Original Article

Effect of Epoetin Alfa and Sodium Valproate in Patients with Myelodysplastic Syndrome

Seyed Ashkan Hosseini, Mahdi Tabarraee, Mojtaba Ghadiani

Novelty in Biomedicine, Vol. 8 No. 4 (2020), , Page 151-155

Background: Myelodysplastic syndrome (MDS) is an important precancerous disease leading to blood malignancies. Prompt diagnosis and treatment would result in better outcome in patients. Purpose of the study was to determine the effect of Epoetin Alfa and Sodium Valproate in patients with MDS.

Materials and Methods: In this interventional quasi-experimental study, 50 consecutive patients with MDS from Taleghani Hospital (Tehran, Iran) in 2016-2017 were enrolled. They underwent treatment for eight months with 10000 units per month from Epoetin Alfa plus 200 mg TDS from Sodium Valproate. The hematological response was determined according to the hemoglobin, platelet, and neutrophil.

Results: Hematological response was present in 68%. The packed cell treatment were decreased significantly (P=0.040) and 56% of patients had no receipt of packed cells after treatment.

Conclusion: It is concluded that Epoetin Alfa plus Sodium Valproate was effective in treatment of patients with Myelodysplastic syndrome and use of this combination therapy is recommended.

Evaluation of Efficacy of Neuro Muscular Electrical Stimulation and Electro Acupuncture in Improving the Pain and Disability in Patients with the Lumbar Degenerative Intervertebral Disk Disease

Shahin Salehi, Zeinab Faraji Qomi, Omid Hesami, Mehrshad Poursaeid Esfahani, Amirhosein Abedi Yekta, Mohammad Hassabi, Mohammad Reza Sohrabi, Morvarid Elahi

Novelty in Biomedicine, Vol. 8 No. 4 (2020), , Page 156-163

Background: Chronic low back pain (CLBP) due to the degenerative intervertebral disk diseases is one of the most common musculoskeletal conditions in contemporary societies. A variety of pharmacological, non-pharmacological and surgical options is available for treatment of CLBP. The use of non-pharmacological methods have drastically increased in recent years, offering fewer complications and expenses. This study was conducted to compare the efficacy of the neuromuscular electrical stimulation (NMES) and electro acupuncture (EAP) with exercise therapy alone in patients with chronic low back pain.

Materials and Methods: This was a randomized case-controlled clinical trial. Sixty patients with CLBP were randomly assigned to 3 groups (20 cases each) of the EAP with exercise therapy, NMES with exercise therapy, and exercise therapy only. Severity of pain and disability improvement were assessed using the visual analog scale (VAS) and Quebec back pain disability scale respectively.

Results: A total of 66 individuals were enrolled, out of which 6 were excluded due to patients’ lack of cooperation. A significant decline in the amounts of Quebec and VAS was observed in the three groups (p<0.001). The pain and disability improvements did not display any significant difference in the NMES or EAP groups compared to the control group. However, the severity of disability and pain in the NMES group were significantly higher than the EAP group (p<0.05).

Conclusion: These findings may indicate an almost identical efficacy of exercise therapy alone compared to the combination with electrical stimulation techniques in improving the pain and disability in patients suffering CLBP.

Background: Neuropathy is one of the complications of diabetes, probably due to the destruction of the extracellular matrix and the thickening of the peripheral nerve basement membrane. However, its mechanisms and the impact of exercise on these disorders has not fully understood. The purpose of the present study was to investigate the effect of aerobic exercise on collagen levels of type I and IV and collagen type I protein changes in the sciatic nerve of diabetic rats.

Materials and Methods: Eighteen 10-week-old Wistar male rats weighing 250 ± 20 g were randomly divided into three groups of healthy control (n=6), diabetic (n=6) and diabetic + aerobic exercise (n=6). For this purpose, after introduction and adaptation of rats to new environment, diabetes was induced by single dose injection of dissolved streptozotocin in sodium citrate buffer at pH=4.5 at 45 mg/kg intraperitoneal. After confirming neuropathic conditions (with behavioral tests), diabetic+exercise rats underwent moderate-intensity aerobic exercise on the treadmill for 8 week. At the beginning and at the end of the period, blood glucose of all rats was measured by glucometer and the mean of each group was measured separately. Changes in collagen type I and IV gene expression, and collagen type I protein levels in sciatic nerve of rats were evaluated by real-time PCR technique and immunohistochemistry, respectively.

