Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 9 2021 10 12 516 523 Farzaneh Kianian Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Mehri Kadkhodaee Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Hamid Reza Sadeghipour Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Behjat Seifi Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2020 10 22 2021 01 25 Inflammation, and remodeling in airways are the two crucial characteristics of asthma, a common respiratory disease. In asthma pathophysiology, the recruitment of granulocytes finally results in inflammation, leading to lung damage. In this regard, failure to clear inflammatory cells by programmed cell death, apoptosis will cause the prolongation of inflammation. On the other hand, in airway epithelial cells, apoptosis may occur, resulting in airway remodeling. Hence, dysregulation of apoptosis has been suggested to contribute to the development of asthma. Importantly, knowledge of the factors related to apoptotic cascade seems vital to explore various pharmacological interventions for the treatment of asthma. In this review, we highlight several important apoptotic and anti-apoptotic factors contributing either to inflammatory cells or airway epithelial cells involved in asthma pathogenesis. https://acta.tums.ac.ir/index.php/acta/article/view/8889

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 9 2021 10 12 524 529 Mohammadhossein Dadgarnia Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Mohsen Abouii Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. Mohammadhossein Baradaranfar Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Sedighe Vaziribozorg 1. Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Vahid Zand Department of Otolaryngology- Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2020 09 28 2021 08 09 This study was attempted to investigate the prevalence of BRAF gene mutation (V600E) in aspiration cytology of patients with suspected papillary thyroid carcinoma (PTC). Seventy-six patients suspected of having PTC who were referred for fine-needle aspiration (FNA) biopsy were included in this cross-sectional study. Ultrasound-guided FNA was taken from the thyroid masses, and samples were sent for cytologic evaluation. Simultaneously, the samples were sent to a genetic laboratory to check the status of BRAFV600E mutation. Patients with FNA positive for PTC were assigned in one group, and those with FNA negative for PTC were assigned to another group. Cytological and molecular results were compared with those of histopathology and sonography. The results showed that the prevalence of the BRAF gene (V600E) mutation in our study was 21.1% (16 out of 76 patients). In addition, the results showed a significant relationship between gene mutation and pathologic findings so that the highest gene mutation was significantly detected in patients with FNA positive for PTC (P=0.001). Also, our results showed a significant relationship between gene mutation and some sonographic findings (calcification, P=0.004) and no significant relation in the other sonographic findings (hypoechoic changes, P=1.12 and regular changes, P=0.194). According to the results of the present study, BRAF mutation (V600E) can be an effective indicator for definitive diagnosis and primary treatment of PTC in suspected cases.   https://acta.tums.ac.ir/index.php/acta/article/view/8828

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 9 2021 10 12 530 535 Maryam Mardani Oral and Dental Disease Research Center, Department of Oral Medicine, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. Azadeh Andisheh-Tadbir Oral and Dental Disease Research Center, Department of Oral and Maxillofacial Pathology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. Sadaf Pourshahian Undergraduate Student, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran. Bijan Khademi Shiraz Institute for cancer research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Mahyar Malekzadeh Shiraz Institute for cancer research, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. 2020 08 30 2021 08 09 Despite a low prevalence, salivary gland tumors (SGTs) represent a diverse set of tumors with a broad range of biological behaviors. Implementation of early detection programs has significantly improved the outcome of treatment and patients' survival. High mobility group box one protein (HMGB1) may likely be a candidate for the detection of SGTs due to its background in other human tumors. This study, for the first time, aimed to investigate the clinical value of HMGB1 in patients with benign and malignant SGTs and analyze its correlation with clinicopathologic outcomes. Using an enzyme-linked immunosorbent assay (ELISA), the serum level of HMGB1 was measured in 85 patients with SGTs (30 benign and 55 malignant cases) and 85 age- and sex-matched healthy individuals. HMGB1 levels had a significant difference between patients with SGTs and healthy controls (2041.4±787.1 pg/ml versus 536.3±374.6 pg/ml, P<0.0001) as well as those with benign and malignant tumors (1680.1±429.7 pg/ml versus 2238.6±867.2 pg/ml, P<0.0001). The serum level of HMGB1 was associated with some clinicopathologic factors, such as the size of the main tumor, clinical stage, and the lymph node metastasis, but not with patients' gender, age as well as the site of the lesions. These results suggest that the serum level of HMGB1 has the potential to be a supportive diagnostic marker for SGTs and can provide a precise assessment of the tumor status. There is no published report regarding the serum level of HMGB1 in SGTs; therefore, further studies are warranted. https://acta.tums.ac.ir/index.php/acta/article/view/8764

