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Background and purpose: Binding a monoclonal antibody to tumor associated antigens is an effective method for cancer therapy because these agents can specifically target malignant cells. In fact, monoclonal antibodies are effective agents for diagnosis, grading and treatment of different kinds of cancers. In this research, a new monoclonal antibody against colon cancer cells was prepared and radiolabeling with technetium-99m evaluated.
Materials and Methods: This research was done in three parts: preparation of hybridoma cell against colon cancer cell line (HT29), production of monoclonal antibody, determination of its characterizations and radiolabeling with technetium-99m.
Results: mAb-D2 is an IgG1 with affinity constant of 7.2 × 109M-1 which can recognize CEA in tumor cells. Radiolabeling showed that 99mTc-HYNIC-mAb-D2 complex is stable, immunoradioactive, and has a desirable biodistribution.
Conclusion: In this study, we gained a new radiopharmaceutical that may be a good candidate for radioimmunoscintigraphy.

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Due to the predisposing conditions in patients with cystic fibrosis (CF) caused by defective mucociliary clearance facilitates of colonization and invasion with bacteria and fungal species has dramatically increased. In different studies many opportunistic fungi such as Candida and Aspergillus species have been frequently isolated from the respiratory tract of patient suffering from cystic fibrosis. Molecular biotyping studies have revealed that some fungal genotypes are capable of chronically colonizing in the airways. Although colonization of Candida species was more common, other fungi such as Aspergillus species, Scedosporium apiospermum, and Exophiala dermatitidis frequently recovered from respiratory secretions of CF patients. Due to the predisposing conditions of fungi agent colonization in these patients, identification and preliminary diagnosis of infectious agents for early treatment and preventing the invasion is highly recommended. On the other hand, regarding the differences in epidemiology, virulence, and susceptibility profile in isolated species of fungi from cystic fibrosis patients, identification and discrimination of ethological agents are crucially important and further studies is highly suggested.

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Çolon lipoma is a rare benign tumor which is usually detected incidentally and is mostly asymptomatic. The author describes a case of obstruction due to lipoma. Â 46-year-old man with a two-month history of abdominal pain, and intermittent nausea, vomiting and melena for 3 weeks is reported. During colonoscopy, it was found that there was a colon mass and the pathological report showed chronic inflammation and a complete obstruction with barium was observed. Due to his constipation, severe abdominal pain and transverse, colectomy was performed. Pathological report showed submucosal lipoma. Finally, he felt well and was discharged from hospital.

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Background and purpose: Colonoscopy is an invasive short-lasting procedure causes the patient's considerable pain, discomfort and anxiety. Therefore, various types of sedation and analgesia techniques have been used during the procedure. The aim of this study was to compare the quality of sedation/analgesia of propofol-fentanyl and midazolam-meperidine combinations in patients undergoing elective colonoscopy. Materials and methods: Eighty-three patients scheduled for elective colonoscopy under sedation were enrolled in this randomized double-blind study. In propofol-fentanil group, patients received fentanyl (1 µg/kg) and propofol (0.5 mg/kg) followed by an infusion of 25 µg/kg/min. Group midazolam-meperidine received meperidine (0.7 mg/kg) with midazolam (0.03 mg/kg). The assessment included measurements of quality of sedation, heart rate, blood pressure, oxygen saturation, and evaluation of the recovery time. Results: The systolic blood pressure, heart rate, and percent of blood oxygen saturation (SPO2) remined stable during the procedure. Sedation level was higher in propofol-fentanil group. Recovery time was 12.68 ± 4.90 and 25.75 ± 2.07 minutes in the propofol-fentanil and midazolam-meperidine groups, respectively (P = 0.023). Conclusion: Propofol-fentanil can provide better sedation, satisfaction and analgesia than midazolam-meperidine during colonoscopy .Therefore, it can be recommend in patients scheduled for elective colonoscopy.

