Pregnancy in the Sickle Cell Disease and Fetomaternal Outcomes in Different Sickle cell Genotypes: A Systematic Review and Meta-Analysis

BackgroundPregnancy is a major concern among women with the sickle cell disease (SCD), and it is associated with increased adverse outcomes. The aim of the present meta-analysis is to report the fetomaternal outcomes in different sickle cell genotypes.MethodsIn this systematic review and meta-analysis, a comprehensive search of databases and search engines such as PubMed, Scopus, Web of Science, ProQuest, Cochrane Library, Science Direct and Google Scholar were performed. Any observational studies that had compared at least one outcome such as maternal outcomes, fetal outcomes, and morbidity between two groups of pregnant women with different types of sickle cell genotypes and pregnant women without SCD were evaluated.ResultsA total number of 9,827 pregnant women with SCD were examined. The results showed that pregnancy in SCD increased the risk of adverse outcomes for the mothers (including postpartum hemorrhage, prematurity, pregnancy-induced hypertension, pre-eclampsia, eclampsia, cesarean section, lower segment cesareansection, maternal death), fetus (including live births, low birth weight, intrauterine growth restriction, APGAR score at 5 min <7, stillbirth, neonatal death, perinatal mortality, acute fetal distress, intrauterine fetal death) and morbidity among the SCD(severe anemia, urinary tract infection, blood transfusion, painful crisis, acute chest syndrome, vaso-occlusive crises).ConclusionAccording to the results of this meta-analysis, pregnancy in the SCD is associated with an increased risk of maternal outcomes, fetal outcomes, and morbidity among SCD patients with different genotypes. Pregnancy in sickle cell hemoglobinopathies needs careful multidisciplinary management and cautious caring so as to decrease maternal and fetal morbidity and mortality.     

Endothelial nitric oxide synthase VNTR (intron 4 a/b) polymorphism association with type 2 diabetes and its chronic complications

Subject and aims

Endothelial derived nitric oxide (eNOS) is involved in several functions playing important role in development of type 2 diabetes and insulin resistance. The aim of this study was to examine the association between eNOS intron 4 VNTR polymorphism and type 2 diabetes in an Iranian population.

Methods

A total of 220 patients with type 2 diabetes and 96 healthy control subjects were recruited from the same area. Genotyping was performed using PCR.

Results

A significant difference was found in genotype frequencies of eNOS polymorphism between patients and controls (aa + ab vs. bb p = 0.02, OR 2.0 95% CI; 1.05-3.96). Also allele a frequency was significantly increased in patients with diabetes compared with controls (p = 0.007, OR 2.1 95% CI; 1.19-4.08). We found that in patients with diabetic neuropathy the frequency of ‘a’ allele was significantly increased compared to the controls p = 0.03, OR = 1.8 95% CI (1.00-3.7). Both genotype and allele frequencies were significantly different between patients who were complication free compared to the controls [aa + ab vs. bb p = 0.007, OR = 2.6 95% CI (1.2-5.8) and p = 0.001, OR = 2.8 95% CI (1.4-5.9)] respectively with the a allele conferring the risk.

Conclusion

The association between eNOS VNTR polymorphism and T2DM seems to be stronger in patients without diabetic complications indicating diverse effect of eNOS polymorphism on diabetes and diabetic microvascular complications.     

Job satisfaction and the factors affecting satisfaction in nurse educators: A systematic review

Objectives

The present study seeks to answer the following two questions: Are nurse educators satisfied with their job? What are the factors affecting job satisfaction in nurse educators?

Mannich bases derived from lawsone and their metal complexes: synthetic strategies and biological properties

Lawsone (2-hydroxynaphthalene-1,4-dione) is a natural product which shows significant biological activity. Aminomethylnaphthoquinone Mannich bases derived from lawsone constitute an interesting class of naphthoquinones and/or their metal complexes have demonstrated a series of important biological properties. So, this review aimed to document the publications concerning the synthesis of aminomethylnaphthoquinone Mannich bases from lowsone, aldehydes and amines and their metal complexes using different conditions, and investigation of their applications.

Lawsone (2-hydroxynaphthalene-1,4-dione) is a natural product which shows significant biological activity.     

Invading of intrauterine contraceptive device into the sigmoid colon through uterine perforation caused by a blunt trauma

Intrauterine contraceptive device (IUCD) is relatively safe but still with some serious risks. Uterus perforation is rare and would be fatal. A case of Cu-7 IUCD invading into the sigmoid colon through uterine perforation caused by a pelvic blunt trauma was presented. Our case showed that uterus perforation by an IUCD could induce utero-sigmoid fistula which is likely to be missed. Imaging is required when the patients with IUCD present abdominal pain, particularly with a history of trauma.     

Aquaporin3 expression and the potential role of aquaporins in motility and mitochondrial membrane potential in human spermatozoa

Aquaporins are water selective channels which play important roles in cell volume regulation during the transmission of spermatozoa to female tract. This study investigated the expression of aquaporin3 and determined the role of aquaporins in human sperm motility and mitochondrial membrane potential (MMP). RT-PCR and flow cytometry analysis were done to investigate aquaporin3 expression levels, and immunolocalisation of aquaporin3 in the spermatozoa was detected using immunocytochemical analysis. The sperm suspension was divided into four groups of spermatozoa: (a) Spermatozoa at 0 hr, (b) spermatozoa in control group, (c) spermatozoa treated with HgCl₂ (as an aquaporin inhibitor) and (d) spermatozoa treated with HgCl₂+ and 2-mercaptoethanol. The sperm samples were examined in terms of sperm motility and mitochondrial membrane potential. Results confirmed aquaporin3 expression in human spermatozoa and immunocytochemistry results showed an intense immunoreactivity in whole sperm tail. After 60 min, HgCl₂ showed a significant decrease in motility and MMP compared to the control group. At this time point, 2-mercaptoethanol in the HgCl₂+ 2-mercaptoethanol group reversed the effects of HgCl₂ as compared to the HgCl₂ group. Present study showed the expression and immunolocalisation of AQP3 in human spermatozoa and the potential role of AQPs in the sperm motility and MMP.     

