Translation and validation of the Persian version of diabetic foot ulcer scaleshort form (DFS-SF)

Foot ulcer in diabetic patients could often result in significantly impaired quality of life. This study aimed to translate and validate the DFS-SF in Iran. The DFS-SF was translated into Persian, and then its validity and reliability were tested in 262 patients with DFUs. Content validity was evaluated using content validity ratio (CVR) and content validity index (CVI), and criterion validity was assessed through Spearman's correlation between dimensions of the DFS-SF and the EQ-5D-5L. Construct validity was measured using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), and convergent-discriminant validity was examined by calculating the average variance extracted (AVE) and composite reliability (CR). Cronbach's alpha and intraclass correlation coefficient (ICC) were calculated to evaluate the reliability of the measure. CVR ≥0.66 and CVI = 0.81 were calculated. Spearman's correlation ranged from 0.23 to 0.78 across all dimensions. The results of EFA showed that all six dimensions of the DFS-SF had an eigenvalue more than 1; accounting for 68.88% of the total variance. CFA confirmed the DFS-SF as a six-dimension structure with good fit indices of χ2/df = 2.15 < 5, RMSEA = 0.06 < 0.08, CFI = 0.91 ≥ 0.90, TLI = 0.90 ≥ 0.90, and RMR = 0.04, as well as with adequate fit indices of GFI = 0.84 ≤ 0.90, NFI = 0.86 ≤ 0.90. Estimates of ≥0.50 for AVE were not observed in two of the six dimensions and CR ≥0.70 was obtained for all dimensions. The reliability was calculated with a Cronbach's alpha of 0.89 and ICC >0.69 for all dimensions. Our findings confirmed the validity and reliability of the Persian DFS-SF; therefore, it can be used to assess QoL in patients with DFSs in clinical and research settings in Iran.     

Atypical manifestations of cutaneous leishmaniasis in a boy from Afghanistan

Cutaneous leishmaniasis is one of the most common forms of leishmaniasis in Afghanistan, which is caused by different Leishmania species that are transmitted to humans by sandflies. Its clinical manifestations are very diverse and depend on a variety of parasite and host factors.     

Role of exosomal miRNA in chemotherapy resistance of Colorectal cancer: A systematic review

The third most common malignancy has been identified as Colorectal cancer (CRC) that conducive to death in most cases. Chemoresistance is a common obstacle to CRC treatment. Circulating exosomal microRNAs (miRNAs) have been shown to reverse chemo-resistance and are promising biomarkers for CRC. The capacity of engineered exosomes to cross biological barriers and deliver functional miRNAs could be used to achieve these proposes. The object of this review is the investigation of the role of exosomal miRNA in the chemo-resistance, diagnosis, and prognosis of CRC. Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, electronic databases, PubMed, EMBASE, Web of Science, Scopus were searched from January 1990 to November 2020. Ultimately, eight articles included five in vitro (16 cell lines) and three in vivo examinations. Three studies demonstrated that increasing or decreasing mRNA expression was associated with increasing and decreasing cell proliferation in vitro. The presence of miRNA in two studies increased the sensitivity of the drug and exhibited a considerable growth inhibitory effect on cancer cell proliferation. The apoptotic rate was significantly increased in four studies by increased mRNA expression and reduced mrna expression. Tumor volume of xenograft models in three studies suppressed by antitumor miRNA activity. In contrast, anti-miRNA activity in one study decreased the tumor volume. Exosomal miRNAs can be regulators of chemo-resistance and predict adverse outcomes in CRC patients. In sum, exosomes containing miRNAs can be a promising biomarker for the prognosis and diagnosis of CRC. Subsequent research should be a focus on delineating the function of exosomal miRNA before clinical use.     

Cytotoxic Effects of Ethanolic Extract of Polypodium Vulgare on Human Malignant Melanoma Cell Line

Background: Melanoma is a malignant tumor that originates from the skin’s melanocytes and has the highest death rate from skin cancer. Developing more efficacious anticancer medications with fewer adverse effects is the key to effective cancer management. Natural products are considered relevant and cost-effective sources of treatment. The plant (Polypodium vulgare) is a small and evergreen fern. One of the most important chemical compounds in the extract of this herb is flavonoids, which are thought to have beneficial effects in the treatment of melanoma through antioxidant properties. Objectives: Due to the limitations of current cancer management and cytotoxic drugs available in the country, the need to study drugs of natural origin has become more prominent. In this regard, the present study aims to investigate the cytotoxic effects of the ethanolic extract of Polypodium vulgare on A375 melanoma cells. Methods: Polypodium vulgare was extracted in 80% ethanol by the maceration. Then, its effects on the cell death of the melanoma cell line A375 compared to the AGO-1522 cell line as control were measured using the MTT-assay technique. The amount of cellular lipid peroxidation was estimated by TBARS assay. The amount of cellular ROS was calculated by fluorescent reagent 2,7-dichlorofluorescein diacetate. Cytochrome c concentration was measured by a cytochrome c immunoassay kit. Results: In this experiment, the anticancer effects of Polypodium vulgare ethanolic extract on human melanoma cell lines were investigated for the first time. Herb extract with a concentration of 0.123 mg/ml significantly increased the death of A375 melanoma cells (p < 0.001), lipid peroxidation (p < 0.01), and reactive oxygen species (ROS) (p < 0.01) and cytochrome c concentration (p < 0.001). Meanwhile, the same amount was ineffective and safe on AGO-1522 normal fibroblast cells. Conclusion: A 0.123 mg/ml concentration of Polypodium vulgare increases apoptosis in melanoma cells. Meanwhile, the same amount was safe on healthy cells. So, it could be considered an effective treatment without side effects in human melanoma.     

