The Effect of Grapex on Wounds Healing in Patients with Scleroderma: A Randomized Controlled Clinical Trial

Background and Aim: Scleroderma (SC) is a connective tissue disease, characterized by diffuse microangiopathy and excessive production of collagen. The current study aimed to investigate the effectiveness of Grapex extract in improving the wound of patients with scleroderma. Methods: This randomized controlled double-blind clinical trial was performed from 2018 to 2019 on patients with scleroderma referred to Golestan Hospital in Ahvaz, Iran. Forty patients with active SC were selected and randomly divided into two groups. Patients applied the ointment twice a day for 4 weeks on the surface of their wounds. After four weeks of using the cream, the rate of wound healing was determined by clinical examination of the wounds. Results: 6 people were excluded from the study due to the lack of referral and final analyzes were performed on 34 patients (16 patients in the control group and 18 patients in the case group). The results of this study showed that there was a significant difference between the two groups in terms of response to treatment (p <0.0001). At the end of the fourth week, 88.89% of the patients in the case group (16 of the 18 patients) achieved complete healing of the wounds in comparison with 18.75% of the control group (3 of the 16 patients). Neither the control group nor the case group had a significant association between response to treatment with age and gender of patients, type of scleroderma, duration of illness, and symptoms. Conclusion: This study showed the effectiveness of Grapex cream ointment in healing scleroderma wounds. Therefore, Grapex cream is an effective, inexpensive, safe, and available medicine that can be used to accelerate wound healing in patients with scleroderma. *Corresponding Authors: Elham Rajaei, Email: [email protected] Please cite this article as: Hemmati AA, Deris Zayeri Z, Rajaei E, Ghanavati M. The Effect of Grapex on Wounds Healing in Patients with Scleroderma: A Randomized Controlled Clinical Trial. Arch Med Lab Sci. 2021;7:1-10 (e1). https://doi.org/10.22037/amls.v7.3105

Low detection of hepatitis B and occult hepatitis B infection in patients with rheumatic diseases

Background A new form of hepatitis B virus (HBV) infection, occult hepatitis B infection (OBI), has been identified and reported among patients with rheumatic diseases. Aim of the work To determine the incidence of HBV infection and OBI in patients with rheumatic diseases referred to major hospitals in the city of Ahvaz in Iran. Patients and methods 136 patients with rheumatic diseases were included. Serological assays for HBV markers (HBsAg, HBcAb and HBsAb) were performed by enzyme-linked immunosorbent assay. All the sera were tested for HBV DNA using nested PCR and real-time PCR. All samples were negative for anti-HCV and anti-HIV antibodies. Results The mean age of the patients was 43.5 ± 12.02 years with a F:M 2.24:1. 2 (1.47%) cases with undifferentiated connective tissue disease tested positive for both HBsAg and HBV DNA. Quantitative HBV real-time PCR was carried out for the 134 negative HBsAg samples and only 1 (0.74%) patient was positive for OBI. The results of sequencing and alignment showed that the detected HBV DNAs belonged to the D genotype, ayw2 subtype. The nucleic acid sequence of OBI case revealed substitution changes in amino acids in the positions of the 171-4 of HBsAg gene. Conclusion A moderate rate of HBV infection and low detection of OBI is found in patients with rheumatic diseases in southwest Iran. The amino acid substitutions and mutation have been observed at the position of 171-4 in the S gene region of HBV DNA which may affect the detection of HBsAg by commercial immunoassay methods

The impact of intra-sacroiliac joint methylprednisolone injection in the recovery of patients with spondyloarthropathy: a randomized controlled trial

Introduction Spondyloarthropathies are a group of chronic inflammatory diseases with specific clinical symptoms in rheumatic diseases. These patients suffer from pain in the joints. Physicians have tried several ways to decrease the pain in these patients. This study aimed to evaluate the effect of intra-sacroiliac joint methylprednisolone injection under the guidance of ultra- sonography in spondyloarthropathy patients. Material and methods In this randomized control trial we studied 60 patients with spondyloarthropathy (30 patients in the intervention group and 30 patients in the control group) from January 2020 to December 2020. The intervention group patients received 40 mg of intra-sacroiliac joint (SIJ) methylprednisolone injection at the beginning in addition to treatment with nonsteroidal anti-inflammatory drugs (inflammatory dose) and sulfasalazine (2 to 3 g/day). Patients’ pain intensity and symptoms were assessed in the 2nd, 4th, 6th, and 8th weeks after glucocorticosteroid injection. Quantitative factors were compared by independent Student’s t-test. Data analysis was performed using SPSS version 22.0 software. A p-value < 0.005 was considered significant. Results There were no statistically significant differences in Visual Analogue Scale (VAS) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) criteria and finger-to-floor (FTF) levels in the intervention and control groups. There were significant differences in VAS and BASDAI criteria and FTF levels 2 weeks after the injection, and this difference remained the same until the end of the 8th week. The p-value was significant (p-value < 0.0001). Conclusions The sacroiliac joint methylprednisolone injection approach with ultrasound guidance seems to be effective in pain relief and function, and patient satisfaction scores. Additionally using the guidance of ultrasonography in this approach is without the risk of radiation exposure

