Novelty in Biomedicine

Background: Keloid and hypertrophic scars (HTS) caused by an imbalance between the production and destruction of collagen during wound healing with an unknown underlying pathophysiological mechanism. This study was designed to evaluate the histamine level in the Keloid and HTS and comparison of results with normal skin.

Materials and Methods: This pilot study included 36 participants, aged from 18 to 70 years with keloid (n=11), HTS (n=13) and normal (n=12) skin. The level of histamine in the skin samples was measured using enzyme-linked immunosorbent assay (ELISA).

Results: Histamine level in keloid samples was significantly higher than in the normal (p=0.0012) or HTS (p=0.0028) groups. However, there was no significant difference between the normal and HTS samples (p=0.92).

Conclusion: The increased histamine level in the keloid tissue may contribute to its pathogenesis and the application of anti-histamines could be of benefit for the prevention and treatment of keloids.

Background: Obesity nowadays becomes a major medical and social problem in the world. Obesity is a pandemic health problem recognized as a disease of time and is also an important cause of morbidity and mortality. The aim of this study was to investigate the persistent histopathologic changes after Helicobacter pylori (H. pylori) treatment in laparoscopic sleeve gastrectomy (LSG) specimens and correlation between high body mass index (BMI) and histopathological findings.

Materials and Methods: Asymptomatic 520 patients were candidate for laparoscopic sleeve gastrectomy (2017-2019) who had not symptom of Helicobacter pylori infection, visually normal endoscopy and had positive H. pylori urease recently. They treated with triple regimen (clarithromycin, amoxicillin for 2 weeks and proton-pump inhibitor (PPI) for 2 month). Eradication was confirmed by urea breath test (UBT). After operation specimens were evaluated histopathologically.

Results: Females were 58.3% of the patients. Mean BMI were 44.2 (females) and 46.3 (males). Normal LSG specimens were 58.3%. Most common abnormal histopathology findings were; chronic mild active and inactive gastritis (21.3%), chronic moderate active and inactive gastritis (16.0%), chronic severe active and inactive gastritis (3.3%), had not follicular gastritis, lymphoid aggregates (0.6 %), intestinal metaplasia (0.2%) and PPI effect (0.2%). Significant correlation was observed between the higher patients BMI (BMI>45) with abnormal histopathology findings specially moderate and severe degree of chronic active and inactive gastritis.

Conclusion: Patients with higher BMI was at more risk for post H. pylori treatment abnormal pathology like chronic active gastritis which is the risk factor for atrophic gastritis may lead to preventable gastric cancer. Patients with higher BMI (≥45) and H. pylori positive urease test with visually normal endoscopy, mainly candidate for the laparoscopic Roux-en-Y gastric bypass (LRYGB). Permanent endoscopic follow up in these patients are impossible, therefore, endoscopic random tissue mapping even after H. pylori treatment is appropriate.

Background: Saffold virus as a new member of cardiovirus genus in picornaviridae family has been suggested to be related to diarrheic cases and human airway diseases. However, relationship between Saffold virus and human diseases is unclear. In order to establish an investigation for the occurrence of Saffold virus among pediatric patients involved to acute gastroenteritis, we implemented a RT-PCR assay for detection and quantification of Saffold virus in stool specimens.

Materials and Methods: In this study, a total of 160 stool samples from September 2018 to May 2019 were collected from presenting pediatric patients with acute gastroenteritis in a Karaj hospital, Iran. After viral RNA extraction, the RT-PCR was performed to amplify the 5’UTR region of Saffold virus genome.

Results: Out of the 160 samples tested, the Saffold virus genomic RNA was detected in 26/160 (16.2%) of stool samples. The high Saffold virus detection rate was related to February (6/26 or 23%). The co-infection of Saffold virus with Aichivirus and Salivirus as other new emerging viruses was also assessed, among which high double or triple mixed-infections were determined.

Conclusion: This is the first documentation of Saffold virus detection in stool samples that demonstrates Saffold virus has been circulating among Iranian pediatric patients. Our results indicated that Saffold virus in association with Aichivirus and Salivirus may be possibly considered as causative agent of acute gastroenteritis.

Background: The COVID-19 is a family of large enveloped non-segmented positive-sense RNA viruses which was first reported in December 2019 in Wuhan, China with a cluster of unexplained pneumonia. Although various medications have been tried to manage the COVID-19 pandemic, there is no exclusive medication or vaccine so far. In this study, we aimed to focus on the effectiveness of Hydroxychloroquine + Kaletra (lopinavir/ritonavir) versus Hydroxychloroquine + Sofosbuvir in patients hospitalized with COVID-19 to given the urgent need for an effective drug against SARS-CoV-2 in the current pandemic context.

