bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of intrathecal midazolam (2mg) as an adjuvant to bupivacaine (0.5%) for spinal anaesthesia in orthopaedic surgery: A case control study
Authors: Sharma Anita , Pathania Jyoti , Verma Yashwant , Singh Surender
Published: February 2022

Spinal anaesthesia is being routinely used for lower abdominal and lower limb surgeries. Bupivacaine is the commonly used anaesthetic agent because of its longer duration of action. Various intrathecal adjuvants like midazolam are sometimes added to enhance the anaesthetic effects and increase the duration of analgesia. We, hereby evaluated the effects of intrathecal midazolam 2mg as an adjuvant to bupivacaine during spinal anaesthesia in orthopaedic surgery.

A total of 60 patients of age 20-50 years were randomly divided into two groups: BM-who received 3.2ml bupivacaine and 0.4ml(2mg) midazolam; and BS-who received 3.2 ml bupivacaine and 0.4ml normal saline.

Mean duration of analgesia was prolonged in the midazolam group (429.33+/-59.54 min) as compared to controls (252+/-42.22 min) (p=0.00). The number of injection diclofenac as rescue analgesic were also significantly less in BM group. Time to achieve maximum sensory level(T4) was also significantly less in BM group. Time to two segment regression and the duration of motor block were more in the midazolam group.

Intrathecal midazolam as an adjuvant significantly prolongs the duration of analgesia and decreases the requirement of rescue analgesia when combined with bupivacaine during spinal anaesthesia. The dose of 2mg seems to safe and effective to achieve the desired results.
Anesthetic management of a single-ventricle pediatric patient with scoliosis: A case report
Authors: Aboalfaraj Ahmad Tareq , Sindi Ziad Sulaiman , Mahmoud Ahmed Haroun , Metwally Ahmed Mounir
Published: February 2022

Single ventricle is a complex cardiac disease which carry high morbidity and mortality and the average 3 years survival rate without Fontan procedure was approximated to be 75%. The most common etiologies are: hypoplastic left heart syndrome and tricuspid atresia. When those patient plan to go for surgery, it’s very essential for anesthetist to understand how the physiology is affected rather than etiology. BT shunt patency, right ventricular function and pulmonary artery pressure should be evaluated before any procedure under anesthesia. Scoliosis corrective surgery is a procedure that has its special considerations related to restrictive pulmonary disease, prone positioning, and major bleeding that may occur, which altogether will add to the risk when being conducted in a single-ventricle patient and will necessitate vigilance and special care during monitoring intraoperatively. Here, we report a simple way to monitor the transpulmonary pressure gradient through two central lines in the femoral and jugular veins as part of the patient’s anesthesia management.
Anaesthetic management in a patient with cervical dystonia undergoing pallidotomy
Authors: Shruthi K  , Konnur Anurita , Sandhya K  , Nethra SS  , Nagaraja Swathi
Published: February 2022

Stereotactic neurosurgery poses number of anaesthetic challenges. Awake craniotomy involves proper patient selection and co-ordination by the multi-disciplinary team. We report a case with isolated cervical dystonia posted for pallidotomy performed under Monitored Anaesthesia Care.

: Awake craniotomy poses a unique challenge by itself. We had to face an additional challenge of difficult airway.
Bacterial isolates and their biofilm formation on contact lenses
Authors: Purushottam M Deborah , Padmaja Nesepogu
Published: February 2022

Using contact lenses without proper care and sterilization measures can lead to eye infection like keratitis and other eye diseases. About 25-30% of cases with corneal ulcers are related to contacts lens use. Microbial agents after their entry, they further invade into corneal layers by their virulence factors and enzymatics secreted by the bacteria. Wearing contact lenses also increase stress on cornea so the cornea has less ability to defend against the bacteria which is invading. Some of the bacteria are also capable of biofilm formation. Biofilms formed on contact lens surfaces has increased resistance to common steriliants used in contact lens care solution.

The main aim of this study is to identify the pathogens that can be grown on the contact lenses and contact lens cases, to identify the production of biofilm by the isolates obtained during this study and to bring awareness about proper sterilization of contact lenses and lens cases during their usage to prevent unnecessary eye infections.

This cross sectional study was carried from October 2019 to June 2021 on MBBS and BDS students in Konaseema Institute of Medical Sciences and Research Foundation, who are using contact lenses and who are asymptomatic. Written consent from all students participating in this study was taken. The samples are collected using sterile swabs. Swabs from both the lens and lens cases are taken and immediately cultured and related biochemical tests are done to identify the organism. For the study of biofilm formation, the bacterial isolates obtained from the specimen are inoculated on to commercially available Congo red agar (CRA).

The data was processed and arranged into distribution tables and cross tables using statistical package for the social sciences (SPSS) version 21.

Total 200 samples were collected and processed for bacterial culture. Among them 145(72.5%) samples showed positive bacterial culures. The most common organisms obtained are which were 30 (20.6%), next common organism isolated were micrococci 24(16.5%), though ASB’s and micrococci are non pathogenic, these were included because the lens and lens cases are preferably to be sterile. The other organisms isolated are 21 (14.4%), 18 (12.4%), 16 (11.04%), 12 (8.2%), 10 (6.9%), 8 (5.5%) and 6 (4.2%). The isolated bacteria are then again streaked on Congo Red Agar to check for the ability of the bacterial isolates to form biofilms. Among 145 bacterial isolates obtained in this study 98 (67.5%) samples showed positive biofilm formation.

