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Background Diabetic foot ulcers (DFUs) are a severe complication of diabetes, often leading to infections caused by multidrug-resistant (MDR) bacteria, which complicate treatment and increase amputation risks. Bacteriophage (phage) therapy, targeting specific bacterial pathogens, has re-emerged as a promising alternative to antibiotics. This systematic review evaluates the efficacy of phage therapy for DFUs. Methods A comprehensive search was conducted in PubMed, Scopus, Web of Science, and Embase up to October 29, 2024, using keywords such as \"phage therapy,\" \"diabetic foot ulcers,\" and \"bacteriophages.\" Included were original English-language studies investigating phage therapy for DFUs, while reviews and non-English articles were excluded. Data extraction and quality assessment were performed independently by two reviewers. Results Twenty-one studies demonstrated phage therapy’s effectiveness against key DFU pathogens, including  Staphylococcus aureus ,  Pseudomonas aeruginosa ,  Enterococcus faecalis , and  Klebsiella pneumoniae . Phage cocktails showed superior efficacy in preventing bacterial regrowth and overcoming resistance compared to single phages. Synergistic effects with antibiotics (e.g., ciprofloxacin) were observed, enhancing biofilm penetration and bacterial eradication. Case studies reported high tolerability and clinical resolution, even in antibiotic-resistant infections. However, evidence remains limited to small-scale studies. Conclusion Phage therapy is a viable, safe option for MDR DFU infections, particularly due to its biofilm-disrupting properties and synergy with antibiotics. The lack of large randomized controlled trials (RCTs) underscores the need for standardized protocols, broader phage cocktails for polymicrobial infections, and optimized delivery methods. Future research should prioritize RCTs to establish efficacy, safety, and regulatory pathways for clinical adoption.

Background Antibiotic-resistant bacteria pose an urgent health threat as mutations have led to resistant strains that evade treatment. These bacteria form biofilms, complicating infection management. Bacteriophages are being recognized for their potential in phage therapy due to their effectiveness in rapidly targeting and eliminating bacterial hosts. Materials and methods This systematic review examined the effectiveness of bacteriophages against biofilms created by antibiotic- and drug-resistant staphylococcal strains. A thorough search of the Embase, Web of Science, PubMed, and Scopus databases was conducted for studies published from 2012 to October 29, 2024, focusing on relevant research while excluding irrelevant studies. Results This systematic review assesses the effectiveness of phage-derived enzymes, including endolysins and depolymerases, as well as whole bacteriophages, in degrading biofilms and clearing bacteria. It also highlights how combining phages with antibiotics or other agents can improve biofilm removal. The review explores the potential applications of phage therapy in various contexts, such as infections related to milk, silicone surfaces, synovial fluid, and prosthetic joint materials. Overall, while phage therapy shows promise as an alternative to antibiotics, additional research is necessary to refine treatment methods and ensure safety. Conclusions Bacteriophages hold potential as a standalone treatment and a complementary option to traditional antibiotics for managing S. aureus biofilms, but further research is needed to understand their clinical potential. Additional studies on phage selection, dosing, and administration methods are necessary, along with exploration of phage–antibiotic synergy mechanisms and assessment of the safety and environmental impacts of phage therapy.

