Determination of Effect of Platelet Rich Plasma Injection on Improving Pain and Function in Young Healthy Athletes with Isolated Grade 2 or 3 Knee Medial Collateral Ligament Sprains

Background: Knee medial collateral ligament (MCL) sprain is common in athletes, which keeps them away from trainings. Platelet-rich plasma (PRP) injection is used as an adjunct for treatment of musculoskeletal injuries. This study was supposed to define effect of PRP injection on high-grade MCL sprain healing, in comparison to rehabilitation alone.Materials and Methods: This study was performed on 46 healthy athletes with high-grade MCL sprains who came to sports medicine clinic of Taleghani Hospital, Tehran over a one-year period (2017-2018). In first visit injury grade, its location, baseline pain, Lysholm score and joint stability was determined. Participants randomly allocated to 2 groups (n=23), “group A” had 12-week functional rehabilitation and “group B” had the same rehabilitation plus a single PRP injection. At 4-week intervals valgus stress testing, pain and Lysholm scores was reassessed. The scores of 4th, 8th and 12th weeks was compared to the baseline scores.Results: Mean baseline pain score in control and intervention group was 5.09±0.949 and 5.26±0.810 respectively that in the fourth week of study reduced to 1.30±0.765 and 2.43±0.507 (p<0.001). In intervention group, fourth week pain was significantly reduced while stability and Lysholm scores of the groups had no significant difference.Conclusion: PRP injection had a short-term statistically significant pain reduction effect that may assist in faster rehabilitation progress, shorter return to play and less detraining which is crucial to professional athletes

Assessing the Relationship between Serum Testosterone Levels and COVID-19 Outcomes in Admitted Patients

Introduction: With the emergence of the worldwide COVID-19 pandemic, a high toll of mortality and morbidity was imposed on Iran. Despite endeavors to control the disease using the social distancing protocols, isolations, quarantine and vaccination, COVID-19 is still afflicting individuals by mutation and development of new variants. Studies suggest higher morbidity and mortality among men compared to women, and in men with underlying diseases. Studies suggest low serum testosterone level as a risk factor for more severe diseases. We aimed to assess the relation of testosterone level with laboratory investigation and its effect on COVID-19 disease outcomes. Materials and Methods: Seventy patients were selected from those referred to Shohada-e-Tajrish hospital during February 2022 till July 2022. The patients were further categorized in two groups regarding their need for respiratory support: patients who did not need invasive respiratory support and patients who needed invasive respiratory support and were admitted to the intensive care unit. Blood samples were collected for laboratory examination. Each patient was followed for one month, and the outcomes were recorded. Results: The mean age of the participants was 64.44 years including 33 men and 37 women. Mean serum total and free testosterone level was 0.45 nmol/L and 1.22 nmol/L, respectively. Demised patients were significantly older and had significantly lower total testosterone levels. D-dimer was significantly higher in demised patients. Conclusion: Serum total testosterone levels can be used as a prognostic factor to predict COVID-19 patients’ prognosis. Serum total testosterone is inversely associated with disease severity, and lower serum total testosterone level is significantly associated with higher mortality. Moreover, inflammatory markers such as D-dimer can be used to determine prognosis and severity

Factors affecting health-promoting lifestyle profile in Iranian male seafarers working on tankers

