Kharameh cohort study (KHCS) on non-communicable diseases and preliminary findings of 3-year follow-up.

PURPOSE: The Kharameh cohort study (KHCS) is one branch of the 'Prospective Epidemiological Research Studies in Iran', located in the south of Iran. The enrolment phase of KHCS spanned from April 2015 to March 2017, during which urban and rural residents of Kharameh were enrolled in the study. KHCS aims to investigate the incidence of non-communicable diseases (NCDs) such as hypertension, diabetes mellitus, cardiovascular diseases and cancer, and its related risk factors in a 15-year follow-up. PARTICIPANTS: KHCS was designed to recruit 10 000 individuals aged 40-70 years old from both urban and rural areas of Kharameh. Thus, a total of 10 800 individuals aged 40-70 years of age were invited and, finally, 10 663 subjects were accepted to participate, with a participation rate of 98.7%. FINDINGS TO DATE: Of the 10 663 participants, 5944 (55.7%) were women, and 6801 (63.7%) were rural residents. The mean age of the participants was 51.9±8.2 years. 41.8% of the participants were aged 40-49, 35.2% were aged 50-59 and the remaining 23% were 60-70 years old. Until March 2020 (first 3 years of follow-up), the total number of patients diagnosed with NCDs was 1565. Hypertension, type 2 diabetes and acute ischaemic heart disease were the most common NCDs. Furthermore, the total number of deaths during the first 3 years of follow-up was 312, with cardiovascular diseases (38.7%) as the most common cause of death, followed by cerebrovascular diseases (11.8%) and cancer (16.2%). FUTURE PLANS: The remaining 12 years of follow-up will inevitably shed light on the genetic, lifestyle/socioeconomic status, and environmental risk and protective factors of NCDs.

Application of multi-gene genetic programming to the prognosis prediction of COVID-19 using routine hematological variables.

Identifying patients who may develop severe COVID-19 has been of interest to clinical physicians since it facilitates personalized treatment and optimizes the allocation of medical resources. In this study, multi-gene genetic programming (MGGP), as an advanced artificial intelligence (AI) tool, was used to determine the importance of laboratory predictors in the prognosis of COVID-19 patients. The present retrospective study was conducted on 1455 patients with COVID-19 (727 males and 728 females), who were admitted to Allameh Behlool Gonabadi Hospital, Gonabad, Iran in 2020-2021. For each patient, the demographic characteristics, common laboratory tests at the time of admission, duration of hospitalization, admission to the intensive care unit (ICU), and mortality were collected through the electronic information system of the hospital. Then, the data were normalized and randomly divided into training and test data. Furthermore, mathematical prediction models were developed by MGGP for each gender. Finally, a sensitivity analysis was performed to determine the significance of input parameters on the COVID-19 prognosis. Based on the achieved results, MGGP is able to predict the mortality of COVID-19 patients with an accuracy of 60-92%, the duration of hospital stay with an accuracy of 53-65%, and admission to the ICU with an accuracy of 76-91%, using common hematological tests at the time of admission. Also, sensitivity analysis indicated that blood urea nitrogen (BUN) and aspartate aminotransferase (AST) play key roles in the prognosis of COVID-19 patients. AI techniques, such as MGGP, can be used in the triage and prognosis prediction of COVID-19 patients. In addition, due to the sensitivity of BUN and AST in the estimation models, further studies on the role of the mentioned parameters in the pathophysiology of COVID-19 are recommended.

Cancer incidence in Southern Iran, 2015-2018: A population based study on cancer registry profile of Fars province.

