Acta Medica Iranica
Volume:58 Issue: 11, Nov 2020

MicroRNAs (miRNAs) are a large family of evolutionary conserved small non-coding RNA molecules that firstly discovered in 1993. They regulate gene expression of about 50% of protein-coding genes at the post-transcriptional level. MiRNAs can target numerous messenger RNAs and subsequent misexpression of them can affect many different signaling pathways. They are playing a pivotal role in cancer development by regulation of the genes expression which involved in the proliferation, survival, differentiation, apoptosis or metastasis of the cancer cells. Several treatment approaches such as inhibition of oncomiRs and restoration of tumor suppressor miRNAs have been established in certain types of cancers and some other miRNA-based strategies are in development for cancer prevention and treatment. Nowadays, cancer is the most important target of miRNA therapeutics and the specific mechanisms by which miRNA mediates cancer pathways needs more research and study.

Malathion is an organophosphorous insecticide widely used in agriculture, residential area and public health programs with a known mechanism of toxicity of inhibition of acetylcholinesterase and induction of oxidative stress. Gold nanoparticles (AuNPs) represent a stable and easily synthesized nanoparticles with extensive use in consumer products and medicine. Due to antioxidant property of AuNPs, it is possible that AuNPs may prevent malathion-induced oxidative damage. In this study, the cytotoxicity of malathion and AuNPs (10 and 20 nm) were measured separately in Caco-2 cells. Then the protective effects of AuNPs were evaluated by measuring the oxidative stress (lipid peroxidation level and glutathione content), and acetylcholinesterase activity. The calculated IC50s values at 48 hr were 326.8±0.32, 43.09±0.65, and 41.46±0.24 µg/ml for malathion, AuNPs 10 and 20 nm respectively. Then, the lowest concentration of AuNPs (1 µg/ml) and IC50 concentration of malathion (326.8 µg/ml) were selected to evaluate the effects of pretreatment of Caco-2 cells with AuNPs before exposure to malathion were evaluated. Interestingly, the results showed remarkably significant protective effects of AuNPs by attenuation the different parameters of oxidative stress and cytotoxicity induced by malathion in cells (p<0.001). It is the first report showing protective effects of AuNPs against malathion-induced cytotoxicity in Caco-2 cell line.

Nonalcoholic fatty liver disease (NAFLD) is one of the most common cause of liver test abnormality and chronic liver disease in the world and can increase liver related mortality. Association of NAFLD with metabolic syndrome increase mortality due to cardiovascular disease too. NAFLD is categorized histologically into the nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH). Liver biopsy has been known as gold standard of evaluating NAFLD, but this procedure is invasive. It is time to replace available and easier way to diagnose, and predict the prognosis for better management of NAFLD. This study was comparing the result of transabdominal ultrasonography with Fibroscan as a new and accurate method for evaluating severity of fatty liver disease. This was a cross-sectional study that was conducted using 101 patients with NAFLD. All patients who had TUS by one experienced radiologist and fibro scan at the same time were included. Visual liver echogenicity was basis of grading in TUS. Fibro scans results are based on controlled attenuation parameters (CAP) which is not operator dependent. Other information, such as age, waist, and BMI, were also gathered. TUS has a low value for the diagnosis of liver fibrosis in NAFLD patients and predicting prognosis. TUS has a good correlation with fibroscan in grade 0 and 1of fatty liver, but in grade 2 and 3 of fatty liver, we can not rely on TUS for accurate grading.

Assessment of pulmonary hypertension (PAH) frequency and its association with interstitial lung disease (ILD), left ventricular diastolic dysfunction (LVDD), left ventricular systolic dysfunction (LVSD), and valvular heart diseases (VHD) in adult patients with rheumatoid arthritis (RA). Cross-sectional study. Cardiology and Rheumatology Departments, Ghaem Medical Center, Mashhad University of Medical Sciences, Mashhad, Iran. A total of 40 patients with RA without history or clinical features of cardiac diseases underwent cardiopulmonary and rheumatological assessment, including history taking, physical examination, chest X-ray, chest High-Resolution Computed Tomography (HRCT), and echocardiography. Echocardiographic variables of patients with RA were measured and analyzed. The relationship between rheumatoid arthritis and pulmonary hypertension. The prevalence of PAH was 60% in RA. The tests showed no significant differences in PAH between age and gender groups. The most common valve involvement among patients was tricuspid insufficiency, followed by mitral insufficiency. Grades I and II LVDD were present in 27.5% and 2.5% of patients, respectively. There were significant correlations between systolic velocity (Sm) and ejection fraction, early diastolic velocity and diastolic velocity, as well as Sm and systolic wave velocity. This study revealed a high prevalence of severe LVDD in RA patients with PAH. Early diagnosis and management of cardiovascular risk factors may prevent the development and progression of PAH in RA patients.

Core decompression is one of the commonest used techniques in the handling of osteonecrosis of the pre-collapsed head of the femur. Core decompression had succeeded in preserving the hip joint and delaying the requisite for total hip replacement, but it had failed in the induction of osteogenesis in the necrotic area, thus augmenting core decompression with biological agents to induce osteogenic activity. To assess the effects of platelet-rich plasma in non-traumatic avascular necrosis of the hip joint (early stage) after core decompression. Interventional comparative study for twenty-four patients (32 hip joints) with AVN of the head of the femur was involved in this prospective study, and they were separated into two groups of 16 hips, group (A) treated by core decompression and PRP injection and group (B) treated by core decompression alone. There was a significant statistical difference in Harris Hip Score and Visual Analogue of the two groups at six months follow up (P<0.05), but this difference was insignificant statistically at 12 months follow up. The radiological success was better in the group (A) as compared to group (B) (13 of 16 versus 10 of 16 hips). The addition of PRP to core decompression for pre-distorted stages of the head of the femur had resulted in improved pain alleviation and functional results and had slowed the disease progression in the one year of follow up.

