Journal of Kerman University of Medical Sciences
Volume:28 Issue: 5, Sep-Oct 2021

This study aimed to measure internal and external HIV stigma and their associated factors among people living with HIV in the southeast of Iran. Using convenience sampling and a standard questionnaire, we recruited 104 HIV-positive patients (40% women) in 2018-2019 from two public clinics in Kerman, Iran. The internal stigma scale ranged from 0-22 and the external stigma scale ranged from 0-11 in which a higher score indicates higher stigma. The mean internal stigma score was 10.7 (SD: 5.2), and that of the external stigma score was 3.1 (SD: 2.9). In multivariable regression analysis, women (Adjusted (Adj). ᵦ=-3.3; p=0.08), and married people (Adj. ᵦ=-5.5; p=<0.001) experienced less internal stigma. In contrast, those who were a member of support group of PLHIV (Adj. ᵦ=2.8; p=0.04), and those infected by sexual contact (Adj. ᵦ=2.1; P=0.006) experienced a higher internal stigma. Moreover, married people (Adj. ᵦ=-1.4; p=0.01), those with high school or higher education (Adj. ᵦ=-1.7; p=0.002), and those with other transmission routes (Adj. ᵦ=-1.4; P=0.01) experienced lower external stigma. People living with HIV feel considerable internal and external stigma. Addressing HIV stigma should be tailored based on gender, education, marriage, peer groups, and risk groups as these factors have different effects on stigma experiences.

The literature regarding the cardiovascular effects of pomegranate has been expanding during recent years. The present study aimed to investigate the cardioprotective effect of pomegranate juice following ischemia and reperfusion.

The animals were anesthetized with thiopental sodium (60 mg kg-1 BW) and their hearts were removed and perfused using Langendorff technique. In the first stage of the experiment, pomegranate juice was dissolved in Krebs solution. The first group was the normoxic control; the remaining 4 groups underwent 30 min global ischemia followed by 90 min reperfusion and received pomegranate juice at 0, 1, 2, and 4% in Krebs solution, respectively. The heart rate, coronary perfusion pressure, left ventricular developed pressure, rate pressure product (RPP), and dp/dtmax were monitored throughout the experiment. The infarct size was also measured via staining with triphenyl tetrazolium chloride. In the second stage, the rats received either placebo or pomegranate juice (4 ml kg-1 BW), daily, for 3 weeks. The hearts isolated from these animals were then studied as mentioned earlier, but no juice was added to the perfusion solution.

The hearts treated with the juice showed significantly higher percentages of RPP and increased dp/dtmax during reperfusion, compared to the control group. Moreover, these hearts showed smaller infarct sizes. In the second stage of the study, all studied hemodynamics were significantly higher in the test group both before and after ischemia. The infarct size was also smaller in the test group.

The results of the present study suggest strong cardioprotective effects of pomegranate juice against myocardial ischemia and reperfusion.

Root perforations are among the most common procedural complications during root canal treatment; these complications have a poor prognosis. This study aimed to evaluate the effect of furcation perforation on the fracture resistance of endodontically treated mandibular molars. Sixty intact extracted mandibular molars were divided into two groups; with a marginal ridge (access only) and without a marginal ridge (MOD and access cavity preparation). The two groups underwent endodontic treatment and were divided into three subdivisions: the first group was prepared without any furcal perforation, the second group had a 1-mm perforation in the furcation area, and the third group was prepared with a 3-mm perforation in the furcation area. The furcation perforation site was filled with calcium hydroxide powder and covered with glass-ionomer (GI). The teeth were restored with posterior composite resin. The teeth were then mounted in acrylic blocks and tested with a Testometric machine under compressive strengths. The fracture resistance diagram of each tooth was drawn. The data were analyzed with two-way ANOVA. The fracture patterns were evaluated after separating the teeth from acrylic blocks. Loss of marginal ridge had no significant effect on fracture resistance measurements (P=0.312), but the furcal perforation variable resulted in significant differences in fracture resistance measurements (P=0.004). Teeth without furcal perforation differed significantly from the teeth with a 3-mm furcal perforation in fracture resistance (P=0.009). The 1-mm furcal perforation group differed significantly from the 3-mm furcal perforation group in fracture resistance (P=0.011). The teeth with a 3-mm furcal perforation exhibited lower fracture resistance than the two other groups.

