The effect of seasonality on reproductive outcome of patients undergoing intracytoplasmic sperm injection: A descriptive cross-sectional study

Background: There is conflicting evidence regarding the impact of season on the assisted reproductive technology outcome. Objective: To retrospectively compare three year outcome of women undergoing their first intracytoplasmic sperm injection cycle, across seasons. Materials and Methods: In this descriptive cross-sectional study, 3,670 women who underwent their first intracytoplasmic sperm injection cycle in Mehr Medical Institute, Rasht, Iran between April 2010 and May 2014 were studied. Women were divided into four groups according to the day of oocyte retrival as: spring (n = 808), summer (n = 994), autumn (n = 1066), and winter (n = 802). Basal and stimulation charecteristics were compared among groups. Results: While sperm concentration and motility were significantly lower during summer, the total number of retrieved and metaphase II oocytes were significantly higher (p = 0.0001, p = 0.0001, p = 0.004, p = 0.02, respectively). Fertilization rate were significantly higher during autumn (p = 0.0001). Also, the number of high- quality transferred embryos were significantly higher during summer and winter (p = 0.03). A similar pattern was observed in implantation rate and pregnancy over the four seasons Conclusion: Despite the fact that intracytoplasmic sperm injection minimize the seasonal effect on pregnancy outcome, changes in pregnancy rate still occur among different seasons without particular pattern. It seems that performing assisted reproductive technology procedures in a particular season should be considered as an effective factor. Key words: Intracytoplasmic sperm injection, Seasons, Pregnancy outcome

Protocol Adherence in Prehospital Medical Care Provided for Patients with Chest Pain and Loss of Consciousness; a Brief Report

Introduction: Although many protocols are available in the field of the prehospital medical care (PMC), there is still a notable gap between protocol based directions and applied clinical practice. This study measures the rate of protocol adherence in PMC provided for patients with chest pain and loss of consciousness (LOC).Method: In this cross-sectional study, 10 educated research assistants audited the situation of provided PMC for non-traumatic chest pain and LOC patients, presenting to the emergency department of a tertiary level teaching hospital, compare to national recommendations in these regards.Results: 101 cases with the mean age of 56.7 ± 12.3 years (30-78) were audited (55.4% male). 61 (60.3%) patients had chest pain and 40 (39.7%) cases had LOC. Protocol adherence rates for cardiac monitoring (62.3%), O2 therapy (32.8%), nitroglycerin administration (60.7%), and aspirin administration (52.5%) in prehospital care of patients with chest pain were fair to poor. Protocol adherence rates for correct patient positioning (25%), O2 therapy (75%), cardiac monitoring (25%), pupils examination (25%), bedside glucometery (50%), and assessing for naloxone administration (55%) in prehospital care of patients with LOC were fair to poor.Conclusion: There were more than 20% protocol violation regarding prehospital care of chest pain patients regarding cardiac monitoring, O2 therapy, and nitroglycerin and aspirin administration. There were same situation regarding O2 therapy, positioning, cardiac monitoring, pupils examination, bedside glucometery, and assessing for naloxone administration of LOC patients in prehospital setting

The effects of crocin on spatial memory impairment induced by hyoscine: Role of NMDA, AMPA, ERK, and CaMKII proteins in rat hippocampus

Objective(s): Crocus sativus L. and its active constituent, crocin, have neuroprotective effects. The effects of crocin on memory impairment have been mentioned in studies but the signaling pathways  have not been evaluated. Therefore, the aim of this study was to evaluate the effects of crocin on the hyoscine-induced memory impairment in rat. Additionally, the level of NMDA (N-methyl-D-aspartate receptors), AMPA (α-amino-3-hydroxy-5-methyl-4-isoxazole-propionicd acid), ERK (extracellular signal-regulated kinases), CaMKII (calcium (Ca2+)/calmodulin (CaM)-dependent kinaseII) mRNA and proteins were determined in rat hippocampus. Materials and Methods: Crocin (10, 20, and 40 mg/kg), hyoscine (1.5 mg/kg), normal saline and rivastigmine  were administered intraperitoneally to male Wistar rats for 5 days. The effects on memory improvement were studied using Morris water maze (MWM) test. Then, the protein levels of NMDA, AMPA, ERK, pERK, CaMKII and p.CaMKII  in hippocampus were analized using the Western blot test. Furthermore, the mRNA levels of NMDA, AMPA, ERK and pCaMKII genes were evaluated using real-time quantitative reverse transcription-polymerase chain reaction (qRT- PCR) method. Results: Aadminestration of crocin (20 mg/kg) and rivastigmine  significantly improved learning and memory impairment induced by hyoscine. Also, administration of hyoscine reduced  protein level of pERK,  while treatment with crocin (20 mg/kg) recovered the protein level.  No changes were observed in the protein levels and mRNA gene expression of NMDA, AMPA, ERK, CaMKII and pCaMKII following adminestration of hyoscine or crocin. Conclusion: Adminestration of crocin improved memory and learning. The effect of crocin in this model can be mediated by alteration in pERK protein level in rat hippocampus