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Background and purpose: Aspergillus is a ubiquitous fungus, which causes a wide spectrum of infections including invasive pulmonary aspergillosis (IPA), depending on the patient’s immune status and underlying lung disease. Among the Aspergillus spp, A. fumigatus remains the predominant agent of IPA. In patients with a preexisting lung cavity from a variety of causes, such as pulmonary tuberculosis (TB) Aspergillus can colonize and grow into the cavity to form a pulmonary aspergilloma. In this present study we assessed TB patients for aspergilloma based on culture and non-culture based methods Materials and methods: During one year, we studied 124 patients with TB at Massih Daneshvari hospital from Tehran, Iran. Sputum specimens were analyzed by direct microscopic examination (DME) with 20% potassium hydroxide. These samples were also processed for fungal culture. The clinical and radiological features or CT-scan report of all patients were recorded. All patients were screened for serum specific IgG against A. fumigatus, using Aspergillus IgG ELISA Kit (Genesis Diagnostics Ltd, Cambridgeshire, UK). The results are expressed in U/mL. IgG 12 U/mL was considered as positive result based on kit manufacturer instruction. Results: Out of 124 patients with tuberculosis (66 male, 58 female, age range: 10-91 years), 54 had abnormal chest radiographic findings. Chest X-ray findings showed that 48 patients (38.7%) exhibited residual cavities (31 cases in right lobe, 10 in left lobe and 7 in both lung). Round shaped mass lesion was detected only in 6 patients (6.8%). DME of sputum was positive in 10 patients for septate fungal hyphae. A. fumigatus was grown from 14 samples of TB patients. Out of 124 TB patients, 55(44.3%) cases were positive for specific serum IgG against A. fumigatus. There was a significant relationship between positive culture, DME and serum IgG profile level (P< 0.05). Totally, three patients (2.4%) met criteria for aspergilloma Conclusion: Colonization with Aspergillus in preexisting lung cavity produced by TB should be considered as a risk factor for aspergilloma

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Background and purpose: Respiratory failures are common diseases among different populations. Pneumocystis jirovecii colonization causes respiratory failure in children and adults with AIDS and patients with predisposing factors of immunosuppression including malignancies, organ transplant, inherited immune deficiencies and immunosuppressive agents. The aim of this study was to evaluate the efficacy of three staining methods including Calcofluor White, Giemsa and Gomori Methenamine Silver in identification of Pneumosystis colonization using Bronchoalveolar lavage (BAL). Materials and methods: A cross sectional descriptive study was performed in 350 patients with respiratory failure who referred to Tehran Shariati Hospital and Sari Imam Khomeini Hospital during August 2013 to September 2014. Totally, 322 BAL samples, 26 induced sputa and 2 samples of sinus washing were evaluated for Pneumocystis jirovecii colonization after staining with the three specific staining methods. Data was then analyzed in SPSS V.16. Results: The patients were 41.2% female and 58.8% male. The mean age of patients was 52 ± 4 years. Calcofluor White staining showed Pneumocystis jirovecii colonization in three patients (0.86%). Conclusion: In this study, Calcofluor White staining presented higher efficacy in identifying Pneumocystis jirovecii in BAL samples compared to other two microscopic procedures.

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Abstract Background and purpose: The yeast fungi including Candida and Malassezia genus are normal flora of the skin of human and male genital region. They could cause balanitis and urinary tract infections. The aim of this study was to determine the prevalence of yeast colonization on preputial area of infant prior to circumcision. Materials and methods: A total of 200 (

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Background and purpose: Awareness of people about drinking water impurities and the demand for better water quality have led to widespread application of point-of-use (POU) water treatment devices. The aim of this study was to investigate the bacteriological quality of water produced by household water treatment devices.

Materials and methods: This cross-sectional descriptive study was performed on 18 household water treatment devices in 2014. Thirty-six inlet and outlet water samples were collected. Bacterial quality of the samples were determined by total and fecal coliform multiple-tube fermentation techniques, heterotrophic plate count (HPC) was done using membrane filter technique on blood agar medium and gram-negative bacteria analysis was performed via membrane filtration technique on EMB agar medium. Isolated colonies were identified using standard biochemical tests.

