A Comparative Investigation of the Bispecific Antibody: Expression in Expi293F Cells and E.coli

Aims: Dual-Character antibodies can simultaneously target two surface markers. Blinatumomab is a C19 / CD3 antibody from the BiTE family (Bispecific T cell engager antibody) and was approved by the US Food and Drug Administration for clinical use. This antibody effectively targets malignant cells in patients with acute infoblastic leukemia. In the production of large quantities of such antibodies on an industrial scale, selecting the appropriate host remains a critical issue. Mammalian cells and strains of E.coli are the most common hosts for producing antibodies and antibody components on an industrial scale, respectively. Methods & Materials: In this study, a dual-specific antibody was used in the mammalian system of plasmid pcDNA3.1 (+) and for expression in the bacterial system of plasmid pET22b. The antibody produced in both systems was purified using nickel affinity resin under similar conditions. Next, SDS-PAGE and Western blot analysis was performed on both study samples. Finally, the binding properties of the antibody secreted from both systems were assessed by the ELISA test. Findings: The present study results suggested that antibodies produced by the mammalian expression system provided better binding properties than the expression system in bacteria. Conclusion: This study indicated that in the case of antibodies to two traits of the BiTE family, like Blinatombe, mammalian cells generate a more efficient and successful expression system; although the bacterium can produce much larger amounts of the antibody.

The Success Rate and Complications of Post-radiofrequency Ablation in Patients With Small Saphenous Insufficiency

Aims: This study aimed to determine the success rate and complications occurring after Radiofrequency Ablation (RFA) in patients with small saphenous insufficiency who underwent RFA in Rasht. Methods & Materials: Patients with small saphenous vein insufficiency who underwent RFA were explored respecting success rate and potential complications, such as pain, hematoma, neuropathy, Endothermal Heat-Induced Thrombosis (EHIT), and skin burns. The study subjects were assessed 2 weeks after the procedure. Reconanalysis was followed up in the study participants by ultrasound at 2 weeks, 3-6 months, and the first year after RFA. Findings: This study examined 62 patients. A 100% success rate was reported and no case of reflux was observed in the first control ultrasound 2 weeks after RFA. The mean pain score significantly decreased (P<0.001). Besides, in one year, 3 cases of recanalization, 7 cases of EHIT, 9 cases of neuropathy, and 1 case of superficial thrombophlebitis were reported; no case of skin burn was observed. Conclusion: Considering the 100% success rate and slight adverse effects of this method, such as pain and recanalization, RFA is an acceptable approach. Furthermore, the incidence of EHIT should be considered.

The Effects of Coping Cat Program on Anxiety, Emotion Regulation, and Resilience in Children Referring to Dentistry: A Case Study

Aims: The number of pediatric dental clients is on the rise. Besides, the relevant methods are costly and concerning; therefore, psychological methods are required to treat pediatric dental anxiety. The current study aimed to evaluate the effects of the Coping Cat Program (CCP) on anxiety, Emotion Regulation (ER), and resilience among 7- to 12-year-old children. Methods & Materials: This was a case study with multiple baselines and a one-month follow-up design. The research sample included 4 subjects referring to the dental clinic in Mashhad City, Iran, in May 2017. The study participants were selected by the purposive sampling method. The study subjects received 16 therapy sessions (2 weekly sessions) based on the CCP. The child version of the Cognitive Emotion Regulation Questionnaire (CERQ-k) and Spence Children’s Anxiety Scale-Child (SCAS-Child) were used to collecting the required data. For data analysis, the graphical analysis method and the determination of recovery percentage were applied. The obtained data were analyzed using SPSS v. 21. Findings: Anxiety scores in the pretest and posttest in the first child ranged from 62 to 44 with the recovery rate of 0.29; in the second child, it ranged from 57 to 37, with a recovery rate of 0.35; in the third child, it ranged from 48 to 35, with a recovery rate of 0.27, and in the fourth child, this rate decreased from 55 to 25 with a recovery rate of 0.54. Resilience scores in the pretest and posttest in the first child ranged from 52 to 75, with a recovery rate of 0.44, in the second child, it was from 43 to 66, with a recovery rate of 0.53; in the third child, it ranged from 58 to 74, with a recovery rate of 0.27, and in the fourth child, it increased from 64 to 89, with a recovery rate of 0.39. ER components also significantly improved in the examined children. Conclusion: The present study data indicated that CCP was effective in reducing anxiety symptoms as well as increasing ER and resilience among children aged 7 to 12 years referring to dentistry. Thus, this method can be used to reduce anxiety symptoms and increase ER and resilience in this population. This method helps the child to become aware of negative thoughts, find evidence respecting their negative thoughts, cope with anxiety, learn skills, and practice and repeat these skills.

