Economic burden of HIV/AIDS Infection in Iran : a modelling approach

Background: The Human Immunodeficiency Viruses/Acquired Immunodeficiency syndrome HIV/AIDS is a leading cause of mortality and morbidity in Low-and-Middle-Income-Countries (LMICs). It might potentially lead to an economic burden on the health system. There is no certainty about the prevalence of HIV/AIDS in Iran. To the best of our knowledge, there is a lack of economic evidence in the country. Therefore, this study aims to estimate the cost of illness of HIV/AIDS infection in Iran. Methods: We applied a societal perspective to capture the direct and indirect costs attributed to HIV/AIDS in Iran. We used data for age-standardized prevalence produced by the country HIV/AIDS Surveillance System for 2018. The study estimates both direct and indirect costs for a hypothetical cohort of the Iranian adult population (here equates to all registered cases with Surveillance System). For mitigating the uncertainty around the estimations, we have used an optimistic and pessimistic analysis. Results: The base case scenario showed that total direct costs and indirect costs attributed to the HIV/AIDS infection were US$7,946,530 and US$ 1,288,586 at the end of 2018. Also, the total cost is 8,785,116 US$. Conclusions: Direct costs have formed approximately 85% of total costs. The policymakers and planners should consider that these costs are only related to diagnosed or registered infected populations. These costs will be raised dramatically with increasing the diagnosed patients

Use of preclinical models for malignant pleural mesothelioma.

Malignant pleural mesothelioma (MPM) is an aggressive cancer most commonly caused by prior exposure to asbestos. Median survival is 12-18 months, since surgery is ineffective and chemotherapy offers minimal benefit. Preclinical models that faithfully recapitulate the genomic and histopathological features of cancer are critical for the development of new treatments. The most commonly used models of MPM are two-dimensional cell lines established from primary tumours or pleural fluid. While these have provided some important insights into MPM biology, these cell models have significant limitations. In order to address some of these limitations, spheroids and microfluidic chips have more recently been used to investigate the role of the three-dimensional environment in MPM. Efforts have also been made to develop animal models of MPM, including asbestos-induced murine tumour models, MPM-prone genetically modified mice and patient-derived xenografts. Here, we discuss the available in vitro and in vivo models of MPM and highlight their strengths and limitations. We discuss how newer technologies, such as the tumour-derived organoids, might allow us to address the limitations of existing models and aid in the identification of effective treatments for this challenging-to-treat disease.MS and JO are supported by BLF-Papworth Fellowships from the British Lung Foundation and the Victor Dahdaleh Foundation. MJG and HEF is supported by the British Lung Foundation and Wellcome Trust grant 206194. RCR is supported by the Cambridge Biomedical Research Centre, Cancer Research UK Cambridge Centre, British Lung Foundation and Royal Papworth Hospital. SJM is supported by the Medical Research Council, British Lung Foundation, Cambridge BRC, Royal Papworth Hospital, and the Alpha1-Foundatio

Conjugated linoleic acid stimulates apoptosis in RH and tehran strains of Toxoplasma gondii, in vitro

Background: The aim of this study was to evaluate the effects of conjugated linoleic acid (CLA) on apoptosis of tachyzoites of T. gondii, RH strain (type I) and the cyst-forming Tehran strain (type II) in vitro. Methods: Toxoplasma strains were injected into the peritoneal cavity of BALB/c mice. The Tehran strain forms cysts in the brain of mice. Bradyzoites within the cysts are reactivated to proliferative tachyzoites, by dexamethasone. Tachyzoites were aspirated from the peritoneum of infected mice, and the percentage of viable parasites was estimated with trypan blue staining. Tachyzoites were inoculated into HeLa cells cultivated in DMEM medium. Different concentrations of CLA were evaluated on T. gondii in HeLa cells by the tetrazolium (MTT) colorimetric assay. Differentiation between apoptosis and cell death was determined by flow cytometry using Annexin V and propidium iodide (PI) double staining. The statistical analysis performed by GraphPad Prism version 6.00. Results: CLA induces apoptosis in virulent (RH) and avirulent (Tehran) strains of T. gondii. The results of MTT indicated that CLA could decrease the proliferation of tachyzoites of both strains in HeLa cells. Conclusion: Conjugated linoleic acid has anti-toxoplasmacidal activity on tachyzoites of T. gondii. Therefore, we recommended further studies on this component in order to achieve a new drug against the parasite. © 2015, Tehran University of Medical Sciences (TUMS). All rights reserved

Efficacy of neuromodulation in fecal incontinence in children; a systematic review and meta-analysis