Background and Aims: Cancer registry profiles provide an insight into the trend of cancer in a specific region. The present study aimed to report the cancer incidence in Fars during 2015-2018, based on the cancer registry of Fars province. Methods: The present population-based study electronically gathered new cancer patient's data from all pathology, radiology, radiotherapy, chemotherapy departments, and mortality data of Fars province. This electronic connection was first established in 2015, in Fars Cancer Registry database. After data gathering, all duplicated patients are removed from the database. The Fars Cancer Registry database includes data such as gender, age, cancer ICD-O code, and city from March 2015 to 2018. Furthermore, the death certificate only (DCO%) and microscopic verification (MV%) were calculated using SPSS software. Results: A total of 34,451 patients with cancer were registered in the Fars Cancer Registry database during these 4 years. Among these patients, 51.9% (n = 17,866) were male, and 48.1% (n = 16,585) were female. Furthermore, the mean age of patients with cancer was about 57.3 ± 19 (60.50 ± 19 in males, 53.86 ± 18 in females). In men, prostate, skin (non-melanoma), bladder, colon and rectum, and stomach are the most common cancers. Also, in women, breast, skin (non-melanoma), thyroid gland, colon and rectum, and uterus were the most common cancers in the studied population. Conclusion: Overall, breast, prostate, skin (non-melanoma), colon and rectum, and thyroid cancers were the most common cancers among the studied population. Healthcare decision-makers could make evidence-based policies to decrease cancer incidence based on the reported data.

Comparison of volatile/inhalational and IV anesthesia in long-term survival of patients with breast cancer: a retrospective study.

OBJECTIVE: Breast cancer is a worldwide health concern, and surgical removal has remained the preferred therapeutic option in most patients. Furthermore, the current study was designed to investigate the disease-free survival and overall survival in breast cancer patients, who receive either propofol or isoflurane during operation. METHOD: This retrospective study was conducted on 994 patients (IV group, n = 530; volatile/inhalational group, n = 464) who underwent breast cancer operation from January 2006 to December 2016 at Faghihi Hospital, Shiraz, Iran. All studied patients were followed up till 2020. Patients are classified into two groups, IV and volatile/inhalational, according to the received anesthesia. For statistical analysis, The Cox regression test was conducted to investigate the association between factors affecting the recurrence of the disease and the Log Rank test was utilized to assess the patients' survival. Finally, to reduce the effect of confounding factors, all patients were matched according to age, tumor size and tumor grade. RESULTS: Based on results from the log-rank test, the volatile/inhalational group had a better recurrence-free survival (P = 0.039) compared to the total IV group. However, the overall survival was not considerably different (P = 0.520). CONCLUSION: The current study showed that although 2-year disease-free survival is higher in the volatile/inhalational group, there is no meaningful association between the 5-year overall survival and anesthesia technique.

Benign or premalignant? Idiopathic granulomatous mastitis later diagnosed as ductal carcinoma breast cancer: Case report and review of literature.

Idiopathic granulomatous mastitis (IGM) is a rare benign infectious disease of the breast, commonly presenting with a unilateral breast mass. Since GM's clinical presentation and imaging can be very similar to breast cancer, diagnosing GM can be challenging. So far, various reports have demonstrated the probable correlation and co-occurrence of granulomatous mastitis and breast cancer. This report presents a 38-year-old female with invasive ductal carcinoma, previously diagnosed as IGM.

The favorable impacts of silibinin polyphenols as adjunctive therapy in reducing the complications of COVID-19: A review of research evidence and underlying mechanisms.

The proceeding pandemic of coronavirus disease 2019 is the latest global challenge. Like most other infectious diseases, inflammation, oxidative stress, and immune system dysfunctions play a pivotal role in the pathogenesis of COVID-19. Furthermore, the quest of finding a potential pharmaceutical therapy for preventing and treating COVID-19 is still ongoing. Silymarin, a mixture of flavonolignans extracted from the milk thistle, has exhibited numerous therapeutic benefits. We reviewed the beneficial effects of silymarin on oxidative stress, inflammation, and the immune system, as primary factors involved in the pathogenesis of COVID-19. We searched PubMed/Medline, Web of Science, Scopus, and Science Direct databases up to April 2022 using the relevant keywords. In summary, the current review indicates that silymarin might exert therapeutic effects against COVID-19 by improving the antioxidant system, attenuating inflammatory response and respiratory distress, and enhancing immune system function. Silymarin can also bind to target proteins of SARS-CoV-2, including main protease, spike glycoprotein, and RNA-dependent RNA-polymerase, leading to the inhibition of viral replication. Although multiple lines of evidence suggest the possible promising impacts of silymarin in COVID-19, further clinical trials are encouraged.

Evaluation of tuberculosis infection in COVID-19 patients: a case of tuberculosis and COVID-19 co-infection.

