Effect of hydro alcoholic extract of artichoke on diabetes treatment and liver enzymes in diabetic adult male rats

Background and aims: Artichoke (Cynara scolymus L.) is a plant of the Asteraceae family. This plant is used in herbal medicine. This study was conducted to evaluate the effect of artichokeextract on insulin, glucagon, glucose, alkaline phosphatase (ALP), alanine amino transferase (ALT) and aspartate amino transferase (AST) in streptozotocin-induced diabetic rats. Methods: In this experimental study, 40 adult male Wistar rats weighting 220-200 g were used. The rats were divided into 4 equal groups including, control, diabetic and 2 diabetic experimental groups. Two experimental groups respectively received 100 and 300 mg/kg of artichoke hydro ethanol extract as intraperitoneal for 6 days. Diabetes was induced by intraperitoneal injection of 60 mg/kg streptozotocin. At the end of the sixth day, blood was taken from the heart of animals. Afterward serum concentration of insulin, glucagon, glucose, ALP, ALT and AST were measured. Then, the parameters measured in the different groups were compared with a control group. Data were evaluated by ANOVA, Duncan test and Student’s t-test. Results: Results showed that artichoke extract significantly reduced the levels of glucagon, glucose, ALP, ALT, AST and increased insulin level compared to control and diabetic groups. It is worth noting that before the experiment, parameters tested were equal in all groups. Conclusion: Artichoke reduces blood sugar so it has a role in treatment of diabetes. Additionally, this herb is effective in control of blood glucose by liver enzymes reducing

A case-control study on comparing resilience, quality of life, and perceived support in patients with type 2 diabetes

BACKGROUND: Diabetes is a chronic endocrine disorder characterized by impaired glucose metabolism. Diabetic foot, retinopathy, neuropathy, and nephropathy are diabetes-related outcomes that can affect resilience, quality of life (QOL), and perceived support. This study was conducted to compare resilience, QOL, and perceived support in patients with type 2 diabetes. METHODS: This study was a correlational study conducted in the form of a case-control design and was carried out in Tehran, Iran. For this purpose, 80 patients including 40 women and 40 men were selected based on purposeful sampling method during summer 2018. Three questionnaires of Connor-Davidson Resilience Scale (CD-RISC), Family Quality of Life Questionnaire (FQOL), and Multidimensional Scale of Perceived Social Support (MSPSS) were completed by the participants during a period of time. Data were analyzed by independent t-test and multivariate analysis of variance (ANOVA) in SPSS software. RESULTS: The difference between the mean scores of men and women in the resilience variable was significant and higher in women (P < 0.05). Moreover, there was a significant difference between the mean scores of men and women in the variables of quality of family life and perceived support and it was higher in women (P < 0.01 for all). CONCLUSION: The relationship between resilience, QOL, and perceived support variables with demographic indices is important and can be clinically relevant in planning appropriate interventions in patients with diabetes

ANTI-FERTILITY EFFECTS OF DIFFERENT FRACTIONS OF ANETHUM GRAVEOLENS L. EXTRACTS ON FEMALE RATS

Our previous studies showed the effects of aqueous and ethanol extracts of Anethum graveolens L. (dill) on female infertility. In the present study we investigated whether different fractions of this herb extract can cause infertility in rats. Female rats were divided into the control groups, the groups receiving either a low (0.5 g/kg)) or a high dose (5g/kg) of water, N-butanol, chloroform and ether fractions of the aqueous plant extract, and the groups receiving either a low (0.045 g/kg) or a high dose (0.45 g/kg) of the same fractions of ethanol extract. The mentioned doses were gavaged in 1mL for 10 days. Vaginal smears were prepared daily. Estradiol and progesterone levels were measured. The left oviduct and ovary were removed, their tissue subsequently being prepared in form of histology slides and stained using haematoxylin-eosin and Masson’s trichrome. Female rats assigned to each group were mated with males; after that, crown-rump lengths and weights of newborn rats were measured. Results showed that each fraction produced some changes such as hormonal level reduction (chloroform fraction), diestrus phase prolongation and infertility (water fraction), and increase in pregnancy duration (chloroform and ether fractions). We concluded that each fraction comprises only some of the mentioned components and therefore recommended the usage of crude extract, especially the aqueous one, in case infertility aims to be induced

The impact of the COVID-19 pandemic on the well-being, work conditions, and education of early career psychiatrists in the WHO Eastern Mediterranean Region: study protocol

BackgroundThe COVID-19 pandemic placed great strain on healthcare professionals, leading to a substantial impact and a redistribution of the workforce. Despite the active involvement of the Eastern Mediterranean Region Office (EMRO) and the World Health Organization in managing mental health crises, there is a knowledge gap concerning the working conditions and training opportunities available for early career psychiatrists (ECPs) during the pandemic period.ObjectivesThis study aims to investigate the impact of the COVID-19 pandemic on ECPs and how it affected their well-being, employment, and educational opportunities.MethodsA mixed methods study has been conducted in Iran, Egypt, and Tunisia, three EMRO member countries. It includes a cross-sectional survey with self-reported questions, and a qualitative study with individual in-depth interviews.DiscussionThe findings of this study will raise awareness to the working conditions of ECPs within the EMRO region and its member societies, both during the COVID-19 pandemic and beyond. The results will serve as a basis for encouraging supervisors and policymakers to mitigate the pandemic’s impact on psychiatric training, strengthen healthcare systems’ preparedness, and equip early career psychiatrists with the necessary skills to deal with the mental health consequences of the COVID-19 pandemic

