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"nBackground: Systemic Lupus Erythematosus (SLE) is a prototypic autoimmune disease with diverse clinical manifestations in association with autoantibodies to components of the cell nucleus. SLE as a chronic autoimmune disease has a worldwide distribution. There is a wide variation in the natural history of SLE among different ethnic and geographic groups. Our SLE registry is one of the largest series in Asia-Pacific region. The aim of this study was to show the manifestations of SLE in Iranian patients. "n"nMethods: This study is on clinical and Para clinical manifestations of SLE according to the database of the Rheumatology Research Center (RRC), Tehran University of Medical Sciences as a major referral center for rheumatic disease in Iran during the period of 1976 to 2009. "n"nResults: A total of 2143 SLE patients were studied. The female to the male ratio was 8.8:1 and the mean age at the presentation was 24.2± 10 Years. Prevalence of clinical manifestations included: musculoskeletal, cutaneous, renal, neuropsychiatric, pulmonary, cardiac and hematologic were 85.2%, 83.1%, 66.6%, 24%, 22.3%, 17.5% and 67.1% respectively. There were seen positive FANA in 78.3% and anti-DNA in 70% of patients. Overlap syndrome and positive family history with other autoimmune diseases were detected in 14.9% and 3.4% of patients respectively. "n"nConclusion: The prevalence of some manifestations (such as cutaneous and renal involvement) in our patients were similar to those of nearby countries (with similar climate), while other manifestations (such as hematologic and joint involvement) were similar to the European countries (with similar ethnicity). Genetic and/or climatic factors may lead to different presentations of lupus.

"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Osteoarthritis is the most common form of arthritis in the world. This study presents the evidence on the prevalence of symptomatic hand osteoarthritis in urban community. To add to the evidence on the prevalence of symptomatic hand osteoarthritis in urban community."n"nMethods: Inhabitants (age≥15 yrs) in 22 randomly selected districts (Tehran) participated in a Community-Oriented Program for Control of Rheumatic Diseases (COPCORD) evaluating major rheumatic disorders, including osteoarthritis. Eventually, 10, 291 inhabitants completed a Questionnaire (75% response-rate). Trained interviewers asked participants whether they had had any pain, swelling, tenderness, or morning stiffness in the right/ left hand during previous seven days. Participants underwent a complete physical examination if they had any musculoskeletal complaint or extra-articular manifestation of rheumatic disease. Osteoarthritis was defined as presence of palpable nodules (Heberden's/ Bouchard's nodes, CMC1's squaring), pain, tenderness, swelling, or a combination of them on that joint (DIP-PIP-MCP-CMC1). Clinical hand osteoarthritis was positive if at least one joint showed osteoarthritis. "n"nResults: Symptomatic hand osteoarthritis was present in 2.8%(CI; 2.3-3.4) (52.6% female, mean age; 37.1±16.3). Prevalence was higher in females (4.3% vs. 1.3%, p=0.000) and increased with age (0.1% in people 70, p=0.000). The most common signs in the DIP, PIP and CMC1 joints were bony enlargement, followed by tenderness and pain on movement. "n"nConclusions: our study confirms the evidence of high prevalence of symptomatic hand osteoarthritis in an urban community. The prevalence, pattern of hand joints involvement and relationship with age and sex in this study performed in an Eastern community resemble those in Westerners, which calls for further attention by appropriate services.

At present, some clinical presentations and serological parameters such as products of complement activation and elevation of autoantibodies (e.g. dsDNA antibodies), erythrocyte sedimentation rate (ESR), levels of C-reactive protein (CRP), or cytokines such as IL-2/IL-2 receptor, IL-6 and IL-10 are used as indirect serological markers with variable degrees of significance. To date, no specific serological parameter is available to assess disease activity in SLE. Soluble serum thrombomodulin is a new marker of endothelial cell injury and vasculitis. The objective of this study was to determine in vivo soluble thrombomodulin as a marker of disease activity in SLE pa-tients and compare serum thrombomodulin in SEL patients with and without renal involvement and inactive SLE patients. Sixty-four patients fulfilling ACR criteria with proven SLE with differ-ent disease activities were tested for serum levels of Thrombomodulin and dsDNA by ELISA. C3, C4 and FANA were also measured by standard laboratory tests. The clinical disease activity was evaluated by the Systemic Lupus Erythematosus Activity Index (SLEDAI). Elevated soluble thrombomodulin had significant correlations with an increased ANA level (P= 0.037), decrease level of C3 (P =0.017), increase of SLEDAI (P=0.003) and strongly associated with renal in-volvement in SLE. Thrombomodulin level and Anti dsDNA in active patients with and without re-nal disease were higher than inactive patients. In SLE, serum thrombomodulin seems to be impor-tant marker for evaluation of disease activity.

Isolated hematuria and its association with proteinuria, and urinary cast and systemic lupus erythematosus (SLE) disease activity, and decision for renal biopsy is a dilemma for physician in SLE patients. The aim of this study was to investigate 1. whether isolated hematuria is associated with active SLE, 2. to determine duration between hematuria and proteinuria and urinary cast, and 3. to determine renal histological type in SLE patients with isolated hematuria. All episodes of isolated hematuria between 1981 and 1997 were identified from Lupus Unit, Rheumatology Research Center database. Isolated hematuria was defined as >5 RBC/hpf in the absence of urinary infection and other renal manifestations. Relation of hematuria was assessed with proteinuria and urinary cast and SLE disease activity. Needle renal biopsy was done in 19 SLE patents with isolated hematuria. 4.42% (31/700) of our cohort had at least one episode of isolated hematuria. Out of 31 patients in whom the isolated hematuria was the first documented renal manifestation, 11 patients (35.48%) developed another renal manifestation (25.8% proteinuria and 9.67% casts). 54.54% (6/11) of patients developed proteinuria and urinary cast within 3 months. The mean time for development of a second renal manifestation for the patients with isolated hematuria was 19.9 months. Renal needle biopsy was performed for 19 patients (5.78% type IV, 63.15% type III and 21.50% type II). The results of the present study indicate that isolated hematuria is not rare in SLE patients. Also, there was no significant relationship between isolated hematuria and anti ds-DNA, C3, C4 and major organ involvement in patients with SLE. Our study suggests that SLE patients who have isolated hematuria should undergo renal biopsy and that isolated hematuria should be considered a manifestation of active renal SLE.

