نشریه دانشور پزشکی
پیاپی 167 (مهر و آبان 1402)

In March 2020, World Health Organization (WHO) declared 2019 coronavirus disease as a pandemic. MERS-CoV and influenza can be a valuable resource in the development of therapeutic agents for COVID-19. Matricaria chamomilla L. (chamomile) is usually useful due to its anti-inflammatory and antibacterial properties and is listed in the pharmacopoeia of 26 countries as a herbal medicine for the treatment of various disorders. This study was conducted to evaluate the potential of chamomile to reduce the level of pro-inflammatory cytokine TNF-α. Peripheral blood mononuclear cells (PBMCs) were isolated from Covid-19 volunteers (n = 3) and treated with concentrations of 200, 300, 400, and 500 µg/ml ethanolic extract extracted from chamomile aerial parts. Tumor necrosis factor alpha (TNF-α) production levels were measured using ELISA method. Chamomile ethanolic extract (all concentrations) significantly reduced the production of pro-inflammatory cytokine TNF-α in peripheral blood cell cultures of covid-19 patients compared to the untreated group (p<0.0001). The results of the present study showed for the first time that chamomile can exert its anti-inflammatory effects by reducing the level of the pro-inflammatory cytokine TNF-α, which can be attributed to the compounds of this plant with anti-inflammatory properties. As a potential alternative for the treatment of inflammatory diseases, this plant needs further investigation.

Studies have shown that liver damage is linked to apoptosis. Carbon tetrachloride is a powerful toxin that is used to induce liver fibrosis and cirrhosis in animal models. The purpose of this study was to investigate the effect of alpha-pinene on the expression of apoptosis-related factors Bax and Bcl-2 in the liver of adult male Wistar rats receiving carbon tetrachloride.

Rats were divided into four groups including control, alpha-pinene, carbon tetrachloride, and carbon tetrachloride-alpha-pinene group. Carbon tetrachloride (2 ml/kg of body weight) was injected intraperitoneally twice a week for six consecutive weeks. Alpha-pinene was also administered intraperitoneally (50 mg/kg of body weight per day) for six consecutive weeks. Real-time PCR was used to evaluate Bax and Bcl-2 mRNA levels at the end of the course.

Carbon tetrachloride significantly increased the expression of pro-apoptotic factor Bax (P= 0.019) and significantly decreased anti-apoptotic factor Bcl-2 (P= 0.042) in the liver of rats compared to the control group. Alpha-pinene treatment caused a significant decrease in Bax mRNA level (P= 0.001) and a significant increase in Bcl-2 mRNA level (P= 0.025) in the carbon tetrachloride-alpha-pinene group compared to the carbon tetrachloride group. In addition, alpha-pinene prevented the occurrence of apoptotic cells in liver tissue sections of CCl4-injectes animals.

Alpha-pinene can prevent apoptosis caused by carbon tetrachloride in the liver of rats and probably has a hepatoprotective effect.

Stenotrophomonas maltophilia (S. maltophilia) is a non-fermenting gram-negative bacterium that has rapidly emerged as an important hospital pathogen in hospitalized patients and is considered a global threat due to the increase of intrinsic antibiotic resistance. The present study was conducted to determine the antibiotic resistance profile of S. maltophilia isolates collected from blood cultures of patients referred to Qazvin hospitals.

In this study, 28 blood samples with the early diagnosis of S. maltophilia were collected. First, the identification of bacteria was performed by using culture and common biochemical tests. The final confirmation of the samples was done by examining 23S rRNA gene using the molecular PCR method. Finally, antibiogram was performed using disc diffusion method according to CLSI 2022 guidelines.

60.71% of patients with positive blood culture were male. The resistance rates to levofloxacin, minocycline and trimethoprim-sulfamethoxazole were 10.71%, 7.14% and 3.57%, respectively.

Considering the appropriate effectiveness of the trimethoprim-sulfamethoxazole, it can be concluded that the isolates are still sensitive to this antibiotic and it is still considered as the best therapeutic option. It is necessary to evaluate the levels of antibiotic resistance using standard methods before prescribing the antibiotics in order to prevent the emergence and spread of resistant strains in the community and the possibility of treatment failure.

Ambiguous situations related to health such as the coronavirus pandemic produce various types of anxiety in people, which can be called death anxiety, after that, intolerance of uncertainty. This study aimed to investigate the relationship between Coronavirus anxiety and death anxiety and intolerance of uncertainty in medical students. This was a descriptive-correlational study based on the structural equation method, which was designed and implemented in the academic year 2021-2022. The statistical population of this research included all medical students of Shahid Beheshti University of Medical Sciences. Accordingly, 350 students (with the educational background of interns or interns and students who went to the ward and at the patient's bedside) were selected as available sampling. The participants responded to Qabadian-Qadikalai's Corona Anxiety Scale, Templer's Death Anxiety Scale, and Freeston et al. Uncertainty Intolerance Questionnaire. The data were analyzed through SPSS-26 and AMOS-25. Death anxiety and uncertainty intolerance have a direct and significant effect on coronavirus anxiety (P<0.001). In other words, GFI (0.892) and AGFI (0.882) and NFI (0.629) obtained indicated that the structural equation model between coronavirus anxiety and death anxiety and intolerance of uncertainty has a good fit. Based on the obtained results, it seems that medical students due to their lack of experience in their job, were very anxious in front of the spread of the coronavirus. Therefore, it is suggested that in future studies, researchers should conduct this study using these tools or similar variables on other samples such as nurses and experienced physicians.

Metoprolol as a β-Blocker is widely used in treatment of some cardiovascular diseases such as hypertension and myocardial infarction. Moreover, cytotoxic, anti-inflammation, anti-angiogenic and anti-tumor effects of metoprolol have been reported. The intention of this study was to examine metoprolol effect on viability of human blood cancerous cells in vitro.

Human leukemic T cells (MOLT-4 and JURKAT) and monocyte (U937) were cultured in Roswell Park Memorial Institute (RPMI) complete medium. Then, the cells (3 ×10 4 cell/well) were treated with different concentrations of metoprolol (1-1000 μg/ml) for 24, 48 and 72 hours. Finally, the viability of cells was determined using trypan blue dye exclusion assay. Analysis of variance (ANOVA) was used to compare the cell viability between different groups.

Metoprolol significantly decreased the viability of all cell lines at 1000 μg/ml concentration after 48 hours incubation time compared with control group. Besides, metoprolol significantly reduced the viability of MOLT-4 and Jurkat cells at ≥ 100 μg/ml concentrations and U937 ≥ 500 μg/ml after 72 hours incubation time in comparison with control group.

Based on results of the present study, metoprolol decreased viability of human blood cancerous cells dose and time dependently. Therefore, anti-tumoral effects of metoprolol reported by other investigators might be partly due to its reducing the viability of cancerous cells. So, metoprolol may have potential implication in therapy of blood tumors along with other cancers.

Patients with cancer are in conditions where they may face challenges that can undermine their human dignity. Preserving the sense of dignity in incurable cancer patients is one of the important goals of palliative care. The present study aimed to determine the sense of dignity from the perspective of cancer patients undergoing chemotherapy at Shahid Mustafa Khomeini hospital.
This descriptive study evaluated the perspective of 200 cancer patients undergoing chemotherapy at Shahid Mustafa Khomeini hospital regarding their sense of dignity using standardized Patient Dignity Inventory questionnaire. The data were analyzed using SPSS software version 19 and T-test, Pearson correlation, Chi-square and ANOVA tests were utilized.
The overall dignity score was 2.5 out of 5, with a standard deviation of 1.06. The dignity scores of the patients were 2.7±1.2 in the dimension of symptom disturbance, 2.4±0.98 in the dimension of anxiety and uncertainty, 2.4±0.95 in the dimension of loss of autonomy, and 2.9±1.5 in the dimension of loss of sense of worth. The sense of dignity did not have a significant correlation with age, marital status, having children and time of cancer diagnosis. However, it had significant correlations with gender (P = 0.006), satisfaction with income (P = 0.0001), education level (P = 0.0001), having religious beliefs (P = 0.0001) and the extent of cancer invasion (P = 0.0001).
The most significant concerns of the studied patients were anxiety, uncertainty and loss of autonomy. Identifying various sources of experienced stress in these patients can greatly assist the therapeutic and caregiving team in making appropriate decisions.

Infertility is one of the problems in gynecology, which refers to infertility after one year of intercourse without pregnancy protection. According to studies, about 11 to 51 million people in the world suffer from the problem of infertility. Considering the prevalence of infertility and the lack of social support, psychological trauma and insufficient information in this field, counseling can help in the management of infertility crisis.

This was a clinical trial study with the approach of one intervention group and one control group, which was conducted in 2017 with the participation of 60 infertile women in Isfahan. The intervention group received the virtual training via voice. In this way, the samples received 5 30-minute educational and counseling sessions during 5 weeks. The data were analyzed by paired t-test and covariance with SPSS version 20.

According to the results of the paired t-test, the average depression score of the subjects in the control group in the post-test compared to the pre-test was not significantly different, but in the intervention group, the average depression score before the intervention was 17.93±8.01, which after the intervention, it decreased by 14.50±6.77.

Virtual education improved depression in the intervention group.

Understanding patients' rights can lead to their observance and an increase in patient satisfaction with the received healthcare services. The aim of this study was assessing the level of awareness of clinical medical students at medical universities in Tehran regarding patients' rights.

This was a cross-sectional descriptive-analytical study conducted at medical faculties in Tehran. A total of 442 medical students were randomly selected. The "Patients' Rights Charter" questionnaire, provided by the Ministry of Health of Iran, was used for data collection. Data analysis was performed using SPSS software, version 19, and independent t-test, Pearson, and ANOVA tests were employed. Significance level was P < 0.05.

14.9% of the medical students had a poor level of awareness, 70.4% had a moderate level, and 14.7% had a good level of awareness. The lowest level of awareness was observed in respecting patient privacy and maintaining patient confidentiality, while the highest level of awareness was in the right to choose and make decisions freely. There was a significant relationship between the students' gender and age and their level of awareness. However, no significant relationship was found between academic level, university of study, prior knowledge of patients' rights, and the level of awareness.

The majority of medical students in this study had a moderate level of awareness. It is recommended to enhance awareness through more precise teaching of medical ethics courses and by conducting educational workshops for students, as well as organizing seminars and courses for medical practitioners, to improve their level of awareness.