Background: Ulcerative colitis (UC) and Crohn's disease (CD) are two major types of inflammatory bowel diseases (IBDs). Toll-like receptors (TLRs) are expressed in the innate immune system compartments, in charge of identifying a wide range of microorganisms. The aim of the present study was to evaluate the expression of TLR-2, -7, and -8 in peripheral blood mononuclear cells (PBMC) of UC patients as a novel non-invasive primary inflammation sensor for monitoring the clinical course of UC candidates. Materials and Methods: In this cross-sectional study, total RNA was extracted from the PBMC of 42 UC patients along with 20 healthy donors. The mRNA levels of TLR-2, -7, and -8 were assessed using the quantitative real-time polymerase chain (qRT-PCR) reaction. Results: The present research study demonstrated no significant changes in TLR-2 mRNA expression in UC patients in comparison with the control group (P = 0.1264), whereas significant elevation (P = 0.0008) was distinguished in the TLR-7 expression of UC participants specifically during the remission course compared with healthy donors and flareup patients (P = 0.0004 and P = 0.0063, respectively). The last selected TLR, TLR-8 was not shown remarkable changes either between UC patients and the control group or between clinical courses of the disease. Conclusion: Here, among three nominated TLRs for predicting UC patients, TLR-7 was potentially selected according to the significant difference in mRNA expression in flareup UC patients and control donors. TLR-7 could be used as a novel non-invasive biomarker for monitoring UC patients in the active course of the disease.

Background: Considering the global prevalence of cancers and the complications of common cancer treatments, there is growing interest in using medicinal herbs to complement cancer treatments and reduce treatment's side effects. Therefore, we investigate the effect of the extract of Nasturtium on the viability of oral cancer cells. Materials and Methods: In this experimental study, we prepared aqueous extract from Nasturtium leaves and human oral cancer cells (OCC-24) and normal fibroblast cells (HF2FF cell line) from a cell bank. Then the toxic effect of different concentrations of the extract on cell viability after 24–48 hours of exposure was investigated with the methylthiazol tetrazolium assay. Ultimately, the optical density was measured at 570 nm by an Elisa Reader. Analysis of inhibitory concentration 50 (IC50) was also performed. The data were analyzed by paired Student's t-test and one-way analysis of variance. Results: Data showed that the extract had statistically significant anticancer effects in concentrations above 0.125 mg/ml for 24-hour exposure and in concentrations above 0.5 mg/ml for 48-hour exposure (p-value <0.05). Also, this extract had an adverse effect on the viability of normal cells; however, this effect occurred in high doses of the extract (p-value <0.05). Analysis of IC50 criteria indicates that with increasing time, a higher concentration of the extract is required to inhibit the viability of cancer cells. Conclusion: Because of the results, this aqueous extract can be suggested as a potential therapeutic agent in oral cancer. The best concentration of the extract was found to be 1 mg/ml.

Background: Gastric cancer is a worldwide life-threatening cancer. The underlying cause of it is still unknown. We have noticed that some cancer/testis antigens (CTAs) are up-regulated in gastric cancer. The role of these genes in gastric cancer development is not fully understood. The main aim of the current study was to comprehensively investigate CTAs' expression and function in stomach adenocarcinoma (STAD). Materials and Methods: A comprehensive list of CTA genes was compiled from different databases. Transcriptome profiles of STAD were downloaded from the cancer genome atlas (TCGA) database and analyzed. Differentially-expressed CTAs were identified. Pathway enrichment analysis, weighted gene correlation network analysis (WGCNA), and overall survival (OS) analysis were performed on differentially-expressed CTA genes. Results: Pathway enrichment analysis indicates that CTA genes are involved in protein binding, ribonucleic acid processing, and reproductive tissues. WGCNA showed that six differentially-expressed CTA genes, namely Melanoma antigen gene (MAGE) family member A3, A6, A12 and chondrosarcoma associated gene (CSAG) 1, 2, and 3, were correlated. Up-regulation of MAGEA11, MAGEC3, Per ARNT SIM domain containing 1 (PASD1), placenta-specific protein 1 (PLAC1) and sperm protein associated with the nucleus X-linked family member (SPANXB1) were significantly associated with lower OS of patients. Conclusion: MAGEA11, MAGEC3, PASD1, PLAC1, and SPANXB1 can be investigated as prognostic biomarkers in basic and clinical studies. Further functional experiments are needed to understand the exact interaction mechanisms of these genes.

