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Showing 174 results for No
Parisa Habibi, Hadi Yousefi, Mehdi Khazaei, Mohammad Zarei, Iraj Salehi, Reza Jamali Delfan, Simin Afshar,
Volume 22, Issue 2 (7-2022)
Abstract
Background & objectives: Menopause and especially acute menopause due to surgery is associated with many complications in women. The aim of this study was to determine the effects of genistein and regular swimming exercise (alone/or in combination) on pain through a possible mechanism of inflammation and oxidative stress in ovariectomized rats.
Methods: In this study, rats were divided into six groups, including: control, sham, ovariectomy (OVX), ovariectomized with eight weeks of swimming exercise training (OVX.E), ovariectomized with eight weeks of genistein administration (OVX.G), and ovariectomized with eight weeks of combined treatment (OVX.G.E). The effects of genistein and/or exercise were evaluated by examining the pain intensity with tail-flick and formalin tests. The serum levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), total antioxidant capacity (TAC), total oxidant status (TOS), and malondialdehyde (MDA) were also evaluated by ELISA and spectrophotometer.
Results: In the OVX group compared to the control group, tail-flick and formalin tests showed an increase in pain response. Also, a significant increase in the serum levels of IL-1β, TNF-α, MDA, TOS and a decrease in TAC was observed in the OVX group, however, in the OVX.E, OVX.G and especially OVX.E.G groups, pro-inflammatory cytokines and oxidative stress as well as pain responses showed a significant decrease compared to the OVX group.
Conclusion: A combination of genistein and regular swimming exercise was synergistically more effective in reducing acute and chronic pain than using them alone in the postmenopausal period.
Faezeh Abbasi, Rahmatollah Parandin, Pouya Pournaghi,
Volume 22, Issue 2 (7-2022)
Abstract
Background & objectives: The pathophysiology of depression is very complex. Rosa canina L fruit contains various antioxidant compounds. The aim of this study was to investigate the anti-depressant and anti-anxiety effects of the aqueous- alcoholic extract of the Rosa canina L fruit in the behavioral tests including forced swimming, tail suspension, maze, and sucrose preference tests, as well as biochemical tests such as antioxidant capacity and malondialdehyde levels. Rosa canina L with high amounts of vitamin C, has anti-depressant and anxiety effects.
Methods: In this experimental study, 60 Syrian male mice were divided into 5 groups of 12, including the control group, the bisphenol A group, and three groups treated with oral bisphenol A at a dose of 125 mg/kg per day and the aqueous- alcoholic extract of the Rosa canina L fruit at doses of 100, 200, 400 mg/kg/day was administered from day 50 to 120 after birth. The data were analyzed using SPSS statistical software and the One Way ANOVA test. The level of significance was set at p<0.05.
Results: The findings showed that bisphenol A significantly increased the duration of immobility in the forced swimming and tail suspension test. The extract at the level of 400 mg/kg decreased the duration of immobility in both tests. Bisphenol A significantly reduced the antioxidant capacity of serum and brain. The extract at the level of 400 mg/kg significantly increased the antioxidant capacity of both the brain and serum.
Conclusion: The findings of this research showed that the fruit of the Rosa canina L has antioxidant effects, and with a significant decrease in antioxidant capacity and immobility in Syrian mice treated with the extract, therefore it has anti-depressant and anxiety effects.
Nahid Ahmadian Yazdi, Aziz Kamran, Somayeh Matin, Afshan Sharghi,
Volume 22, Issue 4 (1-2023)
Abstract
Background & objectives: Even though clinical empathy is one of the clinical competencies of medical students and there is a high emphasis on teaching and learning, it decreases during medical education. This study investigated the relationship between burnout, quality of life and clinical empathy in medical students.
Methods: this exploratory cross-sectional study used the Jefferson empathy questionnaire, WHO quality of life questionnaire and burnout inventory. All three questionnaires are standard, and their validity and reliability have been confirmed in various studies in Iran. The research population was the Ardabil University of Medical Sciences internship medical students, for which the census sampling method was used. Various statistical tests, such as Pearson and spearman correlation, Chi-square, etc., were used for data analysis.
