The association between iron deficiency anemia and febrile seizure

Objective Different studies have reported contradictory results regarding the relationship between iron deficiency anemia (IDA) and febrile seizure (FS). The present study was conducted to determine the effect of IDA on FS in children. Patients and methods This case-control study was conducted among 52 children with FS (the case group) and 18 children with afebrile seizures and 51 children with fever without seizures in the age range of 6 months to 5 years admitted to the pediatric ward of Imam Khomeini Hospital in Ilam from March 2016 to January 2017. Patients were selected using the convenience sampling method. Red blood cell (RBC) count as well as measurement of hemoglobin (Hb), hematocrit (Hct), ferritin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) levels were performed in all patients. The collected data were analyzed using SPSS16 software. Results A total of 34.6 in the FS group, 66.7 in the afebrile seizure group and 41.2 in the fever without seizure group suffered from IDA, which was not statistically significant between the three groups. Hb, Hct and RBC levels were higher in the case group and MCV, MCH, MCHC levels in the case group were lower than those in the control group. The odds ratio (OR) for FS compared to the febrile group was 0.756 95% confidence interval (CI) = 0.34-1.68; p = 0.493 and that for FS compared to seizure was 0.265 (95% CI = 0.085-0.823; p = 0.022). Conclusions This study showed that IDA may have protective effects on the onset of FS, and based on the results, IDA is more common in children with afebrile seizures. Further and more comprehensive studies are recommended

Comparison of Knee-High and Thigh-High Graduated Compression Stockings in Preventing Deep Vein Thrombosis in Patients with Hemorrhagic Stroke

Background: Deep Vein Thrombosis (DVT) is a common complication in patients with hemorrhagic stroke. Prophylaxis and treatment of DVT in these patients is very difficult because there are some limitations regarding the use of anticoagulant drugs. Objectives: The purpose of this study was to compare the effectiveness of knee-high and thigh-high graduated compression stockings in preventing DVT in patients with hemorrhagic stroke. Methods: In this clinical trial, 88 patients with hemorrhagic stroke were randomly assigned to two groups to receive either thighhigh or knee-high graduated compression stockings as prophylaxis for DVT. The prevalence of DVT was studied using clinical symptoms and Doppler ultrasound. Chi-square and Mann Whitney U tests were used to analyze the data. Results: In the thigh-high stockings group, 11 patients (26.8%) and in the knee-high stockings group, 18 patients (38.3%) were affected by DVT during the study. However, no significant difference was observed between the two groups (P = 0.25). Conclusions: There was no significant difference between the two groups in the incidence of DVT. Therefore, either knee-high or thigh-high stockings can be used as prophylaxis, depending on patients’ will, cost and ease of use

The Association Between Borna Disease Virus and Chronic Fatigue Syndrome: A Systematic Review and Meta-Analysis

Context: Several studies have controversial results regarding the association between Borna disease virus (BDV) and chronic fatigue syndrome (CFS). The present systematic review and meta-analysis investigated the association between CFS and BDV. Evidence Acquisition: The present study was conducted based on the PRISMA guidelines for systematic review and meta-analysis studies. To avoid bias, all procedures of the study were performed by two researchers independently. A comprehensive search was performed using online databases, including PubMed, Scopus, Embase, PsycINFO, science Direct, Cochrane Library, web of science, and Google scholar using the MeSH keywords until December 12th, 2016. Heterogeneity among studies was evaluated using Cochran's Q test I-2 Index. Finally, the random effect model was used for combined Odds Ratio (OR) using Review Manger software version 5.3.5. Results: Among 9 eligible studies comprising 610 cases and 2176 controls, the total OR for association between BDV and CFS was estimated to be 10.41 (95 confidence interval CI: 4.24 - 25.55, P < 0.0001). For subgroup analysis by the diagnostic methods (ELISA, RT-PCR, and Western blot), OR was 2.47 (95% CI: 0.77 - 7.96, P=0.13), 12.20 (95% CI: 1.66 - 89.57, P=0.01), and 28.36 (95% CI: 3.76- 213.85, P=0.001), respectively (test for subgroup differences: P=0.08; I-2=59.5). Subgroup analysis for BDV and CFS association by antigens and antibodies had an OR of 12.20 (1.66, 89.57) and 8.20 (3.32, 20.22), respectively (test for subgroup differences: P=0.72; I-2=0). Conclusions: This study supports the association between BDV and CFS and shows the role of viral agents in etiology of CFS. Therefore, viral agents may play a role in the etiology of neuropsychiatric disorders

