مجله پزشکی بالینی ابن سینا
سال بیست و هشتم شماره 1 (پیاپی 99، بهار 1400)

Attention Deficit Hyperactivity Disorder (ADHD) is a common neuropsychological disorder among children that might lead to disruption of daily activities. Therefore, this study aimed to determine the effects of pyridoxine on the treatment and reduction of symptoms severity in children with ADHD under Ritalin treatment. 

This clinical trial included a total of 50 children with ADHD in the age range of 5-12 years who were referred to Emam clinic of Children’s Neurology and Be’sat Hospital, Hamedan, Iran, and were selected using a convenience sampling approach. The participants were divided into two similar treatment groups. One group only received Ritalin as the treatment and the second group received Pyridoxine and Ritalin together. The change in the severity of the symptoms was analyzed using Conners Rating Scale.

The patients in the two treatment groups were identical in terms of age and gender. The mean score of disease severity in both groups reduced up to 23.92 and 32.12 units, respectively, compared to those before intervention (P<0.001). In addition, there was a statistically significant difference between the severity of symptoms before and after intervention in both groups following the intervention (the mean scores of the severity of symptoms were obtained at 65.09 and 54.00, respectively) in children with ADHD (P=0.006).

The addition of Pyridoxine tablets to the treatment diet of children in the age range of 5-12 years suffering from combined symptoms of ADHD led to further reduction of symptoms and an increase in the effectiveness of the treatment.

Coronavirus Disease 2019 (COVID-19) has caused the death of many people, mainly by causing respiratory failure. The method of quarantine for the control of this disease leads to deprivation of vitamin D3 production. In this regard, this study aimed to investigate the relationship between serum vitamin D3 level and risk of COVID-19.

This case-control study was conducted in BouAli Sina Hospital in Qazvin, Iran in September 2020. The statistical population of the case group included patients with COVID-19 referred to this center, while the control group comprised non-COVID-19 patients who referred to the center. Vitamin D3 levels of the participants were assessed and the findings were recorded. The collected data were analyzed using statistical tests.

The case group with positive COVID-19 included 81 patients and the control group consisted of 77 patients. The mean age of the subjects was 44.80±14.40 years, and 67 of them were male. Based on the findings, 66 (81.5%) out of all the patients with COVID-19 were deficient in vitamin D3, while in the control group, 44 (57.1%) subjects were deficient in vitamin D3 (P=0.001).  

In this study, it was found that vitamin D3 is an acceptable protective factor against COVID-19 and its deficiency will increase the risk of developing this disease.

Seborrheic dermatitis is one of the most common inflammatory skin diseases that affect the sebaceous glands. Although the exact role of vitamin D in this disease is still not clearly understood, some studies have shown lower serum levels of vitamin D in seborrheic dermatitis patients. This study aimed to investigate the correlation between vitamin D deficiency and seborrheic dermatitis.

This cross-sectional case-control study was conducted in Sina Hospital, Hamadan, Iran. The study sample included 39 seborrheic dermatitis patients (case group) and 39 healthy individuals (control group) who were matched in terms of gender and age. The groups were then compared regarding serum vitamin D level. Statistical analysis was performed in SPSS software (version 16.0; SPSS Inc.Chicago, IL).

There were no significant differences between the two groups in terms of age, gender, educational level, place of residence, and occupational status. The mean serum levels of vitamin D in the case and control groups were 11.82±5.56 and 21.38±6.79ng/ml, respectively (P=0.001). Furthermore, in the case and control groups, 18 (46.2%) and 1 (2.6%) individuals had vitamin D deficiency; 20 (51.3%) and 34 (87.2%) cases had inadequate vitamin D levels; and 1(2.6%) and 4 (10.3%) subjects had adequate levels of vitamin D, respectively. Therefore, the serum level of vitamin D was significantly lower in the case group, compared to the control group (P=0.001). Moreover, the serum level of vitamin D did not correlate with the duration and severity of seborrheic dermatitis disease (P>0.05).

According to the findings of this study, patients with seborrheic dermatitis had lower serum vitamin D levels, compared to the general population, which may be related to the pathogenicity of the disease.

