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The importance of neopterin in COVID-19: The prognostic value and relation with the disease severity
No full textCoronavirus Disease 2019 COVID-19, caused by severe acute respiratory syndrome coronavirus 2 SARS-CoV-2, has rapidly evolved into a global health emergency. Neopterin NPT, produced by macrophages when stimulated with interferon IFN-gamma, is an essential cytokine in the antiviral immune response. NPT has been used as a marker for the early assessment of disease severity in different diseases. The leading cause of NPT production is the pro-inflammatory cytokine IFN-. Macrophage activation has also been revealed to be linked with disease severity in SARS-CoV-2 patients. We demonstrate the importance of NPT in the pathogenesis of SARS-CoV-2 and suggest that targeting NPT in SARS-CoV-2 infection may be critical in the early prediction of disease progression and provision of timely management of infected individuals. © 2022 The Canadian Society of Clinical Chemist
Rectal vs. sublingual misoprostol in cesarean section: Three-arm, randomized clinical trial
No full textBackground: Misoprostol is a myometrial stimulant with uterotonic properties and can be administered rectally, vaginally, or sublingually. Numerous studies have investigated the effect of misoprostol on the prevention and treatment of PPH (postpartum hemorrhage) after vaginal delivery, but its use to control PPH during cesarean section has not been widely studied. Methods: In this clinical trial study, 180 pregnant women who were candidates for cesarean section were included in the study. They were divided into 3 groups of 60 people (sublingual misoprostol group, rectal misoprostol group, control group). In all three groups, the volume of blood lost was recorded in the checklist at the end of surgery. Data were entered into SPSS software and analyzed. Results: The mean bleeding in the control group was 225.4±63.9, while it was 137.9±33.8 and 118.9±28.5 in the sublingual misoprostol group and rectal misoprostol group, respectively. We had significantly more bleeding in the control group (p<0.001) compared to the other two groups. Conclusion: These results confirm the positive effect of misoprostol in reducing bleeding and show the superiority of using rectal misoprostol compared to other methods of reducing bleeding during cesarean section. © 2022 Babol University of Medical Sciences. All rights reserved
Synthesis of doxorubicin-loaded PBMA-b-POEGMA micelles and assessment of its anticancer activity against breast cancer cells (4T1)
No full textDoxorubicin (DOX) is a chemotherapy drug that possesses many side effects. This study aimed to synthesize PBMA-b-POEGMA poly (butyl methacrylate)-b-poly (oligo ethylene glycol methacrylate) diblock copolymer as a nanocarrier for loading of DOX, promoting anticancer efficacy of the drug, and decreasing its side effects. Hence, PBMA-b-POEGMA diblock copolymer was first synthesized by the RAFT method and then DOX encapsulated into the micellar nanocarrier. Self-assembly behavior of copolymers and physicochemical/biological properties of nanocarriers were assessed. DLS and TEM images showed nanocarriers possessed spherical-uniform structure with the mean size and polydispersity of 27 ± 1.34 nm and 0.13 ± 0.21 for blank-micelles as well as, 45 ± 2.32 nm and 0.18 ± 0.18 for DOX-loaded micelles, respectively. Synthesized micelles also provided high drug encapsulation efficiency (>80%) with a drug loading content of 4.53%. Moreover, the maximum released amount of drug was reported at 69%, with the Korsmeyer-Peppas model, as a more suitable model to describe the release behavior of DOX from nanocarriers. Biologically, block copolymers were biocompatible against COS-7 and 4T1 cell lines, in addition, free-DOX showed higher cytotoxicity than DOX-loaded micelles. Furthermore, 0.5 μg/mL concentration of drug-loaded micelle led to growth inhibition of more than 60% of cancerous cells, during 48 h, so that higher level of cellular uptake of drug and apoptosis in 4T1 cells was induced by drug-loaded micelles. © 2022 Wiley Periodicals LLC
Current challenges and nanotechnology-based pharmaceutical strategies for the treatment and control of malaria
No full textMalaria is one of the prevalent tropical diseases caused by the parasitic protozoan of the genus Plasmodium spp. With an estimated 228 million cases, it is a major public health concern with high incidence of morbidity and mortality worldwide. The emergence of drug-resistant parasites, inadequate vector control measures, and the non-availability of effective vaccine(s) against malaria pose a serious challenge to malaria eradication especially in underdeveloped and developing countries. Malaria treatment and control comprehensively relies on chemical compounds, which encompass various complications, including severe toxic effects, emergence of drug resistance, and high cost of therapy. To overcome the clinical failures of anti-malarial chemotherapy, a new drug development is of an immediate need. However, the drug discovery and development process is expensive and time consuming. In such a scenario, nanotechnological strategies may offer promising alternative approach for the treatment and control of malaria, with improved efficacy and safety. Nanotechnology based formulations of existing anti-malarial chemotherapeutic agents prove to exceed the limitations of existing therapies in relation to optimum therapeutic benefits, safety, and cost effectiveness, which indeed advances the patient's compliance in treatment. In this review, the shortcomings of malaria therapeutics and necessity of nanotechnological strategies for treating malaria were discussed. © 202
