Iranian Red Crescent Medical Journal
Year:2019 | Volume:21 | Issue:3|Papers Count:10

Introduction: Rodenticides are considered a global challenge to public health. Two major compounds in this category include aluminum phosphide and zinc phosphide. However, the simultaneous use of aluminum phosphide and zinc phosphide has not been reported in the literature. Case Presentation: We present the case of a 20-year-old female, who was poisoned with both a rice tablet and powdered rat poison. She was admitted to a university-affiliated hospital, Babol, Iran in July 2016. Resuscitative and supportive measures were applied, including prophylactic intubation, gastric lavage with a bicarbonate solution, and intravenous administration of N-acetylcysteine (NAC), magnesium sulfate, calcium gluconate, and bicarbonate compounds. In case of a blood sugar level above 100 mg/dL, regular insulin was infused. After the diagnosis of phosphine-induced cardiomyopathy, digitization with digoxin was prescribed for the patient. Conclusions: This case report presents the possible positive effects of digoxin, insulin, and antioxidant therapy on simultaneous poisoning with aluminum phosphide and zinc phosphide.

Background: Anti-proliferative effects of probiotics are considerable in the treatment of various cancers, including colon cancer. In the present study, two new Lactobacillus strains as probiotics were isolated from stool samples at a clinical lab. Objectives: The aim of this study was to evaluate the effects of the cell-free lyophilized filtrate of two new strains of Lactobacillus, isolated on viability on Caco-2 cells. Methods: Two new strains of Lactobacillus were isolated from 1 gr of each infant stool specimens from a total of fifty volunteers, according to the principles of a scientific questionnaire. The anti-proliferative effects of the strains were investigated using the MTT assay with Caco-2 cell lines. Results: Out of 50 samples, seven isolates were lactic acid bacteria, two strains of which were probiotics related to L. fermentum (E) and L. rhamnosus (G). The results showed that the two Lactobacillus strains had good anti-proliferative effects against the cancer cell lines tested. These strains were resistant to low pH and 0. 3% bile salt. Cytotoxicity assay revealed that the most effective concentration of strains E (~ 55% to ~ 72%) and G (~ 60% to ~ 80%) on Caco-2 cells was 10000  g/mL after 24 to72 hours. Conclusions: Cytotoxicity effect of the cell-free lyophilized filtrate of bacteria on Caco-2 cells in a dose-and time-dependent manner suggested that these strains might be used in colon cancer therapy.

Background: Porcelain gallbladder is associated with a higher prevalence of malignancy. Prophylactic cholecystectomy is suggested for both symptomatic and asymptomatic patients. Although gallstones are very commonly observed in clinical practices, it is recommended in asymptomatic patients. However, a ring-shaped gallstone may be easily mistaken with porcelain gallstone and requires further investigation using computed tomography (CT) to avoid the unnecessary risks of surgery. Case Presentation: A 71-year-old female with renal dysfunction and diabetes mellitus had a ring-shaped calcification confirmed by abdominal CT scan in Taichung city of Taiwan, in 2016. She had already been followed up for at least seven years. In addition to traditional risk factors, authors believe that renal dysfunction may have also predisposed her to the development of a gallstone. The differential diagnosis of porcelain gallbladder and only ring-shaped gallstone is very important due to different treatments and outcomes. The more attractive part of this case was that the ring-shaped gallstone is rare in clinical practices. Conclusions: For patients with a ring-shaped calcification, clinicians should rule out porcelain gallbladder since such a diagnosis would indicate an increased risk of gallbladder carcinoma.

Background: Helicobacter pylori are the main cause of various gastroduodenal diseases. It is estimated that approximately half of the planet population is infected with H. pylori. KRAS and BRAF genes are the targets of genetic changes in H. pylori-infected patients with gastric cancer (GC) and peptic ulcer (PU). The high frequency of these mutations represents their high potential as a biomarker in early diagnosis of GC. Objectives: The current study aimed at evaluating the frequency of KRAS (Kirsten Rat Sarcoma) and BRAF (BRAF proto-oncogene) gene mutation status in H. pylori-infected patients with GC and PU. Methods: The current cross-sectional and descriptive study was conducted on 80 paraffin-embedded sections including 40 gastric adenocarcinoma and 40 PU tissue samples. The samples were collected from April 2017 to March 2018. H. pylori were identified and confirmed in all samples using the IHC (immunohistochemical) method and the histopathology of all PU andGCtissue samples was available. After DNA extraction from paraffin-embedded sections, and polymerase chain reaction, KRAS and BRAF gene mutations were assessed using the direct sequencing method, and the correlation of mutations and clinicopathological characteristics was also studied. Results: KRAS mutation was observed in codon 12 (n = 7; 17. 5%) and BRAF mutation in codon V600 (n = 4; 10%) in patients with GC. No KRAS and BRAF mutations were observed in patients with PU. Results of the current study also showed that the majority of the examined samples belonged to male patients (70%) and female patients constituted 30% of the samples; patients mean age was 48. 95  12. 11 years. No significant correlation was observed between the mutations and pathological manifestations (age, gender, and tumor grade). Conclusions: KRAS and BRAF gene mutations were revealed in H. pylori-infected patients with GC.