Cloning and Expression of N-terminal Region of IpaD from Shigella dysenteriae in E. coli

Genus Shigella is one of the important members of the family enterobacteriacae. There are numerous antigens in Shigella carrying by a 220 kb plasmid. Among them, IpaD is the key virulence factor of S. flexneri. Apart from having effectors function that is essential for host cell invasion and intracellular survival, this protein also controls the secretion and translocation of other effector proteins into eukaryotic host cells. In the present study, we have cloned and expressed the ipaD in E. coli. The ipaD gene was amplified by PCR. Prokaryote expression vector pET-28a(+)- ipaD was constructed, and used to transform E. coli BL21DE3 plySs. The expression of recombinant protein induced by IPTG was examined by SDS-PAGE. Western blot were used to determine immunoreactivity of IpaD-His by a rabbit monoclonal antibodies against his-tag. SDS-PAGE demonstrated that the constructed prokaryotic expression efficiently produced IpaD at the 1 mmol/L of IPTG. IpaD protein was able to react with the rabbit monoclonal antibody against His-tag.  IpaD is essential for Shigella spp invasion. N-terminal region is most significant functional fragment of IpaD. Purification of IpaD from the wild type of Shigella is difficult furthermore profound study on a specific domain on the N-terminal of IpaD by using the wild type of purified IpaD is not feasible.

Serial Interval Distribution of COVID-19 among Iranian Reported Confirmed Cases

Type of manuscript: short report Introduction:  Serial interval refers to the average time between of the onset of the symptoms of two successive cases. Serial interval distribution can be used for the calculation of the basic reproduction number (R0), transmission rate, and study of an epidemic trend. This study aims to investigate the mean, standard deviation, and distribution of serial interval among the confirmed cases of COVID-19 using a Gamma distribution.      Methods: To determine the serial interval, 60 confirmed infected cases of COVID-19 (based on PCR test results) in February 20th-May 20th, 2020 were selected as the cases. For these cases, 37 transmissions occurred. The data of the dates of the occurrence of primary and secondary symptoms were collected by referring to the COVID-19 surveillance system and interviewing the patients Results: The findings showed that the median and mean of the serial interval were 3.0 and 4.5± 3.5 days. The findings showed that the median of the serial interval was 3.0 days (with the inter-quartile range of 2.0-6.0). The mean serial interval was 4.5± 3.5 days (95% confidence interval: 3.1-5.5). Conclusions: Our report showed a shorter period for a serial interval less than the previous reported interval in China. It seems that regarding the shorter serial interval reported in this study, the basic reproduction numbers reported by the first papers published in Iran have been overestimated regarding the serial interval of 7.5 days. Key words: COVID-19, Serial interval, Gamma distributio

Serial Interval Distribution of COVID-19 among Iranian Reported Confirmed Cases

Type of manuscript: short report Introduction:  Serial interval refers to the average time between of the onset of the symptoms of two successive cases. Serial interval distribution can be used for the calculation of the basic reproduction number (R0), transmission rate, and study of an epidemic trend. This study aims to investigate the mean, standard deviation, and distribution of serial interval among the confirmed cases of COVID-19 using a Gamma distribution.      Methods: To determine the serial interval, 60 confirmed infected cases of COVID-19 (based on PCR test results) in February 20th-May 20th, 2020 were selected as the cases. For these cases, 37 transmissions occurred. The data of the dates of the occurrence of primary and secondary symptoms were collected by referring to the COVID-19 surveillance system and interviewing the patients Results: The findings showed that the median and mean of the serial interval were 3.0 and 4.5± 3.5 days. The findings showed that the median of the serial interval was 3.0 days (with the inter-quartile range of 2.0-6.0). The mean serial interval was 4.5± 3.5 days (95% confidence interval: 3.1-5.5). Conclusions: Our report showed a shorter period for a serial interval less than the previous reported interval in China. It seems that regarding the shorter serial interval reported in this study, the basic reproduction numbers reported by the first papers published in Iran have been overestimated regarding the serial interval of 7.5 days. Key words: COVID-19, Serial interval, Gamma distributio

Estimating the Risk for Chromosomal Abnormalities and Heteromorphic Variants in Azoospermic and Severe Oligozoospermic Men

Objectives: A reasonable number of male infertility cases are related to genetic factors. Considering the high prevalence of chromosomal abnormalities related to male infertility, this study investigated the association of the chromosomal aberrations and chromosome variants with hormonal levels, a positive family history, parental consanguinity and a specific lifestyle. We also aimed to find a predictive factor to estimate the risk of the presence of an abnormal karyotype in the azoospermic and especially sever oligozoospermic men. Materials and Methods: A total of 230 infertile men and 50 healthy controls enrolled in the study for cytogenetic evaluation. Data on patients" characteristics were gathered, accurately. Results: Among aforementioned factors, only luteinizing hormone (LH) >12 IU/l raised the chance of detecting a chromosomal abnormality (P < 0.05). The results also showed a higher level of follicle stimulating hormone (FSH) and parental consanguinity and a positive family history of infertility in infertile men compared with the control group (P < 0.05). The incidence of chromosome abnormalities and chromosomal variants were 15.2% and 10.9%, respectively. The investigated variables revealed no association with the prevalence of chromosome heteromorphic variants. Conclusiond: This study suggests a positive family history of infertility, parental consanguineous marriages and high levels of FSH as strong determinants or risk factors for male infertility. Nonetheless, the presence of these patient characteristics did not prove to have a direct correlation with chromosomal abnormalities in male infertility. Among the various possible risk factors studied, an elevated gonadotropin level provides a better risk assessment for the incidence of chromosomal abnormality in infertile men

