Advanced Biomedical Research最新文献

Background: Hypertension (HTN) is a leading cause of cardiovascular diseases and its control is poor. There is heterogeneity in levels of blood pressure control among various population subgroups. The present study was conducted within the framework of the National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases, and Stroke (NPCDCS) in India. It aims to estimate the proportion of optimal blood pressure control and identify factors associated with uncontrolled HTN consequent to initial screening.

Materials and methods: We assembled a cohort of individuals with HTN confirmed in a baseline screening in sixteen urban slum clusters of Bhopal (2017-2018). Sixteen accredited social health activists were trained from within these slums. Individuals with HTN were linked to primary care providers and followed up for the next two years. Obtaining optimal blood pressure control (defined as SBP <140 and DBP <90 mm of Hg) was a key outcome.

Results: Of a total of 6174 individuals, 1571 (25.4%) had HTN, of which 813 were previously known and 758 were newly detected during the baseline survey. Two-year follow-up was completed for 1177 (74.9%). Blood pressure was optimally controlled in 301 (26%) at baseline and in 442 (38%) individuals at two years (an absolute increase of 12%; 95% CI 10.2-13.9). Older age, physical inactivity, higher body mass index, and newly diagnosed HTN were significantly associated with uncontrolled blood pressure.

Conclusion: We found about six of every ten individuals with HTN were on treatment, and about four were optimally controlled. These findings provide a benchmark for NPCDCS, in terms of achievable goals within short periods of follow-up.

Background: Preoperative anxiety plays a critical role in post-operative pain response and other outcomes. Melatonin is a naturally secreted hormone which has anxiolytic, sedative, and analgesic properties. Pregabalin, analogue of gabapentin which has property of anxiolytic and analgesic effects.

Materials and methods: Total 96 patients undergoing total hip arthroplasty, divided into 3 groups of 32 each and were given placebo (group I), melatonin 6 mg (group II), and pregabalin 150 mg (group III). Anxiety level, postoperative pain score, sedation level and duration as well as characteristics of spinal anaesthesia were assessed with other vital parameters.

Results: Group I showed an increment in the anxiety score from baseline whereas in group II and group III, there was a decline in pre-operative anxiety score from baseline at all the periods of observation and more significantly in group III. Visual analogue scale (VAS) score and total dose of rescue analgesia were highest in group I, but group II and group III were comparable to each other. However, the durations of spinal anaesthesia and motor blockade showed a statistically significant difference with maximum duration in group III followed by II and then I. The level of sedation among the three groups were comparable at all the periods of observation.

Conclusions: Pregabalin was found better for perioperative anxiolysis, post-operative analgesia and for prolongation of duration of spinal anaesthesia when compared to melatonin.

Background: Inflammatory cell death, PANoptosis, has been suggested to orchestrate the lymphocyte decrement among coronavirus disease-2019 (COVID-19) patients. The main aim of this study was to examine the differences in the expression of key genes related to inflammatory cell death and their correlation with lymphopenia in the mild and severe types of COVID-19 patients.

Materials and methods: Eighty-eight patients (36 to 60 years old) with mild (n = 44) and severe (n = 44) types of COVID-19 were enrolled. The expression of key genes related to apoptosis (FAS-associated death domain protein, FADD), pyroptosis (ASC (apoptosis-associated speck-like protein containing caspase activation and recruitment domains (CARD)), the adapter protein ASC binds directly to caspase-1 and is critical for caspase-1 activation in response to a broad range of stimuli), and necroptosis (mixed lineage kinase domain-like, MLKL) genes were examined by reverse transcription-quantitative polymerase chain reaction (RT-qPCR) assay, and compared between the groups. The serum levels of interleukin (IL)-6 were measured by enzyme-linked immunosorbent assay (ELISA) assay.

Results: A major increase in the expression of FADD, ASC, and MLKL-related genes in the severe type of patients was compared to the mild type of patients. The serum levels of IL-6 similarly indicated a significant increase in the severe type of the patients. A significant negative correlation was detected between the three genes' expression and the levels of IL-6 with the lymphocyte counts in both types of COVID-19 patients.

Conclusion: Overall, the main regulated cell-death pathways are likely to be involved in lymphopenia in COVID-19 patients, and the expression levels of these genes could potentially predict the patients' outcome.