Preeclampsia is one of the most critical complications of pregnancy observed in 2%-8% of all pregnancies. Severe preeclampsia has many maternal and neonatal complications that are more prevalent in early-onset preeclampsia. The present study aimed to determine the prevalence of maternal and neonatal outcomes of expectant management of severe preeclampsia before 34 weeks of gestation.

In this retrospective descriptive study, the medical records of 55 mothers who had severe preeclampsia before 34 weeks of gestation and underwent expectant management and those of their neonates within 2014-2019 in Kashan, Iran, were reviewed. The information extracted from the medical records included maternal and neonatal demographic variables and outcomes. All data were analyzed in SPSS software (version 16) using descriptive and inferential statistics. The p-values of less than 0.05 were considered significant.

In this study, the rates of seizure, post-partum hemorrhage, intensive care unit admission, and platelet decline were 5.5%, 1.8%, 3.6%, and 7.3%, respectively. Moreover, 10.9% of mothers had renal failure, and therefore, elevated liver enzymes and hemolysis. Among the neonates, 44.7% and 12.7% of the cases had respiratory distress syndrome (RDS) and low Apgar scores, respectively. It was also revealed that 6.4% of the neonates had convulsions and pneumothorax (PTX), and neonatal mortality was observed in 6.4% of them. No significant relationship was observed between maternal outcomes and gestational age and between neonatal outcomes and the number of deliveries (P>0.05). However, renal failure outcomes had a significant relationship with the number of deliveries (P=0.023), meaning that all mothers with renal failure were nulliparous. It was found that gestational age had a  significant relationship with the outcomes of neonatal death, low 5-minute Apgar score, low birth weight, RDS, and PTX (P<0.05); in other words, lower gestational age led to higher mentioned neonatal outcomes.

Expectant management of early-onset preeclampsia was beneficial for neonates, and the implementation of regular and close monitoring in equipped centers would prevent the increase of maternal complications.

Suicide occurs due to a variety of causes, from heredity and biological factors to environmental factors. The present study aimed to evaluate the serum levels of vitamin D, ferritin, and hemoglobin in patients with attempted suicide referring to hospitals and compare them with the control group.

A comparison was made between the serum levels of vitamin D, ferritin, and hemoglobin of 60 suicidal patients referring to Ali ibn Abitaleb hospital of Rafsanjan from March to september 2020 and those of 60 relatives of selected patients with no history of suicide. The control group completed the Beck Suicide Thought Questionnaire (BSTQ). Chi-square, ANOVA, independent t-test, Mann-Whitney U test, and Kruskal-Wallis statistical tests were used to analyze the data.

The serum level of vitamin D in Patient with attempted suicide was lower, compared to that in controls (P=0.025). Among the age group of 15-35 years, serum levels of vitamin D were lower than those in the control group (P=0.039). Moreover, serum ferritin level in the attempted suicide group was lower than that in the control group (P=0.003). Serum ferritin level was significantly lower among the suidide attempters aged 15-15 years (P= 0.003), men with attempted suicide (P= 0.003) and suicidal women (P= 0.045), as compared to the control group.

As demonstratedd by the results of the present study, vitamin D deficiency and anemia can be two major risk factors for suicide. Therefore, it is necessary to identify and treat these deficiencies in people with psychological disorders, such as depression.

Each type of cancer has its own histopathological findings that determine the type of treatment regimen and the course of the disease. The present study aimed to histopathologically determine the types of gynecological cancers in patients admitted to Baqiyatallah Hospital over a nine-year period.

This retrospective study was conducted based on hospital data of patients who were admitted to Baqiyatallah Hospital and underwent any procedure, treatment, and diagnosis of gynecologic cancers during 2011-2019. Patientschr('39') information was extracted from hospital integrated archiving system.

