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A policy analysis of the national phenylketonuria screening program in Iran
No full textBackground: Phenylketonuria (PKU) screening is a public health measure taken to diagnose and treat the patients with PKU to prevent severe neurological disorders in them. The present study was aimed at analyzing the policies of the national PKU screening (NaPS) program in Iran. Methods: PKU screening program policies were analyzed in compliance with the policy triangle model. Document review and 38 semi-structured interviews were used for data collection. Document review data were analyzed using content analysis, and interview data were analyzed using framework analysis. Results: The national PKU screening (NaPS) program was a decision made at the genetics department of Ministry of Health and Medical Education (MOHME) in Iran. Many internal and external stakeholders were involved in it and valid evidence was used to formulate the policies. Despite some opposition and insufficient support, the program was implemented due to the continuous persistence of parents, interested executives, formulated valid content and a top-down approach. The main barriers included rapid substitution of managers, shortage of Phe-free milk, little awareness of patients� families, social stigma, and inadequate co-operation of some hospital administrators. Conclusions: The policy triangle framework contributed to explaining the different components of the PKU screening program. A successful PKU screening program requires more stability of senior managers in MOHME, enough human resources and Phe-free milk, educating patients� families, and commitment of hospitals administrators. Meanwhile, all the stakeholders need to be involved in the program effectively. © 2021, The Author(s)
Virulence-associated genes and toxin-antitoxin system genes of Shigella flexneri: Presence and expression in normal and thermal stress conditions
No full textBackground: Acute diarrhea is a major public health concern, especially in developing countries. Some research literature demonstrates that toxin-antitoxin systems (TAs) have a regulatory role in different cellular activities. Therefore, the aim of current study is to evaluate the association between the type II TA systems and the virulence/pathogenesis of S. flexneri strains. Methods: Forty S. flexneri strains were identified by phenotypical and molecular methods from patients with Shigellosis at the Infectious and Tropical Diseases Research Center, Ahvaz, Iran. Then, the occurrence of the toxin-antitoxin system genes (mazEF and relBE) and virulence-associated genes (ipaB, set1A, and virF) was detected by PCR-based sequencing assay. Finally, the expression of these genes was characterized in normal and stress conditions (increased temperature) using the Real Time-qPCR assay. Results: The occurrence of ipaB, set1A, and virF genes was 67.5 , 95, and 92.5 respectively. In addition, all strains were positive for mazEF and relBE genes. The Real time-qPCR assay revealed that expression of ipaB and virF in thermal stress was higher than its expression in normal condition. The same was observed for relBE. Conclusions: A possible association was found between mazF and relE expression increase and ipaB and virF expression increase. However, further investigation is required to elucidate the exact association of these genes. © 2020 Elsevier B.V
Diagnosis of latent tuberculosis infection among pediatric household contacts of Iranian tuberculosis cases using tuberculin skin test, IFN- γ release assay and IFN-γ-induced protein-10
No full textBackground: Although the World Health Organization has recommended the diagnosis and prophylactic treatment of latent tuberculous infection (LTBI) in child household contacts of tuberculosis (TB) cases, the national programs in high-burden TB regions rarely implement adequate screening of this high-risk group, mainly because of resource limitations. We aimed to evaluate the prevalence of LTBI among pediatric household contacts of TB cases in two high-burden provinces in Iran. Methods: We conducted a cohort study in children who had been in household contact with a TB index. All subjects were assessed for active TB disease. For LTBI diagnosis, tuberculin skin test (TST) and QuantiFERON®-TB Gold Plus (QFT-Plus) were performed at the time of the index TB case diagnosis, as well as, 3, 12, and 18 months, if the first results were negative. In addition, interferon-γ-induced protein-10(IP-10) concentrations were measured for all participants. Results: A total of 230 children were enrolled, who had contact with an index TB case. Three contacts were diagnosed with active TB. According to the TST/QFT-Plus results, 104 (45.2) children were identified with LTBI during our study. Significantly increased IP-10 levels were found in LTBI patients compared to healthy contacts. Accordingly, more than 50 of LTBI contacts and about 10 of healthy contacts were considered as IP-10-positive. Conclusion: This study alarmingly illustrates a high prevalence of LTBI among Iranian children exposed to TB cases. We, therefore, emphasize that the children living in close contact with an infectious TB case should be screened effectively and receive prophylactic therapy. © 2021, The Author(s)
Developing a package for the provision of spiritual services in healthcare centres in Iran
