Endoplasmic Reticulum as a Therapeutic Target in Cancer: Is there a Role for Flavonoids?

Flavonoids are classified into subclasses of polyphenols, a multipurpose category of natural compounds which comprises secondary metabolites extracted from vascular plants and are plentiful in the human diet. Although the details of flavonoid mechanisms are still not realized correctly, they are generally regarded as antimicrobial, anti-fungal, anti-inflammatory, anti-oxidative; anti-mutagenic; anti-neoplastic; anti-aging; anti-diabetic, cardio-protective, etc. The anti-cancer properties of flavonoids are evident in functions such as prevention of proliferation, metastasis, invasion, inflammation and activation of cell death. Tumors growth and enlargement expose cells to acidosis, hypoxia, and lack of nutrients which result in endoplasmic reticulum (ER) stress; it triggers the unfolded protein response (UPR), which reclaims homeostasis or activates autophagy. Steady stimulation of ER stress can switch autophagy to apoptosis. The connection between ER stress and cancer, in association with UPR, has been explained. The signals provided by UPR can activate or inhibit anti-apoptotic or apoptotic pathways depending on the period and grade of ER stress. In this review, we will peruse the link between flavonoids and their impact on the endoplasmic reticulum in association with cancer therapy.

Impact of the Social Marketing-Based Intervention on Preconception Healthy Behaviors of Women With Sickle Cell Disease.

INTRODUCTION: A suggested method to improve the outcomes of pregnancy with sickle cell disease (SCD) is to engage more women at reproductive age in preconception healthy behavior (PCHB). Social marketing can be a suitable strategy to achieve this goal. We aimed to assess the impact of the social marketing-based intervention on women's engagement in PCHB. METHODS: A quasi-experimental study was conducted in Bandar Abbas and Minab (the two largest cities of Hormozgan province in Iran with a high prevalence of SCD) from 2021 to 2022. A social marketing-based intervention with the main components (participation in PCHB as a "product," social media and traditional promotional channels as a "promotion," selecting healthcare centers as a "place" for implementing the intervention, and free access to medical experts and speciality as a "price") was designed based on formative research. The sample size was estimated at 140 participants in each intervention and control group. The study's main outcome was the level of engagement in PCHB, which was assessed according to the health belief model (HBM). RESULTS: We compared the PCHB scores of both groups. Employing healthy behavior was more dominant in the intervention group. Awareness, perceived severity, perceived susceptibility, perceived benefits, and self-efficacy increased in both groups following intervention, while perceived barriers decreased. An analysis of covariance (ANCOVA) was performed to control and moderate the effect of scores in the pretest. As observed between the adjusted averages, awareness, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and engagement in the PCHB were significantly different between the control and intervention groups after the intervention. A multivariate linear regression analysis showed that awareness, perceived susceptibility, and self-efficacy were strong predictors of PCHB. CONCLUSIONS: Social marketing-based intervention successfully increased PCHB among women of reproductive age with SCD.

Pregnancy in the Sickle Cell Disease and Fetomaternal Outcomes in Different Sickle cell Genotypes: A Systematic Review and Meta-Analysis.

Background: Pregnancy is a major concern among women with the sickle cell disease (SCD), and it is associated with increased adverse outcomes. The aim of the present meta-analysis is to report the fetomaternal outcomes in different sickle cell genotypes. Methods: In this systematic review and meta-analysis, a comprehensive search of databases and search engines such as PubMed, Scopus, Web of Science, ProQuest, Cochrane Library, Science Direct and Google Scholar were performed. Any observational studies that had compared at least one outcome such as maternal outcomes, fetal outcomes, and morbidity between two groups of pregnant women with different types of sickle cell genotypes and pregnant women without SCD were evaluated. Results: A total number of 9,827 pregnant women with SCD were examined. The results showed that pregnancy in SCD increased the risk of adverse outcomes for the mothers (including postpartum hemorrhage, prematurity, pregnancy-induced hypertension, pre-eclampsia, eclampsia, cesarean section, lower segment cesareansection, maternal death), fetus (including live births, low birth weight, intrauterine growth restriction, APGAR score at 5 min <7, stillbirth, neonatal death, perinatal mortality, acute fetal distress, intrauterine fetal death) and morbidity among the SCD(severe anemia, urinary tract infection, blood transfusion, painful crisis, acute chest syndrome, vaso-occlusive crises). Conclusion: According to the results of this meta-analysis, pregnancy in the SCD is associated with an increased risk of maternal outcomes, fetal outcomes, and morbidity among SCD patients with different genotypes. Pregnancy in sickle cell hemoglobinopathies needs careful multidisciplinary management and cautious caring so as to decrease maternal and fetal morbidity and mortality.

Preconception care counselling among women with sickle cell anaemia in the south of Iran: a qualitative study based on social marketing model.

Pregnancy in women afflicted with sickle cell anaemia has certain adverse effects. The present research aimed to promote the quality of preconception care counselling programs. To do this, Hormozgan Province recruited 25 diseased women and five key informants. To acquire the necessary information, in-depth semi-structured interviews were undertaken. Graneheim's directions for guided content analysis were followed while analysing the data. The results were reported in four categories based on the social marketing constructs. Provision of sickle cell services and preconception care counselling were suggested. The participants preferred to be interviewed in comprehensive healthcare centres in their neighbourhood. The high cost of the lab and medical services was raised as an issue. Face-to-face communication together with other care services was suggested. Providing consultation services in nearby places as in the neighbourhood, including local comprehensive care centres, face-to-face interventions, and mass media, can effectively promote preconception care counselling participation.IMPACT STATEMENTWhat is already known on this subject? The high rate of maternal mortality in women afflicted with sickle cell disease in the south of Iran has attracted growing attention to preconception care counselling in these women. It seems that the social marketing model, due to its audience-based nature, is effective in the acceptance of participatory behaviour in preconception care counselling. To the best of the present researchers' knowledge, there is no similar research in this respect in Iran.What do the results of this study add? Participants' discourse analysis has led to the recognition of the social marketing constituent elements in participation in Preconception care counselling. In their accounts, the participants drew attention to 'Provision of sickle cell services' and 'Provision of Preconception care counseling for sickle cell disease' in their accounts. The participants also mentioned personal, organisational, and sociocultural barriers to the rate of participation. The optimal place was determined for the consultation, and the means of communication were also decided on for implementing the program.What are the implications of these findings for clinical practice and/or further research? Policy-makers and programmers can use the present findings to guide the design and implementation of interventional programs to promote participation in Preconception care counselling for women who have sickle cell disease.