Background: Coronary artery disease (CAD) is known as the most common cardiovascular disease. The development of CAD is influenced by several risk factors. Diagnostic and therapeutic methods of this disease have many and costly side effects. Therefore, researchers are looking for cost-effective and accurate methods to diagnose this disease. Machine learning algorithms can help specialists diagnose the disease early. The aim of this study is to detect CAD using machine learning algorithms. Materials and Methods: In this study, three data mining algorithms support vector machine (SVM), artificial neural network (ANN), and random forest were used to predict CAD using the Isfahan Cohort Study dataset of Isfahan Cardiovascular Research Center. 19 features with 11495 records from this dataset were used for this research. Results: All three algorithms achieved relatively close results. However, the SVM had the highest accuracy compared to the other techniques. The accuracy was calculated as 89.73% for SVM. The ANN algorithm also obtained the high area under the curve, sensitivity and accuracy and provided acceptable performance. Age, sex, Sleep satisfaction, history of stroke, history of palpitations, and history of heart disease were most correlated with target class. Eleven rules were also extracted from this dataset with high confidence and support. Conclusion: In this study, it was shown that machine learning algorithms can be used with high accuracy to detect CAD. Thus, it allows physicians to perform timely preventive treatment in patients with CAD.

Background: Biofilm production is an important virulence factor in Staphylococcus aureus. Most of the infections associated with biofilms of this bacterium are very difficult to treat using antibiotics. The present research studied the effects of the two probiotic Lactobacillus species L. casei and L. rhamnosus on S. aureus biofilm. Materials and Methods: Cell-free supernatant (CFS) extracts of L. casei ATCC 39392 and L. rhamnosus ATCC 7469 culture were prepared. The effects of sub-minimum inhibitory concentrations of the CFS extracts on cell surface hydrophobicity (CSH), initial attachment, biofilm formation, and their ability in eradicating S. aureus ATCC 33591 biofilms were assessed. In addition, the effects of CFS extracts on expression of the genes involved in formation of S. aureus biofilms (cidA, hld, sarA, icaA, and icaR) were also evaluated through real-time polymerase chain reaction. Results: CFSs of both Lactobacillus spp. significantly reduced CSH, initial attachment, and biofilm formation and eradicated the biofilms. The above findings were supported by scanning electron microscopy results. These two Lactobacillus CFSs significantly changed the expression of all studied biofilm-related genes. Expression levels of cidA, hld, and icaR genes significantly increased by 4.4, 2.3, and 4.76 fold, respectively, but sarA and icaA genes were significantly downregulated by 3.12 and 2.3 fold. Conclusion: The results indicated that CFS extracts of L. casei and L. rhamnosus had desirable antagonistic and anti-biofilm effects against S. aureus. Consequently, carrying out further research enables us to prepare pharmaceuticals from these CFSs in order to prevent and treat infections caused by S. aureus biofilms.

Background: As the most common complication of endoscopic retrograde cholangiopancreatography (ERCP) is acute pancreatitis, researchers have paid due attention to minimize this complication using various drugs, one of which is epinephrine. Therefore, the present study aimed at evaluating the effectiveness of epinephrine spray on the papilla in preventing post-ERCP pancreatitis (PEP). Materials and Methods: The present double-blind clinical trial was performed on 164 patients undergoing ERCP. Patients in both groups received 50 mg rectal suppository as usual before ERCP. Then, during ERCP, epinephrine or normal saline was sprayed topically on the major papillae. After the intervention, patients were evaluated in terms of the incidence of PEP. Results: The results of the present study revealed that the incidence of PEP in the epinephrine and control groups was 2.4% and 4.9%, respectively (P > 0.05). There was no significant difference between the two groups in terms of the incidence of bleeding after ERCP, number of accidental pancreatic duct cannulation, the increase in vision during common bile duct cannulations, the need for precut sphincterotomy, and the number of hospitalization days (P > 0.05). In addition, the chance of developing PEP was lower and higher in patients with higher ages (odds ratio [OR]: 0.86; P = 0.030) and biliary sludge (OR: 4.97; P = 0.042), respectively. Conclusion: As compared with indomethacin alone (control group), it seems that the administration of epinephrine can be effective in reducing the incidence of PEP, although this relationship was not recognized to be significant in this study and only the age and the presence of sludge had a negative and positive relationship with the incidence of PEP, respectively.

