The effects of Trendelenburg Position on Patient Care during Open Radical Prostatectomy: A Randomized Controlled Clinical Trial

Background: Low quality of surgical field is a common problem during open radical prostatectomy (ORP). Aim: This study was performed aimed to survey the effects of Trendelenburg position on the quality of surgical field, mean arterial blood pressure (MABP), heart rate (HR), regional cerebral oxygen saturation (rSO2) and cognitive function in patients undergoing ORP. Method: This randomized controlled clinical trial study was done on 60 patients candidates for ORP in Shahid Beheshti Hospital of Hamadan in 2022. Patients were selected by the convenience sampling method and were divided into two intervention and control groups using the random blocking method. In intervention group, patients were placed in a 15° head-down tilt before surgery. The control group was remained in a sleeping position on the back during surgery. The surgical field quality was assessed after surgery. The MABP, HR, and rSO2 were assessed after anesthesia induction, after positioning, and consecutively in 30-minute intervals during the surgery. Results: The mean age was 60.93±4.24 years. A significant difference was found between the two groups regarding the surgeon's satisfaction with the surgical field quality (P=0.04). There was a significant difference between the two groups regarding surgery time (t=-3.00, P=0.004). No significant differences were found between the two groups in terms of MABP, HR, and rSO2 in either of the measurements (P>0.05). Implications for Practice: It is recommended to use Trendelenburg position, as a safe position, to improve exposure to the pelvis during surgery

Association of levels of interleukin 17 and T-helper 17 count with symptom severity and etiology of chronic heart failure: a case-control study

Aim To assess the association between the levels of interleukin 17 (IL-17) and T-helper 17 count and symptom severity and etiology of chronic heart failure. Methods This single-center prospective case-control study, conducted from December 1, 2015 to January 1, 2017 in Tehran Heart Center, evaluated gene expression of IL-17, relative count of (CD4+IL17+) Th17 cells and CD4+ helper T-cells in peripheral blood mononuclear cells of 42 patients with CHF and 42 matched controls. A multiple regression model assessed the predictors of peripheral IL-17 expression and Th17 count in patients with CHF. Results IL-17 expression was increased in patients with CHF, both at baseline and after stimulation. IL-17 and Th17 counts were higher in patients with advanced New York Heart Association (NYHA) functional class (class IV) than in controls and patients with class I. Th17 cell population expanded in patients with CHF, more prominently in patients with class IV than in controls and patients with class I, regardless of the ischemic or non-ischemic CHF origin. Multiple regression model showed that NYHA was the only meaningful predictor of IL-17 levels and Th17 count. Conclusion We demonstrated the lymphocytic origin of IL-17 production in advanced CHF and the ability of disease severity to predict IL-17 levels

Association of Interleukin 10 And Transforming Growth Factor β Gene Polymorphisms with Chronic Idiopathic Urticaria

Transforming growth factor β (TGF-β) and interleukin 10 (IL-10) are two anti-inflammatory cytokines that are implicated in the pathogenesis of urticaria. The goal of this study was to examine the possible association of polymorphisms of TGF-β and IL-10 genes with susceptibility to chronic idiopathic urticaria (CIU). This study was conducted on 90 patients with CIU. Polymerase chain reaction (PCR) was done to determine the genotype at 5 polymorphic sites; TGF-β (codon10C/T and codon25G/C) and IL-10 (-1082G/A, -819C/T, and -592C/A). The C allele at codon 25 of TGF-β was more prevalent in CIU patients compared to controls (OR = 9.5, 95% CI = 5.4-16.8, P<0.001). Genotypes of CT and CG at 10 and 25 codons of TGF-β gene, respectively, and AG, CT, and CA for loci of -1082, -819, and -592 of IL-10 gene were significantly higher in CIU patients (P<0.001). In haplotype analysis, frequency of TGF-β haplotypes differed between patients with CIU and controls; CC haplotype was overrepresented, while CG and TG haplotypes were underrepresented (P<0.001). These results suggest that TGF-β and IL-10 genetic variability could contribute to susceptibility to CIU. Additionally, patients with CIU seem to have genotypes leading to high production of TGF-β and IL-10.</p

Does Ramadan fasting have any effects on menstrual cycles?

Background: During the month of Ramadan, millions of Muslims abstain from food and drink daily from dawn to sunset and people actually experience repeated cycles of fasting and refeeding. Menstruation is a normal physiological process that its regularity is controlled by hypothalamic-pituitary-ovarian axis. Etiology of menstrual dysfunction includes weight loss, hypoleptinemia, abnormal eating behaviors, exercise, and psychological stressors. Objective: To investigate the effects of Ramadan fasting on menstrual cycles. Materials and Methods: This analytic cross-sectional study was performed on 80 female college students resident in a dormitory of Hamedan University of Medical Sciences. A questionnaire including demographic characteristics and menstrual calendar was filled by all participants. All analyses were performed using the statistical software SPSS for Windows version 11.5. Results: We found 11.3%, 30%, and 16.3% of participates had abnormal menstrual pattern three months before, during and three months after Ramadan, respectively. In participates who fast more than 15 days, menstrual period had significantly more abnormality than participants who fast less than 15 days. Considering our results we demonstrated that menstrual abnormalities during Ramadan month reach to their peak and three months after Ramadan reduce but do not return to previous condition. Conclusion: This study confirms that menstrual abnormalities including oligomenorrhea, polymenorrhea and hypermenorrhea increased during Ramadan especially in participates with more than 15 days of fasting