Results: Diabetes increased collagen type I and IV gene expression and collagen type I protein levels in the sciatic nerve samples of rats. However, exercise reduced blood sugar levels and expression of collagen type I and IV genes (p=0.05) and collagen type I protein significantly reduced in sciatic nerve (p=0.001).

Conclusion: The results of the present study showed that aerobic exercise as a non-pharmacological strategy by negative regulating type I and IV collagen factors at the gene and protein level, was able to control and inhibit the effects of diabetes on extracellular matrix components in the sciatic nerve.

Daclatasvir/Sofosbuvir versus Ledipasvir/Sofosbuvir in Patients with Hepatitis C Virus Infection Genotypes 1 and 3

Narjes Shokatpour, Shahnaz Sali, Ali Khahanipour, Sara Abolghasemi, Minoosh Shabani

Novelty in Biomedicine, Vol. 8 No. 4 (2020), , Page 171-181

Background: The new direct-acting antiviral agents (DAAs) with high efficacy, low resistance, and low rate of adverse events (AEs) have shown promising outcomes for hepatitis C virus (HCV) treatment. This study assessed the efficacy and safety of Daclatasvir/Sofosbuvir (DCV/SOF) compared to Ledipasvir/Sofosbuvir (LDV/SOF) in patients with HCV infection in the real-world setting in Iran.

Materials and Methods: A total of 42 patients with HCV infection were treated with either LDV/SOF (genotype 1) or DCV/SOF (genotypes 1, 3 or unknown) with or without ribavirin (RBV). Assessment of risk factors, laboratory tests, sustained virologic response at post-treatment week 12 (SVR12), and AEs were performed.

Results: The highest risk factor for HCV transmission was major surgery (50.0%), followed by tattooing (40.5%), phlebotomy (40.5%), and dental surgery (40.5%). No statistically significant relationships between genotypes and risk factors were observed. In both treatment groups (LDV/SOF and DCV/SOF), all of the patients (100%) with or without cirrhosis and treatment-experience achieved SVR12. One patient with a history of failed LDV/SOF therapy achieved SVR12 following retreatment with DCV/SOF. Both treatment regimens were well-tolerated. No serious AEs or discontinuation due to AEs was observed. The most common AE across both treatment groups were fatigue (42.9%), followed by anxiety (28.6%). Numerically, more adverse events were found with the LDV/SOF regimen than with the DCV/SOF regimen.

Conclusion: Our study showed an excellent safety and efficacy of DCV/SOF and LDV/SOF in Iranian patients infected with HCV. The incidence of AEs among patients treated with LDV/SOF was higher than those receiving SOF/DCV.

Evaluation of the Effectiveness of Academic Writing Workshop in Medical Students Using the Kirkpatrick Model

Reza Ghasemi, Maryam Akbarilakeh, Azam Fattahi, Ensieh Lotfali

Novelty in Biomedicine, Vol. 8 No. 4 (2020), , Page 182-195

Background: Research is an important part of the clinical practice. In recent years, several workshops are held to teach research skills to medical students. Evaluating workshops determine that workshop content can lead to higher performance in individuals. The present study aimed to evaluate effectiveness of writing scientific papers workshop for medical students using Kirkpatrick’s model.

Materials and Methods: This was a quasi-experimental study using pretest-posttest design and face to face communication to assess the learning effect of the training intervention. Immediately after workshop, the partici­pants filled out a satisfaction ques­tionnaire for evaluation of level one. To assess level two, pretest and posttest questionnaire was used. To assess level three and four, number of students who started their first research project and who published their first research articles were considered for a 6 months’ period after workshop.

Results: Based on our results, contributors’ gender and semester had no efficacy on knowledge improvement of the participants. Results of four levels of Kirkpatrick’s model showed all participants were satisfied from workshop and participation in this workshop has had a positive effect on participants’ knowledge about writing articles. Obviously, the workshop affect on transfer of knowledge to contributors and it leads to maintenance of change over time.

Conclusion: Impressively the authors found strong evidence to validate that the training effect on students’ understanding of the research process, positively. Such courses enable medical students to investigate properly and improve their knowledge in their field. Therefore, universities must encourage medical students to participate in these workshops.

Docetaxel Enhances the Expression of STING Protein in PC3 Cells, and cGAMP Attenuates this Effect

Shaghayegh Salimi, Mitra Rezaei, Zahra Mousavi, Roya Atabakhshian, Ramin PourIran, Seyed Ali Ziai

Novelty in Biomedicine, Vol. 8 No. 4 (2020), , Page 196-204

Background: The stimulator of interferon genes (STING) agonist (cGAMP) kills the cancer cells through the activation of the innate immune system. PC3 cells are high in BTK and low in STING. In this study, the effect of adding STING agonist, cGAMP, to docetaxel investigated.

