Review Article


Microbial Biofilms as a Risk Factor for Acantahmoeba keratitis

Maryam Norouzi, Maryam Niyyati, Hamerd Behniafar

Novelty in Biomedicine, Vol. 10 No. 1 (2022), 31 January 2022, Page 37-42
https://doi.org/10.22037/nbm.v10i1.35763

Members of the protozoan genus Acanthamoeba are free-living amoebas and the primary causative agent of
amoebic keratitis and granulomatous encephalitis. Amoebic keratitis mainly occurs in individuals who wear
soft contact lenses following trauma and exposure to contaminated sources. As the survival, growth, and
multiplication of this protozoan increases in biofilms, which is the microbial accumulation, several cases of
amoebic keratitis have been reported as co-infections with bacteria, especially Pseudomonas
aureginosa. Pseudomonas improves the binding of this protozoan to soft lens surfaces by its special surface
enzymes, resulting in Acanthamoeba keratitis and sometimes mixed infection. Biofilm accumulates
microorganisms, including bacteria and fungi, on living and non-living surfaces. The firm attachment of these
microbial accumulations to the surface can cause various diseases and resistance to treatment. The critical point
is that bacteria have less destructive effects in the plantonik state, and when the specific signals of these
microbiome cause the recall of other microorganisms and their interaction, they lead to problems.
Unfortunately, the ocular defense barrier, which includes the eyelids, lacrimal glands, and tears, cannot kill
microbial agents when microorganisms accumulate and adhere firmly to the lens surfaces. Due to the great
importance of AK, especially in medical contact lens users, biofilm formation is an important issue that has
been considered in recent years. Biofilm formation-induced drug resistance, which is caused by the
disproportionate density of microorganisms on the inner and outer surfaces of the biofilm. There are several
ways to prevent the formation of biofilms on the surfaces of contact lenses, including the use of antimicrobial
peptides and various antibiotics and coating them on the inner surface of contact lenses to slow-release of
antibiotics and prevent biofilm formation. In the present review article, we aimed to introduce biofilms as one
of the important risk factors for developing Acanthamoeba keratitis and prevention ways of biofilms formation.

DNA-based Nanostructures as Novelty in Biomedicine

Ameneh Mohammadi, Pooria Gill, Pedram Ebrahimnejad, Said Abediankenari, Zahra Kashi

Novelty in Biomedicine, Vol. 10 No. 1 (2022), 31 January 2022, Page 43-75
https://doi.org/10.22037/nbm.v10i1.35408

The application of nanocarriers in medicine and pharmaceuticals suggests a new procedure in nanotechnology
terminology, nanomedicine. DNA has been significantly highlighted due to its amazing functionality and nature
as a nanomaterial in biomedicine. Given that DNA is biocompatible, its use as a nanomaterial in medicine
provides an excellent prospect for the rational engineering of DNA nanostructures. According to new
approaches in disease treatment at gene levels, gene therapy, DNA as a nanomedicine plays an essential role in
the medical sciences. In this field, researchers have published enormous documents regarding the applications
of DNA and DNA-based nanostructures as drug or gene nanocarriers, DNA-based diagnostics, and DNA nano
vaccines. In this review, the novelty of DNA-based nanomedicine has been considered.

The Effect of Different Types of Climates on the Spread of COVID-19

Mohammadamin Farhangnasab, Behzad Pourhossein, Mahsa Golahdouz, Mahsa Taherizadeh, Sara Sharifi, Narges Rostami, Narjes Morovati Moez, Mehran Mahouti, Maryam Fazeli

Novelty in Biomedicine, Vol. 10 No. 1 (2022), 31 January 2022, Page 76-88
https://doi.org/10.22037/nbm.v10i1.36598

Coronavirus disease of 2019 (COVID-19) is the third most common zoonotic disease caused by the coronavirus
virus, SARS in 2002, and Middle East Respiratory Syndrome (MERS) in 2012. The primary origin of
transmission of infection to humans is not well known. However, more prevalence of the disease is caused due
to human-to-human transmission. There are relatively few studies on the impact of climate change on COVID-
19 disease in the world. Recognizing the behavioral features of the SARS-CoV-2 virus and its pathogenicity in
various climatic conditions can offer strategies for control measures, preventing the transmission of the disease,
and minimizing the potential mortality risk of the virus, which provides a basis for more detailed studies in
different climatic regions. This study aimed to evaluate the effect of different types of climate on the spread of
COVID-19.