Addressing the Sexual Function of Women During First Six Month After Delivery: Aquasi-Experimental Study.

INTRODUCTION: Pregnancy and childbirth are important periods of women's life that cause hormonal and bodily changes, and these changes could have significant effects on sexual function. AIM: The aim of this study was to assess the effectiveness of PLISSIT-based counselling model on the sexual function of women during the first six months after childbirth. MATERIAL AND METHODS: This was a randomized controlled clinical trial study from June to November, 2015. Ninety lactating women,with at least one sexual problem, were included in this study. Samples were recruited and randomized into two groups (intervention group and control group). Demographic and obstetric information, Edinberg postpartum depression, Larson's sexual satisfaction and female sexual function index questionnaire were used. Data were collected from participants at two points: before consultation and 4weeks after consultation. The statistical analyses were performed using SPSS software and Data were analyzed using the Paired t-test,dependent t-test with parametric data and Chi-square tests. RESULTS: Ninety women who were the nulliparous and lactating criteria subjects were randomly divided into two groups and all recruited women completed the questionnaires. Mean score of sexual function was 19.35 before consultation and 27.90 after consultation in experimental group. In the control group, mean score of sexual function was 20.55 before consultation and 22.41 after consultation. These differences were statistically significant in pre-counseling stage and 4 weeks after counseling in the two groups (P<0.001 and P=0.002). Four weeks after consultation, there was significant difference in the mean score of sexual function between the control and experimental groups (P<0.001). CONCLUSION: Based on the result of this study, sexual problems in lactating women decreased by using the PLISSIT model. The use of the PLISSIT model is recommended in health care setting.

Factors involved in selecting the birth type among primiparous women.

BACKGROUND: Mortality and disability rates were reported to be respectively 2-3 and 5-10 times higher in C-sections compared to Vaginal delivery. OBJECTIVES: This study was aimed to explore the factors involved in selecting the birth type among primiparous women. METHODS: The present cross-sectional research was conducted on 220 primiparous women, who visited the health-care centers of Bandar Abbas. They were recruited in their first trimester of pregnancy with a simple randomized clustering method. Data were collected in a researcher-designed questionnaire. Its validity was confirmed by a panel of experts and reliability was tested and approved through the test-retest method. Mean, standard deviation, independent sample t-test, and Chi-squared tests for data analysis were done by SPSS 16. P < 0.05 was considered statistically significant. RESULTS: The mean age of the participants was 27.40 ± 6.07 years. The main barriers to the choice of vaginal delivery were the fear of pain and fear of vaginal area tears and ruptures, fear of injury to fetus, and doctor's recommendation. A statistically significant correlation was observed between the age, education, employment, income, awareness, and the reasons for preferring surgical childbirth. CONCLUSIONS: To reduce the rate of unnecessary cesarean sections (C-section), the following recommendations are suggested: Reducing fear of pain in expectant mothers, modifying wrong beliefs about the culture of natural childbirth, increasing awareness of fewer adverse effects of vaginal delivery including the vaginal tears if the mother abides by all midwife(s) instructions during the delivery procedure, providing educational courses for the necessary movements during the delivery, decreasing surgeons' payment for C-section, and increasing payment for natural childbirth and implementing barriers for optional delivery to reduce the C-section.

Exploration of reproductive healthcare needs among adult men regarding sexual transmitted diseases and HIV/AIDS.

INTRODUCTION: One of the most important public health issues is men's sexual and reproductive health. Men are the most important counterparts in the prevention of sexual transmitted diseases and HIV/AIDS. A low level of men's referral to utilize healthcare services and the stigmatization of reporting sexually transmitted diseases in society due to cultural issues calls for the designation of strategies for improving the men's healthcare conditions. In addition, it is required to assess men's healthcare needs with consideration of cultural-contextual, social, and economic issues. The aim of this study was to explore the reproductive healthcare needs of men regarding sexual transmitted diseases and HIV/AIDS. METHODS: This was a qualitative study with 34 men and six women from the general population; health policymakers, reproductive health providers, and clergies were collected in two large cities of Iran, including Tehran and Mashhad, in 2015 through individual in-depth interviews. Participants were chosen through purposive sampling. In-depth individual interviews were conducted to collect data. All interviews were transcribed verbatim and using data analysis through conventional qualitative content analysis. Data were analyzed using conventional qualitative content analysis with MAXqda. RESULTS: The data analysis resulted in the development of four themes and 10 categories. The themes were "men's educational empowerment," "appropriate sociocultural background with advocacy," "organizing sexual needs based on sexual ethics, religious doctrine and women's empowerment," and "meeting men's preventive, caring and welfare needs." CONCLUSION: Because men's reproductive health is intertwined with public health, data collected regarding men's healthcare needs with the consideration of social and cultural factors can be used for designing strategies for reducing the incidence/prevalence rates of STDs and HIV/AIDS.