Ardabil University of Medical Sciences
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A case report on concurrent presentation of non-Hodgkin lymphoma and multiple myeloma
Get PDFBackground: The concurrent presentation of non-Hodgkin lymphoma and multiple myeloma is a very rare condition and only few cases have been reported.Case Presentation: In this case report, we discuss a patient who presented with abdominal pain, weight loss, and melena. After the patient’s admission, several examinations were conducted. Microscopic findings in pathological studies and immunohistochemistry staining studies revealed a malignant non-Hodgkin B-cell lymphoma. A monoclonal free light chain protein was documented in the urine protein electrophoresis. Serum protein electrophoresis was reported to be normal. Bone marrow biopsy demonstrated cellularity plasma cell aggregations as multiple myeloma. Small bowel segmental resection surgery was the treatment plan. To prevent the relapse of chemotherapy, rituximab in combination with cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy was tolerated by the patient. Finally, melena did not last after the resection and hemoglobin returned to its normal range.Conclusion: In conclusion, this case report suggests that both multiple myeloma and non-Hodgkin’s lymphoma are hematopoietic malignancies which originate from B-cell lymphocytes. To understand, properly manage, and treat this rare condition, multiple studies are required, and this can be achieved by comparing similar cases
Immunotherapeutic approaches to curtail COVID-19
No full textCOVID-19, the disease induced by the recently emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has imposed an unpredictable burden on the world. Drug repurposing has been employed to rapidly find a cure; but despite great efforts, no drug or vaccine is presently available for treating or prevention of COVID-19. Apart from antivirals, immunotherapeutic strategies are suggested considering the role of the immune response as the host defense against the virus, and the fact that SARS-CoV-2 suppresses interferon induction as an immune evasion strategy. Active immunization through vaccines, interferon administration, passive immunotherapy by convalescent plasma or synthesized monoclonal and polyclonal antibodies, as well as immunomodulatory drugs, are different immunotherapeutic approaches that will be mentioned in this review. The focus would be on passive immunotherapeutic interventions.
Interferons might be helpful in some stages. Vaccine development has been followed with unprecedented speed. Some of these vaccines have been advanced to human clinical trials. Convalescent plasma therapy is already practiced in many countries to help save the lives of severely ill patients. Different antibodies that target various steps of SARS-CoV-2 pathogenesis or the associated immune responses are also proposed.
For treating the cytokine storm induced at a late stage of the disease in some patients, immune modulation through JAK inhibitors, corticosteroids, and some other cognate classes are evaluated.
Given the changing pattern of cytokine induction and immune responses throughout the COVID-19 disease course, different adapted approaches are needed to help patients. Gaining more knowledge about the detailed pathogenesis of SARS-CoV-2, its interplay with the immune system, and viral-mediated responses are crucial to identify efficient preventive and therapeutic approaches. A systemic approach seems essential in this regard
Socioeconomic - related inequalities in overweight and obesity: findings from the PERSIAN cohort study
Get PDFBackground
Overweight and obesity are major health concerns worldwide, with adverse health consequences during the life span. This study measured socioeconomic inequality in overweight and obesity among Iranian adults.
Methods
Data were extracted from 129,257 Iranian adults (aged 35 years and older) participated in the Prospective Epidemiologic Research Studies in IrAN (PERSIAN) in 14 provinces of Iran in 2014. Socioeconomic-related inequality in overweight and obesity was estimated using the Concentration Index (Cn). The Cn further decomposed to find factors explaining the variability within the Socioeconomic related inequality in overweight and obesity.
Results
Of the total number of participants, 1.98, 26.82, 40.76 and 30.43% had underweight, normal weight, overweight and obesity respectively. The age-and sex standardized prevalence of obesity was higher in females than males (39.85% vs 18.79%). People with high socioeconomic status (SES) had a 39 and 15% higher chance of being overweight and obese than low SES people, respectively. The positive value of Cn suggested a higher concentration of overweight (0.081, 95% confidence interval [CI]; 0.074–0.087) and obesity (0.027, 95% CI; 0.021–0.034) among groups with high SES. There was a wide variation in socioeconomic-related inequality in overweight and obesity rate across 14 provinces. The decomposition results suggested that SES factor itself explained 66.77 and 89.07% of the observed socioeconomic inequalities in overweight and obesity among Iranian adults respectively. Following SES, province of residence, physical activity, using hookah and smoking were the major contributors to the concentration of overweight and obesity among the rich.
Conclusions
Overall, we found that overweight and obesity is concentrated among high SES people in the study population. . Accordingly, it seems that intersectional actions should be taken to control and prevent overweight and obesity among higher socioeconomic groups
Seroprevalence of Varicella Zoster virus in Mashhad population (15- 35 years old)
No full textObjective: Herpes zoster and Chickenpox is a highly contagious disease caused by infection with Varicella Zoster Virus (VZV). Although they are usually a self-limited disease, but severe complications may occasionally occur. The aim of this study was to investigate the seroprevalence of VZV antibody among teenage and young adults of Mashhad city.