Results: Out of 130 students, 128 (98.4%) completed all of the questionnaires. Data analysis showed that 98% of students suffered from moderate burnout and 2% of them had severe burnout. About 44% of students were satisfied or very satisfied with their health status and 33% of students were dissatisfied or very dissatisfied. The mean score of clinical empathy in students was 79.46±9.82. Data analysis showed a statistically significant inverse relationship between quality of life and burnout (p=0.0001).
Conclusions: Considering that the situation of students was not very favorable in terms of all three variables, non-curricular programs seem to be essential for improving student adaptation mechanisms to the job-related situations in medical students and promoting clinical empathy.
Pegah Alempoor, Ata Mahmoodpoor, Kamran Shadvar, Ali Asghar Kheiri, Ali Akbar Ghamari, Parviz Saleh, Seied Hadi Saghaleini,
Volume 23, Issue 2 (7-2023)
Abstract
Background & Objectives: Early warning scores are commonly used by hospital care teams to assess patients and diagnose early signs of their deterioration and initiate further treatment. Due to the existing studies and the lack of sufficient evidence for burned patients, we decided to investigate the value of initial NEWS and MEWS in predicting mortality in burned patients.
Methods: After obtaining permission from the Ethics Committee of TUMS, patients who were candidates for hospitalization in the burn wards of Sina Hospital from July to March 1998 were included. All demographic information including age, sex, APACHE Type of discharge, comorbidities, percentage of burns, initial hospitalization in the burn ward, type and time of initiation and duration of antibiotic use, amount of serum and NEWS and MEWS scores for all patients were enrolled immediately after admission to the ward as well as before discharge from the ward. Data were analyzed after registration in SPSS software version 23.
Results: In this study, 80 cases of burned patients were studied with a mean age of 37.94±18.85 years. The initial NEWS and MEWS indices have a good ability to diagnose burned patients (Area=0.79 and 0.78, p<0.001). The best cut- point based on the Youden index, for the initial NEWS and MEWS indices were obtained at 4.50 and 1.50, respectively.
Conclusion: In this study, for the first time, NEWS and MEWS were examined in predicting mortality in burned patients and it was found that these criteria can predict the prognosis of burned patients.
Aisan Ansari, Soheila Derisavi, Mahdi Rahbar, Amirreza Hoseinpour,
Volume 23, Issue 2 (7-2023)
Abstract
Background: Tooth decay directly and indirectly affects the national economy of some countries. These diseases reduce the number and productivity of the workforce. Medical expenses eat up savings and investments. All these factors reduce the earning power of individuals and households and affect the national economy, so an important part of the social and economic consequences of dental caries is the impact on savings at the household level and national income or gross domestic product at the national level.
Methods: The present study was descriptive, analytical and cross-sectional. The study sample was 260 6-year-old children and 260 adults who were referred to dental centers in 1401, and were randomly selected. The patients with tooth decay received services from the health and treatment centers of Ardabil city.
Results: The total cost of dental services related to tooth decay in 6-year-old children of Ardabil city was equal to 22543323 rials for one tooth, of which 94.23% of these costs are related to direct medical costs, 2.2% to indirect medical costs and 3.57% is related to non-medical indirect costs. The total cost of dental services related to tooth decay in the adult population of Ardabil city was estimated as 3,227,897 rials for one tooth, of which 95.93% of costs are direct medical costs, 2.43% of costs are direct non-medical costs, and 1.65% of costs are indirect costs.
Conclusion: Considering the high prevalence of tooth decay in 6-year-old children and adults in Ardabil city, its treatment imposes a significant part of the costs on Ardabil households, and the limited supply of dental services in the public health sector and the lack of insurance support in paying the costs have caused that families often pay for private services out of their own pockets.
Soheila Derisavy Jorfian, Madi Rahbar, Reza Savareh,
Volume 23, Issue 3 (10-2023)
Abstract
Background: despite the many benefits of dental implants, their cost remains a controversial issue. No study in Iran evaluated the costs and benefits of this treatment accurately, so the present study aimed to investigate the economic burden of implant surgery on the urban households of Ardabil province in 2021.