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 9 2021 10 16 536 544 EN Dolina Gencheva First Department of Internal Diseases, Section of Cardiology, Medical University-Plovdiv, Plovdiv, Bulgaria AND UMHAT “Sveti Georgi” Plovdiv, Clinic of Cardiology, Plovdiv, Bulgaria Fedya Nikolov First Department of Internal Diseases, Section of Cardiology, Medical University-Plovdiv, Plovdiv, Bulgaria AND UMHAT “Sveti Georgi” Plovdiv, Clinic of Cardiology, Plovdiv, Bulgaria Ekaterina Uchikova Department of Obstetrics and Gynaecology, Medical University-Plovdiv, Plovdiv, Bulgaria AND UMHAT “Sveti Georgi” Plovdiv, Clinic of Obstetrics and Gynaecology, Plovdiv, Bulgaria Rosen Mihaylov Independent Medical Diagnostic Laboratory“RAMUS”, Sofia, Bulgaria AND Medical College “Jordanka Filaretova”, Sofia, Bulgaria Blagovesta Pencheva Independent Medical diagnostic laboratory “RAMUS”, Sofia, Bulgaria Gita Yamakova-Vladova Department of Obstetrics and Gynaecology, Medical University-Plovdiv, Plovdiv, Bulgaria AND UMHAT “Sveti Georgi” Plovdiv, Clinic of Obstetrics and Gynaecology, Plovdiv, Bulgaria 2020 09 28 2021 08 09 Hypertensive disorders of pregnancy are one of the leading causes of fetal and maternal mortality worldwide. Aside from the immediate risk they pose for the pregnant woman, there is significant evidence that women after such a pregnancy have a long-term risk for the development of cardiovascular diseases. On the other hand, Galectin-3 is a biomarker that has proven its role in cardiac remodeling, fibrosis, and heart failure. To determine the levels of Galectin-3 in women with gestational hypertension, preeclampsia, and in healthy pregnant women and test for association with premature birth. A prospective single-center clinical, epidemiological study was performed, and data were analyzed for 123 pregnant women-36 with gestational hypertension, 37 with preeclampsia, and 50 controls. ELISA method was used to determine the serum levels of Galectin-3. Mean Galectin-3 level was 6,53 ng/ml in the controls, 7.30 ng/ml in the gestational hypertension group, and 7,59 ng/ml in the preeclampsia group. There was a significant difference in the levels between the controls and each of the pathological groups (P<0,05), while the two pathological groups were not statistically different from each other. Additionally, higher Galectin-3 levels were associated with an OR~2.5 for even preterm birth after adjustment for the presence of the two hypertensive disorders of pregnancy. Gestational hypertension and preeclampsia were associated with significantly higher levels of Galectin-3, which could be indicative of cardiovascular dysfunction in those women, and were also related to premature birth. https://acta.tums.ac.ir/index.php/acta/article/view/8829

