Prognostic value of matrix metalloproteinase-9 expression in oral squamous cell carcinoma and its association with angiogenesis

Background: Breakdown of extracellular matrix (ECM) is one of the important hallmarks of cancer progression which facilitates the invasion of tumoral cells to the surrounding tissue. Matrix metalloproteinases (MMPs) can degrade various components of the ECM and basement membrane. The aim of this study was to determine the role of matrix metalloproteinases-9 protein in the biologic behavior of oral squamous cell carcinoma (OSCC) and its relation with tumor angiogenesis. Material and Methods: In this study 42 OSCC and 15 normal epithelium were reviewed by immunohistochemical staining for matrix metalloproteinases-9 and CD105. Results: Matrix metalloproteinases-9 expression was detected in 32 OSCC specimens (76.1%), with 28 specimens (66.6%) showing moderate or strong expression. We observed that the expression level of matrix metalloproteinases-9 was positively correlated with the status of lymph node metastasis (N0vs. N1) ( P =0.00), and clinical stage (I-II vs. III-IV) in OSCC patients. Microvessel density in intratumoral tissue has an association with lymph node metastasis and advanced clinical stage ( P =0.003 and p =0.01, respectively). We observed that tumors with matrix metalloproteinases-9 overexpression had a higher microvessel density counts compared with tumors with absent or focal immunostaining (16.2±5.6 vs 10.3±3.5 respectively, P =0.03). Conclusions: In conclusion present results demonstrate the marked expression of matrix metalloproteinases-9 and CD105 in OSCC and suggest that the expression of these markers is associated with tumor progression and could offer additional information about the aggressiveness of OSCC. In addition a significant relationship was noted between microvessel density count and expression of matrix metalloproteinases-9 which suggest that MMP9 expression may be closely related to tumor angiogenesi

Comparison of the therapeutic effects of the dietary and topical forms of Zizyphus jujuba extract on oral mucositis induced by 5-fluorouracil: a golden hamster model

Background: Oral mucositis (OM) is a common inflammatory complication among cancerous patients as an ad verse effect of chemotherapy and radiotherapy. The aim of this study was to evaluate the effects and identify the appropriate route of administration of extract of Zizyphus jujuba in 5-flurouracile induced OM induction in golden hamster. Materials and Methods: In a prospective randomized double blind animal study, OM was induced in 56 male golden hamsters by 5-FU (60 mg/kg) on days 0, 5, and 10 of the study. The cheek pouch was scratched with a sterile needle on once daily on days 3 and 4. On days 14-17, 300 mg/kg dietary and 20% Z. jujuba gel and gel base groups were treated and then compared with a control group. Microscopic scores and pouch content of malondialdehyde (MDA), plus activities of superoxide dismutase and myeloperoxidase in pouch tissue were evaluated. Results: Histopathology scores of mucositis were lower in the systemic and 20% Z. jujuba gel groups than the gel base and control groups ( P <0.05). Also, lower MDA level and higher activities of MPO and SOD were detected in the systemic and 20% Z. jujuba gel groups in comparison to the gel base and control groups ( P <0.001). Conclusions: The use of Z. jujuba hydroalcoholic extract in systemic and topical forms may be associated with reduced intensity of OM, diminished concentration of MDA, and increased activity of MPO and SOD on induced OM in golden hamster undergoing 5-FU consumptio

Use of tranexamic acid in bleeding control of transabdominal and transvaginal hysterectomy

BACKGROUND: Hysterectomy is one of the most common gynecology surgeries. This study aimed to compare perioperative bleeding in transabdominal and transvaginal hysterectomy. MATERIALS AND METHODS: This prospective, double-blind, randomized, controlled clinical trial was performed on 80 patients undergoing hysterectomy referred to Shahid Beheshti Hospital, Isfahan, Iran. Patients were divided into two groups of 40; the first group (T) received 1 g intravenous tranexamic acid (TXA) for 20 min preoperatively. The second group (S) received 10 cc normal saline as placebo. Blood samples were taken before and 12 h after surgery for assessment of hemoglobin, hematocrit, and platelet count, the prothrombin time, activated partial thromboplastin time, and serum creatinine as well as volume of blood transfusion. RESULTS: There were no significant differences between the two groups in heart rate, diastolic blood pressure (BP), systolic BP, and mean arterial pressure before, during, and after surgery (P > 0.05). There was no significant difference in blood variables before and after surgery (P > 0.05) except the platelet count that was in the normal range in both groups after surgery (P = 0.022). The mean volume of blood transfused in the case group was significantly lower than the control group during surgery (P = 0.008) and 12 h after surgery (P = 0.01). CONCLUSION: The prophylactic administration of TXA results in a significant reduction in need for blood transfusion and the duration of surgery. Given the lower risks of using TXA compared to the other drugs, it is recommended in hysterectomy to control bleeding

Ketamine versus Ketamine / magnesium Sulfate for Procedural Sedation and Analgesia in the Emergency Department: A Randomized Clinical Trial

Background: The present study was designed to evaluate the effectiveness of magnesium sulfate (MgSO4) in procedural sedation and analgesia (PSA) when combined with ketamine in patients with fractures in emergency departments and required short and painful emergency procedures. Materials and Methods: In this study, 100 patients with fractures and dislocations who were presented to the emergency departments and required PSA for short and painful emergency procedures were randomly allocated to groups of ketamine plus MgSO4or ketamine alone. Train of four (TOF) stimulation pattern was assessed using nerve stimulator machine and compared between groups. Results: The mean age of studied patients was 46.9 ± 9.3 years old. 48% were male and 52% were female. No significant differences were noted between groups in demographic variables. The status of TOF, 2 min after the injection of ketamine (1.5 mg/kg), in both groups was similar. After the injection of the second dose of ketamine (1 mg/kg) the status of TOF in four patients in ketamine plus MgSO4 (0.45 mg/kg) group changed, it was three quarters but in ketamine group, the status of TOF in all patients was four quarters. The difference between groups was not statistically significant (P = 0.12). Conclusion: The findings revealed that for muscle relaxation during medical procedures in the emergency department, ketamine in combination with MgSO4with this dose was not effective for muscle relaxation during procedures

