A systematic review of the efficacy of alternative medicine in the treatment of nausea and vomiting of pregnancy.

To assess the efficacy alternative medicine in the treatment of nausea and vomiting of pregnancy (NVP), three major databases of PubMed, Cochrane Library and Scopus were systematically searched since inception until January 14 2019 to investigate the effects of herbal medicines on NVD. The quality assessment of studies was performed according to Jadad scale. All studies showed that ginger had a positive effect on nausea in pregnant women. Unlike others studies, one study reported that ginger was not beneficial to the treatment of vomiting. Herbal medicines such as matricaria chamomilla, elettaria cardamomum, pomegranate and spearmint syrup, lemon provide safe and effective medical alternatives for treating pregnant women with mild to moderate NVD. The results suggested that ginger were more effective than vitamin B, but at the dose of 35-500 mg ginger, vitamin B6 and ginger had identical effect. However, over a longer treatment period (60 days), vitamin B6 was proved to be more effective than ginger. The same effect was observed in the comparison of quince and vitamin B6 as well as ginger and doxylamine plus pyridoxine. Mentha did not generated a positive effect on nausea and vomiting. However, this finding should be considered in the light of the above limitations.IMPACT STATEMENTWhat is already known on the subject? Previous systematic reviews have shown the superiority of ginger over the placebo. Lemon, chamomile and Mentha have been found to be more effective than the placebo.What do the results of this study add? This systematic review confirmed the results of previous systematic reviews in a larger sample size. Ginger was more effective than vitamin B, but at the dose of 35-500 mg ginger, vitamin B6 and ginger had identical effect. However, over a longer treatment period (60 days), vitamin B6 was proved to be more effective than ginger.What are the implications of these findings for clinical practice and further research? Matricaria chamomilla, elettaria cardamomum, pomegranate and spearmint syrup, lemon and ginger can be recommended to pregnant women for alleviation of NVP.

Electrochemical-based biosensors for microRNA detection: Nanotechnology comes into view.

Nanotechnology plays an undeniable significant role in medical sciences, particularly in the field of biomedicine. Development of several diagnostic procedures in medicine has been possible through the beneficial application of nano-materials, among which electrochemical nano-biosensors can be mentioned. They can be employed to quantify various clinical biomarkers in detection, evaluation, and follow up stages of the illnesses. MicroRNAs, a group of regulatory short RNA fragments, added a new dimension to the management and diagnosis of several diseases. Mature miRNAs are single-stranded RNA molecules approximately 22 nucleotides in length, which regulate a vast range of biological functions from cellular proliferation and death to cancer development and progression. Recently, diagnostic value of miRNAs in various diseases has been demonstrated. There are many traditional methods for detection of miRNAs including northern blotting, quantitative real time PCR (qRT-PCR), microarray technology, nanotechnology-based approaches, and molecular biology tools including miRNA biosensors. In comparison with other techniques, electrochemical nucleic acid biosensor methods exhibit many interesting features, and could play an important role in the future nucleic acid analysis. This review paper provides an overview of some different types of nanotechnology-based biosensors for detection of miRNAs.

Bone scan with technetium 99m-methyl diphosphonate, the missing link in the initial staging of muscle-invasive bladder carcinoma.

BACKGROUND: Accurate staging is crucial to determine the type of treatment for patients with bladder cancer (BCa), especially in high-risk cases. We aimed to assess the role of bone scan in the initial staging of muscle-invasive bladder carcinoma (MIBC). MATERIAL AND METHODS: Forty-five patients with MIBC were referred to our tertiary clinic to perform a technetium 99m-methyl diphosphonate (Tc99m-MDP) bone scan from January 2019 to March 2020. The patients underwent bone scintigraphy with pelvic SPECT/CT before radical cystectomy. Whole-body scanning was performed 4 hours after Tc99m-MDP injection in both anterior and posterior views. Since the most common bone involvement site in these patients is the pelvic bones and the spine, pelvic SPECT/CT was performed in all patients. RESULTS: Frequency of skeletal metastasis was 26.7%. Only 19% of the metastases were detected by previous pelvic CT/MRI images performed for routine staging. All the reported skeletal metastases by previous anatomical imaging methods were detected in the bone scan. There was no statistically significant correlation between bone metastasis and the patient's age, lymph nodes metastasis (LNM), hydronephrosis, and muscle-invasive type. The mean serum calcium level was 8.7 ± 0.57 in patients with bone metastasis and 8.87 ± 0.99 in patients without bone metastasis, which was not statistically significant. CONCLUSION: Bone scan has higher diagnostic performance than conventional imaging methods for detecting bone metastases. It changed the management plan in 8.8% of our patients, so we conclude that performing a whole-body bone scan in the initial staging of MIBC would be helpful.

