Mature cystic teratoma with co-existent mucinous cystadenocarcinoma: describing a diagnostic challenge-a case report

BACKGROUND

Mature cystic teratoma co-existing with a mucinous cystadenocarcinoma is a rare tumor that few cases have been reported until now. In these cases, either a benign teratoma is malignantly transformed into adenocarcinoma or a collision tumor is formed between a mature cystic teratoma and a mucinous tumor, which is either primarily originated from epithelial-stromal surface of the ovary, or secondary to a primary gastrointestinal tract tumor. The significance of individualizing the two tumors has a remarkable effect on further therapeutic management.

CASE PRESENTATION

In this case, a mature cystic teratoma is co-existed with a mucinous cystadenocarcinoma in the same ovary in a 33-year-old Iranian female. Computed Tomography (CT) Scan with additional contrast of the left ovarian mass suggested a teratoma, whereas examination of resected ovarian mass reported an adenocarcinoma with a cystic teratoma. A dermoid cyst with another multi-septate cystic lesion including mucoid material was revealed in the gross examination of the surgical specimen. Histopathological examination revealed a mature cystic teratoma in association with a well-differentiated mucinous cystadenocarcinoma. The latter showed a CK7-/CK20 + immune profile. Due to the lack of clinical, radiological, and biochemical discoveries attributed to a primary lower gastrointestinal tract tumor, the immune profile proposed the chance of adenocarcinomatous transformation of a benign teratoma.

CONCLUSIONS

This case shows the significance of large sampling, precise recording of the gross aspects, histopathological examination, immunohistochemical analysis, and the help of radiological and clinical results to correctly diagnose uncommon tumors.

Relationships between job stress, post-traumatic stress and musculoskeletal symptoms in firefighters and the role of job burnout and depression mediators: a bayesian network model

INTRODUCTION

Job stress, post-traumatic stress disorder (PTSD), and negative psychological outcomes in firefighters can be caused, or aggravated, by their work. These mental disorders can impart musculoskeletal symptoms. This study aimed to investigate relationships between musculoskeletal and psychological disorders in a population of firefighters using a Bayesian network model.

METHODS

This cross-sectional study, conducted in 2022, included 2339 firefighters who completed questionnaires during their rest periods. The questionnaires comprised of demographical information, the Occupational Stress Questionnaire-HSE, the PTSD Checklist, Maslach Burnout Inventory, Center for Epidemiologic Studies - Depression scale (CES-D), and Nordic Musculoskeletal Questionnaire. GeNIe academic software was used to analyze the Bayesian network.

RESULTS

High job stress and high PTSD each increased the probability of musculoskeletal symptoms by 34%. When combined, high job stress and high PTSD increased the probability of musculoskeletal symptoms by 37%. Among the mediator's burnout and depression, depression had the highest association with musculoskeletal symptoms.

CONCLUSIONS

Job stress and PTSD can increase musculoskeletal symptoms and are influenced by psychological mediators (like burnout and depression). Adopting preventive and therapeutic measures to mitigate job stress and PTSD, mitigate and rehabilitate WMSD, and manage associated mediators are critical for the mental and physical health of firefighters.

Retraction: Synthesis, characterization and cytotoxicity evaluation of a novel magnetic nanocomposite with iron oxide deposited on cellulose nanofibers with nickel (Fe3O4@NFC@ONSM-Ni)

[This retracts the article DOI: 10.1039/D1RA01256H.].

Cotyledonoid dissecting leiomyoma of the uterus: a case report and review of the literature

BACKGROUND

Cotyledonoid dissecting leiomyoma, also named Sternberg tumor, is a rare variant of uterine leiomyoma. The tumor is benign, but the appearance and growth pattern are unusual and alarming. In this article, we report a case of cotyledonoid dissecting leiomyoma in a 55-year-old woman as well as review relevant literature.

CASE PRESENTATION

We report a case of cotyledonoid dissecting leiomyoma in a 55-year-old Iranian woman who presented with vaginal bleeding 4 months after menopause. Ultrasound showed two heterogeneous hypoechoic masses on the uterine fundus. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed for the patient. Macroscopically, a large heterogeneous intramural mass (140 mm × 120 mm × 120 mm) with a grape-like exophytic mass on the fundus was observed. Her health status was good after surgery, and the patient was discharged from the hospital after 2 days. In a 1-year follow-up period, no recurrence or any other related complications were found.

CONCLUSION

It is important to recognize this rare variant of leiomyoma to prevent aggressive and inappropriate overdiagnosis and overtreatment. It is suggested to try to use frozen sections for better diagnosis and to preserve fertility in young women suffering from this lesion.

