Galen Medical Journal
Year:2022 | Volume:11 | Issue:1|Papers Count:52

Background: Some studies highlighted the role of Jujuboside A as a potent antioxidant on ischemic neurons. However, the definitive effect of this substance on the change in the expression of the neuroprotective genes has not been clearly identified. Therefore, this study aimed to investigate the effects of Jujuboside A on the expression of proliferation-inducing genes and cell count enhancement in the hippocampus after the induction of transient global ischemia/reperfusion. Materials and Methods: This experimental study was performed on 24 male Wistar rats in four groups control, ischemia, vehicle, and Jujuboside A. Three days after induction of ischemia, the hippocampus of animals was removed and isolated from brain tissue. In order to investigate the results of the intervention, the expression of nuclear factor-κ, B (NF-κ, B), nerve growth factor (NGF), and Brain-derived neurotrophic factor (BDNF) genes were determined using real-time polymerase chain reaction. Results: The results showed that NGF expression was significantly higher in the Jujuboside A group than in the ischemic group (P<0. 05). Moreover, the expression of BDNF in the Jujuboside A group was increased compared to the ischemic group. However, the expression of NFκ, B in the Jujuboside A group was lower than that of the ischemic and control groups, but these changes were not significant (P>0. 05). Conclusion: Jujuboside A can increase the expression of NGF by promoting a protective effect on the hippocampus after transient global ischemia/reperfusion.

Background: Disc herniation is broadly defi ned as a localized or focal displacement of disc material beyond the limits of the intervertebral disc space. The disc material may be the nucleus, cartilage, fragmented apophyseal bone, annular tissue, or any combination thereof. Laser surgery is one of the treatment modalities for treating patients with lumbar disc herniation. This study aims to examine the effect of Percutaneous Laser Disc Decompression (PLDD) in patients with lumbar disc herniation. Materials and Methods: This study was conducted on 58 patients who underwent PLDD (optical fiber inserted through an 18G needle, 8 joules, and 8 watts). Individuals were monitored before and after treatment using the comparing visual analog scale (VAS) pain score (from 0 [no pain] to 10 [severe pain]). Results: The mean age of participants was 63. 19±, 13. 48 years. Regarding gender, 24 patients (41. 4%) were female. The mean VAS score before surgery was 8. 73±, 1. 29, and VAS score after surgery was 55. 2±, 2. 71, which means pain was significantly reduced (P<0. 001). Conclusion: The patients’,post-PLDD pain may decrease,hence, PLDD can use as an appropriate method for treating lumbar disc herniation.

Background: Patellofemoral Pain Syndrome (PFPS) is a common anterior knee compartment pain etiology. It has been aimed to assess the ultrasonographic findings of the patellofemoral joint in patients with PFPS versus healthy individuals. Materials and Methods: The current case-control investigation was performed on 30 cases suffering from patellofemoral joint pain and 30 healthy individuals in Isfahan during 2020-21. All cases underwent ultrasonography to assess cartilage thickness, sulcus angle, and sulcus depth. We also measured the Q angle with a manual goniometer. Results: In healthy individuals, Q angle scores were statistically lower than in the cases group (P=0. 002). The sulcus angle was remarkably higher among the patients compared to the controls. The cartilage thickness (P=0. 88) and sulcus depth (P=0. 543) scores had no statistical difference between the PFPS and healthy subjects (P<0. 05). Conclusions: Patients with PFPS had significantly higher Q angle and lower sulcus angle than the healthy controls.

A professor of neurology often asked their undergraduate medical students: "If you were exiled to an island and could only pick one thing up with you, what would you opt for? ". . .

Background: Internal carotid artery (ICA) agenesis occurs when one or both of the blood vessels that supply blood to the brain do not develop. Congenital agenesis of the ICA rarely occurs. It is usually asymptomatic but may sometimes associate with neurological symptoms such as migraine and pulsatile tinnitus. Moreover, differentiating it from occlusion of ICA is important in patients with stroke. Case Report: We report two cases (63-years-old man and 69-year-old woman) of asymptomatic unilateral ICA agenesis who were referred to our cardiovascular hospital for coronary artery bypass graft. Due to a suspicious history of transient ischemic attack, the patients underwent carotid ultrasonography. With findings suggestive of unilateral ICA agenesis at color Doppler, patients underwent computed tomography angiography that confirmed the diagnosis. Conclusion: Suspecting ICA agenesis at color Doppler imaging of the neck and differentiating it from occluded ICA at CT angiography is important for correct diagnosis and management of the patients.

Background: Schizophrenia (SCZ) is a major psychiatric disorder with unclear etiology and biological diagnosis. Paranoid personality disorder (PPD) is a type-A personality disorder characterized by paranoia and generalized mistrust. The etiology and molecular mechanisms of SCZ and PPD are not clarified. The present study aimed to examine the expression alteration of three major genes of mitochondrial complex I in the peripheral blood of patients with SCZ and PPD, and its correlations with clinical features of patients, especially the five major personality traits. Materials and Methods: This case-control study was performed on 735 SCZ, 742 PPD, and 750 non-psychiatric individuals. The mRNAs level of NDUFS1, NDUFV1, and NDUFV2 were assessed using quantitative real-time polymerase chain reaction, and their correlations with psychiatric symptoms were assessed by the positive and negative syndrome scale and the brief psychiatric rating scale tests, as well as personality traits that were evaluated by NEO Five-Factor Inventory. Results: Findings showed significant overexpression of NDUFS1, NDUFV1, and NDUFV2 in patients with SCZ (P=0. 001, P=0. 002, and P=0. 004, respectively) and PPD (P=0. 001, P=0. 003, and P=0. 006, respectively) compared with non-psychiatrists. In addition, these genes were associated with positive psychiatric symptoms and neuroticism in SCZ (P=0. 008) and PPD (P=0. 01). Conclusion: Overexpression genes that encode subunits of complex I play an important role in SCZ and PPD etiology and severity of symptoms. It may bring evidence about the significant role of bioenergetics dysfunction in psychotic behaviors in different psychiatric situations.

Background: According to a mounting body of evidence, recent observations have highlighted considerable association between obstructive sleep apnea (OSA) syndrome and patients’,obesity and inflammation, however the exact underlying mechanisms remain to be fully understood. In this study, the relationship between OSA and Interleukin-6 and Tumor necrosis factor-alpha was assessed in obese patients and their serum concentrations were compared to non-OSA obese subjects. Materials and Methods: This case-control study was conducted on forty-six obese OSA patients (body mass indices, BMI>30) and 42 obese but otherwise healthy individuals who were admitted to the pulmonary or obesity clinics of the Hazrat-e Rasool General Hospital (Tehran, Iran) between November 2019 and May 2020 were included. The participants completed the NOSAS, EPWORTH and STOPBANG questionnaires. Tumor Necrosis Factor-Alpha (TNF-α, ) and Interleukin-6 (IL-6) serum concentrations were determined using the enzyme-linked immunosorbent assay (ELISA) method. Results: Compared to the non-OSA group, OSA patients had higher systolic and diastolic blood pressure, pCO2, bicarbonate (HCO3) and hemoglobin and lower high-density lipoprotein (HDL) values. IL-6 and TNF-α,serum levels were not significantly different between both groups. Univariate and multivariate linear regression models showed that BMI, systolic blood pressure, pCO2 and HCO3 can positively affect the serum TNF-α,and systolic blood pressure and HCO3 can also positively affect the serum IL-6 values in patients with the OSA. Conclusion: This investigation suggests that among the OSA patients, the heightened inflammatory profile may be influenced by the high BMI. Furthermore, the exclusive relationship between different disease biomarkers and inflammatory agents in OSA patients is intriguing and needs further research.

