فصلنامه کومش
سال بیست و پنجم شماره 2 (پیاپی 94، فروردین و اردیبهشت 1402)

Theranostic nanocarriers can be used simultaneously for the diagnosis and treatment of cancer. In this study, the effect of dotarem- and doxorubicin-loaded nanodroplet as a theranostic agent for ultrasound-guided and -controlled release drug delivery on HeLa cervical cancer cells was investigated.

Folic acid-targeted nanodroplets consisting of dotarm (Gd-DOTA) and doxorubicin (DOX) with alginate shells were synthesized and characterized. In this study, HeLa and L929 cell lines were used as cancer and normal cells, respectively. Intracellular uptake of nanocarriers was evaluated using Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES). Doxorubicin release in response to ultrasound exposure and its effect on cancer treatment were investigated. Ultrasound imaging was performed to assess the ultrasound signal enhancement by nanodroplets.

The characterization results confirmed the successful synthesis of nanodroplets with desirable physicochemical properties. Cytotoxicity test showed that the synthesized nanodroplets had high biocompatibility for normal cells and induced more death in cancer cells (75.3% vs 62.1%). This effect was enhanced under ultrasound exposure (51%). The ICP-OES test showed that the uptake of Gd/DOX-loaded nanodroplets for sonicated cancer cells was approximately 1.5 times higher than that for non-sonicated cells after 12 h. The results showed that the ultrasound exposure significantly increased the doxorubicin release from nanodroplets (77.5% vs 2.1%). Also, ultrasound imaging showed that perfluorohexane nanodroplets could enhance ultrasound signal intensity.

According to the results, doxorubicin- and dotarem-loaded nanodroplets with proper diagnostic and therapeutic properties can be promising theranostic agents in ultrasound-guided and controlled drug delivery for sonodynamic therapy of cancer.

Chronic lymphocytic leukemia (CLL) as a lymphoproliferative disorder that is characterized by the expansion of monoclonal, mature CD5+CD23+ B cells in the peripheral blood, secondary lymphoid tissues, and bone marrow is facing with advent of new therapies targeting crucial biological pathways. Thymoquinone (TQ) is the major bioactive constituent in black seed oil (Nigella sativa) and has been found to exert anti-tumor impacts mainly through the induction of apoptosis. This study aimed to evaluate the in vitro anti-leukemia effects of TQ on peripheral blood mononuclear cells (PBMCs) of CLL patients.

Peripheral blood mononuclear cells (PBMCs) of 6 patients and 6 healthy donors were treated with 15 μg/ml of TQ for 24 h. The cytotoxic effect of TQ was assessed using the MTT assay. Flow cytometry was used to analyze the apoptosis of PBMCs.

Treatment with TQ increased the cytotoxicity of PBMCs of CLL patients more significantly than in Untreated cells (P=0.021). Flow cytometry results indicated that TQ exhibited a significant apoptotic impact on PBMCs of CLL patients compared to the healthy subjects (P=0.001). TQ also induced marked apoptosis in CLL cells compared to the Untreated cells (P=0.006).

Our findings reveal that TQ possesses promising therapeutic potential as an anti-tumor agent for treating CLL mainly through the induction of cell apoptosis and cytotoxicity.

By 2020, colorectal cancer accounted for 10% of global cancer incidence and 9.4% of cancer deaths. Apart from biomedical characteristics, socio-economic status can also play a role in inequality in the outcomes of this disease. In this account, this study aims to analyze the regional socio-economic disparities in the incidence of colorectal cancer in Iran.

This cross-sectional study was executed using provincial data from 2018. The required information was extracted from the report of the statistical yearbook, the report of the Statistics Center, and the national report of the National Cancer Registration Program of the Ministry of Health of Iran. Using STATA 14, concentration indices were estimated and concentration curves were extracted.

Only the concentration index of health insurance coverage percentage and employment percentage was negative. The effect of health insurance coverage on inequality in cancer incidence (CI=-0.364) was also statistically significant (P<0.05). The results showed that per capita income has caused the most inequality (CI=0.632) in the incidence of colorectal cancer (P<0.05). While the effect of provincial employment percentage on incidence inequality was the lowest (CI=-0.064) and was not statistically significant. After per capita income, the per capita expenditure concentration index (CI=0.564) was in second place in terms of inequality (P <0.05). The literacy rate with CI=0.484 was in the next rank of inequality (P<0.05).