Background: Antioxidant compounds are novel approaches in the treatment of neurological disorders. Objectives: The purpose of this study was to examine the antidepressant and anxiolytic effects of the hydroalcoholic extract of Adiantum capillus-veneris (rich in flavonoids with antioxidant properties) in mice under chronic restraint stress (CRS). Methods: This experimental study was conducted in a university-affiliated Experimental Animal Unit, Khuzestan, Iran, from April to June 2018. Forty male Balb/C mice were randomly divided into five groups (n = 8), including under chronic restraint stress (CRS) receiving normal saline, hydroalcoholic extract of A. capillus-veneris (100, 200, and 400 mg/kg/day, i. p), or diazepam (10 mg/kg/day, i. p). After 21 days of the consecutive treatment, anxiolytic and antidepressant activities were evaluated using elevated plus-maze (EPM) and forced swim test (FST). Moreover, serum and brain levels of total antioxidant capacity (TAC) and malondialdehyde (MDA), as well as serum corticosterone, were measured. Results: Immobility time in the FSTwassignificantly decreased (P=0. 002, P=0. 001, P< 0. 0001) after treatingCRSmicewith all doses of the extract. CRS-exposed mice treated with all doses of the extract showed a significantly increased percentage of entries into the open arm (P < 0. 0001, P = 0. 001) and reduced closed arm entries in the EPM (P = 0. 012, P = 0. 024). Extract at all doses significantly increased serum (P < 0. 0001) and brain (P = 0. 011, P = 0. 004, P = 0. 001) TAC in CRS-exposed mice. The extract (200 and 400 mg/kg) also reduced CRS-induced serum and brainMDA(P< 0. 0001, P = 0. 001). Serum corticosterone did not significantly change following the extract treatment. Conclusions: A. capillus-veneris extract showed antidepressant and anxiolytic effects by reducing oxidative stress markers.

Background: Lung adenocarcinoma (LUAD) is the most common histological subtype of non-small cell lung cancer with very poor 5-year overall survival (OS) rate. It is histopathologically difficult to predict clinical outcome in early-stage LUAD. Identifying reliable prognostic biomarker is absolutely critical to benefit from early additional treatment for early-stage LUAD patients. Objectives: The purpose of the current study was to identify critical genes as prognostic biomarkers in early-stage LUAD using gene expression profiles based on the microarray. Methods: In this bioinformatics-based cross-study, gene expression profiles from early-stage LUAD, including GSE10072 and GSE19804 genes were integrated using bioinformatics methods, including differentially expressed gene analysis (DEGA), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and protein-protein interaction (PPI) network construction. Subsequently, the survival analysis of key genes was performed using The Cancer Genome Atlas (TCGA) database and was validated using online Gene Expression Profiling Interactive Analysis (GEPIA) database. Results: A total of 89 up-regulated and 214 down-regulated genes were identified in early-stage LUAD, and the functional changes of 303 differentially expressed genes (DEGs) were mainly related to cell cycle. A PPI network was established by online STRING database with 207 nodes and 775 edges. Centrality analysis showed that CDKN3 and UBE2C genes were identified as key genes implicated in early-stage LUAD. Survival analysis revealed that low mRNA expressions of CDKN3 and UBE2C were significantly associated with longer OS of early-stage LUAD patients. Conclusions: This cross-study found key dysregulated genes involved in early-stage LUAD, which might provide insights into the pathogenesis of early-stage LUAD, and identified UBE2C and CDKN3 might serve as potential diagnostic and prognostic biomarkers and therapeutic targets for early-stage LUAD.

