Ahmadreza Dehpour, PharmD, PhD
Vol 58, No 6 (2020)
Hypertension is a chronic condition, and a major risk factor for other chronic conditions requires management. Considering the growth and extensive use of mobile health (mHealth) technologies and their capabilities, it is essential to examine the effects of these technologies on hypertension control and self-management. The present systematic review examined the effect of using mHealth technologies in controlling blood pressure and investigated the functionalities of mHealth technology on self-management aspects of patients with hypertension. A systematic search was conducted on PubMed, Web of Science, Embase, and Scopus databases. Clinical trials in English investigating the use of mHealth technologies for blood pressure control published from 2005 to 2018 were included in this study. The functionalities of these technologies were also investigated. These functionalities were divided into five categories of monitoring, alarms, feedbacks, education, and communication. The most frequently used technology for hypertension control was smartphones in the 15 articles examined. Moreover, the most frequent functionalities used for self-management of hypertension were communications and reminders, education, monitoring, and feedback, respectively. In the majority of the studies, these functionalities were employed in combination with mHealth technologies, a feature that affects hypertension control and self-management. The use of mHealth technologies, such as smartphones, positively affects hypertension self-management and reduces blood pressure. Functionalities such as communication and reminders, education, monitoring, and feedback are effective in hypertension self-management programs. The simultaneous use of these functionalities combined will be more effective in hypertension self-management programs.
Treatment of colorectal cancer is one of the important challenges due to the increase of resistance to chemotherapeutic drugs. Isolated natural compounds from medicinal plants and other sources often are used as novel drugs for treatment of various human cancer. The aim of this study was to investigate the antioxidant and anticancer activity of Eucalyptus camaldulensis essential oil on colorectal cancer cell line Caco-2. The antioxidant activity of extracted E. camaldulensis essential oil (1000, 800, 400, 200, 100, 50, 25, 12.5, 6, and 3 μg/mL) was evaluated by free radicals inactivation method. Moreover, MTT assay was used to examine the cytotoxic effects of E. camaldulensis essential oil on the Caco-2 cell line. The mRNA expression of BAX and BCL-2 genes was studied using quantitative Real-Time PCR method, in treated cancer cells compared to untreated cells. We indicated a significant, impressive antioxidant activity in 1000 μg/mL of E. camaldulensis essential oil, in a concentration-dependent manner. In addition, we found that this product exerted a cytotoxic effect on cancer cells when 100 μg/mL concentration was considered as half-maximal inhibitory concentration (IC50). Also, the expression of BAX and BCL-2 genes were significantly upregulated and downregulated, respectively, in the treated Caco-2 cells with E. camaldulensis essential oil. In conclusion, our study showed significant antioxidant and anticancer activity in E. camaldulensis essential oil in a concentration and time-dependent manner, which may be due to the reduction of free radicals and induction of apoptosis process in colorectal cancer cells.
The theory of platelet role in cancer progression was recently introduced. We investigated the association of extravasated platelets in colorectal cancer with clinicopathological features, and also the expression of epithelial-mesenchymal transition (EMT) markers. We retrospectively analyzed data from 33 patients with colorectal cancer who underwent surgery between 2013-2016. In formalin-fixed paraffin-embedded tissues, we evaluated the expression of a platelet-specific marker of CD42b and EMT markers using immunohistochemistry. The associations among the expression of the platelet‑specific marker in specimens, EMT, and clinicopathological futures were analyzed. The presence of platelets was observed in 15 out of 33 primary colorectal tumors (45%). According to multivariate analysis, CD42b expression was not correlated with clinical characteristics. Platelet-positive tumor cells did not show EMT marker expression. These data suggest that extravasated platelets may not have a central role in determining patient characteristics and clinical futures.
