The effect of atrovastatin on the ovarian arterial blood flow and serum androgen level in PCOS patient

Various researches have been conducted over the recent years on the therapeutic effects of statins on the metabolic and hyper-androgenic state of the patients suffering from PCOS. The present research seeks to evaluate the treatment with atorvastatin and its effect on the lipid profile level, serum androgen status and morphology and blood flow of polycystic ovaries. A double blind clinical trial was designed for this research where the women with PCOS resorting to the gynecology clinic of Firouzgar Hospital were randomly divided into two groups: case and Control. Early at the beginning of the research, variables such as body mass, lipid profile, blood androgen level, fasting blood Sugar, size of the ovary, and resistance of the stromal artery of ovary were studied. For a period of 6 weeks, one group was given with a daily dose of 40 mg atorvastatin, while the other group just received placebo. All the variables were studied once again after 6 weeks and the results were analyzed using SPSS v.16. The case group included 20 patients suffering from PCOS who received atorvastatin, while there were 20 patients with PCOS in the witness group who just received placebo. The average ages in the atorvastatin and placebo groups were 27.7 ± 3.41 and 30.9 ± 4.8 years old respectively. A significant difference was observed between the two groups in terms of changes in the average cholesterol and LDL levels before and after the intervention. This reduction was more significant in the atorvastatin group. After prescription of atorvastatin, the level of Androstenedione had decreased significantly in treatment group. A statistically significant reduction was observed in the size of left and right ovaries in the group receiving atorvastatin. No significant changes were observed in the size of the ovaries in the group receiving placebo. The average arterial resistance level of left and right ovaries before and after intervention in atorvastatin group exhibited a significant reduction. Having discarded the confounding effect of RI, this difference with the witness group was statistically significant. Keeping in mind the effects of atorvastatin such as improving the lipid profile status and reduction of androstenedione among those with PCOS, it can be used as an auxiliary treatment to control symptoms and long-term side effects among patients. Considering the shrinkage of ovary size and enhancement of blood flow to PCOS ovary, future researches can focus on effectiveness of statins in improving the ovulation status of performance of PCO ovaries

The effect of thermal stresses on the immune system of the potato tuber moth, Phthorimaea operculella (Lepidoptera: Gelechiidae)

The hemocytes of insects are one of important components of immune system of insects against various stresses such as pathogens attack, parasitoids, starvation period and temperature changes. Hemocytes characteristics recognition and frequency in cellular immune studies will help us in order to better pest control. In this study hemocytes of fourth instar larvae of potato tuber moth Phthorimaea operculella (Zeller)were identified after staining with Giemsa and by light microscopy at 40x magnification. Five types of identified hemocytes were prohemocytes (PRs), plasmatocytes (PLs), granulocytes (GRs), oenocytoids (OEs) and spherulocytes (SPs). The effect of different thermal stresses was also investigated for 24 hours on cellular defense of fourth instar larvae. In addition number of various hemocytes and total number of blood cells were investigated. At 35 °C, total hemocyte count (THC) and PLs of larvae was increased significantly compared to the control (25±1 °C). Also, chill stress (4 °C) showed a significant decrease in THC, PLs and OEs compared to the control. These findings could be used as a base for further investigation on the immunology studies of potato tuber moth

Effects of enriched daphnia with microscopic algae on some growth indices and survival rate of Persian sturgeon (Acipenser persicus) larvae

Microalgae as a source of valuable compounds such as fatty acids are isolated from the natural environments and their mass production with high nutritional value is one the necessities of many hatcheries. The present study aimed to determine the effects of enriched daphnia with microscopic algae on some growth indices and survival rate of Persian sturgeon (Acipenser persicus) larvae. Chlorella vulgaris and Scenedesmus dimorphus were purified and cultured. Then, Daphnia longispina was fed microalgae including Chlorella vulgaris and Scenedesmus dimorphus enriched with Docosahexaenoic acid (DHA). The microalgae density to enrich daphnia was estimated at 5× 107 cells mL-1. Three treatments with three replicates and a control group were considered in this study. A total of 30 Acipenser persicus larvae were allocated to each sixty liters tank. Experimental fish were fed daphnia enriched with Chlorella vulgaris (treatment 1), daphnia enriched with Scenedesmus dimorphus (treatment 2) and daphnia enriched with Chlorella vulgaris and Scenedesmus dimorphus (at the rates of 50%) (treatment 3). Persian sturgeon larvae in the control group were fed like VNIRO stage from daphnia caught in pond. Larvae were fed 30% of body weight per day for four times. During the experimental period, water temperature, dissolved oxygen concentration and pH ranged between 18-24°C, 5.8-7.2 mg l-1 and 5.6-8.2, respectively. The minimum (219 ± 98.4 mg) and maximum (315.16 ± 140.8 mg) mean (±SD) weights were observed in the control group and treatment 3, respectively. The results obtained from the body weight increase (BWI %) revealed that there were significant differences between treatment 3 and other treatments. Highest (4.6±1.13% day-1) and lowest (5.5±1.24% day-1) mean (±SD) specific growth rates (SGR) were recorded in fish fed the control group and treatment 3, respectively. Lowest (68%) and highest (85%) survival rates were recorded in the control group and treatment 3, respectively

