Background: Umbilicus visceral manipulation is an effective medical practice in the treatment of ... more Background: Umbilicus visceral manipulation is an effective medical practice in the treatment of a wide range of diseases, including abdominal pain, as described in traditional Persian medicine (TPM) texts. Case description: A 35-year-old married female (G2P2Ab0L2NVD2) from Gorgan, Iran, presented to the TPM health care center affiliated with Golestan University of Medical Sciences on February 21, 2022, due to abdominal pain, obesity, and increased appetite. Conclusion: Tailoring the treatment to the individual characteristics of the client and incorporating TPM measures, such as manual procedures, in conjunction with modern medicine, can play a crucial role in the overall treatment process.
Background: Traumatic brain injury (TBI) is a significant medical concern, with post-traumatic ep... more Background: Traumatic brain injury (TBI) is a significant medical concern, with post-traumatic epilepsy (PTE) being one of its consequences. Epilepsy, with a global prevalence of 1%, is the third most common neurological disorder after stroke and Alzheimer’s disease. Trauma accounts for 20% of symptomatic epilepsy cases. Understanding the prevalence of PTE and the factors influencing it can aid in diagnosis and treatment. This study aims to investigate the relationship between epilepsy prevalence, age, gender, and post-traumatic brain injuries. Methods: This retrospective descriptive study analyzed data from 135 epilepsy patients hospitalized between 2018 and 2021. Statistical analysis involved reviewing relevant data and creating tables and graphs. Results: The findings indicate that epilepsy is more prevalent in men than in women, with the most affected age group being 20-29 years old. Post-traumatic epilepsy emerged as the most common factor among the patients. The prevalence of PTE in this study was 9.6%, closely aligning with the global rate of 7.8%. Conclusion: The prevalence of post-traumatic epilepsy is significantly influenced by geographical conditions and living environments. In developing countries, the high volume of road traffic and increased accident rates contribute to a higher incidence of post-traumatic epilepsy.
Background: Many environmental chemicals are implicated in causing serious adverse health effects... more Background: Many environmental chemicals are implicated in causing serious adverse health effects on the reproductive system. Some medicinal plants taken traditionally for different ailments are particularly toxic to the reproductive organs. This study was undertaken to evaluate the reproductive toxicity of the ethanol leaf extract of Panicum maximum on adult male rats. Methods: The leaves were randomly collected. Ground and powdered leaves were extracted by cold maceration using ethanol. Sixteen adult male rats (130-200 g) were divided into 4 groups. The negative control group (group I) was given 10 mL/kg distilled water, while Group II-IV received 50, 100, and 200 mg/kg of Panicum maximum leaf extract for 21 days. The animals were sacrificed and analyzed for some reproductive parameters at the end of the 21 days. Results: There was a decrease in the body weight of the rats, as well as the testis at 200 mg/kg when compared to the control within the treatment period. Sperm analysis showed a significant decrease in normal sperm cells, sperm variability, active sperm cells, and sperm count in all groups given Panicum maximum leaf extract. There was a significant increase in abnormal and dead sperm cells. Hormonal analysis showed a decrease in follicle-stimulating hormone (FSH) and testosterone (TST) levels, which was significant. The histology of the testis also indicated toxicity of the extract, and it was dose-dependent. Conclusion: Ethanol leaf extract of Panicum maximum is relatively toxic to the male reproductive system.
Background: The prevalence of skin diseases varies geographically due to factors, such as etiolog... more Background: The prevalence of skin diseases varies geographically due to factors, such as etiology, environment, genetics, and lifestyle. The current study aimed to determine the incidence and distribution of skin disorders and to provide a description of the histomorphological spectrum. Methods: This retrospective study was conducted over a period of two years, from June 2021 to May 2023. A total of 202 skin biopsy samples were evaluated. The histopathological examination of the lesions categorized them into eight groups based on the site, pattern of involvement, and cytological features, according to the Lever’s Histopathology of the Skin. Group 1 consisted of diseases limited to the epidermis and stratum corneum; group 2 consisted of diseases with localized superficial epidermal or melanocytic proliferation; group 3 consisted of diseases of the superficial cutaneous reactive unit; group 4 included diseases with acantholytic, vesicular, and pustular morphology; group 5 included diseases with perivascular, diffuse, and granulomatous infiltrate of the reticular dermis; group 6 included tumors and cysts of the dermis and subcutis; group 7 consisted of inflammatory disorders of skin appendages; and group 8 consisted of disorders of the subcutis. Results: A total of 202 skin biopsies were collected from individuals aged 8-87 years. The majority of the cases belonged to the age group of 31-40 years. The male-to-female ratio was 1.2:1. The trunk was the most common site of biopsy, accounting for 40% of the cases, followed by the upper limb in 25% of the cases. Histopathological lesions were categorized into eight groups based on the site, pattern, and cytological features. Neoplastic lesions, both benign and malignant, accounted for 10.9% of the cases. The majority of the lesions were related to group 6, accounting for 38.1% of the cases, with the epidermal cyst being the most common lesion (7.92%). Basal cell carcinoma, observed in 2.97% of the cases, was the most common lesion among the neoplastic lesions. Group 5 lesions were the third most common (19.8%), with leprosy accounting for 9.4% of these cases. Conclusion: Histopathological examination of skin biopsies is considered the gold standard for diagnosis, and it is often supported by ancillary techniques. Leprosy was the most common disease identified in this study, which underscores the importance of effective preventive measures for control.
Background: There is currently a scarcity of population-based records related to the prevalence o... more Background: There is currently a scarcity of population-based records related to the prevalence of gestational diabetes mellitus (GDM) in India. There were various recommendations for screening and diagnostic tests for GDM, and no uniform standard has yet been established. Hence, a comparative study was conducted to assess the usefulness of the glucose challenge test (GCT) and fasting blood glucose (FBG)/post-prandial blood glucose (PPBG) test for the screening of GDM in pregnant women attending the prenatal clinic outpatient department. Methods: This is a comparative observational study involving 300 apparently normal pregnant who were randomly allocated to GCT and FBG/PPBG cohorts of 150 each. The tests were performed at 4 intervals: 8 to 10 weeks, 16 to 20 weeks, 24 to 28 weeks, and 32 to 36 weeks. All diagnosed GDM cases were appropriately handled. Results: Gestational diabetes mellitus was seen in 2.67% of the FBG/PPBG cohort and 5.34% of the GCT cohort. The GCT test identified 25% of GDM subjects before 24 weeks of gestation, 50% in 24 and 28 weeks, and 25% in > 32 weeks of gestation. The highest prevalence of GDM was noted in the 26–30-year age group. The highest prevalence of GDM was noted in pregnant women with ≥ 26 kg/m2 of body mass index (BMI), with 75% in the FBG/PPBG group and 62.5% in the GCT group. The incidence of GDM was higher in primigravida, 75% in the FBG/PPBG group, and 50% in the GCT group. A higher prevalence was observed in pregnant women of class 4 of socioeconomic status, and it was 75% in the FBG/PPBG group and 75% in the GCT group. A higher prevalence was noted in those with higher secondary education. The majority of GDM cases gave birth at term by labor, and there were no assisted vaginal births in this group. Moreover, 75% of GDM cases in the FBG/PPBG cohort and 62.5% of GDM cases in the GCT cohort had Caesarean section. Besides, 50% of infants from GDM mothers in the FBG/PPBG cohort were hospitalized, while 12.75% were admitted in the GCT cohort. The birth weight of neonates from GDM mothers was 3.09 ± 0.5 kg, 3.11 ± 0.6 kg in normal mothers, 2.98 ± 0.6 kg in the FBG/PPBG cohort, and 2.9 ± 0.5 kg in the GCT cohort. Conclusion: Irrespective of the last meal, the GCT in all pregnant women is an effective and easy screening approach for 1-step screening for the early diagnosis of GDM for subsequent management at the early gestational pregnancy, which can minimize the adverse obstetric and perinatal outcomes.
Background: Non-secretory multiple myeloma is a sporadic type of multiple myeloma with the prolif... more Background: Non-secretory multiple myeloma is a sporadic type of multiple myeloma with the proliferation of monoclonal plasmocytes in the bone marrow that cannot secrete or synthesize immunoglobulins. Its prevalence as a hematologic malignancy is low, and it is usually diagnosed by demonstration of monoclonal plasma cells ≥ 10% in the bone marrow with negative results on serum and urine electrophoresis and immunofixation studies. Methods: We present a case report where the patient's serum and whole blood samples were received in the study laboratory to evaluate the complete hemogram and metabolic profile. The metabolic and hematological profiles were deranged, subsequent to which the patient's clinical history was obtained from the treating clinician. It was discovered that the patient had presented with long-term weakness and back ache and was advised routine investigations along with magnetic resonance imaging (MRI) of the spine, which revealed the presence of osteolytic lesions. Following this, a gammopathy panel was requested. Results: Serum protein capillary electrophoresis and immunofixation electrophoresis revealed a normal pattern without any noticeable bands, distortions, or suspicious regions. However, the findings of the comprehensive gammopathy panel were suggestive of non-secretory multiple myeloma. Conclusion: In the absence of a detailed and meticulous work-up, a case of non-secretory multiple myeloma can be easily misdiagnosed. Here, we discuss the case in detail, the diagnostic pitfalls associated with it, and the role of serum free light chain assays in its diagnosis.
Background: Overconsumption of high-calorie foods not only causes obesity and metabolic disorders... more Background: Overconsumption of high-calorie foods not only causes obesity and metabolic disorders but also affects some activities of the nervous system, such as cognitive processes. The present study aimed to investigate the effect of a cafeteria diet from post-weaning to adolescence on the cognitive performance of rats. Methods: Pregnant Wistar rats were fed a normal diet and water from the day of delivery to 20 days postpartum. Male offspring were then assigned to one of 3 groups: a cafeteria diet (sausages, cakes, raisin cookies, carrots, white milk chocolate, and chocolate milk) (CAF), a cafeteria diet with simvastatin (CAF-S), or a control group (CTRL). After the treatments were completed, the cognitive performance of the rats was evaluated using the Morris water maze test. Results: The CAF group showed reduced learning compared to the other two groups, and they took longer to find the hidden platform on all days of the experiment (P ≤ 0.001). The CAF-S group, which received simvastatin at a dose of 50 mg/kg, had a significantly shorter time to find the hidden platform compared to the CAF group (P ≤ 0.05). During the memory recall phase, after removing the platform, the CAF-S group spent less time in the target quadrant compared to the CTRL and CAF-S groups (P ≤ 0.05). Conclusion: The results indicated that the cafeteria diet decreased the rats' learning and long-term memory. This effect is likely due to the high-fat content in the cafeteria diet. However, simvastatin prevented this decrease in the rats fed a cafeteria diet. These findings suggest that interventions targeting the metabolic pathways affected by a cafeteria diet may have potential therapeutic benefits for cognitive disorders.
Background: The literal meaning of halal is "permissible" in Arabic, which refers to a mandatory ... more Background: The literal meaning of halal is "permissible" in Arabic, which refers to a mandatory set of dietary guidelines and Islamic law principles. Halal food is made following the Islamic dietary regulations, ensuring specific standards of cleanliness, hygiene, animal welfare, and the prohibition of the inclusion of harmful chemicals. The emphasis on cleanliness, animal welfare, prohibition of harmful substances, nutritional value, and ethical sourcing contributes to a healthier and more sustainable food system. Methods: An extensive online literature search for articles was performed using various search engines and databases with keywords halal food, food hygiene, and Islamic dietary principles. The reference lists of all the retrieved publications were also explored. Results: Our search was limited to English articles that seemed relevant to this review, and the draft was prepared. Conclusion: The health benefits of halal eating extend beyond religious grounds. Halal food consumption provides a safer option and minimizes the potential for food contamination and the associated health risks. By adhering to halal dietary guidelines, individuals can make conscious choices that promote their well-being while fostering a sense of responsibility towards animals, the environment, and the community at large. Halal food offers a holistic approach to nutrition and health, providing safer, balanced, and ethical food choices.
Background: Hepatic veins, which are a link between portal and systemic circulation, traverse the... more Background: Hepatic veins, which are a link between portal and systemic circulation, traverse the liver substance and drain different segments into the inferior vena cava (IVC). This venous outflow is important for adequate functioning of liver homeostasis. The knowledge of the variations in the number and pattern of openings of the hepatic veins into the floor of IVC is necessary, especially during liver resection and liver transplantation, particularly to decide the method that would be adopted for these aforesaid procedures. Methods: A total of 84 livers present in the Department of Anatomy, Goa Medical College, Goa, were used, from which 9 were excluded. The livers were formalin-fixed and were obtained from donated cadavers. The posterior wall of a retro-hepatic segment of IVC was incised to examine the count of hepatic venous vasculature and the pattern of their openings. Results: The number of hepatic vein openings ranged from 3 to 8. The majority of the livers (32%) had 6 openings. The incidence of the right major hepatic vein was 97.3%, the middle major hepatic vein was 73.3%, and the left major hepatic venous vasculature was 86.6%. The majority of the specimens (n = 25) showed a double opening pattern with 1 separate opening for the hepatic vein of the right side and the middle and left hepatic vein opened by a single trunk. Conclusion: Hepatic venous vasculature showed numerous variations in its draining pattern in the IVC. Understanding these variations is important for hepatic surgeries to improve post-operative outcomes.
Background: Neurodegenerative diseases (NDDs) cause progressive neuronal loss, resulting in morbi... more Background: Neurodegenerative diseases (NDDs) cause progressive neuronal loss, resulting in morbidity and mortality. Research is continued on treatment strategies that can tackle the disease's pathophysiology and cease its progression. Considering the anti-apoptotic and neuroprotective properties of apelin, we hypothesized that apelin-13 could be a therapeutic solution for Alzheimer's disease and similar NDDs. Therefore, we evaluated its effect on scopolamine-treated rats. Methods: Male rats (n=40) were assigned to 5 groups of 8. No intervention was considered for the control group. The scopolamine group received stereotaxic surgery and was treated with 3 mg/kg scopolamine intraperitoneally. The treatment groups were treated with scopolamine plus intraventricular injection of apelin-13 (1.25, 2.5, and 5 µg) into the right lateral ventricles for 7 days. For evaluating the memory impairment, the passive avoidance reactions of the animals, except the control group, were assessed 24 hours following the last injection. Regarding histological analysis, Congo red staining of the hippocampal sections was done, and immunoblotting was used to determine apoptotic biochemical markers, including caspase 3, cytochrome C, and congophilic amyloid-beta plaques. Results: Apelin–13 alleviated scopolamine-related passive avoidance memory impairment and reduced the number of congophilic amyloid-beta plaques in the hippocampus (all P<0.001). It attenuated the decrease in the mean levels of hippocampal apoptotic proteins (caspase 3, cytochrome C) in animals treated with scopolamine (all P<0.05). Conclusion: The neuroprotective effects of apelin-13 suggest its therapeutic effect on neurodegenerative disorders.