The micro organisms can lodge in most of the contact lenses and contact lens cases… which in turn enter into eye due to improper sterilization of lens and lens cases. And most of the bacterial isolates obtained from these contact lenses and contact lens cases are capable of production of biofilm. To avoid infections caused by contact lens users the care of both the contact lenses and lens cases is very important.
Antibiogram of burn wound isolates at Masina hospital, Mumbai, India: A 12-year descriptive cross sectional study
Authors: Saldanha Jovita , Kumar GS Chethan , Shah Kushal , Abhyankar Suhas , Vartak Arvind M
Published: February 2022

: To study the antibiogram of Klebsiella, Pseudomonas and Staphylococcus and its change in sensitivities with time.

: 4909 swabs were taken from790 of patients admitted to the Burns unit of Masina Hospital, Mumbai, over a period of 12 years (2008–2019). The swabs were cultured and percentage antibiotic sensitivity of 6835 predominate isolates to different class of antibiotic was determined and reviewed.

: Klebsiella was the predominant organism in our set-up, followed by Pseudomonas and Staphylococcus aureus. The antibiotic sensitivities of the most predominant organisms are discussed in detail in this article.

: Gram negative nosocomial infection predominate a burn injury. Knowing the predominant target pathogens and their sensitivity pattern towards different antibiotics will avoid misuse of antibiotic, contribute to prescribing the correct antibiotics and timely clinical treatment. A routine microbiological surveillance prior to administrating an antibiotic, a well established infection control department and regular reporting of changing antibiotic trends will help us overcome our battle against emerging multi drug resistant organism, thereby having more successful treatment outcome in burn patients.
Occurrence of dengue infected patients in a tertiary care centre
Authors: Singh Sudhir , Joshi Manisha , Haria Jigar , Farooq Umar , Sharma Shweta R , Sharma Vasundhara , Ahamad Imran
Published: February 2022

Dengue virus is a member of arbovirus, family flaviviridae, genus flavivirus. These are found in common tropical areas of the world or the transmitted through bite of the female mosquito Aedes aegypti and chiefly occurs during the rainy season. It is classified into three parts Dengue Fever, Dengue hemorrhagic fever, Dengue shock syndrome. The signs of dengue: fever, headache, retro orbital pain, muscles pain, joints pain or rashes are usually seen on 3-7 days. DF is also called break bone fever.

: To study the occurrence of dengue infected patients. To determine the frequency of dengue patients presenting with fever of less than 5 days in NS1 Antigen ELISA. To determine the frequency of dengue infected patient presenting with fever for more than 5 days in IgM ELISA.

The study was carried out from period of 2019 to 2021. Blood samples were collected from 161 patients. Serum was separated from blood samples. NS1 Ag detection was done from ELISA method & IgM Ab was detected by using Dengue MAC Capture ELISA test.

: A total of the 161 blood samples were tested, 85 (53%) were positive & 76 (47%) were negative for dengue. The dengue infection was commonly found in males than females, the common age groups of patients presenting with dengue was 11-30years.

Our study focused on continuous monitoring and community action for individuals and dengue controls. This research will help to improve the ways of surveillance, prevention and control.
Speciation of candida species isolated from patients with esophageal candidiasis and their antifungal susceptibility test to fluconazole
Authors: Sharma Shweta R , Ali Mohammad Zulfiqar , Mishra Amit , Farooq Umar , Singh Sudhir , Sharma Vasundhara , Ahamad Imran
Published: February 2022

Esophageal candidiasis is often observed in patients for its development and fluconazole is the therapeutic choice for the treatment.

To determine its frequency, by performing upper gastrointestinal endoscopy and the frequency of various species isolated from patients with EC. To determine the antifungal susceptibility to fluconazole of isolated various species.

From January2020 to December 2020, total 73 patients found eligible for this study from endoscopy unit in Teerthanker Mahaveer medical hospital and research center (Moradabad), who presented whitish plaques consistent with esophageal candidiasis in order to identify species and verify their susceptibility to fluconazole.

Total 4256patients referred to UGI endoscopy at the endoscopy unit, 73(1.7%) had found esophageal candidiasis. Most affected age group from this disease was found 41-60 years (48%). Frequent number of species isolated was 50(68.5%). A total of 15(20.6%) isolated species were resistant to fluconazole, while 2(2.7%) had intermediate sensitivity to this drug.

Esophageal candidiasis prevalence was low although similar or within the results described by other authors. The common causative species was found for this disease and the resistant to fluconazole were considered high.
An evaluation of three different biofilm detection methods in orthopedic implant associated infections and its implication in healthcare system
Authors: Medegar Shobha , Mansabdar Pooja , Patil Asha B
Published: February 2022

: Biofilms are defined as microbially derived sessile communities characterized by the cells that are irreversibly attached to a substratum. These organisms have been associated with implant associated infections

The present study is therefore undertaken 1. To compare the three screening methods used for detection of biofilm formation (Tissue culture plate method, Tube method and Congo red agar method) and 2. To correlate the antibiotic resistance pattern of biofilm producers and non biofilm producers.