Background: Osteoporosis is the most prevalent metabolic bone disease in postmenopausal women associated with reduced bone mass and increased bone fracture. Measuring bone density in the lumbar spine and hip is a reliable measure of bone mass and can therefore specify the risk of fracture. Dual-energy X-ray absorptiometry (DXA) is an accurate non-invasive system measuring bone density, with a low margin of error and no complications. The present study aimed to investigate the relationship between biochemical parameters with bone density in postmenopausal women.

Materials and methods: This cross-sectional study was conducted on 87 postmenopausal women referred to osteoporosis centers in Isfahan. Bone density was measured in the spine and hip area using the DXA system. Serum levels of calcium, phosphorus, alkaline phosphatase, and magnesium were measured by an autoanalyzer, and serum levels of vitamin D were measured by high-performance liquid chromatography (HPLC).

Results: The mean parameters of calcium, phosphorus, alkaline phosphatase, vitamin D, and magnesium did not show a significant difference between the two groups (P-value > 0.05). In the control group, the relationship between alkaline phosphatase and bone mineral content (BMC) and bony area (BA) in the spine was significant with a correlation coefficient of - 0.402 and 0.258, respectively (P-value < 0.05) and BMD and T-score in the femoral neck area showed a direct and significant relationship with phosphorus (correlation = 0.368; P value = 0.038). There was a significant relationship between the Z-score with calcium (correlation = 0.358; P value = 0.044).

Conclusion: There was no significant relationship between the values of calcium, phosphorus, alkaline phosphatase, vitamin D, and magnesium parameters and bone density (spine and hip) in postmenopausal women with osteopenia or osteoporosis.

Background: Hydatidosis is a serious and life-threatening disease that may lead to the death of the host if diagnosed and treated improperly. Apoptosis has been investigated as a mechanism of host innate immunity in suppressing parasites and also the survival of cysts in the human body. The present study investigates the process and role of apoptosis caused by a host cell or parasite in hydatid cysts.

Materials and methods: Survey cytotoxic effect and apoptotic mortality of hydatid-treated lymphocytes were investigated. Also, to determine the mechanism of apoptosis in host and parasite, the mean gene expressions of Bcl-2, Bax, Caspase 3 in hydatid-treated lymphocytes, and Fas-L gene in the laminated-germinal layer of fertile and infertile hydatid cysts were evaluated.

Results: The viability of fertile and infertile hydatid fluid-treated lymphocytes was significantly different compared with the control group. Flow cytometry also showed apoptotic cells. Bax mean gene expression was significantly different between fertile and infertile treated lymphocytes. However, there was no significant difference in the mean expression of Caspase 3, and Bcl-2 genes in these two groups. Although the expression of the Fas-L gene in infertile cysts was higher than in fertile cysts, the result was not significant.

Conclusion: It seems that hydatid cyst fluid may induce apoptosis in lymphocytes so that, hydatid cysts can escape from the immune system and stay alive. On the other hand, the results represent the possible immune path of host apoptosis against the parasite as one of the important routes in infertility of hydatid cysts.

Background: COVID-19 is the leading cause of the recent pandemic in the globe. This disease might have different effects on the maternal and fetal outcomes in pregnancy. The aim of this study was to assess these outcomes in pregnant women with COVID-19 infections in different trimesters.

Materials and methods: This is a prospective cohort study that was performed in February 2020 to August 2021 in Isfahan on 430 pregnant women with definite diagnosis of COVID-19 infection admitted to our medical centers. The included cases were followed based on the gestational age in which they were diagnosed with COVID-19 infection. Patients were divided into three groups (first, second, and third trimesters) based on COVID-19 infection.

Results: The frequency of requiring mechanical ventilation was higher in mothers with COVID-19 in the second trimester (P = 0.049) and the frequency of PIH was significantly higher in mothers with COVID-19 in the third trimester compared to other women (P = 0.009). Fetal growth restriction (FGR) was also observed in 22 patients (5.3%) that was mostly observed with COVID-19 in the third trimester (P = 0.012). Oligohydramnios and fetal distress leading to C/S were observed in 19 patients (4.6%) and 12 patients (2.9%), respectively. The majority of maternal mortality was among cases with COVID-19 infection in the third trimester (44.4%).

Conclusion: We observed higher maternal and fetal complications in women especially those in the third trimester. Our results were in line with the findings of previous studies. Women with COVID-19 infection in the third trimester had highest frequencies of preterm labor and FGR.