Golestan University of Medical Sciences
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Shocked to Happy: Experiences of Iranian Diabetics in Reaction to the Bad News of the Diagnosis Od šoka do sre�e: Iskustva iranskih dijabeti�ara u reakciji na loše vesti o dijagnozi
No full textDiagnosis of a chronic disease like type 2 diabetes mellitus (T2DM) is frequently shocking for patients, which influences their lives. Getting aware of bad news such as obtaining a chronic illness diagnosis is a sensitive issue in patients� lives. Conversely, reactions to the reception of a diagnosis of diabetes are often varied for a few reasons. To manage the diseases through care planning, the identification and modification of the causes of various reactions are necessary. The aim of the present survey was to investigate the reaction of diabetics to the reception of diabetes diagnosis and its possible reasons. In this qualitative study, in-depth interviews were used. Furthermore, traditional content analysis of semi-structured interviews was conducted using a qualitative strategy with 20 individuals with type 2 diabetes. The purposeful sampling approach was employed for recruiting the participants. Eleven male and nine female participants having type 2 diabetes had been transferred to the diabetes association of Iran for receiving consulting assistance in the areas of nutrition, psychology, and health care. Four categories of reactions have arisen from the investigation including behavioral, emotional, contextual, and cognitive reactions. Reactions to the prognosis of diabetes may be different for some reasons. The findings of the present investigation may be employed by health care providers to obtain a more comprehensive understanding of unusual and usual reactions, their causes, and the context in the early years after the diagnosis and planning care programs for disease management. © 2021 Sciendo. All rights reserved
Self-management of patients with chronic diseases during COVID19: A narrative review
No full textIntroduction. COVID-19 pandemic has affected the self-management of patients with chronic disease all over the world. The present study COVID-19 is a review to investigate the chronic patient self-management challenges during the corona epidemic, and providing solutions to solve this problem. Methods. The relevant literature on chronic patient selfmanagement is investigated (from March 2019 to Jan 2021). Databases including Google Scholar, PubMed, Science Direct, Springer were used to search articles from the Latin articles. Also, keywords in this study included self-management, chronic disease, COVID-19. Finally, 26 relevant articles were used in this study. Results. Studies assessed the effective role of self-management in control and prevention of complications of chronic diseases and the challenges related to self-management programs during COVID-19, in addition the role of the health team in patients selfmanagement during the corona epidemics. Conclusion.The main challenges for chronic patients during the COVID-19 include decreased healthcare service and regular follow-ups because of physical restrictions; economic problems, change in lifestyle, and lack of rapid compliance with the changes. In this regard, the health team should provide the best healthcare services using the available resources to reduce suffer and pain of the patients. © 2021 Pacini Editore S.p.A.. All rights reserved
Effectiveness of Integrated and Comprehensive Geriatric Care Program of Ministry of Health on Physical and Mental Health of Older Adults in Golestan Province
No full textObjectives In order to maintain and improve older adults� health, the integrated and comprehensive geriatric care program has been developed and run by ministry of health. The present study was conducted to evaluate the effectiveness of this program on physical and mental health of older adults in Golestan province in 2019. Methods & Materials The present retrospective cohort study employed a multistage clustered random sampling technique to obtain 500 e-health records of older adults during 2017-2019. The data on blood pressure, depression, and BMI were extracted from e-health records. Data analysis was conducted using repeated measure anova, paired t-test and Wilcoxon tests. The SPSS statistics software v. 20 was used to perform data analysis Results Of the 500 cases studied, were male and female, respectively. The Mean±SD age of the participants was 69.97±7.45 years. The results of inferential statistics showed that the mean score of systolic blood pressure was significantly decreased through study period (P<0.001). However, through study period depression score was significantly increased (P�0.05). There was no significant difference in BMI index. Conclusion The results of this study showed that the integrated and comprehensive geriatric program was effective for controlling blood pressure, however was not effective for preventing depression. Therefore, stakeholders should pay more attention towards establishing appropriate program to improve older adults� mental health. © 202
Structural equation model of affecting factors on elder abuse to patients under hemodialysis by family caregivers