Effect of Elaeagnus Angustifolia extract on in vitro wound healing of human dermal fibroblast cells

AIM

The purpose of this study was to determine the impact of Elaeagnus Angustifolia extract (EA) on human dermal fibroblast (HDF) survival, migration, and wound healing-related genes.

METHODS

After preparing the hydroalcoholic extract of EA, MTT and scratch tests were used to determine the effect of EA on the viability and migration of HDFs. In addition, the quantitative polymerase chain reaction (q-PCR) was conducted to evaluate the impact of EA on the expression of wound healing-related genes in HDFs.

RESULT

According to the MTT test, a nontoxic concentration of EA (100 µg/ml) was obtained for further investigations. The scratch test results demonstrated that EA improved HDFs' capacity to migrate when compared to the control group. Additionally, q-PCR results revealed that EA could significantly increase wound healing-related genes (VEGF-A, HLA-G5, and IL-6) in comparison with the control group.

CONCLUSIONS

The EA could have a significant impact on the viability and migration of HDFs. Also, EA increased the expression of wound healing-related genes.

Identification of a Novel ARSA Gene Mutation Through High-Throughput Molecular Diagnosis Method in Two Girls with Late Infantile Metachromatic Leukodystrophy

Metachromatic leukodystrophy (MLD) is a rare leukoencephalopathy caused by pathogenic mutations in the ARSA gene. It manifests as severe motor symptoms, mental problems, and sometimes, seizures. We aimed to investigate the phenotypic manifestations and genetic causes of MLD in an Iranian family. We present the case of a 3-year-old girl who presented with hypotonia, muscular atrophy, and seizures. Neurological and neuromuscular examinations were performed to evaluate clinical characteristics. Whole exome sequencing (WES) was used to detect disease-causing variants. In silico analysis was performed to predict the pathogenicity of this variant. GROMACS software was utilized for molecular dynamic simulation (MDS). Neurological studies revealed marked slowing of motor conduction velocities and an increased motor unit action potential duration. Brain MRI scan revealed white matter abnormalities. By applying WES, we identified a novel homozygous missense variant (NM_000487.6, c.938G > C, p.R313P) in ARSA. Direct sequencing identified this homozygous variant in her asymptomatic younger sister, whereas both parents carried a heterozygous variant. This mutation has not been reported in genetic databases or in literature. In silico analysis predicted that any variation in this DNA position would cause disease, as it is highly conserved. The c.938G > C variant was classified as a pathogenic variant according to ACMG/AMP guidelines. MDS analysis indicated that c.938G > C had a significant impact on both the structure and stabilization of ARSA, ultimately resulting in impaired protein function. The identification of this variant expands the spectrum of ARSA gene mutations associated with MLD and highlights the importance of genetic testing for the diagnosis of MLD.

Urolithin B inhibits proliferation and migration and promotes apoptosis and necrosis by inducing G2/M arrest and targeting MMP-2/-9 expression in osteosarcoma cells

Osteosarcoma (OS) is the most prevalent primary bone cancer, with a high morbidity and mortality rate. Over the past decades, therapeutic approaches have not considerably improved patients' survival rates, and further research is required to find efficient treatments for OS. Data from several studies have shown that urolithin B (UB), the intestinal metabolite of polyphenolic ellagitannins, is emerging as a new class of anticancer compounds, yet its effect on OS cancer cells remains elusive. Herein, we investigated UB's antimetastatic, antiproliferative, and apoptotic effects on the MG-63 OS cell line. Cell viability assay, annexin V/propidium iodide staining, cell cycle arrest analysis, determination of the gene expression of MMP-2, MMP-9, Bax, Bcl-2, and p53 messenger RNA (mRNA), evaluation of reactive oxygen species (ROS) generation and migration, and MMP-2 and MMP-9 protein expression assessments were performed. UB caused late apoptosis, necrosis, G2/M arrest, and ROS generation in MG-63 cells. It increased the mRNA expression of the p53 tumor suppressor and Bax proapoptotic genes. UB also inhibited the migration and metastatic behavior of MG-63 OS cells by downregulating mRNA and MMP-2 and MMP-9 protein expression. In general, although further in vivo investigations are warranted, the current results showed that UB might be utilized as a potential novel natural compound for OS therapy due to its nontoxic, antiproliferative, and antimetastatic nature.

Inflammatory dilated cardiomyopathy associated with psoriasis: a case report

BACKGROUND

Psoriasis is a chronic inflammatory skin disease with a genetic basis. Psoriasis is accepted as a systemic, immune-mediated disease. Hypertension, obesity, metabolic disorders including diabetes mellitus and hyperlipidemia, and psychiatric disorders are more prevalent among children with psoriasis compared to children without psoriasis. In this study, we report a case of dramatic response of inflammatory cardiomyopathy to anti-inflammatory treatment of psoriasis; which might reveal similar pathogenesis basis of these two diseases.

