Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Gene therapy for obsessive–compulsive disorder: Basic research and clinical prospects
No full textBackground: Obsessive-Compulsive Disorder (OCD) is a prevalent psychiatric condition known for its resistance to conventional treatments. Despite available pharmacological and psychotherapeutic interventions, a significant number of patients do not respond adequately to these approaches. Recent genome-wide association studies (GWAS) have identified genetic links to OCD, sparking interest in exploring gene therapy as an alternative treatment method. Main body: Gene therapy involves correcting or replacing defective genes to target the root cause of the disorder. Preliminary studies have shown promising results, focusing on genes such as Brain Derived Neurotrophic Factor (BDNF), oxytocin receptor (OXTR), SLITRK5, and SLC6A4. Continued exploration of genes like SHANK3 and IMOOD, as well as animal models like SLITRK5 knockout mice, offer insights into potential therapeutic targets. However, ethical and technical challenges must be addressed before wider implementation can occur. Ethical considerations include the multifactorial nature of psychiatric disorders, the need for comprehensive treatment, and issues surrounding informed consent, particularly in cases where patients lack insight into their condition. Technical challenges involve safe gene delivery to the brain, potential off-target effects, and achieving optimal gene expression levels. Conclusions: Gene therapy for OCD is still in the early stages of research and development. While current research is still in its infancy, the identification of specific genes and pathways associated with OCD offers a foundation for future therapeutic interventions. Despite the ethical and technical challenges that remain, advancements in genetic engineering and the establishment of animal models provide a hopeful outlook for the development of effective gene therapy strategies. As the field progresses, Further research is essential to fully realize the potential of gene therapy in managing OCD and related psychiatric conditions. © 2025 Elsevier Inc
Design and Psychometric Evaluation of a Questionnaire Assessing Quranic Attitudes and Attachment in Muslim Breast Cancer Patients Undergoing Radiotherapy
No full textBackground: Breast cancer, one of the most prevalent cancers among women, can pose numerous psychological challenges for patients. In this context, the Quranic lifestyle, as a rich source of religious teachings, can play a significant role in promoting mental health and quality of life among patients. Methods: This cross-sectional analytical study was conducted on 85 breast cancer patients in the summer of 2023. A questionnaire with eight items in two dimensions was designed. Face validity was determined using the Item Impact Score (IIS), and content validity was assessed using the Content Validity Index (CVI) and Content Validity Ratio (CVR). Exploratory factor analysis was employed to categorize items and identify dimensions for evaluating construct validity. Cronbach's alpha coefficient was used to determine internal consistency and test-retest reliability was assessed using the Pearson correlation coefficient and Intraclass Correlation Coefficient (ICC). Findings: The mean (standard deviation) of participants age was 42.50 (11.58) years. The final version of the scale consisted of 8 items in 2 dimensions. The overall Cronbach's alpha was 0.94, and for each dimension, it was greater than 0.80. The confirmatory factor analysis results showed the appropriate fit of the latent variable model. Conclusion: The validity and reliability of the scale were confirmed in this study. Therefore, this 8-item scale is proposed as a suitable and efficient tool for measuring attitudes towards the Quran, hope, and quality of life in breast cancer patients undergoing radiotherapy. © 2025 Isfahan University of Medical Sciences(IUMS). All rights reserved
The Neutrophil-to-Lymphocyte Ratio Predicts Cardiovascular Outcomes in Patients With Diabetes: A Systematic Review and Meta-Analysis
No full textThe neutrophil-to-lymphocyte ratio (NLR) has been found as a potential biomarker for acute inflammation and the prognosis of different diseases. Here, we provided a meta-analysis of studies evaluating the association of NLR with cardiovascular outcomes among patients with diabetes. We searched PubMed, Scopus, and Web of Science databases from inception to April 06, 2024, to include papers based on eligible criteria. The outcomes of interest were all-cause mortality, cardiovascular mortality, major adverse cardiovascular events, myocardial infarction, and stroke. The pooled risk ratio (RR) and corresponding 95 confidence intervals (CI) were reported. Meta-analysis was performed using StataMP 14.0. A total of 15 studies involving 407,512 participants were included. Meta-analysis revealed that both categorical and continuous NLRs are linked to increased risk of all-cause mortality (RR = 1.68; 95 CI, 1.49-1.88; P < 0.001 and RR = 1.03; 95 CI, 1.03-1.03; P < 0.001, respectively) and cardiovascular mortality (RR = 2.04; 95 CI, 1.58-2.63; P < 0.001 and RR = 1.25; 95 CI, 1.19-1.32; P < 0.001, respectively) in patients with diabetes. However, NLR was not associated with the risk of major adverse cardiovascular events, myocardial infarction, and stroke in patients with diabetes. Subgroup analysis revealed sample size as the main source of the heterogeneity found between studies. The findings suggest NLR as a prognostic marker for mortality outcomes in patients with diabetes, providing clinicians with a noninvasive and readily available indicator for risk assessment and patient management