Methods & Materials: Seven hundred and twenty four individuals aged between 15 to 35 years were enrolled to our study. Following serum isolation, each serum sample was assessed by ELISA technique for VZV IgG and IgM.
Results: the mean age of study participants were 25.52±5.72 years old. IgM antibody was not found in any participants. The seroprevalence of VZV IgG was 85.09%. The mean age of IgG positive participants was significantly higher than negative participants (p=0.001). Sex, education, marital status, cigarette smoking and comorbidities were not associated with the positive IgG (p>0.05). Marital status was independently associated with the presence of VZV IgG (p=0.44, β=1.20)
Conclusion: most of the study papulation were immune to VZV (85.09%). Marriage was the only determinant of positive IgG in our study
Dimensions analysis of the Hospital Survey on Patient Safety Culture questionnaire in Iran: Psychometric properties
No full textAim
The present study aimed to investigate the possible alternative factorial structure of the patient safety culture model in Iran.
Methods
This study was performed based on data collected by Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire from 420 staff in four hospitals. Internal consistency reliability and construct validity were evaluated by Cronbach's alpha and correlation analysis. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and structural equation modeling (SEM) were used to investigate the possible alternative factorial structure, examine and confirm the obtained structure, alternatively. Kaiser‐Meyer‐Olkin measure and Bartlett test were calculated to determine the factor ability of sample and fit of the factor analysis, alternatively. SPSS and AMOS version 25 were used.
Results
EFA identified 12 dimensions which one dimension has been also created from a new question. Distribution of items in all dimensions differed from the original HSOPSC questionnaire except two dimensions. The obtained structure was a proportional model. The calculation of Cronbach's alpha (∝ = .8) showed that, the internal consistency reliability was appropriate for all items in the questionnaire. Also, construct validity was acceptable for all factors.
Conclusions
The structure of the dimensions obtained in this study was not consistent with the structure of the original HSOPSC model
A comparison between the microleakage of Self-Adhesive Flowable Composite Resin and Two Step Self Etch Adhesive(6th Generation) as coronal barriers in non-vital bleaching
Get PDFBackground and Aim:
Whitening of teeth is one of the priorities in operative dentistry. One of the most useful approaches to bleaching the nonvital teeth, is walking bleaching method. In walking bleaching technique, a coronal barrier is used to avoid microleakage of bleaching agents. Glass Ionomer traditionally used as a coronal barrier but higher incidence of microleakage and the high cost of that material lead us to conduct that study to find a barrier with lower microleakage and better seal.
Since no study up to this date, has observed the effect of Two step self-etch Adhesive (6th generation) as a coronal barrier on prevention of microleakage in the walking bleaching technique, this study has been conducted.
Materials and Methods:
34 single-rooted, newly extracted Maxillary teeth which were from patients aged 45-65 with periodontal issues were selected for this study. Teeth were checked for any anomalies or severe caries and undergone root canal treatment and 2mm of canal filling material was removed for coronal barrier placement before the bleaching process. Next, they were divided into two experimental groups of 12 and positive and negative controls of 5. In one experimental group, Two Step self-etch Adhesive (Kuraray Clearfil SE Bond) and in another, a layer of self-adhesive flowable composite (Kerr Vertise Flow) and on top of that, Microhybrid composite (Kerr point4) were used with the same 2mm thickness above each study groups. In the negative control group, sticky wax was used to reach a complete coronal seal and in the positive control group, no barrier was placed on top of the root canal filling.
Following the placement of Cavit on teeth and incubation in 100% humidity and 37°c temperature, the process of walking bleaching with 35% hydrogen peroxide (Ultradent Opalescence Endo) was performed with the instructions of the manufacturing company in 3 rounds each with 3-day intervals and at the end, a 2% methylene blue solution was used to indicate the amount of microleakage inside the root canals of all samples. Buccolingual sections of all samples were prepared and observed with a stereomicroscope.
Results:
The mean microleakage in groups of 'Two - Step Self etch Adhesive', 'Self Adhesive Flowable Composite Resin', and 'Negative Control' was significantly lower than the 'Positive Control' group (P=0.002).
Also, the mean microleakage in 'Two-Step Self etch Adhesive' group was significantly lower than 'Self Adhesive Flowable Composite Resin' (P<0.001)
The difference of mean microleakage of the 'Negative Control' group was significantly lower than 'Self Adhesive Flowable Composite Resin' and 'Two - Step Self etch Adhesive' (P=0.04).
Conclusion:
The comparison of mean microleakage of experimental and negative control groups with the positive control group shows the placement of a coronal barrier has a noteworthy effect on reducing the amount of microleakage into the root canals in walking bleaching technique.
The significant difference between study groups and positive control group shows that we can use both material as a coronal barrier in nonvital teeth bleaching.