Background: Due to the presence of platelet antigen polymorphisms, human platelet membrane glycoproteins can be identified as an alloantigen or autoantigen. The aim of this study was to determine the frequencies of human platelet antigens (HPAs)-1 to-5 and-15 in Turkmen blood donors and establish a panel of accredited HPAs negative donors as well as an HPA-typed platelet donor registry. Materials and Methods: HPA-1 to-5 and-15 typing was performed by the polymerase chain reaction-sequence-specific primer techniques on 80 unrelated Turkmen donors who were referred to Aq-Qala Blood Transfusion Center in Golestan Province from September 2018 to October 2019. Results: The frequencies of HPA phenotypes were determined as follows: HPA-1aa: 92.5%, HPA-1ab: 7.5%, HPA-2aa: 77.5%, HPA-2ab: 20.0%, HPA-2bb: 2.5%, HPA-3aa: 75.3%, HPA-3ab: 50%, HPA-3bb: 11.2%, HPA-4aa: 100%, HPA-5aa: 78.5%, HPA-5ab: 21.5%, HPA-15aa: 41.2%, HPA-15ab: 56.2% and HPA-15bb: 17.5%. Conclusion: Determining the genotype of HPAs that play an important role in platelet refractory can improve the management of alloimmunization due to the incompatibility of HPAs between the recipients and donors. Therefore, the registration process for national platelet donors can help patients accelerate and improve the quality of transfused platelets.

Background: It is important to synchrony the time, intensity, and respiratory signal of the phrenic nerve between the patient and the ventilator. This study aimed to evaluate the effect of switching from volume-controlled to pressure-controlled ventilation on respiratory distress and asynchrony index improvement. Materials and Methods: In this randomized controlled clinical trial, 70 patients admitted to the intensive care unit under mechanical ventilation were included. Asynchronous evaluation was performed by examining the patient and evaluating and analyzing the graphic flow curve and ventilator pressure, which included trigger and flow asynchronous and asynchronous cycling. In the intervention group, the mode of ventilation was switched to PSIMV such that peak inspiratory pressures would be equivalent to positive end-expiratory pressure (PEEP) in the volume-controlled mode. Finally, again at 60, 75, and 90 min, information about the ventilator and the patient's symptoms, and arterial carbon dioxide levels were sent by arterial gas sample. The asynchronous index was also recorded in both groups. Results: This study showed that the mean of variables such as height, ideal body weight, tidal volume, set rate; Sense, FiO₂, PEEP did not differ significantly between the two groups. The mean of asynchrony was significantly reduced in both control group (16.51 ± 3.35–14.51 ± 2.90; P < 0.001) and intervention group (18.26 ± 6.13–13.32 ± 5.53; P < 0.001). Conclusion: Regardless of the type and severity of the disease, switching the ventilation mode from volume-controlled to pressure-controlled can improve patient adaptation to the ventilator, especially in cases with frequent asynchrony.

Background: The present study aimed at comparing the effect of ketorolac and morphine on the pain control in patients with renal colic. Materials and Methods: The present clinical trial was performed on 272 patients with renal colic that were divided into two groups. Patients in the first and second groups intravenously received morphine at a dose of 1.0 mg/kg and ketorolac at a dose of 30 mg, respectively. Then, systolic blood pressure, diastolic blood pressure, heart rate, respiration rate (RR), and oxygen saturation percentage (SpO2) as well as patients' pain scores before and 5, 15, 30, 60, and 90 min after the intervention were recorded and evaluated. Results: The results of this study revealed that the mean pain scores of patients before and after the intervention were not significantly different between the two groups (P > 0.05). However, patients' pain significantly relieved over time in both groups (reduce: Morphine group = 9.4 and ketorolac group = 9.09; P < 0.001). In addition, nausea, dizziness, and a decreased SpO2 in the morphine group were 5.1%, 2.9%, and 1.5%, respectively, and in the ketorolac group only dizziness was 2.2% (P > 0.05). Conclusion: According to the results of this study, the efficacy of ketorolac in reducing patients' pain was not significantly different from that of morphine. Therefore, considering that the occurrence of complications in the ketorolac group was lower than that of the morphine group, it can be stated that ketorolac is a safer and more reliable drug than morphine in relieving pain in patients with renal colic.

Background: This study aims to evaluate the risk of hypothyroidism (HT) after radiotherapy (RT) of breast and supraclavicular in patients with breast cancer (BC). Materials and Methods: In a historical cohort study, the records of all patients with BC who had been referred to the Mahdieh radiotherapy Center of Hamadan from 2017 to 2019 were reviewed. Demographic characteristics, clinical information, previous and current used treatment methods (surgery, radiotherapy, chemotherapy), number of RT sessions and doses, and HT (TSH >5 mIU/L) were extracted from the patient's documents. Data were analyzed using SPSS software version 16. Results: Out of 304 patients referred to the Center, 266 patients were investigated. The mean TSH was 6.3 ± 7.9 ml/L (1.5 to 65.4). Approximately half of the patients were in Stage 2 of the disease. 37 (16.4%) patients were diagnosed with HT, of which 8.8% were clinical, and 7.5% were subclinical. The mean total dose of HT patients (5621.62 ± 491.67) was significantly higher than other patients (5304.76 ± 937.98). 21 patients (56.8%) in Stage 3 and 4 and 16 (43.2%) patients in Stages 1 and 2 had HT (P = 0.006). Spearman correlation coefficient showed that there was a significant relationship between total dose and TSH hormone (r = 0.624), the number of RT sessions with TSH hormone (r = 0.237), and total dose with T4 hormone (r = -0.232). Conclusion: The findings of this study showed that the risk of HT increases significantly in patients with BC who undergo RT of breast and supraclavicular. Patients with higher stage, more radiation, and more RT sessions are at higher risk of HT.