Materials and Methods: Fifty-four eligible patients with moderate to severe COVID-19 symptoms, according to the WHO criteria entered the study. Patients were randomized into two treatment groups. Thirty-two patients received Hydroxicholoroquine (400 mg stat) and Kaletra (400/100 mg q 12 h) as a control group (group A) and the trial group of 22 patients, received Hydroxicholoroquine (200 mg q 12 h) plus Sofosbuvir (400 mg daily) (group B) for a period of 7 to 14 days. Eventually, collected data included demographic characteristics, underlying diseases, clinical symptoms, laboratory data, and mortality were analyzed.

Results: There was no significant difference in age, sex, and underlying diseases between the two groups. There was no significant statistical difference between the two groups on the seventh day of treatment in terms of cough relief, leukocyte count, and improvement of lymphopenia however in terms of the time of defervescence of fever, there was a significant difference between the two groups.

Conclusion: Therefore, it can be said that our study is one of the first studies in the world to evaluate the effectiveness of sofosbuvir in the treatment of patients with COVID-19. According to our results, although Kaletra was assumed as an effective therapy, its superiority over Sofosbuvir was confined to the earlier effervescence of the 7-day fever and sofosbuvir can be used as an effective treatment, especially in patients with underlying heart disease who are at risk for arrhythmias with Kaletra.

Background: Iran has a high incidence rate for gastric cancer among the Middle East countries. In addition to gastric cancer, peptic ulcer is also life-threatening; thus, investigating the prevalence of Helicobacter pylori infection and other risk factors are essential. The present study was aimed to assess the frequency of H. pylori and the cagA-positive strains in patients with gastric cancer or peptic ulcer at a teaching hospital in Qom, one of the most populated cities of Iran.

Materials and Methods: The presence of H. pylori was investigated in gastric cancer and peptic ulcer biopsy specimens using the standard culture method. PCR analysis was performed to detect the presence of the cagA gene.

Results: The frequency of H. pylori isolates among 86 investigated biopsies was 20 (23.2%). Likewise, the rate of H. pylori was the highest when samples were examined from patients with gastric cancer (25.8%), while it was 21.8% when obtained from peptic ulcer patients. The frequency of the cagA gene in H. pylori isolates was 9 (56.2%), as confirmed by PCR.

Conclusion: Our results indicated that H. Pylori infection and its virulent strains are frequent and widely spread in Qom city. The cagA gene was present in almost half of H. pylori isolates from peptic ulcer or gastric cancer patients. Therefore, it is necessary to screen it in all cases with H. pylori infection for early detection of gastric cancer.

Background: Acute myocardial infarction is an increasing cause of morbidity and mortality in the world. This condition sometimes happens as a result of coronary arteries blockage due to clot formation, spasm or plaque rupture.

Cases Report: A 31-year-old man referred to our hospital with severe exertional chest pain. Electrocardiogram revealed ST- segment elevation in precordial leads. Coronary arteries angiography revealed a visible clot at  proximal part of left anterior descending artery. As the thrombolysis in myocardial infarction (TIMI)  flow of the artery was  normal and the patient became  asymptomatic , conservative management was considered. The patient was commenced on anticoagulant, glycoprotein  2b/3a  inhibitor,  aspirin, and  clopidogrel. Follow-up  angiography  showed normal flow with no clot existence.

Conclusion: Coronary thrombus is an etiology of acute coronary syndrome. Patients often have varying levels of concurrent atherosclerosis. It’s management is anticoagulation, thrombolysis, and occasionally invasive strategies . Some cases can be managed conservatively, so decision-making is an import part of these patients management.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a rapidly emerging viral infection causing coronavirus disease 2019 (COVID-19). The first report of the novel coronavirus, SARS-CoV-2, originated in Wuhan, China, in early December 2019 . Currently, there are no U.S. Food and Drug Administration (FDA)–approved drugs for the treatment of patients with COVID-19. A great deal of effort is ongoing to find effective therapeutics and preventive measures against this transmissible virus with high mortality. As result, available data are limited, and there are minimal randomized controlled trial (RCT) data on the efficacy of antiviral or immunomodulatory agents for the treatment of COVID-19 . Most of the treatment protocols are based on observational studies and anecdotic reports.