Cardiovascular patients� experiences of living with pacemaker: Qualitative study

BACKGROUND: A pacemaker implantation is considered major life event for cardiovascular patients, so they will probably have very interesting experiences of living with this device. The aim of this study was to explore the experiences of cardiovascular patients living with the pacemaker. METHODS: In this qualitative study, 27 patients were chosen through purposive sampling to achieve data saturation, and their experiences were examined using semi-structured interviews. The patients� statements were recorded with their consent and analyzed using content analysis method. RESULTS: Participants� experiences included three main themes: �Problems and limitations,� �feeling and dealing with pacemaker�, and �sources of comfort� and 10 sub-themes including: physical problems, financial problems, social problems, the first encounter, the feeling of living with the pacemaker, how to cope with pacemaker, satisfaction with pacemaker, good family support, hospital and hospital staff performance, and role of religious beliefs. CONCLUSION: Planning to solve social problems, identifying and changing feelings of patients using pacemakers, reinforcing the resources of comfort especially family support seem to be necessary steps for improving quality of life and impact of using pacemaker. © 2015 Isfahan University of Medical Sciences(IUMS). All rights reserved

The protective effect of bone marrow mesenchymal stem cells in a rat model of ischemic stroke via reducing the C-Jun N-terminal kinase expression

Ischemic stroke is the main cause of disability and mortality worldwide. Apoptosis and inflammation have an important role in ischemic brain injury. Mesenchymal stem cells (MSCs) have protective effects on stroke treatment due to anti-inflammatory properties. The inhibition of the C-Jun N-terminal kinase (JNK) pathway may be one of the molecular mechanisms of the neuroprotective effect of MSCs in ischemic brain injury. Twenty-eight male Wistar rats were divided randomly into 3 groups. Except the sham group, others subjected to transient middle cerebral artery occlusion (tMCAO). Bone marrow MSCs or saline were injected 3 h after tMCAO. Sensorimotor behavioral tests were performed 24 and 72 h after ischemia and reperfusion (I/R). The rats were sacrificed 72 h after I/R and infarct volume was measured by TTC staining. The number of apoptotic neurons and astrocytes in the peri-infarct area was assessed by TUNEL assay. The morphology of cells was checked by Nissl staining, and the expression of p-JNK was detected by immunohistochemistry and Western blot. Behavioral scores were improved and infarct volume was reduced by MSCs 24 h and 72 h after tMCAO. TUNEL assay showed that neuronal apoptosis and astroglial activity in the penumbra region were reduced by MSCs. Also, Nissl staining showed lower neuronal apoptosis in BMSCs-treated rats compared to controls. JNK phosphorylation which was profoundly induced by ischemia was significantly decreased after MSCs treatment. We concluded that anti-apoptotic and anti-inflammatory effects of MSCs therapy after brain ischemia may be associated with the down-regulation of p-JNK. © 2019 Elsevier Gmb

Prenatal urban traffic noise exposure impairs spatial learning and memory and reduces glucocorticoid receptor expression in the hippocampus of male rat offspring

Introduction: Exposure to noise stress during early life may permanently affect the structure and function of the central nervous system. The aim of this study was to evaluate the effects of prenatal exposure to urban traffic noise on the spatial learning and memory of the rats' offspring and the expression of glucocorticoid receptors (GRs) in their hippocampi. Methods: Three g\roups of pregnant rats were exposed to recorded urban traffic noise for 1, 2 or 4 h/day during the last week of pregnancy. At the age of 45 days, their male offspring were introduced to the Morris water maze (MWM) for assessment of spatial learning and memory. The corticosterone levels were measured in the offspring's sera by radioimmunoassay, and the relative expression of glucocorticoid and mineralocorticoid receptors (MRs) in their hippocampi was evaluated via RT-PCR. Results: Facing urban traffic noise for 2 and 4 h/day during the third trimester of pregnancy caused the offspring to spend more time and to travel a larger distance than the controls to find the target platform. Analogously, these two groups were inferior to their control counterparts in the probe test. Also, prenatal noise stress elevated the corticosterone concentration in the sera of the rats' offspring and dose-dependently decreased the relative expression of the mRNA of both GRs and MRs in their hippocampi. Conclusions: Urban traffic noise exposure during the last trimester of pregnancy impairs spatial learning and memory of rat offspring and reduces GRs and MRs gene expression in the hippocampus

Prenatal urban traffic noise exposure impairs spatial learning and memory and reduces glucocorticoid receptor expression in the hippocampus of male rat offspring

