SCIENTIFIC JOURNAL OF KURDISTAN UNIVERSITY OF MEDICAL SCIENCES
Year:2020 | Volume:24 | Issue:5 (103) |Papers Count:13

Background and Aim: Despite therapeutic improvements in recent decades, multiple myeloma (MM) still remains as one of the leading causes of death all over the world. Previous studies have indicated role of neurokinin-1 receptor (NK1R) in the pathogenesis of cancer. Therefore, we decided to evaluate cytotoxic and apoptotic effects of aprepitant (NK1R antagonist) on MM-derived KMM-1 cell line. Material and Method: In this experimental study, for assessment of cytotoxic effect of aprepitant on MM cells, KMM-1 (prepared in Tarbiat Modarres University) were exposed to different concentrations of the inhibitor (5, 15, 30 and 45 μ M) and subsequently viability, cell count, metabolic activity, and induction of apoptosis were investigated using trypan blue, MTT, and annexin/PI staining assays respectively. Moreover, in order to examine the molecular mechanism of action of aprepitant in KMM-1 cells, gene expression analysis was performed by real-time PCR. Results: The results indicated that NK1R inhibition using aprepitant resulted in considerable growth suppression of KMM-1 cells. Moreover, we found that the cytotoxic effects were likely due to cell arrest in G1 phase and induction of apoptosis, as revealed by the increased percentage of annexin-V/PI double positive cells among the inhibitor-treated cells (P<0. 05). Also, RQ-PCR analysis revealed aprepitant changed the ratio of expression of pro apoptotic to anti apoptotic genes by way of alteration in the expression levels of Bax and Bcl-2 (P<0. 05). Conclusion: The present study highlighted the efficiency of aprepitant in suppression of the growth of KMM-1 cells; however, further studies are needed to determine the safety and efficacy of this agent for the treatment of MM patients.

Background and Aim: Phenylketonuria is a type of autosomal recessive congenital and genetically induced fungal disease that has not been converted to tyrosine by the lack or lack of the phenylalanine hydroxylase enzyme and has been shown to increase phenylalanine levels in the blood, especially in the brain. The aim of this study was to compare the IQ scores of children with phenylketonuria and healthy children referring to Besat hospital clinic in Sanandaj in 2017-2018. Methods: This historic cohort study was performed on all of the patients at the time of birth, referred to PKU and pediatric clinics, as well as healthy children (for phenylketonuria) referred to other clinics of the children's hospital. The control group was done. Goodinow’ s intelligence test was used to measure cognitive, mental and children's intelligence. Finally, the results of the two groups were analyzed by the statistical consult. Results: The results showed that 46 (69. 7%) were male and 20 (30. 3%) were female. The mean age of the subjects was 6. 34± 2. 52 of years. Result from the current study showed that there was not significant differences between IQ mean in two groups of study (p>0. 05). Conclusion: According to the results of this study, the timely identification and treatment of patients with phenylketonuria has been able to prevent the complications of this disease to a large extent, and keep the children's IQs intact, thereby providing timely and accurate identification and treatment of this disease is necessary among children.

Background: Extra corporeal membrane oxygenation (ECMO) has been considered as a crucial modality for the management of acute respiratory distress syndrome (ARDS). Since ECMO is considered to be an invasive modality and may be associated with some complications, there are strict indications for its use. Here we report successful treatment of a case of severe ARDS with Veno-Venous ECMO. Case presentation: A 30 years o l d male was admitted to Nemazee Hospital i n Shiraz with decreased level of consciousness due to cerebral hemorrhage following fibrinolytic therapy for myocardial infarction with ST elevation (STEMI). After diagnosis of moderate to severe ARDS, VV-ECMO was used for the management of ARDS. In this case, 5 days after starting ECMO, PaCO2 improved and O2Sat was maintained at 97-98%, so weaning was considered. Ventilator mode was BIPAP with FiO2 40% and sweep flow was 1. 7L/min. We clamped the sweep flow and observed whether the patient was able to maintain O2 Sat at 97% with ventilation alone. Then, we decided to disconnect the patient from ECMO. The patient remained stable afterwards. Conclusion: Our case was intubated and was on MV from 10 days prior to ECMO administration. Moreover, our patient had simultaneous multi-organ involvement (nephrotic syndrome and sepsis) which decreased the benefits of ECMO. Despite all these problems, ECMO was started and patient was discharged from ICU with an acceptable health condition.