Socioeconomic characteristics of the provinces have an important role in the inequality of colorectal cancer. Policymakers can improve early detection of the disease in the country's provinces by covering screening services with medical insurance, providing screening credit cards, payment exemptions for the lower deciles, and social marketing.

Lymphoma is the seventh most common malignancy worldwide, which is divided into types of neoplasms, of which three types, Hodgkin's lymphoma (HL), Non-Hodgkin's lymphoma (NHL), and Burkitt's lymphoma are the most common. miRNAs are regulators of gene expression that are involved in physiological processes and are involved in cancer. In the present study, the polymorphisms of pre-miR-3131 rs57408770 and Pri-miR-34b/c rs4938723 genes in patients with Non-Hodgkin's lymphoma were compared with healthy controls.

In this case-control study, 359 specimens were studied, of which 173 were (NHL) patients and 186 were healthy controls. Patients were selected from the patients referred to the cancer clinic of Ali Ibn Abi Talib Hospital. The DNA genome was extracted from the peripheral blood sample by the salting out method. The variants of Pri-mir-34b/c rs4938723 and pre-miR-3131 rs57408770 genotypes were analyzed by PCR-RFLP method.

The results showed that Pri-miR-34b/c rs4938723 homozygous polymorphism increased the risk of (NHL) in codominant and Recessive models. (OR= 2.70, 95% CI =1.13-4.43, P=0.025, OR=2.91, CI 95% =1.17-7.42, P=0.018 respectively). Pre-miR-3131 rs57408770 polymorphism increased the risk of (NHL) in homozygous states in codominant and recessive models. (OR=2.26, 95% CI=1.21-4.25, P=0.006, respectively).

The results showed a significant relationship between pre-miR-3131 rs57408770 polymorphism, Pri-miR-34b / c rs4938723, and (NHL) disease in the Iranian population.

Peripheral neuropathy (PN) is resulted from damage to the peripheral nervous system (PNS) and usually causes weakness, numbness, and neuropathic pain, which is a type of chronic pain. Despite the variety of treatment options, treating neuropathic pain faces challenges and the existing treatments are not yet satisfactory. Nervous steroids show important physiological regulators of PNS function. Progesterone is a neurosteroid that has both analgesic and anti-inflammatory properties. Also, GABA-A receptors play an important role in mediating the effect of progesterone. This study was designed to determine whether progesterone can prevent electrophysiological deterioration of the sciatic nerve in the chronic constriction injury (CCI) model of neuropathic pain in rats and that do this effect through GABA-A receptors.

In this study, 140 male Wistar rats in 14 groups (n=10) were used. Neuropathic pain was created by the CCI method in the relevant groups. After CCI induction, progesterone and bicuculline or their vehicles were administered daily until day 13 post-CCI. After that, nerve conduction velocity (NCV) tests were performed according to Julu methods on days 14 and 27 after CCI.

According to the findings of this study, daily injections of progesterone for 12 days before complete neuropathic pain evolution in CCI rats could prevent significantly the reduction of sensory and motor nerve conduction velocities compared to the CCI group on days 14 and 27 after CCI. Furthermore, this effect of progesterone was blocked by bicuculline administration

The findings of this study showed that before complete neuropathic pain evolution, chronic progesterone administration may prevent electrophysiological disorders of the sciatic nerve (at least to some extent through GABA-A receptors) in CCI-induced peripheral neuropathy and these effects continue in the accepted range time of the CCI mode.

Neuropathic pain intensifies the response to painful and non-painful stimuli. Curcumin is one of the substances that have analgesic and anti-inflammatory properties. Also, exercise as a behavioral and non-pharmacological method has beneficial effects on general health under many neuropathic diseases. Also, the combined effect of these two factors on peripheral nerve conduction velocity of the sciatic nerve in patients and animals has been less studied. So, we suggested the study of the preventive effects of combined curcumin and exercise on electrophysiological parameters of the sciatic nerve in the neuropathic pain model of chronic sciatic nerve compression in rats.

80 Male Wistar rats were randomly allocated to 8 groups (n=10). First, neuropathic pain was induced by the chronic constriction injury (CCI) method in the respective groups. To prevent neuropathic pain, two weeks before surgery, forced exercise was started in the exercise group, and after a 5-day recovery period, was performed again for one week until the 14th day of the experiment. After CCI surgery, 60mg/kg curcumin or its vehicle injection was performed in the curcumin and vehicle groups until day 14, and electrophysiological tests of the sural and tibial nerve were performed on day 15.

The results showed that before stabilizing neuropathic pain on day 14 of the experiment, co-administration of curcumin and forced exercise could prevent sural and tibial nerve conduction velocity (SNCV and MNCV) loss compared to the CCI group.

The findings of this study suggest that co-administration of curcumin and forced exercise may prevent electrophysiological disorders of the sciatic nerve, before the complete stabilizing of peripheral neuropathy.

Deepening society's spirituality needs holistic care, qualified and safe spiritual health services, competency-based education, and evaluation of employee competency. Failure to determine "competencies" and lack of a questionnaire hinders evaluating the a questionnaire hinder evaluating the quality of spiritual health. The aim of the study was to design a psychometrically assessment of the Spiritual Health Services Competence Scale based on the Sound Heart Model.

In the sequential exploratory study, during the combined study of the tool construction, with the hybrid model of Schwartz and Kim, in three stages of theoretical review of pieces of evidence, fieldwork (in-depth individual interviews/focus group discussion), data analysis (the conventional content analysis method), the initial version of the 80-item questionnaire was developed. The validity of the questionnaire was checked with face validity (qualitative: by 10 experts, quantitative: by evaluating the effect of the item), content validity (quantitative: CVR with Lavache's formula, by 14 experts, qualitative: CVI by Walters method and Bassel), construct validity (by exploratory and confirmatory factor analysis), reliability with internal consistency and Cronbach's alpha calculation by using SPSS-22, the Liser software. In this way, the questionnaire was administered to 371 healthcare workers.

The CVR score for 40 items was greater than Lawshe’s number (0.571(. All items had CVI scores higher than 0.79. Exploratory factor analysis showed the 6-factor model (spiritual communication ability as a mentor, skills to strengthen communication and motivation, attitude to spiritual self-care, the Islamic principles of counseling, skills to strengthen secure attachment to God, the knowledge of counseling). By confirmatory factor analysis, the suitability of the model was confirmed (P=0.000). Cronbach's alpha of 0.969 confirmed the reliability.

Considering the necessity of competency-based education, and assessment of the competency of service providers, it is recommended to use a theory-based questionnaire for longitudinal training of health science students to improve the quality and safety of spiritual health services.

The onset of mental disorders usually begins in childhood and carries a high individual and collective burden. The purpose of this study is to investigate the incidence, mortality, and burden of neurological disorders in children during the years 1990-2019 in Iran.

This study is a correlational analytical study during the years 1990-2019 in Iran. In this study, the indicators of incidence, death, prevalence, and disease burden (the index of years of life lost due to premature death and disability) were used. To examine the epidemiological indicators with the dimensions of the human development index, the concentration index was used. Analyzes were performed using Stata-14 software at a significance level of 0.05.

The highest incidence of neurological disorders in both sexes is related to 2019 (8444.82 per 100000) and the highest prevalence of neurological disorders in Iran is related to 1998 (17549.2 per 100000). The most years of life lost due to premature death are related in 1990, it was (218/58 per 100,000). The concentration index for incidence was -0.018 (-0.029, -0.007), death -0.15 (-0.202, -0.11), and prevalence -0.02 (-0.034, -0.005), which shows that incidence, death, and prevalence are more concentrated in years It has been that the socio-economic situation has been weaker. A significant relationship was observed between the death rate caused by neurological disorders and the dimensions of human development. Considerably, with the increase in life expectancy, average years of education, and gross national income, the death rate due to neurological disorders in children decreases significantly.

Considering that from 2015 to 2019, we have seen an increasing trend, therefore attention should be paid to the factors related to the occurrence of these disorders in children, and since the increase in life expectancy and the level of education causes a decrease in the mortality associated with these disorders, attention Improving these indicators can be effective in reducing the mortality of these children.

This study aimed to examine the factor structure and psychometric properties of the Persian version of the Substance Abuse Self-Stigma Scale (SASSS) in a group of patients with substance use disorder.

A total of 266 patients with substance use disorder (204 men and 62 women) aged from 18 to 60 were selected using the convenience sampling method and completed the SASSS and Acceptance and Action Questionnaire-Substance Abuse (AAQ-SA).

Confirmatory factor analysis of the Persian version of the SASSS upheld its original four-factor structure. In addition, our results indicated satisfactory test-retest reliability of the SASSS subscales, ranging from .822 to .953. Also, there was a significant negative correlation between the SASSS scores and AAQ-SA scores (r = - .54), which provides evidence for the divergent validity of the scale. Finally, the results showed good internal consistency of the SASSS (Cronbach’s alpha coefficients ranged from .753 to .845).

