فهرست مطالب mohammad hadi karbalaie niya

As COVID-19 severity and related death is a challenging issue, the protective effect and predictive value of lymphocyte count are critical. The present study investigated the importance of lymphopenia on disease severity and death rate.

This retrospective cross-sectional study was performed from April 2020 to June 2020 on a total of 300 patients with confirmed COVID-19 who attended the Firoozgar Hospital affiliated with the Iran University of Medical Sciences, Tehran, Iran. All of the COVID-19 patients referred to the hospital during the study period and met the inclusion criteria were enrolled and divided into two groups of lymphopenia (lymphocyte count less than 1.0x109/L) (n=138) and non-lymphopenia (n=162). All patient data from the medical records were acquired and utilized for statistical analysis.

Of 300 patients 63.3% were male and 72% had underlying disease. The most common symptoms were dyspnea (50%), cough (41%), and lethargy (40%). Lymphopenia was associated with male gender (P=0.01). Additionally, mean age (P=0.02), ventilator need (P=0.03), and death (P=0.05) were significantly associated with lymphopenia compared to the non-lymphopenia group. The Lymphopenia group had lower levels of O2 saturation (P=0.04), AST (P=0.001), and ALT levels (P=0.02). Based on the chest CT scan results, there was a significant relationship between lymphopenia and the extent of pulmonary involvement (P=0.004)

Lymphopenia could clinically predict the severity of COVID-19. Lymphopenia was associated with male gender, older age, ventilator need, and death. Lymphopenia status had a significant relationship with reduced levels of O2 saturation, AST, ALT, and the extent of pulmonary involvement.

 The coronavirus disease 2019 (COVID-19) vaccines are very good at protecting individuals from serious illness, needing hospital care, and dying from different strains of the virus. However, vaccines might not completely prevent individuals from catching and spreading the virus, and this might depend on some personal factors.

 To find out the immune response of COVID-19 vaccines, this cross-sectional study conducted within June 2021 to May 2023 assessed different types of COVID-19 vaccine antibody responses among healthcare professionals and their associations with demographic factors and comorbidity risk factors.

 This descriptive-analytical study was conducted on recruited healthcare professionals from Sina, Imam Khomeini Complex, 501 AJA, Baqiayatallah, and Firoozgar hospitals in Tehran, Iran. The vaccines whose antibody response was investigated in this study are Sinopharm® (China), AstraZeneca® (United Kingdom), Sputnik® (Russia), and Covaxin® (India). Anti-spike, anti-receptor-binding domain (RBD), and anti-neutralizing immunoglobulin G (IgG) were evaluated by commercial kits according to instructions.

 This study involved 1 029 healthcare workers who were over 18 years old. The average age was 41.48 ± 9.9 years, and 602 (58.5%) of them were male. The vaccines they received were Sputnik V (392 or 38.16%), AstraZeneca (335 or 32.61%), Baharat (45 or 4.3%), and Sinopharm (255 or 24.82%). The Covaxin and AstraZeneca vaccines increased both anti-RBD and anti-neutralizing IgG Ab levels; however, the Sinopharm vaccine increased only the latter. The Sputnik vaccine was the least effective. Gender and diabetes influenced the antibody levels, but age did not.

 This study revealed the substantial effectiveness of COVID-19 vaccines in generating robust antibody responses among healthcare professionals. All four vaccine types, Sinopharm, AstraZeneca, Sputnik, and Covaxin, elicited significant antibody responses in over 70% of participants, highlighting the crucial role of vaccination in building defense against COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), originated more likely from Wuhan, China and spread across the world. According to WHO reports, the virus is responsible for the death of almost seven million people around the world until now. Considering the same clinical manifestations of SARS-CoV-2 and influenza virus, simultaneous infection of these two viruses may affect the treatment process of the patient. Thus, we investigated coinfection of SARS-CoV-2, influenza A (IAV) and B (IBV) in patients with respiratory syndrome from June to August 2021. Nasopharyngeal samples were obtained from 84 COVID-19 patients and were tested for detection of SARS-CoV-2, IAV and IBV by using Reverse Transcriptase Real-time Polymerase Chain Reaction. Out of 84 patients, we found 46 and three COVID-19 and influenza positive cases, respectively. Coinfection was only found in two cases. Both cases were female and aged above 60 years. Findings of the currents study represent low prevalence of the influenza virus infection in the 2021 influenza season as well as low coinfection rates with SARS-CoV-2. This low prevalence may be due to the preventive measurements against the COVID-19.

Celiac disease is a small bowel disorder that occurs upon exposure to dietary gluten and is followed by reduced absorption capacity of the intestine. Serological tests are usually used to assess the prevalence of the disease; however, serological tests without pathological results cannot give a precise assessment. In this regard, we attempted to determine the prevalence of celiac disease in the northern regions of Iran by performing a biopsy among adults with positive serological tests.

This was a population-based cross-sectional study. Serum level of tissue transglutaminase IgA (or, tTg-IgA) was assessed in 5148 individuals, and those with a positive serological test (serum anti-tTG IgA > 20 IU/mL) underwent a biopsy during upper gastrointestinal (GI) endoscopy. Symptoms and other accompanying disorders were also assessed in this study.