Methods: in this descriptive-analytical, cross-sectional study, the economic burden of implant surgery was estimated using the cost of illness method and human capital method. In this study, based on the content and purpose, the prevalence-based approach was used and a suitable checklist was prepared. The statistical population was patients referred to public and private centers providing dental services in Ardabil city. The sample size was calculated to be 160 people and a random sampling method was used for sampling. . Data analysis was done with SPSS version 21 software and Excel software.
Results: The results of the investigation showed that the total cost of implant surgery per unit was (118680744 Rials), 82.11% of these costs were related to direct medical costs, 10.92% were related to non-medical direct costs, and 6.97% were related to indirect medical expenses. Also, the economic burden of implant surgery on Ardabil society was estimated at 71 trillion 467 billion 62 million 235 thousand 635 Rials.
Conclusion: Implant surgery imposes a huge cost on society, so by planning the essential preventive tooth decay strategy, the economic burden imposed by implant surgery on the society of Ardabil can be reduced in the future.
Ramin Abiri, Samira Ghasemi, Malihe Bagheri Ghomi, Masoumeh Shahbazi, Ahmad Emami, Mahdi Mojarrab,
Volume 23, Issue 3 (10-2023)
Abstract
Background: Nosocomial infections are significant parts of the treatment challenges of hospitals. Different species of the Artemisia genus are widely distributed in Iran. The present study aimed to compare the in vitro effects of different aqueous extracts of Artemisia species against nosocomial bacterial strains.
Methods: 24 different aqueous extracts, including decoctions and infusions were prepared from the aerial parts of Artemisia ciniformis, A. turanica, A. kopetdaghensis, A. khorasanica, A. vulgaris, and A. sieberi. Total phenolic contents were determined by the Folin-Ciocalteu method. The minimum inhibitory concentration (MIC) values of the extracts against the bacterial strains including Staphylococcus aureus, Streptococcus pyogenes, Acinetobacter sp., Pseudomonas aeruginosa, Enterococcus faecalis, Staphyloccocus epidermidis, Micrococcus luteus, Klebsiella neumonia and Escherichia coli were measured using the microdilution broth method.
Results: The lowest MIC value was observed for the decoction of A. turanica (0.25 mg/ml) against S. pyogenes. The largest range of bacterial sensitivity (3 strains) was related to the decoction of A. sieberi. The growth of S. epidermidis was inhibited by a larger group of extracts. The highest total phenolic content was recorded for decoction and infusion of A. turanica.
Conclusion: The decoctions of the aerial parts of A. sieberi and A. turanica were superior to the other extracts in terms of the in vitro antibacterial spectrum and selective potency, respectively.
Masoomeh Saboorifar, Ali Shamsazar, Asadollah Asadi, Mostafa Shourian,
Volume 23, Issue 3 (10-2023)
Abstract
Background: Determining the concentration of hydrogen peroxide in liquids and biological samples is very important because of its effects on human health. This study aimed to design a new electrochemical biosensor based on hemoglobin to detect hydrogen peroxide in serum samples.
Methods: In this study, a basic science, a biosensor based on modifying the glassy carbon electrode surface with a nanocomposite consisting of cobalt oxide nanoparticles and multi-walled carbon nanotube functionalized with a carboxyl group (MWCNT/Co3O4) and hemoglobin stabilized on this nanocomposite was made as a biological recognition element.
Results: In optimal conditions, the biosensor was used to measure different concentrations of hydrogen peroxide. The designed biosensor showed a wide linear response range from 10 μM to 500 μM, a detection limit of 0.512 μM, and high reproducibility and stability.
Conclusion: In this innovative research work, MWCNTs/Co3O4 nanocomposite was used to make a diagnostic biosensor. The presented biosensor showed an acceptable performance in the measurement of hydrogen peroxide in serum samples and laboratory solutions.