These findings support the Persian version of the SASSS as a reliable and valid measure for the assessment of self-stigma in patients with substance use disorder

The purpose of the present study was to design occupational therapy interventions with therapeutic reasoning based on the model of human occupation (MOHO) to strengthen handwriting characteristics including readability and speed in Students with a specific learning disorder (SLD) and to compare its effect with common handwriting interventions.

This research was conducted as a semi-experimental interventional study. In this study, 16 children aged 8-10 years with SLD were selected by convenience sampling and assigned non-randomly in two experimental (n=8) and control (n=8) groups. Sampling criteria included studying in the second or third grade of elementary school, being a Persian speaker, having bad handwriting as a family and teacher complaint, and the absence of comorbid disorders. The experimental group received handwriting intervention based on the MOHO, and the control group received common handwriting interventions (sensory-motor and multisensory). The experimental group received 20 treatment sessions of 45 minutes, 7 weeks, and three sessions per week. The outcome measure was the Persian handwriting assessment tool.

The mean difference between the two experimental and control groups in terms of writing speed and variables related to readability, including word shape, word spacing, word alignment, and slope was significant (P≤0.05). Word size as the other readability variable showed no significant difference between the two groups (P<0.05).

The handwriting enhancement program with clinical reasoning based on the MOHO in students with SLD was an effective framework for handwriting intervention.

Identifying the factors affecting the severity of a disease can lead to the adoption of purposeful preventive and therapeutic actions, and subsequently improve health outcomes. This study aimed to investigate the related demographic and underlying factors with the severity of COVID-19 in hospitalized patients.

This cross-sectional study was conducted on 400 patients with COVID-19 hospitalized at Kowsar Hospital of Semnan, Iran. The study tool was a researcher-made questionnaire whose content validity was confirmed by a committee of ten experts with content validity ratio (CVR) and content validity index (CVI) scores equal to 0.92 and 0.89, respectively. The systematic random sampling method was used in this study, and the required data were collected by reviewing medical records and conducting interviews with patients. All analyses were performed using SPSS19, and P<0.05 was considered significant.

The mean age of patients was 56.20 (±59.77) years, and women (53%) and men (47%) had a relatively similar share. Among the patients, 24% were hospitalized in the intensive care unit (ICU) and 7% experienced coma. Also, 99% of patients suffered from serious COVID-19 complications. The rates of pulmonary, cardiovascular, and renal complications were 96%, 68%, and 6%, respectively. There was a significant relationship between the severity of disease with such variables as age, education level, employment status, being native, place of receiving care, previous heart disease, high blood pressure, diabetes, immunodeficiency, obesity, and physical activity or a job requiring physical activity (P<0.05).

The study results showed that a wide range of demographic factors, access to health care, health-seeking behaviors, having an underlying disease, and having a healthy lifestyle are related to the severity of COVID-19.

Children with hearing loss (HL) are susceptible to language delay due to the reduced ability to receive and process audible sounds, and their access to normal language development is the main concern of their family and related professionals. This study aimed to investigate the differences present in macro- and micro-structures of oral narrative, lexical and phonological awareness skills among preschool-aged children with sensorineural HL who wear hearing aids (HA) or cochlear implant prosthesis (CI) and, children with typical development (TD). Also, the association between these language domains was explored.

Twenty-three HL children in the age range of 4 to 7 years old (including 13 children with HA and 10 children with CI), and 12 children with normal hearing were evaluated using storytelling, a lexical task, and three phonological awareness tasks. Narrative samples were transcribed and coded for several macro- (i.e., coherence) and micro-structure (i.e., grammatical complexity and cohesion) measures.

The language measures were not significantly different between children with HA and CI. Compared to their same-age peers, children with HA were significantly weaker in all language domains except syllable segmentation. Also, the scores of CI children were significantly lower than their TD peers in all language measures except syllable segmentation and coherence index (P<0.01). A positive and significant correlation (P<0.05) was observed among phonological awareness skills, lexical performances, and narrative macro- and micro-structure measures in both groups of children with HL and typical development.

Regardless of the type of hearing aids, children with HL are at greater risk for a deficit in basic and higher level language skills and so, need additional speech and language training, especially in preschool years. The associations between different language skills and their effects on language acquisition and rehabilitation of HL children are discussed.