Among the 5148 participants, 23 patients (12 men) had positive anti-tTG IgA test (0.4%) with a mean age of 45.90 ± 12.45 years. The most common symptoms among the 23 individuals were abdominal distension (100%), abdominal pain (78.26%), chronic constipation (60.86%), and three (13.04%) of them had iron deficiency. 16 individuals out of the 23 accepted to undergo a biopsy during upper GI endoscopy. The pathology results showed that eight (four men) of them had biopsy-proven celiac disease (0.15%). The second serum IgA anti-tTG test was negative in individuals with negative pathologies.

The prevalence of celiac disease in Northern Iran was 0.4% and 0.15% based on serological and pathological results, respectively. Half of the patients with positive serum IgA anti-tTG test had negative pathological results, indicating the need to rely on a pathological assessment for a definite diagnosis.

 Since the beginning of the recent pandemic in December 2019, the growing waves of SARS-CoV-2 infection have been a major concern. Also, SARS-CoV-2 itself is increasingly developing during the pandemic. The development of a virus leads to emergent mutations and might change the virus-host interaction.

 The current study was conducted to investigate the prevalence of the circulating lineage of SARS-CoV-2 in Iranian COVID-19 patients.

In a cross-sectional study, nasopharyngeal samples of 83 SARS-CoV-2 positive patients, collected between December 2020 to May 2021 from multiple geographical locations in Iran, were studied. The nasopharyngeal samples were used for RNA extraction, and the extracted RNA was used for one-step RT-PCR analysis. Also, a specific primer pair for the spike was used for the amplification and sequencing via Sanger sequencing.

 Our findings revealed a high prevalence of the B 1.1.7 lineage of the SARS-CoV-2 variant after February 2020 in Iranian COVID-19 patients. The results showed some rare mutations, including M177I, I100C, I100T, L452R, N679K, Q173H, Y145H, A222V, and H49Y in evaluated samples.

 As a preliminary multicenter study in Iran, our study indicated the dominancy of the B 1.1.7 lineage in Iranian COVID-19 patients after February 2020 in all the evaluated provinces. Furthermore, 11 isolates represented deletion mutations in positions 209-211 of the Spike protein, similar to the Omicron (21K) variant (211 del only reported in the Omicron 21K clade). Follow-up studies are recommended for more comprehensive results.

