Background: It is well established that improvement of endothelial dysfunction (ED) could prevent or delay the occurrence of cardiovascular disease (CVD) and its related morbidity and mortality in patients with chronic kidney disease (CKD). In this study we investigated whether administration of vitamin C could be effective by improving brachial artery flow-mediated dilation (FMD) and intima media thickness (IMT), two surrogate markers of ED, in children with CKD or chronic renal failure (CRF). Materials and Methods: In this analytic-experimental study children aged 3-18 years with a diagnosis of CRF and a group of healthy children were enrolled. Vitamin C (250 mg/day) administrated for the two studied groups for 1 month. Endothelial function was evaluated by FMD and IMT measurement using vascular Doppler ultrasonography, before and after trial. Results: In this study 18 patients with CRF and 19 normal children as the control group were studied. At baseline mean of IMT and FMD was not different in the two studied groups (P > 0.05). After vitamin C administration IMT decreased significantly in the two studied groups (P < 0.05). FMD increased in the two studied groups but the difference was significant in the control group (P < 0.05). Conclusion: The findings of this interventional trial have demonstrated that vitamin C could have protective effect on ED of patients with CRF possibly in those with severe form of the disease but for obtaining more conclusive results larger sample size is needed.

Background: The current survey investigates the effect of 12 weeks yoga training on headache frequency, severity, duration and blood nitric oxide levels as well as headache impacts on female migraineurs' lives. Materials and Methods: Thirty-two female patients with migraine took part and were randomly divided into two groups. The control group (n = 14) received medication and the yoga group (n = 18) participated in 12 weeks yoga training in addition to receiving the same medication as that of the control group. Frequency and duration of headache were assessed by a questionnaire. Visual Analogue Scale was used to measure the severity of headache, and the metabolite of NO also was measured by Griess reaction. Headache Impact Test ( HIT-6) was also used to assess the impact of headache on patients' lives. Data were analyzed by t-test mean variance. Results: After 3 months intervention, in the yoga group, there was a significant reduction in the impact of headache on patients' lives, headache frequency, and severity and a non-significant reduction in headache duration in the yoga group. There was no significant difference in the plasma levels of NO between yoga and control groups before and after the study. Conclusion: Based on the results, yoga could be recommended as a complementary method to migraine patients.

Background: Anxiety disorders are frequently common neuropsychiatric disorders. Herbal medicines are widespread and used universal as a treatment compound for anxiety. The present study investigated the effects of hydro-alcoholic extract of Salix aegyptiaca blossom on rat behavior in the elevated plus-maze (EPM) and compared results with the effects of diazepam, as a positive control drug. Materials and Methods: Seventy adult male Wistar rats were divided into seven groups (N = 10). Animals received S. aegyptiaca extract (25, 50, 100 mg/kg) or Diazepam (0.3, 0.6, or 1.2 mg/kg) intraperitoneally and the control group was given the vehicle (10 ml/kg) 30 min before submitting into plus-maze test. The number of entries into the open and closed arms, the percentage of entries into the open arms of the EPM, and the time spent in the open arms were recorded. Results: The results revealed significant increases in percentage of entries into the open arms (P < 0.01) and in the time spent in the open arms (P < 0.01) after administration of diazepam (0.3, 0.6) and S. aegyptiaca (50, 100 mg/kg) in compare with control group. S. aegyptiaca extract has no effects on the total distance covered by animals and number of closed arms entries, whereas diazepam decreased these parameters. The locomotor activity was not significantly changed by S. aegyptiaca. Conclusion: Single-session administration of optimum doses of total extract of S. aegyptiaca has anxiolytic effects in rat similar to the low dose of diazepam. More research is needed for better understanding of anxiolytic properties and neurobiological mechanisms of action and probable interactions of S. aegyptiaca extract with neurotransmitters.

Background: Infantile hemangioma (IH) is the most common tumor during infancy that usually appears as macular and gradually becomes a plaque or tumor. Approximately, 20% of all IH cases results in adverse effects and the Pulsed dye laser (PDL) 585 nm is a vascular laser leading to selective the micro vascular damage. Results of studies on non-selective B-blockers (e.g., timolol) indicate their effectiveness in preventing hemangioma growth. The aim of this study is a comparison of PDL plus timolol and PDL in the treatment of IH. Materials and Methods: This double-blind study was carried out on 30 infants (1-12 months old) and the patients were divided into two groups. Group A was treated with the four sessions PDL and the timolol gel 0.05% and Group B with PDL. Results: There were no differences in the mean age of patients for the diagnosis of hemangioma (Group A: 32.69 ± 24.64 days, Group B: 25.69 ± 21.16 days, P = 0.39) and the mean age at the start of the treatment (Group A: 148.125 ± 85.88 days, Group B: 146.25 ± 60.87 days, P = 0.94). There were a statistical difference in the mean of lesion size reduction (Group A: 17.62 ± 6.97 cm and Group B: 12 ± 5.71 cm, P = 0.018), mean percentage change in size mean (Group A: 71079 ± 23.41% and Group B: 54.59 ± 25.46%, P = 0.050) visual analog scale (Group A: 7.19 ± 1.51, Group B: 5.62 ± 1.78, P = 0.012) after treatment. There was no correlation between the time of beginning the treatment and the results (P = 0.857). Conclusions: Application of timolol with PDL is accompanied by the highest efficacy, cost benefits and the short time of treatment.

Background: When fitting hearing aid as a compensatory device for an impaired cochlea in a patient with sensorineural hearing loss (HL), it is needed to the effective and efficient frequency response would be selected regarding providing the patient's perfect speech perception. There is not any research about the effects of frequency modifications on speech perception in patients with HL regarding the cochlear desensitization. The effect (s) of modifications in frequency response of hearing aid amplification on the results of acceptable noise level (ANL) test is the main aim of this study. Materials and Methods: The amounts of ANL in two conditions of linear amplification (high frequency emphasis [HFE] and mid frequency emphasis [MFE]) were measured. Thirty-two male subjects who participated in this study had the moderate to severe sensorineural HL. Results: There was not any significant difference between ANL in linear amplification of hearing aid with HFE frequency response and ANL in linear amplification of hearing aid with MFE frequency response. Conclusion: The gain modification of frequency response not only does not affect the patient's performance of speech intelligibility in ANL test. This indicates that we need to note to the cochlear desensitization phenomenon when fitting hearing aid as a compensatory device for an impaired cochlea in a patient. The cochlear desensitization has not been considered properly in hearing aid fitting formula which is needed to be explored more about the bio-mechanisms of impaired cochlea.

Background: The infants with congenital cardiovascular diseases are faced with too much problems in the case of their ongoing life. Mothers' stress investigation would be important because can receive the stress from his parents. The aim of the following study was determined anxiety in mothers of children undergoing cardiac surgery. Materials and Methods: The present study was conducted by an analytical study on 69 infants' mothers who were operated due to their cardiovascular abnormalities in Yazd Afshar Hospital (2012). In this study, some demographic information and influential factors were recorded germane to mothers' stress, including residential location, history of infant hospitalization or congenital disease as well as some questions in the case of stimuli of the hospital environment, family support, economic situation and the mothers' awareness of their stress. Results: There are statistically significant differences between mothers' stress and their age (P = 0.03) and infants' age (P < 0.0001). There are not statically significant differences between mothers' stress score mean and their educational level (P = 0.75), the infants' hospitalization history (P = 0.57), the history of congenital of disease in family (P = 0.24) and the family support in infant care (P = 0.08). Conclusion: Those mothers who asserted the stimuli of the hospital environment, infant and its mother support, economic situation and the mothers' awareness lack of disease and infant status as strong stress-making stimuli enjoy a stress high mean.

Background: The medial prefrontal cortex (mPFC) is a part of brain reward system involved in cognitive functions such as learning and memory. The mPFC receives strong dopaminergic innervations from ventral tegmental area (VTA) that comprises a portion of the mesolimbic dopaminergic system (MLDS), and sends glutamatergic projections to both the VTA and nucleus accumbens (NAc). Materials and Methods: In this study, male Wister rats weighing 250-350 g were used. The effect of medial prefrontal cortex (mPFC) electrical stimulation with different current intensities (25, 50,100, and 150 µA) in healthy and addicted rats on passive avoidance memory was studied here. Results: This study showed that 25 and 150 µA had no effect on improving avoidance memory in rats. Current intensities of 50 and 100 µA differ significantly with 25 and 150 µA. The PL of mPFC contributes to memory processing. Conclusions: The electrical stimulations of prelimbic with 50 and 100 µA current intensities were improved avoidance memory in addicted rats while learning impairment is caused in healthy rats while the electrical stimulation with these used current intensities.

Background: It is suggested that bromocriptine could be effective in treatment of prediabetic patients and, consequently, in preventing type 2 diabetes (T2DM). In this study, we investigated the effectiveness of bromocriptine on glycemic and metabolic control of prediabetic patients. Materials and Methods: In this double-blind, placebo controlled trial study, prediabetic patients diagnosed during Isfahan Diabetes Prevention Project (IDPP) were enrolled. They randomized in two bromocriptine (2.5 mg) and placebo-treated groups, for 12 weeks. After physical examination, fasting plasma glucose (FPG), HbA1c, Insulin, cholesterol, HDL-c, and triglyceride were measured and glucose tolerance test (OGTT) was performed. HOMA-IR and LDL-c were calculated. The mean of the data were compared in the bromocriptine and placebo treated groups, before and after intervention by intention to treat analysis using mixed effect model. P values < 0.05 were considered, statistically, significant. Results: In this study, 53 prediabetic patients (27 in the bromocriptine group and 26 in the placebo group) were treated. There were no differences between data of two groups at baseline (P > 0.05). The mean body mass index, systolic blood pressure, fasting plasma glucose and glucose of 30 min, 60 min, 120 min of post OGTT, HbA1c, insulin, HOMA-IR, lipid profile did not change, significantly, in both bromocriptine and placebo-treated groups after 12 weeks (P > 0.05). However, diastolic blood pressure (P = 0.02) and the area under the curve of glucose (P = 0.045) were decreased in the bromocriptine-treated group. Conclusion: Bromocriptine did not have significant effect on glycemic control of prediabetic patients. Further studies, with bigger sample size are recommended.

Background: To develop a non-invasive screening method for colorectal cancer, we evaluated the methylation of ALX4 gene promoter in serum samples from patients with colorectal cancer (CRC) and equal number of healthy individuals. Materials and Methods: In serum samples from 25 patients with colorectal cancer and 25 healthy control subjects, isolated serum free-floating DNA was treated with sodium bisulfite and analyzed by methylation-specific polymerase chain reaction (MSP) with primers specific for methylated or unmethylated promoter CpG island sequences of the ALX4 gene. Results: Methylation of the ALX4 gene promoter was present in the serum DNA of patients with adenoma and colorectal cancer. A sensitivity of 68% and specificity of 88% were achieved in the detection of promoter methylation in colorectal neoplasia samples. The difference in methylation status of the ALX4 promoter between the patients with colorectal neoplasia and the control group was statistically highly significant (P < 0.001). Conclusions: The results indicate that this serum free DNA test of methylation of the ALX4 gene promoter is a sensitive and specific method. Therefore in combination with other useful markers it seems ALX4 has the potential of a clinically useful test for the early detection of colorectal cancer.

