Advanced Biomedical Research
Year:2023 | Volume:12 | Issue:june|Papers Count:30

The current coronavirus disease pandemic, caused by the virus SARS-CoV-2, has been causing acute respiratory syndrome worldwide. Neutralizing immunity plays a major role in protecting oneself against the disease after vaccination or onset of infection. [1] Protective immunity provided by infectious diseases is predicated on the existence of immune memory. Investigation of immune memory to SARS-CoV-2 is necessary to understand protective immunity against COVID-19. However, few studies have investigated real-world antibody titers following infection that provide information for predicting long-time immunity. [2]

Background: Spontaneous pneumothorax is a potentially fatal condition with a high risk of recurrence. The purpose of this study is to compare two different approaches to SP management. In the first group, patients underwent only chemical pleurodesis,in the second group, CT-scan, VATS, and then chemical pleurodesis was performed. Materials and Methods: This study is a non-randomized clinical trial conducted on 65 patients admitted to Al-Zahra Hospital in Isfahan with a primary complaint of sudden dyspnea and a definitive diagnosis of spontaneous pneumothorax. Two studies compared the main outcomes of recurrence within six months and the time until recurrence. Results: Age, sex, and BMI were matched between the two study groups. The side of the pneumothorax, smoking history, and pulmonary disease history did not differ significantly (P > 0. 05). Pneumothorax recurrence did not differ significantly between the two groups (P: 0. 477). Conclusion: This study demonstrated no distinction between VATS and chemical pleurodesis when using only chemical pleurodesis. However, because numerous studies have suggested that one of these techniques may be beneficial for patients with SP, it is recommended to conduct additional randomized controlled trials (RCTs) with a more detailed plan and more comparable procedures, although it appears that meta-analysis design may be effective given the abundance of available RCT studies.

Background: The aim of this study was to investigate the effect of Lieberman community return program on reducing positive and negative symptoms and improving social skills in people with schizophrenia. Materials and Methods: In this clinical trial study, 58 patients with schizophrenia were randomly allocated into two groups of 29. The first group received 16 sessions of Lieberman community return training and the second group received routine care as a control group. All patients were evaluated before intervention and 1 and 3 months after intervention using the Matson Social Skills Questionnaire and Negative and Positive Symptoms Assessment Scale and compared between the two groups. Results: Evaluation of negative symptoms showed that the dimensions of affective flattening, avolition, anhedonia–asociality, attention, and alogia in the intervention group decreased significantly over time (P < 0. 05), but no significant difference was seen in the control group. The mean score of positive symptoms such as hallucinations, delusion, inappropriate affect, and formal thinking disorder in the intervention group were decreased significantly (P < 0. 05), but no significant difference was seen in the control group. Appropriate social skills and overall skill score were increased significantly in the intervention group over time (P < 0. 05). Conclusion: Lieberman community return program is likely to reduce the symptoms of schizophrenia and increase patients' social skills.

Background: High prevalence of pressure ulcers (PUs) and their complications are important dilemmas in the intensive care unit (ICU). Therefore this study was designed to evaluate the effectiveness of topical whey protein formulation in preventing PUs in patients admitted to the ICU. Materials and Methods: In this randomized placebo-controlled clinical trial under registration number [IRCTdeted for blinded article], 80 eligible ICU patients were randomly allocated to receive topical ointment of whey protein or placebo on the sacrum with a diameter of 15 cm twice daily for seven days, in addition to the routine care. The mean risk score for developing PUs was calculated at baseline using the Braden tool, and the PUSH score was used to assess PUs on days 4, 7, and 14. Patients' related demographic and clinical variables were also collected using a medical record for more evaluation. Results: Our results showed that demographic characteristics and the Braden scores' baseline mean were not significantly different between groups (P > 0. 05). The repeated measures ANOVA test revealed that the mean scores of PUs at various times were markedly lower in the whey protein than in the placebo group (P < 0. 001). Conclusion: This intervention can be routinely added as effective, safe, inexpensive, and accessible care to reduce the incidence of PUs for patients at risk of developing this injury.

Biotinidase deficiency is a rare autosomal recessive neurometabolic disorder resulting in biotin deficiency. Our patient presented with seizures and developmental delay since infancy and was started on megavitamin supplements. At 14 years, she presented with motor regression with encephalopathy after discontinuation of vitamins. There were no skin and hair changes. Magnetic resonance imaging (MRI) of the brain showed bilateral symmetrical posterior putamen signal changes. Tandem mass spectroscopy showed increased methyl malonyl carnitine and 3-OH isovaleryl carnitine. There was a low biotinidase level, and a pathogenic variant in the BTD gene in the next-generation sequencing was identified. Special importance is placed on the unusual symmetric posterior putamen involvement seen in MRI of the brain.