Monkeypox is a smallpox-like viral infection caused by a virus of common origin between humans and animals, which belongs to the genus Orthopoxvirus, the Poxviridae family, and sub-family Chordopoxvirinae. The virus was first isolated in 1958 from a group of sick Macaca cynomolgus monkeys. Human infection with the monkeypox virus was first described in Central Africa in 1970 in a 9-month-old child from Zaire (1, 2). The disease is more common in the Congo basin countries of Africa and possibly West Africa, as well as the majority of human cases are reported from Congo basin countries (3, 4). Smallpox is a serious, contagious, and sometimes fatal infectious disease, and its name in Latin means "speckled" and refers to bumps that appear on the skin of the affected person's face and body. Smallpox has been prevalent for thousands of years but has now been eradicated after a successful worldwide vaccination program. The last natural case in the world occurred in Somalia in 1977. After removing the disease from the world, routine vaccination against smallpox was stopped among the public because it was no longer necessary to prevent. In 1970, when an infection with smallpox was close to being eradicated, a previously unknown Orthopox virus called monkeypox was detected in humans. The first known human case in the Équateur province of the Democratic Republic of the Congo occurred when a 9-month-old infant contracted a smallpox-like disease that was eventually confirmed by the World Health Organization as monkeypox in humans (3). Other similar cases occurred in Ivory Coast, Libya, Nigeria, and Sierra Leone between 1970 and 1971, which were attributed to monkeypox infection (2). The monkeypox virus was first isolated in 1958 from vesiculopustular lesions among monkeys kept at the Copenhagen State Serum Institute (5). The close resemblance between smallpox and smallpox in captive monkeys focused attention on the monkeypox virus as a potential threat to smallpox eradication. Before 1970, monkeypox was known only in inhumane hosts. Between 1970 and 1986, 10 cases of monkeypox were reported in humans from West African countries (Sierra Leone, Nigeria, Libya, and Ivory Coast) and 394 cases from the Democratic Republic of the Congo, Cameroon and Central African Republic (2). Monkeypox was limited to rainforests in central and West Africa until 2003 when the first cases were reported in the Western Hemisphere. In late spring 2003, several people in the U.S. Midwest were identified following exposure to meadow dogs (a rodent of the Cynomys species) infected with the monkeypox virus with a fever, rash, respiratory symptoms, and lymphadenopathy (6). Genomic sequencing of monkeypox clades isolated from the United States, West and Central Africa has determined the presence of two distinct clade clades of the virus. U.S. isolates were identical to west African clades. The clinical course of the disease was milder among people infected with the West African clade with minimal transmission from human to human compared to those infected with clades in the Central African region (7). In 2010, using the animal model of the prairie dogs in a re-independent study, it was confirmed that the Congo Basin monkeypox virus clade was more malignant than the monkeypox virus clades in West Africa (8). Therefore, the aim of this study was to provide general information about virology, clinical, diagnostic, virulence, control, and treatment of this viral infection. The Monkeypox virus belongs to the Poxviridae family, which also includes the bovine smallpox virus, vaccinia, and variola (smallpox). Poxviruses are the largest known vertebrate infecting viruses that infect humans and other vertebrates (subfamily Chondropoxvirinae species) as well as arthropods (subfamily Entemopoxvirinae species). There are about 70 known species of Poxviruses, classified in 28 genera and two subfamilies of Chordopoxvirinae and Entomopoxvirinae. The virions of these viruses contain the linear double-stranded deoxyribonucleic acid genome (dsDNA) and enzymes that synthesize messenger ribonucleic acid (mRNA). These viruses multiply in the cytoplasm of host cells (2). The chordopoxvirinae subfamily contains about ten genera that are genetically and antigenic related. The orthopoxvirus genus of the virus includes camelpox, bovine pox, Ectromelia, monkeypox, raccoon pox, Skunkpox, gerbil pox, Uasin Gishu (horsepox virus), vaccinia, variola and Vel pox (a rodent resembling mice). Many smallpox viruses are associated with a particular vertebrate species, suggesting that transmission of these viruses preferably occurs among certain species of vertebrates. Although random transmission to different vertebrate species can occur, no clinical and pathological conditions have been observed in infected hosts leading to the preservation of the virus in these accidentally infected species (9). Orthopoxviruses that can infect humans include variola, vaccinia, bovine smallpox, and monkeypox virus. The variola virus only infects humans, and the Vaccinia virus is a vaccine clade that does not exist in nature and is used to vaccinate smallpox. The Vaccinia virus originated in the 18th century from an unknown vertebrate species. Bovine smallpox can infect cats and cows and transmit the infection to humans as well (2). Monkeypox is also a rodent-infecting virus most seen in West and Central Africa. Unlike smallpox, the monkeypox virus can infect rabbit skin and can be serially transmitted through mouse inoculation. Four viral Orthopoxviruses that can infect humans cause macroscopic lesions on the inoculated chorioallantoic membrane of embryonic eggs (2). These viruses also differ in the ability to replicate in different tissue culture cells. Currently, however, the clearest results for recognizing differences have been obtained by restrictive patterns of viral DNA endonuclease (10). Some genetic differences have been observed between monkeypox viruses isolated from regions in west and central Africa. Genomic studies have shown strong evidence that the monkeypox virus is isolated from the ancestors of the variola virus. This is important because some researchers have been given the possibility that variola may evolve again from the monkeypox virus. Prior to the development of molecular methods, significant efforts were made to detect these four viruses using serological reactions. The results of these studies showed that these viruses share most antigens (11). Results were obtained using absorbed serum in agar diffusion gel test, but were quickly replaced by studies on biological characteristics and DNA limiting patterns. The development of relatively specific antigens has been very efficient for serological studies in humans and animals. For example, this is essential in the possible rapid diagnosis of infection caused by viruses belonging to the orthopox group of viruses, as well as differentiation from chickenpox, as it may cause confusion in adopting clinical measures. For this purpose, it is recommended that the shells of waste be sent to the diagnostic laboratory without a transfer device. Investigation of lesion shells with electron microscopy allows differentiation of orthopox and herpes viruses. Smallpox viruses can be detected in more than 95 percent of lesions, while the varicella-zoster virus can only be detected in half of the material from chickenpox cases. That means negative electron microscopy samples are highly unlikely to be infected with the monkeypox virus (2, 12, 13). Poxviruses are one of the largest and most complex viruses (14). They are brick-shaped particles that vary in width from 220 nm to 450 nm in length and 140 nm to 260 nm in width (15). Therefore, the monkeypox virus is so large that it can be seen by light microscopy and its structure can be solved by electron microscopy. However, a higher-than-limit magnification provided by electron microscopy is required for its ultrastructural separation. The virion consists of four main elements: core, lateral objects, outer membrane, and outer lipoprotein coating. The central core contains double-stranded viral DNA (dsDNA) and core fibers and is surrounded by a solid layer of rod-shaped structures known as the palisade layer. The central nucleus, palisade layer, and lateral objects are enclosed by the outer membrane, which is composed of many surface tubules. Spontaneously released virions often have external lipoprotein coatings, while virions released by cell degradation lack this coating. An adult virion contains at least 80 viral proteins (16).  The monkeypox virus genome is a large linear molecule (197,000 open pairs) of dsDNA, ranked among the largest viral genomes (16). Each end of the genome contains identical but opposite-directional endings with a size of about 6,000 bp (17) with a set of short burst iterations (18) and end-series pin rings (19). The genome consists of about 190 non-overlapping open reading frames (ORF) (more than 180 base pairs in length), containing at least 60 amino acid residues. Of these, there are four in reverse terminal replication (17, 20). The content of guanine and cytosine DNA of the monkeypox virus is low and about 31.1% (21). The two distinct genetic categories of the monkeypox virus include the clades of West Africa and Central Africa (16).

 Hepatitis B virus (HBV) is still the leading cause of hepatocellular carcinoma (HCC). HBV could persist in the low replicate state that is defines as occult hepatitis B virus infection (OBI). Recently, OBI has been defined important in the development and/or exacerbation of HCC and other liver diseases.