Materials and Methods: PC3 cells were treated with docetaxel, cGAMP, and a combination of the docetaxel and cGAMP. Cell toxicity was evaluated by MTT assay, and changes of STING, IRF3, BTK, and DDX41 genes’ expression were quantified by the real-time PCR. STING protein was also detected by Western blotting.

Results: The IC50 of docetaxel was 31.1 nM, and cGAMP did not change it significantly but decreased docetaxel toxicity about 30%. Docetaxel increased IRF3, BTK, and DDX41 gene expression significantly, and STING protein about 5 folds. By adding cGAMP to docetaxel STING, IRF3, and BTK, expression decreased several folds.

Conclusion: In this in vitro study, cGAMP potentiated docetaxel’s effects and alleviated it.

Evaluation of Beclin1 Effect on Apoptosis in Mouse Infected with Street Rabies Virus

Homeira Prizad, Maryam Fazeli, Minoo Mahmoudi, Alireza Jananni, Farzaneh Sheikholeslami

Novelty in Biomedicine, Vol. 8 No. 4 (2020), , Page 205-209

Background: Apoptosis is a programmed cell death in which certain cellular components are packed into small membrane vacuoles by immune cells. Different strains of rabies virus (RABV) have their own biological features, but their effects on apoptosis have been little known. The aim of current research was to evaluate Beclin 1 effect on apoptosis in the mouse infected with the street rabies virus.

Materials and Methods: Exogenous Beclin1 overexpressed by the pIRES2-EGFP-Beclin1 vector in the cortex of NMRI mice. To evaluate the apoptosis, TUNEL assay was done on brain tissues of the rabid mice.

Results: TUNEL assay data showed that small apoptotic cells were seen in the four groups that received the vector alone or with the SRABV, but no significant changes were observed. There are no signs of apoptosis in mouse normal brain cells.

Conclusion: It was previously proven that overexpression of exogenous Beclin1 could induce autophagy but this study showed that overexpression of Beclin 1 does not cause apoptosis in rabies-infected cells.

Letter to editor

Nanomedicine: The Novel Weapon against Parasitic Infections

Mohsen Rahimi, Zahra Arab-Mazar, Sara Rahmati Roodsari

Novelty in Biomedicine, Vol. 8 No. 4 (2020), , Page 210-211

Due to the side effects of drugs and resistance to the used chemicals in the treatment of tropical diseases such as malaria, leishmaniosis, trypanosomiasis and Schistosomiasis, which millions of people around the world are infected, nowadays nanomedicine usage with the production of nanofibers and nanoparticles (nanopowders, nanocrystal or nanocluster). The particles with a diameter of less than 100 nanometers is considered as a special treatment in parasitic diseases1,2.

Due to the intracellular nature of some parasites, their treatment is a major challenge for researchers to develop new drugs. Findings show that Chitosan nanoparticles and metals such as silver, gold, and metal oxides have a lethal or inhibitory effect on various parasites, including giardiasis, leishmaniosis, malaria, or toxoplasma and insect larvae1

The effects of drug release from chitosan nanofibers have also been performed in various external and internal evaluations on lesions caused by Leishmania major and the therapeutic effect of gold and silver nanoparticles on malaria and their concomitant use with bioresonance waves on leishmaniasis2,4.

The main purpose of using nanoparticles is to use it as a drug delivery system and to release the drug agent in order to affect the specific site. Recently, the use of particle systems such as nanomedicine as a physical tool to improve the pharmacokinetic properties of various types of drug molecules in vivo is being developed1,4.

The endocytic pathway transfers nanoparticles to the site of pathogens. The breakdown of these substances by lysosomal enzymes releases drugs into the phagocytic or lysosomal vesicle, or this process is released into the cytoplasm by a diffusion phenomenon. Specific transmission depends on the physical and chemical nature of the molecules1.

In recent years, the use of nanoparticles for the treatment of parasitic diseases has considered, although limited research has conducted in this regard (Table 1).

Finally, it can be concluded that according to recent findings on the inhibitory and long-term effects of nanofibers and nanoparticles on different parasites with less side effects than conventional drugs, more effective and less side effects drugs can be developed. Useful vaccines have also been developed to control parasitic diseases.