bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation and Comparison on the Results of Totally Extraperitoneal Laparoscopic Surgery under General and Spinal Anesthesia for Inguinal Hernia
Authors: Sayadishahraki Masoud , Safaee Masumeh , Alinezhad Zarir 
Published: December 2022

Background:
Totally extraperitoneal (TEP) hernia repair surgery is one of the recently considered hernioplasty methods. Here, in the current study, we aimed to compare the results of TEP hernia repair surgery in the two groups of general anesthesia and spinal anesthesia.

Materials and Methods:
This is a randomized clinical trial that was performed in 2018–2019 in Isfahan on 106 patients undergoing TEP inguinal hernia repair. Patients were randomly divided into two groups. The first group underwent TEP inguinal hernia repair surgery under general anesthesia and the second group of patients underwent TEP inguinal hernia repair surgery under spinal anesthesia. Data regarding surgery duration, intensive care unit admission, pain of patients, mean of analgesic injections after the surgery, and complications such as urine retention, seroma, and hematoma, and wound infection were collected. Data were compared between two groups.

Results:
We found significantly higher duration of surgery in the spinal anesthesia group (P = 0.02). Patients in the spinal anesthesia group had shorter duration of nutrition regime beginning (P = 0.002) and lower frequencies of urine retention (P = 0.001). Further analysis showed that the mean pain severity was significantly lower in spinal anesthesia group compared to general anesthesia during postoperation measurements (P = 0.001) and patients in spinal anesthesia group received less postoperation analgesics compared to the other group (P = 0.001).

Conclusion:
TEP surgery under spinal anesthesia was associated with better clinical results such as lower postoperative pain and analgesics injections compared to general anesthesia.
Association of Subclinical Hypothyroidism with Nonalcoholic Fatty Liver Disease in Patients with Type 2 Diabetes Mellitus
Authors: Sheikhi Vahid , Heidari Zahra 
Published: December 2022

Background:
Nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM) are recognized as two common health problems. Metabolic diseases, such as dyslipidemia, obesity, and hypertension are known risk factors for NAFLD. In addition to these risk factors, other risk factors have been recently suggested, such as thyroid dysfunction.

Materials and Methods:
In this study, adult patients with T2DM were recruited. Various clinical and biochemical parameters including thyroid function tests, liver function tests, and liver sonography in all participants were assessed and compared between with and without NAFLD groups.

Results:
Data from 926 diabetic patients were analyzed; of which, 744 (80.3%) had fatty liver. The prevalence of subclinical hypothyroidism (SCH) in patients with NAFLD was 11.6% and in patients without NAFLD was 6.0% (P = 0.029). Furthermore, the prevalence of overt hypothyroidism was higher in diabetic patients with NAFLD (3.9% vs. 1.6%); this difference was not statistically significant. In univariate logistic regression analysis, hemoglobin A1c (odds ratio [OR]: 8.13); history of insulin consumption (OR: 5.35); duration of diabetes (OR: 2.20); family history of diabetes (OR: 2.85); history of antihypertensive drug use (OR: 2.14) as well as SCH (OR: 2.03) were significant variables for NAFLD. According to the multivariate logistic model, after eliminating the confounding effect of age, sex, and body mass index; the chance of developing NAFLD in patients with SCH was 2.32 times higher than patients without SCH (P = 0.014).

Conclusion:
NAFLD is extremely common in patients with T2DM. The relationship between hypothyroidism and NAFLD is independent of other risk factors.
The Effect of Increasing the Dose of Acetamiprid and Dichlorvos Pesticides on the Reproductive Performance of Laboratory Mice
Authors: Mishani Hamid Salehi , Jalalizand Alireza , Modaresi Mehrdad 
Published: December 2022

Background:
Pesticides are widely used around the world. However, these chemicals are being used more frequently and at increased doses in underdeveloped and developing countries. Although the hazard of pesticides has been studied in ecological fields, the effect of residual amounts of these compounds on the physiological processes of the body has always been debated.

Materials and Methods:
In this experimental study, 45 greenhouse cucumber plants were sprayed with dichlorvos and acetamiprid pesticides in concentrations of twofold (acetamiprid 500 g/1000 L and dichlorvos 4 L/1000 L) and threefold of the recommended dose. After 24 h, the residual amount was obtained. To evaluate the residual effect of the mentioned pesticides, an equivalent of this residue was added to the drinking water of 105 mice.