Background and Aim: patients infected with HIV are susceptible to opportunistic infections such as candidiasis. In normal individuals, Candida spp. exist as normal flora of the mucous membranes. In this study we compared the frequencies of different species of Candida between HIV infected patients receiving anti-retroviral therapy (ART) and normal individuals. Materials and Methods: This case-control study included 60 HIV positive patients receiving antiviral therapy as our case group and 60 normal individuals as control group. Oral samples were prepared by two wet swabs and cultured on Sabouraud dextrose agar. Colonies grown on the culture medium were identified by phenotyping and molecular (PCR) methods at two different temperatures. Results: Candida species were isolated from the oral mucosa of 68. 3% of HIV positive patients and 53. 3% of normal individuals. Rate of colonization of oral cavity by candida showed no significant relationships with the variable parameters of TCD4+ (P = 0. 12), viral load (P = 0. 24), and duration of HIV infection (P = 0. 92), but it had significant relationships with brushing (P = 0. 001), smoking (P = 0. 043) and drug abuse (P = 0. 002). Conclusion: The result showed an increased shift of the yeast colonization from C. albicans to non-albicans species in HIV-infected subjects. Considering the susceptibility of this group to opportunistic infections such as candidiasis, regular and periodic monitoring of these patients is necessary. Tooth brushing, discontinuation of cigarette smoking and drug abuse, together with oral hygiene are recommended.

Background and Aim: The living organisms on the earth are under the influence of natural gravity force and if this gravitational force changes, they will be affected by a unique shock. Weightlessness has important effects on cell function by interfering with biochemical pathways and gene expressions. Study of these changes would be of benefit to astronauts and can improve the quality of human life on earth. In simulated microgravity, the expression of some genes and protein levels produced in cultured cells or laboratory animals have been altered. However, very little information is available on the effects of microgravity on gene expression. Raf kinase inhibitory protein (RKIP) is a regulator of kinase activity and a cell balancing agent that can act as a metastatic inhibitor in a variety of solid tumors, including breast cancer. In general, the RKIP expression in progressive tumors is reduced but its increased expression can result in reduced invasive potency of cancer cells without affecting primary tumor growth. Materials and Methods: In this study, changes of RKIP gene expression were investigated in human MCF-7 breast cancer cells after 24 and 72 hours exposure to microgravity conditions using qReal time PCR method. We used t-test for data analysis and graphpad prism 7 project for plotting graphs. Results: The results showed that microgravity changed gene expression of RKIP and led to increased expression levels of the gene after 24 hours exposure to microgravity. Conclusions: By optimizing the duration of microgravity, we can observe significant changes in RKIP gene expression in MCF-7 cell line which can be considered promising for the treatment of cancer.

Background and Aim: Besides drug regimen, modifying self-care behaviors is effective in controlling high-blood pressure. The purpose of this study was to investigate the effect of group discussion on self-care behaviors in the patients with hypertension. Materials and Methods: In this semi-experimental study, 100 hypertensive patients were selected randomly from 10 health care centers in Arak in 2012. After obtaining informed consent and before intervention, self-care questionnaire was filled out by both groups and blood pressure was measured. Four educational sessions were held weekly for the intervention group, while only lectures were delivered for the control group. After three months, self-care questionnaire was completed and blood pressure was measured again. Using spss (V. 21), data were analyzed by independent and paired t-test, chi square test and multivariate analysis. p<0/05 was considered significant. Results: Self-care score in the intervention group was significantly higher than that in the control group (p <0. 0001). The patients in the intervention group had significantly lower systolic and diastolic blood pressures compared to the control group (p <0. 0001). Conclusion: It seems that group discussion training can be an effective way to improve selfcare behaviors in the hypertensive patients and results in a significant reduction in blood pressure of the patients. Further studies on the impact of other educational methods on the self-care behavior of the patients are recommended.

