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BackgroundThe huge burden of breast cancer (BC) necessitates the profound and accurate knowledge of the most recent cancer epidemiology and quality of care provided. We aimed to evaluate BC epidemiology and quality of care and examine the effects of socioeconomic development and healthcare expenditure on disparities in BC care.MethodsThe results from the GLOBOCAN 2020 study were utilized to extract data on female BC, including incidence and mortality numbers, crude rates, and age-standardized rates [age-standardized incidence rates (ASIRs) and age-standardized mortality rates (ASMRs)]. The mortality-to-incidence ratio (MIR) was calculated for different locations and socioeconomic stratifications to examine disparities in BC care, with higher values reflecting poor quality of care and vice versa. In both descriptive and analytic approaches, the human development index (HDI) and the proportion of current healthcare expenditure (CHE) to gross domestic product (CHE/GDP%) were used to evaluate the values of MIR.ResultsGlobally, 2,261,419 (95% uncertainty interval (UI): 2,244,260–2,278,710) new cases of female BC were diagnosed in 2020, with a crude rate of 58.5/100,000 population, and caused 684,996 (675,493–694,633) deaths, with a crude rate of 17.7. The WHO region with the highest BC ASIR (69.7) was Europe, and the WHO region with the highest ASMR (19.1) was Africa. The very high HDI category had the highest BC ASIR (75.6), and low HDI areas had the highest ASMR (20.1). The overall calculated value of female BC MIR in 2020 was 0.30, with Africa having the highest value (0.48) and the low HDI category (0.53). A strong statistically significant inverse correlation was observed between the MIR and HDI values for countries/territories (Pearson's coefficient = −0.850, p-value < 0.001). A significant moderate inverse correlation was observed between the MIR and CHE/GDP values (Pearson's coefficient = −0.431, p-value < 0.001).ConclusionsThis study highlighted that MIR of BC was higher in less developed areas and less wealthy countries. MIR as an indicator of the quality of care showed that locations with higher healthcare expenditure had better BC care. More focused interventions in developing regions and in those with limited resources are needed to alleviate the burden of BC and resolve disparities in BC care.

Background and objectives: The Ferulago species are perennial aromatic plants and have been used as digestive, flavoring, sedatives, and aphrodisiac agent. Methods: The volatile oil from Ferulago stellata fruits was attained through hydrodistillation methods using a Clevenger-type apparatus. Then, the chemical composition was assessed by gas chromatography mass spectrometry (GC-MS). The antioxidant activity of the volatile oil was evaluated by the DPPH method. The extracts were sequentially obtained by the Soxhlet apparatus with different solvents. To analyze the fatty acid profile, the non-polar extract (n-hexane) was converted to the corresponding methyl ester via saponification and esterification and assessed by GC. The antimicrobial activity of the volatile oil and extracts were evaluated against eight microorganisms and MIC and MBC were attained by the micro broth dilution method. The antiproliferative and acetylcholinesterase inhibitory activity of the extracts was evaluated as well. Results: Fourteen volatile constituents were identified of which the main constituent was 2,4,6-trimethyl benzaldehyde (56.05%). The essential oil indicated high antioxidant activity with IC50 value of 6.05 ± 0.77 μg/mL. The volatile oil showed powerful antimicrobial activity against all strains of the microorganisms with MIC 0.78 to 3.12 µg/mL and MBC between 1.56 and 6.25 µg/mL. The n-hexane extract showed higher cytotoxicity effect compared to other extracts. The result of the fatty acid profile demonstrated that the fruits were rich source of unsaturated fatty acids. Conclusion: F. stellata might be a potent source of antioxidant, antimicrobial, and healthy fatty acid which can be used in the pharmaceutical, cosmetic, and food industries.