The Prevalence of Bacteruria and Its Relationship With ABO Blood Group in Pregnant Women

Aims: Blood Group Antigens (ABO) are present on the surface of all cells, including urinary tract cells. Besides, they are a predisposing factor for infection in various parts of the body. The present study aimed to determine the prevalence of bacteriuria and its relationship with different blood groups. Methods & Materials: This descriptive-analytical (cross-sectional) study was performed in 2019 on 400 pregnant women who were selected by convenience sampling method. For each pregnant woman referring to Allameh Behlool Hospital in Gonabad City, Iran, a form including patients’ demographic characteristics, medical history, and blood type was completed. Data analysis was performed in SPSS using descriptive statistics and the Chi-squared test. The significance level of the tests was considered P<0.05. Findings: Of the explored 400 pregnant women with a Mean±SD age of 27.31±5.9 years, 58 were bacterially positive. There was a significant relationship between bacteriuria and ABO blood groups (P=0.001). The examined pregnant women with blood groups O (48.3) and B (29.3) were at higher risk of bacteriuria. There was a significant relationship between bacteriuria and gestational age (P=0.016); accordingly, 56.9% of the study subjects with bacteriuria were in the third trimester. There was no significant relationship between bacteriuria and educational level (P=0.944), and place of residence (P=0.494). Conclusion: The prevalence of bacteriuria among referred pregnant women was measured to be 14.5%. Moreover, pregnant women in the third trimester of pregnancy with blood types O and B were at higher risks for bacteriuria. Therefore, considerations, such as advising this group about the susceptibility to bacteriuria and urinary tract infections, personal hygiene, and faster referral for diagnostic and therapeutic measures if presenting symptoms, as well as informing doctors and obstetricians about this condition and help to make faster decisions are recommended in this respect.

The Effects of High-intensity Interval Training and Probiotic Consumption on Interleukin-10 and Interferon-gamma Gene Expression of Gut Tissue in an Animal Model of Fatty Liver

Aims: Non-Alcoholic Fatty Liver Disease (NAFLD) is the most common chronic liver disease, often reported in patients with inflammatory bowel disease. This study aimed to investigate the effects of High-Intensity Interval Training (HIIT) and probiotic use on the expression of interleukin-10 and interferon-gamma genes in intestinal tissue in an animal model of fatty liver. Methods & Materials: In this experimental study, 40 male Wistar rats (weighing 200-250 g) were selected. The study rats were randomly divided into 5 groups, including healthy control, fatty liver, fatty liver + HIIT, fatty liver + probiotic, and fatty liver + HIIT + Probiotics. Oral tetracycline was administered at a dose of 140 mg/kg of body weight (as a solution in 2 mL of water) for 7 days with fatty liver. HIIT was performed on tape 5 times a week for 5 weeks. The obtained data were analyzed using One-way Analysis of Variance (ANOVA) and Tukey post-hoc test at the significant level of P<0.05. Findings: The present research results suggested that the expression of interleukin-10 and interferon-gamma genes in the intestinal tissue of steatosis mice in the fatty liver group was significantly higher than in the healthy control group (P=0.001). HIIT and probiotic use significantly reduced the expression of interleukin-10 and interferon-gamma genes in the intestinal tissue, compared to the fatty liver group (P=0.001). Conclusion: According to the obtained data, HIIT and probiotic consumption can help modulate the expression of genes involved in the innate immune system of intestinal tissue caused by fatty liver.