Background and Aim; Gastric cancer is one of the most common cancers in the world. It is well-known that Helicobacter pylori (H. pylori) plays a crucial role in its pathogenesis. Recent studies have shown that H. pylori infection leads to the migration of bone marrowderived mesenchymal stem cells (BM-MSC) into the gastric tissue and their resultant change into gastric cancer in animal models. However, the existence of these cells in human gastric cancers has not yet been studied. Materials and Methods: We selected 10 each precancerous sample (dysplasia and metaplasia) and 15 gastric cancers from the pathology department of Toheed Hospital in Sanandaj. . All of the samples were stained by CD34, CD326, and STRO-1 antibodies and immunohistochemistry technique. Pathologic diagnosis was made by an expert pathologist. Results: CD34 was expressed only on endothelial cells of all samples. CD326 was expressed at a low level in precancerous samples, but its expression was much higher in cancer samples. In contrast, STRO-1 antigen was not detected in any of the samples. Conclusion: CD34 and CD326 were expressed in gastric cancer samples. However, STRO-1 antigen which is a specific marker for BM-MSC was not detected in gastric precancerous and cancer samples. Our data suggested that BM-MSCs were not the origin of the gastric cancer cells or their nature might have been totally changed after transforming into cancer cells.

Background and Aim: Vitiligo is a dermatologic disorder which has autoimmune and genetic basis. Different studies in the world have shown relationship of vitiligo with autoimmune disorders. The purpose of this study was to investigate the association between vitiligo and fasting blood sugar (FBS). Materials and Methods: This cross sectional study was performed between 2016 and 2019 and included 102 patients with vitiligo. Diagnosis of vitiligo was made by our dermatologist and FBS levels of the participants were measured. Results: Mean age of the patients and duration of the disease were 39. 7± 15. 8 years and 56. 1± 34. 1 months respectively. 45 (%44) patients were male, the disorder was most frequent in the housewives. The most common site of involvement was genitalia which was affected in 52 (%31) cases, and the least common site was oral mucosa which was involved in 6 patients (%3. 6). Only 4 (%2. 7) patients had family history of vitiligo. Conclusions: The results showed that there were no significant association between vitiligo and variables of FBS, gender, occupation, site of involvement, family history of vitiligo, history of using medications and also any other disease.

Background and Aim: Acupuncture is one of the most common methods of complementary medicine. The purpose of this study was to evaluate the effect of transcutaneous electrical acupoint stimulation on sleep quality in the patients with chronic insomnia. Materials and Methods: This study was a single-blind clinical trial in which 40 patients with chronic insomnia were randomly placed into intervention (TEAS) and control (sham TEAS) groups. The acupuncture points including SP6, HT7 and LI4 were selected according to the medical guideline of traditional Chinese medicine. The stimulation was performed for 8 sessions, twice a week for one month. The Pittsburgh Sleep Quality Index (PSQI) and actigraphy were used to evaluate the patients' sleep quality before and after intervention. Results: Results showed no significant differences in the mean scores of PSQI between the two groups before and after the intervention (p>0. 05). In regard to the objective characteristics of sleep quality, total sleep time in the intervention group significantly increased (p=0. 015). These alterations were not significant in the sham TEAS group (p=0. 502). Conclusions: The results showed that TEAS can be effective in increasing the total sleep time in the patients with chronic insomnia disorder and this effect can be detectable by a monitoring instrument such as actigraphy.

Background and Aim: Childbirth is one of the important events in women's life, and labor support is an important tissue, because the experience of giving birth may have a positive or negative impact on the women. Considering lack of a suitable questionnaire for measuring labor support behaviors, the present study aimed to translate and evaluate the validity and reliability of the Persian version of the labor support questionnaire. Materials and Methods: This descriptive cross-sectional study included 213 midwives in maternity hospitals of selected medical universities in Tehran from January 2017 to September 2017. Midwives were requested to complete demographic and also labor support questionnaires. At first, we assessed the face and content validity of the instrument qualitatively, and then its construct validity was carried out by confirmatory factor analysis. In order to evaluate the reliability of the instrument, internal consistency and test-retest were used. Results: Qualitative face and content validity of the Persian version of the labor support questionnaire were approved. Also, the construct validity of the questionnaire was confirmed by confirmatory factor analysis. Cronbach's alpha coefficient was 0. 96 and the Pearson correlation coefficient of the t-test was 0. 71, which were indicative of appropriate reliability of the Persian version of the questionnaire. Conclusion: The findings of this study showed that the Persian version of the labor support questionnaire had the necessary validity and reliability. Therefore, this questionnaire can be used as an appropriate instrument for Iranian midwives.