Efficacy of metformin vs. doxycycline in treating acne vulgaris: An assessor-blinded,add-on,randomized, controlled clinical trial

Introduction

Insulin-like growth factor 1 (IGF-1) plays a role in the pathogenesis of acne vulgaris. Metformin can reduce IGF-1 levels and insulin resistance, so it may be useful in treating acne.

Objective

This study compared the efficacy of metformin and doxycycline in treating patients with acne vulgaris.

Methods

In this assessor-blind, add-on, randomized controlled clinical trial, we enrolled 40 patients with moderate acne vulgaris aged 15–40 and randomly divided them into two groups. For two months, the first group received doxycycline 100 mg capsules daily, and the second received metformin 500 mg tablets twice daily. The patients in both groups were adminitered to apply a fingertip (fourth finger) of 5% benzoyl peroxide gel (Pangel®) topically every night over the lesions, and to wash it off after 30 min. Patients were evaluated using the Global Acne Grading System (GAGS) score, Investigator Global Assessment for Acne (IGA) score, Cardiff Acne Disability Index (CADI), Total Acne Lesion Count (TLC), and the number of inflammatory and noninflammatory lesions.

Results

By the end of the study, the GAGS, IGA, CADI, and TLC scores and the number of inflammatory and noninflammatory lesions decreased significantly in both groups (p < 0.001), with no significant difference between the two groups (p > 0.05).

Conclusion

This trial indicates equal efficacy of doxycycline and metformin in reducing acne vulgaris severity, with doxycycline performing better in reducing lesions of the inflammatory type. Confirmatory or equivalence clinical trials should be performed to confirm our results.     

The effect of sumac supplementation on insulin resistance,inflammation, oxidative stress,and antioxidant capacity in adults with metabolic syndrome: A randomized crossover clinical trial

The impact of sumac supplementation was not previously examined in patients with metabolic syndrome (MetS). So, we investigated the influence of sumac supplementation on insulin resistance, inflammation, oxidative stress, and antioxidant markers in adults with MetS. The current study was a single-center, triple-blind, randomized, placebo-controlled crossover clinical trial that was conducted on 47 patients with MetS. Participants were randomly divided into two groups of intervention and control in the first phase. They received capsules containing 500 mg sumac or placebo (lactose) twice a day, after lunch and dinner, for 6 weeks. After a 2-week washout period, the subjects crossed over to the alternate arm. In both arms, fasting venous blood samples were obtained at baseline and at the sixth week of the intervention to determine glycemic status, high-sensitivity C-reactive protein (hs-CRP), malondialdehyde (MDA), total antioxidant capacity (TAC), and antioxidant enzymes activity. The mean (±SD) age, weight, and body mass index of participants were respectively 58.7 ± 5.83 years, 79.9 ± 14.35 kg, and 31.6 ± 4.6 kg/m²; 80.9% of subjects were females (n = 38). Based on per-protocol analyses, the serum fasting insulin concentration was unexpectedly decreased in the placebo group (change in sumac vs. control: 0.95 ± 3.9 vs. −1.17 ± 3.9 mU/L; p = 0.04). Sumac supplementation, compared to control, has marginally enhanced catalase activity (change in sumac vs. control: 2.91 ± 9.5 vs. −1.07 ± 9.1 nmol/min/ml; p = 0.06). This supplementation has also increased serum TAC and the activity of superoxide dismutase, but these changes were not significant. This intervention did not affect other insulin resistance, inflammatory, or oxidative stress markers. We found that 1 g/day sumac consumption for 6 weeks, as adjuvant therapy, could improve the antioxidant defense system in adults with MetS but did not affect insulin resistance, inflammation, or oxidative stress.     

The first case report of Haim Munk disease with neurological manifestations and literature review

HMS can have neurologic MS like manifestations. It is urgent to do more research and report probable unknown associations of HMS for its better management.