Background: Chlordiazepoxide is an anti-anxiety drug commonly used by young people and pregnant women to reduce anxiety. The adverse effects of this drug on cholinergic nervous system function have been demonstrated. Therefore, in this study, the effect of chlordiazepoxide consumption during pregnancy was evaluated on the rats infant hippocampus. Materials and Methods: Nine pregnant Wistar rats were randomly divided (n=3 per group) into control, experimental (daily intraperitoneal injection of chlordiazepoxide at a dose of 10 mg/kg for 21 days), and vehicle (same amount of normal saline) groups. Two weeks after birth, the neonate brains were removed from the skull and prepared for Nissl and TUNEL stainings. The expressions of pro-and anti-apoptotic genes were evaluated. Results: The number of healthy neurons in different areas of the neonatal hippocampus in the experimental group was significantly reduced compared to control and vehicle groups, and the number of apoptotic bodies was increased (P<0. 05). However, there was no significant difference between the numbers of these cells in the control and vehicle groups. The expression of pro-apoptotic genes in the experimental group increased significantly compared to the control group instead of the expression of anti-apoptotic genes decreased significantly. Conclusion: Chlordiazepoxide during pregnancy can cause neuronal damage in the hippocampus of neonatal Wistar rats.

Background: The brain is the most complex and vital organ of the human body. It requires 20-25 % of the total oxygen supply. Because of the limited oxygen and glucose reserves, brain tissue is sensitive to ischemic injury. Indeed, the tolerance of brain tissue for ischemic injury is fragile. Currently, few therapeutic strategies could provide complete neuroprotection. Despite decades of intense research, the beneficial treatment of stroke remains limited. Hence, we aimed to investigate the effect of curcumin on the CA1 region of the hippocampus in a rat model of ischemia/reperfusion (I/R) injury. Materials and Methods: In this experimental research, 24 male Wistar rats were randomly divided into three groups (n=8 per group) as control, I/R, and I/R plus curcumin. All rats underwent bilateral common carotid artery ligation followed by reperfusion. In the treatment group, curcumin (300 mg/kg) was injected 30 minutes before ischemia. Morphological changes of the hippocampus were assessed using Nissl staining, and apoptosis was determined via TUNEL immunohistochemical assays. Results: Nissl staining data showed that the administration of curcumin significantly ameliorated the CA1 pyramidal cell loss due to transient global I/R injury. TUNEL immunohistochemical assays demonstrated that the number of apoptotic cells was significantly lower in the curcumin group than in the I/R groups. Conclusion: Our study demonstrates that curcumin had beneficial activity against ischemia and played a neuroprotective role in the pathogenesis of I/R injury.

Background: Colorectal cancer is a common and fatal disease worldwide with increasing diagnosed cases yearly. Moreover, about 90% of deaths associated with cancers occur due to metastasis, which overcomes tight junction proteins such as claudin and occludin. The present study aimed to evaluate the significance of claudin and occludin expression change in human colorectal cancer. Materials and Methods: In this case-control study, 38 colorectal cancer patients were compared with normal samples regarding the expression levels of claudin and occludin genes by polymerase chain reaction. Results: The expression levels of claudin and occludin significantly decreased in tumor samples compared to normal samples. Conclusion: The change in the expression level of the claudin and occludin genes could be considered an influential factor in turning normal healthy tissues into cancerous cells.

Dear Editor, Diabetes is a group of metabolic disorders characterized and identified by the presence of hyperglycemia in the absence of treatment. . . .

Background: Autism spectrum disorder (ASD) is identified by developmental deficits that lead to repetitive/stereotypic patterns of behavior and impaired social interactions. Studies have been indicated that exercise can decrease stereotypic behaviors in animal models of ASD. This research was designed to discover the effects of different models of forced exercise on stereotypical behaviors in a rat model of ASD induced by thimerosal (THIM). Materials and Methods: Fifty-six male Wistar rats were divided into eight groups. The rats were received saline (1 ml/kg) or THIM (300 μ, g Hg/kg) by four intramuscular injections on 7, 9, 11, and 15 postnatal days. The rats were also treated by several protocols of treadmill exercise, including non-sedentary, sedentary, protocol 1, protocol 2, and a combination of protocols 1 and 2. Results: Our study showed that THIM decreased the grooming time compared to the control group. Moreover, protocol 2 exercise significantly decreased grooming time in stranger zone 2 compared to the THIM group. Conclusions: Our results showed that stereotypical behaviors exaggerated by THIM and moderate exercise could improve ASD-associated behaviors in the THIM-treated rats. Hence, moderate exercise may be a useful protocol for the treatment of ASD.

Background: Fair Distribution of Medical Facilities is one of the most critical issues affecting economic and health indicators. Iranian Social Security Organization (ISSO) is a nongovernmental organization responsible for providing medical services to insured individuals in 77 hospitals, 265 polyclinics, and clinics that has faced much demand from the insured to build a new medical center. So, Due to the significant role of ISSO in meeting the medical needs and its high coverage (almost 42%) in Iran, we aimed to identify the factors influencing medical facilities' fair distribution in the ISSO. Materials and Methods: This applied study was conducted as a descriptive study in the ISSO in 2018. Variables affecting medical facilities distribution were elicited from the literature review and through an interview with 16 experts who were occupied in the healthcare management field. Then, a Likert scale-based questionnaire with 56 items in 7 sections was developed. Questionnaires were distributed among 456 person received questionnaires, and 415 responded to all questions. All participants were experts in the healthcare section of the ISSO all over the country. Data were analyzed via exploratory and confirmatory factor analysis and structural equations using SPSS 23 and AMOS-24 software. Results: By exploratory and confirmatory factor analysis, seven main factors (demographic factors, geographical factors, functional factors, structural factors, humanistic factors, economic factors, and Contract parties factors) were identified as critical factors affecting medical facilities distribution. Each aspect included many components. AMOS software showed the significance of variables by P-value and critical ratio (CR) indices to analyze the conceptual model of the research. Function factors with standard coefficients of 0. 85 had the most, and economic factors with a standard coefficient of 0. 53 had a minor effect on the distribution of medical facilities in the ISSO. Conclusion: To have a more efficient medical facilities distribution in the ISSO must consider all identified factors, special attention should be given to the maximum use of available medical facilities. Furthermore, more attention should be paid to distributing human resources, finance, and medical equipment.

Background: Due to the importance of appropriate sedation and immobility of the patient in cataract surgery, this study was performed to compare the safety and efficacy of a combination of ketamine and propofol (ketofol) in two different ratios. Materials and Methods: This double-blind, randomized clinical trial was carried out on patients who underwent cataract surgery in Feyz Hospital, Isfahan, Iran. Patients were randomly divided into group I (n=30, ketamine/propofol 2: 1 ratio) and group II (n=30, ketamine/propofol 4: 1 ratio). The quality of sedation (using Ramsay sedation scale [RSS]), cardiovascular parameters such as systolic blood pressure (SBP), diastolic blood pressure (DBP), arterial blood pressure, SPO2, and heart rate, as well as patient and surgeon satisfaction, were evaluated in both groups. Results: The SPO2 and heart rate were significantly lower and higher in group I than in group II during various surgery times, respectively (P=<0. 0001 for both comparisons). In terms of patient and surgeon satisfaction, it was found that no patient was dissatisfied with the sedation status in group II, while four patients (13. 3%) in group I were dissatisfied (P=0. 005). However, RSS, SBP, and DBP were significantly different between the two groups (P>0. 05 for all comparisons). Conclusion: It seems that the use of lower ketamine doses in combination with propofol (4: 1) is a safe and preferable option to provide sedation in cataract surgery.

