Arbutin attenuates behavioral impairment and oxidative stress in an animal model of Parkinson's disease

Objective: Arbutin has been shown to have antioxidant and free-radical scavenging properties. The aim of this study was to investigate the effects of arbutin administration on behavioral impairment, and oxidative and nitrosative stress in a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine(MPTP)-induced animal model of Parkinson’s disease (PD). Materials and Methods: PD model was developed by 4 intraperitoneal (i.p.) injections of MPTP (20 mg/kg) with 2 h intervals in mice. Experimental groups received once daily injection of saline as vehicle (control group) or arbutin (50 mg/kg, i.p.) one week before MPTP injections and this protocol was continued seven days post lesion. Behavioral deficits were evaluated using locomotion test, hanging wire test and forepaw stride length. Parameters indicating the oxidation levels including lipid peroxidation marker (TBARS), nitrite, protein carbonyl levels and antioxidant activity including ferric reducing antioxidant power (FRAP) were assessed in serum and midbrain samples. Results: Treatment with arbutin improved motor functions in an MPTP-induced PD model compared to control group (

Four novel ARSA gene mutations with pathogenic impacts on metachromatic leukodystrophy: a bioinformatics approach to predict pathogenic mutations

Metachromatic leukodystrophy (MLD) disorder is a rare lysosomal storage disorder that leads to severe neurological symptoms and an early death. MLD occurs due to the deficiency of enzyme arylsulfatase A (ARSA) in leukocytes, and patients with MLD excrete sulfatide in their urine. In this study, the ARSA gene in 12 non-consanguineous MLD patients and 40 healthy individuals was examined using polymerase chain reaction sequencing. Furthermore, the structural and functional effects of new mutations on ARSA were analyzed using SIFT (sorting intolerant from tolerant), I-Mutant 2, and PolyPhen bioinformatics software. Here, 4 new pathogenic homozygous mutations c.585G>T, c.661T>A, c.849C>G, and c.911A>G were detected. The consequence of this study has extended the genotypic spectrum of MLD patients, paving way to a more effective method for carrier detection and genetic counseling

Comparing the effects of simulation-based training, blended, and lecture on the simulated performance of midwives in preeclampsia and eclampsia

INTRODUCTION: Preeclampsia is the most common medical complication in pregnancy; along with bleeding and infection, it is one of the three causes of death in pregnant women. Most of these deaths were due to delays in the diagnosis and improper midwifery management and care. On the other hand, the quality of midwifery education has a profound effect on the proper provision of services. Therefore, the present study has been done to compare the effect of simulation-, blended-, and lecture-based education on simulated midwife performance in the management of preeclampsia and eclampsia. MATERIALS AND METHODS: This three-group clinical trial study was performed on 90 midwives of selected hospitals in Mashhad in 2016. Midwives were divided into three groups of simulation-, blended-, and lecture-based education using the random number table. The simulation group was trained for 6 h at the Center for Clinical Skills, the blended group was trained for 4 h by lecture, and 6 weeks through the educational website, and the lecture group was trained for 6 h through lecture. An objective structured clinical test was performed before and 2 weeks after the intervention. Data were analyzed using SPSS Version 16 software and descriptive statistics, paired t-test, one-way ANOVA, and Wilcoxon and Kruskal–Wallis tests. Significance level was considered to be P < 0.05 in all cases. RESULTS: The mean score of midwives' performance was not statistically significant before education in all three groups (P < 0.05). The mean score of midwives' performance was significantly increased in all three groups 2 weeks after education (P < 0.001), and the results of intergroup comparison showed that the mean score of performance in the simulation group was significantly higher than the blended group and the lecture group (P < 0.001), and it was higher in the blended group compared to the lecture group (P < 0.001). CONCLUSION: Education increased the midwives' simulated performance in preeclampsia and eclampsia. The performance of the management of preeclampsia and eclampsia in the simulation educational group is more than that of the blended and lecture groups, so we can use the simulation education which is a self-centered method

Developing a Hospital Managerial Performance Assessment Tool in Iran

Background: Performance assessment tries to find the best, valid and cost-effective way of measuring performance and work satisfaction. There are several indicators for health systems performance evaluation which ignore the managerial aspect. We aimed at evaluating the validity and reliability of managerial performance assessment tool for Iranian hospitals. Methods: The current study is a part of larger study which aims at developing a reliable and valid tool for managerial performance assessment tool. The intended tool has seven dimensions of planning, organizing, leadership, information management, resource management, clinical governance, and performance indicators. We conducted a 2-round Delphi study with 18 experts whom were selected purposefully to evaluate the validity of the tool. Reliability was assessed through implementing the tool in three randomly chosen hospitals of Tabriz. Content Validity Index (CVI) and Content Validity Ratio (CVR) along with internal consistency and Cronbach's alpha were calculated for this reason. Results: A checklist with 117 indicators was prepared. After determining the validity and reliability of checklist, scores for these indicators were calculated given the importance scores. The whole tool has the score of 1000. Cronbach's alpha coefficient was 0.76 for the whole checklist. Conclusion: The validated tool in the current research can be used in performance assessment, evidence-based dismissal, installation, and upgrading of hospital managers in order to avoid non proper selection of these managers. Further researches are needed to apply this tool in managerial performance assessment of hospitals in order to measure probable bugs of this model. &nbsp