Role of iron supplementation in promoting maternal and fetal outcome

Zahra Yekta1, Reza Pourali2, Nikol Mladkova3, Mohammad Ghasemi-rad4, Farzane Boromand5, Khosrow Hazrati Tappeh6 1Department of Community Medicine; 2Medical Demonstration Facility, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Islamic Republic of Iran; 3Institute of Cell and Molecular Science, London, United Kingdom; 4Student Research Committee; 5Department of Obstetrics and Gynecology; 6Department of Mycology and Parasitology, Urmia University of Medical Sciences, Urmia, Islamic Republic of Iran Background: The data comparing daily versus intermittent iron supplementation during pregnancy remain controversial. This study was undertaken to compare the efficacy of daily versus two different intermittent iron supplementation regimes on hematologic markers and birth outcomes in nonanemic pregnant women. Methods: Two hundred and ten women with singleton pregnancies, no known disease, and hemoglobin levels >11.0 g/dL were randomly assigned to one of three groups, ie, Group A consuming two iron supplementation tablets once weekly (100 mg iron per week, n = 70), Group B consuming one tablet twice weekly (100 mg iron per week, n = 70) and Group C, consuming one tablet daily (50 mg iron per day, n = 70). No additional micronutrients were supplied. Hemoglobin and serum ferritin levels were measured at 20, 28, and 38 weeks. Pregnancy and birth outcomes (pregnancy termination, method of delivery, birth weight, stillbirth) were analyzed. Results: In total, 201 women completed the protocol. There was a significant difference in mean hemoglobin and ferritin levels in Group B at 38 weeks (P = 0.018 and P = 0.035, respectively) but this difference was not clinically significant (hemoglobin >12 g/dL, ferritin >19 µg/L). There was a significant increase in ferritin in Group C (P = 0.03) at 28 weeks. No significant difference was observed with respect to pregnancy or birth outcome across the groups. All regimens prevented the occurrence of hemoglobin <10.5 g/dL, but weekly supplementation was associated with development of a hemoglobin level <11.0 g/dL (risk ratio 0.044). Conclusion: Twice-weekly supplementation is as effective as daily supplementation, and may represent an acceptable compromise in iron supplementation regimens for nonanemic pregnant women. Keywords: iron supplementation, pregnancy, anemia, outcom

The role of daphnia fed with purified and enriched phytoplankton with PUFA in enhancing growth and survival of Acipenser persicus larvae

In this study, Daphnia longispina were fed with two freshwater green algae species, Chlorella vulgaris and Scenedesmus dimorphus, enriched with Docosahexaenoic acid (DHA). Chlorella vulgaris and Scenedesmus dimorphus were isolated and cultured for mass production. Three treatments with three replicates and a control group were considered to conduct this study. In order to investigate feeding, a total of 30 Acipenser persicus larvae with the initial mean weight of 68±3.6 mg were distributed into 12 plastic tanks of 60 L. Experimental fish larvae were fed daphnia collected from earthen ponds (as control group), daphnia enriched with Scenedesmus dimorphus (treatment 1), daphnia enriched with Chlorella vulgaris (treatment 2) and daphnia enriched with Chlorella vulgaris and Scenedesmus dimorphus (at the rates of 50%) (treatment 3). The microalgae density to enrich daphnia is estimated at 5×107 cells mL^-1. Fish larvae were fed at an amount of 30% body weight per day for four times. During the experimental period, water temperature, dissolved oxygen concentration and pH ranged between 18-24°C, 5.8-7.2 mg l^-1 and 5.6-8.2, respectively. Monounsaturated fatty acids (MUFA) were the highest (32.3 %) in D. longispina enriched with Chlorella vulgaris and the highest concentration of polyunsaturated fatty acids (PUFA) (19.8%) was observed in D. longispina enriched with Scenedesmus dimorphus. The highest (21.6%) and lowest (13.2%) concentrations of PUFA in fish larvae were recorded in treatment 3 and the control group, respectively. The results obtained from the body weight increase (BWI %) revealed that there were significant differences (P≤0.05) between treatment 3 (daphnia enriched with chlorella and scenedesmus) and other treatments. The highest (5.5±1.24% day^-1) and the lowest (4.6±1.13% day^-1) mean specific growth rates (SGR) were recorded in fish fed treatment 3 and the control group, respectively. The lowest (68%) and the highest (85%) survival rates were obtained in the control group and treatment 3, respectively

