Potential Use of the Cholesterol Transfer Inhibitor U18666A as a Potent Research Tool for the Study of Cholesterol Mechanisms in Neurodegenerative Disorders.

Cholesterol is an essential component of mammalian cell membranes and a precursor for crucial signaling molecules. The brain contains the highest level of cholesterol in the body, and abnormal cholesterol metabolism links to many neurodegenerative disorders. The results indicate that faulty cholesterol metabolism is a common feature among people living with neurodegenerative conditions. The researchers suggest that restoring cholesterol levels may become a beneficial new strategy in treating certain neurodegenerative conditions. Several neurodegenerative disorders, such as Alzheimer's disease (AD), Niemann-Pick type C (NPC) disease, and Parkinson's disease (PD), have been connected to abnormalities in brain cholesterol metabolism. Consequently, using a lipid research tool is vital to study further and understand the effect of lipids in neurodegenerative disorders such as NPC, AD, PD, and Huntington's disease (HD). U18666A, also known as 3-(2-(diethylamino) ethoxy) androst-5-en-17-one, is a pharmaceutical drug that suppresses cholesterol trafficking and is a well-known class-2 amphiphile. U18666A has performed many functions, allowing for essential discoveries in lipid studies and shedding light on the pathophysiology of neurodegenerative disorders. Additionally, U18666A prevented the downregulation of low-density lipoprotein (LDL) receptors that are induced by LDL and led to the buildup of cholesterol in lysosomes. Numerous studies show that U18666A impacts the function of cholesterol trafficking to control the metabolism and transport of amyloid precursor proteins (APPs). Treating cortical neurons with U18666A may provide a new in vitro model system for studying the underlying molecular process of NPC, AD, HD, and PD. In this article, we review the mechanism and function of U18666A as a vital tool for studying cholesterol mechanisms in neurological diseases related to abnormal cholesterol metabolism, such as AD, NPC, HD, and PD.

Identify Biomarkers and Design Effective Multi-Target Drugs in Ovarian Cancer: Hit Network-Target Sets Model Optimizing.

Epithelial ovarian cancer (EOC) is highly aggressive with poor patient outcomes, and a deeper understanding of ovarian cancer tumorigenesis could help guide future treatment development. We proposed an optimized hit network-target sets model to systematically characterize the underlying pathological mechanisms and intra-tumoral heterogeneity in human ovarian cancer. Using TCGA data, we constructed an epithelial ovarian cancer regulatory network in this study. We use three distinct methods to produce different HNSs for identification of the driver genes/nodes, core modules, and core genes/nodes. Following the creation of the optimized HNS (OHNS) by the integration of DN (driver nodes), CM (core module), and CN (core nodes), the effectiveness of various HNSs was assessed based on the significance of the network topology, control potential, and clinical value. Immunohistochemical (IHC), qRT-PCR, and Western blotting were adopted to measure the expression of hub genes and proteins involved in epithelial ovarian cancer (EOC). We discovered that the OHNS has two key advantages: the network's central location and controllability. It also plays a significant role in the illness network due to its wide range of capabilities. The OHNS and clinical samples revealed the endometrial cancer signaling, and the PI3K/AKT, NER, and BMP pathways. MUC16, FOXA1, FBXL2, ARID1A, COX15, COX17, SCO1, SCO2, NDUFA4L2, NDUFA, and PTEN hub genes were predicted and may serve as potential candidates for new treatments and biomarkers for EOC. This research can aid in better capturing the disease progression, the creation of potent multi-target medications, and the direction of the therapeutic community in the optimization of effective treatment regimens by various research objectives in cancer treatment.

Pattern of inflicted injuries to motorcyclists referred to Hazrat-E-Rasoul Akram hospital in Tehran during 2015 - 2016.

INTRODUCTION: In recent years, road accidents have been one of the leading causes of death in Iran, with the majority of victims being motorcyclists. Accurate knowledge of the pattern of injuries to those injured is a strategy to reduce the consequences of these fatal accidents. The aim of this study was to investigate the pattern of injuries to motorcyclists. METHODS: The present study was a cross-sectional study that was performed in Rasoul Akram (PBUH) Educational and Medical Center in Tehran. The information was extracted from 500 hospital records of the patients admitted due to motorcycle accidents from September 2015 to September 2016, which was recorded in the data collection checklist. RESULTS: About 67.9% of the injured did not have head injuries and 32.0% of the sample group suffered head injuries. Out of 160 people from the head injury group, 7.2% have Abbreviated Injury Scale (AIS) index = 1 and 93.8% have AIS ≥ 2. A total of 82% of the injured had no neck injuries and 18.0% of the sample group had neck injuries. Of these, 72.2% had AIS = 1 and 17.8% had AIS ≥ 2. About 65.0% of the injured did not have facial injuries and 35.0% of the sample group suffered facial injuries. CONCLUSION: An accurate knowledge of the pattern of injuries to this group of injured, providing pre-hospital services, timely diagnosis and treatment and the use of corrective and effective factors, has an effective role in reducing the incidence and consequences of this deadly accident.

