Acta Medica Iranica

The Immunomodulatory Role of Glucokinase 1 (GCK1) lncRNA in Patients With COVID-19

2026-08-26T13:04:49+0430

Individuals infected with Coronavirus Disease 2019 (COVID-19) may exhibit a wide range of clinical symptoms, from asymptomatic cases to severe complications. This variation is likely associated with differences in immune response intensity, where specific long noncoding RNAs (lncRNAs) are known to regulate the interferon (IFN) signaling pathway. The present study aimed to comparatively investigate the relationship between Glucokinase 1 (GCK1) lncRNA expression and immune system activity in individuals with COVID-19. A total of 100 participants were included in the study. The expression of the GCK1 lncRNA gene was quantified using quantitative real-time polymerase chain reaction (qPCR), and the concentrations of IL-12, IFN-α, IFN-γ, and tumor necrosis factor-alpha (TNF-α) in cell culture supernatants were measured via Enzyme-Linked Immunosorbent Assay (ELISA). The findings revealed a significant upregulation of lncRNA-GCK1 expression in COVID-19 patients compared with the control group. Additionally, the levels of IL-12, IFN-α, TNF-α, and IFN-γ were considerably higher in patients, suggesting a potential association between increased lncRNA-GCK1 expression and an intensified inflammatory response. Collectively, the findings highlight lncRNA-GCK1 as a potential key regulator of immune activation in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and a promising biomarker candidate for monitoring disease dynamics and treatment outcomes.

Evaluation of Comprehensive Hormonal and Growth Factor Biomarker Panel in Female Pattern Hair Loss

2026-08-26T13:05:01+0430

Female pattern hair loss (FPHL) is a common, multifactorial condition with a complex pathophysiology that remains not entirely understood. This study aimed to evaluate the diagnostic and prognostic values of several biomarkers (TGF-β1, DHEA, testosterone, SHBG, and the Free Androgen Index) in patients with FPHL. A case-control study was conducted in Iraq, involving 60 Iraqi women with FPHL and 60 healthy controls. Serum levels of the biomarkers were determined using ELISA. The Ludwig scale was employed to measure disease severity and its correlation with polycystic ovary syndrome (PCOS) or family history. Women diagnosed with FPHL exhibited significantly elevated levels of total testosterone, DHEA, TGF-β1, and FAI, alongside reduced SHBG and estradiol levels (P<0.0001 for all, except estradiol where P=0.0145). Following cross-validation and adjustment for multiple comparisons, FAI demonstrated excellent diagnostic accuracy (Adjusted AUC=0.96), while DHEA, total testosterone, and SHBG also displayed remarkable diagnostic efficacy (Adjusted AUCs> 0.90). TGF-β1, DHEA, total testosterone, and estradiol levels were positively correlated with disease severity. A significant correlation was observed between a positive family history and elevated Ludwig grades (P=0.0074). FPHL is associated with multiple hormonal imbalances that are not limited to increased androgen levels. FAI serves as a robust diagnostic marker, and the panel of TGF-β1, DHEA, SHBG, and E2 has potential diagnostic and prognostic value in clinical settings to guide personalized management. These findings support a multifactorial theory of FPHL and underline the importance of a comprehensive hormonal evaluation as part of the diagnostic algorithm for FPHL.

Investigation of the Association Between HSV-2 Virus and the Risk of Ovarian Cancer