The comparison of the mean microleakage between the experimental groups shows significant difference and it can be concluded that 'Two-Step Self etch Adhesive' is better barrier for walking bleaching technique
Cutaneous Leishmaniasis Situation and Predicting the Distribution of Phlebotomus papatasi and P. sergenti as Vectors of Leishmaniasis in Ardabil Province, Iran
No full textAspirin Sensitivity in Patients with Moderate to Severe Asthma
No full textAsthma induced by ingestion of aspirin occurs when symptoms arise within 30 minutes to three hours after aspirin consumption. Previous data indicate that sensitivity to aspirin may be associated with poorly controlled asthma. This study aims to evaluate the frequency of aspirin sensitivity in patients with moderate to severe asthma receiving conventional asthma therapy. This clinical trial was conducted on 65 patients aged 18 to 65 years with moderate to severe asthma from February 2015 to February 2016 at the Allergy Department, Hazrat-e-Rasoul Hospital, Iran University of Medical Sciences, Tehran. To assess treatment responses in patients, forced expiratory volume in the first second (FEV1) and asthma control test (ACT) scores were measured at baseline and after 3 months. The results of the oral aspirin challenge revealed a prevalence of 35.38% for sensitivity to aspirin. Hypersensitivity reactions to aspirin were detected in 60.9% of the patients with moderate asthma and 39.1% of the patients with severe asthma. All patients with positive aspirin challenge tests suffered from rhinosinusitis and in 56.5% of cases, history of previous hypersensitivity reactions to nonsteroidal anti-inflammatory drugs (NSAIDs) was detected. No meaningful differences were found between those patients with aspirin sensitivity and those with aspirin tolerance neither in mean prebronchodilator FEV1 nor in ACT scores pre- and post-treatment. To conclude, aspirin sensitivity was not found to have an association with an unfavorable response to conventional treatment in patients with uncontrolled asthma
Comparative assessment of Fluride released and antimicrobial effects of three types of glass ionomer cements on streptococcus mutans and lactobacillus acidophilus
Get PDFBackground and Aim: Secondary caries is one of the main causes of the replacement of restorations. Glass ionomoer cement (GIC)has cariostatic properties due the ability for fluoride release. The aim of this study was to compare the antibacterial activity and fluoride release by three different formulations of GIC.
Materials and Methods: in this study , we evaluated fluoride release and antibacterial activity of three GISs including Fuji IX GP Extra, Fuji II LC and Equia Forte against Streptococcus mutans and Lactobacillus acidophilus. The antibacterial activity in well diffusion test and time kill curve was measured. The amountvof released fluoride was measured on the days 1, 2, 3, 4, 7, 14 and 21 by using specific fluoride electrode. We used analysis of variance (ANOVA), Sidak, Games-Howell and Tukey,s test at the significance level of 5%
Results: Fuji IX GP Extra Showed the highest antibacterial activity against both the strains and Equia Forte resulted in significantly lower. (P-value<0/001). Fluride release from Equia Forte significantly was at least (P-value<0/001).
No significant difference was denoted between Fuji IX GP Extra and Fuji II LC in this regard.(p-Value>0/05).
Conclusion: Fuji IX GP Extra had the greatest effect in inhibition of growth of Streptococcus mutans and Lactobacillus acidophilus compared with the other groups due to the fluoride release
Clinical Evaluation of Honey Throat Spray for Auxiliary Treatment of Pharyngitis
Get PDFBackground & objectives: Due to the increasing prevalence of bacterial resistance, there is a growing attention to application of auxiliary treatment of pharyngitis. The aim of this study was to investigate the effect of honey throat spray in the auxiliary treatment of patients with a diagnosis of pharyngitis.
Methods: At the start, different physicochemical quality parameters of the honey sample were evaluated. Then, the bottles of honey and the placebo throat spray were prepared. The numbers of 70 patients with the diagnosis of pharyngitis were included in a one-step and double-blinded study. In addition to standard treatment, each patient received either one of the honey or placebo throat spray. The clinical symptoms of the patients were compared between the two groups at baseline and then at 24 hours, 48 hours, 5 days and 10 days after the starting the treatment procedure.
Results: As per results, the quality of honey sample was met to the standard honey criteria. The treatment and placebo groups were statistically similar in terms of demographic specifications or clinical symptoms at the time to enter the study. Pharyngitis recovery was better in treatment group than in the placebo group; this positive effect was statistically significant for symptoms of morning phlegm and painful swallowing, 24 hours after the starting treatment. In treatment group, after 48 hours, symptoms of fever and painful swallowing were resolved, while this indicator was 23% in placebo group. Also, throat pain of 85.71% of patients in treatment group and 17.14% of patients in placebo group was relieved. Overall, the mean recovery time in treatment group was shorter than placebo group. Conclusion: The findings of this study showed that the use of honey throat spray as auxiliary treatment of pharyngitis can improve the clinical symptoms of pharyngitis and reduce recovery time