: A prospective study was carried out in the department of microbiology, on all orthopedic implant associated infections from September 2015 to July 2016 on aspirated pus samples. A total of 120 non repetitive clinical isolates were taken and subjected to biofilm detection. All the bacterial isolates were identified by standard biochemical tests. Antibiotic susceptibility test of bacterial isolates was performed by Kirby Bauer disk diffusion method according to Clinical Laboratory Standard Institute (CLSI) guidelines on Muller Hinton Agar (MHA). A reference strain of Staphylococcus epidermidis ATCC 35984(positive biofilm producer) and Staphylococcus epidermidis ATCC 12228(non biofilm producer) were used as controls.

Tissue culture plate method was considered as gold standard as it detected 25% biofilm producers which included 12% weak biofilm producers which was missed by congo red agar (CRA) and tube method (TM). Also, this correlated to methicillin resistant staphylococcus aureus (MRSA), ESBL, amp-c and MDR pattern of antibiogram.

: TCP is considered as most reliable screening method for biofilm detection and should be routinely employed to prevent treatment failures as these organisms are intrinsically resistant to many antimicrobials leading to implant associated infections.
Subcutaneous Nocardiosis in a child with T- cell Immunodeficiency: A case report
Authors: Prasad Ratna R , Archana C Choure , Sachinkumar V Wankhede , Vrishali A Muley
Published: February 2022

Nocardia are weakly gram-positive, filamentous bacteria found worldwide in soils. Infection with Nocardia is rare inimmunocompetent patientsbut may leadto severe disease in immunocompromised patients. Reported cases in paediatric age group are few, and the literature is limited. We present a case of Nocardia isolated from pus from a skin lesion of eleven year old immunocompromised male child. Pus from Skin lesion on Ziehl-Neelsen (ZN) stain showed Acid Fast, Branching filamentous Bacteria. Pus culture on Lowenstein-Jensen (LJ) media showed glabrous, tough and waxycolonies. It was confirmed to be Nocardia species on Gram stain and modified ZN Stain. No organism was isolated on culture from Blood, urine and Cerebrospinal fluid (CSF). High clinical suspicion is required for diagnosis of slow growing bacteria such as Nocardia as they can be easily be missed on routine bacteriological culture.
Covid-19 vaccine breakthrough infections amongst health care workers in a tertiary care centre
Authors: Paul Liz Mary , M Shamsudeen
Published: February 2022

The study was conducted to understand the clinical profile of Covid-19 infections amongst health care workers after vaccination

SARS CoV 2 infection was diagnosed with Antigen test / Automated RTPCR in health care workers. All health care workers presenting with symptoms related to Covid-19 atleast 2 weeks after receiving ChAdOx1 nCoV-19 vaccine or high risk primary contacts with asymptomatic infection were included in the study. Detailed clinical profile and other data were collected using a proforma.

82.1 % of the Covid 19 infections after vaccination were defined as Mild Covid-19 and received supportive care at home. Breakthrough infections occurred after a mean duration of 31 days. Since fever and throat pain were the most common presenting symptoms (71.4% and 39.3%), upper respiratory infection was considered as more common. Only 3 patients were defined as Moderate Covid 19 which required hospitalization but did not require oxygen supplementation.

Breakthrough infections after ChAdOx1 nCoV-19 vaccination were mild in majority of the cases and most cases presented with upper respiratory tract infection symptoms. The pattern of breakthrough infections helps in determining the efficacy of vaccines and requirement of booster doses of vaccine.
Atypical Organization of Praxis and Language: A Look Back
Authors: Króliczak Grzegorz , Buchwald Mikołaj , Klichowski Michał , Nowik Agnieszka M. , Piper Brian J.
Published: February 2022

Atypical representations of praxis and language were studied in two forms and combinations: bilateral organization, and right lateralization, independently for each function; when the atypically represented praxis dissociates from typically lateralized language; and when both praxis and language have atypical forms. Direct differences between bilateral and right-lateralized representations were either marginal (for praxis), or nonexistent (for language). Because atypical organization of praxis is over twice as frequent as language in its atypical form, sample size might be an issue only for the latter (as atypical organization of language is very rare). Group averages in their dissociations, and associations in atypical forms, revealed the expected representations of the two functions. These outcomes indicate that merging the two atypical representations of praxis, or language, into one atypical group can reveal the critical aspects of their atypicality, including subcortical contributions, without seriously impeding correct interpretation of the essential underlying neural mechanisms.
Altered Expression Levels of MicroRNA-155 and SOCS-1 in Peripheral Blood Mononuclear Cells of Newly Diagnosed Breast Cancer Patients
Authors: Iranparast Sara , Tahmasebi-Birgani Maryam , Motamedfar Azim , Amari Afshin , Ghafourian Mehri
Published: February 2022

MicroRNA-155 (miR-155) has a critical role in pro-inflammatory activation and tumor progression. In addition, miR-155 has various oncogenic effects in the tumor microenvironment by targeting the suppressor gene of cytokine signaling-1(SOCS-1) and interleukin-6 (IL-6). This study investigated the association of inflammatory changes with the variations of miR-155 expression in newly diagnosed breast cancer (NDBC) patients.
Seventy NDBC patients were categorized as lobular and ductal subgroups and forty healthy individuals participated in this study. The expression rate of miR-155 and its downstream target gene, SOCS-1, as well as the plasma levels of IL-6, were evaluated in peripheral blood mononuclear cells of NDBC patients; using real-time PCR and enzyme-linked immunosorbent assay, respectively.
Our results indicated an over-expression of miR-155 in the PBMCs of NDBC patients which was significantly associated with the tumor grade and the type of ductal carcinoma. In contrast, a significant downregulation of SOCS-1 was observed in NDBC patients compared to the control group, however, there was no significant difference between the two subtypes of BC. Furthermore, a higher concentration of plasma IL-6 was detected in NDBC patients compared to the healthy control group which had an inverse correlation with the SOCS-1 levels.
According to the potential effects of miR-155 on regulating the expression of SOCS-1 and IL-6, we suggest this small transcript as a promising diagnostic marker for various types of BC patients.
A Significant Increase in the Gene Expression of GATA-3 Following the Treatment of Osteoarthritis Patients with Crocin
Authors: Poursamimi Javad , Shariati-Sarabi Zhaleh , Tavakkol-Afshari Jalil , Mohammadi Mojgan
Published: February 2022

