Comparison of programmed death-ligand 1 expression in adenocarcinoma and squamous cell carcinoma of the cervix in paraffin blocks of patients with cervical cancer.

AIMS: Cervical cancer (CC) is a common malignancy in women, predominantly caused by human papillomavirus. The most subtypes are adenocarcinomas (AC) and squamous cell carcinomas (SCC), which show various features and treatment responses. Programmed death-ligand 1 (PD-L1) and programmed cell death protein 1 (PD-1) as Immune checkpoint molecules, play a role in immune evasion. We investigated PD-L1 expression in AC and SCC of the cervix and explored its link to clinical characteristics. METHODS AND RESULTS: The present cross-sectional research was done between 2016 and 2022 on samples in Shahid Beheshti University of Medical Sciences-affiliated hospitals in Iran. Histological tissue samples of CCs (16 AC and 48 SCC) were assessed, and clinical information was obtained by reviewing their medical documents. PD-L1 expression was evaluated by immunohistochemistry and we used the combined positive score. SCC cases showed a higher (not significant) PD-L1 expression. The PD-L1 expression and clinical characteristics were not significantly correlated in both subgroups. CONCLUSION: Although SCC cases exhibited higher PD-L1 expression, this difference was non-significant. More investigations should highlight the role of PD-L1 in CC and the potential benefits of immunotherapy.

Correlation of clinical, laboratory, and short-term outcomes of immunocompromised and immunocompetent COVID-19 patients with semi-quantitative chest CT score findings: A case-control study.

BACKGROUND: As the effects of immunosuppression are not still clear on COVID-19 patients, we conducted this study to identify clinical and laboratory findings associated with pulmonary involvement in both immunocompromised and immunocompetent patients. METHODS: A case-control of 107 immunocompromised and 107 immunocompetent COVID-19 patients matched for age and sex with either positive RT-PCR or clinical-radiological findings suggestive of COVID-19 enrolled in the study. Their initial clinical features, laboratory findings, chest CT scans, and short-term outcomes (hospitalization time and intensive care unit [ICU] admission) were recorded. In addition, pulmonary involvement was assessed with the semi-quantitative scoring system (0-25). RESULTS: Pulmonary involvement was significantly lower in immunocompromised patients in contrast to immunocompetent patients, especially in RLL (p = 0.001), LUL (p = 0.023), and both central and peripheral (p = 0.002), and peribronchovascular (p = 0.004) sites of lungs. Patchy (p < 0.001), wedged (p = 0.002), confluent (p = 0.002) lesions, and ground glass with consolidation pattern (p < 0.001) were significantly higher among immunocompetent patients. Initial signs and symptoms of immunocompromised patients including dyspnea (p = 0.008) and hemoptysis (p = 0.036), respiratory rate of over 25 (p < 0.001), and spo2 of below 93% (p = 0.01) were associated with higher pulmonary involvement. Total chest CT score was also associated with longer hospitalization (p = 0.016) and ICU admission (p = 0.04) among immunocompromised patients. CONCLUSIONS: Pulmonary involvement score was not significantly different among immunocompromised and immunocompetent patients. Initial clinical findings (dyspnea, hemoptysis, higher RR, and lower Spo2) of immunocompromised patients could better predict pulmonary involvement than laboratory findings.

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.

Beam quality and the mystery behind the lower percentage depth dose in grid radiation therapy.

