Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 2 2023 04 17 64 87 Amin Ebrahimi Sadrabadi Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran. AND Department of Research, Cytotech and Bioinformatics Research Group, Tehran, Iran Mina Masoudnia Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Haniye Bakhshi Department of Hematology and Cell Therapy, Faculty of Medicine, Tarbiat Modares University, Tehran, Iran Arsalan Jalili Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran. AND Hematopoietic Stem Cell Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran . AND Department of Research, Parvaz Research Ideas Supporter Institute, Tehran, Iran . Nasser Aghdami Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran 2021 08 24 2022 08 21 During chronic infections, a distinct physiological condition named “exhaustion” arises that is associated with the dysfunctionality in immune cells and their eventual removal from the environment, which evidently help the progress of infection or tumors in human or animal bodies. This state of immune cells could be under the control of different elements such as the antigen load, help from inhibitory cells, lack of costimulatory signals and etc. Exhaustion that has been found in different immune system cells, is usually accompanied by impaired effector function and proliferation of immune cells, poor memory recall, upregulation of inhibitory molecules, compromised metabolism and altered transcription program, and is considered a reversible process, unlike other physiological states like anergy or senescence, organized through the blockage of several factors. Although the emergence of these cells in viral infections and cancer is an undesirable event, the importance of the presence of exhausted cells in autoimmune diseases and organ transplantation is highlighted as a positive change. In this review, we aimed to determine the occurrence of this process in different immune cells, the characteristics obtained by these cells, effective and primitive factors on exhaustion, metabolic and transcriptional cell changes, and the use of these cells in autoimmune diseases and organ transplantation. https://acta.tums.ac.ir/index.php/acta/article/view/9625

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 2 2023 04 17 88 91 Mahmoud Rafieian-Kopaei Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran Hossein Amini Khoei Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran Mohammad Rahimi-Madiseh Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran 2021 01 12 2023 01 15 The use of animal models of diseases is essential for the study of the effects of various drugs and the discovery of new drugs. One of the most common problems in researches on diabetes in animal models is the high rate of mortality after diabetes induction. This leads to disrupt the grouping of diabetic animals for interventional evaluations. We introduce a protocol to reduce the rate of mortality in diabetic rats. To do this, we used alloxan at dose of 185 mg/kg to induce diabetes in rats. In this study in addition to provide 5% glucose solution in drinking water from 2 to 12 hrs post alloxan injection, 2 ml of 50% dextrose solution orally gavaged with 2 hrs intervals up to 12 hrs post diabetes induction, and also from 12 to 24 hrs following alloxan injection 2 ml of 5% glucose solution was given by gavage every 2 hrs. Furthermore, from 6 to 48 hrs post alloxan injection the rats were orally received 1 ml of Ringer's serum with 2 hrs intervals via gavage route. Moreover, one unit of Novolin 70/30 (70% NPH and 30% insulin regular) was subcutaneously injected in the back of the neck area for 5 consistence days from the second day post alloxan injection. In the sixth day following alloxan injection the level of glucose was at level of 280 mg/dL which considered as diabetic level. Our findings showed that by abovementioned interventions the rate of mortality significantly reduced (2 percent) and diabetes well established. https://acta.tums.ac.ir/index.php/acta/article/view/9086

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 2 2023 04 17 92 96 Faeze Abbasi Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran Haleh Dadgostar Department of Sports and Exercise Medicine, School of Medicine, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran Mahrokhsadat Vaziri Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran Sara Lotfian Department of Sports and Exercise Medicine, School of Medicine, Rasoul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran 2020 11 08 2023 01 15 The number of mountaineers and climbers has increased over the last few years. Considering the geographical features of Iran, this increase in the number of climbers is more significant in this country. Because of the importance of mountaineering injuries, a comprehensive survey of these injuries is needed. In this base, we designed a survey to investigate skeletal injuries in mountaineering accidents. This cross-sectional study was conducted on athletes from the Mountaineering Federation of Islamic Republic of the Iran (MFIRI) in 2015 and 2016. A total of 110 athletes were included using a simple random sampling method, and they were examined for any complications after skeletal injuries. Their medical records were reviewed. A total of 110 mountaineers completed the checklists, and 15 mountaineers reported a rock-climbing trauma and injury during 2015 and 2016. The most traumatic location was the lower extremities (46.7%). Additionally, most of trauma occurrences were in descent (80%) and times of day between noon and midnight (64.3%). The mean age of the mountaineers who had a trauma incidence was 37.95±8.76 years. Smoking was significantly different between the two groups. Skeletal injuries during mountaineering and rock climbing mostly affect the lower extremities, followed by the upper extremities and spine. There was no significant difference in age, sex or climbing equipment between the group who had an accident and the group who did not. In this study, there was a relationship between smoking cigarettes and an increased incidence of climbing accidents. Longitudinal studies with larger sample sizes are needed to evaluate this relationship. https://acta.tums.ac.ir/index.php/acta/article/view/8930