 This study tried to determine the frequency of OBI among liver tumor samples.

 This cross-sectional study was performed among patients with HCC and intrahepatic cholangiocarcinoma (iCCA) in hospitals affiliated with Iran University of Medical Sciences. Liver tumor samples (Fresh frozen and formalin fixed paraffin embedded) were processed for isolation of DNA and then subjected to molecular assays, including PCR examinations of HBV genes (S, X, and C), determination of viral loads, detection of HBV-cccDNA, phylogenetic analysis, and assessment of mutations in HBsAg and RT regions.

 In total, there were 93 participants, including HCC (n = 60), iCCA (n = 33); among which, 15% were detected positive for OBI. The OBI among HCC and iCCA were 18.3% and 9.1%, respectively. The mean intrahepatic viral load was 1.3 × 105 ± 1.4 × 102 copies/µl, and 5 had detectable cccDNA. The OBI subjects belonged to the HBV genotype D and subgenotype D1. In the HBsAg protein, T45N (33.3%) and P105A (25%) were the most prevalent mutations. N53K (33.3%), Y54H (25%), L80I (33.3%), and A113G (25%) were missense mutations that were observed in the RT domain.

 HBV-DNA was detected among liver tumor samples with negative HBsAg status. The results of viral load and cccDNA tests are important in identification and prognosis of liver diseases. It’s needed more precise molecular and cohort studies to clarify the functions of OBI in liver diseases.

 The present study was conducted to assess the pattern of HBV Core/Pre-Core mutations and HBV genotype in Iraqi patients with chronic hepatitis B virus (HBV) infection.

 In the current cross-sectional study in an Iraqi province, we evaluated 134 patients diagnosed with HBV hepatitis. We used PCR and, subsequently, Sanger sequencing to assess HBV Core/Pre-Core mutations. Sanger sequencing reads were further used for phylogenetic analysis and multiple sequence alignment. A phylogenetic tree was generated according to the neighbor-joining method.

 The current study revealed that 58 (45%) of the patients were male, and 72 (55%) of them were female. The mean age of the patients was 36 ± 12.7 years, and the mean duration of infection was 5.2 ± 4.8 years. The results revealed 21 nucleic acid alterations in the samples analyzed. The generated phylogenetic tree divided samples into two genotypes. Pre-core/Core mutations were significantly associated with the treatment received (P = 0.0.001) but not with laboratory parameters. Most samples were matched with the genotype D clade, while only four samples were positioned adjacent to the genotype E clade. Direct nucleic acid translation disclosed five nucleic acid variants (73T>G, 347T>G, 364A>G, 365T>C, and 366A>G) on the core protein.

 This study has detected 21 nucleotide variants and 5 amino acid alterations within the coding sequences of the C gene. This study revealed that genotype D represents the primary genotype for the identified viral infections. The current study highlights the importance of these mutations evaluation for future, more comprehensive studies.

 Brain tumors are all primary central nervous system (CNS) tumors with unclear etiologies and viral infections, especially human herpesviruses, which have emerged as a hot topic for comprehensive research.

 The present study aimed at assessing the molecular epidemiology of varicella-zoster virus (VZV) and its association with microRNA 122 (miR-122) expression in CNS tumor samples.

 Fresh frozen tissue samples were collected from 60 CNS tumor patients and 45 healthy controls. A nested PCR assay was performed to detect the VZV-DNA. Subsequently, the expression level of miR-122 was evaluated in the CNS tumor tissue samples of patients and the brain tissue samples were obtained from healthy controls, using a real-time PCR assay.

 Of 60 patients with CNS tumors, 29 were men and 31 were women. VZV-DNA was detected in 13.3% of the CNS tumor tissue specimens. There was no statistically significant association between the presence of VZV-DNA and different types of CNS tumors (P > 0.05). Furthermore, the expression level of miR-122 was significantly downregulated in the CNS tumor tissue samples obtained from the patients compared with those of the healthy controls (P < 0.05). Additionally, the expression level of miR-122 was significantly lower in the VZV-positive tumor samples as compared with those of the VZV-negative tumor samples and the healthy controls.

 Although VZV plays no direct role in the development of CNS tumors, the virus may affect the biology of CNS tumors by decreasing the expression levels of miR-122, which consequently leads to an increased risk of malignancy. However, the experimental data are not conclusive enough; so, further investigations are needed.

Among Human Immunodeficiency Virus (HIV)-infected individuals, Epstein-Barr virus (EBV) and Human Herpesvirus (HHV)-8 could cause significant illness as opportunistic infections. The purpose of the present study was to evaluate the prevalence of EBV and HHV-8 in saliva specimens obtained from HIV-1 infected Iranian individuals under the Highly Active Antiviral Therapy (HAART) regimen compared with naïve patients.

A cross-sectional study was conducted on 103 HIV-1 positive patients who attended the hospitals affiliated with the Iran University of Medical Sciences, in Tehran, Iran, from 2018 to 2019. Enzyme-linked immunosorbent assay (ELISA) test was performed to evaluate HHV-8 and EBV antibodies. A conventional polymerase chain reaction (PCR) was carried out on saliva samples to detect EBV infection and a nested-PCR assay for HHV-8 infection. SPSS (version 20) was used for statistical analysis.

