مجله علمی دانشگاه علوم پزشکی کردستان
سال بیست و هشتم شماره 3 (پیاپی 126، امرداد و شهریور 1402)

 HER-2 Positive breast cancer is one of the aggressive types of cancer and is resistant to chemotherapy drugs such as lapatinib .Amygdalin is a natural compound found in the seeds of fruits such as apricot, peache, apple and almond. In recent years, antitumor effects of amygdalin have been reported in different types of cancer cells. The present study aimed to investigate the cytotoxic effectes of amygdalin in combination with lapatinib, on cell viability and Bax expression in SK-BR-3 breast cancer cell line as a cell line with high expression of HER-2.

After cell culture we evaluated the survival of SK-BR-3 cells by MTT after 48 hours of treatment with different concentrations of amygdalin and lapatinib alone and in combination. The pre-apoptotic Bax expression level was measured by western blot method.

Amygdalin and lapatinib significantly decreased survival of SK-BR-3 cells in a dose-dependent manner. The simultaneous use of amygdalin with lapatinib showed that amygdalin enhanced the lethal effect of lapatinib. Also, amygdalin at the concentration of 10 mg/ml increased the effects of 200 nM lapatinib on the expression of Bax protein.

This study showed that the amygdalin-lapatinib combination could be effective for breast cancer patients with HER-2 overexpression. However, more studies are recommended to obtain more definitive results.

Botulism, a syndrome caused by food poisoning, results from use of food contaminated with the botulinum toxin, which is very dangerous and deadly. Botulism is caused by the effects of bacterial toxins on the terminals of the motor nerves. Botulinum neurotoxins are among the most potent toxins. The aim of this study was to investigate expression, purification and, evaluation of the immunogenicity of the recombinant BoNT/B-HcC protein as an immunogen candidate in mice.

The C-terminus of the receptor-binding domain of  botulinum neurotoxin type B(BoNT/B-HcC) was selected as the antigen for bioinformatics evaluations. The pET17b-BoNT/B-HcC plasmid was transferred to E. coli BL21(DE3) by heat shock. The recombinant protein was purified and analyzed by SDS-PAGE. After verification of the recombinant protein by western blot, immunization of mice was performed. Antibody titers of recombinant proteins were evaluated by indirect ELISA and the results were compared using t-test.

The codon adaptation index (CAI) of the optimized gene was 0.99. The percentage of codons having high-frequency distribution was improved to 78%. Restriction analysis confirmed the 1119 bp construct gene and the recombinant protein with a molecular weight of 43.8 kDa was expressed in the prokaryotic host. The total yield of purified protein was 23 mg of protein per liter of culture. Immunization of mice induced serum antibody response. Statistical analysis showed that the antibody titer was significantly different compared to that of the control sample.

The designed recombinant antigen showed high antigenicity that could be considered as an immunogen against botulinum type B neurotoxin in future studies.

Considering that stress slows down wound healing, the main purpose of this study was to investigate the effects of acute and chronic restraint stress on inducible Nitric Oxide synthase (iNOS) and Nitric Oxide (NO) concentrations in wound tissue in rat.

48 male and female rats in 6 groups (n=8) including male control, male animals exposed to acute stress, male animals exposed to chronic stress, female control, female animals exposed to  acute stress and female animals exposed to chronic stress were used in this study. Tissue samples were collected on the 3rd and 7th days after wound creation. iNOS concentration were measured by ELISA method and the concentration of NO was measured by determining nitrite concentrations in the samples using Griess reagent.

Acute (P< 0.001) and chronic (P< 0.05) stress caused a significant increase in iNOS concentrations on the 3rd  and 7th days post wounding in male animals comparing to the control group. The concentration of iNOS was significantly increased in female animals only in the group exposed to the acute stress and on the 3rd day compared to the control group (P< 0.05). Acute and chronic stress caused a significant (P < 0.001) increase in NO concentrations in male animals when compared with the control group. NO concentrations was increased significantly in female animals exposed to acute stress comparing to the control group on 3rd day post wounding (P< 0.001).

Stress induced elevations in iNOS and NO concentrations could be one of the mechanisms underlying delayed wound healing by stress.

 Zinc oxide nanoparticles are one of the nanoscale materials that by inducing the production of reactive oxygen species, DNA damage and apoptosis may have cytotoxic effects on the reproductive system and endanger male fertility. In the present study, we investigated the antioxidant effect of N-acetylcysteine on sperm and biochemical parameters in mice treated with zinc oxide nanoparticles.

24 adult male NMRI mice with average weight (35.45 ± 2.11 g) were randomly divided into four groups (n = 6) of control, zinc oxide nanoparticles (50 mg/kg), N-acetylcysteine (150 mg/kg) and N-acetylcysteine + zinc oxide nanoparticles and treated intraperitoneally for 28 days. Then the mice were anesthetized and their left epididymis was used to evaluate sperm parameters (number, motility and viability). In addition, serum levels of testosterone, LH and FSH, malondialdehyde and total antioxidant capacity were measured. Using SPSS software, data were analyzed by one-way analysis of variance and Tukey's test. Differences among mean values were considered significant at p<0.05.

We observed a significant decrease in the number, percentage of progressive motility and sperm viability, total antioxidant capacity, serum levels of testosterone, LH and FSH in the zinc oxide nanoparticles group compared to those in the control group (p<0.001). While the plasma malondialdehyde level showed a significant increase (p<0.001). Simultaneous treatment with N-acetylcysteine and zinc oxide nanoparticles improved the above parameters significantly. In N-acetylcysteine group, no significant difference was observed in these parameters compared to the control group (p<0.05).

These findings showed that acetylcysteine has a protective role against the destructive effects of zinc oxide nanoparticles on sperm parameters and biochemical factors by reducing oxidative stress, increasing the level of total antioxidant capacity and testosterone levels.

Obesity increases risk of venous thromboembolism due to increase in coagulation factors. Screening for deep vein thrombosis (DVT) before bariatric surgery can minimize the incidence of venous thromboembolism (VTE) in these patients. This study aimed to determine the importance of color Doppler ultrasound before bariatric surgery to detect subclinical deep vein thrombosis in the patients.

This was a descriptive cohort study. The study population included candidates for bariatric surgery admitted to Modares and Loghman hospitals in Tehran (a bariatric surgery center in Iran) between March-20 and September-20, 2021. Patients were followed up for 30 days after surgery. Census sampling was used. Data were finally entered into SPSS-23 statistical software and analyzed by descriptive tests.

Among 125 patients in this study, 85 (64%) were woman. The patient’s mean and standard deviation of age and Body Mass Index were 33.68 ± 6.8 and 43.15 ± 4.9, respectively. Before surgery, all patients were evaluated for subclinical DVT and the results of the study showed that none of the patients had any evidence in favor of DVT. After the surgery, the patients underwent regular follow-ups for a month, but no positive cases of deep vein thrombosis were reported.

In our study thromboembolic problems were rare in patients before obesity surgery. Therefore, routine ultrasound examination before surgery does not seem reasonable.

Candida species are among the major causes of opportunistic fungal infection in immunocompromised individuals, cancer patients, and organ transplants patients. Resistance to the antifungal medications has been on the rise. On the other hand, there have been several reports about the antimicrobial effects of different species of Ephedra major extract. The aim of the present study was to investigate the antifungal effects of Ephedra major against some Candida species.

In this experimental-laboratory study, after collecting E. major in the spring of 2014 from the mountains located in the west of Kermanshah Province, plant extraction was performed with ethanol, methanol, petroleum ether, and chloroform solvents. Minimum Inhibitory Concentration (MIC) and Minimum Fungicidal Concentration (MFC) of E. major against Candida albicans (ATC1677), Candida tropicalis (CBS94), and Candida glabrata (CBS2175) were evaluated by macrodilution method. Then its chemical composition was determined by GC-MS.

Based on the results of this study, ethanolic, methanolic, petroleum ether, and chloroform extracts of Ephedra major had antifungal effects. Also, the most desirable rate of MIC and MFC were 15.6 and 31.25 mg/ml respectively for chloroform extract against Candida glabrata. The results of GC-MS also showed that phenolic compounds were the most abundant compounds in this plant.

The results showed that the anti-candidal activity of ethanolic, methanolic, petroleum ether, and chloroform extracts of E. major was considerable.

Epidemic keratoconjunctivitis is a type of conjunctivitis caused by adenoviruses that can spread rapidly through direct and indirect contact. The aim of this study was to evaluate the therapeutic effects of povidone-iodine 0.4% and 0.2% in the improvement of the symptoms and signs of patients with epidemic keratoconjunctivitis.

This clinical trial study included 60 patients with a mean age of 27.8±8.4 years who met our inclusion criteria.The patients were randomly divided into three groups. The first group received povidone-iodine 0.4% and betamethasone 0.1% eye drops the second group received povidone-iodine 0.2% and betamethasone 0.1% eye drops and the third group received betamethasone 0.1% eye drop.  Follow-ups visits were on the first, fourth, seventh and tenth days after starting treatment. Parameters examined at each examination were hyperaemia, mucopurulent discharge, eyelid edema, hemorrhage, and subepithelial infiltration.

The results showed significant differences in the mucopurulent discharge among the treatment groups on the fourth day (P = 0.005) and also on the seventh day (P = 0.001) of the examination. There was no significant difference among the 3 groups in regard to sub-epithelial infiltration on the tenth day after treatment (P = 0.287).

Based on the results of this study, povidone-iodine was more effective than steroids alone in relieving some of the signs of EKC, such as mucopurulent discharge.