About 6 percent (2%-7%) of the world’s population is chronically infected by the hepatitis B virus (HBV). The role of fibroscan for fibrosis assessment in HBV patients has not been widely studied. The present study was designed for the assessment of hepatic fibrosis by fibroscan in HBV positive patients. This is a cross-sectional study with two groups of case and control. According to the physical examination, lab data, abdominal ultrasound, and hepatitis viral load, the case group was categorized into three subgroups: inactive carrier, chronic hepatitis, and cirrhosis. The Control group was selected from a healthy population of 145 HBV patients, and 370 healthy persons entered the study. The case group included 35 inactive carriers, 63 chronic hepatitis B, and 47 cirrhotic patients, and their mean amount of fibrosis (measured by fibroscan) was 6.169 kpa, 7.758 kpa, and 24.0255 kpa, respectively. Also, the mean amount of fibrosis was 5.5510 (SD=2.43) in the control group. There was a statistically significant difference between cirrhotic patients and other groups (P<0.001). Also, a strong association between viral load and fibrosis degree was observed in chronic hepatitis B patients (P<0.001, R2=0.7811). Fibroscan is a novel instrument for the estimation of the liver fibrotic stage in HBV cirrhotic patients.

Leprosy is one of the oldest chronic diseases, and similar to other infectious diseases, it causes long-term physical and social effects on the lives of patients and their families. This was a cross-sectional study conducted with 103 patients with leprosy in Mashhad in the Mehrab Khan region in March 2016. The sampling method was convenience sampling. The data was analyzed using SPSS version 19. Descriptive statistics (frequency, percentage, mean and standard deviation) and inferential tests (ANOVA, Pearson correlation, and independent t-test) were used. The results showed that the mean age of patients was 65.2±8.1 years and the mean age of developing leprosy was 15.3±7.03. There was an inverse correlation between the score of overall stigma, internal stigma, and all dimensions of quality of life that was statistically significant, except for the social dimension (r= -0.181…; P=0.067). There was an inverse correlation between the psychological dimension of quality of life and experienced stigma. The highest score of the overall quality of life was related to divorced patients with a mean score of 79.7, which was statistically significant (P=0.016) from those who were not divorced. In post-hoc test, just the difference between widow and divorced were significant regarding quality of life. According to results, there was a negative correlation between the quality of life and all aspects of stigma using the SARI tool.

This study aims to illustrate the problem of (Quasi) Complete Separation in the sparse data pattern occurring medical data. We presented the failure of traditional methods and then provided an overview of popular remedial approaches to reduce bias through vivid examples. Penalized maximum likelihood estimation and Bayesian methods are some remedial tools introduced to reduce bias. Data from the Tehran Thyroid and Pregnancy Study, a two-phase cohort study conducted from September 2013 through February 2016, was applied for illustration. The bias reduction of the estimate showed how sufficient these methods are compared to the traditional method. Extremely large measures of association such as the Risk ratios along with an extraordinarily wide range of confidence interval proved the traditional estimation methods futile in case of sparse data while it is still widely applying and reporting. In this review paper, we introduce some advanced methods such as data augmentation to provide unbiased estimations.

Analyzing child mortality, an important indicator of heath and development of countries, can help policy makers to develop health programs resulted in improving Childs’ health. Recognizing the causes of in-hospital deaths, also, assists health care givers to revise their medical services. The aim of this study was to explore the causes of death in the largest hospital of western Iran. this retrospective descriptive-analytical study conducted in Imam Reza Hospital (IRH) in Kermanshah, data including demographic characteristics (e.g., age), medical information, and causes of death of patients aged ≤ 18 years, from April 2012 to March 2017 were collected using a check list. The causes of mortalities were categorized based on the International Coding of Diseases (ICD, Version 10). Using logistic regression, Chi-square and Cramer's V test in SPSS, the relationships between outcome and predicting variables were assessed. The results showed 1113 deaths among 21,247 people ≤ 18 year people admitted to IRH during 5 years. About 55% were female and 74% neonate, with a dropping trend from 2011 (4.62%) to 2016 (4.00%). Medical records, mostly, used a variety of usual medical terms for the causes of death, rather than using ICD10 categories. Data were analyzed after alternating medical terms and re-coding data using ICD10. Respiratory system diseases by 34% (dominancy of hyaline membrane diseases), infectious diseases by 28% (leading by sepsis), and diseases of the blood by 13% (mostly disseminated intravascular coagulation (DIC)), respectively, were the most common causes of death. Age was the most important associated factor for all-cause mortality associated with infectious diseases and respiratory system diseases (P=0.01).  Having a significant number of neonatal mortality, paying more attention to the neonatal, prenatal and antenatal care is recommended. In addition, the fatality of infectious diseases is concerning and needs paying serious attention by health care system.

Metastasis is responsible for most cancer-related morbidity and mortality. In principle, metastasis is the spread of cancer from the primary site to distant tissues. Pathological consistency may be compromised during metastasis. We report the case of a 55-year-old man with MRI images of the dorsal spine showing the effects of a fifth dorsal collapse. He was referred to our hospital because of back pain, imbalance, inability to walk, and weakness of the lower limb. The histological features of bone tumors were corresponding with cell carcinoma, and bone damage was considered metastatic from a site in the lung. His general situation gently diminished, and He died during radiotherapy.