No full textBackground: The objectives of the present study were to determine the prevalence of older adults with hemodialysis (HD) abuse by family caregivers and the factors affecting it. Method: This is a correlational-causal study, which is conducted in 2018 in Iran. The sample size was 367 in both groups (the older adults and their family caregivers). Data collection was done using an individual-social information questionnaire for the older adults under hemodialysis and their family caregivers, the questionnaire of elder abuse by family caregivers to the older people under hemodialysis, Zarit Burden Interview and the scale of instrumental activities of daily living (IADL). Data were analyzed by the structural equation model (SEM) method. The Fitness of proposed pattern was measured using the following indexes: chi-square/degree of freedom ratio (CMIN/DF), Normed Fit Index (NFI), comparative fit index (CFI), goodness of fit index (GFI), and standardized root mean squared residual (SRMR). The significant level in this study was considered p < 0.05. Results: The results of the present study showed that more than 70 of the older adults suffer from elder abuse by family caregivers on average. The highest median elder abuse was related to emotional misbehavior (21.46 ± 6.09) and financial misbehavior (19.07 ± 5.33), respectively. Moderate care burden was experienced by 63.2 of caregivers. The percentage of older women and men, who needed help with daily activities was 81.4 and 80.5 , respectively. The results showed that the caregivers� level of education and care burden with standard beta coefficient of -0.251 and 0.200 and the educational level of older adults and IADL with the best beta coefficient of -0.299 and � 0.234, had the highest regression effect on elder abuse respectively. According to the results, the model-fit indices of the hypothesized model was meet the criteria, with the NFI = 0.951, GFI = 0.970, CFI = 0.967, and SRMR = 0.041. The outcome was suitable for the recommended level, so the hypothetical model appeared to fit the data. Conclusions: The results of the present study showed that the prevalence of elder abuse by family caregivers among the older adults under hemodialysis is high. Providing psychological counseling can reduce the consequences of elder abuse. © 2021, The Author(s)
Association between opium use and bladder cancer: A case-control study in a high risk area of Iran
No full textBackground: Bladder cancer is one of the common cancers. Currently some studies found an association between opium use and incidence of bladder cancer, however, underreporting and detection bias was high in the previous studies and also some of them did not adjust their results for confounding variables and had small sample size, various and unclear definition of opium use, and lack of data on starting age, duration, dose, and route of opium consumption. In this study we investigated the association between opium use and incidence of bladder cancer, overcoming previous studies limitations and doing sensitivity analyses for underreporting bias. Methods: We performed a population-based case�control study, including 300 cases diagnosed with bladder cancer and 600 controls (matched for age, sex, and place of residence) between 2013�2015. We used conditional logistic regression models to estimate odds ratios (OR) and 95 confidence intervals (CI). Results: Overall, 200 cases (64.9) and 172 controls (27.9) reported regular use of opium, resulting in an adjusted OR (95 CI) of 4.4 (2.9�6.5). Dose response relationship was seen and the adjusted OR for low and high dose consumption groups were 4.2 (95 CI 2.6-6.8) and 4.5 (95 CI 2.9-7.2) respectively. The association between opium use and bladder cancer was statistically significant even after controlling for underreporting bias. Conclusion: This study confirmed that opium use was associated with the bladder cancer incidence. We suggest primary prevention and early detection for bladder cancer, especially in the high risk groups. © 202
Predicting adsorption behavior and anti-inflammatory activity of naproxen interacting with pure boron nitride and boron phosphide fullerene-like cages
No full textThe adsorption of naproxen (NPX) on surface of the boron phosphide (BP) and boron nitride (BN) fullerene-like cages have been studied and discussed by using density functional theory (DFT) and time-dependent density functional theory (TDDFT) calculations. Adsorption results using DFT demonstrated that B12N12 have strong interactions with the carbonyl (-C = O) group of naproxen via covalent bonding, while the interaction of the naproxen through a carbonyl and hydroxyl groups with the B12P12 occurred via electrostatic interactions, suggesting a large desorption time due to a large negative adsorption energy. The effects of hydroxyl (OH) functionalization on the adsorption of NPX via B12N12 has also been investigated. Results reveal that OH functionalization decreases the absolute Eb value of NPX on studied B12N12 fullerene-like cage. Theoretical studies also demonstrated the frequency shifts that is happening because of the adsorption process. The electronic and optical properties of B12N12 and OH-B12N12 in the presence of NPX are significantly sensitive. Interaction results demonstrated that B12N12 with H-donor functional groups such as �OH was effective for the delivery of naproxen as it leads to an increased dipole moment with weak binding energy. The polarity for the NPX loaded OH-B12N12 shows the feasibility of ameliorating the situation of solubility desirable for drug delivery systems in biological devices. Through the analysis of molecular docking, it was found that NPX loaded OH-B12N12 is potent inhibitors of TNF-α receptor and IL-1 receptor targets compared to B12N12 and B12P12 systems. © 2021 Elsevier B.V
Genotyping and sequence characterization of the NSP4 gene of human group A rotavirus strains in Northern Iran