Background: This study analyzed the rate of relapse and functional outcome after surgery for chro... more Background: This study analyzed the rate of relapse and functional outcome after surgery for chronic osteomyelitis of long bones. Methods: This study included 100 cases of chronic osteomyelitis, which were treated with surgical debridement, along with a 6-week course of antibiotics. The patients were divided into two groups based on whether they had undergone preoperative magnetic resonance imaging (MRI) or not. A comparison of relapse rates was then conducted between these two groups. The patients were followed up, and their functional outcomes were examined using the Association for the Study and Application of the Method of Ilizarov Criteria (ASAMI), Lower Extremity Functional Scale (LEFS), Disabilities of the Arm, Shoulder, and Hand (DASH), and Musculoskeletal Tumor Society (MSTS) questionnaires. Logistic regression analysis was used to assess the impact of risk factors on the recurrence or relapse. Results: Sixty patients had chronic osteomyelitis, and 40 patients were infected non-union. Twenty-five patients had preoperative MRI. The mean preoperative LEFS was 44 ± 13.59 (19-73). Preoperative ASAMI showed 4% excellent, 62% fair, 24% good, and 10% were poor. The preoperative MSTS emotional component showed that enthusiastic (0%), satisfied (0%), accepts (36%), and dislikes (60%). Among the infected non-union cases, 2 cases had a total disability, 15 cases had recreational restriction, and 23 cases had a partial disability. Majority cases were gram-positive organism cultured were methicillin-sensitive Staphylococcus aureus accounts 21%, and methicillin-resistant S. aureus accounts 16%. Common antibiotics administered were Cloxacillin in 23 cases, Meropenem in 11 cases, Septran in 8 cases, Linezolid in 8 cases, and Vancomycin in 7 cases. The mean duration of antibiotics administered was 6 weeks. At 1 year postoperative, ASAMI showed a reduction in the number of patients categorized as 'fair' from 12 to 9, while the number of patients classified as 'good' increased from 2 to 6 cases. Fourteen (66.6%) patients who were initially classified under the 'fair' or 'poor' category preoperatively decreased to 9 (42.8%) postoperatively. The number of patients in the 'good' category increased from 6 (28%) preoperatively to 9 (42.9%) at the 6-month postoperative mark. Of the 61 patients, 42 (64.6%) had significant functional improvement at 1 year postoperative among those who had chronic osteomyelitis, while of the 34 patients, 15 (44.1%) patients with infected non-union had significant functional improvement (P = 0.04). 20.7% out of 77 patients who were culture positive went on to have relapse within 1 year follow-up and 15% out of the 20 patients who had no-growth on intraoperative cultures went on to develop relapse following one year post surgery follow-up. Nine patients (24.3%) in the posttraumatic group had recurrence of infection, while 1 patient had relapse at 6 months following surgery. At the 6-month follow-up, the percentage of relapse was 13.3% (n = 2) in the MRI group and 25% (n = 8) in the non-MRI group. Conclusion: The relapse rate was 19.8%. In total, 19.3% of surgical debridement had experienced a recurrence of infection within the first year of follow-up, and 7.3% of patients required repeat surgery during the hospital stay. Factors that determined recurrence were age > 55 years, long bone involvement, fracture, monotherapy, receiving < 6 weeks of antibiotics, and inadequate treatment. Disease burden, financial conflicts, disability, and long duration of treatment affect the patient’s emotional status. These factors may also affect the patient's compliance with the prescribed treatment plan.
Background: Changes in menstrual bleeding in the context of hormonal changes may explain why repo... more Background: Changes in menstrual bleeding in the context of hormonal changes may explain why reports on this phenomenon were published globally during the COVID-19 vaccination period. This study was designed to investigate the relationship between the injection of COVID-19 vaccines, abnormal uterine bleeding (AUB), and hormonal disorders in women of reproductive age who were referred to Sayad Shirazi Hospital in Gorgan (Iran) in 2023. Methods: This cross-sectional study was conducted on patients referred to the Gynecology Center of Sayad Shirazi Hospital (Gorgan). The census method was used for collecting data, and the data of 114 women of reproductive age information who had received at least 1 dose of the COVID-19 vaccine were collected by a questionnaire and analysis of requested tests and their registration and analyzed in SPSS v. 16. Chi-square, independent t-test, and analysis of variance were used, and the significance level was <0.05. Results: In this study, 114 women with an average age of 41.12 years met the inclusion criteria; 27 women had previous abnormal bleeding patterns, which had a clear change in the bleeding process, and the rest had a regular cycle with AUB. Three types of vaccines were used by the women; AstraZeneca had the most side effects, followed by Sinopharm. The participants showed abnormal bleeding during the first year, although in most women, it had started in the first 6 months. COVID-19 vaccination showed a significant relationship with the change in the bleeding process (P=049). Coagulation disorders and partial thromboplastin time (PTT) of more than 35 did not show a significant relationship between disorders, specific hormones, and AUB (P=0.269). However, the presence of hormonal disorders with AUB, despite increased PTT, had a significant relationship with AUB (P=0.011). Conclusion: The results indicated a significant relationship between the injection of vaccines and the occurrence of AUB regardless of hormonal disorders and coagulation disorders, which were more likely to occur in a wider time frame (6 months or more). The results also demonstrated that these side effects were expected among people who receive the vaccine; for health care workers, on the other hand, trying to correct and prevent more side effects. Although different types of vaccines can cause different effects, their long-term effects should be considered, especially in women with the possibility of hormonal changes and abnormal bleeding, and the use of vaccines with fewer complications is recommended.
Background: Breast cancer is one of the most common and deadly cancers among women, which imposes... more Background: Breast cancer is one of the most common and deadly cancers among women, which imposes heavy medical costs. Recurrence, side effects, the lack of a clear preventive plan, and increasing incidence are the other related concerns. This study aimed to review the prevention of breast cancer in Iranian medicine (IM) compared to conventional medicine. Methods: This review study was carried out for the last 21 years (2001-2022) using specific keywords related to breast cancer prevention and then compared to the most famous IM manuscripts. Results: Iranian medicine has special views on preventive plans by introducing the risk factors of diseases. Some known risk factors of breast cancer in IM are constipation, obesity, menses retention, irregular night sleep, low physical exertion, and improper diet. Proven risk factors of breast cancer, including improper lifestyle, western diet, obesity, physical inactivity, delayed childbearing, fewer children, and shorter duration of breastfeeding, are in line with IM evidence. Conclusion: Considering the importance of disease prevention from the perspective of IM, providing the right lifestyle, and introducing the 6 essential principles for health maintenance from the perspective of this medical school may play an important role in preventing breast diseases.
Background: Psychological stress (PS) disrupts the gut microbiome, accelerates cognitive decline,... more Background: Psychological stress (PS) disrupts the gut microbiome, accelerates cognitive decline, and causes a predisposition to certain neurodegenerative diseases. This study was designed to test the hypothesis that the administration of probiotics has beneficial effects on the neurohistology and neurochemistry of the hippocampus following exposure to psychological stress (PS). Methods: Thirty-five adult male Wistar rats weighing 180±5g were randomly assigned to seven groups (n=5) comprising the control, acute PS, acute probiotic treatment (probio), acute PS+probio, chronic PS, chronic probio, and chronic PS+probio groups. Acute stress and chronic PS or probio treatment lasted seven and 14 days, respectively. Each animal in the probio groups was fed 10×106 colony-forming units of lactobacillus acidophilus every other day. In contrast, the PS groups were exposed to predator stress for one hour between 7-10 am daily. The treatments lasted for 14 days. Following euthanasia, blood and hippocampal samples were collected for histology, and ELISA-based assays of interleukin-1β (1IL-1β), Tumor Necrosis Factor-α (TNF-α), dopamine, serotonin, malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), and reduced glutathione (GSH). Results: Data analysis reveals that acute and chronic psychological stress significantly depresses hippocampal serotonin and dopamine levels, induces the overexpression of IL-1β and TNF-α, and causes increased lipid peroxidation and impaired antioxidant parameters. The probiotics groups exhibited statistically better results on all parameters assessed, including bringing hippocampal IL-1β and TNF-α levels toward normal. No obvious histoarchitectural damages were observed in any group. Conclusion: Overall, this study suggests that the gut microbiome might play a significant role in hippocampal function as supplementing it mitigates stress-induced perturbations of hippocampal neurochemistry and redox status.
Journal of Clinical and Basic Research (JCBR), 2023
Background: The liver plays an important role in homeostasis. Chronic liver diseases (CLDs), incl... more Background: The liver plays an important role in homeostasis. Chronic liver diseases (CLDs), including cirrhosis, hepatic failure, jaundice, and portal hypertension, may affect hemopoiesis. The abnormalities in red blood cells (RBC), white blood cells (WBC), and platelet functions in patients with CLD are well-documented. It is thus important to detect and manage these abnormalities to reduce the overall morbidity and mortality of patients with CLD. Aims: The study was conducted to assess the hematological abnormalities and hemostatic derangements and the nature of hematological abnormalities to reduce morbidity. Broadly, the hematological abnormalities are viewed under abnormalities in RBCs, WBCs, platelets, and the coagulation profile. Methods: This was a prospective study conducted for 2 years at the Department of General Medicine, Al Ameen Medical College, Bijapur, Karnataka. A total of 150 patients with CLD were included and analyzed for hematological dysfunction. Results: Severe anemia (<6g/dL) was noted in 9.33% of the cases; 22% of the cases had 6.1 to 8 g/dL Hb (hemoglobin) levels; 38% cases showed Hb of 8.1 to 10 g/dL; and >10 g/dL HB was noted in 45% cases. The majority showed normocytic normochromic anemia on peripheral smear examination, i.e., 56%. Macrocytic anemia was noted in 25.3% of cases. Microcytic hypochromic anemia was found in 38% of the cases. Only 4.67% showed dimorphic anemia. Besides, 66.6% of cases had a WBC count of 4000-11000/cumm, 26.6% had 2000-4000/cumm, 6.67% had < 2000/cumm, and 59% cases had >1 .0 lakh /cumm. In 66.67% of cases,1 lakh – 50000 (mild thrombocytopenia) was noted in 25.3% of cases. Moreover, 6.6% had moderate thrombocytopenia, and 1.3% < 20000 /cumm (severe thrombocytopenia). Conclusion: This study demonstrated that all the patients presented with signs of CLD must be thoroughly evaluated for their complete blood profile to detect hematological abnormalities and should be monitored for any complications. Early initiation of treatment can decrease the overall mortality in these patients.
Journal of Clinical and Basic Research (JCBR), 2023
Background: This study was designed to analyze the efficacy of a urine dipstick to detect urinary... more Background: This study was designed to analyze the efficacy of a urine dipstick to detect urinary tract infection (UTI) in children and to correlate it with the urine culture. Methods: A prospective laboratory descriptive study was conducted at the Department of Pediatrics at Government General Hospital, Kadapa, from February 2022 to September 2023. Urine samples from 250 children of 2 and 12 years of age with UTI symptoms were analyzed using urine dipstick and other clinical/laboratory variables. Results: The urine culture was positive in 38.4% (n=96) of the children and negative in 61.6% (n=154) of the children using the dipstick. Urinary tract infection was more common among female than male children. It was common in children aged 6 to 10 years, accounting for 41.42%. The most prevalent organism isolated was Escherichia coli (24.8%), followed by Klebsiella (8.8%) and other Gram-negative bacilli (5.6%). Urine microscopy for pus cells revealed that 158 (63.2%) samples had no pus cells, 49 (19.6%) had up to 5 pus cells, 35 (14%) had 5-10 pus cells, and 8 (3.2%) had >10 pus cells. Pyuria was found in 56 of the 96 children in the culture-positive group, leukocyte esterase was positive in 123 cases, leukocyte esterase was negative in 88 cases, and the nitrite test was positive in 9 cases. However, the combined dipstick was positive in 121 (48.4%) of all cases. Among the culture-positive group, the combined dipstick was positive in 39 cases and negative in 3 cases. Among the culture-negative cases, the combined dipstick was positive in 28 cases and negative in 126 cases. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of leucocyte esterase and nitrite were 65%, 80%, 69%, and 78% for diagnosing UTI in our study, respectively. The sensitivity, specificity, PPV, and NPV of the combined dipstick compared with urine culture were 95.5%, 80%, 74.9%, and 95.9%, respectively. Conclusion: The combined dipstick + nitrite and leukocyte esterase show higher sensitivity and specificity, making it superior to leukocyte esterase or nitrite alone in diagnosing UTI. When compared to the urine culture, the combined dipstick has higher sensitivity, specificity, and positive and negative predictive values. Therefore, the combined dipstick can be used consistently as a quick screening tool for UTIs when culture facilities are not available.
Journal of Clinical and Basic Research (JCBR), 2023
Background: This study aimed to establish the suitability and acceptability of the curricular cha... more Background: This study aimed to establish the suitability and acceptability of the curricular changes in the subject of anesthesia introduced by competency-based medical education (CBME) for undergraduate medical students. Methods: The sample consisted of 20 subject experts from different teaching institutes who were actively involved in teaching undergraduate medical students and had at least 10 years of teaching experience. The study was conducted in 3 rounds using the Delphi technique. Results: These subject experts identified the topics relevant and important to undergraduate students and also suggested the addition of role-play videos and simulations with some interesting and daring scenarios, case studies, and sessions for regional anesthesia competency. There were suggestions to include topics such as ensuring asepsis during regional anesthesia and visits to the intensive care unit (ICU). The majority of the participants were satisfied with the assessment methods. Two-thirds of the experts agreed that the anesthesia curriculum accurately covers the skills required for an Indian medical graduate. Moreover, 80% of the participants agreed that the suggested curriculum is complete and adequate for the undergraduates. Conclusion: Curricular changes introduced by CBME seem to be aligned with the goal of preparing globally relevant and socially accountable undergraduate medical students.
Journal of Clinical and Basic Research (JCBR), 2023
Background: Using molecular biomarkers of breast cancer (BC) receives optimal treatment. Establis... more Background: Using molecular biomarkers of breast cancer (BC) receives optimal treatment. Established biomarkers like estrogen receptor (ER), progesterone receptor (PR), HER2, and Ki67 may play significant roles in the sub-categorization of BC to predict the prognosis and specific therapy for each patient. This study aims to characterize breast carcinoma using molecular markers (ER, PR, and HER2 neu), identify their sub-types, and attain its relation with Ki67. Methods: This cross-sectional (retrospective) study was conducted over four years at the Department of Pathology, SVS Medical College, Mahabubnagar, from April 2018 to March 2022. Fifty diagnosed cases of breast carcinomas were subjected to routine staining and immunohistochemistry (IHC) with ER, PR, HER 2 neu, and Ki67 using tissue microarray and classified into molecular subtypes. Results: In this study, 32% of participants were in the 50-59 age group. The right breast was involved in 52% of participants. The central quadrant was involved in 44%, UOQ 32%, UIQ 16%, and LOQ 8%. Moderately differentiated tumors exist in 40%, poorly differentiated in 36%, and well-differentiated in 24%. 84% of patients were ER-positive, 70% were PR-positive, and 72% were HER2/neu-positive. 28% of patients with positive Ki-67 were grade I, 22% were grade II, and 50% were grade III. Her2/neu contributed to 12% and triple-negative BC seen in 4%. The association between the ER status and Ki-67 positivity status is not statistically significant, with a P-value of 0.13. The association between the PR status and Ki-67 positivity status is statistically significant, with a P-value of 0.002. The association between the Her2/neu status and Ki-67 positivity status is also statistically significant, with a P-value of <0.0001. Conclusion: Most cases were Ki67 positive and HER2 neu positive. Triple-negative cases showed a high Ki67 index. Ki67 plays a pivotal role in making treatment decisions. The Ki67 index is independent and can be used independently without being correlated with other indices, and Ki67 should be evaluated routinely in breast carcinoma cases.
