mohammadhossein niknam

Depression is one of the current dilemmas in both developed and developing societies. Studies show that the severity of psychiatric symptoms is directly related to the degree of inflammation caused by cytokines secreted by the immune system. Hence, evaluating serum cytokine levels in patients with depression can help to understand the pathogenesis of the disease and make the best therapeutic decisions. The present study investigated the levels of inflammatory cytokines, tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), and interleukin-6 (IL-6) in patients with major depression or bipolar disorder during depressive episodes (BDDE) before and after a 6-month pharmaceutical intervention.
Patients referring to 3 clinics were recruited for the study. The diagnosis of major depression or bipolar disorder in a depressive phase was made according to the Diagnostic and Statistical Manual of Mental Disorders -5(DSM-5) criteria.
There was a significant difference in depression levels between the pre-intervention and 6-month follow-up in both groups. After 6 months, IL-1 and IL-6 levels in the bipolar disorder group had decreased while TNF-α levels had increased. There was also a significant difference between pre-intervention and follow-up levels of IL-1. Serum levels of IL-1 and IL-6 decreased significantly in both groups after the 6-month follow-up, and symptom improvement was observed. TNF-α levels, on the other hand, decreased in the major depression group but increased in the bipolar disorder group.
Considering that inflammation is a major outcome of depression, treatment strategies to reduce inflammation could be a practical approach to improving psychiatric symptoms.

 Ensuring food security is one of the main pillars of sustainable development and combating it should be considered as one of the major goals of a country’s economic and social development plans. This study aimed to review the current threats to food security in Iran and globally.

 This study is a review article based on reviewing scientific literature about food security and food and nutrition policy through reviewing resources available in internal and foreign databases using appropriate keywords ‘food security’, ‘Iran’, ‘world’, ‘food insecurity’, and ‘challenges’.

 The coronavirus 2019 epidemic, climate change, drought and water scarcity, food loss and waste, hot and cold wars and conflicts (types of sanctions), economic crises, and the global increase in food prices all increase the risk of food insecurity worldwide, especially in low-income countries. The government’s economic and supportive policies can directly affect the food basket of low-income households, needed to meet physiological and nutritional needs. Subsidies and government food aid programs can strongly affect food security. It is important to allocate subsidies to vulnerable groups; however, it should be targeted to meet the basic needs of low-income groups.

 In recent years, when the toughest sanctions were imposed on Iran, the Supreme Leader of Iran emphasized on paying attention to “resistance economy”. A resilient economy approach should be taken to ensure national food security through creating sustainable food and nutrition system with the cooperation of all development sectors, and more effective cooperation of the capacity of the Supreme Council of Health and Food Security. In this regard, environmental factors such as domestic water and soil capacities, reducing food loss, waste, and promotion of the production and consumption of local and traditional food, as well as supporting rural agriculture should be taken into consideration.

Ontological and epistemological foundations in the field of self-sacrifice and martyrdom culture are referred to the collection of Islamic knowledge that are used to determine the aims, principles, areas, stages, factors, obstacles, and methods of sacrifice and martyrdom culture which are explained and investigated in the field of nature of being, the reason for being, and the purpose of being.

This study was performed by the library study method and searching related keywords in Persian and English databases, and the main topics were extracted and categorized.

Among the most important foundations of the ontology of the social system of the Holy Qur'an, the principle of monotheism, purposefulness, being hierarchical, the existence of mutual relations in the universe, and obedience of the legislative system to the developmental system can be mentioned, and the summary findings can be the main basis of the values of the self-sacrifice and martyrdom culture.

The main basis of these values in Islam is the three principles of monotheism, justice, and resurrection. Self-sacrifice and martyrdom are formed through the Islamic values established in society, and until Islamic values and axes are not dominant in society, it is not possible to expect the formation of a self-sacrifice and martyrdom culture in society.

A transparent and realistic representation of the self-sacrifice and martyrdom culture requires identifying and rooting out harms and providing appropriate solutions to prevent or correct them. The aim of this study is to introduce the factors and barriers to promoting the self-sacrifice and martyrdom culture and to achieve the worthiest approach to preventing and correcting the threatening anomalies of the pure culture.

This part of the study is a qualitative and documentary analysis and has been done by searching reliable internal sources.