Original Article


Assessment of the Therapeutic Effect of Polyethylene glycol and Lactulose in Patients with Hepatic Encephalopathy

Majid Iranshahi Iranshahi, Parviz Amri, Mohamad Amri

Novelty in Biomedicine, Vol. 10 No. 1 (2022), 31 January 2022, Page 1-8
https://doi.org/10.22037/nbm.v10i1.34096

Background: The mechanism of cerebral dysfunction in hepatic encephalopathy is unknown, although
ammonia produced by intestinal bacteria is an essential factor. This study was performed to compare the effect
of polyethylene glycol with lactulose in patients with hepatic encephalopathy.
Materials and Methods: In this interventional study, which was performed as a three-blind randomized
clinical trial, 60 patients with hepatic encephalopathy referred to Imam Hossein Hospital in Tehran were
randomly selected and divided into two groups receiving polyethylene glycol or lactulose were divided and the
levels of creatinine, ammonia, platelets, hemoglobin, albumin and bilirubin and Hepatic Encephalopathy
Scoring Algorithm, Model for End-Stage Liver Disease and Child-Turcotte-Pugh scores in the patients were
compared in the two groups.
Results: The results showed the frequency distribution of creatinine, ammonia, platelets, hemoglobin,
albumin, and bilirubin and Hepatic Encephalopathy Scoring Algorithm, Model for End-Stage Liver Disease,
and Child-Turcotte-Pugh scores of patients in the two groups were not statistically significant (P>0.05).
Conclusion: In general, based on the results of this study, it is inferred that polyethylene glycol and lactulose
have similar efficacy in patients with hepatic encephalopathy and, therefore, the use of each of them according
to the condition of patients and the discretion of the treating physician Recommended.

The The Association between the Level of Glycosylated Hemoglobin and the Immunogenicity of the Rubella Vaccination

Mehrdad Haghighi, Mehdi Goudarzi, Mohammad Sistanizad, Elham Pourheidar

Novelty in Biomedicine, Vol. 10 No. 1 (2022), 31 January 2022, Page 9-11
https://doi.org/10.22037/nbm.v10i1.35926

Background: Diabetes mellitus (DM) can influence various aspects of the immune system that may alter the
immune response to vaccines. Data about altering the immune response to the rubella vaccine in the presence
of diabetes are not enough. We aimed to evaluate the association between the level of glycosylated hemoglobin
(HbA1C) and the immunogenicity of the rubella vaccination.
Materials and Methods: This cross-sectional retrospective study was conducted on the medical records of
women who were tested to pre-pregnancy to check their antibody levels against rubella and had plasma levels
of HbA1C.
Results: During 3 years, 112 women with anti-Rubella IgG data were finally analyzed. The mean age±SD of
participants was 32.10±4.87. According to the data, we detected no correlation between the plasma levels of
HbA1C and IgG levels against rubella (Correlation Coefficient 0.219, p = 0.020).
Conclusion: We revealed no correlation between the plasma levels of HbA1C and impaired immunogenicity of
the rubella vaccination. We recommended a large-scale controlled clinical trial to evaluate the IgG levels
against rubella in patients with high plasma levels of HbA1C compared to the control group.

