Effective factors on the recurrence of Bipolar mood disorder i in an Iranian population sample using the frailty model with bayesian approach

Objective: Bipolar I disorder is one of the most frequent mental disorders characterized by manic or mixed +/- depressive episodes. Drug treatment has been proved to diminish next episodes, but many other factors are important for exacerbating the conditions. This study aimed to investigate the effective factors on the time and number of episodes in these patients by applying the shared frailty model. Method: In this retrospective longitudinal study, the information of 606 patients with bipolar I disorder, admitted for the first time in Ibn-e-Sina psychiatric hospital in Mashhad from the beginning of 2007 until the end of 2009 were used. These patients were followed up until the end of 2018 for readmission. The Cox model with gamma frailty and Bayesian approach were used to determine the effective factors of frequent recurrences. Results: History of head trauma, substance abuse, and legal conflict had a positive impact on recurrences, while age had a negative effect on recurrences and the risk of recurrence was higher in younger people (P < 0.05). The variance estimation of frailty effect was 0.97 that indicates a correlation between the recurrence intervals of bipolar I patients, owing to a heterogeneity among patients. Conclusion: Based on the results, a higher risk of recurrence of bipolar I disorder was found in younger patients and those with a history of head trauma, substance abuse, and legal conflicts. Further investigations are required to account for the genetic factor and psychosocial exposure during critical periods applying this model

Endoscopic Findings and Histopathological Patterns of Gastric Mucosal Biopsies in Functional Dyspepsia: A Clinicopathological Study

Background: Endoscopic examination of the gastrointestinal tract through macroscopic and histopathological evaluation provides a tool to differentiate the major causes of functional dyspepsia. The distinction is not always clear. This study aimed to assess the frequency and type of the macroscopic and histopathological changes in gastrointestinal tract endoscopy in patients with symptoms of functional dyspepsia. Methods: A cross-sectional study was performed on 97 patients aged 10–85 years who underwent gastroscopy due to functional dyspepsia symptoms. The patients had no history of weight loss, major comorbidities like diabetes or cirrhosis, non-steroidal anti- inflammatory drug (NSAID) consumption, peptic ulcer, or any other confounding causes. Biopsy specimens were taken from the stomach and duodenum for histopathological examination. The presence of Helicobacter pylori infection was established based on histopathological examination and a positive rapid urease test. Results: Gastric biopsies of 97 patients with functional dyspepsia were studied. In histological examination of gastric mucosal biopsies, chronic inflammation was present in 94 (96.9%), activity was seen in 47 (48.5%), glandular atrophy was seen in 3 (3.1%), and intestinal metaplasia was seen in 9 (9.2%) patients. H. pylori was identified on gastric mucosal biopsies in 46 (47.4%) patients based on sections stained with H&E and Giemsa. Conclusion: According to the obtained results, it is concluded that patients with functional dyspepsia have a higher frequency of gastric mucosal inflammation and H. pylori infection

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Comparative study of adult tonsillectomy in two methods: harmonic scalpel and classical surgery

Abstract Background Tonsillectomy is a common surgery to treat tonsillitis. In addition to cold dissection methods, other new methods are also used for tonsillectomy which has several advantages. We compared the cold dissection methods and the harmonic scalpel method and investigated the complications of both methods. Methods This is a descriptive analytical study on 50 patients in the population of 18 to 60 years who had tonsillectomy conditions based on the inclusion criteria. These patients were divided into two groups, harmonic scalpel method and cold dissection methods, and the duration of the operation, the amount of bleeding during the operation, the pain on the first, fourth, and seventh days after the operation, and the bleeding after the operation were measured in them. Results In this study, 36 men and 14 women were examined. The duration of surgery and the amount of bleeding during surgery were significantly less in the harmonic scalpel method group than in the cold dissection methods group (P = 0.000). Postoperative pain on days 1 and 4 after surgery was significantly less in the harmonic scalpel method group than in the cold dissection methods group (P = 0.047). Conclusion According to this study, the amount of bleeding and length of surgery were less in the harmonic scalpel method group. The pain on the first and fourth days after surgery was less in the harmonic group, but the pain on the seventh day was not significantly different from the cold dissection group

The Protective Effect of Garlic Extract againstAcetaminophen-Induced Loss of Mitochondrial MembranePotential in Freshly Isolated Rat Hepatocytes: Effect of garlic extract against acetaminophen cytotoxicity

Overdose of acetaminophen causes severe hepatic necrosis in humans and experimental animals. Studies on its hepatotoxicity remain a very active area since some of current data are still uncertain. In this study, freshly isolated rat hepatocytes were used to determine the effects of garlic extract and its component, allicin on the acetaminophen-induced cell cytotoxicity and to compare with the effect of N-acetyl cysteine as a standard treatment. Garlic extract was prepared via a standardmethod and its allicin and allyl mercaptan contents were determined using analytical and preparative high performance liquid chromatography (HPLC). Rat hepatocytes were isolated using collagenase perfusion and mitochondrial membrane potential and cell cytotoxicity were determined using Rhodamine 123 fluorescence and trypan blue exclusion, respectively. Inclusion of garlic extract and/or N-acetyl cysteine resulted in a reduction in the loss of mitochondrial membrane potential as well as cell death which occurred after acetaminophen addition and therefore,illustrated considerable hepatoprotective effects without significant differences between two treatments. In contrast, pure allicin was not effective significantly. The hepatoprotective effects of garlic extract may be due to the compounds other than allicin such as allyl mercaptan, as allicin has been shown to transform to allyl mercaptan as a major metabolite

