Journal of Kerman University of Medical Sciences
Year:2023 | Volume:30 | Issue:3|Papers Count:11

Background: One of the principal cigarette smokes (CS) mediated diseases is chronic obstructive pulmonary disease (COPD). Methods: In the current case-control study, the relationship between the polymorphisms of interleukin-10 (IL-10), transforming growth factor-β, 1 (TGF-β, 1 ) codon 10, TGF-β, 1 codon 25, interferon-γ,(IFN-γ, ), and tumor necrosis factor-α,(TNF-α, ) in 213 individuals with COPD and susceptibility to the disease, with 100 healthy age and gender-matched people as a control group, was investigated using PCR-ARMS (polymerase chain reaction-amplification refractory mutation system). Moreover, the combination of the polymorphisms of TGF-β, 1 codon 10. 25 regarding this susceptibility was studied in the same condition. Results: There was a significant difference between polymorphism of TGF-β, 1 codon 10 ( + 869 T/C), codon 25 (G + 915C), and susceptibility to the disease (OR = 0. 50,(95 %CI = 0. 24-1. 07, p = 0. 05), ORCC = 5. 31,(95% CI: 1. 22-23. 2),p = 0. 02), thus polymorphism of IL-10 and TGF-β, 1 increased the risk of susceptibility to COPD but the polymorphisms of TNF-α,(G-308A) and IFN-γ,( + 847 T/A) did not show any association. Conclusion: All in all, it is recommended that the patients carrying the above-said genotypes should be paid proper attention, especially those who are exposed to chemicals at their workplaces, pollution, and cigarette smoke.

Background: Alzheimer›, s disease (AD) is characterized by excessive deposition of the amyloid-β,peptide (Aβ, ) in the central nervous system and reducing its level is the goal of many medications. This study aimed to investigate the effect of aerobic training and omega-3 intake on Aβ, 42, neprilysin, and γ,-secretase levels in the hippocampus of male rats Alzheimer›, s model. Methods: Fifty male Wistar rats (age: 12 weeks-old and weight: 222. 31 ±,11. 91 g), were divided into the five groups including control Alzheimer’, s (AC), Alzheimer’, s with omega-3 intake (AO), Alzheimer’, s training (AT), Alzheimer’, s with omega-3 intake and training (AOT) and Healthy Control (HC). AD was induced by the injection of homocysteine (60mM) into the rat brain ventricle. Training on the treadmill with a speed of 20 m/min (60 minutes and 5 days/week) was applied. The supplement group received omega-3 supplement 800 mg/kg of body weight, daily for eight weeks. Levels of Aβ, 42, γ,-secretase, and neprilysin protein were measured using ELISA method. In data analysis, one-way ANOVA and Tukey test as post hoc were used (P < 0. 05). Results: The obtained results showed that the level of Aβ, 42 in the hippocampus of AC group was significantly higher than that of the HC group (P = 0. 001). Also, the level of Aβ, 42 in the hippocampus of AC group was significantly higher as compared to AO, AT, and AOT groups (P values 0. 001, 0. 007, and 0. 003 respectively). The γ,-Secretase level in the hippocampus of AC group was significantly higher than that in the HC group (P = 0. 001). Moreover, the γ,-secretase levels in the hippocampus of the AC group were significantly higher compared to AO, AT, and AOT groups (P values: 0. 002, 0. 001, and 0. 001 respectively). There was no significant difference in neprilysin levels of the hippocampus among the research groups (P = 0. 534). Conclusion: It appears that exercise training and omega-3 consumption, can affect amyloidogenic pathways through reducing the level of γ,-secretase, and lead to reduced level of hippocampus Aβ,in AD subjects. Therefore, aerobic exercise training and omega-3 intake can be studied as a complementary therapy in Alzheimer’, s patients.