CASE PRESENTATION

A 9-year-old Caucasian boy presenting with signs and symptoms of heart failure refractory to conventional therapies was admitted to our pediatric cardiology service. As the patient also had psoriasis, and considering the fact that there might be an association between the two conditions, immunosuppressive drugs were administered, which led to a dramatic improvement in heart function.

CONCLUSIONS

The results of this study add to evidence linking psoriasis with inflammatory dilated cardiomyopathy. Clinicians, particularly cardiologists, must pay special attention to the cardiac complications of systemic diseases.

The effect of hesperetin on estrogen receptor gene expression and its relationship with the downstream pathways of estrogen receptor alpha

BACKGROUND

Estrogen receptor (ER) is a transcription factor that affects the expression of some genes involved in the progression and development of breast cancer (BC). Hesperetin (Hst) is a flavonoid that inhibits the proliferation of BC cells. In this study, we investigated the effect of Hst on the cell viability of MCF-7 cells and the gene expression of the ERα, ERβ, IL-6, Ps2, and Cyclin D1.

METHODS

In this study, cell viability was determined by MTT assay. The cells were seeded in RPMI-1640 medium and then exposed to different concentrations of Hst (0, 25, 50, 100, 200, and 400 µM) for 24 h, and IC50 was calculated. Real-time PCR was used to assess the expression of ERα, ERβ, pS2, Cyclin D1, and IL-6 mRNA. MCF-7 cells were seeded in RPMI-1640 medium and then exposed to different concentrations of Hst (0, 25, 50, 100, and 200 µM) for 24 h. Real-time PCR was carried out using a Step One Real-Time PCR System (ABI, USA) and Amplicon SYBR Green reagents.

RESULTS

The MTT assay revealed increased cytotoxicity with higher concentrations of Hst, and the IC50 was calculated at 200 µM. Real-time PCR analysis following treatment with Hst showed a significant increase in ERα gene expression at 25 µM of Hst and a decrease in expression at 50, 100, and 200 µM of Hst (p < 0.0001). ERβ gene expression significantly decreased across all concentrations of Hst (p < 0.0001), while IL-6 gene expression decreased significantly in all concentrations (p < 0.0001). pS2 gene expression increased significantly with all concentrations of Hst (p < 0.0001), while Cyclin D1 gene expression did not significantly decrease upon Hst exposure (p > 0.05).

CONCLUSIONS

The results of our study demonstrate that Hst has the ability to induce cell death in MCF-7 cells. Furthermore, it was observed that Hst reduces the expression of the ER gene and enhances its activity, which can affect the downstream pathways of the ER.

Predicting the Cognitive Ability of Young Women Using a New Feature Selection Algorithm

Cognitive abilities are the capabilities to perform mental processes that include executive function, comprehension, decision-making, work performance, and educational attainment. This study aimed to investigate the relationship between several biomarkers and individuals' cognitive ability using various machine learning methods. A total of 144 young women aged between 18 and 24 years old were recruited into the study. Cognitive performance was assessed using a standard questionnaire. A panel of biochemical, hematological, inflammatory, and oxidative stress biomarkers in serum and urine was measured for all participants. A novel combination of feature selection and feature scoring techniques within a hierarchical ensemble structure has been proposed to identify the most effective features in recognizing the importance of various biomarker signatures in cognitive abilities classification. Multiple feature selection methods were employed in conjunction with different classifiers to construct this model. In this manner, using three filter methods, the scores of each feature were considered. The combination of high-scoring features for each filter method was stored as the primary feature subset. A high-accuracy feature subset was selected by using a wrapper method. The collection of highly scored features from each filter method formed the primary feature subset. A wrapper method was also employed to select a feature subset with high accuracy. To ensure robustness and minimize random variations in the feature subset search process, a repeative tenfold cross-validation was conducted. The most frequently recurring features were determined. This iterative step facilitated the identification of an optimal feature subset, effectively reducing the dimensionality of features while maintaining accuracy. Among the 47 extracted factors, serum level of NOx (nitrite ± nitrate), alkaline phosphatase (ALP), and phosphate as well as blood platelet count (PLT) was entered into the model of cognitive abilities with the highest accuracy of approximately 70.9% using a decision tree classifier. Therefore, the serum levels of NOx, ALP, phosphate, and blood PLT count may be important markers of the cognitive abilities in apparently healthy young women. These factors my provide a simple procedure to identify mental abilities and earlier cognitive decline in healthy adults.

