Repository of Research and Investigative Information Isfahan University of Medical Sciences
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Pre-diabetes and cardiovascular risk factors in NAFLD patients: a retrospective comparative analysis
No full textObjectives Insulin resistance plays a critical role in the pathophysiology of diabetes mellitus and non-alcoholic fatty liver disease (NAFLD). Moreover, insulin resistance has a central role in atherogensis as the major leading cause of cardiovascular disease (CVD). The aim of the present study was to assess the frequency of pre-diabetes and evaluate the cardiometabolic risk factors among NAFLD patients, comparing those with pre-diabetes to those with normal glucose tolerance. Methods In the current retrospective case-control study, the data of 1031 NAFLD patients was retrieved. Based on blood glucose levels, 337 diabetics, 340 pre-diabetes, and, 354 normal glucose patients were diagnosed. After excluding diabetic NAFLD patients, 694 individuals were divided into two groups: normal glucose and pre-diabetes. Various variables, such as age, anthropometric measurements, hypertension, systolic and diastolic blood pressure, and lipid profiles, were extracted from patient files. Statistical analysis was conducted to assess cardiovascular risk factors in NAFLD patients. Results Higher age, female gender, higher BMI, triglyceride, waist and hip circumference and waist-to-hip ratio were found in pre-diabetic NAFLD individuals compared with normoglycemic ones (P-value<0.05). Multivariable age-, sex-, BMI- and smoking- adjusted logistic regression showed a predicting role of pre-diabetes and NAFLD concurrence with metabolic syndrome (P-value<0.001, OR:4.31, 95 CI: 2.95- 6.29), but not CVD (P-value=0.353, OR:1.37, 95 CI: 0.71- 2.61). Conclusion In this study, nearly one-third of NAFLD patients had pre-diabetes. The mean value of age, BMI, TG, waist and Hip circumference was significantly higher in pre-diabetic patients. The concurrence of pre-diabetes and NAFLD was a predicting factor for metabolic syndrome, but not CVD events
PD-L1 importance in malignancies comprehensive insights into the role of PD-L1 in malignancies: from molecular mechanisms to therapeutic opportunities
No full textThe phenomenon of upregulated programmed death-ligand 1 (PD-L1) expression is common in numerous human malignancies. The overexpression of PD-L1 significantly contributes to immune evasion because its interaction with the PD-1 receptor on activated T lymphocytes impairs anti-tumour immunity by neutralizing T cell stimulatory signals. Furthermore, beyond its immunological interface, PD-L1 possesses intrinsic capabilities that directly modulate oncogenic processes, fostering cancer cell proliferation and survival. This dual function of PD-L1 challenges the efficacy of immune checkpoint inhibitors and highlights its possible application as a direct target for therapy. Recent discoveries concerning the cancer cell-intrinsic signalling pathways of PD-L1 have significantly enhanced our understanding of the pathological implications linked to its tumour-specific expression. These entail the orchestration of tumour proliferation and viability, maintenance of cancer stem cell-like phenotypes, modulation of immune responses, as well as impacts on DNA repair mechanisms and transcriptional regulation. This review aims to deliver an exhaustive synthesis of PD-L1's molecular underpinnings alongside its clinical implications in a spectrum of cancers, spanning both solid neoplasms and haematological disorders. It underscores the necessity for an integrated understanding of PD-L1 in further refining therapeutic strategies and improving patient outcomes
Psychometric Properties of the Persian Version of Sickness Impact Profile-30 (SIP-30) in Community-Dwelling Older Adults
No full textPurpose: Accurate measurement tools are essential for evaluating the health-related quality of life in older adults. We aimed to translate and evaluate the psychometric properties of the Sickness Impact Profile-30 (SIP-30) in community-dwelling older adults. Materials and Methods: One hundred and fifty older adults participated in this study. To evaluate construct validity, its correlation with General Health Questionnaire-28, Geriatric Depression Scale-15, Hospital Anxiety and Depression Scale, Modified Health Assessment Questionnaire, Numeric Pain Rating Scale, and Fullerton Advanced Balance Scale was assessed. Reliability features were also investigated. Results: The results of construct validity analysis demonstrated a moderate to high (r = 0.61-0.84) correlation between the total score of SIP-30 and GHQ-28, GDS-15, HADS, MHAQ, and NPRS. There was a moderate inverse (r = -0.67) correlation between the total score of the SIP-30 and the FAB Scale. Test-retest reliability (ICC > 0.83) and internal consistency (alpha = 0.94) of the Persian SIP-30 were high. Conclusions: The results indicated that the Persian SIP-30 is a reliable and valid measure to assess health-related quality of life in community-dwelling older adults
The study of pubertal stage and age of menarche in girls in Isfahan province, Iran