Background: The aim of this study was to assess the effect of a training package based on the lived experience of substance abusers on sleep problems and mental health. Materials and Methods: The current study was performed on 70 subjects equally distributed into two groups of control and intervention, Data collection tools included the Pittsburgh Sleep Quality Index (PSQI), the General Health Questionnaire (GHQ), and the Basic Adlerian Scales for Interpersonal Success—Adult Form (BASIS-A) Inventory. Data analysis was administered using the independent t-test, paired t-test, and MANCOVA. Statistical significance was considered when the P value < 0. 05. Results: A total of 70 subjects participated in this study,7 (10. 6%) were females and 59 (89. 4%) were males, with a mean age of 36. 29 ± 8. 588 years. The total score of PSQI was 12. 48 (±4. 206) and 13. 16 (±3. 397) for control and intervention groups, respectively, and declined to 12. 33 (±4. 442) and 9. 56 (±4. 45) after the intervention. The intervention resulted in an improved score for scales of belonging, going along, taking charge, harshness, being liked by all, and striving for perfection. Whereas the total score of the GHQ is reduced for both groups, that in the intervention group showed a higher decrease, which was also statistically significant. Conclusion: The developed training package successfully improved participants' sleep quality, mental health, and lifestyle.

Background: Neural tube defects (NTDs) are abnormalities of the brain and spinal cord, which occur as a result of failure in neural tube closure during embryogenesis. Causes of NTDs are complex and multiple, with hereditary, lifestyle, and environmental factors appearing to play a role. In spite of their impact on public health, the role genetics play on NTDs in Ethiopia is lacking. In this study, the role of polymorphisms in MTHFR 677C > T (rs1801133), MTHFR 1298A > C (rs1801131), MTRR 66A > G (rs1801394), RFC1 80A > G (rs1051266), and TCN2 776C > G (rs1801198) on the risk of having NTD-affected pregnancy was investigated. Materials and Methods: One hundred women with NTD-affected pregnancy and 100 women with normal pregnancy were included in the study. DNA was extracted from saliva and genotyping for five polymorphisms in four genes was analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The departure of the genotype's distribution from Hardy–Weinberg equilibrium (HWE) was evaluated using the x2 goodness-of-fit test. Frequencies of genotypes and alleles in case and control mothers were determined and differences between relative frequencies were evaluated by the x2 or the Fisher's exact test. Results: The statistically significant difference was absent in the genotype and allele frequencies for all the analyzed polymorphisms between cases and controls (P > 0. 05). Conclusion: MTHFR 677C > T, MTHFR 1298A > C, MTRR 66A > G, RFC1 80A > G, and TCN2 776C > G polymorphisms lack association with the risk of having a pregnancy affected by NTD. The role of other genes or environmental factors in NTD etiology needs to be investigated.

Background: One of the most debilitating symptoms in breast cancer survivors is cancer-related fatigue (CRF). CRF weakens patients' physical, cognitive, and occupational functions. It is associated with poorer quality of life and may reduce recurrence-free and overall survival. This study aimed to evaluate the efficacy of a group psychoeducational intervention in improving CRF in breast cancer patients. Materials and Methods: Fifty breast cancer patients who suffered from CRF were randomly assigned to receive a group psychoeducational intervention or control group. This study was designed as an eight weeks clinical trial. The psychoeducational intervention mainly consisted of concentrative movement therapy and energy conservation strategies. Primary outcome measures were the changes in the Fatigue Visual Analogue scale, Cancer Fatigue scale, and Piper Fatigue scale at the study endpoint. Measure assessments were made on four occasions: at baseline, after the intervention, one week, and four weeks post intervention. Statistical analysis was performed using SPSS26. Results: The intervention improved CRF significantly (P < 0. 001). All subscales of the Cancer Fatigue scale and the sensory, affective, and cognitive subscales of the Piper Fatigue scale showed statistically significant effects (P < 0. 001) at all time points. However, the behavioral subscale of the Piper Fatigue scale was different only at the end of the study (P < 0. 001). Conclusions: The group psychoeducational intervention improved CRF significantly. All the sensory, behavioral, physical, affective, and cognitive subscales improved. Accessible and confirmatory treatment can help patients to cope with fatigue in communities.