Grid therapy recently has been picking momentum due to favorable outcomes in bulky tumors. This is being termed as Spatially Fractionated Radiation Therapy (SFRT) and lattice therapy. SFRT can be performed with specially designed blocks made with brass or cerrobend with repeated holes or using multi-leaf collimators where dosimetry is uncertain. The dosimetric challenge in grid therapy is the mystery behind the lower percentage depth dose (PDD) in grid fields. The knowledge about the beam quality, indexed by TPR20/10 (Tissue Phantom Ratio), is also necessary for absolute dosimetry of grid fields. Since the grid may change the quality of the primary photons, a new [Formula: see text] should be evaluated for absolute dosimetry of grid fields. A Monte Carlo (MC) approach is provided to resolving the dosimetric issues. Using 6 MV beam from a linear accelerator, MC simulation was performed using MCNPX code. Additionally, a commercial grid therapy device was used to simulate the grid fields. Beam parameters were validated with MC model for output factor, depth of maximum dose, PDDs, dose profiles, and TPR20/10. The electron and photon spectra were also compared between open and grid fields. The dmax is the same for open and grid fields. The PDD with grid is lower (~ 10%) than the open field. The difference in TPR20/10 of open and grid fields is observable (~ 5%). Accordingly, TPR20/10 is still a good index for the beam quality in grid fields and consequently choose the correct [Formula: see text] in measurements. The output factors for grid fields are 0.2 lower compared to open fields. The lower depth dose with grid therapy is due to lower depth fluence with scatter radiation but it does not impact the dosimetry as the calibration parameters are insensitive to the effective beam energies. Thus, standard dosimetry in open beam based on international protocol could be used.

Hypofractionated versus standard chemoradiotherapy in the definitive treatment of uterine cervix cancer: interim results of a randomized controlled clinical trial.

PURPOSE: Concurrent chemoradiation has been the mainstay of treatment for cervix cancer. We aimed to evaluate the non-inferiority of hypofractionated chemoradiation. METHODS: This study was designed as a phase 2, 1:1 randomized, investigator-blinded, controlled, non-inferiority trial and we report the interim results after 50% accrual. Cervical cancer patients with FIGO stages IIA-IIIC were recruited from April 2021 to September 2022. The intervention consisted of 40 Gy of 3D-conformal radiation therapy (RT) in 15 fractions over 3 weeks. In the control group, patients received standard chemoradiation of 45 Gy in 25 fractions over 5 weeks. Both groups received concurrent weekly cisplatin (40 mg/m2). Intravaginal brachytherapy of 28 Gy in 4 weekly fractions was delivered starting 1 week after the end of chemoradiation. The primary outcome was complete clinical response(CCR) at 3 months. Secondary outcomes included acute gastrointestinal (GI), genitourinary(GU), skin, and hematologic toxicities. A p value less than 0.05 was considered significant for analyses. RESULTS: 59 patients were randomized; 30 in the control group and 29 in the intervention group. 20/30 (66.7%) of the patients in the control group and 19/29 (65.5%) in the intervention group achieved a CCR (absolute difference of 0.011, 95% CI - 0.23 to 0.25, p value: 0.13). There was a significantly higher rate of acute grade ≥ 3 GI toxicity in the intervention group (27.6%) compared with the control group (6.7%) (p value 0.032). CONCLUSIONS: Despite an absolute difference of 1.1% in the 3-month CCR, our interim analysis failed to show the non-inferiority of the hypofractionated chemoradiation. Due to the higher GI toxicities, we will continue this trial using intensity-modulated radiation therapy. REGISTRATION NUMBER AND DATE: ClinicalTrials.gov: NCT04831437, 2021.4.1.

Nuts, vegetables, fruits, and protein dietary pattern during pregnancy is inversely associated with risk of childhood allergies: a case-control study.

Allergic diseases are prevalent chronic conditions among children and can lead to significant health and economic issues. It is hypothesized that healthy and high quality diet during pregnancy can prevent the onset of allergic diseases in offspring. This study aimed to investigate the potential relationship between major dietary patterns during pregnancy and allergies in children under one year of age. This case-control study was conducted involving 244 participants (122 mothers of allergic children and 122 healthy controls) who visited pediatricians and allergy outpatient clinics in Khuzestan Province, Iran, between June 2022 and March 2023. Demographic information was recorded using a socio-demographic questionnaire. A food frequency questionnaire was used to identify the foods consumed during pregnancy. Major dietary patterns were extracted using principal component analysis, and the potential relationship between these patterns and childhood allergies was investigated using multivariable logistic regression models. The crude odds ratio (OR) analysis showed that the fourth quartile of "Nut, vegetables, fruits, and protein" dietary pattern was associated with lower occurrence of childhood allergies (OR: 0.214, 95% CI = 0.068-0.679; P trend = 0.211). After adjusting for cofactors in Model 3, this association was still observed in the fourth quartile (OR = 0.108, 95% CI = 0.019-0.613; P trend, 0.001). However, no significant association was observed between "Carbohydrate and cereals" and "Salty" dietary patterns and childhood allergies. The study findings suggest that a maternal dietary pattern rich in nuts, vegetables, and fruits during pregnancy may reduce the risk of allergic diseases in offspring.

