The Role of Preventive Measures or a Previously Immunized Population: A Pilot Study on Coronavirus Disease-19 in Syria

Background: A recent ongoing pandemic of coronavirus disease named coronavirus disease 2019 (COVID-19) has spread in Syria from March 2020 with a pattern of a slow case increase. So far, the government has put the country under lock-down orders as a preventive measure. However, there is a considerable belief in the medical community of our country supposes that the virus has previously passed through the country depending on the high numbers of diagnosed severe respiratory infections early in 2020. Thus, this study was designed to determine the number of people with detectable antibodies to SARS-CoV-2 from two samples of healthy adults with and without a previous history of severe respiratory infection in the last 6 months of the study. Materials and Methods: To this end, samples were collected from 123 and 198 subjects with a previous severe respiratory infection and healthy controls, respectively. Then, immunoglobulin M (IgM) and IgG anti-SARS-CoV-2 antibodies were tested as well. Results: None of the samples from both groups tested IgG positive in the assay while four tested IgM samples were positive. Accordingly, these positive samples were re-analyzed and remained IgM positive in the second test although the reverse transcriptase-polymerase chain reaction for the SARS-CoV-2 virus was negative. Conclusion: Based on our findings, there is no evidence concerning the previous COVID-19 infection in Syria thus it is suggested that all isolation and lock-down orders should be respected as an effective preventive tool in this regard.

Prediction of Alzheimer’s Disease Using Machine Learning Classifiers

Background: Alzheimer’s disease (AD) is the most common brain failure for which no cure has yet been found. The disease starts with a disturbance in the brain structure and then it manifests itself clinically. Therefore, by timely and correct diagnosis of changes in the structure of the brain, the occurrence of this disease or at least its progression can be prevented. Due to the fact that magnetic resonance imaging (MRI) can be used to obtain very useful information from the brain, and also because it is non-invasive, this method has been considered by researchers. Materials and Methods: The data were obtained from an MRI database (MIRIAD) of 69 subjects including 46 AD patients and 23 healthy controls (HC). Individuals were categorized based on two criteria including NINCDS-ADRAD and MMSE, as the gold standard. In this paper, we used the support vector machine (SVM) and Bayesian SVM classifiers. Results: Using the SVM classifier with Gaussian radial basis function (RBF) kernel, we distinguished AD and HC with an accuracy of 88.34%. The most important regions of interest (ROIs) in this study included right para hippocampal gyrus, left para hippocampal gyrus, right hippocampus, and left hippocampus. Conclusion: This study showed that the SVM model with Gaussian RBF kernel can distinguish AD from HC with high accuracy. These studies are of great importance in medical science. Based on the results of this study, MRI centers and neurologists can perform AD screening tests in people over the age of 50 years.

The Relationship Between Serum Vitamin D Level and Severity of Bronchiolitis in Infants Being Referred to in Bandar Abbas Children’s Hospital, Iran

Background: The present study aimed to investigate the relationship between the serum vitamin D level and the severity of bronchiolitis in infants. Materials and Methods: The population of this descriptive-analytical study included all infants within the age range of 1 month to 24 months old with bronchiolitis hospitalized in Bandar Abbas children’s hospital in 2018-2019. According to the exclusion and inclusion criteria, patients were entered in the study and diagnosed with bronchiolitis by a pediatric infectious disease specialist. Then, their serum levels of vitamin D were measured as well. Results: Of the 85 patients, 62.4% and 37.6% were males and females, respectively. The mean serum level of vitamin D was 29.74±13.44 ng/mL. In addition, the mean age in groups with mild-, moderate-, and severe-intensity was 9.27±4.52 months, 5.12±3.95 months, and 3.16±1.16 months (P<0.001), respectively. Further, the Spearman’s correlation between age and serum vitamin D levels was r = 0.05 (P<0.001). Based on the results, there was a statistically significant difference between the mean age in the two study groups (P<0.001). Finally, a statistically significant association was found between the severity of bronchiolitis and vitamin D status (P=0.007). Conclusion: According to the results of the present study, more than half of the infants admitted to the diagnosis of bronchiolitis had insufficient serum levels of vitamin D. There was also a significant association between the severity of bronchiolitis and serum vitamin D levels.