A Review of SARS-CoV-2 Genetic and Structure: Hot Cellular Targets for Virus Entry: Genetic and structure of COVID-19

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) uses several molecules such as angiotensin-converting enzyme 2 (ACE2), cluster of differentiation 26 (CD26), Ezrin, and Neuropilin-1 (NRP-1) for viral entry. In this review, the entire structural and genomic combination and the mechanism of virus entry, are discussed. This study might be useful for further drug design studies. SARS-CoV-2 neutralization allows the immune system to fight the virus before its entry. COVID-19 enters the host bloodstream by infecting endothelial cells via a cluster of differentiation 147 (CD147). SARS-CoV-2 not only uses ACE2 for its entry but also affects ACE-2 and its enzymatic activity on Ang II and bradykinin, it also imbalances the RAAS and bradykinin system and elevates the inflammation. High levels of bradykinin, cause nonproductive cough as the result of fluid extravasation and leukocyte recruitment to the lung. Accordingly, we suggest replicase transcriptase complex (RTC) and specific non-structural proteins (Nsps) such as Nsp7,8, Nsp10, Nsp12, and Nsp16 are perfect targets of study because RTC and Nsps are the golden elements in the maintenance of COVID-19 appearance and masking. Base on this evidence COVID-19 uses various receptors for its entry and it might block these receptors' activity to evade the immune system and spread to other cells. *Corresponding Authors: Elham Rajaei, Email: [email protected];&nbsp;ORCID: https://orcid.org/0000-0002-8231-0138 Please cite this article as: Torabizadeh M, Ghobadi Dana V, Aghapour SA, Zibara K, Deris Zayeri Z, Rajaei E. A Review of SARS-CoV-2 Genetic and Structure: Hot Cellular Targets for Virus Entry. Arch Med Lab Sci. 2021;7:1-9 (e15). https://doi.org/10.22037/amls.v7.3421

Association of erythrocyte sedimentation rate and C-reactive protein and clinical findings with HLA-DQ8 allele in Rheumatoid Arthritis patients

Background ― Rheumatoid arthritis (RA) is an inflammatory, autoimmune disease induced by certain auto-antigens. HLA-DRB1*0401 allele has a significant relationship with RA incident. Additionally, DQβ1*0301, *302(DQ8), *303, and *304 can increase RA risk especially in DQA1*0301 and *302 coincident. Recent studies suggest that distribution of this allele is different in various populations Material and Methods ― 70 patients and 70 healthy controls were analyzed for human leukocyte antigen (HLA) allele by specific primer-polymerase chain reaction (SSP-PCR) method. Patients were evaluated in terms of ESR and CRP. Data analysis was performed in SPSS V.17. Results ― HLA-DQ8 allele was significantly more frequent in RA patients compared to control (P<0.0001). However, no significant relationship was observed between increased ESR (P=0.527), CRP (P=0.505), and mean counts of arthritic (P=0.691) and tender joints (P=0.669) among the patients who were carriers of HLA-DQ8. Conclusion ― There is a significant association between RA and HLA-DQ8 allele, this allele can increase susceptibility to RA. These findings might relate to the ethnical variations of RA patients but we couldn’t find a significant association between CRP and ESR with HLA-DQ8. We recommend to add specific inflammatory markers to CRP as well as assess ESR in larger sample sizes to obtain accurate results

Assessment of Cytokine Expression Profile in Acute Myeloid Leukemia Patients Before and After Chemotherapy

OBJECTIVE: One of the major goals of cancer treatment is the monitoring of chemotherapeutic protocols. Quantitative and comparative cytokine expression profiling could be reliable to be used for biomarkers in deadly and fast-growing cancers such as acute myeloid leukemia (AML). The present study aims to assess and further validate cytokines with probable effects on proliferation and maturation of blood cells in AML. METHODS: Gene expression levels of IL-1β, IL-10, IL-8, TNF-α, and IFN-γ were analyzed before and after chemotherapy and after granulocyte colony-stimulating factor (G-CSF) therapy in 46 AML patients by an in-house quantitative comparative RT-PCR method. RESULTS: Our findings indicated that although the gene expression level of TNF-α was almost constant in all 3 samples, IL-1β, IL-8, and IL-10 expression levels showed a decrease after chemotherapy and an increase after G-CSF therapy. On the other hand, the expression level of IFN-γ had a different pattern with an increase after chemotherapy and a decrease after G-CSF therapy. CONCLUSION: Taken together, the results of this study are in support of the idea that the analyzed cytokines could be useful biomarkers for AML treatment monitoring. However, further molecular epidemiological investigations are suggested to elaborate more cancer monitoring biomarkers