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Over the past three years, since the onset of COVID-19, several scientific studies have concentrated on understanding susceptibility to the virus, the progression of the illness, and possible long-term complexity. COVID-19 is broadly recognized with effects on multiple systems in the body, and various factors related to society, medicine, and genetics/epigenetics may contribute to the intensity and results of the disease. Additionally, a SARS-CoV-2 infection can activate pathological activities and expedite the emergence of existing health issues into clinical problems. Forming easily accessible, distinctive, and permeable biomarkers is essential for categorizing patients, preventing the disease, predicting its course, and tailoring treatments for COVID-19 individually. One promising candidate for such biomarkers is microRNAs, which could serve various purposes in understanding diverse forms of COVID-19, including susceptibility, intensity, disease progression, outcomes, and potential therapeutic options. This review provides an overview of the most significant findings related to the involvement of microRNAs in COVID-19 pathogenesis. Furthermore, it explores the function of microRNAs in a broad span of effects that may arise from accompanying or underlying health status. It underscores the value of comprehending how diverse conditions, such as neurological disorders, diabetes, cardiovascular diseases, and obesity, interact with COVID-19.

Background: This study examined the level of satisfaction of medical and public health students in the management and supervision of Preceptorship in health internships. Method: In this cross-sectional study, all students who have passed their health apprenticeship and internship courses under preceptorship supervision (from 2019 to 2021) were chosen via census method as the study sample (n=208). A modified nursing clinical facilitator questionnaire was used for data collection. Data analysis was done using SPSS 20 through the T-test, ANOVA, and Pearson correlation coefficient. Results: The mean age of the subjects was 23.41±2.46 years, the average academic GPA was 16.85±1.35. The mean satisfaction score with the preceptorship program among public health students was 104.34±23.32 and among medical students was 100.45±24.05. The largest mean was related to the items "the feedback and guidelines of preceptor are honest and correct (10.4±1.10)" and "preceptor does her best to keep the client's secrets confidential and also reminds students to observe this issue (4.50±1.11)". The lowest mean was related to the items "the preceptor gives me the sufficient opportunity for independence in tasks (3.86±1.09)" and "the preceptor attempts to determine and investigate my learning needs and do the training accordingly (3.86±1.11)".Conclusion: This approach could receive a desirable student satisfaction score based on the findings. Thus, the sustenance of this approach can have a good effect on students' training skills. It is suggested that it be implemented and its impact in other fields and internship courses be examined.

Background and Objective: In the present study, the factors related to the acceptance of the COVID-19 vaccine by the parents of children aged 5-12 years were investigated. Materials and Methods: This web-based cross-sectional descriptive study was conducted on 340 parents of children aged 5-12 in Bojnord City in 2022. The data collection tool included the demographic profile form and the attitude and awareness form about the COVID-19 vaccine for children. The data were analyzed by descriptive statistics, chi-squared, and independent t-tests. Results: More than 60% of parents did not want to vaccinate their children against COVID-19. Most parents declared the danger of the vaccine as their most important concern (45.9%). Besides, most parents evaluated their knowledge and awareness about the COVID-19 disease and its vaccine at an average level (57.4%). There was no significant relationship between the level of knowledge and awareness of parents and their acceptance of the COVID-19 vaccine (P

In a descriptive-analytical study, we investigated academic dishonesty among general medical students during clinical rotations and proposed suggestions for improvement. A total of 106 medical students in the clinical periods were randomly selected for the study. We used a questionnaire consisting of four parts: demographic characteristics, causes of dishonesty, types of dishonesty, and suggestions for reducing dishonesty. The results showed that 50% of the students had a history of dishonesty during their clinical rotations. Marital status and the stage of clinical education were found to be related to dishonesty. The main reasons for dishonesty reported by the students were distress during clinical rotations and a lack of alignment between clinical education and their expectations. Common types of dishonesty during clinical rotations included gathering exam information from previous students and falsifying attendance records. The study concludes that the high prevalence of academic dishonesty among medical students during clinical rotations is concerning. It suggests the need to address distress among students, align clinical education with learners’ expectations, and continuously monitor academic integrity to reduce dishonesty.