In a comprehensive review, four macro factors including "cultural", "economic", "political", and "international", and four specific factors including "strategic and policy-making", "environmental-social", "managerial and executive", and "promotion methods" were selected for this part of the study, and the damages related to each factor were identified.

The generalization of the humanizing culture of self-sacrifice and martyrdom to the general culture, educational, training, scientific, and administrative system of the country will be possible through honoring the memory of the martyrs and the epic of their stability and self-sacrifice and identifying, preventing and solving problems, challenges, and obstacles of this genuine culture.

Covid-19 has spread rapidly in the world and has affected the health and other aspects of human being life. The virus which causes this disease has various effects on mental health, and different segments of society such as patients, health care providers and general population. In this article, the effects of this virus on mental health and related risk factors are discussed.

For compiling this review, national and international articles from credible referrences have been used.

Symptoms such as anxiety, depression, post-traumatic stress disorder, psychological distress and stress were reported in the general population and patiets with COVID-19. Factors such as staying at home, social distancing, closing educational centers, mass lockdown, worry about being infected and transmission to others are the risk factors of these diseases.

COVID-19 has a dual effect on human mental health, one of the complications of this disease is psychological complications and on the other hand, patients with mental illness are prone to COVID-19.Considering the numerous and sometimes dangerous effects of Covid 19 on mental health, reducing the dangerous effects of these complications is one of the priorities of the health system. In order to properly manage the effects of Covid 19 on the mental health of the community, urgent call for more attention given to public mental health and policies and also cooperation of the policy makers, scientific experts and the community members to assist people through this challenging time are necessory.

Considering the announcement of national population policies by the Supreme Leader and the importance of efforts to comprehensively pursue the reform of the countrychr('39')s population structure, the issuesofwomen’s healthbecome one of the main priorities of this important issue.
Accordingly, in order to investigation of various dimensions of health and social and executive aspects of policies and programs for promotion of demographic structure of country and to explain the strategies for optimal use of existing capacities and synergy of resources in the current situation, the Department of Women Health of the Academy of Medical Sciences of the Islamic Republic of Iran run present study,aimed to address required services and infrastructure in the field of womenchr('39')s health.

In order to implement national population policies, benefitting from participation of all available relevant stakeholders and key informants, we conducted a specialized scientific experts meeting. Through this qualitative approach data gathering and analysis of finding followed based on content analysis method.

The results of this study show that in each of the four dimensions of physical, mental, social, and spiritual health of women, in order to implement population policies, we need to pay serious attention to the requirements and infrastructure that facilitate and accelerate this important provided.

Providing facilities and required infrastructure, by facilitating and accelerating the processes, provides the possibility of achieving the expected results. Adopting a comprehensive and participatory approach at all stages, from preliminary needs assessments to planning and implementation, is one of the points that can largely guarantee the successful implementation of population policies.

Due to the lack of approved treatment or vaccine against coronavirus, discovering and utilization of natural potentials of the human immunity system is essential in order to combat this virus.

Library studies and international databases including PubMed, Scopus, Google scholar were searched.

The innate immune system, mainly neutrophils and macrophages play a positive role in the initial defense against virus attack, but sustained responses and over expression of inflammatory cytokines and chemokines could lead to the destruction of involved tissues and their loss of function. Acquired immune systems, including T and B lymphocytes by eradicating infected cells, secreting response-boosting cytokines, and producing neutralizing antibodies try to eradicate the infection;however, in many patients this results in exaggeratedTh1 responses, uncontrollable inflammation and tissue damage. Anti-inflammatory, anti-viral, convalescent serum and supportive therapies are currently used for treating the critical patients but none of them show satisfying effects. Molecular and serological diagnostic techniques are rapidly evolving, and several ideas for designing anti-corona vaccines are under preclinical and clinical trials.

Preciseunderstanding of the quality and quantity of immune responses against corona virus and manipulating them in the right direction may be a good solution for COVID-19 problem. Immunology is involved in prevention (vaccine), treatment (anti-inflammatory drugs and enhanced defense) and diagnosis (molecular and serological methods) of COVID-19.

