Analysis of the factors affecting the interval between blood donations using log-normal hazard model with gamma correlated frailty

Background: Time to donating blood plays a major role in a regular donor to becoming continues one. The aim of this study was to determine the effective factors on the interval between the blood donations. Methods: In a longitudinal study in 2008, 864 samples of first-time donors in Shahrekord Blood Transfusion Center, capital city of Chaharmahal and Bakhtiari Province, Iran were selected by a systematic sampling and were followed up for five years. Among these samples, a subset of 424 donors who had at least two successful blood donations were chosen for this study and the time intervals between their donations were measured as response variable. Sex, body weight, age, marital status, education, stay and job were recorded as independent variables. Data analysis was performed based on log-normal hazard model with gamma correlated frailty. In this model, the frailties are sum of two independent components assumed a gamma distribution. The analysis was done via Bayesian approach using Markov Chain Monte Carlo algorithm by OpenBUGS. Convergence was checked via Gelman-Rubin criteria using BOA program in R. Results: Age, job and education were significant on chance to donate blood (P<0.05). The chances of blood donation for the higher-aged donors, clericals, workers, free job, students and educated donors were higher and in return, time intervals between their blood donations were shorter. Conclusions: Due to the significance effect of some variables in the log-normal correlated frailty model, it is necessary to plan educational and cultural program to encourage the people with longer inter-donation intervals to donate more frequently. © 2016, Health Hamadan University of Medical Sciences. All rights reserved

Effects of Ramadan Fasting on the Symptoms of Gastroesophageal Reflux Disease

Introduction: The effects of Ramadan fasting on gastroesophageal reflux disease (GERD) remains unknown, and few studies have been conducted in this regard. The nutritional, physiological, psychological, and behavioral changes in fasting individuals during Ramadan may affect the status of GERD. The present study aimed to evaluate the effects of these changes on the symptoms of GERD using a meticulous method. Methods: This study was conducted on patients with clinically diagnosed GERD by a gastroenterologist, who was followed-up for three consecutive months (from one month before to after Ramadan). Data were collected using GERD health-related quality of life (GERD-HRQL).For ethical considerations; antisecretory drugs were prescribed for all the patients. After data collection, the subjects were divided into two groups of fasting and non-fasting. Data analysis and comparison were performed in SPSS. Results: total, 69 patients with GERD completed the follow-up, including 33 fasting and 36 non-fasting subjects. No significant differences were observed in the changes of the Total, Heartburn and Regurgitation scores between the Fasting and Non-fasting groups from before Ramadan to Ramadan, Ramasdan to after Ramadan and also before to after Ramadan (P>0.05). Conclusion: According to the results, Ramadan fasting has no effects on the symptoms of GERD in the patients using antisecretory drugs during this month

Mesenchymal stem cell therapy in amyotrophic lateral sclerosis (ALS) patients: A comprehensive review of disease information and future perspectives

Amyotrophic lateral sclerosis (ALS) is a rare deadly progressive neurological disease that primarily affects the upper and lower motor neurons with an annual incidence rate of 0.6 to 3.8 per 100,000 people. Weakening and gradual atrophy of the voluntary muscles are the first signs of the disease onset affecting all aspects of patients’ lives, including eating, speaking, moving, and even breathing. Only 5-10% of patients have a familial type of the disease and show an autosomal dominant pattern, but the cause of the disease is unknown in the remaining 90% of patients (Sporadic ALS). However, in both types of disease, the patient’s survival is 2 to 5 years from the disease onset. Some clinical and molecular biomarkers, Magnetic Resonance Imaging (MRI), blood or urine test, muscle biopsy, and genetic testing are complementary methods for disease diagnosis. Unfortunately, with the exception of Riluzole, the only medically approved drug for the management of this disease, there is still no definitive cure for it. In this regard, the use of Mesenchymal Stem Cells (MSCs) for the treatment or management of the disease has been common in preclinical and clinical studies for many years. MSCs are multipotent cells having immunoregulatory, anti-inflammatory, and differentiation ability that makes them a good candidate for this purpose. This review article aims to discuss multiple aspects of ALS disease and focus on MSCs’ role in disease management based on performed clinical trials

Effect of Ramadan fasting on alanine transferase (ALT) in nonalcoholic fatty liver disease (NAFLD)