Background: Seafaring is a risky occupation that is associated with a high incidence of lifestyle-related diseases. The present study was carried out to examine health promotion behaviour and its associated factors in seafarers of the National Iranian Tanker Company. Materials and methods: A cross-sectional study was performed on 200 Iranian male seafarers in 2015. A self-administered socio-demographic and Health Promotion Lifestyle Profile II (HPLP-II) questionnaire was completed. One-way analysis of variance was used to identify significant differences among the various departments. The t-test was utilised to compare the HPLP-II scores according to the demographic variables. Multiple linear regression analysis was performed to assess the association between demographic variables and the overall HPLP-II score, in addition to the six health-promoting lifestyle subscale scores. Results: The mean age of the participants was 35.93 ± 9.51 years. Most of the seafarers were categorised as having a moderate (32%) or good lifestyle (61.5%). The mean lifestyle score was 136.14 ± 19.90, with the subscale spiritual growth showing the highest score (26.16 ± 5.03) and the subscale exercise behaviour showing the lowest score (19.95 ± 4.23). The lowest score for nutrition was found among the seafarers working in the engine department (engine: 20.41 ± 4.50, deck: 23.52 ± 4.97, and galley: 24.83 ± 4.64) (p < 0.05). Working in the engine department was found to have a significant negative effect on the nutrition score (B = –3.57, p < 0.05). Moreover, educational level was found to have a significant positive effect on spiritual growth (B = 2.97, p < 0.05). Conclusions: The findings suggest that health-related issues in this occupation, especially workers in the engine room, are a matter of concern

A novel laryngeal palpatory scale (LPS) in patients with muscle tension dysphonia

Objectives: Laryngeal palpation is a routine clinical method for evaluation of patients with muscle tension dysphonia (MTD). The aim of this study was to develop a new comprehensive valid and reliable “laryngeal palpatory scale” (LPS), based on psychometric criteria. Methods: The scale items were selected based on an in-depth analysis of the literature and an expert focus group. Scale item generation and item reduction were followed by a psychometric assessment. Qualitative and quantitative content validity (the content validity ratio (CVR), content validity index (CVI)), the qualitative face validity, and the inter-rater reliability were determined. For this purpose, 531 patients were assessed and finally 55 patients with primary MTD (26 women, mean age: 40.8 years, SD: 12.5; 29 male, mean age: 41.6 years, SD: 11.8) participated in the study. A weighted kappa (k*) statistic was used to examine the inter-rater reliability for each single item. Results: Based on the CVR, three items were omitted because they had a score of less than 0.62. The CVI for all remaining items was greater than 0.79 and the scale CVI was equal to 0.96. The final 45 items were a result of the study. The inter-rater reliability for each single item ranged from 0.41 to 1, indicating moderate to almost perfect agreement. Conclusions: The LPS is a reliable and valid instrument for assessing patients with MTD. However, future studies are needed to provide adequate data on sensitivity, specificity, concurrent validity, and cutoff scores

Serum Hepcidin and Ferritin Have Not Correlation With Inflammatory Markers in Kidney Transplant Patients

In renal transplant patients, increased ferritin is associated with an increased risk of cardiovascular disease, transplant rejection, and mortality. Serum ferritin elevates in renal transplant patients due to blood product transfusion, inflammation, and malignancies. Hepcidin is also a peptide hormone produced in the liver in response to anemia, hypoxia, or inflammation. The aim of this study was to investigate the relationship between ferritin, hepcidin, iron, TIBC, and serum inflammatory markers in renal transplant patients. The cross-sectional descriptive-analytical study was conducted on 60 renal transplant patients referred to Hazrat-Rasool and Imam-Ali clinics and Al-Mahdi Laboratory of Shahrekord selected by convenience sampling method. Serum ferritin, hepcidin, iron, TIBC, and inflammatory markers levels were determined by standard kits by ELISA. Data were analyzed by SPSS software. Serum iron had a significant negative correlation with erythrocyte sedimentation rate (ESR) (r=-0.418, P=0.001) and a negative correlation with C reactive protein (CRP) (r=-0.243, P=0.061). TIBC had a significantly negative association with ferritin (r=-0.27, P=0.037). Ferritin, hepcidin, and TIBC were not significantly correlated with inflammatory factors. The results of the study showed no significant relationship between ferritin, hepcidin, and TIBC with inflammatory factors in renal transplant patient

Ellagic acid effects on disease severity, levels of cytokines and T-bet, RORγt, and GATA3 genes expression in multiple sclerosis patients: a multicentral-triple blind randomized clinical trial

