Vitamin D and calcium deficiency and its relationship with cardiac function in patients with beta thalassemia

Introduction: Heart disease is the main cause of mortality and morbidity in patients with beta thalassemia. Vitamin D and calcium deficiency also is common in these patients. We studied and compared vitamin D and calcium levels and other parameters with echocardiographic findings in patients with beta thalassemia. Method: A cross-sectional study in patients with Transfusion-dependent thalassemia was conducted. 169 patients with Transfusion-dependent thalassemia were enrolled. Ejection fraction, valvular insufficiency and aortic diameter were determined. The aortic diameter of patients was measured using Mindray DC60 echo model. All of these patients were tested for levels of vitamin D, calcium (Ca), parathyroid hormone (PTH), alkaline phosphatase (ALP), platelet (PLT), and ferritin, Finally, the effect of these factors on aortic root (AR), aortic valve area (AVA) and ejection fraction (EF) was evaluated. One-way ANOVA was used to compare quantitative variables, and chi-square test with 95% confidence level was used to estimate relationships and compare ratios in groups. Results: There was a statistically significant relationship between vitamin D deficiency and Serum Ca (P-value = 0.009). Our results showed that with the increase in the level of vitamin D, the EF also increased and the probability that the aortic root will have a normal size will be higher. Furthermore, disorder in PTH and PLT level causes a decrease in the EF. Conclusion: This study did show an association between Vitamin D deficiency and cardiac function in patients with Transfusion-dependent thalassemia. Vitamin D can be considered as a supplement in thalassemia patients

Štetno djelovanje organofosfornih pesticida na jetra: kratki pregled četrdesetogodišnjeg istraživanja

Organophosphorus pesticides (OPs) are widely used volatile pesticides that have harmful effects on the liver in acute and chronic exposures. This review article summarises and discusses a wide collection of studies published over the last 40 years reporting on the effects of OPs on the liver, in an attempt to propose general mechanisms of OP hepatotoxicity and possible treatment. Several key biological processes have been reported as involved in OP-induced hepatotoxicity such as disturbances in the antioxidant defence system, oxidative stress, apoptosis, and mitochondrial and microsomal metabolism. Most studies show that antioxidants can attenuate oxidative stress and the consequent changes in liver function. However, few studies have examined the relationship between OP structures and the severity and mechanism of their action. We hope that future in vitro, in vivo, and clinical trials will answer the remaining questions about the mechanisms of OP hepatotoxicity and its management.Organofosforni pesticidi (OP) imaju veoma široku primjenu, ali i štetno djeluju na jetru pri akutnoj i kroničnoj izloženosti. Ovaj članak daje pregled 40 godina istraživanja djelovanja OP-ova na jetru s namjerom da predloži neke zajedničke mehanizme njihova toksičnog djelovanja na jetru i liječenje. U istraživanjima se izdvaja nekoliko ključnih bioloških procesa koji sudjeluju u hepatotoksičnosti OP-ova, poput narušavanja antioksidacijskoga obrambenog sustava, oksidacijskoga stresa, apoptoze te mitohondrijskoga i mikrosomalnoga metabolizma. Rezultati većine istraživanja potvrdili su da antioksidansi uspješno ublažavaju posljedice oksidacijskoga stresa u jetri. Međutim, gotovo da i nije istražena povezanost između strukture OP-ova i njihove štetnosti odnosno mehanizama djelovanja. Nadamo se da će buduća in vitro i in vivo istraživanja te klinička ispitivanja odgovoriti na preostala pitanja vezana uz mehanizme hepatotoksičnoga djelovanja OP-ova i njegova uspješnoga liječenja

Why Do Emergency Medicine Residents Experience Burn Out? A qualitative study

Objective: Emergency medicine residents are a high–risk group for burnout syndrome. This was a qualitative study with content analysis on emergency medical residents with 2 aims: evaluating the incidence of occupational burnout syndrome and identifying the points of view and attitudes of emergency medical residents about factors related to occupational burnout syndrome. Method: For this study, 2 sessions of focus group discussions were set up at Imam Khomeini hospital affiliated to Tehran University of Medical Sciences. Each session took 90 minutes, and 20 emergency medicine residents in their first or second year of emergency medicine residency participated in the sessions. Data were coded   by MAXQDA10 software. Results: Data were categorized in 4 themes as follow: (1) the characteristics of emergency medicine; (2) ambiguity in residents’ duties; (3) educational planning; and (4) careers. Data on the proposed solutions by residents were analyzed and coded in 3 groups including (1) changes in personal life; (2) arrangement in shifts; and  (3) educational issues. Conclusion: According to findings of this qualitative study, most of emergency medicine residents have experienced exhaustion sometime during the course of their residency. Psychological supports may help the residents to cope with their career difficulties and probable burn out