Global prevalence of nosocomial infection: A systematic review and meta-analysis

Objectives: Hospital-acquired infections (HAIs) are significant problems as public health issues which need attention. Such infections are significant problems for society and healthcare organizations. This study aimed to carry out a systematic review and a meta-analysis to analyze the prevalence of HAIs globally.   Methods: We conducted a comprehensive search of electronic databases including EMBASE, Scopus, PubMed and Web of Science between 2000 and June 2021. We found 7031 articles. After removing the duplicates, 5430 studies were screened based on the titles/abstracts. Then, we systematically evaluated the full texts of the 1909 remaining studies and selected 400 records with 29,159,630 participants for meta-analysis. Random-effects model was used for the analysis, and heterogeneity analysis and publication bias test were conducted.   Results: The rate of universal HAIs was 0.14 percent. The rate of HAIs is increasing by 0.06 percent annually. The highest rate of HAIs was in the AFR, while the lowest prevalence were in AMR and WPR. Besides, AFR prevalence in central Africa is higher than in other parts of the world by 0.27 (95% CI, 0.22-0.34). Besides, E. coli infected patients more than other micro-organisms such as Coagulase-negative staphylococci, Staphylococcus spp. and Pseudomonas aeruginosa. In hospital wards, Transplant, and Neonatal wards and ICU had the highest rates. The prevalence of HAIs was higher in men than in women.   Conclusion: We identified several essential details about the rate of HAIs in various parts of the world. The HAIs rate and the most common micro-organism were different in various contexts. However, several essential gaps were also identified. The study findings can help hospital managers and health policy makers identify the reason for HAIs and apply effective control programs to implement different plans to reduce the HAIs rate and the financial costs of such infections and save resources

Effect of Intermediate-Dose vs Standard-Dose Prophylactic Anticoagulation on Thrombotic Events, Extracorporeal Membrane Oxygenation Treatment, or Mortality among Patients with COVID-19 Admitted to the Intensive Care Unit: The INSPIRATION Randomized Clinical Trial

Importance: Thrombotic events are commonly reported in critically ill patients with COVID-19. Limited data exist to guide the intensity of antithrombotic prophylaxis. Objective: To evaluate the effects of intermediate-dose vs standard-dose prophylactic anticoagulation among patients with COVID-19 admitted to the intensive care unit (ICU). Design, Setting, and Participants: Multicenter randomized trial with a 2 � 2 factorial design performed in 10 academic centers in Iran comparing intermediate-dose vs standard-dose prophylactic anticoagulation (first hypothesis) and statin therapy vs matching placebo (second hypothesis; not reported in this article) among adult patients admitted to the ICU with COVID-19. Patients were recruited between July 29, 2020, and November 19, 2020. The final follow-up date for the 30-day primary outcome was December 19, 2020. Interventions: Intermediate-dose (enoxaparin, 1 mg/kg daily) (n = 276) vs standard prophylactic anticoagulation (enoxaparin, 40 mg daily) (n = 286), with modification according to body weight and creatinine clearance. The assigned treatments were planned to be continued until completion of 30-day follow-up. Main Outcomes and Measures: The primary efficacy outcome was a composite of venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation, or mortality within 30 days, assessed in randomized patients who met the eligibility criteria and received at least 1 dose of the assigned treatment. Prespecified safety outcomes included major bleeding according to the Bleeding Academic Research Consortium (type 3 or 5 definition), powered for noninferiority (a noninferiority margin of 1.8 based on odds ratio), and severe thrombocytopenia (platelet count &lt;20 �103/µL). All outcomes were blindly adjudicated. Results: Among 600 randomized patients, 562 (93.7) were included in the primary analysis (median interquartile range age, 62 50-71 years; 237 42.2% women). The primary efficacy outcome occurred in 126 patients (45.7%) in the intermediate-dose group and 126 patients (44.1%) in the standard-dose prophylaxis group (absolute risk difference, 1.5% 95% CI,-6.6% to 9.8%; odds ratio, 1.06 95% CI, 0.76-1.48; P =.70). Major bleeding occurred in 7 patients (2.5%) in the intermediate-dose group and 4 patients (1.4%) in the standard-dose prophylaxis group (risk difference, 1.1% 1-sided 97.5% CI,-� to 3.4%; odds ratio, 1.83 1-sided 97.5% CI, 0.00-5.93), not meeting the noninferiority criteria (P for noninferiority &gt;.99). Severe thrombocytopenia occurred only in patients assigned to the intermediate-dose group (6 vs 0 patients; risk difference, 2.2% 95% CI, 0.4%-3.8%; P =.01). Conclusions and Relevance: Among patients admitted to the ICU with COVID-19, intermediate-dose prophylactic anticoagulation, compared with standard-dose prophylactic anticoagulation, did not result in a significant difference in the primary outcome of a composite of adjudicated venous or arterial thrombosis, treatment with extracorporeal membrane oxygenation, or mortality within 30 days. These results do not support the routine empirical use of intermediate-dose prophylactic anticoagulation in unselected patients admitted to the ICU with COVID-19. Trial Registration: ClinicalTrials.gov Identifier: NCT04486508. © 2021 American Medical Association. All rights reserved

