فصلنامه علوم پزشکی دانشگاه آزاد اسلامی
سال بیست و نهم شماره 3 (پیاپی 97، پاییز 1398)

In early 2012, the world of science saw a fascinating discovery called circular RNA as a transcription product of thousands of genes in mice and humans. These circular RNAs have recently been grouped as the encoding RNA in an independent group that their remarkable difference with other RNAs is that these RNAs are not linear, in which two ends connect with a covalent connection creating a loop-shaped structure. These molecules play a role in regulating the expression of genes in mammals, and also, unlike other RNAs, they are very stable. These RNAs are created quite differently by means of a mechanism called back splicing. In this mechanism, in a molecule of RNA, axons or lariat- shaped introns are bonded at two ends of '3 and '5 with a covalent bond, creating circular structures that, unlike other common RNAs in the cytoplasm, are very stable. The circular RNAs act as mRNA sponge and form a set of RNA and protein that engage in transcription regulation by binding to RNA-related proteins. This suggests that these RNAs regulate gene expression at the transcriptional level and then they react by miRNAs. In fact, those circular RNAs that play a role in regulating the function of miRNAs also play a role in the onset and progression of the cancer. In tumor tissues, circular RNAs are reduced in comparison with normal tissues, and this may be for reasons like error occurs in the back splicing mechanism, degradation by unregulated miRNAs or increased cell proliferation. Recently circular RNAs have been identified in exosomic studies and in the movement of chromosomes in cancers, and there is found that the incorrect and abnormal attachment of these types of RNAs is related to drug resistance. Although it is thought that circular RNAs are non-coding, some of them are translated into functional proteins. So far, there are many unknowns about circular RNAs and the mechanism for regulating the expression of genes by them, but there is a lot of evidence to convince us that they will soon be used as biomarkers to diagnose diseases and therapeutic targets for cancers.

Permethrin is a drug used to cure pediculosis known as head lice. This drug is available in two forms: 1) permethrin topical cream 5%, 2) permethrin shampoo 1%. The aim of this study was to find a method and define the simultaneous cis and trans isomers for permethrin, methyl paraben, propyl paraben and butylated hydroxytoluene in topical cream 5% using the method high-performance liquid chromatography.

In order to analyze the measuring method, 5 concentration of samples and concentration of permethrin 5% have been provided, which each were injected to HPLC machine. Three times and the validity index such as selectivity, linearity, accuracy and correctness is analyzed.

According to the results of chromatographs, selectivity, linearity, accuracy and correctness were considered as acceptable areas.

Regarding the point that there is no pharmacopeia method to define the ingredients in permethrin cream simultaneously, it is so important to find an efficient analysis method to identify the peak of all ingredients in one chromatogram, considering the industrial production, time saving and increased efficiency of production units. Meanwhile the method was validated to insure that the results are correct, accurate, assurable and repeatable.

Colorectal cancer is one of the main causes of cancer death and the third most common malignant cancer worldwide. FGF14 is a member of the large family of fibroblast growth factors. These factors control a wide range of biological functions, including cell proliferation, survival, migration and differentiation that disturbing their expression can lead to cancer. The purpose of this study was to determine the expression of FGF14 in colorectal cancer tissue samples and adjacent healthy tissues.

In this case-control study, 35 patients with colorectal cancer and adjacent tumor tissue were classified based on their clinical and pathological characteristics. The expression was studied by real time PCR reaction method.

The relative expression levels of FGF14 in tumoral tissues were shown to be significantly increased compared with their adjacent normal tissues. There was significant correlation between the relative expression level of FGF14 in tumoral tissues and clinicopathological features, such as cancer staging, tumor size, and metastasis.

Increased expression of FGF14 in colorectal cancer tissue compared to the adjacent normal tissues is associated with the cancer progression and development relevant clinicopathological features. Therefore, it may play an important role in the pathophysiology of colorectal cancer.

Biofilms are a collection of microorganisms that have the ability to stick to different levels. Due to the difficulty of treatment of bacterial biofilm infections and their lack of recognition by conventional diagnostic methods, this study aimed to provide a new method of identification and the effect of related drugs on Pseudomonas aeruginosa and Escherichia coli biofilms.

In this study, two strains of Escherichia coli and Pseudomonas aeruginosa were used. Using the microplate method, gentamicin and imipenem combined with bromhexine and also bromhexine alone with different dilutions were used on the biofilm of these bacteria. Then results read out using ELISA reader.

Bromhexine alone and without combining with other substances or types of antibiotics had a positive effect on preventing the formation of biofilms and bacterial adhesion, and reduced Pseudomonas aeruginosa and Escherichia coli in the biofilm.

Biofilm has been able to grow significantly, despite the use of strong antibiotics such as imipenem and gentamicin. Its existence in the body, or devices such as urethral catheters, cardiac artificial valves or other artificial organs, causes a significant disorder within immune system.

Nerve growth factors reduction and blood-brain barrier distribution is one of the characteristics of multiple sclerosis (MS). Active life-style is known as a complementary and important strategy in MS therapy. The aim of the current study was to investigate the relationship between aerobic capacity and physical activity with serum level of nerve growth factors and markers of blood-brain barrier permeability in MS patients with normal weight or overweight.

In this study, 61 patients with MS (31 normal weight and 30 overweight) participated. Aerobic capacity and physical activity level were evaluated by the progressive cycling test and Baecke questionnaire. The levels of nerve growth factors and blood-brain barrier markers were measured by ELISA kit. Pearson and regression test were used to examine the relationship between variables.