Background: Low back pain is one of the most significant musculoskeletal diseases of our time. Intervertebral disk herniation and central degeneration of the disk are two major reasons for low back pain, which occur because of structural impairment of the disk. The reduction of cell count and extracellular matrix, especially in the nucleus pulposus, causes disk degeneration. Different scaffolds have been used for tissue repairing and regeneration of the intervertebral disk in tissue engineering. Various methods are used for fabrication of the porosity scaffolds in tissue engineering. The freeze drying method has disadvantages such as: It is time consuming, needs high energy, and so on. The freeze-gelation method can save a great deal of time and energy, and large-sized porous scaffolds can be fabricated by this method. In this study, proliferation of the nucleus pulposus (NP) cells of the human intervertebral disk are compromised in the fabricated Chitosan-gelatin scaffolds by freeze drying and freeze gelation methods. Materials and Methods: The cells were obtained from the nucleus pulposus by collagenase enzymatic hydrolysis. They were obtained from patients who were undergoing open surgery for discectomy in the Isfahan Alzahra Hospital. Chitosan was blended with gelatin. Chitosan polymer, solution after freezing at -80°C, was immersed in sodium hydroxide (NaOH) solution. The cellular suspension was transferred to each scaffold and cultured in plate for 14 days. Cell viability and proliferation were investigated by Trypan blue and MTT assays. Results: The MTT and Trypan blue assays demonstrated that cell viability and the mean of the cell number showed a significant difference between three and fourteen days, in both scaffolds. Accordingly, there was a significantly decrease in the fabricated chitosan-gelatin scaffold by the freeze-drying method. Conclusion: The fabricated chitosan-gelatin scaffold by the freeze-gelation method prepared a better condition for proliferation of NP cells when compared with the fabricated chitosan–gelatin scaffold by the freeze drying method.

Background: Recently, a lot of research has been conducted to investigate the molecular mechanisms of the low quality of oocytes with granulosa cells (GCs). GCs are one of the major cell types found in follicular fluid and purification of these cells from the follicular fluid is very important for further studies. Although, there are different techniques of purification, a method for separation of highly-pure and minimally-damaged cells is necessary. In this paper, we presented a novel method for high purification of GCs with a large quantity and high purity. Materials and Methods: Follicular fluid was collected from patients who referred for in vitro fertilization and GCs in follicular fluid were extracted by Ficoll, Percoll and Red blood cell lysing buffer (RLB) methods. Then purity of extracted GCs was assessed by flow cytometry and morphological properties of GCs were observed by differential interference contrast microscopy. The purity of deoxyribonucleic acid and ribonucleic acid extracts was examined by NanoDrop 1000, pre-restriction fragment length polymorphism and electrophoresis techniques. Quality and quantity of extracting GCs were affected during the cell separation procedures. Results: Our results showed that each of purification method can affect quality and quantity of extracted cells. Conclusion: RLB method for extraction of GCs was shown to be a convenient procedure in comparison with Ficoll and Percoll methods.

Background: Neurologic and Adaptive Capacity Scoring (NACS) has been introduced as a screening test for diagnosis of central nervous system depression due to intrapartum drugs on the neonate. This test can show neurological and behavioral changes even in the presence of a normal Apgar score. NACS has 20 indicators, each indicator allocating to itself the score zero, one or two. The aim of this study was to compare the effects of different anesthetic techniques on the NACS values. Materials and Methods: This study was performed as a randomized, single-blind clinical trial on 75 infants born with elective cesarean in Shahid Beheshti Hospital, Isfahan. Simple Sampling method was carried out and the information was gathered by questionnaires. Anesthetic techniques included general, spinal or epidural anesthesia. NACS score was assessed at 15^th min, 2 and 24 h after birth and then the anesthesia technique was recorded in the questionnaire. NACS score 35 or above was considered normal and 34 or less was abnormal. Results: In the present study, no significant correlation was found between the anesthesia techniques and NACS score. The mean NACS at 15 min after birthin the general, spinal and epidural groups were 33.5 ± 2.2, 33.0 ± 4.4 and 33.7 ± 1.6 respectively (P = 0.703). Conclusion: All three anesthetic techniques have identical effects on neurological and compatibility capacity of neonates born with elective cesarean; so, this could necessarily be a base to recommend the three methods equally.

Background: Poisoning is one of the most common medical presentations in a hospital. Hypoglycemic patients are at increased risk of toxicity. The purpose of this study was to compare capillary blood glucose and venous blood glucose measurements using glucometer against laboratory blood glucose in case of poisoned patients being in coma. Materials and Methods: During the 6-month study period, a random sample of 98 patients was admitted in the Department of Poisoning Emergency and Clinical Toxicology of Noor Hospital, Isfahan University of Medical Sciences, Iran from May 2010. Data collected included age, gender, poisoning reason, vital signs, and Glasgow Coma Scale. Capillary blood samples were obtained from the fourth fingertip of the non-dominant hand. t-Test, paired t-test, Pearson's correlation analysis, and one-way analysis of variance (ANOVA) were used for analysis. Results: The mean of capillary blood glucose was 115.7 ± 50.2, of venous blood glucose measured by glucose meter was 117.8 ± 47.3, and of glucose measured in vitro was 115.8 ± 55.1. Mean of blood glucose showed no significant difference with the three mentioned methods. The correlation between capillary and intravenous blood glucose samples measured by glucometer was 0.93, between capillary blood glucose and in vitro measured venous blood glucose was 0.78, and between venous blood glucose measured by glucose meter and in vitro measured sample was 0.81. The mean of capillary and venous blood glucose levels measured by glucose meter, capillary and venous blood glucose levels measured in vitro, and venous blood glucose levels measured by glucose meter had no significant differences. Conclusion: Using venous blood sample and measuring the glucose level in it by glucometer is an acceptable and advisable method, and capillary blood glucose measurement by using glucometer is not recommended for patients in coma.

Background: Although it is accepted that inducing cardioplegia is the gold standard in myocardial protection, there is still no consensus on the exact type of the cardioplegia. There are fewer studies on the type of the cardioplegia in hearts of the children than adults and they are contradictory. The effects of esmolol have been reviewed (a type of ultrashort-acting beta-adrenergic antagonist, i.e., ß-blockers) in conjunction with the cardioplegia due to the effect of the β-blockers in reducing the myocardial ischemia and reperfusion. Materials and Methods: The left ventricle ejection fraction (LVEF), systolic blood pressure, central venous pressure (CVP), heart rate, etc., were recorded separately in patients who received the cardioplegia without esmolol (n = 35) and with esmolol (n = 30) and matched for the age and sex. Results: The amount of inotrope used in the group without esmolol (100%) was considerably higher than in the group with esmolol (86.7%). Postoperative arrhythmias did not differ significantly between the two groups. There was no significant difference in the duration of cardiopulmonary bypass (CPB), time of the extubation, length of the ICU stay, the first day EF after surgery, and the first week EF after surgery as well. Creatinine kinase-MB (CKMB) was significantly higher in the group without esmolol during operation than in the group with esmolol. Conclusions: The patients who received cardioplegia along with esmolol had less inotropic requirement after operation, and increase in EF and cardiac output (CO) 1 week after surgery. In addition, it reduced damage to the heart during surgery, and patients may have greater stability in the cardiac conduction system.

Background: Keratoconus is a bilateral non-inflammatory corneal disease. Collagen cross-linking (CXL) is a new treatment option for the disease that uses ultraviolet A light irradiation and riboflavin administration. The aim of this study is to evaluate the effect of CXL on corneal topographic and refractive values in patients with keratoconus younger than 18 years of age. Materials and Methods: For the clinical trial study, 37 patients (64 eyes) younger than 18 years of age with progressive keratoconus were included. Age, sex, family history of keratoconus, and history of allergic disorders and eye rubbing were recorded. Refractive, topographic, and topometric indices were evaluated before and 12 months after the CXL with 3mW for 30 minutes. Results: Mean age (±SD) of the patients was 15.83 ± 1.53 years; 26 (70.3%) of the 37 patients were male. Fourteen (37.8%) had positive family history of keratoconus, 11 (29.7%) had history of allergic disorders, and 15 (40.5%) had positive history of eye rubbing. Of the refractive values, cylinder value decreased significantly from −4.50 ± 0.29 to −4.11 ± 0.28 (P = 0.001). Also, the logarithm of minimal angle of resolution (logMAR) uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) improved significantly 12 months after CXL (P = 0.012 and 0.001, respectively). Maximum keratometry before and after the operation was 53.82 ± 0.72 and 53.33 ± 0.72, respectively (P = 0.018). Differences for simulated K values, the thinnest cornea pachymetry, keratoconus index (KI), index of highest asymmetry (IHA), and index of highest decentration (IHD) before and 12 months after the CXL were statistically significant (P = 0.015, 0.034, <0.001, 0.017, 0.019, and 0.004, respectively). Conclusion: CXL improves the refractory, topographic, and topometric indices in patients with keratoconus younger than 18 years of age.

Backgrounds: In Persian traditional medicine, palm date spathe (PDS) is introduced as an analgesic. Therefore, this study was designed to investigate the analgesic effect of hydroalcoholic extract of PDS on acute and chronic pain in mice in comparison with diclofenac and morphine. Materials and Methods: In this study, which was conducted in summer 2014, 220 male mice (20–30 g) were randomly divided into two categories, each consists of 11 groups as follows: A normal control group, a solvent (Tween 80) control group, 3 morphine positive control groups (2, 4 and 8 mg/kg), 3 diclofenac positive control groups (10, 20 and 30 mg/kg), and 3 main experimental PDS groups (2, 20, and 200 mg/kg). Hot plate was applied on animals in one category and writing test on the other category to assess acute and chronic pain, respectively. Results: In the writing test, the average writing time and number of animals receiving a maximum dosage of morphine, diclofenac, and PDS were significantly less than the control group. In the hot plate test, only groups receiving different doses of morphine at different time points and those received 30 mg/kg diclofenac at 15 min after the intervention showed significant difference with the control group. Conclusion: 200 mg/kg extract of PDS, revealed a significant analgesic effect on chronic pain, but it did not show any analgesic effect on acute pain.

Background: Hepatitis C virus (HCV) infection is a serious public health threat worldwide. Cellular immune responses, especially cytotoxic T-lymphocytes (CTLs), play a critical role in immune response toward the HCV clearance. Since polytope vaccines have the ability to stimulate the cellular immunity, a recombinant fusion protein was developed in this study. Materials and Methods: The designed fusion protein is composed of hepatitis B surface antigen (HBsAg), as an immunocarrier, fused to an HCV polytope sequence. The polytope containing five immunogenic epitopes of HCV was designed to induce specific CTL responses. The construct was cloned into the pET-28a, and its expression was investigated in BL21 (DE3), BL21 pLysS, BL21 pLysE, and BL21 AI Escherichia coli strains using 12% gel sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Finally, the identity of expressed fusion protein was confirmed by Western blotting using anti-His monoclonal antibody and affinity chromatography was applied to purify the expressed protein. Results: The accuracy of the construct was confirmed by restriction map analysis and sequencing. The transformation of the construct into the BL21 (DE3), pLysS, and pLysE E. coli strains did not lead to any expression. The fusion protein was found to be toxic for E. coli DE3. By applying two steps inhibition, the fusion protein was successfully expressed in BL21 (AI) E. coli strain. Conclusion: The HBsAg-polytope fusion protein expressed in this study can be further evaluated for its immunogenicity in animal models.

