Case report
samaneh mortezaei; Mitra Ahadi; seyedmorteza valayi
Abstract
This case report documents a unique presentation of hepatic encephalopathy induced by the reactivation of chronic hepatitis B due to Cytomegalovirus (CMV) infection in a 76-year-old female patient. The patient was admitted with a diminished level of consciousness subsequent to a week of anorexia, intermittent ...
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This case report documents a unique presentation of hepatic encephalopathy induced by the reactivation of chronic hepatitis B due to Cytomegalovirus (CMV) infection in a 76-year-old female patient. The patient was admitted with a diminished level of consciousness subsequent to a week of anorexia, intermittent fever, chills, postprandial nausea, and vomiting. Laboratory tests revealed significant hepatocellular injury, while imaging suggested cirrhosis. The presence of hepatitis B surface antigen and a detectable hepatitis B virus (HBV) DNA qualitative analysis was noted, alongside an elevated CMV viral load, indicating reactivation of chronic hepatitis due to CMV infection. Therapeutic interventions included Ganciclovir for CMV infection, Colistin for an Enterococcus urinary infection, and Tenofovir for hepatitis. Upon stabilization, the patient was discharged for continued medical management. The case highlights the significance of considering reactivation of chronic viral hepatitis in the differential diagnosis of hepatic encephalopathy. It underscores the critical role of comprehensive diagnostic investigation in patients presenting with reduced consciousness, especially those with a history of liver disease. Moreover, it emphasizes the importance of managing concurrent infections in the context of liver disease, and serves as a reminder of the potential for CMV to reactivate chronic hepatitis, leading to serious complications such as hepatic encephalopathy.
Review
Hamedreza Kafash; Asghar Baradaran Rahimi; Sirous Nekooei; Seyede Fateme Mahmoudi Hashemi
Abstract
Background: Nasal airway obstruction (NAO) is a common symptom that affects a person's quality of life. It can be estimated by patient perception or by physical measurements. Computational fluid dynamics (CFD) can be used to analyze nasal ventilation modes. There is a lack of comparative studies for ...
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Background: Nasal airway obstruction (NAO) is a common symptom that affects a person's quality of life. It can be estimated by patient perception or by physical measurements. Computational fluid dynamics (CFD) can be used to analyze nasal ventilation modes. There is a lack of comparative studies for evaluation of airflow regimes using CFD.Objective of the review: Our goal was to determine the different utilities of CFD as an objective method for investigation of nasal airflow characteristics.Search strategy: Selected studies were collected from MEDLINE (Ovid), Google Scholar ,Cochrane Library and EMBASE using a combination of the MeSH terms “septal deviation”, “nasal obstruction”, “Computational fluid dynamics (CFD)”.Evaluation method: We compared all the results obtained by the authors regarding the CFD variables and the assessment of nasal obstruction (clinical or physical).Results: To compare nasal obstruction with CFD variables, most authors use heat flow, Wall Shear Stress (WSS), total pressure, velocity and streamlines. We found that heat flux appeared to be the CFD variable most strongly correlated with patient perception. Total pressure, wall shear stress and velocity are also useful and show a good correlation.Conclusion: More and more research on CFD on the nose has led to a better understanding of nasal obstruction. Further studies need to be done, including temperature and humidity exchange.
Review
Nasrin Moazzen; Fatemeh Shahrahmani; Yalda Ravanshad; anoush azarfar
Abstract
Background: Concern over male infertility has grown, with over half of infertility cases linked to male causes. The effect of radiofrequency electromagnetic radiation (RF-EMR) from mobile phones on sperm DNA fragmentation has been investigated. This mini-review evaluates literature on the correlation ...
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Background: Concern over male infertility has grown, with over half of infertility cases linked to male causes. The effect of radiofrequency electromagnetic radiation (RF-EMR) from mobile phones on sperm DNA fragmentation has been investigated. This mini-review evaluates literature on the correlation between RF-EMR and sperm DNA fragmentation.Methods: A systematic review was conducted using Google Scholar and PubMed databases up to July 2020. MeSH terms related to DNA fragmentation, sperm, mobile phones, radiofrequency, and related synonyms identified relevant studies. Nine studies were selected, and their methodologies examined.Results: The studies reviewed presented diverse findings on the correlation between RF-EMR from mobile phones and sperm DNA fragmentation. Of the nine investigations—five in vitro and four in vivo—all in vivo studies found significant DNA fragmentation in men who used their phones extensively, especially when carried in pants pockets. Three of the five in vitro tests showed a substantial effect, while the other two found no significant change between exposed and unexposed samples.Conclusion: Although more studies reported decreased sperm quality with prolonged and intense RF-EMR exposure, the evidence regarding DNA fragmentation remains inconclusive. With the widespread use of mobile phones, it is critical to further investigate their potential impact on male fertility and reproductive health. Existing evidence underscores the need for continued research in this area.