Background Falcaria vulgaris Bernh among the most important member of Apiaceae family has been used for medical investigation in Iran and some regions in the world. This plant possesses a range of coumarin and flavonoids compounds that have many therapeutic properties such as gastrointestinal and liver diseases, skin ulcers, gastric ulcers, and intestinal inflammation. It has also been found that these compounds lead to cytotoxic effects. Objective This study contains concentrates on the cytotoxic effect and induction of apoptosis on cancerous cells (SW-872) through various extracts and essential oil of Falcaria vulgaris Bernh. It considers the volatile compounds of effective samples. Methods The shoot of the plant was extracted by the Soxhlet apparatus and its essential oil was taken by the Clevenger apparatus. The cytotoxicity of the samples was evaluated by the MTT method and the mechanism of cancer cell death by flow cytometry and finally, the volatile compounds of essential oils and effective extracts were identified by GC-MS. Results The results demonstrated that n-Hexane extract and 40% VLC fraction had the greatest cytotoxic effect on SW-872 cells. While, the most abundant volatile compounds in essential oil and 40% VLC fraction of n-Hexane extract were terpenoid compounds like (+) spathulenol and caryophyllene oxide, in n-Hexane extract tetradecan, and spathulenol were the most, respectively. Conclusion The fraction of 40% n-Hexane was in a concentration-dependent manner and significantly with controlling cells inhibited the growth of cancer cells. A plausible explanation could be made to account for this effect. This inhibition was made through induction of apoptosis and due to the presence of effective volatile compounds such as terpenoids and non-terpenoids which could be considered as valuable natural sources for the isolation of anti-cancer compounds.

Purpose Methods and materials Results Conclusion Personal information and conflict of interest References, Purpose: We aimed to present MRI features of US detected BIRADS-3 lesions and compare the MRI and US findings among patients with ultrasound detected BIRADS-3 masses who also performed MRI imaging by clinician...

Background: Elastofibromadorsi is an uncommon benign pseudotumor. We aimed to assess its demographic, clinical and radiological features. Materials and methods: We retrospectively re-evaluated all thoracic CT scans and MRI's of Babak imaging center to identify cases of elastofibromadorsi. Such variables as age, gender, weight, height, body mass index, handedness, and symptoms were extracted from their medical records. Hounsfield numbers and mass laterality were determined by three radiologists. Also, suspicious patients were asked to undergo punch biopsies. Data were analyzed using SPSS software. Results: Prevalence rate of elastofibroma dorsi was 1.2%, after reviewing 10,056 imaging records. Most patients (69%) were women (pConclusion:Most cases were found unilaterally on the right side of middle-aged women.

Background and objectives: The genus Nepeta is used in traditional medicine for the antiseptic and astringent properties in cutaneous eruptions and snake bites. Nepeta racemosa was investigated here due to the rich source of phytochemical compounds in the Nepeta genus and the lack of any phytochemical studies. Methods: The aerial parts were extracted successively using n-hexane, chloroform, and methanol (MeOH) by maceration method, respectively. The MeOH extract was exposed to C18 Sep-Pak fractionation by a step gradient of MeOH-H2O. Further purification of the fractions by preparative reversed-phase HPLC yielded three compounds. The chemical ingredients of essential oil were determined by GC-MS. Free-radical scavenging activity of the extracts, fractions, as well as their total flavonoid and phenolics contents, were assessed using the DPPH method, AlCl3, and Folin-Ciocalteu reagents, respectively. Results: Phytochemical study of 20% and 40% solid phase extraction fractions of MeOH extract yielded one iridoid (8,9-epi-7-deoxy-loganic acid) and two phenylethanoids (forsythoside B and verbascoside), correspondingly. The 4aα,7α,7aα-nepetalactone (31.70 %), germacrene D (7.39 %), n-hexadecanoic acid (6.47 %), were the main compounds of essentials oil. The MeOH extract demonstrated high activity in terms of antioxidant activity, total phenolics content along with total flavonoids content (0.09 ± 0.01 mg/mL, 1581.80 ± 10.28 mg/100g and 33.01 ± 0.02 mg/100g) as well as 40% SPE fraction (0.01 ± 0.00 mg/mL, 659.20 ± 40.32 mg/100g and 22.5 ± 0.37 mg/100g), respectively. Conclusion: The presence of phenylethanoid derivatives as phenolic compounds appears to be an important antioxidant compound in Nepeta racemosa.

Colorectal cancer (CRC) is a universal heterogeneous disease that is characterized by genetic and epigenetic alterations. Immunotherapy using monoclonal antibodies (mAb) and cancer vaccines are substitute strategies for CRC treatment. When cancer immunotherapy is combined with chemotherapy, surgery, and radiotherapy, the CRC treatment would become excessively efficient. One of the compelling immunotherapy approaches to increase the efficiency of CRC therapy is the deployment of therapeutic mAbs, nanobodies, bi-specific antibodies and cancer vaccines, which improve clinical outcomes in patients. Also, among the possible therapeutic approaches for CRC patients, gene vaccines in combination with antibodies are recently introduced as a new perspective. Here, we aimed to present the current progress in CRC immunotherapy, especially using Bi-specific antibodies and dendritic cells mRNA vaccines. For this aim, all data were extracted from Google Scholar, PubMed, Scopus, and Elsevier, using keywords cancer vaccines; CRC immunotherapy and CRC mRNA vaccines. About 97 articles were selected and investigated completely based on the latest developments and novelties on bi-specific antibodies, mRNA vaccines, nanobodies, and MGD007.

Background: Breast microcalcifications are a category of lesions that can lead to malignancies. They remain a major concern in imaging of suspected cases. Vacuum-assisted biopsy (VAB) has been proposed as a safe and effective measure to evaluate microcalcifications. Objectives: The present study aimed to assess the results of VAB for breast microcalcifications. Patients and Methods: This cross-sectional study was conducted on patients with microcalcifications detected on mammograms. Patients were recruited through simple random sampling during 2019 - 2020, based on the inclusion criteria. The inclusion criteria were microcalcifications on mammography, classified as the breast imaging-reporting and data system (BI-RADS) categories 3, 4B, 4C, and 5, and undergoing mammography-guided VAB for the microcalcifications. Patients with missing data and those who could not be followed-up for at least six months were excluded from the study. They were assessed regarding different imaging characteristics of lesions, including the breast density, BI-RADS classification, microcalcification distribution and morphology, and other demographic and clinical features before biopsy. Additionally, the results of stereotactic-guided VAB were assessed for various benign and malignant pathologies of microcalcifications. The results of descriptive and analytical tests for various radiological and pathological features of lesions were reported. Results: A total of 257 patients, with a mean age of 50.3 ± 8.3 yars, were included in this study. Almost half of the patients (n = 125, 48.6%) had a C-grade breast composition. Regarding the BI-RADS classification, 206 (80.2%) patients were diagnosed with 4B lesions, followed by 44 (17.1%) patients with 4C lesions. The assessment of the pattern of microcalcification distribution in imaging showed that more than half of the patients (n = 148, 57.6%) had lesions in multiple groups. The most prevalent morphology of microcalcifications was punctate amorphous (n = 109, 42.4%). The majority of patients (n = 180, 70%) had benign findings in the pathological assessment, and only 69 (26.8%) had malignant features in pathology. The distribution of malignancies differed among various BI-RADS categories. In the 4B category of lesions, there were 166 benign lesions versus 32 malignant lesions, while in the 4C category, there were 10 benign lesions versus 34 malignant lesions (P < 0.001). Conclusion: This study described the findings of successful stereotactic-guided VAB for breast microcalcifications. VAB can be implemented as a promising assessment tool to evaluate suspected breast microcalcifications effectively.

Background & Objective: Plants are reservoirs of bioactive compounds, which are known to be chemically balanced, effective and least injurious as compared to synthetic medicines. The current resistance and the toxic effects of the available drugs have brought the trend to assess the antileishmanial effect of various plant extracts and their purified compound/s. Alliums are rich sources of steroidal saponins, flavonoids, and sulphuric compounds of which steroidal saponins have recently received more attention due to their important pharmacological activities. Allium austroiranicum is a common edible vegetable in western regions of Iran, especially in “Chaharmahal and Bakhtiari” province, where it is named “Lopo” and is considerably used as a raw vegetable, flavoring agent, and as a medicinal plant. Materials & Methods: The chloroform-methanolic extract was fractionated using MPLC, and the appropriate fractions were then subjected to isolation and purification of the constituents by HPLC. Structure elucidation was done using comprehensive spectroscopic methods including 1D and 2D NMR. Antileishmanial effects of the isolated compound against the promastigotes of Leishmania major were evaluated using MTT method. Results: Phytochemical investigation of chloroform-methanol extract of the plant resulted in the isolation and identification of a Nicotianoside C related steroidal saponin and its chemical structure was determined as (25S)-5α-Spirostan-1β,3βdiol-3-O-{α-L-rhamnopyranosyl-(1→2)-{α-L-rhamnopyranosyl-(1→4)}-[β-D-glucopyranoside}. Investigation of in vitro antileishmanial activity of the isolated compound, in 10 and 50 and 100 μg/mL concentrations, exhibited significant leishmanicidal effects against the promastigotes of Leishmania major. Conclusion: The results established a valuable basis for further studies about A. austroiranicum and anti-parasitic activity of steroidal saponins.

Introduction: Atrophic vaginitis is a common problem in postmenopausal women and results from decreased levels of blood estrogen. It is associated with symptoms of itching, burning, dyspareunia, and postmenopausal bleeding. The present study evaluated the effects of fenugreek extract on atrophic vaginitis. Materials and Methods: This randomized controlled clinical trial was performed on 60 postmenopausal women in Ardabil, Iran, in 2018. The participants were selected using block randomization with the allocation ratio 1:1. Those in the intervention group received 0.5g (the applicator filled to the half-full mark) fenugreek vaginal cream 5% twice a week for 12 weeks. The control group received conjugated estrogens vaginal cream at the dose of 0.625 mg (the applicator filled to the half-full mark) containing 0.3 mg of conjugated estrogens. Atrophic vaginitis was evaluated before and after the treatment through clinical examination, clinical signs, and measurement of Vaginal Maturation Index (VMI). Findings: After the 12-week intervention and modification of the baseline score, the mean (standard error) score for atrophic vaginitis signs was 3.100 (1.43-4.75). This difference was statistically significant in intragroup comparison and in favor of the control group in intergroup comparison (p=0.001). VMI was less than 49% in 86.7% and 46.7% of the participants in the intervention and control groups, respectively. This was a significant difference in favor of the control group (p=0.001). Conclusion: The results of this study showed that total fenugreek extract could be effective in treating signs of atrophic vaginitis, but it was not as effective as ultra-low-dose estrogen.

Background: Eremostachys macrophylla Montbr. & Auch. is one of the wild growing species of herbs found in East Azerbaijan province of Iran. These species are used in folk medicine for the healing of wound, treatment of snake bites, rheumatism and joint pains. The primary aim of this study was to obtain natural pure compounds and this was done by subjecting the aerial parts of Eremostachys macrophylla Montbr. & Auch. to phytochemical analysis. Methods: The air-dried and crushed aerial parts were respectively extracted with n-hexane, dichloromethane (DCM) and methanol (MeOH) solvents using a soxhlet apparatus. The 10%, 20% and 40% of MeOH in water Sep-Pak fractions of the MeOH extract were subjected to a preparative reversed- phase high performance liquid chromatography (RP-HPLC). Also, the isolated pure compounds were identified by one-dimensional nuclear magnetic resonance (1D-NMR) spectroscopic technique. Results: The results obtained in this study showed the presence of seven pure components; (1) Lamalbide, (2) Sesamoside, (3) Phlomiol, (4) Verbascoside, (5) Luteolin-7-O- glucoside, (6) Apigenin-7-O- rutinoside and (7) Kaempferol-3-O- glucoside with iridoid, phenylethanoid and flavonoid structures. Conclusion: The results from the study demonstrated that the aerial parts of E. macrophylla could be a good source of iridoids, phenylethanoids and flavonoids.