"nBackground: There are several evidences that genetic factors besides environmental triggers have important role in initiating the rheumatoid arthritis (RA). The aim of this study was to investigate the association of rheumatoid arthritis with different subtypes of HLA DR4 in Iranian patients. "nMethods: In an un-matched case control study, 110 rheumatoid arthritis patients (case) and 56 knee osteoarthritis patients (control) of outpatient clinic in Shariati Hospital were entered to the study. After blood sampling from case and control groups, DNA was isolated by using salting-out method and HLA DR4 and its subtypes were detected. Association of HLA DR4 and its subtypes with rheumatoid arthritis, rheumatic factor and clinical manifestations of diseases was evaluated. "nResults: Eighty nine (80.9%) of rheumatoid arthritis patients were female and 21 were male. Thirty four of the RA patients (30.9%) and eleven subjects from the control group (19.6%) were HLA DR4 positive (p=0.12). The most frequent subtype of HLA DR4 in RA patients was 0404 and in control group was 0401 (p=0.03). There were not statistically significant association between HLA DR4 and age of disease onset, family history, morning stiffness and rheumatoid factor. Joint swelling and tenderness had association with HLA DR4 (p=0.04 and p=0.03). "nConclusion: Although there were no statistically significant association between rheumatoid arthritis and HLA DR4, but prevalence of this HLA was higher in patients than control. It is possible that in some ethnics, other HLAs may have role in pathogenesis of disease.

Background: Osteoporosis threatens the aged population especially the menopausal women and can lead to life long disability and death. Appropriate knowledge and behavior have an important role in prevention of osteoporosis. In this study the knowledge, attitude and behavior of women regarding osteoporosis is assessed and compared in different age groups.Methods: This cross sectional study includes 390 women in reproductive, premenopausal and menopausal age groups who had come to Shariati hospital clinics and each had answered the designed questionnaire. The questionnaires were scored and analyzed. Women's knowledge, attitude and behavior were assessed and compared by X2 test in the three age groups and P

Background: Trauma is the most common cause of mortality in the first four decades of life. In our country, cardiovascular diseases and trauma are leading causes of mortality, respectively. By gathering information on trauma mortalities, we can learn more about causes, and that knowledge can lead to prevention. Methods: This is a prospective descriptive study in Tehran during 12 months period (Sep 1999- Sep 2000). Two hundred and forty five trauma deaths in six hospitals were evaluated. The data was collected through a questionnaire, designed in Sina Trauma and Surgery Research Center (STSRC) used for the study. The questionnaires were completed by trained physicians visiting trauma patients in emergency room and wards round the clock. Data obtained included patient demographics, level of prehospital care, medical and operative procedures performed in emergency rooms (ER) and wards (according to ICD-10 coding), Glasgow Coma Scale (GCS) and vital signs at time of presentation to emergency rooms, Injury Severity Score (ISS), length of hospital stay and outcome of patients.Results: Twenty and forty five (3%) of 8000 trauma patients was died. Mean age was 40.7 (±23.5) years old and 208 (84.9%) patients were male. The highest mortality rate was seen in the age group of 25 to 30 years. Road Traffic Accident was the main cause of death followed by falling with 174(71%) and 41(16.85), respectively. Among victims of road traffic accident, pedestrians and motorcyclists were prominent with 119 and 28 cases respectively. The majority of cases were dead due to head injuries (69%) and abdominal trauma was the second cause with 19 (7.8%) cases.Conclusions: Based on our findings the mechanism of injury have the positive effect on trauma outcome .Traffic accidents and assault is preventable and must be attended.

Background: Heat-shock proteins are part of a strictly controlled biological system that allows organisms to respond to environmental stresses. Different proinflammatory cytokines are present in the synovial tissue of rheumatoid arthritis patients. Such tissues respond to stress and induce heat-shock proteins. In addition, synovial cells are exposed to mechanical stress caused by joint motion. The effects of mechanical stress on the metabolism of the synovial cells may be substantial, even pathogenic. Heat-shock proteins are often implicated in the pathogenesis of rheumatoid arthritis. Here, we compare the levels of heat-shock protein 70 from the synovial fluid of rheumatoid arthritis and osteoarthritis patients.Methods: Synovial fluid samples from 34 rheumatoid arthritis patients and 34 osteoar-thritis patients were analyzed for heat-shock protein 70 by an ELISA method. Statistical analysis was performed using independent T-test and one-way ANOVA. Differences were considered statistically significant at p< 0.05.Results: The mean value of synovial fluid heat-shock protein 70 levels in rheumatoid arthritis patients was 156.30 ±128.51 and that of osteoarthritis patients was 14.98 ±11.58. The differences were statistically significant at p

