Contribution of Blastocystishominis subtypes and associated inflammatory factors in development of irritable bowel syndrome

Blastocystis hominis with worldwide distribution is a human intestinal protozoa found in all countries. There have been differences in the severity of the pathogenesis of various Blastocystis spp. and a concomitant variation in the plasma concentration of the cytokines in patients with irritable bowel syndrome. In the present study, we aimed to demonstrate the contribution of B. hominis subtypes in the development of irritable bowel syndrome. Stool samples were collected from patients with gastrointestinal disorders. All samples were evaluated through native-lugol method. Total DNA was extracted. A PCR protocol was developed to amplify a specific region of the SSU ribosomal DNA (rDNA) gene. Serum levels of IL-6 and TNF-alpha were determined by immunoassay methods. The ClustalW algorithm was applied to align and blast the nucleotide sequences of the amplified region of the SSU rDNA gene. To evaluate the phylogenetic and molecular evolutionary of the nucleotide sequences, we used the MEGA software. In this study, we found 26 haplotypes of B. hominis in the studied samples which were collectively belong to five subtypes (ST1, ST2 in patients without irritable bowel syndrome vs. ST3 and two unknown subtypes in patients with irritable bowel syndrome). Result of ELISA showed a high level of IL-6 and TNF-alpha in the serum of patients with irritable bowel syndrome. The genetic heterogeneity of B. hominis and the existence of different subtypes of the protozoan in patients with IBS may shed light to the fact that some subtypes of parasites may involve in the pathogenesis of IBS

Contribution of Blastocystishominis subtypes and associated inflammatory factors in development of irritable bowel syndrome

Blastocystis hominis with worldwide distribution is a human intestinal protozoa found in all countries. There have been differences in the severity of the pathogenesis of various Blastocystis spp. and a concomitant variation in the plasma concentration of the cytokines in patients with irritable bowel syndrome. In the present study, we aimed to demonstrate the contribution of B. hominis subtypes in the development of irritable bowel syndrome. Stool samples were collected from patients with gastrointestinal disorders. All samples were evaluated through native-lugol method. Total DNA was extracted. A PCR protocol was developed to amplify a specific region of the SSU ribosomal DNA (rDNA) gene. Serum levels of IL-6 and TNF-alpha were determined by immunoassay methods. The ClustalW algorithm was applied to align and blast the nucleotide sequences of the amplified region of the SSU rDNA gene. To evaluate the phylogenetic and molecular evolutionary of the nucleotide sequences, we used the MEGA software. In this study, we found 26 haplotypes of B. hominis in the studied samples which were collectively belong to five subtypes (ST1, ST2 in patients without irritable bowel syndrome vs. ST3 and two unknown subtypes in patients with irritable bowel syndrome). Result of ELISA showed a high level of IL-6 and TNF-alpha in the serum of patients with irritable bowel syndrome. The genetic heterogeneity of B. hominis and the existence of different subtypes of the protozoan in patients with IBS may shed light to the fact that some subtypes of parasites may involve in the pathogenesis of IBS

Application of lidocaine spray for tracheal intubation in neonates - A clinical trial study

Background: Tracheal intubation is extremely distressing, painful, and may influence heart rate and blood pressure. Sedatives, analgesics, and muscle relaxants are not commonly used for intubation in neonates. Objectives: This study aimed to evaluate the effects of lidocaine spray as a non-intravenous drug before neonatal intubation on blood pressure, heart rate, oxygen saturation and time of intubation. Patients and Methods: In a randomized, controlled study each neonate was randomly assigned to one of the two study groups by staffs who were not involved in the infant's care. The allocation concealment was kept in an opaque sealed envelope, and the investigators, the patient care team, and the assessors were blinded to the treatment allocation. The selected setting was NICU unit of a teaching hospital in Ilam city, Iran and participants were 60 neonates with indication of tracheal intubation with gestational age >30 weeks. Patients in the treatment group received lidocaine spray and the placebo group received spray of normal saline prior to intubation. Main outcome measurements were the mean rates of blood pressure, heart rate, oxygen saturation, intubation time and lidocaine side effects were measured before and after intubation. Results: Totally 60 newborns including 31 boys and 29 girls were entered into the study (drug group n = 30; placebo group n = 30). Boy/girl ratio in treatment and placebo groups were 1.3 and 0.88, respectively. Mean age ± SD of participants was 34.1 ± 24.8 hours (treatment: 35.3 ± 25.7; placebo: 32.9 ± 24.3; P < 0.0001). Mean weight ± SD of neonates was 2012.5 ± 969 g. Application of lidocaine spray caused a significant reduction of mean intubation time among treatment group compared with placebo group (treatment: 15.03 ± 2.2 seconds; placebo: 18.3 ± 2.3 seconds; P < 0.0001). Mean blood pressure, heart rate and oxygen saturation rate, among neonates in treatment group was reduced after intubation compared with their relevant figures before intubation; however, their differences were not statistically significant except for mean oxygen saturation rate that was reduced significantly in placebo group. No side effects were observed during study. Conclusions: Though the current study revealed some promising results in the application of lidocaine spray during neonatal intubation without any considerable side effects; however, the current investigation could only be considered as a pilot study for further attempts in different locations with higher sample sizes and in different situations. © 2015, Growth & Development Research Center