The Effects of Virtual Reality on Patients’ Anxiety Before Dental Surgery

Aims: Anxiety due to dental interventions and its complications are common in cases, like wisdom tooth surgery. Related pharmacotherapy is also associated with adverse effects and are not accepted by some patients. Virtual Reality (VR) is one of the new and non-invasive technologies proposed in this regard. This study aimed to determine the effects of VR on patients’ anxiety before dental surgery. Methods & Materials: In this clinical trial, 60 patients who were candidates for dental surgery in Dental School in Mashhad City, Iran, were randomly assigned to two groups of control and intervention (n=30/group). Initially, in addition to demographic characteristics, patients’ anxiety levels were measured using the Spielberger State-Trait Anxiety Inventory (STAI). Then, the intervention group was placed in VR space for 12 minutes using the Remax-RT-V03 audio-visual device; however, no intervention was performed in the control group. Before surgery, anxiety was re-measured by a questionnaire in two groups with the same time interval (15 minutes after the first stage). The obtained data were analyzed in SPSS by Independent Samples t-test, Paired Samples t-test, and Chi-squared test at a significant level of P≤0.05. Findings: The Mean±SD age of the examined patients was 26.5±4.9 years. In total, 53.3% and 46.7% of the study participants were female and male, respectively. The research groups were homogeneous concerning demographic characteristics. The Mean±SD scores of anxiety in the research units before the intervention were 55.56±7.08 in the experimental group and 53.70±10.53 in the control group, i.e., not significantly different. However, after the intervention, anxiety decreased in the experimental group (45.56±10.52), compared to the control group (54.53±9.83); the difference between the study groups was significant (P<0.001). Conclusion: Applying VR was effective in reducing patients’ anxiety before dental surgery; thus, its use in dental clinics is recommended after additional studies.

Evaluating the Knowledge and Practice of Anesthesiologists and Students About Oral Ginger Complications in Surgery and Anesthesia

Aims: Ginger of the Zingiberaceae family is abundant in individuals’ diets globally. It has well-known properties, including regulating the immune system, anti-cancer, anti-inflammatory, inhibiting hyperlipidemia, anti-nausea, and antioxidant features. Despite these properties, research suggested its increased bleeding and anticoagulation effects. Thus, the excessive use of this drug can adversely impact anesthesia and surgery. This study aimed to determine the knowledge and practice of anesthesia staff and students about the complications of ginger in surgery and anesthesia. Methods & Materials: This descriptive cross-sectional study examined the level of knowledge and practice of 68 anesthesiologists and students of Allameh Bohlol Gonabadi Hospital about the effects of oral ginger in surgery and anesthesia by a two-part researcher-made questionnaire (to determine knowledge and the performance of individuals). The validity of the instrument was determined based on content and face validity methods and the reliability of the instrument was confirmed by Cronbach’s alpha coefficient (α = 0.078). Data analysis was performed using SPSS v. 19. Findings: The Mean±SD age of the research units were 23.42±11.6 years, with a work experience of 1 to 22 years. In total, 66.7% of the research units were female, 70.5% were married, and most (97.4%) them had a bachelor’s degree. The obtained results suggested that 83.3% of the research units had poor knowledge; concerning performance, 78.2% of the study subjects had poor performance in the preoperative examination of the patient. The level of knowledge of research units was significantly related to education (P=0.033). Furthermore, the examined individuals’ performance was significantly related to their work experience (P=0.029). Conclusion: The present study findings indicated that anesthesiologists were unaware of the beneficial and adverse effects of ginger on anesthesia and surgery of patients and failed to well assess the patient respecting ginger overdose and diet. Therefore, considering the importance of herbal medicines and their effects on the surgical process and treatment of patients, it is suggested to provide training workshops and informing the staff.

Comparing Intravenous Dexamethasone, Pethidine, and Ketamine for Postoperative Shivering Prevention in Patients Undergoing General Anesthesia

