@article{ author = {Fayyaz, Elham and MazaheriTehrani, Mohmmad Ali and Panaghi, Leili and Bagherian, Fatemeh}, title = {The Lived experience of primary caregivers of childhood cancer in the end of life: A qualitative study}, abstract ={Background Cancer is one of the leading causes of childhood death worldwide. Cancers under the age of 18 have been epidemiologically called pediatric cancers (1). Childhood cancer is one of the most common and yet deadly diseases among children. Among childhood cancers, leukemia and central nervous system tumours are the most common and have a larger population of patients and caregivers in this category of cancers (2, 3). Diagnosing and treating the disease will involve the whole family in a series of stressors such as frequent medical visits, invasive procedures, severe side effects and changes in family plans, as well as economic issues (4). Parents are more likely to be challenged to balance the physical and emotional effects of a chronic illness imposed on the family, and the distress they face can put all family members at risk of severely declining quality of life (5) Or put other negative consequences incompatibility (6). Caregiving, especially for children with malignant cancers, is an overwhelming task that exposes the caregiver to a variety of different experiences and situations. The purpose of the present study was to understand the lived experience of caregivers in childhood cancer at the end of life of the patient.  Methods The research method is qualitative in terms of interpretive phenomenology. The population participating in this study included all primary caregivers of children and adolescents who had been diagnosed with childhood cancer before the age of 18 and have faced with the failure of the therapeutic process. The sampling method was purposive sampling in which 8 caregivers were selected to participate in the research and they were interviewed and analyzed. All interviews were recorded and then transcribed manually and finally analyzed using the interpretive analysis method. Results Eight semi-structured interviews with participants in the study were conducted and the analysis of interview data led to the identification and classification of two main themes: Surrounded by unpleasant emotions and encountering special events consists of 11 sub-themes: Experience of disability, Loneliness, Anger and failure, Exhaustion, Overwhelmed with worries, In the difficulty of waiting and ambiguity, Surrender, Facing recurrence, Facing the need to make decisions, Facing the certainty of death, Interacting with a child in the shadow of death. Conclusion In the final phase of a childchr('39')s life, the caregiver will be surrounded by a series of negative and unpleasant emotions; on the one hand, they experience a heavy emotional burden, dealing with the childchr('39')s physical condition, and on the other hand, in challenging decision-making processes (20). A caregiver, or more specifically a parent/caregiver, in the final phase of a childchr('39')s life, experiences a variety of negative emotions. the caregiver will experience a strong sense of helplessness and inadequacy(26). Emotions followed by feelings of inability include extreme anger and frustration. As a caring parent, all caregivers strive to maintain hope and improve the childchr('39')s condition (27). The result of these unsuccessful efforts will be an experience of unpleasant feelings such as constant threat and encountering intense ambiguity, or in other words, uncontrollable and unpredictable stimuli that evoke a high volume of persistent anxiety (28). In the last days of the childchr('39')s presence in the hospital, the caregiverchr('39')s fatigue, frustration and feelings of the inability toward the existing condition make the situation extremely exhaustive for the caregiver. The burden of care will be much heavier when the patient is more likely to die. The burnout experience in caregivers can be described by the general adaptation syndrome introduced by Selye (29). Some parts of the surrender that caregivers reported, might be the result of the fatigue caused by constant anxiety. Caregivers pointed to the concept of loneliness in two dimensions; one is feeling lonely and the other is being alone, especially in caregiving tasks. Since the course of treatment in cancer patients will require full-time care, both caregiver and patient are deprived of normal social interactions and experience forced limitations in their relationships. Therefore, Social isolation is one of the consequences of such procedures. The other dimension is related to the deep feelings of loneliness and the lack of being understood by others. For that reason, a distinction must be made between being alone and feeling alone (31). Some researchers have described two components of loneliness, the first of which involves emotional loneliness due to a lack of intimacy or close emotional attachment, and the second is social loneliness (32). In the present study, caregivers complained about the experience of both dimensions of loneliness as well. Another theme that was extracted from the interviews was " encountering special events ". In this context, the sub-themes were about facing new and challenging