In Islamic culture, self-sacrifice and martyrdom are two the level of human perfection. Sacrifice is loss or something you give up, usually for the sake of a better cause or the offering of the life of a human being to a deity. Sacrifice is on a par with other religious duties through which man can reach the highest human level and be praised by God. Martyrdom is "consciously and selectively sacrificing one's life for the sake of a holy and pure ideal" for the sake of God in the words of the Qur'an ", which includes the pleasure of God", and one who attains such a position is a "martyr".

The study method is descriptive, field, survey and applied. This part of the study has been done with a focused group discussion with elites and experts, as well as search in the library and reliable internal sources.

In this section, the concepts of "Islamic value", "human value", "purpose and purposefulness", "martyr and martyrdom", "self-sacrifice and sacrifice", "freedom and liberty"; at the level of lexical semantics, and "the status of intuition and divine presence"; and "the good life (hayat tayyiba)"; "sacrifice and martyrdom in the Holy Quran and Islamic traditions"; and "dimensions of sacrifice"; at the level of analytical semantics is presented. All of these general concepts are also relevant in the fields of health.  

"Martyrdom" is the peak of the pyramid of human values. In the divine worldview, death and martyrdom for the sake of God are better than all the world and its accumulations.

One of the rich resources and supports of the culture of our society is the culture of self-sacrifice and martyrdom that has flowed from Islam. This culture extends to all aspects of society. The healthcare system also has a high level of culture and a high capacity for self-sacrifice and martyrdom. This part of the study deals with semantics and thematics by combining selected opinions of experts and combining them with a selection of authoritative local sources. Topics are categorized and presented in three groups: major, detailed and specific. The results of this part of the study will be the basis for detailed reports.

The study method is descriptive, field, survey, and applied. This part of the study has been done with a focused group discussion with elites and experts, as well as by literature review and with reference to reliable local sources.

The results of the study are presented in 12 major issues and in each issue, a conceptual definition and a list of general and specific topics are presented: "concepts and thematics", "principles and indicators", "harms and threats", "valid and inspiring models" "Individual and family dimensions", "Social dimensions", "Spiritual dimensions", "Cultural and promotional dimensions", "Examples", "Sacrifice and martyrdom in describing witnesses", "Ideals and symbols and ceremonies", and "Relationship of the culture of self-sacrifice and martyrdom with the culture of resistance".

The valid components of the culture of self-sacrifice and martyrdom, derived from Islamic teachings and experiences of revolution and holy defense, are numerous and extensive. This study has identified and described 12 major issues and in each major issue, a list of the most important general and specific topics (related to health) has provided.

Respect for ethics and spirituality, inspired by the ideals of the Islamic revolution and the teachings of the late Imam Khomeini are still highly regarded now 40 years onward, Medical ethics and spirituality in health has been acknowledged to be growing and improving rapidly now 40 years after the Islamic revolution. Healthcare workers in addition to following beliefs and fundamentals of the ethical and spiritual determinants of health, are strict in their beliefs. Developments in the field of ethics and spirituality during the four decades after the revolution, have been reviewed and are presented herein.

A literature review study approach was undertaken and historical documentation was assessed and the data were collected and assessed.

All valid aspects of ethics and spirituality, including theoretical fundamentals, practical aspects of professionalism, human resource, morality, cultural and social considerations, have all been shown to have improved in the Islamic Iranian society.

The incidence of ischemic reperfusion injury (IRI) in early phase posttransplantation and activation of toll-like receptor (TLR-2) and TLR-4 remarkably impact the outcome of a renal allograft.
To investigate whether the expression of TLRs in peripheral blood mononuclear cells (PBMCs) can predict the clinical outcome of kidney allografts.
We obtained blood samples from 52 renal transplant patients before transplant, and 2, 90, and 180 days post-transplantation in order to analyze the surface expressions of TLR-2 and TLR-4 on peripheral blood monocytes. The expression patterns of TLR-2 and TLR-4 were compared between patients with graft dysfunction (GD) and those with well-functioning graft (WFG).
Significantly different mean dynamic changes in surface expression of TLR-2 according to percentage of TLR-2 cells between (the GD and WFG) groups existed at most time-points before and after renal transplantation (p=0.007) with the exception of day 2 post-transplantation. We observed significantly higher mean fluorescence intensities of TLR-2 and TLR-4 on CD14 cells in the GD group compared to the WFG group. This finding was particularly observed 180 days post-transplantation (p=0.001). Based on TLR-2 and TLR-4 protein expression for each step, multiple logistic regression and ROC curve analysis revealed that an increase in CD14 TLR-2 monocytes within the 90 days post-transplantaton was associated with increased risk of GD at 180 and 365 days post-transplantation [odds ratio (OR)=1.27, p=0.005)].
Sequential monitoring of TLR-2 and TLR-4 expression patterns in peripheral blood monocytes appear to be prognostic and predictive biomarkers for early and late kidney allograft outcomes.