Global fertility in 204 countries and territories, 1950–2021, with forecasts to 2100: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background Accurate assessments of current and future fertility—including overall trends and changing population age structures across countries and regions—are essential to help plan for the profound social, economic, environmental, and geopolitical challenges that these changes will bring. Estimates and projections of fertility are necessary to inform policies involving resource and health-care needs, labour supply, education, gender equality, and family planning and support. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 produced up-to-date and comprehensive demographic assessments of key fertility indicators at global, regional, and national levels from 1950 to 2021 and forecast fertility metrics to 2100 based on a reference scenario and key policy-dependent alternative scenarios. Methods To estimate fertility indicators from 1950 to 2021, mixed-effects regression models and spatiotemporal Gaussian process regression were used to synthesise data from 8709 country-years of vital and sample registrations, 1455 surveys and censuses, and 150 other sources, and to generate age-specific fertility rates (ASFRs) for 5-year age groups from age 10 years to 54 years. ASFRs were summed across age groups to produce estimates of total fertility rate (TFR). Livebirths were calculated by multiplying ASFR and age-specific female population, then summing across ages 10–54 years. To forecast future fertility up to 2100, our Institute for Health Metrics and Evaluation (IHME) forecasting model was based on projections of completed cohort fertility at age 50 years (CCF50; the average number of children born over time to females from a specified birth cohort), which yields more stable and accurate measures of fertility than directly modelling TFR. CCF50 was modelled using an ensemble approach in which three sub-models (with two, three, and four covariates variously consisting of female educational attainment, contraceptive met need, population density in habitable areas, and under-5 mortality) were given equal weights, and analyses were conducted utilising the MR-BRT (meta-regression—Bayesian, regularised, trimmed) tool. To capture time-series trends in CCF50 not explained by these covariates, we used a first-order autoregressive model on the residual term. CCF50 as a proportion of each 5-year ASFR was predicted using a linear mixed-effects model with fixed-effects covariates (female educational attainment and contraceptive met need) and random intercepts for geographical regions. Projected TFRs were then computed for each calendar year as the sum of single-year ASFRs across age groups. The reference forecast is our estimate of the most likely fertility future given the model, past fertility, forecasts of covariates, and historical relationships between covariates and fertility. We additionally produced forecasts for multiple alternative scenarios in each location: the UN Sustainable Development Goal (SDG) for education is achieved by 2030; the contraceptive met need SDG is achieved by 2030; pro-natal policies are enacted to create supportive environments for those who give birth; and the previous three scenarios combined. Uncertainty from past data inputs and model estimation was propagated throughout analyses by taking 1000 draws for past and present fertility estimates and 500 draws for future forecasts from the estimated distribution for each metric, with 95% uncertainty intervals (UIs) given as the 2·5 and 97·5 percentiles of the draws. To evaluate the forecasting performance of our model and others, we computed skill values—a metric assessing gain in forecasting accuracy—by comparing predicted versus observed ASFRs from the past 15 years (2007–21). A positive skill metric indicates that the model being evaluated performs better than the baseline model (here, a simplified model holding 2007 values constant in the future), and a negative metric indicates that the evaluated model performs worse than baseline. Findings During the period from 1950 to 2021, global TFR more than halved, from 4·84 (95% UI 4·63–5·06) to 2·23 (2·09–2·38). Global annual livebirths peaked in 2016 at 142 million (95% UI 137–147), declining to 129 million (121–138) in 2021. Fertility rates declined in all countries and territories since 1950, with TFR remaining above 2·1—canonically considered replacement-level fertility—in 94 (46·1%) countries and territories in 2021. This included 44 of 46 countries in sub-Saharan Africa, which was the super-region with the largest share of livebirths in 2021 (29·2% [28·7–29·6]). 47 countries and territories in which lowest estimated fertility between 1950 and 2021 was below replacement experienced one or more subsequent years with higher fertility; only three of these locations rebounded above replacement levels. Future fertility rates were projected to continue to decline worldwide, reaching a global TFR of 1·83 (1·59–2·08) in 2050 and 1·59 (1·25–1·96) in 2100 under the reference scenario. The number of countries and territories with fertility rates remaining above replacement was forecast to be 49 (24·0%) in 2050 and only six (2·9%) in 2100, with three of these six countries included in the 2021 World Bank-defined low-income group, all located in the GBD super-region of sub-Saharan Africa. The proportion of livebirths occurring in sub-Saharan Africa was forecast to increase to more than half of the world's livebirths in 2100, to 41·3% (39·6–43·1) in 2050 and 54·3% (47·1–59·5) in 2100. The share of livebirths was projected to decline between 2021 and 2100 in most of the six other super-regions—decreasing, for example, in south Asia from 24·8% (23·7–25·8) in 2021 to 16·7% (14·3–19·1) in 2050 and 7·1% (4·4–10·1) in 2100—but was forecast to increase modestly in the north Africa and Middle East and high-income super-regions. Forecast estimates for the alternative combined scenario suggest that meeting SDG targets for education and contraceptive met need, as well as implementing pro-natal policies, would result in global TFRs of 1·65 (1·40–1·92) in 2050 and 1·62 (1·35–1·95) in 2100. The forecasting skill metric values for the IHME model were positive across all age groups, indicating that the model is better than the constant prediction. Interpretation Fertility is declining globally, with rates in more than half of all countries and territories in 2021 below replacement level. Trends since 2000 show considerable heterogeneity in the steepness of declines, and only a small number of countries experienced even a slight fertility rebound after their lowest observed rate, with none reaching replacement level. Additionally, the distribution of livebirths across the globe is shifting, with a greater proportion occurring in the lowest-income countries. Future fertility rates will continue to decline worldwide and will remain low even under successful implementation of pro-natal policies. These changes will have far-reaching economic and societal consequences due to ageing populations and declining workforces in higher-income countries, combined with an increasing share of livebirths among the already poorest regions of the world