Association of NFKB1 gene polymorphism (rs28362491) with cardiometabolic risk factor in patients undergoing coronary angiography

Introduction: Genetic and environmental factors are involved in the pathogenesis of cardiovascular diseases (CVDs). The aim of the study was to investigate between the genotype of the NFKB1 gene and the cardiometabolic risk factor in patients undergoing coronary angiography. Methods: This cross-sectional study was conducted on 462 adults (male and women) aged between 35 and 75 years who referred to Afshar Hospital for coronary angiography in 2021- 2022. The polymerase chain reaction restriction fragment length polymorphism method was used to detect the genotype of rs28362491. Biochemical parameters were measured using commercial kits. Gensini and Syntax scores were calculated using the angiography result to assess the extent of coronary artery stenosis. We used multivariate logistic regression analysis to examine the relationship between genotype variants and cardiometabolic risk factors. Results: There was no association between variant genotypes and abnormally levels of serum alanine aminotransferase (ALT) (P value=0.51), aspartate aminotransferase (AST) (P value=0.99), triglyceride (TG) (P value=0.48), total cholesterol (P value=0.79), low density lipoprotein-cholestero (LDL-C) (P value=0.31), high-density lipoprotein-cholesterol (HDL-C) (P value=0.53), fast blood sugar (FBS) (P value=0.39), systolic blood pressure (P value=0.14), diastolic blood pressure (P value=0.64), Gensini score (P value=0.48) and syntax score (P value=0.74) in the crude model even after adjustment for confounding factors. Conclusion: We found no association between the ATTG polymorphism and cardiometabolic risk factors in patients who had coronary angiography. Further investigations are needed to assess the association between variants of 28362491 and cardiometabolic markers

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Mapping geographical inequalities in access to drinking water and sanitation facilities in low-income and middle-income countries, 2000-17

Background: Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-resolution geospatial estimates of access to drinking water and sanitation facilities. Methods: We used a Bayesian geostatistical model and data from 600 sources across more than 88 low-income and middle-income countries (LMICs) to estimate access to drinking water and sanitation facilities on continuous continent-wide surfaces from 2000 to 2017, and aggregated results to policy-relevant administrative units. We estimated mutually exclusive and collectively exhaustive subcategories of facilities for drinking water (piped water on or off premises, other improved facilities, unimproved, and surface water) and sanitation facilities (septic or sewer sanitation, other improved, unimproved, and open defecation) with use of ordinal regression. We also estimated the number of diarrhoeal deaths in children younger than 5 years attributed to unsafe facilities and estimated deaths that were averted by increased access to safe facilities in 2017, and analysed geographical inequality in access within LMICs. Findings: Across LMICs, access to both piped water and improved water overall increased between 2000 and 2017, with progress varying spatially. For piped water, the safest water facility type, access increased from 40·0% (95% uncertainty interval [UI] 39·4–40·7) to 50·3% (50·0–50·5), but was lowest in sub-Saharan Africa, where access to piped water was mostly concentrated in urban centres. Access to both sewer or septic sanitation and improved sanitation overall also increased across all LMICs during the study period. For sewer or septic sanitation, access was 46·3% (95% UI 46·1–46·5) in 2017, compared with 28·7% (28·5–29·0) in 2000. Although some units improved access to the safest drinking water or sanitation facilities since 2000, a large absolute number of people continued to not have access in several units with high access to such facilities (>80%) in 2017. More than 253 000 people did not have access to sewer or septic sanitation facilities in the city of Harare, Zimbabwe, despite 88·6% (95% UI 87·2–89·7) access overall. Many units were able to transition from the least safe facilities in 2000 to safe facilities by 2017; for units in which populations primarily practised open defecation in 2000, 686 (95% UI 664–711) of the 1830 (1797–1863) units transitioned to the use of improved sanitation. Geographical disparities in access to improved water across units decreased in 76·1% (95% UI 71·6–80·7) of countries from 2000 to 2017, and in 53·9% (50·6–59·6) of countries for access to improved sanitation, but remained evident subnationally in most countries in 2017. Interpretation: Our estimates, combined with geospatial trends in diarrhoeal burden, identify where efforts to increase access to safe drinking water and sanitation facilities are most needed. By highlighting areas with successful approaches or in need of targeted interventions, our estimates can enable precision public health to effectively progress towards universal access to safe water and sanitation