Simplified MSI marker panel for diagnosis of colorectal cancer

Background: Colorectal cancers (CRCs) tumors are diagnosed by microsatellite instability (MSI) due to accumulation of insertion/deletion mutations in tandem repeats of short DNA motifs (1–6 bp) called microsatellites. Microsatellite instability (MSI) is not only a hallmark marker for screening of hereditary nonpolyposis colorectal cancer (HNPCC), but also a prognostic and predictive marker for sporadic colorectal cancer. Our objective was to determine and study of five mononucleotide microsatellite markers status among Iranian patients with HNPCC and sporadic colorectal cancer. Material and Methods: In the current investigation 80 sporadic CRC and 80 HNPCC patients were evaluated for MSI. The pentaplex panel including 5 quasimonomorphic mononucleotide repeats (NR-21, BAT-26, BAT-25, NR-27 and NR-24) was used. Results: Our findings showed that the NR-21 was the most frequent instable marker among the other markers. 53% and 25.6% specimens had instability in sporadic CRC and HNPCC, respectively. Furthermore, the frequencies of instability BAT-25 was determined in 20% sporadic CRC and 23% HNPCC samples. Interestingly our results demonstrated that the frequency of instability NR-24 was similar 20% sporadic CRC and 20.5% HNPCC. Moreover, percentage of NR-27 in HNPCC was 19.2 and 0% in sporadic CRC. Finally, BAT-26 was instable in 21.8% HNPCC patients while we could find 6.6% instability for BAT-26 in sporadic cases. Conclusion: It seems that among 5 mononucleotides markers NR-21 was the most useful marker for diagnosis HNPCC and sporadic cancer. Following NR-21, BAT-25 and NR-24 are the most reliable markers. Therefore using a triplex panel including 3 aforementioned MSI markers should be more promising markers for identifying MSI status in both patients with HNPCC and/or sporadic colorectal cancer.     

A comparison between the effects of ginger,pyridoxine (vitamin B6) and placebo for the treatment of the first trimester nausea and vomiting of pregnancy (NVP)

Introduction: Nausea and vomiting of pregnancy (NVP) are one of the most common complains of the early pregnancy period and are bothersome for pregnant women. Some prefer to use herbal medicine instead of chemical agents.

Objective: The purpose of the present study was to compare the effects of ginger, pyridoxine (vitamin B6), and placebo for the treatment of NVP.

Method: The study was performed as a triple blind clinical trial on pregnant women suffering mild to moderate NVP between 6 and 16 weeks of pregnancy. In these women ginger, 500?mg twice daily, vitamin B6 40?mg twice daily and placebo twice daily were administered for 4?d. Rhodes questionnaire was used for evaluation of the severity of symptoms. The severity of NVP was evaluated 24?h before entering the study and up to 4 d after using medications and results were compared among the three groups.

Results: Seventy-seven women finished the study (28 in the Ginger group, 26 in the B6 group, and 23 in the placebo group). The women of the three groups did not have significant differences according to age, gestational age, parity, and severity of each symptom before treatment and educational status. Total score of Rhodes questionnaire for nausea was decreased significantly in three groups after treatment. (p?p?=?.012, and p?=?.03 for ginger, vitamin B6, and placebo, respectively.) Also total score of Rhodes questionnaire for vomiting was decreased in three groups (p?=?.03 for ginger, p?=?.02 for B6, and p?=?.04 for placebo). Ginger and vitamin B6 could reduce the severity of all items of Rhodes questionnaire significantly; however, placebo was significantly effective only on the frequency of nausea, intensity of vomiting and frequency of retching. Ginger and vitamin B6 were more effective than placebo (p?=?.039 and p?=?.007, respectively); however, total score of Rhodes did not show significant difference between ginger and vitamin B6 (p?=?.128). Ginger was more effective for nausea (intensity and distress) and distress of vomit.

Conclusion: Ginger is more effective than placebo for the treatment of mild to moderate NVP and is comparable with vitamin B6.

Trial registration number and registry website: IRCT2015020320923N1     

Herpes zoster in breast cancer: a case report

There is little information on herpes zoster infection in breast cancer patients as a complication during adjuvant chemotherapy. We report a case of herpes zoster in a 65-year-old woman presented with low grade fever and vital signs together with skin symptoms such as severe edema, irritation and itching in the left breast where there was wound drainage. PCR test revealed varicella zoster virus. To the best of our knowledge, the histologic features coupled with PCR led to a diagnosis of herpes zoster.     

Paternal adaptation in first-time fathers: a phenomenological study

Objective: This study aimed to explore men’s experiences of paternal adaptation during their first year of transition to parenthood.

Background: Stepping into fatherhood is one of the most important events that may occur in a man’s life and can lead to fundamental changes in their identity and lifestyle. However, to our knowledge, no studies have been conducted on men’s experiences of paternal adaptation in an Iranian context.

Methods: In this phenomenological study, 15 Iranian men who had the experience of parenting for the first time were recruited using the purposeful sampling method. In-depth semi-structured interviews guided by a questionnaire were used to collect data. The data were analysed using interpretative phenomenological analysis.

Results: The data analysis resulted in the development of 26 themes, 8 subordinate themes and 3 superordinate themes. The superordinate themes included ‘steps toward adaptation’, ‘obstacles to the path of adaptation’ and ‘stabilisation in the paternal position’.

Conclusion: Perceived self-efficacy and satisfaction in fatherhood means an adaptation to the paternal role. Factors influencing paternal adaptation can be classified into the domains of ‘facilitating factors’ and ‘inhibiting factors’.     