Changes in living conditions in modern times have led to the continuously evolving needs of people, especially students at institutions of higher education. Different needs require appropriate guidance and counseling, and improving counseling services for students necessitates assessing their problems and demands. This study aimed to investigate the guidance and counseling needs of students at Semnan University of Medical Sciences, Semnan, Iran.

In this cross-sectional study from 2020-2022, 598 students of Semnan University of Medical Sciences (Semnan, Iran) were selected using a multi-stage method. The data collection tool was a 34-item questionnaire assessing students' guidance and counseling needs across five domains: personal growth and development, career needs, educational needs, family and marriage, and emotional/psychological needs. Students specified their level of need for each item as "need it very much" (4), "need it to some extent" (3), "need it a little" (2) or "don't need it" (1).

Career counseling and personal growth and development were identified as the most essential counseling needs for students. These two areas were the most necessary across both genders, educational levels, faculties, and marital statuses. The most important specific needs were "focusing the senses" for personal growth and development, "familiarity with job opportunities" for career needs, "time management" for educational needs, "dealing with life problems" for family/marital needs, and "coping with life stress" for emotional/psychological needs.

The findings showed career counseling and personal growth and development needs as the foremost counseling needs for students. Thus, implementing extracurricular workshops by experienced professors in specialized fields could address these requirements and reduce student concerns. While facilitating academic progress, such training prepares students for post-graduation roles in society.

The decrease of GLT-1 is associated with the activation and increased expression of the glutamate receptor subunit, NR1, which causes neuropathic pain in multiple sclerosis (MS) by increasing basal cell activity. This study aimed to compare the effect of four weeks of swimming and living in an enriched environment on GLT-1, NR1, and c-FOS, a marker of neuronal activity, in the dorsal horn of the spinal cord in experimental autoimmune encephalomyelitis (EAE), an animal model used to study of MS.

forty female C57BL6 mice were randomly divided into four groups: EAE, control, swimming exercise, and enriched environment. The healthy control group received a saline injection, other groups were induced with myelin oligodendrocyte glycoprotein (MOG35-55). After the induction of EAE, the swimming group performed swimming for 30 minutes, 5 days a week for four weeks, and the environmental enrichment group lived in an enriched environment for four weeks. On day 30 post-induction, the mice were sacrificed, and the spinal cord tissue was removed. GLT-1, NR1, and c-FOS protein levels were measured by immunohistochemistry.

The findings showed that living in an enriched environment and swimming exercise both significantly increased GLT-1 levels and significantly decreased NR1 and c-FOS levels compared to the EAE group. Although, living in an enriched environment compared to swimming exercise, showed that the first was a more effective method.

Exercise, in addition to reducing disease severity, can reduce pain sensitivity in the EAE mice and increase their quality of life by increasing GLT-1, and decreasing NR1 and c-FOS in the spinal dorsal horn.

Today, nanoparticles have been considered an effective anti-cancer factor in cancer therapy and diagnostic studies. In this way, nanoparticles synthesized by biological methods are being developed. This study aimed to green synthesize zinc oxide nanoparticles by Bunium persicum and study toxicity and apoptotic effects in breast cancer cell lines.

Zinc oxide nanoparticles were synthesized by the fruit extract of Bunium persicum and synthesized nanoparticles were evaluated by FESEM, EDS, XRD, and Zeta sizer analyses. Then, the cytotoxicity of ZnO nanoparticles on breast cancer cell line MCF-7 and normal HEK-293 was evaluated by the MTT method within 24 hours, and the IC50 lethality was determined. Finally, P53, Bcl2, and Bax gene expression were analyzed by Real-time PCR.

ZnO nanoparticles with an average size of 100 nm and a polyhedral shape were made using the fruit extract of the Bunium persicum. According to the XRD analysis, the synthesized nanoparticles have a single-phase crystal structure and no impurities. Based on the MTT results, ZnO nanoparticles had cytotoxicity effects on cancer cells (in 16-500 µg/ml concentration) as well as normal HEK-293 cells (in 31-500 µg/ml concentration) (P<0.001). The gene expression results indicated a 2.7-fold increase in P53 (P<0.001), 6.2 in Bax, and 2.3-fold in Bcl2  (P<0.001).

The findings indicated that the fabrication of zinc oxide nanoparticles by fruit extract of Bunium persicum was done successfully. Also, these nanoparticles have toxicity effects on breast cancer cell lines, and this toxicity is probably due to the induction of apoptosis.