Therapeutic effects of garlic (Allium sativum) on female reproductive system: A systematic review.

Complementary and alternative medicine, including Persian medicine (PM), offers a variety of disease prevention and treatment methods, including the application of medicinal plants. The health of the reproductive system is an important issue for women, and understanding the potential effect of garlic (Allium sativum) for preventive and therapeutic purposes in this field is of interest. This systematic review focused on the effects of garlic on the female reproductive system. The method involved a comprehensive search of relevant literature on experimental animal studies using electronic databases from January 2010 to September 2023, followed by selection of eligible studies and data extraction. A total of 18 studies met the inclusion criteria and were included in the review. This review reported that garlic may have positive effects on women's reproductive health, such as improving hormonal balance, relieving PMS symptoms, and potentially supporting fertility outcomes. This review revealed that garlic compounds such as allicin and ajoene can modulate various aspects of the female reproductive system, including regulation of the menstrual cycle, hormonal balance, fertility, and reproductive disorders. This review determined that further research is needed to elucidate the molecular pathways and direct effects of garlic on the female reproductive system. Although garlic has many potential health benefits, it should not be used as a substitute for medications.

The state-of-the-art technic of stereotactic radioablation for the treatment of cardiac arrhythmias: An overview.

Introduction: Cardiac arrhythmias, including ventricular tachycardia (VT), stand as a significant threat to health, often leading to mortality and sudden cardiac death. While conventional treatments for VT exhibit efficacy, cases of refractory VT pose challenges. Stereotactic Arrhythmia Radioablation (STAR) offers a novel approach, delivering precise high-dose radiation to well-defined targets with minimal collateral damage. This study explores the potential of STAR as an alternative therapy, especially for high-risk patients or those with refractory VT. Methods: This research reviews ongoing studies and preliminary investigations into the evaluation of the efficacy and safety of STAR. The method involves targeted radiation delivery, assessing reductions in VT recurrence and the early safety profile in refractory VT patients. However, given STAR's early stage and limited clinical evidence, cautious interpretation is advised. Results: Preliminary findings indicate a reduction in VT recurrence with STAR, suggesting promise as a therapeutic option. Early safety profiles are encouraging, but definitive statements on efficacy and safety require further investigation. Positive initial outcomes underscore the need for additional data and long-term studies. Conclusion: Stereotactic Arrhythmia Radioablation is recently emerging as a promising treatment for refractory VT. While early results are encouraging, careful interpretation is needed, due to STAR's early stages. Ongoing investigations are critical for a comprehensive understanding of its long-term efficacy and tolerability. This review provides fundamental insights into STAR's background, principles, pre-treatment procedures, clinical implications, and toxicity, setting the stage for future research in this evolving therapeutic field.

Prevention of colistin-induced neurotoxicity: a narrative review of preclinical data.