2026-08-26T13:05:52+0430

Ovarian cancer is among the most lethal gynecologic malignancies, and its etiology remains poorly understood. Viral infections, including herpes simplex virus type 2 (HSV-2), have been hypothesized as potential risk factors. This study aimed to evaluate the association between HSV-2 infection and ovarian cancer risk in an Iranian population. A case-control study was conducted at Fatemieh Hospital, Hamadan, Iran, from 2021 to 2022, involving 38 women with histologically confirmed ovarian cancer and 38 age- and marital status-matched healthy controls. Data on demographic characteristics, obstetric history, sexually transmitted diseases (STDs), and family history of genital cancers were collected. HSV-2 serology was assessed using enzyme-linked immunosorbent assay (ELISA). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using univariate and multivariate logistic regression. A post-hoc power analysis was performed. Baseline characteristics were similar between cases and controls. Among cases, 52.6% had epithelial ovarian cancer, 26.3% serous tumors, and 21.1% borderline tumors. Univariate analysis indicated increased odds of ovarian cancer with Chlamydia trachomatis (OR 4.2, 95% CI: 1.04-16.6), HSV-2 (OR 3.1, 95% CI: 0.7-12.8), and STDs overall (OR 4.8, 95% CI: 1.8-12.7). In multivariate analysis adjusting for age, menopausal status, family history, and urban residence, STDs remained significantly associated (adjusted OR 4.8, 95% CI: 1.7-13.2, P=0.003). No significant associations were observed between infections and cancer subtypes. Post-hoc power analysis indicated approximately 35% power to detect the observed HSV-2 difference. Sexually transmitted infections may contribute to ovarian cancer etiology. However, due to low statistical power, the non-significant finding for HSV-2 should be interpreted with caution. Further studies with larger sample sizes are needed to clarify the role of HSV-2 infection.

Effect of Postoperative Hernia Truss Use on Complications Following Laparoscopic Inguinal Hernia Repair

2026-08-26T13:06:43+0430

Inguinal hernia repair is common, but postoperative complications such as pain, seroma, and recurrence remain concerns. Hernia belts have been proposed to provide external support and reduce these risks, though evidence is inconsistent. This study aimed to evaluate whether routine postoperative hernia belt use following laparoscopic transabdominal preperitoneal (TAPP) repair influences complication rates and recovery compared with standard care alone. This quasi-experimental study was conducted at Sina Hospital, Tehran University of Medical Sciences, between June 2023 and June 2024. Adult patients with primary inguinal hernia undergoing elective laparoscopic TAPP repair with mesh placement were enrolled and followed for 12 months. Participants were allocated to an intervention group (standard care plus hernia belt for six weeks) or a control group (standard care only). Primary outcomes included seroma, acute pain, hematoma, surgical site infection (SSI), chronic postoperative inguinal pain (CPIP), and recurrence. Secondary outcomes were length of hospital stay and time to return to normal activity. Statistical analyses included Fisher’s exact test, Poisson regression, and Mann-Whitney U test, with significance set at P<0.05. A total of 82 patients were included (52 in the hernia belt group, 30 in the control group). Baseline demographic and clinical characteristics were comparable between groups. Rates of complications were not significantly different: seroma (23.1% vs. 20.0%, P=0.790), acute pain (23.1% vs. 10.0%, P=0.235), hematoma (17.3% vs. 3.3%, P=0.084), SSI (7.7% vs. 3.3%, P=0.648), CPIP (17.3% vs. 20.0%, P=0.774), and recurrence (7.7% vs. 20.0%, P=0.159). The hernia belt group had a significantly longer median hospital stay (2 vs. 1 days, P=0.001) and a non-significant delay in return to normal activity (5 vs. 4 days, P=0.062). Postoperative hernia belt use following laparoscopic TAPP inguinal hernia was not associated with a statistically significant difference in complication rates and was associated with prolonged hospital stay. Routine use of hernia belts is not supported by current findings, though selective use in high-risk patients may warrant further investigation. Selective application in subgroups such as obese patients or those with large hernia defects may warrant further evaluation in multicentric trials.

Long-Term Recovery From Post-COVID-19 Hyperglycemia: A Three-Years Follow-Up Study in Iraq

2026-08-26T13:06:47+0430

The COVID-19 pandemic has caused several health problems, including newly diagnosed diabetes mellitus (DM) and new-onset hyperglycemia. Research indicates that some individuals with COVID-19 recover from hyperglycemia. To examine the long-term outcomes and factors that may predict recovery from new-onset hyperglycemia following COVID-19 infection over a three-year follow-up period. A prospective longitudinal cohort study was conducted involving 50 patients recently diagnosed with COVID-19 infection based on a positive RT-PCR test and a lung CT scan. All patients developed new-onset hyperglycemia upon admission, had no previous history of DM, had a normal recent HbA1c level, and had not used steroids before diagnosis. All patients were treated with insulin and/or an oral hypoglycemic drug during the periods of COVID-19 infection and hyperglycemia. The study included 50 patients with COVID-19 and new-onset hyperglycemia, of whom 62% were male, 50% were young, 52% were overweight, and 36% had CT lung severity scores between 20 and 30. After 6 months, 54% of the patients had recovered from hyperglycemia; this proportion increased to 60% after 1 year and 64% after 3 years. A higher likelihood of recovery from DM was observed among younger patients (P=0.003), those without a family history of DM (P=0.008), and those with lower CT lung severity scores (P<0.001). Most patients with new-onset hyperglycemia following COVID-19 infection recovered from DM, and the recovery rate progressively increased over the three-year follow-up period.