Effects of Metoclopramide on Feeding Intolerance among Preterm Neonates; A Randomized Controlled Trial

Objective: To evaluate the efficacy and safety of metoclopramide in the treatment of feeding intolerance in preterm neonates less than 36 weeks of gestational age. Methods: A randomized, controlled, masked cross-over study. A block of 4 randomizations was used. The drug group received intravenous metoclopramide before feeding and placebo group received placebo at the same time. The time to full enteral feeding and suspected adverse effects of metoclopramide, length of hospital stay or incidence of NEC or septicemia were the main outcome measures. Findings: Mean (standard deviation) of weight and Apgar score among metoclopramide and placebo groups were 1638.3 +/- 321 gr, 8.9 +/- 1.4 and 1593.3 +/- 318.8 gr, 8.8 +/- 1.3 respectively. Times to full feeding were significantly shorter in the metoclopramide group than in the control group (12.9 +/- 5.6 vs 17.0 +/- 6.3; P<0.0001) and also the numbers of withheld feedings were significantly lower (P<0.0001). According to the regression analysis, lower weight and placebo group were significantly related to increasing of lavage frequency, number of vomits, start time of feeding, number of feeding cessations and decreased feeding completion time (P<0.0001).No adverse effects of this treatment modality were observed in the two groups. Conclusion: Intravenous metoclopramide may be considered as an attempt in facilitating and treatment of feeding intolerance in preterm neonates

A self-assessment predictive model for type 2 diabetes or impaired fasting glycaemia derived from a population-based survey

Aims: There is no cure for diabetes and its prevention is interesting for both people and health policy makers. The aim of this study was to construct a simple scoring system to predict diabetes and suggest a self assessment predictive model for type 2 diabetes in Iran. Methods: This study was a part of a comprehensive population based survey performed in Ilam province during 2011-2012, including 2158 cases >= 25 years. All demographic and laboratory results were entered into the prepared sheets and were analysed using SPSS 16. By identification of relative risks of diabetes and IFG, a predictive model was constructed and proposed for these abnormalities. Results: Totally, 2158 people comprising 72 female, 60 from urban regions, mean age of 45.5 +/- 14 years were investigated and the average height, weight, FBS and waist of participants were as follows respectively: 164 +/-. 8.9 cm, 68.4 +/- 12.3 kg, 5.7 +/- 2.8 mmol/l (102.6 +/- 49.9 mg/dl) and 82.3 +/- 14.3 cm. The prevalence of IFG, diabetes and hyperglycaemia among all participants were 7.8, 11.8 and 19.6 respectively. Regression analysis revealed familial history of diabetes, place of life, age, hypertension, daily exercise, marital status, gender, waist size, smoking, and BMI as the most relevant risk factors for diabetes and hyperglycemia. Conclusion: A self-assessment predictive model was constructed for general population living in the west of Iran. This is the first self-assessment predictive model for diabetes in Iran. (C) 2017 Elsevier B.V. All rights reserved

Comparison between the two drug regimens of PPI+Amoxicillin+ Rifampicin and PPI+Amoxicillin+ Levofloxacin for the treatment of H. pylori infections resistant to the first line drug regimen among patients referred to Ilam clinics

Aim: This study compares the effects of two drug regimens for Helicobacter pylori (H. pylori) infection resistant to the first line drug regimen among patients referred to Ilam clinics, Iran. Background: Single drug regimen is not effective for H. pylori infection and therefore, application of triple or quadruple drug regimens are currently applied. Methods: This study was performed by a before-after comparative method and patients were randomly selected among those consecutively referred to Ilam gastrointestinal clinics. Patients with failure in the first line treatment, were randomly divided into two equal groups and each group was treated by one of the PPI+Amoxicillin+Rifampicin or PPI+Amoxicillin+Levofloxacin drug regimens for 14 days. Six weeks after treatment, patients were tested for H. pylori stool antigen and the results were compared between two groups. Results: In this study, 100 patients including 49 (49) men and 51 (51) women were examined. There was no statistical difference between the two groups for gender, age and living location at the start of study (p = 0.068). The mean age of the patients was 44.55 +/-15.1 years old ranging from 17 to 85 years. Response to treatment among the levofloxacin group, was 90 and in rifampicin group 72 with a significant difference (p<0.04). Conclusion: The response rate of H. pylori infection to the Levofloxacin based regimen was 90; however, the application of rifampicin in combination with other drugs against H. pylori infection (72 response rate), should be limited to reduce the possibility of drug resistance in case of tuberculosis infection