Background: One of the most important factors in reducing the birth rate is male infertility, and one of the main reasons for male infertility is scrotal hyperthermia (SH). Therefore, this study aimed to investigate the protective effect of coenzyme Q10 (CoQ10) along with Fe2O3 nanoparticles on semen parameters in rats with SH. Materials and Methods: Forty-eight adult male Wistar rats were divided into eight groups: healthy control, control group receiving Fe2O3 nanoparticles, control group receiving CoQ10, control group receiving Fe2O3 nanoparticles plus CoQ10, SH group, SH group receiving CoQ10, SH group receiving Fe2O3 nanoparticle, and SH group receiving Fe2O3 nanoparticles plus CoQ10. After killing rats, semen was collected from epididymal tissue, and parameters such as sperm viability, motility, concentration, and morphology were studied. Results: SH significantly reduced sperm concentration, motility, and viability, as well as altering sperm morphology in rats. Nevertheless, CoQ10 strongly improved sperm parameters in SH rats. Fe2O3 nanoparticles led to a sharp decrease in sperm parameters,however, during the simultaneous administration of Fe2O3 nanoparticles with CoQ10, improvement in sperm parameters was seen in the SH rats. Conclusion: Our findings suggest that CoQ10, along with Fe2O3 nanoparticles, has a protective effect against spermatogenic cell death induced by SH. Thus, green synthesis of nanoparticles with the administration of antioxidants, including CoQ10 is recommended for the treatment of SH.

Background: There are several strategies in the management of treatment-resistant depression (TRD), including the administration of other antidepressants, augmentation therapy, electro-convulsive therapy (ECT), and a combination of ECT and antidepressants. The safety of ECT combined with any medication must be confirmed. The aim of this study was to assess the safety of duloxetine and ECT combination therapy. Materials and Methods: In this randomized clinical trial, the probable side effects of ECT plus duloxetine were compared with ECT plus sertraline in two groups of admitted TRD patients. Patients with general medical diseases and/or any contraindications to ECT or any of the two drugs were excluded. General side effects, including nausea, vomiting, and headache reported by patients (hours after ECT) as well as cardiotoxicity by electrocardiogram (immediately after any ECT episode), cognitive status by mini-mental state examination (MMSE, one month after the last ECT), and seizure duration were recorded for each patient. Results: No significant differences were observed in nausea, vomiting, headache, and myalgia between ECT+duloxetine and ECT+sertraline groups. Heart rate, QTc interval, ST-T change, and the incidence of arrhythmia were the same between the two arms of the study. Also, no prolonged seizures and status epilepticus were recorded among the studied patients. The MMSE revealed no marked differences in the cognitive status among patients of the two groups. Conclusion: ECT+duloxetine and ECT+sertraline were equally safe in patients with TRD.

Background: Patients with Coronavirus disease 2019 (COVID-19) pneumonia are at risk of hypoxemic respiratory failure. Hence, many patients may require noninvasive positive pressure ventilation (NIPPV) during their hospital course. Using mechanical ventilation such as bilevel positive airway pressure or a ventilator to provide NIPPV may result in adverse events, including barotrauma. Case Report: We reported two cases (40-and 43-years-old men) of severe COVID-19 pneumonia and hypoxemic respiratory failure who underwent NIPPV for respiratory support. These cases were complicated with barotrauma in their course of hospital admission that manifested with pneumoscrotum. Conclusion: In the cases of pneumoscrotum, it is crucial to understand its underlying etiology and origin since this clinical finding may be the outcome of life-threatening illnesses requiring urgent treatment.

Background: Glioblastoma (GBM) is the most common primary central nervous system malignancy with a low survival without extra logistics. Currently, there is no definitive chemotherapy among the studied options. This study aims to evaluate the neuroprotective effects of dimethyl fumarate (DMF) on surgical brain injuries in patients treated for GBM. Materials and Methods: This randomized, phase II, placebo, triple-blinded, controlled trial was performed on 36 patients with a diagnosis of GBM. All the patients received DMF (240 mg, three-times per day) or placebo (with the same shape and administration route) one week before surgery. Also, patients in both groups after the operation received standard treatments (radiotherapy plus chemotherapy). In addition, Kanofsky's performance status (KPS) score was evaluated at baseline and one month later. Also, serum S100β,was measured 48 hours before and after surgery. Results: There was no significant difference among DMF and control groups with regard to age, gender, and the extent of resections (P˃, 0. 05). The most adverse event in both groups was a headache. Although the serum S100β,level was not markedly changed after surgery, the mean KPS in the DMF group was higher than in the control group after surgery. Conclusion: The DMF could be a possible good regime for the treatment of GBM,however, questions are raised regarding its efficacy and application for the addition to standard treatment.

Dear Editor, After diabetes and thyroid disorders, primary hyperparathyroidism (pHPT) is the third most common endocrine disorder [1]. This complication usually occurs as a benign parathyroid adenoma,hyperplasia and parathyroid carcinoma are less observed. . . .

Background: Adenotonsillar hypertrophy (AH) is the most common cause of respiratory obstruction of the upper airway, and tonsillectomy is one of the most frequently performed surgical interventions in children. It has been proposed that medical treatment in an allergic state could decrease the size of AH. Therefore, this study aimed to compare the outcomes of surgery and medical therapies among allergic children with AH. Materials and Methods: This case-control study was carried out on 68 children with AH in an allergic state who were referred to the Pediatrics Hospital of Tabriz Medical University. They were divided into two groups and matched according to sex, age, and primary clinical signs and symptoms. Patients received surgery (case group) and medication (control groups) for treated AH. Finally, they were compared according to the results of treatment and recurrence rate. Results: The mean age of children in the case and control groups was 6. 3±, 2. 3 and 6. 8±, 2. 1 years, respectively. There was no significant difference in improving clinical signs and symptoms between the two groups. In the case group, no improvement of clinical signs and symptoms was observed in one patient compared with two patients in the control group. In the control group, no decrease in the size of the tonsils was observed in three patients. Recurrence of clinical signs of AH was observed in six (17. 6%) patients of the control group, and there was a significant difference between the two groups (P<0. 001). Conclusion: Our findings showed no significant differences in the outcomes of the two therapeutic methods for AH in an allergic state. However, medical treatment needs a long time to affect, but surgery can act quickly. Recurrence of AH after medical therapy could occur.

