Molecular Epidemiology and Associated Risk Factors of Parasites in Oral Cavity of Children with Malignancies in Western Iran.

Background: This survey was designed to study the molecular epidemiology and risk factors of Entamoeba gingivalis and Trichomonas tenax in children with underlying malignancies and those on chemotherapy in Lorestan province, West of Iran. Methods: The present cross-sectional descriptive study was performed on children who suffering from different types of malignancies or receiving treatment by chemotherapy referring to oncology section of hospitals of Lorestan Province, Iran during May 2021 to April 2022. The frequency of oral cavity protozoa was investigated using microscopic and conventional polymerase chain reaction (PCR). Results: E. gingivalis and T. tenax parasites were found in 23 (25.5%) by microscopic method and 28 (31.1%) using PCR in children with malignancy. Among positive samples, 20 (71.4%) were infected with E. gingivalis; whereas 8 (28.6%) of the participants were positive for T. tenax. In the multivariate model, living in rural regions (OR= 3.437; 95% CI= 1.22-9.63; p=0.019) and using mouthwash (OR= 0.082; 95% CI= 0.018-0.37; p<0.001) were significantly related with the frequency of oral cavity parasites. Conclusion: Our results showed the high frequency of oral cavity parasites in children who suffering malignancies or receiving treatment by chemotherapy in Lorestan province, Iran. The awareness of the main risk factors for oral cavity parasites particularly using mouthwash is necessary in improving public and oral health strategies in children with cancer. Consequently, oncologist and dental practitioners must be aware to identify and manage oral health concerns in in children who suffering from different types of malignancies to prevent the oral diseases and infections.

Perception of hypertension and adherence to hypertension treatment among patients attending a hospital in western Iran: A cross-sectional study.

Background and Aims: Hypertension is the third leading cause of death in the world and is estimated to be increased by about 60% by 2025. Beliefs about hypertension can predict patient adherence to hypertension treatment. This study aims to investigate the perceptions of hypertension and adherence to hypertension treatment among patients in Khorramabad, Iran. Methods: This is a descriptive/analytical study with a cross-sectional design. Participants were 265 patients with a history of hypertension referred to a hospital in Khorramabad, Lorestan Province in western Iran in 2020, who were selected using a convenience sampling method. A demographic form, the brief illness perception questionnaire-revised (BIPQ-R), and Morisky medication adherence scale (MMAS-8) were used for collecting data. The collected data were analyzed in SPSS v.22 software using descriptive statistics, Pearson's correlation test, independent t-test, one-way ANOVA, and regression analysis. Results: The mean scores of BIPQ-R and MMAS-8 were 49.05 ± 15.45 (out of 80) and 3.69 ± 1.62 (out of 8), respectively. There was a significant relationship between the mean scores of MMAS-8 and BIPQ-R in total (p < 0.001). Perceptions of illness consequences (B = 4.59, p = 0.005), personal control (B = 0.190, p = 0.047), and symptoms (B = 1.77, p = 0.005) could significantly predict treatment adherence of patients. In illness perception, there were significant differences among patients with different places of residence (p = 0.032), educational levels (p = 0.001), and employment status (p = 0.010). In treatment adherence, there were significant differences among patients with different places of residence (p = 0.042) and educational levels (p = 0.045). Conclusion: Treatment adherence of hypertensive patients in western Iran is at a low level, while their perception of hypertension is at a moderate level. Clinical physicians are recommended to pay attention to the perception of illness in these patients (especially unemployed and less educated patients living in rural areas) to improve their adherence to treatment and blood pressure control.

Molecular epidemiology and associated risk factors of oral cavity parasites in hemodialysis patients in western Iran.

Renal disorders are able to make patients more susceptible to infections, including those caused oral cavity infections. Today, it has been proven that during end stage renal failure, hemodialysis results in acquired immune response defects through failings of humoral and cell-mediated immune. This survey was intended to assess the molecular epidemiology and associated risk factors of Entamoeba gingivalis and Trichomonas tenax as the main oral cavity protozoa in hemodialysis patients in Lorestan Province, western Iran. The investigation was performed on 73 hemodialysis patients referring to hemodialysis centers of Lorestan Province, Iran during May 2021 to February 2022. The frequency of oral cavity protozoa was investigated using microscopic and conventional polymerase chain reaction (PCR). A provided questionnaire with a number of demographical information and related risk factors was completed for each patient. The results showed that E. gingivalis and T. tenax parasites were found in 18 (24.6%) and 20 (27.4%) of the hemodialysis participants by microscopic and PCR test, respectively. Among samples, 13 (17.8%) of the hemodialysis participants were infected with E. gingivalis; whereas 7 (9.6%) of the participants were positive for T. tenax. No significant association was reported between gender, age, education, flossing, use of mouthwash, and prevalence of oral protozoa in hemodialysis participants. However, a significant correlation was observed among between living in rural regions (OR = 13.16; 95% CI = 2.64-56.81; p = 0.002), brushing teeth (OR = 8.51; 95% CI = 1.71-42.3; p = 0.009) and prevalence of oral protozoa in hemodialysis participants. The findings of these epidemiological study clearly showed the high frequency of oral cavity parasites in hemodialysis patients in Lorestan Province, Western Iran. Awareness of the main risk factors for oral cavity parasites particularly teeth brushing is necessary in refining public and oral health policies in hemodialysis patients. Consequently, dental practitioners, nephrologist, and urologist must be alert of these risk factors to carefully identify and achieve oral health concerns in hemodialysis patients to prevent the oral diseases and infections.

