Ethnical variations in the incidence of congenital heart defects in Gorgan, Northern Iran: A single-center study

Background: Congenital heart disease (CHD) is the most common congenital anomaly in newborns. This study was performed to determine the live birth incidence of CHD by ethnicity and sex in Gorgan, Northern Iran. Methods: In this longitudinal, hospital-based study, 18162 live births in Dezyani Hospital in Gorgan, North of Iran, were screened for CHD, from 2007 through 2009. Clinical examination, echocardiography, color Doppler, and cardio catheterization were used as diagnostic tools. Sex, ethnicity, and type of CHD for each case were recorded in a pre-designed questionnaire. Results: The incidence rates of CHD in the native Fars, Sistani, and Turkmen subjects were 5.73 (95%CI: 4.53-7.15), 12.27 (95%CI: 8.74-16.73), and 15.93 (95%CI: 10.00-24.02) per 1000 live births, respectively. The Turkmen to native Fars and Sistani to native Fars relative risk for congenital CHD malformations was 2.77 (95%CI: 1.73-4.44; p value < 0.001) and 1.29 (95%CI: 0.77-2.18; p value < 0.323), respectively. While atrial septal defect was the most common lesion in the native Fars subjects (2.14 per 1000 [95%CI: 1.42-3.06]) and in the Sistani subjects (2.84 per 1000 [95%CI: 1.29-5.36]), in the Turkmen subjects, ventricular septal defect (4.36 per 1000 [95%CI: 1.59-9.43]), followed by atrial septal defect, was the most frequent lesion. Conclusion: This study showed that the incidence and pattern of CHD among live births in Gorgan, North of Iran, varied according to ethnicity. The risk of CHD was higher in the Turkmen and Sistani groups than in the Fars population

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease

Background: Experimental and clinical data suggest that reducing inflammation without affecting lipid levels may reduce the risk of cardiovascular disease. Yet, the inflammatory hypothesis of atherothrombosis has remained unproved. Methods: We conducted a randomized, double-blind trial of canakinumab, a therapeutic monoclonal antibody targeting interleukin-1β, involving 10,061 patients with previous myocardial infarction and a high-sensitivity C-reactive protein level of 2 mg or more per liter. The trial compared three doses of canakinumab (50 mg, 150 mg, and 300 mg, administered subcutaneously every 3 months) with placebo. The primary efficacy end point was nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death. RESULTS: At 48 months, the median reduction from baseline in the high-sensitivity C-reactive protein level was 26 percentage points greater in the group that received the 50-mg dose of canakinumab, 37 percentage points greater in the 150-mg group, and 41 percentage points greater in the 300-mg group than in the placebo group. Canakinumab did not reduce lipid levels from baseline. At a median follow-up of 3.7 years, the incidence rate for the primary end point was 4.50 events per 100 person-years in the placebo group, 4.11 events per 100 person-years in the 50-mg group, 3.86 events per 100 person-years in the 150-mg group, and 3.90 events per 100 person-years in the 300-mg group. The hazard ratios as compared with placebo were as follows: in the 50-mg group, 0.93 (95% confidence interval [CI], 0.80 to 1.07; P = 0.30); in the 150-mg group, 0.85 (95% CI, 0.74 to 0.98; P = 0.021); and in the 300-mg group, 0.86 (95% CI, 0.75 to 0.99; P = 0.031). The 150-mg dose, but not the other doses, met the prespecified multiplicity-adjusted threshold for statistical significance for the primary end point and the secondary end point that additionally included hospitalization for unstable angina that led to urgent revascularization (hazard ratio vs. placebo, 0.83; 95% CI, 0.73 to 0.95; P = 0.005). Canakinumab was associated with a higher incidence of fatal infection than was placebo. There was no significant difference in all-cause mortality (hazard ratio for all canakinumab doses vs. placebo, 0.94; 95% CI, 0.83 to 1.06; P = 0.31). Conclusions: Antiinflammatory therapy targeting the interleukin-1β innate immunity pathway with canakinumab at a dose of 150 mg every 3 months led to a significantly lower rate of recurrent cardiovascular events than placebo, independent of lipid-level lowering. (Funded by Novartis; CANTOS ClinicalTrials.gov number, NCT01327846.

Electroporation: An Effective Method For In Vivo Gene Delivery

Background: Gene therapy is a promising approach for the treatment of various diseases, including cancer, hereditary disorders, and some viral infections. The development of efficient and safe gene delivery systems is essential for facilitating gene transfer to various organs and tissues in vivo. Objective: In this review, we briefly describe the principal mechanisms of gene delivery systems, particularly electroporation, and discuss the latest advancements in the application of electro-poration for in vivo gene transfer. Methods: A narrative review of all the relevant publication known to the authors was conducted. Results: In recent years, electroporation-based strategies have emerged as an auspicious and versa-tile platform for efficient and controlled delivery of various biomolecules, including nucleic acids. Applying electric pulses of enough magnitude leads to the formation of hydrophilic pores in the cell membrane and allows the entry of otherwise membrane-impermeant molecules, such as DNA. Alt-hough electroporation has been initially developed for in vitro transfection of cells, it has recently advanced to preclinical in vivo applications and finally to clinical trials. Conclusion: Electroporation has already entered the clinical practice for antitumor therapy and may be an essential part of future personalized treatments. Given the ability of electroporation to deliver multiple genes in a single event, it will also certainly be further developed both as a stand-alone delivery approach and when coupled with other technologies. © 2022 Bentham Science Publishers