Background: The results of existing studies regarding the use of neuromodulation in fecal incontinence (FI) are contradictory and therefore, a definitive conclusion cannot be made in this regard. Therefore, the aim of the present study was to evaluate the effectiveness of neuromodulation in controlling FI in children through a systematic review.. Materials and Methods: A decision was made to perform the search in electronic databases of Medline, Embase, Web of Science, CINAHL and Scopus until end of October 2017. In the second step, the abstracts of the extracted studies were evaluated by 2 researchers independently and recorded in the data extraction form. Finally, all studies were summarized and categorized based on the evaluated outcomes and overall effect size was presented. . Results: Five studies were included in the present meta-analysis (including 115 children and adolescent). Pooled analysis also showed that the odds of improvement in the group under treatment with nerve stimulation was up to 20 times higher (OR = 20.29; 95 CI: 8.67 to 47.45; p<0.0001). In addition, using nerve stimulation leads to a significant improvement in fecal incontinence score of patients (SMD = 2.32; 95 CI: 1.12 to 3.52; p<0.0001). Conclusion: It can be concluded that neuromodulation can seemingly be an effective measure in controlling FI in children. However, the lack of standard clinical trials in this field is highly felt and it is suggested to assess the effect of neuromodulation on FI by performing blinded randomized clinical trials in future studies

Efficacy of neuromodulation in fecal incontinence in children; a systematic review and meta-analysis

Background: The results of existing studies regarding the use of neuromodulation in fecal incontinence (FI) are contradictory and therefore, a definitive conclusion cannot be made in this regard. Therefore, the aim of the present study was to evaluate the effectiveness of neuromodulation in controlling FI in children through a systematic review.. Materials and Methods: A decision was made to perform the search in electronic databases of Medline, Embase, Web of Science, CINAHL and Scopus until end of October 2017. In the second step, the abstracts of the extracted studies were evaluated by 2 researchers independently and recorded in the data extraction form. Finally, all studies were summarized and categorized based on the evaluated outcomes and overall effect size was presented. . Results: Five studies were included in the present meta-analysis (including 115 children and adolescent). Pooled analysis also showed that the odds of improvement in the group under treatment with nerve stimulation was up to 20 times higher (OR = 20.29; 95 CI: 8.67 to 47.45; p<0.0001). In addition, using nerve stimulation leads to a significant improvement in fecal incontinence score of patients (SMD = 2.32; 95 CI: 1.12 to 3.52; p<0.0001). Conclusion: It can be concluded that neuromodulation can seemingly be an effective measure in controlling FI in children. However, the lack of standard clinical trials in this field is highly felt and it is suggested to assess the effect of neuromodulation on FI by performing blinded randomized clinical trials in future studies

Combination of laser and human adipose-derived stem cells in repair of rabbit anal sphincter injury: a new therapeutic approach

Background: Anal sphincter injury leads to fecal incontinence. Based on the regenerative capability of laser and human adipose-derived stem cells (hADSCs), this study was designed to assess the effects of co-application of these therapies on anal sphincter recovery after injury. Design: Male rabbits were assigned to equal groups (n = 7) including control, sphincterotomy, sphincterotomy treated with laser (660 nm, 90 s, immediately after sphincterotomy, daily, 14 days), hADSCs (2 × 106 hADSCs injected into injured area of the sphincter immediately after sphincterotomy), and laser + hADSCs. Ninety days after sphincterotomy, manometry and electromyography were performed, sphincter collagen content was evaluated, and Ki67, myosin heavy chain (MHC), skeletal muscle alpha-actin (ACTA1), vascular endothelial growth factor A (VEGFA), and vimentin mRNA gene expression were assessed. Results: The laser + hADSCs group had a higher resting pressure compared with the sphincterotomy (p  0.05). In the laser + hADSCs group, motor unit numbers were higher than those in the laser group (p < 0.0001) but did not differ from the hADSCs group (p = 0.075). Sphincterotomy increased collagen content, but the muscle content (p = 0.36) and collagen content (p = 0.37) were not significantly different between the laser + hADSCs and control groups. Laser + hADSCs increased ACTA1 (p = 0.001) and MHC (p < 0.0001) gene expression compared with laser or hADSCs alone and was associated with increased VEGFA (p = 0.009) and Ki67 mRNA expression (p = 0.01) and decreased vimentin mRNA expression (p < 0.0001) compared with laser. Conclusion: The combination of laser and hADSCs appears more effective than either treatment alone for promoting myogenesis, angiogenesis, and functional recovery after anal sphincterotomy.Arash Sarveazad, Asrin Babahajian, Abazar Yari, Chris K. Rayner, Marjan Mokhtare, Arash Babaei-Ghazani, Shahram Agah, Bahar Mahjoubi, Jebreil Shamseddin, and Mahmoud Yousefifar

Biological basis for novel mesothelioma therapies

Funder: British Lung Foundation (BLF); doi: https://doi.org/10.13039/501100000351Funder: Royal Society through a University Research Fellowship and the Engineering and Physical Sciences Research Council (EPRSC)Funder: China Scholarship Council (CSC); doi: https://doi.org/10.13039/501100004543Abstract: Mesothelioma is an aggressive cancer that is associated with exposure to asbestos. Although asbestos is banned in several countries, including the UK, an epidemic of mesothelioma is predicted to affect middle-income countries during this century owing to their heavy consumption of asbestos. The prognosis for patients with mesothelioma is poor, reflecting a failure of conventional chemotherapy that has ultimately resulted from an inadequate understanding of its biology. However, recent work has revolutionised the study of mesothelioma, identifying genetic and pathophysiological vulnerabilities, including the loss of tumour suppressors, epigenetic dysregulation and susceptibility to nutrient stress. We discuss how this knowledge, combined with advances in immunotherapy, is enabling the development of novel targeted therapies

