Endometrial receptivity is crucial for embryo implantation, and excessive uterine contraction reduces success. Nifedipine which is a calcium channel blocker, could decrease uterine contraction and ...improve pregnancy outcomes.
This study aimed to assess the effect of Nifedipine before embryo transfer on the pregnancy outcome in women undergoing in vitro fertilization (IVF) in a tertiary center in Iran.
150 women who were candidates for IVF were randomly assigned into 2 groups: group 1 received 20 mg Nifedipine 30 min before embryo transfer, and group 2 received no intervention. Blood pressure of the participants was monitored every 10 min for 1 hr under the supervision of an anesthesiologist. Finally, implantation rate and chemical and clinical pregnancy rates were compared between groups.
At the end of the study, 140 participants were included in the final analyses. No significant difference was observed in clinical pregnancy rates between groups (20% vs. 22%, p = 0.51).
Nifedipine administration before embryo transfer does not improve the implantation and clinical pregnancy rates in women undergoing IVF.
The relationship between sleep and hormones have long been recognized. Studies indicated that sleep quality is one of the major modulatory effects on the endocrine system. In this study, we aimed to ...assess the serum concentration of thyroid hormones in individuals who suffered from low quality sleep.
Based on the Pittsburgh Sleep Quality Index and ISMA Stress questionnaire, we divided 83 participants into two groups. Forty-one individuals with low quality sleep group and 42 with good quality sleep group, all from the male students of a medical school in Tehran, Iran, participated in this descriptive and cross-sectional study. Then, serum levels of thyroid hormones including free T
, free T
, and TSH were assessed and compared between two groups.
There were a significant increase in serum levels of FT
(p=0.01) and TSH (p=0.02). There were also meaningful correlations between sleep score and stress score (p=0.008) as well as stress score and FT
(p=0.03) in the case group.
The current study showed that thyroid function tests (T
and TSH) significantly rose in the poor sleep condition. We also found correlations between sleep score, stress score, and FT
in the poor sleep condition group that suggest low sleep quality can affect thyroid hormones.
The coronavirus 2019 disease (COVID-19) is an ongoing outbreak of respiratory disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus can invade various tissues and ...organs, causing multiple organ dysfunctions. Critically ill COVID-19 patients may develop acute respiratory distress syndrome and pneumonia, which are the major causes of hypoxemic respiratory failure and death due to SARS-CoV-2 infection. Thus, ventilation support (invasive or noninvasive), has become a common practice in respiratory treatment of COVID-19 patients. Patients receiving mechanical ventilation usually require sedation to alleviate anxiety, pain and discomfort. On the other hand, current clinical reports have indicated that a significant number of COVID-19 patients require prolonged intensive care unit (ICU) care and ventilation, which increases the risk of delirium. Thus, selection of appropriate sedative medications during this period is of utmost importance. Dexmedetomidine (DEX) is a sedative, anxiolytic and analgesic agent that acts through the α2-adrenoceptor. Its sedative property is notable due to the lack of respiratory depression. In addition, its cytoprotective, immunoregulatory and anti-inflammatory properties have been well established in preclinical settings. Based on these features, a number of recent studies have proposed DEX as a beneficial sedative agent that simultaneously mitigates the excessive inflammation and protects vital body organs in patients with severe COVID-19. In current brief review, we aimed to discuss the therapeutic benefits of DEX in managing different indications of COVID-19.
The 2019 novel coronavirus (officially known as severe acute respiratory syndrome coronavirus 2, SARS-CoV2) was first found in Wuhan, China. On February 11, 2020, the World Health Organization (WHO) ...has declared the outbreak of the disease caused by SARS-CoV2, named coronavirus disease 2019 (COVID-19), as an emergency of international concern. Based on the current epidemiological surveys, some COVID-19 patients with severe infection gradually develop impairment of the respiratory system, acute kidney injury (AKI), multiple organ failure, and ultimately, death. Currently, there is no established pharmacotherapy available for COVID-19. As seen in influenza, immune damage mediated by excessive production of inflammatory mediators contributes to high incidence of complications and poor prognosis. Thus, removal or blocking the overproduction of these mediators potentially aids in reducing the deleterious cytokine storm and improving critically ill patients' outcomes. Based on previous experience of blood purification to treat cytokine storm syndrome (CSS) in severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), here we aimed to review the current literature on extracorporeal hemoperfusion as a potential therapeutic option for CSS-associated conditions, with a focus on severe COVID-19.
