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Abstract Background KIR/HLA mismatch in hematopoietic stem cell transplantation (HSCT), particularly in patients with acute myeloid leukemia (AML), was related to decreased recurrence rates, improved engraftment, and a reduction in graft-versus-host disease, according to recent research (GVHD). Uncertainty exists about the impact of KIR/HLA mismatch on haploidentical-HSCTs treated with post-transplant cyclophosphamide (PTCy). We attempted to analyze the effects of KIR/HLA mismatch on clinical outcomes on transplant outcomes using the cohort of 54 AML patients who received a haplo-HSCT with PTCy. Results In contrast to KIR/HLA match, our findings showed that donor KIR/HLA mismatch was substantially associated with superior OS (HR, 2.92; (P = 0.04)). Moreover, donor KIR/HLA mismatch (KIR2DS1D/C2+ R and KIR2DS2D/C1+ R mismatch versus KIR2DL1D/C2− R mm, KIR2DL2/3D/C1− R mm and KIR3DL1D/Bw4− mm) was correlated with the improvements in OS (HR, 0.74; P = 0.085) and activating. KIR/HLA mismatch versus KIR/HLA match was significantly correlated with improvements in OS (HR, .46; P = 0.03) and inhibitory. KIR/HLA mismatch versus KIR/HLA match was enhancement in the OS (HR, .93; P = 0.06). Despite a higher rate of aGvHD (grade I-IV) in the patients with KIR/HLA mismatch compared to KIR/HLA matched (57% vs. 33% (p = 0.04). However, the KIR/HLA mismatch group saw a decreased relapse rate (3.2% vs. 23%, p = 0.04). Conclusion This analysis shows the significance of KIR/HLA Incompatibility, other clinical variables like CMV, the relationship between donor/recipient and donor age, and the relationship between donor/recipient and donor age in the haplo-donor selection process. It also suggests that KIR and HLA mismatching between donor and recipient could be routinely performed for haplo-donor selection and may improve clinical outcomes after haplo-HSCTs with PTCy.

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.

Fetal hemoglobin is the principal hemoglobin in the human fetus, and the adult levels of fetal hemoglobin (HbF) are less than 1% of total hemoglobin. A steady increase of HbF in patients with hereditary persistence of fetal hemoglobin (HPFH) is associated with complications. The present report describes HPFH in a 26-year-old man with emphasis on its hemoglobin electrophoresis. The patient was admitted with complaints of recurrent weakness and lethargy, weight loss, abdominal pain, and dyspepsia. Splenectomy was planned due to massive splenomegaly and gastrointestinal complications. Ultimately, electrophoresis confirmed the diagnosis of HPFH.

Human papillomavirus (HPV) is the most common sexually transmitted agent worldwide. Early prevention with HPV vaccination is a safe and effective method against this disease. HPV vaccines provided more protection against several oncogenic HPV strains. Three prophylactic HPV vaccines have been approved to target high-risk HPV types and protect against HPV-related disorders. These existing vaccines are based on the recombinant DNA technology and purified L1 protein that is assembled to form HPV empty shells. The prophylactic vaccines are highly immunogenic and can induce production of specific neutralizing antibodies. However, therapeutic vaccines are different from these prophylactic vaccines. They induced cell-mediated immunity against transformed cells, instead of neutralizing antibodies. The second generation of prophylactic HPV vaccines, made from alternative viral components using cost-effective production strategies, is undergoing clinical evaluation. The purpose of this review is to provide a complete and up-to-date review of the types of HPV vaccines and the efficiency of each of them for readers.

Rheumatoid arthritis (RA) as a long-term autoimmune disease is characterized by pain, swelling and joints destruction. The therapeutic efficacy of Guluronic acid (G2013) (patented, DEU: 102016113017.6) was reported in phase I/II clinical trial in RA patients. In this study, we aimed to evaluate the effect of G2013 as a novel non-steroidal anti-inflammatory drug (NSAID) with immunosuppressive property on genes expression of anti-inflammatory and pro-inflammatory cytokines and their transcription factors in the blood sample of RA patients. This study was performed on 12 patients with RA who had an inadequate response to conventional treatments which were disease-modifying anti-rheumatic drugs (DMARDs), NSAID, and biologics. G2013 was administered orally at a dose of 500 mg twice daily for 12 weeks. Before and after the treatment of patients with drug G2013, the peripheral blood mononuclear cells (PBMCs) were isolated for evaluating the gene expression level of interleukin 10 (IL10), interleukin 22 (IL22), interferon γ (IFNγ), and transcription factors specific to the T helper cell lineages, forkhead box P3 (Fox-P3), Aryl hydrocarbon receptor (AHR) and T-box–containing protein expressed in T cells (T-bet) using the real-time PCR method. Since these cytokines have a key role in the progression of RA and disease condition expected induction of IFNγ, AHR, IL22, T-bet, and reduction of IL10, Fox-P3. Results indicated a significant reduction in the level of IFNγ, AHR and a significant induction in IL10, Fox-P3 gene expression in comparison with the control group. In conclusion; the results of this investigation showed a part of the immunological mechanism of G2013 as a novel anti-inflammatory that could reduce pro-inflammatory cytokine and their transcription factors. Furthermore, it increased the anti-inflammatory cytokine and its transcription factor (clinical trial identifier: IRCT2016092813739N5).

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 transfusion- dependent MDS patients (Clinical trial identifier; IRCT20130622013739N11).