Background: The cause of osteoporosis is multifactorial and many dietary factors are important in the prevention of this disease. Antioxidants as free radical scavengers may influence osteoporosis by reducing the effects of oxidative stress that may be associated with bone loss. Vitamin E is an important antioxidant that protects polyunsaturated fatty acids (PUFA) in cell membranes from oxidation. There are only two studies regarding vitamin E plasma levels in subjects suffering from osteoporosis. The purpose of this study was to investigate the association between plasma vitamin E levels and bone mineral density (BMD) in Iranian patients. Methods: Subjects were consecutively recruited between May and September 2005 from among a total of approximately 1000 people referred for instrumental screening for osteoporosis to the Jami Clinic in Tehran. Inclusion criteria for the study group were: a femoral neck T-score of -1 or less, osteopenia, severe osteopenia and osteoporosis. A total of 137 subjects were enrolled. According to their femoral and spinal BMD scores, 54 persons were selected as a control group. The control group consisted of subjects with a femoral neck T-score and spine T-score of -1 or more. In selecting the case group, only the femoral BMD score was used. Plasma vitamin E was measured, after extraction with methanol, by HPLC with UV detection at 280 nm. Methanol, deionized water and butanol (90:4:6) was used as a mobile phase with a C8 column. The flow rate was 1.0 ml. min-1 and the acetate ester of vitamin E was used as an internal standard. Results: The results show no significant difference in plasma vitamin E between the control and case groups, however linear regression analysis does reveal a significant difference between the T-score and plasma vitamin E. Conclusion: Deceleration Femoral bone Density during osteoporosis will be Accelerated with Decrease of Vitamin E Antioxidant level.

Background: Both isokinetic testing and functional tests are commonly used to evaluate anterior cruciate ligament reconstructed (ACLR) patients. The object of this study was to evaluate motor performance of the knee and determine the relationship of isokinetic test scores to scores on a variety of lower extremity functional tests. Methods: Ten healthy subjects and eleven ACLR patients at least six months after surgery performed the following: knee isokinetic tests at 60 and 180 deg/sec; three functional tests including leg vertical jump, single hop, and triple cross-over hop for distance. The International Knee Document Committee Subjective Knee Evaluation Form (IKDCSKEF) was used to score the self-assessment of each study participant. Paired T-test was used to compare the involved and uninvolved knee. Pearson correlation coefficients were used to determine the relationship between the scores on the isokinetic test and functional tests. Significance was determined by P

Background: Pulmonary involvement is a common and serious complication of rheumatoid arthritis. This cross sectional study sought to determine the prevalence of pulmonary disease in patients with rheumatoid arthritis on the basis of history, physical examination, chest X-ray and PFT. Materials and Methods: 103 patients (81 Women, 22 Men) fulfilling the ACR (American College of Rheumatology) criteria for RA (Rheumatoid arthritis) were consecutively included in a cross sectional study. Detailed medical (including respiratory symptoms and the disease activity symptoms) and drug and occupational histories and smoking were obtained. All patients underwent a complete pulmonary and rheumatologic examination and conventional chest radiography. All patients underwent PFT that comprised spirometry and body plethysmography. Results for PFTs were expressed as percentage of predicted values for each individual adjusted for age, sex, and height. Results: On the basis of history: Their mean age was 43.3 ± 2.6 years (range: 17-74) and the mean duration of the disease was 69.3 ± 15.6 months. Rheumatoid factor was positive in% 61.2. No patients were 0.5Pack/Year smoker in whole life. Prevalence of pulmonary involvement based on radiographic and pulmonary function test detected in 41 patients (39/7%). The most frequent respiratory clinical finding was dyspnea (33%), (NYHA grade I in 17.5% and NYHA grade II in 15.5%), Cough (with or without sputum) in 13.6 %, Crackle was the most sign in pulmonary examination (5.8%). Chest X-ray was abnormal in 13.3 % that the most common finding in this study was reticulonodular pattern in 20 patients (19.4 %), and pleural effusion detected in 7 patients (6.7%). PFT was abnormal in 30 patients (29.1 %). A significant decrease of FEF 25%-75% below 1.64 SD. Small airway involvements was the most abnormal finding of PFT. No relation between rheumatoid arthritis disease activity (ESR>30, Morning stiffness>30', Anemia, thrombocytosis) with pulmonary disease was seen. Conclusion: This study suggests a high prevalence of lung involvement in patients with rheumatoid arthritis.Therefore; we recommend a complete investigation in patients with RA with any respiratory symptom.

Lupus erythematosus (LE) is an autoimmune disease. The mortality rate and causes of death are different in various countries. The present study is done to find out the causes of mortality in the systemic lupus erythematosus (SLE) patients in lupus unit of Rheumatology Research Center and other wards of Shariati Hospital. This study was retrospective according to medical records of patients who were referred to Lupus Unit of Rheumatology Research center, ICU, Gynecology and Nephrology wards of Shariati hospital during 10 years, from 1991 till 2001. Of 2021-recorded patient’s files, 165 (7.8%) deaths were already recorded. 84.8% were female and 15.2% male. The duration of disease was 36±12 months. The mean duration of follow up from entering the study till time of death was 25.9±16.8 months. The causes of mortality were as follows: infection (12.1%), respiratory (8.5%), CNS (13.9%), kidney (3.6%), malignancy (1.2%), unknown (7.8%), active lupus (3%). Infection accompanied with other causes (27.9%) , respiratory with other causes (11.5%), CNS with other causes (5.5%) and renal with other causes (4.8%). Infections are the most common cause of death in SLE Iranian patients, which is compatible with some multicentric studies. But in some previous studies myocardial infarction was reported as the main cause of death.