Performance analysis of hospitals before and during the COVID-19 in Iran: A cross-sectional study

BACKGROUND AND OBJECTIVE

The COVID-19 pandemic placed considerable pressure on the health care systems and caused many disruptions to the care hospital system around the globe. This study aimed to analyze the performance of hospitals affiliated with the University of Medical Sciences and Health Services of South Khorasan Province before and during COVID-19.

METHOD

This cross-sectional study tracked the financial performance (FP) and service performance (SP) of 12 hospitals affiliated with South Khorasan University of Medical Sciences and Health Services using the Farabar system and Hospital Information System (HIS). Our study covered two time periods: from February 2018 to February 2020 (pre-COVID-19) and from February 2020 to February 2021 (during COVID-19). SP analysis of hospitals was performed by examining the trend of monthly changes before and during the COVID-19 pandemic and analyzed using SPSS software version 22 and Paired Sample T-Test. FP of hospitals was analyzed through relevant ratios and analyzed using Microsoft Office Excel.

RESULTS

Most SP indicators decreased considerably in all hospitals during COVID-19. FP ratios (e.g., activity and leverage ratios) increased during either or both pre-COVID or COVID periods. Compared to before COVID-19, the operating margin ratio and operating expenses coverage from operating income increased from -0.50 and 66.55 to -1.42 and 41.32, respectively, during COVID-19. Moreover, the net profit margin ratio and Return On Assets (ROA) ratio were increased during COVID-19.

CONCLUSION

COVID-19 has decreased the FP and SP of hospitals due to limitations in providing services to patients since the beginning of COVID-19. Measures such as providing various financing resources and improving the financial resilience of hospitals are essential. Funds should be disbursed to offset hospitals' losses due to reduced elective and outpatient revenue. Policymakers should come up with holistic policies to tackle the adverse impact of such crises in the future, support hospitals financially, and consider allocating additional funding to them during emergencies.

The relationship between dietary patterns and insomnia in young women

AIM

There is mounting evidence that eating habits affect sleeping patterns and their quality. The goal of this study was to evaluate the associations between major dietary patterns, identified using principal component analysis (PCA) and insomnia in young women.

METHODS

The study subjects comprised 159 healthy young women aged 18-25 years. Neuropsychological assessment was performed using standard instruments, including a cognitive ability questionnaire (CAQ), depression and anxiety stress scales (DASS-21), insomnia severity index (ISI), Epworth sleepiness scale (ESS), and quality of life questionnaire (QLQ). Dietary patterns were obtained from a 65-item validated food frequency questionnaire (FFQ) in this study, using PCA.

RESULTS

Two major dietary patterns were identified that were termed: "Traditional" and "Western." The Western pattern was characterized by a high intake of snacks, nuts, dairy products, tea, fast foods, chicken, and vegetable oils. Subjects with moderate/severe insomnia were found to have lower scores for total cognitive ability task, nocturnal sleep hours, and physical and mental health, but higher scores for depression, anxiety, stress, and daytime sleepiness compared to those without insomnia (p < 0.05). After adjustment for potential confounders, high adherence to the Western dietary pattern was associated with higher odds of insomnia (OR = 5.9; 95% confidence intervals: 1.9-18.7; p = 0.003).

CONCLUSION

Our findings indicated adherence to Western pattern may increase the odds of insomnia. Prospective research is required to determine the feasibility of targeting dietary patterns to decrease the odds of insomnia.

Effects of hydroxyapatite nanorods prepared through Elaeagnus Angustifolia extract on modulating immunomodulatory/dentin-pulp regeneration genes in DPSCs

Dental pulp stem cells (DPSCs) are a new type of mesenchymal stem cells (MSCs) found in the oral cavity with immunomodulation and tissue regeneration capacities. This study determined the impacts of nano-hydroxyapatite (nHA) prepared through Elaeagnus Angustifolia extract (EAE) to enhance the relative expression of immunomodulatory/dentin-pulp regeneration genes in DPSCs. To produce nHA and modified nHA via EAE (nHAEA), the sol-gel technique was used. The functional groups of nanoparticles (NPs), morphological, and optical features were determined using Fourier transform infrared (FTIR), X-ray diffraction (XRD), Scanning electron microscopy (SEM) together with energy-dispersive X-ray analysis (EDAX), and Transmission electron microscopy (TEM). The cell viability was then determined using the MTT method in the presence of various EAE, nHA, and nHAEA concentrations. Target gene expression was quantified using a real-time PCR procedure after treating DPSCs with an optimally non-toxic dose of EAE and NPs. The presence of the HA phase was reported with the XRD and FTIR results. According to the results of SEM and TEM, the rod-like NPs could be fabricated. nHAEAs were found to be characterized with low crystallite size, reduced diameter, lengthier, needle-like, and less agglomerated particles compared with nHA. The real-time PCR results demonstrated that nHAEA remarkably increased the expression of human leukocyte antigen-G5 (HLA-G5), vascular endothelial growth factor (VEGF), dentin sialophosphoprotein (DSPP), and interleukin6 (IL6) genes compared to the nHA group. These findings suggest that nHAEAs might have the potential application in the stemness capability of DPSCs for the treatment of inflamed/damaged pulp.