Background: This study has been designed to assess the hyperglycemic response in non-diabetic patients in women undergoing abdominal hysterectomy; who have received a prophylactic dose of ...dexamethasone to alleviate post-operative nausea and vomiting (PONV).
Methods: This was a double blind randomized clinical trial involving seventy women who were candidates for abdominal hysterectomy. The women were randomly assigned into two groups. Group A received 8mgs (in 50 mls normal saline) of IV dexamethasone; post-anesthetic induction and pre-surgery. Group B received 50 mls of normal saline post-anesthetic induction and pre-surgery. Patients were asked whether they had any nausea and vomiting during recovery. The patients’ blood sugar (BS) levels were assessed before surgery, during recovery and then 1, 6, 12, 18, and 24 hours after surgery.
Results: Thirty-three women in each group were monitored. Assessment of the results indicates that nausea and vomiting were not significantly different between the two groups. The age and BS before surgery of the patients were not significantly different. BS levels after surgery were significantly higher for the group receiving dexamethasone; with the exception of the levels during the first hour.
Conclusion: The BS of women undergoing abdominal hysterectomy is significantly higher for those receiving a single dose of dexamethasone, post-operatively, compared to patients receiving a placebo. The finding of this study does not support the role of dexamethasone in the prophylactic anti-emetic treatment in abdominal hysterectomy.
Early prediction of symptoms and mortality risks for COVID-19 patients would improve healthcare outcomes, allow for the appropriate distribution of healthcare resources, reduce healthcare costs, aid ...in vaccine prioritization and self-isolation strategies, and thus reduce the prevalence of the disease. Such publicly accessible prediction models are lacking, however.
Based on a comprehensive evaluation of existing machine learning (ML) methods, we created two models based solely on the age, gender, and medical histories of 23,749 hospital-confirmed COVID-19 patients from February to September 2020: a symptom prediction model (SPM) and a mortality prediction model (MPM). The SPM predicts 12 symptom groups for each patient: respiratory distress, consciousness disorders, chest pain, paresis or paralysis, cough, fever or chill, gastrointestinal symptoms, sore throat, headache, vertigo, loss of smell or taste, and muscular pain or fatigue. The MPM predicts the death of COVID-19-positive individuals.
The SPM yielded ROC-AUCs of 0.53-0.78 for symptoms. The most accurate prediction was for consciousness disorders at a sensitivity of 74% and a specificity of 70%. 2,440 deaths were observed in the study population. MPM had a ROC-AUC of 0.79 and could predict mortality with a sensitivity of 75% and a specificity of 70%. About 90% of deaths occurred in the top 21 percentile of risk groups. To allow patients and clinicians to use these models easily, we created a freely accessible online interface at www.aicovid.net.
The ML models predict COVID-19-related symptoms and mortality using information that is readily available to patients as well as clinicians. Thus, both can rapidly estimate the severity of the disease, allowing shared and better healthcare decisions with regard to hospitalization, self-isolation strategy, and COVID-19 vaccine prioritization in the coming months.
Longer subjective sleep latency and eveningness chronotype are associated with higher BMI. Moreover, COVID-19 lockdown changes have been associated with increased BMI. The aim of this study was to ...investigate the effect of subjective sleep parameters on BMI of medical interns during and before COVID-19 pandemic.
This cross-sectional study was performed among medical interns. Bedtime, sleep latency, waking time, sleep duration, and reduced morningness-eveningness scores were evaluated.
There was significant difference between bedtime before (00:11±50) and during (01:10±85) the pandemic in females (p<0.001). The mean circadian score before and during the pandemic showed significant decrease in females (p=0.011). The correlation between BMI with subjective sleep latency in females before and during the pandemic ((r=0.439, p=0.017), (r=0.422, p=0.014)) was significant.
COVID-19 pandemic was associated with a change toward nocturnal life among female medical interns. Subjective sleep latency was significantly correlated with BMI in females.
Abstract only
INTRODUCTION:
We have shown that the late-pregnant (LP) rodent is more vulnerable to myocardial ischemia-reperfusion injury (IRI) compared to non-pregnant (NP). The molecular mechanisms ...are unknown. Several microRNAs (miRs) are dysregulated in IRI, making them promising therapeutic targets. Our goal is to decipher the mechanisms underlying the higher susceptibility of LP to IRI.