Adverse Events Following Immunizations in Infants Under 1 Year of Age in Lorestan Province, Western Iran / 예방의학회지

Objectives@#Vaccination is an important intervention for preventing disease and reducing disease severity. Universal vaccination programs have significantly reduced the incidence of many dangerous diseases among children worldwide. This study investigated the side effects after immunization in infants under 1 year of age in Lorestan Province, western Iran. @*Methods@#This descriptive analytical study included data from all children <1 year old in Lorestan Province, Iran who were vaccinated according to the national schedule in 2020 and had an adverse event following immunization (AEFI). Data were extracted from 1084 forms on age, sex, birth weight, type of birth, AEFI type, vaccine type, and time of vaccination. Descriptive statistics (frequency, percentage) were calculated, and the chi-square test and Fisher exact test were used to assess differences in AEFIs according to the abovelisted variables. @*Results@#The most frequent AEFIs were high fever (n=386, 35.6%), mild local reaction (n=341, 31.5%), and swelling and pain (n=121, 11.2%). The least common AEFIs were encephalitis (n=1, 0.1%), convulsion (n=2, 0.2%), and nodules (n=3, 0.3%). Girls and boys only showed significant differences in mild local reactions (p=0.044) and skin allergies (p=0.002). The incidence of lymphadenitis (p<0.001), severe local reaction (p<0.001), mild local reaction (p=0.007), fainting (p=0.032), swelling and pain (p=0.006), high fever (p=0.005), and nodules (p<0.001) showed significant differences based on age at vaccination. @*Conclusions@#Immunization is a fundamental public health policy for controlling vaccine-preventable infectious diseases. Although vaccines such as the Bacillus Calmette-Guérin vaccine, oral poliovirus vaccine, and pentavalent vaccine are well-researched and reliable, AEFIs are inevitable.

Perceived social support in pregnant women with gestational diabetes attending hospitals in western Iran compared to healthy controls and its relationship with perceived anxiety.

Background/purpose: Due to the importance of social support in pregnant women, especially those with gestational diabetes that cause anxiety and stress in them and requires effective and enough attention, this study aims to assess perceived social support of pregnant women with gestational diabetes in western Iran compared to healthy controls and its relationship with their perceived anxiety. Methods: This is a descriptive/analytical study with a cross-sectional design conducted on 180 pregnant women with gestational diabetes (n = 89) and without gestational diabetes (n = 91) referred to the obstetrics and gynecology clinics of two hospitals (Asalian and Shahid Rahimi) in Khorramabad, western Iran. Data collection tools were a demographic checklist, the Multidimensional Scale of Perceived Social Support (MSPSS), and the Beck Anxiety Inventory (BAI). Collected data were analyzed in SPSS v.20 software using chi square test, independent t-test, one-way ANOVA, and Pearson correlation test. Results: The difference between the two groups was significant in terms of perceived support from family (p = 0.001), perceived support from friends (p = 0.006), and anxiety (p = 0.047). Pearson correlation test results showed a significant negative relationship between the scores of MSPSS and BAI in patients (r= -0.329, p = 0.001) and controls (r=-0.204, p = 0.006). There was a significant difference in the MSPSS score among diabetic women in terms of having fetal macrosomia (p = 0.005), occupation (p = 0.003), education (p = 0.001), and frequency of pregnancy (p = 0.010). Conclusions: The perceived social support level is higher in diabetic pregnant women compared to healthy peers in western Iran. Improvement of social support from family and friends can reduce the anxiety of pregnant women with/without diabetes.

Prevalence and risk factors of oral cavity parasites in pregnant women in Western Iran.

Background: We aimed to study the frequency and risk factors of oral cavity protozoa (Trichomonas tenax and Entamoeba gingivalis) in pregnant women in Lorestan province, western Iran. Methods: The current cross-sectional descriptive work was performed on 200 pregnant women referring to health centers of Lorestan Province, Iran during August 2021 to February 2022. Two specimens were obtained from each women by means of sterile swabs from saliva and dental plaques. The frequency of oral cavity protozoa was investigated using microscopic and conventional polymerase chain reaction (PCR). Results: E. gingivalis and T. tenax parasites were found in 41 (20.5%) and 46 (23%) of the pregnant women by microscopic and PCR test, respectively. Among positive samples, 29 (63.1%) of the pregnant women were infected with E. gingivalis; whereas 19 (36.9%) of the participants were positive for T. tenax. In the multivariate model, living in rural regions (p < 0.001) and brushing teeth (p = 0.021) were considerably linked with the prevalence of oral cavity parasites. Conclusion: The current study evidently exhibited the high frequency of oral cavity parasites (E. gingivalis and T. tenax) in pregnant women in Lorestan province, Western Iran. Awareness of the main risk factors for oral cavity parasites especially teeth brushing is necessary in refining public and oral health approaches in pregnant women. Thus, dental practitioners and gynecologists must be alert of these risk factors to carefully identify and manage oral health concerns in pregnant women to prevent the oral diseases and infections.