The effect of consecutive ejaculation on the sperm parameters in the oligo-astheno-teratozoospermia (OAT) men
No full textRecently, the World Health Organization recommendation for abstinence time for semen analysis has been challenged in some studies and many of them have supported the advantages of a second short abstinence ejaculation. More evidence is needed to approve this for clinical use. This study aimed to compare the average routine abstinence time (2-7 days) with the short time (1-2 h) on sperm quality based on functional parameters in a population of oligo-astheno-teratozoospermia (OAT) men. The semen samples were retrieved from 50 men with OAT two times: one standard 2-7 days (long ejaculation) and short duration trimming (1-2 hours later the first ejaculation). All semen parameters as well as sperm DNA integrity were compared between groups. Results showed that mean sperm concentration (10.40 vs. 8.76), total sperm count (28.53 vs. 12.24) and mean semen volume (2.69 vs. 1.40) were higher in the first ejaculation (2-7 days of abstinence), while progressive motility (20.52 vs. 13.32), non-progressive motility (53.46 vs. 48.86), morphology (2.46 vs. 1.46) and viability (83.90 vs. 77.96) were significantly higher in the second ejaculation (P < 0.05). The second sample also showed lower immotile (26.82 vs. 38.02) and DNA fragmentation (19.5 vs. 26.96) (P < 0.05). Taking all data into account, an additional short abstinence period (AP) may be a simple and helpful strategy to obtain better sperm quality in couples with male infertility causes, especially in OAT patients. The recommended current guidelines regarding the AP may need to be revisited in severe male factors
Predictors of Poor Sleep Quality in Heart Failure Patients: A Cross-sectional Multivariable Analysis of Clinical, Demographic, and Psychosocial Factors
No full textBackground: Sleep quality is crucial in heart failure (HF) patients, yet its associations with clinical, demographic, and psychosocial factors remain underexplored. This study examined these relationships to identify predictors of poor sleep quality. Study Design: A cross-sectional study. Methods: This cross-sectional was conducted on 354 HF patients at Shahid Chamran Heart Hospital, Isfahan, Iran (September 2023-2024). Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS) were used to evaluate sleep quality, anxiety, and depression, respectively. Random forest (RF) modeling and ordinary least squares (OLS) regression identified predictors of poor sleep quality. Results: Poor sleep quality (PSQI > 7) was observed in 18 of patients who were older (70.00 +/- 6.30, P < 0.001) and had lower ejection fraction (EF) (23.75 +/- 12.79, P < 0.001). This group also had higher systolic blood pressure (BP 140.67 +/- 12.50 mmHg, P = 0.014). beta-blockers, and diuretics, were associated with poor sleep (P < 0.001). Moreover, depression (HADS-depression: 5.36 +/- 0.70, P < 0.001) and anxiety (HADS-anxiety: 4.84 +/- 1.32, P < 0.001) were correlated with poor sleep. The RF model had an area under the curve of 0.79, and OLS regression (R-2 = 0.280) highlighted New York Heart Association (NYHA) class and medication type as significant predictors. Conclusion: Overall, poor sleep quality in HF patients was related to older age, reduced cardiac function, higher blood pressure (BP), complex medication regimens, and increased anxiety and depression. Accordingly, multidimensional management strategies are needed to improve sleep outcomes
Challenges of Intraoperative Documentation and Its Role in Patient Safety: An Integrative Review
No full textBackground:Accurate and complete intraoperative documentation is crucial for maintaining consistency in patient care, facilitating handoffs between surgical teams, and evaluating outcomes. This integrative review aimed to investigate the challenges of intraoperative documentation and its role in patient safety.Materials and Methods:A search of English-language databases including EMBASE, Proquest, Web of Science, PubMed, ScienceDirect, and Scopus was conducted from 2001 to 2022 using the keywords "intraoperative documentation", "patient safety", "documentation", and "intraoperative".Results:Nineteen articles were included from the initial 86 identified studies. Key findings were that protocols, safe surgical plans, accurate documentation, error/complication prevention measures, teamwork, safety culture, checklists, and instrument/sponge counts positively impact patient safety.Conclusions:Operating rooms require precise patient information and documentation pre-, intra- and post-operatively. This review indicates intraoperative documentation can improve surgical team performance and patient safety by facilitating continuity of care, handoffs, and outcomes assessment
Relation Between Smoking and Disability Progression in Iranian Multiple Sclerosis Patients: A Case-Control Study