Evaluation of the Relationship Between Hb F Levels and Nucleated Red Blood Cells with Morbidity in Non Transfusion-Dependent Thalassemia Patients

Recognition of risk factors of morbidities in patients with β-thalassemia intermedia (β-TI) is an important issue that must be evaluated. Non transfusion-dependent thalassemia patients referred to the outpatient clinic of Shiraz University of Medical Science, Shiraz, South Iran were enrolled in this study between 2013 and 2014. Two peripheral blood smears were prepared for evaluating developmental stage of normoblasts. One hundred and thirty-one patients with ages ranging from 3 to 42 years (mean: 23.35?±?7.9) were selected. Sixty-seven patients had at least one morbidity (51.1%). Osteoporosis and gallstones were the most common morbidities (33.6 and 24.4%, respectively). In the univariate model, hemoglobin (Hb), ferritin, Hb F, developmental stage of normoblasts and hydroxyurea (HU) therapy did not differ between patients with and without morbidity (p?>?0.05) but mean age of patients and mean number of normoblasts were higher in patients with morbidity (p?=?0.026 and p?=?0.012, respectively). In the regression model, sex and splenectomy status were different between patients with and without morbidity. It seems that females and splenectomy are risk factors for morbidity in non transfusion-dependent thalassemia patients. [Sex: odds ratio (OR)?=?2.21, 95% confidence interval (95% CI): 1.04-4.72, p?=?0.39. Splenectomy: OR = 3.10, 95% CI: 1.12-8.59, p?=?0.029.] This study shows that Hb F level and developmental stage of normoblasts does not effect the incidence of morbidities in non transfusion-dependent thalassemia patients but sex and splenectomy were effective factors in development of morbidities. Thus, splenectomy should be avoided as much as possible in patients with non transfusion-dependent thalassemia.     

The Effect of Soy Nut Compared to Cowpea Nut on Body Weight,Blood Cells,Inflammatory Markers and Chemotherapy Complications in Children with Acute Lymphoblastic Leukemia: A Randomized Controlled Clinical Trial

No previous studies were found to examine the effect of soy as a whole food on patients with leukemia. The present randomized controlled clinical trial studied the effect of soy nut on children with B-cell acute lymphoblastic leukemia (ALL) who were in the maintenance phase of chemotherapy. The eligible patients were randomized to receive 30?g/day soy or cowpea nut powder for 12 weeks. Dietary intake, physical activity, anthropometric measurements, complete blood count, serum albumin, serum highly sensitive C-reactive protein (hs-CRP), and Tumor necrosis factor alpha (TNF-α) as well as chemotherapy side effects were assessed at the start and the end of the study. In total 29 and 27 children completed the study (aged 6.34?±?2.44 and 5.85?±?2.35 years) in soy and cowpea nut groups, respectively. The total energy and protein intake, and physical activity as well as body weight, body mass index, number of red blood cells, hemoglobin and hematocrit levels, and fatigue were significantly improved in the soy nut group compared to patients who consumed cowpea nut (P?<?0.05). Soy nut intake might improve the nutritional status, anemia, and fatigue in children with ALL. Studies targeting blood cell fractions and disease recurrence are highly recommended.     

The effects of sequential use of oxytocin and sublingual nitroglycerin in the cases of retained placenta

Objectives: To evaluate the effects of adding sublingual nitroglycerin to oxytocin, for delivery of retained placenta after vaginal delivery.

Method: The study was performed as a placebo controlled clinical trial on women who did not finish delivering placenta after 30 min of active management of the third stage of labor. In case group, 1 mg nitroglycerin and in the control group, placebo was prescribed sublingually.

Results: In total, 80 women finished the study. The number of manual removal of placenta did not show significant difference between the two groups [25 women (62.5%) in the case and 30 women (75%) in the control group, p?=?0.335]. There was no significant difference between the two groups according to duration of the third stage of labor, hemoglobin index, decline in HB index?>30% and maternal vital signs after treatment. There was no significant difference between the two groups according to adverse effects [eight women (20%) in the case group and four (10%) in the control group (p?=?0.348)].

Conclusion: The sequential use of oxytocin and sublingual nitroglycerin could not lead to delivery of more placentas and did not reduce the necessity of manual removal of placenta in comparison with placebo.     

Detrimental Effects of COVID-19 Measures on Mental Health and Social-Economic Disparities

The COVID-19 pandemic has struck nations worldwide, pushing worldwide health and socioeconomic systems to extreme limits. Various factors, such as drastic alterations in public environments, prolonged quarantine, revenue loss, and anxiety of disease contraction, have caused mental turmoil. Although there was a need to cope with an excess of psychological strain among the public, post-COVID patients, and those with a previously diagnosed psychiatric condition, mental health programs faced a substantial decline in services, mirroring the dramatic rise in psychological issues. Interestingly, certain coping strategies play protective or deleterious effects on mental health outcomes. Moreover, social media exposure has played a double-edged role in the mental health of the public during the pandemic, leaving grounds for further debates. Protean cultural themes have taken center stage in the discussion on social resilience and compliance to COVID-19 measures, driving their impact through certain work ethics, social capital, and public attitudes in different societies. On the other hand, exceedingly rising poverty rates cemented the deleterious economic impact of the pandemic. Attention has been called to the racial implications of the pandemic, driving millions of individuals with low socioeconomic position (SEP) and belonging to minority groups out of the paid workforce. Interestingly, we turn attention to an array of elements implicated in this dramatic effect, such as public transport, living arrangements, and health insurance coverage among these vulnerable groups. We attempt to address the mechanisms COVID-19 channeled its mental health and socioeconomic impacts by explaining the risk factors and pave the way for stronger crisis management in the future by evaluating the socioeconomic and psychological effects in stark detail.