Background: The mellitus exact role of 17-alpha hydroxyprogesterone caproate in increasing the rate of gestational diabetes mellitus (GDM) is still unclear. This study was aimed to investigate the association of treatment with 17-alpha hydroxyprogesterone caproate with GDM in pregnant women who are at risk for preterm birth (PTB). Materials and Methods: In this clinical trial, 200 singleton pregnant women included 100 pregnant women at risk for PTB or with history of PTB as case group (received weekly injections of 17-alpha hydroxyprogesterone caproate) and 100 healthy pregnant women without history of PTB as control group (did not receive any drug) were evaluated. All women followed until detect or reject of GDM, and abnormal glucose challenge test (GCT) and GDM were calculated in all of them. Results: During study follow-up, 36 women in both groups were excluded and 81 cases 83 controls completed the study and analyzed. Mean of GCT in all studied pregnant women was 128.2 ± 18.1, whereas, in cases was higher than controls but no significant difference was noted between groups (P = 0.56). Abnormality in GCT was observed in 32 (19.5%) of 164 studied women, (18 of cases and 14 of controls), which was not statistically significant (P = 0.34). The frequency of GDM among all studied women was 7.9% (13 of 164), 7 of cases and 6 of controls, which was not significant (P = 0.74). Conclusion: In summary, results demonstrated that weekly administration of 17-alpha hydroxyprogesterone caproate is not associated with higher rates of GDM in pregnant women at risk for PTB.

Background: Oxygen free radicals have become attractive candidates to explain injuries in ischemic heart. An association between raised serum uric acid concentration and increased cardiovascular risk has been recognized, however its role in acute myocardial infarction (AMI) is still unclear. Recently, zinc is also trying to establish its role in tissue injury and oxidative stress. Materials and Methods: This cross-sectional study was carried on 75 AMI patients. 5 ml of blood was drawn from each patient within 6 h of AMI, to estimate plasma malondialdehyde (MDA), serum zinc, whole blood superoxide desmutase, serum uric acid, and whole blood glutathione peroxidase (GPx). The same biochemicals were also determined in 50 age and gender matched controls for comparison. Results: We found significantly increased level of plasma MDA (5.649 ± 0.1780 vs. 2.757 ± 0.1623), serum uric acid (4.533 ± 0.1526 vs. 3.200 ± 0.1616) and significantly decreased levels of serum zinc (104.5 ± 1.874 vs. 115.3 ± 3.077), whole blood GPx (4599 ± 101.1 vs. 5519 ± 81.63) and superoxide desmutase (166.8 ± 1.896 vs. 188.3 ± 4.120). All the parameters studied also showed similar significant changes in male and female cases separately. Conclusion: Raised MDA and decreased zinc, glutathione peroxidase, and superoxide desmutase levels denote the increased oxidative stress. Even being a defense, uric acid is raised as it is abundantly present in our body. Thus, AMI exhibits oxidative stress dependent changes irrespective of gender.

Background: Pneumonia due to ventilator is a prevalent nosocomial infection associated with high morbidity and mortality. This study aimed to determine the change in serum levels of precalcitonin (PCT) and C-reactive protein (CRP) in response to antibiotic treatment in patients hospitalized in intense care unit (ICU) suffering from ventilator-associated pneumonia (VAP). Materials and Methods: This is an analytical and descriptive study performed in 2013 in Ayatollah Kashani Medical Training Center, Isfahan, Iran. The statistical sample includes patients hospitalized in ICU in 2013 suffering from VAP. In this study, 50 patients suffering from VAP were selected, and PCT and CRP levels were measured in them before antibiotic therapy and every 48 h until the end of therapy. The collected data were analyzed by SPSS software. Results: CRP and PCT levels were high before the beginning of antibiotic therapy in all patients suffering from VAP and their CRP level had an increasing trend until 4 days after the beginning of therapy; however, from the 4^th day, it turned into decreasing trend. PCT serum level was higher than normal before the treatment and until 48 h after the therapy, and then it was found to have a decreasing trend. According to variance analysis test with repetition of observations, the mean level of mentioned markers had a meaningful difference before the beginning of antibiotic therapy until the end of antibiotic therapy (P < 0.001). Conclusion: CRP and PCT serum levels can be used as an instrument for determining the effect of antibiotic therapy in patients with VAP.

Background: This study was undertaken with an aim to systematically design a model of factors that would yield an optimized sustained release dosage form of an anti-hypertensive agent, losartan potassium, using response surface methodology (RSM) by employing 3² full factorial design. Materials and Methods: Mucoadhesive buccal patches were prepared using different grades of hydroxypropyl methylcellulose (HPMC) (K4M and K100M) and polyvinylpyrrolidone-K30 by solvent casting method. The amount of the release retardant polymers – HPMC K4M (X₁) and HPMC K100M (X₂) was taken as an independent variable. The dependent variables were the burst release in 30 min (Y₁), cumulative percentage release of drug after 8 h (Y₂) and swelling index (Y₃) of the patches. In vitro release and swelling studies were carried out and the data were fitted to kinetic equations. Results: The physicochemical, bioadhesive, and swelling properties of patches were found to vary significantly depending on the viscosity of the polymers and their combination. Patches showed an initial burst release preceding a more gradual sustained release phase following a nonfickian diffusion process. Discussion: The results indicate that suitable bioadhesive buccal patches with desired permeability could be prepared, facilitated with the RSM.

Background: Aprepitant is one of the effective antiemetic drugs that usually used for a period of 3 days for prevention of anthracycline/cyclophosphamide (AC) induced nausea and vomiting. However, many patients still experience nausea and vomiting on days 3–5. The aim of this study was to evaluate the effect of an increase in duration of aprepitant consumption from 3 to 6 days on the prevention of nausea and vomiting in women receiving AC chemotherapy. Materials and Methods: It was a randomized, crossover, controlled clinical trial. Women with breast cancer and scheduled to receive AC regimens were enrolled in this study. Enrolled patients were randomized into two groups. Group I received 3 days regimen of aprepitant in the first course of AC regimen chemotherapy and 6 days regimen of aprepitant in the second course; Group II received 6 days regimen followed by 3 days regimen. For nausea and vomiting assessment, we used Eastern Cooperative Oncology Group questionnaire. Results: Forty-nine patients were enrolled in this study. Sixty-three percent achieved a complete response with 6 days aprepitant regimen compared with 39% with 3 days regimen (P < 0.001). Ten percent had at least one vomiting episode during the 6 days regimen versus 15% with 3 days regimen (P = 0.034). Nausea was significantly more severe in 3 days regimen of aprepitant than in 6 days regimen. Conclusion: Increase in the duration of aprepitant consumption through 6 days resulted in significantly better prevention of nausea and vomiting than 3 days consumption for women receiving AC chemotherapy.

Background: An adverse transfusion reaction (ATR) is an unfavorable reaction to the transfused unit, the severity of which may be different among individuals depending upon the type of reaction and the patient's susceptibility. Transfusion reactions may be immediate or delayed type depending on the onset and immune or nonimmune type depending on the pathogenesis. A study was conducted to study the frequency of various transfusion reactions and the associated morbidity. Materials and Methods: All ATRs occurring over a period of 3 years at a tertiary care health center were studied in detail according to the institute's protocol. Results: Of 38,013 units of blood and components that had been issued, 101 (0.2%) cases had an ATR. The most common reaction was allergic - 34/101 (33.6%) followed by febrile - 26/101 (25.7%). Other reactions included transfusion-related acute lung injury in 6/101 (5.9%) cases, and immune reactions were seen in 19/101 (18.8%) cases. Conclusion: Allergic and febrile reactions are most common and least harmful, but fatal reactions can also occur, and preventive measures must be taken to avoid such reactions.

Background: Post cardiac surgery routine chest radiographs (CXRs), ordered without any clinical and laboratory indications, is a standard obligatory practice in many cardiothoracic centers. Routine CXRs incur cost, manpower, and radiation. The objective of this study is to assess early outcome in off-pump coronary artery bypass (OPCAB) patients with postoperative routine versus clinically indicated CXR protocols. Materials and Methods: This study is a randomized clinical trial conducted on 231 OPCAB candidates in Afshar Cardiac Center, Yazd, Iran. Patients were categorized into two groups. All 118 patients in group A had routine postoperative CXRs. The 113 patients in group B were selectively exposed to CXR only on clinical indications. All patients were postoperatively followed up for 30 days. Data gathered from both groups were statistically analyzed. Results: Routine postoperative CXRs obtained in 118 OPCAB group A candidates showed abnormal findings in 20 patients that did not require new intervention. One month follow-up of these patients showed no complications. In 113 OPCAB candidates of group B, 7 on-demand CXRs were obtained on clinical evaluation that required added intervention. In a 1-month follow-up of this group, five patients presented with symptomatic complaints. On re-examination, none needed readmission, intervention, or paraclinical evaluation. No complications were observed due to CXR elimination. Conclusion: The study suggests that postoperative CXR selected on clinical grounds in place of routine CXR does not change early postoperative outcome of OPCAB procedure.

Background: Studies show inconsistent effects of forced exercise on cognitive processes. These differences are probably due to the stress of coercion in forced exercise. Because fluoxetine is used to treat complications caused by stress, this study aimed to evaluate the effects of fluoxetine on memory in rats under forced treadmill exercise. Materials and Methods: Experimental groups were the control, the control exercise, the fluoxetine, and the fluoxetine exercise. The exercise program was treadmill running at 22 m/min, 0° inclination for 50 min/day, 6 days/week, for 4 weeks. Fluoxetine (5 mg/kg) was injected 30 min before treadmill. Morris water maze and passive avoidance learning tests were used for evaluation of memory. Acquisition phase of both tests were performed before interventions and memory was evaluated 1-day and 1-week after the last session of exercise and treatments. Results: Our data showed that forced exercise impaired performance in passive avoidance learning test (P < 0.05 and P < 0.01, 1-day and 1-week after the last session of exercise and treatments, respectively). Spatial memory was only impaired after 1-week in the exercise group. Fluoxetine improved spatial memory after 1-day in the control group. However, it had no significant effects on memory in the exercise group. Conclusion: The data correspond to the possibility that forced treadmill exercise can cause stress, and thereby cause damage to memory. The present results suggest that although fluoxetine may improve memory in intact rats but it cannot prevent damages that are caused by forced exercise.

Background: Cancer stem cells have been isolated and characterized in all common cancers. SOX2 and OCT4 are important genes to enhance the self-renewal ability as activate stem cells and inhibit the genes that start differentiation and thus maintain the self-renewal ability of stem cells. Also, the aim of this study is "Comparison of gene expression of SOX2 and OCT4 in normal tissue, polyps, and colon adenocarcinoma using immunohistochemical staining." Materials and Methods: This cross-sectional study conducted on 20 patients so that for each patient, a sample of healthy tissue, dysplastic polyp tissue, and colon adenocarcinoma were provided as microscopic sections and staining on each tissue was performed through immunohistochemistry method by markers OCT4 and SOX2. The collected data were interred into SPSS version 18.0, (SPSS Inc., Chicago, IL, USA) software and the level of significance were considered as <0.05. Results: The study sample consisted of 20 patients including 11 men (55%) and 9 women (45%) with a mean age of 55.6 ± 9.88 years. There was no association between Oct4 and colorectal cancer (CRC) patients (P > 0.05), but there was a significant correlation between Sox2 expression and CRC (P < 0.05). Patients in many aspects such as race, type of polyp, presence of lymph node, grade and intensity of Sox2 in different types of patients' tissues (P < 0.05). Conclusion: Regarding our findings, the expression of Sox2 would be a liable marker for evaluating of cancer progression and could be a treatment target of CRC cells.