A total of 404 patients were diagnosed with gynecological cancers between 2011 and 2019. Among these cancers, ovarian cancer with 212 (52.5%) patients was the most common gynecological cancer. Among patients with ovarian cancer, Serous Adenocarcinoma and Endometrioid Adenocarcinoma with 137 (64.6%) and 29 (13.7%) cases had the highest frequency of pathology, respectively. The mean (standard deviation) age of the patients with gynecological cancer was 55.88 (11.51) years. During the study period, there was a relatively increasing trend for ovarian cancer during 2011-19.

ovarian cancer with Serous Adenocarcinoma was the most common cancer diagnosed in patients admitted to Baqiyatallah Hospital during 2011-19. The relatively increasing trend of this type of female genital cancers during this 9-year period and the observed age pattern highlight the importance of implementing timely screening and treatment programs.

Long non-coding ribonucleic acid (lncRNA) has been identified as an important gene regulator and prognostic marker in various cancers. The present study aimed to investigate the effects of Nuclear Paraspeckle Assembly Transcript1 (NEAT1) gene knockout using Clustered Regularly Interspaced Short Palindromic Repeats-associated Protein 9 (CRISPR/Cas9) in PC-3 cell line.

In this experimental study, recombinant plasmids carrying single guide RNA in the CRISPR system were designed and constructed. The prostate cancer PC3 cell lines were transfected by recombinant vectors, and apoptotic gene expression was evaluated using the quantitative polymerase chain reaction technique. Furthermore, annexin, MTT, and wound healing assays were applied for apoptosis, cell proliferation, and cell migration activities respectively. 

Knockout of NEAT1 gene using CRISPR/Cas9 technique caused significant changes in the expression of apoptosis-related genes in a way that the expression of P21, BCL2, and BIRC5 genes decreased, while the expression of P53 and BAX increased. In addition, in the treatment group, the rate of cell proliferation and migration was reduced compared to those in the control group. Moreover, an increase was observed in the apoptosis rate in genetically modified cells compared to the control group.

As an oncogene, NEAT1 plays an important role in tumorigenesis and its knockout reduces cell survival and migration and increases the apoptosis of cancer cells.

The increased resistance of microorganisms to common antibiotics is one of the major therapeutic challenges for patients. The present study aimed to compare the antibiogram results of two types of antibiotic discs and validate them by the Epsilometer test (E-test) method on bacteria with high antibiotic resistance patterns.

This descriptive-analytical study was performed by the census method on 176 patients admitted to different wards of Sina Hospital in Hamadan from March 2016 to March 2019. The patients entered the study with a positive culture result and underwent the antibiogram using two types of discs. Following that, validation was performed by the E-test method in cases with significant differences. Finally, the results were described and analyzed in SPSS software (version 16) at a 95% confidence interval.

Out of 176 patients, 80 (45.4%) and 96 (54.5%) cases were male and female, respectively. The mean age of patients was reported as 62.44.±20.47 years. The most common culture sites were trachea (45.5%) and urine (42.6%), and the most common cultured microorganisms were E.coli (33.5%), Klebsiella (29.5%), and Acinetobacter (18.8%). The highest correlation coefficients of the results by disk diffusion method were observed in levofloxacin (r=1.00), piperacillin (r=0.917), ciprofloxacin (r=0.907), cotrimoxazole (r=0.904). On the other hand, the lowest correlation coefficients were related to imipenem (r=0.634), cefoxitin (r=0.556), and ceftriaxone (r=0.552).

As evidenced by the obtained results, significant differences were detected between the results of antibiogram in Iranian and imported disks. After verification and validation using E.test, the percentage of agreement was in favor of imported disks.

Giant congenital melanocytic nevus is caused by intrauterine somatic mutations in the genes involved in the mitogen-activated protein kinase pathway. It is a rare melanocytic lesion with a prevalence of 1 per 20,000 live births occurring at birth or shortly thereafter.

Here, we presented the case of a term male neonate with giant congenital melanocytic nevus. He was born to a 33-year-old mother. The initial pediatric examination revealed a skin mosaic pattern in his torso. The pigmented and rough skin of this area, along with several prominent wart-shaped lesions and demarcated borders, confirmed the giant congenital melanocytic nevus.

Despite the rarity of this lesion, it is of great importance since it may associate with severe complications, such as malignant melanoma. Therefore, it is necessary to adopt appropriate medical management by recognizing the nature of the lesion.