Background: Bacterial superinfections are one of the crucial challenges in patients with coronavirus disease 2019 (COVID-19) that are associated with a high mortality rate. The current study was designed to assess bacterial superinfections and antibiotic management in COVID-19 patients admitted to intensive care unit (ICU). Material and Methods: Seventy-three adult intubated patients with COVID-19 were included in a cross-sectional study. The lung aspirate samples were collected in two stages and assessed for bacterial growth by standard methods. Antimicrobial susceptibility testing was performed using the Kirby-Bauer method as recommended by the Clinical Laboratory Standard Institute guideline (2021 edition). Also, demographic and clinical data were collected. The statistical analysis was done by chisquare test and Student's t-test, and a P value <0.05 was considered significant. Results: Forty men and thirty-three women with a mean age of 64.78 ± 13.90 have included in our study. The mean length of hospitalization and stay in ICU were 18.77 ± 12.94 and 13.51 ± 9.83 days, respectively; 84.9% of cases died. Thirty-three patients had a bacterial superinfection mainly caused by Klebsiella spp and Acinetobacter spp; 21.2% of piperacillin/tazobactam consumers' patients survived that; the differences were significant (p = 0.034). A significant relationship was seen between superinfection and length of hospital stay until intubation (p = 0.033). Conclusion: Bacterial superinfection and mortality rates were relatively high in COVID-19 patients admitted to ICU. According to the results, using beta-lactam/beta-lactamase inhibitors antibiotics in hospitalized patients in ICU can effectively control superinfection.

Background: Immune checkpoints are molecules that act as regulators of immune system pathways. However, some tumor cells can express the ligands of immune checkpoints to escape from antitumor immune responses. Some agents, such as antibodies, can inhibit these checkpoints that prevent the immune system from targeting and killing cancer cells. The aim of this study was to express a novel bispecific tandem scFv in periplasmic space of Escherichia coli for simultaneous targeting of two immune checkpoints, cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) and programmed cell death protein 1 (PD-1). Materials and Methods: The bispecific tandem scFv was constructed based on the variable regions gene of anti-PD1 and anti-CTLA-4 antibodies. The optimum codon for expression in E. coli was chemically synthesized and subcloned in periplasmic expression plasmid. After transformation, the effect of cultivation conditions on periplasmic expression of the protein in E. coli BL21(DE3) was evaluated. Then, the bispecific tandem scFv was purified and its binding ability to cells expressing PD-1 and CTLA-4 was evaluated. Results: Expression of tandem scFv with a molecular weight of 55 kDa was verified by Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and western blotting analysis. The best condition for soluble periplasmic expression was obtained to be incubation with 0.5 mM isopropyl β-D-1-thiogalactopyranoside at 23°C. The protein was successfully purified using affinity chromatography with a final yield of 4.5 mg/L. Binding analysis confirmed the bioactivity of purified the tandem scFv. Conclusion: This bispecific tandem scFv could be a potential candidate to cancer immunotherapy, although more biological activity assessments are still required to be carried out.

Background: Following personalized medicine and the development of e-publishing, a large number of case report–dedicated journals have emerged. But the lack of integrated guidelines is a major obstacle to the quality of this evidence. The purpose of this study is to analyze the reporting requirements of case report–dedicated journals to update and strengthen the CARE guidelines. Material and Methods: Quantitative and qualitative research approach has been done using the content analysis method. All case report–dedicated journals were selected from Scopus (54 out of a total of 68 journals). By referring to these journals' websites, all the contents of the authors' guideline section and two sample articles were examined as a unit of analysis. Quantitative data includes frequency and percentile; qualitative data was conducted through open coding, creating categories, and abstraction. Results: 51% of journals are related to Elsevier and Hindawi publications. 14.8% of journals have been launched in the form of companions. 52% of journals endorse the CARE guidelines. Among the CARE elements, title, consent form (100%), discussion, abstract (94.4%), and introduction (90.7%) had the most frequent elements, and timeline and patients' perspective had the least repetition in the authors' guideline. Also, 19 new reporting elements and 27 types of case reports were identified. Conclusions: Improving the reporting and content quality of case reports is very important to benefit from knowledge synthesis services. Medical journals publishing case reports should follow a more integrated process. An updated version of reporting guidelines needs to be available for publishers and editors of journals.

