فصلنامه کومش
سال بیست و چهارم شماره 6 (پیاپی 92، آذر و دی 1401)

Cancer is one of the most important health challenges. The World Health Organization has established tools to reduce the risks and burdens of cancer for countries within a framework called the National Cancer Control Program. this study aimed to design a cancer management model in Iran.

In this comparative study, comparison tables were prepared based on the dimensions of the research objectives. Then the preliminary model of cancer management in Iran was designed. A questionnaire was set up to test the template and validate it. The opinions of 23 experts were used in two stages of the Delphi technique.

In the present study, effective dimensions for cancer management in Iran were introduced: primary prevention, screening, early diagnosis, treatment, palliative care, survivor support, manpower, registration, and cancer research. According to the findings of this study, to optimize the cancer management program in Iran, cancer prevention programs, screening stages, and cancer palliative care services should be covered by insurance. Cancer treatment is decided by a multidisciplinary team. Palliative care specialists should be trained. Other findings are discussed in the main article.

Modeling and localization of cancer management dimensions of successful countries in cancer control, provides the basis for the development of cancer health services management in Iran.

Gastric cancer is a major public health issue worldwide. The factors that initiate cancer are not well understood, however aberrant expression of genes is associated with this cancer. TRIP13 plays pivotal roles in meiotic recombination, DNA repair, and cell cycle progression. An increasing body of evidence suggests that TRIP13 may possess functions other than meiosis and mitosis, particularly in the regulation of tumorigenicity. This study aimed to compare the expression of the TRIP13 gene in cancerous and adjacent tissue of gastric cancer and evaluate its clinical significance in the prognosis and survival analysis of gastric cancer patients.

A total of 50 tumor tissues and marginal control tissues were obtained from gastric cancer patients. First, the relative gene expression of TRIP13 was determined using quantitative real-time reverse transcriptase-polymerase chain reaction (qRT-PCR) and quantified using the 2-ΔΔCT method. Then, bioinformatic approaches were used to evaluate TRIP13 expression in two different cohorts of patients. A data mining study was also performed to determine the prognostic role of TRIP13 expression in the overall survival of gastric cancer patients. Finally, the correlation between gene expression and copy number of TRIP13 was obtained using CCLE database data analysis

The expression of TRIP13 in gastric tumor samples was increased 5.2-fold relative to adjacent normal tissues. Conspicuously, this finding was repeated in bioinformatics analyses and TRIP13 gene expression showed a significant increase in both cohorts of patients. Analysis of TRIP13 gene expression in 37 gastric cancer cell lines showed that the expression of this gene was significantly correlated with the number of copies. We also found a negative correlation between the high expression of TRIP13 and overall survival in gastric cancer patients.

It could be concluded that TRIP13 may act as a promising biomarker and a potential therapeutic target for gastric cancer diagnosis and treatment.

the rate of colonization of bocavirus (a newly recognized respiratory virus) was assessed in children with asthma and non-asthmatic condition due to the importance of bocavirus in preventing and exacerbating of childhood asthma.

In this study, 142 samples of nasopharyngeal swabs were assessed (71 with asthma and 71 without asthma). Viral nucleic acid was extracted and the quantity of human bocavirus was evaluated by the PCR method.

The prevalence of bocavirus was 18.3% (26 positive samples) and 80.77% of positive samples in which the bocavirus genome was found, belonged to the asthmatic group and 19.23% belonged to the non-asthmatic group.  there was a significant association between the severity of asthma and bocavirus colonization.

The results of this study showed that there is an important association between the human buccal virus and childhood asthma. However, more epidemiological studies are needed to simultaneously assess the presence of other respiratory viruses and their role in childhood asthma

Enterohemorrhagic Escherichia coli (EHEC) and serotype O157: H7 is one of the most important diseases causing diarrhea. Shiga-like toxin secreted by the bacteria destroys epithelial cells and, in acute cases, causes hemolytic uremic syndrome (HUS). Antibiotic therapy is not effective against this pathogen, because it increases the production of Shiga toxin. Designing chimeric immunogens can be one of the most effective strategies against bacteria. This study aimed to evaluate the immunogenicity of recombinant chimeric antigen-containing immunogenic regions of flagellin and intimin proteins against E. coli O157: H7.