Background:The objective of this study was to compare the levels of vitamin D in non-pregnant women with a history of recurrent pregnancy loss (RPL) who were seropositive or seronegative for autoantibodies (autoAbs). Methods: The study examined 58 RPL patients with autoAbs (ANA, anti-TPO, or APAs), 34 RPL patients without autoAbs, and 58 healthy women with prior successful pregnancies and without autoantibodies. The levels of 25 (OH) D were measured using the sandwich ELISA technique. Results:Our results showed insufficient serum 25(OH) D levels in study groups, with significantly lower levels observed in RPL patients with or without autoAbs compared to healthy women (P=0.0006). In addition, RPL patients with autoAbs had significantly lower 25(OH) D levels compared to RPL patients without autoAbs. We also found that serum levels of 25(OH) D in RPL patients with autoAbs were significantly lower than in RPL patients without autoAbs (20.51 ± 1.15 ng/ml Vs. 23.69 ± 0.74 ng/ml, P=0.0356). Further analysis indicated that RPL patients who were positive for ANA, and APAs, except anti-TPO, had significantly lower than 25(OH)D serum levels than RPL patients without autoAbs. Conclusion: These findings suggest that RPL patients, especially those with APAs or ANA, have lower vitamin D levels compared to healthy women. This may indicate a link between maternal immune dysregulation due to vitamin D deficiency and the presence of autoantibodies in RPL.

Introduction: Chlorine gas inhalation is a toxic respiratory irritant associated with high lung complications. Despite its wide industrial and domestic applications such as bleaching detergents, there is no specific treatment for chlorine gas poisoning yet and common standard treatments are mostly supportive. In this regard, this study aimed to find a new treatment for this pathogenesis from the perspective of Persian medicine (PM). Materials and methods: In this review study, at first, we searched the etiologies and clinical symptoms associated with chlorine gas poisoning in modern medicine and then compared them with similar etiologies and symptoms in valuable Persian medical manuscripts. Then we reviewed the proposed treatments for similar illnesses from the point of view of PM. Results: The pathology of lung damage caused by inhalation of chlorine gas is reactive airway dysfunction syndrome (RADS), which leads to dyspnea, hypoxemia, respiratory tract obstruction, pneumonia, pulmonary edema, and finally acute respiratory distress syndrome (ARDS). In a comparative study, it seems that this pathology has the closest similarity with the Persian term“Varme-e-harr riye”. The treatment strategy for this syndrome in PM is bloodletting at the first and then the application of cold-temperament foods and medications to improve the lungs. Conclusion: According to the compatibility of acute pulmonary edema caused by chlorine inhalation and “varam-e-harr riye” in PM, it seems that wet cupping can be considered as a suggested primary and emergency treatment for this pathology in future clinical studies. Keywords: Reactive airway dysfunction syndrome (RADS), Persian Medicine, Chlorine gas, Acute pulmonary edema

Background: Gastric disorders are one of the most common human ailments, which impose a huge economic burden on countries. In Persian Medicine (PM), it is possible to predict the susceptibility to gastric diseases with diagnosis of gastric Mizajes (temperaments) and dystemperaments. The semiology of gastric dystemperaments has been investigated in PM textbooks, although the value of each sign and symptom is not mentioned. Consequently, this research is designed to determine the major and minor criteria for classifying gastric dystemperaments on the basis of valid manuscripts and with the help of PM specialists in the present era. Methods: This was a consensus-based study consisting of four phases. In the first phase, reference PM textbooks were studied. Symptoms and signs of gastric dystemperaments were collected and listed in four groups. In the second phase, semi-structured interviews with a sample of PM experts were carried out. Phase three included a focused group discussion with experts. Eventually, findings were integrated from the three study phases in a two-day meeting in Sari City. Results: Selected criteria included eight major and eight minor criteria for hot-cold dystemperament, as well as six major and eight minor criteria for wet-dry gastric dystemperament. Conclusion: Modern lifestyles and the interfering factors are responsible for some changes in diagnostic signs and symptoms according to PM. This was the first step to coordinate PM diagnostic criteria for gastric dystemperaments. Further studies are recommended to reach a unique protocol in the field of PM diagnostics. The next step includes design and validation of national diagnostic tools.

