Iranian Red Crescent Medical Journal
Volume:24 Issue: 7, Jul 2022

Differentiation of stem cells into pancreatic beta cells is a global challenge in reconstructive medicine for the treatment of diabetes. Studies have shown that compounds derived from walnut green skin can differentiate stem cells into beta cells. Flavonoid compounds appear to be the main cause of this differentiation.

This study examined the effect of flavonoid compounds in walnut green skin on the differentiation of pancreatic beta cells.

The present study conducted the differentiation of adipose tissue-derived mesenchymal stem cells (AD-MSCs) into insulin-producing cells under flavonoid extract at doses of 50 and 100 mg/ml for three weeks. For diabetic rats, streptozotocin was injected intraperitoneally at a dose of 60 mg/kg. To evaluate cell differentiation, this study utilized morphology, dithizone (DTZ) staining, insulin-proinsulin production, insulin beta-receptor by the immunofluorescence method, and insulin measurement by the ELISA method. Serum glucose, cholesterol, and lipids were measured by enzymatic colorimetric, enzyme kit, and autoanalyzer, respectively. The expression of pancreatic cell-specific genes, including Pancreatic and Duodenal Homeobox 1 (Pdx1) and Neurogenin-3 (Ngn3), was also assessed by real-time PCR.

Differentiated cells transformed from spindle-shaped to circular or clustered cells under the influence of flavonoid compounds with their specific DTZ staining being positive. The expression of insulin-proinsulin markers, beta receptors, and insulin secretion was also confirmed. Decreased blood lipids and glucose, as well as increased expression of Pdx1 and Ngn3 insulin-producing genes, were significant in the treatment groups (P<0.05).

The findings showed that flavonoid compounds could effectively induce the differentiation of AD-MSCs into insulin-producing cells.

Although it is generally accepted that gynecomastia poses no risk of male breast cancer (MBC), the incidence of atypical changes observed in gynecomastia and their effects on the risk of MBC has been investigated recently.

Therefore, with follow-ups in our series, the present research was conducted to determine the incidence of atypia and its effect on breast cancer in gynecomastia cases.

A total of 151 breast tissues were surgically removed from 108 patients between the ages of 12-90. Atypia was investigated based on gynecomastia in the preparations sampled from these tissues.

Around 22 simple hyperplasia, eight atypical ductal hyperplasia (ADH), and one ductal carcinoma in situ were found in 151 breast tissues. Breast cancer was not observed in any patients during the follow-up period. Atypical ductal hyperplasia was seen in younger patients compared to simple hyperplasia (P=0.021). No relationship was observed between lesion size and the incidence of atypia (P=0.538).ICC values for seven components of geriatric nursing-specific Mini-CEX ranged from 0.639 to 0.919, indicating an acceptable level of reliability for this scale. The mean score of overall geriatric competence was (M= 6.12, SD=.33), which indicated that the geriatric competencies of students enrolled in the study were at a satisfactory moderate level. The highest and the lowest mean scores were observed in history taking /communication (M= 6.71, SD=.71) and physical examination skills (M= 4.99, SD=.67), respectively.

According to the findings of this study, ADH determined in cases with gynecomastia pose no risk of breast cancer in parallel with the current data in the literature. However, it is accepted that the presence of atypia based on gynecomastia needs to be investigated in series with a large number of cases.

Making decisions and planning about tracheostomy is not clear yet.

This study aimed to report intensive care unit (ICU) admission, intubation, and tracheostomy rates among patients in different settings and compare the outcomes of surgical andPercutaneous dilational tracheostomy (PDT) techniquesbetween COVID-19 and non-COVID patients.

Patients admitted to Masih Daneshvary hospital were assessed from February 2020 to May 2021 for intubation and tracheostomy rates. Different aspects and outcomes of two methods of tracheostomy, including surgical and PDT tracheostomy, were compared. Among non-COVID patients, 15 ICU admitted patients with different etiologies of pneumoniawho required mechanical ventilation and tracheostomy were randomly selected and compared to COVID-19 patients.

A total of 7,748 COVID-19 patients were admitted, with 12.7% admitted to ICU with an intubation rate of 5.13%. Tracheostomy was performed for a total of 36 patients (0.46%) for prolonged intubation with a trend of 0.1% to 1.45% in 16 months. Regarding the technique of tracheostomy, 24% and 33.3% of patients survived in surgical and PDT groups, respectively (P=0.44). Surgical tracheostomy and PDT were performed in 26.5% and 40% of non-COVID patients, respectively (P=0.5). The mortality rate was 72.2% and 20% in the surgical tracheostomy and PDT groups, respectively (P=0.003).