situations that generally require using more cognitive abilities under the pressure of intensified and unpleasant emotions. caregivers find themselves in the middle of a variety of important and challenging decisions. One of the most difficult decisions to make is whether continuing the treatment or choosing a new type of therapy among the options; A treatment that could be the last hope before the child dies. Due to the ambiguity of the path ahead, one of the needs expressed by caregivers, in this case, is the urgent need for and informing the caregiver of all possible options and their consequences (20). The caregiverchr('39')s interaction with the child in the final phase is one of the most challenging ones. For the parent/caregiver in this period, communication with the dying child will activate two dimensions: The first is interacting with the child while waiting for the last day, and the second is maintaining the quality of the interaction.    Another sub-theme is the experience of recurrence throughout the treatment process. The parent/caregiver reports feelings of frustration, extreme sadness, inability, and loss of control over the situation. Parents as caregivers consider their responsibility to protect their child and the difference between their desire and the existing reality will lead to feelings of severe failure and guilt (35). Furthermore, owing to the high ambiguity of the situation in this phase, providing sufficient and honest information and helping caregivers to make the right decision in difficult situations, is one of the essential services that health professionals should provide to the caregiver. In conclusion, understanding the lived experience of this important group of caregivers will help specialists in cancer treatment teams to have sufficient knowledge for managing and supporting caregivers and provide higher quality services.}, Keywords = {Keywords: Caregiving, Childhood Cancer, End of life, Qualitative Study.}, volume = {27}, Number = {11}, pages = {1-14}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-6631-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6631-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {Amini, Razieh and Rahimi, Pooneh}, title = {Detection of Pre-treatment mutations leading to resistance to direct hepatitis C virus blocking drugs in patients with chronic hepatitis C}, abstract ={Background and objective: Human is the only host of hepatitis C virus. This virus has a positive single stranded RNA and lipoprotein envelop that has 7 confirmed genotypes. According to studies, genotypes 1a, 3a and 1b are the most common genotypes in Iran. No effective vaccine against HCV infection has been developed instead, advances in antiviral treatment using drugs that directly affect specific viral genomic regions to inhibit virus replication have promising results, particularly in the treatment of genotype 1 of HCV virus as a hard to treat genotype. These drugs have been used in our country for few years to treat patients with chronic hepatitis C infection so, according to the mutation prone characteristic of HCV genome which could be resulted in drug resistance  monitoring of their effectiveness for early detection of resistant mutations has the great importance.The aim of this study was to determine the frequency of drug resistant mutations in NS5A and NS5B regions as targets of new hepatitis C antiviral drugs in patients with chronic HCV-1b infection who were under treatment with these drugs. Methods: In this study, there were 29 volunteers with chronic HCV-1b infection who had failed to be treated with ribavirin and interferon but were considered “naïve” to direct acting anti-viral drugs. Viral genome was extracted from blood samples using Roche Viral RNA Extraction Kit. RT-PCR and nested PCR was performed by using specific external and internal primers separately by using the TaKaRa kit. The PCR products were sequenced and the results were verified by Bio Edit software version (7.9.5.3). Multiple alignment was performed by using CLUSTAL W software in MEGA version (6(. Results: Resistance mutations against anti HCV drugs in this study were identified in 5 (17.24%) patients out of 29 patients against daclatasvir and ledipasvir drugs. However, all patients responded to anti-HCV therapy due to the absence of resistant mutations in NS5b region that is the viral genomic target region of sofosbovir, and this response was sustained at follow-up. Conclusion: Use of Sofosbuvir in treatment of patients with chronic HCV-1b infection which is the most difficult to treat HCV genotypes, was very promising. Despite identification of resistant mutations against Daclatasvir and Ledipasvir the use of Sofosbuvir resulted in complete treatment of patients. However, due to the mutable nature of the virus, monitoring of occurrence of possible resistant mutations against Sofosbuvir is necessary to achieve HCV elimination in our country.}, Keywords = {Hepatitis C virus, Genotype 1b, Daclatasvir, Ledipasvir, Sofosbuvir}, volume = {27}, Number = {11}, pages = {15-24}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-6035-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6035-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {YousefiTalouki, Pardis and Tehrani, Pedram and Shojaei, Shahrokh}, title = {The Relationship between Thermomechanical Properties with Morphology in PCL / PHBV / MWCNT Biodegradable Nanocomposites with Application in Neural Tissue Engineering}, abstract ={  The purpose of this study was to find a combination of nanocomposite polymer with biomechanical and physical properties suitable for use in the treatment of nerve damage.In this research PCL  and PHBV  with a ratio of 25/75, 10/90 And its nanocomposites were prepared using the same MWCNT nanoparticle with different weight percentages of 1 and 3 wt% by solvent method. To evaluate morphological properties were used Samples prepared of test SEM, TEM and DMA. In the SEM test has been shown that the two polymers are compatible and, we did not see anything in the compatibility by increasing the composition . In the TEM test, is showed we had phase separation And CNT had a tended and And relative to PHBV is Incompatible and how much nanoparticles increase, CNTs are more likely to be spun. In DMA test is shown that PCL is softer than PHBV and  After combining PCL and PHBV, the modulus decrease that its reason is combination hard material with soft material. In the XRD test, it has been shown that the PCL sample has a much better and more stable crystallinity and crystallinity than PHBV. By alloying and the presence of carbon nanoparticles, it was found that the sample, which had the highest percentage of PCL and 3 percent by weight of carbon nanoparticles, gave us a much larger crystalline structure.}, Keywords = {Tissue Engineering, Poly Caprolactone, Polyhydroxybutyrate Valerate, Multi-Wall Carbon Nanotube}, volume = {27}, Number = {11}, pages = {25-38}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-6117-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6117-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {Alipour, Marzieh and Naeimi, Siros and Moghanibashi, Mohammad Mahdi and KhasheiVarnamkhasti, Khalil and Mahmmodian, Zeynab}, title = {Association between Glutathione peroxidase1 gene (GPX1pro198Leu) polymorphism with preeclampsia in south of Iran}, abstract ={Introduction: Preeclampsia is a common and serious hypertensive disorder affecting approximately 5-8 % of pregnancies. The biology of the disease is complex and not understood. This disease associated with increased blood pressure more than 140/90 mmHg in the second half of pregnancy and proteinuria more than 300 mg/24 h and is considered as one of the three leading causes of maternal and fetal mortality and related complications. This complication is a systemic disorder and can lead to difficulties in the mother, such as kidney and liver dysfunction. As well as, the risk of injury in the fetus, such as fetal growth restriction, which is considered as one of the most important causes of neonatal mortality, is common. Various factors are involved in the onset of this disease including vascular activating proteins, oxidative stress, endothelial damage and other cases (1-5). Oxidative stress is an imbalance between the production of ROS and antioxidant defences, resulting in increased levels of ROS with resultant damage of cellular components including DNA, proteins and lipids. Normal pregnancy is characterised by a low grade oxidative stress; there are increased circulating levels of oxidised low-density lipoproteins and a reduction in total antioxidant capacity in pregnant women when compared with non-pregnant women. Excessive oxidative stress is generally thought to be involved in the pathology of many pregnancy-related disorders such as fetal growth restriction (FGR), preeclampsia and miscarriage. Dysfunctional placentation is proposed to provoke a hypoxic reperfusion injury causing elevated oxidative stress in preeclampsia. By 10–12 weeks’ gestation in normal pregnancy maternal blood flow in the placenta causes a local increase in oxygen and elevation in the activity of the antioxidant enzymes. One of the most relevant enzymatic antioxidants is glutathione peroxidase (GPx). Currently there is no treatment for preeclampsia except delivery of the placenta and the baby, with the attendant risk of iatrogenic prematurity and significant neonatal morbidity and mortality. As a result, intensive research endeavours have focused on defining the molecular mechanisms of preeclampsia and the identification of new pre symptomatic biomarkers of the condition (6-11). It seems that the polymorphisms in the Glutathione peroxidase1 gene is one of the leading causes of the disease (13, 14). This study aimed of this study was to evaluate the relationship between Glutathione peroxidase1 gene (GPX1pro198Leu) polymorphism with preeclampsia. Materials and method: In the present case-control study conducted at Islamic Azad University of Kazerun in 2017, 150 preeclampsia patients with systolic blood pressure ≥ 140 mm Hg or diastolic blood pressure ≥ 90 mm Hg with two repetitions and at least 6 hours apart and also Proteinuria /0 0.3 g in 24-hour urine with ≥ +1 were in urine strip test were selected from patients referred to Vali-e-Asr Hospital in Kazerun for further molecular studies. In order to select women in the case group, first all diagnosed with preeclampsia were selected as candidates for the study, and after reviewing the clinical history, women with a history of any internal diseases were excluded from the study. The women in the control group (150 women) were selected from healthy pregnant women who had referred to the hospital for routine examinations and were matched to the patient group in terms of gestational age and place of residence. 5 ml of peripheral blood was collected from the subjects. Then DNA was extracted by salting out method. Polymorphism was determined using PCR-RFLP method. Data were analyzed using SPSS software and Chi-square statistical tests. Results: Results showed that the products of each genotype appeared on the gel as bands of 261 and 75 bp for CC homozygotes, 336, 261 and 75 bp for CT heterozygotes and 336 bp for TT homozygotes. The results of chi-square test showed a significant relationship between the control group and the patient in the frequency of CC, CT and TT genotypes in the GPx1Pro 198Leu polymorphism position (PGPX1 = 0.047). There was no significant relationship between the control group and the patient in the frequency of both C and T alleles in the Gpx1Pro198Leu polymorphic position (PGPX1 = 0.671). The results of the study of the relationship between Gpx1Pro 198Leu polymorphism and paraclinical factors, including; Severity of preeclampsia, urinary protein excretion, patient swelling, age at onset of disease, primi para, multiple pregnancy, previous history of preeclampsia, history of miscarriage, diabetes mellitus and hypothyroidism showed that except for the multipara parameter (PGPX1 = 0. 018) Significant relationship between other parameters studied such as Severity of preeclampsia (PGPX1 = 0.209), urinary protein excretion (PGPX1 = 0.710), patient swelling (PGPX1 = 0.419), age at onset of disease (PGPX1 = 0/069), primipara (PGPX1 = 0/160), previous history of Preeclampsia (PGPX1 = 0/539), history of miscarriage (PGPX1 = 0/708), diabetes mellitus (PGPX1 = 0 / 110) and hypothyroidism (PGPX1 = 0.221) with the mentioned polymorphism was not seen in the patient and control groups. Conclusion: Due to serious risks of preeclampsia to mothers and infants, identifying markers that can predict the risk of this outcome is importance. Researchers have linked the gene polymorphisms to individual disease susceptibility and response to drug, and suggest that their presence may be a predictor of disease risk. In the present study, the relationship between Glutathione peroxidase1 gene (GPX1pro198Leu) polymorphism with preeclampsia was investigated. This polymorphism, by replacing cytosine with thymine at nucleotide 599 (C.599C> T) of exon 2 of the GPX1 gene, converts the amino acid proline to leucine and affects enzyme activity. The results showed that the frequency of CC, CT and TT genotypes, despite the frequency of C and T alleles in the Gpx1Pro198Leu polymorphism site, the gene encoding glutathione peroxidase 1 among pregnant women with preeclampsia and Healthy pregnant women have a significant difference. In 2012, a polymorphism (rs713041) related to the gene encoding the enzyme glutathione peroxidase 4 with preeclampsia was also demonstrated. Similarly, in this study, the existence of a significant difference in the percentage of homozygous individuals for the C allele in the polymorphic position indicates the association of polymorphism with the incidence of the disease (19). There are also other studies linking the T allele of the Gpx1Pro198Leu polymorphic site to the occurrence of some diseases such as They have proven lung malignancy (20), cerebral hemorrhage (21) and coronary artery disease (22). Also, in a recent study conducted in 2018, the presence of CAT-21A / T polymorphism in the catalase-encoding gene has been introduced as a predisposing factor for preeclampsia (23). In this study, the association of Gpx1Pro198Leu polymorphism with factors such as; Severity of preeclampsia, urinary protein excretion, patient swelling, age at onset of disease, primi para, multiple pregnancy, previous history of preeclampsia, history of miscarriage, diabetes mellitus and hypothyroidism Checked out. In other cases except for the multiplicity parameter, no significant relationship was observed with Gpx1Pro198Leu polymorphism. However, since the occurrence of preeclampsia is most likely the result of the interaction of several polymorphic genes (24), the absence of a significant association between a gene polymorphism and disease risk factors will not be unexpected, so it is better to achieve a more reliable assessment of polymorphism status in different genes should be examined. Considering the significant relationship between Gpx1Pro198Leu polymorphism and the occurrence of preeclampsia, which emphasizes the role of genetic predisposition in the occurrence of this disease, the presence of this polymorphism can be predicted as a factor Considered the cause of preeclampsia.}, Keywords = {GPX1, Polymorphism, Preeclampsia}, volume = {27}, Number = {11}, pages = {39-47}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-6417-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6417-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {RahimiAhmadBaladi, Saeed and Tadibi, Vahid and HosseinpourDelavar, Sedigheh and Amiri, Ehsan and Jalilvand, Mohamm}, title = {Effect of sixteen weeks of regular exercise training on serum levels of aminotransferases and lipid profiles in healthy non-athlete men}, abstract ={Background and Aim: Dyslipidemia and liver dysfunction are associated with a sedentary lifestyle. The aim of this study was to investigate the effect of sixteen weeks of exercise on serum levels of aminotransferases and lipid profiles in non-athletes men. Research method: In the present Quasi-experimental research, 150 military personnel from Andimeshk and Dezfoul cities were selected by random sampling method and randomly divided into training and control groups. Exercise was performed for sixteen weeks of functional training in three sessions per week. Each training session is approximately 60-90 minutes of training consist of 3-6 sets with 6-9 workout stations with resistance, power and Functional training,  for the upper body, the torso and lower body. Paired sample t-test and independent t-test were used to analyze the data. Results: After the training period, there was founded a significant decrease in serum levels of ALT (P = 0.005) and AST (P = 0.034) enzymes and a significant increase in serum HDL (P = 0.003). Also, changes in ALT (P < 0.001), AST (P < 0.001), and HDL (P = 0.002) were significant in the exercise group compared to the control group. Discussion and Conclusion: Based on the findings of the present study, it can be said that functional training have been able to prevent lipid accumulation in liver tissue by improving lipid profile and had effective on liver function and health due to decreased serum ALT and AST levels as biomarkers related to liver function.  }, Keywords = {Functional training, Aminotransferases, Lipid profile, Liver}, volume = {27}, Number = {11}, pages = {49-58}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-6247-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6247-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {HadadEsfahani, Marzieh and Mohamadynejad, paris}, title = {Altered expression of Lnc-OC1 and SIRT1 genes in colorectal cancer tissue}, abstract ={Backgrounds: SIRT1 plays an important role in many physiological processes, including metabolism, neuronal protection, senecence and inflammatory, by staging histones and multiple transcription factors. However, the complex mechanisms of SIRT1 signaling in tumors are not yet fully understood, as it acts as both an oncogen and a tumor suppressor. On the other hand, it has been shown that the Lnc-OC1 gene inhibits cell proliferation, colony formation, invasion and migration by inhibiting miR-34a, and thus plays an incognito role in tumor formation. Given the regulatory role of miR-34a in the expression of SIRT1 gene, the aim of this study was to simultaneously evaluate the expression of Lnc-OC1 and SIRT1 expression in tumor tissue of patients with colorectal cancer compared with healthy colonic tissue. Materials and methods: In the present case-control study, a total of 35 samples of tumor tissue and healthy tissue of patients with colorectal cancer were extracted and after cDNA synthesis, the expression of Lnc-OC1 and SIRT1 genes in both tumor and healthy tissue of each person was compared. GraphPad Prism and Excel software were used to analyze the data, and after confirming that the sample size was normal with the Shapiro test, the T-test was used to examine the differences in gene expression in the tumor tissue of patients with colorectal cancer and healthy tissue. p value less than 0.05 was considered as a significant difference. Results: In the present study, the expression of Lnc-OC1gene in tumor tissues was significantly increased compared to healthy tissue (p = 0.002). In contrast, the expression of the SIRT1 gene in healthy tissues showed a significant increase compared to tumor tissue (p <0.0001). Thus, in colorectal cancer, the expression of the Lnc-OC1gene appears to increase and the expression of the SIRT1 gene decreases. Conclusion: Discussion: It seems that in colorectal cancer, increased Lnc-OC1 gene expression is associated with decreased SIRT1 gene expression, which, if confirmed in larger studies, could be a therapeutic target in colorectal cancer.}, Keywords = {Colorectal cancer, Lnc-OC1 gene, SIRT1 gene.}, volume = {27}, Number = {11}, pages = {59-71}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-6253-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6253-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {Mehraeen, Esmaeil and SeyedAlinaghi, SeyedAhmad and Saeidi, Solmaz and heydari, mohamm}, title = {Identifying the self-care instructions for Patients with coronavirus not requiring hospitalization during the COVID-19 pandemic}, abstract ={Introduction: Recently, the rapid spread of the Coronavirus Disease 2019 (COVID-19) has become a health challenge in worldwide. Dealing with outbreaks of highly pathogenic COVID-19 in the first stage requires preventive actions and self-care behaviors from individuals themselves. The purpose of this study was to determine self-care instructions for people not requiring hospitalization for COVID-19 disease. Methods: This study was a narrative review to identify self-care instructions for people not requiring hospitalization for COVID-19. A regular search was conducted in PubMed, Science Direct, Scopus, and Google scholar. In this manner, related studies and guidelines in the English language were reviewed. The keywords used were: Self-care, Coronavirus, Covid-19, and Instructions. Results: Based on the findings, self-care instructions for people with COVID-19 that not requiring hospitalization were identified in 10 main categories. According to WHO guidelines, patients and household members should be educated about personal hygiene, and how to care for the member of the family suspected of having COVID-19 disease as safely as possible to prevent the infection from spreading to household contacts. Conclusion: Since there is no definitive treatment and the unknown behavior of COVID-19, self-care behaviors have been the best possible strategy to control the virus.}, Keywords = {Self-care, Coronavirus Disease 2019, Guidance, WHO, COVID-19}, volume = {27}, Number = {11}, pages = {72-82}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-6269-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6269-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {Ahmadi, Aslan and Jamali, Mina and Sanaei, Ay}, title = {Acute isolated uvula swelling: A rare manifestation in patients with COVID-19}, abstract ={Acute and isolated inflammation of the uvula is one of the rare manifestations of COVID-19 virus. In this article, we have introduced two definite cases of this disease without significant pulmonary manifestations. Causes of acute and isolated swelling of the uvula include bacterial infections, viral infections, angioedema, direct mechanical trauma to the uvula - some systemic and inhaled drugs, and idiopathic causes. In this study, two patients, who referred to our otolaryngology department with acute swelling and isolated uvula with a diagnosis of COVID-19, along with lack of sufficient knowledge about the course of the disease and how to respond to treatment in these patients due to lack of similar cases in the articles, are introduced. The first patient was a 41-year-old man who complained of a foreign body sensation in his throat, dyspnea, and progressive sore throat. The patient reports a history of low-grade fever and occasional fatigue and dry cough from about 9 days ago, which partially improved. In the two days before the visit, the patient had progressively nausea following the sensation of a foreign body in the throat. The patient neither reported a history of smoking or drug use, nor a previous history of underlying disease. On initial examination, the inside of the uvula was swollen and erythematous. Baseline oxygen oxygenation was 91% at baseline, reaching 96% after receiving oxygen through the nasal cannula. Respiratory rate was 26 beats per minute and heart rate was 112 beats/minute. The patientchr('39')s body temperature was recorded at 38 degrees. Due to the swelling of the uvula and the feeling of suffocation, the patient was prescribed 8 mg of intravenous dexamethasone. For rule out accompanying epiglottitis and other accompaniments, lateral neck and chest radiographs were taken from the patient without epiglottitis. Other diagnostic tests were requested according to the air space opacity in the lower left lung area and the history of viral infection symptoms. The patient was admitted to the intensive care unit for accurate monitoring of respiratory and vital signs. Within hours of receiving intravenous dexamethasone, uvula swelling was significantly reduced. Following definitive diagnosis of COVID-19 based on paraclinical tests performed for the patient, hydroxychloroquine, naproxen, coamoxyclav and atorvastatin were started with continued intravenous dexamethasone and the patient was discharged the day after admission due to improvement of symptoms and relative relief of swelling. The patient was transferred to the ward and discharged two days later with a quarantine order and continued medical treatment at home, and two weeks after discharge the patientchr('39')s symptoms completely disappeared. The second patient was a 28-year-old man who had referred to the otolaryngology department a few hours earlier without any symptoms, including fever and pulmonary symptoms, with a mild headache two days ago, a sore throat, and a foreign body. The patient did not report any history of allergies, underlying disease, or smoking. As in the first patient, severe swelling of the uvula with erythema was observed during the initial examination. The patientchr('39')s basal oxygen level was 94%. The patient had a respiratory rate of 20 beats per minute and a heart rate of 90 beats per minute. With the initiation of supportive measures and receiving 8 mg of intravenous dexamethasone and rejection of the presence of concomitant epiglottitis and improvement of the patientchr('39')s general condition, CT scan of the chest was performed with axial parenchyma. Scattered Ground-glass turbidity was observed on CT scan and other diagnostic tests were requested according to the CT scan view and clinical findings. After one day of hospitalization and improvement of uvula swelling and due to the appropriate level of oxygen secretion, the patient was discharged from the hospital with a quarantine order and with prescriptions of hydroxychloroquine, naproxen, cetirizine, co-amoxyclav, and atorvastatin. Like the first patient, the patientchr('39')s symptoms completely improved after two weeks of follow-up. The basis of treatment of acute isolated uvula edema is the symptomatic treatment. Treatment options for isolated Iola edema include acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), and antibiotics that cover common organisms, as well as corticosteroids and antihistamines. In addition to receiving the COVID-19 treatment protocol, our patients underwent routine treatments for uvulitis patients, and their recovery was similar to that of other patients with acute edema and isolated uvula with causes other than COVID-19 in the studies. According to our findings, COVID-19 can be taken into consideration in the differential diagnosis of acute systemic diseases with viral causes.}, Keywords = {Acute Isolated Uvulitis, COVID-19, Dexamethasone}, volume = {27}, Number = {11}, pages = {83-89}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-6567-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6567-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {Shahmoradi, Elaheh and Halvaei, Im}, title = {Sperm freeze-drying; effects on sperm parameters}, abstract ={Today, sperm cryopreservation is a routine practice in infertility clinics. One of the alternative methods to preserve sperm is freeze-drying. This process consists of three steps. The first step is sample freezing, during which the solvent is separated from the solvent. Water forms ice crystals and the solute is placed between the ice crystals. Freezing may be done in a separate device or in a freeze dryer. The second step is the primary drying, in which the pressure of the device is reduced and heat is used to begin sublimation of the ice crystals. During the third step, which is the secondary drying, the final absorption of the remaining water is usually done by increasing the temperature of the product and slightly reducing the water vapor pressure in the container (17). This method has many advantages, including that it eliminates the need for liquid nitrogen for long-term storage and the dried samples can be stored at 4˚C or room temperature. To use sperm, rehydration must be done. In the preservation of human sperm by freeze-drying, the general lack of movement in the dried specimens indicates severe damage to the plasma membrane of the sperm. The effect of the physical and chemical environments to which sperm are exposed and the subsequent swelling and shrinkage as a result of water flow cause damage to the organelles, the lipid structure of the cell plasma membrane, and the water channels in the membrane (9). After freeze-drying, sperm become immobile in all culture media. Sperm viability has been reported following freeze-drying in various animal species (16). One of the anomalies that occurs after sperm freezing drying is morphological anomalies, especially in the tail, where curved tails have the highest proportion of these anomalies (9). When sperm returns to isotonic conditions after exposure to high osmolarity solutions, this causes the tail to twist and bend around the sperm head. In addition, changes in water content during cell dehydration may lead to tail twisting. The acrosome is the part of the sperm that is highly affected by freeze-drying in all culture media, regardless of semen status or storage temperature, which can be preserved in this technique (22). The effect of freeze-drying on DNA structure is contradictory. Numerous studies have shown that DNA integrity can be maintained following this method (9, 28). Adding trehalose to freeze-drying media help to maintain the sperm DNA integrity (36). The use of trehalose in freeze-drying can also lead to the preservation of microtubules (23). This article reviews the studies on freeze-drying of sperm and its effects on sperm parameters.}, Keywords = {freeze-drying, sperm, sperm motility, acrosome}, volume = {27}, Number = {11}, pages = {90-100}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-6301-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6301-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} } @article{ author = {karani, Paris}, title = {The importance of exercise and the use of masks on the immune system during the coronavirus pandemic}, abstract ={Abstract With the onset of a new wave of coronavirus in Iran, athletes and ordinary people are still looking for high-intensity exercise or the use of masks, so researchers have suggested doing exercise in accordance with health protocols. In this review study, researchers examine the effect of different training intensities on the immune system and the importance of masked exercise. Finally, it can be said that doing moderate-intensity exercise with health protocols can prevent the coronavirus from being infected}, Keywords = {Coronavirus, exercise, mask}, volume = {27}, Number = {11}, pages = {100-107}, publisher = {Iran University of Medical Sciences}, url = {http://rjms.iums.ac.ir/article-1-6630-en.html}, eprint = {http://rjms.iums.ac.ir/article-1-6630-en.pdf}, journal = {Razi Journal of Medical Sciences}, issn = {2228-7043}, eissn = {2228-7051}, year = {2021} }