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Behavioural and clinical factors associated with depression among individuals with diabetes,”

ABSTRACT Depression has been linked to greater mortality and morbidity in diabetic patients, but this issue has not been adequately studied in the Islamic Republic of Iran. This cross-sectional study described the prevalence of depression in patients attending a diabetes clinic in Urmia and determined the associated sociodemographic, behavioural and clinical factors. Of 295 patients, 128 (43.4%) had depression scores (≥ 15) on the Beck Depression Inventory. The mean score for all patients was 15.4 (SD 9. 5). Those with depression were significantly older and less educated than those without depression, had a longer duration of diabetes and were more likely to suffer complications. On logistic regression analysis, older age was the only variable significantly associated with depression. Facteurs comportementaux et cliniques associés à la dépression chez les individus diabétiques RÉSUMÉ Une relation a été établie entre une mortalité et une morbidité plus fortes chez les patients diabétiques, mais le sujet n'a pas été correctement étudié en République islamique d'Iran. Cette étude transversale décrivait la prévalence de la dépression chez les patients suivis dans une clinique du diabète à Urmia et définissait les facteurs socio-démographiques comportementaux et cliniques qui y sont associés. Sur 295 patients, 128 (43,4 %) avaient un score de dépression (≥ 15) sur l'Inventaire de la dépression de Beck. Le score moyen pour l'ensemble des patients était 15,4 (écart type 9,5). Les patients souffrant de dépression étaient nettement plus âgés et moins éduqués que ceux qui n'en souffraient pas, étaient diabétiques depuis plus longtemps et présentaient davantage de risques de complications. À l'analyse de régression logistique, l'âge était la seule variable significative associée à la dépression. ‫املتوسط‬ ‫لرشق‬ ‫الصحية‬ ‫املجلة‬ ‫عرش‬ ‫السادس‬ ‫املجلد‬ ‫الثالث‬ ‫العدد‬ 28