Background: Advances in Imaging has been used increasingly to assess coronary lumen and myocardial perfusion with more accuracy. Objectives: The aim of this study was to evaluate the diagnostic performance of one-stop cardiac CT myocardial perfusion imaging (CT-MPI) combined with coronary artery CT angiography (CCTA) for the detection of functionally relevant myocardial ischemia of aortic valve degeneration (AVD). The study was approved by the patient and passed by the ethics committee. Methods: This study was a case-control study using random sampling. A total of 109 (109/480) patients suspected of CAD were prospectively enrolled from January 2017 to December 2018 with chest pain as their chief complaint in Renmin Hospital of Wuhan University, Wuhan, Hubei, China. All patients underwent CT-MPI and CCTA on a wide detector Revolution CT. Myocardial blood flow (MBF) was quantified and compared between normal perfusion and abnormal myocardial segments based on AHA-17-segment model. CCTA images were evaluated qualitatively based on SCCT-18-segment model. Radionuclide myocardial perfusion imaging (MPI) is the gold standard; the diagnostic accuracy of CT-MPI, CCTA, and CT-MPI combination with CCTA in the diagnosis of myocardial ischemia of AVD with hemodynamic stenosis was evaluated. Results: All patients underwent CCTA combined with CT-MPI examination, 69 patients (63. 30%) with 182 myocardial segments(15. 52%) were detected with decreased blood perfusion, the MBF value was lower than that of normal segments [(83. 06 20. 11) mL. 100 mL-1. min-1 vs. (120. 02  28. 71) mL. 100 mL-1. min-1; t = 14. 361, P < 0. 001]. There were 1914 segments (97. 56%) that could be used for the diagnosis in CCTA, 302 (15. 78%) segments have clinical significance in this study. Compared with the MPI, the diagnostic sensitivity, specificity, positive and negative predictive value of CT-MPI for myocardial ischemia of AVD were 73. 33%, 73. 68%, 89. 80%, 70. 00%, respectively, 90. 00%, 68. 42%, 88. 24%, 72. 22% for CCTA, and 88. 46%, 70. 59%, 90. 20%, 66. 67% combined with CT-MPI and CCTA. Logistic regression analysis was performed that the AVD was associated with the detection rate of calcified plaques (r = 5. 207, P < 0. 05), and calcification of the aortic valve were associated with the detection of plaques in the three and six segments of coronary arteries (P < 0. 05). Conclusions: Both good CCTAand CT-MPI images can be obtained at the one-stop scanning by Revolution CT. This can be used for the diagnosis of AVD combined with myocardial ischemia. Revolution CT can accurately measure myocardial hemodynamic changes, and provide imaging evidence for the diagnosis and treatment of aortic valve degeneration.

Background: Despite the mental, physical, and behavioral problems of premenstrual syndrome (PMS) in reproductive women, there is no general agreement on effective treatment. Objectives: To determine the safety and effectiveness of herbal medicine capsules of peppermint oil as a novel formulation used for the severity management of PMS symptoms. Methods: A randomized, double-blind, placebo-controlled trial was carried out on 50 high school students who were diagnosed with PMS in Babol, Iran. The subjects were divided into two groups based on blocked randomization to receive capsules of Colpermin® containing the peppermint oil (187 mg peppermint oil/0. 2 mL), or placebo twice daily for 10 days, from the 15th day of one period to the first day of the next period for two cycles. The degree of PMS was assessed using Delany’ s PMS checklist with 28 items as primary, at the first luteal phase of the menstrual cycle and at the third luteal phase. Results: The PMS score was decreased for the two menstrual cycles, from 30. 3 10. 1 to 15. 5 6. 0 in peppermint oil group and from 23. 2 7. 0 to 20. 7 8. 0 in the placebo group. The mean difference of the total PMS score between the two groups was-9. 77; 95% CI:-12. 52 to-7. 02 (P < 0. 0001). The number of participants needing treatment (NNT) for the peppermint oil group was approximately two compared with that of the placebo group. Conclusions: The proposed novel peppermint oil formulation was proved to be safe and may be used as an effective treatment for reducing the severity of PMS symptoms.

Background: Hepcidin is a key regulator of iron homeostasis, while the clinical utility of hepcidin remains uncertain in hemodialysis (HD) patients. Objectives: Our study aimed to evaluate the predictive effect of serum hepcidin-25 on mortality in HD patients. Methods: A prospective observational cohort study of chronic HD patients were conducted at Xuzhou Central Hospital, Jiangsu, China, during years 2015-2017. The data on demographic factors, dialysis vintage, comorbidities, and laboratory measures were collected. Kaplan-Meier survival analysis was used to compare the effect of serum hepcidin-25 levelsonmortality. Logistic regression models and multivariate Cox proportional hazard models were performed to identify the predictors of all-cause mortality in HD patients. Results: A total of 159 patients were included in this cohort, who were stratified into three groups by tertiles of hepcidin-25 values, and their 2-year overall mortality rate was 11. 94%. The Kaplan-Meier analysis showed that patients with the highest tertile of serum hepcidin-25 had significantly higher all-cause mortality than in the two lower tertiles (P < 0. 001). Serum hepcidin-25 was an independent risk factor for all-cause mortality after multivariate adjustments using logistic regression models and Cox proportional hazard models. Conclusions: A higher level of serum hepcidin-25 in chronic HD patients could be associated with increased mortality. Further studies are needed in a larger size of HD patients with a longer term of follow up.

Dear Editor, Ezgeleh is a city in Kermanshah province, in western Iran. According to the census 2016, the city population was 1502 individuals. At 21: 48 PM on the 12th of November 2017, an earthquake with a magnitude of 7. 3-Richter Scale struck the city at the depth of 11-kilometer. The epicenter was in Ezgeleh, a district of Salase-e-Babajani county near the city of Sar-Pol-e-Zahab, both of which sustained the highest damage. Based on the last statistics by the forensic medicine association, the number of the lives lost in Kermanshah earthquake was 620 individuals. Additionally, 9388 individuals were injured, and about 70000 individuals became homeless.