Journal of Advances in Medical and Biomedical Research
Year:2021 | Volume:29 | Issue:133|Papers Count:9

Background & Objective: Clostridium perfringens is an anaerobic bacterium, commonly present in retail foods. Its enterotoxin-producing ability, short generation time, ability to grow at elevated temperatures, and spore-forming ability allow C. perfringens to survive in food-processing temperatures, and cause foodborne illness. The aim of study was to screen dehydrated vegetables contaminated with Clostridium perfringens enterotoxin (CPE) and C. perfringens alpha-toxin (CPA). Materials & Methods: This descriptive-analytical study was carried out on 140 samples (70 unpacked and 70 packed). The samples included dehydrated vegetables collected from different areas of Tehran, Iran. Samples were inoculated on peptone and sulfite polymyxin sulfadiazine (SPS) agar for enrichment. The enrichment culture was then incubated on anaerobic condition for 48 hours. The black colonies were selected for identification test and polymerase chain reaction (PCR). The bacterial colonies were identified by biochemical tests, and duplex PCR was performed for CPE and CPA genes. Results: In general, 13 samples (9. 3%) were identified as contaminated with C. perfringens using phenotypic methods; all of the isolates were also positive for CPA, but negative for CPE gene. The contamination rate for packed and unpacked vegetables was 12. 8% and 5. 7%, respectively. Conclusion: Our findings showed that contamination of packed samples was higher than unpacked ones, which might be due to drying as well as packaging process. We found that these isolates were negative for enterotoxin.

Background & Objective: Breaking bad news to patients, especially those diagnosed with cancer, is one of the challengeable issues in the field of medicine. Hence, this study was designed to assess physicians' performance as well as importance of their training on how to deliver bad news to patients diagnosed with cancer. Materials & Methods: This prospective cross-sectional study assessed physicians’ performance in delivering bad health-related news to patients. A total of 12 hematologists and oncologists from Imam Khomeini Hospital and Shariati Hospital in Tehran, Iran were included in the study. A questionnaire including six statements (SPIKES model) was used to evaluate the performance of physicians. The time of breaking the cancer diagnosis news to patients by the physicians and educational records were evaluated with the average score of the physicians related to each statement. Results: There was no significant difference between the statements and age or gender (P>0. 05); but there was a significant correlation between ending the discussion (conversation), summarizing the content, and using the word "cancer” during the conversation (P<0. 05). Additionally, there was a significant correlation between the time spent on informing the patient about the cancer diagnosis and concluding the discussion and summarizing the statements (P<0. 05). Conclusion: Guidelines introducing the most harmless methods for delivering bad news with minimal negative effects on the patients’ mental health can be helpful for the medical staff. As a result, they can fulfill this critical task with less stress and minimum complications for the patients.

Background & Objective: Occurrence of oxidative stress in uncontrolled diabetes mellitus affects spermatogenesis and testicular functions. As the promising antioxidant activities of fullerene C60 nanomaterial have been demonstrated by previous reports, the current study aimed to determine its effects on the markers of oxidative stress damage in streptozotocin-induced diabetes testes in rats. Materials & Methods: To perform the current study, 32 male Wistar rats were assigned to four groups (each group, n=8) as follows: two control (normal and diabetic) and two treated (normal and diabetic) groups. Streptozotocin at dose of 45 mg/kg (i. v. injection) was used to induce diabetes at the beginning of the test. Treated rats orally received fullerene C60 (1 mg/kg/day) for 8 weeks. The markers of oxidative stress damage were assessed in the testes at the end of the study, including malondialdehyde (MDA) and glutathione (GSH) contents as well as superoxide dismutase (SOD) and catalase (CAT) activities. One-way ANOVA and Tukey’ s post-hoc test were used to analyze the data. Results: Blood glucose level was not altered in the fullerene-treated normal and diabetic animals. Diabetes induction increased MDA level, but decreased CAT activity in the testes of diabetic animals compared to the normal animals. Administering fullerene C60 significantly decreased MDA content and increased the activity of CAT in the testes of diabetic animals compared to the untreated diabetic rats. Fullerene C60 administration in normal animals also decreased the activity of SOD in the testes. Conclusion: According to our findings, fullerene C60 nanoparticles could reduce oxidative stress damage in diabetic condition in rat testicular tissue probably through potentiating the antioxidant defense system.

