Journal of Research in Medical Sciences
Volume:25 Issue: 9, Sep 2020

Primary immune thrombocytopenia (ITP) decreases platelet count as well as increases the risk of bleeding due to platelet destruction in an autoimmune disorder. For many years, prednisone (PDN) has been the standard first-line treatment in ITP practical guidelines. The current randomized clinical trial compared the efficacy of treatments between three-pulse high-dose dexamethasone (HD-DXM) and the traditional PDN regimen among untreated patients with ITP in accordance with platelet count responses and adverse events.

We randomly assigned eligible patients with ITP to receive PDN or a three-pulse regimen of HD-DXM. In the HD-DXM group, 40 mg of DXM was administered intravenously for 4 consecutive days and was repeated in 14-day intervals for three pulses of treatment. Patients in the PDN group received 1.0 mg/kg of PDN orally per day for 4 consecutive weeks. The Mann–Whitney test was used for comparing the median of platelet count between the two groups, and logistic regression was used to evaluate odds ratio (OR) in the response rate of platelet count between the two groups. Blindness was not applied for both patients and physicians.

The initial response rate of platelet count in the HD-DXM group was significantly higher than the PDN group (P < 0.05). According to the results of logistic regression, the initial and sustained response (SR) rate of platelet count in the HD-DXM group was significantly higher than the PDN group (OR: 5.68 and 4.17, respectively, P < 0.05). In fact, in the HD-DXM group, more patients reached SR after the 8-month follow-up (88.9% vs. 66.6%, P < 0.05).

In patients with ITP disease who have not received any kind of treatment, HD-DXM was more effective than conventional PDN therapy.

The COVID‑19 outbreak is public health emergency, spreads easily from human to human, and may cause acute severe respiratory syndrome. The anesthesia teams who perform this procedure are at risk aerosolization and need special consideration and safety measures. Cardiac anesthesiologist follows two aims, recognition of COVID‑19 patients that need surgery and decreasing the risk of perioperative viral transmission to coworkers. An isolated operating room (negative pressure operating room for COVID‑19) should be available. It is important to regulate workflow and practices, anesthesia management, healthcare, and staff. Cardiac anesthesiologist and health‑care workers must be use guidelines to treat patients with COVID‑19

In vitro models are common tools in nephrology research. However, their validity has rarely been scrutinized.

Considering the critical role of transforming growth factor (TGF)‑β and hypoxia pathways in kidney fibrosis, kidney‑derived cells were exposed to TGF‑β and/or hypoxic conditions and the expression levels of some genes related to these two signaling pathways were quantified in a time‑course manner. Furthermore, a unilateral ureteral obstruction mouse model was generated, and the expressions of the same genes were assessed.

In all in vitro experimental groups, the expression of the genes was noisy with no consistent pattern. However, in the animal model, TGF‑β pathway‑related genes demonstrated considerable overexpression in the ureteral obstruction group compared with the sham controls. Interestingly, hypoxia pathway genes had prominent fluctuations with very similar patterns in both animal groups, suggesting a periodical pattern not affected by the intervention.

The findings of this study suggest that in vitro findings should be interpreted cautiously and if possible are substituted or supported by animal models that are more consistent and reliable. Furthermore, we underscore the importance of time‑course evaluation of both case and control groups in gene expression studies to avoid misconceptions caused by gene expression noise or intrinsic rhythms.

Background:

 Hepatitis C virus (HCV) infection is one of the most important risk factors for liver failure which can lead to chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Approximately 170–200 million (almost 3% of the world’s population) people have been reported to have HCV infection worldwide. HCV has six genotypes and multiple subtypes. HCV genotyping and identification of subtypes are critical steps for HCV vaccine development. 

Materials and Methods:

 In this community‑based study, we aimed to investigate the HCV genotypes in infected patients referring to the laboratory of Hajar Hospital of Shahrekord city (the capital of Chaharmahal and Bakhtiari Province) in Iran from November 21, 2016, to October 21, 2017. During 2016–2017, the sera were obtained from 2377 individuals referring to the laboratory of Hajar Hospital of Shahrekord, Iran. The anti‑HCV antibody was tested for all sera by enzyme‑linked immunosorbent assay test. Following HCV RNA isolation and cDNA synthesis, HCV genotype detection was performed by quantitative reverse transcription‑polymerase chain reaction. 

Results:

Genotypes 3, 1a, and 1b were found in 28.6% (95% confidence interval [CI]: 17.0%–40.0%), 9.5% (95% CI: 2.1%–17.0%), and 3.2% (95% CI: 0.0%–7.6%) of the patients, respectively. In 5 patients (7.9%, 95% CI: 1.1%–14.8%), however, we did not observe any genotypes. We could not find any significant difference between the plasma viral load of infected patients and different genotypes. There was no significant difference either between age groups and genotypes (P > 0.05). 