Ramin Abiri, Samira Ghasemi, Nastaran Sharei, Masumeh Shahbazi, Seyed Ahmad Emami, Mahdi Mojarrab,
Volume 24, Issue 1 (4-2024)
Abstract
Background: Nosocomial infections are considered as the important parts of the treatment challenges in hospitals. The genus Artemisia is widely distributed in Iran. Their species produce antibacterial, antiviral, and antifungal compounds belonging to different groups including phenols, terpenoids, sterols and polyacetylenes. The purpose of the present study is to investigate the in vitro effects of different hydroethanolic extracts of Artemisia species against bacterial strains in nosocomial infection.
Methods: 12 different extracts, including 50% and 70% hydroethanolic extracts were prepared from the aerial parts of Artemisia ciniformis, A. turanica, A. kopetdaghensis, A. khorasanica, A. vulgaris, and A. sieberi. The winterization of the extracts produced corresponding defatted extracts. The minimum inhibitory concentration (MIC) values of the extracts against the bacterial strains Staphylococcus aureus, Streptococcus pyogenes, Acinetobacter sp., Pseudomonas aeruginosa, Enterococcus faecalis, Staphylococus epidermidis, Micrococcus luteus, Klebsiella pneumoniae and Escherichia coli were measured using the microdilution broth method. Total phenolic contents were determined by the Folin-Ciocalteu method.
Results: Among the extracts analyzed in this experiment, the lowest MIC value was observed for the 50% hydroethanolic extract of A. turanica (0.25 mg/ml) against S. epidermidis. The largest range of bacterial sensitivity (6 strains) was related to the 50% hydroethanolic extracts of A. turanica (defatted and non-defatted) and A. kopetdaghensis (defatted). The growth of S. epidermidis was inhibited by all of the extracts. The highest total phenolic content and yield of extraction were recorded for 70% hydroethanolic extract of A. sieberi and 50% hydroethanolic extract of A. ciniformis, respectively.
Conclusion: The 50% hydroethanolic extract of A. turanica was superior to the other extracts in terms of the in vitro antibacterial spectrum and selective potency. A. turanica and A. kopetdaghensis are probably suitable choices for further phytochemical and antibacterial investigations.
Maryam Nazari, Nilofar Saeli, Mohsen Arzanlou, Saghar Jafari-Ramedani, Hafez Mirzanejad-Asl, Farzad Khademi, Aida Alinezhad,
Volume 24, Issue 1 (4-2024)
Abstract
Background: Antibiotic resistance represents a critical global concern within the medical community, posing significant challenges in the treatment of infections caused by drug-resistant pathogens. Over the years, broad-spectrum fluoroquinolones have been extensively used to treat infections caused by both Gram-positive and Gram-negative bacteria, including Pseudomonas aeruginosa. In this study, we decided to assess the prevalence of plasmid-mediated quinolone resistance mechanisms among clinical isolates of P. aeruginosa in Ardabil hospitals.
Methods: We analyzed a total of 200 clinical isolates of P. aeruginosa, collected between June 2019 and May 2023. The antibiotic resistance profiles of these strains against various fluoroquinolone antibiotics were determined using the disk diffusion method. Additionally, we investigated the presence of qnrA, qnrB, qnrC, qnrD, and qnrS genes through polymerase chain reaction (PCR) analysis. Furthermore, we assessed the expression levels of efflux pump genes and outer membrane porin genes using the quantitative reverse transcription PCR (qRT-PCR) in fluoroquinolone-resistant P. aeruginosa strains.
Results: Our findings revealed that 69% of P. aeruginosa strains were resistant to fluoroquinolones. The resistance rates for different fluoroquinolones were as follows: ciprofloxacin 55.5%, ofloxacin 62%, norfloxacin 53.5%, lomefloxacin 55.3%, and levofloxacin 55.5%. Notably, 78.9% of these strains exhibited multidrug resistance (MDR). Among the qnr genes, qnrB was the most prevalent (2.9%). No other qnr genes were identified. Interestingly, 75% of P. aeruginosa strains carrying the qnrB gene showed overexpression of efflux pump genes, while 100% exhibited down-regulation of the oprD gene.
Conclusion: Given the high prevalence of fluoroquinolone-resistant P. aeruginosa clinical isolates in Ardabil hospitals and the multifactorial nature of resistance, continuous monitoring of antibiotic resistance trends and understanding the underlying resistance mechanisms are crucial for selecting appropriate treatment strategies.
Taher Sadeghian, Saeideh Allahyari,
Volume 24, Issue 1 (4-2024)
Abstract
Background: Oral mucositis as a complication of chemotherapy has posed significant challenges to the quality of life in cancer patients. Tricyclic antidepressants, including nortriptyline can control the pain caused by mucositis by inhibiting sodium channels. Since patient compliance and rapid drug effect are the goals of the proposed formulation, it was decided to prepare and evaluate a nortriptyline mouthwash according to the United States Pharmacopeia.
Methods: Based on the pharmacopeia, the necessary excipients in the nortriptyline mouthwash were determined, and the amount of each was specified. After validating the UV spectrophotometric technique, drug interaction with the mouthwash container was investigated. In addition to measuring the aqueous activity, necessary microbiological tests were also performed.
Results: The UV spectroscopy method validation for nortriptyline was performed at the obtained maximum absorption wavelength (238.5 nm). The findings of the investigation of the interaction of polyethylene terephthalate container with nortriptyline indicate almost no drug adsorption into the internal part of the mouthwash container over 28 days. The results of antibacterial and antifungal/antimycotic tests were within the standard range of the United States Pharmacopeia. The mouthwash's aqueous activity was also found to be 0.81, indicating an unfavorable environment for microbial growth.
Conclusion: This study has shown that the prepared nortriptyline mouthwash meets microbiological resistance standards and there is no interaction between the active drug ingredient and the proposed container. Therefore, this formulation can be suggested as a promising candidate for clinical exploration.
Kamaloddin Hamidi Nokhostin,
Volume 24, Issue 1 (4-2024)
Abstract
Enzymes have been used experimentally in the preparation of fermented, food, and medicinal products since mankind started a regular life in the form of early civilizations, without any information about their nature being available. It has been more than a century since scientists have obtained information about the enzymatic reactions and the enzyme structure, and a newer and more practical attitude towards them is obtained day by day. Today, these proteins play roles as biomarkers in the diagnosis, monitoring and treatment of diseases. Enzymes roles as receptor for some hormones and their qualitative and quantitative changes interfering in the onset of some diseases such as diabetes have been known. In addition, they are used as accurate and specific tools in the assay of some biochemical analytes, phenotypic identification of bacteria and biosensor design. The basis of the mechanism of some drugs is enzyme inhibition. Meanwhile, some enzymes are directly used as drugs. The enzymes are applied in some immunoassay techniques, genetics and proteomics laboratory methods. In modern biotechnology, enzymes are used to produce plenty of products. This review article aimed to take a new, updated and comprehensive approach to several roles that enzymes play in various fields from diagnosis, monitoring and treatment of diseases to their application in medical, genetics and proteomics laboratory methods.
Morad Beiranvand, Hossein Hamidinejat, Somayeh Bahrami, Mohammad Reza Tabandeh, Meysam Makki,
Volume 24, Issue 2 (7-2024)
Abstract
Background: A zoonotic obligate intracellular protozoan parasite, Toxoplasma gondii, infects all warm-blooded animals as well as humans worldwide. Identification of the level of infection in intermediate hosts gives us an important data about understanding the role of this parasite in human health as well as estimating the economic loss in livestock. Therefore, the main aim of this study was the isolation and identification of T. gondii from aborted goat fetuses by PCR in Lorestan province.
Methods: From autumn 2023 to summer 2024, the brain and liver of 100 goat fetuses were examined for T. gondii by PCR based on the amplification of 529 base pair fragments from repetitive regions of the parasite genome. The study was performed in three aborted fetus groups, less than 2 months, 2 to 4 months and more than 4 months.
Results: From a total of 100 examined samples, conventional PCR detected the T. gondii infection in 6 (6%) and 2 of the brain and liver fetuses respectively.
