A. R. Dehpour, PharmD, PhD
A. Javadian, MD
Vol 58, No 5 (2020)
This study was conducted to compare the neurocognitive changes in an episode of primary psychosis in a group treated with minocycline and control. In this randomized controlled clinical trial, 40 patients with schizophrenia were randomized into two groups and underwent eight weeks of treatment with either minocycline (100 mg twice per day) or placebo in addition to routine treatment. Patients were evaluated using the Wechsler Adult Intelligence Scale (WAIS), Positive and Negative Syndrome Scale (PANSS), and Wisconsin Card Sorting Test (WCST) at baseline and at weeks 4 and 8. General linear model repeated measures showed a significant effect for time treatment interaction on the scores of WAIS, PANSS, and WCST of patients in the minocycline group (P>0.05). Regardless of the type of intervention, there was a remarkable difference between the mean scores of WAIS, PANSS, and WCST measured on three stages. Minocycline seems to be a safe and effective adjuvant in the management of patients with schizophrenia.
Bone marrow-derived mesenchymal stem cells (BMSCs) are of specific attention due to their potential clinical use in cell transplantation. These cells could secrete cytokines and growth factors upon stimulation or suppression in regenerative medicine. This study was to evaluate the influence of BMSCs on the proliferation of K562 cells as chronic myeloid leukemia (CML) cell lines through the ERK pathway. For this purpose, BMSCs were extracted from Rattus Norvegicus and were co-cultured with K562 cells. In the following, at the end of the 7th day, the K562 cell was collected and subjected to ERK protein expression measurement as well as ERK gene expression by flow-cytometry and real time-PCR, respectively. Also, the cell proliferation and PDT of K562 cells were measured in the control and experimental groups. The results were shown that BMSCs were positive for mesenchymal (CD44 and CD90) and negative for hematopoietic (CD34 and CD56) markers. In addition, it was shown that BMSCs mediated CML cell line proliferation arrest via a significant reduction of the ERK protein expression in the co-culture groups versus in the K562 cell line control group. Taken together, the data concluded that the co-culture of BMSCs with CML cell lines could secrete a substantial amount of cytokines and growth factors, thus inhibiting the proliferation of CML cell lines via the ERK signaling pathway. The identity of molecules, cytokines, and growth factors involved in the anti-proliferative effect of bone marrow-derived MSCs require further investigation, and this effect could important in the basic experimental study as a therapeutic strategy.
The present study investigates the association of cardiovascular risk factors such as metabolic syndrome (MetS), fiber-rich regimen, and Glomerular Filtration Rate (GFR) with elevated high-sensitivity C-reactive protein (hsCRP) levels. We designed a cross-sectional study based on data of the third National Survey of non-communicable diseases (SuRFNCD-2007); among 2125, Iranian adults (1168 women) aged 25-64 years. Demographic and anthropometric characteristics were collected. Biochemical assessments, were determined on venous blood samples. Quantitative highly sensitive CRP was measured via enzyme-linked immunoassay. Elevated CRP was defined as values above 3 mg/l. Metabolic syndrome was defined according to the ATP III (Adult Treatment Panel III report, 2005). GFR was calculated with the MDRD formula. Multivariable logistic regression accompanied by complex sample survey analysis, including stratified weighting, were recruited. The fiber-rich regimen was determined by the daily consumption of more than five units of vegetables or fruits. Mean age of the population was 39.4±4.5 years. Adjusted odds ratios for prediction of high CRP pertaining to High LDL, Low Physical activity, BUN, MetS ATP III, Declined GFR (per 30 units reduction), optimal Fiber intake, and Current Smoking were calculated. Corresponding values with 95 % CI were 1.36 (1.04-1.85), 1.31(1.11-4.20), 1.04(1.04-1.12), 1.47 (1.04-2.09), 1.22 (1.11-3.36), 0.84 (0.87-1.48), 1.74 (0.39-1.38), respectively. We figured out that MetS, declined GFR in early stages of CKD, and low physical activity were related to high inflammatory state, while fiber-rich regimen decreased the likelihood of high CRP in smokers.
We aimed to investigate the association of pretreatment host and/or viral related factors with sustained virological response (SVR) rate in chronic hepatitis C (CHC) infected patients. This cohort study was performed on 200 IFN-naïve Iranian CHC patients who were treated with pegylated interferon-α (PEG-IFN-α) plus ribavirin (RBV). Pretreatment levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), fasting blood sugar (FBS), HCV load and genotype were determined, and the pattern of changes was monitored throughout the course of treatment. The baseline FBS value in the non-responder group was significantly higher than that of the SVR group. The SVR group showed a rapid and continuous decline of ALT/AST activity from the beginning of the treatment, while the ALT level was fluctuating in non-responder and relapse groups. Persistent normalization of transaminases during combination antiviral therapy was significantly associated with SVR rate. Besides, age and FBS levels had the greatest impact on SVR. Minocycline seems to be a safe and effective adjuvant in the management of patients with schizophrenia.