Study of Risk Factors Effects Recurrence of Lumbar Disc Herniation (LDH) after Open Spine Surgery

Hamid Hoboubati, Masoud Khoshbin, Azadeh Kargar, Gholamhossein Halvani, Mohammadhossein Ahmadieh, Rohollah Fallah Madvari, Hamideh Bidel

Novelty in Biomedicine, Vol. 10 No. 1 (2022), 31 January 2022, Page 12-16
https://doi.org/10.22037/nbm.v10i1.34872

Background: Low back pain is one of the most common diseases worldwide. Factors such as occupational,
personal, and environmental causes affect low back pain development and spread. Lumbar Disc Herniation
(LDH) is one of the main causes of low back pain. This study aimed to investigate the risk factors for LDH.
Materials and Methods: This descriptive cross-sectional study examined the recurrence of LDH among 301
patients after lumbar surgery over three years. Demographic and medical information of individuals were
obtained using individuals' medical records. People were interviewed for the job and other information. Based
on LDH recurrence, individuals were divided into two groups with/without recurrence. SPSS Ver.17 software
and appropriate statistical tests were used to analyze the data.
Results: The incidence of LDH recurrence was 28 (9.3%) in the samples. In this study, the number of male
samples was 154 (51.2%) with a recurrence of 9.7% and 147 female samples (48.8%) with recurrence of 8.8%,
and the mean age of the samples was 48.62 (13.35), with a range of Changes 15-79 years. Based on the results
of statistical tests, there was no statistically significant relationship between risk factors and recurrence of
LDH.
Conclusion: Factors such as gender, age, smoking, physical characteristics, and occupational conditions cause
or accelerate the recurrence of LDH in patients. The low volume of the group with LDH recurrence in this study
caused no significant relationship between recurrence and risk factors.

Immune Responses Elevation by Intranasal Administration of Chitosan Microparticles Adjuvanted Poly-Epitope against Streptococcus pneumoniae in BALB/c Mice

Sahar Sadeghi, Mojgan Bandehpour, Mostafa Haji Molla Hoseini, Bahram Kazemi

Novelty in Biomedicine, Vol. 10 No. 1 (2022), 31 January 2022, Page 17-26
https://doi.org/10.22037/nbm.v10i1.35527

Background: Designing inhaled vaccine formulations against respiratory pathogens like Streptococcus
pneumoniae (S. pneumoniae) lead to more effective mucosal and local immunity in the upper respiratory tract.
Choosing chitosan (the chitin de-acetylated derivative) as a biocompatible, biodegradable, and non-toxic
biopolymer and a suitable mucosal adjuvant can help to stimulate both systemic cellular and humoral immunity,
as well as local protection, is valuable. The purpose of this study is the determination the ability of the designed
pneumococcal immunogenic polytope to evoke a bactericidal response when adjuvanted with chitosan
microparticles.
Materials and Methods: We chose virulence proteins from S. pneumoniae (Pneumolysin, Neuraminidase, ZinkMetalloproteinase, Hydrolase) and designed a new multi-epitope construct by linking their individual predicted
T and B cell epitopes. Intranasal immunization with PNEU protein and chitosan microparticle administered in
BALB/c mice.
Results: Our formulation showed enhanced systemic IgG-2a, IgA, and mucosal IgA antibody concentrations,
revealing significant humoral responses to the polytope. The polytope increases the number of IFN-γ-
producing cells in the re-stimulation of splenocytes in the culture medium and a rise in the concentrations of
IL-6, IL-17, and TNF-α along with the regulatory responses of IL-10 presented the capacity of the formulation
to provoke immune responses. The bactericidal test ultimately confirmed the high efficacy of the vaccine in
inhibiting the bacteria.
Conclusion: Immunological responses were significantly induced after intranasal administration of the S.
pneumoniae computational predicted polytope accompanied by chitosan microparticles as a potent mucosal
adjuvant. Bactericidal assay confirmed effective immune responses in S. pneumoniae inhibition.