Introduction: Exposure to noise stress during early life may permanently affect the structure and function of the central nervous system. The aim of this study was to evaluate the effects of prenatal exposure to urban traffic noise on the spatial learning and memory of the rats' offspring and the expression of glucocorticoid receptors (GRs) in their hippocampi. Methods: Three g\roups of pregnant rats were exposed to recorded urban traffic noise for 1, 2 or 4 h/day during the last week of pregnancy. At the age of 45 days, their male offspring were introduced to the Morris water maze (MWM) for assessment of spatial learning and memory. The corticosterone levels were measured in the offspring's sera by radioimmunoassay, and the relative expression of glucocorticoid and mineralocorticoid receptors (MRs) in their hippocampi was evaluated via RT-PCR. Results: Facing urban traffic noise for 2 and 4 h/day during the third trimester of pregnancy caused the offspring to spend more time and to travel a larger distance than the controls to find the target platform. Analogously, these two groups were inferior to their control counterparts in the probe test. Also, prenatal noise stress elevated the corticosterone concentration in the sera of the rats' offspring and dose-dependently decreased the relative expression of the mRNA of both GRs and MRs in their hippocampi. Conclusions: Urban traffic noise exposure during the last trimester of pregnancy impairs spatial learning and memory of rat offspring and reduces GRs and MRs gene expression in the hippocampus

Multiscale fluctuation-based dispersion entropy and its applications to neurological diseases

Fluctuation-based dispersion entropy (FDispEn) is a new approach to estimate the dynamical variability of the fluctuations of signals. It is based on Shannon entropy and fluctuation-based dispersion patterns. To quantify the physiological dynamics over multiple time scales, multiscale FDispEn (MFDE) is developed in this paper. MFDE is robust to the presence of baseline wanders or trends in the data. We evaluate MFDE, compared with popular multiscale sample entropy (MSE), multiscale fuzzy entropy (MFE), and the recently introduced multiscale dispersion entropy (MDE), on selected synthetic data and five neurological diseases’ datasets: 1) focal and non-focal electroencephalograms (EEGs); 2) walking stride interval signals for young, elderly, and Parkinson’s subjects; 3) stride interval fluctuations for Huntington’s disease and amyotrophic lateral sclerosis; 4) EEGs for controls and Alzheimer’s disease patients; and 5) eye movement data for Parkinson’s disease and ataxia. The MFDE avoids the problem of the undefined MSE values and, compared with the MFE and MSE, leads to more stable entropy values over the scale factors for white and pink noises. Overall, the MFDE is the fastest and most consistent method for the discrimination of different states of neurological data, especially where the mean value of a time series considerably changes along with the signal (e.g., eye movement data). This paper shows that MFDE is a relevant new metric to gain further insights into the dynamics of neurological diseases’ recordings. The MATLAB codes for the MFDE and its refined composite form are available in Xplore

Challenges of managing diabetes in Iran: Meta-synthesis of qualitative studies

Background: Although several diabetes management and control programmes are introduced in Iran, many patients do not achieve diabetes-related clinical goals as recommended. The aim of this study was to identify the qualitative evidence for the challenges regarding diabetes management. Methods: A systematic review of qualitative studies following PRISMA guidelines was undertaken. Scopus, PubMed, Science Direct, and Web of Knowledge were searched as well as Persian databases including Magiran, Irandoc and SID from inception to August 2019. The included Studies were either in English- or Persian-language qualitative studies reporting the perspectives of patients, their relatives, or healthcare service providers. Content of the findings were analysed and organized according to Chronic Care Model framework. Results: Twelve studies met the inclusion criteria. Six main themes were identified including holistic understanding of patients, leadership and governance difficulties, service delivery, workforce, financing, and information and research. Conclusion: Challenges regarding the management of diabetes in Iran is multifaceted. Reforming the health care system or developing complementary strategies is essential to improve suitable health care model for patients with chronic conditions such as diabetic patients. © 2020 The Author(s)

Neuroprotective Effects of Oxytocin Hormone after an Experimental Stroke Model and the Possible Role of Calpain-1

Background Different mechanisms will be activated during ischemic stroke. Calpain proteases play a pivotal role in neuronal death after ischemia damage through apoptosis. Anti-apoptotic activities of the oxytocin (OT) in different ischemic tissues were reported in previous studies. Recently, a limited number of studies have noted the protective effects of OT in the brain. In the present study, the neuroprotective potential of OT in an animal model of transient middle cerebral artery occlusion (tMCAO) and the possible role of calpain-1 in the penumbra region were assessed. Methods Adult male Wistar rats underwent 1 hour of tMCAO and were treated with nasal administration of OT. After 24 hours of reperfusion, infarct size was evaluated by triphenyltetrazolium chloride. Immunohistochemical staining and Western blotting were used to examine the expression of calpain-1. Nissl staining was performed for brain tissue morphology evaluation. Results OT reduced the infarct volume of the cerebral cortex and striatum compared with the ischemia control group significantly (P < .05). Calpain-1 overexpression, which was caused by ischemia, decreased after OT administration (P < .05). The number of pyknotic nuclei in neurons increased dramatically in the ischemic area and OT attenuated the apoptosis of neurons in the penumbra region (P < .01). Conclusion We provided evidence for the neuroprotective role of OT after tMCAO through calpain-1 attenuation. Key Words Stroke tMCAO calpain-1 oxytoci