No full textSpirituality has a signi�cant role in the individuals' physical and mental health, nevertheless health care professionals neglect these needs. This study was aimed at developing a package for the provision of spiritual services in healthcare centers. The study was conducted in two sections. In the review section, the papers related to the topic were selected among accredited scientific sites. In the qualitative section, the data were collected through Focused Group Discussions (FGDs) and individual interviews, and was analyzed using content analysis. The package was designed at two levels: basic and specialized. At basic services, teaching spiritual life style and at the level of specialized services, evaluation and spiritual history, spiritual counselling, and care and spiritual support were envisaged. For implementation of spiritual interventions, an �Implementation Steering Committee� is suggested to be established while the main stakeholders in the healthcare system and experts from the seminary are in attendance. © 2021 Informa UK Limited, trading as Taylor & Francis Group
Acute Ischemic Stroke in a 10-Month-Old Baby Recovered with Aspirin
No full textAcute ischemic stroke is rare in children and often brings enduring and permanent morbidity in pediatric population. While there are numerous recommendations for initial treatment, evidence on effectiveness of different therapies among children is limited. Here, we describe a 10-month-old boy who presented with fever, restlessness, seizure and postictal left limb weakness. Examination revealed left hemiplegia and hemiparesthesia. Computed tomography (CT) head showed loss of gray-white matter distinction with diffuse hypodensity in the right temporoparietal lobes and right caudate nucleus. Magnetic resonance imaging (MRI) brain demonstrated diffusion restriction in favor of acute ischemic stroke in the right middle cerebral artery (MCA) territory. Brain MR angiography (MRA) demonstrated complete occlusion of proximal aspect of M1 segment of right MCA. Genetic testing determined a homozygous 4G/4G polymorphism of the PAI-1 gene. Antiplatelet therapy was started after diagnosis and continued for 8 days with antibiotic therapy. Stroke in children and infants is an infrequent condition associated with substantial morbidity and mortality that needs clinicians' care. This case highlights the significance of awareness about stroke in children and emphasizes on further research to compile evidence-based guidelines for acute stroke therapy in children. © 2021 CSIRO. All rights reserved
A systematic review and meta-analysis for association of Helicobacter pylori colonization and celiac disease
No full textBackground and objectives Based on some previous observational studies, there is a theory that suggests a potential relationship between Helicobacter pylori (H. pylori) colonization and celiac disease (CeD); however, the type of this relationship is still controversial. Therefore, we aimed to conduct a systematic review and meta-analysis to explore all related primary studies to find any possible association between CeD and human H. pylori colonization. Data sources Studies were systematically searched and collected from four databases and different types of gray literature to cover all available evidence. After screening, the quality and risk of bias assessment of the selected articles were evaluated. Synthesis methods Meta-analysis calculated pooled odds ratio (OR) on the extracted data. Furthermore, heterogeneity, sensitivity, subgroups, and publication bias analyses were assessed. Results Twenty-six studies were included in this systematic review, with a total of 6001 cases and 135512 control people. The results of meta-analysis on 26 studies showed a significant and negative association between H. pylori colonization and CeD (pooled OR = 0.56; 95 CI = 0.45-0.70; P < 0.001), with no publication bias (P = 0.825). The L'Abbé plots also showed a trend of having more H. pylori colonization in the control group. Among subgroups, ORs were notably different only when the data were stratified by continents or risk of bias; however, subgroup analysis could not determine the source of heterogeneity. Conclusions According to the meta-analysis, this negative association might imply a mild protective role of H. pylori against celiac disease. Although this negative association is not strong, it is statistically significant and should be further considered. Further investigations in both molecular and clinic fields with proper methodology and more detailed information are needed to discover more evidence and underlying mechanisms to clear the interactive aspects of H. pylori colonization in CeD patients. Copyright: © 2021 Amlashi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Biomonitoring of Multiple Mycotoxins in Urine by GC-MS/MS: A Pilot Study on Patients with Esophageal Cancer in Golestan Province, Northeastern Iran
No full textA pilot study to investigate the occurrence of 10 mycotoxins (deoxynivalenol, DON; 3-acetyldeoxynivalenol, 3-ADON; 15-acetyldeoxynivalenol, 15-ADON; fusarenon-X, FUS-X; diacetoxyscirpenol, DAS; nivalenol, NIV; neosolaniol, NEO; zearalenone, ZON; zearalanone, ZAN; T-2 toxin, T-2; and HT-2 toxin, HT-2) in esophageal cancer patients was performed with the urinary biomarkers approach in Golestan, Iran. Urine multimycotoxin analysis was performed by dispersive liquid-liquid microextraction and gas chromatography-tandem mass spectrometry (GC-MS/MS) analysis, and values were normalized with urinary creatinine (μg/g). Four mycotoxins, namely NEO (40), HT-2 (17.6), DON (10), and HT-2 (5.8), were detected in the analyzed urine samples. DON was only detected in the control group (5.09 μg/g creatinine), while T-2 (44.70 μg/g creatinine) was only present in the esophageal cancer group. NEO and HT-2 were quantified in both control and case groups, showing average of positive samples of 9.09 and 10.45 μg/g creatinine for NEO and 16.81 and 29.09 μg/g creatinine for HT-2, respectively. Mycotoxin co-occurrence was observed in three samples as binary (NEO/HT-2 and T-2/HT-2) and ternary (DON/NEO/HT-2) combinations, reaching total concentrations of 44.58, 79.13, and 30.04 µg/g creatinine, respectively. Further investigations are needed to explore a causal association between mycotoxin contamination and esophageal cancer. For this pilot study in Golestan, the low sample size was a very limiting factor