Background Human T-cell leukemia virus type 1 (HTLV-1) is a well-known retrovirus, particularly prevalent in northeastern Iran, where it is associated with a range of disorders, including liver dysfunction. Previous studies have demonstrated that HTLV-1 infection can alter lipid profiles, yet no research has examined lipid indices and liver function tests in these patients in the long term. Methods This data is part of the Mashhad stroke and heart atherosclerotic disorder (MASHAD) study. A total of 1116 participants were randomly selected, including 837 healthy individuals and 279 HTLV-1-infected patients. Following a 10-year follow-up period, Serum levels of liver enzymes were measured. Lipid indices such as the Atherogenic Index of Plasma (AIP), Body Adiposity Index (BAC), Castelli risk index (CRI-I, CRI-II), Lipid Accumulation Product (LAP), Visceral Adiposity Index (VAI), Triglyceride-glucose index (TyG), and Triglyceride and HDL-C Ratio (THR) were calculated. Results Multivariable-adjusted regression analysis demonstrated a significant coefficient for the Visceral Adiposity Index (VAI) in HTLV-infected patients compared to healthy controls (B: -0.014, 95% CI: -0.02, 0.00, p  = 0.046). However, no significant differences were observed in other lipid indices between HTLV-infected patients and healthy individuals. Regarding liver enzymes, significant variations were noted in HTLV-infected patients compared to healthy controls: Aspartate Aminotransferase (AST) (B: 2.978, 95% CI: 1.34, 4.61, p  < 0.001), Alanine Aminotransferase (ALT) (B: 3.687, 95% CI: 1.59, 5.78, p  = 0.001), Alkaline Phosphatase (ALP) (B: 18.232, 95% CI: 6.81, 29.65, p  = 0.002), and Gamma-Glutamyl Transferase (GGT) (B: 3.714, 95% CI: 0.18, 7.24, p  = 0.039). Conclusion Individuals with HTLV-1 infection exhibit reduced VAI but elevated levels of liver enzymes such as AST, ALT, ALP, and GGT, indicating liver damage. These findings emphasize the virus’s involvement in liver pathology. Also, HTLV-I is associated with reduced visceral fat tissue.

Background Non-high-density lipoprotein-cholesterol (non-HDL-C) has been identified as a potential biomarker for metabolic syndrome (MetS). However, its predictive capability for MetS varies among different ethnic groups, necessitating further investigation. This study aimed to assess the role of non-HDL-C in the early diagnosis of MetS in the Iranian population through a longitudinal study with a 10-year follow-up period. Methods Our study enrolled 4684 individuals from the MASHAD (Mashhad Stroke and Heart Atherosclerotic Disorder) cohort who were followed for 10 years to examine the association between non-HDL-C and the incidence of MetS. Additionally, the contribution of individual MetS components to the overall burden was evaluated. Results A total of 1599 subjects developed MetS, while 3085 did not. Non-HDL-C levels ≥ 130 were associated with a 42% higher risk of developing MetS (relative risk (RR), 1.42; 95% confidence interval (CI), 1.25–1.62). Regarding MetS components, elevated waist circumference (WC) showed the strongest association with MetS incidence (RR, 2.32; 95% CI, 1.45–2.9), whereas triglyceride (TG) levels ≥ 150 mg/dL demonstrated the weakest association (RR, 1.23; 95% CI, 1.04–1.46). Additionally, higher HDL-C levels were reported to be 20% protective against the risk of MetS (RR, 0.8; 95% CI, 0.73–0.86). Moreover, fasting blood glucose (FBG) levels ≥ 100 mg/dL were not significantly linked to MetS burden, while systolic blood pressure (BP) levels ≥ 130 mmHg or diastolic BP levels ≥ 85 mmHg increased the risk of MetS incidence (RR, 1.25; 95% CI: 1.11–1.41). Conclusions Elevated non-HDL-C and increased WC serve as significant predictors of MetS in Iranians. Strategies targeting non-HDL-C levels and weight loss should be emphasized to mitigate the risk of MetS development.

Background: Considering the high prevalence and clinical importance of herpes simplex virus (HSV) infection worldwide, we aimed to evaluate the seroprevalence of HSV-1 and HSV-2 in a population aged between 15 and 35 years in Mashhad, Iran.Methods:This cross-sectional study was conducted on 916 cases composed of 288 (31.4%) men and 628 (68.6%) women. Using ELISA method, the presence of IgM and IgG antibodies against HSV-1 and HSV-2 was assessed.Results:Among the population studied, 681 (74.3%) cases were positive for anti-HSV antibodies, while 235 (25.7%) cases were negative. Moreover, no IgMs were found and all positive subjects had IgG antibodies. Age (p < 0.001), occupation (p < 0.001), education (p = 0.006), smoking (p = 0.029), and BMI (p = 0.004) demonstrated a significant association with HSV-1 and HSV-2 infection.Conclusion:Our study indicates a high seroprevalence of HSV infection; however, there was no cases positive for IgM antibodies, suggesting the high prevalence of latent infection.