Osteoarthritis (OA) is known to be the most prevalent form of joint disease. We conducted this clinical trial to investigate the effects of KrocinaTM, a natural product containing crocin, on the gene expression of unique transcription factors of various T cell subsets in patients with OA.
We collected 40 peripheral blood samples of OA patients receiving Krocina™ and equal number of those who took a placebo (IRCT2015021910507N2, NCT03375814). RNA extraction was performed from the cultured peripheral blood mononuclear cells of the OA patients who received Krocina™ and placebo and SYBR Green Real-time PCR technique was applied to assess the relative gene expression of T-bet, GATA3, ROR-γt, and FOXP3 as the unique transcription factors of various T cell subsets.
The relative gene expression of T-bet and ROR-γt insignificantly decreased in the Krocina™ receiving group as compared to the placebo group. In addition, the relative gene expressions of GATA-3 and FOXP3 after the treatment with KrocinaTM showed a significant and insignificant increase, respectively. Moreover, an insignificant decrease was observed in the gene expression of GATA-3 and FOXP3 in the placebo group. A significant and insignificant decrease in the gene expression of T-bet and ROR- γt was detected in the OA patients who received a placebo. GATA-3 is known as a unique transcription factor for the differentiation of T-cells to the Th2 subset.
The significant increase in the gene expression of GATA-3 in the patients with OA treated with crocin may suggest the beneficial effect of crocin on shifting towards the Th2 subset and enhancing an anti-inflammatory condition.
Evaluating Mannuronic Acid Effect on Gene Expression Profile of Inflammatory Mediators in Rheumatoid Arthritis Patients
Authors: Omidian Saiedeh , Aghazadeh Zahra , Ahmadzadeh Arman , Aslani Mona , Hosseini Mostafa , Abbasi Simin , Mirshafiey Abbas
Published: February 2022

Rheumatoid arthritis (RA) is a multisystem disorder. Various studies have shown the important role of inflammatory factors tumor necrosis factor α (TNF-α), interleukin (IL)-6, IL-22, MYD88, and toll-like receptor 2 (TLR2) in this disease. In this study, we investigated the anti-inflammatory effects of B-D-Mannuronic acid (M2000), as a new immunosuppressive drug, on the expression of these inflammatory markers in peripheral blood mononuclear cells (PBMCs) of RA patients.
The blood samples of 24 active RA patients and healthy volunteers were used for PBMCs separation. The cells were cultured with LPS (1 µg/mL), low (5 µg/mL), moderate (25 µg/mL), and high (50 µg/mL) doses of M2000 and a single dose of diclofenac (1 µg/mL) to evaluate TNF-α, IL-6, IL-22, MYD88, and TLR2 genes expression by quantitative real-time (qRT-PCR). Cell surface expression and MFI of TLR2 were assessed; using flow cytometry.
Our findings exhibited a significant reduction of TNF-α, IL-6, and MYD88 gene expressions after treatment with three doses of M2000 and an optimum dose of diclofenac. TLR2 gene expression was significantly diminished by moderate and high doses of M2000 and a single dose of diclofenac. Moreoversurface expression of TLR2 was significantly downregulated by moderate and high doses of M2000, while MFI of this was significantly reduced by three doses of M2000.
The results of this research showed that M2000 was able to significantly reduce the gene expression of inflammatory markers TNF-α, IL-6, MYD88, and TLR2 in patients PBMCs. These data revealed a part of the mechanisms of M2000 in the treatment process.
Immunochemical Characterization of Ligustrum Vulgare (Privet) Pollen Allergens: Study of Common Allergenic Plant in Iran
Authors: Abdoli Sereshki Haleh , Falak Reza , Assarehzadegan Mohammad-Ali , Nabavi Mohammad , Shams Mohammad-Hossein , Ranjbar Maral
Published: February 2022

