Salivary Oxidative Stress, Total Protein, Iron and pH in Children with ß-Thalassemia Major and their Correlation with Dental Caries.

Statement of the Problem: Iron overload in ß-thalassemia major leads to oxidative damage to tissues, which may have an important role in the onset and progression of oral diseases. Purpose: The aim of this study was to evaluate the salivary oxidative stress indicators, total protein, iron, and pH in children with ß-thalassemia major and their relationship with the status of dental caries in comparison with healthy children. Materials and Method: In this case-control study, 68 ß-thalassemia major and healthy children, who were age- and sex matched, were selected. Two mililiters of saliva was collected from each child. The pH was measured using pH meter paper. Thiobarbituric acid reactive substances (TBARS) as salivary lipid peroxidation index, total antioxidant capacity (TAC), total protein, and iron were measured by spectrophotometry. Data were analyzed by SPSS ver. 22 software with Pearson and independent samples t-test. Results: TBARS, TAC, iron and dmft index in the ß-thalassemia major group were significantly higher and pH was significantly lower than the control group (p< 0.001). The total protein difference between the two groups was not significant (p= 0.081). Conclusion: Considering the higher salivary TBARS in the ß-thalassemia major group, oxidative stress can be considered as a risk factor for dental caries in children with ß-thalassemia major. Prescription of antioxidant supplements especially natural antioxidants in the diet of children with ß-thalassemia major is recommended to reduce oxidative stress.

Vital role of chest CT in diagnosis of coronavirus disease 2019 (COVID-19).

In December 2019, a new virus called coronavirus disease 2019 (COVID-19) causing severe acute respiratory syndrome emerged in Wuhan, China, and rapidly spread to other areas of China and other regions of the world. Since it was a discovery, COVID-19 has spread to several countries and to this date, affecting about 2,329,651 people and caused about 160,721 deaths. Since most COVID-19 infected cases were diagnosed with pneumonia and characteristic chest computed tomography (CT) scan patterns, radiological examinations have become an important tool in early diagnosis. Nowadays, CT findings combined with normal blood cells (WBCs), lymphopenia and a history of epidemiological exposure have been used as criteria for clinical diagnosis of COVID-19. It is noteworthy that reverse transcription polymerase chain reaction (RT-PCR) test is still gold standard for the diagnosis. This review focuses on role of chest CT in the clinical evaluation of disease progression and more accurate diagnosis.

HBS Ag seroclearance and seroconversion time in Patients with chronic hepatitis B Infection.

BACKGROUND: Hepatitis B Surface antigen (HBsAg) seroclearance and seroconversion (development of antibodies against HBsAg) can increases the survival of Chronic hepatitis B (CHB) patients. The aim of this study was to determine the percentage and timing of HBsAg seroclearance and seroconversion in patients with chronic hepatitis B infection. METHODS: 1026 patients with CHB infection who referred to a private clinic were included. These patients had been followed-up for an average of 15 years. The patients whose HBs Ag was cleared from the blood and remained negative until the end of follow-up were designated as HBs Ag serocleared and the patients whose HBs Ab was positive during follow-upwas designated as HBs Ag seroconverted. The time of seroclearance and seroconversion of patients was recorded. Liver function tests, alpha-fetoprotein (AFP) and Hepatitis B early antigen (HBe Ag) status were extracted from the patients' medical records. Data were analysis with SPSS 17. RESULTS: The duration of follow-up was from 2 to 410 months and most patients were males (58.2%).The survival rate of HBs Ag positivity after 5, 10 and 15 years were 95.6, 89.4 and 80.7%, and 98, 93.5 and 84.9% of patients had not yet developed anti-HBs antibodies after 5, 10 and 15 years, respectively. Age, gender and taking medication had no effect on HBs Ag clearance from the blood or anti-HBs production. CONCLUSION: The HBs Ag seroconversion is a rare occurrence, but the incidence of this may increase with time, age and drug consumption. Though there was no relationship in our patients.

Clinical and laboratory findings from patients with COVID-19 pneumonia in Babol North of Iran: a retrospective cohort study.

BACKGROUND: In December 2019, China has experienced an outbreak of novel coronavirus disease 2019 (COVID-19). Coronavirus has now spread to all of the continents. We aimed to consider clinical characteristics, laboratory data of COVID-19 that provided more information for the research of this novel virus. METHODS: We performed a retrospective cohort study on the clinical symptoms and laboratory findings of a series of the 100 confirmed patients with COVID-19. These patients were admitted to the hospitals affiliated to Babol University of Medical Sciences (Ayatollah Rohani, Shahid Beheshti and Yahyanejad hospitals) form 25 February 2020 to 12 March 2020. RESULTS: Nineteen patients died during hospitalization and 81 were discharged. Non-survivor patients had a significantly higher C-reactive protein (CRP) (MD: 46.37, 95% CI: 20.84, 71.90; P = 0.001), white blood cells (WBCs) (MD: 3.10, 95% CI: 1.53, 4.67; P < 0.001) and lower lymphocyte (MD: -8.75, 95% CI: -12.62, -4.87; P < 0.001) compared to survivor patients Data analysis showed that comorbid conditions (aRR: 2.99, 95% CI: 1.09, 8.21, P = 0.034), higher CRP levels (aRR: 1.02, 95% CI: 1.01, 1.03, P = 0.044), and lower lymphocyte (aRR: 0.82, 95% CI: 0.73, 0.93, P = 0.003) were associated with increased risk of death. CONCLUSIONS: Based on our findings, most non-survivors are elderly with comorbidities. Lymphopenia and increased levels of WBCs along with elevated CRP were associated with increased risk of death. Therefore, it is best to be regularly assessed these markers during treatment of COVID-19 patients.

Neurologic manifestations in patients with COVID-19: A case report.

BACKGROUND: There are very few reports about the neurological complications of COVID-19. We describe two COVID-19 patients with neurologic presentations. CASE PRESENTATION: Herein we present neurological manifestations in 2 hospitalized patients with COVID-19. The patients showed most common symptoms of COVID-19 along with common conflicts in CT scans of lung such as ground-glass opacities (GGOs). First case revealed two episodes of generalized tonic-clonic seizures; brain CT scan in second patients revealed an extensive hypodense lesion in the left cerebellar hemisphere. All cases received supportive care, antibiotics, and antiviral medications. All cases were discharged with a good general condition. CONCLUSION: The current case series report the association between neurological involvements and COVID-19. Clinicians should be aware of neurologic symptoms in the setting of COVID-19, which might even be the first presentations of this infection.

Influenza Vaccination and Guillain-Barré Syndrome: Reality or Fear.

Guillain-Barré syndrome (GBS) is an inflammatory disorder and an acute immune-mediated demyelinating neuropathy that causes reduced signal transmissions, progressive muscle weakness, and paralysis. The etiology of the syndrome still remains controversial and uncertain. GBS can be initiated and triggered by respiratory tract infections such as influenza, and intestinal infections such as Campylobacter jejuni. In addition, there is considerable evidence suggesting links between influenza vaccination and GBS. As reported previously, the incidence of GBS in individuals receiving swine flu vaccine was about one to two cases per million. Despite the influenza vaccine efficacy, its association with an immune-mediated demyelinating process can be challenging as millions of people get vaccinated every year. In this review we will discuss the association between influenza infection and vaccination with GBS by focusing on the possible immunopathological mechanisms.

Spontaneous relapse in patients with inactive chronic hepatitis B virus infection.

BACKGROUND: Chronic hepatitis B virus infection (HBV) may reactivate during the course of the disease and is called spontaneous relapse. The purpose of this study was to evaluate the incidence of relapse of hepatitis in subjects with inactive HBV carriers. METHODS: This follow-up study was performed on 785 patients with inactive HBV carriers that were followed-up at six month intervals. The presence of serum HBsAg and anti-HBe, without HBeAg, HBV DNA levels <2000 IU/ml with normal alanine aminotransferase (ALT) levels was defined as inactive carriers. Patients who developed ALT ≥80 IU/L with HBV DNA levels ≥2000 IU/ml were considered as spontaneous relapse. RESULTS: Seven hundred- eighty five cases (441 males, 344 females) of chronic HBV infected individuals were followed-up. The mean age at the entrance of the study was 30.5±11.8 years. The mean follow-up duration was 5.9±5 years. Relapse was seen in 35 (4.5%) cases, in 27 out of 441 (6.1%) males and in 8 out of 344 (2.3%) females and in 4.2% subjects ≥30 years versus in 4.7% cases of under 30 years (p>0.05). The development of relapse in males was higher than females (hazard ratio 2.53, 95% CI 1.2-5.6, p=0.021), but age ≥30 or <30 years did not have effect (hazard ratio1.21, 95% CI 0.62-2.36, p=0.58). CONCLUSIONS: The results show that spontaneous relapse of hepatitis may develop during the course of chronic HBV infection. We suggest that all patients with chronic hepatitis B, regardless of their age, be examined for the possibility of relapse.

Zika virus: epidemiology, clinical aspects, diagnosis, and control of infection.

Zika virus (ZIKV) is an emerging pathogen of huge public health significance to human beings. Although majority of infections are benign with self-limiting symptoms, the recent outbreak has established an association with the increased incidence of some congenital anomalies such as microcephaly. In other words, due to the large extent of the virus and mosquito vectors, the infection has become a thoughtful health problem for human societies, though now, there are no antiviral therapies or vaccines against this virus. In spite of extensive research carried out by scientists, not so much information has been gathered about this viral infection. In the current review, we prepared an overview of the remarkable progress made in understanding about the epidemiology, immunology, clinical presentation, and diagnosis methods of ZIKV infection.

Causal role of infectious agents in cancer: An overview.

Cancer is a complex group of diseases with multiple eventual causes. The underlying causes are not fully known. Thus, learning more about the known causes of cancer is an important issue. Moreover, among these factors, infection and its association to cancers is controversial. Although, it seems that the genome instability of the cells can initiate cancer development. The purpose of this review was to present the role of infection in the development of cancer. Infectious agents, such as hepatitis B (HBV) and C viruses (HCV), Epstein-Barr virus (EBV), human papillomavirus (HPV), human immunodeficiency virus type 1 (HIV-1), Helicobacter pylori (H. pylori) and Streptococcus bovis (S. bovis) contribute to the pathogenesis of different cancers. These cancers include hepatocellular carcinoma, Burkitt's lymphoma, nasopharyngeal carcinoma, cervical cancers, non-Hodgkin lymphoma, Kaposi sarcoma, adenocarcinoma and lymphoma. Screenings of infectious diseases in cancer patients may open up areas of research in the identification of optimizing cancer control strategies.

Effects of Regular Treadmill Exercise on a DNA Oxidative-Damage Marker and Total Antioxidant Capacity in Rat Hippocampal Tissue.

BACKGROUND AND PURPOSE: Regular exercise can result in changes in the levels of oxidative stress in the hippocampus; however, little attention has been paid to physical-activity-induced neuronal protection to exposure to lead compounds. This study investigated the effects of regular treadmill exercise on a DNA oxidative-damage marker [8-hydroxy-2'-deoxyguanosine (8-OHdG)] and the total antioxidant capacity (TAC) of hippocampal tissue in lead-acetate exposed rats. METHODS: This study investigated the effects of 8 weeks of regular treadmill exercise on 8-OHdG and the TAC of hippocampal tissue in lead-acetate-exposed rats. Wistar rats were randomly divided into four groups: baseline, sham (control), lead, and exercise+lead. The exercise program involved running on a treadmill with increasing intensity five times a week for 8 weeks. Animals in the lead and exercise+lead groups received lead acetate at 20 mg/kg body weight intraperitoneally three times weekly for 8 weeks. Animals in the sham group received solvent (ethyl oleate) at 30 mg/kg body weight three times weekly for 8 weeks. TAC and 8-OHdG were measured by spectrophotometric and ELISA techniques, respectively. Data were analyzed by ANOVA and Tukey's post-hoc test with a significance cutoff of p≤0.05. RESULTS: The level of 8-OHdG and the TAC were significantly higher and lower, respectively, in the lead group than in the baseline and sham groups (p<0.01). However, the 8-OHdG level and TAC value in hippocampal tissue were significantly decreased and increased, respectively, in the exercise+lead group relative to the lead group (p<0.05). CONCLUSIONS: The TAC of hippocampal tissue may be directly associated with neural protection mechanisms of exercise following lead acetate injection, and the beneficial effects of regular exercise in preventing hippocampal neuronal damage could be due to decreased hippocampal oxidative stress such as reflected by a lower 8-OHdG level and increased TAC.

A study of the incidence of BCG vaccine complications in infants of Babol, Mazandaran (2011-2013).

BACKGROUND: BCG vaccination which is administered to prevent tuberculosis is sometimes associated with serious complications. This study aimed to determine the incidence of complications of BCG vaccination in Babol. METHODS: All infants who received BCG vaccination between 2011-2013 in health centers of Babol entered the study. Data regarding complications of vaccine were extracted according to the National Inventory of babies. All complicated cases were confirmed by the Academic Committee to review the adverse consequences of the vaccine. RESULTS: Among the 15984 vaccinated neonates, 150 (0.93%) cases presented lymphadenitis. 46.5% were females and 53.5% were males; 43% were rural residents and 57% were urban residents. No cases of lymphadenitis including 1% of lymphadenitis with abscess formation were recovered without treatment. Disseminated infection occurred in 3 cases of immune deficient patients who responded to the treatment. Most complications occurred during 4 months after vaccination. CONCLUSION: According to the results of this study, the prevalence of lymphadenitis in Babol was higher than the standard of WHO. This may be attributed to type and vaccine storage and injection technique. These findings justify further training of health-center workers.

Role of oxidative stress in pathogenesis of metabolic syndrome.

The metabolic syndrome (MS) recognized as a major cause of type 2 diabetes and cardiovascular diseases, has become one of the major public health challenges worldwide. The pathogenesis of the metabolic syndrome is multiple and still poorly understood. No single factor has yet been identified as an underlying causal factor. There is a growing belief, however, that obesity, especially visceral obesity, may play an important role in the development of the syndrome. Visceral adiposity seems to be an independent predictor of insulin sensitivity, impaired glucose tolerance, dyslipidemia and elevated blood pressure. An increasing number of studies confirm that oxidative stress, chronic inflammation and angiogenesis all play important roles in the pathogenesis of MS. Chronic hyperglycemia causes oxidative stress in tissues prone to complications in patients with diabetes. Oxidative stress occurs in a cellular system when the production of free radical moieties exceeds the antioxidant capacity of that system. If cellular antioxidants do not remove free radicals, radicals attack and damage proteins, lipids, and nucleic acids. The oxidized or nitrosylated products of free radical attack have decreased biological activity, leading to loss of energy metabolism, cell signaling, transport, and other major functions. These altered products are also targeted for proteosome degradation, further decreasing cellular function. Accumulation of such injury ultimately leads a cell to die through necrotic or apoptotic mechanisms. In conclusion, a puzzle of many pieces of evidence suggests that free radical overgeneration may be considered the key in the generation of insulin resistance, diabetes, and cardiovascular disease.

Quantification and comparison of bone-specific alkaline phosphatase with two methods in normal and paget's specimens.

BACKGROUND: Bone-specific alkaline phosphatase (BAP) is synthesized by the osteoblasts and is presumed to be involved in the calcification of bone matrix, though its precise role in the formation process is unknown. The aim of the present study was to measure the BAP activity in Paget's and normal specimens by two different techniques. METHODS: Total ALP (TAP) as well as BAP activity-measuring tests were repeatedly undertaken at different times during the day and different days on the serum samples (inter and intra assay). Precision and repeatability of the phenylalanine inhibition (PHI) and heat inactivation (HI) techniques were approved during ten times repetition of all the tests on two normal samples besides one sample from Paget's disease of bone. The measurement of TAP and BAP activities was also carried out on 50 serum samples from normal adults using the standard IFCC-AACC and the established methods, respectively. RESULTS: Coefficients of Variation (CV) for intra-assay of BAP were 2.33% and 3.16% by HI and PHI methods, respectively. Also, the inter-assay CV of BAP was 2.87% and 3.49% for mentioned methods in Paget's sample, respectively. In addition, the correlation of HI and PHI methods was found to be r= +0.873 for bone-specific isoenzyme. CONCLUSION: Regarding the appropriate precision, repeatability and correlation of HI and PHI techniques, as well as their cost effectiveness can be of use in the quantification of bone alkaline phosphatase isoenzyme activity, especially when bone is involved.