Results:
Pesticide residues were obtained for twofold and threefold concentrations of the recommended dose, 1.5 and 2.5 (mg/kg cucumber) for acetamiprid and 0.5 and 1 (mg/kg cucumber) for dichlorvos, respectively. Application of these chemicals at higher doses not only significantly reduced the body weight, food consumption, testosterone production, testicular germ cells and embryo numbers, but also increased the levels of follicle-stimulating hormone and luteinizing hormone in mice.

Conclusions:
The emergence of biological disorders and reducing reproductive potential in male mice can be attributed to the addition of pesticides to their drinking water. Therefore, to reduce the hazards caused by insecticides, it is recommended to familiarize farmers with the harmful effects of overdose of pesticides and monitoring the residuals in agricultural products.
Chronic Kidney Disease and COVID-19 Infection
Authors: Moeinzadeh Firouzeh , Mortazavi Mojgan , Shahidi Shahrzad , Mansourian Marjan , Yazdani Akram , Zamani Zahra , Seirafian Shiva 
Published: December 2022

Background:
To organize efforts to manage the coronavirus disease 2019 (COVID-19), it is necessary to understand which groups are at higher risk of infection. Kidney disease seems to be substantial in COVID-19 patients, but there are limited data on COVID-19 incidence and fatality among chronic kidney disease (CKD) patients. In this study, we intend to examine the association between CKD and susceptibility to COVID-19 infection.

Materials and Methods:
Participants were selected from those recruited in a population-based cross-sectional survey of CKD prevalence and associated risk factors in Iranian people 18 years and older. A three-part questionnaire was used for COVID-19 infection clinical symptoms and epidemiologic and hospitalization data.

Results:
A total of 962 individuals including 403 CKD patients and 559 healthy controls were recruited in this study. Healthy controls were suffering more from common cold signs, cough, fever, sore throat, headache, anosmia, dyspnea, and abdominal pain (all P < 0.05). Furthermore, the number of healthy individuals with myalgia was marginally higher compared to the CKD patients (P = 0.057). Data regarding the number of CKD patients with/without COVID-19 infection throughout different CKD stages revealed that there was no significant difference between the two groups in terms of COVID-19 infection in different stages of CKD (P = 0.956).

Conclusion:
We found that some of the clinical presentations of COVID-19 including common cold symptoms, cough, fever, sore throat, headache, anosmia, dyspnea, and abdominal pain were higher among healthy individuals compared to the CKD group. On the other hand, the susceptibility to COVID-19 infection was not significantly different in various early stages of CKD.
Predictors of Mortality for Patients with ST-Elevation Myocardial Infraction after 2-Year Follow-Up
Authors: Jamalian Marjan , Roohafza Hamidreza , Soleimani Azam , Massoumi Gholamreza , Mirmohammadsadeghi Amirhossein , Dorostkar Neda , Yazdekhasti Safoura , Azarm Maedeh , Sadeghi Masoumeh 
Published: December 2022

Background:
Mortality of ST-elevation myocardial infarction (STEMI) patients is increasing in world. This study defines predictors of mortality in patients who have STEMI.

Materials and Methods:
This study was a part of the ST-elevated myocardial infarction cohort study in Isfahan conducted on 876 acute myocardial infarction (MI) followed for 2 years that 781 patient entered. The effect of predictors of mortality includes demographic, physiological, and clinical characterizes compared in two groups alive and died patients. MACE was defined as nonfatal MI, nonfatal stroke, and atherosclerosis cardiovascular disease-related death was recorded. Univariate and multiple logistic regression analyses were performed. All analyses performed using SPSS 20.0. P < 0.05 considered statistically significant.

Results:
A total 781 patients, 117 (13%) that 72 (8.5%) was in-hospital died. The mean (standard deviation) age of the patients was 60.92 (12.77) years and 705 (81.3%) patients were males. Significant factors that affected mortality on analysis of demographic and physiological parameters were age (P < 0.001), sex (P = 0.004), transfusion (P = 0.010), STEMI type (P < 0.001), number epicardial territories >50% (P = 0.001), ventilation options (P < 0.001), smoker (P = 0.003), and diabetes (P = 0.026). Significant clinical factors affected mortality were ejection fraction (EF) (P < 0.001), creatinine (P < 0.001), hemoglobin (P < 0.001), low-density lipoprotein-cholesterol (LDL-C) (P = 0.019), and systolic blood pressure (P < 0.001). Multiple logistics regression model definition significant predictors for mortality were age (P < 0.001), heart rate (HR) (P = 0.007), EF (0.039), LDL-C (P = 0.002), and preangia (P = 0.022).