A significant correlation was found between the level of physical activity and aerobic capacity with brain-derived neurotrophic factor (BDNF) and S100 calcium-binding protein B (S100B) in all participants, while BDNF concentrations were only associated with the aerobic capacity in the normal weight group. There was a significant relationship between s100b and both variables in the overweight group. Regression results showed that aerobic capacity independently predicted 20% and 30% of changes in BDNF and s100b.

In general, physical activity and fitness levels have a significant correlation with BDNF and s100b in people with MS, which can be modulated by the body composition. Therefore, physical activity can consider as complementary therapies in people with multiple sclerosis.

Klebsiella species are common causes of nosocomial, ulcers, blood and urinary tract infections, and also acquired pneumonia from the hospital and various intra-abdominal infections. Bacterial resistance mechanisms against antibiotics are different, but one of these resistance mechanisms, which is very problematic, is the production of β-lactamase enzymes in bacteria. The aim of this study was to determine the antibiotic resistance pattern and the presence of beta-lactamase genes in Klebsiella isolated from burn wounds among patients referred to Shahid Motahhari Hospital in Tehran.

100 strains collected for confirmation of production of broad-spectrum beta-lactamases (ESBLs) were tested by CDT (Combined Disk Test). Finally, β-lactamase genes were investigated using polymerase chain reaction.

The highest resistance rate was observed to ampicillin (93%). 23% of isolates produced ESBLs. The highest frequency of genes was bla shv gene (26.8%).

The presence of beta-lactamase genes with high antibiotic resistance is very worrying. Since the present genes can spread through mobile genetic elements in bacteria, among bacteria, it is considered to be a serious alert in the treatment of infections caused by Klebsiella.

Previous studies suggest that dysregulation of the immune system is involved in the pathophysiology of autism spectrum disorders (ASD). The aim of the present study was to investigate some pre-and anti-inflammatory cytokines in the serum of children with autism and healthy children and to determine the correlation between these cytokines and hs-CRP.

Serum levels of IL-1β, IL-1RA, IL-6, IL-10, TNF-α cytokines and hs-CRP were assessed in twenty boys with autism spectrum disorder, aged 6 to 14 years, and 20 healthy controls. To analyze the data, multivariate analysis of variance analysis was used to compare the variables in the two groups, and Pearson correlation coefficient was utilized to assess the relationship between the levels of the cytokines and hs-CRP at the level of 0,05. SPSS software version 21 was used.

The results showed that the level of all cytokines as well as hs-CRP in the autistic group was significantly higher than normal children (p<0.001), but there was no statistically significant relationship between cytokines and hs-CRP levels in children with autism (p>0.05).

The results suggest that abnormal immune responses such as increased levels of cytokines can be served as one of the biological markers of ASD.

Inter-professionals collaboration between nurses and physicians are essential for improving the quality of health care services. The purpose of this study was to determine the factors influencing participation in clinical decision making from the viewpoint of nurses and doctors.

In this cross-sectional study, 140 nurses and 100 Physicians in educational Hospitals to Qazvin University of Medical Sciences were evaluated using two separate researcher-made questionnaires (doctor and nurse versions) in four levels of individual, social, clinical and organizational factors.

The attitude of physicians to participation in clinical decision making in individual (23.07%), social (18.46%), organizational (18.07%), and clinical (16.92%) factors was good. Nurses had good attitude to individual (34.61%) and organizational (34.99%) factors, and medium attitude to social (28.45%) and clinical (26.15%) regarding participation in clinical decision making. The attitude of physicians to factors affecting participation was better than nurses (p<0.001).

Based on the results of this study, the use of proper management practices and the provision of workshops for the implementation of physician- nurses’ contributions is necessary.

The number of coronary artery bypass grafts is increasing as one of the most effective treatments. Adherence to the treatment regimen is one of the determinants of the effectiveness of this
intervention. The aim of this study was to evaluate the compliance of treatment regimen in patients underwent coronary artery bypass graft surgery in Tehran's Social Security Hospitals.

This descriptive-analytical study was performed on 255 patients in Milad and Shahid Lavasani Hospitals in 2017. Data were collected through a demographic and adherence to treatment regimen questionnaire. Data were analyzed using SPSS v18 software by applying descriptive statistics and regression modeling.

Most subjects had a rather favorable diet (98.8%), drug (72.9%) and physical activity (90.6%) adherence. In terms of drug and physical activity, the share of people who had unfavorable compliance was 25.9% and 9.4%, respectively. The mean score for the treatment regimen was 3179.76. Gender, having caregivers, history and frequency of admission, blood lipids, and blood pressure had a role in explaining the rate of compliance with the treatment regimen.

The findings of this study showed that the overall adherence rate of the treatment regimen in patients underwent coronary artery bypass graft surgery was at a relatively desirable level. The importance of adherence to the treatment regimen in preventing recurrence of disease and future disabilities encourages us to design and implement some interventions to improve the patients' willingness and ability to adhere the treatment regimen

Regarding the high frequency of drug errors and its importance in increasing financial costs and health of the patients, this study was conducted with the aim of determining the prevalence and types of drug errors among medical and nursing team.

In this cross –sectional study, of 903 medical errors, 385 reported drug errors were recorded in safety unit and mortality and morbidity committee of Besat Hospital in Hamadan during 2014-2015. The data were gathered in a checklist, including the types of drug errors, the wards and time of occurrence.

Of the 903 reported  medical errors totally, only 385 drug errors was reported (42.6%). The most errors were in dose of medicines (22.8%) and false timing of drug delivery (19.7%). The highest rate of drug error was reported in surgical (11.6%) and pediatrics (9.8%) wards.

The results showed that improving pharmacologic knowledge of nurses and physicians is important on of the patients’ safety. It is required to implement credit scales by the management team to lower incidence of drug errors.