Effects of Vitamin D Supplementation on Bone Health and Bone-related Parameters in HIV-infected Patients: A Systematic Review and Meta-analysis
No full textPurpose: There is growing evidence that bone health is decreased in individuals with HIV infection. Vitamin D deficiency is also highly prevalent among HIV-infected patients. The literature was systematically reviewed to determine whether bone health and bone-related parameters may improve with vitamin D supplementation in HIV-infected individuals. Methods: Four databases were systematically searched for randomized clinical trials of vitamin D supplementation in HIV infection, published from January 1990 to September 2021. No language or publication restrictions were applied. Standardized mean differences (SMD) with 95 CIs are reported. A random-effects model was used to perform meta-analysis. Findings: Ten studies met the inclusion criteria (N = 733 participants at study completion). The mean ages of the patients in the included trials ranged from 10 to 49 years. The meta-analysis indicated that with vitamin D supplementation, serum 25-hydroxy vitamin D (25OHD) level was significantly increased (SMD, 1.86; 95% CI, 1.02 to 2.70; I2 = 94.4%), but there were no significant effects on levels of serum 1,25-dihydroxy vitamin D (1,25-OH2D) (SMD, 0.29; 95% CI, �0.07 to 0.64; I2 = 67.4%), total bone mineral density (SMD, 0.07; 95% CI, �0.23 to 0.37; I2 = 00.0%), spine bone mineral density (SMD, 0.15; 95% CI, �0.19 to 0.49; I2 = 17.3%), and parathyroid hormone level (SMD, �0.18; 95% CI, �0.37 to 0.02; I2 = 1.2%) in HIV-infected patients. Implications: This study showed that vitamin D supplementation can improve serum 25(OH)D in HIV-infected patients. The effects of vitamin D supplementation on other bone health�related parameters such as bone mineral density and parathyroid hormone in HIV-infected patients need to be further investigated in larger-scale, well-designed randomized, controlled trials. © 2022 Elsevier Inc
Recent advances in development of nano-carriers for immunogene therapy in various complex disorders
No full textImmunotherapy is a novel preference for the treatment of various complex diseases. Considering the application of varying agents for suppression or activation of the immune system, immunogene therapy was confirmed to stand as a proper alternative for other immunotherapeutic strategies due to its capability in targeting cells with more specificity that leads to controlling the expression of therapeutic genes. This method facilitates the local and single-dose application of most gene therapies that result in the usage of high therapeutic doses with a low risk of systemic side effects while being cost-efficient in long-term administrations. However, the existing barriers between the administration site and cell nucleus limited the clinical uses of genetic materials. These challenges can be overcome through the promising method of exerting non-carriers with high stability, low toxicity/immunogenicity, and simple modifications. In this study, we attempted to review the potential of nanoparticle application throughout the immunogene therapy of different diseases including cancer, microbial diseases, allergies, inflammatory bowel disease, rheumatoid arthritis, and respiratory infections. We included the outline of some challenges and opportunities in regards to the delivery of genetic materials that are based on nano-systems through immunotherapy of these disorders. Next to the promising future of these vectors, more detailed analyses are required to overcome the current limitations in clinical approaches. © 2022 Mashhad University of Medical Sciences. All rights reserved
Protective role of nutraceuticals against myocarditis
No full textMyocarditis is an inflammatory disease of the myocardium that mostly affects young adults. The disease is commonly caused by viral infection, medications, autoimmune disorders, and inflammatory conditions. Nearly 50 of the cases of myocarditis are due to post-viral immune response in a setting of an identifiable or non-identifiable infection. The clinical manifestation is nonspecific ranging from asymptomatic courses to sudden death in infants and young patients. This review describes the properties of phytochemicals as plant-derived active ingredients which can be used in the prevention and treatment of myocarditis and its associated risk factors. Meanwhile, it has illustrated epidemiological analyses, mechanism of action, and the metabolism of phytochemicals in animal and human clinical trials. We also mentioned the precise mechanism of action by which phytochemicals elicit their anti-viral, anti-inflammatory, antioxidant, and immunomodulatory effects and how they regulate signal transduction pathways. Nevertheless, comprehensive clinical trials are required to study the properties of phytochemicals in vivo, in vitro, and in silico for a proper management of myocarditis. Our findings indicate that phytochemicals function as potent adjunctive therapeutic drugs in myocarditis and its related complications. © 2021 The Author