Patients' mean age ± SD was 43.9 ± 16 (range 18-82 years), and from among 103 participants, 59 (57.3%) were male. The results of PCR showed that HHV-8 infection was found in 19 (18.4%), and EBV infection was found in 61 (59.2%) participants. Also, HHV-8 antibody was detected in 73 (70.9%), and EBV antibody in 97 (94.2%) patients. A significant association was observed between patients under treatment with HAART and HHV-8 DNA or EBV DNA infection in saliva.

HIV-infected patients demonstrated a remarkable rate of EBV and HHV-8 in saliva, which could have a great role in the shedding of viruses. Also, they may contribute to the establishment of further opportunistic infections and devastating complications.

Colorectal cancer (CRC) is the third common cause of malignancy in Iran, and its incidence rate has been raised due to an increase in individual and environmental risk factors.

The present study aimed to define the role of human papillomavirus (HPV) infection in CRC, then by drawing a phylogenetic tree, we aimed to analysis the sequences of isolated HPVs, and finally determine the viral genome physical status for HPV-16.

A nested-PCR (nPCR), direct sequencing, and INNO-LiPA HPV genotyping assay were carried out for HPV detection, and a quantitative real-time PCR assay (qRT-PCR) was conducted for the physical status of the viral genome.

Among 157 subsets, there were 66 cases and 91 controls. Moreover, 5.7% (9/157) were HPV positive by nPCR, among whom 9.1% (6/66) were cases and 3.3% (3/91) were control groups (P = 0.750). The qRT-PCR analysis showed three forms of integrated, episomal, and mixed forms in our three HPV-16 strains. A higher rate of HPV infection was detected in the CRC cases; however, it was not statistically significant.

Although there were limited positive results, higher ages (> 65) were related to HPV involvement and CRC outcome. Furthermore, 9.1% of the CRC cases were infected with HPVs. The HPV-16 genome integration is observed in high-grade cancer cases with severe malignancy in CRC patients.

Hepatitis C virus (HCV) genotype distribution is different in various regions. A variety of strategies could be used to detect HCV genotypes and subtypes. The aim of the present study was to introduce a genotyping method by an in-house protocol that could be used to determine HCV drug-resistant variants and phylogeny studies.

Samples from 91 patients with thalassemia were used for HCV genotyping by Cobas 4800 platform, and 50 cases of 1a, 1b, and 3a genotypes underwent amplification and sequencing of NS5A and NS5B by using consensus primers via conventional reverse transcription-polymerase chain reaction (RT-PCR) method. An ABI 3730xl system used for direct sequencing. Raw sequences were analyzed by popular bioinformatics software MEGA6 and CLC workbench 5. Phylogenetic construction was drawn using 1000 replicates bootstrap by the neighbor-joining method. Multiple sequence alignment (MSA) was performed for mutation detection.

Sequencing results of 50 HCV isolates subtypes 1a (31/45), 3a (15/22) and 1b (4/8) NS5A and NS5B genes showed there were 72 NS5A and 105 NS5B mutations. Moreover, 8 resistant associated substitutions (RASs) were identified in nine thalassemia cases by multiple sequence alignment (MSA) protein analysis. The phylogenetic tree construct drew confirmed by the Cobas HCV genotyping results.

The phylogenetic analysis could be a useful tool for HCV genotyping in case of determining the drug-resistant substitutions; however, it is time-consuming and needs expert analysis and interpretation. This preliminary study in Iranian patients with thalassemia introduces specific conventional RT-PCR to find RASs to direct acting antivirals (DAAs) and subtype determination at the same time.

During community-wide outbreaks, patients and their families may suffer from anxiety after making behavioral changes. This study aimed to investigate the anxiety, knowledge, and lived experiences of families with COVID-19 patients admitted to medical centers.

The present multi-center study was conducted by a mixed method using convenient sampling in hospitalized COVID-19 patients in Firoozgar and Rajaie Hospitals between May and July 2020. Anxiety was measured using a short form of the State-Trait Anxiety Inventory. The participants’ level of knowledge was assessed by an online questionnaire. The lived experiences of the families were explained through semi-structured interviews. Data were analyzed by Chi square, ANOVA, independent-samples t test, Kruskal Wallis, and Mann–Whitney tests in SPSS 16. P values≤0.05 were considered statistically significant.

The mean age of the 324 family members, who participated in the study was 45.1±13.3 years. The mean anxiety score of the subjects was 13.5±4.1, and 63.6% of the participants had moderate to severe anxiety. The subjects’ mean score for knowledge on COVID-19 was 7.15±1.32. The highest mean percentage of data received by the subjects on COVID-19 (42.7%) was obtained through radio and television broadcasting. A total of 251 important phrases were obtained from interview analysis and code extraction, out of which five main themes and 17 sub-themes were extracted.

Our findings showed that anxiety was relatively high in families with COVID patients during the pandemic, and it was associated with age, sex, income, and familial relationships. The level of knowledge on the COVID-19 disease in families was moderate. Therefore, relevant interventions and raising people’s awareness are recommended.

The human papillomavirus (HPV) is associated with more than 70% of the cervical neoplasm. The current study aims to evaluate the distribution of HPV genotypes in suspected women cytological specimens from Tehran, Iran.