Evaluation of Lomustine-Loaded Iron Nanoparticles on Caspase-6 Gene Expression and Cell Viability in U87Mg Cell Line

Background: Every year, many people around the world die from cancers. Among all types of cancers, brain cancer has been recognized as one of the most deadly cancers due to the late detection and limitations of current therapies, and thus it remains an unresolved problem. Glioblastoma occurs in different parts of the central nervous system and is one of the most important causes of cancer death in people. In addition, there are many problems for the treatment of cancer cells. One of the limiting factors is the resistance of cancer cells to chemotherapy drugs. In this regard, the use of nanoparticles (NPs) is an effective method for overcoming this problem. Materials and Methods: In this study, iron oxide-NPs were synthesized and loaded on the folic and lomustine. Further, the size and morphology of NPs were assessed by transmission electron microscopy, X-ray photoelectron spectroscopy, and dynamic light scattering. Then, the U87-MG cell line was cultured in the Dulbecco’s Modified Eagle Medium and treated with nano, nano-folic, nano-lomustine (LUM), LUM, and complex, followed by evaluating 50% inhibitory concentration, tetrazolium assay, and caspase-6 activity. Results: Our results showed that cell viability decreased in LUM container groups by increasing the incubation time. Based on the caspase-6 activity analysis, the mortality rate increased in LUM container groups after 3 days. These findings indicated that LUM, complex, and nano-LUM increase cell death in U87MG. Conclusion: Finally, the results suggested that LUM in NPs could be applied as a safer form of drug delivery for targeting cancer.

Frequency of tramadol toxicity in Shahid Mohammadi Hospital in Bandar Abbas

Background: Tramadol is a synthetic drug with central mechanisms which binds to µ-opioid receptors. Recently, increased consumption and serious complications have been reported about this drug. Thus, the aim of this study was to determine the frequency of tramadol toxicity in Shahid Mohammadi Hospital in Bandar Abbas. Materials and Methods: This retrospective descriptive study was performed on individuals with tramadol toxicity admitted to Shahid Mohammadi Hospital, Bandar Abbas during 2013- 2014. Information was collected through patients’ medical files using a checklist including demographic characteristics, toxicity complications, and patients’ clinical outcomes. The acquired data were then analyzed using SPSS software. Results: The mean age of 53 patients was 24.71±7.76 years, of which 69.8% were males and 49.1% had a history of drug abuse. In addition, the seizure was observed in 49.1% of them, and 47.2% of cases simultaneously used another drug, along with tramadol. Further, the history of mental disorders was reported in 24.5% of patients. Clinical manifestations included a decreased level of consciousness (49.1%), nausea and/or vomiting (45.3%), and headache (30.2%). Furthermore, the duration of hospital stay was 48 hours in 90.6% of patients. Eventually, a significant correlation was found between seizure and drugs other than tramadol (P=0.001), gender (P=0.004), and occupation (P=0.010). Conclusion: Most cases of tramadol toxicity occur in students and young adults, resulting in complications such as seizure, decreased levels of consciousness, and nausea and/or vomiting. Accordingly, awareness of the complications of tramadol and meticulous observations over its methods of delivery could reduce the associated harms.

Effective Dose Calculation for Patients Undergoing X-ray Examinations in Erbil Hospitals

Background: In conventional X-ray examinations, patients are exposed to radiation. Biological hazards from radiation of any source is expressed as effective dose, and is measured in millisieverts (mSv). The purpose of this study was to assess and calculate the effective dose values for patients undergoing posteroanterior (PA) chest, abdomen, anteroposterior (AP) pelvis, and cervical spine X-ray examinations in general hospitals of Erbil city and compare it with those of other studies. Materials and Methods: A total of 255 patients between 20-70 years of age participated in this work (85 per hospital). The patients’ characteristics included age, sex, examination type, projection posture, and exposure parameters captured by NOMEX Multimeter including tube potential and current-time product. The mean effective doses (EDs) of four different examinations (chest (PA), pelvis (AP), abdomen, and cervical spine) were measured using the Monte Carlo method and compared with those of other studies. Results: The mean EDs were calculated 1.04, 2.01, 3.12, and 3.22 mSv for chest (PA), pelvis (AP), abdomen, and cervical spine, respectively. All ED values in this study were higher than those of published studies. The aim of the study was to increase the awareness of the radiographer and patients undergoing conventional X-ray diagnostic radiology on the risk of ionizing radiation for radiological protection in Erbil hospitals. Conclusion: The mean EDs were increased by an increase in the age; this may increase the probability of cancer incidence and heritable diseases. Hence, dose optimization is required due to more probable incidence of cancer when compared to other studies.