Clinical Experts' Opinion Improves the Attitude of Medical Students Toward ‌Basic Sciences' Courses

The medical curriculum consists of basic pre-clinical and clinical parts. Basic sciences are required for diagnostic and clinical reasoning but students do not have a positive attitude toward basic sciences, mostly because of the lack of clinical relevancy. Basic sciences have many applications in the prevention, diagnosis, and treatment of a broad range of diseases but do not attract the attention of medical students. The aim of this study was to investigate the influence of clinical experts' opinions on the attitude of medical students toward basic sciences, particularly immunology. The opinion of six clinical specialists in different fields was recorded in a video clip, presenting the application of basic sciences and immunology in their routine practice. The attitude of second-year medical students toward the basic science courses was evaluated by a questionnaire containing four ranking questions and one short answer. The video clip was streamed and after that, students were answering the same questions. In total, 188 students including 129 s-year students (M/F ratio: 0.92) and 59 third-year students M/F ratio: 0.90) participated in the study. For all ranking questions, the mean score was significantly increased after watching the interviews' film streaming. Before watching the video clip, only 14.9% of students considered immunology as an important course but after that, the percentage significantly increased to 58.5% (P < 0.001). The results of this study showed that knowing clinical specialists' opinions about basic sciences significantly improved the attitude of students toward basic science courses, in particular immunology.

The maternal reduced uteroplacental perfusion model of preeclampsia induces sexually dimorphic metabolic responses in rat offspring

BACKGROUND

Offspring born to preeclamptic mothers are prone to obesity, diabetes and hypertension in later life, but still, studies investigating the underlying mechanism are limited. Here, we aimed to investigate the impact of the reduced uteroplacental perfusion (RUPP) rat preeclampsia model on offspring metabolic outcomes.

METHODS

Timed pregnant Wistar rats underwent RUPP or sham surgeries on day 14 of gestation. Glucometabolic parameters were evaluated on postnatal days (PND), 14 (childhood), and 60 (young adult). In addition, intraperitoneal glucose tolerance test (IPGTT), homeostatic model assessment of insulin resistance (HOMA-IR), immunohistochemical staining for insulin in pancreatic islets, arterial blood pressure and 24-h urine protein (24hUP) excretion were performed at PND60.

RESULTS

Male, but not female, young adult rats (PND60) of RUPP dams exhibited an impaired IPGTT, decreased circulatory insulin and weakened pancreatic insulin immunoreactivity. Compared to the male offspring of the sham group, the body mass of male RUPP offspring significantly caught up after PND42, but it was not sex-specific. RUPP pups also exhibited upregulations in glucagon (only males) and ghrelin (both sexes with a more significant increase in males) during PND14-PND60. However, in sham offspring (both sexes), glucagon levels were downregulated and ghrelin levels unchanged during PND14-PND60. The blood pressure, HOMA-IR and 24hUP values did not alter in RUPP pups.

CONCLUSIONS

The overall results suggest that maternal RUPP has negative and sex-specific impacts on insulin, glucagon and ghrelin regulations in offspring and that, as young adults, male RUPP rats may be more prone to develop obesity and diabetes.

Effect of red beetroot juice on oxidative status and islet insulin release in adult male rats

INTRODUCTION

Beetroot is rich in inorganic nitrate and it has been shown that inorganic nitrate has beneficial effects on metabolic syndrome. This study aims to investigate the effect of red beetroot juice (RBJ) on carbohydrate metabolism in adult insulin-resistant rats.

MATERIALS AND METHODS

Sixteen male Wistar rats (32 weeks old) were divided into two equal groups: control and RBJ. Treatment with drinking water (control) and 100% RBJ (RBJ) was lasted for 5 weeks. At the end of the 4th week the intraperitoneal glucose tolerance test was performed and at the end of the study period animals were sacrificed and blood and tissue (aorta, heart, and liver) samples were collected. Furthermore, pancreatic islets were isolated and their insulin secretion activity was investigated in different glycemic conditions.