In the current cross-sectional study, HPV genotype prevalence was investigated in 433 subject women. DNA extraction was performed by High Pure Viral Nucleic Acid kit. A semi-automatically hybriSpot 24™ (HS24) setting was used for HPV typing and data interpreted by hybriSoft™ software according to instructions.

Pathologic data showed 181 (41.8%) had non-malignant lesions, 212 (49%) had inflammation and 40 (9.2%) reported LSIL in primary Pap-smear result. HPV was found in 143 (33%) specimens and the most comment high-risk and low-risk HPV types were HPV-16 and -6, respectively. Also, 62 (43%) were co-infected with multiple genotypes includes, 34 (24%) cases had co-infection with two HPV types, 17 (12%) cases had co-infection with three HPV types, 6 (4%) cases had co-infection with four HPV types and 5 (3%) cases had co-infection with five HPV types. There was statistically different domination on high-risk genotype in most of the co-infected samples (p<0.01).

Current study indicates that the lesion pathology assessment was significantly associated with the HPV infection (p<0.01). Furthermore, the age group assessment shows that most of the HPV positive cases were 21 to 40 (p<0.01). The HPV infection prevalence in the current study was 33% and the most frequently reported high-risk and low-risk HPV types were 16 and 6, respectively.

The current preliminary study aimed to assess the clinical symptoms of the 67 Iranian COVID-19 patients and investigate the possible beneficial effects of the naproxen compared to the standard therapeutic regimen.

We assessed 67 COVID-19 patients. All COVID-19 cases were confirmed by computed tomography (CT) and real time-polymerase chain reaction tests. We evaluated the clinical symptoms of the patients at the admission time. Also, a group of 28 patients received naproxen besides their standard treatment. Clinical presentations, radiographic features, white blood cells (WBC) in peripheral blood, hemoglobin, platelets, C-reactive protein, erythrocyte sedimentation rate, blood urea nitrogen, lactate dehydrogenase, Albumin, and Creatine Phosphokinase were evaluated.

The patients' clinical symptoms show that cough (89.6%) was the most repeated signed at the admission time, followed by fever at 78.7%, fatigue at 70%, and myalgia at least 64.2%. Unilateral slight ground-glass opacity was the most abundant presentation by 64.1% in CT. The laboratory assessment in patients indicates that mean WBC was 6193 ± 3258 (x106 /L), and mean lymphocyte was 27.8 ± 12%. The survival rate and the hospitalization days for patients with or without the Naproxen regimen were not statistically significant.

The most common clinical symptoms in Iranian patients with COVID-19 at the admission time include cough, fever, fatigue, and myalgia. Based on the current study results, the survival rate and the hospitalization days for patients with or without Naproxen usage were not statistically significant. The laboratory parameters could not show any particular statistically significant differences.

Due to widespread of coronavirus disease 2019 (COVID‑19) infection, identification of its risk factors and clinical characteristics are important. The aim of the present study was to assess Vitamin D levels in individuals with severe acute respiratory syndrome coronavirus‑19 infection and to report on its potential as a predictive marker.

All patients, diagnosed with COVID‑19 infection from February 16 to March 21, 2020, and referred to Firoozgar Hospital, Tehran, Iran, were enrolled in this study. Vitamin D analysis was undertaken on patient serum samples using a commercial kit (Pars Azmoon Co., Tehran, Iran). SPSS v. 22 was used for statistical analysis.

Vitamin D serum concentration was analyzed in a total of 317 patients whose mean age ± standard deviation was 62.05 ± 15 years and with 62.5% being male. A significant association of Vitamin D level and death was observed. Higher levels of serum Vitamin D had protection against death (odds ratio = 0.955 [95% confidence interval = 0.923–0.988], P = 0.008).

As a preliminary study in the Iranian population who suffered COVID‑19 disease, we identified that Vitamin D deficiency was associated with a higher death rate and intensive care unit admission.

COVID-19 was first discovered in Wuhan, China, and has spread rapidly around the world. The most important manifestation of COVID-19 was ARDS-like lung injury at first, but the involvement of other organs, such as kidney, heart, liver, and skin, was gradually reported. It is important to report and share all atypical manifestations of this disease to help other physicians to gain more knowledge about this new viral disease. As mentioned, there are also studies that show different types of cutaneous involvement in these patients, but due to the lack of more detailed studies in this field, and on the other hand, the possible usefulness of skin lesions as a diagnostic or alarming sign in the COVID-19 era, in this study we report a COVID-19 patient with a large hemorrhagic blister similar to sepsis-induced skin lesion. Despite the lack of common symptoms of the disease, the lung scan of the patient was positive for COVID-19.

To the editor:Since the initial onset of the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic from Wuhan, China in December 2019, the virus is now spread all around the world, and the disease is named COVID-19. Based on the WHO report on April 18, 2021, there are now more than 140 million confirmed cases and three millions deaths due to this disease[1]. The virus pathogenesis, clinical features, and therapeutic approaches have comprehensively been reviewed[2]. In addition, it has been indicated that patientschr('39') medical background and the age factor are associated with the mortality rate[2]. Regardless of the clinical presentations and the disease mortality, the mental effects of the current pandemic among medical staff and the general population are critically important, and the pandemic might trigger stress, anxiety, and depression[3]........