Conclusion: This study shows a notable level of infection in goat fetuses, and as a result, T. gondii should be considered an important agent involved in the abortion of goats in the Lorestan province of Iran. On the other side, it is necessary to pay more attention to the risk of transmission of this parasite from farmed animals to humans, especially pregnant women and people with suppressed immune system.
Saghar Jafari-Ramedani, Fereshteh Hasanpour, Alireza Mohammadnia, Farzad Khademi, Aida Alinezhad,
Volume 24, Issue 3 (10-2024)
Abstract
Background: The Gram-negative pathogen Pseudomonas aeruginosa (P. aeruginosa) is a common cause of hospital-acquired infections. This bacterium is continuously increasing its resistance to commonly used antimicrobial drugs, posing significant challenges for clinical treatment. Therefore, this study aimed to investigate the trend of antibiotic resistance in P. aeruginosa from 2019 to 2023 in hospitals in Ardabil city.
Methods: This cross-sectional descriptive study utilized 200 clinical isolates of P. aeruginosa obtained from urine, respiratory, wound, blood, and cerebrospinal fluid samples of patients who visited Ardabil hospitals between June 2019 and May 2023. The sensitivity and resistance of P. aeruginosa isolates to antibiotics-including piperacillin, piperacillin / tazobactam, ceftazidime, cefepime, aztreonam, imipenem, meropenem, amikacin, tobramycin, netilmicin, ciprofloxacin, ofloxacin, norfloxacin, levofloxacin, and colistin-were assessed using the disk diffusion and agar dilution methods.
Results: Over a period of 4 years, the resistance of P. aeruginosa to various antibiotics was observed as follows: piperacillin 45.5%, piperacillin/tazobactam 31%, ceftazidime 44%, cefepime 46%, aztreonam 12%, imipenem 67.5%, meropenem 52%, amikacin 43%, tobramycin 45.5%, netilmicin 39.2%, ciprofloxacin 55.5%, ofloxacin 62%, norfloxacin 53.5%, levofloxacin 55.5%, and colistin 9%. It is worth mentioning that the trend of antibiotic resistance in P. aeruginosa to all tested antibiotics increased during the first and second years, decreased in the third year, and then experienced a significant increase again in the fourth year. Throughout this period, the emergence of multidrug-resistant (MDR) strains of P. aeruginosa has also been on the rise.
Conclusion: The present study confirmed that the overall trend of resistance to various antibiotics among P. aeruginosa strains isolated from patients in Ardabil is on the rise.
Hamidreza Azari- Dastjerdi, Mohammad Javad Saeedi Borujeni, Mehdi Abrishami, Nasim Jafari Pozve,
Volume 24, Issue 4 (1-2025)
Abstract
Background: Sinonasal polyposis is a common respiratory disorder that reduces the quality of life of patients and causes secondary complications. The present study was designed to compare the severity of nasal septal deviation in patients with recurrent and non-recurrent sinonasal polyposis.
Methods: The present study is a case-control study conducted between 2018 and 2023 in the ENT Department of Gharazi Hospital, Isfahan. 80 patients with sinonasal polyposis were divided into two groups of 40: control (patients with non-recurrent sinonasal polyposis) and case (patients with recurrent sinonasal polyposis). For this purpose, the anatomical structures of the nose and paranasal sinuses were evaluated in the preoperative CT scan sample, and the severity of nasal septal deviation was calculated using OsiriX software.
Results: In the recurrent group, the mean angle of nasal septum deviation was 11.65±4.52 degrees and in the non-recurrent group, it was 9.7±3.76 degrees. Based on the independent t-test, there was a statistically significant difference between the two groups (p=0.039). The results also showed that asthma (p=0.043) and smoking (p=0.039) caused significant changes in the studied groups.
Conclusion: The results showed that recurrent sinonasal polyposis causes severe septal deviation more often than non-recurrent. A definitive statement on this issue requires a more detailed study with a larger sample size and also an investigation of the risk factors involved in the recurrence of polyposis.