Background & Objective: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a worldwide pandemic disease. There is currently no effective cure for this virus, but some types of herbs can be a good choice for reducing its symptoms. There are some reports that Thymus vulgaris has high antioxidant compounds effective in strengthening the immune system, as well as antiviral effects in reducing the respiratory symptoms. Therefore, we speculated that T. vulgaris could be useful for reducing some of the symptoms in patients suffering from coronavirus disease 2019 (COVID-19). Materials & Methods: First, thyme essential oil was prepared, and a questionnaire regarding the patients’ symptoms was designed. Then, 83 patients with COVID-19 were randomly selected and divided into control and thyme-receiving groups. The questionnaire was completed and emphasized to consume 5 mL of the syrup or essential oil three times per day. Finally, one week after the first visit, the questionnaire was completed again to determine the effects of thyme on the mentioned symptoms. Then, the test results were reviewed and reported. Results: The results one week after taking thyme showed that the fever (P<0. 027), dizziness (P<0. 003), cough, dyspnea, muscular pain, headache, anorexia, weakness and lethargy, fatigue, and chest wall pain were significantly reduced (P<0. 001). Also, blood urea nitrogen (BUN) (P<0. 004), neutrophil count (P<0. 001), and calcium were (P<0. 034) decreased, but lymphocyte count was increased significantly (P<0. 001). Conclusion: Thyme plant, which has high antioxidant properties, strengthens the immune system, and by inducing the antiviral effect could reduce the symptoms of coronavirus; therefore, it is recommended for reducing the symptoms of COVID-19.

Background & Objective: Although patient’ s rights seem to be accepted theoretically, the subject is often neglected in practice. Respect for patient’ s rights by health care providers may optimize health outcomes and the quality of life. In addition, a perfect connection is created between health care services and patients’ needs and expectations. This study aimed to identify the deficits of patients' rights and find out whether an education-based program can result in higher respect for patient’ s rights. Materials & Methods: This descriptive survey was conducted before and after the execution of an educational-based program. A structured interview was used to collect data from 204 participants. The categorized questions were reviewed and classified by 6MP classification according to the patient’ s rights. Following undertaking an education-based program, the structured interview was utilized to recollect data from the participants. Outcome measures were the percentage of deficits in terms of the patient’ s rights before and after the education-based program. Results: There were high percentages of deficiencies in “ the right to receive optimal health services” and “ access to optimal and sufficient information” sections. Almost no compliance was observed in the other rights of patients. Our results indicated that 187 deficits recorded in the pre-test phase reduced to 57 in the post-test phase. Moreover, the number of deficits declared by the participants significantly (P<0. 05) diminished in all dimensions of the 6MP classification. This means that the identified deficits following the conducted education-based program were dramatically improved (three folds improvement). Conclusion: According to the findings of the present study, an education-based program may play an important role in promoting respect for patient’ s rights. This suggests health care systems consider a practical and ethical (not merely legal and official) perspective for patient’ s rights which in turn would optimize the quality of services provided by health care providers.

Background & Objective: Colorectal cancer (CRC) is one of the most prevalent malignancies in the world. The early detection of CRC is not only a simple process but also is the key to treatment. Data mining algorithms could be potentially useful in cancer prognosis, diagnosis, and treatment. Therefore, the main focus of this study is to measure the performance of some data mining classifier algorithms in predicting CRC and providing an early warning to the high-risk groups. Materials & Methods: This study was performed on 468 subjects, including 194 CRC patients and 274 non-CRC cases. We used the CRC dataset from Imam Hospital, Sari, Iran. The Chi-square feature selection method was utilized to analyze the risk factors. Next, four popular data mining algorithms were compared in terms of their performance in predicting CRC, and, finally, the best algorithm was identified. Results: The best outcome was obtained by J-48 with F-measure=0. 826, receiver operating characteristic (ROC)=0. 881, precision=0. 826, and sensitivity =0. 827. Bayesian net was the second-best performer (F-Measure=0. 718, ROC=0. 784, precision=0. 719, and sensitivity=0. 722) followed by random forest (F-Measure=0. 705, ROC=0. 758, precision=0. 719, and sensitivity=0. 712). The multilayer perceptron technique had the worst performance (F-Measure=0. 702, ROC=0. 76, precision=0. 701, and sensitivity=0. 703). Conclusion: According to the results of this study, J-48 could provide better insights than other proposed prediction models for clinical applications.