Prevalence and Correlates of Psychiatric Disorders in a National Survey of Iranian Children and Adolescents

Objective: Considering the impact of rapid sociocultural, political, and economical changes on societies and families, population-based surveys of mental disorders in different communities are needed to describe the magnitude of mental health problems and their disabling effects at the individual, familial, and societal levels. Method: A population-based cross sectional survey (IRCAP project) of 30 532 children and adolescents between 6 and 18 years was conducted in all provinces of Iran using a multistage cluster sampling method. Data were collected by 250 clinical psychologists trained to use the validated Persian version of the semi-structured diagnostic interview Kiddie-Schedule for Affective Disorders and Schizophrenia-PL (K-SADS-PL). Results: In this national epidemiological survey, 6209 out of 30 532 (22.31%) were diagnosed with at least one psychiatric disorder. The anxiety disorders (14.13%) and behavioral disorders (8.3%) had the highest prevalence, while eating disorders (0.13%) and psychotic symptoms (0.26%) had the lowest. The prevalence of psychiatric disorders was significantly lower in girls (OR = 0.85; 95% CI: 0.80-0.90), in those living in the rural area (OR = 0.80; 95% CI: 0.73-0.87), in those aged 15-18 years (OR = 0.92; 95% CI: 0.86-0.99), as well as that was significantly higher in those who had a parent suffering from mental disorders (OR = 1.96; 95% CI: 1.63-2.36 for mother and OR = 1.33; 95% CI: 1.07-1.66 for father) or physical illness (OR = 1.26; 95% CI: 1.17-1.35 for mother and OR = 1.19; 95% CI: 1.10-1.28 for father). Conclusion: About one fifth of Iranian children and adolescents suffer from at least one psychiatric disorder. Therefore, we should give a greater priority to promoting mental health and public health, provide more accessible services and trainings, and reduce barriers to accessing existing services

Ghrelin and ghrelin/total cholesterol ratio as independent predictors for coronary artery disease: a systematic review and meta-analysis

Download PDFPDF Review Ghrelin and ghrelin/total cholesterol ratio as independent predictors for coronary artery disease: a systematic review and meta-analysis http://orcid.org/0000-0001-7611-7799Maryam Niknam1, Taraneh Liaghat2, Mehrdad Zarghami3, Mehdi Akrami2, Seyed Mehdi Shahnematollahi2, Ahmad Ahmadipour4, Fatemeh Moazzen5, http://orcid.org/0000-0002-3628-9438Sahar Soltanabadi2 Correspondence to Dr Sahar Soltanabadi, Cardiovascular Research Center, Shiraz University of Medical Sciences, Shiraz 7175735865, Iran (the Islamic Republic of); [email protected] Abstract The present meta-analysis aimed to summarize the available data regarding the circulating levels of ghrelin in patients with cardiovascular diseases (CVDs). A comprehensive search was performed in electronic databases including PubMed, Scopus, EMBASE, and Web of Science up to January 20, 2021. Since the circulating levels of ghrelin were measured in different units across the included studies, they were expressed as the standardized mean difference (SMD) and 95% CI (summary effect size). A random-effects model comprising the DerSimonian and Laird method was used to pool SMDs. Sixteen articles (20 studies) comprised of 1087 cases and 437 controls were included. The pooled results showed that there were no significant differences between cases and controls in terms of ghrelin levels (SMD=−0.61, 95% CI −1.38 to 0.16; p=0.120; I2=96.9%, p<0.001). The ghrelin concentrations in the CAD stratum were significantly lower than in controls, whereas they increased in other disease strata. New combined biomarkers demonstrated a significant decrease in the SMD of the ghrelin/total cholesterol (TC) ratio (−1.02; 95% CI −1.74 to –0.29, p=0.000; I2=94.5%). However, no significant differences were found in the SMD of the ghrelin/high-density lipoprotein cholesterol ratio, ghrelin/low-density lipoprotein cholesterol ratio, and ghrelin/triglyceride (TG) ratio in cases with CVDs compared with the control group. Ghrelin was associated with CAD; therefore, it may be considered a biomarker for distinguishing between patients with and without CAD. Furthermore, the ghrelin/TC ratio could be proposed as a diagnostic marker for CVD