نشریه دانشگاه علوم پزشکی بیرجند
سال سی و یکم شماره 1 (پیاپی 98، بهار 1403)

Sarcoidosis is a granulomatous disorder characterized by non-caseating granulomas in multiple organs and an unknown cause. This chronic inflammatory disease is heterogeneous in terms of manifestations, duration, and severity. Although its aetiology is not well understood, there are indications of the genetic basis and the involvement of specific microorganisms and vitamin D in the development of this disease. Sarcoidosis can affect individuals of any age; however, it is more commonly observed in young adults and middle-aged subjects. The clinical course of the disease is unpredictable; nevertheless, in general, it can manifest as pulmonary, cardiac, cutaneous, ocular, skeletal-muscular, neurological, and renal involvement. Pulmonary involvement occurs in most patients and respiratory failure is the most common cause of death associated with sarcoidosis. Although numerous biomarkers have been evaluated in recent decades for patients with sarcoidosis, the diagnostic method is complex and no single diagnostic test can confirm the disease. Future research should focus on the combination of biomarkers and more refined imaging techniques, such as computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET). By utilizing these techniques and markers, it may be possible to design diagnostic and therapeutic approaches. Corticosteroids are considered the mainstay of treatment for most patients. Moreover, novel therapies, including the administration of rituximab and repository corticotropin injection (a combination of adrenocorticotropic hormone analogs and other pituitary peptides [RCI, Acthar® Gel]), have been reported to be effective in some cases.

The combination of resistance training (RT) with a ketogenic diet (KD) is acknowledged as an effective strategy to improve body composition. The present meta-analysis aimed to investigate the combined effect of RT and KD on body composition factors.

A comprehensive search was conducted in Web of Science, Scopus, PubMed, Magiran, and Scientific Information Database (SID) until March 2023 without limiting the year of publication. Meta-analysis was performed to investigate the combined effect of RT and KD on body composition. In order to calculate the effect size, weighted mean difference (WMD), and 95% confidence interval were calculated using fixed and random effect models.

A total of 20 studies with 544 adults were included in the present meta-analysis. The results indicated that RT and KD caused a significant decrease in body weight (BW) [-2.15 kg (CI: -3.27 to -1.03), P=0.001,], body fat percentage [-1.57% (CI: -2.53 to -0.61), P=0.001], compared to the control group in adults. While free fat mass (FFM) [-0.39 kg (CI: -1.17 to 0.37), P=0.3], and body mass index (BMI) were not significant [-0.34 kg/m2 (CI: -1.14 to 0.46), P=0.4].

The results of the present meta-analysis indicated that the KD, compared to the non-KD, had a beneficial effect on reducing BW and fat percentage in people who follow RT. However, the effects of KD combined with RT on increasing FFM were not observed. However, the results of this research regarding the effects of the combination of KD and RT on FFM changes are still challenging, and there is a need to increase the number of investigations in this field to provide a decisive conclusion to examine the combined effects of KD and RT on FFM.

Simulation-based medical education is effective for developing and improving critical care-related clinical skills training and reducing patient safety threats. The present study aimed to describe the technological approach of building and evaluating a prototype of a Lung Box (LB) mechanical ventilation simulator.

In this practical study with an analytical approach, the device's body, constructed from 5 mm plexiglass sheets, occupies a respiratory circuit, an airflow obstruction system, a pressure gauge manometer, a spring-loaded manual system to apply limits on the bag inflation range, a tidal volume measurement system, a respiratory trigger simulator system, and a four-layer accordion-style plastic bag assembly that can be inflated and deflated with air. Additionally, there is a user manual storage box along with it.

The design and drawing of the device's map were performed with AutoCAD software, and the parts were assembled after laser cutting. The device was connected to the ICU ventilator, and the respiratory mode of continuous forced ventilation was selected. Prior to ventilation, the tidal volumes were selected to be 0.60, 0.55, 0.50, 0.45, and 0.40 ml, and respiratory rates were set as 18, 15, 12, and 9 bpm. The simulation of the respiratory trigger was performed with different values ​​of flow sensitivity (0.05-15 lit/min). There was no statistically significant difference (P>0.05) in terms of the reproducibility of the values ​​of the selected variables for the test Lung (TL) with those chosen for LB.

In this technical study, a prototype educational mechanical ventilation simulator was developed and functionally tested using the concepts of fluid dynamics and respiratory physiology. Compared with conventional TL, this device is accurate and efficient enough.

Tetralogy of Fallot (TOF) is one of infants' most common types of complex congenital heart defects (CHD). Several molecular mechanisms may play a role in its development, such as mutations in cardiac gene network components, cardiac gene regulatory pathways, dysfunction of cilia-expressing genes, and dysfunction of genes determining the left and right axis of the heart. The present study aimed to investigate the nucleotide changes of the CCDC103 gene and its relationship with CHD of the TOF type.

The present work was conducted for the first time in Iran as a case-control study on 85 children with TOF. The control group involved 56 healthy children without a family history of heart disorders. Touchdown polymerase chain reaction (PCR) and Sanger sequencing were used to evaluate point mutations in the CCDC103 gene. Moreover, bioinformatics databases were employed to predict the impact of nucleotide changes on protein structure and function.

A total of five heterozygous single nucleotide changes were detected in this gene (three missense mutations: p.S115R, p.C191R, p.M201V, a synonymous change without amino acid change, and a change in the 3'-UTR region). In addition, bioinformatics results predicted that p.C191R mutation is pathogenic and harmful.

The results indicated that in addition to the genes known in the pathogenesis of TOF, changes in the CCDC103 gene in the ciliary signaling pathway can play a role in causing heart defects.