RESULTS

Compared to the control group, RBJ-treated rats showed lower blood glucose and insulin levels in the glucose tolerance test. Serum and tissue levels of nitric oxide in the RBJ group were significantly higher than those in the control group. The liver peroxidation and serum aspartate transaminase levels were significantly increased in the RBJ-treated animals compared to the control group. The islets of RBJ group exhibited lower insulin secretion, especially in 16.7 mM glucose concentration (supraphysiologic condition) than control group.

CONCLUSIONS

RBJ consumption improves glucose metabolism in rats via increasing nitric oxide metabolites in an insulin-independent manner. However, future studies are needed to minimize the potential hepatic adverse consequences.

Effects of naloxone and diazepam on blood glucose levels in tramadol overdose using generalized estimating equation (GEE) model; (an experimental study)

BACKGROUND

Tramadol is a synthetic opioid and poisoning is increasing around the world day by day. Various treatments are applied for tramadol poisoning. Due to the unknown effects of tramadol poisoning and some of its treatments on blood glucose levels, this study was conducted to investigate the overdose of tramadol and its common treatments (naloxone, diazepam), and their combination on blood glucose levels in male rats.

METHODS

This study was conducted in 45 male Wistar rats. The animals were randomly divided into five groups of 9. They received a 75 mg/kg dose of tramadol alone with naloxone, diazepam, and a combination of both of these two drugs. On the last day, animals' tail vein blood glucose levels (BGL) were measured using a glucometer at different times, including before the tramadol injection (baseline) and 1 hour, 3 hours, and 6 hours after wards. The rats were anesthetized and sacrificed 24 h after the last injection. Blood samples were then taken, and the serum obtained was used to verify the fasting glucose concentration. Data were analyzed using SPSS software at a significance level of 0.05 using a one-way analysis of variance (ANOVA) and a generalized estimating equation (GEE).

RESULTS

According to the GEE model results, the diazepam-tramadol and naloxone-diazepam-tramadol groups showed blood glucose levels five units higher than the tramadol group (p < 0.05). The diazepam-tramadol group had significantly higher blood glucose levels than the naloxone-tramadol group (p < 0.05). The mean blood glucose levels before the intervention, 3 hours and 6 hours after the injection of tramadol did not differ between the groups, but the blood glucose levels 1 hour after the injection of tramadol in the group of naloxone-tramadol were significantly lower than in the control group (p < 0.05). Blood glucose levels did not differ between the groups 24 h after injection of tramadol.

CONCLUSION

The results of the present study showed tramadol overdose does not affect blood glucose levels. The diazepam-tramadol combination and the diazepam-naloxone-tramadol combination caused an increase in blood glucose levels.

The protective effect of crocin on cisplatin-induced testicular impairment in rats

BACKGROUND

Side effects of cisplatin (CIS) such as testicular toxicity restrict its clinical use. Instead, evidence indicates that crocin (CR) has synergistic anti-cancer potential with CIS and exhibited beneficial effects on CIS-induced hepatorenal damage. The aim of this study was to investigate the protective potential of CR against CIS-induced testicular toxicity in rats.

METHODS

Fifty adult male Wistar rats randomly assigned to five equal groups including control, CIS, and CIS plus CR at doses of 6.25 mg/kg (CIS + CR6.25), 25 mg/kg (CIS + CR25), and 100 mg/kg (CIS + CR100). CIS and CIS + CR groups received a single intraperitoneally (i.p.) injection of CIS (7 mg/kg). CR (6.25-100 mg/kg i.p.) injections were started three days before the CIS injection and continued once a day for up to 13 days. On the 14th day, all animals were sacrificed and their blood samples and testes were removed for biochemical and histological analyses.

RESULTS

Compared to the control group, CIS significantly decreased relative testis weight (0.28 vs. 0.39, p < 0.001), testosterone level (0.3 vs. 2.31 ng/mL, p < 0.001), germinal layer area (25,886 vs. 35,320 µm2, p < 0.001), superoxide dismutase (SOD) (0.9 vs.1.73 U/mg, p < 0.001) and increased testicular lipid peroxidation (3.05 vs. 15.35 nmol/mg, p < 0.001). CR at 25 mg/kg ameliorated testicular lipid peroxidation and enhanced SOD activity compared to CIS group (p < 0.05). Besides, CR treatment at the maximum dose (100 mg/kg) resulted in reversing CIS effects on testis weight, testosterone level, SOD, lipid peroxidation, and germinal layer area.

CONCLUSIONS

These findings demonstrated that CR co-treatment could prevent CIS-induced testicular toxicity in rats.