Conclusion:

 The findings of the present study determined that HCV genotype 3 was the predominant genotype followed by the genotypes 1a and 1b in Chaharmahal and Bakhtiari Province.

The application of supplements, herbal extracts, and exercise training for treatment of diseases and reducing chronic inflammation has been increased progressively among people. Thus, the aim of this investigation was to study the combined aquatic extract of Ferulago angulata boiss with aerobic exercise on pro‑inflammatory indices in obese males.

In this semi‑experimental study, forty young obese men (mean and standard deviation of age 34.59 ± 2.24 years, body mass index (BMI) 33.14 ± 2.75 kg/m2 ) were selected by purposed sampling and were randomly divided into four equal groups (n = 10), training, training‑supplementation, supplementation, and control. Participants in the supplementary groups received 50 mg/ml F. angulata extracts daily for 12 weeks. Aerobic training program included 12 weeks of training, 3 sessions/week, and each session was 20 min at 60%–%–70% of maximal oxygen consumption. Blood samples were taken from the participants 48 h before and after the intervention in fasting state. Data were analyzed using dependent t‑test, one‑way analysis of variance, and post hoc Tukey test at a significant level of P < 0.05.

After 12 weeks of exercise and supplementation, levels of interleukin (IL)‑6 (P = 0.001), IL‑18 (P = 0.03), IL‑1 β (P = 0.001), tumor necrosis factor alpha (P = 0.001), weight (P = 0.001), BMI (P = 0.001), body fat percent (P = 0.001), and waist‑hip ratio (P = 0.001) decreased significantly and the mean changes of these indicators in training + supplementation group were significantly augmented as compared to the other three groups.

It appears that aerobic training plus F. angulata extract consumption have better effect on improvement of serum inflammatory factors in obese young men.

The production of stress oxidative condition in body which is caused by consumption of ecstasy (3,4‑methylenedioxymethamphetamine [MDMA]) leads to a liver damage. As an antioxidant, Vitamin E can protect cells and tissues against the deleterious effects of free radicals. This study evaluates the protective effects of Vitamin E on MDMA induced liver toxicity.

Twenty‑eight male albino mice were randomly assigned to four equal groups. Group 1 received saline (control), Group 2 received MDMA and saline, Group 3 received MDMA, and Vitamin E and Group 4 received Vitamin E. MDMA was injected with single daily dose, three sequential days/week for 5 weeks. At the end of the period, blood samples were collected for a biochemical analysis and then the mice were sacrificed by cervical dislocation for histopathological and biochemical examinations of liver.

The administration of Vitamin E attenuated the increased levels of alanine transaminase, aspartate transaminase, and alkaline phosphatase enzymes in serum. Vitamin E treatments significantly restored endogenous antioxidant enzymes (reduced glutathione and superoxide dismutase enzyme) activities as compared with MDMA‑treated animals. Histological examination of liver revealed significant morphological tissue injuries in hepatocytes after MDMA being used, but in coadministration of vitamin E and MDMA, these morphological alterations reduced.

The study showed that MDMA administration has adverse effects on the liver. Vitamin E lessened the deleterious impact considerably.

The precise measurement of childbirth satisfaction demands a reliable tool specifically designed for maternal care and birth satisfaction. It was designed to measure the degree of women’s satisfaction with childbirth. The purpose of the present study was to translate and analyze the psychometric properties of the Birth Satisfaction Scale‑Revised (BSS‑R) in Iranian women.

This is a methodological cross‑sectional study. Five health centers in various regions of Kashan were affiliated to Kashan University of Medical Sciences, Kashan, Iran. Two hundred and twelve mothers who were referred to the health centers and had childbirth during the last year were included. The face and content validity were obtained after backward–forward translation of the Iranian version of BSS‑R by 12 faculty board members in midwifery and reproductive health fields. The construct validity of the tool was determined using confirmatory factor analysis on 212 women in the postpartum period. The internal consistency and reliability of the tool was evaluated by Cronbach’s alpha coefficient and intraclass correlation coefficient (ICC). The collected data were analyzed in SPSS (version 16.0) and EQS 6.1.

The result of face and content validity was minor modifications in some words. Confirmatory analysis results indicated that there was an acceptable fit with a three‑factor model. Cronbach’s alpha was estimated for the whole tool 0.74, and the alpha of the three subscales ranged from 0.698 to 0.801. ICC for determining reliability was 0.77.

The Iranian version of BSS‑R was a reliable and valid tool for assessing the women’s satisfaction with their childbirth care.