Comparison of the effectiveness of home visits and telephone follow-up on the self-efficacy of patients having un-dergone coronary artery bypass graft surgery (CABG) and the burden of their family caregivers: A randomized con-trolled trial.

OBJECTIVES: This study aimed to compare home visits and telephone follow-up effectiveness on patients' self-efficacy undergoing Coro-nary Artery Bypass Graft Surgery -CABG- and caregivers' burden. METHODS: In this randomized clinical trial, 114 patients undergoing CABG were assigned to the three groups of home visits, telephone follow-up, and control based on the stratified block randomization. The self-management program of the home visit group included four face-to-face 60-minute training sessions once a week, and for the telephone follow-up group, four 30-minute telephone counseling sessions twice each week for a month. The control group received routine care. Data were collected using the cardiac rehabilitation self-efficacy questionnaire and the caregiver burden scale before and after the interven-tion. RESULTS: Before the study, there were no statistically significant differences between the three groups in terms of the means of self-efficacy and caregiver burden scores. However, there was a statistically significant difference between the home visit and control groups (p<0.001) and between the telephone follow-up and control groups (p<0.001) after the intervention, with in-creased self-efficacy and reduced caregiver burden reported. In contrast, there was no significant difference between the home visit and telephone follow-up groups regarding self-efficacy and caregiver burden scores. CONCLUSIONS: Both methods of self-management education have similar effectiveness in increasing self-efficacy and reducing the care-giver burden after discharge for patients who have undergone CABG.

A comparative study on the health-promoting behaviors of patients with and without hypertensive heart disease in Iran.

BACKGROUND: Health-promoting behaviors can affect the psychological and physical consequences of hypertension. For the prevention and control of hypertension, lifestyle modification has been recommended. This study aimed to investigate the health-promoting behaviors of patients with hypertensive heart disease in Iran and compare them with those of healthy people. MATERIALS AND METHODS: This was a descriptive comparative study with cross-sectional design. Participants were 141 patients with hypertensive heart disease (mean age = 39 ± 10.2 years) referred to the cardiac clinic of Madani Hospital in Khorramabad, Iran, and 141 healthy people selected from those referred to the hospital. The Persian version of the revised Health-Promoting Lifestyle Profile-II (HPLP-II) was used to evaluate the health-promoting behaviors of participants. After collecting data, they were analyzed in SPSS v. 22 software using descriptive statistics and statistical tests including independent t-test and one-way ANOVA. RESULTS: The overall HPLP-II score was 142.34 ± 30.48 in patients and 150.52 ± 37.07 in controls. The highest and lowest HPLP-II dimension scores in both groups were related to health responsibility and stress management dimensions. There was a significant difference between groups only in dimensions of nutrition (P = 0.017) and physical activity (P = 0.016), and in the overall score (P = 0.044), whose scores were lower in patients compared to controls. The difference in HPLP-II score of patients with different demographic characteristics (marital status, place of residence, gender, age, educational level, and occupation) was not statistically significant. CONCLUSION: Patients with heart disease caused by high blood pressure in Iran have poorer diet and physical activity compared to healthy people. Educational interventions with a focus on the importance of dietary regime and exercise are recommended for them.

Comparison of the effectiveness of home visits and telephone follow-up on the self-efficacy of patients having undergone coronary artery bypass graft surgery (CABG) and the burden of their family caregivers: A randomized controlled trial / Comparación de la efectividad de las visitas domiciliarias y el seguimiento telefónico sobre la autoeficacia de los pacientes sometidos a cirugía de derivación arterial coronaria con injerto y la carga para sus cuidadores familiares: Un ensayo controlado aleatorio / Comparação da efetividade das visitas domiciliares e o seguimento telefónico sobre a autoeficácia dos pacientes submetidos a cirurgia de derivação arterial coronária com enxerto e a carga para seus cuidadores familiares: Um ensaio controlado aleatório

Objective. This study aimed to compare home visits and telephone follow-up effectiveness on patients' self-efficacy undergoing Coronary Artery Bypass Graft Surgery -CABG- and caregivers' burden. Methods. In this randomized clinical trial, 114 patients undergoing CABG were assigned to the three groups of home visits, telephone follow-up, and control based on the stratified block randomization. The self-management program of the home visit group included four face-to-face 60-minute training sessions once a week, and for the telephone follow-up group, four 30-minute telephone counseling sessions twice each week for a month. The control group received routine care. Data were collected using the cardiac rehabilitation self-efficacy questionnaire and the caregiver burden scale before and after the intervention. Results. Before the study, there were no statistically significant differences between the three groups in terms of the means of self-efficacy and caregiver burden scores. However, there was a statistically significant difference between the home visit and control groups (p<0.001) and between the telephone follow-up and control groups (p<0.001) after the intervention, with increased self-efficacy and reduced caregiver burden reported. In contrast, there was no significant difference between the home visit and telephone follow-up groups regarding self-efficacy and caregiver burden scores. Conclusion. Both methods of self-management education have similar effectiveness in increasing self-efficacy and reducing the caregiver burden after discharge for patients who have undergone CABG.