Background: Renal ischemia-reperfusion (RIR) is a major cause of renal dysfunction that acts through different mechanisms. We investigated the role of L-Arginine as an endogenous nitric oxide (NO) precursor and NG-nitro-L-Arginine methyl ester (L-NAME) as an NO inhibitor on kidney and liver function in RIR model. Materials and Methods: Fifty-eight Wistar rats were randomly assigned to four groups. Groups 1 (sham-operated, n = 13) received a single dose of saline (4 ml/kg, i.p.) and 2 (Ischemia [Isch], n = 14) received a single dose of saline (4 ml/kg, i.p.). Groups 3 (Isch + L-NAME, n = 15) received a single dose of L-NAME (20 mg/kg, i.p.) and 4 (Isch + L-Arginine n = 16) received a single dose of L-Arginine (300 mg/kg, i.p.), After 2 h, renal failure was induced by clamping both renal pedicles for 45 min, followed by 24-h reperfusion in Groups 2-4. Finally, blood samples were obtained, and kidney tissue samples were subjected for pathology investigations. Results: The body weight decreased, and the serum levels of blood urea nitrogen (BUN) and creatinine (Cr), and kidney tissue damage score (KTDS) increased significantly in the Isch and Isch + L-NAME groups compared with the sham group while L-Arginine improved weight reduction (P < 0.05), and it reduced the serum levels of BUN and Cr, and KTDS when compared with the Isch and Isch + L-NAME groups. Kidney weight increased significantly in all groups compared with the sham group. L-Arginine reduced the liver tissue level of malondialdehyde and increased alkaline phosphatase. Conclusion: L-Arginine as an NO precursor can improve kidney function against RIR. It also improves oxidative stress in liver tissue.

Background: There is no agreement about the effect of adding opioids to local anesthetics in peripheral nerve blocks. The aim of this study was to investigate the effect of adding different opioids with equipotent doses of lidocaine in axillary brachial plexus block using ultrasonography and nerve locator guidance. Materials and Methods: In a prospective, randomized, double-blind clinical trial study, 72 adult patients aged 18-65 years old scheduled for orthopedic surgery of the forearm and hand with axillary brachial plexus block were selected and randomly allocated to four groups. Meperidine (pethidine), buprenorphine, morphine, and fentanyl with equipotent doses were added in 40cc of 1% lidocaine in P, B, M, and F groups, respectively. The onset and duration of sensory and motor blocks, severity of patients' pain, duration of analgesia, hemodynamic and respiratory parameters, and adverse events (such as nausea and pruritus) during perioperative period were recorded. Results: The onset time for the sensory block was similar in the four groups. The onset time for the motor block was significantly faster in morphine and pethidine groups (P = 0.006). The duration of sensory and motor blocks was not statistically different among the four groups. The quality of motor blockade was complete in 100% of patients receiving pethidine or morphine and 77.8% of patients receiving buprenorphine or fentanyl (P = 0.021). Conclusion: In the upper extremity surgeries performed under axillary brachial plexus block addition of morphine or pethidine to lidocaine may be superior to other opioids (i.e. fentanyl and buprenorphine) due to better quality and quantity of motor blockade and faster onset of the block.

Background: Increases in intracranial pressure (ICP) require a rapid recognition to allow for adequate treatments. The aim of this study was to determine whether transocular Doppler and optic nerve sheath diameter (ONSD) monitoring could reliably identify increases in ICP. Materials and Methods: This is a cross-sectional case-control study, which was carried out on 2013. Subjects were chosen from patients who admitted to the neurology and neurosurgery departments and the intensive care unit of Alzahra Hospital (Isfahan, Iran). To measure the ICP, the authors used ultrasound to measure the diameter of the optic nerve sheath and transocular Doppler (TOD) to measure blood flew velocity in ophthalmic artery (OA) and ophthalmic vein (OV) in both groups. Results: The mean of ONSD was 4.8 mm (SD 0.77) in patients with raised ICP and 3.2 mm (SD 0.3) in healthy volunteers which was significant (P < 0.001). The mean (SD) of TOD parameters were also significantly more in OA and OV of patients with raised ICP. Conclusion: Ultrasound methods has been proposed as an alternative safe technique for invasive ICP measuring methods.

Background: Nausea and vomiting are frequently seen in patients undergoing cesarean section (CS) under regional anesthesia. We aimed to compare the antiemetic efficacy of ondansetron and dexamethasone combination with that of the use of each agent alone to decrease the incidence of postdelivery intra- and post-operative nausea and vomiting during CS under spinal anesthesia. Materials and Methods: A randomized, prospective, double-blind study was performed on 90 patients undergoing planned CS under spinal anesthesia. The patients received 4 mg ondansetron in Group O, 8 mg dexamethasone in Group D, and 4 mg ondansetron +8 mg dexamethasone in Group OD intravenously within 1-2 min after the umbilical cord was clamped. Frequency of postdelivery intra- and post-operative nausea and vomiting episodes was recorded. Results: A total of 90 eligible patients were included in the study. There were 30 patients in Group O, 30 patients in Group D, and 30 patients in Group OD. Intraoperative nausea in Group D was more than the other two groups. Postoperative nausea in group OD was lesser than the other two groups. Intraoperative vomiting in Group OD was lesser than the other two groups. There was no statistically significant difference among the groups in postoperative vomiting (P > 0.05). Conclusion: Combined use of dexamethasone and ondansetron for the same indication seems to increase the antiemetic efficacy.

Background: Cesarean section is a major operation that can be the predictor of postoperative pain and discomfort and, therefore, providing the effective postoperative analgesia is an important factor to facilitate sooner movement of the patient, better care of infants. The aim of this study was to determine the preventive effect of ilioinguinal nerve block on pain after cesarean section. Materials and Methods: In a randomized clinical trial study, 80 female candidates for cesarean section under general anesthesia were selected and divided into two groups. In the first group, ilioinguinal nerve was blocked and in the control group, ilioinguinal nerve block was not done. Finally, postoperative pain was compared between the two groups. Results: The mean pain intensity at 6 and 24 h after operation had no significant difference between two groups but in the rest of the times, it was different between two groups. Furthermore, in sitting position, except for 6 h, the pain intensity at the rest of the time had a significant difference between two groups. The pain intensity in 12 h after operation had a significant difference while in 24 h after operation; there was no difference between two groups. Doing repeated measures, ANOVA also indicated that the process of changes in the pain intensity in three positions of rest, sitting and walking had no significant difference up to 24 h after operation (P < 0.001). Conclusion: Control of pain after cesarean as one of the most common factors for abdominal surgery will lead to decrease the staying of the patient in hospital, reduce morbidity and lower use of narcotics and analgesics after surgery.

Background: Atopic dermatitis is a chronic skin disease with increasing prevalence worldwide and a considerable burden especially among children. To circumvent the problems related to oral azathioprine (AZT) we aimed to evaluate its topical variant and assess its efficacy in patients aged 2-18. Materials and Methods: In a single-blind trial, we randomized the patients into two groups, one treated with topical emollient containing AZT and betamethasone (BM), and the other treated solely with topical emollient of BM. The treatments were administered twice a day for 8 weeks in both groups. The efficacy, recurrence, and the presence of side effects were evaluated using SPSS 20. Results: The amount of reduction in severity scoring for atopic dermatitis (SCORAD) score was significantly greater in the group treated with the topical AZT (P = 0.024). Incidentally, there were no difference between two treatments in difference in proportions of recurrence and adverse effects as well as SCORAD reduction in subgroups of sex and age (all P > 0.05). Conclusions: Our results showed the superiority of topical AZT over BM with a low recurrence and adverse effects. No expectation of severe side effects, like those of oral AZT, is the major advantage of topical AZT. The sample size was an issue in uncovering the value of AZT in the subgroups. Conducting prolonged studies of quality-of-life and comparing the topical AZT potency relative to the common alternatives are recommended areas of future work.

Background: Cholecystokinin (CCK) has roles in learning and memory, but the cellular mechanism is poorly understood. This study investigated the effect of CCK on spatial learning and memory, neuronal proliferation and apoptosis in the hippocampus in rats. Materials and Methods: Experimental groups were control and CCK. The rats received CKK octapeptide sulfated (CCK-8S, 1.6 μg/kg, i.p.) for 14 days. Spatial learning and memory were tested by Morris water maze and finally immunohistochemical study was performed; neurogenesis by Ki-67 method and apoptosis by Terminal deoxynucleotidyl transferase mediated dUTP Nick End Labeling (TUNEL) assay in hippocampal dentate gyrus (DG). Results: Cholecystokinin increased Ki-67 positive cells and reduced TUNEL positive cells in the granular layer of hippocampal DG. CCK failed to have a significant effect on spatial learning and memory. Conclusion: Results indicate neuroprotective and proliferative effects of CCK in the hippocampus; however, other factors are probably involved until the newly born neurons achieve necessary integrity for behavioral changes.

Background: Considering maximal aerobic running speed (MAS) as a useful tool to evaluate aerobic capacity and monitor training load in soccer, there is an increasing need to develop indirect assessment methods of MAS, e.g., submaximal tests. The aim of this study was to examine the prediction of MAS from the physical working capacity (PWC) in heart rate (HR) 170 beat/min test (PWC ₁₇₀ ). Materials and Methods: This cross-sectional study was done on adolescent (n = 67) and adult soccer players (n = 82) were examined for anthropometric characteristics, PWC ₁₇₀ and performed Conconi test to assess MAS. Results: Midfielders scored higher than goalkeepers (GKs) and defenders in MAS while GKs scored lower than all the other playing positions. Although this trend was also observed in PWC ₁₇₀ , statistical difference was only observed between midfielders and GKs. Players with higher MAS had also higher PWC ₁₇₀ in both age groups (P < 0.05). The odds ratio of a player of the best PWC ₁₇₀ group to belong also to the best MAS group was 3.96 (95% confidence interval 2.00; 7.84). That is players with high-performance in the PWC ₁₇₀ were about 4 times more likely than those with low PWC ₁₇₀ to achieve a high score in MAS. Regression analysis suggested body fat (BF) percentage, PWC ₁₇₀ , maximal HR and age as predictors of MAS (R = 0.61, R² = 0.37 and standard error of estimate [SEE] =1.3 km/h, in total; R = 0.74, R² = 0.55 and SEE = 1.2 km/h, in adolescents; R = 0.55, R² = 0.30 and SEE = 1.3 km/h, in adults). Conclusions: While there was only moderate correlation between MAS and PWC ₁₇₀ , the former can be predicted from the latter when BF, HR _max , and age are considered (large to very large multiple correlation coefficients).

Background: Having pleasurable sexual intercourses plays a major role in marital life satisfaction. Many of the medical and psychiatric disorders may affect the sexual function of the patients. The present study aims to investigate the relative frequency of sexual dysfunctions in the patients hospitalized in psychiatric wards and that of the patients in other specialized wards. Materials and Methods: This study is a descriptive-analytical, cross-sectional one, carried out on 900 patients hospitalized in psychiatric, cardiac, orthopedic, ophthalmology, and dermatology and plastic surgery wards of 5 hospitals in Isfahan. Data collection tools included demographic questionnaire and Arizona Sexual Experiences Scale (ASEX). Results: Sexual dysfunction in the patients hospitalized in psychiatric wards (38%) was significantly higher than in the patients in other wards (27%), (P = 0.00). Among the patients hospitalized in psychiatric wards, those with bipolar disorder (37.3%) had the highest prevalence rate of sexual dysfunction. The patients with schizophrenia, major depression, substance abuse, and anxiety disorders had the following rates respectively. Among the patients in non-psychiatric wards, those in cardiac wards (37.1%) had the highest prevalence rate of sexual dysfunction. There was a significant relationship between the drug uses, mostly psychiatric drugs especially anti-psychotics, and the occurrence of sexual dysfunction. Conclusion: Considering the significant relative frequency of sexual dysfunction in psychiatric patients and undesired effects of simultaneous occurrence of both of these disorders in the patients, more emphasis is recommended to be placed on the prevention and proper treatment of these disorders in the patients.