Background: Diagnosis and treatment of multiple sclerosis (MS) in its advanced state have been one of the medical community's concerns so far. Cell therapy has been a modern and successful treatment. However, it has not yet been effective enough to treat MS. This study aimed to find the relationship between neural stem cells (NSCs) and MS, and by considering important signaling pathways of pathogenesis, the most important microRNAs (miRNAs) for its diagnosis and treatment were investigated. Materials and Methods: Using the bioinformatics approaches and appropriate databases, the relationship between NSCs and MS were recognized, and after obtaining common genes between them, the protein products by them were evaluated. Finally, after nominating essential genes, we isolated and analyzed the microarrays involved in these pathways. Results: In the first step, 76 upregulated and 1600 down-regulated common genes between NSCs and MS were recognized. Upregulated genes obtained axon guidance, NCAM, and RHO signaling pathways, and the cell cycle, RNA metabolism, and DNA repair signaling pathways by down-regulated genes. Then, high-expression PAK3, ROBO2, and LIMK2, and low-expression AURKA, BIRC5, BLM, and BRCA1 proteins were identified. Accordingly, high-expression miRNAs included hsa-miR-4790-5p, hsa-miR-4281, and hsa-miR-4327, but low-expression miRNAs included hsa-miR-103b, hsa-miR-638, and hsa-miR-4537 were recognized. Conclusion: Our study indicated that the abovementioned important miRNAs have a major role in diagnosing and treating MS.

Background: The Coronavirus disease 2019 (COVID-19) pandemic has raised concerns regarding the application of assisted reproductive technology (ART) in the world. Many ART programs have been delayed or continued with new precautions due to the ambiguity about vertical transmission and pregnancy safety. Regarding the possible risks of SARS-CoV-2 infection on ART and the resultant embryos, this study aimed to investigate the presence of SARS-CoV-2 in follicular fluid, granulosa cells, and oocytes of COVID-19-infected women undergoing ART. Materials and Methods: COVID-19-positive polymerase chain reaction tests were reported for five women undergoing ART cycles on the day of oocyte retrieval. SARS-CoV-2 tests were performed on oocytes, granulosa cells, and follicular fluid obtained from these COVID-19-infected women. Results: SARS-CoV-2 RNA was detected only in one follicular fluid sample,however, other follicular fluid samples, granulosa cells, and oocytes were negative regarding viral RNA. Conclusion: Given the unknown effects of COVID-19 on human reproduction and ART, strict precautions should be taken during the COVID-19 pandemic.

Background: Low back pain could related to disc herniation and managed by surgery. Also, less invasive options, including epidural corticosteroid injection, are available,however, it is associated with side effects. This study aimed to evaluate the effectiveness of autologous conditioned serum (ACS) in treating unilateral lumbar radicular pain. Materials and Methods: In this randomized, controlled, double-blind clinical trial study, a total of 68 patients received the transforaminal epidural injection, 28 patients received ACS, and 30 patients received 40 mg triamcinolone. Under fluoroscopic guidance in anterior-posterior and lateral views, a single injection of ACS or triamcinolone was done via the transforaminal epidural technique. Pain intensity was assessed with a visual analogue scale (VAS) and Oswestry disability index (ODI) at three weeks, three months, and six months. Results: A significant reduction in pain intensity was observed in patients of two groups. There was no significant difference between the two groups during the three months of the study. At the final evaluation at six months, the ACS group showed superiority over the triamcinolone based on the VAS score (P<0. 05) and ODI (P=0. 007). Conclusions: ACS therapy is a new effective option in treating lumbar radicular pain due to herniated disc. Since no specific complication has been reported, it can be used as a substitute for corticosteroids in such cases.

Background: Histone deacetylase inhibitors (HDACIs) are novel anticancer agents that induce cell death and cycle arrest. Several studies reported that HDACIs induce apoptosis via two well-defined intrinsic/mitochondrial and death receptor pathways. In addition to HDACIs, DNA methyltransferase inhibitors effectively revert the promoter hypermethylation of tumor suppressor genes and apoptosis induction. The current study aimed to investigate the effect of sodium butyrate and epigallocatechin-3-gallate (EGCG) on the genes expression of the intrinsic pathway (BAX, BAK, APAF1, Bcl-2, and Bcl-xL), p21, and p53 on PA-TU-8902, CFPAC-1, and CAPAN-1 human pancreatic cancer cell lines. Materials and Methods: The PA-TU-8902, CFPAC-1, and CAPAN-1 cells were treated with sodium butyrate and EGCG. To determine cell viability, cell apoptosis, and the relative gene expression level, the 3-(4, 4-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay, flow cytometry, and real-time quantitative reverse transcription polymerase chain reaction were done, respectively. Results: Both compounds changed the expression levels of the mentioned genes in a p53-dependent and-independent manner, which induced cell apoptosis and inhibited cell growth in all three cell lines. Conclusion: We indicated that sodium butyrate and EGCG could induce apoptosis in human pancreatic cancer cell lines.

Background: One of the alternatives for lower-limb orthopedic surgery is spinal anesthesia. It can affect the hemodynamic status and cause the prolonged motor and sensory blocks, as well as urinary retention, which are less common in the unilateral technique. Different drugs are used to improve the quality of the block and reduce its complications. Dexmedetomidine, a selective alpha-2 adrenergic receptor agonist, and fentanyl, an opioid medication, could administration as an adjuvant to increase the intrathecal block quality. Hence, this study aimed to compare unilateral spinal anesthesia with bupivacaine/dexmedetomidine (BD) and bupivacaine/fentanyl (BF) regimes on the sensory-motor block among patients with lower-limb orthopedic surgeries. Materials and Method: This randomized, double-blind clinical trial was performed on 36 patients who underwent lower-limb orthopedic surgeries in Qaem Hospital, Mashhad, Iran. The patients were randomly divided into two groups. Patients who received 5. 7 mg hyperbaric bupivacaine 0. 5% plus 10 μ, g fentanyl (BF group) or 5 μ, g dexmedetomidine (BD group) were administered for inducing unilateral spinal anesthesia. Patients and investigators responsible for data collection were not awarded from allocation groups. The sensory-motor block level, duration, postoperative analgesia, and complications were recorded and compared between the two groups. Results: No significant difference was observed between the two groups in hemodynamic changes (i. e., systolic and diastolic blood pressure and heart rate) before and after the blockage (P˃, 0. 05). Also, there was no difference in the sensory-motor block level and anesthesia-related complications between BF and BD groups (P˃, 0. 05). Conclusion: In patients for whom the use of opioids for unilateral spinal anesthesia is contraindicated, dexmedetomidine could be considered an appropriate alternative.

Background: Myofascial pain dysfunction syndrome (MPDS) is among the most common causes of facial pain. This study compared the efficacy of low-level laser (LLL) acupuncture and cupping for the treatment of MPDS. Materials and Methods: This double-blind, before-after, randomized clinical trial evaluated 60 MPDS patients that were divided into two groups for LLL acupuncture (808 nm, 0. 5 W, 30 J, 4 J/cm2 energy density, 60 seconds,group 1), and cupping (group 2) of masticatory muscle trigger points. Both treatments were performed for maximally eight sessions once every other day. The level of pain at the trigger points was measured upon admission, before and 5 minutes after treatment in each session, at ten days, and two months after treatment completion by a visual analog scale (VAS). The painless maximum mouth opening (MMO) and patient satisfaction with treatment were also assessed at the time as mentioned earlier points. Results: Averagely, 4. 5 treatment sessions were required to achieve a 50% reduction in VAS pain score, with no significant difference between the two groups (P=0. 9). Both treatments significantly decreased the number of trigger points and pain score, but this reduction occurred significantly sooner in the cupping group (P<0. 01). MMO significantly improved in both groups after treatment with no significant difference between them (P=0. 2). Patients were significantly more satisfied with LLL acupuncture (P<0. 05). Conclusion: Both cupping and LLL acupuncture are equally effective for MPDS,thus, the patient can choose the type of treatment after receiving sufficient information regarding the two modalities.