An Update on the Role of mpMRI and ⁶⁸Ga-PSMA PET Imaging in Primary and Recurrent Prostate Cancer

The objective of this work was to review comparisons of the efficacy of 68Ga-PSMA-11 (prostate-specific membrane antigen) PET/CT and multiparametric magnetic resonance imaging (mpMRI) in the detection of prostate cancer among patients undergoing initial staging prior to radical prostatectomy or experiencing recurrent prostate cancer, based on histopathological data. A comprehensive search was conducted in PubMed and Web of Science, and relevant articles were analyzed with various parameters, including year of publication, study design, patient count, age, PSA (prostate-specific antigen) value, Gleason score, standardized uptake value (SUVmax), detection rate, treatment history, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and PI-RADS (prostate imaging reporting and data system) scores. Only studies directly comparing PSMA-PET and mpMRI were considered, while those examining combined accuracy or focusing on either modality alone were excluded. In total, 24 studies comprising 1717 patients were analyzed, with the most common indication for screening being staging, followed by relapse. The findings indicated that 68Ga-PSMA-PET/CT effectively diagnosed prostate cancer in patients with suspected or confirmed disease, and both methods exhibited comparable efficacy in identifying lesion-specific information. However, notable heterogeneity was observed, highlighting the necessity for standardization of imaging and histopathology systems to mitigate inter-study variability. Future research should prioritize evaluating the combined diagnostic performance of both modalities to enhance sensitivity and reduce unnecessary biopsies. Overall, the utilization of PSMA-PET and mpMRI in combination holds substantial potential for significantly advancing the diagnosis and management of prostate cancer.</p

An Update on the Role of mpMRI and 68Ga-PSMA PET Imaging in Primary and Recurrent Prostate Cancer

The objective of this work was to review comparisons of the efficacy of 68Ga-PSMA-11 (prostate-specific membrane antigen) PET/CT and multiparametric magnetic resonance imaging (mpMRI) in the detection of prostate cancer among patients undergoing initial staging prior to radical prostatectomy or experiencing recurrent prostate cancer, based on histopathological data. A comprehensive search was conducted in PubMed and Web of Science, and relevant articles were analyzed with various parameters, including year of publication, study design, patient count, age, PSA (prostate-specific antigen) value, Gleason score, standardized uptake value (SUVmax), detection rate, treatment history, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and PI-RADS (prostate imaging reporting and data system) scores. Only studies directly comparing PSMA-PET and mpMRI were considered, while those examining combined accuracy or focusing on either modality alone were excluded. In total, 24 studies comprising 1717 patients were analyzed, with the most common indication for screening being staging, followed by relapse. The findings indicated that 68Ga-PSMA-PET/CT effectively diagnosed prostate cancer in patients with suspected or confirmed disease, and both methods exhibited comparable efficacy in identifying lesion-specific information. However, notable heterogeneity was observed, highlighting the necessity for standardization of imaging and histopathology systems to mitigate inter-study variability. Future research should prioritize evaluating the combined diagnostic performance of both modalities to enhance sensitivity and reduce unnecessary biopsies. Overall, the utilization of PSMA-PET and mpMRI in combination holds substantial potential for significantly advancing the diagnosis and management of prostate cancer

Four Novel p.N385K, p.V36A, c.1033–1034insT and c.1417–1418delCT Mutations in the Sphingomyelin Phosphodiesterase 1 (SMPD1) Gene in Patients with Types A and B Niemann-Pick Disease (NPD)

Background: Types A and B Niemann-Pick disease (NPD) are autosomal-recessive lysosomal storage disorders caused by the deficient activity of acid sphingomyelinase due to mutations in the sphingomyelin phosphodiesterase 1 (SMPD1) gene. Methods: In order to determine the prevalence and distribution of SMPD1 gene mutations, the genomic DNA of 15 unrelated Iranian patients with types A and B NPD was examined using PCR, DNA sequencing and bioinformatics analysis. Results: Of 8 patients with the p.G508R mutation, 5 patients were homozygous, while the other 3 were heterozygous. One patient was heterozygous for both the p.N385K and p.G508R mutations. Another patient was heterozygous for both the p.A487V and p.G508R mutations. Two patients (one homozygous and one heterozygous) showed the p.V36A mutation. One patient was homozygous for the c.1033–1034insT mutation. One patient was homozygous for the c.573delT mutation, and 1 patient was homozygous for the c.1417–1418delCT mutation. Additionally, bioinformatics analysis indicated that two new p.V36A and p.N385K mutations decreased the acid sphingomyelinase (ASM) protein stability, which might be evidence to suggest the pathogenicity of these mutations. Conclusion: with detection of these new mutations, the genotypic spectrum of types A and B NPD is extended, facilitating the definition of disease-related mutations. However, more research is essential to confirm the pathogenic effect of these mutations