Iranian Red Crescent Medical Journal
Volume:23 Issue: 8, Aug 2021

Heterocyclic compounds are generally introduced as important valuable sources of pharmacologically active compounds. Amongst these compounds, the indole is largely distributed within the bioactive molecules, containing antitumor agents. Due to their unique physiochemical and biological properties, indole and its derivatives have been used as privileged scaffolds for designing antitumor agents.

The current experimental study aimed to evaluate the anti-cancer effects of a novel compound with indole-core-base on acute myeloid leukemia (AML) cells.

Following being cultured, AML cells that had been multiplicities were treated by the demonstrated concentration of novel indole compounds (at doses of 100-300μg/mL) for 24h. The percentage of living and dead cells was subsequently determined bytrypan bluedye (MERK, Germany). The survival rate of treated cells was also examined by MTT assay. The calculated fold changes of the studied genes expression against β-actinwere determined by the real-time polymerase chain reaction(PCR) technique. The collected data were statistically analyzed by student t-test and repeated measure test.

Results showed that the intended novel indole-core-based derivative (C18H10N2F6O) followed both dose-dependent cytotoxic and anti-proliferative patterns on the AML cell line. The compound was able to induce apoptosis in 50% of the cells at the dose of 250μg/mL. Real-time PCR analysis indicated that in compound-treated cellsthe gene expression level of Bcl-2 has been downregulated, while Baxwas upregulated, compared to untreated control cells.

Despite the lack of knowledge in this regard, in this study, results of this leading mechanism(s) that may run by the compound indicated that indole3carbaldehyde derivative has cytotoxic effects on AML cells in a dose-dependent fashion

Dentists are more at risk of respiratory infectious diseases, compared to other Health Care Workers (HCWs).

This study aimed to determine the relationship of knowledge, attitude, and fear with Coronavirus Disease-2019 (COVID-19) preventive measures amongst Iranian dentists.

This cross-sectional study was conducted in the northern provinces of Iran. In total, 340 dentists were selected using a multi-stage sampling method, and they were requested to complete the data collection tools, such as demographic characteristics form, knowledge scale, fear scale, attitude scale, and COVID-19 preventive measures scale. The obtained data were then analyzed by independent t-test, chi-square test, one-way ANOVA, correlation coefficient, and stepwise regression.

Dentists' knowledge about issues, such as incubation period, laboratory test, virus survival time on surfaces, and method disinfection was weak. Nearly, 60% of the dentists had a favorable attitude towards the prevention of COVID-19, while their belief was not good on issues, such as adequacy of routine protocols, vulnerability towardsCOVID-19, suppressed immune system, patient's responsibility, and stigma. Moreover, 82.1% of dentists were fearful of being infected by patients, providing treatment to the suspected ones, the possibility of transmitting the infection to family members, post-infection quarantine, and treatment costs. Additionally, the total score of practice toward COVID-19 preventive measures in dentists was relatively high (21.88±3.8), whereas their practice in criteria, such as presenting a special disinfectant solutionor mask for patients, disinfecting surfaces, air conditioning, and examining patients' symptoms was not satisfactory. Regression analysis demonstrated that job history, knowledge, attitude, and fear were significant predictors of dentists' practice describing 62.7% of the variance in practice towards COVID-19 preventive measures.

The findings revealed that dentists had a comparatively good level of knowledge, attitude, and practice towards COVID-19 preventive measures. The current study suggests that dentists' anxiety, fear, and attitude could be remarkably reduced through providing adequate Personal Protective Equipment and subsequently enhancing preventive practice, raising awareness via online training regarding new guidelines, and presenting real-time statistics on the number of HCWS infected with COVID-19.

Anxiety following acute myocardial infarction is a particularly important issue. Prayer is one of the basic human needs that is related to mental health.

In this regard,this study aimed todetermine the effect of recitation of Tawassul prayer on anxiety and physiological parameters of patients with myocardial infarction.

This clinical trial was performed on 80 patients for 6 months from August 2017 to March 2018. They were selected by the targeted sampling method and randomly assigned to two groups with gender and age block randomization. The subjects were asked to complete the anxiety subscale of the Hospital Anxiety and Depression Scale. Physiologic parameters were measured and participants in the intervention group listened to the recitation of the TawassulPrayer with headphones.

In the intervention group, the mean of anxiety scores before and after intervention were 11.17±3.06 and 5.81±3.16, respectively, which had a significant difference (P<0.001). There was a significant difference between the two groups in terms of the mean scores of anxiety before and after intervention (P<0.001) and the respiratory rate before and after intervention (P=0.025).