Background: Recently, the non-toxic properties of natural plant products have gained more focus as anticancer agents. Therefore, this study aimed to assess the apoptosis effects of the ethanolic extract of Oxalis corniculata on the MCF-7 breast cancer cell line. Materials and Methods: In this experimental study, aerial parts of O. corniculata were collected in Lahijan city (Iran), and after confirmation, they were dried and extracted with ethanol for 24 h. Then, the total phenolic and flavonoid contents of the extract were measured. The 2, 2-diphenyl-1-picrylhydrazyl radical scavenging assay was used to measure the antioxidant properties of the extract. Selected cell lines (MCF-7 and human dermal fibroblast) were cultured in 6-wells dishes (1×106 cells/well). After 72 h of treating the extract, cytotoxicity was assessed using 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl-2H-tetrazolium bromide (MTT) assay. The expression of apoptotic genes (such as p53, bcl-2, bax, and CD95) was studied by real-time polymerase chain reaction (PCR). Results: The extract's total phenolic content was 31. 30±, 02 μ, g of gallic acid equivalents/mg of dry extract, and the total flavonoid content was 49. 61±, 04 μ, g of quercetin as equivalents/mg of extract. The antioxidant activity of O. corniculata was measured at the dose of 619. 2 μ, g/μ, l, indicating that it decreases cancer cell viability and enhances apoptosis. Within the half maximal inhibitory concentrations, real-time PCR revealed substantial increases in p53 (P<0. 001), CD95 (P<0. 05), and bcl-2 expression (P<0. 05) in MCF-7 cells treated with O. corniculata. Conclusion: This study suggests that O. corniculata may cause apoptosis by oxidative stress in cancer cells.

Background: The drug-induced liver injury (DILI) has a wide range of clinical presentations, from asymptomatic liver enzyme elevations to cirrhosis. Herbal dietary supplements may be beneficial to reduce the risk of hepatotoxicity. This study aimed to evaluate the effects of different doses of clove extracts on humoral factors in rats with hepatotoxicity induced by thioacetamide. Materials and Methods: In this experimental study, rats were divided into nine groups (10 rats per each). The Control group received no treatment. The Sham group was treated with oral administration of distilled water (0. 5 ml) for 21 days. The positive control group received thioacetamide (50 mg/kg for three days) intraperitoneally. The clove group was divided into three subgroups and given daily oral administrations of 50, 150, and 300 mg/kg of clove hydroalcoholic extracts (for 21 days). Rats in the experimental group were divided into three subgroups and subjected to 50 mg/kg thioacetamide injection after receiving hydroalcoholic extracts of clove (50, 150, and 300 mg/kg, respectively) for 21 days in the last three days. All rats were sacrificed after 48 hours to measure liver function parameters (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total plasma protein, and albumin). Results: The rats that received thioacetamide showed liver damage by increased serum liver biomarkers and decreased levels of total plasma protein and albumin compared to the control group. The different doses of clove extract resulted in a significant improvement of liver damage by reduced serum liver enzymes levels and increased total plasma protein and albumin. Conclusion: Oral administration of the different doses of the clove extract (50, 150, and 300 mg/kg) for 21 consecutive days could significantly improve the changes associated with serum biomarkers of hepatotoxicity.

Mesenchymal stromal/stem cells (MSCs) are a source of stem cells that can be easily harvested and differentiated into numerous cells. Over the past few decades, these cells have been introduced as promising therapeutic candidates for different diseases. Different studies have shown the role of these cells in regenerative medicine. Tumor growth is correlated with the interactions between MSCs and tumor cells in the tumor microenvironment. The precise key role played by MSCs in the progression of tumors is under question, and the effect of MSCs on the tumor is controversial it might involve the development of tumor initiation or prevent the spread of already existing ones. In this study, we reviewed the role of MSCs in the tumor microenvironment and their influence on promoting or inhibiting tumor progression.

Spinal cord injury (SCI) is an injury of the spine that could be life-threatening and lead to partial or complete loss of autonomic, sensory, and motor function below the injured area. Surgery decompression and steroid injection are the current treatments for SCI, but neither is particularly effective, and there is a growing demand for a more potent treatment. Mesenchymal stem cells (MSCs) are novel therapeutic agents that were used in different inflammatory diseases. These cells have immunomodulatory and regenerative properties which make them a promising candidate for neurological disorders such as SCI. MSCs are easily expandable in vitro and have the capacity for multilineage differentiation. These cells, which can be derived from adipose tissue, bone marrow (BM), Wharton jelly, or umbilical cord, have immunomodulatory and paracrine capabilities. They can release a variety of cytokines and other substances that suppress the growth of B cells, T cells, and natural killer cells (NKCs) as well as alter the activity of dendritic cells (DCs). In this study, we reviewed clinical studies that showed the effects of MSCs from different sources in the SCI.

Multiple sclerosis (MS) is a high-prevalence autoimmune and neurodegenerative disease that affects young adults. An ideal treatment for MS should have two characteristics. First, its immunosuppression and immunomodulation effects reduce the abnormal immune response, and second, it improves repair by enhancing intrinsic repair processes or even cell replacement. Most available therapies have the first characteristic. Recent studies have proposed mesenchymal stem cells (MSCs) as a new therapeutic candidate for MS. Different clinical trials and animal models of MS have shown the therapeutic effect of MSCs. In the current study, we reviewed the therapeutic effects of MSCs in the animal model and patients with MS.

Neurological complications are considered the leading cause of disability and the second cause of death worldwide. Although the most common neurological disorders affecting a large population are Alzheimer's (AD) and Parkinson's diseases (PD), no definitive treatment has been propounded in the clinic. As in recent years, special attention has been paid to medicinal herbal products as one of the ways to meet the challenges of treating diseases. This review study aimed to introduce the naringin neuroprotective effects as an abundant flavonoid in grapes and citrus fruits on the most common neurological disorders, including AD and PD. For this purpose, the specified keywords were searched in PubMed, Web of Science, Scopus, Embase, and Google Scholar, and the results were entered into the study after a concise overview. The findings show naringin can confront neurological disorders through several mechanisms such as modulating stress response pathways, preventing apoptosis, oxidative stress, and neuroinflammation, excessive chelating amounts of metal ions, thereby improving cognitive impairment and memory loss induced by neurological disorders. However, further studies, particularly on human, are critical for the final confirmation of obtained findings.

Background: Programmed death-1 (PD-1) and inducible costimulator (ICOS) are immune checkpoint receptors participating in tumor immune evasion, which counters the activation signal provided through the T-cell receptor ligation. This study aimed to investigate the relationship between the expression of PD-1 and ICOS on mononuclear cells (MNCs) isolated from the peripheral blood of acute myeloid leukemia (AML) patients and their response to induction chemotherapy. Materials and Methods: Peripheral blood samples (5 cc)were collected from 56 AML patients at first diagnosis before and after the inductiontherapy regimen for AML. PD-1 and ICOS expression were analyzed in all patients beforeand after the standard induction therapy regimen. Results: The expression of PD-1 andICOS significantly decreased (66. 7 and 16. 3 fold, respectively) in AML patients followingchemotherapy compared to its baseline value (P=0. 01 and P=0. 001, respectively). The expressions of PD-1 and ICOS were significantly different between favorable andpoor risk groups. Conclusions: Lower PD-1 and ICOS expressions on the surface ofMNCs before induction therapy were associated with a better response to treatments. In addition, PD-1 and ICOS expression on MNCs decreased after induction therapy.