Meta- analysis
Morvarid Irani; Ali Saberi; Zahra shojaeian; Mohamad Ghorbani; Nahid Maleki
Abstract
Background: Uterine fibroids or Leiomyoma (UFs) are one of a common problem that affects the quality of life in women. Recently use of vitamin D for treating Leiomyoma has been considered. Study's PurposeThis Systematic Review was performed with aim to evaluate the current evidence for the efficacy of ...
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Background: Uterine fibroids or Leiomyoma (UFs) are one of a common problem that affects the quality of life in women. Recently use of vitamin D for treating Leiomyoma has been considered. Study's PurposeThis Systematic Review was performed with aim to evaluate the current evidence for the efficacy of vitamin D in treating uterine fibroids.Methods: Relevant studies were identified from the following Electronic searching of Medline, PubMed, Scopus, Cochrane, Embase, Web of science, SID and Google Scholar up to Feb 2021. Inclusion criteria consist of Both English and Persian, published, clinical trials using vitamin D as medical for treatment of uterine fibroids. In the long run four RCTs met the inclusion criteria. The quality of these trials was evaluated by two researchers who carried out the data extraction, using Oxford Center for Evidence Based Medicine checklist. Statistical analysis was performed by Comprehensive Meta-analysis (CMA) Version 2. To assess the publication bias and heterogeneity, Egger’s and Begg’s tests and I2 were used, respectively. In addition, the Random effects model was employed to perform the meta-analysis. Findings: The heterogeneity in the studies was determined as 95.17% (p<0.000). There was publication bias among the studies included; the p-values of Egger’s and Begg’s tests were 0.05 and 0.05, respectively. The effects of Vit D on UFs was statistically significant [mean difference (MD) =2.88; 95% confidence interval (CI): (4.72-1.044); p<0.002]. Conclusion: Vitamin D for treating uterine fibroids can be an effective method, but more studies are needed to confirm these findings.
Case report
Bita Barazandeh Shirvan; Javad Akhondian; Parvaneh Layegh; Narges Hashemi; Ehsan Ghayoor Karimiani; Razie Rezaie; Paria Najarzadeh Torbati; mehran beiraghi toosi
Abstract
Objective: Ataxia telangiectasia-like disorder (ATLD) is a rare autosomal recessive disorder caused by mutations in the MRE11 gene. The diagnosis of patients with Ataxia telangiectasia-like disorder and Ataxia telangiectasia may be challenging due to similar clinical manifestations. In the present study, ...
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Objective: Ataxia telangiectasia-like disorder (ATLD) is a rare autosomal recessive disorder caused by mutations in the MRE11 gene. The diagnosis of patients with Ataxia telangiectasia-like disorder and Ataxia telangiectasia may be challenging due to similar clinical manifestations. In the present study, we describe a patient with a homozygous variant of uncertain significance (VUS) in the MRE11 gene that was correlated clinically with ATLD. Methods: We performed a brain MRI scan to find the cause of the patient's ataxia. After ventriculoperitoneal shunting due to obstructive hydrocephalus, there was no clinical change; so, we carried out whole exome sequencing. Additionally, Variants were classified using several databases and predicted according to the ACMG 2015 guidelines. Results: A 2-year-6-month-old boy with ataxia, tonic seizure, and speech delay was found during studies. The WES and in silico analysis identified a homozygous variant of uncertain significance (VUS) in the MRE11 NM_005591.4 (MRE 11): c.173 G>T (p. GIv58Val).Conclusion: This case report highlights that genetic testing can be useful for the precise diagnosis when clinical manifestations are not associated with MRI results. Furthermore, we could categorize a variant in the MRE11 gene from VUS to likely pathogenic based on clinical features.
Original article
Sahar Ravanshad; Marieh Alizadeh; Aida Bakhshi; Sepideh Hejazi; Mina AkbariRad; Hassan Mehrad-Majd
Abstract
Introduction: The COVID-19 pandemic has underscored the necessity of investigating the relationship between radiological and laboratory findings with disease outcome in COVID-19 patients. This study aimed to explore the association between CT-scan finding and laboratory results with disease outcome, ...
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Introduction: The COVID-19 pandemic has underscored the necessity of investigating the relationship between radiological and laboratory findings with disease outcome in COVID-19 patients. This study aimed to explore the association between CT-scan finding and laboratory results with disease outcome, including recovery without complications, ICU admission, or mortality.Methods: This retrospective cross-sectional study analyzed medical records and laboratory data from COVID-19 patients at our institution from September 2020 onwards. All demographic, laboratory findings, as well as CT-scan data such as ground-glass opacity, consolidation, pleural effusion, cardiomegaly, mediastinal lymphadenopathy, and pulmonary involvement score at admission were collected. Patients were categorized based on outcome status and compared for all study variables. Results: Significance differences were observed for CT-score values between deceased patients and those who recovered (P<0.001), indicating a more severe lung changes in patients who died due to COVID-19. Additionally ICU-admitted patients had higher likelihood of underlying comorbidities and elevated CT-score levels. Laboratory markers such as ESR, Ferritin, LDH, Neutrophil count, and RDW were significantly higher in patients requiring ICU admission (P<0.05). Deceased patients were more likely to have underlying diseases, ground glass opacity, cardiomegaly, and higher CT-scores. Laboratory markers such as ESR, CRP, Ferritin, LDH, and others were also significantly higher in expired patients.Conclusion: There was a strong association between laboratory and CT-scan findings with disease outcomes in COVID-19 patients. The combination of laboratory markers and CT-scan findings can serve as robust predictors of disease outcomes. Further studies are needed to validate these findings in larger cohorts.
Original article
Roohallah Yousefi; Ali Jamshidi
Abstract
Introduction: Tribulus terrestris is rich in bioactive compounds such as saponins, flavonoids, and alkaloids, which have been researched for their therapeutic properties. Its diuretic effects can help with hypertension and edema, its aphrodisiac properties can aid sexual function, and its antilithic ...
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Introduction: Tribulus terrestris is rich in bioactive compounds such as saponins, flavonoids, and alkaloids, which have been researched for their therapeutic properties. Its diuretic effects can help with hypertension and edema, its aphrodisiac properties can aid sexual function, and its antilithic properties can prevent kidney stone formation. The physicochemical and pharmacological characteristics of Tribulus terrestris are currently being studied.Methods and Materials: We utilized the PubChem database to gather data on the studied compounds, including their formulas and structures. Subsequently, we employed SwissADME software to assess the physicochemical and pharmacological properties of these compounds in Tribulus terrestris (TT).Results and Discussion: Steroidal saponins and sterols exhibit varying solubility levels in physiological fluids due to their hydrophobic nature and glycosylation patterns. Flavonoids, on the other hand, demonstrate favorable solubility. Compounds like (25R)-Spirosta-3,5-dien, β-sitosterol, and stigmasterol have low polarity, whereas Terrestrosin K, Terrestrosin F, Terrestroside B, Protodioscin, and Kaempferol-3-O-rutinoside can form more hydrogen bonds. Steroidal saponins are more readily absorbed in the gastrointestinal tract and can penetrate the blood-brain barrier. Kaempferol, chrysin, and quercetin show inhibitory effects on specific cytochrome P450 enzymes. β-sitosterol and stigmasterol have high rates of skin absorption. The bioavailability score ranges from 0.11 to 0.55, and synthetic accessibility scores are generally high.Conclusion: The steroidal saponins and flavonoids found in Tribulus terrestris show therapeutic potential for conditions such as hypertension, edema, and sexual dysfunction. Many of them possess favorable pharmaceutical properties for clinical use.
Original article
Elahe Derakhshan-Nezhad; Ali Khakshour; Hengameh Anari Moghadam; Zahra Chaichy
Abstract
Aims: Intussusception is the second leading cause of acute abdominal pain in preschool children and infants, which is idiopathic in origin at this stage of life. Management options include hydrostatic reduction and surgery with subsequent procedures. Considering the urgency of intussusception, the existence ...
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Aims: Intussusception is the second leading cause of acute abdominal pain in preschool children and infants, which is idiopathic in origin at this stage of life. Management options include hydrostatic reduction and surgery with subsequent procedures. Considering the urgency of intussusception, the existence of multiple interventional methods, and unequal complications of these methods, this research aimed to evaluate the characteristics of intussusception patients and therapeutic interventions performed to manage intussusception in Akbar Children's Hospital in Mashhad, Razavi Khorasan Province, Iran.Methods & Materials: This descriptive cross-sectional research was performed on all children under 18 years of age, who admitted to this hospital from 2017 to 2022 and underwent reduction or surgery with the final diagnosis of intussusception. Patient information was extracted from the hospital's information system (HIS). All data were analyzed using SPSS software Version 26.Results: Totally, 348 patients were included in this research, of whom 68.4% were male. The mean age of the patients was 32.18 ±39.54 (SD) months; 35.1% were less than one year, 45.4% were between 1 and 5 years, and 19.5% were more than 5 years. Out of 348 patients, 318 (91.8%) cases had the first visit, 22 (6.5%) had the second visit, and eight (1.9%) had the third visit. Regarding the treatment type, 304 (87.5%) patients were cured with reduction, and 44 patients underwent surgery.Conclusion: This study findings showed that most of the patients (87.5%) recovered with reduction, and a limited percentage of them needed surgery, indicating the effectiveness of the reduction method.