Background and Objectives: Helicobacters are gastric and enterohepatic and live in the gut. The role of enterohepatic Helicobacters as intestinal pathogens is uncertain, while stomach Helicobacters are well-known. The prevalence of Helicobacter species in cat feces helps us understand their impact on cat health and human disease transmission. This study used PCR to identify Helicobacter spp. in feces samples from healthy and diarrhoeic cats, independent of the reason. The study also compared intestinal and stomach Helicobacter species. Materials and Methods: PCR analysis was performed on fecal samples from 40 cats, with 20 cats having diarrhea and 20 cats showing no symptoms. The PCR analysis aimed to detect Helicobacter's presence using a method that identifies the bacteria through the 16S rRNA gene. Results: The diarrhoeic group had a greater prevalence of infection (17:9 ratio), with an overall 65% infection rate detected. Cats that were older than 2 years showed a higher incidence of disease. H. canis had the highest occurrence rate (69.2%), followed by H. bilis, H. bizzozeronii, and H. salomonis. Significantly, H. pylori, H. felis, and H. heilmannii were not reported. Conclusion: H. canis was the predominant species found in both healthy and diarrheic cats, indicating the need for more investigation. The detection of the gastric species H. salomonis and H. bizzozeronii further complicates the classification. This highlights the complex nature of Helicobacter infections in cats, emphasizing the need for further investigation to guide the development of preventative measures and treatment techniques for both veterinary and public health purposes.

Background: Due to the fact that various factors are involved in the development of chronic kidney disease, this disease appears with different clinical and laboratory symptoms. The variety in type and number of clinical symptoms often misguides the treating physician. The aim of this study is to extract the key features of the disease and find the best data mining methods to improve the accuracy of kidney disease diagnosis. Methods: This cross-sectional study was conducted from September 2021 to March 2023 for 30 months at Rafsanjan Ali Ebn Abi Taleb Hospital. Predictive models were developed and tested using different combinations of disease characteristics and seven data mining methods in RapidMiner Studio software. The limitations of the study are as follows: 1) The models were based on 40-year-old and older patients records, which may limit the generalization of results to a wider age group. 2) Despite the high accuracy and comprehensiveness of the method, the models were based only on the information of kidney disease patients at Ali Ibn Abi Talib Rafsanjan Hospital. 3) The climate parameter has not been considered in the data set of the investigation to discover the hidden relationships of this parameter with the kidney disease. Results: The results of the experiments in this study showed that the proposed prediction model using the Bayes method and eight identified key features (age, renal biopsy, uremia, sedimentation, albumin, edema, nocturnal enuresis, and urine-specific gravity), can detect kidney disease in people of different clinical characteristics, with 99.38% accuracy. Conclusion: Considering that the early diagnosis of kidney disease and the adoption of appropriate treatment methods can prevent the progression of kidney damage, in this study, an attempt has been made to achieve this goal by using new statistical methods and artificial intelligence techniques. Based on the proposed method and the conducted experiments, the most important features and the best data mining method were obtained, and finally, kidney disease prediction was possible with high accuracy.

The current study aims to evaluate the potential role of extracorporeal shock wave therapy (ESWT) on functional status, physical disability, and pain in patients suffering from low back pain (LBP). ESWT may provide superior therapeutic outcomes in reducing pain and ameliorating the patient's functional status regarding LBP.

Background: Leishmania is a vector-borne protozoon, which causes visceral, cutaneous and mucocutaneous leishmaniosis in human and animals. Monocyte-derived exosome vaccines can be used as prophylaxis and immunotherapy strategies. The aim of this study was to design a multiple-epitope candidate vaccine using leishmaniolysin (GP63) and rK39 proteins against Leishmania major and L. infantum for monocyte-derived exosome preparation. Methods: This study was carried out in Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran, 2023–2024. Effective immunodominant epitopes were selected from two antigenic proteins of GP63 and rK39 using various immunoinformatics and bioinformatics approaches. Vibrio cholerae β-subunit was used as an adjuvant to stimulate immune responses. Then, appropriate linkers were selected for the fusion of epitopes. The 3D model of candidate vaccine was predicted and validated. Results: This designed candidate vaccine could effectively be used as a prophylaxis strategy against leishmaniosis. Conclusion: A candidate vaccine was designed using bioinformatic and immunoinformatic studies with virtual acceptable quality; however, effectiveness of this vaccine should be verified through further in-vitro and in-vivo studies.

not needed for editorial

Kienbock disease (KD) was described by Robert Kienbock in 1910 as osteomalacia of the lunate. A century has passed since the first description of KD, and numerous theories, classifications, and treatments have been published for achieving the best outcomes for this disease, but the treatments remain controversial among surgeons. Various classifications have been proposed for KD based on radiography, MRI, arthroscopy, and morphology from 1947 to 2017. Recently, the pioneers of KD (Lichtman and Bain) proposed a new classification based on all the previous classification (radiographic, MRI, and Arthroscopy). This classification seems to be the best evaluation method and treatment for KD. We recommend using this new classification for assessment of Kienbock disease.

Intertrochanteric (IT) fractures are responsible for almost half of the fractures in the elderly. The financial burdens of IT fractures are considerable, not only because of their influence on morbidity and mortality but also because they might lead to functional limitation, alleviated quality of life, and a limited possibility to work. There are several methods of fixations for IT fractures, such as cephalomedullary nailing, dynamic hip screw (DHS), proximal femur plate, and external fixator. Most of the patients with this fracture were unsuitable for anesthesia and surgical procedure. The external fixator is a fast, non-invasive, and bloodless method for fixation which would be performed with light sedation. In the present study, we reviewed recent literature regarding external fixators for IT fractures.