Background: Brucellosis is one of the most prevalent zoonoses, with an annual incidence of half a million cases
globally. Most parts of Iran are endemic for Brucellosis. Given the worse prognosis, knowledge and early
diagnosis of the complicated forms is especially important. The present study aimed to identify the clinical and
paraclinical predictive alarms for complications in Brucellosis.
Materials and Methods: This study was done as a retrospective study on records of inpatients suffering active
Brucellosis in Imam Hussein Medical Center, SBMU, Tehran in 15 years (2001April-2016 March) as the census.
Epidemiological, clinical, and laboratory data were collected in the formerly prepared questionnaire. According
to their clinical and paraclinical findings, cases were studied in two groups: Complicated and Uncomplicated.
All data were analyzed and compared using SPSS version 19.0 ANOVA and K2 tests (P values < 0.05).
Results: In 95 patients suffering Brucellosis, 56 (59%) were male, and 39 (41%) were female. 69 (73%) cases
were evaluated as uncomplicated, and 26 (28%) cases were as complicated. 11(28%) of females and 20 (35%)
male cases were complicated without significant statistical difference. Arthritis was the most common form,
followed by the nervous system. The mean patient age was 35.46 22.2 years, (ranging 1- 86) with no
difference in two groups and different complications. The frequency of the previous history of Brucellosis and
unpasteurized dairy product use was more common in complicated cases but was not significant. Myalgia
(92% vs. 50%) and fever (50% vs. 9%) were significantly more common in complicated Brucellosis. Lab test
results had no significant mathematical difference.
Conclusion: Myalgia and fever were significantly more common in complicated Brucellosis. There was no
significant difference in other classical symptoms of Brucellosis as sweating, malaise, fatigue, and chills between the two groups and no significant difference in serologic tests titer and lab tests.

The The Correlation between Anti-Cytomegalovirus and AntiToxoplasma gondii Antibodies with the Plasma Level of Glycosylated Hemoglobin

Mehrdad Haghighi, Mehdi Goudarzi, Mohammad Sistanizad, Elham Pourheidar

Novelty in Biomedicine, Vol. 10 No. 1 (2022), 31 January 2022, Page 34-36
https://doi.org/10.22037/nbm.v10i1.35925

Background: Viral infections play an important role in the pathogenesis of diabetes mellitus (DM). The
association between some viral infections, including cytomegalovirus (CMV) and the development of DM was
reported by some articles, but about T. gondii data is limited. We aimed to evaluate the correlation between antiCMV and anti-Toxoplasma gondii (T. gondii) antibodies with the plasma level of glycosylated hemoglobin
(HbA1C).
Materials and Methods: This is a cross-sectional retrospective study conducted on the medical records of women who tested for pre-pregnancy checkups and had antibody levels against CMV and/or T. gondii, and plasma level
of HbA1C.
Results: During 4 years, data from 117 patients with anti-CMV IgG, and 186 with anti-T. gondii IgG was
finally analyzed. According to the data, we did not detect any correlation between the plasma levels of HbA1C
and IgG levels against CMV (Correlation Coefficient 0.150, p = 0.108) and T. gaondii (Correlation Coefficient
0.076, p = 0.300).
Conclusion: In conclusion, we recommended a large-scale controlled clinical trial to compare the plasma level
of HbA1C between patients with confirmed CMV or T. gondii infection and the control group.

Case Report


Background: Misoprostol is a safe drug that is one of the prostaglandins analogs. It has uterotonic solid potential and is good for postpartum hemorrhage (PPH). Misoprostol has some side effects; hyperpyrexia is a rare side effect after misoprostol administration.
Cases Report: A 21-year- woman, Gravid 1 Parity 1, 18 hours after cesarean section, suffered from uterus atony
and vaginal bleeding that rectal misoprostol was administered. Her PPH was managed with misoprostol and other uterotonics. She developed a fever, and because of the Coronavirus disease (covid-19) pandemic, we suspected it and assayed it, but it was negative.
Conclusion: In this rare case, hyperpyrexia occurred after rectal misoprostol administration because of dose and prostaglandin effect on the hypothalamus. In this critical situation that covid-19 is pandemic, we suggest to
specialists that keep in mind fever and hyperpyrexia may occur consequently the misoprostol administration.