فصلنامه علوم پزشکی دانشگاه آزاد اسلامی
سال سی و پنجم شماره 1 (پیاپی 119، بهار 1404)

Many medical and non-medical research laboratories around the world are constantly trying to produce an effective vaccine or antiviral medicine. Current medical knowledge of the world has made significant progress in line with the corona virus and cancer treatment. Meanwhile, many natural compounds found in cyanobacteria have attracted the attention of many physicians due to their durability and high reliability. Cyanobacteria are rich in bioactive compounds that exhibit diverse biological activities including anti-proliferative, cytotoxic and anti-neoplastic properties. Many of these compounds are currently being studied in clinical trials. In this review article, newly discovered bioactive compounds from different cyanobacteria species that have strong antiviral activity against respiratory infections and also compounds such as apratoxin, simplostatin 1, bartolosides, chylobolid, bisbromoamides, carmaphysins and anamides that have anticancer activity on numerous cancer cell lines are introduced. The studies show that currently, there are no clear guidelines on the approval of bioactive compounds derived from cyanobacteria for the treatment of diseases. Although the use of these compounds is not usually accompanied by side effects, more research should be focused on these compounds to increase their safety and effectiveness. In this review article, by studying the latest available articles, the effectiveness of natural compounds in cyanobacteria in the treatment of viral and cancer diseases is discussed.

The evolution of resistance to imatinib and disease progression are multifactorial events in CML patients. These events are not only determined by BCR-ABL1 dependent pathway but also are involved a number of other genetic and epigenetic aberrations including DNA methylation. We aimed to investigate the role of DDIT3 (DNA-damage-inducible transcript 3) gene methylation in relation to respose to imatinib, CML progression, and also investigate the impact of the smoking on methylation level.

50 CML patients at different clinical stages of the disease (including 20 good response and 30 non-mutated imatinib resistant patients) and 15 health control were recruited for methylation levels evaluation of promoter DDIT3 gene by MS-HRM (Methylation Sensitive High Resolution Melt) analysis.

There was significant difference in the mean (±standard deviation) of DDIT3 methylation percentage between two response groups (63.8±17.79 vs 47.75±14.18, P=0.002). DDIT3 promoter hypermethylation in 51-100% level indicated a higher risk for progression to advance phase (OR= 5.75; 95% CI: 1.40-23.49; P= 0.01) and imatinib resistance (OR= 8.5; 95% CI: 1.96-36.79; P= 0.004). Importantly, smokers were associated with a higher percentage of DDIT3 methylation (OR= 11.8; 95% CI, 2.67-52.67; P=0.001).

Our findings indicated that hypermethylation of DDIT3 gene is associated with imatinib resistance, CML progression and smoking. Further investigations on a more number is needed to confirm of these results that could be suggest as potential biomarker of disease progression and resistance to imatinib.

Today, antibiotic resistance against bacteria causing infection is very common and biological production of nanoparticles is a suitable alternative. In the present study, the synthesis of silver nanoparticle of Hypericum perforatum plant and its antioxidant and antibacterial properties were investigated in comparison with antibiotic gentamicin.

After collecting plant and preparing the aqueous extract, 1 mM silver nitrate was added for nanoparticle synthesis. The effect of pH parameters and silver nitrate concentration for the optimization of green nanoparticle was evaluated by spectrophotometry and SEM. Antioxidant properties were investigated by DPPH and ABTS free radical methods. Finally, the antibacterial properties of the above nanoparticle were determined by diffusion method in agar and minimum growth inhibitory concentration (MIC) and minimum bactericidal concentration (MBC).