Technology advances in this century, especially, in molecular generics yields high volume, high dimensional data. This creates many unprecedented challenges for statisticians who are responsible for analysis of such data. Although logistic regression method is quite popular in association analysis in medical researches but it has some serious limitations in handling high dimensional data. In present study, our goal is introduce a modern model-free statistical method called random forest that we believe is able to overcome difficulties of the classical statistical methods in finding association between predictors and a trait. In this study, the nonparametric random forest technique was employed to determine the important factors associated with ankylosing spondylitis (AS) disease. Genetic materials including information on HLA-B27 status (positive/negative) and 12 polymorphisms of the ERAP-1 gene were collected on 401 patients and 316 healthy controls. The data were analyzed both with the logistic regression method and random forests technique and the results were compared. Based on a stepwise logistic regression, HLA-B27 and rs28096 polymorphism were significantly associated with the disease. However, using the random forests technique, we found that HLA-B27 and rs1065407 were the main factors associated with diseases and in fact rs28096 polymorphism becomes the third in importance ranking. The results from our study indicate some discrepancies between logistic regression and random forest analyses of high-dimensional data such as the genetic data that we are dealing here. Although logistic regression is quite popular, easy to employ, and is a predominant statistical method among researchers, but it has some serious limitations. On the other hand, more modern statistical such random forest enjoy a more methodological sophistication and yield more accurate and reliable results. Therefore, researchers should be aware of such alternatives and should use these alternatives accordingly and as situation arise in screening tests especially in genetic data analyses.

Apart from genetic and environmental factors, activation of autoreactive mechanisms has been proposed to play a role in the pathogenesis of schizophrenia. In re-cent years, considerable work has been carried out to understand the role and contribution of the immune system in this disease. To investigate the T cell response to phytohaemagglutinin (PHA) and determine the serum levels of anti-nuclear antibody (ANA), anti-cytoplasmic antibody (ACA), and circulating immune complexes (CIC) in schizophrenic patients. A total of 30 drug-free schizophrenic patients and 42 healthy controls were enrolled in this study. T cell proliferation in response to PHA was measured using Methyl Thiazol Tetrazolium test. ANA and ACA were measured by indi-rect immunofluorescence. CIC concentration was determined using poly ethylene glycol precipitation assay. Mean PHA response was 1.96 ± 0.83 in patients and 3.72±1.39 in healthy controls (p < 0.001). ANA and CIC concentrations were not signifi-cantly different between two groups. In addition, ACA was detected only in patients. Increased production of ACA together with lower T cell response to mito-gens in our patients provides evidence for the involvement of autoimmune mechanisms in the pathogenesis of schizophrenia.

Schizophrenia has been associated with altered immunity. Different studies regarding natural killer cell activity (NKA) in schizophrenic patients have shown inconsistent results. To evaluate NK cell activity in schizophrenic patients in comparison with healthy control individuals. 30 medication-free schizophrenic patients and 41 healthy sex، age and smoking status matched individuals were included in this study. NK cell activity of case and control subjects was measured by Methyl-Thiazol-Tetrazolium (MTT) test. Statistical analysis of the data was done using SPSS 11. 5 software. NK activity of patients and normal subjects had a mean of 36. 94 ± 26. 15 (Mean ± SD) and 22. 31 ± 17. 92، respectively. A significant increase in NK activity in schizophrenic patients compared to controls (P = 0. 011). Among patients، NK activity of smokers was significantly lower than that of non-smokers (P = 0. 02). Other demographic factors didn''t show any influence on NK activity. The higher activity of NK cells in the schizophrenic patients as compared with the control population could explain the low incidence of cancer in these patients. Decreasing the effect of smoking on NK activity in the patients could be one of the responsible factors for the inconsistency in the results of different studies.