The COVID-19 pandemic affected millions of people worldwide, becoming a challenge of every nation. Since the COVID-19 can present wide spectrum of clinical signs and symptoms, patients with symptoms similar to that of COVID-19 may be misdiagnosed during the context of COVID-19 pandemic. In this regard, various co-infections may affect the outcome of COVID-19 patients if it lefts undiagnosed, especially during the administration of immunosuppressive drugs. Similar to COVID-19, TB affect the lungs and respiratory airways primarily. These two diseases have resembling symptoms, including dry cough, fever, and dyspnea. Due to the importance of early COVID-19 diagnosis, many other respiratory infectious diseases such as tuberculosis (TB) may be missed. Herein, a case of COVID-19 and tuberculosis co-infection is presented.

Nano-curcumin supplementation in critically ill patients with sepsis: a randomized clinical trial investigating the inflammatory biomarkers, oxidative stress indices, endothelial function, clinical outcomes and nutritional status.

Sepsis is a severe reaction and excessive immune response to infection, which can lead to organ dysfunction, and death. This study aimed to investigate the protective effect of nano-curcumin (NC) on inflammatory biomarkers, endothelial function, oxidative stress indices, biochemical factors, nutritional status, and clinical outcomes in patients with sepsis. In the present double-blind placebo-controlled randomized clinical trial, 40 ICU-admitted patients were randomly allocated into either NC or placebo group for 10 days. Both nano-curcumin (160 mg) and placebo were administered via a nasogastric tube twice a day. The mRNA expression of nuclear-related factor 2 (Nrf-2), BCL2 associated X (BAX), B-cell lymphoma 2 (BCL-2), and toll-like receptor 4 (TLR-4) genes in the peripheral blood mononuclear cells (PBMCs), and the serum levels of primary, secondary, tertiary, and exploratory outcomes were assessed before the baseline and on days 5 and 10. There were significant improvements in the primary outcomes, including inflammatory markers (IL-6, IL-18, IL-1ß, IL-10, TLR-4, BCL-2 and BAX), markers of endothelial function (ICAM-1 and VCAM-1), and oxidative stress indices (malondialdehyde (MDA), nuclear-related factor 2 (Nrf-2), catalase, superoxide dismutase (SOD), and TAC) (p < 0.005) in the NC group compared to the placebo group after 10 days, while no significant increase was observed in the glutathione peroxidase (GPx) level between the two groups. However, no significant decrease was observed in the levels of secondary outcomes, including biochemical factors (creatinine, fasting blood sugar (FBS), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), total bilirubin, triglycerides (TG) and total cholesterol (TC)) (P > 0.05). Our results showed that in the tertiary outcome (nutritional status), there was no significant increase (P > 0.05) except for TLC (P = 0.003). NC supplementation also resulted in a significant decrease in the exploratory outcomes including the SOFA score and the duration of mechanical ventilation (P < 0.05). Supplementation with NC may be a promising treatment strategy for critically ill patients with sepsis. However, further experiments are suggested to investigate the effects of nano-curcumin on biochemical pathways involved in sepsis.

Rectus sheath hematoma in COVID-19 patient: The importance of abdominal pain in the course of COVID-19.

We report herein a case of a 58-year-old woman with COVID-19. During the hospitalization, the patient complained of acute abdominal pain, and abdominal CT revealed the rectus sheath hematoma (RSH). Since corticosteroids and anti-coagulation are commonly administered in COVID-19 patients, physicians should consider RSH as a possible diagnosis for acute abdominal pain.

Minocycline can reduce testicular apoptosis related to varicocele in male rats.

The current research aimed to assess the impacts of Minocycline on varicocele-induced regulation of apoptotic-related genes and oxidative stress in the testis of adult Wistar rats. Thirty-two rats were divided into 4 groups: sham, varicocele (VcI), varicocele treated with Minocycline (VcI + Mno) for 56 days and healthy rats treated with minocycline (Mno). After 8 weeks, the oxidative stress markers levels in serum were investigated, afterwards, the level of Bax and Bcl-2 expression were assessed through 'immunocytochemistry' and RT-qPCR assays. Also, the rate of apoptosis was evaluated through the TUNEL method. Johnson's score, 'the width of epithelium' and 'seminiferous tubules diameter' were ameliorated in the VcI + Mno group in comparison with the Vcl group. Administration of Minocycline raised the 'Glutathione peroxidase' and 'Superoxide dismutase' levels in serum and declined the Malondialdehyde level in serum (p = 0.001). Furthermore, current study represented that minocycline reduced Bax and enhanced the expression of Bcl-2 gene and protein in comparison with the Vcl group (p < 0.05). In addition, Minocycline administration significantly declined the rate of apoptosis in germ cells (p < 0.05). Our study demonstrated that the administration of Minocycline could improve testicular injury in varicocele-induced rats by its antioxidant activity.

Therapeutic Effects and Mechanisms of Action of Garlic (Allium sativum) on Nonalcoholic Fatty Liver Disease: A Comprehensive Systematic Literature Review.

Nonalcoholic fatty liver disease (NAFLD) is globally the leading cause of hepatic dysfunction. Garlic has many physiological benefits, including anti-inflammatory, antioxidant, anticancer, lipid-lowering, and antidiabetes effects. The present study aimed to systematically review the effects of garlic (Allium sativum) and its mechanisms of function in managing NAFLD and its associated complications. The guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statements were applied to perform the study (CRD42021289348). The Scopus, Embase, Web of Science, Cochrane PubMed, and Google Scholar databases were searched until February 2022. According to the inclusion criteria, finally, 12 studies were entered into the study. The evidence provided in the study revealed that garlic could regulate the development of NAFLD via several mechanisms of action, such as lowering body weight, modulating lipid and glucose metabolism, and reducing inflammation and oxidative stress (OS). Overall, the beneficial effects of garlic in the treatment of NAFLD make it a potential therapeutic and efficient agent in managing NAFLD and its related risk factors. There is an insufficient number of clinical trials addressing the effects of garlic in humans; therefore, conducting more human research in the future is recommended.

COVID-19 patients may present with myocarditis: A case report emphasizing the cardiac involvement of SARS-CoV-2.

The Coronavirus disease 2019 (COVID-19), which was declared to be pandemic on March 12, 2020, is the latest health concern worldwide. COVID-19 patients may develop cerebrovascular complications either during the course of COVID-19 or even as an initial presentation of the disease. Herein, a case of myocarditis in a COVID-19 patient without any respiratory signs and symptoms is presented.

A comprehensive systematic review of the therapeutic effects and mechanisms of action of quercetin in sepsis.

BACKGROUND: Sepsis is a life-threatening condition caused by a dysregulated host response to infection. Several studies have indicated that flavonoids exhibit a wide variety of biological actions including free radical scavenging and antioxidant activities. Quercetin, one of the most extensively distributed flavonoids in the vegetables and fruits, presents various biological activities including modulation of oxidative stress, anti-infectious, anti-inflammatory, and neuroprotective activities. METHODS: The present systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statements. We searched Web of Sciences, Google Scholar, PubMed, Scopus, and Embase databases up to February 2021 by using the relevant keywords. RESULTS: Out of 672 records screened, 35 articles met the study criteria. The evidence reviewed here indicates that quercetin supplementation may exert beneficial effects on sepsis by attenuating inflammation and oxidative stress, downregulating the mRNA expression of toll-like receptors (TLRs), modulating the immune response, and alleviating sepsis-related organ dysfunctions. CONCLUSION: Due to the promising therapeutic effects of quercetin on sepsis complications and the lack of clinical trials in this regard, future human randomized clinical trials are warranted.

Primary omental torsion in a pediatric patient.

Omental infarction although infrequent should be considered as a possible cause of acute abdomen precisely in those with negative appendectomy.

A Comprehensive insight into the effect of chromium supplementation on oxidative stress indices in diabetes mellitus: A systematic review.