Introduction: There are different mathematical models describing the propagation of an epidemic. These models can be divided into phenomenological, compartmental, deep learning, and individual-based methods. From other viewpoints, we can classify them into macroscopic or microscopic, stochastic or deterministic, homogeneous or heterogeneous, univariate or multivariate, parsimonious or complex, or forecasting or mechanistic. This paper defines a novel univariate bi-partite time series model able to describe spreading a communicable infection in a population in terms of the relative increment of the cumulative number of confirmed cases. The introduced model can describe different stages of the first wave of the outbreak of a communicable disease from the start to the end. Methods: The outcome of the model is relative increment, and it has five positive parameters: the length of the first days of spreading and the relative increment in these days, the potent of the mildly decreasing trend (after the significant decrease), and the adjusting coefficient to adapt this trend to the initial pattern, and the fixed ratio of the mean to the variance. Results: We use it to describe the propagation of various disease outbreaks, including the SARS (2003), the MERS (2018), the Ebola (2014-2016), the HIV/AIDS (1990-2018), the Cholera (2008-2009), and the COVID-19 epidemic in Iran, Italy, the UK, the USA, China and four of its provinces; Beijing, Guangdong, Shanghai, and Hubei (2020). In all mentioned cases, the model has an acceptable performance. In addition, we compare the goodness of this model with the ARIMA models by fitting the propagation of COVID-19 in Iran, Italy, the UK, and the USA. Conclusion: The introduced model is flexible enough to describe a broad range of epidemics. In comparison with ARIMA time series models, our model is more initiative and less complicated, it has fewer parameters, the estimation of its parameters is more straightforward, and its forecasts are narrower and more accurate. Due to its simplicity and accuracy, this model is a good tool for epidemiologists and biostatisticians to model the first wave of an epidemic.

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by synovial tissue transformation and fibroblast-like synoviocyte (FLS) proliferation. Galectin-3 is gaining attention as a diagnostic and prognostic biomarker for RA diagnosis. Elevated levels of Galectin-3 cause RAFLSs to stimulate and generate proinflammatory agents, contributing to cartilage degradation and osteoclast formation. This systematic review and meta-analysis aimed to evaluate published evidence and support future investigation of Galectin-3 as an early biomarker for RA. A systematic search was performed through four databases, including PubMed, the Web of Science, Scopus, and Embase, to find the studies examining Galectin-3 in individuals with RA compared to healthy controls. The risk of bias was evaluated using the Newcastle-Ottawa Quality Assessment Scale. Random-effects meta-analysis comparing serum/plasma Galectin-3 levels between individuals with RA and healthy control groups was performed to determine the standardized mean differences (SMD) along with 95% confidence intervals. Following the initial search, studies went through screening. 12 studies, involving 773 patients with RA and 411 healthy controls, were included. Meta-analysis of the included studies revealed that individuals with RA had significantly higher levels of circulatory Galectin-3 compared to healthy control groups (SMD 0.957, 95% CI 0.393 to 1.520). Univariable meta-regression showed no significant association between age, publication year, sample size, or the male percentage with effect size. According to the results, Galectin-3 might be useful as a biomarker for RA. To support these findings, further investigations of Galectin-3 as a possible early biomarker of RA is necessary. [ABSTRACT FROM AUTHOR]

Purpose: We synthesized folic acid-conjugated Fe3O4/Au-pralidoxime chloride Nanoparticles (Fe2O3/Au@PAM NPs) for use as dual-modal contrast agents for Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) in the diagnosis of breast cancer. Materials and Methods: Fe2O3/Au@PAM NPs labeled or not to folic acid were synthesized and analyzed by dynamic light scattering, transmission electron microscopy, and vibrating sample magnetometry. The ability of these NPs to create image contrast was also investigated in silico and in vitro (in MCF-7 breast cancer cells and A549 lung cancer cells) with CT and MRI. Results: Dynamic light scattering and transmission electron microscopy revealed that the Fe2O3/Au@PAM NPs were nearly spherical. The average diameter of Fe2O3/Au NPs increased from 11.6 nm to 98 nm after folic acid conjugation. The saturation magnetization values of Fe2O3/Au@PAM NPs with and without folic acid conjugation were 25.56 and 32.6 emu/g, respectively. Conjugation of folic acid to NPs greatly improved their uptake by cancer cells. The additional coating of NPs with FA reduced the T2 relaxation time and signal intensity for MRI. Folic acid-labeled MCF-7 cells had a radiodensity measurement of 208 Hunsfield Units (HU) compared to 95 HU for A549 cells. For breast cancer cells, NPs labeled with folic acid significantly improved the X-ray absorption coefficient as a sign of active cellular uptake compared to NPs without labeling. Conclusion: Folic acid-labeled Fe2O3/Au@PAM NPs can serve as dual CT/MRI contrast agents and improve the sensitivities of both modalities for the detection of cancer cells.

Purpose: The danger of radiation at low doses continues linearly, and without a threshold, investigations concluded that although the risk of cancer from Computed Tomography (CT) scans is low, it is not zero. This study aims to determine the patient's radiation dose and estimate the Lifetime Attributable Risk (LAR) of cancer incidence for a single chest CT scan in children. Materials and Methods: We divided 1,105 children into four age groups: 0 years, 5 years, 10 years, and 15 years. Dosimetric data of chest CT scan were plugged in VirtualDoseCT software, and organ dose and effective dose were calculated. The cancer risk based on organ dose is estimated according to the BEIR VII report. Results: The highest dose in boys was related to lung (5.13 - 6.8 mSv) and heart (5.27-5.97 mSv), and in girls, lung (4.98 - 5.91 mSv), breast (4.24 - 5.21 mSv), and heart (4.9 - 5.71 mSv) had the highest dose. The highest LAR (per 100,000) was obtained for the breast in the age group of 0 years (61.01), followed by the breast for the age group of 5 years (46.16) and lung in the age group of 0 years (43.32) in girls. Conclusion: This study shows a better concept of radiation dose in the chest CT scan in children and how much effective dose and organ dose values increase the cancer risk.