Polymyxin E or colistin is an effective antibiotic against MDR Gram-negative bacteria. Due to unwanted side effects, the use of this antibiotic has been limited for a long time, but in recent years, the widespread of MDR Gram-negative bacteria infections has led to its reintroduction. Neurotoxicity and nephrotoxicity are the significant dose-limiting adverse effects of colistin. Several agents with anti-inflammatory and antioxidant properties have been used for the prevention of colistin-induced neurotoxicity. This study aims to review the preclinical studies in this field to prepare guidance for future human studies. The data was achieved by searching PubMed, Scopus, and Google Scholar databases. All eligible pre-clinical studies performed on neuroprotective agents against colistin-induced neurotoxicity, which were published up to September 2023, were included. Finally, 16 studies (ten in vitro and eight in vivo) are reviewed. Apoptosis (in 13 studies), inflammatory (in four studies), and oxidative stress (in 14 studies) pathways are the most commonly reported pathways involved in colistin-induced neurotoxicity. The assessed compounds include non-herbal (e.g., ascorbic acid, rapamycin, and minocycline) and herbal (e.g., curcumin, rutin, baicalein, salidroside, and ginsenoside) agents. Besides these compounds, some other measures like transplantation of mitochondria and the use of nerve growth factor and mesenchymal stem cells could be motivating subjects for future research. Based on the data from experimental (in vitro and animal) studies, a combination of colistin with neuroprotective agents could prevent or decrease colistin-induced neurotoxicity. However, well-designed randomized clinical trials and human studies are essential for demonstrating efficacy.

Anti-tumor Effects of Cisplatin Synergist in Combined Treatment with Clostridium novyi-NT Spores Against Hypoxic Microenvironments in a Mouse Model of Cervical Cancer Caused by TC-1 Cell Line.

Purpose: Despite the development of anti-human papillomavirus (HPV) vaccines, cervical cancer is still a common disease in women, especially in developing countries. The presence of a hypoxic microenvironment causes traditional treatments to fail. In this study, we presented a combined treatment method based on the chemotherapeutic agent cisplatin and Clostridium novyi-NT spores to treat normoxic and hypoxic areas of the tumor. Methods: TC-1 Cell line capable of expressing HPV-16 E6/7 oncoproteins was subcutaneously transplanted into female 6-8 week old C57/BL6 mice. The tumor-bearing mice were randomly divided into four groups and treated with different methods after selecting a control group. Group 1: Control without treatment (0.1 mL sterile PBS intratumorally), Group: C. novyi-NT (107 C. novyi-NT). Group 3: Receives cisplatin intraperitoneally (10 mg/kg). Fourth group: Intratumoral administration of C. novyi-NT spores + intraperitoneal cisplatin. Western blot analysis was used to examine the effects of anti-hypoxia treatment and expression of hypoxia-inducible factor 1 (HIF-1) and vascular endothelial growth factor (VEGF) proteins. Results: The results clearly showed that combined treatment based on C. novyi-NT and cisplatin significantly reduced the expression of HIF-1 alpha and VEGF proteins compared to cisplatin alone. At the same time, the amount of necrosis of tumor cells in the combined treatment increased significantly compared to the single treatment and the control. At the same time, the mitotic count decreased significantly. Conclusion: Our research showed that developing a combined treatment method based on C. novyi-NT and cisplatin against HPV-positive cervical cancer could overcome the treatment limitations caused by the existence of hypoxic areas of the tumor.

Internet Addiction and Sleep Disorders among Medical Students.

Background: Considering the increasing use of the Internet in Iranian society, especially among students, and the importance of sleep quality, the present study investigated the relationship between sleep quality and Internet addiction among medical students in Shiraz. Methods: In this descriptive-analytical study, the sample included students of the Shiraz University of Medical Sciences who were selected by a multistage sampling method in 2018. Each faculty was considered to be stratified, and the samples were selected from all strata by simple random sampling. A total of 400 student questionnaires were eligible for analysis. The level of sleep disturbance was measured using the Pittsburgh Sleep Quality Index (PSQI), and Young's Internet Addiction Test (IAT) was used to evaluate Internet addiction. Cronbach's alpha for PSQI and IAT was 0.77 and 0.93, respectively. Results: 109 (%28.9) and 58 (%14.4) of all the people under study were at risk of Internet addiction or poor sleep quality, respectively. The highest percentage of poor sleep quality was in those who were addicted to the Internet (60%), but the lowest percentage was observed in the group without addiction (27%). In addition, there was a significant correlation between Internet addiction and subjective sleep quality (r = 0.191, p = 0.05), sleep latency (r = 0.129, p = 0.01), sleep duration (r = 0.119, p = 0.01), habitual sleep efficiency (r = 0.186, p = 0.05), sleep disturbances (r = 0.169, p = 0.01), use of sleeping medication (r = 0.203, p = 0.05), and daytime dysfunction (r = 0.188, p = 0.05). Conclusion: These findings help national health officials and planners in Iran to design appropriate and effective interventions to improve students' health and prevent Internet addiction.