Background: Traumatic brain injury (TBI) is a leading cause of death among patients in developed countries. The patients' prognosis depends on the trauma-induced primary damage as well as the secondary brain damage, including electrolyte disturbances. Therefore, prevention, diagnosis, and timely treatment lead to better prognosis. Herein, the aim is to prognosticate about the mortality in patients with TBI through serum osmolarity at admission. Materials and Methods: In this cross-sectional study, 141 patients with TBI were assigned through convenience sampling. The level of serum osmolarity was examined once the patients were admitted to emergency department and later, the outcome was recorded. Finally, we analyzed the relationship between osmolarity level and patient outcome in age groups. Results: The mean serum osmolarity in the age group of under 18 years, 18 to 60 years, and more than 60 years was equal to 295.3 ± 10.02 mOsm/L, 297.2 ± 6.5 mOsm/L, and 301.6 ± 7.6 mOsm/L, respectively (P-value <0.001). Osmolarity with a cut-off point of more than 298.90 and sensitivity and specificity of 70.49 and 62.86, respectively, had appropriate diagnostic value for predicting mortality in these patients (P-value <0.001). Conclusion: According to the results of this study, serum osmolarity can have an appropriate diagnostic value in predicting mortality in patients with TBI. In addition, in different age categories, the osmolarity serum in the mortality of these patients was significantly different. Therefore, due to the high importance of serum osmolarity in the mortality of patients, careful monitoring of fluid therapy status of trauma patients should be implemented to prevent the development of hyperosmolarity for the patient with irreversible outcomes.

Background: Chronic kidney disease (CKD) is an important comorbidity in Coronavirus Disease 2019 (COVID-19) patients considering its high prevalence. We aimed to figure out the relationship between CKD and COVID-19 mortality in this study. Materials and Methods: In total, 116 CKD patients (estimated glomerular filtration rate [eGFR] lower than 60 mL/min/1.73 m²) and 147 control subjects confirmed with COVID-19 were studied. Data regarding demographics, sign and symptoms, laboratory findings, and chest computed tomography were collected. Association between CKD and in-hospital mortality were analyzed using logistic regression models adjusted for confounders. Results: Mortality rate was significantly higher in CKD than non-CKD (30.17 vs 4.76, P < 0.001) COVID-19 patients. Multivariate logistic regression showed that CKD was significantly correlated with in-hospital mortality in the total sample (Odds ratio (OR) = 8.64, confidence interval (CI): 3.67–20.35) and gender subgroups (females: OR = 4.77, CI: 1.38–16.40, males: OR = 13.43, CI: 3.85–46.87) (P < 0.05) of COVID-19 patients in the crude model. Whereas, the correlation did not remain significant in the fully adjusted model in the total sample (OR = 1.70, CI: 0.35–8.19) and gender subgroups (females: OR = 1.07 CI: 0.06–19.82, males: OR = 0.87, CI: 0.07–10.33) (P > 0.05) of COVID-19 patients. Conclusion: This study suggested an independent association between CKD and in-hospital mortality in COVID-19 patients. Therefore, more intensive surveillance of COVID-19 patients with CKD is to be warranted.

Background: The hypo-perfusion of the kidneys can lead to impairment in renal function and induce renal injury in case of delayed diagnosis and treatment. To date, laboratory markers are routinely used to determine the fluid volume status of the patients. The current study aims to evaluate the values of inferior vena cava (IVC) collapsibility index in hypovolemia diagnosis among critical patients admitted at the intensive care unit (ICU). Materials and Methods: This is a cross-sectional study performed on 67 patients admitted to the ICU due to acute kidney injury from May 2018 to October 2019. Hypovolemia was assessed assessing IVC collapsibility using ultrasonography. Laboratory data, including urine osmolality, urine-plasma creatinine ratio, sodium excretion fraction and urinary sodium level were checked. Afterward, IVC collapsibility index was measured for each patient using ultrasonography and the values of this index in accordance with the mentioned criteria was evaluated. Accordingly, reciever operating curve was depicted. Results: There was no significant asosociation between IVC collapsibility index with fractional excretion of sodium (P = 0.69), urine Na (P = 0.93) and urine osmolality ([P = 0.09]), while urine: Plasma creatinie ration revealed a significant association with IVC collapsibility index at cut point of 40.5% with sensitivity and specificity of 96% and 44% (P = 0.017, area under the curve: 0.67, 95% confidence interval: 0.551–0.804), respectively. Conclusion: According to the findings of this study, IVC collapsibility detected via ultrasonography was not an appropriate index to figure out hypovolemia in ICU patients. Furthermore, detailed studies are recommended.