Objetivo. Comparar la eficacia de las visitas domiciliarias y del seguimiento telefónico sobre la autoeficacia de los pacientes sometidos a cirugía de derivación arterial coronaria con injerto (CABG en inglés) y la carga de sus cuidadores. Métodos. En este ensayo clínico aleatorio, 114 pacientes sometidos a CABG se asignaron a uno de los tres grupos de investigación: visitas domiciliarias, seguimiento telefónico y control sobre la base de la aleatorización en bloque estratificada. El programa de educación en autoeficacia en el grupo de visitas domiciliarias incluía cuatro sesiones presenciales de formación de 60 minutos una vez a la semana, y para el grupo de seguimiento telefónico, cuatro sesiones de asesoramiento telefónico de 30 minutos dos veces por semana por un mes. El grupo de control recibió atención rutinaria. Los datos se recogieron mediante el cuestionario de autoeficacia de la rehabilitación cardíaca y la escala de carga del cuidador antes y después de la intervención. Resultados. Antes del estudio, no hubo diferencias entre los tres grupos en cuanto a las medias de las puntuaciones de las escalas de autoeficacia y carga del cuidador. Sin embargo, se encontró una diferencia estadísticamente significativa entre los grupos de visitas domiciliarias y de control (p<0.001) y entre los grupos de seguimiento telefónico y de control (p<0.001) después de la intervención, con un aumento de la autoeficacia y una reducción de la carga del cuidador. Es de anotar que no hubo diferencias significativas entre los grupos de visita domiciliaria y de seguimiento telefónico en cuanto a las puntuaciones de autoeficacia y de carga del cuidador. Conclusión. Ambos métodos de educación en este estudio tuvieron una efectividad similar en el aumento de la autoeficacia y la reducción de la carga de los cuidadores tras el alta de los pacientes sometidos a CABG.

Objetivo. Comparar a eficácia das visitas domiciliares e do seguimento telefónico sobre a autoeficácia dos pacientes submetidos a cirurgia de derivação arterial coronária com enxerto (CABG em inglês) e a carga dos seus cuidadores. Métodos. Neste ensaio clínico aleatório, 114 pacientes submetidos a CABG foram designados a um dos três grupos de investigação: visitas domiciliares, seguimento telefónico e controle sobre a base aleatorizada em blocos estratificada. O programa de educação em autoeficácia no grupo de visitas domiciliares incluía quatro sessões de formação presenciais de 60 minutos uma vez por semana, e para o grupo de seguimento telefónico, quatro sessões de assessoramento telefónico de 30 minutos duas vezes por semana durante um mês. O grupo de controle recebeu atenção rotineira. Os dados se recolheram mediante o questionário de autoeficácia da reabilitação cardíaca e a escala de carga do cuidador antes e depois da intervenção. Resultados. Antes do estudo, não houve diferenças entre os três grupos enquanto às médias das pontuações das escalas de autoeficácia e carga do cuidador. Porém, se encontrou uma diferença estatisticamente significativa entre os grupos de visitas domiciliares e de controle (p<0.001) e entre os grupos de seguimento telefónico e de controle (p<0.001) depois da intervenção, com um aumento da autoeficácia e uma redução da carga do cuidador. É importante anotar que não houve diferenças significativas entre os grupos de visita domiciliar e de seguimento telefónico enquanto às pontuações de autoeficácia e de carga do cuidador. Conclusão. Ambos os métodos de educação neste estudo tiveram uma efetividade similar no aumento da autoeficácia e a redução da carga dos cuidadores após a alta dos pacientes submetidos a CABG.

Co-occurrence of childhood functional constipation and gastroesophageal reflux disease (GERD).

OBJECTIVE: Functional constipation (FC) and Gastroesophageal Reflux Disease (GERD) are common gastrointestinal disorders in children. The aim of this study is to investigate the correlation between functional constipation and GERD in children. METHODS: In this cross-sectional study, a total of 82 children aged <16 years who referred to the pediatric gastroenterology clinic of (XXX) and were diagnosed with functional constipation according to ROME III criteria, and gastroesophageal reflux disease according to clinical history and DeMeester Score. Questionnaire was used to obtain the data regarding age, sex, cause of the visit, presence or absence of any symptom was noted, clinical examinations and difficulty in defecation. RESULTS: Of the 82 children with FC and GERD, 45 were boys and 37 were girls. Among children with FC and GERD, FC was reported in 50 (61%) cases prior to the onset of GERD, whereas 32 (39%) of the children had reflux before FC. The mean age of participants presented with FC was 5.66 ± 3.52 and that of GERD was 5.24 ± 2.83. The difference in mean age was not statistically significant. Of the children with gastroesophageal reflux disease, there were 13 (40.6%) males and 19 females while 32 (64%) males and 18 females had FC and the gender-based difference was statistically significant between the 2 groups. CONCLUSION: The prevalence of functional constipation in children was higher than gastroesophageal reflux disease. Gastroesophageal reflux disease and functional constipation should be simultaneously considered for therapeutic interventions and patients with functional digestive diseases should be monitored and followed-up.