Given the study results, both surgical and percutaneous techniques are feasible for COVID-19 patients, and the decision about the optimal timing of intubation needs more inquiry.

Hospitals, similar to other organizations, are complex social systems influenced by elements, such as staff, resources, and structures, that work to achieve specific goals. In terms of goals and missions, hospitals are divided into teaching and non-teaching categories. There are many differences in the nature and needs of these two types of hospitals that must be considered for proper operation by policymakers and managers.

The present study compared issues between non-teaching and teaching hospitalsin Iran.

A qualitative study was conducted using semi-structured interviews according to an interview guide with 40 Iranian hospital managers and policymakersselected through purposivesampling in 2021. Data were analyzed through thematic analysis with an inductive approach using the MAXQDA software (version 10).

According to the results, the main categoriesof differences between non-teaching and teaching hospitals in Iran were as follows: legal and social responsibility, cost-effectiveness and efficiency, supply of resources, empowerment of human capital, goals and missions, external and internal communications, revenue-cost management, organizational structure, customer satisfaction, organizational behavior, clinical and support departments, hospital processes, type and level of services, manpower, performance evaluation, and the organization of the teaching mission.

Practical findings of this study include understanding the complexity and instability of command unity in teaching hospitals, understanding the differences in organizational hierarchy, developing a mechanism to cover costs for clients, increasing the legal and social responsibility of the management team, prioritizing organizational goals, coordinating policy demands with providing resources, funding the teaching mission, organizing multiple supervisory organizations, establishing transparent communication between hospitals and colleges, understanding the complexity of processes, considering the change of individual and group communication, changing the performance appraisal system, and paying for performance. It is suggested that policymakers consider these issues in providing the resources and facilities needed for hospitals based on their function.

Cardiac syndrome X(CSX) is a heart condition associated with Microvessel dysfunction, causing angina with severe chest pain. The CSX often severely impairs the quality of life and imposes a considerable additional cost burden on the health care system.

The present study aimed to assess the effectiveness of mobile health (mHealth) intervention on health-related quality of life (HRQoL) among CSX patients.

This randomized control trial (RCT) study was conducted at the Clinic of Tehran Heart Centre from March to August 2019. A total of 100 CSX outpatients were selected by randomized sampling and assigned to the intervention (n=50) and control groups (n=50). This study was focused on the effectiveness of the mHealth intervention in HRQoL. The pre-test and post-test were conducted via questionnaires.

Repeated measure MANOVA test for both groups across time pointed to a significant difference between the two groups in HRLQoL subscales at a 0.05 level of significance (F (3,95) = 7.358; P<0.001; Wilk's Λ = 0.811, η2= 0.189). The result indicated the positive effect of the intervention on HRQoL for CSX patients. Bonferroni test also revealed that the experimental and control groups did not differ significantly in three subscales of the questionnaire in the pre-test (P>0.05); nonetheless, they were significantly different in the post-test (P<0.05).

The HRQoL is considered an essential outcome measure in cardiac diseases, especially CSX, which is associated with impaired HRQoL. As evidenced by the results of the current study, the mHealth program, as a low-cost intervention, can promote the HRQoL among these patients.

Nurses have difficulties in caring for patients with obesity (PWO) due to their large size and complex care needs. As there have been few studies on these challenges, it is necessary to identify them for PWO through access to nurses’ experiences.

This study aimed to explain the nurses’ experiences of the challenges of caring for admitted PWO.

This qualitative study was performed on 12 nurses working in two large urban teaching hospitals in Iran. They were selected using the purposive sampling method. Data were collected using semi-structured interviews during 2018-2020. Content analysis and MAXQDA software (version 10) were used to analyze data.

According to the results, "threat to the patient safety" was the main theme extracted from nurses’ experiences, which included three categories, namely "from care difficulty to inaccurate care", "exacerbation of clinical complications", and "limited self-care". The category of "from care difficulty to inaccurate care" consisted of the subcategories of "care difficulty" and "inevitability of performing inaccurate care". The category of "exacerbation of clinical complication" was composed of the subcategories of "domino-like deterioration of the clinical condition", "multiple physical problems", "patient injury", and "death". The category of "limited self-care" included the subcategories of "patient difficulties with personal hygiene", "limited ability to move/change position", and "inability to meet defecation needs".

According to nurses, "threat to patient safety" was the main challenge of caring for PWO. Patients with obesity could receive competent care from nurses who have a thorough awareness of the obesity threat to patient safety.