Background: The seniors' lifestyle is an important public-health issue. Hence, assessing the association of cell phone use as a rapidly spreading technology on older adults' lifestyle can be useful for planning prevention and health-promotion policies. Materials and Methods: This cross-sectional study was conducted from March 2020 to March 2021 in Isfahan Comprehensive Health Care Centers to investigate the impact of cell phone use on the lifestyle of the elderly. The Cell-Phone Over-Use Scale and the lifestyle checklist were the assessment tools employed for this purpose. Results: Of the 300 participants with a mean age of 67.93 ± 5.14 years, 46% were male and 54% female. The average value of cell phone usage score was 47.88 ± 26.56, which was categorized into low 36%, moderate 41%, and overuse 23%. A positive and significant correlation was reported between the level of cell phone use in males (β =10.711, [0.95 confidence interval {CI} =4.262–17.160]) and people who have used a substance or opium in the past year (β =10.819, [0.95 CI = 3.677–17.961]). The present results found no significant association between cell phone use patterns and age, level of education, body mass index, television time, sports time, smoking in the past year, marital relationship, and living alone. Conclusion: In this study, we demonstrated a correlation between cell phone use and some demographic and lifestyle variables, namely sex and drug abuse.

Background: Different techniques have been introduced to reduce the complications of nasotracheal intubation. The aim of this study was to compare the incidence of nasotracheal intubation complications in finger-guided and conventional methods. Materials and Methods: In this double-blind randomized trial study, 70 patients who were candidates for oral and maxillofacial surgery who required nasal intubation were included in the study finally of which 33 patients with conventional method and 35 patients with finger-guided tubes in the nasopharynx were analyzed at the end of the study. Variables such as success rate, hemodynamic response, and complications of intubation were compared between the two groups. Results: There was no significant difference between the two groups in terms of hemodynamic response to intubation (P > 0.05). There was a significant difference between the two groups in terms of success in tracheal intubation (P < 0.05). There was a significant difference between the two groups in terms of epistaxis immediately after intubation (P < 0.05). There was no significant difference between the two groups in terms of nasal turbine fractures (P > 0.05). However, the frequency of submucosal intubation in the conventional method was significantly higher than the other group (P = 0.02). Conclusion: Nasotracheal intubation using the finger guiding technique in the nasopharynx is associated with a higher success rate and less complications after intubation such as epistaxis and submucosal intubation compared to the conventional method.

Background: The roles of Epstein–Barr virus (EBV) in breast cancer and breast lymphoma by transfecting EBV DNA have been indicated in different studies, but few investigations have been conducted on its roles in recurrence of breast cancer. Here, we aimed to evaluate the roles of EBV in recurrent breast cancer tissue. Materials and Methods: This is a cross-sectional retrospective study that was performed in 2020–2021 in Isfahan on patients with breast cancer. The study population consisted of 30 tissue samples from recurrent breast cancer and 30 samples from nonrecurrent breast cancer. We collected demographic data of patients including age using a checklist. Other collected data were type of cancer, stages of cancer, tumor size in greatest dimension, lymph node involvements, and presence of metastasis. Furthermore, we evaluated all of the pathology samples from both groups for the presence of DNA of EBV and compared the data of both groups. Results: The DNA of EBV was positive in 8 patients of the relapsed group (26.6%) and 7 patients in the nonrelapsed patients (23.3%). There was no significant difference between two groups regarding positive DNA of EBV (P = 0.39). There were no significant differences between two groups of positive DNA of EBV with and without recurrent breast cancer regarding type of cancer (P = 0.63), stage of cancer (P = 0.19), tumor size in greatest dimension (P = 0.31), mean lymph node involvement (P = 0.27), number of lymph node involvement (P = 0.43), and metastasis (P = 0.69). Conclusion: EBV might have no significant role in recurrence of breast cancer.

Background: The present study aimed at investigating the topical effect of the combination of Plantago ovata and vinegar on the improvement of rural cutaneous leishmaniasis lesions. Materials and Methods: The present randomized double-blind controlled clinical trial was performed on 42 patients with rural skin leishmaniasis. In the case group, in addition to injecting glucantime into the lesion according to the latest national instructions, a combination of P. ovata and vinegar was applied topically twice a day for 8 weeks. In the control group, only glucantime injection into the lesion was performed for 8 weeks according to the latest national guidelines. At the end of the 1^st, 2^nd, 3^rd, 4^th, 8^th, and 12^th weeks after the intervention, the lesion area and improvement were evaluated and recorded. Results: The results of the present study indicated the lesion area in the case group with the mean of 0.35 ± 0.39 cm and 0.18 ± 0.27 cm in the 8^th and 12^th weeks, respectively was significantly less than that of the control group with the mean of 0.64 ± 0.78 cm and 0.56 ± 0.44, respectively (P < 0.05). Twelve weeks after the intervention, 84.1% of the lesions in the case group and 65.9% of the lesions in the control group were completely improved (P < 0.05). Conclusion: According to the results of the present study, the improvement of leishmaniasis lesion with the topical application of the combination of P. ovata and vinegar was significantly more than that of the control group in the 8^th and 12^th weeks after the intervention.