Ethnobotanical Survey of Medicinal Plants used to Treat Cardiovascular Disorders in Ghasemloo Valley of Urmia City.

AIMS: Many pharmaceutical plants belonging to this region are used as the traditional drug by traditional physicians of the Urmia city in order to treat signs of disorders and cardiovascular system diseases. BACKGROUND: The Ghasemloo valley located in Urmia city is one of the typical areas in northwestern Iran and includes many pharmaceutical and plant species. OBJECTIVE: Many pharmaceutical plants belonging to this region are used as the traditional drug by traditional physicians of the Urmia city in order to treat several symptoms of disorders and cardiovascular system diseases. METHOD: A study was performed among 35 grocers in Urmia city to identify effective and famous pharmaceutical plants in the treatment of cardiovascular and related diseases. Firstly, a complete list of Urmia grocers was prepared by the Food and Drug Administrator of the Urmia University of Medical Sciences. The direct observation and interview, alongside collecting herbarium samples of usual and effective indigenous medicinal plants, were used to identify disorders and different signs of cardiovascular diseases. Questionnaires included personal information of grocers, and completed indigenous plants list containing information, including the plant's local name, the used organ, method of use, and the traditional therapeutic effect. Herbarium samples mentioned in the questionnaire were collected from the region and sent to the Jahad-e-Keshavarzi Research Centers and the Agriculture Faculty of Urmia university to determine the genus and species. After identifying and confirming the plant species, data related to the plant and results of cardiovascular research conducted on them were collected and recorded with reference to valid scientific sites. Data were entered into the Excel 2010 program and then analyzed. RESULT: 60 medicinal plants of 26 families in Urmia were identified as effective in the treatment of cardiovascular diseases from interviews and questionnaires; some plants mentioned in this study had known traditional therapeutic effects on cardiovascular disorders in the literature and some were identified with new effects. Results showed that the most therapeutic effects in cardiovascular diseases belonged to families Rosaceae (15%), Fabaceae (13%), Asteraceae (13%), and Apiaceae (10%). The most used organs of plants were the leave (23%) and fruit (19%). Plants were used mainly as an infusion (68%) in the traditional method. Most plants of this study were used to treat the blood cholesterol (29%), hypertension (9%), blood coagulation, prevention of bleeding (9%), and decrease in abdominal fat (9%). CONCLUSION: Some herbs introduced in this study have new therapeutic effects introduced for the first time. It is necessary to study the therapeutic effects of indigenous plants presented in this research in order to prove studied and mentioned therapeutic effects and provide a study field for researchers in relation to identifying effective substances and studying claimed clinical effects of these plants on different cardiovascular diseases.

Chitosan-Based Nanomaterials as Valuable Sources of Anti-Leishmanial Agents: A Systematic Review.

BACKGROUND: The current chemotherapy agents against various forms of leishmaniasis have some problems and side effects, including high toxicity, high cost, and the emergence of resistant strains. Here, we aimed to review the preclinical studies (in vitro and in vivo) on the anti-leishmanial activity of chitosan and chitosan-based particles against Leishmania spp. METHODS: This study was conducted based on the 06-PRISMA guidelines and registered in the CAMARADES-NC3Rs Preclinical Systematic Review and Meta-Analysis Facility (SyRF) database. Various English databases such as PubMed, Google Scholar, Web of Science, EBSCO, ScienceDirect, and Scopus were used to find the publications related to the anti-leishmanial effects of chitosan and its derivatives and other pharmaceutical formulations, without a date limitation, to find all the published articles. The keywords included "chitosan", "chitosan nanoparticles", "anti-leishmanial", "Leishmania", "leishmaniasis", "cutaneous leishmaniasis", "visceral leishmaniasis", "in vitro", and "in vivo". The language for data collection were limited to English. RESULTS: Of 2669 papers, 25 papers, including 7 in vitro (28.0%), 7 in vivo (28.0%), and 11 in vitro/in vivo (44.0%) studies conducted up to 2020 met the inclusion criteria for discussion in this systematic review. The most common species of Leishmania used in these studies were L. major (12, 48.0%), L. donovani (7, 28.0%), and L. amazonensis (4, 16.80%). In vivo, the most used animals were BALB/c mice (11, 61.1%) followed by hamsters (6, 33.3%) and Wistar rats (1, 5.5%), respectively. In vitro, the most used Leishmania form was amastigote (8, 44.4%), followed by promastigote (4, 22.2%), and both forms promastigote/amastigote (6, 33.3%). CONCLUSION: According to the literature, different types of drugs based on chitosan and their derivatives demonstrated considerable in vitro and in vivo anti-leishmanial activity against various Leishmania spp. Based on the findings of this review study, chitosan and its derivatives could be considered as an alternative and complementary source of valuable components against leishmaniasis with a high safety index. Nevertheless, more investigations are required to elaborate on this result, mainly in clinical settings.

