Golestan University of Medical Sciences
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Population-based cancer survival in the Golestan province in the northeastern part of Iran 2007�2012
No full textObjective: We studied 5-year relative survival (RS) for 14 leading cancer sites in the population-based cancer registry (PBCR) of Golestan province in the northeastern part of Iran. Methodology: We followed patients diagnosed in 2007�2012 through data linkage with different databases, including the national causes of death registry and vital statistics office. We also followed the remaining patients through active contact. We used relative survival (RS) analysis to estimate 5-year age-standardized net survival for each cancer site. Multiple Imputation (MI) method was performed to obtain vital status for loss to follow-up (LTFU) cases. Results: We followed 6910 cancer patients from Golestan PBCR. However, 2162 patients were loss to follow-up. We found a higher RS in women (29.5, 95 CI, 27.5, 31.7) than men (21.0, 95 CI, 19.5, 22.5). The highest RS was observed for breast cancer in women (RS=49.8, 95 CI, 42.2, 56.9) and colon cancer in men (RS=37.9, 95 CI, 31.2, 44.6). Pancreatic cancer had the lowest RS both in men (RS= 8.7, 95 CI, 4.1, 13.5) and women (RS= 7.9, 95 CI, 5.0, 10.8) Conclusion: Although the 5-year cancer survival rates were relatively low in the Golestan province, there were distinct variations by cancer site. Further studies are required to evaluate the survival trends in Golestan province over time and compare them with the rates in the neighboring provinces and other countries in the region. © 202
The effects of earplugs and eye masks on sleep quality of patients admitted to coronary care units: A randomised clinical trial
No full textSleep is an essential need for patients admitted to coronary care units. The present clinical trial aimed to determine the effect of using eye masks and earplugs on the sleep quality of patients with coronary heart disease (CHD). A total of 68 eligible patients with CHD were randomly allocated into four groups of 17 (control, eye masks, earplugs, and eye masks with earplugs). All three interventions were performed during the night from 10:00 p.m. to 7:00 a.m. the next day. The outcomes were the quality of sleep, measured by the Verran and Snyder-Halpern (VSH) Sleep Scale, and the urinary levels of nocturnal melatonin and cortisol, measured by urine samples taken during the night (from 10:00 p.m. to 7:00 a.m.). The study outcomes were measured on the third and fourth days. Sleep disturbance was statistically significantly lower in patients with earplugs (visual analogue scale mean difference MD: 74.31 mm, SE: 11.34, p = 0.001). Sleep effectiveness was statistically significantly higher in patients with eye mask (MD: 36.88 mm, SE: 8.75, p = 0.001). The need for sleep supplementation was statistically significantly lower in patients with eye masks (MD: 39.79 mm, SE: 7.23, p = 0.001). There was a significant difference in melatonin levels between eye masks and the control group (p = 0.03). For urinary cortisol levels, there were significant differences between eye masks and the control group (p = 0.007), earplugs and the control group (p = 0.001), and eye masks with earplugs and the control group (p = 0.006). The mean scores for comfort, effectiveness, and ease of use were highest for the group that used eye masks (2.88, 2.94, and 3.18, respectively). As a result, all three interventions improved the sleep quality of patients. However, the interventions had different effects on the three dimensions of the VSH Sleep Scale, as well as the urinary levels of cortisol and melatonin. © 2021 European Sleep Research Societ
Molecular Characterization, Virulence Determinants, and Antimicrobial Resistance Profile of Methicillin-Resistant Staphylococcus aureus in the North of Iran; a High Prevalence of ST239-SCC mec III/t037 Clone
No full textObjectives: Emergence and prevalence of methicillin-resistant Staphylococcus aureus (MRSA) have become a major universal health concern, limiting therapeutic options. Methods: A total number of 37 MRSA isolates, including 19 clinical isolates from hospitalized patients and 18 colonizing isolates from health care workers were identified from 3 hospitals, in Gorgan, North of Iran. Antimicrobial susceptibility test was performed using the disk diffusion method and E-test. The presence of virulence and antibiotic resistance determinants were evaluated by PCR. The genotypical characterization was further analyzed using multi-locus sequence, spa, staphylococcal cassette chromosome, mec (SCCmec), and agr typing. Results: The frequency of MRSA among S. aureus isolates was 38.14 (37/97). The most frequent S. aureus resistant