Background: Health-care workers (HCWs) are in the frontline for fighting the coronavirus disease 2019 (COVID-19) pandemic and are at higher risk of acquiring the infection. Therefore, the defining immunity status among HCWs helps mitigate the exposure risk. In this study, we investigated the anti-SARS-CoV-2 immunoglobulin G (IgG) and immunoglobulin M (IgM) and also the associated risk factors in the HCWs working in Isfahan University of Medical Sciences COVID-19 referral hospitals. Materials and Methods: In a cross-sectional study, demographics, COVID-19 symptoms during the past 2 weeks, and health-care details were collected from 200 consenting health workers of COVID-center-hospitals of Isfahan University of Medical Sciences from 23 October to 21 December 2020. The recombinant SARS-CoV2 nucleocapsid protein enzyme-linked immunosorbent assay-based IgM, and IgG antibody tests were evaluated. Data were analyzed using Chi-square and independent-t-student tests, and P < 0.05 was considered significant. Results: One hundred and forty-one women and 59 men with a mean age of 36.4 ± 7.77 years participated in the study. IgG Ab and IgM Ab were positive in 77 (38.5%) and 12 (6%) of samples, respectively, and both antibodies were detected in 9 (4.5%). Higher ages, direct contact with the patients with COVID-19, muscle pain, loss of taste and smell, fever, and cough were the factors associated with antibody seropositivity against SARS-CoV2. Conclusion: This study demonstrated that the prevalence of HCWs with antibodies against SARS-CoV-2 is relatively high in Isfahan University referral hospitals. The development of safety protocols and screening and vaccination strategies in the frontline HCWs must be implemented to reduce the burden of infection.

Background: Endotracheal intubation is employed to create a safe airway in patients requiring mechanical ventilation. The relatively high prevalence rate of unplanned displacement of the endotracheal tube (ETT) can be associated with serious complications. This study was conducted to evaluate the effectiveness of a newly designed tube holder in Iran (Irafit), the Thomas ETT holder and the traditional method using adhesive tape. Materials and Methods: The present manikin-based study was performed on the human mannequin. For this purpose, the mannequin was first subjected to oral intubation by a skilled emergency medicine specialist. Then, three methods of adhesive tape, Irafit-ETT holder, and Thomas-ETT holder were used. The mean of displacement in width of the mouth, length of the ETT, and depth as well as ETT removal was recorded. Results: The results of the present study revealed that the displacement in depth was significantly less in the Irafit-ETT holder as compared with the other two groups following the application of a tug (P < 0.001). The displacement in the length of the ETT with and without the application of a tug was significantly less in the Irafit-ETT holder and Thomas-ETT holder groups as compared with the adhesive tape group (P < 0.001). Conclusion: According to the results of the present study, it can be stated that both ETT holder devices (Thomas vs. Irafit) were not distinct in terms of displacements in length and width; however, the Iranian model was more successful in minimizing the displacement in depth.

Background: Nasal polyp (NP) is the most common benign tumor that can cause nasal obstruction and more annoying problems in patients. Recently, investigators have been focusing on complementary therapies alone or in conjunction with endoscopic nasal and sinus surgery. However, given the association of Vitamin D (VD) deficiency and chronic rhinosinusitis with nasal polyposis (CRSwNP) in previous studies, it may be possible to prevent the recurrence of NP and the development of rhinosinusitis by controlling serum levels of VD and maintaining it at a normal level. The current study aimed to investigate the efficacy of VD supplementation in preventing CRSwNP recurrence after endoscopic surgery. Materials and Methods: This clinical trial composed of vitamin D deficient patients with CRSwNP who were candidates for endoscopic sinus surgery in two groups of cases and controls. After endoscopic sinus surgery for all patients, we administered VD supplementation (50,000 IU) once a week for 8 weeks for cases and no further intervention for controls. The severity of symptoms was assessed using Sino-nasal outcome test (SNOT-22) and NP recurrence and recorded pre- and postintervention. Results: The findings indicated a higher mean change of SNOT-22 in the case group compared to that of the control group (36.03 ± 10.71 vs. 29.90 ± 11.99; P = 0.041). Moreover, the percentage of NP recurrence in cases was lower than controls; so that receiving VD supplementation has significantly reduced the chance of NP recurrence (odd ratio [95% confidence interval]: 0.298 [0.099–0.900]; P = 0.032). Conclusion: According to the result of the study, the administration of VD supplementation after endoscopic sinus surgery can reduce the severity of CRSwNP symptoms and NP recurrence significantly.

