehran, Iran.

The present historical cohort study was conducted on 523 pregnant women presenting to two university-affiliated hospitals in Tehran, Iran, 2017 - 2018. The level of unconjugated estriol was determined at the 14th - 17th week of pregnancy, and gestational diabetes was diagnosed at the 24th - 28th week of pregnancy using the oral glucose tolerance test with 75 grams of glucose. Data were collected through interviews and sampling was carried out using a convenience sampling method.

Out of 523 pregnant women examined, 63 (12%) were placed in the gestational diabetes group and 460 (88%) in the non-gestational diabetes group. The best cutoff point for unconjugated estriol was determined using the ROC curve as 0.965 MOM. We obtained 66.66% sensitivity, 54.78% specificity, 16.8% positive predictive value, and 92.30 negative predictive value for the UE test.

Given the acceptable sensitivity (66.66%) and specificity (54.78%) obtained for the UE test and the area under the ROC curve of 0.60, it appears that the UE test can be considered a new, accessible, and reliable screening test for gestational diabetes.

Researchers are interested in finding new agents with natural sources to cure oxidant-induced diseases.

The study aimed at determining the antioxidant potential and protective effect of S. grossheimii extract against alcohol-induced fatty liver.

This experimental study was performed in Bu-Ali Sina University, Hamedan, Iran. In 2016 - 2017. The sample size was determined to include 22 male Wistar rats (150 - 200 g) using Morgan’s table. In total, 18 rats were divided into three different groups to receive (1) 1 mL water daily (control), (2) 1 mL alcohol daily (alcohol group), and (3) 1 mL extract (500 mg/kg) and alcohol daily (alcohol + extract). Tissue and blood samples were obtained to determine the protective effect of S. grossheimii extract against alcohol-induced fatty liver by histological and biochemical examinations. The antioxidant activity of the extract was also assessed by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay.

The extract possessed stronger antiradical activity (IC50: 0.102 ± 0.002 mg/mL) than Vitamin C (IC50: 0.162 ± 0.009 mg/mL). The histological studies found liver tissue injury in group 2 and biochemical examinations indicated significantly lower (P < 0.05) total protein content (0.205 ± 0.002 mg/g.W.t) and superoxide dismutase (42.11 ± 0.18 U protein/min) enzyme tissue activity than group 1 (TP: 0.236 ± 0.003 mg/g.W.t and SOD: 62.22 ± 0.90). In addition, the levels of malondialdehyde (MDA) and hydrogen peroxide (H2O2) were significantly higher (P < 0.05) than group 1. Also, alkaline phosphatase (ALP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) serum enzyme levels (314.33 IU/L) were significantly higher (P < 0.05) in alcohol-treated animals than in group 1 (152.33 IU/L). However, these injuries were remarkably lower (P < 0.05) in animals treated by the extract (group 3).

The results demonstrated the strong pharmaceutical activity of S. grossheimii extract to apply as a new antioxidant agent, especially for the treatment of fatty liver.

Genome-wide association studies (GWAS) have recently shown that Single Nucleotide Polymorphism (SNP) rs17465637 on chromosome 1p41 is associated with atherothrombotic Coronary Artery Disease (CAD). However, whether rs17465637 acts as a protective factor or a risk factor for acute myocardial infarction (AMI) is not well understood in the general population.

In this article, we aimed to determine whether this locus was related to susceptibility to AMI in a Chinese Han population.

A retrospective experimental study was performed in Guangxi province, People’s Republic of China, on January 1, 2012, to December 31, 2017. We recruited 688 patients who were matched for age, lifestyle, and socioeconomic status from the Chinese Han population and subdivided them into two groups of 344 AMI patients and 344 healthy controls. We used standardized questionnaires to collect information on demographics, socioeconomic status, and lifestyle factors. Genotypes of SNP rs17465637 were determined by the TaqMan assay. Diagnostic criteria and research protocols were based on the guidelines of the European Resuscitation Commission. Statistical analysis was performed by SPSS version 22.0.

The percentage of the AA genotype in the AMI group was 22.97%, which was greater than that of the control group (13.08%) (kappa = -0.082, P < 0.001). The AA genotype of SNP rs17465637 had significant differences between different infarct sites (kappa = -0.011, P < 0.05). There were interactions between the CC genotype and BMI ≥ 24 kg/m2 (OR = 4.060, 95% CI = 1.680 - 9.812, P = 0.002) and smoking ≥ 20 cigarettes/d (OR = 2.732, 95% CI = 1.495 - 4.991, P = 0.001).

This study revealed that the AA genotype of SNP rs17465637 was positively correlated with the risk of AMI. Subjects with the AA genotype were positively correlated with extensive anterior of AMI. Also, interactions between the CC genotype of SNP rs17465637 and BMI or smoking seem to increase the risk of AMI.

Recurrent Pregnancy Loss (RPL) is an important medical problem comprising approximately 15% of all pregnancies. Sperm DNA damage and level of seminal ROS may have a role in RPL.

The main aim of the present study was to appraise the efficacy of antioxidants for improving these parameters in RPL patients.

In a clinical trial, 90 couples suffering from RPL were divided into two groups from April 2014 to December 2015 at the Yazd Research and Clinical Center for Infertility in Iran. Group I received supplemental vitamin E (400 µg) daily in combination with Se (200 µg) and the other group received vitamin E plus zinc for three months. Sperm parameters, sperm DNA damage, and seminal ROS were evaluated before and after treatment and compared between the two groups. Data were analyzed by SPSS and P values of ≤ 0.05 were considered statistically significant.