Background: Neonatal hypoxic-ischemic encephalopathy (HIE) is one of the most common causes of long-term neurological disabilities among children. Various types of cellular stress stimuli, including oxidative stress, inflammation, and hypoxia, induce heme oxygenase-1 (HO-1) enzyme for different kinds of tissues. The purpose of this study was to evaluate the plasma level of HO-1 enzyme in neonatal HIE patients and to determine the relationship between HO-1 enzyme level and clinical severity of HIE.Methods: In this case-control study, the plasma level of HO-1 enzyme was measured through sandwich ELISA in 28 newborns with a proven diagnosis of HIE and 31 healthy full-term newborns admitted to Bentolhoda Hospital, Bojnourd, Iran. Newborns with HIE were classified according to the Sarnat staging to mild, moderate, and severe HIE. Maternal and neonatal data were recorded in checklists and compared between the two groups.Results: The mean plasma level of HO-1 enzyme in HIE patients was significantly higher than that in the control group (104.0 ± 4.01 and 91.63± 2.67 pg/ml, respectively, P=0.011). We also found that plasma HO-1 levels were significantly higher in severe neonatal HIE patients compared to mild and moderate neonatal HIE patients (121.0 ± 8.48Vs. 91.23 ± 3.35 and 105.5 ± 5.76, P ˂ 0.001). Conclusion: Our findings suggested that HO-1enzyme may be associated with the pathophysiology and clinical severity of neonatal HIE. We suggest further research on the correlation of plasma level of HO-1 enzyme at birth with the multi-organ dysfunction and abnormal neurodevelopmental outcomes in full-term newborns with HIE.

Introduction: The association of maternal vitamin D status with preterm labor has been considered in the recent decade, although reported findings have been inconsistent. This study was performed aimed to compare serum 25-hydroxy vitamin D levels between women with idiopathic preterm labor and women with term labor. Methods: This case-control study was performed in 2020 on 60 women aged 18-35 years who had referred to Bentolhoda Hospital in Bojnourd for delivery. Serum levels of 25-hydroxyvitamin D were determined in 30 women with idiopathic preterm delivery with gestational age of 28 to 37 weeks (case group) and 30 women with term delivery (control group) by sandwich ELISA. Patients' information including demographic information, clinical status and pregnancy history were collected through a questionnaire. Data were analyzed by SPSS 16 software (version 16) and Chi-square and Pearson correlation coefficient test. P

Objective: In spite of the great advances in the field of traumatic brain injury (TBI), it still remains as a global health problem. Phlebotomy has been mentioned as an effective treatment for TBI in Persian medicine. This study aimed to evaluate the possible effect of saphenous vein phlebotomy (SVP) on the alleviation of neuroinflammation and oxidative stress after TBI. Methods: Seventy-two adult male Wistar rats were randomly divided into three main groups: sham, TBI and TBI + SVP group. Animal model of TBI was made through a controlled cortical impactor (CCI) device and SVP treatment was applied 10 min after TBI. Then, neurological function, body temperature, cerebral edema, blood–brain barrier integrity, brain apoptosis, oxidative stress, and inflammation were assessed. Results: Our results indicated that SVP was associated with improvement of neurological scores 24 h post-TBI. In addition, SVP application significantly alleviated proinflammatory cytokines (IL- 1β, IL-17, and TNF-α) and oxidative stress factors as shown by reduction of malondialdehyde (MDA) and elevation of superoxide dismutase (SOD) with no significant effect on glutathione peroxidase (GPx) and nitric oxide (NO) in the brain 6 h after TBI. Besides, it reduced body temperature, attenuated severity of brain edema, and also reduced caspase-3 and number of apoptotic neurons. Conclusion: This study showed that SVP could ameliorate the severity of acute TBI, partly through alleviation of neuroinflammation, oxidative stress, and apoptosis. Further studies are necessary for more understanding the involved mechanism(s).