Postoperative pyoderma gangrenosum: A rare complication after appendectomy

Pyoderma gangrenosum (PG) is an uncommon inflammatory ulcerative skin disease. It is characterized by painful progressive necrosis of the wound margins. Rarely, postoperative pyoderma gangrenosum (PPG) manifests as a severe disturbance of wound healing following surgical interventions. Only rare cases of this complication have been reported after appendectomy. We report a case of PPG in a 29-year-old female after appendectomy. She was successfully treated with oral prednisolone. Postoperative pyoderma gangrenosum should be kept in mind in the differential diagnosis of any postoperative delayed wound healing, because this disease is simply distinguished from a postoperative wound

Modulation of extracellular atrioventricular node field potential pattern and ventricular rhythm by morphine in experimental atrial fibrillation in isolated rabbit heart

Introduction: Endorphins are produced by cardiomyocytes, and exert different effects on the heart. The aim of the present study is to assess morphine effects on extracellular atrioventricular (AV) node field potential pattern and ventricular rhythm of isolated rabbit heart during experimental atrial fibrillation (AF). Methods: Effects of different concentrations of morphine (10, 20, 50 and 100 μM) were assessed by applying basic stimuli protocols involving Wenckebach, recovery, zone of concealment and concealed conduction parameters during experimental atrial fibrillation in isolated rabbit heart. Two-way ANOVA was used to compare the groups. Results: Morphine significantly suppressed basic parameters of AV node. Morphine (100 μM) significantly increased wenckebach index (153.6±3.9 to 169.8±2.9 ms) and functional refractory period (156.9±3.0 to 176.4±3.5 ms) (P 0.05). Conclusion: The present results showed that morphine has concentration-dependent effects on AV node electrophysiological properties. Morphine at low concentrations can decrease nodal conduction and refractoriness of AV node, but in high concentrations causes increased nodal conduction without concealed conduction changes. Dual effects of morphine can explain the unpredictable behavior of heart in cardiac tachyarrhythmias

Identification of mutation for drug resistance gene in cutaneous leishmaniasis

Background: Cutaneous leishmaniasis is a common parasitic disease and one of the health problems world wide. The pentavalent antimonial drugs (e.g. pentostam and Glucantime) are the first line treatment for leishmaniasis, and resistance to these drugs is a serious problem. Using PCR method, this study was carried out to identify the mutation for sodium stibogluconate resistance gene in cutaneous leishmaniasis cases referred to different health centers during 2006-8. Materials and Methods: This descriptive study was conducted on 150 isolates of leishmania major and leishmania tropica to identify the mutation in drug resistance gene. Promastigote clones were cultured in enriched RPMI 1640 medium and then the genomic DNA was isolated and using a pair of primers, a 400 bp of the gene was amplified. Finally, the PCR products were screened by conformation sensitive gel electrophoresis (CSGE) method and then the mutation was confirmed using RFLP with Sdu1 enzyme. Results: Screening using CSGE and RFLP methods showed that 6.3 of the samples carried a mutation for drug resistance gene.Conclusion: Results showed a resistance for cutaneous leishmania against sodium stibogluconate. Further studies are required to determine the biochemical mechanism of this resistance

Detection of drug resistance gene in trichomonas vaginalis by PCR

Background: Trichomoniasis is a worldwide protozoan parasitic disease. Considering the importance of the disease in public health and the controversial ideas about the prevalence of drug resistance, this study was designed to determine the prevalence of metronidazole resistance gene in trichomonas vaginalis (T. vaginalis) with PCR-RFLP method in Tehran and in Kashan. Materials and Methods: In this descriptive study 140 samples of T. vaginalis in patients with T. vaginalis infections were collected and assessed microscopically. Then they were isolated and examined by culturing in dorset's medium, DNA extraction and PCR amplification. The PCR products were analyzed using RFLP and suspected samples were sequenced. Results: All but 7 samples were T. vaginalis positive by PCR. Sixty-two samples (44.4) were examined by microscopic, culture and PCR techniques 12 samples (8.5) by microscope and PCR, 56 samples (40) by culture and PCR and other 3 samples (2.1) were positive only by PCR. Two samples (1.5) were also examined for detection of mutation in 18S rRNA gene with RFLP in Tehran. Conclusion: This study shows that T. vaginalis infections in the female population living in Tehran are metronidazole-resistant. Since metronidazole is considered as the drug choice for T. vaginalis infections, more studies are recommended for identification of the drug resistance mechanisms and prevention of the disease