Background: Several case-control studies have suggested that global and loci-specific deoxyribonucleic acid (DNA) methylation in peripheral blood mononuclear cells (PBMCs) of DNA might be potential biomarkers of cancer diagnosis and prognosis. In this study, for the first time, we intended to assess the diagnostic power of the methylation level of tumor suppressor candidate 3 (TUSC3) gene promoter in patients with colorectal cancer (CRC). Materials and Methods: In the current study, we quantitatively assessed the promoter methylation level of TUSC3 in PBMCs of 70 CRC cases and 75 non-cancerous subjects via methylation quantification of endonuclease-resistant DNA (MethyQESD) method. Results: The methylation level of the TUSC3 was meaningfully higher in CRC cases than in non-CRC subjects (43. 55 ± 21. 80% vs. 16. 07 ± 13. 63%, respectively,P < 0. 001). The sensitivity and specificity of this gene for the detection of CRC were 88. 6% and 76. 0%, respectively. The receiver operating characteristic (ROC) curve examination discovered an area under the curve (AUC) of 0. 880, representing a very high accuracy of the TUSC3 methylation marker in distinguishing CRC subjects from healthy individuals. However, there was no substantial diversity in methylation level between various CRC stages (P: 0. 088). Conclusion: For CRC screening, PBMCs are a reliable source for DNA methylation analysis and TUSC3 promoter methylation can be utilized as a hopeful biomarker for early and non-invasive diagnosis of CRC.

Background: Growing evidence strongly indicates pivotal roles of gender differences in the occurrence and survival rate of patients with bladder cancer, with a higher incidence in males and poorer prognosis in females. Nevertheless, the molecular basis underlying gender-specific differences in bladder cancer remains unknown. The current study has tried to detect key genes contributing to gender differences in bladder cancer patients. Materials and Methods: The gene expression profile of GSE13507 was firstly obtained from the Gene Expression Omnibus (GEO) database. Further, differentially expressed genes (DEGs) were screened between males and females using R software. Protein–protein interactive (PPI) network analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG), Gene Ontology (GO), and Kaplan–Meier survival analyses were also performed. Results: We detected six hub genes contributing to gender differences in bladder cancer patients, containing IGF2, CCL5, ASPM, CDC20, BUB1B, and CCNB1. Our analyses demonstrated that CCNB1 and BUB1B were upregulated in tumor tissues of female subjects with bladder cancer. Other genes, such as IGF2 and CCL5, were associated with a poor outcome in male patients with bladder cancer. Additionally, three signaling pathways (focal adhesion, rheumatoid arthritis, and human T-cell leukemia virus infection) were identified to be differentially downregulated in bladder cancer versus normal samples in both genders. Conclusion: Our findings suggested that gender differences may modulate the expression of key genes that contributed to bladder cancer occurrence and prognosis.

Background: Alagille syndrome (ALGS) is an autosomal dominant disease caused by JAG1 or NOTCH2 mutation. It is diagnosed by the presence of three out of five features: characteristic facies, posterior embryotoxon, peripheral pulmonary stenosis, vertebral defects, and interlobular bile duct paucity. This study aimed to review the prevalence, clinical presentations, diagnosis, treatment, and outcome of patients with ALGS. Materials and Methods: This is a retrospective review of patients with ALGS at the Pediatric Department, Salmaniya Medical Complex, Bahrain, between August 1994 and October 2022. The diagnosis was based on clinical, laboratory, radiological, histopathological, and genetic findings. Results: Five patients were found to have ALGS. The prevalence of ALGS in Bahrain was 1. 04 patients per 100, 000 (0. 001%). Four were Bahraini and three were females. Median birth weight was 2. 3 (2. 3–2. 5) kg. All patients presented at the time of birth with low birth weight, cholestatic jaundice, clay-colored stool, heart murmur, and dysmorphic facial features. All had congenital heart diseases, two had butterfly vertebrae, and one had posterior embryotoxon. All had elevated liver enzymes and normal abdominal ultrasound. Three had positive hepatobiliary iminodiacetic acid scan and one had bile duct paucity in liver biopsy. Three had intraoperative cholangiogram. Four were positive for JAG1 mutation. All received ursodeoxycholic acid and fat-soluble vitamins. Two required liver transplantation. Conclusion: ALGS is a rare disorder in Bahrain. Diagnosis is challenging as the disease can be associated with or misdiagnosed as biliary atresia. Patients with ALGS are at high risk of morbidity either by unnecessary intraoperative cholangiogram or unavoidable liver transplantation.

Background: Evaluation of ovarian tumors based on tumor markers could have high clinical importance. In this study, we aimed to assess the predictive value of HE4 and Risk of Ovarian Malignancy Algorithm (ROMA) compared to CA-125 in the Malignancy of ovarian epithelial masses. Materials and Methods: This cross-sectional study was performed in 2020–2021 including 203 patients. Serum HE4 and CA-125 levels were checked before surgery. According to the pathology report (benign, borderline, or malignant epithelial mass), the predictive values of the three markers were evaluated. Results: About 146 cases were benign,14 cases were borderline and 43 cases were malignant. Most patients (69. 8%) in the malignant group were in stage 3. Significantly higher levels of all three markers (CA-125, HE4, and ROMA) were found in patients with malignant tumors compared to benign or borderline tumors (P < 0. 001 for all). The sensitivity of CA-125 was the highest (90. 7%) in pre-and post-menopausal patients but the specificity of HE4 and ROMA were higher than CA-125 (98. 1% and 97. 5%, respectively, versus 86. 9% for CA-125). In post-menopausal patients, both sensitivities of HE4 and ROMA were 90. 5% and the specificity and sensitivity of CA-125 were the highest (95. 2% and 100%). In premenopausal patients, the sensitivity of ROMA (90. 9%) and the specificity of HE4 (100%) were the highest. Conclusions: HE4 and ROMA are not necessary for postmenopausal patients in low-resource areas and a check of serum CA-125 will be enough. The higher-cost, ROMA, and HE4 checks are recommended in premenopausal people because they are more sensitive.