No full textRotavirus is known to be responsible for remarkable numbers of severe diarrheal episodes and even death in infants and young children. In this study, we aimed to survey genetic diversity and variation analysis of viroporin, which is encoded by the rotavirus NSP4 segment. Thirty-five rotavirus-positive specimens were obtained, and RNA extraction and polymerase chain reaction amplification were performed. After the sequencing process, four specimens were excluded, and the final 31 samples remained for genetic diversity and variation analysis. The predominant single G/P combination was G1P8 (~78%), followed by G2P8 (~13%), and equal percentages (3%) of G2P4, G3P8, and G-non-typeable-P8. Further analyses revealed that variations could be found in the three regions of NSP4, including VP4 binding site (aa 112�146), double-layered particle binding site (aa 161�175), and finally, in the predicted amphipathic alpha-helix. Phylogenic tree analysis demonstrated that the mentioned samples clustered with genotype E1 and E2 reference sequences. As previously reported in the literature, in this study, it was revealed that no apparent correlation exists in the deduced amino acid sequences corresponding to this region between the rotaviruses collected from patients with and without diarrhea. © 2021 Wiley Periodicals LL
Engineering Gene Therapy: Advances and Barriers
No full textCurrently, 33 gene-therapy drugs/products have been approved in the clinic. Over 3000 completed and ongoing clinical gene therapy trials have been reported worldwide. The development/maturation of tools for gene manipulation and gene delivery, as well as molecular advances in the diagnosis of genetic diseases, have played a central role in gene therapy, which have greatly revolutionized the field. Versatile and diverse genetic tools for gene manipulations and deliveries, with the possibility of short and long-term effects, are vital advantages of gene therapy tools, paving the road for the development of new therapies. However, efficacy and safety concerns, immune system responses, laborious approaches for developing and manufacturing, unknown gene-therapy drug interactions with the host and the high cost of drugs/products, are significant barriers in gene therapy. Here, the authors review the attempts for engineering of the gene manipulations that have been undertaken in the last three decades and used in clinical trials focusing on 1) gene-editing platforms, 2) viral gene delivery systems, and 3) nonviral gene tools. In this comprehensive review, the principles of these gene manipulation tools as well as advances and barriers for their application in modern therapies are discussed. Furthermore, trends and future directions in gene therapy are discussed. © 2021 The Authors. Advanced Therapeutics published by Wiley-VCH Gmb
Dual effects of atorvastatin on angiogenesis pathways in the differentiation of mesenchymal stem cells
No full textAtorvastatin (ATO) can improve the transplantation efficacy of mesenchymal stem cells (MSCs) after acute myocardial infarction. The present study aimed at ATO effects on the angiogenesis-signaling pathways from MSCs' differentiation to tissue angiogenesis. MSCs were first prepared from BALB/c mouse bone marrow. MTT assay was then done for the biodegradability of MSCs with the extracellular matrix. After that, the differentiation of cells into the bone and fat tissues was confirmed by Alizarin and Oil Red O staining. The extracellular matrix was then combined with the cells to the implant. Animals were intraperitoneally treated with ATO (2 and 40 mg/kg, daily) three days before cell transplantation to one week after. Finally, the assays were carried out by electron microscopy, immunocytochemistry, ELISA, Western blot, and RT-qPCR techniques. A phase-contrast microscope confirmed the morphology of cells. The cell differentiation into bone and fat tissues was confirmed by Alizarin red staining and flow cytometry, and the cell proliferation was confirmed by MTT assay. Unlike ATO 40 mg/kg group, ATO 2 mg/kg was significantly increased the CD31, eNOS, podocalyxin, von Willibrand factor, and alpha-smooth muscle actin proteins levels compared to the control group in vitro experiment. The expression of CD31 and VEGF proteins, as angiogenesis markers, and Ki-67 protein, as a proliferation marker, was significantly higher in a low dose of ATO (2 mg/kg) than that of the control group in vivo experiment. Unlike ATO 40 mg/kg, the expression levels of ERK, AKT, NF-�B, Rho, STAT3, Ets-1, HIF-1α, and VEGF proteins and genes were significantly increased in ATO 2 mg/kg compared to the control. A low dose of ATO can be a beneficial tool in the function of MSCs and their differentiation to tissue angiogenesis. © 2021 Elsevier B.V
ANXA1 with Anti-Inflammatory Properties Might Contribute to Parkinsonism
No full textWe here describe the identification of a novel variant in the anti-inflammatory Annexin A1 protein likely to be the cause of disease in two siblings with autosomal recessive parkinsonism. The disease-segregating variant was ascertained through a combination of homozygosity mapping and whole genome sequencing and was shown to impair phagocytosis in zebrafish mutant embryos. The highly conserved variant, absent in healthy individuals and public SNP databases, affected a functional domain of the protein with neuroprotective properties. This study supports the hypothesis that damaged microglia might lead to impairments in the clearance of accumulated and aggregated proteins resulting in parkinsonism. ANN NEUROL 2021;90:319�323. © 2021 American Neurological Association