The effect of probiotics on gestational diabetes and its complications in pregnant mother and newborn: A systematic review and meta‐analysis during 2010–2020

This study was aimed to evaluate the effect of probiotics consumption on gestational diabetes (GD) and its complications in pregnant mother and newborn. The study was registered on PROSPERO (CRD42021243409) and all the enrolled articles were collected from four databases (Medline, Scopus, Embase, and Google Scholar) as randomized controlled trials (RCTs) from 2010 to 2020. A total of 4865 study participants from 28 selected studies were included in this review. The present meta‐analysis showed that the consumption of probiotics supplementation has the potential to decrease GD‐predisposing metabolic parameters such as blood glucose level, lipid profile, inflammation, and oxidative markers which may reduce GD occurrence among pregnant women.     

Herbal Medicines in Idiopathic Heavy Menstrual Bleeding: A Systematic Review

Idiopathic heavy menstrual bleeding (HMB; IHMB) is a common gynecological problem with no pelvic pathology or general bleeding disorder. Herbal remedies are commonly used to treat HMB. This systematic review aimed to assess the effectiveness and safety of herbal preparations for the treatment of IHMB. MEDLINE, Ovid, and the Cochrane Central Register of Controlled Trials were searched from inception to 23 August 2015. Only randomized controlled trials were considered. Three randomized controlled trials were included in this systematic review. Different herbal preparations were used in the included trials. In two studies, Ginger capsules and myrtle fruit syrup significantly reduced the menstrual duration and blood loss compared with placebo based on the pictorial blood loss assessment chart score (p < 0.001, p = 0.01). In another trial, Punica granatum flower capsules were as effective as tranexamic acid capsules in reducing the mean (SD) pictorial blood loss assessment chart score, with no significant difference between the two treatments (p = 0.3). The results show that the methods used in these trials may reduce menstrual bleeding in women with IHMB. Additional well‐designed trials are needed to investigate the safety and efficacy of herbs for the treatment of women with IHMB or other forms of HMB.     

Metallic SPIONP/AgNP synthesis using a novel natural source and their antifungal activities

The green synthesis of nanoparticles (NPs) is important because of the favorable potential of plant biomolecules involved in the synthesis of NPs. This study aimed to provide a fast, easy, cheap, and environmentally friendly method for the synthesis of superparamagnetic iron oxide NPs (SPIONP) and silver nanoparticles (AgNPs) using Stachys lavandulifolia and an evaluation of their use as antifungal agents against Aspergillus niger and Fusarium solani. The physicochemical properties of AgNPs and SPIONPs were studied using FESEM, HRTEM, XRD, VSM, UV-Vis, and EDX spectroscopy. The sizes and morphologies of the AgNPs and SPIONPs, measured via electron microscopy, were 12.57 nm and 10.70 nm, respectively. Nanoparticles have previously been shown to have antifungal activities, and SPIONPs and AgNPs can show antifungal resistance. These NPs can be used as a substitute for widely used toxic fungicides to promote food safety and public health.

AgNPs and SPIONPs showed inhibitory effects against the radial growth of the mycelia of the pathogenic fungi A. niger and F. solani.     

The Impact of Molecular Testing on the Surgical Management of Patients with Thyroid Nodules

Background

The use of molecular tests as an adjunct to FNA diagnosis of thyroid nodules has been increasing. However, the true impact of these tests on surgical practice has not been demonstrated. This study examines the usefulness of molecular testing on surgical management decisions in patients referred for thyroid surgery at a tertiary care center.

Methods

Clinical information was collected from patients who presented to Johns Hopkins Hospital for surgical consultation regarding a thyroid nodule and who underwent molecular testing between August 2009 and March 2013. Tests included an RNA-based gene expression classifier, a DNA-based somatic mutation panel, BRAF, NRAS, and/or RET/PTC translocation. A surgical management algorithm was created by consensus of four thyroid surgeons. Postsurgical pathology analysis in each case was then used to judge the appropriateness of the surgical decision-making and the usefulness of preoperative molecular testing, in guiding surgical planning.

Results

Of 114 patients assessed by preoperative molecular testing, 87 (72 %) underwent surgery. Surgical management was altered in nine (10 %) patients on the basis of molecular testing. Of these, surgical management change was appropriate, relative to the postoperative pathology analysis, for three patients and inappropriate for six patients.

