مجله دانشگاه علوم پزشکی ایلام
سال سی و یکم شماره 3 (پیاپی 140، امرداد 1402)

Lungs are one of the most common sites for metastatic tumors in the body. In addition, primary lung tumors are the most common cause of death due to neoplasms in both genders. Treatment strategies are completely different for primary and metastatic lung tumors making accurate diagnosis of lung tumors an effective factor in planning the correct treatment. The development of personalized medicine and targeted therapy, especially in the treatment of primary lung tumors, has highlighted the importance of correct diagnosis of these tumors.

Case report: 

The Pathology Center of Imam Khomeini Hospital Cancer Institute in Tehran, Iran, as a referral center for cancer across the country, is faced with a large number of lung biopsies, and therefore, there will be numerous diagnostic challenges. In this article, we presented two cases of primary female genital tract (cervical) tumors that during follow up lung masses were detected. Diagnosis on lung biopsy assigned as primary lung adenocarcinoma. Both cases referred to our lab for second opinion accompanied with related resected sample and implementation of further supplementary markers documented metastatic origin of tumors.

In both cases, similarity in immunohistochemical characteristics of metastatic tumors with primary lung adenocarcinoma, especially positive nuclear TTF1 staining led to misdiagnosis of lung tumor origin. This finding emphasizes on the use of other specific markers related to primary site of tumor to decrease possibility of incorrect diagnosis of the origin of the tumor in metastatic setting. Due to remarkable influence of primary versus metastatic origin of lung tumor on selection of treatment, pathologists should be considered correct diagnosis and notice to similarity of immunohistochemical markers of primary lung tumors to other organs and implementation of more specific markers are necessary.

Gastrointestinal bleeding (GIB) is one of the most important diseases in internal medicine, which can occur due to bleeding in any of the gastrointestinal organs. The best diagnostic method for identifying the source of bleeding in patients is endoscopy and colonoscopy. Therefore, this study was conducted to determine the causes and the most common risk factors for GIB in patients referring to Shahid Mustafa Khomeini Hospital in Ilam.

In this retrospective analytical study, all patients with clear gastrointestinal bleeding symptoms, including melena, hematemesis, hematochezia, and passing clots, who referred to Shahid Mustafa Khomeini Hospital in Ilam from 2014 to 2019, were evaluated. The demographic information of the patients, their medical history, and the description of the medications they were taking, which were recorded in their medical records, were entered into the questionnaire form. Data analysis was performed using descriptive and inferential statistical methods.

In this study, 650 patients with an average age of 57.24 years, ranging from 19 to 99 years, were included. The majority of patients were in the older age group (above 60 years) and were male. The most common complaint among patients was hematemesis (41.4%), while anemia was the least common complaint (1.8%). The most common causes of gastrointestinal bleeding in both genders were peptic ulcer, gastric mass, and esophageal varices. There was a significant correlation between age and gastrointestinal bleeding symptoms (p < 0.05). Gastrointestinal bleeding symptoms, including hematemesis, melena, and rectorrhagia, were more common in men and in smokers. Alcohol consumption also had an impact on the occurrence of gastrointestinal bleeding with hematemesis, melena, and rectorrhagia.

Endoscopy and colonoscopy are the best diagnostic methods for patients with gastrointestinal bleeding. Therefore, this study was conducted to determine the causes and the most common risk factors for GIB in patients referring to Shahid Mustafa Khomeini Hospital in Ilam from 2014 to 2019. The findings of this study can help improve the diagnosis and management of gastrointestinal bleeding in these patients.

Suicide is a tragic and complex public health problem that affects individuals, families, and communities. The current study aimed to predict suicidal ideation based on cognitive emotion regulation strategies, perceived social support, self-efficacy, perfectionism, and spiritual health in students at Ilam universities, Ilam, Iran.

The current study was a cross-sectional study conducted in 2021. A total of 463 working students studying in Ilam universities were selected and included in the study through the available sampling method. A questionnaire was used for data collection. To determine the relationship between the variables and suicidal thoughts, the Pearson correlation test was used, and to investigate the predictors associated with suicidal thoughts, stepwise regression analysis was performed.

The research results showed a significant negative relationship between the variables of perceived social support, self-efficacy, spiritual health, and positive emotion regulation strategies (i.e., acceptance, positive reorientation, planning, positive appraisal, and underestimation) and a significant positive relationship between perfectionism variables and negative emotion regulation strategies (i.e., self-blame, rumination, catastrophizing, and blaming others) with suicidal thoughts. The highest correlation coefficient was related to perceived social support, which was the most important predictive variable in this study (r=-0.71). Perceived social support, existential health, rumination, perfectionism, self-efficacy, self-blame, and acceptance variables were able to become significant as predictive variables in the regression equation. In total, these factors explained 66% of the variance of suicidal thoughts.