Ligustrum vulgare (Privet) pollen proteins are responsible for allergies in susceptible individuals in many regions of the world. This study investigated the immunochemical characterization of Privet pollen extract and the occurrence of skin prick test reactivity to Privet and other allergenic pollen grains in allergic rhinitis patients.
All subjects experienced a skin prick test with twenty-two allergen extracts. sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) separated Privet pollen extract, IgE-immunoblotting, and specific ELISA procedures determined the allergenic profile on forty-five Privet allergic patients.
A positive allergic reaction to L. vulgare pollen extract was observed in forty-five (31.4%) out of 145 patients. Ten resolved protein fractions were found on SDS-PAGE, ranging from 10 to 80 kDa. IgE-specific antibodies interacted with several allergenic protein bands from Privet-allergic patients in the immunoblotting assay. The most significant interaction was observed in proteins with molecular weights of approximately 15, 18, 43, and 66 kDa.
Privet pollen is regarded as a potent allergen composed of IgE-binding constituents. Considering the high allergenicity of Privet pollen grains and since many countries are rich in this plant, identification and production of recombinant forms of common allergens in this species can be used for developing more efficient diagnostic, therapeutic, and preventive approaches.
Prototypic P2X7 Receptor Agonist, BzATP, Induced the Expression of Unfolded Protein Response Genes in Human M1 Macrophages
Authors: Akhtari Maryam , Zargar Seyed Jalal , Javinani Ali , Ashraf-Ganjouei Amir , Vojdanian Mahdi , Jamshidi Ahmadreza , Mahmoudi Mahdi
Published: February 2022

Purinergic receptors stimulation by adenosine triphosphate (ATP) contributes significantly to macrophage activation, and also macrophage cell death. Upon the macrophage activation, the protein load of the endoplasmic reticulum is increased which is resulted in the activation of unfolded protein response (UPR). In the current study, we aimed to evaluate the connection between prototypic P2X7 receptor agonist, extracellular 2ʹ(3ʹ)-O-(4-Benzoylbenzoyl)-ATP (BzATP), and the UPR pathway in macrophages.
The monocyte-derived macrophages from blood samples of 14 healthy volunteers were skewed toward M1 macrophages after incubation with LPS and IFN-γ. M1 macrophages were treated with 200 µM BzATP. The expression levels of UPR genes, including CHOP, HERP, GADD34, XBP1, and ATF6 in macrophages before and after treatment were measured using real-time polymerase chain reaction.
The results demonstrated that the expression of CHOP, HERP, and ATF6 is significantly decreased and the expression level of GADD34 and XBP1 is significantly increased after M1 polarization. BzATP not only significantly increased the expression levels of CHOP, GADD34, ATF6, and HERP but also significantly decreases the XBP1 expression level in M1 macrophages.
The present study showed that BzATP induces cellular stress in M1 macrophages by elevating the expression levels of UPR genes including CHOP, GADD34, ATF6, and reducing cell viability.
Decreased Expression of Cytotoxic T lymphocyte-associated Protein 4: A Risk Factor of Myocardial Infarction
Authors: Mansouri Fatemeh , Mohammadzad Mir Hosein Seyed
Published: February 2022

Cardiovascular diseases are the most prevalent disease worldwide and pose a considerable threat to human health. Cytotoxic T lymphocyte-associated protein 4 (CTLA-4) plays a crucial role in the maintenance of immune diseases; however, its role in the progression of cardiovascular disorders is still unknown. The present study aimed to evaluate the relationship between CTLA-4 and myocardial infarction (MI).
The Kyoto encyclopedia of genes and genomes database and the pathway studio database has revealed the role of CTLA4 as an inhibitory receptor on activated T cells. The relative expression of the CTLA-4 gene was assessed on the peripheral blood cells in 80 MI patients and 80 healthy individuals using quantitative real-time polymerase chain reaction (qRT-PCR) and also receiver operating characteristic (ROC) analysis was performed to evaluate the sensitivity and specificity of CTLA-4.
We noticed the decreased expression of CTLA-4 levels in patients, compared to the control group (2.73±1.55 vs. 5.36±1.34). The study revealed the sensitivity of 0.89, specificity of 0.83, the accuracy of 0.9, and the area under the ROC curve (AUC) of 0.901 (95% CI: 0.727-0.776) for CTLA-4.
The results highlighted the critical role of CTLA-4 as an inhibitory receptor in the maintenance of cardiovascular risks.
Scales of Magt1 Gene: Novel Mutations, Different Presentations
Authors: Haskologlu Sule , Baskin Kubra , Aytekin Caner , Islamoglu Candan , Ceylaner Serdar , Dogu Figen , Tacyildiz Nurdan , Unal Emel , Ikinciogullari Aydan
Published: February 2022

Loss-of-function mutations in magnesium transporter 1 (MAGT1) gene cause X-linked magnesium deficiency with Epstein–Barr virus (EBV) infection and neoplasm (X-MEN), a disease with quite diverse clinical and immunological consequences. The phenotypic characteristics of the initially described patients included CD4+ T cell lymphopenia, immune deficiency, EBV viremia, and EBV-related lymphoproliferative disease. To date, a total of 25 patients have been reported. The spectrum of the MAGT1 defect ranges from other viral infections (HSV, VZV, CMV, MCV) and sinopulmonary bacterial infections, autoimmune diseases, non-EBV driven lymphoproliferative disease, Castleman disease, HHV8+ Kaposi's sarcoma, vasculitis (Kawasaki) to glycosylation defects in new patients. Here, we report 2 patients from two different families with novel MAGT1 mutations and different clinical features. The first patient presented with B cell lymphoma and low IgM level without recurrent infections. The second patient presented with recurrent upper respiratory tract infections, Kawasaki-like disease, hypogammaglobulinemia, and T cell lymphopenia. X-MEN disease is the first phenotype identified due to MAGT1 mutation. The identification of new mutations and atypical presentations will clarify whether there is a relationship between the genotype and the phenotype and the characteristics of the disease.
The Association between Proportion HLA-BW4 or HLA-BW6 May Causes Immunity Failure in COVID-19
Authors: Chegni Hamid , Abbasi Ardeshir , Rajayi Hajar , Mohammad Hassan Zuhair
Published: February 2022