Relationship between anthropometric indices and arterial stiffness: Insights from an epidemiologic study.

Background: Obesity and arteriosclerosis are both independently associated with cardiovascular disease risk. Obesity also may increase arterial stiffness. Aims: This study aimed to investigate the association between anthropometric indices and non-invasive arterial stiffness parameters, using data from a large population-based cohort of seemingly healthy women and men. Methods: A total of 5023 eligible participants were included in the study. The pulse wave velocity (PWV), central blood pressures, and bio-impedance measures were obtained at the time of enrollment. Multiple regression analysis was performed to assess the relationship between anthropometric indices with arterial stiffness parameters. Results: The mean age of participants was 45.3 ± 8.8 years, 2368 (47.1%) were males and 2655 (52.8%) were females. The prevalence of participant with underweight, normal weight, overweight, and obesity were 0.73%, 33.2%, 48.7%, and 17.2% respectively. Systolic and diastolic blood pressure, fatty liver, and hypertension were significantly higher in overweight/obesity participants. The overweight/obesity participants had significantly higher PWV than the normal-weight group (471.5 ± 42.6/496.7 ± 47.5 cm/s vs. 448.1 ± 41.4 cm/s, p < 0.001). Conclusion: The prevalence of diabetes, hypertension, fatty liver disease, chronic lung disease, and also kidney stones were significantly higher in overweight and individuals with obesity. Body mass index, body fat mass, waist-hip ratio abdominal circumference, neck circumference, visceral fat area, total body water, 50-kHz whole body phase angle are positively correlated with PWV. Augmentation index had no significant correlation with body mass index, arm, hip, and abdominal circumferences.

The visceral adiposity index and lipid accumulation product as predictors of cardiovascular events in normal weight subjects.

INTRODUCTION: Visceral adipose tissue (VAT) has an important role in the incidence of cardiovascular disease (CVD) than obesity by itself. The visceral adiposity index (VAI) and lipid accumulation product (LAP) are surrogate indices for measuring VAT. The aimed of this study was to investigate the association of these markers with cardiovascular events among populations with different BMI category in Mashhad, northeast of Iran. METHOD: The present study comprised a prospective cohort of 9685 men and women (35-65 years) who were recruited from MASHAD study. BMI category was defined as normal weight (BMI <25), over weight (25 ≤ BMI<30) and obese (BMI≥30). Demographic, laboratory evaluations, anthropometric and metabolic parameters were performed. Logistic and Cox regression analyses were used to determine the association and risk of cardiovascular events with VAT and LAP. RESULTS: The mean VAI and LAP in CVD patients were significantly higher than in healthy ones in all 3 groups. In terms of CVD event prediction, VAI and LAP had significant association with the incidence of CVD in the second (RR (95% CI): 2.132 (1.047-4.342) and 2.701 (1.397-5.222), respectively) and third tertiles (RR (95% CI): 2.541 (1.163-5.556) and 2.720 (1.159-6.386), respectively) in the normal group, but this association was only found in the third tertiles (RR (95% CI): 2.448 (1.205-4.971) and 2.376 (1.086-5.199), respectively) in the overweight group. The result couldn't find this association for the obese group. CONCLUSION: In this study, we found that there was a significant association between LAP and VAI and cardiovascular events in normal weight and over-weight groups; however, no significant relationship was found in the obese group.

Unusual clinical presentation of cutaneous leishmaniasis in a patient with corticosteroid-induced immunosuppression.

Clinicians should always consider rare, atypical, and opportunistic infections in patients undergoing long-term systemic corticosteroid therapy. Diagnosis needs further evaluations and special consideration.

The Association between Anthropometry Indices and Serum Concentrations of Gamma-Glutamyl Transferase, Alkaline Phosphatase, Alanine Aminotransferase, and Aspartate Aminotransferase.

BACKGROUND: Nowadays, metabolic syndrome (MetS) has become a great public health crisis that threatens too many lives worldwide. Many previous studies have been investigated the association between MetS and anthropometric indices. This study is aimed at investigating the association between anthropometric indices with gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), alanine aminotransferase (ALT), and aspartate aminotransferase (AST). We were using data from a large population-based cohort of seemingly healthy women and men. METHODS: A total of 7216 participants were included in this study. The serum levels of GGT, ALP, ALT, and AST with bioimpedance measures were obtained at the time of enrollment. Multiple regression analysis was performed to assess the relationship between anthropometric indices and serum levels of the aforementioned laboratory tests. RESULTS: Serum levels of GGT, ALP, ALT, and AST significantly correlated with body mass index (BMI). Only ALP had a significant association with visceral fat area (VFA). AST, ALT, and ALP levels had a positive correlation with 50 kHz whole-body phase. CONCLUSION: From the findings of this study, body mass index consistently appeared a good predictor of elevated hepatic enzymes and triglycerides. Thus, it can be helpful in clinical settings to identify patients at risk of nonalcoholic fatty liver disease, which is closely related to metabolic syndrome.

Association between Clinical Characteristics and Laboratory Findings with Outcome of Hospitalized COVID-19 Patients: A Report from Northeast Iran.

Coronavirus disease 2019 (COVID-19) was first discovered in December 2019 in China and has rapidly spread worldwide. Clinical characteristics, laboratory findings, and their association with the outcome of patients with COVID-19 can be decisive in management and early diagnosis. Data were obtained retrospectively from medical records of 397 hospitalized COVID-19 patients between February and May 2020 in Imam Reza Hospital, northeast Iran. Clinical and laboratory features were evaluated among survivors and nonsurvivors. The correlation between variables and duration of hospitalization and admission to the intensive care unit (ICU) was determined. Male sex, age, hospitalization duration, and admission to ICU were significantly related to mortality rate. Headache was a more common feature in patients who survived (p=0.017). It was also related to a shorter stay in the hospital (p=0.032) as opposed to patients who experienced chest pain (p=0.033). Decreased levels of consciousness and dyspnea were statistically more frequent in nonsurvivors (p=0.003 and p=0.011, respectively). Baseline white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were significantly higher in nonsurvivors (p < 0.001). Patients with higher WBC and CRP levels were more likely to be admitted to ICU (p=0.009 and p=0.001, respectively). Evaluating clinical and laboratory features can help clinicians find ways for risk stratifying patients and even make predictive tools. Chest pain, decreased level of consciousness, dyspnea, and increased CRP and WBC levels seem to be the most potent predictors of severe prognosis.

Endogenous stimuli-responsive linkers in nanoliposomal systems for cancer drug targeting.

There are various drug delivery systems (DDSs) among which nanoliposomal formulations are among the most prominent. Despite the superiority of nanoliposomal DDSs compared to conventional drug delivery methods, recent reports have claimed that they can deliver small amounts of the injected dose to target site by passive targeting. However, our understanding of tumor microenvironment features, including dysregulation of pH, the high intracellular concentration of glutathione, change in the amount and expression of some enzymes, reactive oxygen species, hypoxia, and ATP concentrations, has driven the scope of research into the use of these endogenous stimuli for a design of smart linkers. These linkers optimize the release of payloads in favorable target sites and avoid premature releasing in non-favorable off-target sites. In this review, we discuss particular linkers, which are able to respond to the specific endogenous conditions, and could be used in nanoliposomal DDSs, based on pathophysiological changes that occur in tumors. Furthermore, structural and chemical properties of these linkers and other potential linkers, which could be used in nanoliposomal DDSs, have been reviewed.