Iranian Red Crescent Medical Journal
Volume:21 Issue: 4, Apr 2019

Alongside the re-emergence of public health emergencies, increasing displaced population in the world contributes to worsening the situation. We reviewed the partnerships of community-based organizations (CBOs) with health systems to identify the roles and responsibilities of CBOs in public health emergencies. The research team searched articles in Web of Science, PubMed, Science Direct, Scopus, Wiley, Google Scholar, World Health Organization (WHO), and Centers for Disease Control and Prevention (CDC) websites. Two independent reviewers decided to include articles if they addressed the role of CBOs in the happened public health emergencies. STROBE and Case Study checklists were used to examine the quality of the studies. After reaching 542 articles, 34 of them met the eligibility criteria. Articles mostly focused on high-income countries and the epidemics as disasters. Primary health care, logistic services, and communication were the most participatory services. However, just 14% of articles in childcare and 3% in elderly care services showed a partnership with the health system. Also, the emergence of influenza pandemics in the years after 2010 was a starting point for increased participation of the CBOs in public health emergencies. Health authorities should lead the CBOs’ participation to provide childcare and elderly services in public health emergencies. Moreover, low-income countries should promote the responsibility of protecting communities by considering the supportive role of CBOs in public health emergencies based on all potential capabilities.

There are five different kinds of death; natural death due to any disease, accidental death, suicidal death, homicidal death, and undetermined death. This study aimed to determine the major causes of death based on the autopsied reports to aid the development of preventive strategies. This study was a retrospective cross-sectional study consisting of autopsy reports of all suicidal, homicidal and occupational deaths recorded in all forensic medicine dissection halls in thirty-two provinces of Iran from March 2011 to March 2015. A questionnaire was designed containing all the information required for our studies such as gender, age, cause of death, and the autopsy reports. There were 19288 suicides, 11655 homicides, and 8558 occupational deaths during five years. Among suicidal deaths, there were seventy percent male and thirty percent female. Most victims (about 22%) were between 18 to 24 years old (Mean age ± SD: 33.1 ± 13.1 years). The highest cases of suicide were 52% hanging, and 25% poisoning, respectively. Among homicidal victims, there were 18% males and 20% females. Most victims were between 25 to 29 years old (24%) (Mean age ± SD: 32.4 ± 15.6 years). The most common methods were 46% firearms, and 29% stab wounds, respectively. Among occupational deaths happened in 99% of males and 1% of females. The most common victims’ age-group was 30 - 39 years old (25%) (Mean age ± SD: 35.8 ± 10.3 years). Seventy-four percent of cases were caused by blunt trauma as a result of falling from a height. The second common cause of death was Electrocution (21% of the cases). The analysis of the causes of suicidal, homicidal, occupational deaths, can aid the development of preventive strategies to decrease the occurrence of these kinds of preventable deaths in Iran.

Rutin (quercetin-3-rhamnosyl-glucoside), a flavonoid, is derived from plants and has antioxidant properties. This study aimed to evaluate the effect of different concentrations of rutin on mouse ovary heterotopic allotransplantation. The present animal experimental study was conducted on 40 female adult Balb/c mice weighing 30 ± 5 g at the Jundishapur University of Medical Sciences, Ahvaz, Iran, during 2016 - 2018. The mice were divided by permuted block randomization into 8 groups (n = 5): OVX (ovariectomy), as the negative control; normal (positive control); OVX + OVA (ovariectomy and transplantation) (control), treated with 0.5 mL of normal saline; OVX + OVA + 10 mg/kg of rutin; OVX + OVA + 30 mg/kg of rutin; OVX + OVA + 60 mg/kg of rutin; OVX + OVA + 100 mg/kg of rutin; and the autograft. Groups were treated daily. Fourteen days after transplantation, ovarian grafts were collected and processed histologically for follicle number counting. Serum estrogen (E2) and progesterone (P4) levels were evaluated. Furthermore, the expression of Estrogen Receptor alpha (ERα), Estrogen Receptor beta (ERβ), and Progesterone Receptor (PR) in the uterine endometrial tissue was tested using qRT-PCR and western blotting. A decrease in the number of mature follicles and increase in the number of atretic follicles (mean ± SD: OVX + OVA + 30 = 19.00 ± 1.000, OVX + OVA + 60 = 25.00 ± 5.000, and OVX + OVA + 100 = 23.00 ± 2.646) were observed in all groups treated with rutin in comparison with the control group (mean ± SD: 12.33 ± 2.517) (P value < 0.05). The level of E2 and P4 (mean ± SD: OVX + OVA + 100 = 6.133 ± 1.026) increased in comparison with the OVX + OVA group (mean ± SD: 0.4667 ± 0.2517) (P value < 0.05). The protein expression of ERα (mean ± SD: OVX + OVA + 10 = 1.615 ± 0.1701 and OVX + OVA + 30 = 1.744 ± 0.1779) in comparison with the control group (mean ± SD: 0.7089 ± 0.1131), and ERβ (mean ± SD: OVX + OVA + 10 = 0.7747 ± 0.4365, OVX + OVA + 30 = 0.9220 ± 0.1245, OVX + OVA + 60 = 0.7701 ± 0.2150, and OVX + OVA + 100 = 0.6676 ± 0.1547) increased in a dose-dependent manner in all groups treated with rutin in comparison with the OVX + OVA group (mean ± SD: 0.1534 ± 0.06109) (P value < 0.05). No significant changes in PR were found in groups treated with rutin in comparison with the control group. The results of the present study indicated that rutin increases E2 and P4 levels in ovarian hetero allograft mice. Rutin also upregulated the expression of ERα and ERβ but had no significant effect on PR.

Breast cancer is an important cause of death among women. Prevention of cancer through dietary intervention has recently received increasing interest. Lately, dietary polyphenols have gained much attention for their health benefits, including anticancer properties. Dalbergin as a polyphenol is synthesized from a common neoflavene intermediate. This study aimed to examine whether dalbergin can be useful in the chemotherapy of estrogen receptor-positive T47D cell line. This experimental study was performed at the Laboratory of Biophysics and Molecular Biology, the Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran, from October 2017 to November 2019. The doubling time of T47D cells was obtained from the growth curve. The cytotoxic effect of dalbergin on T47D breast cancer cells was evaluated. To assess the clonogenic ability, T47D cells were treated with dalbergin for 48 hours and then, the colony assay was performed. A Real-Time PCR was used to determine the transcription levels of p53, Bcl-2, and STAT3 genes. The doubling time of T47D cells was 28.02 ± 4.22 hours (P < 0.05). Dalbergin decreased the viability of the T47D cell line. The half-maximal inhibitory concentration (IC50) values of dalbergin for T47D cells were found to be 1 µM in 24 hours, 0.001 µM in 48 hours, and 0.00001 µM in 72 hours of treatment (P < 0.05). In the clonogenic assay, 0.001 µM dalbergin for 48 hours could reduce the surviving fraction of T47D cells (P < 0.05). Additionally, dalbergin could change the mRNA levels of p53, Bcl-2, and STAT3 genes (P < 0.05). Our results indicated that dalbergin has some anticancer effects probably through inducing apoptosis in cancerous cells by changing mRNA levels of apoptosis-related proteins.

Cancer is the second leading cause of death globally, and it was responsible for almost 9.6 million deaths in 2018. Breast cancer (BC) is the most common cancer among women with almost two million new cases worldwide in 2018. Thus, it is necessary to study new methods to estimate the survival predictive factors in BC patients. This cohort study aimed to fit a Cox model to BC data using partial likelihood (PL) and new maximum penalized likelihood (MPL) methods in order to determine the predictive factors of survival time and compare the accuracy of these two methods. This prospective cohort study used the data of 356 women with BC registered at the Cancer Research Center of Shahid Beheshti University of Medical Sciences in Tehran, Iran. The patients were identified from 1999 to 2015. The Cox model by new MPL and PL methods was used with variables such as the stage of cancer, tumor grade, estrogen receptor, and several other variables for univariate and multiple analyses. The mean age ± standard deviation (SD) of patients at diagnosis was about 48 ± 11.27 years ranging from 24 to 84 years. Using the new MPL method, in addition to lymphovascular invasion and recurrence variables, estrogen receptor (P = 0.045) also had a statistically significant relationship with survival. The standard errors of most variables were smaller when using the MLP method than the PL method. The overall one-year, two-year, five-year, and 10-year survival rates based on the baseline hazard estimate were 96%, 92%, 70%, and 51%, respectively. In the analysis of BC data, new MPL method can help identify the factors that affect the survival of patients more accurately than usual methods do. This method decreases the standard error of most variables and can be applied for identifying predictive factors more accurately than previous methods.

Ankaferd Blood Stopper® (ABS) is a hemostatic product comprising a standardized mixture of Thymus vulgaris, Glycyrrhiza glabra, Vitis vinifera, Alpinia officinarum, and Urtica dioica. It is used to control bleeding after extracorporeal injuries, traumatic cuts, dental operations, and surgical intervention. ABS was reported to exhibit antibacterial and germicidal activities. This in vitro study aimed to determine the antifungal activity of ABS. In total, 114 Candida strains; 65 Candida albicans and 49 non-albicans isolated from the oral cavity of patients with oral stomatitis, as well as three reference strains of C. albicans ATCC 90028, C.parapsilosis ATCC 22019, and C.krusei ATCC 6258, were tested by agar well diffusion, disk diffusion, and time-kill curve methods in this study. The results obtained for ABS were compared with those obtained for amphotericin B (AMB). ABS and AMB exhibited inhibitory zones with mean diameters of 18.2 ± 1.4 (12-20) mm, 20.6 ± 1.2 (18 - 23) mm by disk diffusion and 18.3 ± 1.3 (15 - 20) mm, 19.9 ± 2.6 (18 - 22) mm, respectively, by agar well diffusion methods for C. albicans. On the other hand, ABS and AMB showed inhibition zones with mean diameters of 19.4 ± 1.5 (18 - 24) mm, 19.1 ± 2.8 (13 - 30) mm by disk diffusion and 19.8 ± 2.1 (18 - 25) mm, 18.7 ± 2.3 (13 - 23) mm by agar well diffusion methods for non-albicans Candida isolates. ABS exhibited higher activity against non-albicans Candida species compared to C. albicans (P < 0.001). By the time kill-curve method, ABS achieved a 4 log10 cfu/mL decrease in C. albicans ATCC 90028, C. parapsilosis ATCC 22019, and C. krusei ATCC 6258, as well as seven different Candida spp. isolates of C. albicans, C. glabrata, C. tropicalis, C. guilliermondii, C. kefyr, C. krusei, and C. parapsilosis, respectively. ABS can be an alternative for treating superficial infections.