Takayasu arteritis (TA) is a chronic inflammatory disorder characterized by vascular damage and fibrosis in the intima that commonly occurs in the aorta. In many damaged sites in TA patients, natural killer (NK) cells have been shown to be hyperactivated and produce inflammatory cytokines and toxic components. Killer cell immunoglobulin-like receptors (KIRs) are found on NK cells and interact with human leukocyte antigen (HLA) class I ligands to activate or suppress NK cells. The present study assessed the possible role of KIR and their HLA ligand genes in susceptibility to TA in Iranian patients. This case-control study included 50 TA patients and 50 healthy subjects. DNA was extracted from whole peripheral blood samples, and polymerase chain reaction with sequence-specific primers (PCR-SSP) was performed to recognize the presence or absence of polymorphism in 17 KIR genes and 5 HLA class I ligands in each participant. Among the KIR and HLA genes, a significant decrease was detected in the frequency of 2DS4 (full allele) in TA patients (38%) compared with healthy controls (82%) (OR=0.13, 95% CI=0.05–0.34). However, none of the KIR and HLA genotypes or the interactions between these genes were associated with susceptibility to TA. The KIR2DS4 gene might be involved in the regulation of activation as well as the production of cytotoxic mediators of NK cells in patients with TA.

This study aimed to assess the antinociceptive activity of extracts and fractions of Paeonia daurica subsp. macrophylla in BALB/c mice. Various doses of hydro-alcoholic extract (HE), hexane fraction (F-hexane), methanol (F-MeOH), and chloroform (F-CHCl3), as well as aqueous extracts (AE), were evaluated by a well-known model, a formalin-induced pain test in mice. All extracts, piroxicam 0.1 mg/kg, and negative control groups were administered 30 minutes before formalin injection. Flinching, licking, and biting reflexes were measured as painful factors compared with controls at intervals of 0 to 5 minutes, 0 to 15, and 0 to 60 minutes after formalin injection. The acute oral toxicity test of total ethanolic and aqueous extracts showed no signs of toxic effect up to a dose of 5000 mg/kg. In the formalin test at a time interval of 0 to 5 minutes, there was no significant difference between the results of the study groups. In the range of 0 to 15 minutes, the effect of AE (1 g/kg), HE (2, 3 g/kg), and F-hexane (1 g/kg) was significantly higher than the positive control group (p

Background and Objectives: Helicobacters are gastric and enterohepatic and live in the gut. The role of enterohepatic Helicobacters as intestinal pathogens is uncertain, while stomach Helicobacters are well-known. The prevalence of Helicobacter species in cat feces helps us understand their impact on cat health and human disease transmission. This study used PCR to identify Helicobacter spp. in feces samples from healthy and diarrhoeic cats, independent of the reason. The study also compared intestinal and stomach Helicobacter species. Materials and Methods: PCR analysis was performed on fecal samples from 40 cats, with 20 cats having diarrhea and 20 cats showing no symptoms. The PCR analysis aimed to detect Helicobacter's presence using a method that identifies the bacteria through the 16S rRNA gene. Results: The diarrhoeic group had a greater prevalence of infection (17:9 ratio), with an overall 65% infection rate detected. Cats that were older than 2 years showed a higher incidence of disease. H. canis had the highest occurrence rate (69.2%), followed by H. bilis, H. bizzozeronii, and H. salomonis. Significantly, H. pylori, H. felis, and H. heilmannii were not reported. Conclusion: H. canis was the predominant species found in both healthy and diarrheic cats, indicating the need for more investigation. The detection of the gastric species H. salomonis and H. bizzozeronii further complicates the classification. This highlights the complex nature of Helicobacter infections in cats, emphasizing the need for further investigation to guide the development of preventative measures and treatment techniques for both veterinary and public health purposes. [ABSTRACT FROM AUTHOR]

Introduction: Myocardial perfusion imaging (MPI) faces a challenge in diagnostic accuracy due to gastric wall uptake (GWU). Previous studies have linked GWU to proton pump inhibitors (PPIs) intake, but only a minority of patients on PPIs show activity accumulation. Our study aimed to investigate the influence of PPIs on GWU in MPI by single photon emission computed tomography (SPECT) and assess the necessity or benefits of discontinuing PPIs before the procedure. Methods: The 368 patients who underwent a two-day stress/rest [99mTc]Tc-MIBI SPECT/CT MPI were divided into three groups: (i) Control group (n=114, without the consumption of any gastroprotective medication), (ii) continued medication(n=48, on PPI treatment) and (iii) discontinued medication (n=206, PPI discontinued for one day or more before MPI). Rest SPECT images were analysed for clinically relevant GWU. Results: Based on our study, out of 114 patients in group (i),16 individuals (14%), and 10 patients from 48 patients in group (ii) (20.8%) demonstrated radioactivity accumulation in the gastric wall. In group (iii), despite discontinuing PPIs use, 20.3% of patients showed GWU. Statistical analysis of these three groups and their subgroups did not show any significant difference in terms of gastric wall uptake of [99mTc]Tc-MIBI in MPI. Conclusion: Concisely, our study found no significant link between PPI use and gastric wall activity in MPI. Further data is needed before adjusting drug guidelines in nuclear medicine centers. Multicenter studies with larger patient cohorts must explore the PPI-GWU relationship, utilizing SPECT/CT scans for precise interference location determination. [ABSTRACT FROM AUTHOR]

Background: Leishmania is a vector-borne protozoon, which causes visceral, cutaneous and mucocutaneous leishmaniosis in human and animals. Monocyte-derived exosome vaccines can be used as prophylaxis and immunotherapy strategies. The aim of this study was to design a multiple-epitope candidate vaccine using leishmaniolysin (GP63) and rK39 proteins against Leishmania major and L. infantum for monocyte-derived exosome preparation. Methods: This study was carried out in Faculty of Veterinary Medicine, University of Tehran, Tehran, Iran, 2023-2024. Effective immunodominant epitopes were selected from two antigenic proteins of GP63 and rK39 using various immunoinformatics and bioinformatics approaches. Vibrio cholerae ß-subunit was used as an adjuvant to stimulate immune responses. Then, appropriate linkers were selected for the fusion of epitopes. The 3D model of candidate vaccine was predicted and validated. Results: This designed candidate vaccine could effectively be used as a prophylaxis strategy against leishmaniosis. Conclusion: A candidate vaccine was designed using bioinformatic and immunoinformatic studies with virtual acceptable quality; however, effectiveness of this vaccine should be verified through further in-vitro and in-vivo studies. [ABSTRACT FROM AUTHOR]

The severe coronavirus disease 2019 (COVID-19) is associated with increased levels of blood interleukin (IL)-6. Therefore, it is hypothesized that modulating the levels or effects of IL-6 could diminish airway inflammation and alter the course of COVID-19. We conducted a controlled, randomized, double-blind clinical trial on hospitalized patients with severe COVID-19 in Iran. The patients were randomly distributed by block randomization to take either standard-of-care (SOC) plus 1 or 2 doses of tocilizumab 8 mg/kg or SOC alone. The endpoint was defined by clinical improvement and discharge. We enrolled 40 patients (20 patients in each group) from 10 July to 10 December 2020. After randomization, 1 patient in the SOC arm and 3 patients in the tocilizumab arm refused to participate and were eliminated from the study. The mean age of participants was 59.62±15.80 in the tocilizumab group (8 women and 9 men) and 63.52±12.83 years old in the SOC group (9 women and 10 men) groups. The number of patients who recovered did not differ significantly between the tocilizumab and SOC groups (12 [70.6%][70.6%] vs. 15 [78.9%]), respectively). Hospitalization rates were also similar between the groups (Log-rank test, p=0.615; hazard ratio, 0.83; 95% CI [0.39–1.78]). The results show that tocilizumab could not be a beneficial agent for treating severe cases of COVID-19 patients and would not significantly improve clinical outcomes. [ABSTRACT FROM AUTHOR]

Background: The importance of magnetic resonance imaging (MRI) screening in high-risk women is well-known; however, its utility in women at average or intermediate risk is not well-established. The main purpose of the study was to investigate the added value and cancer detection rate (CDR) of using abbreviated MRI protocols in average or intermediate-risk women. Methods: A total of 431 asymptomatic women with average or intermediate risk of breast cancer who underwent screening abbreviated MRI from May 2019 to May 2022 were recruited. CDR in screening MRI among average or intermediate-risk women and in low or high-breast composition was calculated. Results: In 173 patients with intermediate risk, 5(1.16%) malignant lesions were detected and in 258 average-risk patients, 10(2.32%) added cancers were found in screening abbreviated MRI compared to mammography. Among the 15 malignant lesions, more cancers in high breast composition were detected (11 vs. 4 cases); however, there was no statistically significant difference between the cancer detection rate and breast composition. In intermediate-risk women with high breast composition, 3 (0.69%) malignant lesions, and in average-risk women with high breast composition, 8 (1.85%) added cancers were found. Conclusion: We provided 3.48% added cancer detection in screening abbreviated MRI compared to mammography. Therefore, screening abbreviated MRI with less image acquisition and interpretation time may be useful as a supplemental screening tool for cancer detection especially in high breast composition. [ABSTRACT FROM AUTHOR]

Background: Dietary Supplement (DS) is a manufactured preparation intended to supplement the diet; unlike medications, they are not intended to diagnose, treat or cure disease. Iran’s Food and Drug Administration (FDA) has been collecting sales data from distribution companies. This datasheet is a remarkable source for the market analysis of medicines and dietary supplements. No study exists on the state of the market for dietary supplements in Iran. Our study attempted to address this issue and the related challenges in this area. Methods: The data of this study was derived from the official statistical sales data of dietary supplements compiled by the FDA in 2015, as well as a statistical dataset of dietary supplements managed by Iranian dietary supplementary manufactures syndicate in 20112015. Results: Dietary supplements market in 2015 included over 1380 products. Nutritional baby formula has assigned the largest share by value, followed by general tonics and dietary supplements for anemia. Adults and children are the greatest consumer groups. The 4-year period analysis suggested growth in the different sections of the market. Conclusion: DS market in Iran is experiencing significant growth, both by value and volume. The per capita expenditure of DSs in Iran is lower than the global average. This could be due to the lower price of the locally produced supplements, in comparison with the imported branded ones, as well as the lack of awareness of the general population about the specialized products. The economic sanctions of Iran and unsustainable policies of the Iranian FDA regarding the licensing and importation of the dietary supplements, also the allocation of subsidized foreign exchange for the production of those are the challenges of this market.