BackgroundMultiple sclerosis (MS) is a chronic autoimmune disease. Ellagic acid is a natural polyphenol and affects the fate of neurons through its anti-inflammatory and antioxidant properties. The present study aimed to investigate ellagic acid effects on disease severity, the expression of involved genes in the pathogenesis of MS, and the levels of related cytokines.MethodsThe present study was a triple-blind clinical trial. Eligible patients were randomly assigned to two groups: Ellagic acid (25 subjects) for 12 weeks, receiving 180 mg of Ellagic acid (Axenic, Australia) and the control group (25 subjects) receiving a placebo, before the main meals. Before and after the study, the data including general information, foods intake, physical activity, anthropometric data, expanded disability status scale (EDSS), general health questionnaire (GHQ) and pain rating index (PRI), fatigue severity scale (FSS) were assessed, as well as serum levels of interferon-gamma (IFNγ), interleukin-17 (IL-17), interleukin-4 (IL-4) and transforming growth factor-beta (TGF-β), nitric-oxide (NO) using enzyme-linked immunoassay (ELISA) method and expression of T-box transcription factor (Tbet), GATA Binding Protein 3 (GATA3), retinoic acid-related orphan receptor-γt (RORγt) and Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) genes were determined using Real-Time Quantitative Reverse Transcription PCR (RT-qPCR) method.FindingsEllagic acid supplementation led to a reduction in IFNγ, IL-17, NO and increased IL-4 in the ellagic acid group, however in the placebo group no such changes were observed (−24.52 ± 3.79 vs. -0.05 ± 0.02, p < 0.01; −5.37 ± 0.92 vs. 2.03 ± 1.03, p < 0.01; −18.03 ± 1.02 vs. -0.06 ± 0.05, p < 0.01, 14.69 ± 0.47 vs. -0.09 ± 0.14, p < 0.01, respectively). Ellagic acid supplementation had no effect on TGF-β in any of the study groups (p > 0.05). Also, the Tbet and RORγt genes expression decreased, and the GATA3 gene expression in the group receiving ellagic acid compared to control group significantly increased (0.52 ± 0.29 vs. 1.51 ± 0.18, p < 0.01, 0.49 ± 0.18 vs. 1.38 ± 0.14, p < 0.01, 1.71 ± 0.39 vs. 0.27 ± 0.10, p < 0.01). Also, ellagic acid supplementation led to significant decrease in EDSS, FSS and GHQ scores (p < 0.05), and no significant changes observed in PRI score (p > 0.05).ConclusionEllagic acid supplementation can improve the health status of MS patients by reduction of the inflammatory cytokines and Tbet and RORγt gene expression, and increment of anti-inflammatory cytokines and GATA3 gene expression.Clinical trial registration: (https://en.irct.ir/trial/53020), IRCT20120415009472N22

Morbidity and mortality from road injuries: results from the Global Burden of Disease Study 2017

BackgroundThe global burden of road injuries is known to follow complex geographical, temporal and demographic patterns. While health loss from road injuries is a major topic of global importance, there has been no recent comprehensive assessment that includes estimates for every age group, sex and country over recent years.MethodsWe used results from the Global Burden of Disease (GBD) 2017 study to report incidence, prevalence, years lived with disability, deaths, years of life lost and disability-adjusted life years for all locations in the GBD 2017 hierarchy from 1990 to 2017 for road injuries. Second, we measured mortality-to-incidence ratios by location. Third, we assessed the distribution of the natures of injury (eg, traumatic brain injury) that result from each road injury.ResultsGlobally, 1 243 068 (95% uncertainty interval 1 191 889 to 1 276 940) people died from road injuries in 2017 out of 54 192 330 (47 381 583 to 61 645 891) new cases of road injuries. Age-standardised incidence rates of road injuries increased between 1990 and 2017, while mortality rates decreased. Regionally, age-standardised mortality rates decreased in all but two regions, South Asia and Southern Latin America, where rates did not change significantly. Nine of 21 GBD regions experienced significant increases in age-standardised incidence rates, while 10 experienced significant decreases and two experienced no significant change.ConclusionsWhile road injury mortality has improved in recent decades, there are worsening rates of incidence and significant geographical heterogeneity. These findings indicate that more research is needed to better understand how road injuries can be prevented

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe