Progressive multifocal leukoencephalopathy in a patient with B-cell chronic lymphocytic leukemia after COVID-19 vaccination, complicated with COVID-19 and mucormycosis: a case report.

BACKGROUND: Progressive multifocal leukoencephalopathy (PML) is a rare and fatal opportunistic viral demyelinating infectious disease of the central nervous system (CNS). There are various clinical presenting symptoms for the disease. CASE PRESENTATION: This paper presents a clinical case of PML in a patient with B-Chronic lymphocytic leukemia (B-CLL), previously treated with Chlorambucil, later complicated later with COVID-19 and mucormycosis. CONCLUSION: PML can develop in the setting of cellular immune dysfunction. Late diagnosis of this disease based on nonspecific symptoms is common, therefore when we face a neurological complication in a CLL or immunocompromised patient, we should consider PML infection. A remarkable feature of this case is the possible triggering effect of COVID-19 vaccination for emergence of PML as the disease can be asymptomatic or sub-clinical before diagnosis.

Designing of a pH-activatable carbon dots as a luminescent nanoprobe for recognizing folate receptor-positive cancer cells.

During recent years, cancer has been recognized as a well-known disorder all over the world. One of the important factors to tackle this problem better than past decades is early diagnosis that takes into practice by state-of-the-art visual equipment for detection cancer cells. Herein, in this research, we synthesized carbon dots with pH-dependent behavior from a green source by hydrothermal method with high quantum yield and blue fluorescence. Folic acid-conjugated carbon dots by an efficient and optimal conjugation method were set upped which determined cancer cells visually. These synthesized and conjugated nanoparticles entered into the cancer cells more comprehensive than normal cells by receptor-mediated endocytosis and could distinguish cancer cells from normal ones by fluorescence imaging. Ultimately, synthesized nanoparticles in this research can be considered as an efficient fluorescent nanoprobe for cancer pre-diagnosis.

The LncRNA H19 rs217727 Polymorphism Is Associated with Oral Squamous Cell Carcinoma Susceptibility in Iranian Population.

Lack of protein-coding capacity is a main characteristic of long noncoding RNAs (lncRNAs) which, as molecular biomarkers, have found a novel pharmacological application in cancer and are reported to be important regulators of gene expression. H19 is reportedly involved in cancer progression and tumorigenesis. One of the most common types of head and neck cancers is oral squamous cell carcinoma (OSCC). The main objective of the present study was to evaluate the correlation of OSCC susceptibility with H19 gene in an Iranian population. This research was performed on 400 subjects of both sexes referred to the Namazi Hospital affiliated with the Shiraz University of Medical Sciences (SUMS). Individuals aged 15-88 years were divided into two groups: pathologically diagnosed patients with new-onset OSCC and healthy controls. After written and informed consent was obtained from the individuals, genomic DNA was extracted. The tetra-primer ARMS-PCR technique was performed for DNA genotyping by the use of specific primer pairs. The susceptibility of OSCC and H19 gene polymorphism sites was further analyzed (rs217727 and rs2107425). The allele and genotype frequencies of H19 rs2107425 polymorphism were similar between OSCC cases and controls. The H19 rs217727T allele frequency was significantly higher in OSCC cases (P = 0.002), and the polymorphism of H19 rs217727 was associated with OSCC susceptibility in the codominant (OR = 6.04, 95%CI = 1.70 - 21.42, P = 0.001 for TT genotype), dominant (OR = 1.62, 95%CI = 1.08 - 2.43, P = 0.01), and recessive (OR = 5.32, 95%CI = 1.51 - 18.69, P = 0.003) models. This study showed that rs217727 and OSCC susceptibility were statistically correlated in the Iranian population.

Waist Circumference and Spirometric Measurements in Chronic Obstructive Pulmonary Disease.

OBJECTIVES: The aim of this study was to evaluate whether the waist circumference of patients with chronic obstructive pulmonary disease (COPD), had an impact on lung function. METHODS: There were 180 patients with COPD recruited into this prospective cross-sectional study. The age, weight, body mass index and waist circumference (WC) were measured. Spirometry parameters including forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1), were measured and FEV1/FVC calculated. RESULTS: The mean FEV1/FVC in both normal weight and overweight patients, did not statistically significantly correlate with WC. The COPD assessment test, positively correlated with WC ( p = 0.031). A positive correlation with body mass index ( p < 0.001), smoking ( p = 0.027), and global initiative for chronic obstructive lung disease score ( p = 0.009), were observed to positively associate with WC. WC, age, C-reactive protein, duration of disease, and gender (male), were observed to be statistically significant risk factors for the severity of COPD. CONCLUSION: WC was not observed to impact upon lung function in this study but it was a predictive factor for COPD severity in patients.

In ovo injection of flavanone on bone quality characteristics, biochemical parameters and antioxidant enzyme status of blood in daily chicks.

In ovo injection (IOI) of Naringin (N), flavanone was examined on post-hatch blood biochemical parameters, antioxidant status and bone characteristics. Fertile eggs (n = 700) were distributed in seven groups with 100 eggs. On 14th and 17.5th days of incubation, four groups were injected using 15 or 30 mg active ingredient levels of naringin/0.5 ml saline/egg, low and high level, into amnion sac. Controls include sham (injected normal saline, 0.5 ml/egg on day 14 and 17.5th) and un-injected group. IOI of high naringin and saline on 14th day of incubation resulted in lower hatchability and then higher mortality in last week of embryonic life. On day hatch, high levels of injected groups more body weight compared to the control. Chick length was increased at high levels of naringin on day 17.5th compared to control and saline injected. Quality traits of bones were improved in naringin-injected groups compared to control. IOI of naringin influenced thyroid hormones on 14th day of incubation. Naringin groups influenced the Alkaline phosphatase (ALP), Calcium (Ca), superoxide dismutase (SOD), blood biochemical and lipids. Totally, amniotic IOI of naringin in last days of developing embryo may be useful for hatched chick, development of leg long bone or effect on biochemical metabolites by levels of flavanone that it needs more research.

CD73 a novel marker for the diagnosis of benign and malignant salivary gland tumors.

BACKGROUND: Ecto-5'-nucleotidase (CD73) plays an important role in the development of several types of cancer; however, its prognostic significance in salivary gland tumors remains unknown. The current study was conducted to investigate the expression of CD73 in such tumors. MATERIAL AND METHODS: In this retrospective study, immunohistochemical expression of CD73 was evaluated in 25 pleomorphic adenomas, 20 mucoepidermoid carcinomas and 20 adenoid cystic carcinomas using the Envision technique. Labeling indices of CD73 expression were calculated and compared between lesions. RESULTS: Immunohistochemical analysis demonstrated that the CD73 expression was significantly higher in salivary gland tumors than in normal salivary gland tissue (p<0.001). CD73 expression was significantly higher in mucoepidermoid carcinoma and adenoid cystic carcinoma compared to pleomorphic adenoma p<0.001). In addition, the expression of CD73 was significantly higher in lymph node metastasizing cancers compared to non-metastasizing malignancies (P<0.001). In contrast, there was no significant association between CD73 expression and other clinicopathological variables such as age, gender, tumor size and distant metastasis (P>0.05). CONCLUSIONS: The findings suggest that CD73 can be an independent and useful biomarker for predicting the clinical behavior of salivary gland tumors. Key words:Ecto-5'-nucleotidase, immunohistochemistry, salivary gland tumors.

Biochemical, hematological, and pathological related healing effects of Elaeagnus angustifolia hydroalcoholic extract in 5-fluorouracil-induced oral mucositis in male golden hamster.

Oral mucositis (OM) is one of the cancer chemotherapy-related side effects which can affect the quality of life of affected patients. This study was designed to investigate the healing effect of Elaeagnus angustifolia in 5-flurouracil (5-FU)-induced OM in golden hamster. Fifty-six adult male golden hamsters received three intraperitoneal injections of 5-FU at a dose of 60 mg/kg on days 0, 5, and 10. The cheek pouch mucosa was scratched superficially under local anesthesia. Then, two horizontal scratches were made across the everted cheek pouch on days 3 and 4. All treatments were started on day 12 for equal number of animals in control group with no treatments, gel base group that was treated with carboxy methyl cellulose as gel base which used in preparation of the topical gel, topical gel group that used gel containing 10% hydroalcoholic extract of E. angustifolia (HEEA) topically, and dietary group which was treated with 300 mg/kg HEEA. At 2 and 5 days after treatment, blood and pouch tissue sampling were done and analyzed for blood composition, tissue malondialdehyde (MDA) level, and myeloperoxidase (MPO) and superoxide dismutase (SOD) activities plus histopathological evaluations. Both topically and orally HEEA-treated groups showed a significant relief in OM compared to the control and base gel groups. However, the systemic form had higher efficiency in some parts especially decreasing the MPO (0.27 ± 0.17 vs. 0.56 ± 0.17 IU/L) and increasing SOD (6.46 ± 0.15 vs. 5.36 ± 0.18 IU/L) activities in pouch tissue in comparison to topical form mostly at 5 days after treatment. It seems that hydroalcoholic extract of E. angustifolia can be used as an appropriate drug choice for the treatment of oral mucositis based on its healing stimulatory and anti-inflammatory properties.

Healing acceleration of oral mucositis induced by 5-fluorouracil with Pistacia atlantica (bene) essential oil in hamsters.

BACKGROUND: Oral mucositis is a common debilitating condition in patients with cancer receiving cytotoxic therapies. This study aimed to evaluate the effects of topical administrations of the essential oil extracted from hull of Pistacia atlantica fruit (bene) on healing of oral mucositis in golden hamsters. METHODS: Forty hamsters with oral mucositis induced by 5-fluorouracil administered on days 0, 5 and 10 and buccal mucosal scratching were randomly divided into four equal groups: group 1 received no additional treatment, group 2 received gel base, and groups 3 and 4 received gels containing 5% and 10% oil, respectively. From day 12, after blood sampling of all animals, a half randomly selected fraction of each group (four half groups) received once-daily topical administration of either gel type (gel base, 5% and 10%) or no treatment (control subgroup) over the buccal pouches for 3 days and the remaining halves received the same treatments for 6 days. On each final day 15 and 18, the corresponding subgroups underwent consecutively the repeated blood sampling, mucosal clinical examination and excision for histopathology. RESULTS: Comparisons on macro- and microscopical oral mucositis scorings demonstrated dose-dependent healing promotion in the subgroups receiving active gels (P < 0.05). The blood samplings revealed the chemotherapy-related pancytopenia with no significant difference among all subgroups on either end point (P > 0.05). CONCLUSIONS: The healing effect of the bene oil could mainly be local and attributed to its antioxidants and fatty acid contents present in non-saponified and saponified fractions, respectively.

The Relation between Diverse Phenotypes of PCOS with Clinical Manifestations, Anthropometric Indices and Metabolic Characteristics.

Critical issue regarding to variation of findings based on different phenotypes led investigators to define whether they are distinct features or overlapping ones. Therefore, we aimed to investigate the association between diverse phenotypes of PCOS (Poly Cystic Ovary Syndrome) with clinical manifestations, anthropometric indices, and metabolic characteristics. This was a descriptive cross-sectional study conducted in 15-39 years old women with PCOS referred to infertility clinics in the north part of Iran, Rasht during 2010-2011. Data were gathered through an interview by a form consisted of demographic characteristics, laboratory findings, ovarian volume and anthropometric indices. A total of 214 patients consisted of 161 PCOS (cases) and 53 normal women (controls) participated in this study. The most prevalent phenotype in PCOS population was IM/PCO/HA (54%), followed by IM/HA (28%) and IM/PCO (13%). PCO/HA was present only in 6 PCOS patients (5%). PCOS patients were significantly younger than controls (P=0.07). Results showed that increased ovarian volume were higher in PCOS group in comparison with controls and IM/PCO/HA, and IM/PCO had respectively the largest ovarian volumes. Also, a significant relation was observed based on Cholesterol, 17OHP, LH, TG, 2hpp, and LH/FSH between patients with PCOS and control groups. There were significant differences in demographic, anthropometric, hormonal and ultrasound findings between PCOS and controls. Therefore, it seems that classification of the characteristics of each phenotype could offer an appropriate guide for screening risks of PCOS and may facilitate performing most favorable treatment for these complications.

The effect of an absorbable gelatin dressing impregnated with triamcinolone within the olfactory cleft on polypoid rhinosinusitis smell disorders.

BACKGROUND: Chronic rhinosinusitis (CRS) is an inflammatory process that causes different clinical symptoms: nasal blockage and congestion, posterior and anterior nasal drip, and smell disorder ranging from reduced olfaction (hyposmia) to complete loss of smell (anosmia). It has been suggested that mechanical blockage of olfactory clef after polypectomy is responsible for the persistent impairment of olfaction in some cases. The aim of this study was to evaluate the efficacy of application of steroids at the olfactory cleft in improving olfactory function in patients who underwent sinus surgery. METHODS: A double-blind, randomized controlled trial was conducted in Yazd, Iran, between March and December 2012. Eligible patients who had CRS with polyposis and underwent functional endoscopic sinus surgery were recruited. An absorbable gelatin dressing combined with triamcinolone (case) or normal saline (control) was applied at the site of surgery. Olfaction was assessed by butanol threshold tests before and 8 weeks after surgery. RESULTS: A total of 60 patients were enrolled into the study and were equally divided into triamcinolone and control groups. Subjects in both arms of trial experienced augmentation of smell function throughout the study; however, patients who received triamcinolone had better improvement after 8 weeks (p = 0.007). Complete remission rate was 100% in the triamcinolone group and the corresponding figure was 76% in the control group. CONCLUSION: We suggest that application of triamcinolone at the olfactory cleft can boost the effect of surgery in restoring olfactory function.

Comparing the effects of cryotherapy with nitrous oxide gas versus topical corticosteroids in the treatment of oral lichen planus.

BACKGROUND: Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa with treatment challenges for clinicians. AIMS: The objective of this study is to compare the effects of cryotherapy as a new modality with topical corticosteroids as a conventional therapy in the treatment of OLP. MATERIALS AND METHODS: Thirty patients with bilateral OLP lesions were selected. From each patient a lesion on one side was chosen randomly for a single session of cryotherapy with nitrous oxide gas and the lesion on the other side received triamcinolone acetonide 0.1% ointment in orabase. Treatment outcome was measured by means of an appearance score, pain score (visual analogue scale), and severity of lesions before treatment and after 2, 4 and 6 weeks of treatment. STATISTICAL ANALYSIS USED: Paired samples t-test and Wilcoxon test. RESULTS: In both methods of treatment sign score, pain score and severity of lesions was significantly reduced in all follow-up sessions (P<0.05). But the treatment outcome and relapse was not significantly different between the two treatment methods (P>0.05). CONCLUSION: Cryotherapy with nitrous oxide gas is as effective as topical triamcinolone acetonide in the treatment of OLP with no systemic side effects and needs less patient compliance. It can be considered as an alternative or adjuvant therapy in OLP patients to reduce the use of treatments with adverse effects.