Diabetes mellitus is a metabolic disorder defined as an increase in blood glucose levels (hyperglycaemia) and insufficient production or action of insulin produced by the pancreas. Chronic hyperglycaemia leads to increased reactive oxygen species (ROS) production and oxidative stress, which consequently results in insulin resistance, beta cell degeneration, dyslipidaemia, and glucose intolerance in diabetic patients. Chromium has an essential role in the metabolism of proteins, lipids, and carbohydrates through increasing insulin efficiency. This systematic review aimed to evaluate chromium supplementation's potential roles in oxidative stress indices in diabetes mellitus. A systematic search was performed in PubMed, Scopus, Google Scholar, Cochrane, and Science Direct databases until November 2020. All clinical trials and animal studies that assessed chromium's effect on oxidative stress indices in diabetes mellitus and were published in English-language journals were included. Finally, only 33 out of 633 articles met the required criteria for further analysis. Among 33 papers, 25 studies were performed on animals, and eight investigations were conducted on humans. Twenty-eight studies of chromium supplementation lead to reducing oxidative stress indices. Also, 23 studies showed that chromium supplementation markedly increased antioxidant enzymes' activity and improved levels of antioxidant indices. In conclusion, chromium supplementation decreased oxidative stress in diabetes mellitus. However, further clinical trials are suggested in a bid to determine the exact mechanisms.

Prevalence and Subtype Analysis of Blastocystis hominis Isolated from Patients in the Northeast of Iran.

Blastocystis hominis is the most common intestinal parasite found in humans and many other hosts. Pathogenicity of Blastocystis spp. remains controversial, and it has been suggested that it may be associated with specific subtypes of the organism. This study identified the B. hominis subtypes and their prevalence rates in the northeast of Iran. A total of 1878 samples were collected from the northeast of Iran from January to December 2017. The patients' demographic details were recorded. Samples were examined by a wet mount, and genomic DNA was extracted from positive samples. Also, PCR was done on the positive samples, and sequencing and phylogenetic analysis were subsequently performed. From 1878 collected stool samples, 152 (8.1%) Blastocystis samples were detected by the microscopic method. Of the 152 samples, Blastocystis spp. were found in 53.6% of the men and 28.9% of the women who showed clinical gastrointestinal symptoms, and a significant relationship was observed between gender and clinical symptoms (P = 0.002). A meaningful relationship was found between the season and infection with this parasite (P value = 0.003). The results of the sequencing of 22 PCR products showed the dominance of ST3, which was isolated from 10 (45.45%) patients, while ST1, ST2, and ST7 were found in 4 (18.19%), 7 (31.81%), and 1 (4.55%) patients, respectively. In this study, ST7 had a low prevalence in the northeast of Iran, and similar to previous studies, ST3 was the dominant subtype.

Chromium picolinate balances the metabolic and clinical markers in nonalcoholic fatty liver disease: a randomized, double-blind, placebo-controlled trial.

OBJECTIVE: Nonalcoholic fatty liver disease (NAFLD) is a complicated disease and is considered as a severe global health problem affecting 30% of adults worldwide. The present study aimed to evaluate changes in oxidative stress, adipokines, liver enzyme, and body composition following treatment with chromium picolinate (CrPic) among patients with NAFLD. PARTICIPANTS AND METHODS: The current randomized, double-blind, placebo-controlled study was conducted on 46 NAFLD patients with the age range of 20-65 years. Patients were randomly classified into two groups, receiving either 400 µg CrPic tablets in two divided doses of 200 µg (23 patients) or placebo (23 patients) daily for 12 weeks. The participants' body composition and biochemical parameters were evaluated at the baseline and after 12 weeks. RESULTS: Serum levels of liver enzymes reduced significantly only in the CrPic group (P < 0.05 for all), but not between the groups after the intervention. Besides, there were significant differences between the study groups regarding body weight and body fat mass, total antioxidant capacity, superoxide dismutase, malondialdehyde, leptin, and adiponectin post-intervention (P = 0.017, P = 0.032, P = 0.003, P = 0.023, P = 0.012, P = 0.003, and P = 0.042, respectively). However, glutathione peroxidase and resistin levels did not differ significantly between groups (P = 0.127 and P = 0.688, respectively). DISCUSSION AND CONCLUSION: This study showed that consuming 400 µg/day of CrPic for 12 weeks in patients with NAFLD causes a significant change in leptin, adiponectin, oxidative stress (expect glutathione peroxidase), and body weight, compared to baseline. Nevertheless, it does not affect liver enzymes. Therefore, the CrPic supplementation may improve adipokines, some anthropometric indices, and oxidative stress in patients with NAFLD.

Application of artificial neural networks to predict the COVID-19 outbreak.

