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This descriptive, cross-sectional study aimed to assess the correlations between the knowledge, attitude, and performance of the students of Hamadan University of Medical Sciences, Iran, regarding waste recycling in 2020-2021. A questionnaire was used for data collection, and the sample population consisted of 70 male and female students. Data were analyzed using SPSS version 21 by Mann-Whitney and Kruskal-Wallis (α=0.05). The sample population included 87.1% women and 12.9% men. In total, 22.9% of students received special training to recognize the adverse effects and management of waste while 77.1% of them received no training. In addition, 22.9% of students reported the contraction of infectious diseases in themselves or others around them due to contact with garbage or contaminated equipment. The marital status had a significant difference with the amount of knowledge of the studied students for determining the type of awareness regarding the importance of recycle waste while gender represented no substantial difference in this regard. Based on the results, a positive correlation was observed between attitude and awareness, as well as the performance with knowledge and attitude. Knowledge, attitude, and performance are meaningful predictors of waste management. According to the results, the importance of waste management should be emphasized to student in the community in terms of the current health conditions. It also seems that the influential factors in waste management should be fully identified in interventional programs, and appropriate interventions should be planned and implemented accordingly.

The discovery of hematologic improvement and bone marrow modification by the drug β-D mannuronic acid (M2000) during treatment of rheumatoid arthritis in phase 1/2/3 clinical trials prompted us to design a new trial to target hematologic deficits in myelodysplastic syndromes (MDS). In this open-label, randomized phase 2 clinical trial, the potential effect and tolerability of drug M2000 was assessed in patients with low- and intermediate-1-risk MDS. The primary efficacy end point was hematologic improvement after 12 weeks of β-D-mannuronic acid therapy. Among 34 enrolled patients, half received their conventional therapy plus β-D-mannuronic acid, and the other half received only conventional drugs. In the conventional + β-D mannuronic acid treatment group, hematologic improvement and development of transfusion independence and/or reduction in transfusion requirements were seen in 12 patients (92.3%) and 1 patient (7.7%), respectively. Moreover, 5 patients (38.5%), 2 patients (15.4%), and 1 patient (7.7%) in the β-D-mannuronic acid-treated group showed hematologic improvement of the major parameters of erythroid, neutrophil, and platelet responses, respectively, based on the International Working Group criteria), whereas in the conventional treatment group as control, no hematologic improvements including erythroid, neutrophil, and platelet response was seen. In this trial, the addition of β-D mannuronic acid to conventional treatment showed promising results in MDS patients with low and intermediate-1 risk with effects on hematologic improvements without significant adverse effect.

Myelodysplastic Syndromes (MDSs) is a heterogeneous group of hematologic neoplasms that causes cytopenia and dysplasia in one or more major bone marrow cell lines. The patients with this syndrome develop clinical complications associated with progressive bone marrow destruction leading to an increased risk for acute myelogenous leukemia. In the treatment of this syndrome, repeated infusion of Red Blood Cells (RBCs) may lead to iron overload, which is associated with a reduction in the survival rate of patients. In this paper, we report a case with MDS whose risk of dependence on blood transfusion was interstitial and received 4 units of packed RBCs once every 4 weeks. He had enrolled in our current clinical trial of β-D-mannuronic acid (M2000) in Iranian MDS patients. This 68-year-old man was treated with M2000, 500-mg capsule every 12 hours for 3 months. After 3 months of treatment, he experienced a non-requirement to blood transfusion following a hemoglobin increase of more than 2.5 g/dL in his blood sample. Moreover, the patient’s life quality was improved. This case report showed that M2000 drug might be an effective treatment for transfusiondependent MDS patients (Clinical trial identifier; IRCT20130622013739N11).

β-d-Mannuronic acid (M2000), a novel non-steroidal anti-inflammatory drug (NSAID) with immunosuppressive properties, has been previously shown to exhibit potential therapeutic effects on autoimmune diseases. Immunosuppression therapy has been a standard approach for myelodysplastic syndrome (MDS) for many years. We evaluated the effect of M2000 on isolated peripheral blood mononuclear cells (PBMCs) from patients with MDS. The PBMCs were isolated from 13 patients with MDS and 13 normal donors. The cells were then treated with low, moderate, and high doses of M2000 and diclofenac as a control group. The level of interleukin (IL)-6, tumor necrosis factor alpha (TNF-α), IL-3, granulocyte colony-stimulating factor (G-CSF) gene expression and the serum level of IL-6 and TNF-α production were evaluated by real-time polymerase chain reaction and enzyme-linked immunosorbent assay methods, respectively. Our findings indicated a significant reduction in the production of IL-6 and TNF-α as inflammatory cytokines. Furthermore, the level of G-CSF gene expression was significantly increased. In conclusion, M2000, a newly designed NSAID, has a remarkable effect on isolated PBMC in patients with MDS, which might bring a potential hope for its oral administrations in these patients.