Background: Rosacea is a multifactorial skin inflammatory disorder with an unknown cure. Genetics and environmental factors such as microorganisms are involved in the rosacea etiology, for example, Helicobacter pylori have been suggested in rosacea progression. The present study investigated the relationship between H. pylori eradication and rosacea patient's improvement. Materials and Methods: H. pylori infection was investigated in 60 rosacea patients and 65 sex-and age-matched healthy control through enzyme-linked immunosorbent assay (ELISA) and HpSag tests. After infection confirmation, randomly half of the rosacea patients were treated for H. pylori eradication (test), and others received standard treatment (control). HpSag and ELISA tests were repeated after infection eradication and disease flow was surveyed for 60 days. The groups were compared using the ANOVA (Analysis Of Variance) test at the significant level of P < 0. 05. Results: At the baseline, the mean of immunoglobulin G (IgG) (59. 27 ± 41. 4 RU/mL) and immunoglobulin M (IgM) (11. 55 ± 6. 1 RU/mL) in rosacea patients was higher than the level of IgG (41. 38 ± 54. 33 RU/mL) and IgM (8. 11 ± 8. 91 RU/mL) in healthy control (P < 0. 04) and (P < 0. 01), respectively. Also, the values for H. pylori infection were positive in all patients and 10 healthy controls. The mean titer of IgM and IgG in the test and control patients groups were different at baseline and after treatment. Furthermore, in the test patients group, the mean of IgG was reduced in active rosacea after treatment, and 63. 9% of active patients showed rosacea remission after H. pylori eradication. Conclusion: Data suggest the exacerbating role of H. pylori in rosacea, and its eradication along with other therapeutic methods causes rosacea improvement.

The world has experienced a global medical and socioeconomic burden following the coronavirus disease 2019 (COVID-19) pandemic. COVID-19 is a systemic disease and may affect different organs including the kidneys. Current literature contains reports on COVID-19-related conditions such as acute kidney injury, and complications experienced by chronic kidney disease, end stage kidney disease, and kidney transplant patients. Here, we discuss the incidence of kidney allograft rejection, immunosuppression management and rejection risk, donor-specific antibodies and previous rejection episodes, and rejection outcomes in kidney transplant recipients with COVID-19 by reviewing current studies.

Background: Coronavirus disease 2019 (COVID-19) is an infectious disease that the physiological changes in pregnancy can make pregnant patients more susceptible to more severe forms of this infection. Hence, the treatment of COVID-19 in pregnant women can be challenging. This study was designed to evaluate the safety and efficacy of Remdesivir in pregnant women with COVID-19. Materials and Methods: This study was conducted on 150 pregnant women with moderate to severe COVID-19 infection. Remdesivir was prescribed and continued for 5 or 10 days according to the patient's condition. Maternal and pregnancy outcomes and also recovery rates were evaluated. Moreover, additional variables were examined: age, gestational age, symptoms, O2 saturation and laboratory tests at admission, the interval between symptom initiation and admission to hospital and Remdesivir prescription, hospitalization days, and ICU admission. Results: The mean age was 32. 37 years. Cough and dyspnea were the most prevalent symptoms (74% and 68. 7%, respectively). At the time of admission, 79 (52. 7%) women needed low-flow oxygen support, 67 (44. 7%) needed high-flow oxygen support, and 4 (2. 7%) were intubated. Fifty-four (36%) patients required ICU care. In patients who died (12 women), Remdesivir was prescribed later than those discharged (P value, 0. 04). Patients with favorable pregnancy outcomes received Remdesivir earlier than those with unfavorable pregnancy outcomes (P value: 0. 008). The recovery rate was 70% (89. 9% in the low-flow oxygen, 50. 7% in the NIPPV/high flow oxygen, and 0% in the intubated women). Conclusion: The results suggest that the early prescription of Remdesivir in pregnant women with moderate COVID-19 can improve the outcomes.

Background: The hip joint's limitation causes lumbopelvic compensatory motions, accumulating tissue stress on the lumbar spines. It is essential and valuable to evaluate hip rotation range of motion (ROM) in different low back pain (LBP) classifications to understand them and plan the best exercise program. This study aimed to compare hip rotation ROM between subjects with and without LBP classified in movement system impairment (MSI). Materials and Methods: In this cross-sectional study, 100 subjects with LBP were classified into different MSI subgroups (mean age of 41. 66 ± 7. 82 years), and 100 healthy subjects (mean age of 38. 96 ± 8. 84 years) participated. Passive and active hip medial and lateral rotations ROM in prone and supine positions for dominant and non-dominant lower limbs were measured. Results: Generally, in the LBP group, minimal lateral rotation as compared to controls in movement tests measuring hip rotation ROM actively and passively, in prone and sitting positions, and for dominant and non-dominant limbs (P < 0. 05). There were no significant differences among the LBP subgroups (P > 0. 05). Conclusions: Due to LBP, regardless of the MSI categories, remarkably restricted hip lateral rotation ROM.

MicroRNAs are a large group of small, non-coding ssRNAs (miRNAs) that have an epigenetically pivotal role in gene expression and other biological processes in cells and can be regarded as capable biomarkers for the early detection and management of cancer. The aim of the present review article is to summarize the evidence for recognizing the molecular mechanism, target genes, and clinical significance of miR-647 in different cancers. Multiple studies have demonstrated that aberrant expression of miR-647 could be found in a variety of malignancies, such as bladder cancer, cervical cancer, colorectal cancer, gastric cancer, glioma, hepatocellular carcinoma, non-small cell lung cancer, ovarian cancer, and prostate cancer have reported, notably, increase or decrease in expression of miR-647 so that it can function as a tumorigenic (oncomiR) or tumor suppressor gene. MiR-647 is effective in the proliferation, migration, and invasion of cancer cells by playing a function in cell cycle pathways. MiR-647 can be a valuable potential biomarker for assessing the extent of cancer, prognosis, and response to therapy and shows great therapeutic efficacy in different solid tumors. Moreover, serum concentrations of miR-647 are directly effective in decreasing overall survival and disease progression. So, an efficient therapeutic target can be the effect on miR-647 expression by antitumor drugs.

Background: COVID-19 is the leading cause of the recent pandemic in the globe. This disease might have different effects on the maternal and fetal outcomes in pregnancy. The aim of this study was to assess these outcomes in pregnant women with COVID-19 infections in different trimesters. Materials and Methods: This is a prospective cohort study that was performed in February 2020 to August 2021 in Isfahan on 430 pregnant women with definite diagnosis of COVID-19 infection admitted to our medical centers. The included cases were followed based on the gestational age in which they were diagnosed with COVID-19 infection. Patients were divided into three groups (first, second, and third trimesters) based on COVID-19 infection. Results: The frequency of requiring mechanical ventilation was higher in mothers with COVID-19 in the second trimester (P = 0. 049) and the frequency of PIH was significantly higher in mothers with COVID-19 in the third trimester compared to other women (P = 0. 009). Fetal growth restriction (FGR) was also observed in 22 patients (5. 3%) that was mostly observed with COVID-19 in the third trimester (P = 0. 012). Oligohydramnios and fetal distress leading to C/S were observed in 19 patients (4. 6%) and 12 patients (2. 9%), respectively. The majority of maternal mortality was among cases with COVID-19 infection in the third trimester (44. 4%). Conclusion: We observed higher maternal and fetal complications in women especially those in the third trimester. Our results were in line with the findings of previous studies. Women with COVID-19 infection in the third trimester had highest frequencies of preterm labor and FGR.

Endometrial carcinoma is one of the most frequent gynecological cancers in developed countries. Lymphovascular space invasion (LVSI), histological grade, and myometrial invasion (MMI) are important prognostic factors of endometrial carcinoma. LVSI is considered an independent poor prognostic factor in endometrial carcinoma. Based on the importance of LVSI, this study aimed to discuss the association of LVSI with tumor grade and MMI. A search of PubMed, EMBASE, Web of Science, Scopus, Google Scholar, and Cochrane Library was carried out to collect related studies. Consequently, most studies showed that LVSI is significantly associated with higher histologic grade and deep MMI.

Background: The Toll-like receptor 4 (TLR4) gene promotes migration in adenocarcinoma cells. Morphine is an agonist for TLR4 that has a dual role in cancer development. The promoter or inhibitor role of morphine in cancer progression remains controversial. This study aims to evaluate the effects of morphine on the TLR4, myeloid differentiation primary response protein 88-dependent (MyD88), and nuclear factor-kappa B (NF-κB) expressions in the human MDA-MB-231 breast cancer cell line. Materials and Methods: The cells were examined after 24 hours of incubation with morphine using the Boyden chamber system. TLR4, MyD88, and NF-κB mRNA expressions were assessed using quantitative real-time polymerase chain reaction (RT-PCR). The concentration of interleukin-2 beta was also measured using the ELISA assay. Results: According to the findings, three doses of morphine (0. 25, 1. 25, and 0. 025 μM) increased the expression of the TLR4 and NF-κB genes, whereas no significant change was observed in the mRNA expression of MyD88. Furthermore, treatment with morphine and lipopolysaccharide (LPS) significantly decreased the expression of TLR4, MyD88, and NF-κB. However, no significant change was observed in interleukin 2 beta concentration. Conclusions: These findings confirmed the excitatory effects of morphine on TRL4 expression and the MYD88 signaling pathway in vitro.

Background: The new coronavirus is an agent of respiratory infections associated with thrombosis in vital organs. This study aimed to propose a better diagnosis and treatment of coagulation disorders caused by the new coronavirus (Covid-19). Materials and Methods: Search in Cochrane central, Web of Science, PubMed, Scopus, and Ovid will be done. Also, according to the inclusion criteria, cross-sectional studies, cohort, clinical trial, and case-control will be included without gender and language restriction. Participants will also be Covid-19 patients with coagulation disorders. Any disagreement in the stages of screening, selection, and extraction of data between the two reviewers will be resolved by discussion, then if not resolved, the opinion of expert reviewers will be used. The risk of bias will be assessed using the NOS (Newcastle–Ottawa scale) tool for cross-sectional study, cohort and case-control, and the Cochrane checklist for clinical trials study. Metaanalysis of included studies that are similar based on the methodology will be done. Also, a fixed or random-effect model will be used for this it. Heterogeneity indices (I2), odds ratio (OR), risk ratio (RR), mean difference, and %95 confidence interval will also be calculated by Stata V. 13. 0 (Corporation, College Station TX). Results: Treatment with anticoagulants will reduce the severity of thrombosis and lung disease in patients. D-dimer measurement will also be a diagnosis indicator of thrombosis. Conclusions: Simultaneous study of coagulation disorders and thrombosis in patients and development of a Godliness based on it will play a treatment role in the follow-up of the coronavirus disease.

Background: Hydatidosis is a serious and life-threatening disease that may lead to the death of the host if diagnosed and treated improperly. Apoptosis has been investigated as a mechanism of host innate immunity in suppressing parasites and also the survival of cysts in the human body. The present study investigates the process and role of apoptosis caused by a host cell or parasite in hydatid cysts. Materials and Methods: Survey cytotoxic effect and apoptotic mortality of hydatid-treated lymphocytes were investigated. Also, to determine the mechanism of apoptosis in host and parasite, the mean gene expressions of Bcl-2, Bax, Caspase 3 in hydatid-treated lymphocytes, and Fas-L gene in the laminated-germinal layer of fertile and infertile hydatid cysts were evaluated. Results: The viability of fertile and infertile hydatid fluid-treated lymphocytes was significantly different compared with the control group. Flow cytometry also showed apoptotic cells. Bax mean gene expression was significantly different between fertile and infertile treated lymphocytes. However, there was no significant difference in the mean expression of Caspase 3, and Bcl-2 genes in these two groups. Although the expression of the Fas-L gene in infertile cysts was higher than in fertile cysts, the result was not significant. Conclusion: It seems that hydatid cyst fluid may induce apoptosis in lymphocytes so that, hydatid cysts can escape from the immune system and stay alive. On the other hand, the results represent the possible immune path of host apoptosis against the parasite as one of the important routes in infertility of hydatid cysts.

Background: The spike surface glycoprotein of SARS-CoV-2 is the essential protein in virus attachment to the target cell and cell entrance. As this protein contains immunodominant epitopes and is the main target for immune recognition, it is the critical target for vaccine and therapeutics development. In the current research, we analyzed the variability and mutations of the spike glycoprotein isolated from 72 COVID-19–positive patients from Iran's first three waves of disease. Materials and Methods: The RNA was extracted from nasopharyngeal samples of confirmed COVID-19 cases and served as a template for cDNA synthesis and reverse transcriptase polymerase chain reaction. The reverse transcriptase polymerase chain reaction products of each sample were assembled and sequenced. Results: After analysis of 72 sequences, we obtained 46 single nucleotide polymorphisms, including 23 that produce amino acid changes. Our analysis showed that the most frequent mutation was the D614G (in the samples of the second and third waves). Conclusions: Our findings suggest that developing effective vaccines requires identifying the predominant variants of SARS-CoV-2 in each community.

