مجله دانشکده پزشکی اصفهان
پیاپی 693 (هفته اول دی 1401)

Chronic lymphocytic leukemia (CLL) is one of the most common blood malignancies. The chief cells involved in this malignancy are in the G0 phase of cell division and have no proliferative activity; however, what determines the severity and prognosis of this disease is cell proliferation. Ki-67 antigen is a nuclear protein that is present in all cell proliferative phases except G0. The present study was aimed to investigate the prognostic value of Ki-67 antigen expression in patients with CLL and their disease behavior.

The current cross-sectional study has been conducted on 50 CLL patients in 2017. The disease severity based on Rai's staging system, lymphadenopathy, organomegaly, and complete blood count and differentiation (CBC diff) were assessed at study initiation and within six months. Besides, Ki-67 antigen level was assessed via flow-cytometry. Eventually, the prognostic value of Ki-67 antigen to determine CLL prognosis was assessed utilizing Receiver operation curve (ROC)

The study population had the mean age of 64.12 ± 10.42 years old and predominantly consisted of males (68%), and had the mean Ki-67 antigen level of 2.48 ± 1.73 (%). Rai's stage deterioration to 3 or 4, organomegaly, white blood cells (WBC) doubling and concurrent Rai's staging deterioration and WBC doubling (P = 0.002) were directly associated with Ki-67 antigen levels. At the cut-point of 3.44%, Ki-67 antigen had the sensitivity and specificity of 87.5% an 92.9%, with area under the curve (AUC) 0f 0.940 (95%CI: 0.835-0.988; P < 0.001).

According to this study, Ki-67 antigen is a valuable prognostic biomarker for CLL progression activity. Besides, at the cut-point of 3.44%, Ki-67 antigen had an acceptable predictive value for the progression manner of CLL disease.

Candidiasis is an important health problem and one of the most common infections of the female genital tract. The purpose of this study is to evaluate the effect of the formulated antifungal extract of Vaginahil® as a purified and formulated fraction of the ethyl acetate extract of Allium hirtifolium plant in the treatment of candidal vaginitis.

Fractions were prepared from ethylene acetate extract of Allium hirtifolium (mountain shallot) and their MIC against Candida albicans was determined. The most effective fraction with an anti-fungal effect was formulated and named Vaginiheal®. In total 30 women with confirmed vulvovaginal candidiasis infection were divided into two groups, one treated with Vaginiheal® and the other as control group without significant changes in age, education level, and occupation. Vaginiheal® was used to treat 15 women (n = 15) and the control group (n = 15) was treated with Clotrimazole.

The isolated fraction with the greatest antifungal effect had a MIC of 60 μg.ml-1 against Candida albicans. There was no significant difference between the women treated with Vaginiheal® and the group of women treated with Clotrimazole in terms of age, employment status, and pregnancy history. Our obtained results showed, Vaginiheal® treatment can lead to improvement and acceleration of complete treatment, reduction of inflammation, and decreasing of abnormal vaginal secretions in women with vulvovaginal candidiasis compared to the group treated with Clotrimazole.

Vaginiheal® should be considered as a new and effective medicinal option in the treatment of women with vulvovaginal candidiasis and its recurrent type.

Stomach cancer is the fifth most common disease and the third cause of death in the world. Therefore, in order to prevent and reduce the incidence of stomach cancer, factors related to logistic regression and neural network models were investigated.

In this study, a survey was conducted on 1,170 people as (n = 390) cases and (n = 780) controls. The data collection tool was based on the researcher's checklist. The samples were selected by available sampling method and their information was collected by face-to-face and telephone interviews. The fitting power in the logistic regression model and neural network was compared with receiver function characteristic curve (AUROC), sensitivity and specificity. By introducing the superior model, significant and related factors with stomach cancer were reported.

The results showed that the accuracy, sensitivity and specificity of the neural network were 96.4%, 93.7% and 81.9%, respectively. But the accuracy, sensitivity and specificity of the logistic regression model were reported as 95.9%, 91.1% and 84.4%, respectively. The neural network model indicates the variables of age (0.646), fruit consumption (0.713), history of self-medication (0.652), history of gastric ulcer (0.734), family history of cancer (0.852) and Family history of stomach cancer (0.836) were associated with the incidence of stomach cancer.

Considering that in the present study, the fit of the neural network was superior to logistic regression and it does not need any special assumptions, so it is suggested to the researchers that the neural network model can be preferred over logistic regression.