Morteza Akbari, Saeed Sadigh-Eteghad, Ali Bahadori, Hossein Ghassemi-Moghaddam, Mojtaba Ziaee,
Volume 25, Issue 1 (4-2025)
Abstract
Immunotherapy has emerged as a promising and effective approach in cancer treatment by stimulating the body’s immune system to target and eliminate malignant cells. Despite its significant therapeutic potential, several challenges remain, including accurate patient selection, identification of appropriate therapeutic targets, and the minimization of adverse effects.
Artificial intelligence (AI) plays a critical role in addressing these challenges by analyzing complex genomic, proteomic, and clinical datasets. Machine learning and deep learning algorithms can accurately identify patients likely to respond to immunotherapy, enabling the development of personalized treatment plans while avoiding unnecessary interventions in low-response individuals.
A key application of AI is predicting the efficacy of immune checkpoint inhibitors such as PD-1 and CTLA-4. By integrating medical imaging and genomic data, AI models can forecast treatment outcomes, enhance diagnostic precision, and reduce healthcare costs. Furthermore, AI is increasingly used in drug development, where it simulates novel molecular structures and predicts their therapeutic efficacy, thereby accelerating drug discovery and lowering development expenses. AI also contributes to identifying and managing side effects, improving the safety profile of immunotherapy.
Nevertheless, the implementation of AI in oncology is not without limitations. These include the need for high-quality, annotated datasets, algorithmic interpretability, and ethical concerns such as data privacy, algorithm transparency, and psychological impacts of extensive genetic testing, excessive diagnostic testing, potential treatment discrimination, and unclear legal responsibilities.
This article concludes that with robust data infrastructure and the advancement of interpretable AI models, the full potential of AI in cancer immunotherapy can be realized. This synergy promises a major leap toward precision medicine and a brighter future in cancer care.
Maryam Ekran, Atabak Sedigh-Namin, Effat Iranijam, Shafagh Aliasgarzadeh, Nazli Javaheri, Afshan Sharghi,
Volume 25, Issue 2 (7-2025)
Abstract
Background: Thrombocytopenia is a clinical manifestation of coronavirus disease 2019 (COVID-19), potentially leading to bleeding and affecting disease prognosis. This study aimed to compare the prevalence of thrombocytopenia in deceased and recovered COVID-19 patients admitted to the Intensive Care Unit (ICU) of Imam Khomeini Hospital, Ardabil.
Methods: This cross-sectional study was conducted on 458 patients with confirmed COVID-19 admitted to the ICU of Imam Khomeini Hospital from April to September 2021. After applying exclusion criteria, 403 patients (136 recovered and 267 deceased) were analyzed. Demographic, clinical, and laboratory data, including thrombocytopenia severity, were extracted from medical records and analyzed using statistical tests (e.g., Chi-square and logistic regression).
Results: Thrombocytopenia was observed in 18.4% (25 of 136 patients) of recovered patients and 76% (203 of 267 patients) of deceased patients. The mean age of patients with thrombocytopenia was significantly higher in the deceased group (70.27±13.62 years) compared to the recovered group (61.20±15 years) (p=0.001). Heart failure was significantly associated with thrombocytopenia (p=0.038). Patients treated with remdesivir showed higher thrombocytopenia prevalence in the recovered (84%) and deceased (65.2%) groups, but this was not statistically significant.
Conclusion: Older age and heart failure were associated with increased thrombocytopenia in deceased COVID-19 patients. Severe thrombocytopenia was linked to a higher mortality risk.
Mohsen Salehi, Alireza Zeraatchi, Farzaneh Karamitanha, Gholamreza Hamidkholgh,
Volume 25, Issue 2 (7-2025)
Abstract
Background: Effective management of acute pain in patients with long-bone fractures is essential for comfort and procedural facilitation. While intravenous morphine is the gold standard for pain relief, it is associated with significant adverse effects. This study investigates the efficacy and safety of nebulized fentanyl as a noninvasive alternative to intravenous morphine in managing acute pain from long-bone fractures, alongside assessing patient satisfaction.
Methods: In a randomized, double-masked clinical trial conducted in the Emergency Department, 240 patients aged 20–50 years with long-bone fractures and visual analog scale (VAS) pain scores greater than five were randomly assigned to receive either nebulized fentanyl (4 µg/kg) or intravenous morphine (0.1 mg/kg). Pain scores were recorded at baseline and at 5, 10, 15, 30, and 60 minutes after the intervention. Secondary outcomes included the need for rescue analgesia, adverse effects, and patient satisfaction, which were analyzed statistically using a significance level of α = 0.05.
Results: At 5 minutes, the pain intensity difference between groups was Δ5 = x5 units (95% CI: [L5, U5]), and at 60 minutes, Δ60 = x60 units (95% CI: [L60, U60]). The need for rescue analgesia showed numeric differences at 15 and 30 minutes. Nausea/vomiting were more prevalent in the morphine group. Patient satisfaction was comparable between the two groups.
Conclusion: Both nebulized fentanyl and intravenous morphine are effective for acute pain relief, though morphine offers superior early relief. Nebulized fentanyl presents a viable alternative with fewer systemic side effects.
Nasim Hajighahramani, Fatemeh Ghasempour,
Volume 25, Issue 2 (7-2025)
Abstract
Background: Breast cancer is a leading cause of cancer-related mortality in women, and finding effective treatments is essential. Among different cancer immunotherapy strategies, vaccines play a prominent role. This study aimed to design a multi-epitope peptide vaccine based on Virus-Like Particles (VLP) against breast cancer using computational methods.
Methods: Antigen sequences of HER2, MUC1, Alpha lactalbumin, Mammaglobin-A and the MS2 adjuvant were retrieved. T-helper (HTL) and cytotoxic T lymphocyte (CTL) inducing epitopes were identified using servers such as IEDB, and their antigenicity and allergenicity were analyzed. Molecular docking was performed using HPEPDOCK between selected epitopes and corresponding MHC molecules. The best selected epitopes and adjuvants were connected by linkers. The designed vaccine’s properties, including allergenicity, antigenicity, solubility, and physicochemical properties were assessed. B-cells and IFN-γ inducing epitopes were identified. Finally, the vaccine’s 3D structure was modeled, refined, and validated.
Results: Epitopes from HER2, MUC1, Alpha lactalbumin, and Mammaglobin-A were identified through immunoinformatics analyses and selection of common HLAs in Iran. The 3D structure of the vaccine was designed, optimized, and validated, showing good stability, solubility, and antigenicity.
Conclusion: This study designed a VLP-based subunit vaccine with adjuvant properties that can enhance antigen presentation and induce robust B and T lymphocyte responses. The vaccine is a promising candidate for preventive or therapeutic use against breast cancer, though experimental and clinical studies are necessary to confirm its efficacy.
Parham Mansouri, Dariush Shanehbandi,
Volume 25, Issue 2 (7-2025)
Abstract
Colorectal cancer (CRC) remains one of the most prevalent gastrointestinal malignancies, posing significant challenges in diagnosis and treatment. Recent research has highlighted exosomes and their non-coding RNA (ncRNA) cargo as key players in tumor progression and novel diagnostic tools. Exosomes are extracellular vesicles (50-150 nm) secreted by normal and cancer cells that mediate intercellular communication. This comprehensive review examines the role of exosomal miRNAs, lncRNAs, and circRNAs in critical oncogenic processes including angiogenesis, metastasis, drug resistance, and immune modulation. Emerging evidence demonstrates that specific exosomal ncRNA contents may serve as sensitive and specific biomarkers for early detection, prognosis prediction, and monitoring of treatment response. However, challenges persist regarding standardization of exosome isolation methods and the need for expanded clinical validation. Advances in exosome research technologies hold promise for translating these findings into personalized medicine approaches. This review synthesizes current knowledge on the pathophysiological significance of exosomal ncRNAs in CRC and their clinical potential as diagnostic and therapeutic targets, while addressing existing limitations and future research directions in this rapidly evolving field.
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