Evaluation of job satisfaction of forensic medicine specialists and comparison with job satisfaction of some medical specialists in Tehran.

INTRODUCTION: Job satisfaction is a main factor to increase efficiency, productivity, and individual satisfaction in the organization. The purpose of this study is to determine the forensic expertise amount of job satisfaction and to compare them with other specialists in different. MATERIALS AND METHODS: In this cross-sectional study, 150 individuals were included in three groups of specialists including forensic, internal medicine, and pediatric. Data were collected by Brayfield and Rothe Job Satisfaction Questionnaire. SPSS software version 23 was used for statistical analysis. RESULTS: High levels of job satisfaction among forensic professionals were higher than low job satisfaction, but the same was true for the other two groups. In this study, job satisfaction status in the three groups of specialists was not significantly correlated with their type of expertise (P = 0.19). There was no significant relationship between job satisfaction and gender (P = 0.19). In addition, the mean age of the specialists with low and high job satisfaction was not significantly different (P = 0.99). In this study, although the mean of work experience in professionals with high job satisfaction was higher than those with low job satisfaction, this difference was not significant (P = 0.23). CONCLUSION: The results of this study showed that job satisfaction was high among forensic medical professionals and was not significantly different from other specialist groups including pediatric and internal medicine. In addition, job satisfaction was not significantly different in terms of age, gender, and work experience.

Job Burnout, Stress, and Satisfaction among Emergency Nursing Staff after Health System Transformation Plan in Iran.

INTRODUCTION: Job burnout, stress, and satisfaction are linked to quality of care, patient outcomes and retention of staff. This study was conducted to determine the mentioned issues among emergency nurses. METHODS: This cross-sectional study was conducted on all nurses working in the emergency departments of 10 hospitals in Tehran, Iran, in 2017. Standard questionnaires were used for gathering the data of participants regarding job burnout, stress, and satisfaction. RESULTS: 709 (90%) participants returned the completed questionnaires (58.9% female). The mean age of the nurses was 33 (SD = 7) years. The level of job burnout was moderate in 76.1%, low in 22.5%, and high in 1.4% of the nurses. The level of burnout in the married nursing staff was lower than single nurses (3.78 ± 0.98 versus 4.14 ± 0.58, p = 0.049). The level of job satisfaction was moderate in 61.1%, low in 22.2%, and high in 16.7%. There was a significant correlation between age and job satisfaction (p = 0.027, r = 0.3). Job burnout was directly correlated with job stress (p ≤0.001, r = 0.57) and job burnout was negatively correlated with job satisfaction (p = 0.001, r = -0.41). CONCLUSION: More than 60% of the studied emergency nurses had moderate levels of job burnout, stress, and satisfaction. Job burnout had a direct correlation with job stress and indirect correlation with job satisfaction. Planning to reduce burnout of the emergency nursing staff seems to be necessary.

A Survey of Current Practice of Informed Consent in Iranian Hospitals.

BACKGROUND: Informed consent is legal and ethical process which is considered as important issue in quality of patient's treatment. The aim of the current study was to assess current informed consent of patients admitted in Iranian selected Hospitals, 2016. MATERIALS AND METHODS: This cross-sectional study was conducted on 2150 patients admitted in 11 public Hospitals. Data was collected using a dichotomous questionnaire with 30 questions. Statistical analysis was done using SPSS software (version 18). RESULTS: The results shown that 46% of patients had medium perception about informed consent, 44% believed to get insufficient information and 66% claimed to have active participation in treatment process. The significant associations were found between some dimensions and important parameters: Understanding of information dimension and education level (p = 0.008), Participation (in decision-making) dimension and type of hospitalization (p = 0.01), and level of patients' information dimension with resident address (p = 0.027) and medical specialty (p < 0.001). CONCLUSION: In our study the current informed consent of patients wasn't in desirable condition. The Necessary measures are required to achieve a level that the patients' informed consent convert to informed choices. Hospital healthcare team need to take proper actions such as give proper information, patient training, sufficient information and etc.

Prophylactic effect of riboflavin on pediatric migraine: a randomized, double-blind, placebo-controlled trial.