Silver nanoparticles from Hypericum perforatum extract showed highest absorption at 430 nm. Silver salt concentration and alkaline pH had an effect on its quantity. It is worth mentioning that resulting nanoparticle has antioxidant properties so that depending on concentration it has an inhibitory effect on free radicals with ABTS and DPPH methods; in these two methods by increasing concentration from 40 mg/ml to 250 mg/ml, amount of free radical inhibition increases and value of IC50 at  concentration of 40 mg/ml with ABTS and DPPH methods is 34.7±0.27 and 47.4±0.59, respectively The examination of results of antibacterial properties, shown that synthesized silver nanoparticles had the most antibacterial activity against standard strains of Listeria monocytogenes, Escherichia coli, Staphylococcus aureus and Salmonella enterica, respectively.

Hypericum perforatum extract is able to regenerate Ag+ ion and silver nanoparticles.Super nanoparticle has acceptable antioxidant and antimicrobial power.

In this study, a rapid, simple, and advanced reverse phase high-performance liquid chromatography (RP-HPLC) method was developed for the quantification of sulfasalazine in human plasma.

Sulfasalazine was extracted from plasma matrices using a simple protein precipitation method by acetonitrile. Chromatographic conditions were optimized (mobile phase compositon, flow rate, injection volume and temperature of the oven). The method was validated in protein precipitated human plasma for linearity, selectivity, accuracy, precision, limit of detection, limit of quantification.

The chromatographic separation was conducted on C18 brisa LC2 column (250 mm × 4.6 mm, 5μ) using isocratic elusion with mobile phase consisting of the mixture of acetonitrile: 10mM Ammonium acetate pH adjusted to 4.6 (30:70 v/v) with a flow rate of 1.0 ml/min at ambient temperature. Detection was carried out by UV detector at 361 nm. Calibration curves made in the human plasma were linear in the range of 3.125-50 μg/ml with the value of r2 > 0.9999. The LOD and LOQ was 0.5 and 2.5 µg/ml, repectively.

The developed and validated HPLC-UV method is suitable for accurately determining sulfasalazine levels in pharmacokinetic studies of new formulations.

Considering the growing trend of the elderly population in Iran, problems related to their care and health, attention to psychological treatments, and issues such as self-care behaviors and psychological well-being are important. Therefore, the aim of this research was to the effectiveness of behavioral activation intervention on increasing self-care behaviors and psychological well-being of the elderly.

The current study was a quasi-experimental study with a pre-test-post-test design with a 2-month follow-up and a control group. Among all the elderly people aged 65-90 who visited the communication center in Saeed Abad town in 2023, 40 people were selected by convenience sampling and assigned into 2 groups of experimental and control. The self-care questionnaire of Hemmati Maslak Pak et al (2015) and the psychological well-being scale of Ryff (1989) were used to collect data at three time points: pre-test, post-test, and follow-up. The experimental group received 8 sessions of Kanter et al.'s (2009) behavioral activation intervention protocol. The data were analyzed using univariate covariance analysis (ANCOVA) by SPSS-26 software.

There was a significant difference between the experimental and control groups in terms of self-care behaviors (F=46.18) and psychological well-being (F=54.74). These results were consistent after a 2-month follow-up (P<0.001). After receiving the behavioral activation intervention, the experimental group showed significant improvements in both self-care behaviors and psychological well-being.

This study suggests that a behavioral activation intervention can be an effective method for improving the self-care behaviors and psychological well-being of elderly individuals

The present study was conducted with the aim of determining the effectiveness of acceptance and commitment therapy on intensity pain and pain catastrophizing in women with chronic pain.

This study was semi-experimental with a pretest-posttest and follow-up with a control group design. The statistical population was made up of female patients with chronic pain referred to Emma Reza hospital in Tabriz city in 2023. In total, 30 people were selected by purposive sampling method, and randomly divided into two groups (15 people each). Members of the experimental group received their treatment in eight sessions of 1.5 hours; however, the control group did not receive any treatment. Both groups answered the 20-question sleep quality Pittsburgh McGill pain intensity and 29-question Sullivan et al pain catastrophic Questionnaires, before, after and 3 months after the intervention. Data were Analyzed using ANOVA with repeated measures.