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 2 2023 04 17 97 104 Ériky Fernandes Guimarães Silva Campus Toledo, Universidade Federal do Paraná, Toledo, Brazil Bruna Fernandes Campus Toledo, Universidade Federal do Paraná, Toledo, Brazil Luan Gabriel Pinto Campus Toledo, Universidade Federal do Paraná, Toledo, Brazil Angélica Marcussi Campus Toledo, Universidade Federal do Paraná, Toledo, Brazil Anderson Dillmann Groto Campus Toledo, Universidade Federal do Paraná, Toledo, Brazil Federal do Paraná Kádima Nayara Teixeira Campus Toledo, Universidade Federal do Paraná, Toledo, Brazil 2021 01 13 2023 01 21 COVID-19 is caused by SARS-CoV-2 which has structural and non-structural proteins (NSP) essential for infection and viral replication. There is a possible binding of SARS-CoV-2 to the beta-1 chain of hemoglobin in red blood cells and thus, decreasing the oxygen transport capacity. Since hydroxychloroquine (HCQ) can accumulate in red cells, there is a chance of interaction of this drug with the virus. To analyze possible interactions between SARS-CoV-2 NSP and hemoglobin with the HCQ using molecular docking and implications for the infected host. This research consisted of a study using bioinformatics tools. The files of the protein structures and HCQ were prepared using the AutoDock Tools software. These files were used to perform molecular docking simulations by AutoDock Vina. The binding affinity report of the generated conformers was analyzed using PyMol software, as well as the chemical bonds formed. The results showed that HCQ is capable of interacting with both SARS-CoV-2 NSP and human hemoglobin. The HCQ/NSP3 conformer, HCQ/NSP5, HCQ/NSP7-NSP8-NSP12, HCQ/NSP9, HCQ/NSP10-NSP16 showed binding affinity. In addition, the interaction between HCQ and hemoglobin resulted in polar bonds. Interaction between SARS-CoV-2 NSP and HCQ indicates that this drug possibly acts by preventing the continuity of infection.   https://acta.tums.ac.ir/index.php/acta/article/view/9090

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 2 2023 04 17 105 108 Farrokh Heidari Otorhinolaryngology Research Center, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammadreza Firouzifar Otorhinolaryngology Research Center, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran Benyamin Mousavi-Asl Otorhinolaryngology Research Center, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran Sepideh Alvandi Otorhinolaryngology Research Center, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran Firouzeh Heidari Otorhinolaryngology Research Center, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran. Parnian Khamushian Otorhinolaryngology Research Center, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran Reza Ansari Otorhinolaryngology Research Center, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran Saeed Sohrabpour Otorhinolaryngology Research Center, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran Ebrahim Karimi Otorhinolaryngology Research Center, Amir A’lam Hospital, Tehran University of Medical Sciences, Tehran, Iran 2021 01 15 2023 01 21 Since the late 2019 months’ pandemic of Corona Virus Disease-2019 (COVID-19), it has spread globally and claimed abundant lives due to its expeditious interpersonal transmission and high mortality rate. Early studies showed that the upper aerodigestive tract procedures had the highest rates of nosocomial spread due to high viral load in upper respiratory and pharyngeal secretions. Between March 10 and April 10, 2020, a total of 28 rigid endoscopies were performed under general anesthesia for the removal of esophageal foreign bodies at our center. All the patients were screened on admission for symptoms of COVID-19 and a chest CT scan was performed and they were later followed up for further investigations. No patient had symptoms of COVID-19 (fever, cough, and dyspnea) on admission, and only one patient (3.57 %) had a suspicious CT scan for COVID-19. The mean age of 27 asymptomatic cases, including 14 men and 13 women, was 45.2 years old. Their average hospital stay was 0.8 days. all patients were later interviewed, inspected, and closely observed for any upcoming symptoms which would raise suspicion for COVID-19 during isolation. Of the 27 patients who cooperated, none showed COVID-19 symptoms. What makes this experiment prominent is that with suitable plans in a careful and precautionary manner, we can provide first-rate care for patients and meanwhile protect physicians during this pandemic promptly. Conclusion: what makes this experiment prominent is that with suitable plans in careful and precaution manner, we are able to provide first-rate care for patients and meanwhile protect physicians during this epidemic in a timely manner. https://acta.tums.ac.ir/index.php/acta/article/view/9093