Type 1 Diabetes (T1D) is a chronic and progressive autoimmune disorder.Cytokines play a critical role in the pathogenesis of T1D. IFN- polymorphism was investigated in T1D and compared with normal controls. Thirty patients suffering fromT1D and 40 normal controls were studied simultaneously using PCR technique. IFN- gene was evaluated at position 5’UTR +5644. There was a significant difference between patient and control groups in TT genotype (P<0.05). In this study, we found a negative association between IFN- gene at position 5’UTR +5644 and T1D in Iranian patients pointing to T allele as a protective factor against T1D.

Pulmonary tuberculosis (PTB) has recently become a major problem indeveloped countries especially in immune compromised HIVinfected individuals. Cytokines, their genes and receptors have been implicated in the protective immunity, pathophysiology and development of tuberculosis. In the present study the genotype frequencies of a number of polymorphic genes coding for cytokines or for cytokine receptors have been investigated in a case control study including a group of 40 Iranian PTB patients and 40 healthy individuals. The allelic polymorphism of cytokines SNPs were analyzed according to the protocols of the cytokine component designed for the 13th IHW by the Heidelberg University group. Using PCR-SSP method the following cytokine genes have been determined: IL-1 (T/C –889), IL-1 (C/T +3962), IL-1R (C/T pstI 1970), IL-1RA(T/C mspaI 1100), IL-4RA(G/A+1902), IL- 12 (C/A –1188), TGF- (C/T codon 10, G/Ccodon 25), TNF- (G/A –308, G/A –238), IL-2 (T/G –330 G/T +166), IL-4 (T/G –1098, T/C –590, T/C –33), IL-6 (G/C –174, G/A nt 560), IL-10 (G/A –1082, C/T –819, C/A –592). From IL-1R cluster (pro- inflammatory cytokines) a positive significant association was found at position pstI 1970 C/T polymorphismwhere theC allele was over presented in the PTBpatients (60% vs. 37.5%, P = 0.04).Asignificant negative association at codon 10 TGF- C/T polymorphism has also been shown in our patients, where the T allele was not detected in the patients but 10% of the control subjects expressed this allele (Fisher exact test, P = 0.05). At this codon allele T (Leucine substitution) is associated with high TGFproduction. For TNF an insignificant tendency was found at position -308 A/G polymorphismwhere theG allele carried by 80% of cases and 65% of controls (P = 0.07).At position -238 a negative association was found at the GApolymorphism(10% vs. 25%, P = 0.07). For IL-6 an insignificant positive association at position -174 C/G *Corresponding author: Dr. Ali Akbar Amirzargar, Department of Immunology, Immunogentic Laboratory, Medical School, Tehran University of Medical Sciences. e-mail: Amirzargar_Ali@yahoo.com Cytokine gene polymorphismin Pulmonary TBpolymorphism, G allele (57.5% vs. 37.5, P = 0.07) was found. At the other cytokine genes no specific association were found. In conclusion it is suggested that C allele at position pstI 1970 of IL-1 cluster increases and T allele at codon 10 of TGF- decreases in PTB patients.

Type 1A Diabetes Mellitus (T1DM) is a chronic and progressive auto- immune disorder resulting from immune mediated destruction of Langerhans islet beta cells. The etiology of T1DM like the other autoimmune diseases is unknown and many factors are involved, Both humoral and cell-mediated immunity have a critical role in T1DM pathogenesis. The cytokines, the immunomodulatory peptides, are responsible for the immune cell recruitment and producing auto-antibodies by the immune effector cells. To evaluate the role of cytokines in sensitivity or resistance to T1DM, we have employed IFN gamma to determine their gene polymorphisms and their association with T1DM.
30 patient suffering from T1DM and 40 normal control were studied simultaneously .PCR technique was used to characterize the polymorphisms of cytokine. Salting out method was performed for DNA isolation .The polymorphosime of IFN gamma gene was determined on position UTR`5.The PCR products were evaluated by Gel Electerophoresis Technique.
There was a significant difference between patient and control group in TT allele IFN gamma gene: p In this study, we found a negative association between IFN gamma gene at position 5`UTR and T1DM in study group that means this allele may be a protective factor against T1DM.