Immunogenic regions of flagellin and intimin proteinswere selected for bioinformatics evaluations. Plasmid H7-Int pET28a- was transferred to E. coli BL21(DE3). Expression of the recombinant chimeric protein was induced by IPTG and evaluated by SDS-PAGE. The recombinant protein was purified using a Ni-NTA affinity chromatography column and confirmed by Western blotting. Immunogenicity of the protein was performed in mice with pure protein and antibody titers were determined by ELISA. Bacterial shedding and mortality in mice were examined.

Expression of recombinant protein in E.coli led to the production of a protein with a molecular weight of 70 kDa. The total yield of purified protein was 80 mg/L. Immunization of mice with recombinant protein induced humoral immunity. Bacterial shedding in immunized mice’s feces was significantly reduced (102 CFU / ml). 100% and 80% of the immunized mice survived challenged with 10LD50 and 100LD50 of bacteria respectively.

The results showed that the chimeric protein provides good protective immunity in mice and can be considered an immunogenic candidate against E. coli O157: H7.

Covid-19 epidemic results from an infection caused by SARS-CoV2. Evolution-based analyses on the nucleotide sequences show that SARS-CoV2 is a member of the genus Beta-coronaviruses and its genome consists of a single-stranded RNA, encoding 16 proteins. Among the structural proteins, the nucleocapsid is the most abundant protein in virus structure, highly immunogenic, with sequence conservatory. Due to a large number of mutations in the spike protein, the aim of this study was to investigate bioinformatics, expression of nucleocapsid protein and evaluate its immunogenicity as an immunogenic candidate

B and T cell epitopes of nucleocapsid protein were examined in the IEDB database. The PET28a-N plasmid was transferred to E. coli BL21(DE3) expression host, and IPTG induced recombinant protein expression. The protein was purified using Ni-NTA column affinity chromatography, and the Western blotting method was utilized to confirm it. Finally, mice were immunized with three routes of purified protein. Statistical analysis of the control group injection and test results was carried out by t-test from SPSS software.

The optimized gene had a Codon adaptation index (CAI) of 0/97 Percentage of codons having high- frequency distribution was improved to 85%. Expression of recombinant protein in E.coli led to the production of BoNT/B-HCC with a molecular weight of 45 kDa. The total yield of purified protein was 43 mg/L. Immunization of mice induced serum antibody response. Statistical analysis showed that the antibody titer ratio was significantly different compared to the control sample and the antibody titer was acceptable up to a dilution of 1.256000

According to the present study results, the protein can be used as an immunogenic candidate for developing vaccines against SARS-CoV2 in future research.

Internal Shoulder impingement is one of the most common problems in athletes with postural asymmetry. The present study aimed to investigate the effect of postural restoration exercises on patients' disabilities and the torque of the shoulder rotator muscles.

In this clinical trial study, 23 patients with internal shoulder entrapment were randomly divided into control and intervention groups. A positive Ober's test on the left hip indicated pelvic asymmetry and was considered a criterion for admission. Patients in the intervention group were treated with postural restoration exercises for six weeks. The control group did not receive any intervention. Internal and external rotator muscle torque and shoulder functional disability were measured using the Biodex isokinetic and DASH (Disability of Arm, Shoulder, and Hand) questionnaires, respectively. The variables were measured before the intervention, six weeks after the intervention, and four weeks after the completion of the intervention at angular velocities of 60 and 120 o/s at 45o, 70o, and 90o of shoulder abduction. Data analysis was performed using ANOVA with repeated measurements for intergroup comparison.

Findings of the present study showed a significant increase (P=0.000) in the isokinetic torque of the shoulder rotator muscles and also a significant decrease in functional disability (P=0.000) in the intervention group compared to the control group

The results of this study showed that postural restoration exercises in athletes with pelvic asymmetry can improve functional disability and increase shoulder rotational muscle torque

Weight gain and obesity are one of the most important health issues and one of the most severe public health problems. This study aimed to determine the effect of 10 weeks of High-Intensity Interval training (HIIT) and Mini-Trampoline training (MTT) with calorie restriction (CR) on body composition and aerobic capacity in overweight and obese women.