The article's abstract is not available.
Nutritional Literacy Measurement among Iranian Elderly Population
Authors: Sharifnia F , Ghaffari M , Rakhshanderou S
Published: February 2022

Background & Objective: One of the criteria for determining health is health-promoting behaviors. A high level of nutrition literacy is an important factor for differences in diet and nutritional behaviors which promotes health. Therefore, the present study investigates nutrition literacy status and its related factors in the older adults in Tehran.
Materials & Methods: This is a descriptive-analytic (correlational) study. The study population included 270 older adults of Tehran city selected using random cluster sampling in Tehran in 2018. Data collection was carried out using a 28-item nutrition literacy scale (NLS) and demographic characteristics questionnaire. Then, data analysis was conducted using SPSS ver. 16 and descriptive statistics and Chi-square, Kruskal–Wallis, Spearman correlation coefficient and multiple regression tests.
 Results: In this study, the majority of the older adults were in the group aged 60–64 years (41.9%). According to NLS, 52.2% of the older adults had inadequate nutritional literacy, 37% had borderline nutritional literacy, and only 10.7% of them had adequate nutrition literacy (p<0.001). Also, there was a significant relationship between nutrition literacy and age, sex, level of education, and occupation.
Conclusion: The majority of Iranian elderly had inadequate and borderline nutritional literacy, and only one-tenth of them had adequate nutrition literacy. Therefore, due to low nutritional literacy and its relationship with age, the elderly need to receive simple and understandable information to communicate and understand health information to make appropriate decisions, and it needs more attention from health workers, health workers and physicians.
Development and Validation of a Questionnaire for Emotional Divorce Measurement: A Mixed Research on Family Mental Health Context
Authors: Bagheri P , Ghelichi Ghojogh M , Armanmehr V , Delshad Noghabi N , Moshki M , Moradi N
Published: February 2022

Background & objectives: Emotional divorce, seems to be a reducing factor in the quality of marital life and mental health. This study aimed to design, construct and validate an emotional divorce instrument.
Materials & Methods: This study was an applied, psychometric survey using a multi-stage sampling method conducted on 805 women living in Iran between 2015 to 2018. After determining the items in a semi-structured qualitative study, face, content, structure, and concurrent validity as well as the split-half and Cronbach's alpha coefficient methods for reliability evaluation were used. For all analyses, the SPSS19 software (IBM Corp, 2013) and for confirmatory factor analysis (CFA) LISREL 8.8 was used.
Results: 36.81% of the total variance was justified by 63 factors with Eigenvalues of less than 1 and 63.19% by the first 12 factors with an Eigenvalue of higher than 1. The final questionnaire consisted of 66 questions. The total Cronbach’s alpha coefficient was 0.979. The exploratory factor analysis (EFA) resulted in five factors consisting of "love and interest in the spouse", "attention to the needs and practice the tasks", "controversy and misbehavior", "mental health", and "respect and appreciation". The results of the CFA confirmed model derived from the EFA (Chi-Square=7653.70, df =2503, P-value= 0.0000, RMSEA = 0.051).
Conclusion: The reliability of this questionnaire was high in two consecutive evaluations. The structural validity also led to the identification of the desired number of items. Hence, this questionnaire seems to be an appropriate tool for assessing emotional divorce as a feature of quality of marital life. However, further investigation is needed for tool efficiency assessment in different communities.
Evaluation of Insulin and Estradiol in Women with Polycystic Ovary Syndrome and its Relationship With BMI
Authors: Danesh H , Mazloomi S , Barartabar Z , Alizadeh N , Pilehvari SH
Published: February 2022

Background & Objective:  Polycystic ovary syndrome (PCOS) is a complex endocrine and metabolic disorder, which is characterized by ovulatory dysfunction and hyperandrogenism. This study was done to evaluate insulin and estradiol (E2) in women with PCOS and its relationship with Body mass index (BMI).
Materials & Methods: This case-control study included, 104 women with polycystic ovary syndrome as a case group and 100 women without polycystic ovary syndrome as a control group. Concentrations of insulin, glucose and E2 were measured in fasting blood samples.
Results: Insulin level was 7.02 ± 3.29 in control group, 11.41 ± 3.84 in the case group. FBS level was 82.75 ± 7.18 in control group versus 84.03 ± 5.82 in case group. E2 level was 70.74 ± 53.03 in control group and 60.21 ± 40.58 in case group. The insulin resistance level was 1.45 ± 0.74 in the control group versus 2.37 ± 0.83 in case group. According to correlation analysis, the insulin variable had a significant positive association with BMI (p < 0.0001, r=.245), although no significant correlation was seen between E2 and BMI (p-value = 0.245, r=.092)
Conclusion: Present data showed that E2 levels were not different in PCOS and non-PCOS patients, but insulin levels in PCOS were significantly increased and PCOS women had significant insulin resistance which is dependent on BMI.
Protective Effects of Vitamin D on Testicular Tissue, Oxidative Stress and Apoptotic Genes Expression in Rats Treated with Simvastatin
Authors: Kiyarad E , Najafi Tazekand GH , Farrocki F
Published: February 2022

