Efficacy of nicorandil treatment for prevention of contrast-induced nephropathy in high-risk patients undergoing cardiac catheterization: A prospective randomized controlled trial

Background: Contrast-induced nephropathy (CIN) remains to be a potentially serious complication of radiographic procedures and is the third leading cause of the acute kidney injury (AKI) among hospitalized patients. This clinical trial was performed to assess the preventive effect of oral nicorandil on CIN in high-risk patients undergoing cardiac catheterization. Methods: In this prospective, randomized, controlled trial, 128 patients with at least two risk factors for CIN undergoing elective percutaneous coronary intervention (PCI) were randomly assigned to either the nicorandil group or the control group. Patients in the nicorandil group (n = 64) received 10 mg nicorandil, daily from 30 min before and up to 3 days after procedure and intravenous hydration for 2 h before and 6 h after the procedure, whereas patients in the control group (n = 64) just received intravenous hydration. Serum creatinine (SCr) was measured before contrast exposure and at 72 h. CIN was defined as an increase of 25% in SCr or > 0.5 mg/dL 72 h after contrast administration. Results: Contrast-induced nephropathy occurred in 14 out of 64 (21.9%) patients in the control group and in 3 out of 64 (4.7%) patients in the nicorandil group. There was a significant difference in the incidence of CIN between the two groups at 72 h after administering the radiocontrast agent (p = 0.008). Moreover, there were significant differences between the two groups in SCr and estimated glomerular filtration rate 72 h after radiocontrast administration (p < 0.05). Conclusions: The findings revealed that oral nicorandil had substantial efficacy over hydration protocol for the development of CIN in high-risk patients undergoing cardiac catheterization.

Dysregulation of NF-κB-Associated LncRNAs in Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a long-standing neurodevelopmental condition with prominent effects on social behavior of affected children. This disorder has been linked with neuroinflammatory responses. NF-κB has been shown to affect these responses in the orbitofrontal cortex of patients with ASD, thus being implicated in the pathogenesis of ASD. We measured expression of some NF-κB-associated lncRNAs and mRNAs (DILC, ANRIL, PACER, CHAST, ADINR, DICER1-AS1, HNF1A-AS1, NKILA, ATG5 and CEBPA) in the peripheral blood of ASD kids vs. healthy children. Expression quantities of ADINR, ANRIL, DILC, NKILA and CHAST were meaningfully higher in ASD cases compared with healthy kids (Posterior Beta = 1.402, P value < 0.0001; Posterior Beta = 2.959, P value < 0.0001; Posterior Beta = 0.882, P value = 0.012; Posterior Beta = 1.461, P value < 0.0001; Posterior Beta = 0.541, P value = 0.043, respectively). The Bonferroni corrected P values for these lncRNAs remained significant except for CHAST and DILC. Expression levels of other genes were not considerably different between cases and controls. Expressions of ATG5, DICER-AS1 and DILC were correlated with age of ASD patients (P < 0.0001). Among ASD cases, the most robust correlation has been detected between ADINR and NKILA (r = 0.87, P < 0.0001). Expression of none of genes has been correlated with age of healthy children. Among this group of children, expression levels of ADINR and CHAST were robustly correlated (r = 0.83, P < 0.0001). ANRIL had the greatest AUC value (AUC = 0.857), thus the best diagnostic power among the assessed genes. NKILA ranked the second position in this regard (AUC = 0.757). Thus, NF-κB-associated lncRNAs might partake in the pathogenesis of ASD

Analysis of ROQUIN, Tristetraprolin (TTP), and BDNF/miR-16/TTP regulatory axis in late onset Alzheimer’s disease

Alzheimer’s disease (AD) is a heterogeneous degenerative disorder of the brain that is on the rise worldwide. One of the critical processes that might be disturbed in AD is gene expression regulation. Tristetraprolin (TTP) and RC3H1 gene (ROQUIN) are two RNA-binding proteins (RBPs) that target AU-rich elements (AREs) and constitutive decay elements (CDEs), respectively. TTP and ROQUIN, members of the CCCH zinc-finger protein family, have been demonstrated to fine-tune numerous inflammatory factors. In addition, miR-16 has distinct characteristics and may influence the target mRNA through the ARE site. Interestingly, BDNF mRNA has ARE sites in the 3’ untranslated region (UTR) and can be targeted by regulatory factors, such as TTP and miR-16 on MRE sequences, forming BDNF/miR-16/TTP regulatory axis. A number of two microarray datasets were downloaded, including information on mRNAs (GSE106241) and miRNAs (GSE157239) from individuals with AD and corresponding controls. R software was used to identify BDNF, TTP, ROQUIN, and miR-16 expression levels in temporal cortex (TC) tissue datasets. Q-PCR was also used to evaluate the expression of these regulatory factors and the expression of BDNF in the blood of 50 patients with AD and 50 controls. Bioinformatic evaluation showed that TTP and miR-16 overexpression might act as post-transcriptional regulatory factors to control BDNF expression in AD in TC samples. Instead, this expression pattern was not found in peripheral blood samples from patients with AD compared to normal controls. ROQUIN expression was increased in the peripheral blood of patients with AD. Hsa-miR-16-5p levels did not show significant differences in peripheral blood samples. Finally, it was shown that TTP and BDNF, based on evaluating the receiver operating characteristic (ROC), effectively identify patients with AD from healthy controls. This study could provide a new perspective on the molecular regulatory processes associated with AD pathogenic mechanisms linked to the BDNF growth factor, although further research is needed on the possible roles of these factors in AD