Results: Total and fecal coliform bacteria were negative at all inlet samples, but were positive at two of the outlet samples. HPC were higher than the maximum limits of 500 cfu/ml at 67% of the outlet samples. Pseudomonas, Alcaligenes, Serratia and Shigella genus were found with higher frequencies at both inlet and outlet samples. However, frequencies of Proteus and gram positive Bacillus have increased in the outlet samples.

Conclusion: The removal of residual chlorine by household water treatment devices causes developing biofilm on the filters and storage tank of the devices by the bacteria present in distribution network. Consequently, the number and variety of bacteria are increased in water produced by POU water treatment devices.

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Background and purpose: Turmeric (Curcuma longa L.) has received much interest by researchers due to numerous biological properties. The aim of this study was to compare the anticancer and antioxidant properties of turmeric extracts on colon cancer cells Caco-2 and to survey DNA fragmentation by the extracts.
Materials and methods: In order to investigate the cytotoxicity and antioxidant properties and DNA fragmentation, turmeric extracts were prepared by maceration, ultrasonic-assisted extraction (UAE), and soxhlet. The effect of these extracts and curcumin on colon cancer cells Caco-2 was examined by MTT and NBT assay. Then, to study the DNA fragmentation by the extracts DNA-Binding was done.
Results: MTT assay showed that the lowest survival rates were observed for cells treated with the extracts of hexane and ethanol. The results of the NBT showed that the highest amount of percentage of free radicals reduction occurred with maceration extract, ultrasonic extract, and extraction by hexane and ethanol. According to DNA-Binding test, ultrasonic extraction was highly effective in degeneration of DNA.
Conclusion: Investigations show that different extracts of turmeric alone or in combination with chemical anticancer drugs could be used as a new approach in treatment of cancer. Turmeric extract using hexane and ethanol has a great potential in development of modern drugs and can be introduced as a useful source of new leading compounds or pharmacophores.
 

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Background and purpose: Opioid analgesics cause bradycardia and respiratory depression.  The aim of this study was to investigate the efficacy of diclofenac suppository on pain and dose reduction of injectable fentanyl in patients undergoing colonoscopy.
Materials and methods: In a clinical trial, 500 patients undergoing colonoscopy were randomly divided into two groups to receive either diclofenac or glycerin (placebo) administered 30 min before colonoscopy. Five minutes before colonoscopy, fentanyl (50 μg/iv) was administered, and then, if pain persisted during colonoscopy, fentanyl 50 μg was administered as a rescue. Baseline demographic and clinical data and other information, including cecal arrival time, patients’ and gastroenterologist’s satisfaction, pain intensity based on visual analogue scale (VAS), rescue dose of fentanyl, frequency of hypotension and apnea were compared between the two groups.
Results: The groups were similar in age, sex, and baseline clinical parameters (P> 0.05). Cecal arrival time was shorter in the group that received diclofenac (10.59±3.8 min) than the placebo group (12.41±2.5 min) (P= 0.035). Mean pain score was found to be lower in diclofenac group (3.2±54.2) than the placebo group (5.10±2.8) (P <0.0001). Frequency of fentanyl administration in diclofenac group (6%) was lower than that in placebo group (24.8%) (P <0.0001). Frequency of hypotension and apnea events were observed to be lower in the group that received diclofenac (P< 0.05).
Conclusion: In this study, diclofenac suppository had positive effects on reducing the pain intensity, the dose of fentanyl, and side effects, therefore, it is recommended in colonoscopy analgesia protocols.
 
(Clinical Trials Registry Number: IRCT2016092629976N1)
 

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 Background and purpose: Appropriate drug regimen during colonoscopy is one of the matters of concern in anesthesia. This study was conducted to compare the efficacy of propofol-ketamine combination and propofol-fentanyl in colonoscopy.
Materials and methods: In a single-blind randomized clinical trial, 200 patients aged 18-60 years candidate for colonoscopy, were randomly allocated into two groups to receive either fentanyl-propofol (PF) or ketamine-propofol (PK) using block randomization. Recovery time (end of injection until Steward Score was 6) as the primary outcome and vital signs, complications, total dose of propofol, and satisfaction of the doctor performing the colonoscopy as secondary consequence were compared between the two groups.
Results: Recovery time was 2.97 ± 0.89 min in the fentanyl-propofol group and 8.84 ± 1.73 min in ketamine-propofol group (P<0.001). Systolic and diastolic blood pressure and heart rate significantly decreased in the fentanyl-propofol group compared with the other group (P <0.001) which was persistent until five minutes after colonoscopy. Restlessness was seen in 28 patients receiving propofol-ketamine but no patient in fentanyl-propofol group developed this condition (P <0.001). Satisfaction of the doctor performing the colonoscopy and propofol dose were significantly better in patients that received ketamine-propofol (P<0.05).
Conclusion: Fentanyl-propofol combination was associated with faster recovery time and less restlessness than the ketamine-propofol compound, but the latter combination is recommended as it led to better hemodynamic stability, greater satisfaction of the doctor, and reduced dose of propofol.

 (Clinical Trials Registry Number: IRCT20190529043750N1)
 

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Background and purpose: Colonoscopy is a standard method for the diagnosis and treatment of colorectal diseases. The aim of the present study was to compare the analgesic effect of oral oxycodone and intravenous fentanyl in patients undergoing colonoscopy.
Materials and methods: This study was conducted as a randomized clinical trial in 80 patients aged 20 to 69 years who were candidates for colonoscopy in two equal groups. Patients in the first group received oral oxycodone and intravenous normal saline, while the second group received oral placebo and 50 micrograms of intravenous fentanyl. 0.5 mg/kg propofol was administered intravenously to both groups. If pain occured, 10 mg propofol was injected. Data on age, gender, vital signs, satisfaction of the endoscopist and pain intensity of the patients were recorded using a numerical rating scale. The data were analyzed using the chi -square test and t-test and SPSS software, with a P˂0.05 value considered significant.
Results: The two groups were similar in terms of age (P=0.64) and gender (P=0.055).The mean pain score in the oxycodone group was 3.22±1.78 and in the fentanyl group 2.00±1.43 (P= 0.001). The need for a propofol rescue dose during colonoscopy was higher in the oxycodone group than in the fentanyl group (P= 0.56). There were no significant differences between the two groups in terms of heart rate, respiratory rateand colonoscopist satisfaction (P>0.05).
Conclusion: Considering that oral oxycodone has a good analgesic effect compared to intravenous fentanyl, this drug can be used as an analgesic for patients undergoing colonoscopy.

(Clinical Trials Registry Number: IRCT20181216041991N1)
 

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Background and purpose: Today, despite the abundance of chemical drugs, the use of medicinal plants is increasing; Curcumin (curcumin) is a yellow pigment obtained from the turmeric plant and is considered the effective ingredient of turmeric. This crystalline and crystallized product is widely used in Indian medicine. Recently, the beneficial effects of curcumin on stomach, colon, and mouth cancers have been proven in mice. Curcumin usually plays its role through pharmacological processes such as antioxidant, anti-inflammatory, antithrombotic, apoptotic, and hepatoprotective effects. Antioxidative, antiproliferative, and antiangiogenic properties of curcumin have been noticed in recent years. However, the low solubility of curcumin and its severe degradation have made it impossible to introduce it in clinical use. In recent years, studies and reviews have been conducted to prepare and design polymeric micelles (PMMCs) on a nanoscale to improve the cellular transport of curcumin. Green tea flavonoids, including epicatechin, have recently received attention. In in vitro research, these compounds have been proposed as antioxidants by inhibiting lipid peroxidation, trapping free radicals, and chelating metal ions, and this property is mentioned due to their unique structure (therefore, the purpose of this study is to determine the effect The synergism of curcumin and epicatechin has been carried out in the investigation of apoptosis and cell proliferation of HT29 cell lines and apoptotic factors.
Materials and methods: This study is experimental. After obtaining HT29 cells from the Pasteur Institute cell bank and completing cell passage and proliferation, the cells were distributed in triplicate wells across 7 test groups and 2 control groups (positive and negative). In test groups 1, 2, and 3, three concentrations of curcumin nanomicelles (10, 20, 50 µg/ml) were incubated in triplicate. In groups 4, 5, and 6, three concentrations of epicatechin (10, 20, 50 µg/ml) were incubated for 24 hours. Test group 7 consisted of HT29 cells treated with the IC50 concentration of nanomicelle curcumin combined with the IC50 concentration of epicatechin. Group 8, the positive control, consisted of cells treated with 5FU (100 µg/ml), while group 9, the negative control, consisted of cells exposed only to the cell culture medium. After the 24-hour incubation period, an MTT assay was performed to assess cell proliferation, and Annexin flow cytometry was used to determine the level of apoptosis.
Results: In this study, epicatechin and curcumin have been able to decrease cell viability of colon cancer cells (HT29) and increase the percent of apoptotic cells P<0.05, which was in a dose-dependent manner, also the combination of these two drugs caused a synergistic effect in high dose P<0.05. Epicatechin in concentrations of 20, 10 μg/mL, 50, and 100 has a significant difference compared to the negative control group with P<0.05, which has caused a decrease in cell viability in colon cancer cells with increasing dose. Curcumin is the group Nanomicelle with epicatechin at IC50 concentration compared to the positive control group of 5-FU in HT-29 cell line has greatly reduced cell viability of HT-29 cell line showed that curcumin and epicatechin nano micelles had a synergistic effect. The results of cell apoptosis have shown that curcumin and epicatechin nano micelle groups at IC50 concentrations had a synergistic effect.
Conclusion: epicatechin and curcumin have been able to increase the death rate of colon cancer cells (HT29) by increasing apoptosis, which indicates the anti-cancer effects of these compounds. So it can suggest these compounds in colon cancer therapeutics.
 

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Background and purpose: Inflammatory bowel diseases (IBD) are chronic and recurrent inflammatory disorders of the gastrointestinal tract, classified into two main categories: ulcerative colitis and Crohn's disease. Mesalazine is the most commonly prescribed drug for the treatment of inflammatory bowel disease (IBD); however, its rapid absorption in the small intestine reduces its local effects in the colon. The use of mesalazine in coated pellet form as a multi-unit drug delivery system may enhance its effectiveness compared to conventional pharmaceutical forms such as tablets. Arthritis is one of the extra-intestinal manifestations of IBD, which can be alleviated by acetaminophen. The aim of this study is to design a multi-unit oral drug delivery system (pellets) that simultaneously delivers mesalazine to the large intestine and acetaminophen to the stomach.
Materials and methods: In this experimental study, mesalazine pellets were prepared using the extrusion-spheronization method and coated with pH-dependent polymers (Eudragit® L100 and Eudragit® S100) as well as a combination of time-dependent (Eudragit® RS) and pH-dependent polymers (Eudragit® L100). Drug release was evaluated in simulated gastrointestinal environments, and the optimal formulations were identified. Subsequently, acetaminophen was loaded onto the optimized pellets using a fluid bed coater. The drug release profile was assessed using a continuous dissolution testing method. Thermal analysis, infrared spectroscopy, mechanical testing and scanning electron microscopy were performed to evaluate the physicochemical properties and investigate potential interactions.
Results: Pellets coated with 40% Eudragit® RS and 60% Eudragit® L100, as well as those coated with 100% Eudragit® S100, were found to be more suitable for colon drug delivery than other formulations. Continuous dissolution testing showed that acetaminophen was released in a pH 1.2 environment within 2 hours, while mesalazine remained intact and reached the large intestine. Physicochemical tests indicated that the pellets had a smooth surface, uniform coating, and appropriate hardness, with no detectable interactions between the drugs and excipients.
Conclusion: This study demonstrated that the optimized formulation effectively enables the targeted delivery of acetaminophen to the stomach and mesalazine to the colon in a single dosage form.