Background: The studies reported that chemokines Chemokine (C-C motif) ligand 2 (CCL2) and Chemokine (C-C motif) ligand 5 (CCL5) have tumor-promoting roles in breast cancer (BC). The aim of the present study was to evaluate the effect of 4 weeks of continuous aerobic exercise (AE) on chemokines CCL2 and CCL5 and their relative receptors in animal model of human BC. Materials and Methods: BALB/c mice were divided randomly into four groups included cancer control (CC) and three other groups. The total duration of the experiment was 14 weeks, including 2 weeks of familiarization of mice with treadmills and three of 4-week periods of experiment. Tumor inoculation and formation were performed in the second 4-week period. Group 1 received AE in the first 4-week, Group 2 received AE in the second 4-week and Group 3 in the third 4-week. Results: The CCL2 was reduced significantly in Groups 1, 2, and 3 compared to control (F_3,12 = 4705, P = 0.0001). In terms of CCL5, a significant decrease was seen only between Group 3 and control. Western blot results showed a significant reduction in C-C chemokine receptor Type 2 (CCR2) between Group 1 versus CC and Group 2 versus CC (F_3,20 = 1.812, P = 0.004). In terms of C-C chemokine receptor Type 5 (CCR5) a significant decrease was observed between Group 2 versus control and Group 3 versus control (F_3,20 = 273.3, P = 0.042), (P = 0.004). Conclusion: It can be concluded that 4-week AE significantly reduces the chemokines CCL2 and CCL5 and their respective receptors levels CCR5 and CCR2 in different stages, and it may have an inhibitory effect on tumor growth.

Background: Nonalcoholic fatty liver disease (NAFLD) is a common obesity-related disease. In this study, we aimed to investigate the effects of pioglitazone on NAFLD in morbid obese patients. Materials and Methods: This is a randomized controlled trial study that was performed in 2020–2021 on 44 patients who had grade 3 NAFLD. At the beginning of the study, we collected the following data: age, gender, body mass index (BMI), fasting blood glucose (FBS), lipid profile, aspartate aminotransferase, alanine aminotransferase (ALT), and the total size and volume of the liver and the left lobe of the liver. Patients in the control group were given a special diet. For patients in the treatment group, pioglitazone 15 mg tablets were administered twice daily for 4 months. Results: At the beginning of the study, all patients in both groups had grade 3 of NAFLD. After the treatments, 50% of the pioglitazone group had grade 1 NAFLD, and 50% of other patients had grade 2 that showed significant improvements in patients (P < 0.001). We also found significant improvements in the following items in the intervention group: liver size (P < 0.001), size of the left liver lobe (P < 0.001), FBS (P = 0.036), ALT (P = 0.011), and BMI (P < 0.001). No significant improvements were found in the control group (P > 0.05). Conclusion: The use of pioglitazone for 4 months resulted in improvements in fatty liver stage, liver size, BMI, FBS, and lipid profile. These data show the effectiveness of pioglitazone in NAFLD.

Background: Epigenetic mechanisms play an important role in the regulation of gene expression and genetic information. DNA methyltransferases are a family of enzymes that methylate DNA at the promoter region of the gene which can significantly contribute to gene silencing and carcinogenesis. In addition, histone deacetylation leads to gene silencing and tumorigenesis. Our previous work indicated that histone deacetylase (HDAC) inhibitors can induce its apoptotic role through down-regulation of HDACs. This study aimed to investigate the effect of 5'-fluoro-2'-deoxycytidine (FdCyd) and sodium butyrate on the genes of intrinsic apoptotic pathway (BAX, BAK and APAF1, Bcl-2, and Bcl-xL), p21, p27, and p53 gene expression, cell viability, and apoptosis in human hepatocellular carcinoma Hep3B, SMMC-7721, and HA22T/VGH cell lines. Materials and Methods: The Hep3B, SMMC-7721, and HA22T/VGH cells were cultured and treated with FdCyd and sodium butyrate. To determine cell viability, cell apoptosis, and the relative gene expression level, MTT assay, flow cytometry assay, and quantitative real-time polymerase chain reaction were done, respectively. Results: Both compounds induced significant cell growth inhibition and cell apoptosis significantly (P < 0.0001). Sodium butyrate up-regulated the BAX, BAK, APAF1, p21, p27, and p53 and down-regulated Bcl-2, and Bcl-xL significantly in all three cell lines. Similar results were observed in the Hep3B, and SMMC-7721 cell lines treated with FdCyd. It has no significant effect on p53 gene expression in HA22T/VGH. The expression of the other genes in this cell line was similar to other cell lines. Conclusion: Both compounds induced their roles through the intrinsic apoptotic pathway to induce cell apoptosis.