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Introduction: The death of neurons and cerebral edema are the main consequences of stroke. However, inflammatory processes play key roles in aggravating cerebral damage following a stroke. This study aimed to investigate the effects of Viola odorata extract (VOE) on the infarct volume (IV), neurologic deficits (ND), and the expression of NF-κB and VCAM-1 in the Middle Cerebral Artery Occlusion (MCAO) model., Methods: The animals were randomly separated into 6 groups: (1) control group, (2) vehicle-treated group, (3) MCAO group, (4) VOE25 group, (5) VOE50 group, and (6) VOE75 group (n= 12). VOE (25, 50, and 75 mg/kg) and distilled water were administered daily for 30 days. Two hours after the last gavage, the rats were exposed to MCAO for 60 minutes. Twenty-four hours later, IV, ND , and NF-κB/VCAM-1 expressions were evaluated., Results: Viola odorata extract exhibited excellent neuroprotective effects by reducing IV (mainly in the core and subcortex areas), and induced downregulation of NF-κB and VCAM-1 expression., Conclusion: Viola odorata could also activate intracellular pathways, reducing the expression of NF-κB and VCAM-1 . It is useful for developing a novel medical herb for treating cerebral ischemia., Highlights: A stroke occurs when the blood supply to a part of the brain is interrupted or reduced.Viola odorata extract (VOE) reduced the infarct volumes (IV) in rats' brains 24 h after middle cerebral artery occlusion (MCAO).VOE may decrease IV in the MCAO model by downregulating the NF-κB/VCAM-1 expression., Plain Language Summary: A stroke is a medical condition in which poor blood flow to the brain results in cell death. After an interruption of blood flow, energy stores are rapidly depleted, and complex cellular cascades induce excitotoxic cell death. So far, no effective and specific treatment has been suggested for the stroke. In this study, the neuroprotective effects of the viola odorata extract (VOE) were screened. The V. odorata extract exhibited excellent neuroprotective effects by reducing infarct volume and inducing downregulation of NF-κB/VCAM-1 expression. This finding suggests that V. odorata may be useful for developing a novel medical herb for treating cerebral ischemia., Competing Interests: Conflict of interest The authors declared no conflict of interest., (Copyright© 2022 Iranian Neuroscience Society.)

Introduction: As the COVID-19 pandemic ravages the world, nursing resources, and capacities play an essential role in disease management. This literature review focuses on the central issues related to the nursing care of patients affected by COVID-19., Material and Methods: This literature review was conducted with an extensive search of databases, including PubMed, Web of Science (WOS), and Scopus, using the keywords "COVID19", "2019-nCoV disease", "2019 novel coronavirus infection", "Nurse", "NursingCare", and" Nursing management." The span of the literature search was between December 01, 2020, and January 12, 2021. A total of 28 original and English-language articles were selected for inclusion in the review., Results: Nursing interventions such as monitoring, oxygen therapy, and the use of Extra Corporeal Membrane Oxygenation (ECMO) in the care of COVID-19 patients, caring for ICU patients with COVID-19, rehabilitation of COVID-19 patients, nurses' experiences and barriers in the care of patients with COVID-19, and also the ethical challenges in the care of patients with COVID-19, were found to be valuable in managing COVID-19 patients., Conclusion: Nurses have a pivotal role to play in the care of patients with COVID-19. Therefore, providing comprehensive and quality nursing care supported by experience and research is necessary to successfully reduce the length of hospital stay and decrease the morbidity and mortality rates of COVID-19., (© the Author(s).)

Objectives: Breast cancer is known as one of the deadliest forms of cancer, and it is increasing globally. There are a variety of proven and controversial risk factors for this malignancy. Herein, we aimed to undertake a systematic review and meta-analysis focus on the epidemiology of breast cancer risk factors in Iran., Methods: We performed a systematic search via PubMed, Scopus, Web of Science, and Persian databases for identifying studies published on breast cancer risk factors up to March 2019. Meta-analyses were done for risk factors reported in more than one study. We calculated odds ratios (ORs) with corresponding 95% confidence intervals (CIs) using a fixed/random-effects models., Results: Thirty-nine studies entered into the meta-analysis. Pooling of ORs showed a significant harmful effect for risk factors including family history (OR: 1.80, 95%CI 1.47-2.12), hormonal replacement therapy (HRT) (OR: 5.48, 95%CI 0.84-1.74), passive smokers (OR: 1.68, 95%CI 1.34-2.03), full-term pregnancy at age 30 (OR: 3.41, 95%CI 1.19-5.63), abortion (OR: 1.84, 95%CI 1.35-2.33), sweets consumption (OR: 1.71, 95%CI 1.32-2.11) and genotype Arg/Arg (crude OR: 1.59, 95%CI 1.07-2.10), whereas a significant protective effect for late menarche (OR: 0.58, 95%CI 0.32-0.83), nulliparity (OR: 0.68, 95%CI 0.39-0.96), 13-24 months of breastfeeding (OR: 0.68, 95%CI 0.46-0.90), daily exercise (OR: 0.59, 95%CI 0.44-0.73) and vegetable consumption (crude OR: 0.28, 95%CI 0.10-0.46)., Conclusions: This study suggests that factors such as family history, HRT, passive smokers, late full-term pregnancy, abortion, sweets consumption and genotype Arg/Arg might increase risk of breast cancer development, whereas late menarche, nulliparity, 13-24 months breastfeeding, daily exercise and vegetable consumption had an inverse association with breast cancer development., (© 2020 Amir Shamshirian et al., published by De Gruyter, Berlin/Boston.)

Objective: A systematic review and meta-analysis was carried out to examine the role of hydroxychloroquine (HCQ) in the treatment of COVID-19., Methods: We performed a systematic search in PubMed, Scopus, Embase, CochraneLibrary, Web of Science, Google Scholar, and medRxiv pre-print databases using available MeSH terms for COVID-19 and hydroxychloroquine. Data from all studies that focused on the effectiveness of HCQ with or without the addition of azithromycin (AZM) in confirmed COVID-19 patients, which were published up to 12 September 2020, were collated for analysis using CMA v.2.2.064., Results: Our systematic review retrieved 41 studies. Among these, 37 studies including 45,913 participants fulfilled the criteria for subsequent meta-analysis. The data showed no significant difference in treatment efficacy between the HCQ and control groups (RR: 1.02, 95% CI, 0.81-1.27). Combination of HCQ with AZM also did not lead to improved treatment outcomes (RR: 1.26, 95% CI, 0.91-1.74). Furthermore, the mortality difference was not significant, neither in HCQ treatment group (RR: 0.86, 95% CI, 0.71-1.03) nor in HCQ plus AZM treatment group (RR: 1.28, 95% CI, 0.76-2.14) in comparison to controls. Meta-regression analysis showed that age was the factor that significantly affected mortality ( P <0.00001)., Conclusion: The meta-analysis found that there was no clinical benefit of using either HCQ by itself or in combination with AZM for the treatment of COVID-19 patients. Hence, it may be prudent for clinicians and researchers to focus on other therapeutic options that may show greater promise in this disease.

Background: Myocardial infarction (MI) as a term for a heart attack happens due to reduced blood flow to heart myocardium and lack of oxygen supply caused by plaques in the interior walls of coronary arteries. With respect to the importance of MI etiology, we aimed to study the relationship of MI and blood examination variables., Methods: This study was conducted in Mazandaran Heart Center as a hospital-based case-control Comprising 894 participants including 465 cases and 429 controls, individually matched by sex and age. Considered blood markers were analyzed using routine laboratory methods and equipment., Results: Of all participants, 64.3% of the cases and 51.0% of the controls were males with a mean age of 61.2 (±13.8) in cases and 62.4 (±14.) in controls. We could not find any differences between cases and controls for total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and alkaline-phosphatase (ALP) (P>0.05). However, levels of creatine-kinase-muscle/brain (CK-MB) (P<0.0001), fasting-blood-sugar (FBS) (P<0.0001), aspartate-aminotransferase (AST) (P<0.0001), alanine-transferase (ALT) (P<0.0001) and erythrocyte sedimentation rate (ESR) (P=0.001) were significantly higher in cases compared to the controls (P<0.05). Multivariable analyses revealed that the risk of MI was associated with high levels of AST (adjusted OR=24.3, 95%CI=3.5±165.6, P=0.001) and LDL (adjusted OR=7.4, 95%CI=1.0±51.8, P=0.001)., Conclusion: Our investigation indicated that the levels of CK-MB, FBS, AST, ALT and ESR were significantly higher in patients with MI. Besides, our findings showed that the risk of MI in cases with high levels of AST and LDL was about 24 and 7 times more than the control group respectively., (© 2020 Shamshirian A, et al.)