Background & Objective: The clinical outcomes and treatment options for acute myeloid leukemia (AML) patients are highly dependent upon molecular markers. In this study, Wilms tumor 1 (WT1) (exons 7 and 9) mutations, single-nucleotide polymorphism (SNP) rs16754, and WT1 expression levels in 130 random AML patients were screened; FMs-like tyrosine kinase-3 internal tandem duplication (FLT3-ITD), nucleophosmin (NPM1), and CCAAT/enhancer-binding protein alpha (CEBPA) mutations were also evaluated. Materials & Methods: Overall, 130 AML patients were recruited for this study. WT1 mutations were determined by Sanger sequencing, and expression levels were determined by real-time polymerase chain reaction (PCR). The Kaplan-Meier method was used to calculate overall survival (OS) and disease-free survival (DFS). Results: The frequency of WT1 mutations in the study population was 5. 4%, and it did not affect OS (P=0. 98), DFS (P=0. 97), or complete remission (CR) rates in AML patients. The major allele of SNP rs16754 in the current study was A. No significant differences were found for OS (P=0. 52), DFS (P=0. 42), or CR rates among all SNP rs16754 genotypes. The overexpression of WT1 was observed in 83% of patients at diagnosis. No significant difference was found for OS (P=0. 84), DFS (P=0. 82), or CR rates between AML patients with high and low WT1 expression levels. Conclusion: The results of the current study do not support WT1 mutation, SNP rs16754, or WT1 overexpression at diagnosis, as they were found to be poor prognostic markers in AML patients.

Autoimmune hemolytic anemia (AIHA) is a heterogeneous and relatively unknown disease caused by premature immune destruction of red blood cells. While its occurrence is uncommon among children, it is sometimes severe and resistant to treatment. The warm-reactive type contains 70 % to 80% of all cases, in which the first-line treatment is considered to be a steroid. Moreover, splenectomy, rituximab (a monoclonal antibody), and immunosuppressive drugs are used in refractory cases, with unclear efficacy and deep suppression of the immune system, which consequently lead to various side effects. This study reports the successful treatment of a life-threatening case using a new method. In this regard, it was stated that using the capacity of Iranian traditional medicine (ITM) as one of the complementary therapies can help in the treatment of this disease. In this case report, we documented the successful treatment of a severe and refractory warm AIHA in a boy, who was resistant to the currently recommended treatments such as corticosteroids, rituximab, and cyclosporine at different time periods. Based on ITM, a novel treatment was performed, which was daily swallowing 4-6 live small freshwater fishes (from Cyprinidae family) for an eight-week period and later being tapered. As a result, this treatment had a rapid response with no side effects. At the time of performing this study, the patient was in his 5th-year disease-free period. For future research, we recommend the researchers to study the use of this novel treatment in case of resistance to the current established therapies of warm AIHA disease.

Dear Editor in Chief: Recently, some evidence has shown that the failure of iron homeostasis may occur in critically ill patients and can lead to iron overload. Elevated ferritin levels as a body iron burden index in critically ill patients may be associated with depressed level of consciousness and greater mortality. However, the necessity of using iron-chelating agents in clinical situation is still unknown for these cases. Oxidative stress, inflammation and increased iron stores are concepts related to each other. Oxidative stress has been defined by an imbalance between pro-oxidant and antioxidant conditions, which along with boosted inflammatory response have been commonly reported in critical situation in patients admitted to the intensive care unit (ICU). Inflammation and oxidative stress can also be considered as one of the most important probable causes of increased iron stores in critical patients...