Glycine betaine affects the antioxidant system and ion accumulation and reduces salinity-induced damage in safflower seedlings

Safflower (Carthamus tinctorius L.) is an important oilseed crop, usually grown on a small scale and in salt-affected soils. Salinity stress can cause oxidative damage to plants. Upregulation of the antioxidant defense system induced by glycine betaine (GlyBet) alleviates the damaging effects of oxidative stress in plants. In the present investigation, seeds were treated with 0, 10, 30 and 60 mM of GlyBet solutions. Germination and the primary growth of the seedling were examined using sodium chloride salt (NaCl) at 0 (non-stress), 50, 100 and 150 mM concentrations. The obtained results indicate that at 50 and 100 mM NaCl, priming with 30 and 60 mM GlyBet increased root and shoot lengths compared to the control (0 mM). In addition, at all stress levels, priming with 60 mM GlyBet led to lower malondialdehyde, total soluble sugars and proline contents than in control seedlings. Priming with GlyBet increased catalase (CAT), superoxide dismutase (SOD) enzyme activities and protein content, while it reduced the activity of peroxidase under salinity stress. In addition, priming with GlyBet reduced the Na+/K+ ratio of seedlings and increased K+ under all salinity stress levels. Priming with 60 mM GlyBet also reduced the Na+ content under 150 mM NaCl. Together, these results show that 60 mM GlyBet had the most pronounced effect on tolerance to salinity stress in safflower seedling. The glycine betaine-increased tolerance to salt in safflower was mainly related to increased CAT and SOD activities, and the prevention of cell membrane damage as a result of reduced lipid peroxidation and improved ion homeostasis under salinity stress condition

Changes in the Position of Mandibular Third Molars Following Extraction and Non-Extraction Orthodontic Treatments

Introduction: Impaction of third molars can be associated with a number of sequelae, each requiring a different type of treatment. The purpose of this study was to assess the changes in the position of lower third molars following extraction and non-extraction orthodontic treatments. Methods: Pre- and post-treatment panoramic radiographs of 26 class I malocclusion patients (4 male and 22 female) who were treated on a non-extraction basis were compared with those of 30 class I malocclusion patients (5 male and 25 female) who received orthodontic treatment following the extraction of all first premolars. In each group, the lower third molar angulations and their distance from the lower border of the mandible were assessed. Results: Paired t-tests and independent t-tests detected significant changes in the position of the lower third molars in the extraction group. Both the left and right molars became more upright and their distance from the lower border of the mandible increased. Similar changes were only seen in the position of the right mandibular third molars in the non-extraction group. Conclusion: Tooth extractions can bring about favorable changes in the position of mandibular third molars and possibly reduce their incidence of impaction

Relapsing anemia associated with parvovirus B19 infection in a kidney transplant recipient: A case report and review of the literature

Key clinical message PB19 infection should be considered an uncommon cause of posttransplant anemia in renal transplant recipients, particularly those whose anemia is not associated with common etiologies. IVIG treatment and reduced immunosuppression could be beneficial. Abstract Parvovirus B19‐associated relapsing anemia is rare in kidney transplant recipients. Herein, we report a case of relapsed anemia due to parvovirus B19 infection in a 53‐year‐old woman 18 months after kidney transplantation. The patient presented with palpitations, shortness of breath, dizziness, weakness, and lethargy. Early laboratory findings showed a WBC count of 6.000/μL, RBC count of 1.89/μL, hemoglobin (Hb) 3.5 g/dL, hematocrit (Hct) 15%, platelet count 266.000/μL, MCV 89, reticulocyte count 0.8%, and serum iron 221 μg/dL. Upon further evaluation, the RT‐PCR test for BK polyomavirus and cytomegalovirus (CMV) was negative, while the parvovirus B19 RT‐PCR was positive. The patient was treated with blood transfusion and IVIG 25 g daily for 5 days. Two months after discharge, the patient presented, complaining of palpitation, shortness of breath, and dizziness, with RBC 2.7/μL, Hb 6.5 g/dL, Hct 25%, and MCV 85. Again, the CMV RT‐PCR was negative, while the parvovirus B19 RT‐PCR was positive. Tacrolimus and mycophenolic acid were stopped, and IVIG 25 g daily for 5 days was administered. Consequently, her Hb level increased to 9 g/dL, and the patient was discharged with prednisolone 5 mg daily and cyclosporine 50 mg daily instead of tacrolimus. Viral infection, particularly PB19 infection, should be considered in the differential diagnosis of posttransplantation anemia in KTRs. IVIG treatment and modification of immunosuppressive medications are suggested standard therapies for such patients. The function of transplanted kidneys should be carefully monitored during treatment