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 61 2 2023 04 17 109 114 Alireza Kamali Department of Anesthesiology, School of Medicine, Arak University of Medical Sciences, Arak, Iran Ali Chehrei Clinical Research Development Unit of Ayatollah Khansari Hospital, Arak University of Medical Sciences, Arak, Iran Mohammad Hasanian Department of Radiology, Arak University of Medical Sciences, Arak, Iran. Masoomeh Sofian Infectious Disease Research Center (IDRC), Arak University of Medical Sciences, Arak, Iran. Masoud Bahrami Infectious Disease Research Center (IDRC), Arak University of Medical Sciences, Arak, Iran. Behzad Khansarinejad Department of Microbiology and Immunology, Arak University of Medical Sciences, Arak, Iran Nader Zarinfar Department of Infectious Disease, School of Medicine, Arak University of Medical Sciences, Arak, Iran. Rahmatollah Moradzadeh Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran Hosein Sarmadian Department of Infectious Disease, School of Medicine, Arak University of Medical Sciences, Arak, Iran Fateme Safi Department of Radiology and Radiotherapy, School of Medicine, Arak University of Medical Sciences, Arak, Iran 2020 12 04 2023 01 15 Novel coronavirus disease 2019 (COVID-19) has become a public health concern with over 6.5 million cases and 390,000 deaths around the world. This research aimed to find an association between computed tomography (CT) scores and clinical and laboratory findings to estimate the extent of lung infection in patients with COVID-19. The study sample enrolled 129 patients diagnosed with COVID-19 from January to February 2020. The chest CT images and clinical data were reviewed, images were segmented and scored by the degree of involvement from 0 to 4, and the relationship between them and clinical and laboratory findings were analyzed statistically. This study included 74 men and 59 women with a mean age of 55.08 years. Different abnormalities were observed; the mean CT score was 8.5 Medical Sciences, Abadan, Iran.AND Department of Health Information Technology, Abadan University of Medical Sciences, Abadan, Iran Fatemeh Maghsoudi Department of Public Health, School of Health, Abadan University of Medical Sciences, Abadan, Iran Mohammad Hosein Assareh Zadegan Dezfuli Student Research Committee, Abadan University of Medical Sciences, Abadan, Iran Ali Reza Balizadeh Karami Student Research Committee, Abadan University of Medical Sciences, Abadan, Iran Esmat Radmanesh Student Research Committee, Abadan University of Medical Sciences, Abadan, Iran. AND Department of Physiology, School of Medicine, Abadan University of Medical Sciences, Abadan, Iran 2021 02 19 2021 08 11 SARS-CoV-2 that causes Coronavirus disease 2019 (COVID-19) was first known in Wuhan, China, in December 2019. The aim of this study was to evaluate the level of common hepatic, renal, and cardiac diagnostic markers in hospitals in patients with severe COVID 19. In this study, 259 patients with symptoms of severe COVID-19 and a positive RT-PCR assay of nasopharyngeal samples were enrolled. Inclusion criteria are positive for COVID-19 patients at the diagnosis of an infectious disease physician. Diagnostic markers of liver, kidney, and heart were evaluated by age and gender. In this study, 48.3% of patients severe with COVID-19 were male, and 51.7% were female. The mean of markers such as LDH, Direct Bilirubin, SGOT, SGPT, D-dimer was higher than normal, which was observed in men more than women. The mean of CK-MB also was higher than normal, which was observed in women more than men. The highest mean of markers was seen in the older ages. The mean of BUN was observed in the age range of 55-64 years and above 65 years above normal. But the mean of CPK, creatinine, potassium and alkaline phosphatase were normal. The results of the present study showed an increase in the level of some of the most important diagnostic markers of hepatic, renal, and cardiac in patients with COVID 19. This increase was greater in some markers, including SGOT, SGPT, Direct bilirubin, LDH, D-dimer, in men than in women, and more in older patients. https://acta.tums.ac.ir/index.php/acta/article/view/9175