Comparison of the effect of intravenous dexamethasone and methylprednisolone on the treatment of hospitalized patients with COVID-19: a randomized clinical trial

Objective: In this study, we aimed to compare the effects of intravenous dexamethasone and methylprednisolone on the treatment of inpatients with COVID-19. Methods: In this randomized clinical trial, 143 patients under 80 years of age with moderate to severe COVID-19 were enrolled and randomly assigned to two groups: dexamethasone (8 mg/day) and methylprednisolone (60 mg/day in two divided doses). The primary outcome was the length of hospital stay. The secondary outcomes included: duration of oxygen therapy, absolute leukocyte and lymphocyte count, hypokalemia, hyperglycemia, intensive care unit admission, and mortality in the two groups for 28 days. Data were analyzed by SPSS version 26 using t-test, chi-square, and analysis of variance. Results: The duration of hospitalization was significantly (P <0.001) shorter in the dexamethasone group than in the methylprednisolone group (8 [95% confidence interval [CI]:6-10] and 11 [95% CI: 7-14], respectively). In addition, the duration of oxygen therapy in the dexamethasone group (7 [95% CI: 5-9]) was significantly (P <0.001) shorter than in the methylprednisolone group (10 [95% CI: 5.5-14]). The mortality rate was 17.1% (95% CI: 8.1-26.1) in the dexamethasone group and 12.3% (95% CI: 4.6-20.0) in the methylprednisolone group, which was not statistically significant (P = 0.46). Conclusion: Results showed better effectiveness of 8 mg/day dexamethasone compared with 60 mg/day methylprednisolone based on the shorter hospital stay, which can be considered in the therapeutic protocol of COVID-19. Trial registration:: IRCT20210223050466N1

ABO Blood Groups Associations with Ovarian Cancer: A Systematic Review and Meta-analysis

Background: Ovarian Cancer (OC), as the seventh most common cancer throughout the world, is one of the most lethal gynecologic malignancies in women. In addition to well-studied risk and prognostic factors of OC, such as age, obesity, stage, histology, etc., ABO blood groups associations with OC has been attracted the investigators� focus in the recent decade. The objective of this study is to find any relationships between ABO blood groups and OC through a meta-analysis. Methods: The databases of PubMed, Embase, and Web of Science were systematically searched by available MeSh terms for �Ovarian Cancer�, and �ABO blood group� up to August 1, 2020. Hazard ratio (HR) or odds ratio (OR) were extracted and used from studies for outcome estimation whenever appropriate with 95 confident interval (CI). Data were analyzed using CMA v. 2.2.064. Results: Fourteen papers, including 58,193 participants, entered in the systematic review. The meta-analysis indicated a substantially higher risk of developing OC in individuals with blood group A (OR 1.17, 95 CI 1.01�1.36) and AB (OR 1.27, 95 CI 1.02�1.59), but the subject was not significant in individuals with blood group B (OR 1.11, 95 CI 0.81�1.51). No associations were found between OC overall survival and blood group A (HR 1.14, 95 CI 0.79�1.64), AB (HR 1.00, 95 CI 0.69�1.45), and B (HR 0.88, 95 CI 0.58�1.33). Recurrence rates of OC for blood groups A, AB, B, and O were 30.8, 34.3, 33.6, and 32.0, respectively. Rates of mortality in different blood groups are as follows: A (31.8), AB (31.1), B (26.2), and O (33.8). Conclusion: This systematic review and meta-analysis revealed a considerably increased risk of developing OC among individuals with blood group A and AB. However, no substantial impacts were found for ABO blood groups on the overall survival of the OC patients. © 2020, Association of Gynecologic Oncologists of India

Molecular Identification of Trichostrongylus Species Among Small Ruminants in Mazandaran Province, Iran

Background: Trichostrongylus is an intestinal parasite that is highly prevalent in humans and livestock worldwide. There is limited information about the prevalence and epidemiology of Trichostrongylus species among the infected livestock in Mazandaran Province, northern Iran. This study aimed to identify Trichostrongylus spp. among small ruminants using morphometric and molecular methods. Materials and Methods: Small intestinal organs of sheep and goats, slaughtered in Mazandaran Province, were examined for infectivity with Trichostrongylus parasites. Primary species identification was conducted based on the morphological characterization of the male worms. The internal transcribed spacer (ITS) II regions of the ribosomal DNA of the worm tissues were amplified using the polymerase chain reaction (PCR) assay and then the product was subjected to sequencing. Subsequently, the PCR products of the ITS II region were subjected to digestion by HinfI and DraI restriction enzymes using the PCR-restriction fragment length polymorphism (RFLP). Results: Of 180 samples, 98 (54.44%) were confirmed positive for Trichostrongylus based on the conventional PCR. The digestion of the PCR products with HinfI and DraI facilitated the identification of three Trichostrongylus species, namely Trichostrongylus colubriformis (35%, 90.81%), Trichostrongylus axei (4%, 4.08%), and Trichostrongylus vitrinus (5%, 5.1%). Both morphometric and RFLP techniques resulted in the differentiation of the three Trichostrongylus species. Conclusion: The present study was the 1st attempt in the last 30 years for the identification of Trichostrongylus species in small ruminants in Mazandaran Province. The findings of this study can be helpful for epidemiological and ecological studies, the establishment of effective control programs, and the management of gastrointestinal parasites in Mazandaran Province