Journal of Clinical and Basic Research (JCBR), 2023
Background: The coronavirus disease 2019 (COVID-19) can have a variety of effects on pregnant wom... more Background: The coronavirus disease 2019 (COVID-19) can have a variety of effects on pregnant women, from mild symptoms to severe complications. Those with underlying medical conditions are at an increased risk for severe disease and adverse pregnancy outcomes. This study was designed to investigate the maternal and neonatal outcomes of pregnant mothers infected with COVID-19 who were referred to Sayad Shirazi Hospital, Gorgan (Iran), in 2019-2022. Methods: This cross-sectional study was conducted on 160 pregnant women. The women who had just given birth were either suspected of having coronavirus or had a definite diagnosis of coronavirus either during hospitalization or during hospitalization who were included by the simple census. The data were collected from medical records and through telephone interviews. The chi-square test was used to compare categorical variables between the groups. The qualitative data were evaluated with quantitative variables by the analysis of variance. The significance level was less than 0.05. Results: The difference in the access of minorities to medical and health service centers affected the pregnancy results (P=019 (. A high rate of Cesarean delivery (58.1%), a high prevalence of gestational diabetes (19.3%) and hypothyroidism (21.2%), and the need for high insulin injections during the COVID-19 infection (39.37%) were also found, which were independent of the patients. Diabetes and previous gestational diabetes showed high statistics. Conclusion: This study demonstrated a high concentration in people with hypothyroidism and patients who need insulin due to hyperglycemia after contracting COVID-19 during pregnancy. According to this study, contracting COVID-19 increases the level of maternal and fetal problems, and women with hypothyroidism should be considered as a risk factor for contracting this disease and having a more serious condition, hyperglycemia, and the need for insulin, except for the remaining complications of this disease is expected.
Journal of Clinical and Basic Research (JCBR), 2023
Background: Infertility is an important issue for couples that may cause various psychological an... more Background: Infertility is an important issue for couples that may cause various psychological and emotional problems. Female infertility disorders play a major role in approximately 50-80% of the causes of infertility in various areas in Nigeria. Moringa oleifera has been proposed as a plant with female fertility enhancement effects. The objective of this study was to assess the fertility-improving effects of ethanol extract of M. oleifera leaf and to determine the phytochemical components causing these effects by in silico analyses. Methods: The in vitro effects on fertility were evaluated using Drosophila melanogaster (fruit fly) because of its genetic similarities to humans. The copulation duration, mating latency, and the number of emergences from the fruit fly after mating were determined. Three doses (0.025%, 0.05%, and 0.1% w/w) of the M. oleifera ethanol extract were administered to three different groups, while a control group only received feed mixed with ethanol. For in silico studies, 62 compounds were obtained from the PubChem library by mining compounds from articles related to M. oleifera. Next, a ligand library was generated and docked against various targets of interest (estrogen, progesterone, kisspeptin, liver X, PPARG, and 15-PGDH receptors as well as 17β hydroxysteroid dehydrogenase and insulin-degrading enzymes) which have female fertility-enhancing effects. Results: The in vivo experiments showed that M. oleifera had no effect on copulation duration and mating latency, but interestingly, it enhanced the fertility/emergence of the treated fruit flies. In silico studies suggested that phytochemicals such as rutin, marumoside B, myricetin, and quercetin showed docking scores that may well support previous works on M. oleifera enhancement of female fertility. Conclusion: The results showed that M. oleifera can enhance fertility in female fruit flies.
Background: Umbilicus visceral manipulation is an effective medical practice in the treatment of ... more Background: Umbilicus visceral manipulation is an effective medical practice in the treatment of a wide range of diseases, including abdominal pain, as described in traditional Persian medicine (TPM) texts. Case description: A 35-year-old married female (G2P2Ab0L2NVD2) from Gorgan, Iran, presented to the TPM health care center affiliated with Golestan University of Medical Sciences on February 21, 2022, due to abdominal pain, obesity, and increased appetite. Conclusion: Tailoring the treatment to the individual characteristics of the client and incorporating TPM measures, such as manual procedures, in conjunction with modern medicine, can play a crucial role in the overall treatment process.
Background: Traumatic brain injury (TBI) is a significant medical concern, with post-traumatic ep... more Background: Traumatic brain injury (TBI) is a significant medical concern, with post-traumatic epilepsy (PTE) being one of its consequences. Epilepsy, with a global prevalence of 1%, is the third most common neurological disorder after stroke and Alzheimer’s disease. Trauma accounts for 20% of symptomatic epilepsy cases. Understanding the prevalence of PTE and the factors influencing it can aid in diagnosis and treatment. This study aims to investigate the relationship between epilepsy prevalence, age, gender, and post-traumatic brain injuries. Methods: This retrospective descriptive study analyzed data from 135 epilepsy patients hospitalized between 2018 and 2021. Statistical analysis involved reviewing relevant data and creating tables and graphs. Results: The findings indicate that epilepsy is more prevalent in men than in women, with the most affected age group being 20-29 years old. Post-traumatic epilepsy emerged as the most common factor among the patients. The prevalence of PTE in this study was 9.6%, closely aligning with the global rate of 7.8%. Conclusion: The prevalence of post-traumatic epilepsy is significantly influenced by geographical conditions and living environments. In developing countries, the high volume of road traffic and increased accident rates contribute to a higher incidence of post-traumatic epilepsy.
Background: Many environmental chemicals are implicated in causing serious adverse health effects... more Background: Many environmental chemicals are implicated in causing serious adverse health effects on the reproductive system. Some medicinal plants taken traditionally for different ailments are particularly toxic to the reproductive organs. This study was undertaken to evaluate the reproductive toxicity of the ethanol leaf extract of Panicum maximum on adult male rats. Methods: The leaves were randomly collected. Ground and powdered leaves were extracted by cold maceration using ethanol. Sixteen adult male rats (130-200 g) were divided into 4 groups. The negative control group (group I) was given 10 mL/kg distilled water, while Group II-IV received 50, 100, and 200 mg/kg of Panicum maximum leaf extract for 21 days. The animals were sacrificed and analyzed for some reproductive parameters at the end of the 21 days. Results: There was a decrease in the body weight of the rats, as well as the testis at 200 mg/kg when compared to the control within the treatment period. Sperm analysis showed a significant decrease in normal sperm cells, sperm variability, active sperm cells, and sperm count in all groups given Panicum maximum leaf extract. There was a significant increase in abnormal and dead sperm cells. Hormonal analysis showed a decrease in follicle-stimulating hormone (FSH) and testosterone (TST) levels, which was significant. The histology of the testis also indicated toxicity of the extract, and it was dose-dependent. Conclusion: Ethanol leaf extract of Panicum maximum is relatively toxic to the male reproductive system.
Background: The prevalence of skin diseases varies geographically due to factors, such as etiolog... more Background: The prevalence of skin diseases varies geographically due to factors, such as etiology, environment, genetics, and lifestyle. The current study aimed to determine the incidence and distribution of skin disorders and to provide a description of the histomorphological spectrum. Methods: This retrospective study was conducted over a period of two years, from June 2021 to May 2023. A total of 202 skin biopsy samples were evaluated. The histopathological examination of the lesions categorized them into eight groups based on the site, pattern of involvement, and cytological features, according to the Lever’s Histopathology of the Skin. Group 1 consisted of diseases limited to the epidermis and stratum corneum; group 2 consisted of diseases with localized superficial epidermal or melanocytic proliferation; group 3 consisted of diseases of the superficial cutaneous reactive unit; group 4 included diseases with acantholytic, vesicular, and pustular morphology; group 5 included diseases with perivascular, diffuse, and granulomatous infiltrate of the reticular dermis; group 6 included tumors and cysts of the dermis and subcutis; group 7 consisted of inflammatory disorders of skin appendages; and group 8 consisted of disorders of the subcutis. Results: A total of 202 skin biopsies were collected from individuals aged 8-87 years. The majority of the cases belonged to the age group of 31-40 years. The male-to-female ratio was 1.2:1. The trunk was the most common site of biopsy, accounting for 40% of the cases, followed by the upper limb in 25% of the cases. Histopathological lesions were categorized into eight groups based on the site, pattern, and cytological features. Neoplastic lesions, both benign and malignant, accounted for 10.9% of the cases. The majority of the lesions were related to group 6, accounting for 38.1% of the cases, with the epidermal cyst being the most common lesion (7.92%). Basal cell carcinoma, observed in 2.97% of the cases, was the most common lesion among the neoplastic lesions. Group 5 lesions were the third most common (19.8%), with leprosy accounting for 9.4% of these cases. Conclusion: Histopathological examination of skin biopsies is considered the gold standard for diagnosis, and it is often supported by ancillary techniques. Leprosy was the most common disease identified in this study, which underscores the importance of effective preventive measures for control.
Background: There is currently a scarcity of population-based records related to the prevalence o... more Background: There is currently a scarcity of population-based records related to the prevalence of gestational diabetes mellitus (GDM) in India. There were various recommendations for screening and diagnostic tests for GDM, and no uniform standard has yet been established. Hence, a comparative study was conducted to assess the usefulness of the glucose challenge test (GCT) and fasting blood glucose (FBG)/post-prandial blood glucose (PPBG) test for the screening of GDM in pregnant women attending the prenatal clinic outpatient department. Methods: This is a comparative observational study involving 300 apparently normal pregnant who were randomly allocated to GCT and FBG/PPBG cohorts of 150 each. The tests were performed at 4 intervals: 8 to 10 weeks, 16 to 20 weeks, 24 to 28 weeks, and 32 to 36 weeks. All diagnosed GDM cases were appropriately handled. Results: Gestational diabetes mellitus was seen in 2.67% of the FBG/PPBG cohort and 5.34% of the GCT cohort. The GCT test identified 25% of GDM subjects before 24 weeks of gestation, 50% in 24 and 28 weeks, and 25% in > 32 weeks of gestation. The highest prevalence of GDM was noted in the 26–30-year age group. The highest prevalence of GDM was noted in pregnant women with ≥ 26 kg/m2 of body mass index (BMI), with 75% in the FBG/PPBG group and 62.5% in the GCT group. The incidence of GDM was higher in primigravida, 75% in the FBG/PPBG group, and 50% in the GCT group. A higher prevalence was observed in pregnant women of class 4 of socioeconomic status, and it was 75% in the FBG/PPBG group and 75% in the GCT group. A higher prevalence was noted in those with higher secondary education. The majority of GDM cases gave birth at term by labor, and there were no assisted vaginal births in this group. Moreover, 75% of GDM cases in the FBG/PPBG cohort and 62.5% of GDM cases in the GCT cohort had Caesarean section. Besides, 50% of infants from GDM mothers in the FBG/PPBG cohort were hospitalized, while 12.75% were admitted in the GCT cohort. The birth weight of neonates from GDM mothers was 3.09 ± 0.5 kg, 3.11 ± 0.6 kg in normal mothers, 2.98 ± 0.6 kg in the FBG/PPBG cohort, and 2.9 ± 0.5 kg in the GCT cohort. Conclusion: Irrespective of the last meal, the GCT in all pregnant women is an effective and easy screening approach for 1-step screening for the early diagnosis of GDM for subsequent management at the early gestational pregnancy, which can minimize the adverse obstetric and perinatal outcomes.
Background: Non-secretory multiple myeloma is a sporadic type of multiple myeloma with the prolif... more Background: Non-secretory multiple myeloma is a sporadic type of multiple myeloma with the proliferation of monoclonal plasmocytes in the bone marrow that cannot secrete or synthesize immunoglobulins. Its prevalence as a hematologic malignancy is low, and it is usually diagnosed by demonstration of monoclonal plasma cells ≥ 10% in the bone marrow with negative results on serum and urine electrophoresis and immunofixation studies. Methods: We present a case report where the patient's serum and whole blood samples were received in the study laboratory to evaluate the complete hemogram and metabolic profile. The metabolic and hematological profiles were deranged, subsequent to which the patient's clinical history was obtained from the treating clinician. It was discovered that the patient had presented with long-term weakness and back ache and was advised routine investigations along with magnetic resonance imaging (MRI) of the spine, which revealed the presence of osteolytic lesions. Following this, a gammopathy panel was requested. Results: Serum protein capillary electrophoresis and immunofixation electrophoresis revealed a normal pattern without any noticeable bands, distortions, or suspicious regions. However, the findings of the comprehensive gammopathy panel were suggestive of non-secretory multiple myeloma. Conclusion: In the absence of a detailed and meticulous work-up, a case of non-secretory multiple myeloma can be easily misdiagnosed. Here, we discuss the case in detail, the diagnostic pitfalls associated with it, and the role of serum free light chain assays in its diagnosis.
Background: Overconsumption of high-calorie foods not only causes obesity and metabolic disorders... more Background: Overconsumption of high-calorie foods not only causes obesity and metabolic disorders but also affects some activities of the nervous system, such as cognitive processes. The present study aimed to investigate the effect of a cafeteria diet from post-weaning to adolescence on the cognitive performance of rats. Methods: Pregnant Wistar rats were fed a normal diet and water from the day of delivery to 20 days postpartum. Male offspring were then assigned to one of 3 groups: a cafeteria diet (sausages, cakes, raisin cookies, carrots, white milk chocolate, and chocolate milk) (CAF), a cafeteria diet with simvastatin (CAF-S), or a control group (CTRL). After the treatments were completed, the cognitive performance of the rats was evaluated using the Morris water maze test. Results: The CAF group showed reduced learning compared to the other two groups, and they took longer to find the hidden platform on all days of the experiment (P ≤ 0.001). The CAF-S group, which received simvastatin at a dose of 50 mg/kg, had a significantly shorter time to find the hidden platform compared to the CAF group (P ≤ 0.05). During the memory recall phase, after removing the platform, the CAF-S group spent less time in the target quadrant compared to the CTRL and CAF-S groups (P ≤ 0.05). Conclusion: The results indicated that the cafeteria diet decreased the rats' learning and long-term memory. This effect is likely due to the high-fat content in the cafeteria diet. However, simvastatin prevented this decrease in the rats fed a cafeteria diet. These findings suggest that interventions targeting the metabolic pathways affected by a cafeteria diet may have potential therapeutic benefits for cognitive disorders.
