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 Soleiman Mohammadzadeh Department of Psychiatry, Neuroscience Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran Borhan Moradveisi Department of Pediatrics, Kurdistan University of Medical Sciences, Sanandaj, Iran Daem Roshani Social Determinates of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran Rasoul Nasiri Lung Disease and Allergy Research Center, Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran Alireza Eskandarifar Department of Pediatrics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran Armen Malekiantaghi Department of Pediatric, Bahrami Children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran Kambiz Eftekhari Department of Pediatric, Bahrami Children’s Hospital, Tehran University of Medical Sciences, Tehran, Iran. AND Pediatric Gastroenterology and Hepatology Research Center, Tehran University of Medical Sciences, Tehran, Iran 2020 07 17 2021 06 02 Chronic constipation is one of the most common problems in children. It can cause anxiety and psychological problems in patients and parents. The purpose of this study was to investigate the relationship between obsessive-compulsive disorders (OCD) in children with chronic functional constipation. This is a case-control study performed at the gastroenterology clinic of Besat Hospital Sanandaj for one year. The children aged 7-14-year-old with chronic functional constipation were selected as a case group, and the healthy children were recruited as a control group, who referred for growth control. Then, the Maudsley questionnaire for obsessive-compulsive disorders was completed by a trained assistant. With this questionnaire, the presence or absence of OCD and its type can be determined. Forty-three children were selected as the case group and sixty-seven children as the control group. The mean age of the case and control group was 9.3±1.5 and 8.8±1.6 years, respectively. Based on the results, there was a significant difference between the groups in terms of checking, cleaning, slowness, doubting, and total obsessive score (P˂0.05). Therefore, all five types of obsessive-compulsive disorder in the case group were greater than the control group. Obsessive-compulsive disorders were more common in children with functional constipation, and the total obsessive score in these children than the healthy children was a significant difference. https://acta.tums.ac.ir/index.php/acta/article/view/8635

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 8 2021 09 22 504 509 Maryam Deldar Department of Biostatistics, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran Robab Anbiaee Department of Radiotherapy, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. AND Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Kourosh Sayehmiri Department of Biostatistics, Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran 2020 11 17 2021 07 05 Predicting survival time has many Effective implications in life quality management for the remainder of the patient's life. Also, survival data are highly variable and make accurate predictions difficult or impossible. Random Survival Forest by repeated tree construction on Bootstrap samples and averaging on the results of these trees reduce the prediction error and cause further generalization of these results. In this retrospective study, the records of 141 patients with epithelial ovarian cancer who were referred to the oncology and radiotherapy ward of Imam Hossein Hospital in Tehran from 2007 to 2018 were used. Random Survival Forest was fitted to the data to investigate the key factors affecting the first recurrence of epithelial ovarian cancer. The mean age of the patients in our study was 52 (23-82) years and the median time to the first recurrence in these was 17 (0.5-127) months, respectively. According to RSF results, using variable importance criterion (VIMP) metastatic tumor with relative importance 2.665 and also using minimal (MD) by depth 2.349, tumor stage with relative importance 1.993 and depth 2.678, and maximum platelet count with relative importance 2.132 and depth 2.683 were the most important variables affecting in the first recurrence of Epithelial Ovarian Cancer. One of the disadvantages of classical methods is the inappropriate fitting of many variables and the need for specific assumptions. More advanced methods such as RSF without the need for any specific assumptions with less prediction error can well explain event variations when exposed to high-dimensional data. https://acta.tums.ac.ir/index.php/acta/article/view/8947

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 8 2021 09 22 510 512 Zahra Saffarian Department of Dermatology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Shahin Hamzelou Department of Dermatology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Fateme Shirzad Moghadam Department of Dermatology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran 2020 06 07 2021 08 09 Generalized pustular psoriasis is a rare variant of pustular psoriasis. During the pandemic of COVID-19, every patient referred to medical centers with fever or other flu-like symptoms would be first evaluated for COVID-19. Here, we report a case of pustular psoriasis who were under biologic immunosuppressive treatment (Infliximab) and was admitted to take her every eight weeks injection of infliximab. During evaluations before the injection, persistent fever and high CRP was detected. Due to these findings, she was suspected of having COVID-19, and this suspicion delayed routine medical care and infliximab infusion for her main disease, pustular psoriasis. After two negative results of the COVID-19 PCR test, Infliximab infusion was done, and surprisingly the fever disappeared, and CRP level decreased. https://acta.tums.ac.ir/index.php/acta/article/view/8530

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 8 2021 09 22 513 515 Atousa Hakamifard Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran Tahereh Gholipur-Shahraki Depa