Forty-eight overweight and obese women with a mean (age: 32.71±4.11 yrs, weight: 75.19±4.86 kg) participated in the present study based on the inclusion criteria and voluntarily. Subjects were randomly divided into four equal groups (12 subjects): Experimental group 1: MTT with CT, Experimental group 2: HIIT with CR, Experimental group 3: CR, and Control group: No restriction calories were divided. Body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHTR), skeletal muscle mass (SMM), and body fat percent (PBF) were analyzed using the Boca Model X1 body composition analyzer, and for aerobic capacity, the Cooper test was used. CR (deduction of 500 calories from the daily energy intake of individuals) was for 10 weeks. HIIT and MTT have performed three sessions per week and each session was one hour of high-intensity exercise. The control group was asked to continue their daily activities and maintain a normal diet.

A 10-week period of MTT with CR improved BMI (P=0.001), WHR (P=0.004), BF and PBF (P<0.001), but HIIT had no effect on body composition (P<0.05). CR diet had a positive effect on BMI (P=0.001), WHR (P=0.009), BF (P=0.044). HIIT with CR (P<0.001) and MTT with CR (P<0.001) improved aerobic capacity and among these, HIIT had a greater effect on aerobic capacity (P<0.001).

The results showed that MTT with CR improves the body composition in overweight and obese women. Also, the effect of HIIT on increasing aerobic capacity was greater.

Attention to the quality of life of patients after coronary artery bypass graft (CABG) surgery is one of the priorities of nursing care. Although postoperative heart rehabilitation programs are performed in most centers, it does not seem to be sufficient to improve quality of life and require complementary programs. The purpose of this study was to determine the effect of yoga-based cardiac rehabilitation programs on the quality of life of patients after CABG surgery.

The present study is an experimental study that was performed in the intensive care unit of Shahid Beheshti Hospital in Shiraz in the first half of 2021. Participants were selected using convenience sampling and then randomly divided into two groups intervention and control. For the intervention group, a yoga-based cardiac rehabilitation program was performed virtually for one month. To collect data, the Ferrans, and Powers quality of life index - cardiac version was used.

There was no significant difference between the two groups in terms of demographic characteristics and quality of life scores before the intervention (P<0.05). Also, after the intervention, the difference between the mean score of quality of life between the two groups was significant (P<0.001). In the experimental group, the mean score of quality of life significantly improved from the pre-test to the post-test. but did not differ significantly in the control group. Importantly, this program affected all aspects of quality of life except mental health.

Yoga-based cardiac rehabilitation has an effect on the quality of life of patients after CABG surgery, so it is suggested that this intervention be used to help improve the lives of these patients

In recent years, yoga has been used as an intervention to improve memory function. The present study aims to investigate the effect of super-brain yoga practices on the consolidation and reconsolidation of motor memory in young girls.

Participants were 24 young girls in Lendeh, selected based on the inclusion criteria of the study and then randomly divided into two groups: experimental group (performing ten blocks of 80 trials in the acquisition phase, performing super brain yoga, recalling the tasks after 15 minutes and performing the retention test after one hour) and the control group (performing ten blocks of 80 trials in the acquisition phase, recalling the tasks after 14 days from the last training block of the acquisition phase and performing the retention test after one hour). Data was collected using the Altering Serial Reaction Time Task.

The results of variance analysis with the repeated measure in acquiring phase demonstrated that the subjects’ performance improved during the training trials (P<0.05) and the subjects had a better performance in the ninth and tenth training blocks than in the first. In the first retention test, both the super brain yoga group and control group made progress (P<0.05), however, the super brain yoga group made more progress than the latter. In the second memory test, the yoga practice group performed better than in the first retention test and the tenth training block.

Remarkably, the results of the study show that applying the intervention super brain yoga not only led to memory inhibition but also acted as a facilitator for consolidating and reconsolidating motor memory

One way to reduce the level of heat strain is to use personal evaporative cooling coats. such as the wrist, ankle, head and neck. The purpose of this study is to design, construct, and determine the cooling power of local cooling coatings and evaluate their efficiency in improving perceptual indicators in the laboratory.