Background & Objective: Cardiovascular diseases (CVDs) are the deadliest disease globally, which in order to reduce this mortality rate statin has been used during last decades. In line, it has been revealed that statins negatively affect testicular tissue. Thus, in the current project, we aimed to investigate the vitamin D protective effects during simvastatin (SIM) administration.
Materials & Methods: In this project, 48 male mature Wistar rats were randomly divided into 6 control and experimental groups. The experimental groups were subdivided into Low and High dose SIM-received and Vitamin D co-treated SIM-received groups. After 45 days, the body weight of the animal groups was measured and then they were euthanized and testicles were removed. The right testicular tissue was fixed in fixative solution, while the left testicular tissue was used for biochemical and molecular analysis. To evaluate the pathological changes, hematoxylin and Eosin (H&E) staining were performed. The Malondialdehyde (MDA), Total antioxidant capacity (TAC), catalase (CAT) and Ferric-reducing antioxidant power (FRAP) levels were examined in order to evaluate the Reactive oxygen species (ROS) and antioxidant levels. Finally, Bax, Bcl-2, p53 and Caspase-3 mRNA levels were analyzed using real- time PCR.
Result: Our observations revealed that the MDA, Bax, p53 and caspase-3 level enhanced in the sole-SIM-received groups compared to control group, while level of TAC, catalase and Bcl-2 diminished in SIM-received groups versus control group. In contrast, Vitamin D-co-treated animals showed a significant enhancement in level of TAC, catalase and Bcl-2 compared to sole-SIM-received animals (p≤0.05).
Conclusion: The vitamin D-co-administration can positively protect testicular tissue against SIM-induced oxidative stress condition by enhancing enzymatic activity of antioxidant defense and anti-apoptotic genes activation.
The Impact of Maternal Age on Chromosomal Aneuploidy, Blastocyst Quality, and Pregnancy Outcomes During Intracytoplasmic Sperm Injection Cycles
Authors: Aghajani SH , Salehzadeh A , Ghasemian F , Mehrafza M , Hosseini A
Published: February 2022

Background & Objective: Assisted reproduction techniques and preimplantation genetic testing (PGT) for aneuploidies help infertile couples achieve a healthy live birth. The objective of this study was to investigate if there is a correlation between chromosomal aneuploidy and maternal age.
Materials & Methods: We used 277 embryos with 6-8 cells and graded A derived from intracytoplasmic sperm injection cycles. There were two subgroups: fresh-PGT cycles (n = 38) and Frozen Embryo Transfer (FET) cycles (n = 38). The PGT cycles results were evaluated by fluorescence in situ hybridization and polymerase chain reaction assays. Couples (n = 76) with PGT on the third day were classified into four maternal age groups: ≤35 years (n = 35), 36-40 years (n = 24), 41-45 years (n = 11), and ≥46 years (n = 6). The rate of aneuploidy, blastocyst quality, and pregnancy was assessed in FET and fresh-PGT cycle.
Results: Aneuploidy rate in 13, 18, 21, X, and Y chromosomes in FET and fresh-PGT cycles are not significantly related to maternal age (p = 0.1). Significant differences were found in a decreased chemical pregnancy (p = 0.001), clinical pregnancy (p = 0.001), ongoing pregnancy (p = 0.001), and live birth rate (p = 0.001) among both groups. Decreased blastocyst rate increased maternal age in fresh PGT and FET PGT (p = 0.02). Early and clinical pregnancy loss was not related significantly to maternal age.
Conclusion: After evaluating cycle characteristics, an association was found between maternal age and declined pregnancy outcomes in embryos. There was a significant relationship between increasing female age with decreasing blastocyst rate.
The effect of meteorological parameters on PM2.5 concentration changes in 2018 (Case study: Tehran)
Authors: Maleki Ramin , Molaei Iman
Published: February 2022

Introduction: Studies in different parts of the world have shown that exposure to air pollutants has a negative effect on human health.
Materials and methods: For statistical analysis between the dependent variable Particulate Matter less than 2.5 μm (PM2.5) concentration and independent variables (wind speed, precipitation, humidity, and temperature) R version 3.6.2 was used. Spearman correlation coefficient was used to determine the correlation between the parameters with the dependent variable. In addition, the multiple linear regression model was used to investigate the relationship and prediction between the independent variables and the dependent variable. In the present study, the effect of meteorological parameters on PM2.5 concentration in different seasons in Tehran in 2018 was studied using Pearson correlation and linear regression statistical analyzes.
Results: Based on the results, it was found that PM2.5 had no significant relationship with meteorological parameters. Only in summer, there was a significant relationship between the dependent variable and the independent variable (wind speed) (p-value=0.01) and there was also an inverse relationship between these variables (r=-0.65). Multiple linear regression was also used to investigate the significant effect of independent variables on the dependent variable.
Conclusion: According to the coefficients of determination in this model, 47, 16, 45, and 20% of the dependent variable change in autumn, winter, spring, and summer, respectively, can be explained by meteorological parameters (independent). Due to the fact that the concentration of PM2.5 in Tehran is higher than the national standard, more attention of officials is necessary to improve air quality in Tehran.
Incineration of medical waste: Emission of pollutants into the environment
Authors: Taghilou Samaneh , Torkashvand Javad , Kermani Majid , Farzadkia Mahdi
Published: February 2022