The epidemiology of traumatic injuries in elderly patient fractures varies widely among countries. There is quantitative information to determine the prevalence and gender/age distribution of traumatic injuries in the elderly patient. The aim of the current study was to reveal the prevalence and age and gender distribution of various traumatic injuries in an elderly patient refers to as a tertiary orthopedic hospital in Iran. In a prospective descriptive study, all elderly patients with traumatic injuries attending the Orthopedic Trauma Unit of our center in 2001-2011 were included. Demographic details, the cause of injury, injury classification was recorded. For each gender, we calculated the numbers with fractures, dislocations, soft tissue injuries, ligamentous injuries, and lacerations and derived average age and gender-specific prevalence. During a period of 10 years, a total of 1172 elderly patients were admitted, 588 (50.1%) males, and 584 (49.9%) females. 849 patients (72.4%) had fractures. 323 (27.5%) of the patient had other limb injuries were include soft tissue injuries, lacerations, ligamentous injuries, and dislocations. The three most common fracture sites were proximal femur (40.02%), distal radius/ulna (12.47%), and proximal humerus (6.53%). The most prevalent traumatic injury among the elderly was fractures with a higher rate in females. The most common fracture sites were proximal of the femur and distal of radius and ulna bones.
Recurrent abortion is a worldwide issue. Anticardiolipin antibodies (ACA) are found to be among the most important factors related to recurrent spontaneous early pregnancy loss. This study aimed to investigate the prevalence of anticardiolipin IgM and IgG antibodies in women with recurrent abortion in Kurdistan Region of Iraq. The present study was conducted in Duhok and Zakho cities for the period from April 2014 to May 2019. A total of 1230 women aged between 18 to 46-year-old were included in this study. ELISA was used for the detection of anticardiolipin antibodies. Among the studied subjects, the prevalence of anticardiolipin antibodies was 74 (6.02%) for ACA IgM and 56 (4.6%) for ACA IgG. It was also observed that 16 (1.3%) subjects were positive for both ACA IgM and IgG antibodies. Additionally, the highest anticardiolipin antibody positivity rates were recorded in patients older than 30-year-old (P<0.01). The IgM ACA positivity was higher in Zakho city 45 (7.2%) when compared to Duhok city 29 (4.6%) (P<0.04). In conclusion, anticardiolipin antibodies can have a positive association among women with recurrent abortion. Therefore, it is suggested that women with recurrent abortion should be screened for anticardiolipin antibodies; this could increase fetal survival by initiating early anticoagulant therapy when other causes of abortion are excluded.
Cardiac complications are the most important cause of mortality and morbidity in Beta-Thalassemia Major (B-TM). The aim of our study was to determine the influence of Average Annual Mean Serum Ferritin (AAMSF) levels on cardiac function in patients suffering from B-TM. In this cross-sectional study, 50 patients of 5-15 years with B-TM were enrolled in the absence of clinical signs and symptoms of cardiac dysfunction. Left ventricular function was studied by using tissue Doppler image (TDI), pulse wave Doppler (PWD). AAMSF level was measured for 12 months. Patient groups were subdivided into two groups, group A with AAMSF level below 1000 ng/ml and group with B with AAMSF level above 1000 ng/ml. The Case group included 24(48%) males and 26(52%) females which were compared with 50 healthy subjects composed of 27(54%) males and 23 (46%) females (control group). The AAMSF Levels were 1054.60±687.95 ng/ml. By using PDW, in patients with AAMSF below 1000 ng/ml, The Parameters of the E, A, E/A E-DT had no significant difference with health groups (P=0.808, P=0.820, P=0.231 and P=0.061, respectively). No significant difference was revealed in parameters of E’, IVCT and ET in patients with AAMSF below 1000 ng/ml by using TDI in comparison to control (P=0.155, P=0.683, P=0.222, respectively).however, other TDI indexes including A’, E’/A’, IVRT, S,’ LVMPI, E/E’ had a significant difference with health group (P=0.014, P=0.041, P=0.045, P=0.002, P=0.021, and P=0.002, respectively). At patients with above AAMSF 1000 ng/mL, both PDW and TDI parameters had significant differences with the health group. There was no correlation among AAMSF levels and PWD or TDI indexes. The evidence from this study suggests that subclinical systolic and diastolic LV dysfunction has happened with AAMSF level above 1000 ng/ml, and according to our result, TDI is found more useful than PWD for subclinical cardiac evaluation.