Graft-versus-host disease (GVHD) is a life-threatening complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Identifiying the probable risk factors can help the clinicians manage the consequences of GVHD. The main aim of this study was to analyze the correlation of body mass index (BMI) as a risk factor with the GVHD incidence. This retrospective study was conducted on 199 patients who received allo-HSCT during 2007-2017, as well as their donors. Almost all included patients received 10/10 human leukocyte antigen )HLA(-matched allogeneic stem cell transplants. The clinical data, including BMI, underlying disease and GVHD incidence, were collected from the clinical records. In the present study, GVHD was seen in 77 (38.6%) patients, including 59 acute and 18 chronic GVHD. The most frequent BMI range in both donors (35.5%) and recipients (45.2%) was between 18.5- 24.9 kg/m2. The transplants in which the BMI of donors were below 18.5 kg/m2 had 58% lower odds of GVHD incidence, compared to those with obese donors (CI: [0.21-0.85]; P = 0.05). Conversely, the donors with a BMI between 18.5 and 24.9 kg/m2 led to a 19% higher odds of GVHD incidence, especially acute GVHD, than transplants from donors with BMI above 30 kg/m2 (CI: [0.68-2.09]; P = 0.09). The recipients with a BMI between 18.5 and 24.9 kg/m2 had the odds of GVHD incidence 63% more than those with a BMI above 30 kg/m2 (CI: [0.89-3.06]; P= 0.3). The findings of the present study suggest the donor's BMI as a probable GVHD risk factor so that the BMI lower than 18.5 kg/m2 was statistically correlated with a decreased incidence of GVHD.

A novel liposomal pilocarpine formulation as an ophthalmic drug delivery system has been designed to treat patients with glaucoma. The purpose of the present study was to formulate and evaluate liposomes loaded with pilocarpine and to evaluate permeation through rabbit cornea. Liposomes containing pilocarpine were prepared using thin film method. The quantities of soya lecithin and cholesterol were changed to enhance the encapsulation of the drug. The physicochemical properties of the prepared liposomes were evaluated according to their viscosity, pH, particle size, in vitro drug release, and transcorneal rabbit permeation. Dialysis membrane method was utilized to assess drug release profile. The results indicated that the mean particle sizes of liposomes were 120.5-212 nm and the pH and viscosity of formulations were in the range of 6.30-6.63 and 43.85-80.1 cps, respectively. According to the release study results, maximumally 60% of the drug released from liposomal formulations after 24 hours of the experiment. Also, the cumulative percentage of the drug permeated through rabbit cornea was differing from 3.86 to 14.9%. Irrespective from the composition and characteristics of the different liposomal formulations, they significantly increased the drug partitioning, permeability coefficient and flux of pilocarpine in rabbit cornea ex vivo model in comparison to control drug solution. The present study proved that any alteration in composition and nature of pilocarpine liposomal formulations may affect the drug permeability parameters through corneal membrane and also physico-chemical properties. It is probably due to the change in corneal structure in the presence of different liposomes composition.

The aim of this study was to evaluate the concentration of zinc finger protein 510 (ZNF510) in the saliva of patients with oral lichen planus and healthy individuals in 2019. This cross-sectional analytical study was performed on 24 patients with oral lichen planus and 25 healthy individuals referred to the School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran, between June and October 2019. In the case group, the severity of lesions was determined according to the Thongprasom index. Unstimulated saliva was collected from the subjects and the samples were examined for the presence of the ZNF510 protein using ELISA method. The data were statistically analyzed through SPSS 23. For data analysis, Kolmogorov-Smirnov test, the independent t-test, the independent samples Kruskal-Wallis test, and one-way analysis of variance were used. This study included 32 females (65.3%), and 17 males (34.7%). The subjects’ age range was between 23-70 years and the mean age of them was 46.26 ± 10.90 years. The mean ZNF510 (ppm) in the case group was 86.12 ± 34.88, while in the control group, it was 46.43 ± 23.32. The two groups were significantly different in terms of the mean ZNF510 (P <0.001). In patients with non-keratotic lichen planus, the mean ZNF510 was significantly higher than that in those with keratotic lesions (P = 0.028). Moreover, in patients with oral lichen planus, the severity of lesions according to the Thongprasom index was significantly and directly related to the ZNF510 concentration (P = 0.002). The concentration of ZNF510 protein in the saliva can be a good indicator for assessing the severity of oral lichen planus lesions and its diagnosis. However, its clinical application is possible only if extensive prospective studies are performed.