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 9 2021 10 12 545 549 Mir Amir aghdashi Department of Internal Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran Khadije Makhdomi Department of Internal Medicine, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran. AND Nephrology and Kidney Transplant Research Center, Imam Khomeini Hospital, Urmia University of Medical Sciences, Iran Arash Rashidi Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran. 2020 07 20 2021 08 16 Lupus nephritis (LN) is a severe form of systemic lupus erythematosus (SLE) with renal involvement. It affects the kidneys in about 50% of SLE patients. The aim of this study was to assess the evaluation of proteinuria recovery time and its related factors associated with lupus nephritis patients in Urmia-Northwest of Iran. A retrospective cohort study was carried out, in which medical records of 80 patients with systemic lupus nephritis referred to Imam Khomeini university hospital were reviewed. According to these records, the biopsy-proven renal disease has been progressed from September 2009 to September 2013. Proteinuria, less than 0.5 g/24h, was defined as proteinuria recovery. The time elapsed from the diagnosis of proteinuria to its recovery is considered as the duration of proteinuria recovery (month). The findings were analyzed by STATA11 statistical software. The mean age at diagnosis of lupus nephritis was 26.50±8.10 years (14-51 years). The mean creatinine level at the start of treatment was 1.20±0.61 mg/dl (0.5-2.80). Proteinuria recovery time was four months for 25% of patients, six months for 50% of patients (median time), and 12 months for 75% of them. The higher class of LN had a trend toward 31 % lower risk of proteinuria recovery (HR: 0.73, 95% CI 0.56-0.96; P=0.02), the expected risk is 1.94 times greater in women as compared with men (HR: 1.94, 95% CI 1.1-3.48; P=0.02). The patients in this study population respond to treatment in less time, and in comparison with other studies, their proteinuria recovers earlier. Class of lupus nephritis (negative) and gender (positive) were predictive factors of proteinuria recovery among LN patients.       https://acta.tums.ac.ir/index.php/acta/article/view/8644

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 9 2021 10 12 550 554 Shiva Borzouei Department of Internal Medicine, Shahid Beheshti Hospital, Hamadan University of Medical Sciences, Hamadan, Iran Mohammad Eslahchi Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran Farzaneh Esna-Ashari Department of Community Medicine, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran AND School of Public Health and Research Center forHealth Sciences, Hamadan University of Medical Sciences, Hamadan, Iran Azar pirdehghan associate professor in community and medicine department,Hamadan university of medical sciences 2020 07 18 2021 08 09 Gestational diabetes is a metabolic disease that can have multiple maternal and fetal complications. Therapeutic adherence can help controlling blood sugar and reducing its complications. This study investigates the medication adherence among pregnant women and the effective factors on it. This cross-sectional study was conducted on 104 pregnant women with gestational diabetes who were referred to the endocrinology clinic of Shahid Beheshti hospital in Hamadan, Iran, in 2018. Input criteria were those over 18 years of age, and output criteria included heart, kidney, and thyroid disorders. Medication adherence was evaluated using Morisky's 6-question questionnaire (MMAS-6). Analyzes were conducted using SPSS version 21 at the significance level of less than 0.05. Based on the results, 77.9% of the women lived in the city, 65.4% had a college education, and 73.1% were housewives. 58.7% of them had good medication adherence. There was a significant relationship between adherence and glycemic control. Address and level of education had a significant relationship with medication adherence. People with higher levels of health literacy had significantly higher medication adherence. Low education level, rural residence, and low health literacy level are determinants of poor medication adherence in pregnant women with gestational diabetes, which indicates the need for more training for these people. https://acta.tums.ac.ir/index.php/acta/article/view/8638

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 9 2021 10 12 555 559 Mojtaba Meybodian Department of Otolaryngology,Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Mohammadhossein Baradaranfar Department of Otolaryngology,Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Sedighe Vaziribozorg Department of Otolaryngology,Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran Samira Mahmoodifar the quantity of dietary fiber for some foods. So, choosing some foods in accordance with those quantities may raise the risk of some chronic diseases. Calculation of dietary fiber quantity and assessment of proper dietary fiber levels in accordance with the Codex Alimentarius Commission (CAC), U.S. Food and Drug Administration (FDA), and the suggested method were accomplished in 8,027 foods. Choosing some foods in accordance with the CAC at 100 g or CAC and FDA at serving (the serving is taken from the RACC) to attain enough dietary fiber overstepped energy necessities and could cause obesity or overweight. Choosing some foods in accordance with the CAC at 100 g or CAC at 100 kcal to attain enough dietary fiber did not fulfill dietary fiber necessities and could cause dietary fiber deficits. Some foods that fulfilled dietary fiber necessities were not proper food options in accordance with the CAC at 100 g to attain enough dietary fiber. In the suggested method, the calculation of dietary fiber quantity and assessment of proper dietary fiber levels in foods are accomplished with consideration of RACCs and the energy quantity of foods. Hence, choosing foods in accordance with the suggested method fulfilled dietary fiber necessities and did not overstep energy necessities. https://acta.tums.ac.ir/index.php/acta/article/view/9411