Prayer affected the level of anxiety and respiratory rate. This prayer is useful for reducing anxiety and improving the respiratory rate in patients with myocardial infarction.

During the Coronavirus Disease-2019 (COVID-19) pandemic, palliative care units and nursing homes became risky in terms of infection transmission. The measures that are taken in the general population have also been strictly applied for caregivers. However, to achieve success, the personal compliance of the caregivers is as important as setting the rules.

This study aimed to evaluate the demographic characteristics, knowledge levels, and attitudes towards the measures taken for pandemics of the caregivers who were caring for their patients in the palliative care unit. It was also attempted to evaluate the relationship between these parameters and their quality of life (QOL).

The level of knowledge and the level of agreement with themeasures with questions prepared by three physicians working in the palliative care unit were assessed in this study. The QOL was also evaluated using the 3-level version of EQ-5D (EQ-5D-3L).

Education, employment, smoking, as well as parental and marital status, were found to be related to a high level of knowledge. It has been shown that the level of knowledge is higher in female caregivers and those who were caregiving for less than three years. The caregivers of Alzheimer's disease patients were also revealed to know more about the COVID-19 pandemic. Single, male, employed, smoking, and experienced less than three years caregivers were seemed to have a higher level of agreement with the measures. In addition, it was concluded that the QOL was positively correlated with the level of knowledge and negatively correlated with the compliance of the measures.

It is essential to know the characteristics and beliefs of the caregivers in pandemic management in palliative care; accordingly, more studies should be conducted on this issue

Intrathoracic displacement of a humeral head fracture is extremely rare. Only slightly more than 30 cases have been reported in thisregard. Since few cases have been reported, there is no consensus on how to treat this injury. The etiology, injury mechanism, related lesions, and treatment of the injury are diverse.

A 73-year-old female presented with multiple fractures of the left ribs, bilateral lung contusions, extensive emphysema of the anterior and posterior chest wall, massive left hemopneumothorax, fracture-dislocation of the proximal humerus, and intrathoracic displacement of the humeral head. The patient was sent to the operating room for emergency thoracotomy surgery. The head of the humerus was confirmed to be completely removed from the thoracic cavity during the operation. After discussion with the orthopedic surgeon, the humeral head was discarded considering avascular necrosis; moreover, open reduction and internal fixation were not performed. The orthopedic surgery team performed reverse shoulder arthroplasty three weeks later. During follow-up, the patient’s shoulder was free from pain, and its range ofmovement included 110° flexion, 70° abduction, 35° external rotation, and 50° internal rotation.

Intrathoracic displacement of the humeral head due to proximal humeral fracture is a very rare and serious trauma that requires multidisciplinary treatment. Considering the extremely high risk of humeral head necrosis, actively removing broken bone fragments of the humeral head in the early stage is recommended, and we advocate for shoulder arthroplasty for elderly patients. Detailed preoperative evaluations and individualized operation plans should be made to achieve the best effect.

Heart problems are one of the main causes of death in patients with idiopathic inflammatory myopathies, such as polymyositis (PM) and dermatomyositis (DM). Speckle tracking echocardiography (STE) and global longitudinal strain (GLS) are non-invasive, accurate, repeatable, and angle-independent imaging techniques that facilitate a full global and regional evaluation of the left ventricular (LV) function.

This study aimed to evaluate myocardial dysfunction in DM and PM patients using STE and GLS methods.

The present control-case study was conducted on 30 polymyositis and dermatomyositis patients and 40 healthy people as the control group. Both groups showed no symptoms of cardiovascular diseases. Both groups underwent two-dimensional STE and GLS evaluation. The GLS value was taken as a marker of LV systolic dysfunction.

The 2D GLS value of LV was significantly lower in the DM and PM patients, compared to the control group. A mild diastolic dysfunction was observed in seven (23.3%) patients, and 23 (76.7%) patients had a normal state. The patients’ age and duration of the disease were found to be significantly correlated with the left ventricular diastolic dysfunction. No significant difference was observed between the DM and PM patients with the control group in terms of pulmonary artery pressure level.

Although the DM and PM patients had normal left ventricular ejection fraction values, there was a significant difference between the patients in these two groups and the control group in terms of LV dysfunction using GLS. Therefore, GLS is a useful variable that can be used to diagnose sustained and subclinical disorders in LV systolic function of DM and PM patients.

Mitral valve area (MVA) is technically measured using both two-dimensional (2D) planimetry and three dimensional multi planar reconstruction (3D-MPR) techniques; however, studies have always overestimated MVA using the former method.

This study aimed to assess the correlation between MVA assessed by 2D and 3D techniques and the impact of left atrial volume index (LAVI) on the discrepancy between MVA assessed by two echocardiography techniques.