Glass ionomer cements (GICs) are the most common restorative material in pediatric dentistry. GlCs have the ability to chemically bond to enamel and dentine and can release fluoride. In clinical situations, microleakage is a major challenge when using glass ionomer cement. Therefore, this study was designed to compare the microleakage of two types of glass ionomer in primary teeth restorations.

This experimental study included 80 maxillary anterior deciduous teeth. Class V cavities measuring 1.5 × 2 × 3 mm were prepared on the teeth. The specimens were randomly divided into two groups as follows: 1) Fuji II LC, 2) Equia Forte. The teeth were subjected to 500 thermocycles between 5 °C and 55°C by immersion in hot and cold water for 25 seconds. The samples were immersed in the fuchsia solution for 24 hours to test dye penetration. Then, the center of the restorations was cut buccolingually and the amount of microleakage was evaluated and scored under a stereomicroscope. Data were analyzed by chi-square test.

Based on the results of this study Fuji II LC GIC showed higher microleakage scores than Equia Forte GIC and a statistically significant difference was observed between the groups. (P <0.05)

Equia Forte GIC may be a useful restorative material in the primary teeth restoration for young children due to the low microleakage score and the relatively quick placement.

Caring for children with cancer can impose a heavy care burden on their parents. The aim of this study was to determine the effect of educational support program on the care burden of the parents of children with cancer admitted to the oncology department of Besat Hospital in Sanandaj in 2021.

This semi-experimental study was conducted in the oncology department of Besat Hospital in Sanandaj in 2021. 31 participants were randomly selected. Data were collected using Zarit care burden questionnaire before, immediately after and one month after the intervention. After the educational needs assessment, based on the educational needs of the caregivers, training courses were held for the parents. Then, in a period of one month, parents' communication with the researcher, parents' education and meeting their needs were supported. Using SPSS version 24 software, data were analyzed by descriptive and inferential statistics.

A decrease of 12.29 ± 9.33 units in the total care burden score before the intervention compared to that immediately after the intervention and a decrease of 6.54 ± 5.012 units in the total care burden score immediately after the intervention compared to that one month after were observed which were significant. Therefore, the burden of care decreased significantly after the intervention (P=0.001).

The results of this study showed that use of educational support program could reduce the care burden of caregivers.

A comprehensive understanding of the current state of geriatric care in Iran is necessary in order to strengthen and align it for responding to the current and future needs of the elderly in the country. The purpose of this study was to identify the challenges and barriers in the elderly care system in Iran.

This was a qualitative study. Forty semi-structured interviews were carried out with various participants involved in providing care to the elderly across the country in 2019. Participants were selected using maximum variation sampling. Using MAXQDA10 software, data were analyzed by the qualitative content analysis method based on six building blocks of health systems developed by the world health organization.

Challenges and barriers in the elderly care system were categorized into six groups: service delivery, health workforce, health information system, access to essential medicine, financing, and governance/leadership. Also, some of the most important challenges of the elderly care system included: absence of a single organization with sufficient power as the steward for providing the elderly services, lack of integration of services for the elderly from primary care to specialized care; shortage or inadequate distribution of skilled manpower; lack of insurance coverage for home care services for the elderly; lack of registry system or database for the elderly; lack of or weakness in elderly-friendly activities in the service centers.

The current elderly care system in Iran faces many challenges in all six building blocks of the World Health Organization. Reforming and redesigning the elderly care system based on the findings of this study is necessary and urgent in order to meet the needs of the elderly in the country.

One type of review study is a narrative review that is used to summarize the studies of a field. The most common use of this type of review is when there is no single hypothesis on the subject. Therefore, these studies provide an opportunity to present the knowledge and experience of the author in a specific area. Some authors encounter errors in writing narrative review articles that reduce the quality of the article.

Gestational trophoblastic disease consists of a wide range of tumors related to the uterus, including complete and incomplete hydatidiform mole, placental trophoblastic tumor, and choriocarcinoma, which have different tendencies to local invasion and metastasis. In this study, we report a case of twin pregnancy with one fetus and a concomitant mole in a 40-year-old woman.

Case report: 

A 40-year-old woman at 17-week of pregnancy referred with complaints of shortness of breath, headache and high blood pressure. Fetal heart rate was 110. According to the ultrasound of the fetus, the size of the placenta was much larger than normal and had cystic areas. The patient was diagnosed as a case of twin pregnancy with one fetus and a concomitant mole. Emergency hysterotomy was performed. The patient was discharged from the hospital after one week in good general condition and recommended to check weekly βHCG titer test and control blood pressure.

Molar pregnancy is diagnosed by abdominal ultrasound and serum βHCG measurement. Considering pregnancy complications such as gestational hypertension and metabolic disorders such as hyperthyroidism and bleeding which can increase after such pregnancies, early diagnosis and treatment are essential to reducing maternal mortality. In addition, after termination of such pregnancies, examination of the patients for early detection of trophoblastic tumors is very important.