Cardiovascular diseases are a major cause of morbidity and mortality. Chronic inflammation is an important risk factor for atherosclerosis, and viral infections can cause cardiovascular disease by developing inflammation. Infection with human T-lymphotropic virus (HTLV) is endemic in some parts of the world such as Japan, Africa, Caribbean islands, South America, and Iran. HTLV-1 is an oncogenic retrovirus, and can cause adult T-cell leukemia/lymphoma (ATL or ATLL). It also causes HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). A number of inflammatory diseases such as uveitis, arthritis, and Sjogren's syndrome are also associated with the virus. A few case reports have shown the direct involvement of the heart in HTLV-1-positive patients who develop ATLL. The purpose of this study was to review the literature relevant with the role of HTLV in cardiovascular diseases.

Depression and Anxiety are two important public health problems that are known to be associated with viral infections. The association between the intake of nutrients such as zinc and copper with symptoms of depression has been studied previously. The aim of the current study was to investigate the association between depression with human T cell lymphotropic virus type 1 (HTLV-1) infection and serum content of zinc and copper in a large Iranian population cohort. The study population consisted of 279 HTLV-1-positive patients who were identified after recruitment as part of a large cohort study: the Mashhad Stroke and Heart Association Disorder (MASHAD) study. They were divided into two groups of diagnosed with or without depression based on their symptoms. Serum zinc and copper levels of all subjects were measured using the flame atomic absorption spectrometry. The population sample comprised of 279 individuals infected with HTLV-1 of whom 192 (68.8%) were women. The mean serum zinc in the group with and without depression was 78.69 ± 13.79 μg/dl and 86.87 ± 19.44 μg/dl, respectively ( p  < 0.001). Also, the serum copper level was higher in the depressive group (116.75 ± 39.56) than in the non-depressive group (104.76 ± 30.77) ( p 0.004). The association between serum zinc and copper with depression in HTLV-1-infected patients which was shown in this study could be considered in the treatment strategies in these patients.

Copper (Cu) and zinc (Zn) are important trace elements that are also structural ions of superoxide dismutase (SOD), which reduce oxidative stress. Zinc deficiency and excess copper have been reported to be associated with inflammation. The human T-lymphotropic virus type 1 (HTLV-1) is a retrovirus, which is believed to cause systemic inflammation. The aim of this study is to measure levels of Zn, Cu, SOD, and prooxidant-antioxidant balance (PAB) in HTLV-1-positive patients and investigate the association between serum Zn and Cu concentrations and levels of oxidative stress in them. The serum samples of 1,116 subjects who had participated in the \"Mashhad Stroke and Heart Atherosclerotic Disorder\" study, including 279 HTLV-1-positive and 837 HTLV-1-negative patients, were used. Levels of Zn, Cu, SOD, and PAB were measured. Zinc and SOD levels were lower in the HTLV-1-positive group; however, the difference was statistically significant only for the level of SOD ( =0.003). On the other hand, levels of copper and PAB were significantly higher in HTLV-1 positive subjects; =0.004 and =0.002, respectively. In HTLV-infected patients, serum Zn concentration is lower and Cu concentration is higher than healthy controls. This altered situation might be either primary or secondary to HTLV-1 infection, which should be investigated in larger studies. We showed that SOD is significantly lower in HTLV-1-infected subjects. As in some other viruses that evolve different mechanisms to potentiate virus replication by changing the physiologic condition of host cells, HTLV-1 too probably decreases the activity of copper-zinc SOD1 by suppressing its gene.

Changes in medical education have drawn attention to student-based learning. It is necessary that teachers' educational roles be redefined to conform to these changes. While numerous educational activities are listed for medical teachers, it seems that they involve themselves in only some of these roles. We conducted this study to assess the importance of different educational roles in the view of medical faculties. A questionnaire that consisted of a total of 12 roles classified into six categories including information provider, role model, facilitator, examiner, planner, and resource developer was prepared. Faculty members were asked to score the importance of each role using a 1-10 scale. Participants assigned the highest score to \"on-the-job role model\" (9.47) and the lowest score to \"curriculum planner\" (8.31) from their own point of view. They also assigned the highest score to \"planning or participating in student exams\" (8.10) and the lowest score to \"learning facilitator\" (6.51) from the perspective of the importance of roles in their school's programs. Faculty members are generally familiar with different educational roles but they need to be informed about some of the roles which have gained lower scores in this study.