Efficacy of adipose derived stem cells on functional and neurological improvement following ischemic stroke: A systematic review and meta-analysis

Background: The evidence on the efficacy of adipose derived stem cells (ADSCs) in the treatment of stroke is controversial. Therefore, the aim of present systematic review and meta-analysis is to evaluate the efficacy of ADSCs administration in the treatment of animal models of ischemic stroke. Methods: An extensive search was performed on electronic databases of Medline, Embase, Scopus, CENTRAL and Web of Science until December 31, 2018. Animal studies that used ADSCs in treatment of ischemic stroke were included. The data were recorded as mean and standard deviation and then a pooled standardized mean difference (SMD) with 95 confidence interval (95 CI) was reported. Results: Twenty articles were included in the present meta-analysis. It was observed that administration of ADSCs improves motor function (SMD = 2.52, 95 CI: 1.67 to 3.37, p < 0.0001) and neurological status (SMD = 2.05, 95 CI: 1.33 to 2.78, p < 0.0001) in animals following an ischemic stroke. Multivariate meta-regression showed the model of stroke induction (p = 0.017) and the number of transplanted cells (p = 0.007) affect the efficacy of ADSCs administration on motor function improvement following the stroke. Conclusion: Moderate to high levels of evidence indicate a strong efficacy of ADSCs transplantation on motor function and neurological improvement following ischemic stroke in animal models. However, no reports regarding the dose-response effect of ADSCs administration on stroke exist in the literature. As a result, further pre-clinical studies are recommended to be conducted on the matter. © 2020 The Author(s)

Frequency of Intestinal Parasites in Tehran

"nBackground: For a long time, intestinal parasite infections are among the major problems of public health in Iran. Our aim was epidemiological studies on the frequency of intestinal parasites in patients re­ferred to three hospitals in Tehran during 2007-2008."nMethods: During 2007-2008, by simple random selection, 1000 stool samples were collected from Mi­lad, Hazrat-e-Rasoul and Shahid Fahmideh hospitals in Tehran, Iran. We examined the samples using di­rect smear, formol-ethyl acetate concentration, Agar-plate culture and Ziehl-Neelsen staining tech­nique."nResults: The frequency of intestinal parasites were: Blastocystis hominis 12.8%, Giardia lamblia 2.5%, En­tamoeba coli 4.8%, Iodamoeba butschlli 0.9%, unknown 4 nuclei cysts 0.4%, Endolimax nana 3.2%, Chilomastix mesnili 0.4%, Strongyloides stercoralis 0.1%, Hymenolepis nana 0.2% and Taenia sagi­nata 0.2%. Coccidian parasites were not found. Results show that infection with intestinal parasites does not statistically significant according to sex and age."nConclusion: The intestinal parasites, especially helminthic infections have been decreased during re­cent years

Substitution of lysine for isoleucine at the center of the nonpolar face of the antimicrobial peptide, piscidin-1, leads to an increase in the rapidity of bactericidal activity and a reduction in toxicity

Purpose: Piscidin-1 is an effective antimicrobial peptide (AMP) against a variety of microbes. However, its toxicity has been reported as a limitation for its potential therapeutic applications. The toxicity of piscidin-1 may be related to the long nonpolar face of this AMP. Here, we investigated different piscidin-1 analogs to reach a peptide with the reduced toxicity. Material and methods: In vitro and in vivo antibacterial activity and toxicity of piscidin-1 analogs generated by replacement of isoleucine at the border (I9) or the center (I16) of the nonpolar face of piscidin-1 by alanine or lysine were investigated. Results: The results indicated that among all peptides, piscidin-1 with the highest HPLC retention time (RT) and I16K-piscidin-1 with the lowest RT had the highest and lowest cytotoxicity, respectively. Although I16K-piscidin-1 possessed the same MIC value as the parent peptide (piscidin-1) and other analogs, I16K-piscidin-1 exhibited a higher rapidity of bactericidal action at 5×MIC. The β-galactosidase leakage and propidium iodide staining assays indicated a higher pore-forming capacity of I16K-piscidin-1 relative to the parent peptide (piscidin-1). Taken together, RT is suggested to have a direct association with the toxicity and an inverse association with the rapidity of bactericidal action and pore-forming capacity. After infection of mice with clinical colistin-resistant Acinetobacter baumannii or clinical methicillin-resistant Staphylococcus aureus strains, treatment with I16K-piscidin-1, but not piscidin-1 and other analogs, resulted in a significantly stronger bactericidal potency. Furthermore, I16K-piscidin-1 exhibited the lowest in vivo toxicity. Conclusion: Overall, in vitro and in vivo comparison of piscidin-1 and its analogs together documented that replacement of isoleucine at the center of the nonpolar face of piscidin-1 (I16) by lysine leads to not only a decrease in toxicity potential but also an increase in bactericidal potential