Comparing Nurses and Patients’ Views About Caring Behaviors and its Dimensions in Nurses

Background: Care is a fundamental value in the nursing profession. Nurses’ caring behaviors are effective in patients’ satisfaction as one of the important indicators of the quality of health care. This study was conducted to compare the views of hospitalized patients and nurses about the caring behavior of nursing staff in Khalkhal. Materials and Methods: The present comparative-descriptive study was performed on 200 patients and 60 nurses of Imam Khomeini hospital in Khalkhal in 2018. Sampling was performed by a simple random sampling technique, and Caring Behavior Inventory (CBI-42) was used as the data collection tool. Finally, data were analyzed using SPSS software by descriptive statistical methods and the independent t-test. Results: The means and standard deviations of the total caring behavior from patients’ and nurses’ views were 5.42 ± 0.94 and 30.5 ± 0.59, respectively. There was no significant statistical difference between the nurses’ and patients’ viewpoints regarding each of the caring behaviors (P>0.05) although a statistically significant difference was observed between the overall score of nurses’ and patients’ views (t=2.67, P=0.048). Conclusion: Considering the key role of nurses in treating patients, the need for using appropriate caring behaviors will increase patients’ satisfaction with the treatment system. Therefore, it is suggested that training courses focus on patient-centered care in order to strengthen caring behaviors in nurses.

Assessing the Effect of Carcinoembryonic Antigen Tumor Marker Progression on Survival after Mastectomy in Patients With Breast Cancer: A Joint Survival Longitudinal Approach

Background: Breast cancer remains the most prevalent neoplasm in women, with more than 450000 deaths each year, worldwide. In cancer researches, several factors such as serum tumor markers have an important role in screening, treatment, and recurrence of the disease. Carcinoembryonic antigen (CEA) is one of the most widely used serum tumor markers in the clinical evaluation of patients with breast cancer. This study aimed to evaluate whether increasing serum CEA levels is an indicator of breast cancer patient’s survival or not. Materials and Methods: This retrospective study was done at Hematology Department of Shafa Hospital of Ahvaz, southwest of Iran. Only those patients who had mastectomy during 2006-2014 and regularly referred to the hospital were included. The joint survival longitudinal model was applied to analyze the data. JM package in R software was used for joint modeling analysis. Results: The five-year survival rate was 73.0%. Age and follow-up time were associated with CEA tumor marker values. Higher age is associated with higher CEA values over time (P=0.0156). There was a significant linear increasing trend in CEA values over time (P=0.0465). There was a significant difference between patients with and without nodal involvement (HR [95% CI]: 1.880 [1.330- 5.565]; P=0.0298). There was a positive correlation between CEA tumor marker levels and death (HR [95% CI]: 2.770 [1.369-5.603]; P=0.0046). Conclusion: Higher age is associated with higher CEA values over time. The involvement of lymph nodes increases the hazard of death. Death is more likely to occur in patients with higher CEA tumor marker levels.

Effect of Educational Counseling on Knowledge and Attitude of Pregnant Women Towards Sex During Pregnancy

Background: Insufficient information about sex during pregnancy as well as negative attitude towards it may lead to serious problems in the couple’s communication and sexual relationship. Therefore, this study was conducted to determine the effect of educational counselling on sexual knowledge and attitude of pregnant women during 2014-2015. Materials and Methods: This study was performed on 200 pregnant women referred to 5 health care centers in Kerman. The random allocation method was used to assign mothers to intervention (n=100) and control (n=100) groups. Data were collected by demographic information, sexual knowledge, and attitude questionnaires. Data were analyzed by paired and independent t test, Fisher exact test, chi-square test, Mann-Whitney, Wilcoxon, ANOVA, Kruskal-Wallis, and Pearson’s and Spearman’s correlation tests in SPSS software version 22.0. Results: The mean scores of sexual knowledge and attitude before educational counselling in intervention group were 33.7±15.44 and 50.09±10.88, respectively. Before the intervention, no significant differences were observed between the two groups in knowledge and attitude. One month after the counselling, the mean scores of knowledge and attitude in the intervention and control groups were respectively 79.03±8.71 and 67.88±8.62, indicating a significant difference (P<0.0001). Conclusion: The results of this study confirmed the positive role of counseling and education in increasing knowledge and creating positive attitude towards sexual relationships in pregnant women.

Manifestly Altered MicroRNAs in Poly Cystic Ovary Syndrome

MicroRNAs (miRNAs) constitute a large family of small non-coding RNAs which regulate gene expression at the surface following transcription. They are widely involved in many physiological and pathological processes including polycystic ovarian syndrome (PCOS). PCOS is an endocrine disorder in women. Currently, there is no comprehensive information about the role of miRNAs in PCOS. Thus, this paper has attempted to collate studies on miRNAs in order to determine important changes in their miRNA expression profile in the total blood, serum, plasma, follicular fluid, and granulosa cells in PCOS patients alongside the genes which are targeted for regulation by these miRNAs. This study presents a new approach for using miRNAs and their target genes for diagnosing and treating PCOS.