BACKGROUND AND AIM: Riboflavin may have an acceptable effect on migraine among children. This study was carried out to determine the prophylactic effect of riboflavin on migraine in children. METHODS: This randomized clinical trial study was performed at Shahid Beheshti Hospital in Kashan, Iran from December 2012 to February 2015. Ninety children with migraine were allocated randomly into 3 groups (placebo, low-dose and high-dose riboflavin). The outcomes (frequency, intensity and duration of headaches) were measured at baseline and 12 weeks of medication in each group, and the decrease of them were compared. SPSS software version 16 was used for analysis of the data. Descriptive statistics, Chi-square, Fisher's exact and t-test were used for statistical analyses. RESULTS: There was a significant decrease of migraine frequency (p=0.000) and mean duration (p=0.000) in the high-dose group compared with the placebo group. No significant reduction of frequency and mean duration of attacks were reported in the low-dose group compared to the placebo group (p=0.49 and p=0.69 respectively). There was no significant reduction of migraine intensity in the low-dose and high-dose groups compared to the placebo group (p=0.71 and p=0.74 respectively). CONCLUSION: High-dose riboflavin is a safe, well tolerated, cost-effective method of prophylaxis for children with migraine. TRIAL REGISTRATION: The trial was registered at the Iranian Clinical Trial Registry with number IRCT2013020412361N1. FUNDING: The study was supported by the Deputy of Research, Kashan University of Medical Sciences (grant number 91073).

Sex prediction potential of hyoid metric measurements in Iranian adults.

OBJECTIVES: Human hyoid is sexually dimorphic and is useful for sexing unknown skeletal remains. We aimed to find sex prediction potential of three linear dimensions of hyoid bones obtained from a series of cadavers with Persian ethnicity. METHODS: This cross-sectional study was carried out in 2015 at Forensic Pathology Organization of Tehran, Iran. We directly measured three linear dimensions of a series of hyoid samples obtained from cadavers during their neck autopsy in a convenience method. These dimensions were width, length and distance between lesser horns of hyoid. Height and weight of cadavers were also documented. Cadavers were of Persian ethnicity and at least 25-year-old. Data were analyzed by SPSS16. Logistic Regression Model was applied to find independent sex predictor(s) of hyoid. Statistically significant level was considered <0.05. RESULTS: Hyoids of 349 adult cadavers (176 females and 173 males) with mean±SD age of 39.91±8.13years were investigated. Male cadavers had significantly higher BMI values (p-value<0.001). Mean±SD for width, length and distance between lesser horns of hyoids were 34.45±4.70, 34.61±4.67 and 22.71±2.80mm, respectively. All measured dimensions had greater mean values in males (all with p-values<0.001). After adjusting for BMI, length and distance between lesser horns of hyoid were independent predictors of sex with odd's ratio of 4.67 and 1.97, respectively. Combining these two measurements provided sex classification accuracy of 97.4%. CONCLUSION: Special metric hyoid indicators can help in accurate sexing of skeletal remnants of adult Iranians. Further studies will find the strongest sex predictors of hyoid bones among Persians.

Comparison of gastric juice soluble triggering receptor expressed on myeloid cells and C-reactive protein for detection of Helicobacter pylori infection.

BACKGROUND AND AIM: Triggering receptor expressed on myeloid cells (TREM-1) is a receptor on phagocytes that is triggered by infectious agents. The soluble form of it (sTREM-1) can be elevated in gastric juice by Helicobacter pylori (H. pylori) infection of gastric mucosa. The aim of this study was to compare the diagnostic values of sTREM-1 and C-reactive protein (CRP) for detection of H. pylori infection in gastric mucosa. METHODS: In this diagnostic accuracy study on cases who underwent endoscopy from March 2015 to July 2016 in Shahid Beheshti Hospital, Kashan, Iran, gastric juice sTREM-1 and CRP concentrations were measured by enzyme-linked immunosorbent assays (ELISA) and their diagnostic values were compared to detect H. pylori infection. Gold standard test was histopathology. Data were entered into SPSS software version 16. Statistical analysis was made by Kolmogorov-Smirnov, Chi-square, Independent-samples t-test, Kruskal-Wallis, Mann-Whitney U, Pearson product-moment correlation, Receiver operating characteristic curve (ROC), Brier score, Nagelkerke R square and scaled reliability test. RESULTS: Of a total of 160 cases, 81 (50.6%) were H. pylori-positive based on pathology. The level of sTREM-1 in H. pylori-positive patients was significantly higher than H. pylori-negative patients (p=0.000), but no significant difference between CRP concentrations was shown between groups (p=0.7). Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and accuracy of sTREM-1 were 82%, 75%, 3.3, 0.25, 78% and for CRP were 62%, 40%, 1.02, 0.98, 51% respectively for diagnosis of H. pylori infection. True positive and negative rates were 66 (81.5%) and 59 (74.7%) for sTREM-1 and 50 (61.7%) and 31 (39.2%) for CRP. The levels of sTREM-1 and CRP were not significantly different between endoscopic finding groups (p=0.97, p=0.2 respectively). CONCLUSION: Despite CRP, sTREM-1 was a relatively acceptable indicator of H. pylori infection of gastric mucosa.