Presence of phthalate derivatives in the essential oils of a medicinal plant Achillea tenuifolia

Background

Phthalate, esters of phthalic acid, are mainly applied as plasticizers and cause several human health and environment hazards. The essential oils of Achillea species have attracted a great concern, since several biological activities have been reported from varieties of these medicinal species. On the other side, due to the problems regarding the waste disposal in developing countries, phthalate derivatives can easily release from waste disposal to the water and soil resulting in probable absorption and accumulation by medicinal and dietary plants. As a matter of fact, although the toxicity of phthalate derivatives in human is well-known, food crops and medicinal plants have been exposing to phthalates that can be detected in their extracts and essential oils. Achillea tenuifolia (Compositea) is one of these herbaceous plants with traditional applications which widely growing in Iran.

Finding

The plant root was subjected to hydro-distillation for 4 h using Clevenger type apparatus to obtain its essential oil before and after acid treatment. Both of the hydro-distilled essential oils were analysed by GC-MS method resulted in recognition of their constituent. Phthalate contamination as (1, 2-benzenedicarboxylic acid, bis (2-methylpropyl) ester (5.4%) and phthalic acid (4.5%), were identified in the first and second extracted oils, respectively.

Conclusion

As a warning, due to the potential role of phthalates to cause reproductive toxicity, disturb of endocrine system and causing cancers, medicinal plants have to be considered through quality control for detection of these compounds.     

Sodium and Potassium Intake of Urban Dwellers: Nothing Changed in Yazd,Iran

To assess the daily salt intake of people aged 20-74 years based on the 24-hour urinary sodium excretion in urban population of Yazd, a population-based cross-sectional study was conducted. This is a substudy of Yazd Healthy Heart Project in Iran. From 2004 to 2005, two thousand people of the urban population of Yazd city, aged 20-74 years, were enrolled in the main study. Overall, 219 volunteer participants of 20-70 years were enrolled in this substudy. Sample frame was the household numbers according to the database of Yazd City Health Services. Calcium, phosphorus, sodium, potassium, and creatinine were measured in the urine samples collected from the participants over a 24-hour period. Sodium content in urine over 24 hours was 171.7±82.9 mmol/day in males and 127.8±56.1 mmol/day in females (p<0.0001) while potassium content was 49.4±23.2 mmol/day in males and 41.5±25.1 mmol/day in females (p=0.2). Estimated average daily salt (NaCl) intake was 10.0±4.8 g/day in males and 7.5±3.3 g/day in females (p<0.0001). Only one participant had the ideal Na/K ratio of less than one. Na/K ratios greater than one and less than two were seen in 11.3% (n=24), and a ratio equal to or greater than 2 was observed in 82.3% (n=118) of the participants. The average Na/K ratio was 3.69±1.58. Unlike many developed countries where sodium intake declined over the past few decades, the daily sodium intake in Yazd is high, and daily potassium intake is low. This is similar to what was observed four decades ago in an area not far from Yazd. Efforts must be directed towards health promotion interventions to increase public awareness to reduce sodium intake and increase potassium intake.Key words: 24-hour urine, Blood pressure, Cardiovascular disease, Hypertension, Policy, Potassium, Prevention, Salt, Sodium, Iran     

Dihydronaphthofurans: synthetic strategies and applications

Dihydronaphthofurans (DHNs) are an important class of arene ring-fused furans which are widely found in many natural and non-natural products and drug candidates with relevant biological and pharmacological activities. Furthermore, vinylidene-naphthofurans exhibit photochromic properties when exposed to UV or sun light at room temperature. For these reasons, a vast array of synthetic procedures for the preparation of dihydronaphthofurans including annulation of naphthols with various reagents, cycloaddition reactions ([3 + 2], [4 + 1] and Diels–Alder), intramolecular transannulation, Friedel–Crafts, Wittig, Claisen rearrangement, neophyl rearrangement and other reactions under various conditions have been developed over the past decades. This review aims to describe the different strategies developed so far for the synthesis of dihydronaphthofurans and their applications. After a brief introduction to the types of dihydronaphthofurans and their biological activities, the different synthetic approaches such as chemical, photochemical, and electrochemical, methods are described and organized on the basis of the catalysts and the other reagents employed in the syntheses. The subsequent section focuses on biological and pharmacological applications and photochromic properties of the target compounds.

Dihydronaphthofurans (DHNs) are an important class of arene ring-fused furans which are widely found in many natural and non-natural products and drug candidates with relevant biological and pharmacological activities.     

Occurrence of acute cholinergic syndrome in an infant due to donepezil ingestion

Donepezil and acetyl cholinesterase inhibitors are the most commonly prescribed medications for the treatment of Alzheimer''s disease. We describe a 2‐year‐old infant who was referred to the emergency department after developing cholinergic syndrome 6 hours after ingesting 10 mg of his grandmother''s donepezil tablets and was finally discharged in stable condition.