No full textBackground:To compare characteristics of patients with multiple sclerosis (MS) between cigarette smokers and non-smokers. Methods:A case-control study was performed on patients registered in the Kashani MS center from April 2019 to April 2020 in Isfahan, Iran. In total, 136 smoker patients and 220 non-smokers participated in the study and completed the questionnaire. Results:The frequency of male gender in the smoker group was significantly higher than in the non-smokers (64.7 vs. 15, P = 1, P < 0.001). The Expanded Disability Status Scale (EDSS) of more than 4.5 was significantly higher in smokers (26.5 vs. 18, P = 0.023). There was a relation between an EDSS of more than 4.5 and an interval between smoking initiation and disease onset (P = 0.004). Long duration of smoking was associated with a higher disability scale (16.4 +/- 9.5 vs. 9.8 +/- 7.3, P = 0.008). Men smoked for a longer period of time before developing MS than women (9.24 +/- 10.07 vs. 4.47 +/- 7.61, P = 0.002). The average daily cigarette consumption was 7.74 +/- 6.65 in women and 10.84 +/- 9.44 in men (P = 0.024). Duration of smoking before the onset of the disease was 4.47 +/- 7.61 years in women and 9.24 +/- 10.07 in men (P = 0.002). Conclusions:Our data suggest that there is a possible relationship between disability score and the duration of smoking before the onset of MS. It also revealed that the duration of smoking can affect the progression of the disease. Further studies are suggested to confirm these findings
Apoptosis-inducing proteins with reduced expression in breast cancer: A review article
No full textBreast cancer is considered one of the most abundant malignancies with high morbidity and mortality. Traditional cancer treatments possess various weaknesses, including a lack of specificity and numerous side effects. Novel cancer therapies aim to overcome the shortcomings of traditional therapies and offer more efficient and safe treatments. Designing and identifying novel proteins that can practically and specifically inhibit tumors by inducing apoptosis can interest researchers in this field. This review discusses recent studies on the use of four promising proteins, KAI1, Apoptin, BIF-1, and DFF-40, for breast cancer treatment. This study also focuses on alterations in the expression of the androgenic proteins and novel strategies for better penetration and delivery of these proteins. Lastly, prospects for protein-based targeted cancer therapy and future studies in this field are highlighted
Evaluation of the effects of cartilage decellularized ECM in optimizing PHB-chitosan-HNT/chitosan-ECM core-shell electrospun scaffold: Physicochemical and biological properties
No full textCartilage regeneration is still a highly challenging field due to its low self-healing ability. This study used a coreshell electrospinning technique to enhance cartilage tissue engineering by incorporating cartilage extracellular matrix (ECM). The core of fibers included poly(3-hydroxybutyrate)-Chitosan (PHB-Cs) and Halloysite nanotubes. The shell of fibers consisted of Cs and ECM (0, 1, 3, 5 wt). Subsequently, the scaffolds were named 0E, 1E, 3E, and 5E. The study aimed to assess the impact of ECM on cellular behavior and chondrogenesis. Our findings indicate that ECM reduced fiber diameter from 775 nm for the 0E scaffold to 454 nm for the 1E scaffold. Water contact angle measurements revealed an increasing trend by ECM addition, from 42 degrees for 0E to 67 degrees for 1E. According to mechanical analysis, the 1E scaffold represented the highest strength (5.81 MPa) and strain (3.17). Based on these analyses, the 1E was considered the optimum scaffold. MTT analysis showed cell viability of over 80 for the 0E and 1E. Also, the gene expression level was assessed for Collagen II, Aggrecan, SOX 9, and Collagen X. The results represented that in the 1E scaffold Collagen II, Aggrecan, and SOX 9 were more upregulated at the end of the 21st day. However, in the 1E scaffold collagen X, as a hypertrophy marker, was downregulated at the end of the experiment. Overall, these results confirmed the potential of the 1E scaffold to be introduced as a promising cartilage tissue engineering scaffold for further studies
Development and psychometric evaluation of the faculty members research vitality instrument: Protocol for mixed methods study
No full textBACKGROUND: Academic institutions are not just sites of education but also centers of innovation and research. The academic faculty is the cornerstone of these establishments and plays a crucial role in the progress of knowledge via research. To understand the significance of faculty members' research vitality, we must first analyze the concept itself. It is well acknowledged but not yet fully understood that university faculty members must participate in "research vitality" in order to do high-quality research. The creation and assessment of faculty members' "Research Vitality Instruments" is the goal of this study. MATERIALS AND METHODS: This mixed methods study will be conducted to develop and validate an instrument to measure research vitality in faculty members in three consecutive phases. In the first phase, a scoping review will be conducted to conceptualize the research vitality construct that would be completed by the second and qualitative phase that aims to explore the opinions of faculty members using semi-structured interviews. In the third phase, the psychometric properties of the instrument would be evaluated based on the stands for Consensus-based Standards for the selection of health Measurement guideline. DISCUSSION: This study first explains the concept of research vitality and identifies its dimensions and then designs a tool to measure the research vitality of faculty members of medical sciences universities. This tool can be used to get a detailed understanding of the research vitality of faculty members, which is an important component of producing quality knowledge in the field of health