Synthesis, characterization and cytotoxicity evaluation of a novel magnetic nanocomposite with iron oxide deposited on cellulose nanofibers with nickel (Fe3O4@NFC@ONSM-Ni)

A heterogeneous, magnetically recoverable nanocomposite, Fe3O4@NFC@ONSM-Ni(ii) was prepared by immobilization of a novel Ni(ii) Schiff base complex on Fe3O4@NFC nanoparticles followed by treatment with melamine. This trinuclear catalyst has been characterized using several analytical techniques including FT-IR, TEM, Fe-SEM, EDX, DLS, ICP, TGA, VSM, and XRD. It was used as an efficient catalyst for one-pot solvent-free synthesis of 1,4-dihydropyridine and poly-hydro quinoline derivatives through Hantzsch reaction. This catalyst showed remarkable advantage over previously reported catalysts due to suitable conditions, short reaction time, high efficiency and lower catalyst load and timely recovery of the magnetic catalyst. Moreover, the effects of Fe3O4@NFC@ONSM-Ni(ii) nanoparticles on the in vitro proliferation of human leukemia cell line (k562) and human breast cancer cells (MDA-MB-231) were investigated. The results of MTT and Hochest assays suggested that the nanoparticles could effectively inhibit the proliferation of these cancer cells in a time- and concentration-dependent manner.

N-acetylcysteine dose-dependently improves the analgesic effect of acetaminophen on the rat hot plate test

BACKGROUND

Acetaminophen (APAP) induced hepatotoxicity is a clinically important problem. Up to now, interventive therapy with n-acetylcysteine (NAC) has been considered as a gold-standard treatment for APAP overdose. However, no study has focused on the efficacy of these drugs' concurrent administration on probable enhancing therapeutic outcomes. Thus, this study was aimed to investigate the analgesic effect of co-administration of NAC and acetaminophen in male rats. The NAC-APAP drug formulation may demonstrate the stranger antinociceptive effect.

METHODS

Forty-eight male Sprague-Dawley rats (12-14 weeks) randomly divided into six equal groups; control, APAP (received 300 mg/kg APAP), NAC (received 600 mg/kg NAC) and APAP+ NAC groups that received simultaneously 300 mg/kg APAP with 200-600 mg/kg NAC (AN200, AN400, AN600). All administrations were done orally for once. The antinociceptive effect was recorded by measurement of latency period on a hot plate in 30, 60, and 90 min after administrations.

RESULTS

The results showed that NAC's concurrent administration with APAP, dose-dependently increased APAP analgesic effects (p< 0.0001). Moreover, NAC treatment exhibited an antinociceptive effect in 60 and 90 min, per se. The treatments had no adverse effect on liver enzymes and oxidative stress.

CONCLUSION

Co-administration of NAC with APAP can improve the antinociceptive effect of APAP. It is suggested that this compound can enhance analgesic effects of APAP and eventually lead to a reduction in acetaminophen dose. Further studies are needed to evaluate the molecular mechanism of this hyper analgesic effect.

Photocatalytic degradation of penicillin G from simulated wastewater using the UV/ZnO process: isotherm and kinetic study

PURPOSE

Pharmaceutical contaminants, including antibiotics, present in the environment, especially water resources, are a main concern for human and environmental health due to their stability and non-degradability. Accordingly, the purpose of this study was to investigate the photocatalytic removal of penicillin G antibiotic from simulated wastewater using a photocatalytic process [UV/ZnO] in an isotherm and kinetic study.

METHODS

In the current research, the ZnO nanoparticles [ZnO NPs] were initially characterized by scanning electron microscope [SEM] and X-ray diffraction [XRD]. Then, its efficiency was investigated in the photocatalytic degradation process of penicillin G. The evaluated parameters in the adsorption process penicillin G antibiotic were pH [1-5], penicillin G concentration [10-30 mgL-1], NP dosage [0.5-4.5 gL-1] and contact time [5 to 200 min]. Then, the effect of pH [3, 5, 7, 9, 11, and], penicillin G concentration [10-30 mgL-1], NP dosage [0.01-1.5 gL-1] and contact time [5 to 200 min] in the photocatalytic degradation (UV/ZnO) was studied. The residual penicillin G concentration was measured using a spectrophotometery at a wavelength of 283 nm.

RESULTS

The results indicated that the penicillin G removal efficiency of photocatalytic process [UV/ZnO] using ZnO was 74.65% at the concentration of 10 mgL-1, the pH value of 5, the ZnO NP dosage of 0.1 gL-1 and the contact time of 180 min, as well as the kinetics of degradation followed the pseudo-first-order kinetic model.

CONCLUSION

It can be concluded that the use of this process is appropriate an effective for the removal of the antibiotic pollutants.

Blood lead level risk factors and reference value derivation in a cross-sectional study of potentially lead-exposed workers in Iran

OBJECTIVES

This exploratory investigation aimed to measure blood lead levels and associated risk factors in exposed workers in Iran, and to derive appropriate reference values for blood lead in this population as a means of epidemiological comparison.

DESIGN

Cross-sectional.

SETTING

Manufacturing plants with potential lead exposure in Southern Khorasan Province, Iran.

PARTICIPANTS

The study included 630 workers, selected through stratified random sampling.

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary measures in this exploratory investigation were venous blood lead concentration (BLC) and associated risk factors of age, gender, work experience, cigarette smoking and history of opium use. The secondary measures were symptoms associated with lead toxicity. Data analyses were conducted using Student's t-test, Mann-Whitney U test, one-way analysis of variance, Kruskal-Wallis test, Spearman correlation coefficient and regression analysis.

RESULTS

Mean and median BLCs were 6.5±8.1 μg/dL and 3.9 μg/dL (IQR: 2.9-5.8), respectively. Of the subjects, 85 (13.5%) had BLC ≥10 μg/dL. The derived reference BLC value in this study was 30 μg/dL for men and 14 μg/dL for women. Increasing work experience and age were associated with BLC >10 μg/dL. Radiator manufacturers were up to 12.9 times (95% CI 4.6 to 35, p<0.005) more likely than painters to have BLC >10 μg/dL. Most subjects reported multiple symptoms.

CONCLUSIONS

The mean BLC was above the maximum recommended concentration. There was a significant relationship between higher BLC and age or working in a printing factory or radiator manufacturing. These findings can direct efforts towards reducing occupational lead exposure.

Comparison of Blood Lead Levels in Patients With Alzheimer's Disease and Healthy People

BACKGROUND

It is argued that breakdown of β-amyloid in the brain causes deposition of senescent plaques and therefore Alzheimer's disease (AD). One of the influential factors for increasing level of this protein is exposure to lead. Our aim was to compare blood lead levels (BLLs) between patients with AD and healthy controls.

METHODS

This case-control study was performed on all patients with cognitive impairment who were referred to the Neurological Clinic of Birjand in 2016 to 2017. Patients were referred to the laboratory for measurement of their serum levels of lead. The controls and patients were matched by age and sex.

RESULTS

In the AD case group, the average BLL was 22.22 ± 28.57 μg/dL. Mann-Whitney U test showed that BLLs were significantly higher in the patients than in the controls. The unadjusted odds ratio for BLL among the patients was 1.05 (95% confidence interval: 1.01-1.09; P = .01) compared to the controls.

CONCLUSION

In the present study, BLL was associated with AD.

Epidemiological and clinical profiles of acute poisoning in patients admitted to the intensive care unit in eastern Iran (2010 to 2017)

BACKGROUND

Acute poisoning is a common chief complaint leading to emergency department visits and hospital admissions in developing countries such as Iran. Data describing the epidemiology of different poisonings, characteristics of the clinical presentations, and the predictors of outcome are lacking. Such data can help develop more efficient preventative and management strategies to decrease morbidity and mortality related to these poisonings. This manuscript describes the epidemiology of acute poisoning among patients admitted to the intensive care unit (ICU) in Birjand, Iran.

METHODS

This retrospective, cross-sectional study was conducted to characterize acute poisonings managed in the ICU during a 7-year period from March 2010 to March 2017 in a single center in Birjand, Iran. Patient characteristics, suspected exposure, the route of exposure, and outcome data were collected from hospital medical records.

RESULTS

During the study period, 267 (64% male and 36% female) patients met inclusion criteria. Pharmaceutical medication (36.6%), opioids (26.2%) followed by pesticides (13.9%) were the most common exposures 38.2% of these cases were identified as suicide attempts. There were different frequencies in terms of xenobiotic exposure in relation to gender (p = 0.04) and the survival (p = 0.001). There was a significant difference between various xenobiotics identified as the cause of poisoning (p = 0.001). Mortality rate in our study was 19.5%. The incidence of outcomes was significantly higher in patients poisoned with opioids, pesticides, benzodiazepines, and tricyclic antidepressants (p < 0.05). The median length of hospital stay was higher in pesticide-poisoned patients (p = 0.04).

CONCLUSION

Opioids and pesticides were the most common exposures. The mortality rate of the poisoned patients in the ICU was proportionately high. The mortality rate due to opioid poisoning is a major concern and the most significant cause death due to poisoning in the region. Further monitoring and characterization of acute poisoning in Birjand, Iran is needed. These data can help develop educational and preventative programs to reduce these exposures and improve management of exposures in the prehospital and hospital settings.