Background: Breast cancer patients’,caregivers seem to face several challenges and problems that affect their physical and mental health. Spiritual intelligence, as the foundation of individuals›,beliefs, plays an essential role in promoting the mental health of caregivers. The aim of this study was to determine the relationship between caregiver burden and spiritual intelligence in caregivers of breast cancer patients. Methods: This descriptive-correlational study was conducted on 309 breast cancer caregivers at Shahid Ramezanzadeh Radiotherapy Center, Yazd, Iran, based on census method in 2020. Data were collected using three questionnaires: Demographic Information, caregiver burden inventory (CBI) and Spiritual Intelligence Self-Report Inventory (SISRI). Statistical analyses were done using Spearman’, s rank correlation, Mann-Whitney and Kruskal-Wallis test in SPSS-20. Results: The mean total score of caregiver burden was 48. 12 ±,20. 93. The highest and the lowest mean scores were in the dimension of social pressure (10. 33 ±,5. 09) and physical pressure (8. 14 ±,4. 09), respectively. The mean total score of spiritual intelligence in caregivers was (67. 32 ±,30. 84). The highest mean score was in the transcendent awareness dimension (20. 54 ±,18. 75) and the lowest was in the personal meaning production dimension (13. 07 ±,6. 10). There was a significant inverse relationship between the mean total score of spiritual intelligence and caregiver burden (r =-0. 63, P < 0. 001). Conclusion: Caregivers of breast cancer patients who have more spiritual intelligence, experience less burden of care. In fact, higher levels of spiritual intelligence act as a protective factor against the burden of care. Therefore, strengthening spiritual intelligence in oncology and radiotherapy centers is recommended.

Background: The presence of autoantibodies is a prerequisite for the diagnosis of autoimmune hepatitis (AIH). However, most autoantibodies are not disease-specific, and serological overlap between AIH and other chronic liver diseases is common. Since the prognostic parameters of AIH are limited, this study aimed to investigate the relationship between histopathological findings on liver biopsy with different types of autoantibodies associated with AIH and how autoantibodies can predict the severity and extent of disease. Methods: The present study was performed on 30 patients with a definite diagnosis of AIH according to the International Autoimmune Hepatitis Group (IAIHG) criteria. Pediatric AIH patients underwent liver tissue examinations at the time of diagnosis at accession, which confirmed characteristic histological changes. AIH-related serologic major and minor autoantibodies were measured using indirect immunofluorescence assays and ELISA kit (EUROIMMUN, Germany), respectively, and were compared within all patients, and the results were recorded. Finally, the obtained data were analyzed using SPSS V25 software. Results: Out of 30 patients, 17 (56. 66%) were female, and the age range of patients was 17-11 years (8. 46 ±,6. 95). Anti-nuclear antibody (ANA) (73. 3%), smooth muscle antibody (SMA)-anti-smooth muscle actin antibody (ASMA) (70%), perinuclear antineutrophilic cytoplasmic antibodies (p-ANCA) (63%), and liver kidney microsomal (LKM) (43. 3%) were the most common autoantibodies found in children with AIH. There was a significant relation between the severity of histological findings and the presence of LKM antibodies (P < 0. 05). The highest sensitivity for predicting severe AIH based on histopathological findings was ANA autoantibody positivity and the presence of at least two primary autoantibodies (LKM and SMA-ASMA). On the other hand, positive LKM antibodies had the highest specificity and positive predictive value (PPV) in AIH severity prediction. Conclusion: The results of the present study suggested that there might be a significant correlation between the presence of primary LKM autoantibodies and biopsy results, so it can possibly act as an accurate autoantibody for predicting the severity of AIH, while other AIH-related autoantibodies did not seem to have a significant correlation with biochemical and histological findings.

Background: Elevated serum levels of osteopontin (OPN) have been associated with cardiovascular disease, diabetic nephropathy, and autoimmune disease activity. The aim of this study was to investigate the relationship between OPN serum levels and renal damage in type 2 diabetes patients. Methods: This analytical cross-sectional study was carried out in Yazd, Iran from April to September 2017. Micro-albuminuria and creatinine (Cr) in 750 patients were measured and 180 included patients were divided into the three groups of 60 subjects based on the level of micro-albuminuria,normal (group A), micro proteinuria (group B) and macro proteinuria (group C). Body weight, height, blood pressure, body mass index (BMI), HbA1c and OPN were assessed. Results: Among 179 patients, 60 of them were normal for proteinuria, 59 patients had micro-proteinuria and 60 ones had macroproteinuria. The mean age of participants was 58. 96 ( ±,11. 10) years (range 26-80 years), 90 patients (50. 8%) were males and 88 ones (49. 2%) were females. The mean OPN levels were significantly higher in group C compared to group B, and in group B compared to group A (P = 0. 0001). Serum OPN was correlated positively with HbA1c (P: 0. 012), Cr (P = 0. 010) and glomerular filtration rate (GFR) (P = 0. 002). There was a significant difference in the mean of OPN level among the subgroups with the history of ischemic heart disease (IHD) and HbA1C (P = 0. 035, and 0. 047 respectively). Conclusion: These findings suggest that OPN is involved in chronic disease activity, and there is an independent association between plasma levels of OPN, and nephropathy in diabetic patients.

Background: Polycystic ovary syndrome (PCOS) is one the most common diseases in women in the fertility age. PCOS alters ovarian follicles and affects blood lipid profiles, liver enzymes and hormones. In this study, we tried to investigate the effects of coenzyme Q10 (CoQ10) on PCOS pathological conditions. Methods: Twenty-four female rats were randomly divided into the three groups,1: control group, 2: PCOS group (received 1 mg/ kg letrozole daily for 21 days, PO) and 3: PCOS + CoQ10 group (received 1 mg/kg letrozole with 10 mg/kg of CoQ10 for 21 days orally). Blood lipid profiles, liver enzymes, blood glucose and testosterone levels were measured and ovarian histopathology was evaluated. Results: Histological examination showed reduced number of antral follicles in PCOS + CoQ10 group as compared with PCOS group (P < 0. 001). PCOS increased the alanine aminotransferase (ALT) enzyme by acting on the liver (P < 0. 01). Administration of CoQ10 during PCOS induction was able to reduce ALT levels (P < 0. 01). PCOS increased the cholesterol (P < 0. 05), fasting blood sugar (FBS) (P < 0. 05), triglyceride (P < 0. 001), low-density lipoprotein (LDL) (P < 0. 05) and testosterone levels (P < 0. 001) compared to the control group. However, CoQ10 treatment significantly reduced the above-mentioned parameters compared to the PCOS group. Conclusion: The results of the present study confirm that CoQ10 has a therapeutic potential for PCOS-induced lipid and hormonal changes and ovarian tissue damages. CoQ10 supplementation and its concomitant use with letrozole could inhibit the development of PCOS in rats. Testosterone reduction could be an important mechanism for CoQ10 beneficial effects.

Background: The COVID-19 pandemic had caused unexpected strain on healthcare systems in most countries in 2020. Although different survival models were used in clinical decision-making for COVID-19 patients, the effect of different risk factors in patients has not been identified clearly. Elderly patients, especially with comorbidities, were introduced as the most susceptible group at the risk of death. This study aimed to determine the threshold of age that influences chronic diseases and other factors that increase the cure rate of COVID-19 patients. Methods: This observational study was conducted at Shahid Sadoughi hospital in Yazd, Iran. All participants were older than 18 years old with confirmed COVID-19 and completed the day-30 and day-180 follow-ups. The Bayesian method was used through the cure rate models, practical models in survival with a single change-point to detect the threshold of age, illustrating each risk factor’, s effect on the cure rate of patients. Results: The analysis included 901 confirmed COVID-19 cases with a mean age of 54. 93 ±,17. 37 years. From all, 58. 7% (n = 529) were men and 9. 9% (n = 83) death occurrences were recorded. Sixty-five years of age was estimated as the effective changepoint that could change the cure rate of patients at the end of the follow-up times. Conclusion: The cure rate at any time during 30 and 180 follow-up days was noticeably higher in COVID-19 patients younger than 65 years who had cancer.

Background: Class II malocclusion is one of the most prevalent occlusion discrepancies. Knowledge of growth changes in craniofacial components can help clinicians plan orthodontic treatment, determine the proper timing to initiate the treatment, and predict the treatment outcome, especially in growth modification protocols. This study evaluates craniofacial skeleton changes in class II malocclusion subjects compared to class I malocclusion. Methods: In this cross-sectional study, cephalograms of 858 individuals aged between 7 and 23 were investigated. The samples were divided into the class I group (ANB angle 0–, 4) and class II group (ANB angle ≥,4 degrees), including 426 and 432 cephalograms, respectively, and each group was divided into seven subgroups considering age. Cephalometric analysis was performed using OnyxCeph software, and statistical analyses of variance, mean, paired t test, and independent samples t test were performed using SPSS software. Results: The results showed no significant differences between class I and class II groups in variables related to the cranial base and vertical facial height. In class II groups, the SNA angle was significantly greater. The total mandibular height (Co-Gn), facial angle (Npog-FH), and SNB angle were significantly greater in class I compared to the class II group. Conclusion: Protrusion of the maxilla affects the formation of class II malocclusion, but an underdeveloped mandible is the main component of Class II malocclusion formation. With increasing age, especially after puberty, the mandible may become more retruded in class II patients.

Hairy cell leukemia (HCL) and HCL-like disorders, including HCL-variant, are disorders of heterogeneous mature lymphoid B-cells known for their hairy cell infiltration accompanied by a specific genetic profile, various clinical presentations, and, as they are uncommon hematological malignancies characterized by pancytopenia, the need for appropriate therapy. Sometimes HCL creates diagnostic challenges for clinicians, and its coincidence or association with mast cell and plasma cell infiltration is a rare condition. Herein, we report a case of HCL with confusing manifestations. A 44-year-old man was referred to the hospital for weakness, fatigue, and watery, non-bloody diarrhea. The laboratory tests showed pancytopenia, leading to a referral for bone marrow aspiration and biopsy. Medium to large cells exhibiting widespread cytoplasm, oval nuclei similar to monocyte nuclei (kidney-shaped) accompanied by an increased number of mast cells, and plasma cells were observed in the biopsy sample. In flow cytometry, the neoplastic cells were positive for CD19, FMC7, and the co-expression of the CD20/CD25, CD11C/CD22, and CD103 markers. In immunohistochemical staining, the mast cells were positive for CD117, the plasma cells were positive for CD138, and the hairy cells were positive for CD20. Overall, hematopathologists must be aware of various morphologic confounding factors such as lack of typical cell morphological features and increased plasma cell and mast cell infiltration in the diagnosis of patients with HCL.

Background: Fluoride can arrest dental caries and prevent its progression. The most important advantage of fluoride is that there is no need for cavity preparation,in this respect, it eliminates the utilization of air motors. Furthermore, it provides a good choice for younger children without cooperation ability and patients requiring special care. This study aimed to review the literature about fluoride and to advise public health specialists about the types of fluoride and that fluoride is still a right and safe choice in the COVID-19 pandemic. Methods: Through a search in electronic databases containing Medline, Scopus, Web of Science, and PubMed, a total of one hundred forty-two systematic reviews and original articles in the period of 2008-2021 were selected. The following keywords were used: pediatric dentistry, coronavirus, oral health, tooth remineralization, COVID-19, fluoride, dental fluorosis, and preventive dentistry. Results: Data from selected papers was extracted and classified to evaluate the importance of fluoride in the prevention of dental caries. Fluoride has been selected as a good choice for the prevention and control of dental caries during the coronavirus pandemic. Conclusion: The research has focused on increasing the awareness of public health specialists, advising them that any type of fluoride use is expedient and safe during the COVID-19 pandemic.

Many healthcare providers have come to an understanding of the need for addressing the spiritual dimension of human beings. From a holistic view, human beings are first and foremost spirits and should be regarded as a whole, not merely their bodies (1). Contrary to the notion of looking at patients as cases of a disease occupying hospital beds and subject to different drugs or medical interventions, patients are more and more being recognized as humans who should be considered as a whole, including physical and spiritual dimensions that correlate with and influence each other. In view of the spiritual dimension overarching other dimensions of human beings (2) and the spiritual distress faced by many patients, the healthcare system should take care not to disturb the spirituality of patients but rather try to enhance and improve it (3). Spiritual care, in this way, can improve the effectiveness and quality of care services through reform in professional care by addressing spiritual needs as a part of holistic care (4). Spiritual care or caring spiritually To meet patients’,spiritual needs, some healthcare institutions have recruited specialized personnel as chaplains or pastoral care providers (5). This approach to spiritual care is mainly targeted toward patients with particular needs including end-of-life care, critical care patients, or palliative care (6). With the recognition that every human being has spiritual needs, it seems necessary to extend spiritual care coverage to include all patients. This could be accomplished through integrating spiritual care and incorporating it with all healthcare processes, which requires the engagement of all healthcare providers. The appropriate attention of healthcare professionals to spirituality as a dimension of their professional activities requires a degree of capabilities and competencies of healthcare providers regarding spiritual care (7). The competencies encompass not only a set of knowledge and skills but also all factors necessary to perform the expected tasks with excellence, including attitude, emotions, and motivation. Thus, a main part of the competencies of healthcare providers lies in the inner motivation, which comes from the personal spirituality of healthcare providers and is a significant determinant of effective spiritual care (8). In other words, those who are comfortable with their own spirituality are more likely to provide care spiritually. Therefore, the departure point in any movement towards spreading and consolidating spiritual care is the spirituality of healthcare providers, as it has been embodied in the charter of spiritual care for patients (9). This denotes that to radiate and spread spirituality to others, one should be blessed with spirituality, whereas the exchange between patients and healthcare providers could strengthen the spirituality of both parties. Within a culture of improved spirituality of healthcare providers, all the care is provided embedded with spirituality (10),therefore, there is an atmosphere of caring spiritually spread throughout the health centers. . .