Background: The effects of Ramadan fasting on NAFLD are unknown and there are very limited studies have done in this area. Some nutritional and behavioral changes of fasting people in Ramadan can affect NAFLD. These include nutrition with high fat and calories, altering in weight and sleep and low physical activity. We decided to evaluate the effects of these changes on one of the important indicators of deterioration of NAFLD, ALT.Methods: Sixty patients with fatty liver disease performed two consecutive ALT exams before and after Ramadan month of whom finally 34 were fasting and 26 nonfasting. After collecting data they were divided in two groups of fasting and nonfasting and compared using SPSS software.Results: Mean ALT change from before to after Ramadan was higher and positive in fasting (+7.38±8.47 IU/L) compared to nonfastng patients that was negative (-0.12±10.15 IU/L) (P=0.002) and this change was mainly in patients who had fasted 21-30 days.Conclusion: Ramadan fasting may increase ALT. It is needed to perform more studies in patients with NAFLD during Ramadan fasting with larger sample size and in various conditions especially weight loss with patients’ education for observing dietary regimen

Are mesenchymal stem cells able to manage cytokine storm in COVID-19 patients? A review of recent studies

The Covid-19 disease has recently become one of the biggest challenges globally, and there is still no specific medication. Findings showed the immune system in severe Covid-19 patients loses regulatory control of pro-inflammatory cytokines, especially IL-6 production, called the “Cytokine storm” process. This process can cause injury to vital organs, including lungs, kidneys, liver, and ultimately death if not inhibited. While many treatments have been proposed to reduce cytokine storm, but the safety and effectiveness of each of them are still in doubt. Mesenchymal stem cells (MSCs) are multipotent cells with self-renewal potential capable of suppressing overactive immune responses and leading to tissue restoration and repair. These immuno-modulatory properties of MSCs and their derivatives (like exosomes) can improve the condition of Covid-19 patients with serious infectious symptoms caused by adaptive immune system dysfunction. Many clinical trials have been conducted in this field using various MSCs around the world. Some of these have been published and summarized in the present article, while many have not yet been completed. Based on these available data, MSCs can reduce inflammatory cytokines, increase oxygen saturation, regenerate lung tissue and improve clinical symptoms in Covid-19 patients. The review article aims to collect available clinical data in more detail and investigate the role of MSCs in reducing cytokine storms as well as improving clinical parameters of Covid-19 patients for use in future clinical studies

Chromosomal Instability in Various Generations of Human Mesenchymal Stem Cells Following the Therapeutic Radiation

Background. Radiotherapy is a crucial treatment for most malignancies. However, it can cause several side effects, including the development of secondary malignancies due to radiation-induced genomic instability (RIGI). The aim of this study was to evaluate genomic instability in human mesenchymal stem cells (hMSCs) at different X-ray radiation doses. Additionally, the study aimed to examine the relative expression of certain genes involved in DNA repair, proto-oncogenes, and tumor suppressor genes. Methods. After extracting, characterizing, and expanding hMSCs, they were exposed to X-ray beams at doses of 0, 0.5, 2, and 6 Gy. Nuclear alterations were evaluated through the cytokinesis-block micronucleus (CBMN) assay at 2, 10, and 15 days postirradiation. The expressions of BRCA1, BRCA2, TP53, Bax, Bcl2, and KRAS genes were analyzed 48 hr after irradiation to evaluate genomic responses to different radiation doses. Results. The mean incidence of micronuclei, nucleoplasmic bridges, and nuclear buds was 4.8 ± 1.6, 47.6 ± 6, and 18 ± 2.6, respectively, in the nonirradiated group 48 hr after the fourth passage, per 1,000 binucleated cells. The incidence of micronuclei in groups exposed to 0.5, 2, and 6 Gy of radiation was 14.3 ± 4.9, 32.3 ± 6.5, and 55 ± 9.1, respectively, 48 hr after irradiation. The expression levels of the BRCA2, Bax, TP53, and KRAS genes significantly increased after exposure to 6 Gy radiation compared to the control groups. However, there was no significant increase in BRCA1 and Bcl2 gene expression in our study. Conclusion. This study demonstrated significant nuclear alterations in the 10 days postirradiation due to the RIGIs that they inherited from their irradiated ancestral cells. While chromosomal instability is a prevalent event in malignant cells, so it seems necessary to optimize radiotherapy treatment protocols for tissues that contain stem cells, especially with IMRT, which delivers a low dose to a larger volume of tissues