BACKGROUND: Millions of people have been infected worldwide in the COVID-19 pandemic. In this study, we aim to propose fourteen prediction models based on artificial neural networks (ANN) to predict the COVID-19 outbreak for policy makers. METHODS: The ANN-based models were utilized to estimate the confirmed cases of COVID-19 in China, Japan, Singapore, Iran, Italy, South Africa and United States of America. These models exploit historical records of confirmed cases, while their main difference is the number of days that they assume to have impact on the estimation process. The COVID-19 data were divided into a train part and a test part. The former was used to train the ANN models, while the latter was utilized to compare the purposes. The data analysis shows not only significant fluctuations in the daily confirmed cases but also different ranges of total confirmed cases observed in the time interval considered. RESULTS: Based on the obtained results, the ANN-based model that takes into account the previous 14 days outperforms the other ones. This comparison reveals the importance of considering the maximum incubation period in predicting the COVID-19 outbreak. Comparing the ranges of determination coefficients indicates that the estimated results for Italy are the best one. Moreover, the predicted results for Iran achieved the ranges of [0.09, 0.15] and [0.21, 0.36] for the mean absolute relative errors and normalized root mean square errors, respectively, which were the best ranges obtained for these criteria among different countries. CONCLUSION: Based on the achieved results, the ANN-based model that takes into account the previous fourteen days for prediction is suggested to predict daily confirmed cases, particularly in countries that have experienced the first peak of the COVID-19 outbreak. This study has not only proved the applicability of ANN-based model for prediction of the COVID-19 outbreak, but also showed that considering incubation period of SARS-COV-2 in prediction models may generate more accurate estimations.

Assessment of Three Mathematical Prediction Models for Forecasting the COVID-19 Outbreak in Iran and Turkey.

COVID-19 pandemic has become a concern of every nation, and it is crucial to apply an estimation model with a favorably-high accuracy to provide an accurate perspective of the situation. In this study, three explicit mathematical prediction models were applied to forecast the COVID-19 outbreak in Iran and Turkey. These models include a recursive-based method, Boltzmann Function-based model and Beesham's prediction model. These models were exploited to analyze the confirmed and death cases of the first 106 and 87 days of the COVID-19 outbreak in Iran and Turkey, respectively. This application indicates that the three models fail to predict the first 10 to 20 days of data, depending on the prediction model. On the other hand, the results obtained for the rest of the data demonstrate that the three prediction models achieve high values for the determination coefficient, whereas they yielded to different average absolute relative errors. Based on the comparison, the recursive-based model performs the best, while it estimated the COVID-19 outbreak in Iran better than that of in Turkey. Impacts of applying or relaxing control measurements like curfew in Turkey and reopening the low-risk businesses in Iran were investigated through the recursive-based model. Finally, the results demonstrate the merit of the recursive-based model in analyzing various scenarios, which may provide suitable information for health politicians and public health decision-makers.

Investigation of Toxoplasma gondii Infection in Aborted Fetuses of Sheep Using PCR: A Study in North Khorasan Province, Iran.

Toxoplasma gondii is a zoonotic obligate intracellular protozoan parasite that infects warm-blooded animals as well as humans worldwide. The purpose of this study was to delineate the prevalence of Toxoplasma infection in aborted fetuses of sheep in North Khorasan province, Iran. Three hundred and ninety-nine samples of the liver (133 samples), placenta (133 samples), and brain (133 samples) from 133 aborted fetuses of sheep were collected from 2015 to 2017. The ages of aborted fetuses were higher than 120 days' gestational age in this study. According to the samples, sixteen out of 133 aborted fetuses of sheep were infected with T. gondii. Toxoplasma DNA was found in the placenta (68.75%) and liver (31.25%) samples of infected fetuses using the PCR method. The highest and lowest rates of Toxoplasma infection were observed during 2016 and 2017, respectively. Shirvan and Faruj provinces were recognized as the two most infected districts among others. There was a significant difference between the year and abortion rate in sheep due to infection by the Toxoplasma parasite (P < 0.05). Furthermore, no significant difference between the prevalence of T. gondii infection and aborted fetuses was seen (P > 0.05) in different areas. According to the present study, T. gondii infection can be one of the causes of fetus abortion of sheep in North Khorasan province, Iran.