Background: Multiple Sclerosis (MS) is a neurological disease in which demyelination and axonal loss leads to progressive disability. Cognition impairment is among the most common complication. Studying axonal loss in the retina is a new marker for MS. The main goal of our study is to search for correlations between magnetic resonance imaging (MRI) findings and the retinal nerve fiber layer (RNFL) thickness at the macula and head of the optic nerve and Wechsler Adult Intelligence Scale-Revised (WAIS-R) Scores that assess multiple domains of intelligence, and to explore the relationship between changes in the RNFL thickness with intellectual and cognitive dysfunction. Materials and Methods: A prospective cross-sectional study was conducted at the University Hospital of Kashani, Isfahan, Iran, from September to December 2013. All patients were assessed with a full-scale intelligence quotient (IQ) on the WAIS-R. An optical coherence tomography study and brain MRI were performed in the same week for all the patients. Statistical analysis was conducted by using a bivariate correlation, by utilizing SPSS 20.0. A P value ≤ 0.05 was the threshold of statistical significance. Results: Examination of a 100 patients showed a significant correlation between the average RNFL thickness of the macula and the verbal IQ (P value = 0.01) and full IQ (P value = 0.01). There was a significant correlation between brain atrophy and verbal IQ. Conclusion: The RNFL loss was correlated with verbal IQ and full IQ.

Background: Surgeries may trigger the stress response which leads to changes in blood glucose level, and studies suggest that different sedation and anesthesia methods have different effects on blood glucose level. The aim of this study was to investigate changes of blood glucose levels in diabetic patients and compare them in two sedation methods of propofol + fentanyl and midazolam + fentanyl. Materials and Methods: Totally, 80 diabetic candidates for cataract surgery who had all the inclusion criteria, underwent cataract surgery using two methods of propofol (1 mg/kg/h) + fentanyl (2 μg/kg) (Group P) and midazolam (0.03 mg/kg) + fentanyl (2 μg/kg) (Group M) for light sedation. In the end, 70 patients (Group P n = 35 and Group M n = 35) remained in the study. Patients' blood glucose levels, vital signs, and hemodynamic data were assessed 30 min prior to the surgery, each 15 min during surgery and at the end of surgery. Results: Hemodynamic parameters did not have a statistically significant difference between the two groups mean blood glucose level in Group M was 149.15 mg/dl and in Group P was 149.2 mg/dl, and based on repeated measures analysis of variance test, significant differences were not observed between the two groups (P = 0.99). T-test showed no significant differences in the blood glucose level at any time of the study between the two groups. Conclusions: Light sedation methods of propofol + fentanyl and midazolam + fentanyl did not have any differences in alteration of blood glucose level.

Background: Cardiac multidetector computed tomography (MDCT) has been mainly applied in the diagnosis of valvular heart morphology and function along with the assessment of coronary artery disease. This study aimed to evaluate the diagnostic performance of coronary MDCT angiography for the diagnosis of mitral valve prolapse (MVP), as compared to transthoracic echocardiography (TTE). Materials and Methods: A total of 40 patients who had undergone both TTE and MDCT within a three-month period were included in the study. Two parameters of mitral valve leaflet thickness and leaflet billowing were measured using both techniques. The MDCT results were compared with those of TTE, which was the reference standard. Results: Implementing the Receiver Operating Characteristic (ROC) test on the data for MDCT-measured leaflet billowing received from MDCT angiography suggests that the area under the ROC curve is 96% for a declared variable, which is absolutely significant (P < 0.001), and MDCT-measured leaflet billowing is an appropriate index for the diagnosis of mitral valve prolapse. On the basis of the achieved cut-off point from the ROC analysis (which equals 2.5 mm leaftlet billowing) the MDCT-measured leaflet billowing takes a sensitivity and specificity of 68.4 and 95.2%. The false positive and false negative results are 4.8 and 31.6%. The positive and negative predictive values (PPV and NPV) of the revealed test indicate 92.9 and 76.9%, respectively. Finally, the consistency of the MDCT measured leaflet billowing for diagnosing the mitral valve prolapse is 82.5%. Based on the mentioned test, the consistency of the MDCT-measured leaflet thickness test is 47.5%. Conclusion: Along with the assessment of coronary arteries, the presence or absence of MVP can be reliably evaluated by MDCT angiography.

Background: Extended-spectrum β-lactamases (ESBLs) and AmpC enzymes have been observed in virtually all species of the family Enterobacteriaceae. The β-lactamase producing bacteria cause many serious infections, including urinary tract infections. These enzymes are predominantly plasmid mediated. There are no recommended guidelines for detection of this resistance mechanism and there is a need to address this issue as much as the detection of ESBLs. This study was undertaken to characterize ESBL and AmpC producers among Escherichia coli by polymerase chain reaction (PCR), which were initially screened by phenotypic method. Materials and Methods: A total of 90 isolates of E. coli were recovered from the urinary tract during a 7-month period, and were screened for ESBLs and AmpC production by disk diffusion test using cefoxitin (30 μg) disks and confirmed by combined disk diffusion test using phenyl boronic acid. The presence of genes encoding CIT, FOX, and TEM was detected by PCR. Results: On disk diffusion test, 59 of 90 isolates were resistant to third generation of cephalosporins; of these 37 (62.7%) and 3 (5%) were ESBL and AmpC producers, respectively. PCR showed that 29 (49.1%) and 3 (5%) were positive for blaT_EM and bla_CMY-2 , respectively. Conclusion: ESBL- and AmpC-producing E. coli isolates cause significant resistance to cephalosporin. There is a need for a correct and reliable phenotypic test to identify AmpC β-lactamases and to discriminate between AmpC and ESBL producers. This work showed that boronic acid can differentiate ESBL enzymes from AmpC enzymes.

Background: Influenza H1N1 is very important worldwide and point mutations that occur in the virus gene are a threat for the World Health Organization (WHO) and druggists, since they could make this virus resistant to the existing antibiotics. Influenza epidemics cause severe respiratory illness in 30 to 50 million people and kill 250,000 to 500,000 people worldwide every year. Nowadays, drug design is not done through trial and error because of its cost and waste of time; therefore bioinformatics studies is essential for designing drugs. Materials and Methods: This paper, infolds a study on binding site of Neuraminidase (NA) enzyme, (that is very important in drug design) in 310K temperature and different dielectrics, for the best drug design. Information of NA enzyme was extracted from Protein Data Bank (PDB) and National Center for Biotechnology Information (NCBI) websites. The new sequences of N1 were downloaded from the NCBI influenza virus sequence database. Drug binding sites were assimilated and homologized modeling using Argus lab 4.0, HyperChem 6.0 and Chem. D3 softwares. Their stability was assessed in different dielectrics and temperatures. Result: Measurements of potential energy (Kcal/mol) of binding sites of NA in different dielectrics and 310K temperature revealed that at time step size = 0 pSec drug binding sites have maximum energy level and at time step size = 100 pSec have maximum stability and minimum energy. Conclusions: Drug binding sites are more dependent on dielectric constants rather than on temperature and the optimum dielectric constant is 39/78.

Background: β-thalassemia major is a hereditary disease with inefficient erythropoiesis. Level of inflammatory cytokine is elevated in these patients. In this study, we investigate the effect of aryl hydrocarbon receptor (AhR) ligand, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), on the expression of inflammatory mediators in β-thalassemia major patient's lymphocytes. Materials and Methods: Peripheral blood mononuclear cells of patients and healthy participants was isolated and cultured in favor of lymphocytes increment. Based on the treatment, we divided the cell into four groups. The orders of group's treatments were no treatment, tumor necrosis factor-α (TNF-α) treatment, TNF-α and TCDD treatment, TCDD treatment in Group 1–4, respectively. After cell culture, we extracted the cells RNA and converted them to cDNA. Real-time polymerase chain reaction was performed to assessment relative expression of caspase-1, NLRP3, and AhR. We compared all patient groups with equal healthy (control) groups. Results: Results showed that expression of caspase-1 in patients (Groups 1 and 2) was significantly lower than healthy individuals (P < 0.05). Although, no significant difference was found (Groups 1, 2, and control) in AhR gene expression (P > 0.05). Expression of AhR in other groups of patients (3 and 4) was significantly lower than control groups (P < 0.05). Expression of caspase-1 in Group 4 was significantly larger than the control group (P < 0.001). Conclusions: We show here that chronic inflammation decrease caspase-1 expression and exposure of human lymphocytes to TCDD promote caspase-1 expression. Furthermore, activation of AhR with TCDD decreases AhR expression in lymphocytes of β-thalassemia major disease.

Background: Urinary tract infections (UTIs) caused by uropathogenic Escherichia coli (UPEC) and Proteus mirabilis are the most important pathogens causing UTIs. The FimH from type 1 pili of UPEC and the MrpH from P. mirabilis play critical roles in the UTI process and have presented as ideal vaccine candidates against UTIs. There is no effective vaccine against UTI and the development of an ideal UTI vaccine is required. Materials and Methods: In this study, we planned to design a novel fusion protein of FimH from UPEC and MrpH from P. mirabilis. For this purpose, we modeled fusion protein forms computationally using the Iterative Threading Assembly Refinement (I-TASSER) server and evaluated their interactions with toll-like receptor 4 (TLR4). The best fusion protein was constructed using overlap extension polymerase chain reaction (OE-PCR) and the biological activity of fusion was evaluated by the induction of interleukin-8 (IL-8) in the HT-29 cell line. Results: Our study indicated that based on the Protein Structure Analysis (ProSA)-web and the docking results, MrpH.FimH showed better results than did FimH.MrpH, and it was selected for construction. The results of bioassay on the HT-29 showed that FimH and MrpH.FimH induced significantly higher IL-8 responses than untreated cells or MrpH alone in the cell line tested. Conclusions: In the present study, we designed and constructed the novel fusion protein MrpH.FimH from UPEC and P. mirabilis based on in silico methods. Our bioassay results indicate that the MrpH.FimH fusion protein is active and capable of inducing immune responses.

Background: Activation of aryl hydrocarbon receptor (AhR) leads to diverse outcome in various kinds of cells. AhR activation may induce apoptosis or prevent of apoptosis and cell death. Recent studies suggest that apoptosis effects of AhR can be modulated by inflammatory cytokine like tumor necrosis factor alpha (TNF-α). In this study, we try to investigate the possible interaction of TNF-α with the 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin (TCDD), a ligand of AhR, on peripheral lymphocytes. Materials and Methods: Human peripheral blood mononuclear cells (PBMCs) were isolated from peripheral blood by discontinuous density gradient centrifugation on ficoll. Isolated PBMCs were divided into four groups: Control group, TNF-α administered group, TCDD administered group, co-administered group with TCDD and TNF-α. Cells were maintained for a week in lymphocyte culture condition. Then, TNF-α was added to group 2 and 4. Finally, apoptosis and necrosis were analyzed in all samples using flowcytometry. Result: In group 4, the mean percent of necrosis and apoptosis in TCDD treatment groups was significantly larger than other groups; (P < 0.05). Furthermore, there was no significant difference between the mean percent of cell death in TNF-α administered group and TCDD administered group (P > 0.05). However, the mean percent of cell death in co-administered group with TCDD and TNF-α was significantly lower than other groups; (P < 0.05). Conclusion: TNF-α could significantly inhibit effects of TCDD on lymphocytes apoptosis. Combination effects of TNF-α and TCDD on lymphocyte increase cell survival.

