Intravascular Hemolysis following Acute Zinc Phosphide Poisoning; a Case Report

Zinc phosphide (ZnP) is low-cost, accessible, and very effective as a rodenticide. It has been used for many human suicide poisonings around the world, including Iran. Nonspecific gastrointestinal symptoms and cardiotoxicity are the most serious complications of ZnP poisoning, which are associated with a high mortality rate. The aim of this paper was to report a poisoned patient that ingested ZnP with suicidal attempt and faced complications due to hemolysis

Association of Serum Leptin with Prognostic Factors in Breast Cancer

Background: Nowadays, cytokines such as Leptin and adiponectin are introduced as prognostic factors which, according to some studies, are also associated with body mass index. This study aimed to determine serum leptin level and its relationship with prognostic factors in breast cancer patients. Methods: This case–control study was conducted in the oncology department of Tohid Hospital, Sanandaj, Iran, between 2019 and 2020. Hundred new cases of breast cancer patients with histological evidence were enrolled in this study. Additionally, 100 age- and BMI-matched healthy individuals were recruited as the control group. The serum leptin level was measured using the ELISA method. Results: Serum leptin levels were significantly higher in breast cancer patients compared to the control group (21.68 ± 9.16 vs 11.89 ± 4.45; p < 0.001). There was no significant relationship between plasma leptin levels with ER, PR, and HER2 expressions (p > 0.05). Also, no significant associations were noted between leptin levels and grading and disease staging (p > 0.05). Conclusion: The study found that leptin is higher in breast cancer patients than in healthy individuals, however, it did not prove that leptin is a predictive or prognostic factor

Efficacy of Enema via Cecostomy for Fecal Disorders in Children: A Systematic Review and Meta-Analysis

Background   Some controversy exists about the role of cecostomy in the management of fecal disorders. The present meta-analysis aims provide a comprehensive evaluation on the role of cecostomy on management of fecal incontinence and constipation in children.   Materials and Methods   An extensive search was performed on the Medline, Embase, Scopus, and Web of Science until July 2017. Two independent researchers screened the title and abstracts of the studies and then relevant studies were included. Finally, pooled effect size was presented as standardized mean difference (SMD) or pooled prevalence with 95% confidence interval (95% CI).   Results   14 articles were entered (740 children). The success rate of cecostomy in management of fecal disorders was 90.6% (success rate=90.6%; 95% CI: 86.4 to 94.2). The most common side effects of this technique include granulation tissue formation (29.6%), cecostomy tube leakage (8.5%), tube dislodgement (7.0%), and tube site infection (2.3%).   Conclusion   The results of the present meta-analysis show that the cecostomy is safe and an effective technique in the management of fecal disorder in children. However, the findings presented on the eligible articles have have shown a low level of evidence and it is suggested that clinical trials should be conducted in this field

Ubiquitin C-Terminal Hydrolase-L1 (UCH-L1) in Prediction of Computed Tomography Findings in Traumatic Brain Injury; a Meta-Analysis

Introduction: Ubiquitin C-terminal hydrolase-L1 (UCH-L1) is one of the promising candidates, with an acceptable diagnostic value for predicting head computed tomography (CT) scan findings. However, there has been a controversy between studies and still, there is no general overview on this. Therefore, the current systematic review and meta-analysis attempted to estimate the value of UCH-L1 in predicting intracranial lesions in traumatic brain injury.Methods: Two independent reviewers screened records from the search of four databases Medline, Embase, Scopus and Web of Science. The data were analyzed in the STATA 14.0 statistical program and the findings were reported as a standardized mean difference (SMD), summary receiver performance characteristics curve (SROC), sensitivity, specificity, and diagnostic odds ratio with 95% confidence interval (95% CI).Results: Finally, the data of 13 articles were entered into the meta-analysis. The mean serum level of UCH-L1 was significantly higher in patients with CT-positive than in TBI patients with CT negative (SMD = 1.67, 95% CI: 1.12 to 2.23, I2 = 98.1%; p <0.0001). The area under the SROC curve for UCH-L1 in the prediction of intracranial lesions after mild TBI was 0.83 (95% CI: 0.80 to 0.86). Sensitivity, specificity and diagnostic odds ratio of serum UCH-L1 was 0.97 (95% CI: 0.92 to 0.99), 0.40 (95% CI: 0.30 to 0.51) and 19.37 (95% CI: 7.25 to 51.75), respectively. When the analysis was limited to assessing the serum level of UCH-L1 within the first 6 hours after mild TBI, its sensitivity and specificity increased to 0.99 (95% CI: 0.94 to 1.0) and 0.44 (95% CI: 0.38 to 0.052), respectively. In addition, the diagnostic odds ratio of 6-hour serum level of UCH-L1 in the prediction of intracranial lesions was 680.87 (95% CI: 50.50 to 9197.97).Conclusion: Moderate level of evidence suggests that serum/plasma levels of UCH-L1 have good value in prediction of head CT findings. It was also found that evaluation of serum/plasma level of UCH-L1 within the first 6 hours following TBI would increase its predictive value. However, there is a controversy about the best cutoffs of the UCH-L1

Seizure Prevalence and Its Related Factors in Tramadol Intoxication; a Brief Report

Introduction: Seizure is known to be a serious complication of tramadol consumption even in its therapeutic doses. The aim of this study was to determine the prevalence of seizure and its related factors in tramadol intoxicated patients referred to emergency department (ED). Methods: In this cross-sectional study, all individuals, admitted to ED following tramadol intoxication were divided into two groups based on the presence or absence of seizures. Demographic data as well as clinical, electroencephalogram and imaging findings were compared between the two groups using SPSS software version 22. Results: 167 patients with the median age of 23 (13-45) years were studied (85% male). Seizure was seen in 97 (58.0%) cases. Risk of seizure had increased 3.7 times in patients with a history of seizure (OR: 3.71 Cl 95%: 1.17 - 11.76). Tramadol dose was significantly higher in patients who had seizure more than once (Median: 2800 IQR: 1800-4000), compared to those who had one seizure episode (Median: 850 IQR: 1800-400) (p <0.0001). Conclusion: Based on the findings of this study, history of seizure increased the risk of seizure in patients taking tramadol, and the increase in dose correlated with a significant increase in seizure frequency

Seroprevalence of West Nile Virus in Regular Blood Donors Referred to the Blood Bank of Kurdistan Province, Iran

Background: West Nile virus is an infection that is most commonly caused by infected mosquito bites, however, blood transfusions, organ transplants, breast feeding, pregnant mother-to-the-fetus transmission, and occupational transmission among laboratory and medical staff are also the less common routes of infection. Given the endemic nature of this virus in the Middle East, the aim of this study was to investigate the presence of this virus in regular blood donors, as the reliable source of blood supply needed for patients in hospitals. Methods: In this descriptive-analytical study, venous blood samples were collected from 259 regular blood donors referred to the Blood Transfusion Organization of Kurdistan. After separating blood serum, the amount of IgM and IgG antibodies against West Nile virus was measured via ELISA test. Results: Concerning antibodies, IgG and IgM against West Nile virus were positive in 14 patients (5.4%) and 3 patients (1.2%), respectively. Seropositive IgG levels were observed in 11 patients over the age of 40 (12.5%) but only in 3 patients under 40 years of age (1.8%). The difference was statistically significant (OR = 7.95; 95% CI: 2.16–29.32; p &lt; 0.01). Conclusion: Given the value of blood and blood products obtained from regular blood donors for therapeutic purposes and the significant prevalence of the virus and considering the presence of cases with positive IgM, it seems necessary to screen blood donors in blood transfusion centers in the western parts of Iran

Potential diagnostic and prognostic value of serum and cerebrospinal fluid biomarkers in traumatic spinal cord injury: a systematic review

It remains unclear whether biomarkers in the serum or cerebrospinal fluid (CSF) can be used for diagnosis or prognosis of spinal cord injuries (SCI). Therefore, a systematic review was undertaken to evaluate the prognostic or diagnostic value of serum and CSF biomarkers in assessing the severity of SCI and the outcome of patients. Two independent reviewers summarized the human studies retrieved from the electronic databases of Medline, Embase, Scopus and ISI Web of Science until April 2018. Seventeen studies were included (1065 patients aged 16 to 94 years old). Although the findings of the included studies suggest that inflammatory and structural proteins may be useful in assessing the severity of SCI and prediction of neurological outcome, the level of evidence is generally low. Given limitations to the available evidence, further investigation in this field is required using large prospective datasets with rigorous analysis of sensitivity, specificity and prediction

Human Adipose-Derived Stem/Stromal Cells from Children or Adults?

Discovering a cell type with the highest efficiency and the least side-effects is one of the priorities of scientists active in this field. Of all the cells, mesenchymal stem cells have been and still are of interest to the researchers for use in pre-clinical and clinical studies due to being easily accessible, pluripotency, secretion of numerous growth factors, low risk of immunological rejection, and not having ethical issues for clinical use. Of all mesenchymal cells, human adipose-derived stem/stromal cells (hADSCs) are more safely and easily accessible, produce more growth factors compared to other mesenchymal stem cells, have the ability to differentiate to various cell lines, secrete high levels of angiogenic factor and their feasibility, safety and efficacy have been confirmed. Therefore, in the last decade, it has received more attention from researchers, compared to other cell sources. Since distribution and function of adipose tissue is versatile and changes at any age during the lifetime, it is expected that at different ages, hADSCs also show different functions and abilities. Therefore, it is hypothesized that autologous implantation is not necessarily always the best choice. Autologous transplantation of hADSCs is only the best choice in ages that these cells have the optimum efficacy. If it is determined in what age these cells have the highest efficacy, choosing the type of implantation will be an important factor in achieving the best response to treatment

Posterior Tibial Nerve Stimulation in Fecal Incontinence: A Systematic Review and Meta-analysis

Introduction: The present systematic review and meta-analysis aims to investigate the role of Posterior Tibial Nerve Stimulation (PTNS) in the control of fecal incontinence (FI). Methods: Two independent reviewers extensively searched in the electronic databases of Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, CINAHL, and Scopus for the studies published until the end of 2016. Only randomized clinical trials were included. The studied outcomes included FI episodes, FI score, resting pressure, squeezing pressure, and maximum tolerable pressure. The data were reported as Standardized Mean Differences (SMD) with 95% confidence interval. Results: Five articles were included in the present study (249 patients under treatment with PTNS and 239 in the sham group). Analyses showed that PTNS led to a significant decrease in the number of FI episodes (SMD=-0.38; 95% CI: -0.67-0.10; P=0.009). Yet, it did not have an effect on FI score (SMD=0.13; 95% CI: -0.49-0.75; P=0.68), resting pressure (SMD=0.12; 95% CI: -0.14-0.37; P=0.67), squeezing pressure (SMD=-0.27; 95% CI: -1.03-0.50; P=0.50), and maximum tolerable pressure (SMD=-0.10; 95% CI: -0.40-0.24; P=0.52). Conclusion: Based on the results, it seems that the prescription of PTNS alone cannot significantly improve FI