V2O5-Fe3O4/rGO Ternary Nanocomposite with Dual Applications as a Dye Degradation Photocatalyst and OER Electrocatalyst.

The design and synthesis of structured nanomaterials with dual properties have always been highly attractive in various fields, especially in the reduction of environmental pollution as well as the generation of renewable energy. In this study, the synthesized ternary V2O5-Fe3O4/rGO nanocomposite was investigated to evaluate both the photocatalytic and electrocatalytic activities for the removal of methylene blue (MB) dye under UV/visible light radiation and oxygen evolution reaction (OER), respectively. The magnetized V2O5-Fe3O4/rGO nanocomposite is characterized by TEM, FE-SEM (with coupling by elemental mapping), EDS, XRD, FTIR, Raman, PL, DRS, and UV-vis analyses. The obtained results show that the graphene oxide substrate is decorated very well using Fe3O4 and V2O5 nanoparticles and converted to reduced graphene oxide (rGO). Furthermore, the V2O5-Fe3O4/rGO nanocomposite is considered as an active catalyst material to modify the commercial glassy carbon electrode for OER using linear sweep voltammetry (LSV). The photocatalytic activity of this novel nanocomposite revealed 89.2% (kobs = 1.7 × 10-2 min-1) and 76% (kobs = 8.3 × 10-3 min-1) degradation efficiencies of MB dye under UV and visible light irradiation at room temperature, respectively, and the surface area of the V2O5-Fe3O4/rGO nanocomposite was examined to be 705.8 cm2/g by N2 adsorption-desorption isotherms. In addition, electrochemical measurements determined the best OER performance of the ternary nanocomposite with the lowest overpotential (458 mV) and Tafel slope (132 mV dec-1) compared to the rGO substrate, Fe3O4, V2O5 nanoparticles, and binary nanocomposites. This work shows much enhancements in both photocatalytic and electrocatalytic activities due to the synergistic effect of the decorated GO support with V2O5 and Fe3O4 nanoparticles.

Effect of elevated temperature, sea water acidification, and phenanthrene on the expression of genes involved in the shell and pearl formation of economic pearl oyster (Pinctada radiata).

Our study aims to examine the effect of some stressors on the gene expression levels of shell matrix proteins in a pearl oyster. Oysters were exposed to the different combinations of the temperature, pH, and phenanthrene concentration is currently measured in the Persian Gulf and the predicted ocean warming and acidification for 28 days. The expression of all the studied genes was significantly downregulated. Time and temperature had the greatest effects on the decreases in n19 and n16 genes expression, respectively. Aspein and msi60 genes expression were highly influenced by pH. Pearlin was affected by double interaction temperature and phenanthrene. Moreover, a correlation was observed among the expression levels of studied genes. This study represents basic data on the relationship between mRNA transcription genes involved in the shell and pearl formation and climate changes in pollutant presence conditions and acclimatizing mechanism of the oyster to the future scenario as well.

Walnut consumption and gut microbial metabolism: Results of an exploratory analysis from a randomized, crossover, controlled-feeding study.