The current study aims to evaluate the potential role of extracorporeal shock wave therapy (ESWT) in functional status, physical disability, and pain in patients suffering from low back pain (LBP). ESWT may provide superior therapeutic outcomes in reducing pain and ameliorating the patient's functional status regarding LBP. [ABSTRACT FROM AUTHOR]

Kienbock disease (KD) was described by Robert Kienbock in 1910 as osteomalacia of the lunate. A century has passed since the first description of KD, and numerous theories, classifications, and treatments have been published for achieving the best outcomes for this disease, but the treatments remain controversial among surgeons. Various classifications have been proposed for KD based on radiography, magnetic resonance imaging (MRI), arthroscopy, and morphology from 1947 to 2017. Recently, the pioneers of KD (Lichtman and Bain) proposed a new classification based on all the previous classifications (radiography, MRI, and arthroscopy). This classification seems to be the best evaluation and treatment method for KD. We recommend using this new classification for the assessment of KD. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) manifests as chronic inflammation within the gastrointestinal tract. The study focuses on a long noncoding RNA (lncRNA) known as Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1). MALAT1's misregulation has been linked with various autoimmune diseases and regulates proinflammatory cytokines. The role of IL6 in immune-triggered conditions, including IBD, is another focal point. In this research, the expression of MALAT1 and IL6 in IBD patients was meticulously analyzed to uncover potential interactions. The study involved 33 IBD patients (13 with Crohn's disease and 20 with ulcerative colitis) and 20 healthy counterparts. Quantitative real-time polymerase chain reaction determined the MALAT1 and IL6 gene expression levels. The competitive endogenous RNA (ceRNA) regulatory network was constructed using several tools, including LncRRIsearch and Cytoscape. A deep dive into the Inflammatory Bowel Disease database was undertaken to understand IL6's role in IBD. Drugs potentially targeting these genes were also pinpointed using DGIdb. Results indicated a notable elevation in the expression levels of MALAT1 and IL6 in IBD patients versus healthy controls. MALAT1 and IL6 did not show a direct linear correlation, but IL6 could serve as MALATl's target. Analyses unveiled interactions between MALAT1 and IL6, regulated by hsa-miR-202-3p, hsa-miR-1-3p, and has-miR-9-5p. IL6's pivotal role in IBD-associated inflammation, likely interacting with other cytokines, was accentuated. Moreover, potential drugs like CILOBRADINE for MALAT1 and SILTUXIMAB for IL6 were identified. This research underscored MALAT1 and IL6's potential value as targets in diagnosis and treatment for IBD patients. [ABSTRACT FROM AUTHOR]

Takayasu arteritis (TA) is a chronic inflammatory disorder characterized by vascular damage and fibrosis in the intima that commonly occurs in the aorta. In many damaged sites in TA patients, natural killer (NK) cells have been shown to be hyperactivated and produce inflammatory cytokines and toxic components. Killer cell immunoglobulin-like receptors (KIRs) are found on NK cells and interact with human leukocyte antigen (HLA) class I ligands to activate or suppress NK cells. The present study assessed the possible role of KIR and their HLA ligand genes in susceptibility to TA in Iranian patients. This case-control study included 50 TA patients and 50 healthy subjects. DNA was extracted from whole peripheral blood samples, and polymerase chain reaction with sequence-specific primers (PCR-SSP) was performed to recognize the presence or absence of polymorphism in 17 KIR genes and 5 HLA class I ligands in each participant. Among the KIR and HLA genes, a significant decrease was detected in the frequency of 2DS4 (full allele) in TA patients (38%) compared with healthy controls (82%) (OR=0.13, 95 CI=0.05–0.34). However, none of the KIR and HLA genotypes or the interactions between these genes were associated with susceptibility to TA. The KIR2DS4 gene might be involved in the regulation of activation as well as the production of cytotoxic mediators of NK cells in patients with TA. [ABSTRACT FROM AUTHOR]

Introduction: Large Vessel Vasculitis (LVV) is a chronic inflammatory process that affects the aorta and its main branches. LVV include Takayasu's Arteritis (TA) and Giant Cell Arteritis (GCA). The diagnosis of TA is made according to clinical criteria and based on the criteria of the American College of Rheumatology (ACR). Monitoring of disease progression and response to treatment is also done using the National Institutes of Health (NIH) criteria. Despite these criteria, diagnosing and evaluating TA activity is a challenging issue and usually occurs in the advanced stages of the disease. The lack of a comprehensive and non-invasive diagnostic method for diagnosing and monitoring the course of TA is obvious. The aim of this study was to evaluate the diagnostic agreement between 2- [18F]FDG PET-CT scan and clinical criteria for assessing TA disease activity. Methods: Twenty-four known cases of TA, who met the inclusion criteria, were enrolled in this study. The disease-related constitutional signs and symptoms, as well as laboratory and imaging findings were recorded. Patients underwent 2-[18F]FDG PETCT imaging with standard protocol. Fused PET-CT images were reviewed and, if necessary, images without attenuation correction were visualized as well. Also, 24 control patients of the same age and sex, among the patients who were referred to the imaging center for oncological indications were examined to compare the uptake of different vascular territories. Results: Out of 15 active patients (according to the NIH criteria), 2-[18F]FDG PET-CT scan was able to correctly identify 14 patients. Also, out of 9 inactive patients, PET scan was negative in eight patients showing that 2-[18F]FDG PET-CT scan could well differentiate between active and inactive status of the disease (p-value < 0.0001). Sensitivity, specificity, positive predictive value and negative predictive value of scan in this study were 93.3%, 88.9%, 93.3% and 88.9%, respectively. The study also showed that the severity of vascular lesion uptake was not affected by immunosuppressive drugs, including corticosteroids and methotrexate. Scan findings were comparable with the results of anatomical imaging in terms of disease activity and the number of vascular lesions with p-value = 0.1 and 0.304, respectively. Conclusion: In this study we showed that 2-[18F]FDG PET-CT has comparable results with other imaging modalities and NIH criteria; therefore, it can play an important role in assessing the severity of TA, even when patients are on immunosuppressive drugs. [ABSTRACT FROM AUTHOR]