Retinoblastoma tumors are the most common intraocular malignancy in childhood, leading to death after two years. The Human Adenovirus (HAdV) infection could be critical in the retinoblastoma pathogenesis due to the virus and retinoblastoma 1 interactions. The objective of the current study was to investigate the possible presence of the HAdV genome in the retinoblastoma patientchr('39')s tumors.

In this study, we evaluated the HAdV infection in 96 pathological confirmed retinoblastoma samples. The DNA was extracted from formalin-fixed paraffin-embedded blocks, and the virus infection was assessed using polymerase chain reaction. SPSS version 22 was used for statistical analysis.

The mean age ± SD of the retinoblastoma patients was 28.89 ± 17 months. In addition, the demographic evaluation indicated that 43 (46.7%) of patients were female. The retinoblastoma laterality assessment indicates 87 (90.4%) unilateral and 9 (9.4%) bilateral tumors. Growth pattern analysis indicates endophytic 58 (77.3%), exophytic 8 (10.7%), and 9 (12%) of tumors with mix endophytic and exophytic patterns. The polymerase chain reaction results could not found any evidence of HAdV infection in all 96 formalin-fixed paraffin-embedded samples.

The study results suggest that there is not any association between HAdV infection and retinoblastoma tumors in studied samples. The HAdV infection may not a concern in retinoblastoma pathogenesis. Further investigations are recommended in this field of study.

Direct-acting antivirals (DAAs) against hepatitis C virus (HCV) infection showed the presence of resistant-associated substitutions (RASs). The aim of the present study was to carry out a follow-up of patients with baseline RASs to report the impact of RASs on DAA therapy outcome.

In a cohort study, we analyzed NS5A and NS5B RASs among nine thalassemia cases by baseline RASs. In a 2-year follow-up, we analyzed viral markers and biochemical and hematological parameters of the participants and their sustained virologic response (SVR). Statistical analyses were performed using SPSS software version 22.

RASs for HCV subtype 1a included M28V, L31M, and H58P. For subtype 1b: L28M, R30Q, S24F, and C316N. And for subtype 3a: C316S, and S24F. In patients with cirrhosis (n = 5), ALT (p = 0.001) and AST (p = 0.007) levels were significantly reduced after treatment, and creatinine level slightly increased (p = 0.025). However, no significant data was observed in non-cirrhotic patients following the treatment. 

CONCLUSION:

The present study did not show any adverse effects of DAA therapy among patients with thalassemia suffering from chronic HCV infection with baseline RASs. Furthermore, reduction in ferritin and liver stiffness levels after DAA therapy could show the efficacy of DAA in such patients

 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [COVID-19] quickly turned into a pandemic. Gastrointestinal involvement, especially liver diseases, is one of the main complications of COVID-19 patients.

 The current study aimed to evaluate the high incidence of liver involvement in COVID-19 hospitalized patients and its association with mortality.

 A total of 560 hospitalized patients with a confirmed diagnosis of COVID-19 were included. Death was considered as the outcome. In addition to liver enzymes, demographic, clinical, and other laboratory data were also collected. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels ≥ 40 were considered as abnormal. To investigate the association between abnormal levels of liver enzymes and death, multiple regression logistic was used.

 According to the findings, 29.1% (95% CI = 25.3% - 32.9%) of patients had high levels (≥ 40 IU) of ALT, and 45.1% (95% CI = 40.9% - 49.3%) had high levels of AST (≥ 40 IU). The frequency (based on %) of high levels of AST (≥ 40 U/liter) was significantly higher in patients who died [67.3% (95% CI = 54.5% - 80.1%] of COVID-19 than those who survived [44.9% (95% CI = 39.7% - 50.0%)] (P-value < 0.001). No significant difference was detected in ALT between expired [29.1% (95% CI = 16.7% - 41.5%)] and survived patients [30.7% (95% CI = 25.9% - 35.5%] (P-value = 0.791). AST was found to have an independent association with death in multiple logistic regression (Wald = 4.429, OR (95% CI) = 1.014 (1.008 - 1.020), P-value = 0.035).

 Liver involvement is a common finding in COVID-19 hospitalized patients. Higher levels of AST were significantly associated with an increased mortality rate in COVID-19 patients.

Introduction:

Diabetes mellitus and hypertension are described as the most common comorbidities among COVID-19 patients. We investigated the adverse effect of ACEIs in diabetic and nondiabetic patients with COVID-19.

 Methods:

This prospective study consisted of 617 RT-PCR-confirmed COVID-19 inpatients. Demographic and baseline characteristics, underlying comorbid diseases, and antihypertensive drugs were evaluated. Study outcome (in-hospital death) was evaluated with the Kaplan-Meyer method and Cox regression model. Statistical analyses were performed with SPSS software for Windows. P values < .05 were considered significant.