Cancer, which is characterized by irregular cell metabolism and the development of metastasis risk, is still a significant risk and life-threatening. Although there are several unique advantages for cancer treatment, some problems, such as poor drug targeting efficacy, increased tumor hypoxia, severe coronary syndromes, excessive ventricular conduction, and drug-induced drug resistance, have emerged in recent years. Chemotherapy and increased risk of tumor metastasis have limited their potential clinical use.

In this experimental study, a total of 36 embryonic eggs were randomly selected. Then, four treatments, including control, 40, 80, and 120 µg/ml hydroalcoholic extract of Berberis vulgaris (B. vulgaris) fruit, and nine replications were tested. On the third day of incubation, the eggs were exposed to an open window, and on the eighth day, the experimental groups were treated with 40, 80, and 120 µg/ml alcoholic extract of B. vulgaris fruit, which was collected from Qaen city in South Khorasan Province, Iran. On the 12th day, the chorioallantoic membrane of all samples was photographed using a photo stereomicroscope, the numbers/diameters of vascular branches were measured using the Image J software (1.46r), and the resulting data were analyzed using the SPSS software (version 22) and the least significant difference (LSD) test (P≤0.01)

The mean number of vessels in the experimental groups was equal to (6.23+0.81) and (22.89+0.81), which indicated a significant dose-dependent reduction compared to the mean number of vessels measured in the control group (15.73+0.29) and (53.87+2.07) (P=0.003).

The use of the hydroalcoholic extract of B. vulgaris in three doses of 40, 80, and 120 µg/ml can reduce the number of branches and the diameter of vessels in the chorioallantoic membrane of chicken embryos, which indicates the process of angiogenesis inhibition.

According to the increasing evidence, abnormal expression of microRNAs is associated with tumorigenesis, tumor spread, and relapse in leukemias, including chronic myeloid leukemia (CML). The present study aimed to investigate the effect of miR-155 overexpression in K562 cells on cell cycle arrest and apoptosis induction.

The pLenti-III-pre miR-155-GFP vector was used to increase miR-155 expression in the K562 cell line through nucleofection compared to the pLenti-III-Backbone-GFP vector as a control group (Backbone). The flow cytometry method was employed to confirm the expression of the vector containing miR-155 in damaged cells. After transfection, the expression levels of miR-155, BAX, BCL2, CASP3, and TP53 were measured by the RT-qPCR method. The propidium iodide (PI) dye was used to study the cell cycle, and the stained cells were read by flow cytometry. The statistical significance was also defined as a P-value less than 0.05.

After confirming the increase in miR-155 expression when cells transfected with miR-155 were compared with cells transfected with Backbone, cell cycle arrest was observed in the miR-155 group. In the cells with increased expression of miR-155, the change in G0/S and G1/S ratios compared to Backbone was shown to be 7.5 and 4.5, respectively (P<0.05). Moreover, 48 hours after transfection and in the group expressing miR-155, the expression of TP53, BAX, and CASP3 genes increased, and the expression of BCL2 decreased (P<0.05).

The increase in the level of miR-155 caused cell cycle arrest and increased pro-apoptotic gene expression, which indicates that miR-155 inhibits tumor growth in CML.

The quality of reports plays a crucial role in patient care. Statistics reveal instances of negligence in patient care due to ineffective reporting by nurses, underscoring the need for enhanced efforts in nursing student education. Given the variety of methods available for teaching report writing, this study aimed to compare the efficacy of workshop and virtual training approaches in improving the quality of report writing among nursing students at Birjand University of Medical Sciences.

This interventional study involved 111 nursing students from Birjand, randomly allocated into three groups of virtual training (n=36), workshop training (n=36), and control (n=39). For students in the workshop training group, educational content was delivered through a workshop comprising three 4-hour sessions covering six topics. For the virtual training group, educational material was provided as text, audio, and visual files via Telegram over one week (six days dedicated to training and one day for summarizing the content) and sent to students daily at specified times. The status of students' report writing skills was assessed before and after the intervention (immediately and two weeks post-training).

The mean score for report writing quality immediately after the completion of the workshop training program was 91.4 ± 58.80 in the workshop training group, significantly higher than that in the other groups studied. Moreover, the mean score for report writing quality two weeks after completing the training program in the workshop training group was 16.5 ± 91.78, significantly higher than that in the other two groups. The mean difference in report writing quality scores immediately after training completion in the workshop training group was significantly greater than in the other groups (P<0.001).

Based on the findings of this study, the workshop method was more effective than the virtual approach for teaching report writing to nursing students.

The most important way to control COVID-19, with high contagiousness and no specific treatment, is prevention. Due to the lack of a similar study, this research aimed to assess Covid-19 anxiety and the factors affecting the preventive behaviors of Covid-19 from the perspective of clients referring to the comprehensive health centers according to the social and cultural beliefs of the region. This cross-sectional study was conducted on 400 patients referring to comprehensive health centers of Birjand during the outbreak of COVID-19 in 2022. In this study, after obtaining informed consent from the clients, a researcher-made questionnaire regarding COVID-19 preventive behaviors, the COVID-19 anxiety scale, and the demographic information checklist were completed by participants. The most preventive behavior in the studied clients was wearing a mask when leaving home. The mean score of preventive behavior in women was significantly higher than that of men (P<0.001), and the mean score of preventive behavior according to the occupation of the clients was significantly different from each other (P=0.010). There was a positive and significant relationship between the anxiety score and preventive behavior of subjects, with a correlation coefficient of 0.321 (P<0.001). The correlation coefficient between risk perception and preventive behavior against Covid-19 was 0.325, while between vulnerability and preventive behavior, it was 0.333. Considering the relationship between anxiety and preventive behavior of individuals, it is possible to promote preventive behavior in individuals by increasing the awareness and appropriate information about the serious complications of the disease, as well as the ways of transmission through the national media and cyberspace.