Therapeutic Potential of Green Synthesized Copper Nanoparticles Alone or Combined with Meglumine Antimoniate (Glucantime®) in Cutaneous Leishmaniasis.

BACKGROUND: In recent years, the focus on nanotechnological methods in medicine, especially in the treatment of microbial infections, has increased rapidly. AIM: The present study aims to evaluate in vitro and in vivo antileishmanial effects of copper nanoparticles (CuNPs) green synthesized by Capparis spinosa fruit extract alone and combined with meglumine antimoniate (MA). METHODS: CuNPs were green synthesized by C. spinosa methanolic extract. The in vitro antileishmanial activity of CuNPs (10-200 µg/mL) or MA alone (10-200 µg/mL), and various concentrations of MA (10-200 µg/mL) along with 20 µg/mL of CuNPs, was assessed against the Leishmania major (MRHO/IR/75/ER) amastigote forms and, then tested on cutaneous leishmaniasis induced in male BALB/c mice by L. major. Moreover, infectivity rate, nitric oxide (NO) production, and cytotoxic effects of CuNPs on J774-A1 cells were evaluated. RESULTS: Scanning electron microscopy showed that the particle size of CuNPs was 17 to 41 nm. The results demonstrated that CuNPs, especially combined with MA, significantly (p < 0.001) inhibited the growth rate of L. major amastigotes and triggered the production of NO (p < 0.05) in a dose-dependent manner. CuNPs also had no significant cytotoxicity in J774 cells. The mean number of parasites was significantly (p < 0.05) reduced in the infected mice treated with CuNPs, especially combined with MA in a dose-dependent response. The mean diameter of the lesions decreased by 43 and 58 mm after the treatment with concentrations of 100 and 200 mg/mL of CuNPs, respectively. CONCLUSION: The findings of the present study demonstrated the high potency and synergistic effect of CuNPs alone and combined with MA in inhibiting the growth of amastigote forms of L. major, as well as recovery and improving cutaneous leishmaniasis (CL) induced by L. major in BALB/c mice. Additionally, supplementary studies, especially in clinical settings, are required.

Fe3O4@piroctone olamine magnetic nanoparticles: Synthesize and therapeutic potential in cutaneous leishmaniasis.

BACKGROUND: In recent years, magnetic nanoparticles (NMP) as novel materials have been widely used for biomedical, diagnostic and therapeutic purposes like microbial infection therapy. The purpose of this study is to synthesize PO coated iron oxide magnetic nanoparticles (Fe3O4@PO NPs) and their anti-leishmanial effects in vitro and in vivo against cutaneous leishmaniasis. METHODS: Fe3O4 magnetic nanoparticles were synthesized by the coprecipitation of Fe2 + and Fe3 + ions and used as a nanocarrier for the production of Fe3O4@PO NPs. The in vitro antileishmanial effects of PO-coated Fe3O4 NPs and Fe3O4 NPs (10-200 µg/mL) was determined against the intracellular amastigotes of Leishmania major (MRHO/IR/75/ER) and, then, examined on cutaneous leishmaniasis induced in male BALB/c mice by L. major. The rate of infectivity, production of nitric oxide (NO), and cytotoxic activates of Fe3O4 NPs and Fe3O4@PO NPs on J774-A1 macrophage cells were determined. RESULTS: The size scattering of the Fe3O4 NPs and Fe3O4@PO NPs were in the range among 1-40 and 5-55 nm, respectively. The obtained IC50 values were 62.3 ± 2.15 µg/mL, 31.3 ± 2.26 µg/mL, and 52.6 ± 2.15 µg/mL for the Fe3O4 NPs and Fe3O4@PO NPs, and MA, respectively. The results revealed that the mean number of parasites and the mean diameter of the lesions was considerably (p < 0.05) decreased in the infected mice treated with Fe3O4 NPs and Fe3O4@PO NPs. The Fe3O4 NPs and Fe3O4@PO NPs significantly (p < 0.05) prompted the production of NO as a dose-dependent manner. The promastigotes pre-incubated in Fe3O4 NPs and Fe3O4@PO NPs at the concentration of 5 µg/mL had the ability to infect only 41.7% and 28.3% of the macrophages cells. The selectivity index of greater than 10 for Fe3O4 NPs and Fe3O4@PO NPs showed its safety to the J774-A1 macrophage cells and specificity to the parasite. CONCLUSION: The results of this survey indicated the high potency of Fe3O4@PO NPs to inhibit the growth of amastigote forms of L. major as well as recovery and improvement CL induced by L. major in BALB/c mice without significant cytotoxicity. The results also indicated that, although the possible anti-leishmanial mechanisms of Fe3O4@PO NPs have not been clearly understood, however, the triggering of NO may be considered as one of the possible anti-leishmanial mechanisms of these nanoparticles. However, additional studies, in particular in clinical contexts, are mandatory.

High Potency of Organic and Inorganic Nanoparticles to Treat Cystic Echinococcosis: An Evidence-Based Review.