Background: Pelvic floor disorders include urinary incontinence, fecal incontinence, and pelvic floor prolapse, which are common complaints in women. Patients that suffer from uterine prolapse could benefit from surgical procedures that stabilize pelvic ligaments. Here, we aimed to compare the high uterosacral and sacrospinous ligament suspension surgeries. Materials and Methods: This clinical trial was performed in 2019–2021 on 64 women with uterine prolapse. Demographic data of the patients, including age, body mass index (BMI), past medical diseases, history of delivery, type of delivery, and duration of hospitalization, were collected. We assessed their urinary symptoms, prolapse degree, and sexual symptoms using the Female Sexual Function Index (FSFI) and Pelvic Floor Disability Index (PFDI-20) questionnaires before surgical interventions. Patients were divided into two groups undergoing high uterosacral and sacrospinous ligament suspension. They were followed up 6 and 12 months after surgeries. Results: Patients treated with sacrospinous ligament suspension had higher frequencies of surgical complications (P = 0. 039), and the most common complication was low back pain (15. 6%). The uterine prolapse andC point degree improved significantly in all cases after 6 and 12 months (P < 0. 001). The Pelvic Organ Prolapse Quantifications System (POP-Q) scores improved significantly in both groups 6 and 12 months after surgery (P < 0. 001), and patients who underwent sacrospinous ligament suspension had significantly lower pain intensity compared to the other group (P = 0. 003). FSFI scores improved significantly in patients treated in both groups (P < 0. 001). Conclusion: Both high uterosacral and sacrospinous ligament suspension techniques significantly improved pain, uterine prolapse, and C point degree.

Background: The phenotypic range of limb-girdle muscular dystrophies (LGMDs) varies significantly because of genetic heterogeneity ranging from very mild to severe forms. Molecular analysis of the DYSF gene is challenging due to the wide range of mutations and associated complications in interpretations of novel DYSF variants with uncertain significance. Thus, in the current study, we performed the NGS analysis and its results are confirmed with Sanger sequencing to find the plausible disease-causing variants in patients with muscular dystrophy and their relatives via segregation analysis. Materials and Methods: Nine patients with LGMD type 2B (LGMD2B) characteristics were screened for putative mutations by the whole-exome sequencing (WES) test. Either the patients themselves or their parents and first relatives were investigated in the segregation analysis through Sanger sequencing. The majority of variants were classified as pathogenic through American College of Medical Genetics and Genomics (ACMG) guidelines, segregation results, and in silico predictions. Results: Results revealed eight variants in DYSF gene, including three splicing (c. 1149+4A>G, c. 2864+1G>A, and c. 5785-7G>A), two nonsense (p. Gln112Ter and p. Trp2084Ter), two missense (p. Thr1546Pro and p. Tyr1032Cys), and one frameshift (p. Asp1067Ilefs), among nine Iranian families. One of the eight identified variants was novel, including p. Asp1067Ilefs, which was predicted to be likely pathogenic based on the ACMG guidelines. Notably, prediction tools suggested the damaging effects of studied variants on dysferlin structure. Conclusion: Conclusively, the current report introduced eight variants including a novel frameshift in DYSF gene with noticeable pathogenic effects. This study significantly can broaden the diagnostic spectrum of LGMD2B in combination with previous reports about DYSF mutations and may pave the way for a rapidly high-ranked identification of the accurate type of dysferlinopathy.

Background: Elevated brain cholesterol increases the risk of Alzheimer's disease. Production of 24-hydroxycholesterol (24s-OHC) by neurons prevents cholesterol accumulation in the brain. In this study, we investigated the effect of 24s-OHC on the HMG-COA reductase and ABCA1 which are involved in the brain cholesterol homeostasis with or without β-amyloid in astrocytes. Methods and Materials: Astrocytes were treated with 24s-OHC with or without Aβ. Western blot and real-time polymerase chain reaction were done to detect protein and gene expression of β-hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMGCR) and ABCA1, respectively. Cholesterol release was determined using a quantitation kit. Results: Protein levels of HMGCR and ABCA1 were significantly increased by Aβ,however, the 24s-OHC was able to restore their levels and diminish the effect of amyloid-β. Aβ did not have a significant effect on HMGCR expression, while 24s-OHC reduced it by 68%. Aβ-induced ABCA1 expression did not increase cholesterol efflux as the lower levels of cholesterol in conditioned medium of Aβ-treated cells were found. Conclusion: Our novel findings show that Aβ affects two key elements in the brain cholesterol homeostasis, HMGCR and ABCA1, which are crucial in cholesterol synthesis and efflux. Since 24s-OHC could suppress the Aβ effects on enhancement of HMGCR and ABCA1, therefore the cytochrome P450 46A1 (Cyp46A1), which is exclusively expressed in the central nervous system and responsible for producing of 24s-OHC, could consider as a therapeutic target in the cholesterol-related neurodegenerative diseases such as Alzheimer's disease.