Phytochemical analysis and anticholinesterase activity of aril of Myristica fragrans Houtt

Abstract In this study, the ethyl acetate fraction of Myristica fragrans Houtt. was investigated for its in vitro anticholinesterase activity as well as neuroprotectivity against H2O2-induced cell death in PC12 neuronal cells and the ability to chelate bio-metals (Zn2+, Fe2+, and Cu2+). The fraction was inactive toward acetylcholinesterase (AChE); however, it inhibited the butyrylcholinesterase (BChE) with IC50 value of 68.16 µg/mL, compared with donepezil as the reference drug (IC50 = 1.97 µg/mL) via Ellman’s method. It also showed good percentage of neuroprotection (86.28% at 100 µg/mL) against H2O2-induced neurotoxicity and moderate metal chelating ability toward Zn2+, Fe2+, and Cu2+. The phytochemical study led to isolation and identification of malabaricone A (1), malabaricone C (2), 4-(4-(3,4-dimethoxyphenyl)-2,3-dimethylbutyl)benzene-1,2-diol (3), nectandrin B (4), macelignan (5), and 4-(4-(benzo[d][1,3]dioxol-5-yl)-1-methoxy-2,3-dimethylbutyl)-2-methoxyphenol (6) which were assayed for their cholinesterase (ChE) inhibitory activity. Compounds 1 and 3 were not previously reported for M. fragrans. Among isolated compounds, compound 2 showed the best activity toward both AChE and BChE with IC50 values of 25.02 and 22.36 μM, respectively, compared with donepezil (0.07 and 4.73 μM, respectively)

Investigating the incidence of complications caused by common national vaccinations in children and infants in Shahrood city

Background: With a national vaccination program, we have achieved success in the prevention of infectious diseases in the community especially in children. Despite this great success, the side effects of vaccination may not encourage some people in the community to get vaccinated. In this study, we investigate the prevalence of common side effects of vaccination in Shahrood city. Methods: This study investigated the incidence of complications caused by vaccination in infants and children under seven years old in Shahrood city in a 5-year period from April 2016 to March 2020. We collected demographic and clinical information, by referring to the health centers and complications recorded after routine vaccinations such as fever, rash, diarrhea, swelling and other complications of vaccination were collected. Results: Findings Among the 429 registered complications between 2016 and 2020, most complications were related to pentavalent and trivalent vaccines. Among the registered complications, high fever is the most common complication in both term and pre-term groups. (202 cases, 47.1%) other complications included maculopapular rash (59 cases), mild local complications (55 cases), vomiting (41 cases), and continuous screaming (36 cases), respectively. Among these, 123 cases were resolved without treatment, 297 cases were resolved with drug treatment on an outpatient basis, and only  eight cases required hospitalization. Conclusion: In general, the vaccination program is highly effective despite having limited side effects.  Knowing this information, can increase vaccination in the country

Evaluation and comparison of statistical models of hemodialysis adequacy in hemodialysis patients in two groups (fistula and permanent catheter) in Arak dialysis center

Background: Adequacy of dialysis is a very important issue in dialysis patients, so comparing the adequacy of dialysis in different dialysis methods is very important. Therefore, due to the fact that the number of people undergoing dialysis  through fistulas and catheters varies in different centers, and depending on different centers, there is a possibility of decreasing or increasing the adequacy of dialysis, so we decided to do this comparison in Arak support center. Methods: In this analytical-cross-sectional study, the dialysis patients of Hami Arak Center from April 2019 to September 2019 were divided into two groups (the first group with permanent catheter, the second group with arteriovenous fistula) based on vascular access. The both groups were matched in terms of age, sex, weight, pump speed, filter size and also the duration of dialysis. All patients were dialyzed with the same type of dialysis machine, and the duration of hemodialysis for all samples was 4 hours in each session. To confirm the reliability of the device, it was calibrated before each use and the same setting was used for all samples. The blood samples were taken from the arterial route before dialysis and starting the dilution with heparin or normal saline. Statistical models of dialysis adequacy of patients in two groups were measured using the Kt/V criterion, SPSS and AMOS data analysis was performed. Results: In the analysis of covariance of BUN before dialysis, there is a statistically significant difference in the studied groups (P<0.05), also in the UF and URR variables, dialysis time and the number of times of dialysis in three consecutive repetitions, there is a statistically significant difference in the studied groups. (dime fistula and catheter) are not present (P<0.05). Conclusion: In this study, during repeated repetitions, 22% of the dialysis adequacy in the two groups did not have good adequacy, and 78% of the patients in the two groups had appropriate dialysis adequacy