Conclusion:
The set of factors can increase or decrease mortality in these patients. Significant predictors of mortality STEMI patients by 2-year follow up were age, HR, EF, LDL-C, and preangia. It seems that more articles need to be done in different parts of Iran to confirm the results.
Expression Optimizing of Recombinant Oxalyl-CoA Decarboxylase in Escherichia coli
Authors: Kahaki Fatemeh Abarghooi , Dehnavi Seyed Mohsen 
Published: December 2022

Background:
One of the most common diseases of the urinary tract is stones of this system, including kidney stones. About 70%–80% of kidney stones are calcium oxalate. Oxalyl-CoA decarboxylase is a single polypeptide included of 568 amino acids which play a key role in oxalate degradation.

Materials and Methods:
The aim of current study is high-level expression of oxalyl-CoA decarboxylase in Escherichia coli BL21 (DE3). To achieve this aim, oxalyl-CoA decarboxylase gene was cloned upon pET-30a (+) with T7 promoter. The vector containing the oxalyl-CoA decarboxylase gene was transformed into E. coli and the expression of the gene was examined on a laboratory scale and fermentor. Atfirst, the effect of temperature, culture medium, and induction time on oxalyl-CoA decarboxylase expression at three levels was examined.

Results:
The obtained data showed that the highest expression was related to the terrific broth culture medium and temperature of 32°C with an inducer concentration of 1 mM. Under this situation the ultimate cells dry weight and the final oxalyl-CoA decarboxylase expression were 2.46 g/l and 36% of total protein, respectively. Then induction time was optimized in a bench bioreactor and productivity of oxalyl-CoA decarboxylase was calculated. Under optimized condition the cell density, biomass productivity and oxalyl-CoA decarboxylase concentration reached 4.02 g/l, 0.22 g/l/h, and 0.7 g/l which are one of the highest reported rates.

Conclusion:
This study demonstrated that high levels of oxalyl-CoA decarboxylase can be achieved by optimizing the expression conditions.
Assessment of Endothelial Function in Iranian Healthy Obese Patients after Bariatric Surgery
Authors: Melali Hamid , Behjati-Najafabadi Hamid , Tabesh Faezeh , Sayadishahraki Masoud , Hasehmi-Jazi Seyed Mohamad 
Published: December 2022

Background:
Endothelial function plays a critical role in cardiovascular homeostasis. Morbid obesity is associated with an enhanced risk of atherosclerosis and chronic inflammation. Bariatric surgery (BS) is a promising method used recently for weight loss; however, the number of studies that have examined the effect of BS on endothelial function is limited. This study aimed to investigate the association between endothelial function evaluated by flow-mediated dilation (FMD) and weight loss after BS.

Materials and Methods:
This is a cross-sectional study conducted in Isfahan, Iran, and included 40 healthy obese individuals who underwent BS as an intervention group and 40 healthy obese patients who did not undergo BS as a control group in a 6-month follow-up duration period. FMD as an indicator of endothelial function was evaluated in these participants. FMD <7.1% is considered abnormal.

Results:
There was no significant difference between control and BS groups in terms of age and body mass index (BMI) at baseline. The mean ± standard deviation (SD) of FMD in the BS group pre- and post-intervention were 12.95 ± 6.90 and 37.65 ± 13.52 respectively and the mean ± SD of FMD in the control group were 15.88 ± 6.85 and 15.85 ± 5.83. The association between significant weight loss after BS and FMD was strongly significant (P < 0.001).

Conclusions:
According to the results of this study, it can be concluded that BS has been effective in terms of improving the FMD as an indicator of endothelial function.
Therapeutic Effect of Kidney Tubular Cells-Derived Conditioned Medium on the Expression of MicroRNA-377, MicroRNA-29a, Aquapurin-1, Biochemical, and Histopathological Parameters Following Diabetic Nephropathy Injury in Rats
Authors: Mansouri Esrafil , Orazizadeh Mahmoud , Mard Seyyed Ali , Gorji Armita Valizadeh , Rashno Mohammad , Fakhredini Fereshtesadat 
Published: December 2022

Background:
Diabetic nephropathy (DN) is a critical complication of diabetes mellitus. This study evaluates whether administration of conditioned medium from kidney tubular cells (KTCs-CM) has the ability to be efficacious as an alternative to cell-based therapy for DN.