The response of microRNA (miR-1), upstream regulators (Myogenic Differentiation 1 (MyoD1) and Myocyte Enhancer Factor 2C (Mef2C)), and a downstream target (Histone Deacetylase 4 (Hdac4)) to an acute bout of Resistance Exercise (RE) in Extensor Digitorum Longus (EDL) and soleus muscles has remained elusive. In this experimental study, we investigated the effect of an acute bout of RE on the expression of miR-1, MyoD1, Mef2C, and Hdac4 genes in the slow and fast-twitch muscle of rats. The current study was conducted at Tarbiat Modares University, Tehran, Iran, in 2017. Fifteen male Wistar rats were randomly divided into two groups, control (n = 5) and RE (n = 10). The RE protocol consisted of four sets of five repetitions of climbing a ladder with weights attached to the tails of rats. The soleus and EDL muscles of rats were collected at 3 h (n = 5) and 6 h (n = 5) post-RE. The real-time polymerase chain reaction was used to measure the levels of miR-1, MyoD1, Mef2C, and Hdac4 mRNA expression. The miR-1 expression in EDL muscle was significantly lower at 3 h and 6 h post-exercise in the RE group than in the control group (P < 0.01). The miR-1 expression in soleus muscle was significantly lower at 3 h post-exercise in the RE group than in the control group (P < 0.007) but it was significantly higher at 6 h post-exercise (P < 0.036). The expression of MyoD1, Mef2C, and Hdac4 genes in the EDL muscle was higher in the RE group than in the control group (P < 0.01). The expression of these genes in response to RE had more fluctuations in soleus muscle. It can be concluded that miR-1 expression in extensor digitorum longus and soleus muscles of rats responds to resistance exercise in different manners and this coincides with a change in upstream regulators and downstream target.

Sickle cell disease (SCD) is a congenital hemoglobinopathy. A low Hb level and high hemoglobin-to-hematocrit ratio may lead to the vaso-occlusive crisis in patients, for the management of which hyperbaric oxygen, hydration, and pain relief therapy are proposed. In this study, we sought to compare the effects of morphine and ketorolac on relieving painful sickle cell crisis. In this double-blind, randomized clinical trial, we recruited 92 SCD patients who referred to the Emergency Department of a university-affiliated hospital, in Mashhad, Iran, from December 2016 to May 2017. The patients were randomly assigned to two groups of ketorolac and morphine injections for relieving pain crisis according to the clinical conditions of the patients. Pain severity was measured by the visual analogue scale before and after the intervention. Data were analyzed using SPSS software. A total of 92 SCD patients were evaluated, while, 19 (21%) were female and 73 (79%) were male, with the mean age of 20.77 ± 8.6 years. At the pre-injection phase, the mean pain scores were 9.1 ± 0.4 and 9.1 ± 0.7 in the ketorolac and morphine groups, respectively. After the intervention, the mean pain scores were 3.7 ± 1.2 and 4.9 ± 2.1 in the ketorolac and morphine groups, respectively. A significant association was found between the pain score after drug injection and the administered drug (P = 0.006). The management of pain crisis with ketorolac injection yielded the same results as the morphine injection in SCD patients. However, ketorolac was found to be associated with fewer side effects than morphine; thus, it can be beneficial for managing SCD patients suffering pain crisis.

Vancomycin damage to the kidney is one of the severe adverse reactions. The primary objective of this study was to discuss how the clinical pharmacists should deal with the results of therapeutic drug monitoring (TDM) for Vancomycin. A case of severe acute kidney injury in a 60-year-old woman receiving Vancomycin as empirical therapy is reported here. The patient was admitted to the respiratory intensive care unit (RICU) of the First Affiliated Hospital of Bengbu Medical College, China, on 15 Oct 2015. On Day 7, the steady-state serum trough concentration and peak concentration of Vancomycin were 102.2 and 111.9 μg/mL, respectively. Clinical pharmacists immediately contacted the clinicians and advised them to discontinue Vancomycin therapy as soon as possible, and the proposal was adopted. On Day 8, serum creatinine (SCr) increased to 719 μmol/L, and creatinine clearance rate (CrCl) decreased to 6 mL/min; then, the patient was given dialysis treatment. After she underwent dialysis treatment, SCr decreased to 330 μmol/L and CrCl increased to 14 mL/min on Day 19; then, the patient was discharged after she accepted the doctor’s advice to start a home-dialysis program outside the hospital. In this case, clinical pharmacists contacted the doctor to avoid further aggravated renal damage timely when they found a significant increase in Vancomycin concentrations. It indicates that the Vancomycin level can be used as an indirect marker of renal function as increased Vancomycin level results from and contributes to acute kidney injury.