Background: The outbreak of the new coronavirus disease 2019 (COVID-19) is majorly threatening the health of people worldwide. Since patients with chronic diseases, including diabetes mellitus (DM), are among the main groups at risk of severe COVID-19,hence, this study was aimed to investigate the mortality rate of COVID-19 among patients with DM. Materials and Methods: This cross-sectional study was performed on 211 DM patients with COVID-19 who were referred to Educational Kowsar Hospital in Semnan, Iran. After a definitive diagnosis of COVID-19, basic characteristics, including gender, weight, height, and clinical information (such as initial signs and symptoms, underlying diseases, complications during hospitalization, and type of treatment received) were collected. Results: The mean age of patients was 64. 92±, 12. 7 years, and 51. 7% were male. Totally 20. 9% of patients were expired. The most frequent underlying diseases were hypertension and ischemic heart disease. The simultaneous presence of cardiovascular diseases in DM patients with COVID-19 was correlated with a considerable mortality rate increment. Cough on arrival significantly predicted mortality reduction to less than one-third (P=0. 009). Also, oxygen saturation of less than 90% on arrival was a significant predictor of an increase in mortality by more than double (P<0. 001). Conclusion: According to the results of multivariate logistic regression, it was found that DM can increment the probability of contracting COVID-19, and the rate of mortality was also higher in these patients.

Background: Testicular ischemia-reperfusion (I/R) injury is a urological emergency that can lead to male infertility. So far, no suitable treatment has been found for it. Therefore, in the present study, we investigate the therapeutic effects of concomitant administration of coenzyme Q10 (CoQ10) and titanium dioxide nanoparticles (TiO2-NPs) on testicular I/R damage in rats and the expressions of genes involved in mitochondrial apoptosis, miR-21, and circRNA0001518. Materials and Methods: In this study, after induction of testicular torsion/detorsion, CoQ10 and TiO2-NPs were administered to the rats for ten days. Then, sperm extracted from the epididymides were analyzed for concentration, viability, morphology, and motility. The amount of apoptosis in testicular cells was studied by flow cytometry. Also, the expressions of the Bax and Bcl-2 genes, as well as miR-21 and circRNA0001518 levels were evaluated. Results: Sperm parameters improved in the rats’,testicular that received CoQ10. Administration of TiO2-NPs to healthy rats increased apoptosis and the Bax/Bcl-2 expression ratio. However, its administration to testicular I/R rats alone or in combination with CoQ10 caused a decrease in apoptosis, the Bax/Bcl-2 expression ratio, and an increase in miR-21 and circRNA0001518 expressions. Conclusion: Overall, individual or joint administration of TiO2-NPs or CoQ10 can have therapeutic effects on testicular I/R by altering the expressions of genes in the mitochondrial apoptotic pathway and their regulatory elements.

The coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been recognized as a worldwide pandemic and mostly affects the respiratory system. A considerable proportion of patients,however, might also experience gastrointestinal (GI) manifestations. Several investigations have assessed GI and hepatic involvement in this disease, although the mechanisms of these involvements in relation to the progression of COVID-19 remain unclear. This review summarized the clinical observations and the main mechanisms behind GI, liver, and pancreatic involvement among COVID-19 patients.

Women with multiple sclerosis (MS) of reproductive age are becoming pregnant at an alarmingly high rate. Disease control is required during the preconception, prenatal, and postpartum periods to reduce the likelihood of relapses of MS while minimizing hazards to the mother and fetus. It has long been understood that the disease activity of MS noticeably decreases in the third trimester of pregnancy, then noticeably increases in the first three months after delivery before returning to its pre-pregnancy baseline. Relapse during pregnancy and high rates of relapse before becoming pregnant have both been linked to an increased risk of postpartum attacks. In patients with relapse MS, recent results continue to support the notion that pregnancy does not affect long-term disease progression (and may even have the opposite effect),the situation is less clear for patients with progressive MS. It is comforting to know that none of the MS disease-modifying medications have been shown to cause teratogenic consequences. This review discusses the effects of pregnancy on disease activity and how to handle relapses when pregnant and breastfeeding.

Dear Editor, The novel human severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly contagious virus and the coagulopathies are now known major causes of mortality. SARS-CoV-2 could be a highly prothrombotic virus that produces unidentified modifications in the coagulation cascade, leading to a progressive increase in D-dimer as the severity and extent of micro thrombosis increases [1] and widespread microvascular or macrovascular thrombosis could explain several disparate phenomena observed in COVID-19. . .

Background: The global prevalence of hypertensive pregnancy disorders (HPDs) is 5. 2%-8. 2%. Lipid profiles made up of triglycerides (TG), total cholesterol (TC), low-density lipoprotein-cholesterol (LDL), and high-density lipoprotein-cholesterol (HDL) could affect the arterial vessel wall leading to HPDs. Preeclampsia (PE), among the most severe maternal-fetal HPDs, has affected 0. 2%-9. 2% of all pregnancies. The current study aimed to investigate the role of lipid profiles in predicting PE in the first and early third trimesters of pregnancy. Material and Method: A large-scale prospective cohort study was conducted from early pregnancy onward in a normal population in the south of Iran. Fasting blood samples were examined for TG, TC, HDL, and LDL, as well as LDL/HDL ratio levels in the first and early third trimesters. Result: Of 486 pregnant women, 37 women developed HPDs, of which 20 (54%) developed PE. In the PE group, the levels of serum lipid profiles, including TG, TC, LDL, and HDL significantly raised with gestational age (P<0. 05). After adjusting for maternal age and body mass index, TG, TC, LDL, and LDL/HDL ratio levels were associated with a higher risk of PE (odds ratio [OR]=1. 025, 1. 035, 1. 03, 2. 08, and 1. 026, 1. 044, 1. 03, 2. 14, P<0. 001) regarding the first and early third trimesters, respectively. The optimum cut-off points for TG, TC, LDL, and LDL/HDL ratios predicting PE were estimated to be 180. 5 mg/dl, 197. 5 mg/dl, 136 mg/dl, and 3. 66 in the first, and 220 mg/dl, 204 mg/dl, 155. 5 mg/dl, and 3. 97 in the early third trimesters. Conclusion: Dyslipidemia during pregnancy may help predict PE development that can be sustained with lipid-lowering drugs.

Background: The process of steroidogenesis is crucial to the normal function of the ovaries. In individuals with polycystic ovary syndrome (PCOS), the activity of related enzymes in this process is disrupted. In the present study, the effect of trans-anethole was investigated on gene expression of steroidogenesis enzymes in PCOS model rats. Materials and Methods: In this experimental study, thirty female rats were divided into six groups (n=5 per group). Fifteen PCOS rats in three groups received intraperitoneal injections of distilled water, 50, and 80 mg/kg of trans-anethole, respectively. Also, 15 intact rats in three groups received intraperitoneal injections of distilled water, 50, and 80 mg/kg trans-anethole. The expression of steroidogenesis genes was determined using real-time reverse transcription polymerase chain reaction. Results: The mRNA level of Cyp19 significantly increased in intact rats receiving 80 mg/kg trans-anethole compared to the control group. The Cyp19 level in PCOS groups was significantly reduced compared to the control group. The mRNA level of Cyp19 in PCOS groups that resived 50 or 80 mg/kg trans-anethole increased compared to PCOS rats, but this increase was not statistically significant. The mRNA level of Cyp17 did not significantly change in intact and PCOS rats that received trans-anethole compared to the control group. Conclusion: Trans-anethole may improve PCOS complications due to its involvement in regulating steroidogenesis.