Our results revealed normal sperm parameters in RPL patients. Sperm parameters substantially improved in the two treated groups (P ≤ 0.05). The ROS level dramatically reduced in the two groups (P = 0.01). The evaluation of chromatin integrity with AB staining did not show any remarkable changes in group 1 (P = 0.3), but it showed a considerable rate reduction in group 2 (P = 0.04). Also, it showed significant decreases with TB, CMA3, and TUNEL assays in both groups (P = 0.001). However, we did not find any significant difference between the two groups.

Supplemental vitamin E in combination with selenium or zinc may improve semen quality by decreasing the level of seminal ROS and sperm DNA damage in RPL patients. We advocate their use for improving the quality of the men’s sperm DNA.

Cytomegalovirus End-Organ Disease (CMV-EOD) is a seriously debilitating illness in patients with advanced HIV-1 infection, typically occurring with CD4+ cell counts of < 100 cells/mm3.

This study aimed to evaluate the prevalence of CMV-EOD in adult patients with advanced HIV-1 infection (CD4+ count < 100 cells/mm3).

Using a convenience sampling method, a cross-sectional study was conducted on 82 patients with advanced HIV-1 infection in Iran between April 2016 and April 2018. We collected baseline characteristics (age, sex, route of HIV-1 transmission, Hepatitis C Virus (HCV) infection, Hepatitis B Virus (HBV) infection, CMV IgG, and treatment status for HIV-1 infection) and CD4 counts. The entire patients underwent clinical examinations for the diagnosis of CMV-EOD by experienced clinicians. Statistical analysis was used to measure the differences between categorical variables and the outcome of CMV-EOD diagnosis.

Fourteen (17.07%) out of 82 HIV-1-infected patients were diagnosed with opportunistic infection due to CMV. Among 14 patients with CMV-EOD, retinitis occurred in the majority of patients (64.28%), followed by colitis (21.42%) and encephalitis (14.28%). No significant correlation was found between the outcome of CMV-EOD and HBV infection (P = 1.00), HCV infection (P = 0.55), and treatment status for HIV-1 infection (P = 0.53). We detected CMV-EOD more frequently among injecting drug users and patients with positive CMV-IgG (P = 0.12 and P = 0.41, respectively). The ophthalmic examination had clinical usefulness for HIV-1 positive patients with CD4 counts of < 100/mm3.

It is assumed that the CD4+ cell count is not the sole predictor of the risk of developing CMV-EOD. Further large-scale studies are required for a better understanding of risk factors involved in the occurrence of CMV-EOD in HIV-1 positive patients.

Muscle strength assessment is a convenient clinical test that has shown to correlate with the nutritional status of dialysis patients. Articles written in English to investigate the association between Handgrip Strength (HGS) and mortality in Maintenance Hemodialysis (MHD) patients are mainly from Brazil and several other non-Asian countries.

This study aimed to examine the association of HGS with all-cause mortality in Chinese MHD patients.

The current multicenter observational longitudinal study enrolled MHD patients from June 2015 to June 2016. The study setting was seven dialysis centers of tertiary general hospitals in Guizhou province, China. Patients were followed up until June 2018. The ROC curves were plotted to seek the best cutoffs for HGS to predict mortality in men and women. Survival analysis was done using the Kaplan-Meier survival curve and the Cox proportional hazard model.

We enrolled 857 MHD patients and followed up for 24.9 ± 10.2 months. During the follow-up, 204 (23.8%) patients died, 39 (4.6%) received renal transplantation, 18 (2.1%) switched to peritoneal dialysis, and 118 (11.7%) were transferred to nonparticipating dialysis units. The cutoff value of HGS to predict all-cause mortality was 12.4 kg for women and 25 kg for men. Utilizing the cutoffs to fit the survival curve of Kaplan-Meier, the correlation of HGS with mortality was verified for both genders. After adjustment for demographic and biochemical variables, HGS remained an independent predictor of all-cause mortality.

Handgrip strength was strongly associated with all-cause mortality in patients receiving MHD. The cutoff values to predict all-cause mortality were 12.4 kg for women and 25 kg for men. Handgrip strength may be incorporated into clinical practice for assessing functional status and predicting prognosis in MHD patients.

The rise in marital violence has led to growing concern about people with this condition. Emotion-focused Therapy (EFT) is one of the well-established treatments that consider both family interaction and emotion in the creation of secure attachment.

This study aimed to evaluate the effectiveness of EFT in marital violence reduction and family functioning improvement.

This study was conducted in 2018-2019 among married women with family problems referring to counseling centers in Tehran, Iran. We randomly allocated 32 women with a mean marriage age of 24.27 ± 6.18 years to EFT and control groups. Marital violence and family functioning were measured before and after EFT using a domestic violence questionnaire and the family assessment device scale constructed based on the McMaster Model of Family Functioning (MMFF). Emotion-focused group therapy was conducted in the intervention group for eight 90-min sessions. The control group was exposed to no intervention. The Kolmogorov-Smirnov test was utilized to evaluate the distribution of variables. We used the independent t-test, chi-square test, Friedman test, Mann-Whitney test, ANOVA, ANCOVA, and MANCOVA for data analysis.

Marital violence decreased significantly after the intervention (-11.25 vs. -1.62, P < 0.001). Moreover, family functioning improved after the intervention (6.25 vs. -1.69, P = 0.001) in the EFT group compared to the control group.

The EFT was an effective intervention in this study. The findings implicate the significance of essential interventions for marital violence reduction and family functioning improvement.