Background: Peripheral nerve injuries have significant effects on patients' life quality. To make patients' therapeutic expectations more realistic, prediction of repair outcome has significant importance. Materials and Methods: Totally, 74 patients with 94 nerve injuries (44 median and 50 ulnar nerves) were evaluated and followed up for 5 years between 2008 and 2013 in two main university hospitals of Isfahan. Patients' age was 6–64 years. 24 nerves were excluded from the study and among the remaining; 53 nerves were repaired primarily and 17 nerves secondarily. 42 nerves were injured at a low-level, 17 nerves at intermediate and 11 at a high one. Medical Research Council Scale used for sensory and motor assessment. S₃₊and S₄scores for sensory recovery and M₄and M₅scores for motor recovery were considered as favorable results. The follow-up time was between 8 and 24 months. Results: There was no significant difference between favorable sensory outcomes of median and ulnar nerves. The difference between favorable motor outcomes of the median nerve was higher than ulnar nerve (P = 0.03, odds ratio = 2.9). More favorable results were seen in high-level injuries repair than low ones (P = 0.035), and also cases followed more than 18 months compared to less than 12 months (P = 0.041), respectively. The favorable outcomes for patients younger than 16 were more than 40 and older, however, their difference was not significant (P = 0.059).The difference between primary and secondary repair favorable outcomes was not significant (P = 0.37). Conclusion: In patients older than 40 or injured at a high-level, there is a high possibility of repetitive operations and reconstructive measures. The necessity for long-term follow-up and careful attentions during a postoperative period should be pointed to all patients.

Background: This study aimed to investigate the potential health concerns of trace elements and mineral content of commonly consumed greenhouse vegetables in Isfahan, Iran. Materials and Methods: Six kinds of greenhouse vegetables namely; Raphanus sativus (Radish), Cucumis sativus (Cucumber), Solanum lycopersicum (Tomato), green Capsicum annuum (Green bell pepper), yellow C. annuum (Yellow bell pepper), and red C. annuum (Red bell pepper) were collected from Isfahan greenhouses, between December 2012 and March 2013. The vegetables were analyzed in order to determine the concentrations of trace elements and trace minerals using instrumental neutron activation analysis (INAA). Results: The results of INAA showed that the concentrations of aluminum, bromine, cobalt, rubidium and strontium of these vegetables were varied from 7.2 to 28.4 mg/kg, 0.6–11.7 mg/kg, 0.1–0.5 mg/kg, 4.2–8.4 mg/kg, and 12.0–141.0 mg/kg, respectively. The trace mineral concentrations of As, Cr, Cs, Sc, Th, and U in all of the samples were less than the defined tolerable upper intake level. Conclusion: The results of this study revealed that considering the measured trace elements and mineral content levels, Isfahan greenhouse vegetables do not impose any serious health harmful effects for individuals in the studied area due to their meal consumptions.

Background: Stroke is the second cause of death among elderly people. Oxidative stress plays an important role in brain damage after stroke. Currently, Vitamin D has been shown as an antioxidant. The aim of this study was to evaluate the status of Vitamin D, antioxidant enzymes, and the relation between them in ischemic stroke patients. Materials and Methods: This case–control study was carried out on 36 patients with ischemic stroke patients and 36 matched subjects as controls. Intake of fruits and vegetables, exposure of sunlight, serum lipid profile, concentrations of serum 25-dihydroxy Vitamin D (25(OH) D), activities of serum superoxide dismutase, and glutathione peroxidase enzymes were determined. Results: Severe Vitamin D deficiency was seen in 30% of the patients versus 11% of the controls (P < 0.05). Consumption of fruits and vegetables was lower in patients than that of controls (P < 0.05). Activities of antioxidant enzymes and intake of fruits were positively correlated in stroke patients (P = 0.02). The most potent predictors of stroke risk were hypertension, high levels of low-density lipoprotein cholesterol (LDL-C) and history of cardiovascular disease (CVD) (odds ratios: 3.33, 3.15, and 3.14, respectively, P < 0.05 for all). There was no association between 25(OH) D levels with activities of serum antioxidant enzymes and lipid profile in the two groups. Conclusion: Ischemic stroke patients have higher prevalence of severe Vitamin D deficiency and lower intakes of fruits and vegetables. Intake of fruits was positive correlated to higher antioxidant enzymes levels. High levels of blood pressure, history of CVD, and high LDL-C levels are the strongest predictors of ischemic stroke.

Background: This study was designed to evaluate the effect of cumin on nonalcoholic steatohepatitis (NASH) in compare to placebo. Materials and Methods: One hundred patients with histopathological diagnosis NASH in two groups of case and control received oral cumin capsule or placebo thrice daily for 6 months. Clinical and laboratory data were body mass index (BMI), serum triglyceride, serum total cholesterol, alanine aminotransferase (ALT), aspartate aminotransferase (AST), high-density lipoprotein (HDL), low-density lipoprotein (LDL), fasting blood sugar (FBS), steatosis grade, and side-effects and were measured at baseline and after treatment period using standard clinical chemistry techniques. The grade of steatosis was assessed by liver sonography in 3 stages (mild, moderate and severe). Results: Of 100 eligible patients during follow-up 10/50 cases and 9/50 controls were excluded. At baseline and after treatment BMI, triglyceride, cholesterol, ALT, AST, HDL, LDL, and FBS were not statistically significant between groups (P ≥ 0.5). BMI, triglyceride, cholesterol, ALT, AST, LDL, and FBS after treatment decreased compare to baseline but were not statistically significant (P ≥ 0.5). The mean of changes in the level of BMI, triglyceride, cholesterol, ALT, LDL and FBS were not statistically significant (P ≥ 0.5). The mean of changes in AST and HDL between groups was significant (P < 0.05). The grade of steatosis before and after treatment between studied groups was not statistically significant (P ≥ 0.5). Side-effects were not statistically significant among the two groups. Conclusion: Findings show that there the effect of cumin in in the treatment of NASH was not significantly different in compare to placebo.

Background: Schizophrenia severely influences function and quality of life. The benefit of newer antipsychotics in improving the quality of life in schizophrenia still remains controversial. The aim of the present study is to evaluate the effect of memantine on global function and quality of life in patients with schizophrenia. Materials and Methods: This was a randomized controlled trial on inpatient cases of schizophrenia in Noor University Hospital, Isfahan, Iran. A number of 64 patients were selected through sequential sampling; patients were randomly allocated in intervention and placebo groups. The intervention group was treated with memantine plus previously administered, stabled-dose, atypical antipsychotic, while the control group received placebo plus previously administered, stabled-dose, atypical antipsychotic. Memantine administration was initiated at 5 mg daily; the dosage was increased at weekly intervals by 5 mg and finally up-titrated to 20 mg daily within 4 weeks. All patients were assessed by means of Global Assessment of Functioning (GAF) and quality of life scale (QLS) initially and every four weeks to the end of the 12^th week. Results: Analysis of baseline GAF and QLS scores showed no significant differences between the two groups (P = 0.081 and P = 0.225, respectively). GAF and QLS scores increased in both groups; but it was higher in the intervention group. The difference between the two groups was statistically significant. (P < 0.001 and P < 0.001, respectively) memantine was well tolerated, with no significant side effects. Conclusion: Add-on memantine was significantly effective in improving the global function of patients as well as their quality of life.

Background: As a common pathophysiological condition worldwide, metabolic syndrome (MetS) is a clustering of multiple risk factors implicating in the development of many chronic disorders. Of note, obesity-induced chronic, low-grade inflammation is a major cause of insulin resistance and MetS. In the present study, we evaluated the association of rs3091244 variant of the C-reactive protein(CRP) gene, a well-recognized systemic inflammatory marker, with MetS in Iranian children and adolescents. Materials and Methods: Genotyping was performed by mismatched polymerase chain reaction-restriction fragment length polymorphism in 100 MetS and 100 normal individuals aged 9–19 years recruited in the central part of Iran in 2011. A t-test or one-way ANOVA with post-hoc multiple comparisons were used to analyze the differences between groups. Statistical significance was defined as P ≤ 0.05. Logistic regression used to evaluate the association between alleles of the CRP rs3091244 and increased MetS risk. Results: There were no differences in the genotype frequencies or allele distribution for −286C>A>T CRP polymorphism between MetS and control groups. Logistic regression showed that only the T allele of the CRP rs3091244 and not any of the genotypes confers a borderline significant (P = 0.059) increased MetS risk compared to A allele with the odds ratio of 1.70 (0.98–2.96). Conclusions: This study suggests that in Iranian children and adolescents, −286C>A>T CRP polymorphism is not associated with the increased risk for MetS.

Background: Different studies have been done to obtain sufficient number of neural cells for treatment of neurodegenerative diseases, spinal cord, and traumatic brain injury because neural stem cells are limited in central nerves system. Recently, several studies have shown that adipose-derived stem cells (ADSCs) are the appropriate source of multipotent stem cells. Furthermore, these cells are found in large quantities. The aim of this study was an assessment of proliferation and potential of neurogenic differentiation of ADSCs with passing time. Materials and Methods: Neurosphere formation was used for neural induction in isolated human ADSCs (hADSCs). The rate of proliferation was determined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and potential of neural differentiation of induced hADSCs was evaluated by immunocytochemical and real-time reverse transcription polymerase chain reaction analysis after 10 and 14 days post-induction. Results: The rate of proliferation of induced hADSCs increased after 14 days while the expression of nestin, glial fibrillary acidic protein, and microtubule-associated protein 2 was decreased with passing time during neurogenic differentiation. Conclusion: These findings showed that the proliferation of induced cells increased with passing time, but in early neurogenic differentiation of hADSCs, neural expression was higher than late of differentiation. Thus, using of induced cells in early differentiation may be suggested for in vivo application.

Background: Corneal collagen cross-linking (CXL) is gaining popularity as a treatment in arresting the progression of keratoconus. It is a relatively new therapy using ultraviolet-A (UVA) with a photosensitizer to increase corneal stiffness. The purpose of this study was to evaluate visual, keratometric and topographic outcomes after corneal CXL in progressive keratoconic eyes. Materials and Methods: In this prospective nonrandomized clinical study, 140 eyes of 110 patients with progressive keratoconus were treated by combined riboflavin/UVA CXL. Mean sphere, mean cylinder uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refractive spherical equivalent, corneal topography, pachymetry, and endothelial cell morphology were examined preoperatively and 12–24 months postoperatively. Results: The preoperative mean sphere was −3.33 ± 3.13 diopter (D) and decreased to −3.09 ± 3.09 D (P = 0.007). The preoperative mean cylinder was −4.05 ± 2.29 D and changed to −3.79 ± 2.23 D (P = 0.011). UDVA changed from 0.95 ± 0.64 logarithm of the minimum angle of resolution (logMAR) to 0.85 ± 0.59 logMAR (P = 0.003). Thirty-five eyes (25%) gained one or more lines of preoperative UDVA, 87 eyes (62.1%) did not change and 18 eyes (12.8%) lost one or more lines of the preoperative UDVA. CDVA in 80% of the patients remained stable (no lines lost). Statistical analysis of keratometry, pachymetry, and endothelial cell count did not show the significant difference after surgery. Conclusion: Our study showed improvement in visual and refractive results of the corneal CXL and confirmed that CXL is the safe and effective procedure.

Background: The aim of this study was to compare the efficacy intravenous (IV) ondansetron with ketamine plus midazolam for the prevention of shivering during spinal anesthesia (SA). Materials and Methods: Ninety patients, aged 18–65 years, undergoing lower extremity orthopedic surgery were included in the present study. SA was performed in all patients with hyperbaric bupivacaine 15 mg. The patients were randomly allocated to receive normal saline (Group C), ondansetron 8 mg IV (Group O) or ketamine 0.25 mg/kg IV plus midazolam 37.5 µg/kg IV (Group KM) immediately after SA. During surgery, shivering scores were recorded at 5 min intervals. The operating room temperature was maintained at 24°C. Results: The incidences of shivering were 18 (60%) in Group C, 6 (20%) in Group KM and 8 (26.6%) in Group O. The difference between Groups O and Group KM with Group C was statistically significant (P < 0.05). No significant difference was noted between Groups KM with Group O in this regard (P > 0.05). Peripheral and core temperature changes throughout surgery were not significantly different among three groups (P > 0.05). Incidence (%) of hallucination was not significantly different between the three groups (0, 3.3, 0 in Group O, Group KM, Group C respectively, P > 0.05). Conclusion: Prophylactic use of ondansetron 8 mg IV was comparable to ketamine 0.25 mg/kg IV plus midazolam 37.5 µg/kg IV in preventing shivering during SA.