The use of transfer energy capacitive and resistive (TECAR) therapy to treat musculoskeletal pain has not been clearly established. Hence, this study was conducted to combine the available results. We searched the main databases, including PubMed (January 1950), Web of Knowledge (January 1945), Scopus (January 1980), and ProQuest (January 1983) until December 2021, to find the related studies. Only those studies were included that assessed the pain in participants who received TECAR therapy and compared it with a control group. Using the random effect model, standardized mean difference (SMD) was calculated at a 95% confidence interval (CI). The differences between patients and control group were-1. 04 after four weeks of intervention (95% CI:-1. 59 to-0. 48, I2=86. 9%) and-1. 80 after eight weeks (95% CI:-2. 15 to-1. 46, I2=87%), which was significant (P<0. 001). The intra-group pain comparison before and after two, four, and eight weeks of TECAR therapy obtained SMD levels of-3. 96 (95% CI:-5. 28 to-2. 65, I2=96. 9%),-4. 12 (95% CI:-5. 98 to-2. 26, I2=97. 3), and-5. 03 (95% CI:-7. 23 to-2. 83, I2=92. 2%), respectively. Despite some limitations, our findings may assist clinicians in decision-making about TECAR therapy for the approach to musculoskeletal pain based on evidence-based medicine.

Dear Editor, Approximately six million people in the United States are affected by neurological diseases (NDs), and their incidence and severity are linked to genetic and environmental factors [1]. . . .

Ovarian cancer is described as one of the most common types of cancer and the leading cause of cancer-related deaths due to the high aggressiveness of this malignancy. However, the current therapeutically strategies failed to confront ovarian cancer or are accompanied by significant adverse effects leading to the recurrence of the disease and/or affecting the quality of life of survivors. On the other hand, ovarian cancer is recognized as a heterogenous disorder that is specified by alteration in a variety of molecular and cellular markers. Thereby, researchers are keen to find a novel therapeutical strategy representing high efficacy and safety, as well as be able to modulate altered biomolecules and signaling pathways. Icariin is a phytoestrogen with desired properties that are suggested for several chronic complications, particularly different types of cancer. The aim of the present study was to reveal the ameliorative characteristics of icariin and then discuss the antitumoral activities of this phytochemical against ovarian cancer with an emphasis on the modified molecular signaling pathways.

Prostate cancer is recognized as one of the most common cancers affecting the male population. The prostate is revealed to be a hormone-dependent tissue as testosterone and dihydrotestosterone could bind to the androgen receptor, activate it, and initiate the nuclear translocation of this receptor, followed by subsequent signaling cascades. Regarding this androgen dependency on the prostate, it is believed that androgen deprivation therapies can confront aggressive prostate cancer as a first-line treatment. However, prostate cancer could overcome hormone deprivation strategies through several cellular mechanisms, such as intratumoral androgen production and the production of ligand-independent androgen receptor splice variants, known clinically as castration-resistant prostate cancer. Due to the limited efficacy of first-generation anti-androgens in complete blockage of androgen receptor activity, recently, four second-generation anti-androgens, including abiraterone acetate, enzalutamide, apalutamide, and darolutamide approved by the United States Food and Drug Administration, and considered standard of care for patients with advanced prostate cancer. In addition to some reports of drug resistance treatments, cardiotoxicity, including heart failure, ventricular repolarization, hypertension, myocarditis, atrial fibrillation, and ischemic heart diseases, is commonly observed in patients who underwent abiraterone acetate and/or enzalutamide therapy. However, cardiotoxicity has rarely been observed after treatments of apalutamide and/or darolutamide.

The efficacy of melatonin in the treatment of patients with coronavirus 2019 (COVID-19) is controversial. This review has summarized the evidence on the efficacy of oral melatonin compared to placebo in patients with mild to moderate COVID-19 infection. We searched four international online databases and all randomized clinical trials (RCTs) that investigated the effects of melatonin compared with the placebo on clinical outcomes, including mortality, discharge time, O2 saturation (SaO2), and c-reactive protein (CRP) levels in patients with COVID-19 infection, were included. The standard random-effects model with hybrid continuity correction was used to pool the risk ratio (RR), weighted mean difference (WMD), and the I2 index to assess the heterogeneity. A total of 272 patients from five RCTs were included. Our meta-analysis showed melatonin compared to placebo, decreased discharge time (WMD=-0. 93 days,95% confidence interval [CI]:-2. 94 to 1. 07, P=0. 36,I2=56. 78%) and the risk of mortality (RR=0. 72,95% CI: 0. 25 to 2. 13, P=0. 56,I2=0. 0%) in COVID-19 patients. Melatonin intake compared to placebo significantly increased SaO2 (WMD=1. 38%,95% CI: 0. 09 to 2. 68, P=0. 04,I2=49. 82%) and decreased the CRP levels (WMD=-7. 24 mg/l,95% CI:-11. 28 to-3. 21, P<0. 001) in a sensitivity analysis. Our findings showed the efficacy of melatonin compared to placebo in patients with mild to moderate COVID-19 infection.

Several studies have reported that coronavirus disease 2019 (COVID-19) can lead to multi-organ dysfunction. COVID-19 has been linked to a variety of neurological symptoms, according to the literature. The various paths via which the brain can be infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as well as the symptoms of COVID-19 in neurological diseases, are discussed. COVID-19 symptoms have been observed in neurological illnesses such as epilepsy, ischemic stroke, multiple sclerosis, Alzheimer's disease, subarachnoid hemorrhage, Guillain–, Barré,syndrome, and Parkinson's disease in several investigations.

Background: During the Coronavirus 2019 (COVID-19) outbreak, Iranian medical sciences students were at higher risk of contracting this virus because they were in infected environments. So, they are predisposed to high levels of anxiety that could worsen their lives. The determent of factors and levels of anxiety could be helpful to reduce anxiety and control its worse effects. Hence, this study aimed to measure the anxiety index and its factors among medical sciences students during the COVID-19 pandemic in Iran. Materials and Methods: In this cross-sectional study, an online survey was sent to students from 27 medical sciences universities in Iran from 20th December 2020 to 10th March 2021. The online survey consists of the Health Anxiety Inventory (HAI) for measured general health anxiety as well as the baseline characteristics of students. Results: 723 students responded, including 483 (66. 8%) females and mean HAI score was 16. 76±, 8. 35. Based on our findings, gender, past medical, and drug history were significantly related to the high level of anxiety. However, there was no coloration between HAI scores with age, the field of study, study duration, university location, and attendance in the hospital and/or COVID-19 ward (P˃, 0. 05). Conclusions: Students with notable past medical history and/or drug history and female students more than others were predisposed to anxiety in a pandemic such as COVID-19. Hence, in a pandemic situation, psychological care should concern them.