Celiac disease in Iranian irritable bowel syndrome patients; a systematic review and meta-analysis

Aim: The present study was conducted to evaluate the prevalence, clinical symptoms and pathological findings of celiac disease (CD) in irritable bowel syndrome (IBS) patients in Iran. Background: Several studies show high prevalence of CD in IBS patients, but the results are contradictory. Methods: The present study was conducted based on MOOSE protocol and results were reported according to PRISMA guideline. The search was done using international online databases (Scopus, PubMed, Science Direct, Cochrane Library, Embase, and Web of Science), national databases and Google Scholar search engine. Results: The pooled prevalence of CD in 2,367 Iranian IBS patients was estimated to be 6.13 (95CI: 4.11-9.05). The prevalence of CD in men and women with IBS was 4.28 (95 CI: 2.45-7.37) and 7.19 (95 CI: 4.51-11.28), respectively. The serological prevalence of anti tTG-IgA (11 studies with 2901 IBS patients) and AGA-IgG (4 studies with 936 IBS patients) was estimated to be 5.35 (95CI: 3.60-7.89) and 6.35 (95CI: 2.05-18.03), respectively. The clinical symptoms of CD among IBS patients included predominant diarrhea (47.87 95%CI: 22.46-74.43), predominant constipation (17.34% 95%CI: 9.17-30.35), and alternative diarrhea and constipation (27.84% 95%CI: 11.57-53.23). According to pathological findings based on marsh classification, the prevalence of CD at stages 1, 2 and 3 were 30.89% (95%CI: 13.25-56.68), 36.56% (95%CI: 21.74-54.45) and 52.87% (95%CI: 14.48-88.13), respectively. Conclusion: In the present meta-analysis, we observed a high prevalence for CD among Iranian IBS patients, which is higher than global estimates. Examination of all IBS patients in terms of CD seems to be necessary, but cost-effectiveness should be considered

A Meta-Analysis of The Prevalence and Etiology of Infertility in Iran

Infertility is a serious health issue in the world affecting approximately 8-10 of couples worldwide. The meta -analy-sis study was performed to assess the prevalence and etiologic factors associated with infertility in Iran. We made sure that the implementation of study and reporting the results were consistent with the MOOSE and PRISMA guidelines, respectively. All stages of the research were conducted by two authors, and the disagreement at each stage of the re-search was resolved by consensus. On January 1, 2020, we started a detailed literature search on international online databases, and Iranian Online databases, as well as specialized journals, several authentic international publishers and Google Scholar. We reviewed the reference list of identified articles for missed articles and then searched online for them. Data analysis was performed to estimate the prevalence using a random effects model. The lifetime infertility prevalence was found to be 11.3 95% confidence interval (CI): 8.6-14.7 and the current infertility was evaluated to be 3.7% (95% CI: 3.2-4.3). The prevalence of primary infertility (based on 45 articles consisting of 51,021 samples) as well as secondary infertility (based on 13 articles consisting of 35,683 samples) in Iran were estimated to be 18.3% (95% CI: 15.4-21.6) and 2.5% (95% CI: 1.6-4.0), respectively. The prevalence of female, male, both and unexplained causes was estimated to be 32.0% (95% CI: 27.6-36.8), 43.3% (95% CI: 38.2-48.6), 12.5% (95% CI: 9.6-16.2) and 13.6% (95% CI: 10.2-17.8), respectively. The prevalence of causes related to ovulation, uterine tubes, and endome-triosis in infertile women was estimated to be 54.0% (95% CI: 45.6-62.2), 15.5% (95% CI: 11.3-21.0), 6.2% (95% CI: 3.5-10.6), and 5.4% (95% CI: 2.5-11.3), respectively. In summary, the estimate of infertility burden in Iran did not change between 1990 and 2017 and its prevalence remains high. This research presents a unified and up-to-date overview regarding the burden of infertility in Iran

Investigating the effect of short-term educational program on readiness of patient’s candidate for endoscopy

Background: Gastrointestinal endoscopy is one of the main diagnostic tools for gastrointestinal examination. In this study, we measured the effect pre-procedure education on the readiness of patients for the endoscopy. Method: This quasi-experimental study was performed on 70 patients aged 35-60 years who were candidates for endoscopy from SEP 2018 to MAY 2019. Data were collected by a valid and reliable, 22 items’ questionnaire that developed by the researcher. Data were analyzed by SPSS, version 16. Results: mean score of readiness for endoscopy in the intervention group 105.8 (5.3) was significantly higher than control group 62.6 (7.8), (p<0.001). Also, the level of readiness of the intervention group was 11.4 good and 88.6 very good. The level of readiness of the control group was 91.4 moderate and 8.6 good. Conclusions: Considering the effect of pre-procedure education on the readiness of patients for the endoscopy, it can be inferred that providing educational programs before endoscopy can be helpful. © 2020, Indian Journal of Forensic Medicine and Toxicology. All rights reserved