Comparison of the serum and salivary antibodies to detect gastric Helicobacter pylori infection in Kashan (Iran).

BACKGROUND AND AIM: Helicobacter pylori (H. pylori) is an important and common contagious human pathogen which may cause peptic ulcer and also gastric cancer. The definite diagnosis of it is made through invasive tests. Recently, non-invasive tests including serologic tests of serum and saliva have been conducted for diagnosis of H. pylori infection. In this research, the diagnostic values of serum and salivary serology were compared together to use salivary anti-H. pylori test as an alternative method in the future. METHODS: During this prospective case-control study on patients who were candidates for endoscopy and gastric biopsy from March 2015 to April 2016 in Shahid Beheshti hospital, Kashan, Iran, serum and salivary samples were obtained for measurement of Immunoglobulin G (IgG) antibody levels against H. pylori by enzyme-linked immunosorbent assay (ELISA). Histopathology was the gold standard test. Statistical analysis was performed by SPSS software version 16. Statistical tests included Kolmogorov-Smirnov, independent-samples t-test, Chi-square, Mann-Whitney U, Kruskal-Wallis, McNemar and correlation. RESULTS: Of 123 patients, sixty-one patients (49.6%) were H. pylori-positive according to histology. The median levels of anti-H. pylori antibodies in serum (p<0.001) and saliva (p<0.001) of H. pylori-positive cases were significantly higher than H. pylori-negative cases. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and accuracy of serologic tests in serum were 75%, 79%, 3.5, 0.3, 77% and for saliva were 85%, 82%, 4.7, 0.18, 84% respectively. CONCLUSION: Diagnostic values of salivary ELISA are comparable to serum ELISA and can be used as an alternative modality for diagnosis of H. pylori infection.

Risk Factors of Mortality Due to Acute Opium Poisoning: A Report from the Largest Intoxication Referral Center in Iran.

BACKGROUND: Studies have shown that Iran has a high rate of opiate abuse and the most prevalently used is opium. This study was aimed to evaluate risk factors in patients with acute opium intoxication who referred to Loghman Hakim Hospital, Tehran, Iran, in 2011. METHODS: A total number of 383 patients with acute opium overdose, who were referred to the Emergency Department of Loghman Hakim Hospital in Tehran during 2011, were enrolled into this descriptive, cross-sectional study. Clinical data including level of consciousness, vital signs, mode of consumption, medical management, and laboratory results were recorded. Independent t-test was used to analyze the results. FINDINGS: Level of consciousness at admission was lower in patients who expired compared to survivors (P = 0.020). Respiratory depression and tachycardia were both more common among patients who expired compared to survivors (P = 0.001). Increase in urea, creatinine, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), serum glutamic oxaloacetic transaminase (SGOT), and serum glutamic pyruvic transaminase (SGPT) was more common among patients who died compared to survivors and the relationships between death due to opium poisoning and increase in these factors were all statistically significant (P ≤ 0.001). CONCLUSION: The findings of this study clarify the importance of clinical and laboratory findings of patients with opium poisoning in predicting their outcome, although further studies in this context are appreciated.

Nasal Carriage and Resistance Pattern of Multidrug Resistant Staphylococcus aureus Among Healthy Children in Kashan, Iran.

BACKGROUND: Nasal carriage of Staphylococcus aureus is a substantial source of human infections. Detection and treatment of nasal carriage in children with methicillin-resistant and multidrug resistant S. aureus (MRSA and MDRSA, respectively) may be an important modality in prevention of infections. OBJECTIVES: This study determined the prevalence, antibiotic resistance patterns and risk factors for nasal carriage of MDRSA among healthy children. PATIENTS AND METHODS: This cross-sectional study was carried out on 350 one-month to 14-year-old healthy children in Kashan city, Iran. From all health-care centers, four were chosen by simple random sampling. Nasal samples were cultured in blood agar medium for S. aureus and antibiotic susceptibility profile was determined by disc diffusion and E-test. Risk factors for nasal carriage of MDRSA were also determined. RESULTS: A total of 92 (26.3%) S. aureus isolates were obtained, of which 33 (35.9%) were MRSA and 27 (29.3%) were MDRSA. Of MRSA strains, 19 (70.4%) were MDRSA. S. aureus isolates showed 52.2% resistance to cephalothin, 33.7% to co-trimoxazole, 26.1% to clindamycin, 26.1% to ciprofloxacin, 4.3% to vancomycin, and 35.9% to oxacillin. The risk factors for nasal carriage of MDRSA were antibiotic usage during the last three months (P = 0.006), family size of more than four members (P = 0.044), and parental smoking (P = 0.045). CONCLUSIONS: MDRSA was not uncommon among healthy children in Kashan and prevention of its spread in the population is judicious.