Comparison of recombinant human follicle stimulating hormone (rhFSH), human chorionic gonadotropin (HCG) and human menopausal gonadotropin (HMG) on semen parameters after varicocelectomy: a randomized clinical trial

Background: The most frequent physical finding in infertile men is varicocele, in which one of the mechanisms that can affect seminal parameters is oxidative stress.Objective: Our study aimed, for the first time, to compare the efficacy of recombinant human follicle-stimulating hormone (rhFSH), human chorionic gonadotropin (HCG) and human menopausal gonadotropin (HMG) on sperm parameters and fertility after varicocelectomy.Materials and Methods: 113 infertile men with varicocele were divided into four groups. Group A received HCG 5000 IU weekly, group B received HMG 75 IU three times a week, group C received rhFSH 75 IU three times a week and group D received no medical treatment after varicocelectomy.Results: After three months, in group A sperm morphology improved (p=0.007), causing a 32% pregnancy rate. In group B, sperm motility (p=0.023) and morphology (p=0.014) improved, causing a 57% pregnancy rate. In group C, all of the investigated semen parameters increased (p<0.05), causing a 62.5% pregnancy rate. Only rhFSH improved sperm concentrations to >20×106 mL (p=0.027). In group D, sperm morphology increased (p=0.038), but other parameters remained unchanged and no pregnancies occurred.Conclusion: It can be concluded that drugs can reduce induction time for spermatogenesis and fertility in comparison with varicocelectomy alone. For these purposes, rhFSH is more effective than other drugs

Two-Stage Joint Model for Multivariate Longitudinal and Multistate Processes, with Application to Renal Transplantation Data

In longitudinal studies, clinicians usually collect longitudinal biomarkers’ measurements over time until an event such as recovery, disease relapse, or death occurs. Joint modeling approaches are increasingly used to study the association between one longitudinal and one survival outcome. However, in practice, a patient may experience multiple disease progression events successively. So instead of modeling of a single event, progression of the disease as a multistate process should be modeled. On the other hand, in such studies, multivariate longitudinal outcomes may be collected and their association with the survival process is of interest. In the present study, we applied a joint model of various longitudinal biomarkers and transitions between different health statuses in patients who underwent renal transplantation. The full joint likelihood approaches are faced with the complexities in computation of the likelihood. So, here, we have proposed two-stage modeling of multivariate longitudinal outcomes and multistate conditions to avoid these complexities. The proposed model showed reliable results compared to the joint model in case of joint modeling of univariate longitudinal biomarker and the multistate process

Evaluation of zinc finger E-box binding homeobox 1 and transforming growth factor-beta2 expression in bladder cancer tissue in comparison with healthy adjacent tissue

Purpose: The fifth most common cancer is allocated to bladder cancer (BC) worldwide. Understanding the molecular mechanisms of BC invasion and metastasis to identify target therapeutic strategies will improve disease survival. So the aim of this study was to measure expression rate of zinc finger E-box binding homeobox 1 (ZEB1) and transforming growth factor-beta2 (TGF-β2) mRNA in tissue samples of patients with BC and its healthy adjacent tissue samples and their association with muscle invasion, size and grade of the tumor. Materials and Methods: Tissue samples were collected from 35 newly diagnosed untreated patients with BC from 2013 to 2014. Total RNA was extracted from about 50-mg tissue samples using TRIzol reagent. TAKARA SYBR Premix EX Tag II was applied to determine the rate of mRNA expression by real-time polymerase chain reaction (PCR). To obtain final validation, PCR product of ZEB1 and TGF-β2 were sequenced. STATA 11 software was used to analyze the data. Results: The expression level of ZEB1 in tumor samples was significantly more than of in healthy adjacent tissue samples. Up-regulation of TGF-β2 showed a strong association with muscle invasion (p=0.017). There was also demonstrated a relationship between over expression of ZEB1 with the tumor size (p=0.050). Conclusions: It looks ZEB1 and TGF-β2 had a role in BC patients. In this study ZEB1 expression was higher in BC tissues than that of in healthy control tissues. There was demonstrated a markedly association between overexpression of TGF-β2 and muscle invasion. Therefore, they are supposed to be candidate as potential biomarkers for early detection and progression of BC

Pharmacogenetic tests to predict the efficacy of aspirin desensitization in patients with aspirin-exacerbated respiratory diseases; HLA-DQB302

<div><p>This study is aimed at investigating the association of <i>HLA-DRB1,</i><i>HLA-DQA1,</i> and <i>HLA</i>-<i>DQB1</i> variability with the response to aspirin desensitization (AD). A total of 16 patients with aspirin-exacerbated respiratory diseases (AERD, 81.3% were female) with median age of 29 ± 4.3 years were included in this study. Following 6 months, Sino-Nasal Outcome Test-22 (SNOT-22), medication, symptom scores, and forced expiratory volume in 1 s (FEV1) (all p < 0.001) improved significantly. However, only seven patients (43.7%) had clinically significant improvement in all of the medication and symptom scores and FEV1, who were considered responders to AD. Responders to AD had significantly higher symptom scores compared with non-responders at baseline (20 ± 1.18 vs 10 ± 1.27; p = 0.003). <i>HLADQB1*0302</i> was significantly lower in non-responders than in responders to AD (0.12 [0.02–0.76]; p = 0.022). Sensitivity and specificity of HLA-DQB1*0302 to predict response to AD was 71.4% (95% CI: 35.8–91.7) and 81.8% (95% CI: 52.3–94.8). This study introduces <i>HLA-DQB1*0302</i> as a genetic marker for favorable response to AD.</p></div