The appropriate activity of the knee agonist-antagonist muscles is important to resist against abnormal abduction-adduction moments loads around knee joint and reduce the risk of knee injuries. Exercise training has been commonly used as an intervention to improve neuromuscular activity of the synergic and/or agonist-antagonist muscles. However, maximizing the effectiveness of exercise interventions for improving neuromuscular activity between muscle groups has been less investigated. The aim of this study was to investigate the improvement in neuromuscular activity of quadriceps and hamstrings muscles after resistance eccentric training versus concentric training.  

26 male subjects randomly recruited for this controlled laboratory study. Subjects were randomly divided into two groups, eccentric training group (No = 13), and concentric training group (No = 13). Maximal knee extension force and bipolar surface electromyography (EMG) signals from quadriceps and hamstrings muscles were recorded before and after concentric and eccentric strength training. Root mean square (RMS) was computed from raw EMG signals.

Percent increase in maximal voluntary isometric contraction (MIVC) of quadriceps muscle after eccentric training was significantly higher than that after concentric training (P < 0.05). Moreover, eccentric training resulted in a greater increase in RMS of EMG for quadriceps and hamstrings muscles compared to concentric exercise training (P < 0.05).

The higher increase in neuromuscular activities within the quadriceps and hamstring muscles observed after eccentric exercise may indicate that resistance training using eccentric contraction is more effective in improving neuromuscular activity of the agonist and antagonist muscles.

Semen analysis is considered as an important tool in infertility assessment process. One of the reasons implicated for altered semen quality, is bacteriospermia. This study aimed to determine the prevalence of bacteriospermia in seminal fluid and its effect on semen characteristics of infertile men attending infertility clinics in Kerman. Totally, 200 fertile and infertile men were investigated. Spermiogram, culture, isolation and identification were conducted according to WHO guideline and standard bacteriological methods. Semen parameters including sperm motility, sperm count, sperm morphology, sperm viability and the percentage of round cells in seminal fluid, showed significant difference between fertile and infertile groups. Also, in infertile men, abnormal sperm morphology was significantly higher among oligospermic specimens than normospermic ones.Bacteriospermia was found in 10% of infertile men and Staphylococcus aureus was the most common organism which was mostly isolated from teratozoospermic and asthenozoospermic specimens, however this finding was not statistically significant. Totally, asymptomatic bacteriospermia did not show any association with either infertility or abnormal semen parameters. Other bacterial/ non- bacterial agents or even factors other than infectious agents, may affect semen quality. However, to determine the exact role of bacteriospermia in infertility, further studies as well as evaluation of the outcome of bacteriospermia treatment, especially in those infected with S. aureus, are required.

Carcinoids tumors are slow-growing tumors which originate mainly from the small intestine and can produce biogenic peptides and amines. These products could cause carcinoid syndrome, and also, fibrosis in the peritoneum and mesentery.

 A 50-year-old man complaining of lower limb edema, ascites, and weight loss presented for evaluation. CT scan of the abdomen and pelvis revealed liver enlargement and the increased thickness of cecum and terminal ileum. The patient consented to an exploratory colonoscopy, which led to laparotomy resulting from sigmoid colon perforation. Large retroperitoneal fibrosis developing with colon and mesentery of sigmoid was found during surgery. Hepatomegaly with microscopic tumoral infiltration of the liver was observed and diagnosis of metastatic carcinoma in the liver was confirmed by pathological examination.

The most common sites of primary carcinoid tumors are appendix, ileum, and cecum. One of the less common manifestations of carcinoid tumors is fibrotic reactions around or beyond the tumor that in the reported patient, there was a very extensive fibrosis in the mesentery and peritoneum and serosa covering the colon and intestines, which presented with edema of the lower extremities because of the pressure on the IVC and with perforation of the colon during colonoscopy.