isolates were found to be obstinate against penicillin (98) and gentamicin (82.5). Additionally, the lowest resistance rates were found against daptomycin (0), vancomycin (2.7), and quinupristin-dalfopristin (5.4). All MRSA isolates were susceptible to daptomycin with minimum inhibitory concentration (MIC)50/MIC90 of 0.25/0.5 μg/mL. One isolate belonging to sequence type 239 (ST239)-SCCmecIII/t037 clone (MIC �16 μg/mL) was resistant to vancomycin. All but 1 isolate that shares ST22-SCCmec IV/t790 strain were positive for both tsst and pvl genes. The most predominant MRSA isolates (27) were associated with ST239-SCCmec III/t037, and ST239-SCCmec III/t924 (16.2) clones, subsequently. In our study, circulating MRSA strains were genetically diverse with a high prevalence of ST239-SCCmec III/t037 clone. Conclusion: These findings emphasize the need for future and continuous surveillance studies on MRSA to prevent the dissemination of existing multidrug resistance MRSA clones in an effective manner. © 2021 S. Karger AG, Basel
A case report of Ring chromosome 18 with systemic Lupus Erythematosus and Crohn�s disease
No full textBackground: Ring Chromosome 18 is a rare chromosomal disorder caused by missing pieces of one or both ends of chromosome 18. The clinical phenotype of the Ring 18 syndrome depended on the rate and the locality of genetic material lost. Here, we report a 27 years old girl with symptoms including microcephaly, mental and motor retardation, hypotonia, and autoimmune diseases consist of Rheumatoid arthritis, Systemic Lupus Erythematosus, and Crohn's disease. This research contributes to a better understanding of disease and can lead to improvement in diagnosis and treatment. Method and result: The Chromosomal analysis was performed based on the GTG banding technique on peripheral blood lymphocytes. Karyotype analysis indicated the existence of a Ring chromosome 18 with deletions at 18p11.32 and18q22-2. Following that, the parental karyotype of the affected girl confirmed that Ring 18 was caused by a de novo mistake very early in embryonic development. Conclusion: Ring chromosome 18 is a rare chromosomal disorder that is generally caused by de novo errors very early in the development of the embryo. Previously studies have reported a relationship between autoimmune diseases and Ring 18. Our patient has disclosed specific types of autoimmune diseases, including Systemic Lupus Erythematosus, and Crohn's disease. © 2021, The Author(s), under exclusive licence to Springer Nature B.V
Perforation as the First Manifestation of Marginal Ulcer Following One Anastomosis Gastric Bypass: a Multicenter Case Series and Review of Literature
No full textOne anastomosis gastric bypass (OAGB) has attracted increasing attention over the past decades due to its higher safety, simplicity, and efficacy over other bariatric techniques. Marginal ulcers (MUs) after OAGB are usually asymptomatic, potentially leading to life-threatening conditions, such as bleeding and perforation. However, the precise mechanisms and predisposing factors of perforation at the anastomotic site of OAGB remain unknown. In this study, we report six patients with a history of laparoscopic OAGB presenting with an acute abdomen and pneumoperitoneum. All patients underwent an open surgical intervention after the initial resuscitation. All patients underwent an exploratory laparotomy. Four patients were treated with omental patch repair. For one of them, Braun�s side-to-side jejunojejunostomy was also performed. One patient converted to Roux-en-Y gastric bypass (RYGB), and one patient converted to normal anatomy. Five out of six patients showed favorable outcomes after management. However, one of the patients, which presented with septic shock, expired 24 h after the emergent exploratory laparotomy. The mean interval between OAGB and MU perforation was 19 months, and the mean size of perforation was 2.08 cm. Perforation of an anastomotic ulcer after OAGB is rare and should be included in the differential diagnosis of patients presenting with an acute abdomen following OAGB; this may even occur years after OAGB. Patients can present with a perforated MU as the first manifestation. Adequate fluid resuscitation, along with administration of proton pump inhibitors (PPI) and antibiotics, should be considered in the primary management. Surgical options (oversewing, conversion to RYGB, and conversion to normal anatomy) vary according to the patient�s general condition, size and location of the perforation, and degree of contamination. © 2021, Association of Surgeons of India
Melatonin: A smart molecule in the DNA repair system
