Publications by authors named "Hossein Akbari"

88 Publications

Effects of Potential Probiotic Enterococcus casseliflavus (EC-001) on Growth Performance, Immunity, and Resistance to Aeromonas hydrophila Infection in Common Carp (Cyprinus carpio).

Probiotics Antimicrob Proteins 2021 Mar 15. Epub 2021 Mar 15.

Department of Fisheries, Science and Research Branch, Islamic Azad University, Tehran, Iran.

The effects of different levels of dietary Enterococcus casseliflavus (EC-001), as a potential probiotic, were investigated on the growth performance, hemato-biochemical parameters, immune responses, and resistance to Aeromonas hydrophila infection in common carp (Cyprinus carpio) fingerlings. Accordingly, fish (N = 720; 12.0 ± 0.5 g) were distributed into four treatments receiving different dietary levels of E. casseliflavus, EC-001 (0 [control], 1 × 10, 10, and 10 CFU g feed), for 8 weeks. The fish fed with a diet containing 10 CFU g showed the highest weight gain and specific growth rate, along with the lowest feed conversion ratio, compared with the control group (P < 0.05). Red and white blood cells, hemoglobin, hematocrit, neutrophils, and monocytes significantly increased in the fish fed with 1 × 10 and 10 CFU g (P < 0.05). Dietary inclusion of 1 × 10 and 10 CFU g significantly increased serum total protein, albumin, and immunoglobulin content (P < 0.05). Feeding the fish with 1 × 10 CFU g resulted in a significant increase in serum and skin mucus lysozyme activity compared with the other groups (P < 0.05). Complement component 3 and skin mucus protease activity were also significantly higher in all the fish treated with dietary E. casseliflavus (EC-001) compared with the control group (P < 0.05). The cumulative mortality in the treated fish was lower (ranging from 10 to 22%) than the control group (31%) after challenging the fish with A. hydrophila infection, while the fish fed with E. casseliflavus (EC-001) at 1 × 10 CFU g exhibited the lowest mortality rate (P < 0.05). In conclusion, our results revealed the potential probiotic effects of E. casseliflavus (EC-001) for enhancing growth performance, immunity, and disease resistance of common carp.
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http://dx.doi.org/10.1007/s12602-021-09771-xDOI Listing
March 2021

Contamination of obsterics and gynecology hospital air by bacterial and fungal aerosols associated with nosocomial infections.

J Environ Health Sci Eng 2021 Feb 27:1-8. Epub 2021 Feb 27.

Department of Environmental Health Engineering, Social Determinants of Health (SDH) Research Center, Kashan University of Medical Sciences, Kashan, Iran.

Bacterial and fungal bioaerosols are a global concern due to nosocomial infections, especially in developing countries. Our study aimed to detect fungal and bacterial bioaerosols in different wards of an obstetrics and gynecology hospital air samples. 240 bioaerosol samples were collected by performing impaction method from different wards of a hospital in the central part of Iran, during two seasons. Fungi genera and bacteria species are recognized by cultivation. Concentrations of bacteria and fungi were ranged from 44 to 75 CFU/m and 8 to 22 CFU/m, respectively. Labor Delivery and Recovery (LDR) and Emergency room had first and second most contaminated air among all the hospital wards. No significant difference between microbial load of wards which used natural ventilation and heating, ventilating, and air conditioning (HVAC) system was observed. The microbial load was not affected significantly by temperature, working shift, and Inpatient Bed Occupancy Rate (IBOR). Fungal load related significantly with relative humidity. (detected in 48.3% of samples) and (27%) were the most predominant isolated bacteria and fungi, respectively. The results revealed that the level of bacteria and fungi responsible for nosocomial infections in the air of this hospital is very low. Although levels of microbial contamination are relatively low, it is important to investigate the effect of bioaerosols on nosocomial infections, especially in neonates.
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http://dx.doi.org/10.1007/s40201-021-00637-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914036PMC
February 2021

Designing a national model for assessment of nursing informatics competency.

BMC Med Inform Decis Mak 2021 02 2;21(1):35. Epub 2021 Feb 2.

Health Information Management Research Center, Department of Health Information Management and Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Pezeshk Blvd, 5th of Qotbe Ravandi Blvd - Pardis Daneshgah, Kashan, Islamic Republic of Iran.

Background: Due to the need for informatics competencies in the field of nursing, the present study was conducted to design a psychometric instrument to determine the qualification of informatics competencies of employed nurses in educational care centers.

Methods: The questionnaire was made by reviewing existing scientific resources and assessment tools. Two hundred nurses were selected using simple random sampling. Structural equation modeling was used using the measurement model technique and the average variance was calculated. Linear structural relations (LISREL) software was used to test the assumptions and correlations of the model.

Results: Findings showed relatively good estimation in the fit of first-order measurement model. The informatics knowledge subscale with a determining rate of 0.90 had the greatest explanatory effect among the subscales and informatics skill with a determining rate of 0.67 and basic computer skill with a determining rate of 0.60 were observed. The second-order measurement model of fitness indicators showed that the three factors can well explain the multidimensional construct of informatics competency.

Conclusions: The designed tool can be used to develop educational strategies in relation to nursing students in the field of informatics and prepare them in the rich environment of information technology, which can be helpful in training nursing instructors.
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http://dx.doi.org/10.1186/s12911-021-01405-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7852364PMC
February 2021

Investigating the Relationship between Serum Levels of Interleukin-22 and Interleukin-1 Beta with Febrile Seizure.

Iran J Allergy Asthma Immunol 2020 Aug 25;19(4):409-415. Epub 2020 Aug 25.

Department of Biostatistics and Public Health, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran.

A febrile seizure is the most common type of seizure in young kids, which is not fully known. Inflammatory mediators can affect the pathogenesis of the disease. Considering the controversy about the impacts of interleukin 1 beta (IL-1β) and the lack of a study on interleukin 22 (IL-22), the purpose of the present study was to investigate the relationship between IL-22 and IL-1β serum levels with febrile seizure in young kids. Our case-control study has been conducted on 120 young kids aged 6-60 months with the sign of the fever. Rectal temperature was measured for allcases. Patients with febrile seizure (n=60) and patients with fever and without a seizure (n=60) were investigated as case and control groups, respectively. Serum levels of IL-22 and IL-1β were measured in all participants through the ELISA method. The serum level of IL-1β was significantly higher in the case group compared to the control group (p˂0.001), while there were no significant differences between the two groups in terms of IL-22 (p=0.92). Unlike IL-1β (p≤0.021), IL-22 showed no difference between two groups according to some demographic and clinical features like gender, age group, family history of febrile seizure, family history of epilepsy, and evolutionary status (p>0.22). Logistic multiple regression analysis showed that, unlike IL-1β (p˂0.001), IL-22 does not change the chance of febrile seizure in the study groups (p=0.737). The findings of this study indicated that, unlike IL-1β, IL-22 has not any changes/effects in the febrile seizure.
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http://dx.doi.org/10.18502/ijaai.v19i4.4115DOI Listing
August 2020

An Odd Keloid Formation after Treatment of Congenital form of Boutonniere Finger.

Indian J Plast Surg 2020 Dec 28;53(3):455-456. Epub 2020 Dec 28.

Hazrate Fatemeh Hospital, Iran University of Medical Sciences,Tehran, Iran.

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http://dx.doi.org/10.1055/s-0040-1721861DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7775236PMC
December 2020

Anti-Cancer and Antibacterial Effects of Terfezia boudieri-Derived Silver Nanoparticles.

Comb Chem High Throughput Screen 2020 Nov 16. Epub 2020 Nov 16.

Applied Stem Cell Laboratory, Medicine/Heart and Vascular Institute, The Tulane University School of Medicine, New Orleans, Louisiana. United States.

Background: The use of nanoparticles has markedly increased in biomedical sciences. The silver nanoparticles (AgNPs) have been investigated for their applicability to deliver chemotherapeutic agents in cancer treatment. However, the existing chemical and physical methods of synthesizing AgNPs are considered inefficient and expensive, and are fraught with toxicity.

Objective: Natural products have emerged as viable candidates for nanoparticle production, including the use of Terfezia boudieri (T. boudieri), a member of the edible truffle family. Accordingly, our goal was to synthesize AgNPs using the aqueous extract of T. boudieri (green synthesized AgNPs). Since certain infectious agents are linked to cancer, we further investigated their potential as anti-cancer and antibacterial agents.

Methods: The physico-chemical properties of green synthesized AgNPs were analyzed by UV-Vis, FT-IR, XRD, SEM and TEM. In addition, their potential to inhibit cancer cell (MCF-7 and AGS) proliferation as well as the growth of infectious bacteria were investigated. Synthesis of AgNPs was confirmed by the presence of an absorption peak at 450nm by spectroscopy.

Results: The size of nanoparticles ranged between 20-30nm and exerted significant cytotoxicity and bactericidal effects in a concentration and time dependent manner compared to T. boudieri extract alone. Interestingly, synthesis of smaller AgNPs correlated with longer synthesis time and enhanced cytotoxic and bactericidal properties.

Conclusion: This study shows that synthesis of smaller AgNPs correlated with longer synthesis time and enhanced cytotoxic and anti-bacterial effects.
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http://dx.doi.org/10.2174/1386207323999201117113401DOI Listing
November 2020

The use of mobile phone functionalities by patients with asthma and their desire to use for self-care purposes.

BMC Med Inform Decis Mak 2020 10 30;20(1):281. Epub 2020 Oct 30.

Health Information Management Research Center, Department of Health Information Management and Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Pezeshk Blvd, 5th of Qotbe Ravandi Blvd - Pardis Daneshgah, Kashan, Iran.

Background: Mobile health (mHealth) has good potential for promoting self-care in patients suffering from chronic diseases. The patients' positive attitude toward this technology is a key factor for the successful implementation. The present study was conducted to investigate the asthma patients' use of mobile phone functionalities and their desire to receive self-care services through this technology.

Methods: This survey study was conducted in Iran in 2018. The study population consisted of 146 patients suffering from asthma. The data collection tool was a questionnaire containing items on the demographic characteristics of patients, current use of mobile phone functionalities, and desire to use them for receiving self-care services. Data were analyzed using descriptive and analytical statistics.

Results: Out of the 160 questionnaires distributed, 146 (91.25%) were completed. The majority of the participants had smartphones (84.9%). Less than half of the participants occasionally used mobile phone functionalities including mobile phone calls (42.5%) and mobile Internet (40.4%) to receive asthma-related information. A significant number of the participants had never used smartphone applications (72.6%) and E-mail (66.4%) to receive asthma-related information. The participants had their greatest use of Internet search, followed by social media, to receive information about asthma symptoms, allergenic and irritating substances, medicinal therapy, and how to use therapy aids. The participants were most willing to use social media for receiving asthma information, communicating with other patients, receiving reminders about doctor's appointment, and receiving warnings about the lack of asthma control.

Conclusion: In Iran as a developing country, asthma patients use Internet search mostly to receive instructional information and are willing to use social media rather than other mobile phone functionalities to receive self-care services. These patients believe that mobile phones are appropriate for receiving instructional information and reminders.
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http://dx.doi.org/10.1186/s12911-020-01301-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7602318PMC
October 2020

Effect of intraoperative dexmedetomidine infusion during functional endoscopic sinus surgery: a prospective cohort study.

Patient Saf Surg 2020 13;14:38. Epub 2020 Oct 13.

Department of Radiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran.

Background: Dexmedetomidine, an α2 agonist, has well-known anesthetic and analgesic-sparing effects. We designed this study to evaluate the effect of intraoperative dexmedetomidine infusion on intra operative blood loss and postoperative pain in functional endoscopic sinus surgery.

Methods: This prospective cohort study included 90 patients planning to undergo endoscopic sinus surgery, who were randomly divided into three groups. 2 to 2.5 mg/kg of propofol was used in all groups to induce anesthesia. One group received dexmedetomidine 0.2 μg/kg per hour infusion whereas the other group received dexmedetomidine 0.5 μg/kg per hour infusion. The control group received normal saline infusion.

Results: The mean age of patients was 41.02 ± 11.93. 33 patients in the dexmedetomidine 0.2 μg/kg/h group, 30 patients in the dexmedetomidine 0.5 μg/kg/h group and 27 patients in the placebo group. The lowest amount of bleeding was related to the dexmedetomidine 0.5 μg/kg/h group. The volume of bleeding between the three groups was significantly different ( = 0.012). The satisfaction of the surgeon in the dexmedetomidine 0.5 μg/kg/h group was more than other groups. There was a significant relationship between the satisfaction of the surgeon and the treatment groups ( < 0.001). The lowest duration of surgery was related to the dexmedetomidine 0.2 μg/kg/h group. The most Trinitroglycerin (TNG) consumption was in the placebo group and the highest dose of labetalol was in the dexmedetomidine 0.5 μg/kg/h group. There was no significant difference in the TNG and labetalol consumption between three groups. The lowest consumption of morphine and pethidine in the dexmedetomidine 0.5 μg/kg/h group.