The data of 75 patients with moderate to severe mitral stenosis assessed by both 2D planimetry and 3D-MPR techniques were retrospectively reviewed. Clinical and echocardiographic variables were evaluated. Left atrial (LA) volume was determined using biplane area-length method.

The mean MVA assessed by the 2D and 3D techniques was 1.03±0.24 cm2 and 0.99±0.25 cm2 with a mean discrepancy of 0.04±0.15 cm2, respectively. A strong association was observed between the MVA values assessed by 2D planimetry and 3D-MPR methods (r coefficient = 0.817, P<0.001) indicating a slight discrepancy between the two techniques in assessing MVA measure. The pointed discrepancy was affected by none of the baseline characteristics and LAVI value. There was an adverse association between LAVI value and MVA measured by both 2D planimetry (r coefficient = -0.291, P= 0.011) and 3D-MPR (r coefficient=-0.260, P=0.024).

In contrast to the left atrial dimension, the discrepancy in MVA values assessed by 2D planimetry and 3D-MPR is not influenced by LAVI adjusted for baseline parameters.

Myocardial Infarction (MI) is one of the most important cardiovascular diseases and the leading cause of 39% of deaths in Iran. Due to the different geographical diversity in Zanjan province, Iran, this study aimed to investigate the incidence, age-specific, and regional distribution of myocardial infarction in Zanjan province, Iran.

This cross-sectional study was conducted at Zanjan University of Medical Sciences (ZUMS), Zanjan, Iran, in 2020. Data were collected from nine hospital information systems. The incidence rate, age-specific, and regional distribution of MI were calculated for each county. Chi-square test, independent sample t-test, and binary logistic regression methods were used to investigate significant relationships between variables. All statistical analyses were performed using RStudio and R software.

In total, 3,723 MI patients were hospitalized in ZUMS hospitals during 2014-2019. The overall incidence rate of MI was 348 cases (95% CI, 337-359) per 100,000 population. Moreover, the prevalence of this condition was higher in males compared to females and at age 80 and over. The incidence rates of MI increased by 84% from 49 cases (95% CI: 47-55) in 2014 to 90 cases (95% CI: 88-99) in 2019 (P<0001). Moreover, the highest incidence rate of MI was observed in Khorramdareh and Ijrood counties.

This study provided an overview of the current status of MI incidence in Zanjan province, Iran. The highest incidence of MI was observed in males and at the southeast of the studied area. This study can help health authorities and policymakers prioritize resource allocation and employ prevention programs to reduce the incidence rate of MI.

Lateral Humeral condyle fracture is the most common intra-articular fracture in pediatric elbow.

The present study aimed to analyze the differences between X-ray and magnetic resonance imaging (MRI) in the evaluation of the stability of pediatric lateral humeral condyle fracture and the degree of fracture displacement.

A total of 78 patients with acute elbow trauma were selected and hospitalized in our orthopedic department from July 2018-July 2019. All patients were examined with X-ray and MRI. The sensitivity and specificity of X-ray and MRI in the diagnosis of lateral humeral condyle fracture and the integrity of the trochlear cartilage chain fracture were calculated. The X-ray and MRI were examined respectively to check the value of lateral and posterior fracture space of lateral humeral condyle fracture.

Callus repair was observed according to the observation of fracture line during operation or the follow-up imaging examination of conservative treatment. It was confirmed that out of 78 patients with elbow joint trauma, 72 cases were diagnosed with the fracture of lateral condyle of humerus, and the other 6 patients were cured without fracture signs. The sensitivity of MRI in the diagnosis of pediatric lateral condylar fracture was 100%, which was significantly higher than that of X-ray (88.89%) (P<0.05). The results of X-ray and MRI in the diagnosis of pediatric lateral condylar fracture were generally consistent (kappa value = 0.465;< 0.01). Among the 72 confirmed cases, 35 subjects had a fracture of trochlear cartilage chain. The sensitivity of MRI in the diagnosis of pediatric fracture of lateral condyle of humerus was 97.14%, which was significantly higher than that of X-ray (62.86%) (P<0.05). The difference was statistically significant (P<0.05). The sensitivity of 3d-fs-fspgr or 3d-fspgr was significantly higher than that of fs-t2wi and fs-pdwi (P< 0.05).

As evidenced by the obtained results, MRI was superior to X-ray in the diagnosis of pediatric humeral epicondylar fracture stability and evaluation of fracture displacement. Furthermore, 3d-fs-fspgr or 3d-fspgr was the best MR sequence to show the pediatric humeral epicondylar fracture. These findings can provide a theoretical basis for the establishment of clinical treatment plan.