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 11 2021 11 17 662 668 Ali Asgari Infectious Diseases Research Center, AJA University of Medical Sciences, Tehran, Iran Ebrahim Hazrati Department of anesthesiology and critical care, AJA University of Medical Sciences, Tehran, Iran Saeed Soleiman-Meigooni Infectious Diseases Research Center, AJA University of Medical Sciences, Tehran, Iran Mohsen Rajaeinejad AJA Cancer Epidemiology Research and Treatment Center (AJA‐ CERTC), AJA University of Medical Sciences, Tehran, Iran Sam Alahyari Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Malihe Nasiri Department of biostatics, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2021 06 29 2021 08 11 The global crisis caused by the SARS Corona virus-2 infection is continuing through 2021, with more than 3.5 million deaths. Several risk factors for this virus’s severity and death were documented, including diabetes, hypertension, and ischemic heart disease. To evaluate the relation between serum vitamin D3 level, the disease severity, and prognosis of the patients with SARS Corona virus-2 infection. Patients with COVID-19 were evaluated for serum vitamin D levels and laboratory data. Correlation between vitamin D levels and laboratory data with disease severity and prognosis was assessed. Cox and logistic regression tests, as well as ROC curves, were used for data analysis. Ninety-eight patients with Corona virus-2 disease (COVID-19), which consisted of sixty patients with moderate COVID-19 in the general wards, and thirty-eight patients with severe COVID-19 in the intensive care unit (ICU), were evaluated. The mean age in the general wards was lower than in ICU (60.96±14.86 compared to 67.94±16.46, P=0.001), and the mean serum vitamin D level in the patients admitted in the general wards was higher than in the ICU (31 ng/mL compared to 20.57 ng/mL, P=0.003). Furthermore, vitamin D deficiency (25 (OH) D <25 ng/ml) significantly increased the risk of severe disease. (odds ratio=2.91, P=0.019) and mortality (odds ratio=3.64, P=0.026). Vitamin D deficiency is a risk factor for disease severity and poor prognosis in COVID-19. Vitamin D levels of 25 ng/mL can be used as a cut-off value for predicting severity and prognosis. https://acta.tums.ac.ir/index.php/acta/article/view/9507

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 59 11 2021 11 17 669 674 Akbar Soleymani Babadi Department of Pulmonary Diseases, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran Alireza Kashefizadeh Shahid Dr Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Nooshin Dalili Department of Nephrology, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. AND Chronic Kidney Disease Research Center (CKDRC), Shahid Beheshti University of Medical Sciences, Tehran, Iran Laya Ohadi Shahid Beheshti University of Medical Sciences, Tehran, Iran Abbas Gheisoori Department of Internal Medicine, School of Medicine, Shahid Mostafa Khomaeini Hospital, Ilam University of Medical Sciences, Ilam, Iran. Hossein Kazemizadeh Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2021 07 03 2021 08 09 The most lethal adverse effect of COVID-19 is acute respiratory distress syndrome, which can lead to rapid death. This symptom even causes concern for patients who have recovered and have been discharged. Therefore, it is obligatory to test and monitor variations in their lungs’ function after recovery. In this study, we evaluated the pulmonary function of 64 patients with severe COVID-19, six weeks to 3 months after discharge. Pulmonary function parameters were measured by spirometry and body box according to the criteria of the American Thoracic Society and under the supervision of an adult pulmonologist. According to the forced expiratory volume (FEV1)/forced vital capacity (FVC) ratio and total lung capacity (TLC) values, it was found that 3.1% of people had an obstructive pattern, 40.63% of