Background: Sexual function in patients with cardiovascular disease (CVDs) is often associated with anxiety and irrational beliefs. Moreover, 60-78% of patients with CVDs report sexual problems. Some studies suggest that sexual counseling is necessary for these patients but is not usually provided for them. Online or telephone counseling may be helpful during the covid-19 pandemic, but studies on its application to sexual function appear to be limited. This study aimed to investigate the effectiveness of online vs. telephone counseling of rational-emotional-behavioral therapy (REBT) on the sexual function of women undergoing cardiac rehabilitation. Materials and Methods: In this randomized clinical trial study, 46 women diagnosed with CVDs under rehabilitation were assigned into online and telephone groups. Overall, eight 60-min intervention sessions were held (once a week). The Female's Sexual Function Index (FSFI) questionnaire was completed by the women at baseline, week 8th, and follow-up week 12th (main outcome). Results: FSFI scores between the two groups at baseline (online: 13. 28±, 2, telephone: 12. 68±, 1. 52, P=0. 254) compared to week 12th (online 28. 86±, 2. 44, telephone, 26. 6±, 2. 10, P=0. 002) were significantly different. As for within-group comparison in baseline compared to week 12th statistically significant difference was observed in all subscales of FSFI (P<0. 05). Conclusion: Online and telephone REBT counseling can improve the sexual function of women undergoing cardiac rehabilitation, but online counseling appears to be more effective. Thus, this method is recommended to improve the sexual function of these women during the covid-19 pandemic.

Cardiovascular diseases (CVDs) are considered the most common disorder and the leading cause of mortality globally. The etiology of CVDs depends on a variety of genetic and acquired parameters. Nowadays, a dramatic surge appeared in published reports to find the association between microRNAs (miRNAs) and CVDs in order to understand the cause of the disease, rapid diagnosis with the introduction of valid biomarkers, and target as a therapeutic approach. Apigenin is a novel nutraceutical flavonoid that cardioprotective properties are suggested. The current review aimed to evaluate the beneficial features of this phytochemical against CVDs with an emphasis on its ability to regulate the miRNAs. The findings demonstrated that Apigenin could regulate cardiac miRNAs, including miR-103, miR-122-5p, miR-15b, miR-155, and miR-33. Consequently, preventing CVDs is possible through different effects such as the promotion of cholesterol efflux, prevention of hyperlipidemia, alteration in ATP Binding Cassette Subfamily A Member 1 (ABCA1) levels, reducing of cardiocytes apoptosis, and retarding myocytes fibrosis. Also, it can regulate signaling pathways, protect against endothelial dysfunction, maintain oxidative balance, and decrease inflammatory factors and reactive oxygen species. Hence, apigenin regulatory characteristics affecting miRNAs expression could introduce this flavonoid as a novel cardioprotective phytochemical against different CVDs.

Background: Atherosclerosis is known to be a significant reason for cardiovascular diseases (CVDs). Hypertension, dyslipidemia, diabetes, obesity, smoking, physical inactivity, and unhealthy diet are the most important causes of atherosclerosis. This study aimed to determine the relationship between DASH Diet Index, Dietary Inflammatory Index (DII), Mediterranean Diet (MEDI-LITE) Index, and CVDs risk factors. Materials and Methods: Out of 4997 patients, all eligible patients with CVDs (n=264) were chosen as the patient group, and 264 healthy individuals were included in the healthy group. Dietary intake and anthropometric measures were evaluated, including height, weight, hip and waist circumference, blood pressure, and lipid profile. Results: Among the three dietary indices, the DASH diet score was significantly higher in the healthy group than in the patient group (P=0. 02). An inverse relationship was found between the DASH Diet Index and waist-to-hip ratio (r=-0. 33, P=0. 042), Visceral Adiposity Index (VAI,r=-0. 16, P=0. 044), systolic blood pressure (r=-0. 13, P=0. 035), triglycerides (r=-0. 36, P=0. 046), total cholesterol (r=-0. 47, P=0. 02), and low-density lipoprotein-C (LDL-C) levels (r=-0. 09, P=0. 03) in the patient group. Additionally, the MEDI-LITE Index was inversely associated with body mass index (BMI,r=-0. 12, P=0. 04), waist circumference (r=-0. 065, P=0. 05), triglyceride (r=-0. 25, P=0. 015), total cholesterol (r=-0. 4, P=0. 02), LDL-C levels (r=-0. 2, P=0. 006), and systolic blood pressure (r=-0. 122, P=0. 005) in the patient group. Also, a significant positive relationship was observed between the DII and BMI in both patients and healthy individuals (r=0. 76, P=0. 006 vs. r=0. 24, P=0. 01, respectively) and hip circumference (r=0. 638, P=0. 035) in the patients group. However, no significant relationship was observed between DII and CVDs risk factors. Conclusion: Patients with higher DASH diet scores had lower waist-to-hip ratio, VAI, total cholesterol, LDL-C, triglycerides, and lower blood pressure. In addition, patients with higher MEDI-LITE scores had lower BMI, waist circumference, triglycerides, total cholesterol, LDL-C, and lower blood pressure, but no correlation was found in the healthy group.

Background: Preeclampsia (PEC), affecting 5-10% of all pregnancies, is a multisystem disease diagnosed by hypertension (HTN) and protein in the urine or multi-organ problems without signs of proteinuria occurring after 20 weeks of gestation. PEC is the most common cause of maternal death and can lead to premature delivery. The current study aimed to investigate the accuracy of neutrophil-lymphocyte ratio (NLR) for predicting PEC in the first and early-third trimesters of pregnancy in a normal population in the south of Iran. Materials and Methods: A large-scale cohort study was performed from early pregnancy onward during November 2018-2019 in a normal population from Fars province, Southwest Iran. Four hundred forty-nine pregnant women were followed prospectively, and normal blood pressure (normotensive), gestational HTN, and PEC groups were compared in terms of white blood cells (WBC) count, neutrophil, lymphocyte, and NLR. Results: The serum levels of WBC count, neutrophil, and NLR significantly increased from the first to the early-third trimesters of pregnancy (P<0. 05),however, lymphocytes decreased (P<0. 05). The NLR cut-off points for predicting PEC were 2. 79 (sensitivity=86. 7% and specificity=92. 6%) in the first and 3. 2 (sensitivity=90. 5% and specificity=79. 4%) in the early-third trimesters. Conclusion: Our findings revealed that NLR could be an accurate predictive factor for PEC in the first and early-third trimesters of pregnancies,however, more studies are needed to investigate the immunomodulatory drugs for the prevention of PEC.

Background: Despite the benefits of radioactive iodine (RAI) therapy as an adjunctive treatment for thyroid cancer, it can be associated with several side effects. The main purpose of this study was to determine the changes in serum alkaline phosphatase (ALP), calcium (Ca), and parathyroid hormone (PTH) at different doses of RAI therapy among patients who were referred to the nuclear medicine department of Namazi Hospital, Shiraz. Materials and Methods: This cross-sectional study was conducted on 60 patients with papillary thyroid cancer who underwent RAI therapy at different doses of 100, 150, and 200 mCi. The ALP, Ca, and PTH levels of patients were measured before and 60 days after RAI therapy. Results: Our study revealed that RAI therapy at all doses significantly increased ALP level in comparison with baseline amounts (P≤, 0. 05). However, changes in PTH and Ca levels were not significant among patients who received different doses of RAI (P˃, 0. 05). Conclusion: RAI therapy could affect important hormones and enzymes such as ALP and PTH. This issue can be considered in diagnostic and therapeutic prescriptions of RAI for the treatment of thyroid cancer.