No full textBackgroundThe onset age of pubertal changes varies widely among girls and has undergone changes over time around the world. This study aimed to determine the age of onset of puberty in healthy Iranian girls living in Isfahan province.MethodsThis cross- sectional study was conducted among 13,886 students aged 6-18 years. They were selected by multistage random cluster sampling from urban and rural areas of Isfahan province of Iran. Pubertal stage was determined according the 5-level Tanner stages proposed by Marshall and Tanner. Trained physicians determined the breast development through both visual inspection and palpation, in addition, mothers assessed their daughter's pubic hair growth using Tanner's Sexual Maturation Scale (SMS) by comparison to standard pictures. The data were analyzed by the status quo method. Probit regression analysis was used to evaluate the median age of onset for each characteristic including menarche, breast and pubic hair.ResultsA total of 13,886 healthy girls with mean age (SD) of 11.97 (2.9) were studied. Overall 6968 (50.2) girls experienced menstruation with a median (95CI) age of 12.05(11.88-12.21) years at its onset. The median age for onset of breast development was 9.89 (95 CI: 9.77 - 10.02) years and for onset of pubic hair development was 10.14 (95 CI: 9.88- 10.39) years. The 3rd percentile for breast stage 2 (B2) and pubic hair stage 2 (PH2) was 6.85 and 6.75 years, respectively, and the 97th percentile for B2 and PH2 was 12.94and 13.54 years, respectively.ConclusionAccording to our findings, the onset of puberty before 6.85 years should be considered as precocious puberty for Iranian girls. Our study indicated the secular trend toward earlier menarche in girls. Nationally representative surveys and longitudinal studies are necessary to determine the exact age of puberty for future international comparisons
Molecular Assays Versus Mycological Methods for Diagnosis of Rhino Orbital Mucormycosis: Analysis of 120 Clinical Specimens from COVID-19 Patients
No full textBackgroundMucormycosis, a fungal emergency, poses a serious threat to both COVID-19 and non-COVID-19 individuals due to its invasive nature, rapid progression, and high rates of morbidity and mortality. This underscores the crucial need for timely detection and management. In this study, we investigated the utility of real-time PCR (RT-qPCR) assays for detecting Mucorales in clinical specimens, and assessed the performance of both SYBR Green and TaqMan probe RT-qPCR in amplifying Mucorales-specific 18S rDNA genes. We conducted accuracy analyses using direct examination with KOH as a standard for the laboratory diagnosis of mucormycosis. Additionally, we compared the results with culture and duplex PCR.Patients/MethodsBoth SYBR Green and TaqMan RT-qPCR were optimized using Mucorales-specific oligonucleotides to amplify the conserved 18S rDNA targets. DNAs extracted from 120 rhino sinus specimens, which all were collected from COVID-19 patients upon suspicion of invasive fungal infections, were used for molecular diagnosis. The results of both RT-qPCR assays were compared with the result of direct microscopy, culture, and duplex Mucorales-specific PCR assay.ResultsSYBR Green real-time PCR produced a distinct melting temperature (Tm) pattern (80.24 +/- 0.70 degrees C) and detected Mucorales in 51 out of 120 clinical samples. When compared to direct examination with KOH, the standard method for diagnosing mucormycosis, SYBR Green PCR demonstrated a sensitivity of 91.67 (95 confidence interval (CI): 86.7-96.5) and a specificity of 90.28 (95 CI: 84.9-95.5). In contrast, TaqMan-probe PCR identified Mucorales in 34 out of 120 samples, with a sensitivity of 64.58 (95 CI: 56-73.1) and a specificity of 95.83 (95 CI: 92.26-99.39).ConclusionSYBR Green-based PCR can be used as a reliable confirmatory test for diagnosing mucormycosis, particularly in cases with atypical hyphae, mixed infections (featuring both septate and non-septate hyphae), or when the direct examination is positive but culture results are negative. The lower sensitivity of the TaqMan-probe PCR may be attributed to factors such as using a degenerate probe, which can lead to false-negative results
Cold plasma enhances the generation of reactive oxygen species and the uptake of nanoparticles in cancer cells
No full textObjectives: Cold plasma, which is a rich source of reactive oxygen species (ROS) and also generates them when it comes into contact with cells, is being investigated for its potential to target cancer cells. ROS are crucial in causing tumor damage and are divided into long- and short-term species. Among them, the analysis of shortlived radicals such as hydroxyl radicals (HO,) is much more important because they are primarily responsible for biological damage and can also generate long-lived radicals. Moreover, selecting nanoparticles (NPs) to treat cancer is important; however, what matters most is how well the NPs are absorbed by the tumor. To minimize adverse effects, the challenge of many cancer treatments is selectivity. Cold plasma and gold (GNPs) were used in this study to target melanoma cells, and increase ROS production and GNP absorption. Methods: The research involved testing efficiency with an MTT assay on melanoma cells and selectivity on healthy fibroblast cells. Flow cytometry measured apoptosis rates, whereas a chemical dosimeter measured the amount of free radicals generated in each treatment group. The average gold content absorbed in each cell was measured with inductively coupled plasma optical emission spectroscopy (ICP-OES) with and without cold plasma therapy. Results: The findings demonstrated that while cold plasma caused cancer cells to undergo apoptosis, healthy cells remained unaffected. This effect was greatest when GNPs were used. The presence of cold plasma led to the significant production of HO,. Additionally, it was observed that cold plasma enhanced the uptake of GNPs in cancer cells while having no effect on healthy cells. Conclusion: The findings of this study suggest that the approach of combining GNPs and cold plasma could offer an optimized targeted therapeutic option for addressing the challenges associated with melanoma management