Results:

 Mean ± SD age was 58.49 ± 15.80 (range: 18 to 94) years old. Cox regression analysis revealed that age (adjusted hazard ratio [HR] = 1.04, 95% CI: 1.03 to 1.06), diabetes mellitus (adjusted HR = 2.07, 95% CI: 1.32 to 3.26), immunocompromised patients (adjusted HR = 2.33, 95% CI: 1.29 to 4.21), acute kidney injury (AKI) (adjusted HR = 3.23, 95% CI: 2.01 to 5.19), ICU admission (adjusted HR = 2.48, 95% CI: 1.46 to 4.21), Asthma and COPD (adjusted HR = 2.13, CI:1.6 to 4.28) and ACEI (adjusted HR = 3.08, 95% CI: 1.56 to 6.06), respectively were associated with in-hospital death. Among diabetic patients, ACEI (adjusted HR = 3.51, 95% CI: 1.59 to 7.75), AKI (adjusted HR = 3.32, 95% CI: 1.76 to 6.45) and ICU admission (adjusted HR = 3.64, 95% CI: 1.530 to 8.65) were associated with increased mortality. The Kaplan-Meier survival curve showed a lower survival rate in diabetic patients with ACE inhibitor (adjusted HR = 3.36, 95% CI: 2.25 to 7.71).

Conclusion:

 ACEIs may harm the diabetic patient’s outcome with COVID-19. Further studies can confirm if ACE inhibitors have an adverse effect on COVID-19 diabetic patient’s mortality.

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection in many populations, including military recruits receiving basic training. Therefore, this study was set out to determine the molecular epidemiology, genotype and phylogenetic features of RSVs in patients with respiratory infection as a case study.

In this study, military barracks of Tehran, Iran, between January to March 2017 exposed to respiratory diseases were used for sampling. Throat swabs were taken, a reverse transcriptase-polymerase chain reaction (RT-PCR) assay was performed to identify RSV and then the genotyping and phylogenetic analyses of RSVs in patients with a respiratory infection.

Among 400 Iranian military trainees with respiratory symptoms, RSV infection was identified in 2.75% (11/400) using RT-PCR. Sequencing showed the incidence of type A (2.5%, n=10) to be much higher than type B (0.25%, n=1); Sore throat was the most common symptom among RSV patients. Phylogenetic analysis revealed that the majority of strains from the studied samples were more consistent with those from the Philippines and the US strains.

This study is the first to document RSV as a major cause of acute respiratory illness among military trainees in Iran. The prevalence of RSV is substantial in the cold season and the prevalence of genotype A is dominant in the country, leading to take essential steps in preparing a preventive vaccine against this viral infection.

Colorectal cancer (CRC) as a major health problem has increased globally. The etiology of CRC is among the critical issues. Smoking, obesity, and infectious diseases are probable risk factors of CRC. Meanwhile, chronic infections, such as chronic hepatitis B (CHB) is under investigation.

The aim of the present study was to determine the rate of HBV genome infection in patients with CRC compared with healthy subjects’ colon tissues.

Archived formalin-fixed paraffin-embedded (FFPE) blocks of 157 patients who underwent total colonoscopy that were referred to hospitals affiliated to Iran University of Medical Sciences, Tehran, IR Iran, were enrolled. They were categorized into 66 CRC cases and healthy colon tissues as the control group. After DNA extraction from FFPE specimens a Syber Green Real-time polymerase chain reaction (PCR) method was carried out. SPSS software version 16 was used for statistical analysis.

Of a total of 157 specimens, the mean age ± std. deviation of 66 patients with CRC was 59.3 ± 14.4, and 57.6% (38/66) of them were males. The mean age ± std. deviation of 91 healthy controls was 57.2 ± 14.6, and 57.1% (52) of them were males. By using real-time PCR we found that there were 6.4% (10/157) HBV positive, of them 9% (6/66) had CRC, and 4.4% (4/91) were healthy controls. Different variables did not have any significant differences.

Although some studies reported the association between HBV infection and CRC outcome, we could not prove it. It suggests the role of other risk factors in colorectal cancer incidence. Further studies with larger sample size and different study populations are recommended.

Hepatitis B virus (HBV) is the leading cause of hepatocellular carcinoma (HCC). The exact molecular contributors to the development of HBV-related HCC are not yet completely understood. Recent studies demonstrated that the deregulation of the Wnt pathway is highly associated with the development of HCC. Besides, HBV is known to have roles in the deregulation of this pathway. The present study evaluated the molecular aspects of the Wnt pathway in HBV-related HCC in liver tissue samples. Viral characterization was done by identifying the HBx mutations and the assessment of intrahepatic viral load. The expression of Wnt pathway genes was assessed using real-time PCR and methylation-specific PCR. The intrahepatic viral load was significantly higher in tumor samples than in normal tissues (P = 0.0008). Aberrant expression was observed in Wnt-1, Wnt-7a, FZD2, FZD7, β-catenin, URG7, c-Myc, SFRP5, and GSK3β, among which Wnt1, FZD2, SFRP5, Gsk3β, and URG7 were associated with HBV. HBx mutations at positions I88, L116, and I127 + F132 were associated with the decreased expression of GSK3β and overexpression of URG7 and Wnt1. Alterations in the expression level of β-catenin, as well as some mutants of HBx, were correlated with the level of c-Myc. HBV-related HCC seems to be mostly coordinated with epigenetic behaviors of HBx, such a multi-functional peptide with suppressing/trans-activating functions.