Transverse vaginal septum is a rare mullerian anomaly. Patients with a complete transverse vaginal septum generally complain of primary amenorrhea. Here, we presented a rare case of high transverse vaginal septum with abdominal mass during infancy in addition to chronic pelvic pain and cyclic hematuria during adulthood. The patient was a 26-year-old female with complain of severe abdominal and pelvic pain with significant weight loss. She had a history of surgery for correction of hydrometrocolpos (fluid accumulation in the uterus and vagina) because of transverse vaginal septum at infancy period. She had no gynecologic follow-up until the age of 26 years. At the last surgical evaluation, diffuse pelvic endometriosis with advanced metastatic colon cancer was noted. After diagnosis of transverse vaginal septum during infancy period, detailed counseling should be performed about the other treatment and follow-up which is needed to prevent severe complications that could affect the quality of life.

Helicobacter pylori is a gram-negative spirochete that usually affects the gastric mucosa and has a prevalence of more than 50% of people worldwide. It has been revealed that Helicobacter pylori infection is not only associated with chronic gastritis and peptic ulcers, but also with some hematologic disorders such as immune thrombocytopenia, iron deficiency anemia and gastric mucosa-associated lymphoid tissue lymphoma. Immune thrombocytopenia is an acquired autoimmune disorder with low platelet count due to devastation of autoantibody-coated platelets.

In the present study, it was reported an Iranian patient with severe immune thrombocytopenia (platelet count 1×109/L) and Helicobacter pylori infection who achieved a long lasting platelet recovery after Helicobacter pylori eradication therapy. The patient was followed up for two years and no failure in platelet response was observed.

Accordingly, Helicobacter pylori treatment is not only useful in immune thrombocytopenia patients with mild and moderate thrombocytopenia but also may be beneficial in severe cases of immune thrombocytopenia.

Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in children, but rare in adults, especially those in the middle age and older. Embryonal rhabdomyosarcoma in the head and neck region is relatively common, but rarely found intra-orally. A clear etiologic risk factor for the neoplastic growth of this malignancy has not been identified yet. Here, we report a case of an adult addict patient, with locally extensive embryonal rhabdomyosarcoma (ERMS) of tuberosity and palate, who received chemotherapy and radiotherapy, but died due to the progression of the disease 15 months after the diagnosis.We also carried out an overview of previous articles reporting this sarcoma in the oral cavity through searching keywords on the following online databases, without any date limitations: Pubmed, Scopous, MEDLINE, Google Scholar, and MD-Consult.Our search revealed only 8 articles reporting the occurrence of embryonal RMS in the maxilla among adults and none of them referred to any addict patient. The occurrence of oral ERMS in adults is a rare phenomenon associated with poor prognosis. Furthermore, addiction can contribute to more rapid tumor growth, treatment resistance, and reduced survival through mutagenic induction, immunosuppression, and angiogenesis.

Burn wound is one of the most common injuries worldwide. However, its management still remains a health concern and research is ongoing for more efficient therapies. Persian medicine has described different methods in this regard. Previous reviews have mostly focused on the herbal-based therapies for burn management. Hence, the current study aimed to review both non-herbal and herbal-based therapies used in Persian medicine for their burn healing properties, and to compare them with new evidence. The most important texts of Persian medicine were reviewed for burn wound classification, managements and treatment approaches. Moreover, herbal, minerals, and animal-based products claimed to possess burn wound healing activity, were extracted. In the next step, digital databases were searched to find new supporting data for the extracted-traditional remedies and their healing mechanisms. More than one hundred traditional medicinal herbs, minerals, and animal-based products have been recommended to treat burn wound in Persian medicine among them, the healing effect of thirty-five herbs and eight non-herbal treatments (mineral and animal-based compounds) were supported by new evidence. Otherwise, there was not new evidence reporting the healing effect of seventy-three herbs and sixteen non-herbal compounds extracted from Persian Medicine literature. Although some managements of burn wounds in Persian medicine have been confirmed by new evidence, the efficacy of a plenty of materials needs to be methodically evaluated. Hence, it could introduce new clues for future research.