BACKGROUND & AIMS: The effect of walnut-related modulation of gut microbiota composition on microbiota functionality is unknown. The aim was to characterize the effect of a walnut-enriched diet (WD), compared to a fatty acid-matched diet devoid of walnuts (WFMD) and a diet where oleic acid replaces alpha-linolenic acid (ORAD), on bacterial gene expression. METHODS: A 3-period, randomized, crossover, controlled-feeding study was conducted. Participants were provided a 2-week run-in standard western diet (SWD; 50% kcal carbohydrate, 16% protein, 34% fat, 12% SFA). Following the SWD in random sequence order, participants were provided the WD, WFMD, and ORAD (48% carbohydrate; 17% protein; fat 35%; 7% SFA). The WD contained 18% of energy from walnuts (57 g/d/2100 kcal). The WFMD and ORAD were devoid of walnuts; liquid non-tropical plant oils were included in these diets. Metatranscriptomic analyses were performed as an exploratory outcome. RESULTS: The analytical sample included 35 participants (40% female) with a mean ± SD age of 43 ± 10 y and BMI of 30.3 ± 4.9 kg/m2. The ⍺-diversity of taxa actively expressing genes, assessed by observed species (p = 0.27) and Pielou's Evenness (p = 0.09), did not differ among the diets. The ⍺-diversity of actively expressed genes was greater following the WD compared to the WFMD and ORAD as assessed by the observed genes and Pielou's Evenness metrics (p < 0.05). ß-Diversity of the actively expressed genes differed following the WD compared to the WFMD (p = 0.001) and ORAD (p = 0.001); ß-diversity did not differ between the WFMD and ORAD. Active composition analyses showed increased Gordonibacter (p < 0.001) activity following the WD vs. the ORAD. Greater expression of many genes was observed following the WD compared to the WFMD and ORAD. Following the WD, greater expression of metabolism-related genes encoding glycine amidinotransferase (GATM; K00613) and arginine deiminase (K01478) was observed compared to the WFMD. Greater expression of glycine amidinotransferase (GATM; K00613) by Gordonibacter was also observed following the WD vs. the WFMD and ORAD. CONCLUSION: Our results suggest walnut intake may increase endogenous production of homoarginine through gut microbiota-mediated upregulation of GATM, which is a novel mechanism by which walnuts may lower cardiovascular disease risk. However, given the exploratory nature replication is needed. CLINICAL TRIAL REGISTRATION: Clinicaltrials.gov (NCT02210767).

Awareness, Treatment, and Control of Hypertension among 10663 Adults Based on the Baseline Data of the Kherameh Cohort Study.

Background: A comprehensive strategy to reduce the complications of hypertension (HTN) should include prevention approaches, such as increasing awareness, early diagnosis, and adequate treatment. The present study aimed to assess awareness, treatment, and control of HTN and their related factors in Kherameh, Iran. Methods: This cross-sectional study was performed on 10 663 individuals aged between 40 and 70 years using the Kherameh cohort data. HTN was defined as either systolic/diastolic blood pressure ≥140/90 mmHg or taking medications. Logistic regression was used to investigate the relationship between awareness, treatment, and control of HTN and demographic factors, comorbidities, and a family history of diseases. Results: Out of 10 663 participants, 4719 (44.3%) were men, and the average age of the participants was 51.94±8.27 years. The rates of the prevalence, awareness, treatment, and control of HTN were 27.7% (95% CI, 26.86 to 28.54), 80.3% (95% CI, 79.56 to 81.04), 78% (95% CI, 77.22 to 78.78), and 53.6% (95% CI, 52.66 to 54.54), respectively. Age, gender, body mass index, and cardiovascular disease were associated with all the dependent variables in the regression model. Additionally, occupation, diabetes, chronic diseases, a history of cardiovascular disease in first and second-degree relatives and a history of chronic diseases in second-degree relatives were related to all the dependent variables except for treatment. Conclusion: A high percentage of the patients were aware of their disease, but a smaller proportion were on medication. Consequently, about half the patients had blood pressure below 140/90 mmHg.

Adherence to a healthy diet and odds of metabolic syndrome: A cross-sectional study.