Development and Psychometric Study of a Persian Version of the Body Image Questionnaire for Individuals With Gender Dysphoria

2026-08-26T13:06:50+0430

Body dissatisfaction is a major concern among individuals with gender dysphoria, for the assessment of which psychometric tools with appropriate reliability and validity are needed. This study aimed (1) to translate and culturally adapt both gender versions of the English-language “Body Image and Satisfaction Questionnaire” (BIQ-M and BIQ-F: Meyer-Bahlburg, 2008) into Persian and (2) to conduct a psychometric validation study of the Persian versions. After translation and cultural adaptation, content and face validity were assessed. A total score for each gender version was calculated by summing responses to Likert-scaled dissatisfaction items. The Dissatisfaction Scales were analyzed for internal consistency (Cronbach’s alpha) and discriminant validity in a sample of 51 individuals with gender dysphoria (25 transgender women, 26 transgender men) and 43 cisgender individuals (20 men, 23 women). Group differences were examined using t-tests and ANCOVA. Explanatory factor analysis has been used to assess the construct validity of the questionnaires. Cronbach’s alpha coefficients for the Dissatisfaction Scales of BIQ-M and BIQ-F were 0.931 and 0.948, respectively. EFA showed four domains for each BIQ-M and BIQ-F questionnaires, describing more than 75% of the variations. Transgender participants scored significantly higher on the scales than cisgender controls (P<0.001). Item-level analyses confirmed these differences, and ANCOVA showed no significant confounding effect of age. The Persian versions of the BIQ-M and BIQ-F demonstrated excellent reliability and plausible construct and criterion validities, thus making them suitable for clinical and research use among Persian-speaking individuals with gender dysphoria.

Efficacy of Intravenous Dexamethasone and Magnesium Sulfate Injection on Pain After Laparoscopic Cholecystectomy

2026-08-26T13:08:50+0430

Postoperative pain is a complex physiological response to tissue damage. Providing effective postoperative analgesia prevents complications and improves patients’ quality of life. The present study aimed to compare the effects of intravenous dexamethasone and magnesium sulfate on pain after laparoscopic cholecystectomy (LC). In this double-blind randomized controlled clinical trial, 60 patients aged 18 to 70 years undergoing laparoscopic cholecystectomy were randomly divided into two groups, (dexamethasone group and magnesium sulfate group) after obtaining written consent. The magnesium sulfate group received 50 mg/kg of magnesium sulfate diluted in 100 mL of 0.9% normal saline after endotracheal intubation for 15 min, and group D received 0.1 mg/kg (up to a maximum of 8 mg) intravenous dexamethasone 15 minutes before anesthesia induction. Pain levels were compared between the two groups based on a Visual Analog Scale (VAS). Pain intensity decreased in both groups, but VAS scores was significantly lower in the dexamethasone group at 1, 2, and 24 hours after surgery. The incidence of complications including chills, itching, and nausea and vomiting was lower in the dexamethasone group, but no statistically significant difference was found. Heart rate and mean arterial pressure decreased in both groups. Hemodynamic stability was significantly higher in the magnesium sulfate group at 1, 2, and 24 hours after surgery. Although magnesium sulfate has fewer effects on patients’ hemodynamics and reduces pain intensity, the administration of dexamethasone has greater and more extensive effects in controlling pain and reducing complications in patients after laparoscopic cholecystectomy.