The results showed that the acceptance and commitment therapy reduced the intensity pain and pain catastrophizing women with chronic pain in the post-test compared to the control group (P<0.001). The effect of acceptance and commitment therapy on intensity pain and pain catastrophizing was lasting in the follow-up phase (P<0.001).

It seems that acceptance and commitment therapy can reduce the intensity pain and pain catastrophizing in women with chronic pain, therefore it is likely to be a useful treatment strategy to improve the intensity and pain catastrophizing in women with chronic pain

Colon cancer is one of the most common cancers in the world, and today screening with colonoscopy plays a significant role in early detection and prevention of the progression of this cancer.

This retrospective and cross-sectional study was done on 160 patients referred to gastroenterology clinics who have indications for colonoscopy according to criteria. Based on the presence or absence of adenoma in the colonoscopy, the patients were divided into two groups. The serum level of gamma glutamyl transferase was checked in the adenoma and non-adenoma groups, and the results were compared. Gamma glutamyl level above 32 U/l in women and 49 U/l in men was considered as the cut-off level. The results were analyzed with SPSS software.

No significant correlation was observed between age and Gamma GT level (R=0.031) and there was no significant relationship between gender and Gamma GT level (p: 0.58). But on the other hand, a significant relationship was found between having an adenoma and high gamma GT levels (p: 0.002).

According to results, it can be concluded that age and gender factors do not relate to the high level of gamma GT, but the relationship between this enzyme and adenoma was significant. Therefore, it can be said that the high level of gamma GT is an influential factor in having adenoma.

Sepsis is one the most causes of mortality and morbidity in neonate. There are not specific signs, symptoms and definitive laboratory test for diagnosis of sepsis. There are physiologic immunodeficiency in neonate. Therefore, a specific diagnostic test and rapid treatment is very important. In this study we express neonatal sepsis affects thyroid hormones. We should do neonatal screening test after recovery of sepsis.

We measured serum TSH and T4 in 64 neonates who had sepsis.

56.3% were male and 47.3% were female. 51% had sign and symptoms of sepsis. Respiratorty distress was the most common sign. 78% required to use oxygen. Some had abnormal laboratory test, including 46% positive PCR and 3% positive blood culture. Mean TSH and T4 values were 5.69 miu/ml and 86.3 ng/ml, respectively. TSH and T4 were more than normal average.

Thyroid hormones change during neonatal sepsis.

In order to provide quality and effective care, the treatment system needs to develop and strengthen innovation in nurses. The present study aimed to investigate the correlation between job characteristics and innovative behaviors in nurses working in hospitals.

The current cross-sectional study was done on all nurses working in selected hospitals affiliated to Shahid Beheshti University of Medical Sciences in 1997. The sample size was 317 people. Three questionnaires, including Hockman and Oldham job characteristics, counter innovative behaviors and demographic information questionnaire were used to collect data. The data was analyzed using statistical tests and SPSS version 21 software.

In summary, the mean job characteristics in the five fields investigated in nurses were very good. The characteristics of skill diversity (6.94 ± 2.53) and independence and freedom of action (7.08 ± 2.43) were within a good range. The job nature (9.56 ± 2.51), job importance (10.83 ± 2.51), and feedback of the results (11.01 ± 2.62) were also very good. The study also found a significant correlation between job characteristics and innovative behaviors in the studied nurses. Skill variety, job nature, job importance, independence and freedom of action, and feedback had a significant correlation with innovative behaviors at the rates of 0.407, 0.451, 0.602, 0.437, 0.568, and 0.895, respectively

The improvement of job characteristics provides a suitable platform for the growth and development of innovative behaviors in nurses.

Supportive care is providing necessary and necessary services for living with cancer in order to meet the needs of patients in all stages of the disease, which will not happen without a good understanding of the needs of patients. Therefore, the present study was conducted to determine the correlation between unmet supportive care needs and demographic characteristics in patients with various types of cancer.