The Hospitalization Rate of Cerebral Venous Sinus Thrombosis before and during COVID-19 Pandemic Era: A Single-Center Retrospective Cohort Study

Objectives: There are several reports of the association between SARS-CoV-2 infection (COVID-19) and cerebral venous sinus thrombosis (CVST). In this study, we aimed to compare the hospitalization rate of CVST before and during the COVID-19 pandemic (before vaccination program). Materials and methods: In this retrospective cohort study, the hospitalization rate of adult CVST patients in Namazi hospital, a tertiary referral center in the south of Iran, was compared in two periods of time. We defined March 2018 to March 2019 as the pre-COVID-19 period and March 2020 to March 2021 as the COVID-19 period. Results: 50 and 77 adult CVST patients were hospitalized in the pre-COVID-19 and COVID-19 periods, respectively. The crude CVST hospitalization rate increased from 14.33 in the pre-COVID-19 period to 21.7 per million in the COVID-19 era (P = 0.021). However, after age and sex adjustment, the incremental trend in hospitalization rate was not significant (95% CrI: -2.2, 5.14). Patients \u3e 50-year-old were more often hospitalized in the COVID-19 period (P = 0.042). SARS-CoV-2 PCR test was done in 49.3% out of all COVID-19 period patients, which were positive in 6.5%. Modified Rankin Scale (mRS) score ≥3 at three-month follow-up was associated with age (P = 0.015) and malignancy (P = 0.014) in pre-COVID period; and was associated with age (P = 0.025), altered mental status on admission time (P\u3c0.001), malignancy (P = 0.041) and COVID-19 infection (P = 0.008) in COVID-19 period. Conclusion: Since there was a more dismal outcome in COVID-19 associated CVST, a high index of suspicion for CVST among COVID-19 positive is recommended

Prevalence of Academic Burnout and Its Related Factors among Medical Student in Qom, Iran

Background and Objectives: Academic burnout negatively affects students and those around them in terms of subjective well-being, psychology, and physiology. This study aims to determine academic burnout and its related factors in students of Qom University of Medical Sciences. Methods: This cross-sectional study was conducted on 274 medical students studying in second and higher semesters in Qom University of Medical Sciences, 2015. The samples were selected using stratified sampling method. The Breso et al.'s Academic Burnout Inventory and demographic characteristics questionnaire were completed by students. Data were analyzed using Pearson correlation coefficient and multivariate analysis of variance at significance level of 0.05. Results: The mean age of the subjects was 21.9&plusmn;3.7 years and the mean score of academic burnout was 1.73&plusmn;0.64 (range:0-4). According to the results of multivariate analysis of variance, there were statically significant relationships between academic burnout and variables of residence status and interest in the academic discipline (p<0.05). In addition, the results of Pearson correlation coefficient were indicative of an inverse statistical correlation between academic burnout status and the variables of age (r=-166, p<0.0001) and educational status (r=-0.242, p<0.0001). Conclusion: Considering the significant relationship between grade point average and interest in academic discipline with all subscales, planning to create a positive attitude towards academic discipline in students can be a protective factor against academic burnout as well as improvement of educational status

Relationship between spiritual intelligence and ethical decision making in Iranian nurses

Background: Nurses, on a daily basis, face ethical dilemmas that arise from situations involving conflicting values or beliefs. Overall, ethical decision making of nurses seems to be a challenging aspect of their duties. This study has examined the relationship between spiritual intelligence and ethical decision making in nurses working in hospitals in Iran. Proportional stratified sampling was used in this study. Data were collected from 376 nurses who completed the Spiritual Intelligence Self-Report Inventory (SISRI) and Nursing Dilemma Test. Statistical analyses were done using descriptive statistics and Pearson correlations. Findings: The mean spiritual intelligence score was 49.5 ± 14.6, and mean ± SD of the Nursing Principled Thinking was 52.8 ± 12.1 and Practical Consideration was 28.16 ± 7.6. The mean score in the postconventional level was higher than the two other levels. Significant negative correlations exist between the preconventional component of the Nursing Dilemma Test and Personal Meaning Production and the Critical Existential Thinking components of the SISRI (p < .05). There were significant positive correlations between the postconventional (Nursing Principled) and Critical Existential Thinking, Personal Meaning Production, and total score of the SISRI. Conclusion: Hence, we have concluded that spiritual intelligence plays a positive role in the ethical decision making of nurses

Comparing the Outcomes of IVIg with Combination of IVIg and Methylprednisolone in Children with Acute Idiopathic Thrombocytopenia; a Bayesian Logistic Approach