Materials and Methods:
CM of rabbit kidney tubular cells (RK13; KTCs) has been collected and after centrifugation, filtered with 0.2 filters. Four groups of rats have been utilized, including control, DN, DN treated with CM, and sham group. After diabetes induction by streptozotocin (50 mg/kg body weight) in rats, 0.8 ml of the CM was injected to each rat three times per day for 3 consecutive days. Then, 24-h urine protein, blood urea nitrogen (BUN), and serum creatinine (Scr) have been measured through detection kits. The histopathological effects of CM on kidneys were evaluated by periodic acid–Schiff staining and the expression of microRNAs (miRNAs) 29a and 377 by using the real-time polymerase chain reaction. The expression of aquapurin-1 (AQP1) protein was also examined by Western blotting.

Results:
Intravenous injections of KTCs-CM significantly reduced the urine volume, protein 24-h, BUN, and Scr, decreased the miRNA-377, and increased miRNA-29a and AQP1 in DN treated with CM rats.

Conclusion:
KTCs-CM may have the potential to prevent kidney injury from diabetes by regulating the microRNAs related to DN and improving the expression of AQP1.
Cutaneous Leishmaniasis Based on Climate Regions in Iran (1998-2021)
Authors: Rejali Mehri , Dashtaki Nadia Mohammadi , Ebrahimi Afshin , Heidari Asieh , Maracy Mohammad Reza 
Published: December 2022

Background:
Climate change can facilitate the expansion of leishmaniasis and create the suitable habitat for vector and reservoir species. The objective of this study was to estimate the prevalence of cutaneous leishmaniasis (CL) at the climatic regions of Iran.

Materials and Methods:
The literature search was conducted to identify all published studies reporting the prevalence or incidence of CL in humans in Iran. A total of 350 articles that reported leishmaniasis in Iran were retrieved, due to eligibility criteria, only 42 studies were selected to the final systematic review and meta-analysis procedure. Random effects meta-analysis was done with the estimate of heterogeneity being taken from an inverse-variance model. Subgroup analysis was conducted and it stratified the studies according to climatic regions. Between-study heterogeneity was assessed by using I
2 and Cochran's Q method I
2 value of heterogeneity. Meta regression was used to investigate factors potentially contributed the between-study heterogeneity.

Results:
Individual studies showed that prevalence per 100,000 population estimated the range from 1.5 to 318.7 with the overall random pooled prevalence of 83.3 (95% confidence interval 74.5–92.1). Subgroup analysis by climatic regions showed that many studies were conducted in the desert areas and also, it has more prevalent than the other climatic regions.

Conclusions:
Leishmaniasis was more prevalent in regions with dry and desert climates than the other climatic regions. One of the advantages of this work is that the majority of selected studies have been conducted on population-base. However, some of the studies have been designed poorly or have had a lack of internal validity.
Laparoscopic Surgery for Atypical Endometrial Hyperplasia with Awareness Regarding the Possibility of Endometrial Cancer
Authors: Kamii Misato , Nagayoshi Yoko , Ueda Kazu , Saito Motoaki , Takano Hirokuni , Okamoto Aikou 
Published: December 2022

Objectives:
Although atypical endometrial hyperplasia (AEH) is considered a precancerous disease, the frequency with which AEH and endometrial cancer (EC) coexist is not low. Broadly, total laparoscopic hysterectomy (TLH) is performed for treating AEH; however, it is unclear what perioperative precautions need to be taken. This study aimed to clarify the points to be considered when performing TLH for AEH.

Materials and Methods:
We retrospectively identified 57 patients who underwent TLH for AEH in our hospitals. We extracted data on clinical characteristics, preoperative examinations (endometrial sampling and diagnostic imaging), surgical procedures, and final pathological diagnoses. Then, we statistically analyzed the difference in clinicopathological features and preoperative examinations between patients postoperatively diagnosed with EC and those diagnosed with AEH.

Results:
Twenty patients (35%) who underwent TLH for AEH were diagnosed with EC postoperatively (16 [28%] with stage IA EC and four [7.0%] with stage IB EC). We found no significant differences in clinical characteristics and preoperative evaluations between patients postoperatively diagnosed with EC and those diagnosed with AEH. The group with stage IB EC had a significantly higher median age and a significantly higher proportion of postmenopausal patients and patients with adenomyosis.