Methods:
The left anterior descending coronary artery of female Sprague-Dawley rats (2-3 months old NP and LP, 20-21 days pregnant) was occluded for 45 minutes followed by 3 hours reperfusion. Myocardial necrosis was assessed using TTC staining. MicroRNA-microarray profiling was performed on hearts of NP and LP rats subjected to IRI (Ocean Ridge Biosciences). In vitro, female cardiomyocytes were transfected either miR98 mimic or inhibitor (40uM), followed by 3 hours hypoxia and 6 hours reoxygenation. Human blood samples were collected from NP, LP, and coronary heart disease (CHD) patients. Data were expressed as mean±SEM. P<0.05 was considered statistically significant.
Results:
MicroRNA-microarray profiling revealed miR-98-5p (miR-98) is upregulated in the hearts of LP IRI rats compared to NP IRI by 2.3 folds, which we confirmed with qPCR (1.89±0.15, n=5 animals/group). miR98 is significantly increased in the plasma of healthy LP compared to healthy NP women (2.32±0.44, LP n=9, NP n=7), and significantly increased in LP with CHD compared to healthy LP (4.41±0.73, CHD n=5). TargetScan revealed STAT3 and PGC-1α to be targets of miR98. We confirmed significantly decreased expression of STAT3 and PGC-1α in LP IRI rat myocardium compared to NP IRI (STAT3 0.48±0.12 n=5 and PGC-1α 0.39±0.17 n=5). MiR98 overexpression in female cardiomyocytes subjected to hypoxia/reoxygenation (H/R) significantly decreased STAT3 (0.75±0.11) and PGC-1α (0.52±0.16), and increased apoptosis (1.89±0.09), inflammation (2.12±0.18), and oxidative stress (2.3±0.22), while miR-98 knockdown resulted in the opposite effect (n=4).
Conclusions:
MiR98 is upregulated in LP rats subjected to IRI compared to NP IRI and in LP human plasma samples with CHD compared to healthy NP and LP. miR98 promotes oxidative stress, inflammation, and apoptosis in the setting of H/R
in vitro
by targeting STAT3 and PGC-1α.
Abstract only
INTRODUCTION:
We have shown hearts of late-pregnant (LP) rats have higher vulnerability to ischemia-reperfusion injury (IRI) compared to non-pregnant (NP) rats, and administration of ...intralipid (ITLD), a clinically safe fat emulsion, at the onset of reperfusion protects the LP rat heart against IRI. Our goal is to decipher the mechanisms for the ITLD-mediated cardioprotection in LP against IRI.
Methods:
We occluded the left anterior descending coronary artery of female Sprague-Dawley rats (2-3 months old NP and LP, 20-21 days pregnant) for 45 minutes followed by 3 hours reperfusion. The ITLD group was given ITLD at the onset of reperfusion (5mg/kg of 20%). We assessed myocardial necrosis via TTC staining and sent the hearts for microRNA-microarray profiling (Ocean Ridge Biosciences). In vitro, female cardiomyocytes were transfected either miR122 mimic, miR122 inhibitor, or scramble control (40uM), followed by 3 hours hypoxia and 6 hours reoxygenation. We collected human blood samples from NP, LP, and LP coronary heart disease (CHD) patients. P<0.05 was considered statistically significant. Values are expressed as mean±SEM.
Results:
MicroRNA-microarray profiling showed microRNA-122-5p (miR122) is downregulated 4-fold in the heart of LP rats subjected to IRI compared to healthy pregnant rats and upregulated 10-fold in the heart of LP rats that received ITLD at reperfusion, which we confirmed with qPCR (0.32±0.12, 90.2±10.3, n=5 animals/group). miR122 is significantly decreased in the plasma of healthy LP women compared to healthy NP women (0.6±0.16, LP n=9, NP n=7) and decreased in LP women with CHD compared to healthy LP (0.43±0.13, CHD n=5). TargetScan showed PKM2 to be a target of miR122. We confirmed significantly increased PKM2 in LP IRI rat myocardium compared to NP IRI (1.88±0.32) and significantly decreased in LP IRI rat administered ITLD (0.32±0.18). MiR122 overexpression in female cardiomyocytes subjected to hypoxia/reoxygenation (H/R) significantly decreased PKM2 (0.35±0.12), apoptosis (0.77±0.12) and oxidative stress (0.51±0.12), while miR122 knockdown expressed the opposite effect (n=4).
Conclusions:
Intralipid protects the heart in late pregnancy against ischemia/reperfusion injury by upregulating miR122, which targets PKM2.
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