Frontal fibrosing alopecia (FFA), a form of lichen planopilaris (LPP), is primary cicatricial alopecia commonly affecting postmenopausal women. For the first time, we investigated the diagnosis of FFA and LPP in patients presenting with the chief complaint of facial papules and roughness. This cross-sectional was performed among 68 patients with facial papules. We described the epidemiology, comorbidities, clinical presentations, and the association between facial papules and LPP or FFA. All the patients were female with a mean age of 47.84 years. Scalp alopecia was observed in all the patients presenting with facial papules, of which 89.7% had FFA. Five patients were diagnosed with LPP without FFA. Most of the patients were premenopausal (73.5%), and 70.6% had grade I FFA. Concomitant cutaneous lichen planus involvement was observed more frequently than mucosal involvement. The most frequent comorbidities were hypothyroidism, dyslipidemia, and hypertension. History of alopecia areata was detected in 8.8% of the patients. Androgenetic alopecia (AGA) was present in 17 patients (25%). Facial papules are the silent and early signs of FFA and LPP. Paying attention to these early signs along with metabolic disturbances can help with the early diagnosis of the disease, especially among premenopausal women.
Congenital absence of the vagina with variable uterine development known as Mullerian agenesis or Mayer-Rokitansky-Kuster-Hauser syndrome. Cervicovaginal agenesis in the presence of normal uterus is very rare. Conservative surgery has recently been suggested in patients with congenital cervicovaginal atresia in order to relieve the symptoms and maintain fertility. A 13-year-old female referred to a pelvic floor clinic, because of primary amenorrhea and severe cyclic pelvic pain. Ultrasonography revealed a large amount of blood accumulation in the uterine cavity, and also, the cervicovaginal agenesis was reported. Both ovaries were normal. A neovagina was created by dissection of the space between the bladder and rectum. Under ultrasonography guidance, two Pezzer catheters were inserted between uterine ending and neovagina, so the catheters kept the canal patent, a soft mould was applied to prevent the vaginal stricture. Cervicovaginal agenesis, accompanied by normal functional endometrium, is a rare but challenging Mullerian anomaly in the case of surgical treatment. One of the successful conservative treatment in a fully educated patient is the vaginal reconstruction and uterovaginal anastomosis by stenting and continues the application of vaginal mould.
Myocardial infarction (MI) in pregnancy is a rare and critical topic. In time diagnosis and management is mandatory for preventing both mother and fetus from possible mortality and morbidities. Both traditional cardiovascular risk factor and some factors which are present during pregnancy are related to MI during pregnancy. Management of ST-segment elevation MI during pregnancy is almost the same as other women. In the present report, we have discussed a case of anterior ST-segment elevation MI during the late third trimester of pregnancy, which ended up in a successful vaginal delivery. However, in the post-partum period, the patient developed severe bleeding and uterine atony, which was managed medically and with the massage.
Cone-rod dystrophy (CORD) is one of the most common genetic eye disorders. Recent genetic studies have demonstrated that it is a genetically heterogeneous disease among patients. Molecular genetic analysis of the 22 genes was performed in a family with Cone-rod dystrophy. Bioinformatics was applied for Next Generation Sequencing, and the variants were confirmed by Sanger sequencing. In this study, the nonstop mutation in the PDE6C gene (a normal stop codon is 859th codon of PDE6C located in exon 22 TAA (Stop) --> CAA (Gln) = Stop859Q) leads to a termination-site change and run-on into the 3' untranslated region (UTR) that predicts an extended protein which was found in the family. This mutation has not been described in patients with the CORD phenotype. Also, this is the first study indicating that a nonstop mutation in the homozygous state in PDE6C is responsible for the congenital recessive CORD phenotype.