INTRODUCTION: Metabolic syndrome (MetS) is a major health concern around the world. Dietary factors, including diet quality, play a significant role in its pathophysiology. Healthy Eating Index (HEI) is a tool used as a valid measurement of the individual's diet quality. We aimed at investigating the relationship between diet quality as assessed by HEI-2015 and the risk of MetS and its components in a cross-sectional sample of suburban individuals from PERSIAN Kavar cohort study (PKCS), Fars province, Iran. METHODS: 2225 individuals meeting the eligibility criteria participated in the study. The relevant data were obtained from the baseline phase of PKCS. MetS was defined according to cut-offs presented by the National Cholesterol Education Program Adult Treatment Panel III (ATP III). HEI-2015 was calculated for the included individuals. Odds ratios were estimated. P-values <0.05 were considered as significant. RESULTS: The overall prevalence of MetS was 27.3%. Individuals with lower HEI-2015 scores had higher odds for MetS and its components. We observed that those who were categorized as the top HEI-2015 tertile had 42% (OR: 0.58; 95% CI: 0.38-0.90) lower odds of high blood pressure in the overall population. Also, the odds of high serum triacylglycerol was lower (OR: 0.72; 95% CI: 0.57-0.90) in those with the highest HEI-2015 scores. CONCLUSION: We found that higher dietary quality measured by HEI will decrease the risk of developing MetS, hypertension, and hypertriglyceridemia among Iranian adults. However, future interventional studies are required to further elucidate the issue.

A Review on the Efficacy and Safety of Intrathecal Administration of Novel Medications for Leptomeningeal Metastases in Solid Cancers.

Leptomeningeal disease (LMD) is a rare and lethal manifestation that may occur in the advanced stages of solid tumors and hematological malignancies. With advances in diagnostic techniques, the detection and confirmation of the presence of LMD have increased. Although its optimal treatment remains a challenge, the use of the intrathecal route for the delivery of novel therapeutics is now considered a promising drug delivery strategy to complement radiation and systemic-based therapies. Although methotrexate, cytarabine, and thiotepa have a long history in the treatment of LMD, other medications have also been shown to be beneficial. In this article, we have reviewed the effects of novel medications administered via the intrathecal route for the treatment of solid tumors. We have searched PubMed, Scopus, and Google Scholar databases till the end of September 2021 using the following keywords: ''leptomeningeal disease'', ''leptomeningeal carcinomatosis'', ''leptomeningeal metastases'', ''solid tumors'', ''solid cancers'', and ''intrathecal''. Our literature findings have uncovered that most studies on LMD, which occurs secondary to solid cancers, are available as 'case reports', and few clinical trials have been conducted to date. Single-drug (monotherapy) or combination drug therapy, administered via the intrathecal route, especially in metastatic breast and lung cancer, has been shown to improve patients' symptoms and overall lifespan, while exhibiting a low and acceptable prevalence of side effects. However, judgments/conclusions about the effectiveness and safety of these drugs still require further clinical evaluation.

Investigation of the effect of Low-Level Laser Therapy on arm lymphedema in breast cancer patients: A noninvasive treatment for an intractable morbidity.

Purpose: This article aims to study the effect of Low-Level Laser Therapy (LLLT) on arm lymphedema in patients who have breast cancer. Methods and Materials: Twenty-three patients were selected in a nonrandomized phase-2 clinical trial. After measuring the circumference of the affected and unaffected limbs at 6-points, the volume of the limbs, the degree of mental symptoms on visual analog scale by the patient upon entering the study, and performing an ultrasound on the patient's axilla to locate the fibrotic areas, a low-level laser device at a therapeutic dose of 2 J/cm2 was used to treat the patients three times a week for 4 weeks, and after an 8-week gap, for another similar period. Measurement of circumference and volume of affected and unaffected limbs and mental symptoms were carried out at the end of the 4th week, the beginning of the 12th week, and the end of the 16th week, and the obtained results were compared with those before the treatment. Results: We noted that the average reductions in the circumference and volume of the affected limb, as compared with the unaffected limb, were about 16% and 21.7%, respectively, and improvement in the patient's mental symptoms was about 32%. Another notable observation was the great enthusiasm of most patients to continue their treatment, particularly from the second cycle onward. Conclusions: LLLT can, at least in association with current standard methods, be used for arm lymphedema to introduce further reductions in pain and volume.