Simultaneous molecular detection of common bacterial enteropathogens in children with diarrhea by multiplex-pcr assay
No full textBackground: Diarrhea remains a major threat to children in low- and middle-income countries, which is the sec-ond cause of death among children in the world. The aim of the present study was to develop and evaluate a multi-plex-PCR assay for direct detection of common bacterial enteropathogens in fecal specimens. Methods: One hundred and three stool specimens were collected from children under 5 years of age with gastroen-teritis during a six-month period in Ilam, Iran. The multiplex PCR assay simultaneously detected Shigella spp., Campylobacter jejuni, Enteropathogenic Escherichia coli (EPEC), Enterotoxigenic Escherichia coli (ETEC), and Salmonella enterica in stool samples. Results: Our results demonstrated that the prevalence of Shigella spp. Campylobacter jejuni, EPEC, ETEC, and Salmonella enterica were 21.35, 10.67, 1.94, 0.97 and 0, respectively. In addition, Shigella spp. with Campylobacter jejuni and EPEC with Campylobacter jejuni coinfection were observed in sample 11 (10.67). The analytical sensitivity of the multiplex PCR assay was estimated to be 0.01 ng/μL of genomic DNA from culture. The analytical specificity was determined to be 100 by using common and standard enteropathogenic bacterial strains. Conclusions: The molecular method developed in the study was rapid, sensitive, and specific for detection of com-mon bacterial enteropathogens. © 2021 Verlag Klinisches Labor GmbH. All rights reserved
Design and characterization of keratin/PVA-PLA nanofibers containing hybrids of nanofibrillated chitosan/ZnO nanoparticles
No full textIn this paper, designing electrospun composite nanofibers containing poly (lactic acid) (PLA) and keratin/poly (vinyl alcohol) (K/PVA) as the major components and natural nanofibrillated chitosan (CHNF)/ZnO nanoparticles (ZnONPs) (CSZ) combination as the nanofiller ingredient, has been investigated. PLA solution from one syringe and K/PVA from another one with incorporation of CHNF (CS), CSZ (2:1), (1:1) and (1:2) were electrospun and produced nanofibers were formed on the rotating collector. Addition of CHNF and ZnONPs amounts in CSZ combination resulted in reduction of the diameter of nanofibers. The highest hydrophilicity was reported for K/PVA/CS-PLA/CS sample with the contact angle of about 43 ± 3°. AFM results for K/PVA-PLA, K/PVA/CS-PLA/CS and K/PVA/CSZ(2:1)-PLA/CSZ(2:1), K/PVA/CSZ(1:2)-PLA/CSZ(1:2) samples indicated that the surface roughness factor for these nanofibers was about 708, 277, 378 and 658 nm, respectively. DSC analysis for K/PVA/CSZ(1:2)-PLA/CSZ(1:2) structure exhibited that the peaks related to the melting points of PLA and PVA shifted to higher temperatures. Overally, K/PVA/CSZ(2:1)-PLA/CSZ(2:1) nanofiber with diameter of 352.50 ± 31 nm, contact angle of 48 ± 3°, tensile strength of 0.96 ± 0.18 MPa is suggested as a proper wound healing scaffold that has highest antibacterial as well as potential to increase cell proliferation. © 202
Crocin promotes apoptosis in human EBV-transformed b-lymphocyte via intrinsic pathway
No full textBackground: As a major carotenoid in saffron, crocin demonstrates potent anti-cancer impacts. However, its anti-lymphoma effects remain vague, especially in the human EBV-associated B-cell lymphoproliferative disorders. This study examined crocin's apoptogenic potential and its underlying mechanism in CO 88BV59-1 cell line vs. normal human peripheral blood B cells. Methods: CO 88BV59-1 cells were treated with crocin alone or in combination with vincristine for up to 72 h. The cell viability was examined using a resazurin assay. Flow cytometry using annexin V and propidium iodide labeling was performed to detect apoptotic cells. Also, the expression levels of genes and proteins involved in apoptosis (CASP3, CASP8, CASP9, P53, Bax, and Bcl-2) were respectively determined via real-time PCR and Western blot analysis. Results: Crocin concentration-dependently reduced cell viability in CO 88BV59-1 cells with no significant toxicity toward normal B cells. Similar to vincristine, crocin significantly increased apoptosis in these cells during 72 h of incubation. Furthermore, the combination of crocin (80 μM) and vincristine (1 μM) enhanced apoptosis in CO 88BV59-1 cells. Therefore, this synergistic effect was detected in human EBV-transformed B-lymphocyte. CASP3, CASP9, P53, and Bax/Bcl-2 ratio expressions were significantly raised in CO 88BV59-1 cells, whereas CASP8 was unaltered. It was proposed that crocin promoted apoptosis in CO 88BV59-1 cells in a time- and concentration-dependent manner via the induction of the intrinsic pathway. Conclusion: The results suggest that crocin may serve as a good alternative/coadjuvant to vincristine in EBV-associated B-cell lymphoproliferative disorders. © 2021 Universita Cattolica del Sacro Cuore. All rights reserved