The Heart Tissue Molecular Response to Resistance Training in Comparison to Irisin Injection: A Focus on VEGF Gene/Protein Expression and Correlations with Serum Irisin Levels
No full textBackground: Angiogenesis is crucial in the recovery and maintenance of heart function. Irisin may mediate the cardiac health-promoting impact of exercise training. The aim of this study was to comparatively assess VEGF gene/protein expression in the heart tissue and correlations with serum irisin levels following resistance training, in comparison to exogenous irisin injection. Methods: Twenty-one NMRI mice were randomly assigned to the three group (n = 7 for each group): control, resistance exercise, and irisin. Exercised mice, for 8 weeks, three sessions per week and four sets of five repeats for each session were considered and mice climbed up a 1-m-height ladder with a slope of 80 degrees with a weight equal to 30 of mouse's body weight fastened to their tails and gradually increased up twofold of body weight. The Irisin group received 100 mu g/kg/week irisin for 8 weeks, intraperitoneally. The cardiac expression of the VEGF gene, by real-time PCR, the level of VEGF protein, by IHC (immunohistochemistry) and western blot analysis, and serum irisin concentration, by ELISA, were evaluated. Results: The expression of the VEGF gene and protein, as well as serum Irisin levels, increased in all experimental mice compared to the control group (P 0). Conclusions: There appears to be an interaction between resistance exercise and cardiac angiogenesis factors, mediated by irisin. So, irisin could be considered in cardiovascular health interventions, aiming to target specific molecules or pathways
Protective Effects of Donkey Milk on Ethanol-Induced Gastric Ulcer in Rat
No full textGastric ulcer (GU) is the most common health concern that occurs due to an imbalance between gastric protective mucosal and aggressive factors. Ethanol-induced GU in animal models resembles the pathophysiology of human ulcers. Natural products with fewer side effects are highly requested to attenuate their GU effects. The present study was conducted to investigate the potential protective effects of donkey milk against ethanol-induced GU in rats. The male Wistar were divided into four groups, including normal control (distilled water), donkey milk (1 cm3/animal) and ranitidine (200 mg/kg). Donkey milk and ranitidine were given to rats orally daily for 10 consecutive days before induction of ulcer by ethanol. After 24 h of fasting, GU was induced by oral administration of ethanol. After an hour, the rats were sacrificed, and gastric samples were taken for pathologic analysis, malondialdehyde (MDA) and glutathione (GSH) assessments. The results showed that the severity of ethanol-induced gastric damage was significantly reduced by donkey's milk pretreatment and then ranitidine. Reduction of ulcer score and MDA level, and also increasing GSH in the gastric tissue in comparison with other groups supports our results. This study described the gastroprotective and antioxidative effects of donkey milk that were determined with ulcer inhibition percentage
Pulmonary Valve Replacement Using an Intraoperatively Created Trileaflet Autologous Pericardial Valve: A Case Series
No full textBackground: Pulmonary valve replacement is inevitable for the majority of patients with long-standing pulmonary regurgitation. The purpose of this study was to describe the experience of employing a novel technique to create an intraoperatively handmade trileaflet pulmonary valve with glutaraldehydetreated autologous pericardium (the AAA valve). Methods: This case series study was conducted from September 2018 to March 2021 at Shiraz University of Medical Sciences, Shiraz, Iran. The surgical technique involved harvesting and treating with glutaraldehyde of the pericardium, constructing a trileaflet valve by encapsulating the pericardium within a Dacron tube with a diameter of 22 mm and a length of 20 mm, and implanting it into the pulmonary valve position. Results: The AAA valve was constructed for 10 patients with a mean age of 16.20 +/- 5.81 years, seven of whom had undergone surgery for tetralogy of Fallot. The patients' mean follow-up length was 32.30 +/- 13.64 months. The AAA valve regurgitation was none to moderate. At the time of follow-up, all patients had AAA valve stenosis that was less than moderate, except for one case. Cardiac magnetic resonance imaging and echocardiography results confirmed mild leaflet motion restriction in the patient with moderate stenosis. The anatomic valve parameters in MRI revealed amean geometric height, coaptation height, and effective height of 20.23 +/- 2.40 mm, 10.42 +/- 1.67 mm, and 14.34 +/- 2.24 mm, respectively. One patient died from non-cardiac causes. Conclusion: The surgical establishment of a native pericardial valve in the pulmonary valve position yielded satisfactory short-term to midterm results and might be considered a viable alternative to the available options