Since there is no potential, effective vaccine available, treatment is the only controlling option against hydatid cyst or cystic echinococcosis (CE). This study was designed to systematically review the in vitro, in vivo, and ex vivo effects of nanoparticles against hydatid cyst. The study was carried out based on the 06- PRISMA guideline and registered in the CAMARADES-NC3Rs Preclinical Systematic Review and Meta-analysis Facility (SyRF) database. The search was performed in five English databases, including Scopus, PubMed, Web of Science, EMBASE, and Google Scholar without time limitation for publications around the world about the protoscolicdal effects of all the organic and inorganic nanoparticles without date limitation in order to identify all the published articles (in vitro, in vivo, and ex vivo). The searched words and terms were: "nanoparticles", "hydatid cyst", "protoscoleces", "cystic echinococcosis", "metal nanoparticles", "organic nanoparticles", "inorganic nanoparticles, "in vitro", ex vivo", "in vivo". Out of 925 papers, 29 papers including 15 in vitro (51.7%), 6 in vivo (20.7%), ex vivo 2 (6.9%), and 6 in vitro/in vivo (20.7%) up to 2020 met the inclusion criteria for discussion in this systematic review. The results demonstrated the most widely used nanoparticles in the studies were metal nanoparticles such as selenium, silver, gold, zinc, copper, iron nanoparticles (n = 8, 28.6%), and metal oxide nanoparticles such as zinc oxide, titanium dioxide, cerium oxide, zirconium dioxide, and silicon dioxide (n = 8, 28.6%), followed by polymeric nanoparticles such as chitosan and chitosan-based nanoparticles (n = 7, 25.0%). The results of this review showed the high efficacy of a wide range of organic and inorganic NPs against CE, indicating that nanoparticles could be considered as an alternative and complementary resource for CE treatment. The results demonstrated that the most widely used nanoparticles for hydatid cyst treatment were metal nanoparticles and metal oxide nanoparticles, followed by polymeric nanoparticles. We found that the most compatible drugs with nanoparticles were albendazole, followed by praziquantel and flubendazole, indicating a deeper understanding about the synergistic effects of nanoparticles and the present anti-parasitic drugs for treating hydatid cysts. The important point about using these nanoparticles is their toxicity; therefore, cytotoxicity as well as acute and chronic toxicities of these nanoparticles should be considered in particular. As a limitation, in the present study, although most of the studies have been performed in vitro, more studies are needed to confirm the effect of these nanoparticles as well as their exact mechanisms in the hydatid cyst treatment, especially in animal models and clinical settings.

Prevalence of body image concern among schoolgirls aged 12-17 years in Iran.

BACKGROUND/AIM: Adolescent girls' concerns about their body images can negatively affect their social and academic performance. This study aimed to determine the prevalence of body image concern (BIC) in adolescent schoolgirls in Iran and its risk factors. PATIENTS AND METHODS: This epidemiological study with cross-sectional design was conducted in 2018 on 396 middle schoolgirls aged 12-17 years (mean age = 14 years) living in Khorramabad, Iran. For screening BIC, the Persian version of BIC inventory (BICI) was used. Their birth order, school grade, school type, father's education, and household income were also recorded. Collected data were analyzed in SPSS v. 18 software using descriptive statistics and Chi-square test. RESULTS: Of 396 girls, 106 (26.8%) had BIC, 89 (84%) reported moderate BIC, and 17 (16%) severe BIC. Their mean BICI score was 40.84 ± 12.93 (out of 42). Most of them reported to spend a significant amount of time checking their appearance in the mirror (n = 81, 20.5%) and examining flaws in their appearance (n = 74, 18.7%). A few of them were embarrassed to leave the house because of the appearance and avoided from looking at the appearance in the mirror (n = 6, 1.5%). There was no significant difference in BIC severity in terms of birth order, school grade, school type, father's education, and household income factors (P > 0.05). CONCLUSION: The prevalence of BIC among schoolgirls in Iran is high. Appropriate therapeutic interventions should be carried out to improve their quality of life, mental health, and self-esteem to reduce the BIC prevalence.

Effects of Hydroxytyrosol on Expression of Apoptotic Genes and Activity of Antioxidant Enzymes in LS180 Cells.

PURPOSE: Colorectal cancer is the third-most commonly occurring cancer in developed countries. Hydroxytyrosol is a potent antioxidant that has several activities, such as oxidative-stress control, inhibition of cell proliferation, and induction of apoptosis. In this study, the effect of hydroxytyrosol on the expression of genes effective in apoptosis - BAX, BCL2, CASP3, P53, PPAR G, and NFE2L2 - and antioxidant-enzyme activity in LS180 cells of human colorectal cancer was investigated. METHODS: The human colorectal cancer cell line LS180 was treated with different concentrations of hydroxytyrosol for 24 hours. Expression of BAX, BCL2, CASP3, NFE2L2, PPAR G, and P53 was investigated using real-time PCR. The activity of antioxidant and malondialdehyde enzymes was measured by calorimetric methods. RESULTS: Analysis of gene expression showed that hydroxytyrosol significantly increased the expression of CASP3 and the BAX:BCL2 ratio in treatment groups compared to the control (P<0.05). Also, hydroxytyrosol significantly reduced the expression of the NFE2L2 gene (P<0.05). Calorimetric analysis showed that hydroxytyrosol increased activity of the antioxidant enzymes catalase, superoxide dismutase, and glutathione peroxidase in treatment groups significantly more than the control group and reduced thiobarbituric acid-reactive substances on an oxidative stress index (P<0.05). CONCLUSION: Hydroxytyrosol may induce apoptosis in colorectal cancer cells by increasing the expression of CASP3 gene and increasing the BAX:BCL2 ratio. Also, hydroxytyrosol may increase the activity of antioxidant enzymes and reduce the proliferation of LS180 cells by changing the antioxidant-defense system in cancer cells.