Background: The expression pattern of microRNAs in placenta-derived exosomes plays a crucial role in the regulation of immune responses and inflammation at the fetal–maternal interface. Objective: Considering the immunomodulatory properties of miR-17 and miR-29a, we determined their expression levels in placenta-derived exosomes in a lipopolysaccharide (LPS)-induced abortion mice model. Materials and Methods: A total of 14 pregnant BALB/c mice, aged 6–8 wk, were randomly divided into two groups (n = 7/each) on the gestational day 11.5. While the mice in the experimental group were treated with LPS, those in the control group were treated with Phosphate buffered saline; 5 hr after the treatment, the placental cells were isolated and cultured for 48 hr. Then, the cell culture supernatants were collected and used for isolation of exosomes. The isolated exosomes were confirmed by western blot and scanning electron microscopy. The miRNAs were then extracted from exosomes, and cDNA synthesized. The expression levels of miR-17 and miR-29a were evaluated by quantitative real-time PCR analysis. Results: Our results showed that the expression levels of miR-29a in placenta-derived exosomes obtained from the experimental group increased significantly compared to the control group. Also, the expression levels of miR-17 in the placenta-derived exosomes obtained from the experimental group were found to decrease; however, it did not show significant changes compared with the control group (p > 0.05). Conclusion: Inflammatory reactions at the fetal–maternal interface can alter miRNAs expression patterns in placenta-derived exosomes, especially miRNAs with immunomodulatory effects such as miR-29a.

Abstract Background The fucose-mannose ligand (FML) of Leishmania infantum is a complex glycoprotein which does not elicit adequate immunogenicity in humans. In recent years, adjuvant compounds derived from plants have been used for improving the immunogenicity of vaccines. Glycyrrhizin (GL) is a natural triterpenoid saponin that has known immunomodulatory activities. In the present study, we investigated the effects of co-treatment with FML and GL on the production of cytokines and nitric oxide (NO) by macrophages, in vitro. Methods Lipopolysaccharide (LPS) stimulated murine peritoneal macrophages were treated with FML (5 μg/ml) of L. infantum and various concentrations of GL (1 μg/ml, 10 μg/ml and 20 μg/ml). After 48 h of treatment, cell culture supernatants were recovered and the levels of TNF-α, IL-10, IL-12p70 and IP-10 were measured by sandwich ELISA and NO concentration by Griess reaction. Results Our results indicate that the treatment of activated macrophages with FML plus GL leads to enhanced production of NO, TNF-α and IL-12p70, and reduction of IL-10 levels in comparison with FML treatment alone. Conclusions Therefore, we concluded that GL can improve the immunostimulatory effect of FML on macrophages and leads to their polarization towards an M1-like phenotype.

Since the edifice of conventional medicine is built on the pillars of past achievements, review or re-investigate the old medical manuscripts may lead to significant achievements. Avicenna was a famous Persian medieval physician and one of the pioneers of neuroscience. The aim of this study is to evaluate Avicenna's approach to traumatic brain injury (TBI), based on his main book on medicine, “Canon of Medicine”. Avicenna divided the TBI treatments into three categories: topical therapies, oral therapies, such as diets and medications, and manipulation therapies including phlebotomy, enema, foot bath, cupping, and massage. Although some of these recommendations are supported by current knowledge, many of them are still unknown and need scientific investigation to expand our knowledge of TBI treatments in the medieval period.

Abstract Objective Multiple sclerosis is a chronic demyelinating disease of the central nervous system that can cause severe disability and impair the quality of life (QoL). Methods In the current cross‐sectional, case–control study, we investigated personality traits, anxiety and depression levels, in 101 patients in the case group and 202 individuals as a control group. The personality traits of the participants were collected via the Neuroticism‐Extraversion‐Openness Five‐Factor Inventory (NEO‐FFI) questionnaire. We evaluated the level of anxiety and depression based on the Hospital Anxiety and Depression Scale questionnaire. Results Our study showed in patients with disease duration above 1 year, the rates of agreement (29.78), anxiety (8.83), and depression level (6.39) were significantly higher than the control group (27.19, 6.47, and 4.97, respectively). Although patients with disease duration below 1 year showed a higher level of agreement and conscientiousness (29.65 and 34.35, respectively) than controls (26.6 and 30.86, respectively). The level of anxiety and depression in patients with a disability index above 4.5 was significantly higher than patients with a disability index below 1. Patients with a disability index below 1 showed a higher rate of extraversion and agreement and conscientiousness (31.47, 31.53, and 35.07, respectively) than controls (25.5, 26.23, and 3033, respectively). In addition, patients with a disability index above 4.5 showed a higher level of agreement (35.64), conscientiousness (35.5), anxiety (9.64), and depression (7.5) than controls (25.96, 30.71, 6.96, and 4.71, respectively). Conclusions In conclusion, anxiety and depression levels were much higher among MS patients compared with controls and the severity of these conditions correlate with the score of the disability index. Therefore, a complete comprehension of these conditions by the neurologist could be vital in improving patients’ QoL and increasing compliance and adherence to pharmacological therapy.

Objective(s)The fractions of Candida albicans have been used as an immunomodulator. The present work assessed theeffect of different fractions of C. albicans on nitric oxide (NO) production by mice peritoneal macrophages.Materials and MethodsCell wall and cytoplasmic fractions of C. albicans ATCC 10321 strain were extracted. Mice peritonealmacrophages were purified and cultured. Different concentrations of both fractions and also killedC. albicans cells were used for macrophages stimulation and evaluation of NO production. NO amount wasdetected in culture supernatants of macrophages by Griess reagent. Also, MTT assay was performed toassess the viability of macrophages.ResultsThe results elucidated that suppressive effect of cell wall proteins on NO release was significant at the doseof 100 μg/ml (P=0.01), while cytoplasmic fraction increased NO amount at the dose of 1 μg/ml compared tothe control group (P=0.003). Augmentation of NO production was statistically significant at 200 killedC. albicans per well (P=0.006).ConclusionAccording to our findings, cytoplasmic fractions and killed C. albicans have a positive effect on NOproduction by peritoneal macrophages, while cell wall fractions did not. Therefore, it is proposed thatC. albicans fractions can be studied more as inflammation modulators.Keywords: Candida albicans, Macrophages, Nitric Oxide

Background: The training of healthcare professionals is crucial for the effective delivery of healthcare services. Numerous studies have cited insufficient training as a key factor contributing to students' lack of essential skills. This study aimed to assess the level of satisfaction among medical and public health students regarding the management and supervision of preceptorship during their health internship and practicum periods. Method: This cross-sectional study included all students who completed their health internships and practicums under preceptorship supervision from 2019 to 2021 (n=208). Data were collected using the revised Nursing Clinical Facilitator Questionnaire and analyzed with SPSS 20. Results: The mean age of participants was 23.41±2.46 years, and their average GPA was 16.85±1.35. The mean satisfaction score with the educational program was 104.34±23.32 for public health students and 100.45±24.05 for medical students. The highest mean scores were related to the honesty of feedback from preceptors and maintaining the confidentiality of clients. The lowest mean scores were related to providing sufficient opportunities for independence and efforts to identify and address students' learning needs. Conclusion: Based on the findings, this approach appears to achieve a high level of student satisfaction. Continuing this approach could have a positive impact on students' skill development. It is recommended that this model be implemented and evaluated in other disciplines and internship programs as well. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to compare the levels of vitamin D in nonpregnant women with a history of recurrent pregnancy loss (RPL) who were seropositive or seronegative for autoantibodies (autoAbs). Methods: The study examined 58 RPL patients with autoAbs (ANA, anti-TPO, or APAs), 34 RPL patients without autoAbs, and 58 healthy women with prior successful pregnancies and without autoantibodies. The levels of 25 (OH) D were measured using the sandwich ELISA technique. Results: Our results showed insufficient serum 25(OH) D levels in study groups, with significantly lower levels observed in RPL patients with or without autoAbs compared to healthy women (P=0.0006). In addition, RPL patients with autoAbs had significantly lower 25(OH) D levels compared to RPL patients without autoAbs. We also found that serum levels of 25(OH) D in RPL patients with autoAbs were significantly lower than in RPL patients without autoAbs (20.51 ± 1.15 ng/ml Vs. 23.69 ± 0.74 ng/ml, P=0.0356). Further analysis indicated that RPL patients who were positive for ANA, and APAs, except anti-TPO, had significantly lower than 25(OH)D serum levels than RPL patients without autoAbs. Conclusion: These findings suggest that RPL patients, especially those with APAs or ANA, have lower vitamin D levels compared to healthy women. This may indicate a link between maternal immune dysregulation due to vitamin D deficiency and the presence of autoantibodies in RPL. [ABSTRACT FROM AUTHOR]

Background: Neonatal hypoxic-ischemic encephalopathy (HIE) is one of the most common causes of long-term neurological disabilities among children. Various types of cellular stress stimuli, including oxidative stress, inflammation, and hypoxia, induce heme oxygenase-1 (HO-1) enzyme for different kinds of tissues. The purpose of this study was to evaluate the plasma level of HO-1 enzyme in neonatal HIE patients and to determine the relationship between HO-1 enzyme level and clinical severity of HIE. Methods: In this case-control study, the plasma level of HO-1 enzyme was measured through sandwich ELISA in 28 newborns with a proven diagnosis of HIE and 31 healthy full-term newborns admitted to Bentolhoda Hospital, Bojnourd, Iran. Newborns with HIE were classified according to the Sarnat staging to mild, moderate, and severe HIE. Maternal and neonatal data were recorded in checklists and compared between the two groups. Results: The mean plasma level of HO-1 enzyme in HIE patients was significantly higher than that in the control group (104.0 ± 4.01 and 91.63± 2.67 pg/ml, respectively, P=0.011). We also found that plasma HO-1 levels were significantly higher in severe neonatal HIE patients compared to mild and moderate neonatal HIE patients (121.0 ± 8.48Vs. 91.23 ± 3.35 and 105.5 ± 5.76, P ˂ 0.001). Conclusion: Our findings suggested that HO-1enzyme may be associated with the pathophysiology and clinical severity of neonatal HIE. We suggest further research on the correlation of plasma level of HO-1 enzyme at birth with the multi-organ dysfunction and abnormal neurodevelopmental outcomes in full-term newborns with HIE. [ABSTRACT FROM AUTHOR]

Due to the known anti-inflammatory and antiviral effects of zinc, 25(OH)D, and vitamin B12, in this study, we explored the association between serum levels of these micronutrients in coronavirus disease 2019 (COVID-19) patients at the time of admission and the clinical outcomes. This study was carried out on 293 patients with COVID-19, who were hospitalized at Imam Hassan hospital (Bojnourd, Iran). We collected demographic data, clinical characteristics, values of serum biochemical parameters in the first week of admission, and clinical outcomes from electronic medical records. We also measured serum levels of zinc, 25(OH)D, and vitamin B12 within 3 days of admission. Of the 293 hospitalized, the median age was 53 years, and 147 (50.17%) were female. Thirty-seven patients (12.62%) were admitted to the intensive care unit (ICU), and forty-two (14.32%) died. We found that the serum levels of zinc, vitamin B12, and 25(OH)D were lower in patients who died than those who were admitted to ICU or non-ICU and survived; however, these differences were not statistically significant for vitamin B12 and 25(OH)D (p > 0.05). The serum concentrations of zinc, vitamin B12, and 25(OH)D at the time of admission did not affect the length of hospital stay in patients with COVID-19. In general, it seems that serum levels of 25(OH)D, vitamin B12, and especially zinc at the time of admission can affect clinical outcomes in COVID-19 patients. [ABSTRACT FROM AUTHOR]

Background: The roots and leaves of Arctium lappa (burdock) have been used for different therapeutic purposes, especially for diseases linked to chronic inflammation. Objectives: The present study was designed to evaluate and compare the immunomodulatory activities of root extract of burdock and leaves extract of burdock in vitro. Methods: In this experimental study, PHA- or LPS-stimulated splenocytes were treated with different concentrations of root or leaves extract of burdock and proliferation of splenocytes measured by MTT assay. The levels of IFN-γand IL4 in the supernatants of PHAstimulated splenocytes determined using ELISA. We also studied the effects of root and leaves extract of burdock on Nitric Oxide production by LPS-stimulated macrophages using the Griess reagent. The data were analyzed by one-wayANOVA followed by Tukey's post-test using GraphPad Prism software, version 5.0. Results: Our findings showed that both root and leaves extract of burdock have suppressive effects on LPS-stimulated splenocytes proliferation, IL-4 secretion from PHA-stimulated splenocytes, and NO production from LPS-stimulated macrophage and stimulatory effects on PHA-stimulated splenocytes proliferation, and IFN-γsecretion from PHA-stimulated splenocytes. Although both root and leaves extract of burdock had similar immunomodulatory effects in vitro, stronger immunomodulatory effects seen in root extract of burdock. Conclusions: According to our results, we suggest that root of burdock is better option than leaves of burdock in modulation immune responses and inflammations. [ABSTRACT FROM AUTHOR]