Breast cancer is a common term for a malignant tumor that arises from the epithelial component of the breast. Concurrent chemoradiotherapy’s efficacy and safety are controversial, considering the impact on patients' quality of life.

The aim of this study was investigating the efficacy and safety of concurrent chemoradiotherapy with docetaxel in locally advanced breast cancer who have received a modified radical mastectomy.

A cohort of 110 female patients with locally advanced breast cancer were included in the present study and divided by chemoradiotherapy mode into a concurrent chemoradiotherapy group (n=58) and a sequential chemoradiotherapy group (n=52). Docetaxel was administered concurrently during radiotherapy in the concurrent group, whereas the sequential group underwent adjuvant radiotherapy 1-3 weeks after chemotherapy. Then, the two groups were compared with respect to clinical efficacy, levels of tumor markers across vascular endothelial growth factor (VEGF) and Carcinoembryonic antigen (CEA), adverse reactions, and the 3-year overall survival (OS) rate.

The results showed that the mean age, operation, evaluation of Post treatment VEGF (pg / mg) and Post treatment CEA (/g / L), effectiveness of treatment in two sequential and concurrent treatment groups was not significant The results showed that the amount of Prior treatment VGEF (pg / mg) and Post treatment VGEF (pg / mg) in the two groups were statistically significant difference. Which shows the positive effect of this treatment before and after the intervention. Comparison of survival time in the two groups did not show a significant difference.

The chemotherapy protocol with a combination of cyclophosphamide, fluorouracil and epirubicin with concurrent docetaxel presented higher efficacy and prolonged the overall survival in locally advanced breast cancer patients who had undergone a radical mastectomy, while it did not significantly increase the toxicity.

Few studies have investigated the changes in postoperative quality of life; serum Livin, epidermal growth factor (EGF), and interleukin (IL)-8 levels; and traumatic stress in patients with early gastric carcinoma after endoscopic submucosal dissection.

We aimed to determine the effect of endoscopic submucosal dissection on postoperative life satisfaction and serum Livin, EGF, and IL-8 levels in early gastric carcinoma patients.

Seventy-three early gastric carcinoma patients were divided into the control (n = 35, traditional radical surgery) and case (n = 38, endoscopic submucosal dissection) groups based on surgical approaches.

The operative time, gastrointestinal recovery time, length of hospital stay, perioperative bleeding, EuroQol visual analog scale scores, gastrin, and motilin levels were significantly superior to those in the control group, whereas serum Livin, EGF, IL-8, and C-reactive protein levels, as well as the total incidence of postoperative complications, were significantly lower in the case group than in the control group (all P < 0.05).

Endoscopic submucosal dissection in early gastric carcinoma patients provides the advantages of a short operative time, less perioperative bleeding, rapid postoperative recovery, and less traumatic stress and postoperative complications, as well as reduced serum Livin, EGF, IL-8, and tumor marker levels.

Levofloxacin is a fluoroquinolone antibiotic with extensive anti-bacterial effects.Levofloxacin is widely used for treatment of urinary and vaginal infections.

This research surveyed the cytotoxicity effects of levofloxacin on ovarian follicles of mice in both in vitroand in vivoconditions, as well as its anticancer effect on human ovarian cancer cell line (SKOV3).

For in vitrostudy, the ovaries of animals were isolated and treated with levofloxacin at doses of 1, 2, 5, and 10 μg/ml for 6 days. For in vivostudy, animals were treated with levofloxacin at concentrations of 100, 200, 400, and 800 mg/kg for 24 days. Histopathological and morphological examinations of ovarian tissues were performed. Real-time PCR and Western Blot techniques were performed to analyze apoptosis-related genes and proteins of ovarian tissues.

Levofloxacin at higher concentrations caused morphological changes and remarkably decreased the number of primary, secondary, and adult follicles compared to the control group. The percentage of viable SKOV3 cells was 10.12%, 7.63%, and 2.17% following exposure to levofloxacin (at a concentration of 800 μg/ml) for 24, 48, and 72 h, respectively.The half-maximal inhibitory concentration of levofloxacin against SKOV3 was found to be 181.1, 74.84, and 27.58 μg/ml at 24, 48, and 72 h, respectively. The percentage of SKOV3 cells apoptosis following exposure to levofloxacin after 72 h at 20, 80, and 200 μg/ml doses was 11%, 42%, and 52%, respectively. Real-time PCR revealed up-regulation of Baxand Caspase-3genes after exposure to levofloxacin in SKOV3 cells, whereas the expression of Bcl2was significantly decreased in a concentration-depended manner.

The present study demonstrates that levofloxacin induces apoptosis of both ovarian follicles and human ovarian cancer cell lines