Background: The literal meaning of halal is "permissible" in Arabic, which refers to a mandatory ... more Background: The literal meaning of halal is "permissible" in Arabic, which refers to a mandatory set of dietary guidelines and Islamic law principles. Halal food is made following the Islamic dietary regulations, ensuring specific standards of cleanliness, hygiene, animal welfare, and the prohibition of the inclusion of harmful chemicals. The emphasis on cleanliness, animal welfare, prohibition of harmful substances, nutritional value, and ethical sourcing contributes to a healthier and more sustainable food system. Methods: An extensive online literature search for articles was performed using various search engines and databases with keywords halal food, food hygiene, and Islamic dietary principles. The reference lists of all the retrieved publications were also explored. Results: Our search was limited to English articles that seemed relevant to this review, and the draft was prepared. Conclusion: The health benefits of halal eating extend beyond religious grounds. Halal food consumption provides a safer option and minimizes the potential for food contamination and the associated health risks. By adhering to halal dietary guidelines, individuals can make conscious choices that promote their well-being while fostering a sense of responsibility towards animals, the environment, and the community at large. Halal food offers a holistic approach to nutrition and health, providing safer, balanced, and ethical food choices.
Background: Hepatic veins, which are a link between portal and systemic circulation, traverse the... more Background: Hepatic veins, which are a link between portal and systemic circulation, traverse the liver substance and drain different segments into the inferior vena cava (IVC). This venous outflow is important for adequate functioning of liver homeostasis. The knowledge of the variations in the number and pattern of openings of the hepatic veins into the floor of IVC is necessary, especially during liver resection and liver transplantation, particularly to decide the method that would be adopted for these aforesaid procedures. Methods: A total of 84 livers present in the Department of Anatomy, Goa Medical College, Goa, were used, from which 9 were excluded. The livers were formalin-fixed and were obtained from donated cadavers. The posterior wall of a retro-hepatic segment of IVC was incised to examine the count of hepatic venous vasculature and the pattern of their openings. Results: The number of hepatic vein openings ranged from 3 to 8. The majority of the livers (32%) had 6 openings. The incidence of the right major hepatic vein was 97.3%, the middle major hepatic vein was 73.3%, and the left major hepatic venous vasculature was 86.6%. The majority of the specimens (n = 25) showed a double opening pattern with 1 separate opening for the hepatic vein of the right side and the middle and left hepatic vein opened by a single trunk. Conclusion: Hepatic venous vasculature showed numerous variations in its draining pattern in the IVC. Understanding these variations is important for hepatic surgeries to improve post-operative outcomes.
Background: Neurodegenerative diseases (NDDs) cause progressive neuronal loss, resulting in morbi... more Background: Neurodegenerative diseases (NDDs) cause progressive neuronal loss, resulting in morbidity and mortality. Research is continued on treatment strategies that can tackle the disease's pathophysiology and cease its progression. Considering the anti-apoptotic and neuroprotective properties of apelin, we hypothesized that apelin-13 could be a therapeutic solution for Alzheimer's disease and similar NDDs. Therefore, we evaluated its effect on scopolamine-treated rats. Methods: Male rats (n=40) were assigned to 5 groups of 8. No intervention was considered for the control group. The scopolamine group received stereotaxic surgery and was treated with 3 mg/kg scopolamine intraperitoneally. The treatment groups were treated with scopolamine plus intraventricular injection of apelin-13 (1.25, 2.5, and 5 µg) into the right lateral ventricles for 7 days. For evaluating the memory impairment, the passive avoidance reactions of the animals, except the control group, were assessed 24 hours following the last injection. Regarding histological analysis, Congo red staining of the hippocampal sections was done, and immunoblotting was used to determine apoptotic biochemical markers, including caspase 3, cytochrome C, and congophilic amyloid-beta plaques. Results: Apelin–13 alleviated scopolamine-related passive avoidance memory impairment and reduced the number of congophilic amyloid-beta plaques in the hippocampus (all P<0.001). It attenuated the decrease in the mean levels of hippocampal apoptotic proteins (caspase 3, cytochrome C) in animals treated with scopolamine (all P<0.05). Conclusion: The neuroprotective effects of apelin-13 suggest its therapeutic effect on neurodegenerative disorders.
Background: This study analyzed the rate of relapse and functional outcome after surgery for chro... more Background: This study analyzed the rate of relapse and functional outcome after surgery for chronic osteomyelitis of long bones. Methods: This study included 100 cases of chronic osteomyelitis, which were treated with surgical debridement, along with a 6-week course of antibiotics. The patients were divided into two groups based on whether they had undergone preoperative magnetic resonance imaging (MRI) or not. A comparison of relapse rates was then conducted between these two groups. The patients were followed up, and their functional outcomes were examined using the Association for the Study and Application of the Method of Ilizarov Criteria (ASAMI), Lower Extremity Functional Scale (LEFS), Disabilities of the Arm, Shoulder, and Hand (DASH), and Musculoskeletal Tumor Society (MSTS) questionnaires. Logistic regression analysis was used to assess the impact of risk factors on the recurrence or relapse. Results: Sixty patients had chronic osteomyelitis, and 40 patients were infected non-union. Twenty-five patients had preoperative MRI. The mean preoperative LEFS was 44 ± 13.59 (19-73). Preoperative ASAMI showed 4% excellent, 62% fair, 24% good, and 10% were poor. The preoperative MSTS emotional component showed that enthusiastic (0%), satisfied (0%), accepts (36%), and dislikes (60%). Among the infected non-union cases, 2 cases had a total disability, 15 cases had recreational restriction, and 23 cases had a partial disability. Majority cases were gram-positive organism cultured were methicillin-sensitive Staphylococcus aureus accounts 21%, and methicillin-resistant S. aureus accounts 16%. Common antibiotics administered were Cloxacillin in 23 cases, Meropenem in 11 cases, Septran in 8 cases, Linezolid in 8 cases, and Vancomycin in 7 cases. The mean duration of antibiotics administered was 6 weeks. At 1 year postoperative, ASAMI showed a reduction in the number of patients categorized as 'fair' from 12 to 9, while the number of patients classified as 'good' increased from 2 to 6 cases. Fourteen (66.6%) patients who were initially classified under the 'fair' or 'poor' category preoperatively decreased to 9 (42.8%) postoperatively. The number of patients in the 'good' category increased from 6 (28%) preoperatively to 9 (42.9%) at the 6-month postoperative mark. Of the 61 patients, 42 (64.6%) had significant functional improvement at 1 year postoperative among those who had chronic osteomyelitis, while of the 34 patients, 15 (44.1%) patients with infected non-union had significant functional improvement (P = 0.04). 20.7% out of 77 patients who were culture positive went on to have relapse within 1 year follow-up and 15% out of the 20 patients who had no-growth on intraoperative cultures went on to develop relapse following one year post surgery follow-up. Nine patients (24.3%) in the posttraumatic group had recurrence of infection, while 1 patient had relapse at 6 months following surgery. At the 6-month follow-up, the percentage of relapse was 13.3% (n = 2) in the MRI group and 25% (n = 8) in the non-MRI group. Conclusion: The relapse rate was 19.8%. In total, 19.3% of surgical debridement had experienced a recurrence of infection within the first year of follow-up, and 7.3% of patients required repeat surgery during the hospital stay. Factors that determined recurrence were age > 55 years, long bone involvement, fracture, monotherapy, receiving < 6 weeks of antibiotics, and inadequate treatment. Disease burden, financial conflicts, disability, and long duration of treatment affect the patient’s emotional status. These factors may also affect the patient's compliance with the prescribed treatment plan.
Background: Changes in menstrual bleeding in the context of hormonal changes may explain why repo... more Background: Changes in menstrual bleeding in the context of hormonal changes may explain why reports on this phenomenon were published globally during the COVID-19 vaccination period. This study was designed to investigate the relationship between the injection of COVID-19 vaccines, abnormal uterine bleeding (AUB), and hormonal disorders in women of reproductive age who were referred to Sayad Shirazi Hospital in Gorgan (Iran) in 2023. Methods: This cross-sectional study was conducted on patients referred to the Gynecology Center of Sayad Shirazi Hospital (Gorgan). The census method was used for collecting data, and the data of 114 women of reproductive age information who had received at least 1 dose of the COVID-19 vaccine were collected by a questionnaire and analysis of requested tests and their registration and analyzed in SPSS v. 16. Chi-square, independent t-test, and analysis of variance were used, and the significance level was <0.05. Results: In this study, 114 women with an average age of 41.12 years met the inclusion criteria; 27 women had previous abnormal bleeding patterns, which had a clear change in the bleeding process, and the rest had a regular cycle with AUB. Three types of vaccines were used by the women; AstraZeneca had the most side effects, followed by Sinopharm. The participants showed abnormal bleeding during the first year, although in most women, it had started in the first 6 months. COVID-19 vaccination showed a significant relationship with the change in the bleeding process (P=049). Coagulation disorders and partial thromboplastin time (PTT) of more than 35 did not show a significant relationship between disorders, specific hormones, and AUB (P=0.269). However, the presence of hormonal disorders with AUB, despite increased PTT, had a significant relationship with AUB (P=0.011). Conclusion: The results indicated a significant relationship between the injection of vaccines and the occurrence of AUB regardless of hormonal disorders and coagulation disorders, which were more likely to occur in a wider time frame (6 months or more). The results also demonstrated that these side effects were expected among people who receive the vaccine; for health care workers, on the other hand, trying to correct and prevent more side effects. Although different types of vaccines can cause different effects, their long-term effects should be considered, especially in women with the possibility of hormonal changes and abnormal bleeding, and the use of vaccines with fewer complications is recommended.
Background: Breast cancer is one of the most common and deadly cancers among women, which imposes... more Background: Breast cancer is one of the most common and deadly cancers among women, which imposes heavy medical costs. Recurrence, side effects, the lack of a clear preventive plan, and increasing incidence are the other related concerns. This study aimed to review the prevention of breast cancer in Iranian medicine (IM) compared to conventional medicine. Methods: This review study was carried out for the last 21 years (2001-2022) using specific keywords related to breast cancer prevention and then compared to the most famous IM manuscripts. Results: Iranian medicine has special views on preventive plans by introducing the risk factors of diseases. Some known risk factors of breast cancer in IM are constipation, obesity, menses retention, irregular night sleep, low physical exertion, and improper diet. Proven risk factors of breast cancer, including improper lifestyle, western diet, obesity, physical inactivity, delayed childbearing, fewer children, and shorter duration of breastfeeding, are in line with IM evidence. Conclusion: Considering the importance of disease prevention from the perspective of IM, providing the right lifestyle, and introducing the 6 essential principles for health maintenance from the perspective of this medical school may play an important role in preventing breast diseases.
Background: Psychological stress (PS) disrupts the gut microbiome, accelerates cognitive decline,... more Background: Psychological stress (PS) disrupts the gut microbiome, accelerates cognitive decline, and causes a predisposition to certain neurodegenerative diseases. This study was designed to test the hypothesis that the administration of probiotics has beneficial effects on the neurohistology and neurochemistry of the hippocampus following exposure to psychological stress (PS). Methods: Thirty-five adult male Wistar rats weighing 180±5g were randomly assigned to seven groups (n=5) comprising the control, acute PS, acute probiotic treatment (probio), acute PS+probio, chronic PS, chronic probio, and chronic PS+probio groups. Acute stress and chronic PS or probio treatment lasted seven and 14 days, respectively. Each animal in the probio groups was fed 10×106 colony-forming units of lactobacillus acidophilus every other day. In contrast, the PS groups were exposed to predator stress for one hour between 7-10 am daily. The treatments lasted for 14 days. Following euthanasia, blood and hippocampal samples were collected for histology, and ELISA-based assays of interleukin-1β (1IL-1β), Tumor Necrosis Factor-α (TNF-α), dopamine, serotonin, malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), and reduced glutathione (GSH). Results: Data analysis reveals that acute and chronic psychological stress significantly depresses hippocampal serotonin and dopamine levels, induces the overexpression of IL-1β and TNF-α, and causes increased lipid peroxidation and impaired antioxidant parameters. The probiotics groups exhibited statistically better results on all parameters assessed, including bringing hippocampal IL-1β and TNF-α levels toward normal. No obvious histoarchitectural damages were observed in any group. Conclusion: Overall, this study suggests that the gut microbiome might play a significant role in hippocampal function as supplementing it mitigates stress-induced perturbations of hippocampal neurochemistry and redox status.
Journal of Clinical and Basic Research (JCBR), 2023
Background: The liver plays an important role in homeostasis. Chronic liver diseases (CLDs), incl... more Background: The liver plays an important role in homeostasis. Chronic liver diseases (CLDs), including cirrhosis, hepatic failure, jaundice, and portal hypertension, may affect hemopoiesis. The abnormalities in red blood cells (RBC), white blood cells (WBC), and platelet functions in patients with CLD are well-documented. It is thus important to detect and manage these abnormalities to reduce the overall morbidity and mortality of patients with CLD. Aims: The study was conducted to assess the hematological abnormalities and hemostatic derangements and the nature of hematological abnormalities to reduce morbidity. Broadly, the hematological abnormalities are viewed under abnormalities in RBCs, WBCs, platelets, and the coagulation profile. Methods: This was a prospective study conducted for 2 years at the Department of General Medicine, Al Ameen Medical College, Bijapur, Karnataka. A total of 150 patients with CLD were included and analyzed for hematological dysfunction. Results: Severe anemia (<6g/dL) was noted in 9.33% of the cases; 22% of the cases had 6.1 to 8 g/dL Hb (hemoglobin) levels; 38% cases showed Hb of 8.1 to 10 g/dL; and >10 g/dL HB was noted in 45% cases. The majority showed normocytic normochromic anemia on peripheral smear examination, i.e., 56%. Macrocytic anemia was noted in 25.3% of cases. Microcytic hypochromic anemia was found in 38% of the cases. Only 4.67% showed dimorphic anemia. Besides, 66.6% of cases had a WBC count of 4000-11000/cumm, 26.6% had 2000-4000/cumm, 6.67% had < 2000/cumm, and 59% cases had >1 .0 lakh /cumm. In 66.67% of cases,1 lakh – 50000 (mild thrombocytopenia) was noted in 25.3% of cases. Moreover, 6.6% had moderate thrombocytopenia, and 1.3% < 20000 /cumm (severe thrombocytopenia). Conclusion: This study demonstrated that all the patients presented with signs of CLD must be thoroughly evaluated for their complete blood profile to detect hematological abnormalities and should be monitored for any complications. Early initiation of treatment can decrease the overall mortality in these patients.
Journal of Clinical and Basic Research (JCBR), 2023
Background: This study was designed to analyze the efficacy of a urine dipstick to detect urinary... more Background: This study was designed to analyze the efficacy of a urine dipstick to detect urinary tract infection (UTI) in children and to correlate it with the urine culture. Methods: A prospective laboratory descriptive study was conducted at the Department of Pediatrics at Government General Hospital, Kadapa, from February 2022 to September 2023. Urine samples from 250 children of 2 and 12 years of age with UTI symptoms were analyzed using urine dipstick and other clinical/laboratory variables. Results: The urine culture was positive in 38.4% (n=96) of the children and negative in 61.6% (n=154) of the children using the dipstick. Urinary tract infection was more common among female than male children. It was common in children aged 6 to 10 years, accounting for 41.42%. The most prevalent organism isolated was Escherichia coli (24.8%), followed by Klebsiella (8.8%) and other Gram-negative bacilli (5.6%). Urine microscopy for pus cells revealed that 158 (63.2%) samples had no pus cells, 49 (19.6%) had up to 5 pus cells, 35 (14%) had 5-10 pus cells, and 8 (3.2%) had >10 pus cells. Pyuria was found in 56 of the 96 children in the culture-positive group, leukocyte esterase was positive in 123 cases, leukocyte esterase was negative in 88 cases, and the nitrite test was positive in 9 cases. However, the combined dipstick was positive in 121 (48.4%) of all cases. Among the culture-positive group, the combined dipstick was positive in 39 cases and negative in 3 cases. Among the culture-negative cases, the combined dipstick was positive in 28 cases and negative in 126 cases. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of leucocyte esterase and nitrite were 65%, 80%, 69%, and 78% for diagnosing UTI in our study, respectively. The sensitivity, specificity, PPV, and NPV of the combined dipstick compared with urine culture were 95.5%, 80%, 74.9%, and 95.9%, respectively. Conclusion: The combined dipstick + nitrite and leukocyte esterase show higher sensitivity and specificity, making it superior to leukocyte esterase or nitrite alone in diagnosing UTI. When compared to the urine culture, the combined dipstick has higher sensitivity, specificity, and positive and negative predictive values. Therefore, the combined dipstick can be used consistently as a quick screening tool for UTIs when culture facilities are not available.
Journal of Clinical and Basic Research (JCBR), 2023
Background: This study aimed to establish the suitability and acceptability of the curricular cha... more Background: This study aimed to establish the suitability and acceptability of the curricular changes in the subject of anesthesia introduced by competency-based medical education (CBME) for undergraduate medical students. Methods: The sample consisted of 20 subject experts from different teaching institutes who were actively involved in teaching undergraduate medical students and had at least 10 years of teaching experience. The study was conducted in 3 rounds using the Delphi technique. Results: These subject experts identified the topics relevant and important to undergraduate students and also suggested the addition of role-play videos and simulations with some interesting and daring scenarios, case studies, and sessions for regional anesthesia competency. There were suggestions to include topics such as ensuring asepsis during regional anesthesia and visits to the intensive care unit (ICU). The majority of the participants were satisfied with the assessment methods. Two-thirds of the experts agreed that the anesthesia curriculum accurately covers the skills required for an Indian medical graduate. Moreover, 80% of the participants agreed that the suggested curriculum is complete and adequate for the undergraduates. Conclusion: Curricular changes introduced by CBME seem to be aligned with the goal of preparing globally relevant and socially accountable undergraduate medical students.
Journal of Clinical and Basic Research (JCBR), 2023
Background: Using molecular biomarkers of breast cancer (BC) receives optimal treatment. Establis... more Background: Using molecular biomarkers of breast cancer (BC) receives optimal treatment. Established biomarkers like estrogen receptor (ER), progesterone receptor (PR), HER2, and Ki67 may play significant roles in the sub-categorization of BC to predict the prognosis and specific therapy for each patient. This study aims to characterize breast carcinoma using molecular markers (ER, PR, and HER2 neu), identify their sub-types, and attain its relation with Ki67. Methods: This cross-sectional (retrospective) study was conducted over four years at the Department of Pathology, SVS Medical College, Mahabubnagar, from April 2018 to March 2022. Fifty diagnosed cases of breast carcinomas were subjected to routine staining and immunohistochemistry (IHC) with ER, PR, HER 2 neu, and Ki67 using tissue microarray and classified into molecular subtypes. Results: In this study, 32% of participants were in the 50-59 age group. The right breast was involved in 52% of participants. The central quadrant was involved in 44%, UOQ 32%, UIQ 16%, and LOQ 8%. Moderately differentiated tumors exist in 40%, poorly differentiated in 36%, and well-differentiated in 24%. 84% of patients were ER-positive, 70% were PR-positive, and 72% were HER2/neu-positive. 28% of patients with positive Ki-67 were grade I, 22% were grade II, and 50% were grade III. Her2/neu contributed to 12% and triple-negative BC seen in 4%. The association between the ER status and Ki-67 positivity status is not statistically significant, with a P-value of 0.13. The association between the PR status and Ki-67 positivity status is statistically significant, with a P-value of 0.002. The association between the Her2/neu status and Ki-67 positivity status is also statistically significant, with a P-value of <0.0001. Conclusion: Most cases were Ki67 positive and HER2 neu positive. Triple-negative cases showed a high Ki67 index. Ki67 plays a pivotal role in making treatment decisions. The Ki67 index is independent and can be used independently without being correlated with other indices, and Ki67 should be evaluated routinely in breast carcinoma cases.
Journal of Clinical and Basic Research (JCBR), 2023
Background: The coronavirus disease 2019 (COVID-19) can have a variety of effects on pregnant wom... more Background: The coronavirus disease 2019 (COVID-19) can have a variety of effects on pregnant women, from mild symptoms to severe complications. Those with underlying medical conditions are at an increased risk for severe disease and adverse pregnancy outcomes. This study was designed to investigate the maternal and neonatal outcomes of pregnant mothers infected with COVID-19 who were referred to Sayad Shirazi Hospital, Gorgan (Iran), in 2019-2022. Methods: This cross-sectional study was conducted on 160 pregnant women. The women who had just given birth were either suspected of having coronavirus or had a definite diagnosis of coronavirus either during hospitalization or during hospitalization who were included by the simple census. The data were collected from medical records and through telephone interviews. The chi-square test was used to compare categorical variables between the groups. The qualitative data were evaluated with quantitative variables by the analysis of variance. The significance level was less than 0.05. Results: The difference in the access of minorities to medical and health service centers affected the pregnancy results (P=019 (. A high rate of Cesarean delivery (58.1%), a high prevalence of gestational diabetes (19.3%) and hypothyroidism (21.2%), and the need for high insulin injections during the COVID-19 infection (39.37%) were also found, which were independent of the patients. Diabetes and previous gestational diabetes showed high statistics. Conclusion: This study demonstrated a high concentration in people with hypothyroidism and patients who need insulin due to hyperglycemia after contracting COVID-19 during pregnancy. According to this study, contracting COVID-19 increases the level of maternal and fetal problems, and women with hypothyroidism should be considered as a risk factor for contracting this disease and having a more serious condition, hyperglycemia, and the need for insulin, except for the remaining complications of this disease is expected.
Journal of Clinical and Basic Research (JCBR), 2023
Background: Infertility is an important issue for couples that may cause various psychological an... more Background: Infertility is an important issue for couples that may cause various psychological and emotional problems. Female infertility disorders play a major role in approximately 50-80% of the causes of infertility in various areas in Nigeria. Moringa oleifera has been proposed as a plant with female fertility enhancement effects. The objective of this study was to assess the fertility-improving effects of ethanol extract of M. oleifera leaf and to determine the phytochemical components causing these effects by in silico analyses. Methods: The in vitro effects on fertility were evaluated using Drosophila melanogaster (fruit fly) because of its genetic similarities to humans. The copulation duration, mating latency, and the number of emergences from the fruit fly after mating were determined. Three doses (0.025%, 0.05%, and 0.1% w/w) of the M. oleifera ethanol extract were administered to three different groups, while a control group only received feed mixed with ethanol. For in silico studies, 62 compounds were obtained from the PubChem library by mining compounds from articles related to M. oleifera. Next, a ligand library was generated and docked against various targets of interest (estrogen, progesterone, kisspeptin, liver X, PPARG, and 15-PGDH receptors as well as 17β hydroxysteroid dehydrogenase and insulin-degrading enzymes) which have female fertility-enhancing effects. Results: The in vivo experiments showed that M. oleifera had no effect on copulation duration and mating latency, but interestingly, it enhanced the fertility/emergence of the treated fruit flies. In silico studies suggested that phytochemicals such as rutin, marumoside B, myricetin, and quercetin showed docking scores that may well support previous works on M. oleifera enhancement of female fertility. Conclusion: The results showed that M. oleifera can enhance fertility in female fruit flies.
Uploads
Papers by JCBR jcbr
Case description: A 35-year-old married female (G2P2Ab0L2NVD2) from Gorgan, Iran, presented to the TPM health care center affiliated with Golestan University of Medical Sciences on February 21, 2022, due to abdominal pain, obesity, and increased appetite.
Conclusion: Tailoring the treatment to the individual characteristics of the client and incorporating TPM measures, such as manual procedures, in conjunction with modern medicine, can play a crucial role in the overall treatment process.
Methods: This retrospective descriptive study analyzed data from 135 epilepsy patients hospitalized between 2018 and 2021. Statistical analysis involved reviewing relevant data and creating tables and graphs.
Results: The findings indicate that epilepsy is more prevalent in men than in women, with the most affected age group being 20-29 years old. Post-traumatic epilepsy emerged as the most common factor among the patients. The prevalence of PTE in this study was 9.6%, closely aligning with the global rate of 7.8%.
Conclusion: The prevalence of post-traumatic epilepsy is significantly influenced by geographical conditions and living environments. In developing countries, the high volume of road traffic and increased accident rates contribute to a higher incidence of post-traumatic epilepsy.
Methods: The leaves were randomly collected. Ground and powdered leaves were extracted by cold maceration using ethanol. Sixteen adult male rats (130-200 g) were divided into 4 groups. The negative control group (group I) was given 10 mL/kg distilled water, while Group II-IV received 50, 100, and 200 mg/kg of Panicum maximum leaf extract for 21 days. The animals were sacrificed and analyzed for some reproductive parameters at the end of the 21 days.
Results: There was a decrease in the body weight of the rats, as well as the testis at 200 mg/kg when compared to the control within the treatment period. Sperm analysis showed a significant decrease in normal sperm cells, sperm variability, active sperm cells, and sperm count in all groups given Panicum maximum leaf extract. There was a significant increase in abnormal and dead sperm cells. Hormonal analysis showed a decrease in follicle-stimulating hormone (FSH) and testosterone (TST) levels, which was significant. The histology of the testis also indicated toxicity of the extract, and it was dose-dependent.
Conclusion: Ethanol leaf extract of Panicum maximum is relatively toxic to the male reproductive system.
Methods: This retrospective study was conducted over a period of two years, from June 2021 to May 2023. A total of 202 skin biopsy samples were evaluated. The histopathological examination of the lesions categorized them into eight groups based on the site, pattern of involvement, and cytological features, according to the Lever’s Histopathology of the Skin. Group 1 consisted of diseases limited to the epidermis and stratum corneum; group 2 consisted of diseases with localized superficial epidermal or melanocytic proliferation; group 3 consisted of diseases of the superficial cutaneous reactive unit; group 4 included diseases with acantholytic, vesicular, and pustular morphology; group 5 included diseases with perivascular, diffuse, and granulomatous infiltrate of the reticular dermis; group 6 included tumors and cysts of the dermis and subcutis; group 7 consisted of inflammatory disorders of skin appendages; and group 8 consisted of disorders of the subcutis.
Results: A total of 202 skin biopsies were collected from individuals aged 8-87 years. The majority of the cases belonged to the age group of 31-40 years. The male-to-female ratio was 1.2:1. The trunk was the most common site of biopsy, accounting for 40% of the cases, followed by the upper limb in 25% of the cases. Histopathological lesions were categorized into eight groups based on the site, pattern, and cytological features. Neoplastic lesions, both benign and malignant, accounted for 10.9% of the cases. The majority of the lesions were related to group 6, accounting for 38.1% of the cases, with the epidermal cyst being the most common lesion (7.92%). Basal cell carcinoma, observed in 2.97% of the cases, was the most common lesion among the neoplastic lesions. Group 5 lesions were the third most common (19.8%), with leprosy accounting for 9.4% of these cases.
Conclusion: Histopathological examination of skin biopsies is considered the gold standard for diagnosis, and it is often supported by ancillary techniques. Leprosy was the most common disease identified in this study, which underscores the importance of effective preventive measures for control.
Methods: This is a comparative observational study involving 300 apparently normal pregnant who were randomly allocated to GCT and FBG/PPBG cohorts of 150 each. The tests were performed at 4 intervals: 8 to 10 weeks, 16 to 20 weeks, 24 to 28 weeks, and 32 to 36 weeks. All diagnosed GDM cases were appropriately handled.
Results: Gestational diabetes mellitus was seen in 2.67% of the FBG/PPBG cohort and 5.34% of the GCT cohort. The GCT test identified 25% of GDM subjects before 24 weeks of gestation, 50% in 24 and 28 weeks, and 25% in > 32 weeks of gestation. The highest prevalence of GDM was noted in the 26–30-year age group. The highest prevalence of GDM was noted in pregnant women with ≥ 26 kg/m2 of body mass index (BMI), with 75% in the FBG/PPBG group and 62.5% in the GCT group. The incidence of GDM was higher in primigravida, 75% in the FBG/PPBG group, and 50% in the GCT group. A higher prevalence was observed in pregnant women of class 4 of socioeconomic status, and it was 75% in the FBG/PPBG group and 75% in the GCT group. A higher prevalence was noted in those with higher secondary education. The majority of GDM cases gave birth at term by labor, and there were no assisted vaginal births in this group. Moreover, 75% of GDM cases in the FBG/PPBG cohort and 62.5% of GDM cases in the GCT cohort had Caesarean section. Besides, 50% of infants from GDM mothers in the FBG/PPBG cohort were hospitalized, while 12.75% were admitted in the GCT cohort. The birth weight of neonates from GDM mothers was 3.09 ± 0.5 kg, 3.11 ± 0.6 kg in normal mothers, 2.98 ± 0.6 kg in the FBG/PPBG cohort, and 2.9 ± 0.5 kg in the GCT cohort.
Conclusion: Irrespective of the last meal, the GCT in all pregnant women is an effective and easy screening approach for 1-step screening for the early diagnosis of GDM for subsequent management at the early gestational pregnancy, which can minimize the adverse obstetric and perinatal outcomes.
Its prevalence as a hematologic malignancy is low, and it is usually diagnosed by demonstration of monoclonal plasma cells ≥ 10% in the bone marrow with negative results on serum and urine electrophoresis and immunofixation studies.
Methods: We present a case report where the patient's serum and whole blood samples were received in the study laboratory to evaluate the complete hemogram and metabolic profile. The metabolic and hematological profiles were deranged, subsequent to which the patient's clinical history was obtained from the treating clinician. It was discovered that the patient had presented with long-term weakness and back ache and was advised routine investigations along with magnetic resonance imaging (MRI) of the spine, which revealed the presence of osteolytic lesions. Following this, a gammopathy panel was requested.
Results: Serum protein capillary electrophoresis and immunofixation electrophoresis revealed a normal pattern without any noticeable bands, distortions, or suspicious regions. However, the findings of the comprehensive gammopathy panel were suggestive of non-secretory multiple myeloma.
Conclusion: In the absence of a detailed and meticulous work-up, a case of non-secretory multiple myeloma can be easily misdiagnosed. Here, we discuss the case in detail, the diagnostic pitfalls associated with it, and the role of serum free light chain assays in its diagnosis.
Methods: Pregnant Wistar rats were fed a normal diet and water from the day of delivery to 20 days postpartum. Male offspring were then assigned to one of 3 groups: a cafeteria diet (sausages, cakes, raisin cookies, carrots, white milk chocolate, and chocolate milk) (CAF), a cafeteria diet with simvastatin (CAF-S), or a control group (CTRL). After the treatments were completed, the cognitive performance of the rats was evaluated using the Morris water maze test.
Results: The CAF group showed reduced learning compared to the other two groups, and they took longer to find the hidden platform on all days of the experiment (P ≤ 0.001). The CAF-S group, which received simvastatin at a dose of 50 mg/kg, had a significantly shorter time to find the hidden platform compared to the CAF group (P ≤ 0.05). During the memory recall phase, after removing the platform, the CAF-S group spent less time in the target quadrant compared to the CTRL and CAF-S groups (P ≤ 0.05).
Conclusion: The results indicated that the cafeteria diet decreased the rats' learning and long-term memory. This effect is likely due to the high-fat content in the cafeteria diet. However, simvastatin prevented this decrease in the rats fed a cafeteria diet. These findings suggest that interventions targeting the metabolic pathways affected by a cafeteria diet may have potential therapeutic benefits for cognitive disorders.
Methods: An extensive online literature search for articles was performed using various search engines and databases with keywords halal food, food hygiene, and Islamic dietary principles. The reference lists of all the retrieved publications were also explored.
Results: Our search was limited to English articles that seemed relevant to this review, and the draft was prepared.
Conclusion: The health benefits of halal eating extend beyond religious grounds. Halal food consumption provides a safer option and minimizes the potential for food contamination and the associated health risks. By adhering to halal dietary guidelines, individuals can make conscious choices that promote their well-being while fostering a sense of responsibility towards animals, the environment, and the community at large. Halal food offers a holistic approach to nutrition and health, providing safer, balanced, and ethical food choices.
Methods: A total of 84 livers present in the Department of Anatomy, Goa Medical College, Goa, were used, from which 9 were excluded. The livers were formalin-fixed and were obtained from donated cadavers. The posterior wall of a retro-hepatic segment of IVC was incised to examine the count of hepatic venous vasculature and the pattern of their openings.
Results: The number of hepatic vein openings ranged from 3 to 8. The majority of the livers (32%) had 6 openings. The incidence of the right major hepatic vein was 97.3%, the middle major hepatic vein was 73.3%, and the left major hepatic venous vasculature was 86.6%. The majority of the specimens (n = 25) showed a double opening pattern with 1 separate opening for the hepatic vein of the right side and the middle and left hepatic vein opened by a single trunk.
Conclusion: Hepatic venous vasculature showed numerous variations in its draining pattern in the IVC. Understanding these variations is important for hepatic surgeries to improve post-operative outcomes.
Methods: Male rats (n=40) were assigned to 5 groups of 8. No intervention was considered for the control group. The scopolamine group received stereotaxic surgery and was treated with 3 mg/kg scopolamine intraperitoneally. The treatment groups were treated with scopolamine plus intraventricular injection of apelin-13 (1.25, 2.5, and 5 µg) into the right lateral ventricles for 7 days. For evaluating the memory impairment, the passive avoidance reactions of the animals, except the control group, were assessed 24 hours following the last injection. Regarding histological analysis, Congo red staining of the hippocampal sections was done, and immunoblotting was used to determine apoptotic biochemical markers, including caspase 3, cytochrome C, and congophilic amyloid-beta plaques.
Results: Apelin–13 alleviated scopolamine-related passive avoidance memory impairment and reduced the number of congophilic amyloid-beta plaques in the hippocampus (all P<0.001). It attenuated the decrease in the mean levels of hippocampal apoptotic proteins (caspase 3, cytochrome C) in animals treated with scopolamine (all P<0.05).
Conclusion: The neuroprotective effects of apelin-13 suggest its therapeutic effect on neurodegenerative disorders.
Methods: This study included 100 cases of chronic osteomyelitis, which were treated with surgical debridement, along with a 6-week course of antibiotics. The patients were divided into two groups based on whether they had undergone preoperative magnetic resonance imaging (MRI) or not. A comparison of relapse rates was then conducted between these two groups. The patients were followed up, and their functional outcomes were examined using the Association for the Study and Application of the Method of Ilizarov Criteria (ASAMI), Lower Extremity Functional Scale (LEFS), Disabilities of the Arm, Shoulder, and Hand (DASH), and Musculoskeletal Tumor Society (MSTS) questionnaires. Logistic regression analysis was used to assess the impact of risk factors on the recurrence or relapse.
Results: Sixty patients had chronic osteomyelitis, and 40 patients were infected non-union. Twenty-five patients had preoperative MRI. The mean preoperative LEFS was 44 ± 13.59 (19-73). Preoperative ASAMI showed 4% excellent, 62% fair, 24% good, and 10% were poor. The preoperative MSTS emotional component showed that enthusiastic (0%), satisfied (0%), accepts (36%), and dislikes (60%). Among the infected non-union cases, 2 cases had a total disability, 15 cases had recreational restriction, and 23 cases had a partial disability. Majority cases were gram-positive organism cultured were methicillin-sensitive Staphylococcus aureus accounts 21%, and methicillin-resistant S. aureus accounts 16%. Common antibiotics administered were Cloxacillin in 23 cases, Meropenem in 11 cases, Septran in 8 cases, Linezolid in 8 cases, and Vancomycin in 7 cases. The mean duration of antibiotics administered was 6 weeks. At 1 year postoperative, ASAMI showed a reduction in the number of patients categorized as 'fair' from 12 to 9, while the number of patients classified as 'good' increased from 2 to 6 cases. Fourteen (66.6%) patients who were initially classified under the 'fair' or 'poor' category preoperatively decreased to 9 (42.8%) postoperatively. The number of patients in the 'good' category increased from 6 (28%) preoperatively to 9 (42.9%) at the 6-month postoperative mark. Of the 61 patients, 42 (64.6%) had significant functional improvement at 1 year postoperative among those who had chronic osteomyelitis, while of the 34 patients, 15 (44.1%) patients with infected non-union had significant functional improvement (P = 0.04). 20.7% out of 77 patients who were culture positive went on to have relapse within 1 year follow-up and 15% out of the 20 patients who had no-growth on intraoperative cultures went on to develop relapse following one year post surgery follow-up. Nine patients (24.3%) in the posttraumatic group had recurrence of infection, while 1 patient had relapse at 6 months following surgery. At the 6-month follow-up, the percentage of relapse was 13.3% (n = 2) in the MRI group and 25% (n = 8) in the non-MRI group.
Conclusion: The relapse rate was 19.8%. In total, 19.3% of surgical debridement had experienced a recurrence of infection within the first year of follow-up, and 7.3% of patients required repeat surgery during the hospital stay. Factors that determined recurrence were age > 55 years, long bone involvement, fracture, monotherapy, receiving < 6 weeks of antibiotics, and inadequate treatment. Disease burden, financial conflicts, disability, and long duration of treatment affect the patient’s emotional status. These factors may also affect the patient's compliance with the prescribed treatment plan.
Methods: This cross-sectional study was conducted on patients referred to the Gynecology Center of Sayad Shirazi Hospital (Gorgan). The census method was used for collecting data, and the data of 114 women of reproductive age information who had received at least 1 dose of the COVID-19 vaccine were collected by a questionnaire and analysis of requested tests and their registration and analyzed in SPSS v. 16. Chi-square, independent t-test, and analysis of variance were used, and the significance level was <0.05.
Results: In this study, 114 women with an average age of 41.12 years met the inclusion criteria; 27 women had previous abnormal bleeding patterns, which had a clear change in the bleeding process, and the rest had a regular cycle with AUB. Three types of vaccines were used by the women; AstraZeneca had the most side effects, followed by Sinopharm. The participants showed abnormal bleeding during the first year, although in most women, it had started in the first 6 months. COVID-19 vaccination showed a significant relationship with the change in the bleeding process (P=049). Coagulation disorders and partial thromboplastin time (PTT) of more than 35 did not show a significant relationship between disorders, specific hormones, and AUB (P=0.269). However, the presence of hormonal disorders with AUB, despite increased PTT, had a significant relationship with AUB (P=0.011).
Conclusion: The results indicated a significant relationship between the injection of vaccines and the occurrence of AUB regardless of hormonal disorders and coagulation disorders, which were more likely to occur in a wider time frame (6 months or more). The results also demonstrated that these side effects were expected among people who receive the vaccine; for health care workers, on the other hand, trying to correct and prevent more side effects. Although different types of vaccines can cause different effects, their long-term effects should be considered, especially in women with the possibility of hormonal changes and abnormal bleeding, and the use of vaccines with fewer complications is recommended.
Methods: This review study was carried out for the last 21 years (2001-2022) using specific keywords related to breast cancer prevention and then compared to the most famous IM manuscripts.
Results: Iranian medicine has special views on preventive plans by introducing the risk factors of diseases. Some known risk factors of breast cancer in IM are constipation, obesity, menses retention, irregular night sleep, low physical exertion, and improper diet. Proven risk factors of breast cancer, including improper lifestyle, western diet, obesity, physical inactivity, delayed childbearing, fewer children, and shorter duration of breastfeeding, are in line with IM evidence.
Conclusion: Considering the importance of disease prevention from the perspective of IM, providing the right lifestyle, and introducing the 6 essential principles for health maintenance from the perspective of this medical school may play an important role in preventing breast diseases.
Methods: Thirty-five adult male Wistar rats weighing 180±5g were randomly assigned to seven groups (n=5) comprising the control, acute PS, acute probiotic treatment (probio), acute PS+probio, chronic PS, chronic probio, and chronic PS+probio groups. Acute stress and chronic PS or probio treatment lasted seven and 14 days, respectively. Each animal in the probio groups was fed 10×106 colony-forming units of lactobacillus acidophilus every other day. In contrast, the PS groups were exposed to predator stress for one hour between 7-10 am daily. The treatments lasted for 14 days. Following euthanasia, blood and hippocampal samples were collected for histology, and ELISA-based assays of interleukin-1β (1IL-1β), Tumor Necrosis Factor-α (TNF-α), dopamine, serotonin, malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), and reduced glutathione (GSH).
Results: Data analysis reveals that acute and chronic psychological stress significantly depresses hippocampal serotonin and dopamine levels, induces the overexpression of IL-1β and TNF-α, and causes increased lipid peroxidation and impaired antioxidant parameters. The probiotics groups exhibited statistically better results on all parameters assessed, including bringing hippocampal IL-1β and TNF-α levels toward normal. No obvious histoarchitectural damages were observed in any group.
Conclusion: Overall, this study suggests that the gut microbiome might play a significant role in hippocampal function as supplementing it mitigates stress-induced perturbations of hippocampal neurochemistry and redox status.
Aims: The study was conducted to assess the hematological abnormalities and hemostatic derangements and the nature of hematological abnormalities to reduce morbidity. Broadly, the hematological abnormalities are viewed under abnormalities in RBCs, WBCs, platelets, and the coagulation profile.
Methods: This was a prospective study conducted for 2 years at the Department of General Medicine, Al Ameen Medical College, Bijapur, Karnataka. A total of 150 patients with CLD were included and analyzed for hematological dysfunction.
Results: Severe anemia (<6g/dL) was noted in 9.33% of the cases; 22% of the cases had 6.1 to 8 g/dL Hb (hemoglobin) levels; 38% cases showed Hb of 8.1 to 10 g/dL; and >10 g/dL HB was noted in 45% cases. The majority showed normocytic normochromic anemia on peripheral smear examination, i.e., 56%. Macrocytic anemia was noted in 25.3% of cases. Microcytic hypochromic anemia was found in 38% of the cases. Only 4.67% showed dimorphic anemia. Besides, 66.6% of cases had a WBC count of 4000-11000/cumm, 26.6% had 2000-4000/cumm, 6.67% had < 2000/cumm, and 59% cases had >1 .0 lakh /cumm. In 66.67% of cases,1 lakh – 50000 (mild thrombocytopenia) was noted in 25.3% of cases. Moreover, 6.6% had moderate thrombocytopenia, and 1.3% < 20000 /cumm (severe thrombocytopenia).
Conclusion: This study demonstrated that all the patients presented with signs of CLD must be thoroughly evaluated for their complete blood profile to detect hematological abnormalities and should be monitored for any complications. Early initiation of treatment can decrease the overall mortality in these patients.
Methods: A prospective laboratory descriptive study was conducted at the Department of Pediatrics at Government General Hospital, Kadapa, from February 2022 to September 2023. Urine samples from 250 children of 2 and 12 years of age with UTI symptoms were analyzed using urine dipstick and other clinical/laboratory variables.
Results: The urine culture was positive in 38.4% (n=96) of the children and negative in 61.6% (n=154) of the children using the dipstick. Urinary tract infection was more common among female than male children. It was common in children aged 6 to 10 years, accounting for 41.42%. The most prevalent organism isolated was Escherichia coli (24.8%), followed by Klebsiella (8.8%) and other Gram-negative bacilli (5.6%). Urine microscopy for pus cells revealed that 158 (63.2%) samples had no pus cells, 49 (19.6%) had up to 5 pus cells, 35 (14%) had 5-10 pus cells, and 8 (3.2%) had >10 pus cells. Pyuria was found in 56 of the 96 children in the culture-positive group, leukocyte esterase was positive in 123 cases, leukocyte esterase was negative in 88 cases, and the nitrite test was positive in 9 cases. However, the combined dipstick was positive in 121 (48.4%) of all cases. Among the culture-positive group, the combined dipstick was positive in 39 cases and negative in 3 cases. Among the culture-negative cases, the combined dipstick was positive in 28 cases and negative in 126 cases. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of leucocyte esterase and nitrite were 65%, 80%, 69%, and 78% for diagnosing UTI in our study, respectively. The sensitivity, specificity, PPV, and NPV of the combined dipstick compared with urine culture were 95.5%, 80%, 74.9%, and 95.9%, respectively.
Conclusion: The combined dipstick + nitrite and leukocyte esterase show higher sensitivity and specificity, making it superior to leukocyte esterase or nitrite alone in diagnosing UTI. When compared to the urine culture, the combined dipstick has higher sensitivity, specificity, and positive and negative predictive values. Therefore, the combined dipstick can be used consistently as a quick screening tool for UTIs when culture facilities are not available.
anesthesia introduced by competency-based medical education (CBME) for undergraduate medical students.
Methods: The sample consisted of 20 subject experts from different teaching institutes who were actively involved in
teaching undergraduate medical students and had at least 10 years of teaching experience. The study was conducted in 3
rounds using the Delphi technique.
Results: These subject experts identified the topics relevant and important to undergraduate students and also suggested
the addition of role-play videos and simulations with some interesting and daring scenarios, case studies, and sessions for
regional anesthesia competency. There were suggestions to include topics such as ensuring asepsis during regional
anesthesia and visits to the intensive care unit (ICU). The majority of the participants were satisfied with the assessment
methods. Two-thirds of the experts agreed that the anesthesia curriculum accurately covers the skills required for an Indian
medical graduate. Moreover, 80% of the participants agreed that the suggested curriculum is complete and adequate for
the undergraduates.
Conclusion: Curricular changes introduced by CBME seem to be aligned with the goal of preparing globally relevant and socially accountable undergraduate medical students.
This study aims to characterize breast carcinoma using molecular markers (ER, PR, and HER2 neu), identify their sub-types, and attain its relation with Ki67.
Methods: This cross-sectional (retrospective) study was conducted over four years at the Department of Pathology, SVS Medical College, Mahabubnagar, from April 2018 to March 2022. Fifty diagnosed cases of breast carcinomas were subjected to routine staining and immunohistochemistry (IHC) with ER, PR, HER 2 neu, and Ki67 using tissue microarray and classified into molecular subtypes.
Results: In this study, 32% of participants were in the 50-59 age group. The right breast was involved in 52% of participants. The central quadrant was involved in 44%, UOQ 32%, UIQ 16%, and LOQ 8%. Moderately differentiated tumors exist in 40%, poorly differentiated in 36%, and well-differentiated in 24%. 84% of patients were ER-positive, 70% were PR-positive, and 72% were HER2/neu-positive. 28% of patients with positive Ki-67 were grade I, 22% were grade II, and 50% were grade III. Her2/neu contributed to 12% and triple-negative BC seen in 4%. The association between the ER status and Ki-67 positivity status is not statistically significant, with a P-value of 0.13. The association between the PR status and Ki-67 positivity status is statistically significant, with a P-value of 0.002. The association between the Her2/neu status and Ki-67 positivity status is also statistically significant, with a P-value of <0.0001.
Conclusion: Most cases were Ki67 positive and HER2 neu positive. Triple-negative cases showed a high Ki67 index. Ki67 plays a pivotal role in making treatment decisions. The Ki67 index is independent and can be used independently without being correlated with other indices, and Ki67 should be evaluated routinely in breast carcinoma cases.
Methods: This cross-sectional study was conducted on 160 pregnant women. The women who had just given birth were either suspected of having coronavirus or had a definite diagnosis of coronavirus either during hospitalization or during hospitalization who were included by the simple census. The data were collected from medical records and through telephone interviews. The chi-square test was used to compare categorical variables between the groups. The qualitative data were evaluated with quantitative variables by the analysis of variance. The significance level was less than 0.05.
Results: The difference in the access of minorities to medical and health service centers affected the pregnancy results (P=019 (. A high rate of Cesarean delivery (58.1%), a high prevalence of gestational diabetes (19.3%) and hypothyroidism (21.2%), and the need for high insulin injections during the COVID-19 infection (39.37%) were also found, which were independent of the patients. Diabetes and previous gestational diabetes showed high statistics.
Conclusion: This study demonstrated a high concentration in people with hypothyroidism and patients who need insulin due to hyperglycemia after contracting COVID-19 during pregnancy. According to this study, contracting COVID-19 increases the level of maternal and fetal problems, and women with hypothyroidism should be considered as a risk factor for contracting this disease and having a more serious condition, hyperglycemia, and the need for insulin, except for the remaining complications of this disease is expected.
Methods: The in vitro effects on fertility were evaluated using Drosophila melanogaster (fruit fly) because of its genetic similarities to humans. The copulation duration, mating latency, and the number of emergences from the fruit fly after mating were determined. Three doses (0.025%, 0.05%, and 0.1% w/w) of the M. oleifera ethanol extract were administered to three different groups, while a control group only received feed mixed with ethanol. For in silico studies, 62 compounds were obtained from the PubChem library by mining compounds from articles related to M. oleifera. Next, a ligand library was generated and docked against various targets of interest (estrogen, progesterone, kisspeptin, liver X, PPARG, and 15-PGDH receptors as well as 17β hydroxysteroid dehydrogenase and insulin-degrading enzymes) which have female fertility-enhancing effects.
Results: The in vivo experiments showed that M. oleifera had no effect on copulation duration and mating latency, but interestingly, it enhanced the fertility/emergence of the treated fruit flies. In silico studies suggested that phytochemicals such as rutin, marumoside B, myricetin, and quercetin showed docking scores that may well support previous works on M. oleifera enhancement of female fertility.
Conclusion: The results showed that M. oleifera can enhance fertility in female fruit flies.
Case description: A 35-year-old married female (G2P2Ab0L2NVD2) from Gorgan, Iran, presented to the TPM health care center affiliated with Golestan University of Medical Sciences on February 21, 2022, due to abdominal pain, obesity, and increased appetite.
Conclusion: Tailoring the treatment to the individual characteristics of the client and incorporating TPM measures, such as manual procedures, in conjunction with modern medicine, can play a crucial role in the overall treatment process.
Methods: This retrospective descriptive study analyzed data from 135 epilepsy patients hospitalized between 2018 and 2021. Statistical analysis involved reviewing relevant data and creating tables and graphs.
Results: The findings indicate that epilepsy is more prevalent in men than in women, with the most affected age group being 20-29 years old. Post-traumatic epilepsy emerged as the most common factor among the patients. The prevalence of PTE in this study was 9.6%, closely aligning with the global rate of 7.8%.
Conclusion: The prevalence of post-traumatic epilepsy is significantly influenced by geographical conditions and living environments. In developing countries, the high volume of road traffic and increased accident rates contribute to a higher incidence of post-traumatic epilepsy.
Methods: The leaves were randomly collected. Ground and powdered leaves were extracted by cold maceration using ethanol. Sixteen adult male rats (130-200 g) were divided into 4 groups. The negative control group (group I) was given 10 mL/kg distilled water, while Group II-IV received 50, 100, and 200 mg/kg of Panicum maximum leaf extract for 21 days. The animals were sacrificed and analyzed for some reproductive parameters at the end of the 21 days.
Results: There was a decrease in the body weight of the rats, as well as the testis at 200 mg/kg when compared to the control within the treatment period. Sperm analysis showed a significant decrease in normal sperm cells, sperm variability, active sperm cells, and sperm count in all groups given Panicum maximum leaf extract. There was a significant increase in abnormal and dead sperm cells. Hormonal analysis showed a decrease in follicle-stimulating hormone (FSH) and testosterone (TST) levels, which was significant. The histology of the testis also indicated toxicity of the extract, and it was dose-dependent.
Conclusion: Ethanol leaf extract of Panicum maximum is relatively toxic to the male reproductive system.
Methods: This retrospective study was conducted over a period of two years, from June 2021 to May 2023. A total of 202 skin biopsy samples were evaluated. The histopathological examination of the lesions categorized them into eight groups based on the site, pattern of involvement, and cytological features, according to the Lever’s Histopathology of the Skin. Group 1 consisted of diseases limited to the epidermis and stratum corneum; group 2 consisted of diseases with localized superficial epidermal or melanocytic proliferation; group 3 consisted of diseases of the superficial cutaneous reactive unit; group 4 included diseases with acantholytic, vesicular, and pustular morphology; group 5 included diseases with perivascular, diffuse, and granulomatous infiltrate of the reticular dermis; group 6 included tumors and cysts of the dermis and subcutis; group 7 consisted of inflammatory disorders of skin appendages; and group 8 consisted of disorders of the subcutis.
Results: A total of 202 skin biopsies were collected from individuals aged 8-87 years. The majority of the cases belonged to the age group of 31-40 years. The male-to-female ratio was 1.2:1. The trunk was the most common site of biopsy, accounting for 40% of the cases, followed by the upper limb in 25% of the cases. Histopathological lesions were categorized into eight groups based on the site, pattern, and cytological features. Neoplastic lesions, both benign and malignant, accounted for 10.9% of the cases. The majority of the lesions were related to group 6, accounting for 38.1% of the cases, with the epidermal cyst being the most common lesion (7.92%). Basal cell carcinoma, observed in 2.97% of the cases, was the most common lesion among the neoplastic lesions. Group 5 lesions were the third most common (19.8%), with leprosy accounting for 9.4% of these cases.
Conclusion: Histopathological examination of skin biopsies is considered the gold standard for diagnosis, and it is often supported by ancillary techniques. Leprosy was the most common disease identified in this study, which underscores the importance of effective preventive measures for control.
Methods: This is a comparative observational study involving 300 apparently normal pregnant who were randomly allocated to GCT and FBG/PPBG cohorts of 150 each. The tests were performed at 4 intervals: 8 to 10 weeks, 16 to 20 weeks, 24 to 28 weeks, and 32 to 36 weeks. All diagnosed GDM cases were appropriately handled.
Results: Gestational diabetes mellitus was seen in 2.67% of the FBG/PPBG cohort and 5.34% of the GCT cohort. The GCT test identified 25% of GDM subjects before 24 weeks of gestation, 50% in 24 and 28 weeks, and 25% in > 32 weeks of gestation. The highest prevalence of GDM was noted in the 26–30-year age group. The highest prevalence of GDM was noted in pregnant women with ≥ 26 kg/m2 of body mass index (BMI), with 75% in the FBG/PPBG group and 62.5% in the GCT group. The incidence of GDM was higher in primigravida, 75% in the FBG/PPBG group, and 50% in the GCT group. A higher prevalence was observed in pregnant women of class 4 of socioeconomic status, and it was 75% in the FBG/PPBG group and 75% in the GCT group. A higher prevalence was noted in those with higher secondary education. The majority of GDM cases gave birth at term by labor, and there were no assisted vaginal births in this group. Moreover, 75% of GDM cases in the FBG/PPBG cohort and 62.5% of GDM cases in the GCT cohort had Caesarean section. Besides, 50% of infants from GDM mothers in the FBG/PPBG cohort were hospitalized, while 12.75% were admitted in the GCT cohort. The birth weight of neonates from GDM mothers was 3.09 ± 0.5 kg, 3.11 ± 0.6 kg in normal mothers, 2.98 ± 0.6 kg in the FBG/PPBG cohort, and 2.9 ± 0.5 kg in the GCT cohort.
Conclusion: Irrespective of the last meal, the GCT in all pregnant women is an effective and easy screening approach for 1-step screening for the early diagnosis of GDM for subsequent management at the early gestational pregnancy, which can minimize the adverse obstetric and perinatal outcomes.
Its prevalence as a hematologic malignancy is low, and it is usually diagnosed by demonstration of monoclonal plasma cells ≥ 10% in the bone marrow with negative results on serum and urine electrophoresis and immunofixation studies.
Methods: We present a case report where the patient's serum and whole blood samples were received in the study laboratory to evaluate the complete hemogram and metabolic profile. The metabolic and hematological profiles were deranged, subsequent to which the patient's clinical history was obtained from the treating clinician. It was discovered that the patient had presented with long-term weakness and back ache and was advised routine investigations along with magnetic resonance imaging (MRI) of the spine, which revealed the presence of osteolytic lesions. Following this, a gammopathy panel was requested.
Results: Serum protein capillary electrophoresis and immunofixation electrophoresis revealed a normal pattern without any noticeable bands, distortions, or suspicious regions. However, the findings of the comprehensive gammopathy panel were suggestive of non-secretory multiple myeloma.
Conclusion: In the absence of a detailed and meticulous work-up, a case of non-secretory multiple myeloma can be easily misdiagnosed. Here, we discuss the case in detail, the diagnostic pitfalls associated with it, and the role of serum free light chain assays in its diagnosis.
Methods: Pregnant Wistar rats were fed a normal diet and water from the day of delivery to 20 days postpartum. Male offspring were then assigned to one of 3 groups: a cafeteria diet (sausages, cakes, raisin cookies, carrots, white milk chocolate, and chocolate milk) (CAF), a cafeteria diet with simvastatin (CAF-S), or a control group (CTRL). After the treatments were completed, the cognitive performance of the rats was evaluated using the Morris water maze test.
Results: The CAF group showed reduced learning compared to the other two groups, and they took longer to find the hidden platform on all days of the experiment (P ≤ 0.001). The CAF-S group, which received simvastatin at a dose of 50 mg/kg, had a significantly shorter time to find the hidden platform compared to the CAF group (P ≤ 0.05). During the memory recall phase, after removing the platform, the CAF-S group spent less time in the target quadrant compared to the CTRL and CAF-S groups (P ≤ 0.05).
Conclusion: The results indicated that the cafeteria diet decreased the rats' learning and long-term memory. This effect is likely due to the high-fat content in the cafeteria diet. However, simvastatin prevented this decrease in the rats fed a cafeteria diet. These findings suggest that interventions targeting the metabolic pathways affected by a cafeteria diet may have potential therapeutic benefits for cognitive disorders.
Methods: An extensive online literature search for articles was performed using various search engines and databases with keywords halal food, food hygiene, and Islamic dietary principles. The reference lists of all the retrieved publications were also explored.
Results: Our search was limited to English articles that seemed relevant to this review, and the draft was prepared.
Conclusion: The health benefits of halal eating extend beyond religious grounds. Halal food consumption provides a safer option and minimizes the potential for food contamination and the associated health risks. By adhering to halal dietary guidelines, individuals can make conscious choices that promote their well-being while fostering a sense of responsibility towards animals, the environment, and the community at large. Halal food offers a holistic approach to nutrition and health, providing safer, balanced, and ethical food choices.
Methods: A total of 84 livers present in the Department of Anatomy, Goa Medical College, Goa, were used, from which 9 were excluded. The livers were formalin-fixed and were obtained from donated cadavers. The posterior wall of a retro-hepatic segment of IVC was incised to examine the count of hepatic venous vasculature and the pattern of their openings.
Results: The number of hepatic vein openings ranged from 3 to 8. The majority of the livers (32%) had 6 openings. The incidence of the right major hepatic vein was 97.3%, the middle major hepatic vein was 73.3%, and the left major hepatic venous vasculature was 86.6%. The majority of the specimens (n = 25) showed a double opening pattern with 1 separate opening for the hepatic vein of the right side and the middle and left hepatic vein opened by a single trunk.
Conclusion: Hepatic venous vasculature showed numerous variations in its draining pattern in the IVC. Understanding these variations is important for hepatic surgeries to improve post-operative outcomes.
Methods: Male rats (n=40) were assigned to 5 groups of 8. No intervention was considered for the control group. The scopolamine group received stereotaxic surgery and was treated with 3 mg/kg scopolamine intraperitoneally. The treatment groups were treated with scopolamine plus intraventricular injection of apelin-13 (1.25, 2.5, and 5 µg) into the right lateral ventricles for 7 days. For evaluating the memory impairment, the passive avoidance reactions of the animals, except the control group, were assessed 24 hours following the last injection. Regarding histological analysis, Congo red staining of the hippocampal sections was done, and immunoblotting was used to determine apoptotic biochemical markers, including caspase 3, cytochrome C, and congophilic amyloid-beta plaques.
Results: Apelin–13 alleviated scopolamine-related passive avoidance memory impairment and reduced the number of congophilic amyloid-beta plaques in the hippocampus (all P<0.001). It attenuated the decrease in the mean levels of hippocampal apoptotic proteins (caspase 3, cytochrome C) in animals treated with scopolamine (all P<0.05).
Conclusion: The neuroprotective effects of apelin-13 suggest its therapeutic effect on neurodegenerative disorders.
Methods: This study included 100 cases of chronic osteomyelitis, which were treated with surgical debridement, along with a 6-week course of antibiotics. The patients were divided into two groups based on whether they had undergone preoperative magnetic resonance imaging (MRI) or not. A comparison of relapse rates was then conducted between these two groups. The patients were followed up, and their functional outcomes were examined using the Association for the Study and Application of the Method of Ilizarov Criteria (ASAMI), Lower Extremity Functional Scale (LEFS), Disabilities of the Arm, Shoulder, and Hand (DASH), and Musculoskeletal Tumor Society (MSTS) questionnaires. Logistic regression analysis was used to assess the impact of risk factors on the recurrence or relapse.