Conclusions

In this study, molecular testing of thyroid nodule did not alter the surgical management of the majority of patients with thyroid nodules. These results indicate that molecular testing may be overused in patients for whom the results would not change surgical management. Furthermore, our data question the usefulness of the molecular tests examined in guiding preoperative surgical decision-making.     

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

MethodsThis 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.ResultsThe 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).ConclusionsThe 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 decade of reform in medical education: Experiences and challenges at Tehran University of Medical Sciences

Abstract

Purpose: In this paper, we present the major curricular reform in MD program of Tehran University of Medical Sciences, the oldest and the largest medical university in Iran, initiated about a decade ago.

Materials and methods: Following a comprehensive program evaluation, many of the basic challenges of the traditional curriculum were revealed, namely, lack of pre-defined competencies for graduates, over-reliance on teacher-centered teaching methods, over-emphasis on knowledge base in student assessments, and focusing solely on biomedical aspects of patient care. In 2010, a vision statement for reform was created and approved by the University Council. The new curriculum was launched in 2011.

Results: The changes included: revising the content of the courses, assimilating horizontal and vertical integration, emphasizing clinical skills, encouraging active involvement in patient management, providing more opportunity for supervised practice, integrating behavioral and psychosocial topics into the curriculum, incorporating interactive teaching methods, assessing students’ higher levels of cognition, and strengthening workplace assessments. To evaluate the changes, data were continuously collected and analyzed from the beginning.

Conclusions: Changing the curriculum of an MD program is a laborious task which should be planned and undertaken carefully and cautiously. It is an endless, yet invaluable and satisfying endeavor toward better future.     

Simvastatin treatment reduces heat shock protein 60, 65, and 70 antibody titers in dyslipidemic patients: A randomized,double-blind,placebo-controlled,cross-over trial

ObjectiveThis study aimed to evaluate the effects of statin therapy on serum levels of antibodies to several specific heat shock proteins (HSPs) in dyslipidemic patients.Design and methodsParticipants (n = 102) were treated with simvastatin (40 mg/day), or placebo in a randomized, double-blind, placebo-controlled, cross-over trial. Anti-HSP60, 65, 70, and hs-CRP levels were measured before and after each treatment period. Seventy-seven subjects completed the study.ResultsTreatment with simvastatin was associated with significant reductions in serum anti-HSP60, 65, and 70 titers in the dyslipidemic patients (10%, 14%, and 15% decrease, respectively) (p < 0.001). There have been previous reports of reductions in serum CRP with statin treatment, and although median CRP levels were 9% lower on simvastatin treatment, this did not achieve statistical significance.ConclusionWhile it is unclear whether HSP antibodies are directly involved in atherogenesis, our findings suggest that simvastatin inhibits autoimmune responses that may contribute to the development of cardiovascular disease.     

The relationship between the internal jugular vein and common carotid artery in the carotid sheath: the effects of age, gender and side

The internal jugular vein is often used for central venous catheter placement. The variations in the location of this vein along the major neck vessels (in the carotid sheath) may account for unsuccessful cannulations or iatrogenic arterial injuries. The aim of this study was to delineate the relation of the internal jugular vein and common carotid artery in the lower neck, and to assess the effects of age, gender and side on these anatomical structures. Two-dimensional ultrasonographic examinations of the right and left supraclavicular triangle were performed in 219 adult individuals who had no history of neck surgery or known pathology. The location of the internal jugular vein in relation to the common carotid artery was recorded. An anterolateral location of the internal jugular vein was the most common configuration observed on both sides (84% right side and 91.8% left side) followed by the lateral (14.2% right and 6.4% left) and anterior (1.4% right and 1.8% left) locations. A single case of a medial internal jugular vein was observed on the right side (0.23% of both sides). Subjects with a laterally located internal jugular vein were older than those with an anterolateral configuration (P<0.01). No gender differences were found with regard to these two configurations (P=0.867). The laterally located internal jugular vein was more frequent on right sides (P=0.007). Such information may be potentially useful for clinicians who are managing critically ill patients or patients undergoing hemodialysis.     

Mehdi-ODM; a modified digital monitoring of the occlusion therapy for amblyopia

Graefe's Archive for Clinical and Experimental Ophthalmology -