This descriptive-analytical study was conducted on 350 cancer patients referred to medical centers affiliated to Tehran Islamic Azad University of Medical Sciences using available sampling in 2023. The questionnaire of supportive care needs of cancer patients (supportive care needs survey) was used, which had five areas of physical needs and daily functioning, health and information system, support and patient care, mental and sexual. Data analysis were done using SPSS version 26 and descriptive and inferential statistics.

The patients had the most need in the physical area and daily functioning (101.52±27.7) and the least need in the sexual area (53.91±33.5). There was a significant statistical correlation between the variables of marital status, occupation, lifestyle, addiction and level of education with supportive care needs in cancer patients (p<0.001).

This study showed that the unmet needs of cancer patients are high in physical and daily functioning. Although the confirmation of these findings requires more studies

Improving the mental condition of nurses exerts a direct effect on patient care, duration, and treatment process. Thus, this study aimed at determining the level of occupational burnout and moral conflicts among nurses, as well as the relationship between these two variables.

In this descriptive correlational study, the research population consisted of the nurses working in the intensive care unit of the selected hospitals affiliated to Tehran Islamic Azad University of Medical Sciences and the whole population was studied. Demographic Information Questionnaire, Maslach Burnout Inventory, and Falcó-Pegueroles Moral Conflict Questionnaire were used to collect data.

The mean frequency of occupational burnout of nurses working in ICU wards was 41.81 (SD=15.37) and the mean intensity of occupational burnout was 44.77 (SD=15.56). The mean frequency of moral conflict of the samples was 27.36 (SD=11.74) and the mean intensity of moral conflict was 27.46 (SD=10.24). Regarding frequency, there was a positive and significant relationship between moral conflict and occupational burnout and its dimensions except for “Individual adequacy”. Besides, the results suggested that regarding intensity, there was only a positive and significant relationship between moral conflict and depersonalization dimension.

The results of study revealed that frequency of occupational burnout and moral conflict are correlated, and frequency of moral conflicts in nurses working in intensive care unit has a significant effect on creating and increasing occupational burnout. Therefore, one of the most important ways to reduce occupational burnout and moral conflict is to reduce frequency of moral conflicts in intensive care unit and on nurses working in this ward.

Crimean Congo hemorrhagic fever (CCHF) is a hemorrhagic fever caused by a viral agent. Among Asian countries, Iran is an endemic region for CCHF. Reports about this infection in Iran show that adults are more affected by this disease than children. However, rural children, especially boys, are at a higher risk of CCHF than other children due to contact with livestock and their secretions. In areas with higher prevalence, it is necessary to consider the diagnosis of this disease in children who mention the symptoms of fever, petechiae and purpura, ecchymosis, decreased level of consciousness, and a history of contact with animals. Since there is no definitive treatment for this disease, timely diagnosis and hospitalization of the patient is the only way to increase the probability of survival in severe cases. The present case report presents a fatal case of definitive CCHF in a six-year-old boy with confirmed CCHF by PCR

The prevalence of multiple synchronous primary cancers has increased in recent decades. The development of simultaneous multiple primary cancers in a patient may depend on hereditary, environmental, iatrogenic factors, or unknown factors. The detailed clinical history of these patients, reviewing the primary pathology reports, and the impact of immunohistochemical diagnostic methods on the planning and treatment process for these patients are the main objectives of our report.

in this article, we present two cases of dual primary cancers. The first case is a 46-year-old healthy woman with no significant past medical or family history of cancer and no history of using immunosuppressive drugs, who presented with advanced metastatic breast and lung cancers with sudden-onset neurological deficits. The second case is a 52-year-old healthy woman with no history of intervening factors and simultaneous locally advanced breast cancer and early-stage thyroid cancer, presenting with a large mass in her right breast and axilla.

 Sampling from simultaneous masses in different tissues in a patient with a cancer diagnosis can play an important role in identifying multiple primary cancers. Moreover, newer techniques such as IHC have definitively proven the diagnosis of multiple primary cancers in individuals and serve as a reliable method for selecting the best and most optimal therapeutic approach for these patients s