Ketamine and magnesium in brain act as an N-methyl-D-aspartate receptor antagonist that has been shown to be useful in the reduction of acute postoperative pain and analgesic consumption in a variety of surgical interventions. We hypothesized that combination of low dose ketamine and magnesium would reduce early postoperative opiate consumption and analgesic requirement after 6 weeks. This was a randomized, prospective, controlled-placebo trial involving elective and eligible patients undergoing lumbar spine surgery. Seventy patients in the treatment group were administered 0.5 mg/kg intravenous ketamine and 1 gram of magnesium as an intravenous bolus slowly during 3 minute before incision and 0.25 mg/kg/hr ketamine and 0,5 g/hr magnesium intravenous infusion during surgery. Seventy patients in the placebo group received saline of equivalent volume. Patients were observed for48 h postoperatively and followed up at 6 weeks. The primary outcome was 48h morphine consumption. The severity of pain was lower in the intervention group than in the placebo group during 48 hr post-operatively, morphine consumption in this group also decreased significantly during this period. Intraoperative ketamine-magnesium reduces opiate consumption in the 48-h postoperative period. This combination may also reduce pain intensity throughout the postoperative period in this patient population.
An atrial septal defect (ASD), sometimes called a hole in the heart is a type of congenital heart defect in which there is an abnormal opening in the dividing wall between the upper filling chambers of the heart (the atria). To determine the outcome of surgical closure in patients with atrial septal defects, we designed a retrospective study, including 120 patients present with an atrial septal defect after surgical closure done in the cardiac teaching center in Sulaimani city. The data collected include the patients that admitted which are known cases of ASD and treated by open heart surgery during the last nine years from 1st of January 2008 until the 1st of January 2018. A total of 120 children diagnosed with Atrial Septal Defect (ASD) were included in this study with a mean age of 7.8±4.4 years; 32.5% of them were 1-5 years old, 50.8% of them were in the age group 6-12 years, and 16.7% of them were in the age group 13-19 years. Only three ASD children received medical treatment while all of them were treated surgically with open-heart surgery. The mean age of ASD children at surgery was7.8±4.4 years; 5.8% of them were 1-2 years old, 28.4% of them were 3-5 years old, 49.1% of them were in the age group 6-12 years, and 16.7% of them were in the age group 13-19 years. There was a significant association between primum ASD type and large ASD with posteroinferior deficient rims (P=0.04). A significant association was observed between primum ASD type and large IAS (P=0.006). Mean ASD diameter was significantly higher among patients with primum ASD type (P=0.01). The outcome of surgical closure of the atrial septal defect in children is effective and safe. Ventricular arrhythmia in the form of ectopic was the postoperative complication in one patient. The main echocardiography findings of children with atrial septal defects were large ASD with posteroinferior deficient rims.
Her-2 (ErbB-2) is an oncogene frequently overexpressed in breast and gastric adenocarcinomas, and anti-Her-2 targeted therapy can be given to such patients. Her-2 overexpression and role of anti-Her-2 targeted therapy in cases of gallbladder adenocarcinomas (GBC) are still debatable. Scoring protocols for Her-2 expression in breast and gastric carcinomas are standardized, however, not for carcinomas arising in other body organs like the gallbladder. This study is conducted to evaluate the expression of Her-2 in patients with GBC, which may benefit from targeted therapy. It is a cross-sectional study conducted on patients with GBC (n=63; 53 women and ten men). An automated immunohistochemical technique was used with an anti-ErbB2 antibody. Scoring was conducted according to the CAP (College of American Pathologists) criteria for breast cancer. Positive (3+) Her-2 staining was observed in 8/63 (12.7%). Nine cases (14.3%) showed equivocal staining (2+) pattern. All of the tumors showing Her-2 overexpression were moderately differentiated. This study indicates that a significant number of GBC cases show Her-2 overexpression. This subgroup may benefit from inhibitors of the Her-2 pathway. Standardization of scoring protocol for Her-2 expression in GBC is needed to better evaluate the predictive potential of Her-2 for the treatment of these tumors.
Acute transient swelling of the parotid glands during or after surgery under general anesthesia was prescribed by previous colleagues. This complication is called anesthesia mumps. We present a case of bilateral parotid swelling noticed early in the intraoperative period. A 52-year-old male patient was scheduled for internal fixation of right tibial fracture under general anesthesia. The surgical procedure was uneventful and lasted for 2.5 hours. But 30 minutes after the beginning of surgery, swelling of both parotid regions was noted. In the recovery unit, the patient had moderate swelling of both parotids, expanding down to the mandibular angle with no complaint of pain, difficulty in swallowing, and dyspnea. Swelling decreased in size after five days and resolved in seven days. It is important to recognize anesthesia mumps as a rare complication that can appear during surgery or in the early postoperative period.
Splenic artery aneurysm (SAA) is rare, often with no sign patient, discovered accidentally in ultrasonography and imaging studies. A healthy 45-year-old woman was referred to us by abdominal pain in the epigastric region-imaging showed a large mass located between the spleen, stomach, and pancreas. CT scan showed two true aneurysms of a 4 mm and 12 mm diameter in the middle third and distal part of the splenic artery. SAAs that are lesser than 2cm can be controlled; however, our patient was given an open surgery, and splenectomy with the removal of the aneurysm has done.
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