Based on the research findings, the variables of cognitive emotion regulation strategies, perceived social support, self-efficacy, perfectionism, and spiritual health may be important components and predictors of suicidal thoughts. Therefore, it is important to pay attention to these components in suicide prevention programs and treatment and counseling methods

Alzheimer's disease is a common progressive neurogenerative disease that leads to dementia and destruction of brain cells, especially in areas related to learning and memory such as the hippocampus. The role of the Arc gene in synaptic flexibility and memory consolidation has been proven and its expression is strongly influenced by neuronal activity. The aim of this study was to investigate the effect of Lactobacillus fermentum on the expression of Arc (effective in synaptic flexibility and memory consolidation) and CREB (effective in stabilizing synaptic changes during learning) genes, involved in the memory of Alzheimer's rats.

Material & ethods:

In this study that was conducted in 2019, 30 male Wistar rats were divided into 5 groups (control, Alzheimer and 3 groups as treatment). In the treatment groups, simultaneously with induction of Alzheimer by stereotaxic method with streptozotocin, supernatant of Lactobacillus fermentum PTCC 1744 in MRS broth with doses of 108, 107, and 106 cfu/ml was injected intraperitoneally for 21 days. After RNA extraction from hippocampus samples, cDNA was synthesized and the expression of the genes was evaluated by real-time PCR and LinReg PCR software.

The data showed an increase in gene expression of Arc and CREB in the treatment groups with a dose of 106 cfu/ml compared to the Alzheimer's group and the difference was significant (P <0.001).

Extracellular compounds of L. fermentum may inhibit the progression of neuronal lesions due to their antioxidant and anti-inflammatory effects and may be effective in improving Alzheimer's.

Non-adherence to medication in HIV-positive patients leads to the occurrence of HIV-related diseases and ultimately reduces the quality of life and immune system function of these patients. Therefore, the present study was conducted to identify and explain the factors that influence medication non-adherence in HIV-positive Iranian patients.

The present applied study was conducted in 2020-2021 using the descriptive method. First, by reviewing the research literature and interviewing experts in the field of HIV treatment, the main factors influencing medication non-adherence in HIV-positive patients were identified, based on which the research questionnaire was designed. Data were collected from 590 HIV-positive patients and analyzed using exploratory factor analysis and   SPSS23 and LISREL software.

Four factors, namely organizational factors (16 items), individual factors (19 items), educational factors (7 items), and communication factors (7 items) were identified as effective factors for medication non-adherence in HIV-infected patients. Communication factors, individual factors, educational factors, and organizational factors with factor loadings of 0.76, 0.74, 0.73, and 0.71, respectively, had an impact on medication non-adherence in HIV-positive patients.

To improve medication adherence among HIV patients, behavioral disease counseling experts and therapists should pay more attention to communication factors (improving patients social support from family and friends) and individual factors (not coping with the disease state and the effects of stigma and disclosing the disease).

Healthcare workers, who work at the frontline of providing health services, are at risk of occupational stress due to several conditions. Therefore, the present study was conducted to determine the effects of virtual training based on Bandura's self-efficacy theory on occupational stress of healthcare workers in Bushehr, Iran.

This semi-experimental study was conducted on 63 healthcare workers in Bushehr city in 10 comprehensive healthcare centers randomly selected as intervention and control centers (n=5 each). The intervention group received four sessions of virtual training based on self-efficacy theory in the form of a webinar, while the control group received no training. The information of the studied subjects was collected using a questionnaire consisting of four sections, namely demographic information assessment, self-efficacy assessment, and occupational stress assessment before, two weeks, and one month after the educational intervention. The data were analyzed using SPSS software version 24.

In general, knowledge and self-efficacy increased in the intervention group after training, and changes in knowledge and self-efficacy were significantly different between the two groups during the study period (P<0.001). In the intervention group, occupational stress improved two weeks and one month after training, compared to the pre-training period, whereas in the control group, although the changes were significant, these changes manifested as an increase in stress intensity. There was a significant difference in occupational stress changes between the two groups during the study period (P<0.001), and the condition improved in the intervention group.

The results of this study suggested that virtual stress management education based on self-efficacy theory could increase knowledge levels and self-efficacy and improve occupational stress in healthcare workers.

Doxorubicin (DOX), an anthracycline antibiotic, is one of the most effective anticancer agents used to treat breast cancer. Multidrug resistance is a major problem in the treatment of breast cancer, and researchers have tried to find an efficient strategy to overcome it. In this study, the synergistic anticancer effects of resveratrol (RSV) and DOX on human breast cancer cell lines (MCF-7) were investigated.

This research was conducted in 2021-2022 in Afra Laboratory (Tehran, Iran). MCF-7 breast epithelial cells were treated with concentrations of 12.5, 25, 50, 100, and 200 μg/ml RSV for 24, 48, and 72 h, and then the wells containing the cells of this group were treated with different doses of DOX (0.25, 0.5, 2.5, 1, and 5 μg/ml for 24, 48, and 72 h). Afterward, the survival rate of the cell was evaluated using MTT assay and flow cytometry methods.

The results showed that the effect of resveratrol was less than 50% after 24 hours, indicating the effective role of time. In general, the antioxidant property of resveratrol decreased with an increase in concentration, so that the highest percentage of radical inhibition was recorded at a concentration of 25 μg/ml. The percentage of inhibition by DOX was also higher than the inhibition by RSV. However, for both samples, the percentage of radical inhibition decreased with increasing concentration.

Resveratrol treatment increased the cytotoxic activity of DOX against breast cancer cell growth when administered concurrently or 24 h before DOX. These results suggested that treatment with a combination of RSV and DOX might be a useful strategy to enhance the efficacy of DOX by promoting the intracellular accumulation of DOX and reducing multidrug resistance in human breast cancer cells.

Sleep disorders are the most common behavioral complaints in children. Therefore, this study was conducted to determine the sleep habits of children admitted to Amirkabir Hospital, Arak, Iran.

In this descriptive cross-sectional study, children aged 4 to 12 years admitted to Amirkabir Hospital clinic in 2021 were randomly studied. Data obtained from the Children's Sleep Habits Questionnaire were analyzed using SPSS24.0 software.

A total of 295 children with a mean age of 7.26±2.27 years were studied. The prevalence of the disorder in sleep habits was 67.4%. Among the children with disturbed sleep habits, 193 (96.9%) had poor sleep habits and 6 (3.1%) had average sleep habits. The total sleep habits score was significantly higher in girls, unwanted children, and children with divorced parents, low parental education level, and incompatible parents (P<0.05). However, there was no significant association between the total sleep habits score and children's age (P>0.05).

In this study, most children showed disturbed sleep habits. Considering that children's poor sleep habits may be a contributing factor for stress, pressure, and tension in the family, mass education and psychiatric intervention are needed in this regard.

Cancer is a complex disease in which gene expression changes. This study was conducted with the aim of investigating the effects of MT1JP lncRNA in controlling lung cancer cells.

TC-1 [JHU-1] cells were transfected with pcDNA3.1(+)-MT1JP, Plko.1-EGFP-PURO-siRNA and empty plasmids, and the expression of MT1JP gene and siRNA fragment was confirmed by RT-PCR reaction. The role of MT1JP in migration was investigated by scratch assay and apoptosis by flow cytometry. The expression change of candidate genes involved in apoptosis and cell proliferation (Bim, AKT, Bax and Bcl-2) was evaluated by q-PCR reaction.

The results showed that the expression of Bim gene showed a significant increase in the presence of high expression of MT1JP, while the expression of Bim gene decreased significantly with silencing of MT1JP by siRNA. The expression of Bax and Bcl-2 genes showed a significant increase and decrease, respectively, in the presence of high expression of MT1JP. In the cells transfected with pcDNA3.1(+)-MT1JP, the AKT gene showed a decrease in expression, and on the other hand, in the cells transfected with siRNA, the AKT gene had a significant increase in expression (p < 0.05). Also, the scratch assay results showed that MT1JP lncRNA has an inhibitory role on cell migration. Flow cytometry data showed that transfection by pCDNA3.1(+)-MT1JP could increase cell apoptosis levels.

The present study showed that lncRNA MT1JP inhibits cell proliferation and migration and at the same time increases apoptosis of TC-1 [JHU-1] cells. This study may help improve our understanding of lung cancer, however further studies are needed.

One of the problems caused by COVID-19 is decreased lung function and muscle weakness. Excessive increase in the curvature of the thoracic spine is known as a kyphosis deformity. The purpose of this study was to compare the quality of breathing in COVID-19 patients with that of individuals with and without kyphosis.

This study was a causal-comparative study. The statistical population of this study consisted of individuals aged 18 to 30 years old from the city of Urmia in 2021. Of this population, 30 individuals were selected as a group with kyphosis and 30 individuals without kyphosis according to the inclusion criteria. The respiratory quality of the two groups was measured with the St. George’s Respiratory Questionnaire, and the circumference of the thoracic arch was determined with a flexible ruler. Data analysis was performed with SPSS version 25 using the independent t-test.

The mean scores of individual data, including age, height, and weight, were obtained at 24.50±3.64 years, 164.07±4.87 cm, and 66.07±9.54 kg in the group with kyphosis and 23.57±3.91 years, 163.20±4.77 cm, and 64.37±10.96 kg in the group without kyphosis, respectively. There was no significant difference between the two groups when comparing scores for pulmonary symptoms (P=0.83), activity (P=0.69), social and psychological impact (P=0.71), and total questionnaire score (P=0.65).

Respiratory physical, psychological, and social complications occurred in both groups with and without kyphosis. Although the complications were more severe in individuals with kyphosis, they were not significantly different from those in the group without kyphosis. It is possible that conducting similar studies examining the lung volumes of people with different degrees of kyphosis abnormalities would yield different results.