Background This study aimed to evaluate the effectiveness of Intravenous immunoglobulin (IVIg) and combination of IVIg and Methylprednisolone for childhood Idiopathic (autoimmune) Thrombocytopenia (ITP) treatment; in addition investigate the related factors to develop chronic form of under 15 years ITP. Materials and Methods This retrospective study conducted on 88 ITP patients that treated with IVIg or combination of IVIg and Methylpredinosolon. Children were treated with IVIg 2 mg/kg/d or combination of IVIg 2 mg/kg/d and Methylpredinosolon20 mg/kg/dfor maximum 5 days. The numbers of patients with a platelet count > 50,000/μl, after treatment initiation, were the primary outcome. Odds Ratio (OR) as well as 95% Bayesian Credible interval (Crl), were estimated using a Bayesian Logistic regression model. Results  The median age of subjects was 3.5+ 4.42 years (Interquartile: 2 8.5). About 13% of patients were discharged from hospitalization in day 2 and day 3. The ITP of 23% of children were progressed to chronic form. The following factors were significantly associated with the development of chronic ITP, combination of IVIg and Methylprednisolone [OR: 3.24, 95% Crl: [1.06 11.11]), and day 2 and 3 of discharge from hospitalization (OR: 7.72, 95% Crl: (1.14 67.16)].  Conclusion The current results, suggest that the both IVIg and combination of IVIg are equally effective in providing a platelet level > 50,000/μl early. In addition patients how received combination drug were more likely to develop to chronic ITP. Therefore, we suggest that this route must be preferentially used in decision making for treatment childhood ITP

Validation of humidex in evaluating heat stress in the outdoor jobs in arid and semi-arid climates of Iran

Introduction: Regarding development of several thermal indices and limitations of each, in this research applicability and validity of temperature- humidity index (Humidex) were examined against the standard heat index, Wet Bulb Globe Temperature -WBGT, as well as tympanic temperature of subjects. Material and Method:&nbsp; This cross-sectional study was done on 163 subjects at spring and summer (2013) in outdoor jobs of arid and semi-arid climates of Iran. Environmental parameters as well as tympanic temperature of subjects were measured simultaneously and then heat indices were determined. Data were analyzed using linear correlation charts and Kappa coefficient of agreement by means of SPSS software version 20. Results: A strong correlation was obtained between WBGT and Humidex in both arid and semi-arid regions (r>0.98), while the correlation between Humidex and tympanic temperature was moderate (r=0.5-0.8). Based on the obtained Kappa value, the agreement coefficient between Humidex and WBGT was 0.878. This value was obtained equal to 0.226 for the Humidex and tympanic temperature. Conclusion: The results of this study showed that Humidex can be applied as an appropriate substitute for the WBGT index. However, if evaluation of environmental condition with low air temperature or very hot situation is considered, relying only on the Humidex results will not provide a realistic estimation of thermal strain imposed to individuals

Perceived Benefits and Barriers about Self-medication among Women Referring to Health Center in Qom City - 2016

Abstract Background: Self-medication is one of the biggest problems of social, health and economic societies such as Iran. The aim of this study was to determine the benefits and barriers about self-medication among women referring to health center in Qom city. Materials and Methods: This cross-sectional descriptive-analytical study carried out on women referred to health centers in Qom city- 2016. In the current study, 226 people were selected from among the health centers by multistage sampling. A standard questionnaire was used on knowledge about self-medication, perceived benefits, perceived barriers and self-medication. Data were analyzed by SPSS V.20 using independent t-test and Chi-square. Results: According to the results of this study, 74.3 percent of women had a history of self-medication that 43.8 percent of them was in the past 6 months. The mean of knowledge about self-medication and perceived barriers in people with a history of self-medication was significantly higher than those who had not a history of self-medication (p<0.05). While, the perceived benefits was not significantly associated with a history of self-medication (p=0.79). Conclusion: Given the high prevalence of self-medication and the relationship between knowledge and perceived barriers with self-medication, therefore, educational program is necessary for women about the effects and consequences of self-medication through the media

The effect of omega-3 fatty acids on clinical and paraclinical features of intractable epileptic patients: a triple blind randomized clinical trial

Abstract Long chain omega-3 fatty acids (omega-3 FAs) supplements have been shown to exert beneficial effects in patients with epilepsy through elevation of seizure thresholds and dampening of inflammatory responses. In this triple blind randomized, placebo-controlled parallel group trial of omega-3 FA supplementation, 180 mg eicosapentaenoic acid (EPA) and 120 mg docosahexaenoic acid (DHA) as well as placebo capsules were administered twice a day in 50 patients with refractory seizure during a 16-week period respectively. Seizure frequency and duration were reduced after completion of the treatment in the supplement group. The supplementation resulted in a significant decrease in TNF-α and IL-6 concentrations. Further studies are needed to compare different omega-3 FA compositions and determine the most effective dose and treatment duration as well as the long term benefits of this supplementation