Journal of Advances in Medical and Biomedical Research
Volume:28 Issue: 129, Jul Aug 2020

Diabetic retinopathy (DR) is a common microvascular complication of type 2 diabetes mellitus (T2DM) and the leading cause of vision loss in working-age adults. Vitamin A (retinol) has a role in the mechanism of vision process and retinol binding protein-4 (RBP4), is a carrier of vitamin A, and as an adipokine may be associated with increased risk for insulin resistance and DR. This case-control study was aimed to determine and analyze plasma RBP4-to-vitamin A ratio in relation with terms of DR severity.

In the present analytical cross-sectional study, 51 T2DM patients, aged 48-73 years old, were enrolled from those attending to the Ophthalmology Center of Vali-e Asr Hospital, Zanjan, Iran. Patients were categorized as non-retinopathy diabetic patients (NRDP) without any eye problem, those with mild non-proliferative DR (mild NPDR) (n=12), those with severe non-proliferative diabetic retinopathy (severe NPDR) (n=12), and those with proliferative DR (PDR) (n=12); a control group (n=15) was also considered. Anthropometric parameters, BMI, and WHR were determined and blood sample weas taken from each participant after overnight fasting (12-14h) to measure their biochemical parameters. Serum RBP4 and vitamin A levels were measured via ELISA and C18 reverse-phase HPLC methods, respectively.

Plasma RBP4 concentration was significantly higher in three different stages of DR than that of the control group suffering from diabetes (77.0±11.0, 81.7±10.9 and 88.3±11.9 vs. 71.4±12.3, respectively; P=0.004). The ratio of plasma RBP4-to-retinol in DR groups was found to be significantly higher than that in the control group suffering from diabetes (0.21±0.06, 0.27±0.12 and 0.28±0.07 vs. 0.16±0.14, respectively; P=0.001).

Higher plasma RBP4-to-vitamin A ratio was related to DR severity. Further experimental studies with larger scales are recommended.

The mechanism of analgesic and anxiolytic activity of resveratrol in neuropathic pain conditions remains obscure. The present study was conducted to examine whether the analgesic and anxiolytic activities of resveratrol are associated with α1- and α2-adrenoceptors of the anterior cingulate cortex (ACC), which is a key area of the cortex in the pain process, following neuropathic pain in rats.

Neuropathic pain was created by chronic constriction injury (CCI) of the sciatic nerve. Male Wistar rats were assigned to the sham, CCI, CCI+resveratrol (40μg/5μL), CCI+resveratrol+prazosin (α1-adrenoceptor antagonist,30μg/5μL), and CCI+resveratrol-Yohimbine (α2-adrenoceptor antagonist, 30μg/5μL) groups. The rats received intra-ACC injection of the drug on the day of CCI and for 6 days post-CCI on a daily basis. Cold allodynia (using acetone test) and anxiety (using elevated plus maze, EPM) were examined on days 2, 4, and 6 following CCI.

CCI model significantly increased cold allodynia and anxiety. Resveratrol significantly decreased cold allodynia. Prazosin induced no significant changes in allodynia as compared with the CCI+resveratrol treated group. But the animals in this group had no significant difference from the day before the surgery or compared with the sham group. Prazosin significantly decreased entries into open arms. Additionally, yohimbine significantly increased cold allodynia as compared with the CCI+resveratrol treated group. However, it induced no significant changes in the EPM parameters. Our findings also demonstrated a significant correlation between allodynia and anxiety in CCI rats.

It is suggested that the mechanism of analgesic and anxiolytic activities of resveratrol in the ACC of rats is different, and is mediated through α2- and α1-adrenoceptors, respectively.

Non-technical skills are critical for patient safety and good surgical outcomes. Thus, surgeons should master these skills. This study aimed to assess non-technical skills among Iranian orthopedic surgeons.

This cross-sectional study was conducted in two orthopedic surgery wards in 2019. A total of 22 orthopedic surgeons were observed in this survey. The data were collected using Non-Technical Skills for Surgeons (NOTSS) through observing and recording events during surgeries.

“Leadership” was the best non-technical skill with score of 3.14 out of 4, while “communication and teamwork” had the lowest score (3.02 out of 4). There was a significant relationship between work experience and “projecting and anticipating future state” (P=0.009).

The studied orthopedic surgeons showed acceptable non-technical skills. However, poor behaviors were observed in some domains. Educational programs, policymaking interventions, and supervision can improve the surgeons’ non-technical skills.

Phenylketonuria (PKU) is a metabolic disorder that is caused by mutations in the phenylalanine hydroxylase (PAH) gene. The multiplicity of mutations in the PAH gene of PKU leads to the cases, in which the pathogenic mutation cannot be detected. In these cases, the variable number of tandem repeat (VNTR), which is the polymorphic marker associated with the PAH gene, is used to identify PKU carriers. The present study was conducted to investigate the allele frequency of this marker in PKU population of Golestan Province (north of Iran).

In this cross-sectional descriptive study, 26 non-relative PKU patients (1-23 years old, phenylalanine: 4.5-250 mg/dl) were identified from different regions of Golestan Province within a one-year period (2016). Genomic DNA was then extracted from leukocytes using the high pure PCR template preparation kit (Roche) and the fragments containing the PAH VNTR were evaluated using PCR-sequencing method.