Medical waste incinerator is a  matter  of  concern  for  the  environment  and public health due to secondary pollutants. The present work aims to evaluate the toxic emissions from medical waste incineration, such as Polychlorinated Dibenzo-Dioxin/Furan (PCDD/Fs), Polycyclic Aromatic Hydrocarbons (PAHs), and the inorganic components in ambient air and  ash. Hence, this study discusses several strategies to reduce emissions. For this purpose, searches were done in Scopus, Web of Science, and PubMed databases from 2000 to 2020. After the search, screening was done according to the predefined criteria, 96 papers were finally selected for this study.   The results show that the emissions levels depend on many factors like the composition of the feeding, waste type, waste classification, segregation practice, types of incinerators, operation conditions (designed temperature, retention time, and excess oxygen), and air pollution control devices. For instance, emissions of Medical Waste Incinerators (MWIs) rise sharply with a decrease in temperature, increase in oxygen levels and chlorine content    in waste, and the absence or weak function of air pollution control systems. This review prepared a comprehensive detailed for decision-makers to help them to understand the environmental consequences of using incinerators. However, there is a gap in finding efficient methods to reduce emissions of incinerators.
Interaction of SARS-CoV-2 With RAS / ACE2 in the Female Reproductive System
Authors: Zafari Zangeneh Farideh
Published: February 2022

Objective: The purpose of this review was to investigate current knowledge of COVID-19 by highlighting its effect on female reproductive tract.
Materials and methods: In this study, all articles related to the effect of SARS, MERS, and CoV-19 viruses on the female reproductive system from 2003 to 2021 were reviewed.
Results: The coronavirus enters the host cell by binding to the enzyme that is most abundant in the host lung. The corona or spike (S) protein of this virus is the main tool for binding to the receptor in the host cell membrane and facility the entrance of CoV into the target cells. This receptor is the Angiotensin-Converting Enzyme-2 (ACE2), but the high expression of this receptor can be a mystery to increase infection in host cells. The overexpression of ACE2 in different tissues has a close connection to the severity of this viral infection. Infection in the female reproductive system requires more attention because it may affect the generation and future progeny by damaged gametes.
Conclusion: The existing evidence proposes that ACE2 is widely expressed in the reproductive tract includes: ovary, uterus, vagina, and placenta.
Breastfeeding and Contraceptive Methods in Women with Severe Acute Respiratory Syndrome Coronavirus- 2 (SARS-COV-2) Infection in Peripartum Period
Authors: Rani Reena , Dhakate Mrinalini , Goswami Deepti , Gupta Sangeeta , Bhasin Sangeeta , Rathore Asmita Muthal , Tempe Anjali
Published: February 2022

Objective: This study aimed to assess the exclusive breastfeeding and contraceptive methods among women delivering within 1-week of a positive test for severe acute respiratory syndrome coronavirus- 2 (SARS-CoV-2) infection.
Materials and methods: In this study, 106 women with SARS-CoV-2 infection who were either asymptomatic or had mild disease were included. They were admitted for maternity care at a tertiary center between May to September 2020. The data was collected during their hospital stay and subsequently by telephonic or in-person interviews at 4-6 weeks and 8-10 weeks postpartum for contraceptive use, breastfeeding and use of facemask and hand-hygiene.
Results: Sixty-three (59.4%) women had vaginal delivery and 43 (40.6%) required cesarean-section. Only one of the 98 newborns who were tested for SARS-CoV-2 turned out positive. Initiation of breastfeeding was delayed by an average of three days due to preparing the Reverse transcription polymerase chain reaction (RT-PCR) report. Exclusive breastfeeding was practiced by 69% and mixed feeding by 26%. Pre breastfeeding hand hygiene and facemask use declined after discharge (100% to 53.75% at 8-10 weeks postpartum). Out of 106, 86 (81%) women used no contraception at 8-10 weeks postpartum, continued with post-placental-IUD in 8/106 (7.5%) and tubal-sterilization during cesarean in 8/106 (7.5%) cases. Only 4/106 (4%) adopted alternative methods like barrier contraception.
Conclusion: The practice of exclusive breastfeeding remains unchanged among women who suffered from SARS-CoV-2 infection in the peripartum period while uptake of postpartum contraception was minimal except for the women who opted for long term contraceptive methods in the immediate postpartum period.
Hardware Failure as a Rare Complication of Percutaneous Coronary Intervention: A Case Report
Authors: Ayyappa Krishna Sanka PapaRao Veera Venkata , Bathala Madhava Rao , Poddar Aayush , Kumar Raman Karthik Ravindra , Sudhakar Ignatius Chakravarthi Paulraj , Padmanabhan Chandrasekar
Published: February 2022

Percutaneous coronary intervention (PCI) is increasingly employed in the treatment of complex coronary artery disease. The entrapment or fracture of a coronary angioplasty guidewire is a rare complication of PCI. We herein describe a 61-year-old man who presented with chronic stable angina. The patient’s coronary angiogram revealed triple-vessel coronary artery disease, and he was scheduled for primary PCI. During the procedure, the guidewire fractured within the right coronary artery. Despite multiple attempts, the wire could not be retrieved. The wire unraveled in its coils, and its stretching resulted in its eventual snapping in the right radial artery. The initial plan was to attempt guidewire retrieval through a brachial cut-down, and if successful, to manage the obtuse marginal lesion by PCI, thereby precluding general anesthesia and a sternotomy. Unfortunately, the guidewire snapped at the brachial level, necessitating its retrieval by coronary artery bypass surgery. The patient remained asymptomatic and event-free over 6 months of follow-up.