Background and Aim: Vulvovaginal candidiasis (VVC) is one of the most common gynecologic problems among the women of childbearing age. Considering the adverse effects of chemical therapies, we performed this systematic review and meta-analysis to assess the effect of honey and yogurt on vaginal candidiasis. Material and Methods: In this systematic review and meta-analysis we searched databases of PubMed, ISI Web of science, Scopus, Cochrane, SID, Magiran, Irandoc, Google Scholar, using the following sets of keywords: (Vulvovaginal candidiasis, Genital vulvovaginal Candidiasis, Candidiasis, genital vulvovaginal, Candida albicans, Monilial vaginitis, Vaginal yeast infections, Yeast infections, Vaginal, Genital candidiasis, Vulvovaginal moniliasis), (Treatment, Azole, Antifungal agents, Antifungal fungicides, Therapeutic fungicides, clotrimazole, clotrimazole), (honey, Bee-honey), yogurt, (controlled trial, clinical trial) and their Persian equivalent. Data were analyzed by Stata software. Heterogeneity was assessed by chi-square and I2 index and we used the random effects models to pool the data. Results: Heterogeneity analysis showed no heterogeneity between the results of studies in regard to complaints of itching, redness and vaginal inflammation and vaginal discharge caused by candida vulvovaginitis. After comparing honey & yogurt group with control group we found (95% CI: 0. 09-0. 99, p = 0. 002, OR = 0. 22) for clinical symptom of pruritus and (95% CI: 0. 11-0. 87; p = 0. 026, OR= 0. 95) for clinical symptoms of redness and inflammation of vulva and vagina and (95% CI: 0. 13-0. 82, OR = 0. 32, p= 0. 018) for vaginal discharge, which were statistically significant. Conclusion: The results of meta-analysis showed that the effect of honey and yogurt on vaginal candidiasis was statistically significant. Therefore, honey and yogurt can be used as an alternative treatment or in addition to the chemical antifungal drugs in the treatment of vaginal candidiasis.

Background and Aim: Cholestasis is characterized by blockade of bile flow from the liver to the intestine, which leads to accumulation of bile acids within liver and plasma; it is associated with metabolic disorders and cause hepatocellular necrosis and apoptosis during cholestatic liver diseases. Mitochondria are critical cellular organelles that produce most of the cellular energy. Mitochondrial morphology varies from an interconnected filamentous network to isolated dots. These processes are called mitochondrial fission and fusion. Disrupted mitochondrial morphology has been observed in cholestatic liver disease. Optic Atrophy 1 (OPA1) is one of the proteins involved in mitochondrial fusion and plays an anti-apoptotic role. The aim of this study was to evaluate the effect of α-lipoic acid (LA) on OPA1 gene expression in pancreas of rat after bile duct ligation (BDL). Materials and Methods: Thirty-six male Wistar rats were randomly divided into six groups each containing six rats including: control, sham-operated, cholestatic, cholestatic+LA, cirrhotic, and cirrhotic+LA. After 14 days in cholestasis groups and six weeks in cirrhosis groups, serum samples and liver and pancreas tissue samples prepared for total bilirubin assays, histopathological analysis and pancreatic OPA1 gene expression evaluation by Real-time PCR technique. Total bilirubin data and gene expression data were analyzed by one-way ANOVA and Kruskal-Wallis statistical tests. Results: The results revealed that serum levels of total Bilirubin were significantly increased in BDL groups as compared with the control and sham operation groups (P<0. 0001). Concerning histology, the inflammation Symptoms and tissue necrosis were noted with BDL group. These symptoms were reduced by lipoic acid treatment in the cholestatic group. The result of pancreatic OPA1 gene expression showed the significant increase in cholestatic rats and significant decrease in cirrhotic groups as compared with other groups (P<0. 05). In cholestatic group, restoring the expression of OPA1 gene was shown in the presence of lipoic acid. Conclusion: Changing OPA1 gene expression in obstructive rat suggest the causal role of mitochondrial dynamics in pathogenesis of cholestatic disease. In this study, the effect of lipoic acid in OPA1 mRNA level reflects implications of oxidative stress in signaling pathway of cholestasis.