Conclusions: Infusion of dexmedetomidine 0.5 μg/kg/h decreased blood loss and consumption of morphine and pethidine in patients who underwent endoscopic sinus surgery.
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http://dx.doi.org/10.1186/s13037-020-00264-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7557003PMC
October 2020

Prevalence of Carpal Tunnel Release as a Risk Factor of Trigger Finger.

World J Plast Surg 2020 May;9(2):174-178

Department of Plastic and Reconstructive Surgery, Hand and Microsurgery, Hazrat-E-Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran.

Background: Carpal tunnel release (CTR) is acknowledged as a predisposing factor for the development of the trigger finger. However, the incidence of new-onset trigger finger after CTR surgery has been inconsistently reported. In this study, we aimed to evaluate the prevalence of CTR as a risk factor of the development of the trigger finger.

Methods: In a retrospective study, 57 consecutive patients who underwent surgery for the treatment of trigger finger were included. The severity of carpal tunnel syndrome (CTS) was determined using the electromyogram test and nerve conduction study. The clinical and demographic characteristics of the patients were extracted from their medical profiles and compared between patients who did and did not develop a trigger finger after CTR.

Results: Post-CTR trigger finger was detected in 15 (26.3%) patients. The trigger finger occurred approximately six months after CTR surgery. The thumb and ring fingers were the most commonly involved fingers. Ten out of 15 (66.7%) patients who developed a post-CTR trigger finger had mild-to-moderate CTS, and five (33.3%) patients had severe CTS. No significant difference was found between the patients who did and did not develop a trigger finger after CTR.

Conclusion: The rate of developing a post-CTR trigger finger was remarkable in our study. Therefore, the potential sequelae should be discussed with patients, preoperatively.
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http://dx.doi.org/10.29252/wjps.9.2.174DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7482536PMC
May 2020

Comparative Analgesic Effects of Intradermal and Subdermal Injection of Sterile Water on Active Labor Pain.

Anesth Pain Med 2020 Apr 25;10(2):e99867. Epub 2020 Apr 25.

Shahid Akbarabadi Clinical Research Development Unit (ShACRDU), Shahid Akbarabadi Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.

Background: The labor pain is one of the factors encouraging pregnant women for cesarean section delivery. Recently, intradermal and subdermal injection of distilled water has shown to be effective in improving this pain.

Objectives: The present study aimed to determine which method has a greater impact on labor pain reduction.

Methods: In this double-blind, randomized clinical trial, 121 nulliparous women with a gestational age of ≥ 37 weeks were randomly divided into three groups: (1) 0.5 cc sterile water injection subdermally at four sacral points with insulin needles (n = 40); (2) 0.5 cc sterile water injection intradermally (n = 39); and (3) needle contact with the mentioned points as the placebo (n = 42). Before the intervention, the VAS score was measured for labor pain, and it was repeated 10, 30, 60, and 90 min after the intervention. The results were compared between the three groups.

Results: Before the intervention, the mean VAS pain score had no significant difference between the three groups. However, 30, 60, and 90 min after the intervention, the mean pain score was significantly lower in the intradermal and subdermal injection groups than in the control group (P = 0.001); however, the difference between the intradermal and subdermal injection groups was not significant.

Conclusions: The injection of distilled water by either intradermal or subdermal method was associated with a significant reduction in the pain score during labor, but there was no difference between these two methods in terms of decreasing labor pain. As sterile water injection is a safe, effective, and low-cost method, it is proposed to increase the knowledge of midwives and obstetricians about this method.
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http://dx.doi.org/10.5812/aapm.99867DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7352939PMC
April 2020

Pregnancy and burns: Guidelines for safe management.

Burns 2020 May 4. Epub 2020 May 4.

Department of Epidemiology, Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Background: IThe incidence of burns in pregnancy is very low, therefore little is confirmed in the specific management of pregnant women who are burned.

Purpose: We conducted a study to survey the frequency of pregnancy in our patients and evaluate the risk factors of mortality for mother and foetus. Finally we provide recommendations about management of mother and child.

Materials And Methods: Retrospectively, we surveyed data of our pregnant patients for an 18 year period. All demographic data, gestational age, history of previous pregnancy or miscarriage, diabetes, suicide, number of operations, presence of inhalation injury, TBSA, percentage of burn in abdomen and lower extremity, early excision and outcome of mother and foetus were gathered in a special questionnaire. Uni-variate regression and multi-variate regression were done for mortality of mother and child.

Results: We treated 89 pregnant patients. Mean (SD) of mother's age and their pregnancy age were 24.08±5.56 years and 19.18±9.24 weeks, respectively. Mean TBSA (SD) was 36 (18%). Median of TBSA was 38 (IQR: 25, 70). Median of TBSA in Abdomen was 8 (IQR: 7, 9). Median of TBSA in lower extremities was 18 (IQR: 9, 34). Nine cases were due to attempted suicide. For 34 patients skin grafting was done. The main cause of death of the mothers was sepsis. The infections were due to Pseudomonas aeruginosa, Acinetobacter, E. coli, Klebsiella and Staphylococcus. In uni-variate regression model, TBSA, gestational week, and burns involving the abdomenwere related to maternal mortality. In multi-variate regression model, TBSA had high influence on maternal mortality, with every percent of burn surface area, the risk of mortality increased by 3.4% (p-value <0.005). In a uni-variate regression, TBSA and abdominal burn was associated with foetal mortality. However, in the multi-variate regression, only inhalation injury and TBSA had association with foetal mortality. Inhalation injury increased foetal mortality up to 16 times (p-value <0.05).

Conclusion: TBSA burned is the only major risk factor of maternal mortality. TBSA burned and inhalation injury are the main risk factors of foetal mortality.
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http://dx.doi.org/10.1016/j.burns.2020.04.005DOI Listing
May 2020

The correlation of helios and neuropilin-1 frequencies with parkinson disease severity.

Clin Neurol Neurosurg 2020 05 7;192:105833. Epub 2020 Apr 7.

Department of Biostatistics and Public Health, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran.

Objectives: Parkinson disease (PD), a neurodegenerative disease, has also some immunologic basis in which several regulatory factors, like Helios and Neuropilin-1 (NRP-1) may show some roles in its pathogenesis. We aimed to evaluate the circulatory frequency of T regulatory cells (Tregs) expressing Helios and NRP-1 in PD.

Patients And Methods: In this case-control study, 83 patients with PD and 83 healthy controls were enrolled. The diagnosis of PD was accomplished in accordance with clinical diagnostic criteria of the UK Parkinson Disease Society Brain Bank. The modified Hoehn and Yahr (H and Y) were used to measure the severity of PD. Flow cytometry was used to evaluate the circulatory frequency of CD4+CD25+Foxp3+Tregs expressing and Helios and NRP-1 in all participants. Also, correlation of H and Y with such frequencies was evaluated.

Results: Our findings showed that frequency of CD4+CD25+Foxp3+Tregs expressing NRP-1 (P = 0.04) and Helios (P = 0.01) in patients with PD was significantly higher than those in healthy subjects. The frequency of Tregs expressing Helios and NRP-1 showed a negative correlation with H and Y criteria and disease duration. Multiple linear regression analysis indicated that the severity of PD is the only effective factor on the frequency of CD4+CD25+Foxp3+NRP-1+Tregs (P = 0.012) and CD4+CD25+FoxP3+ Helios + Tregs (P = 0.038).

Conclusion: Our study showed that the increased frequency of Tregs expressing Helios and NRP-1 is associated with the severity of PD.
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http://dx.doi.org/10.1016/j.clineuro.2020.105833DOI Listing
May 2020

Effect of Intravenous Propofol and Inhaled Sevoflurane Anesthesia on Postoperative Spirometric Indices: A Randomized Controlled Trial.

Anesth Pain Med 2019 Dec 3;9(6):e96559. Epub 2019 Dec 3.

School of Public Health, Kashan University of Medical Sciences, Kashan, Iran.

Background: Anesthetic drugs may directly or indirectly affect respiratory function. We investigated the effects of intravenous propofol and inhaled sevoflurane anesthesia on postoperative spirometric indices in patients undergoing inguinal herniorrhaphy surgery.

Methods: We randomly assigned 111 patients, aged 18 - 65 years, undergoing inguinal herniorrhaphy surgery, to receive either intravenous propofol or inhaled sevoflurane. Forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), and FEV1/FVC were measured before and after anesthesia. Comparisons between the two groups were made using the -test and ANOVA.

Results: There were no significant differences between the two groups in terms of age, sex, height, body weight, BMI, pain score, ASA class, operation duration, and received analgesics. The FEV1 and FVC values significantly decreased after the operation in the sevoflurane group.

Conclusions: Both intravenous propofol and inhaled sevoflurane can decrease postoperative spirometry parameters. However, it seems that patients receiving propofol have less decreased spirometric indices.
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http://dx.doi.org/10.5812/aapm.96559DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7118678PMC
December 2019

The study of factors associated with pregnancy outcomes in patients with systemic lupus erythematosus.

BMC Res Notes 2020 Mar 30;13(1):185. Epub 2020 Mar 30.

Department of Biostatistics and Public Health, Faculty of Health, Kashan University of Medical Sciences, Pezeshk Blvd, 5th of Qotb-e Ravandi Blvd, P.O.Box: 8715973449, Kashan, Iran.

Objectives: Systemic lupus erythematosus (SLE) is an autoimmune disease that can lead to unfavorable pregnancy complications in women. This study aimed to evaluate the factors associated with pregnancy outcomes in patients with SLE.

Results: Fifty-nine pregnant women with SLE (121 pregnancies) participated in this retrospective cohort study. The mean age of the patients was 33.74 ± 3.80 years (range 21 to 48 years). Fetal loss occurred in 43.8% of pregnancies. The most common laboratory findings in SLE patients were antinuclear antibody (81.4%) and anti-ds DNA positivity (54.2%). High levels of C-reactive protein (CRP) during pregnancy, renal involvement, anti-double-stranded DNA positivity, anti-phospholipid antibody (APA) positivity and younger age at disease onset were significantly correlated with unfavourable pregnancy outcomes. A significant difference was observed between duration of SLE and low birth weight (P = 0.003), pre-eclampsia (P = 0.012) and still birth (P = 0.036). High CRP, APA positivity, anti-dsDNA positivity and kidney involvement were predictors of adverse pregnancy outcomes in SLE patients. Renal involvement increased risk of pregnancy with complication 8.5 times (OR = 8.5, 95% CI 1.396-63.373, P = 0.017). Antiphospholipid syndrome (APS) also was associated with an odds ratio of 5.18 (95% CI 1.681-13.647, P = 0.001).
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http://dx.doi.org/10.1186/s13104-020-05039-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7108499PMC
March 2020

Comparison of the Never Repair with Fibrin Glue and Perineural Micro-Suture in Rat Model.

World J Plast Surg 2020 Jan;9(1):44-47

Department of Plastic and Reconstructive Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Background: Many different methods for nerve repair have been introduced. Nerve repair with micro-suture is the gold standard one; however, the use of fibrin glue is a promising method. This study compared the never repair with fibrin glue and perineural micro-suture in rat model.

Methods: Ten 3-4 month old male rats, weighting between 250-300 grams were divided into two groups. Left sciatic nerves of the rats were transected and repaired with fibrin glue (Tissucol) in one group (A) and direct peri-neural micro-suture in another group (B). The time of nerve repair was compared between the two groups after 8 weeks. A biopsy from was taken from anastomosis site and the histopathological assessment was undertaken for axonal growth rate after anastomosis and compared between the two groups.

Results: The time of repair in group A was significantly lower than group B. Axonal growth rate was pretty similar between the two groups, and the difference was not significant. The mean (SD) time for repair of nerves with micro-sutures was 7.1 (1.5) minutes and the mean (SD) for repair of nerves with fibrin glue was 2.5 (0.5) minutes and the difference was significant. The number of calcification such as psammoma bodies was significantly higher in fibrin glue group.

Conclusion: Nerve repair with fibrin glue was shown to be simpler and more time saving. The number of axons after the repair was not different in the two groups. We showed that fibrin glue may have more tissue reactions compared with micro-sutures.
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http://dx.doi.org/10.29252/wjps.9.1.44DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068193PMC
January 2020

Conditions of experienced stigma in people living with HIV in Iran: a qualitative comparative analysis.

Sociol Health Illn 2020 06 11;42(5):1060-1076. Epub 2020 Mar 11.

Department of Sociology, Tarbiat Modares University, Tehran, Iran.

Stigma against people living with HIV (PLWH) seriously affects their quality of life. Moreover it can lead them to hide their HIV status from others, which in turn endangers public health. Many studies dealing with HIV-related stigma focus on the consequences of this phenomenon and pay less attention to the social conditions which affect different types of HIV-related stigma (anticipated, internalized and enacted stigma [ES]). Therefore, in this study, we tried to achieve more understanding about effective causal conditions of various types of experienced stigma. First of all, data were collected from 19 PLWH, using semi-structured interviews from those who had visited the Counseling Center for Behavioral Diseases in Mashhad. Secondly, the data were analyzed by applying a mixture of two methods: thematic analysis and qualitative comparative analysis (Boolean Algebra). The analysis of the data reveals that a combination of informing family members about HIV status, lack of family support, and medical support lead to anticipated stigma; a combination of religious beliefs and poor self-esteem results in internalized stigma and a combination of lack of family support, mistreatment by community, poor self-esteem, poverty and no religious beliefs lead to ES.
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http://dx.doi.org/10.1111/1467-9566.13077DOI Listing
June 2020

Evaluating the effect of a herb on the control of blood glucose and insulin-resistance in patients with advanced type 2 diabetes (a double-blind clinical trial).

Caspian J Intern Med 2020 ;11(1):12-20

Gastroenterology & Hepatology Disease Research Center, Qom University of Medical Science, Qom, Iran.

Background: Different benefits of various herbal medicines in decreasing blood sugar have been reported in different clinical trials so far. Considering the growing tendency toward these combinations and the booming market, inappropriate advice is growing accordingly. Hence, it is necessary to evaluate the effects and possible complications of such combinations on health status and blood glucose control.

Methods: Two 38-subject groups were formed and a 12-week treatment program was administered for both groups. The inclusion criteria were failure to control blood glucose with two oral medicines, unwillingness to inject insulin. The medicine was prepared in capsules by Booali Company. Each capsule weighed 750 mg and contained nettle leaf 20% (w/w), berry leaf 10% (w/w), onion and garlic 20% (w/w), fenugreek seed 20% (w/w), walnut leaf 20% (w/w), and cinnamon bark 10% (w/w) all in powder.

Results: At the beginning of the study, there was no significant difference between the subjects regarding the evaluated parameters, but after the intervention, the level of glucose was significantly lower in fasting (P=0.0001) and 2-hour postprandial (P=0.002) levels. The level of glycated hemoglobin A1c (HbA1c) (P=0.0001) also decreased from 0.33±9.72 % to 0.20±8.39 %. Finally, the level of insulin resistance reduced from 1.9±4.1 to 1.4±2.6 (P=0.001) after consuming herbal medicine.

Conclusion: According to the results of the current study, the herbal combination was effective in controlling blood sugar, and considering the reduction of HbA1c by 1.31 %, it seems that the herbal combination is an effective medicine to treat diabetes.
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http://dx.doi.org/10.22088/cjim.11.1.12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6992722PMC
January 2020

Enhancing Asthma Patients' Self-Management through Smartphone-Based Application: Design, Usability Evaluation, and Educational Intervention.

Appl Clin Inform 2019 10 13;10(5):870-878. Epub 2019 Nov 13.

Department of Health Information Management and Technology, School of Allied Health Professions, Kashan University of Medical Sciences, Kashan, Iran.

Objective: The aim of this study was to design and evaluate a smartphone-based application for improving self-management in patients with asthma and evaluate its effects on their knowledge.

Methods: In this applied research, based on the Clinical Practice Guideline and a systematic review, a questionnaire was designed to determine the application information content and functionality requirements by 15 pediatric and adult asthma and allergy specialist. Then the application was designed and developed using Adobe Air software on the Android operating system. Usability evaluation of the mobile application was performed using the standard questionnaire for user interaction satisfaction (QUIS), which completed by 30 patients with asthma, 8 information technology (IT) specialists, and 2 asthma and allergy specialists. Self-management knowledge of 30 asthma patients was measured using a researcher-made questionnaire before and after using the application.

Results: The number of specialists in the both Delphi rounds was 15 and the mean work experiences were 17.6 years. The most important elements for asthma self-management were avoiding exposure to allergen and triggers (96%), drug treatment (94.6%), and how to use the therapeutic tools (92.4%), and the most important functionalities were alerting the patients when they did not control asthma (92%), setting reminders for timely drug use (85.4%) and therapeutic tools (82.6%), recording prescription drugs (82.6%), and peak flow meter values (82%). Usability evaluation showed that 30 patients with asthma, 8 IT specialists, and 2 physicians evaluated the application at a "good" level. The mean score of the patients' knowledge before intervention was 2.43 ± 0.95 which after intervention was significantly increased to 4.3 ± 0.56 ( < 0.001).

Conclusion: Considering the desirable outcomes of application evaluation and a positive impact of this educational intervention on asthma patients' knowledge, it is possible to use mobile-based self-management programs to help these patients to manage illness and gain knowledge and self-management skills.
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http://dx.doi.org/10.1055/s-0039-1700866DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6853806PMC
October 2019

The Study of Relationship between Serum Levels of Soluble fms-like Tyrosine Kinase-1 and Soluble Fibrinogen-like Protein 2 with Delayed Graft Function after Kidney Transplantation.

Iran J Allergy Asthma Immunol 2019 Aug 17;18(4):412-418. Epub 2019 Aug 17.

Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Delayed graft function (DGF) is a transplant complication which means a need to dialysis throughout the first week after transplantation. This study aimed to ascertain the relationship between the two immunomodulatory factors of soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble fibrinogen-like protein 2 (sFGL-2) with DGF after transplantation. This case-control study was done in 2 groups of 58 kidney transplant patients with and without DGF. The control group included the patients who didn't show DGF symptoms. Then, serum levels of sFlt-1and sFGL-2 in all blood samples were measured by ELISA. Serum sFlt-1 and sFGL-2 levels were significantly higher in the DGF group compared to those in the control group (p≤0.001). sFlt-1 and sFGL-2 serum levels significantly affect DGF (p<0.001) in such a way that they may be diagnostic factors of DGF. This study showed a significant relationship between sFlt-1 as well as sFGL-2 and DGF. Therefore, plasma levels of sFlt-1 and sFGL-2 may be used as diagnostic tools to determine the risk of DGF.
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http://dx.doi.org/10.18502/ijaai.v18i4.1419DOI Listing
August 2019

Profile of drug users in the residential treatment centers of Tehran, Iran.

Health Promot Perspect 2019 6;9(3):248-254. Epub 2019 Aug 6.

Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

The current study aimed at determining the pattern of drug dependence and its related factors in mid-term residential treatment centers (MTRCs). The current cross-sectional study was conducted on all drug dependent people residing in MTRCs of Tehran, Iran, who were voluntarily seeking treatment from April to August, 2018. Required data were collected through face-to-face interviews. Drug dependence was categorized into four groups: soft opioids, hard opioids, methamphetamine, and combination of hard opioids and methamphetamine. The association of potential risk factors with drug dependence was measured using chi-square test and multinomial logistic regression. Out of 1868 participants in the current study, 97% were male. Mean age (SD) of the participants was 38.1 (9.9). The different types of drug dependence were hard opioids (43.0%),soft opioids (29.5%), methamphetamine (15.4%), and a combination of hard opioids and methamphetamine (12.1%). The prevalence of injecting drug use was 2.7%. In comparison with the reference group (soft opioids), being un-married and unemployment, significantly increased the risk of using the three groups of drugs (odds ratios [ORs]: 1.5-3.34, P values: <0.001-0.033).Age ≥30 years at the initiation of drug use, and using current drug for more than 10 years, significantly increased the risk of using hard opioids and a combination of hard opioids and methamphetamine (ORs: 1.65-2.31, P values: <0.001-0.030). Age ≥50 years significantly decreased the risk of using the three groups of drugs (ORs: 0.21-0.43, P≤0.001). Different pattern of drug dependence found in MTRCs, they were mostly hard opioid users, lower injecting drug use and higher mean of age.
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http://dx.doi.org/10.15171/hpp.2019.34DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6717926PMC
August 2019

Comparison of psychiatric screening Instruments: GHQ-28, BSI and MMPI.

J Family Med Prim Care 2019 Apr;8(4):1337-1341

Halal Research Center of IRI, FDA, Tehran, Iran.

Background: Clinical interview comprises a method for of psychiatric disorders diagnosis. Given the cost, time, and expertise required for clinical assessment; alternative tools to accurately substitute clinical interviews are having high value. We conduct this study to compare the screening accuracy of GHQ-28, BSI, and MMPI.

Materials And Methods: Considering a diagnostic value, this study was conducted on 983 students and 3 psychiatric screening tools; GHQ-28, BSI, and MMPI were completed by students. Among the whole participants, 237 students were interviewed by the clinical psychiatrists on the basis of DSM-IV-IR Criteria. Based on ANOVO and Chi-square, results compare was made. Kappa correlation -coefficient was calculated in a pairwise manner; eventually the diagnostic accuracy of each tool was determined by the means of ROC analysis.

Results: The diversity of psychiatric disorders by GHQ-28, was about 39.1, on the basis of BST was 44.8% and 44% for MMPI. The sensitivity and specificity of GHQ-28 was 85.9% and 87.8% considering 21.5 as the cut-off point; respectively. Considering 41/5 as the cut-off point for the BSI test, sensitivity and specificity were 81.2% and 90.8%; respectively, and 88.2% and 91.4% for the MMPI test with the cut-off point of 63.5 compared to clinical interview, the MMPI test was associated with the greatest accurate staging, ranging about 90.3%.

Conclusions: The results of this study according to clinical assessment reveal that GHQ-28, BSI, and MMPI psychiatric tools have high sensitivity and specificity and MMPI possessed the greatest efficiency compared to other evaluated tools.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_135_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6510097PMC
April 2019

The investigation of relevancy between and gene expression and disease severity of multiple sclerosis.

J Immunoassay Immunochem 2019 13;40(4):396-406. Epub 2019 May 13.

f Research Center for Biochemistry and Nutrition in Metabolic Diseases , Kashan University of Medical Sciences , Kashan , Iran.

: and (protein inhibitor of activated STAT 1,2) play key roles in the pathogenesis of autoimmune and inflammatory diseases. This study aims to evaluate the gene expression of these factors in multiple sclerosis (MS) patients compared to healthy individuals and correlate them with the severity of MS. : Sixty participants, including 30 patients with MS and 30 healthy controls were studied. The expression of and genes in peripheral blood samples of all participants was measured by real-time PCR. The severity of MS was evaluated using the Expanded Disability Status Scale (EDSS). Finally, we evaluated the correlation between the expression of and genes with disease severity. : The expression of gene was increased in patients with MS compared to healthy subjects ( value<.001). Also, there was a significant correlation between the expression of and genes with disease severity according to EDSS. : Our study suggests the expression of and genes as a prognostic and diagnostic marker in MS disease.
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http://dx.doi.org/10.1080/15321819.2019.1613244DOI Listing
August 2019

The Prognostic Value of Rotterdam Computed Tomography Score in Predicting Early Outcomes Among Children with Traumatic Brain Injury.

World Neurosurg 2019 05 21;125:e139-e145. Epub 2019 Jan 21.

Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran; Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran; Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran; Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran; Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran; Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran.

Background: Prediction of traumatic brain injury (TBI) among children is of great importance for accurate clinical decision making.

Objectives: This study aimed to determine the prognostic value of the Rotterdam scoring system in predicting early outcome among children with TBI.

Methods: This study was conducted in 2017 on 506 children with brain injury in Kashan, Iran. A checklist was used to collect demographic and clinical characteristics of patients such as age, sex, mechanism of trauma, Glasgow Coma Scale (GCS) score, need for surgery, and brain injury outcome. Moreover, each participant's computed tomography scan was evaluated and scored using the Rotterdam system. Sensitivity, specificity, positive and negative predictive values, and the best cut-off score were calculated for the Rotterdam system. The relationships of the Rotterdam score with participants' characteristics were examined using the χ test, whereas the predictors of brain injury outcome were identified using the logistic regression analysis.

Results: Pediatric death rate was 4.3%. Most deaths were among children who were male, aged <4, had developed brain injury owing to traffic accidents, had a GCS score of 3-8, suffered from compressed skull fracture and frontal lobe injury, had cerebral edema, and had a Rotterdam score of 5. The sensitivity and specificity of a Rotterdam score 3 were 86.4% and 97.9%, respectively. The logistic regression analysis indicated that only GCS and Rotterdam scores were significant predictors of brain injury outcome.

Conclusions: At a cut-off score of 3, the Rotterdam system can be used to predict TBI outcome among children with acceptable sensitivity and specificity.
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http://dx.doi.org/10.1016/j.wneu.2018.12.221DOI Listing
May 2019

Effect of vitamin C and vitamin E on lung contusion: A randomized clinical trial study.

Ann Med Surg (Lond) 2018 Dec 9;36:152-157. Epub 2018 Nov 9.

Kashan University of Medical Sciences, Departments of Nutrition, Iran.

There is association between lung contusion (lC) and a progressive inflammatory response. The protective effect of vitamin C and vitamin E, as strong free radical scavengers on favourite outcome of (LC) in animal models, has been confirmed.

Design: to evaluate the effect of vitamins, E and C on arterial blood gas (ABG) and ICU stay, in (LC), with injury severity score (ISS) 18 ± 2, due to blunt chest trauma.

Methods: This study was a randomized, double-blind, placebo-controlled clinical trial. Patients with (ISS) 18 ± 2 blunt chest trauma, who meet criteria, participated in the study. A total of 80 patients from Feb 2015 to Jun2018and were randomly divided into 4 groups. Patients received intravenous vitamin E (1000IU mg), was (group I); intravenous vitamin C (500) (group II). Vitamin C + vitamin E = (group III), and intravenous distilled water = (control group) or (group IV). ABG, serum cortisol, and CRP levels were determined at baseline, 24 h and 48 h after the intervention.

Results: a significant decrease in ICU stay in group III compared to other groups (p < 0.001). Co-administration of vitamin C and vitamin E showed significant increases pH (values to reference range from acidemia"), oxygen pressure, and oxygen saturation in group III compared to other groups (p < 0.001). A significant decrease in carbon dioxide pressure was also detected after receiving vitamin C and vitamin E in group III, compared to other groups (p < 0.001). There was no significant difference cortisol and CRP levels between groups after the intervention.

Conclusion: Co-administration of vitamin C and vitamin E, improve the ABG parameters and reduce ICU stay.
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http://dx.doi.org/10.1016/j.amsu.2018.10.026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6240669PMC
December 2018

Correlation of serum levels and gene expression of tumor necrosis factor-α-induced protein-8 like-2 with Parkinson disease severity.

Metab Brain Dis 2018 12 13;33(6):1955-1959. Epub 2018 Aug 13.

Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R., Iran.

Different immune-mediated mechanisms involved in the pathogenesis of Parkinson disease (PD) as a neurodegenerative and inflammatory disease. According to our knowledge, there is no report evaluating Tumor necrosis factor-α-induced protein-8 like-2 (TIPE2), a cytokine maintaining immune homeostasis, in PD. We analyzed the correlation of the serum levels and circulatory gene expression of TIPE2 with severity of PD. In this case-control study, 43 patients with PD and 40 healthy subjects were enrolled. The diagnosis of PD was performed byclinical diagnostic criteria of the UK Parkinson's Disease Society Brain Bank. The severity of PD was evaluated by modified Hoehn and Yahr (H and Y) scale. Serum levels and gene expression of TIPE2 were assessed by Elisa and real time PCR, respectively. The mean serum levels and gene expression of TIPE2 in patients with PD did not have significant difference compared to healthy subjects. Linear multiple regression analysis showed that increased serum levels of TIPE2 are positively related to age and severity of PD (P ≤ 0.0001). In addition, the gene expression of TIPE2 was found to be associated with age (P < 0.0001). Our study showed that the serum levels of TIPE2 and its gene expression might be important prognostic biomarkers of PD.
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http://dx.doi.org/10.1007/s11011-018-0302-7DOI Listing
December 2018

T Helper 22 Pathway Evaluation in Type 1 Diabetes and Its Complications.

Iran J Allergy Asthma Immunol 2018 Jun;17(3):258-264

Nephrology and Urology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

A subset of CD4+ T cells named T helper (Th)22 cells play some pathogenic roles in some autoimmune disorders such as type 1 diabetes (T1D). We aimed to study the correlation between the circulatory number of these cells and serum levels of its related cytokines with T1D as well as diabetic complications including metabolic control, atherosclerosis, and nephropathy. Fortynine patients with T1D and 43 healthy controls underwent the assessment of circulatory number of Th22 cells (by flow cytometry), serum level of Th22 related cytokines including Interleukin-22 (IL-22), Interleukin-10 (IL-10), Transforming growth factor-β (TGF-β), Tumor necrosis factor-α (TNF-α) (by ELISA) and carotid intima-media thickness (cIMT) measurement (by doppler ultrasonography). In addition, fasting blood and urine samples were taken to measure levels of hemoglobin A1C, lipid profile, cell blood count (CBC), serum and urine creatinine and urine protein in all participants. Th22 frequency and serum levels of IL-22 and TNF-α in patients were significantly higher than those in controls (p<0.001). Serum levels of IL-10 and TGF-β in healthy individuals were higher than those in patients (p<0.001). None of the Th22 related markers had a significant correlation with diabetic complications. There was only a significant effect of IL-22 on HbA1C variations. Th22 pathway has a significant correlation with T1D but not with its complications of cIMT and Urine Albumin/Creatinine Ratio (UACR). We report that Th22 pathway is not a good prognostic as well as diagnostic marker of early macrovascular complications in T1D.
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June 2018

The Effects of Vitamin D Supplementation on Biomarkers of Inflammation and Oxidative Stress in Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Horm Metab Res 2018 Jun 8;50(6):429-440. Epub 2018 Jun 8.

Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran.

In this systematic review and meta-analysis of randomized controlled trials (RCTs), the effects of vitamin D supplementation on biomarkers of inflammation and oxidative stress in diabetic patients are summarized. The following databases were searched up to December 2017: MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. The quality of the relevant extracted data was assessed according to the Cochrane risk of bias tool. Data were pooled using the inverse variance method and expressed as mean difference with 95% Confidence Intervals (95% CI). Heterogeneity between studies was assessed by the Cochran Q statistic and I-squared tests (I). Overall, 33 studies were included in the meta-analyses. Vitamin D supplementation were found to significantly reduce serum high-sensitivity C-reactive protein (hs-CRP) (WMD 0.27; 95% CI, - 0.35, - 0.20; p<0.001) and malondialdehyde (MDA) levels (WMD - 0.43, 95% CI - 0.62, - 0.25, p<0.001) in diabetic patients. In addition, vitamin D supplementation were found to increase markers of nitric oxide (NO) release (WMD 4.33, 95% CI 0.96, 7.70), total serum antioxidant capacity (TAC) (WMD 57.34, 95% CI 33.48, 81.20, p<0.001) and total glutathione (GSH) levels (WMD 82.59, 95% CI 44.37, 120.81, p<0.001). Overall, this meta-analysis shows that in diabetic patients, taking vitamin D had significant effects on hs-CRP and MDA levels, and significantly increased NO, TAC and GSH levels.
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http://dx.doi.org/10.1055/a-0630-1303DOI Listing
June 2018

Evaluating Serum Levels of IL-33, IL-36, IL-37 and Gene Expression of IL-37 in Patients with Psoriasis Vulgaris.

Iran J Allergy Asthma Immunol 2018 Apr;17(2):179-187

Trauma Research Centre, Kashan University of Medical Sciences, Kashan, Iran.

Serum levels of interleukin (IL)-33, IL-36 and IL-37 have been reported to be up-regulated in various T helper (Th)1/Th17 mediated autoimmune/inflammatory diseases. Although IL-33 and IL-36 expression are increased in skin lesions of patients with psoriasis, their serum levels in such patients have not yet been adequately studied. We aimed to evaluate serum level of IL-33, IL-36 and IL-37 cytokines and IL-37 gene expression in patients with autoimmune/inflammatory disease of psoriasis and to explore their correlation with disease severity. Such evaluation further clarifies disease pathogenesis and may be utilized in clinical practice. 47 patients with psoriasis vulgaris and 47 healthy individuals were included. Serum IL-33, IL-36 and IL-37 levels were measured by Elisa and gene expression of IL-37 measured by real time PCR in all participants. The disease activity was assessed by the psoriasis area and severity index (PASI). Linear Correlation between interleukin measures and PASI score was calculated. Also sensitivity and specificity of such measurements were determined. Serum IL-36 and 37 levels in patients with psoriasis vulgaris were significantly higher than those in healthy controls and positively correlated with disease activity (PASI score). Serum IL-33 levels in patients were equal to those in healthy controls but positively correlated with disease activity. Serum IL-36 levels were significantly higher than serum IL-33 levels. Gene expression of IL-37 levels in patients were higher than healthy controls but was not correlated with disease activity. Serum IL-36 and IL-37 levels are generally increased in psoriasis vulgaris and correlated with disease severity. Therefore, serum IL-36 and IL-37 levels may be markers of treatment and diagnosis of psoriasis.
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April 2018

Association of Regulatory T Cells with Diabetes Type-1 and Its Renal and Vascular Complications Based on the Expression of Forkhead Box Protein P3 (FoxP3), Helios and Neurophilin-1.

Iran J Allergy Asthma Immunol 2018 Apr;17(2):151-157

Department of Biostatistics and Public Health, Faculty of Health, Kashan University of Medical Sciences, Kashan, Iran.

In recent years, it has been recognized that regulatory T cells (Tregs) play a critical role in maintaining immune tolerance. Moreover, the expression of two markers named Helios and neurophilin-1 (NRP-1) has been highlighted in such cells. Helios, an intracellular transcription marker, largely differentiates twomost operative sub group of Tregs, namely naturally occurring (nTreg) and induced (iTreg) Tregs, and NRP-1 is reckoned as a membranous activity marker of Tregs. We aimed to count peripheral mononuclear cells expressing such markers in a group of type 1 diabetes patients to elucidate the possible role of Tregs in the pathogenesis of such disease and its complications. Blood samples from 61 adult patients with type 1 diabetes and 61 sex and age-matched healthy controls were tested to count two types of Tregs, namely naturally occurring and inducible types, according to the expression of cell surface markers of CD4/CD25/CD47-FITC/PE/APC and intracellular markers of FoxP3/Helios-PE-CY5/eFlour450 by flow cytometry, respectively.We also investigated the relation between expression of such markers with HbA1c, urine albumin/creatinine ratio (UACR), and common carotid intima thickness (CIMT). The circulatory frequency of both Helios+ and Helios- T-cells were significantly decreased in patients compared to those in healthy controls (p<0.001). There was also a significant decrease in circulatory frequency of Helios+ NRP-1+ and Helios- NRP-1+ cells in the patients compared to controls (p=0.029). According to expression of Helios and NRP-1 markers, the number and function of both Tregs were decreased in diabetic patients. Moreover, the neurophilin expression was inversely associated with complications of type 1 diabetes.
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April 2018

Comparing Effectiveness of Mindfulness-Based Relapse Prevention with Treatment as Usual on Impulsivity and Relapse for Methadone-Treated Patients: A Randomized Clinical Trial.

Addict Health 2017 Jul;9(3):156-165

Assistant Professor, Department of Biostatistics and Epidemiology, School of Public Health, Kashan University of Medical Sciences, Kashan, Iran.

Background: Impulsivity is one of the causes of relapse that can affect treatment outcomes. Studies have shown that addiction treatments can reduce impulsivity in drug-dependent individuals. Studies also have suggested that mindfulness is associated with impulsivity. However, no study has investigated the effectiveness of the mindfulness-based intervention on impulsivity in opioid-dependent individuals. This study aimed to compare the effectiveness of mindfulness-based relapse prevention (MBRP) with treatment as usual (TAU) in terms of impulsivity and relapse for methadone-treated patients.

Methods: The present randomized controlled clinical trial was performed in Kashan, Iran, in 2015. The study population was opioid-dependent patients referred to Maintenance Treatment Centers. Seventy patients were selected by random sampling and were assigned in two groups (MBRP and TAU) randomly. The participants of two groups filled out Barratt impulsivity scale (BIS-11) as a pre-test and 8 weeks later as post-test and 2 months later as a follow-up. Both groups received methadone-therapy. The MBRP group received 8 sessions of group therapy, while the control group did not receive any group psychotherapy session. Finally, data from 60 patients were analyzed statistically.

Findings: The MBRP group had decreased impulsivity significantly (P < 0.001). The mean impulsivity score was 74.76 ± 4.72 before intervention that was significantly decreased to 57.66 ± 3.73 and 58.86 ± 3.57 after the intervention and follow-up (P < 0.001), respectively. In addition, significant differences were observed between MBRP and TAU groups for relapse frequency (P < 0.050).

Conclusion: This study showed that MBRP compared to TAU can decrease the mean impulsivity score in opioid-dependent and reduce relapse probability. These findings suggest that MBRP is useful for opioid-dependent individuals with high-level impulsivity, and relapse prevention.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5894795PMC
July 2017