Conclusion:
It is important to recognize the risk of coexisting EC when performing TLH for AEH. High-precision endometrial sampling and contrast-enhanced magnetic resonance imaging are recommended for diagnosing AEH. In addition, surgical procedures for AEH are required to prevent cancer spillage in consideration of its coexistence, such as tubal sealing before manipulator insertion or avoiding using manipulator.
An integrated multidisciplinary model of care for addressing comorbidities beyond reproductive health among women with polycystic ovary syndrome in India
Authors: Patil Anushree Devashish , Vaidya Rama Ashok , Begum Shahina , Chauhan Sanjay L. , Mukherjee Srabani , Kokate Pratibha P. , Joshi Beena Nitin 
Published: December 2022

Background & objectives:
Polycystic Ovary Syndrome (PCOS) is becoming an area of global and national health concern. It requires a life cycle approach from adolescence to menopause. To comprehensively address the wide spectrum of this disorder, a multidisciplinary model of care was established for women with PCOS in a government setting in India with an objective to screen and manage multifaceted manifestations of PCOS and to diagnose and treat associated comorbidities such as metabolic syndrome, dermatologic manifestations and psychological issues.

Methods:
A model of integrated multidisciplinary PCOS clinic was implemented for services and research at ICMR-National Institute for Research in Reproductive and Child Health (NIRRCH), Mumbai Maharashtra, India. This is a one-stop holistic centre for managing menstrual, cosmetic, infertility, obesity, metabolic and psychological concerns of women affected with PCOS. Two hundred and twenty six women diagnosed with PCOS using the Rotterdam criteria were screened for metabolic comorbidities with anthropometry, ultrasonography, hormonal and biochemical tests and for psychological problems. Analysis was performed using SPSS version 19.0.

Results:
Mean body mass index (BMI) was 26.1 kg/m2, higher for Asians. Hirsutism was observed in 53.6 per cent of women. Metabolic syndrome was seen among 35.3 per cent and non-alcoholic fatty liver in 18.3 per cent. Psychological issues such as anxiety and depression were identified in majority of the women 31.4 per cent of women could achieve pregnancy at the end of one year of multidisciplinary management.

Interpretation & conclusions:
The results of the present study suggest that an integrated multidisciplinary approach led to the early identification and treatment of comorbidities of PCOS, especially metabolic syndrome. There is hence an urgent need to implement multidisciplinary PCOS clinics in government health facilities.
Cost of delivering primary healthcare services through public sector in India
Authors: Chauhan Akashdeep Singh , Prinja Shankar , Selvaraj Sakthivel , Gupta Aditi , Muraleedharan V.R. , Sundararaman Thiagarajan 
Published: December 2022

Background & objectives:
Public health spending on primary healthcare has increased by four times (in real terms) over the last decade and continues to constitute more than half of the total public health expenditure. The present study estimated the cost of providing healthcare services at sub centre (SC) and primary health centre (PHC) level in four selected States of India.

Methods:
A total of 51 SCs and 33 PHCs were selected across the four States (Himachal Pradesh, Odisha, Kerala and Tamil Nadu) of India. The economic cost of delivering health services at these facilities was assessed using bottom-up costing methodology during the reference year of 2014-2015. The cost of capital items was annualized and allocation of shared resources was based on appropriate apportioning statistics.

Results:
The mean annual cost of providing health services at SC and PHC was

JOURNAL/ijmer/04.03/02223309-202209000-00003/372FF01/v/2023-02-02T183910Z/r/image-tiff

0.69 million (US$ 11,392) and

JOURNAL/ijmer/04.03/02223309-202209000-00003/372FF01/v/2023-02-02T183910Z/r/image-tiff

5.1 million (US$ 83,837), respectively. Nearly 3/4th and 2/3rd of this cost at the level of SC (74%) and PHC (63%) were spent on salaries. In terms of unit cost, the costs per antenatal care and postnatal care visit were

JOURNAL/ijmer/04.03/02223309-202209000-00003/372FF01/v/2023-02-02T183910Z/r/image-tiff

221 (173-276) and

JOURNAL/ijmer/04.03/02223309-202209000-00003/372FF01/v/2023-02-02T183910Z/r/image-tiff

333 (244-461), respectively, at SCs. Similarly, the costs of per patient outpatient consultation and per bed day hospitalization at PHC level were

JOURNAL/ijmer/04.03/02223309-202209000-00003/372FF01/v/2023-02-02T183910Z/r/image-tiff

121 (91-155) and

JOURNAL/ijmer/04.03/02223309-202209000-00003/372FF01/v/2023-02-02T183910Z/r/image-tiff

1168 (955-1468), respectively.

Interpretation & conclusions:
The cost estimates from the present study can be used in economic evaluations, assessing technical efficiency and also for providing valuable information during scale-up of health facilities.