Comparison of Fibrinogen/Albumin Ratio Between Women With Recurrent Pregnancy Loss and Those With First-Time Miscarriage

2026-08-26T13:08:54+0430

The fibrinogen/albumin ratio (FAR) serves as a valuable marker of systemic inflammation and coagulation. However, its capacity to distinguish patients with recurrent pregnancy loss (RPL) from those experiencing a first-time spontaneous miscarriage has yet to be established. This study aimed to compare FAR levels between women with RPL and those who underwent a first-trimester miscarriage, as well as to assess the discriminative performance of FAR using receiver operating characteristic (ROC) curve analysis. In this cross-sectional, diagnostic-comparison study, 120 women in their first trimester were enrolled and divided into three groups: RPL, first-time miscarriage, and healthy early pregnancy (n=40 per group). Plasma fibrinogen and serum albumin levels were measured, and the FAR was calculated. Differences between the groups were analyzed using appropriate parametric or nonparametric methods. Subsequently, ROC analysis was performed to evaluate the area under the curve (AUC), optimal cut-off points (via the Youden index), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Women with RPL, compared with healthy pregnant controls, were characterized by significantly elevated fibrinogen (403.50±15.62 mg/dL vs 307.25±45.35 mg/dL), decreased albumin (332.25±32.78 mg/dL vs 376.25±44.36 mg/dL), and markedly increased FAR levels (1.2425±0.0699 vs 0.8289±0.1566) (all P<0.001). Compared with the first-time miscarriage group, the RPL group also showed higher fibrinogen (403.50±15.62 mg/dL vs 354.75±28.99 mg/dL), lower albumin (332.25±32.78 mg/dL vs 345.50±39.68 mg/dL), and higher FAR (1.2425±0.0699 vs 1.0434±0.1023) (P≤0.002). ROC analysis identified an FAR cut-off value of 0.975 for discriminating between RPL and healthy pregnancy (AUC=0.875; sensitivity 82.5%; specificity 87.5%) and 1.083 for discriminating between RPL and first-time miscarriage (AUC=0.777; sensitivity 57.5%; specificity 65.0%). FAR is significantly elevated in women with RPL and strongly discriminates between RPL and healthy early pregnancy. It moderately discriminates between RPL and first-time miscarriage, suggesting that it could be useful as a screening/stratification biomarker but should not be used as a single diagnostic test for distinguishing between miscarriage subtypes. External multicenter validation, harmonized assay methods, and incorporation of FAR into multimarker predictive models are recommended prior to clinical implementation.

Metastatic Prostate Adenocarcinoma to Colon, Mimicker of Colon Carcinoma: Report of a Rare Case

2026-08-26T13:09:21+0430

Prostate cancer is the second most frequent malignancy in men worldwide. Approximately 20% of patients present with metastatic disease. The most common metastatic sites of prostate cancer are bone, lung and pleura, non-regional lymph nodes, liver, adrenals, and brain. Metastasis of prostate cancer to the stomach and intestines is rare. Differentiation between primary and secondary colorectal cancers is difficult. Here we report a 70-year-old man who was referred to the hospital with abdominal pain, weakness, and melena. An abdominopelvic computed tomography scan was done for further investigation. As a result, colon wall thickness was increased and multiple metastatic bone foci were present. Microscopically, the results revealed malignant tumor of atypical cells with hyperchromatic nuclei. The pathologist reported a malignant undifferentiated tumor and suggested immunohistochemistry (IHC) for differentiation between malignant lymphoma and carcinoma. According to high serum PSA level, a PSA staining was also suggested and performed. IHC results showed positivity for CK (Cytokeratin) and PSA, but negativity for CK7, CK20, and LCA (Leukocyte Common Antigen) in favor of metastatic carcinoma to the colon of prostate origin.

A Rare Case of Hydatid Cyst Mimicking Multinodular Goiter With Multiorgan Involvement

2026-08-26T13:10:01+0430

Hydatid disease is a parasitic zoonosis caused by Echinococcus granulosus, most commonly affecting the liver and lungs. Involvement of the thyroid gland is extremely rare and can mimic more prevalent conditions such as multinodular goiter (MNG). A 26-year-old Iranian woman with a history of consuming contaminated water presented with a painless anterior neck nodule in the thyroid area. Initially diagnosed with multinodular goiter, she underwent total thyroidectomy under general anesthesia. later diagnosed histopathologically as a hydatid cyst of the thyroid, with concurrent cysts identified in the liver and spleen. This case highlights the importance of considering hydatid disease in the differential diagnosis of cystic thyroid lesions, particularly in endemic areas, and discusses diagnosis and management methods.