Background: This study was aimed to evaluate the prevalence of obstructive sleep apnea (OSA) and restless legs syndrome (RLS) in patients with end-stage renal disease (ESRD) after kidney transplantation. Materials and Methods: Two hundred kidney transplant recipients were enrolled in this cross-sectional study. Data on age, gender, etiology of ESRD, history of previous kidney transplantation, serum creatinine, and the presence or absence of OSA and RLS were collected. Symptoms of RLS were identified using the RLS questionnaire which was completed by the patients. The Berlin questionnaire and polysomnography were used for diagnosing OSA. Results: The mean age of the studied patients was 45.86 ± 10.24 years. The prevalence of OSA was 26% (52 of 200 studied patients) and of RLS was 51.5% (103 of 200 studied patients). Majority of the patients with high-risk OSA were male and significantly older than the patients with low-risk OSA (P < 0.05). The prevalence of RLS was higher in patients with high-risk OSA and a higher level of creatinine compared to that in those with a low risk of OSA (P < 0.0001). Level of creatinine in patients with positive RLS was significantly higher than in those with negative RLS (P < 0.0001). OSA was observed in almost 42% of patients with positive RLS, compared to 9% of patients with negative RLS (P < 0.0001). Conclusion: In summary, our results indicate that the prevalence of OSA and RLS in kidney transplant recipients was higher than in the general population. Also, there was a significant association between OSA and RLS in these patients.

Background: Stress urinary incontinence (SUI) is considered as one of the major hygienic problems among women. The main aim of the study is to assess the potential risk factors associated with SUI among Iranian women. Materials and Methods: This study was conducted on 90 married women with history of SUI diagnosed by an urologist and were selected randomly. Their pelvic muscles contraction (PMC) and the history of the subjects were assessed for some of risk factors such as age, height, weight, body mass index (BMI), pregnancy history, miscarriage, type of delivery (normal vaginal delivery or cesarean section), number of offspring born healthy in addition to other risk factors such as chronic cough, constipation and hypothyroidism by use of POP Questionnaire. Data were analyzed using Pearson correlation coefficient and SPSS version 18 Software. Results: There was a significant relation between SUI and height (P < 0.05, r = 0.45), vaginal delivery (NVD) (P < 0.05, r = 0.2), number of genitourinary surgery (P < 0.05, r = 0.42), hypothyroidism and constipation (P < 0.05). An inverse relatively strong significant relation was found between SUI and cesarean section (P < 0.05, r = –0.50) No significant relation was found between SUI and weight, BMI, age, chronic cough and miscarriage, and other study parameters. An inverse significant relation between PMC and weight (P < 0.05, r = –0.52), BMI (P < 0.05, r = –0.42) and number of genitourinary surgery (P < 0.05, r = –0.18). Conclusion: Cesarean section had a preventive effect on SUI versus normal vaginal delivery. The rate of SUI was higher in taller women or those suffering from hypothyroidism or constipation or who had genitourinary surgery. The women with high BMI had lower pelvic floor muscles strength.

Background: Self-care management has recently been suggested as an effective approach for secondary prevention of hypertension. This study was conducted to examine whether self-care behaviors could modulate blood pressure levels and also comparing the different training methods of self-care on patients' adherence and controlling hypertension. Materials and Methods: This study was a prospective randomized controlled clinical trial, conducted on 180 hypertensive patients referring to four centers in Isfahan, Iran, between July and December 2013. Block randomization method were applied to divide eligible subjects into four equal groups, including group A in which the patients and their family were educated by cardiology resident about self-care behaviors through eight sessions, group B and group C were obtained self-care education through four pamphlets or eight short message services (SMS), respectively and group D were obtained only usual care of hypertension without any training about self-care management. Results: Increasing vegetable intake and frequency of subject who took antihypertensive medication regularly and the reduction in the frequency of subjects who consumed high salt were significantly more in group A than the others (P = 0.001, P < 0.001 and P < 0.001, respectively). The systolic and diastolic blood pressure had significantly more reduction in the group A than the other groups (−8.18 ± 18.3 and − 3.89 ± 4.1; P < 0.001, respectively). Conclusions: The self-care management education integration into the usual care along with using SMS and other educational materials may improve the efficient and effective adherence strategies.

Background: It has been suggested that doxepin in addition to enhancement of noradrenaline and serotonin levels may have neuroprotective effects. Therefore, this study investigated the effect of doxepin on gene expression of brain-derived neurotrophic factor (BDNF), tumor necrosis factor alpha (TNF-α), mitogen-activated protein kinase 14 (MAPK14), and serine-threonine protein kinase AKT1 in rat hippocampus. Materials and Methods: Male rats were divided randomly into three groups: Control, doxepin 1 mg/kg, and doxepin 5 mg/kg. Rats received an i.p injection of doxepin for 21 days. Then the hippocampi were dissected for the measurement of the expression of BDNF, TNF-α, MAPK14, and AKT1 genes. Results: Our results showed no significant effects of doxepin on gene expression of BDNF, TNF-α, MAPK14, and AKT1 genes in the hippocampus. Conclusions: These results did not show significant effects of doxepin on the genes that affect the neuronal survival in intact animals. However, more studies need to be done, especially in models associated with neuronal damage.

Background: An important role of nitric oxide (NO) in neuroinflammation has been suggested. It is also suggested that NO has a critical role in learning and memory. Neuro-inflammation induced by lipopolysaccharide (LPS) has been reported that deteriorates learning and memory. The effect of L-arginine (LA) as a precursor of NO on LPS-induced spatial learning and memory and neuronal plasticity impairment was evaluated. Materials and Methods: The animals were grouped into: (1) Control, (2) LPS, (3) LA-LPS, and (4) LA. The rats received intraperitoneally LPS (1 mg/kg) 2 h before experiments and LA (200 mg/kg) 30 min before LPS. The animals were examined in Morris water maze (MWM). Long-term potentiation (LTP) from CA₁area of the hippocampus was also assessed by 100 Hz stimulation in the ipsilateral Schaffer collateral pathway. Results: In MWM, time latency and traveled path were higher in LPS group than the control group (P < 0.001) whereas in LA-LPS group they were shorter than LPS group (P < 0.001). The amplitude and slope of field excitatory postsynaptic potential (fEPSP) decreased in LPS group compared to control group (P < 0.05 andP < 0.01) whereas, there was not any significant difference in these parameters between LPS and LA-LPS groups. Conclusion: Administration of LPS impaired spatial memory and synaptic plasticity. Although LA ameliorated deleterious effects of LPS on learning of spatial tasks, it could not restore LPS-induced LTP impairment.

Background: Lassa fever is a severe, often-fatal and one of the most virulent disease in primates. However, the mechanism of escape of virus from the T-cell mediated immune response of the host cell is not explained in any studies yet. In our studies we had aimed to predict B- and T- cell epitope of Lassa virus protein, for impaling the futuristic approach of developing preventive measures against this disease, further we can also study its presumed viral- host mechanism. Materials and Methods: Peptide based subunit vaccine was developed from all four protein against Lassa virus. We adopted sequence, 3D structure and fold level in silico analysis to predict B-cell and T-cell epitopes. The 3-D structure was determined for all protein by homology modeling and the modeled structure validated. Results: One T-cell epitope from Glycoprotein (WDCIMTSYQ) and one from Nucleoprotein (WPYIASRTS) binds to maximum no of MHC class I and MHC class II alleles. They also specially bind to HLA alleles namely, A*0201, A*2705, DRB*0101 and DRB*0401. Conclusions: Taken together, the results indicate the Glycoprotein and nucleoprotein are most suitable vaccine candidates against Lassa virus.

Background: Colorectal cancer (CRC) (adenomatous, adenocarcinoma) is one of the major causes of mortality and morbidity in human societies. Considering the importance of cyclooxygenase-2 (COX-2) expression in the incidence of CRC, in this study, the rate of COX-2 gene expression on polyps and CRCs were addressed. Materials and Methods: This is a cross-sectional descriptive analytic study carried out on the blocks of sampled tissue of adenomatous and colorectal adenocarcinoma polyps on 68 patients referred to Digestive Clinic in Isfahan Shariati Hospital in 2013. Patients were divided into two groups of polyps (n = 52) and cancer (n = 16). Given the presence of CRC or polyps by colonoscopy, samples were sent to the laboratory to measure the rate of COX-2 gene expression using immunohistochemistry. Results: In polyp group, 41 individuals (78.8%) had two or <2 polyps, 24 cases (46.2%) had a tubular polyp, and about a third of all patients had a big polyp. The most frequency of the polyp site was related to sigmoid with 19 cases (36.54%), in cancer group, it was related to the rectum with 9 cases (56.25%) that there was no significant difference between two groups (P < 0.05). The overall prevalence of COX-2 expression was positive in 51 cases (75%) and negative in 17 cases (25%). COX-2 gene expression was separately observed in 38 individuals (73.10%) in the polyp group and in 13 cases (81.25%) in the cancer group, and no significant difference was found (P > 0.05). Conclusion: There is no relationship between COX-2 gene expression and the surface of adenomatous and colorectal adenocarcinoma polyps.

Background: This study was performed to evaluate the learning curve and related complications of ultrasound (US) guided central venous catheter (CVC) insertion in infants. Materials and Methods: This study was performed in Imam Hosein Hospital of Isfahan from September 2014 to March 2015. Participants were infants consecutively candidate for CVC insertion. Three steps were designed to complement the learning. For each step of learning, 20 patients were considered and for every patient one CVC was inserted: (1) In the first step, venous puncture and guide wire passage was performed by an experienced radiologist and the surgeon was taught how to do it, then CVC was placed by the surgeon. (2) In the second step, venous puncture and guide-wire passage was performed by the surgeon under the supervision of the same radiologist, and then CVC was placed by the surgeon. (3) In the third step, US-guided CVC insertion was performed by the surgeon completely, and the radiologist came to the operating room only if it was necessary. In each of these steps, the time spent of the US probe on the skin until the guide wire passage into the vein was recorded for every patient. All perioperative complications were recorded. Results: The mean point for the time spent of the US probe on the skin until the guide wire passage into the vein was 84.9 ± 13.6, 119.1 ± 15.2, and 90.3 ± 11.2 s in the step 1, 2 and 3, respectively (P = 0.04). There was no significant difference between the frequencies of complications among tree steps. Conclusion: US-guided percutaneous CVC insertion is a safe and reliable method which can be easily and rapidly learned.