Background: p16 is a cyclin-dependent kinase inhibitor and a cardinal regulator of the cell cycle. The relationship between p16 overexpression and poor prognosis of breast cancer has been reported in some studies. This study aimed to evaluate p16 expression in breast cancer in comparison to normal breast tissue and determine the association between p16 expression and clinicopathological parameters in breast cancer. Materials and Methods: Paraffin blocks of 110 samples were studied. These included 40 invasive breast carcinoma (tumor group) and normal tissue adjacent to the tumor (tumor control), as well as 30 normal mammoplasty specimens (normal control). Samples were from the pathology archive of Alzahra Hospital, Isfahan, Iran, from 2016 to 2020. p16 expression was studied and compared in these three groups using the immunohistochemistry technique. Moreover, the relationship between p16 expression and age, tumor size, carcinoma subtype, tumor grade, and lymph node involvement was investigated in the tumor group. SPSS version 16 was used to analyze data. Results: p16 expression showed a significant difference between the tumor group and the two control groups with a significantly higher expression in the tumor group. There was a significant direct relationship between the intensity of p16 expression and the number of involved lymph nodes (P < 0. 001). No significant relationship was detected between p16 expression and other clinicopathological factors. Conclusion: p16 seems to have a rather significant expression in breast cancer in comparison to normal breast parenchyma. However, among clinicopathological parameters, we found only a direct relationship between lymph node involvement and intensity of p16 expression.

Background: Osteoporosis is the most prevalent metabolic bone disease in postmenopausal women associated with reduced bone mass and increased bone fracture. Measuring bone density in the lumbar spine and hip is a reliable measure of bone mass and can therefore specify the risk of fracture. Dual-energy X-ray absorptiometry (DXA) is an accurate non-invasive system measuring bone density, with a low margin of error and no complications. The present study aimed to investigate the relationship between biochemical parameters with bone density in postmenopausal women. Materials and Methods: This cross-sectional study was conducted on 87 postmenopausal women referred to osteoporosis centers in Isfahan. Bone density was measured in the spine and hip area using the DXA system. Serum levels of calcium, phosphorus, alkaline phosphatase, and magnesium were measured by an autoanalyzer, and serum levels of vitamin D were measured by high-performance liquid chromatography (HPLC). Results: The mean parameters of calcium, phosphorus, alkaline phosphatase, vitamin D, and magnesium did not show a significant difference between the two groups (P-value > 0. 05). In the control group, the relationship between alkaline phosphatase and bone mineral content (BMC) and bony area (BA) in the spine was significant with a correlation coefficient of − 0. 402 and 0. 258, respectively (P-value < 0. 05) and BMD and T-score in the femoral neck area showed a direct and significant relationship with phosphorus (correlation = 0. 368,P value = 0. 038). There was a significant relationship between the Z-score with calcium (correlation = 0. 358,P value = 0. 044). Conclusion: There was no significant relationship between the values of calcium, phosphorus, alkaline phosphatase, vitamin D, and magnesium parameters and bone density (spine and hip) in postmenopausal women with osteopenia or osteoporosis.

Background: The involvement of lateral habenula and the ineffective dose of morphine on reward-related learning and memory is less well-known. This study looked into the effects of electrical stimulation, GABAB receptor blockade, and a combination of both with morphine on conditioned place preference. Materials and Methods: In this experiment, male rats were anesthetized with ketamine/xylazine (six rats in each group). A 5-day biased conditioned place preference paradigm was used for the behavioral test. The effects of electrical stimulation and phaclofen plus a low dose of morphine on the acquisition and expression phases were examined during conditioning sessions and before the test phase, respectively. Results: The conditioning scores were reduced by antagonist injection during the acquisition phase. Interestingly, different intensities exhibited opposite effects on the acquisition phase. Conditioned place preference scores during the acquisition phase were significantly induced by 25 μA electrical stimulation, while conditioning scores were suppressed by electrical stimulation at 150 μA. Phaclofen (2 μg/rat) combined with high intensity induced aversion during the acquisition phase, while inhibiting expression. In contrast, high intensity with phaclofen (1 μg/rat) inhibited only the acquisition session. However, low intensity during the acquisition phase had an additive effect that was prevented by pretreatment with phaclofen (2 μg/rat), but this response was modified by the antagonist's low dose. Conclusions: A behavioral technique called conditioned place preference is frequently used to evaluate learning that is related to rewards. Therefore, lateral habenula electrical stimulation and phaclofen plus morphine could affect place preference through the involvement of the reward system

Background: In order to improve the complete recovery of nausea and vomiting, we conducted a study with the aim of preventing acute and delayed nausea and vomiting in children undergoing moderate emetogenic chemotherapy. Materials and Methods: A clinical trial study was done on 130 children received chemotherapy. Patients received olanzapine and placebo. All groups received granisetron along with dexamethasone (DEX). The severity of chemotherapy-induced nausea and vomiting (CINV) induced by chemotherapy was compared in two groups. Results: The severity of nausea on the first, second, third, and fourth days was not significantly different (P >. 05) in two groups. The number of patients without vomiting was significantly different during the first 24 hours after chemotherapy between patients in the two groups (82. 3% vs 64. 5%,P =. 016). Conclusion: This study showed that olanzapine, which acts as an inhibitor of neurotransmitters, had a favorable efficacy in controlling acute and delayed CINV. More studies with large sample size are needed to compare the effect of olanzapine with other agents including aprepitant and palonosetron in the prevention of CINV.