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 1 2023 03 07 36 42 Ehsan Sadeghian Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Aidin Yaghoobi Notas Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Reza Eslamian Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Ali Ghorbani Abdehgah Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammadreza Mohajeri Tehrani Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Shariati Hospital, Tehran 2021 09 09 2023 01 27 Surgical site infection (SSI) is one of the most important complications of surgery and is known in quality improvement programs as a very important indicator for evaluating the performance of surgeons and hospitals. In recent studies, interesting effects for vitamin D such as antimicrobial effects, wound healing, immune regulation, etc. have been considered and the effectiveness of this vitamin on the above has been proven in laboratory environments and animal models. Therefore, the present study was designed and performed to evaluate the effect of vitamin D tablets before surgery on surgical site infection in patients referred to Shariati Hospital. This study was performed as a randomized controlled trial (RCT) on 200 patients who underwent surgery in Shariati Hospital in Tehran and in the general surgery department between 1397 and 1398. Patients were randomly assigned to two groups of 100 persons, including intervention and control. In all patients, vitamin D levels were measured and recorded 15 days before surgery. The intervention group included patients who received 2 tablets of fifty thousand units of vitamin D seven to ten days before the operation. The second group also included patients who did not undergo any intervention and only in order to maintain blindness of the same size and simultaneously with the first group. They received a placebo. Finally, all patients were followed at intervals of one, three, seven and thirty days after surgery and then compared to the extent of infection at the site of surgery and other desired variables. In this study, 200 persons with a mean age of 47.78 years were examined. 57.5% (115 persons) were female and the rest were male. Overall, 19 (9.5%) of the patients studied underwent surgery at the site of follow-up within one month of follow-up (14 in the control group and 5 in the intervention group). Detection between the two groups was observed in terms of infection (P=0.030). In general, based on the results of the analysis, in the present study, there was a statistically significant relationship between surgical site infection with low serum vitamin D level, increase in the number of hospital days, female gender, wound classification, ASA class of patients and vitamin D consumption before surgery. (P<0.05). The results of this study showed that there is a significant relationship between surgical site infection and consumption of edible vitamin D as well as serum vitamin D levels before surgery so that vitamin D deficiency can be considered as an independent risk factor for infection. Hospitals were considered, including surgical site infections. Therefore, performing preoperative tests as well as performing the required interventions can be very effective in improving this index and reducing surgical site infections. https://acta.tums.ac.ir/index.php/acta/article/view/9656

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 1 2023 03 07 43 51 Seyed-Mousa Mahdizadeh Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran . AND Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Monavvar Afzalaghaei Department of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran. AND Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Mehrsadat Mahdizadeh Social Determinants of Health Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. AND Department of Health Education and Health Promotion, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran 2021 09 14 2022 12 11 One of the global crises that people are dealing with today is the COVID-19 pandemic. The outbreak of this disease as a social phenomenon has affected all aspects of life. This study aimed to identify adult people's experiences during the COVID-19 outbreak. This qualitative research was performed with a conventional qualitative content analysis approach in Mashhad, Iran, from April to November 2020. twenty-five participants were selected through a purposeful sampling method with maximum diversity until data saturation was reached. Data were collected using semi-structured face-to-face interviews with open-end questions and analyzed with MAXQDA10 software. Two main categories were extracted (1) difficulties in multiple domains (psychological and informational problems, social challenges, spiritual and religious challenges, and economic problems), (2) adaptation to the epidemic (purposive self-care, ignoring the disease and health instructions, faith in God and optimism). The participants faced extensive challenges, which were made worse by the confusion and ambiguity about the information, quarantine, and social isolation. To continue living, the participants tried to adapt to situations. These results provide a guiding framework for policymaking and intervention. https://acta.tums.ac.ir/index.php/acta/article/view/9667

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 1 2023 03 07 52 56 Leili Koochakzadeh Department of Pediatrics, Children’s Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammad Kajiyazdi Department of Pediatric Hematology and Oncology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran