Background: Colorectal cancer (CRC) is one of the most prevalent cancers worldwide. Objective: Considering the side effects of chemotherapy treatments, we reviewed the anti-cancer effects and mechanisms of bromelain on colon cancer cells in this study. Methods: The PRISMA guidelines were followed in the design of this systematic review. Various databases, including PubMed, Web of Science, Cochrane Library, and Scopus, were thoroughly searched. Finally, 14 articles were retrieved after considering the study's inclusion and exclusion criteria. The desired data were extracted, entered into an Excel file, and the study results were reviewed. Results: According to the included studies, bromelain can significantly reduce the survival and death of cloned cancer cells through different mechanisms. These mechanisms include impeding tumor growth and metastasis by reducing mucins production/secretion and increasing/reducing reactive oxygen species (ROS) production. Moreover, bromelain induces apoptosis via reduced expression of Bcl-2, extracellular signal-related kinase (ERK), Akt, activation caspase system (caspase-3, 7, 8, and 9), and extranuclear p53. Ferroptosis was another mechanism of causing cell death. In addition, bromelain activates the autophagy pathway, lysosome formation, and deregulation of other autophagyrelated proteins. Conclusion: Bromelain effectively inhibits colon cancer cells' growth, proliferation, and metastasis and reduces their survival by different mechanisms. Therefore, after examining clinical studies, it can be used as an effective drug for treating CRC.

AbstractIntroductionPancreatic cancer is thought to have an extremely dismal prognosis. Most cancer-related deaths occur from metastasis rather than the primary tumor, although individuals with tumors smaller than 1 cm in diameter have more than 80% 5-year survival. Thus, the current protocol introduces PanCanAID project which intends to develop several computer-aided-diagnosis (CAD) systems to enhance pancreatic cancer diagnosis and management using CT scan imaging.Methods and analysisPatients with pathologically confirmed pancreatic ductal adenocarcinoma (PDAC) or pancreatic neuroendocrine tumor (PNET) will be included as pancreatic cancer cases. The controls will be patients without CT evidence of abdominal malignancy. A data bank of contrast-enhanced abdominopelvic CT scans, survival data, and demographics will be collected from ten medical centers in four provinces. Endosonography images and clinical data, if available, will be added to the data bank. Annotation and manual segmentation will be handled by radiologists and confirmed by a second expert radiologist in abdominal imaging. PanCanAID intelligent system is designed to (1) detect abdominopelvic CT scan phase, (2) segment pancreas organ, (3) diagnose pancreatic cancer and its subtype in arterial phase CT scan, (4) diagnose pancreatic cancer and its subtype in non-contrast CT scan, (5) carry out prognosis (TNM stage and survival) based on arterial phase CT scan, (6) and estimate tumor resectability. A domain adaptation step will be handled to use online data and provide pancreas organ segmentation to reduce the segmentation time. After data collection, a state-of-the-art deep learning algorithm will be developed for each task and benchmarked against rival models.ConclusionPanCanAID is a large-scale, multidisciplinary AI project to assist clinicians in diagnosing and managing pancreas cancer. Here, we present the PanCanAID protocol to assure the quality and replicability of our models. In our experience, the effort to prepare a detailed protocol facilitates a positive interdisciplinary culture and the preemptive identification of errors before they occur.

Background: Chemotherapy with Adriamycin, Bleomycin, Vinblastine, and Dacarbazine (ABVD regimen) cannot cure all patients with Hodgkin lymphoma. In this study, we evaluated the efficacy and adverse effect of a new regimen consist Irinotecan, Cisplatin, and Dexamethasone (ICD) in relapsed and refractory Hodgkin lymphoma as the second to fifth line of treatment. Materials and Methods: We performed a retrospective study in 26 relapsed or refractory patients with Hodgkin lymphoma receiving at least the first-line chemotherapy regimen (ABVD) and (ICD) as salvage therapy in Thaleghany Hospital from 2012 to 2018. This regimen consisted of Irinotecan 65mg/m2 D1, D8, Cisplatin 30mg/m2 D1, D8, and dexamethasone 40mg D1, 2, 8, and 9 was administered every 3 weeks for 6 cycles. Treatment was discontinued in cases of disease progression or severe toxicity. Response to treatment was evaluated after two cycles. Patients with complete and partial remission were candidates for high-dose chemotherapy and autologous stem cell transplantation. Twenty-four patients were enrolled in the study. The mean age of 22 patients was 31.5 (19-67) years. Seven patients (29.1%) were in the first recurrence, and 17 (70.8%) were in the second or subsequent recurrence. Results: According to this study, three patients (12.5%) had complete response, 13 (45%) had partial response, four (16.6%) had stable disease, and four (16.6%) had progressive disease. Nine patients (37.5%) received high-dose chemotherapy and autologous stem cell support after ICD regimen. None of the cycles of chemotherapy were delayed due to treatment-related adverse event. Overall survival after six months in all patients was 91%, and mortality rate was 8.3% at the end of the study. Conclusion: The goal of salvage chemotherapy in relapsed or refractory Hodgkin Lymphoma is achieving CR or PR preparation patients for stabilization with BMT. Thus, we recommend ICD as one of the most effective protocols with overall response rate of 66% in this population.

BackgroundCoronary slow flow (CSF) is an angiographic entity distinguished by the delayed filling of the epicardial coronary arteries in the lack of significant obstructive artery disease. The pathological causes are still unknown. This study aimed to elucidate the relationship between clinical and laboratory-related risk factors in atherosclerosis patients diagnosed with CSF.ResultsThe research encompassed a study group of 142 individuals, with a mean age of 52.47 ± 10.62, and a male representation of 47.7%. A thorough statistical analysis was conducted, indicating that there were no noteworthy variations in age, gender, smoking history, hematocrit, blood sugar, and HDL levels between the groups of cases and controls (P > 0.05). Subsequent analysis of the data indicated that there were significant differences in history of hypertension, LDL, and BMI measurements between the groups of subjects who were designated as cases and those who were designated as controls. Our study revealed that male gender, a history of hypertension, and BMI were identified as independent predictors of CSF (P < 0.05).ConclusionsAfter modeling regression, we were able to conclude that male gender, BMI, and history of hypertension are reliable predictors of slow coronary flow. These findings add to our growing understanding of the complex interplay between clinical and laboratory risk factors in the development and progression of CSF.

In spite of the major role of early maladaptive schemas in vulnerability to various psychological disorders, studies about the relationship between early maladaptive schemas and insomnia disorder are scarce. Hence, the aim of the current study was to explore the contribution of early maladaptive schemas in insomnia severity by comparing a sample of patients with chronic insomnia and good sleepers. Patients with chronic insomnia and good sleepers were evaluated using Young Schema Questionnaire-Short Form (YSQ-SF), Depression Anxiety and Stress Scale (DASS-21), and Insomnia Severity Index (ISI). The study enrolled 117 patients with chronic insomnia and 76 good sleepers. All early maladaptive schemas (EMSs) except for enmeshment showed significant correlations with insomnia severity. After controlling for depression/anxiety symptoms, logistic regression analysis showed that the EMSs including emotional deprivation, vulnerability to harm, and subjugation schemas were significantly associated with insomnia severity. These preliminary findings suggest that EMSs may constitute a vulnerability factor for developing insomnia. Early maladaptive schemas may require attention in the existing treatments of insomnia.

Background: Sepsis is a syndrome involving physiological, pathological, and biochemical abnormalities caused by infection and leads to the dysfunction of various organs, including the liver and kidneys. It can lead to high mortality rates. Objectives: This study aimed to evaluate the hepatic, renal, and coagulation diagnostic markers in patients with sepsis. Methods: This cross-sectional analytical study was performed on patients with sepsis admitted to Abadan and Khorramshahr educational hospitals during March 21 2019-March 19, 2020. The hospital information system (HIS) collected the information of 305 patients with sepsis, including hepatic, coagulation, and renal diagnostic factors, as well as age and gender. Results: It was observed that the mean of blood sugar (BS) (145.82 ± 105.10 mg/dL), BUN (29.64 ± 27.41 mg/dL), and creatinine (1.69 ± 1.9 mg/dL) in sepsis patients was higher than normal. In addition, the mean of diagnostic markers of the liver, including ALT (47.27 ± 76.63 U/L), AST (74.38 ± 163.96 U/L), LDH (684.69 ± 383.96 U/L), total bilirubin (1.39 ± 1.02 mg/dL), and direct bilirubin (0.60 ± 0.65 mg/dL), was higher than normal. The mean of PT (16.73 ± 9.31 sec) and INR (1.72 ± 1.53) was also higher than the normal level. Conclusions: In hospitalized patients with sepsis, BS, renal diagnostic markers, hepatic diagnostic markers, and coagulation markers are higher than normal, indicating the destructive effect of sepsis on kidney and liver function.

Background: Diabetes mellitus is the most common chronic metabolic disorder that increases both susceptibility and mortality rates in patients with the coronavirus disease 2019 (COVID-19). We conducted a study on diabetic patients with COVID-19 to investigate the relationship between laboratory indicators and peripheral oxygen saturation (SPO2 ). Methods: In this analytical-cross-sectional study, the required information of diabetic patients with COVID-19 admitted to Taleghani educational hospital in Abadan from March 20, 2020 to March 19, 2021 was obtained by referring to the hospital information system of Abadan University of Medical Sciences and patient files. Results: Two hundred patients were studied, of which 88 (44%) were men and 112 (56%) were women. The mean age of the studied patients was 60.57±14.84. Among all the investigated markers, blood urea nitrogen (BUN), serum glutamate oxalate transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), lactate dehydrogenase (LDH), and respiratory rate (RR) were higher than the normal range, while SPO2 was lower than the normal range. Based on the linear regression analysis results, a significant relationship was observed between the decrease in SPO2 of patients with disease outcome, duration of hospitalization in the intensive care unit (P&lt;0.001), RR (P&lt;0.001), mean corpuscular volume (MCV) (P=0.02), CRP+3 (P=0.002), platelet (PTT) (P=0.03), alkaline phosphatase (ALP) (P=0.002), and LDH (P=0.003). Conclusion: The results showed that some laboratory diagnostic markers were higher than the normal range, while SPO2 was lower than the normal range. Moreover, a significant relationship was found between SPO2 index and disease outcome, duration of hospitalization in intensive care unit (ICU), and some diagnostic markers of the liver, inflammation, and coagulation.

Abstract Background: The present article aims to elucidate the prevalence of Human Papillomavirus (HPV) infection and possible association between HPV infection and semen parameters in infertile Iranian men. Materials and methods: This cross-sectional study included semen samples from 140 male partners in couples seeking fertility evaluation. Standard semen analysis was performed. In addition, sperm DNA fragmentation index (DFI), sperm chromatin maturation, presence of anti-sperm antibodies, leukocyte count, and Fructose and Zinc concentration were also assessed. Nested PCR and INNO-LiPA assay were used to identify HPV-DNA sequences in semen samples and determine HPV genotype, respectively. Results: HPV DNA was detected in 18/140 (12.85%) of the semen samples (10% high-risk (HR), 2.14% low-risk (LR) genotypes, and one sample was excluded). Our findings revealed that HPV18 was the most prevalent type (8.57%). According to our result, the presence of HPV DNA in the semen samples was associated with a higher white blood cell count (leukocytospermia) (P=0.02). We also observed that LR HPV-positive semen samples were associated with higher DFI values (P = 0.01). Conclusion: This study showed that the presence of HPV in semen samples was associated with leukocytospermia. We also observed that the presence of low-risk genotypes in semen samples was associated with higher sperm DFI values. These results point to the importance of careful screening for the presence of HPV in semen samples from infertile men. It should also be noted that more studies are required to have a more comprehensive view of the relationship between HPV infection and semen quality.

Background: In December 2019, a new virus, the coronavirus disease 2019 (COVID-19) was identified as the cause of a cluster of cases of pneumonia of unknown etiology in Wuhan, China. The COVID-19 disease increases cardiovascular events both directly and indirectly. This study aimed to investigate the laboratory diagnostic markers of cardiovascular patients with COVID-19 in Ayatollah Taleghani hospital in Abadan from March 20, 2019 to March 19, 2020. Materials and Methods: This study is a cross-sectional analytical study. Some demographic, laboratory, and clinical information of 200 cardiovascular patients with COVID-19 admitted to Taleghani hospital, Abadan, was received randomly by referring to the medical records section and medical records section and health information system (HIS) as well as searching in the patient records. Inclusion criteria included cardiovascular patients with COVID-19 who had been admitted to Ayatollah Taleghani hospital in Abadan with the diagnosis of a cardiologist and infectious disease specialist, and those whose information was available in HIS. The results were analyzed using SPSS software version 24. Results: The mean age of cardiovascular patients with COVID-19 was reported to be 66.98±18.14. The results revealed that the mean of fasting blood sugar (FBS), serum glutamic oxaloacetic transaminase (SGOT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), creatinine (Cr), blood urea nitrogen (BUN), and erythrocyte sedimentation rate (ESR) was higher than the normal level in these patients. In addition, the mean oxygen saturation (SpO2) was observed to be lower than normal. Reducing the level of SpO2 to less than 90% was significantly related to increasing age, death, patients with a history of lung disease, the duration of hospitalization in ICU, and intubation. This reduction also led to an increase in respiratory rate (RR), LDH, ESR, and C-reactive protein (CRP+1) in cardiovascular patients with COVID-19. Conclusion: In cardiovascular patients with COVID-19, FBS, some kidney markers, liver markers, and inflammatory markers were observed to be higher than normal, and a significant relationship was observed between the reduction of SpO2 and some laboratory diagnostic markers, which requires extensive studies with larger sample size.

Fixation of plateau posterolateral fracture (PLF) is challenging because the fracture site is mostly covered by vital neurovascular structures. We operated on 15 cases of PLF using a direct lateral approach. This study aims to report on clinical results. Between 2017 and 2019, 15 cases of PLFs were fixed with a direct lateral approach and a tricortical autologous bone graft from the iliac crest. A depression of more than 2mm was indicated for the surgical treatment. Clinical evaluation included Lysholm score, International Knee Documentation Committee Score (IKDC) score, and Tegner activity scale after two years follow-up. The last follow-up was at 24months after the operation. The mean postoperative Tegner activity scale did not change significantly compared to before the injury (6.5 (6-7) vs. 7 (6-8, p = 0.5)). The postoperative IKDC and Lysholm scores improved significantly compared to before the operation (p < 0.001). The full range of motion was seen in all patients except one who was manipulated after three months. Surgical treatment using a direct lateral approach is a safe procedure for PLFs that results in good, short-term clinical and radiologic outcomes without fibular osteotomy or compromising the important neurovascular structures. IV.