Results: Sixty patients had chronic osteomyelitis, and 40 patients were infected non-union. Twenty-five patients had preoperative MRI. The mean preoperative LEFS was 44 ± 13.59 (19-73). Preoperative ASAMI showed 4% excellent, 62% fair, 24% good, and 10% were poor. The preoperative MSTS emotional component showed that enthusiastic (0%), satisfied (0%), accepts (36%), and dislikes (60%). Among the infected non-union cases, 2 cases had a total disability, 15 cases had recreational restriction, and 23 cases had a partial disability. Majority cases were gram-positive organism cultured were methicillin-sensitive Staphylococcus aureus accounts 21%, and methicillin-resistant S. aureus accounts 16%. Common antibiotics administered were Cloxacillin in 23 cases, Meropenem in 11 cases, Septran in 8 cases, Linezolid in 8 cases, and Vancomycin in 7 cases. The mean duration of antibiotics administered was 6 weeks. At 1 year postoperative, ASAMI showed a reduction in the number of patients categorized as 'fair' from 12 to 9, while the number of patients classified as 'good' increased from 2 to 6 cases. Fourteen (66.6%) patients who were initially classified under the 'fair' or 'poor' category preoperatively decreased to 9 (42.8%) postoperatively. The number of patients in the 'good' category increased from 6 (28%) preoperatively to 9 (42.9%) at the 6-month postoperative mark. Of the 61 patients, 42 (64.6%) had significant functional improvement at 1 year postoperative among those who had chronic osteomyelitis, while of the 34 patients, 15 (44.1%) patients with infected non-union had significant functional improvement (P = 0.04). 20.7% out of 77 patients who were culture positive went on to have relapse within 1 year follow-up and 15% out of the 20 patients who had no-growth on intraoperative cultures went on to develop relapse following one year post surgery follow-up. Nine patients (24.3%) in the posttraumatic group had recurrence of infection, while 1 patient had relapse at 6 months following surgery. At the 6-month follow-up, the percentage of relapse was 13.3% (n = 2) in the MRI group and 25% (n = 8) in the non-MRI group.
Conclusion: The relapse rate was 19.8%. In total, 19.3% of surgical debridement had experienced a recurrence of infection within the first year of follow-up, and 7.3% of patients required repeat surgery during the hospital stay. Factors that determined recurrence were age > 55 years, long bone involvement, fracture, monotherapy, receiving < 6 weeks of antibiotics, and inadequate treatment. Disease burden, financial conflicts, disability, and long duration of treatment affect the patient’s emotional status. These factors may also affect the patient's compliance with the prescribed treatment plan.
Methods: This cross-sectional study was conducted on patients referred to the Gynecology Center of Sayad Shirazi Hospital (Gorgan). The census method was used for collecting data, and the data of 114 women of reproductive age information who had received at least 1 dose of the COVID-19 vaccine were collected by a questionnaire and analysis of requested tests and their registration and analyzed in SPSS v. 16. Chi-square, independent t-test, and analysis of variance were used, and the significance level was <0.05.
Results: In this study, 114 women with an average age of 41.12 years met the inclusion criteria; 27 women had previous abnormal bleeding patterns, which had a clear change in the bleeding process, and the rest had a regular cycle with AUB. Three types of vaccines were used by the women; AstraZeneca had the most side effects, followed by Sinopharm. The participants showed abnormal bleeding during the first year, although in most women, it had started in the first 6 months. COVID-19 vaccination showed a significant relationship with the change in the bleeding process (P=049). Coagulation disorders and partial thromboplastin time (PTT) of more than 35 did not show a significant relationship between disorders, specific hormones, and AUB (P=0.269). However, the presence of hormonal disorders with AUB, despite increased PTT, had a significant relationship with AUB (P=0.011).
Conclusion: The results indicated a significant relationship between the injection of vaccines and the occurrence of AUB regardless of hormonal disorders and coagulation disorders, which were more likely to occur in a wider time frame (6 months or more). The results also demonstrated that these side effects were expected among people who receive the vaccine; for health care workers, on the other hand, trying to correct and prevent more side effects. Although different types of vaccines can cause different effects, their long-term effects should be considered, especially in women with the possibility of hormonal changes and abnormal bleeding, and the use of vaccines with fewer complications is recommended.
Methods: This review study was carried out for the last 21 years (2001-2022) using specific keywords related to breast cancer prevention and then compared to the most famous IM manuscripts.
Results: Iranian medicine has special views on preventive plans by introducing the risk factors of diseases. Some known risk factors of breast cancer in IM are constipation, obesity, menses retention, irregular night sleep, low physical exertion, and improper diet. Proven risk factors of breast cancer, including improper lifestyle, western diet, obesity, physical inactivity, delayed childbearing, fewer children, and shorter duration of breastfeeding, are in line with IM evidence.
Conclusion: Considering the importance of disease prevention from the perspective of IM, providing the right lifestyle, and introducing the 6 essential principles for health maintenance from the perspective of this medical school may play an important role in preventing breast diseases.
Methods: Thirty-five adult male Wistar rats weighing 180±5g were randomly assigned to seven groups (n=5) comprising the control, acute PS, acute probiotic treatment (probio), acute PS+probio, chronic PS, chronic probio, and chronic PS+probio groups. Acute stress and chronic PS or probio treatment lasted seven and 14 days, respectively. Each animal in the probio groups was fed 10×106 colony-forming units of lactobacillus acidophilus every other day. In contrast, the PS groups were exposed to predator stress for one hour between 7-10 am daily. The treatments lasted for 14 days. Following euthanasia, blood and hippocampal samples were collected for histology, and ELISA-based assays of interleukin-1β (1IL-1β), Tumor Necrosis Factor-α (TNF-α), dopamine, serotonin, malondialdehyde (MDA), catalase (CAT), superoxide dismutase (SOD), and reduced glutathione (GSH).
Results: Data analysis reveals that acute and chronic psychological stress significantly depresses hippocampal serotonin and dopamine levels, induces the overexpression of IL-1β and TNF-α, and causes increased lipid peroxidation and impaired antioxidant parameters. The probiotics groups exhibited statistically better results on all parameters assessed, including bringing hippocampal IL-1β and TNF-α levels toward normal. No obvious histoarchitectural damages were observed in any group.
Conclusion: Overall, this study suggests that the gut microbiome might play a significant role in hippocampal function as supplementing it mitigates stress-induced perturbations of hippocampal neurochemistry and redox status.
Aims: The study was conducted to assess the hematological abnormalities and hemostatic derangements and the nature of hematological abnormalities to reduce morbidity. Broadly, the hematological abnormalities are viewed under abnormalities in RBCs, WBCs, platelets, and the coagulation profile.
Methods: This was a prospective study conducted for 2 years at the Department of General Medicine, Al Ameen Medical College, Bijapur, Karnataka. A total of 150 patients with CLD were included and analyzed for hematological dysfunction.
Results: Severe anemia (<6g/dL) was noted in 9.33% of the cases; 22% of the cases had 6.1 to 8 g/dL Hb (hemoglobin) levels; 38% cases showed Hb of 8.1 to 10 g/dL; and >10 g/dL HB was noted in 45% cases. The majority showed normocytic normochromic anemia on peripheral smear examination, i.e., 56%. Macrocytic anemia was noted in 25.3% of cases. Microcytic hypochromic anemia was found in 38% of the cases. Only 4.67% showed dimorphic anemia. Besides, 66.6% of cases had a WBC count of 4000-11000/cumm, 26.6% had 2000-4000/cumm, 6.67% had < 2000/cumm, and 59% cases had >1 .0 lakh /cumm. In 66.67% of cases,1 lakh – 50000 (mild thrombocytopenia) was noted in 25.3% of cases. Moreover, 6.6% had moderate thrombocytopenia, and 1.3% < 20000 /cumm (severe thrombocytopenia).
Conclusion: This study demonstrated that all the patients presented with signs of CLD must be thoroughly evaluated for their complete blood profile to detect hematological abnormalities and should be monitored for any complications. Early initiation of treatment can decrease the overall mortality in these patients.
Methods: A prospective laboratory descriptive study was conducted at the Department of Pediatrics at Government General Hospital, Kadapa, from February 2022 to September 2023. Urine samples from 250 children of 2 and 12 years of age with UTI symptoms were analyzed using urine dipstick and other clinical/laboratory variables.
Results: The urine culture was positive in 38.4% (n=96) of the children and negative in 61.6% (n=154) of the children using the dipstick. Urinary tract infection was more common among female than male children. It was common in children aged 6 to 10 years, accounting for 41.42%. The most prevalent organism isolated was Escherichia coli (24.8%), followed by Klebsiella (8.8%) and other Gram-negative bacilli (5.6%). Urine microscopy for pus cells revealed that 158 (63.2%) samples had no pus cells, 49 (19.6%) had up to 5 pus cells, 35 (14%) had 5-10 pus cells, and 8 (3.2%) had >10 pus cells. Pyuria was found in 56 of the 96 children in the culture-positive group, leukocyte esterase was positive in 123 cases, leukocyte esterase was negative in 88 cases, and the nitrite test was positive in 9 cases. However, the combined dipstick was positive in 121 (48.4%) of all cases. Among the culture-positive group, the combined dipstick was positive in 39 cases and negative in 3 cases. Among the culture-negative cases, the combined dipstick was positive in 28 cases and negative in 126 cases. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of leucocyte esterase and nitrite were 65%, 80%, 69%, and 78% for diagnosing UTI in our study, respectively. The sensitivity, specificity, PPV, and NPV of the combined dipstick compared with urine culture were 95.5%, 80%, 74.9%, and 95.9%, respectively.
Conclusion: The combined dipstick + nitrite and leukocyte esterase show higher sensitivity and specificity, making it superior to leukocyte esterase or nitrite alone in diagnosing UTI. When compared to the urine culture, the combined dipstick has higher sensitivity, specificity, and positive and negative predictive values. Therefore, the combined dipstick can be used consistently as a quick screening tool for UTIs when culture facilities are not available.
anesthesia introduced by competency-based medical education (CBME) for undergraduate medical students.
Methods: The sample consisted of 20 subject experts from different teaching institutes who were actively involved in
teaching undergraduate medical students and had at least 10 years of teaching experience. The study was conducted in 3
rounds using the Delphi technique.
Results: These subject experts identified the topics relevant and important to undergraduate students and also suggested
the addition of role-play videos and simulations with some interesting and daring scenarios, case studies, and sessions for
regional anesthesia competency. There were suggestions to include topics such as ensuring asepsis during regional
anesthesia and visits to the intensive care unit (ICU). The majority of the participants were satisfied with the assessment
methods. Two-thirds of the experts agreed that the anesthesia curriculum accurately covers the skills required for an Indian
medical graduate. Moreover, 80% of the participants agreed that the suggested curriculum is complete and adequate for
the undergraduates.
Conclusion: Curricular changes introduced by CBME seem to be aligned with the goal of preparing globally relevant and socially accountable undergraduate medical students.
This study aims to characterize breast carcinoma using molecular markers (ER, PR, and HER2 neu), identify their sub-types, and attain its relation with Ki67.
Methods: This cross-sectional (retrospective) study was conducted over four years at the Department of Pathology, SVS Medical College, Mahabubnagar, from April 2018 to March 2022. Fifty diagnosed cases of breast carcinomas were subjected to routine staining and immunohistochemistry (IHC) with ER, PR, HER 2 neu, and Ki67 using tissue microarray and classified into molecular subtypes.
Results: In this study, 32% of participants were in the 50-59 age group. The right breast was involved in 52% of participants. The central quadrant was involved in 44%, UOQ 32%, UIQ 16%, and LOQ 8%. Moderately differentiated tumors exist in 40%, poorly differentiated in 36%, and well-differentiated in 24%. 84% of patients were ER-positive, 70% were PR-positive, and 72% were HER2/neu-positive. 28% of patients with positive Ki-67 were grade I, 22% were grade II, and 50% were grade III. Her2/neu contributed to 12% and triple-negative BC seen in 4%. The association between the ER status and Ki-67 positivity status is not statistically significant, with a P-value of 0.13. The association between the PR status and Ki-67 positivity status is statistically significant, with a P-value of 0.002. The association between the Her2/neu status and Ki-67 positivity status is also statistically significant, with a P-value of <0.0001.
Conclusion: Most cases were Ki67 positive and HER2 neu positive. Triple-negative cases showed a high Ki67 index. Ki67 plays a pivotal role in making treatment decisions. The Ki67 index is independent and can be used independently without being correlated with other indices, and Ki67 should be evaluated routinely in breast carcinoma cases.
Methods: This cross-sectional study was conducted on 160 pregnant women. The women who had just given birth were either suspected of having coronavirus or had a definite diagnosis of coronavirus either during hospitalization or during hospitalization who were included by the simple census. The data were collected from medical records and through telephone interviews. The chi-square test was used to compare categorical variables between the groups. The qualitative data were evaluated with quantitative variables by the analysis of variance. The significance level was less than 0.05.
Results: The difference in the access of minorities to medical and health service centers affected the pregnancy results (P=019 (. A high rate of Cesarean delivery (58.1%), a high prevalence of gestational diabetes (19.3%) and hypothyroidism (21.2%), and the need for high insulin injections during the COVID-19 infection (39.37%) were also found, which were independent of the patients. Diabetes and previous gestational diabetes showed high statistics.
Conclusion: This study demonstrated a high concentration in people with hypothyroidism and patients who need insulin due to hyperglycemia after contracting COVID-19 during pregnancy. According to this study, contracting COVID-19 increases the level of maternal and fetal problems, and women with hypothyroidism should be considered as a risk factor for contracting this disease and having a more serious condition, hyperglycemia, and the need for insulin, except for the remaining complications of this disease is expected.
Methods: The in vitro effects on fertility were evaluated using Drosophila melanogaster (fruit fly) because of its genetic similarities to humans. The copulation duration, mating latency, and the number of emergences from the fruit fly after mating were determined. Three doses (0.025%, 0.05%, and 0.1% w/w) of the M. oleifera ethanol extract were administered to three different groups, while a control group only received feed mixed with ethanol. For in silico studies, 62 compounds were obtained from the PubChem library by mining compounds from articles related to M. oleifera. Next, a ligand library was generated and docked against various targets of interest (estrogen, progesterone, kisspeptin, liver X, PPARG, and 15-PGDH receptors as well as 17β hydroxysteroid dehydrogenase and insulin-degrading enzymes) which have female fertility-enhancing effects.
Results: The in vivo experiments showed that M. oleifera had no effect on copulation duration and mating latency, but interestingly, it enhanced the fertility/emergence of the treated fruit flies. In silico studies suggested that phytochemicals such as rutin, marumoside B, myricetin, and quercetin showed docking scores that may well support previous works on M. oleifera enhancement of female fertility.
Conclusion: The results showed that M. oleifera can enhance fertility in female fruit flies.