Aims: Postoperative shivering is unpleasant and annoying for the patient, occurring in up to 65% of cases undergoing general anesthesia. Various mechanisms were suggested for postoperative shivering. Shivering after anesthesia can cause complications, such as cardiovascular conditions, bleeding, and infection. This study compared the effects of dexamethasone, pethidine, and ketamine on the prevention of shivering after general anesthesia. Methods & Materials: In total, 164 patients with ASA classes one and two in the age range of 20-60 years under general anesthesia with orthopedic surgery, urology, and general surgery were included in the study. This study was a double-blind, randomized, placebo-controlled study. The study patients were divided into 4 groups of 41 subjects. After the induction of anesthesia and before surgery, in the first group, dexamethasone 0.15 mg/kg body weight, in the second group, ketamine 0.5 mg/kg, in the third group, pethidine 0.5 mg/kg, and in the fourth group, normal saline 0.9% were all given in 2 cc volume. After surgery, the examined patients were monitored for visible shivering by the researcher. The obtained data were analyzed using SPSS. Findings: The frequency and severity of shivering were lower in the dexamethasone (P=0.009), pethidine (P=0.004), and the ketamine (P=0.000) groups, compared to the control group. Besides, there was a significant difference between each of these 3 groups and the controls. The frequency and severity of shivering in the dexamethasone group were not significantly different from those of the pethidine group (P=0.565). The frequency and severity of shivering in the dexamethasone and ketamine groups were not statistically significant (P=0.071). The frequency and severity of shivering in the pethidine group with ketamine were not statistically significant (P=0.063). Conclusion: The obtained results indicated that dexamethasone, pethidine, and ketamine were effective in preventing postoperative shivering. There was no difference between these medications in the prevention of postoperative shivering.

Stressors and Coping Strategies During the Outbreak of Coronavirus Disease 2019 Among Hospital Staff: A Case Study in Iran

Aims: The emergence of COVID-19 disease has created significant stress and anxiety for health care workers. This study aimed to investigate the stressors and coping strategies in the staff of Allameh Bohlool Hospital in Gonabad City, Iran, during the outbreak of the COVID-19 disease. Methods & Materials: This cross-sectional study was performed on 252 employees of Allameh Bohlool Hospital in Gonabad from March 2020 to April 2020. Study tools included a brief form of coping styles (Brief-COPE) and a researcher-made questionnaire of stressors due to the emergence of COVID-19 among health care workers. The obtained data were analyzed using linear regression and ordinal regression models at the significance level of 0.05. Findings: About 74.2%, 69.4%, 52.7%, 52.7%, and 99.2% of the hospital staff had moderate to high stress in the domains of internal, family-social, workplace-related, infection control, and government measures, respectively. The degree of using adaptive and maladaptive coping styles used by staff were 52.0% and 23.8% at the moderate to the high level, respectively. Maladaptive coping styles had a positive and significant relationship with stress intensity so that for each unit increase in maladaptive coping score, the odds of experiencing higher levels of stress increased 1.24 to 1.45 times (P<0.001). Also, the odds of experiencing higher levels of stress in those who had sports activities was 24% to 76% lower (P=0.003). Conclusion: The findings of the present study indicated a high level of stress among hospital staff. Also, the use of maladaptive coping styles and sports activities had a significant positive and negative relationship with stress intensity, respectively. Therefore, designing effective interventions focusing on reducing maladaptive coping patterns among hospital staff and encouraging people to engage in sports activities can help manage stress as much as possible due to the outbreak of COVID-19 disease.

The Effect of Hydroethanolic Extract of Pomegranate Peels and High-intense Interval Training on C-reactive Protein, Catalase and Superoxide Dismutase in Rats

Aims: Heavy exercise can damage the immune system by oxidative stress. The role of herbal supplements during and after strenuous exercise is unknown. Therefore, the present study aimed to determine hydroethanolic extract of pomegranate peels and a period of high-intensity interval training on the C-reactive protein and antioxidant enzyme activity in rats. Methods & Materials: This research was an experimental study. The statistical population was rats, of which 36 Wistar rats were randomly selected and were divided into 4 groups (control, hydroethanolic extract of pomegranate peels, high-intensity interval training, and hydroethanolic extract of pomegranate peels + high-intensity interval training). After 8 weeks of interval training and supplementation, blood samples were taken from the rats. Then, the C-reactive protein and the activity of the antioxidant enzymes of superoxide dismutase and catalase were assessed by 1-way analysis of variance. Findings: The results showed that in the group of hydroethanolic extract of pomegranate peels + high-intensity interval training, the superoxide dismutase (P=0.000) and catalase (P=0.003) significantly increased, and the C-reactive protein (P=0.002) decreased. Tukey’s test confirmed the significance of these changes in the hydroethanolic extract of pomegranate peels+high-intensity interval training compared to the control group. Conclusion: The combination of high-intensity interval training and hydroethanolic extract of pomegranate peels could strengthen the immune system, potentially enhances athletic performance, and accelerates recovery after exercises. The hydroethanolic extract of pomegranate peels and high-interval training synergistically boost the immune system and increase physical endurance.