Initially, the design and construction of local cooling coatings were performed using anthropometry. Then the cooling power of the mentioned coatings was calculated. Finally, the efficiency of the coatings designed to improve perceptual indicators on 16 students (8 men and 8 women) was tested in a climate chamber with a temperature of 35 ± 0.23°C and a temperature of 30±5%.

The average cooling power of cooling coats at 30% relative humidity at 30°C, 35°C and 40°C was 67, 77 and 89 watts, respectively. At the mentioned temperature and in 60% relative humidity, the cooling power was 34, 40 and 55 watts. As the relative humidity increased, the cooling power of the coats decreased. Also, the mean of thermal sensation and heat comfort during activity with a cooling cover and without a cooling cover in sitting and walking treadmill positions were significant (P-value≤0.05).

Local evaporative cooling coat on the head, neck, wrists and ankles can be reasonably effective in repelling excess heat entering the body and improving perceptual indicators. The best performance of these coats is in hot and dry environments.

Exclusive breastfeeding for up to 6 months has an important role in infant and maternal health and prevention of child mortality. And the present study aimed to examine the factors affecting exclusive breastfeeding in children under 6 months and evaluate the achievement of the World Health Organization's goal for 2025 at the national level.

In this national survey, Data from 1845 mothers/caregivers with children under 6 months were examined Information on breastfeeding and infant nutrition during the past 24 hours, demographic information and socio-economic status in 1396 were collected. The survey questionnaire is derived from the DHS questionnaire designed by WHO and the food intake section is based on the standard questionnaire of MICS designed by UNICEF. The role and importance of factors affecting exclusive feeding were determined by logistic regression and chi-square tests.

The rate of exclusive breastfeeding among infants (˂ 6 months) was 45.9%. The percentage of exclusive feeding was higher in girls compared to boys and it decreased with age (P=0.00). Mothers' employment outside the home is one of the effective factors in the discontinuation of exclusive feeding. In this study, the Husband's Occupation, parents' education, and socioeconomic status were not associated with exclusive breastfeeding (P>0.05).

We showed that the age and sex of the children and the occupation of the mothers have a significant effect on exclusive breastfeeding. Also, the national rate of exclusive breastfeeding has decreased compared to the previous studies. Thus, health policies should be aimed at raising the awareness of mothers and protecting employed mothers from breastfeeding.

According to the high incidence and complications of postoperative pain, nausea, and vomiting the current study aimed to assess the combination of acetaminophen-metoclopramide and ketamine-metoclopramide in comparison with a control group in decreasing post-vitrectomy pain, nausea, and vomiting.

The current randomized clinical trial has been conducted on 96 patients undergoing elective deep vitrectomy in three treatment groups of acetaminophen-metoclopramide(n=32) which received acetaminophen (10 mg/kg) and metoclopramide (0.15 mg/kg); ketamine-metoclopramide(n=32) which received ketamine (0.1 mg/kg) and metoclopramide (0.15 mg/kg); and the control group (n=32) who received 100 ml of sterile normal saline, all of the drugs were infused intravenously and within 20 minutes before the end of the procedure.  Pain and nausea intensity based on Visual Analogue Scale (VAS) and vomiting incidence and vital signs in the first postoperative 24 hours were assessed.

Hemodynamic parameters did not statistically differ between the study groups during the first 24 hours after surgery. Significant improvements were noticed in all the groups regarding pain, nausea intensity, and vomiting incidence in all the groups (P-value<0.05); however, the comparison of the groups showed the lowest pain (P-value=0.001), nausea (P-value=0.04) intensity scores and vomiting incidence (P-value=0.01) in ketamine-metoclopramide treated patients.

Based on the findings of this study, both acetaminophen-metoclopramide and ketamine-metoclopramide significantly reduced pain, nausea, and vomiting; however, generally, ketamine-metoclopramide had better results. None of the drug compounds caused serious side effects and hemodynamic disturbances

Changing position is one of the typical nursing care in intensive care units. This study aimed to investigate the effect of body positioning on intra-abdominal pressure and endotracheal tube cuff pressure and their relationship with each other in patients undergoing mechanical ventilation

This was a before-after clinical trial study performed on 70 patients over eight months. Eligible patients were placed in one of the positions of bed angle (flat, 30, and 45 degrees) and body position sideways toward an opposite direction to the mechanical ventilator. The intra-abdominal pressure and the endotracheal tube cuff pressure were measured with each change in body position and head of the bed. Data were analyzed at a significance level of 0.05.