No full textDNA repair is an important pathway for the protection of DNA molecules from destruction. DNA damage can be produced by oxidative reactive nitrogen or oxygen species, irritation, alkylating agents, depurination and depyrimidination; in this regard, DNA repair pathways can neutralize the negative effects of these factors. Melatonin is a hormone secreted from the pineal gland with an antioxidant effect by binding to oxidative factors. In addition, the effect of melatonin on DNA repair pathways has been proven by the literature. DNA repair is carried out by several mechanisms, of which homologous recombination repair (HRR) and non-homologous end-joining (NHEJ) are of great importance. Because of the importance of DNA repair in DNA integrity and the anticancer effect of this pathway, we presented the effect of melatonin on DNA repair factors regarding previous studies conducted in this area. © 2021 John Wiley & Sons Lt
FITC-conjugated single chain Nimotuzumab can specifically recognize and enter EGFR-overexpressing cells
No full textThe epidermal growth factor receptor (EGFR) is regarded as an ideal target for cancer therapy and imaging. EGFR-targeting antibodies or antibody fragments can be engaged to specifically deliver small molecules with therapeutic or diagnostic properties to EGFR-overexpressing cancer cells. Cell-penetrating peptides (CPPs) are short amino acid sequences that are added to drug carriers or recombinant proteins and are believed to increase cellular internalization. In the current study, we evaluated the ability of FITC-conjugated single-chain Nimotuzumab molecules (containing or lacking CPP) in recognizing and entering EGFR-overexpressing cancer cells. The molecules were found to enter the cancer cells in an efficient manner and emit signals. No obvious difference was found between CPP-containing and CPP-lacking molecules in entering cancer cells. © 2022, The Author(s), under exclusive licence to Springer Nature B.V
Global prevalence of Giardia duodenalis in cattle: A systematic review and meta-analysis
No full textGiardia duodenalis is an important intestinal parasite responsible for diarrhea in humans and animals worldwide. Up to now, G. duodenalis infections in cattle have been reported in many studies around the world. Hence, the aim of the present study is to report on the distribution of G. duodenalis in cattle at global scale and to evaluate the global prevalence, risk factors and genetic characterization of G. duodenalis infection among cattle worldwide. International databases were systematically searched to identify relevant studies. A random-effects meta-analysis model was used to estimate the overall and the subgroup-pooled prevalence of G. duodenalis across studies, and the variance between studies (heterogeneity) was quantified by I2 index. One hundred and fifty-eight articles (including 195 datasets), from 48 countries met eligibility criteria for analysis. Considering detection methods, the pooled prevalence was estimated to be 24 (95 confidence interval (CI), 19�30) using copro-antigen techniques, 22 (95 CI, 17�28) using molecular, and 16 (95 CI, 12�20) using microscopic detection. Molecular methods showed that the highest number of reports were associated with assemblage E (45/46; 97.83 studies), assemblage A (33/46; 71.74 studies) and assemblage A+E (10/46; 21.74 studies). The pooled prevalence different of subgroups (WHO regions, countries, and type of cattle) were analyzed separately. Moreover, a significant association was observed between G. duodenalis infection with cattle suffering from diarrhea (odds ratio (OR), 2.61; 95 CI, 1.50�4.55) and pre-weaned calves (OR, 1.79; 95 CI, 1.08�2.95). These results suggest that the corresponding control scheme and effective management measures should be formulated to reduce the transmission of G. duodenalis infection according to the difference of geographical conditions in different areas. © 2022 Elsevier B.V
Are Dyskeratosis Congenita patients at higher risk of symptomatic COVID-19?
No full textDyskeratosis Congenita (DC) is a rare and heterogeneous disease. This disorder is resulted from a defect in the telomere maintenance in stem cells. Telomerase RNA component, shelterin complex, and telomerase reverse transcriptase are mutated in this disease. Many studies have previously confirmed shorter leukocyte telomere length in DC. On the other hand, the association between telomere length and Coronavirus disease 2019 (COVID-19) indicated that people with a short telomere background mostly show more severe symptoms related to COVID-19, and the mortality rate among them increases as well. Because patients with DC have an abnormally short telomere length, in the current study, we hypothesized that they are at higher risk of developing symptomatic COVID-19 that requires further clinical care. © 2022 Elsevier Lt