AZAR eye and vision cohort study.

According to World Health Organization (WHO), currently, 2.2 billion people are living with visual impairment worldwide, of which almost half could have been prevented. There are both modifiable and unmodifiable factors leading to visual disability and, ultimately, blindness. Several population-based studies in different parts of Iran have tried to determine these factors concerning their specific population and environment-related characteristics. AZAR Eye and Vision cohort is the second-largest cohort study in the whole country. AZAR Eye and Vision cohort is the ophthalmologic branch of AZAR cohort which is the largest eye cohort study in the country, which is trying to determine the prevalence and incidence of visual impairment, blindness, and other major ophthalmologic conditions and their associated risk factors in East Azerbaijan province located in Iran, a middle eastern country. A recently emerging phenomenon is the drying of the ultra-salty lake of Urmia located in the West Azerbaijan province which is a direct neighbor of our studied population and has caused recurrent salt storms in the immediate near areas. This phenomenon could adversely affect visual health via different conditions which our study will elucidate. The enrollment phase took place between 2014 and 2017 and 11,208 participants were enrolled out of 15,000 participants in the primary cohort. The resurvey phase will begin five years after the enrollment phase. In this phase, 30% of the participants are randomly selected to be reexamined and complete questionnaires. The participants showing any issues such as diabetes and being a glaucoma suspect will be included in the resurvey phase, too. Data categories gathered include demographics, lifestyle factors, past medical and drug histories, and a diet quality and quantity questionnaire including 130 edible items. Urine, hair, nail, and 25-ml blood samples, were collected from the participants. Then they were referred to an optometrist to complete an ophthalmologic questionnaire and undergo eye examination and lensometry. Then they underwent slit-lamp examinations and pictures were taken of the lens and fundus. People with suspected visual impairment were referred to an ophthalmology clinic. The data are processed and a four-level quality check is performed on each block. The most common visual impairment is cataracts. This study's most important aim is to evaluate the effect of local environmental and ethnic factors on eye diseases in this specific population.

The association between low carbohydrate diet and odds of metabolic syndrome in adults: A cross-sectional study.

OBJECTIVE: Metabolic syndrome (MetS) has become a major health problem across the globe. Various investigations have been conducted to find the underlying lifestyle-related causes of MetS. Modifiable dietary factors are specifically the center of interest, including the macronutrient composition of the regimen. We aimed to study the association between a low-carbohydrate diet score (LCDS) with MetS and its components in a Kavarian population, located in the center of Iran. METHODS: The present study is a cross-sectional investigation conducted on a healthy sub-sample of PERSIAN Kavar cohort meeting our inclusion criteria (n = 2225). General, dietary, anthropometric, and laboratory data were obtained for each individual using validated questionnaires and measurements. Possible associations between LCDS and MetS and its components were verified using relevant statistical analyses, including analysis of variance and covariance (ANOVA and ANCOVA) and logistic regression. P-values <0.05 were considered as significant. RESULTS: Compared with the lowest LCDS tertiles, those who were assigned to the upper tertiles had lower chance of MetS, after adjusting for potential confounders (OR: 0.66; 95% CI: 0.51-0.85). Moreover, those who assigned to the top LCDS tertile had 23% (OR: 0.77; 95% CI: 0.60-0.98) and 24% (OR: 0.76; 95% CI: 0.60-0.98) lower odds of abdominal adiposity and abnormal glucose homeostasis, respectively. CONCLUSION: We observed a protective effect of low-carbohydrate diet against metabolic syndrome and its components, including abdominal obesity and abnormal glucose homeostasis. However, these initial findings need to be confirmed, especially in the format of clinical trials to ensure causality.