Mean intra-abdominal pressure was different in positions (P<0.001). The mean intra-abdominal pressure at the flat angle was (7.4±0.49) CmH2O at the lowest and 45 degrees was (11.98±0.45) CmH2O at the highest. The mean intra-abdominal pressure in the supine position was significantly lower than in other positions (P<0.001). The endotracheal cuff pressure was significantly higher in lying down on the opposite side of the ventilator than in other positions (P<0.001). There is no significant relationship between intra-abdominal pressure and endotracheal tube cuff pressure (P=0.15).

The results showed that at the flat angle and opposite direction to the mechanical ventilator, the tube cuff pressure was maximal and at an angle of 45° and the position of the opposite side of the mechanical ventilator, the intra-abdominal pressure was the highest. Although there was no significant relationship between intra-abdominal pressure and endotracheal tube cuff pressure, when lying on the opposite side of the mechanical ventilator, intra-abdominal pressure and endotracheal tube cuff pressure were abnormally high. Therefore, it is recommended to avoid the patient in this situation.

Knee osteoarthritis is the most common arthritis and musculoskeletal disease. The low efficacy and significant side effects of synthetic drugs in the treatment of this disease have led many researchers to look for a drug that is effective but has fewer side effects. Recently, ginger is one of the most popular herbal remedies in the treatment of this disease. This study aimed to compare the effect of ginger by skin patch and oral capsule on pain intensity, joint dryness, and daily performance of patients with osteoarthritis of the knee.

This was a three-group clinical trial study that was performed on patients referred to Afshar orthopedic clinic in Dezful in 2015. Sampling was available. Subjects were randomly divided into three groups according to the table of random numbers: skin patch, ginger capsule, and control. All three groups received treatment prescribed by an orthopedic specialist. In addition, the ginger capsule group used 2 500 mg ginger capsules daily and the ginger skin patch group used one ginger skin patch daily in the middle of the waist for 9 weeks. The data collection tool was a demographic questionnaire and a translated version of the Arthritis Index of Western Ontario and McMaster Universities (WOMAC). One-way analysis of variance, paired t-test, and Tukey post hoc test aswas used to analyze the data. A significant level were considered 0.05.

The total number of participants in the study was 135.In the groups of ginger capsules, ginger skin patch, and control. the mean pain intensity before the intervention was 13.08, 14.52, and 13.55, respectively, and after the intervention, it decreased to 7.05, 8.62, and 11.37(P<0.00).

Ginger in both oral capsules and skin patches is effective in reducing the severity of pain and dysfunction in patients with osteoarthritis of the knee. It seems that only oral capsules reduce joint dryness and the ginger skin patch is ineffective.

Exposure to ethanol as a neurotratogen in the developmental period has destructive effects on the central nervous system and causes neurological disorders in adulthood. These disorders are associated with apoptosis in areas of the brain such as the hippocampus, by activating the oxidative-inflammatory cascade and high levels of nerve degeneration. Simvastatin, used as a drug to treat hypercholesterolemia, can cross the blood-brain barrier and its neuroprotective effects have been confirmed in several diseases of the nervous system. This study aimed to evaluate the protective activities of simvastatin on memory disorders and nerve cell necrosis in the rat hippocampus by postnatal alcohol exposure.

Male rat infants received 5.27 g / kg milk powder soluble ethanol on days 2-10 after birth by gavage. They also received 10 and 20 mg/kg of simvastatin on days 2-10 after birth subcutaneously. Cognitive memory abnormalities were assessed 36 days after birth by the new object detection and then, the number of necrotic cells was assessed by nissl staining.

Behavioral data showed that in the groups treated with simvastatin, the new object recognition memory increased compared to the ethanol group (P<0.01). In addition, in the ethanol group, an increase in cell death was observed in the CA1 region of the hippocampus, and treatment with simvastatin showed a significant decrease in the number of necrotic cells (P<0.01).

This study showed that simvastatin has a protective effect on alcohol-related neurological defects, although more research is needed in the future.