EZH2 as a new therapeutic target in brain tumors: Molecular landscape, therapeutic targeting and future prospects
No full textBrain tumors are responsible for high mortality and morbidity worldwide. The brain tumor treatment depends on identification of molecular pathways involved in progression and malignancy. Enhancer of zeste homolog 2 (EZH2) has obtained much attention in recent years in field of cancer therapy due to its aberrant expression and capacity in modulating expression of genes by binding to their promoter and affecting methylation status. The present review focuses on EZH2 signaling in brain tumors including glioma, glioblastoma, astrocytoma, ependymomas, medulloblastoma and brain rhabdoid tumors. EZH2 signaling mainly participates in increasing proliferation and invasion of cancer cells. However, in medulloblastoma, EZH2 demonstrates tumor-suppressor activity. Furthermore, EZH2 can regulate response of brain tumors to chemotherapy and radiotherapy. Various molecular pathways can function as upstream mediators of EZH2 in brain tumors including lncRNAs and miRNAs. Owing to its enzymatic activity, EZH2 can bind to promoter of target genes to induce methylation and affects their expression. EZH2 can be considered as an independent prognostic factor in brain tumors that its upregulation provides undesirable prognosis. Both anti-tumor agents and gene therapies such as siRNA have been developed for targeting EZH2 in cancer therapy. © 202
Evaluation of Lamivudine Resistance Mutations in HBV/HIV Co-infected Patients
No full textBackground and Aim: The drug resistance mutations are key elements in the failure of long-term treatment of Hepatitis B virus (HBV) and human immunodeficiency virus (HIV) infections. The mutation in the YMDD motif in the P gene of HBV is the most critical factor in antiviral drug (especially lamivudine) resistance. This study aimed to assess the YMDD motif and other polymerase gene mutations in individuals with HBV/HIV coinfection. Materials and Methods: All enrolled patients were under lamivudine treatment. Blood samples were collected from 37 HBV/HIV-positive patients, and DNA was extracted. The P gene was amplified by the PCR method with appropriate primers. The PCR products for detecting mutations in the P gene were sent to the Macrogen. To investigate the P gene mutations, the obtained sequences were compared with the polymerase gene of the HBV standard sequence in the GeneBank (accession number AB033559). Results: The mean age of the patients was 34.1±5.7 years, of which 59.5 were male, and 40.5 were female. Of all patients, 56 were drug abusers, 35 had risky sexual behavior, 56 had prison history, and 33 had addicted wives. The 37 extracted samples were sequenced successfully. Among the studied samples (n =37), 28 patients had simultaneous mutations of YIDD and FLMAQ, 1 patient had YINN and FLIPH and 1 patient had YIDD and FSLAQ. Conclusion: In summary, drug-resistant variants were detectable in most coinfected patients with chronic Hepatitis B (CHB) and HIV. As a result of mutations, therapeutic strategies sometimes are not effective. Therefore, recognition and monitoring of drug resistance mutations are critical. © 2021, This is an original open-access article distributed under the terms of the Creative Commons Attribution-noncommercial 4.0 International License which permits copy and redistribution of the material just in noncommercial usages with proper citation
Effect of communication skills training using the calgary-cambridge model on interviewing skills among midwifery students: A randomized controlled trial
No full textBackground: An effective interview can strengthen the clinician-patient relationship and improve treatment outcomes. We aimed to assess the effect of communication skills training using the Calgary-Cambridge model on interviewing skills among midwifery students. Materials and Methods: In this randomized controlled trial, 30 midwifery students of Golestan University of Medical Sciences were selected using the convenience sampling method and randomly assigned through minimization into the intervention (n = 15) and control (n = 15) groups in 2018. The routine interventions were administered for the control group, and four sessions of communication skills training based on the Calgary-Cambridge model was performed in small groups for the intervention group. Evan and colleague's History-taking Rating Scale was used before and four weeks after the intervention. Data were analyzed using paired and independent-sample t and Mann-Whitney U tests at the significance level of less than 0.05. Results: The mean (SD) scores of interviewing skill before and after the intervention was 33.71 (7.34) and 54.50 (8.16), respectively, in the intervention group (t 13 = 9.26, p < 0.001) and 33.64 (6.02) and 33.93 (5.39) in the control group, respectively (p = 0.85). The difference between the two groups was significant (t 26 = 7.86, p < 0.001). Conclusions: Communication skills training based on the Calgary-Cambridge model can be used as an effective method to improve interviewing skills among midwifery students. © 2022 Wolters Kluwer Medknow Publications. All rights reserved