Comparison of thyroid disease prevalence in patients with celiac disease and controls.

AIM: This study aimed to investigate the prevalence of thyroid disease (TD) in untreated CD patients and to evaluate the effect of gender and age on its prevalence. BACKGROUND: Celiac disease (CD) is a form of intestinal malabsorption syndrome which is closely related to endocrine disorders, especially autoimmune thyroid disease and diabetes. The prevalence of TD is possibly high among patients with CD which necessitates the need for screening for TD among them. METHODS: This comparative cross-sectional study was conducted on 288 consecutive untreated patients with CD (mean age, 27.9±14) and 250 controls (mean age, 29.01±13.15) referred for endoscopy in a hospital located in Iran. Thyroid function was evaluated by measuring T3, T4, and TSH levels using ELISA technique, and testing anti-thyroperoxidase (anti-TPO) antibodies through electrochemiluminescence method. Data analysis was conducted in SPSS v.22 software using descriptive statistics and chi-squared test. RESULTS: Thyroid disease prevalence was 4-fold higher in patients than in controls (13.6% vs. 3.2%, p<0.05). Hypothyroidism was diagnosed in 30 patients and 7 controls, while hyperthyroidism was observed in 9 patients and in one control. Chi-squared test results reported a significant difference in TD prevalence between patients and controls based on gender and age (p<0.05). In both groups, women were significantly more affected than men, and the TD prevalence was higher in younger patients compared to adults. CONCLUSION: There was a strong association between thyroid dysfunction and CD. In this regard, it is necessary to screen patients for TD.

Evaluation of dynorphin and kappa-opioid receptor level in the human blood lymphocytes and plasma: Possible role as a biomarker in severe opioid use disorder.

BACKGROUND: The dynorphin (DYN)/kappa opioid receptor (KOR) system plays an important role in the development of addiction, and dysregulation of this system could lead to abnormal activity in the reward pathway. It has been reported that the expression state of the neurotransmitters and their receptors in the brain is reflected in peripheral blood lymphocytes (PBLs). METHODS: We have evaluated the PBLs and plasma samples of four groups: 1) subjects with severe opioid use disorder (SOD), 2) methadone-maintenance treated (MMT) individuals, 3) long-term abstinent subjects having former SOD, and 4) healthy control subjects (n = 20 in each group). The mRNA expression level of preprodynorphin (pPDYN) and KOR in PBLs has been evaluated by real-time PCR. Peptide expression of PDYN in PBLs has been studied by western blot, and DYN concentration in plasma has been measured by ELISA. RESULTS: The relative expression level of the pPDYN mRNA and PDYN peptide in PBLs were significantly up-regulated in SOD, MMT, and abstinent groups compared to control subjects. No significant difference was found in the plasma DYN concentration between study groups. The expression level of the KOR mRNA in PBLs was significantly decreased in all three study groups compared to the control subjects. CONCLUSION: the expression changes in the DYN/KOR system after chronic exposure to opioids, including methadone, seems to be stable and does not return to normal levels even after 12 months abstinence. These long-time and permanent changes in PBLs may serve as a biomarker and footprint of SOD development in the periphery.

Relationship between anger and drug addiction potential as factors affecting the health of medical students.

BACKGROUND: One of the psychobehavioral factors that can predict drug abuse in students is anger. This study aimed to evaluate the association between anger and drug addiction potential in medical students in Iran in relation to their gender and college. MATERIALS AND METHODS: This descriptive and analytical cross-sectional study was conducted on 373 students of five colleges at Lorestan University of Medical Sciences in Iran. For collecting data, Persian versions of state-trait anger expression inventory-2 and addiction potential scale were employed. Data were analyzed in SPSS software using t-test, one-way ANOVA, and Pearson correlation test. RESULTS: There was a significant positive relationship between subjective components of anger (sate anger, trait anger, anger expression-out, and anger expression-in) and addiction potential in samples (P < 0.05), while anger regulation components (anger control-in and anger control-out) had significant negative correlation with addiction potential (P < 0.05). Moreover, a significant difference was found in mean addiction potential scores between samples based on gender and college. With respect to mean anger scores, the difference between students based on gender was significant only in terms of state anger and anger expression-in, while we found no significant difference between them based on college except in anger expression-out (P < 0.05). CONCLUSION: Subjective components of anger can predict drug addiction potential in medical students. It is recommended that anger management programs should be provided to the medical students as one of the most important community groups in the field of public health.