PCR products of PAH VNTR alleles produced 334, 454, 484, 514, and 604 bp fragments. They were corresponding to the presence of alleles with 3, 7, 8, 9, and 12 copies of the repeat units, respectively. In addition, the distribution of VNTR alleles was as follows: 28.85%, 28.85%, 17.3%, 19.23%, and 5.77%.

 This study is the first report regarding the genetic structure of PKU population using PAH VNTR alleles in Golestan Province. Considering the population diversity in Iran, it is necessary to investigate the frequency and distribution of VNTR alleles in different parts of the country.

Capparis spinosa L. belongs to the Capparaceae family for which biological roles such as antioxidant, anti-inflammatory, and antidiabetic effects have been reported. Some active chemical groups including flavonoids, phenols, alkaloids, tannins, and minerals have been detected in these plants [Sci Rew1] . This study aimed to extract the C. spinosa alcoholic extract from different parts of the plant, measure the content of phenols and flavonoids, and evaluate the effects of bud extracts on the viability and oxidative state of the islets of Langerhans isolated from rat pancreas.

In this experimental setup, the hydroalcoholic extracts of different parts of the plant were obtained based on the maceration method. Folin-Ciocalteu and rutin were used as the standard reagents to measure phenols and flavonoids. The islets of Langerhans were isolated from the pancreas of male rats (n=16) and incubated for 24 hours. Then, the islets were exposed to the plant extract for 24 hours after which cellular viability and reactive oxygen species were measured.

The C. spinosa bud alcoholic extract markedly increased the survival of the islet cells. This effect was dose-dependent, and the greatest effects were observed at103 and 104 μgmL-1. At the mentioned concentrations, ROS production was reduced by 37% and 72% respectively comparing to the control.

The results indicated that C. spinose may have protective effects on the endocrine pancreas by increasing viability and decreasing ROS in the islets, and can thus be considered as a promising agent for prophylaxis and therapy in diabetes management.

Septoplasty is one of the most common nasal surgeries. After septoplasty, the nasal pack is routinely used to control bleeding, which can lead to complications such as pain and anxiety. This study aims to compare the effect of septoplasty with and without nasal packing on outcomes and complications of the surgery.

In this randomized clinical trial, 50 patients undergoing septoplasty surgery at Besat Hospital, Hamadan, Iran, (during 2018 and 2019) were selected among the patients and randomly allocated in two groups of septoplasty with nasal pack (group A, 25 patients) and septoplasty without nasal pack (group B, 25). Anxiety score, pain score, bleeding rate, hematoma, respiratory status and local infection were compared in both groups. Data were analyzed by SPSS software.

The incidence of complications of throat irritation, tearing and headache and facial pain during the first 24 hours after septoplasty in group A was 48%, 76% and 64%, respectively, and in group B, it was 12%, 0% and 0%, respectively (P <0.05). Mean score of anxiety and pain in the patients during 24 hours and first week after septoplasty and mean score of nasal obstruction during 24 hours, first week and three months after septoplasty in group A were significantly higher than those in group B (P <0.05).

The use of nasal packs following septoplasty can cause throat irritation, tearing, increased pain, anxiety and respiratory problems in patients and it seems to have no effects on the duration of bleeding during 24 hours after the surgery.

Tuberculous empyema (TE) is an uncommon form of pleural tuberculous (TB). Although the incidence of TE has significantly decreased, it still threatens public health. Patients with TE experience a protracted illness and significant morbidity and mortality risk. Male sex is a significant risk factor for TE. Herein, we report an adult case of TE admitted to a tertiary care hospital of Iran with clinical characteristics, treatment modalities, and outcomes of this disease. The duration of illness and duration of chest tube drainage equaled 7 months and 48 days, respectively. Our patient required surgery despite the administration of antituberculosis drugs and chest tube drainage. Due to the presence of parenchymal lesions, bronchopleural fistula, and failure of lung re-expansion after chest tube insertion, the patient required decortication with the closure of the bronchopleural fistula and additional thoracoplasty. In the case presentation, we emphasize difficulties encountered in the treatment of such patients.

Every 30 seconds, one lower limb amputation due to diabetes is performed in the world. This study was conducted on a 64-year-old woman with a diabetic foot on her left leg [Sci Rew1] . The patient had pain with a visual analog scale (VAS) score of 80 mm on 100 mm. This study aimed to evaluate the effect of a product derived from leeches in the treatment of DFUs. Wound grade 1 according to Wagner’s classification system was covered with leech cream. A decoction of Hirudo orientalis was prepared by lyophilizing leeches at -80°C, the proteins containing biologically active substances (BAS) were extracted with normal saline, and this BSA was formulated in the form of cream. In vitro control of this pharmaceutical product was estimated according to the activity of these BSA. The leech cream was applied twice a day from the knee to the tail of the left toe for a month. The patient used no antibiotics and only received hygiene. After treatment, the patient was followed up for two months. Pain decreased significantly in terms of VAS: 40 mm after two days. At the end of the 3rd day, the pain completely disappeared. The granulation tissue was apparent on the toeschr('39') ulcers after a week. The diameter of the wound was reduced by ~50% in three weeks. After four weeks, the ulcers were completely healed. After two months follow up there was no sign of wound recurrence. Topical leech cream enhanced the wound healing process and, therefore, may have curative effects on DFUs.