Background: Incidence rates of Meniere's disease vary considerably from 157/100,000 in the United Kingdom to 15/100,000 in the United States. Furthermore, in Iran prevalence of Meniere's disease is high, whereas we have not a reliable statistical study on it. A wide range of treatments are used for the treatment of the condition with no consensus on the most effective intervention. The aim of the present study, which involved 37 patients treated because of severe vertigo due to persistent Meniere's disease from 1996 to 2011, was to compare the effectiveness of two surgical methods cochleosacculotomy and endolymphatic sac decompression on vertigo and tinnitus. Materials and Methods: In a cross-sectional study, we compared two surgical approaches in patients with Meniere's disease who did not respond to usual medical treatment. Twenty-three patients underwent cochleosacculotomy surgery and 14 patients endolymphatic sac decompression surgery. We compared all the patients for resolving of vertigo, tinnitus. Results: After surgery, in patients of both group vertigo was improved significantly (P < 0.0001), tinnitus was improved, but it was not significant (P > 0.05) and hearing level was worse than before (especially in patients who had undergone cochleosacculotomy) (P < 0.0001). Conclusion: Based on the data of the current study, cochleosacculotomy and endolymphatic sac decompression improved vertigo in patients with persistent Meniere's disease.

Background: Early screening and diagnosis of right ventricular (RV) dysfunction and pulmonary artery hypertension is vital in patients with end-stage renal disease (ESRD) because of its relation to patients' survival. The present study is aimed to address and compare RV function parameters and pulmonary artery pressure (PAP) before and shortly after hemodialysis in patients with ESRD. Materials and Methods: This quasi-experimental study performed at Alzahra Hospital in Isfahan in 2014, 40 consecutive patients with ESRD that referred to hemodialysis ward were assessed by M-mode echocardiography and tissue Doppler imaging before and 30 min after completing hemodialysis to assess RV function parameters and PAP. Results: Following hemodialysis, mean body weight, both systolic, and diastolic blood pressures (BPs) and also mean systolic PAP significantly decreased, while tricuspid annulus plane systolic excursion (TAPSE), RV fractional area change (RVFAC) significantly increased 30 min after hemodialysis compared with before this procedure. However, systolic myocardial remained unchanged. Changes in body weight after dialysis was adversely associated with patients' age and duration of dialysis. Moreover, change in PAP was positively associated with the level of serum creatinine. Conclusion: Early reduction in body weight and BP, as well as improvement in RV function, and PAP is predictable shortly after starting hemodialysis in patients with ESRD. We found that RVFAC and TAPSE values were dependent on preload, but RV S' velocity was load independent. Change in body weight is predicted more in older patients and those who undergoing prolonged hemodialysis. Change in PAP is strongly affected by the severity of renal failure, but RV function may not be influenced by age or duration of dialysis.

Background: Modulatory effects of tamoxifen (TAM) on the central nervous system have been reported. The effects of TAM on spatial and nonspatial learning and memory impairments induced by scopolamine and the brain tissues oxidative damage was investigated. Materials and Methods: The ovariectomized (OVX) rats were divided and treated: (1) Control (saline), (2) scopolamine (Sco; 2 mg/kg, 30 min before behavioral tests), (3–5) Sco-TAM 1, Sco-TAM 3 and Sco-TAM 10. TAM (1, 3 or 10 mg/kg; i.p.) was daily administered for 6 weeks. Results: In Morris water maze (MWM), both the latency and traveled distance in the Sco-group were higher than control (P < 0.001) while, in the Sco-TAM 10 group it was lower than Sco-group (P < 0.05). In passive avoidance test, the latency to enter the dark compartment was higher than control (P = 0.05 – P < 0.01). Pretreatment by all three doses of TAM prolonged the latency to enter the dark compartment compared to Sco-group (P < 0.05 – P < 0.001). The brain tissues malondialdehyde (MDA) concentration was increased while, superoxide dismutase activity (SOD) decreased in the Sco-group compared to control (P < 0.05 – P < 0.01). Pretreatment by TAM lowered the concentration of MDA while, increased SOD compared to Sco-group (P < 0.05 – P < 0.001). Conclusions: It is suggested that TAM prevents spatial and nonspatial learning and memory impairments induced by scopolamine in OVX rats. The possible mechanism(s) might at least in part be due to protection against the brain tissues oxidative damage.

Background: Immune responses play significant roles in protection against leishmaniasis. Polymorphisms within the interleukin 4 receptor alpha chain (IL-4Rα) gene affect the production of cytokines, which is important for the clearance of many pathogens. The aim of the current study was to identify the relationship between visceral leishmaniasis (VL) infection and polymorphisms at positions T1432C and A1652G of IL-4Rα in an Iranian population. Materials and Methods: This cross-sectional study was performed during 2004–2012 and included three groups of participants: VL patients (Group 1, n = 124), seropositive healthy controls (Group 2, n = 101), and seronegative healthy controls (Group 3, n = 55). The IL-4Rα T1432C and A1652G polymorphisms were evaluated using a polymerase chain reaction-restriction fragment length polymorphism technique, and anti-Leishmania antibody titers were determined by using immunofluorescence technique. Alleles and genotypes were compared between groups of the study as well as Groups 1 and 2 based on the titer of antibodies. The validity of the data was analyzed using Hardy–Weinberg equilibrium and one-way analysis of variance, as well as χ² tests. Results: The polymorphisms at IL-4Rα positions T1432C and A1652G were significantly associated with active VL infection. These results demonstrated that the IL-4Rα T1432C and A1652G polymorphisms were not associated with anti-Leishmania antibody production. Conclusion: Our results indicate that these IL-4Rα polymorphisms may be risk factors for the development of VL.

Background: Health care environments have been the setting for a number of pertussis outbreaks. Immunity after vaccination wanes overtime leading to a growing population of susceptible adolescents and adults. A number of pertussis outbreaks have occurred in hospitals resulting in transmission to health care workers (HCWs), and other patients. The aim of this study was to assess immunity status of a group of basic medical students and interns who worked in hospitals for about 4 years. Materials and Methods: In a cross-sectional study, we measured the serum antibody titer of cases by enzyme-linked immunosorbent assay test. All 70 subjects have received pertussis vaccine in the routine childhood vaccination schedule. All cases were healthy and had no symptoms of any respiratory diseases. We also obtained a pharyngeal culture on Bordet-Gengou Agar for isolating Bordetella pertussis. Results: The results of B. pertussis pharyngeal culture was positive for 5 (7.1%) cases and negative for 65 (92.9%). The IgM, IgA, and IgG serum antibody was positive in 1.4%, 7.1%, and 11.4% of cases, respectively. The mean age of cases had no significant effect on serum antibody titers (P = 0.23). Conclusions: This study showed that majority of cases do not have protective serum antibody against B. pertussis. Working in hospitals does not affect seroprevalence and carrier state of B. pertussis. Immunization schedules that include no booster doses are at increased risk of pertussis. Due to the importance of the transmission in health care settings, vaccination of HCWs is a priority.

Background: The cesarean section is one of the most common procedures to prevent health-threatening risks to the mother and infant. Increasing rate of cesarean section attracted the attention of professionals and the overall objective of this study was to determine the frequency of maternal and neonatal morbidity and mortality rates in the two methods of delivery. Materials and Methods: In a comparative cohort study, 300 cases undergoing caesarean section and 300 cases with vaginal delivery were selected in two main hospitals of Isfahan, Iran during 2013 and 2014. Demographic characteristics and factors related to mortality and morbidity of mothers and infants were studied. Mothers were also recruited 6 weeks after delivery to ask for complications. Mothers and infants mortality and morbidity were studied and analyzed by SPSS 22 software. Results: Follow-up of deliveries up to 1-month after delivery suggested 2 cases of infant death (7%) in vaginal delivery group, while no case of infant death was reported in cesarean delivery group (P = 0.5). Incidence of fever was observed in first 10 days after delivery in 7 cases in the vaginal delivery group and 11 cases in the cesarean delivery group (2.3% vs. 3.7%, P = 0.4). Conclusion: Despite all the benefits of vaginal delivery compared with cesarean section, in many cases, especially in emergency cesarean section delivery can substantially reduce the maternal and neonatal mortality and morbidity. It is recommended to assess the complications of each method in all pregnant women about to give birth, and then decide on the method of delivery.

Background: The impact of standard percutaneous nephrolithotomy (PCNL) on short or long-term renal function has been evaluated in many studies. We evaluated the effect of tubeless PCNL on early renal function. Materials and Methods: A total of 117 patients referring to our university center for PCNL were enrolled in the study if they were matched with the inclusion criteria. Serum creatinine and hemoglobin (Hb) levels were measured before PCNL and 6, 24, 48, and 72 h after the operation. Glomerular filtration rate (GFR) was calculated using Cockroft-Gault formula. Results: There were 79 (67.5%) men and 38 women (32.5%) with the mean age of 49.94 years ranging from 18 to 80 years in the study group. The mean creatinine level elevated in the first 48 h after PCNL but it started to reduce on the 3^rd day (mean preoperative creatinine level: 1.32 ± 0.18 mg/dL, mean creatinine level after 48 h: 1.59 ± 0.24 mg/dL, creatinine level after 72 h: 1.42 ± 0.21245 mg/dL) (P < 0.0001). GFR values had the same rise and fall pattern as serum creatinine level (mean preoperative GFR: 74.89 mL/min, mean GFR after 48 h: 64.04 mL/min, GFR after 72 h: 69.54 mL/min, P < 0.0001). PCNL also affected blood Hb level. The mean preoperative Hb level was 15.06 ± 0.87 g/dL and it significantly decreased to 13.09 ± 1.06 g/dL after the operation (P < 0.0005). Conclusions: Tubeless PCNL like standard PCNL decreases GFR in the very early postoperative days. It is recommended that factors that might have a negative impact on renal function during first few days after PCNL be avoided.

Background: In this study, we aimed to investigate the effectiveness of silver nitrate (SN) versus tetracycline in pleurodesis among patients with malignant pleural effusion (MPE). Methods: In this prospective randomized clinical trial, patients with unilateral MPE candidate for pleurodesis were enrolled. The patients randomly allocated in two groups for receiving 20 mL 0.5% SN or 2.5 g tetracycline diluted in 30 cc normal saline and 0.1% lidocaine, through the chest tube. Patients were followed-up immediately (during 24 h) and 1-month after the procedure for evaluating recurrence of the pleural effusion using chest radiograph. They were clinically evaluated for chest pain and/or dyspnea and fever using a questionnaire that completed by the surgeon. The results were compared with two groups. Results: During this trial, 50 patients with MPE candidate for pleurodesis were selected and randomized into two interventional groups (25 patients in each group). Immediate and late recurrence of pleural effusion after pleurodesis were similar in two groups (P > 0.05). All patients in tetracycline group had fever and chest pain, but in SN group fever and chest pain were reported in 3 (12%) and 12 (48%) of patients, respectively (P < 0.05). Conclusion: SN is at least as effective as tetracycline for MPE treatment. In addition, its side effects were lower than tetracycline. Other advantages of SN are its low cost, availability, and safety. For more accurate results, it is recommended to design further trials with larger sample size and with lower doses of both SN and tetracycline.

Background: Cryptorchidism is a common problem which is prevalent in 3% of male infants. This study aimed to determine the effect of both trans fixation and Dartos pouch fixation methods on the postoperative recurrence rate and testicular changes. Materials and Methods: In a clinical trial study, 70 children were randomly divided into two groups. In the first group, the correction of cryptorchidism was done by Dartos pouch without suture and in the second group; testis was sutured using common trans fixation. The size of testicles was measured before and 6 months after surgery, children were followed on postoperative complications, trauma to testicles and recurrence of disease in both groups. Data were analyzed using SPSS soft ware. Results: The mean size of testicles was 87.16 ± 20.6 mm² in the group with fixed testicle and 182.4 ± 37.9 mm² in the group with not-fixed testicle before operation and the difference between the two groups was significant (P &#61; 0.013). After surgery, the mean size of testicles was 90.8 ± 19.9 mm² in the group with fixed testicle and 183.7 ± 41.2 mm² in the group with not-fixed testicle and the difference between them was significant (P &#61; 0.026). The average of changes in testicular size was 3.62 ± 1.93 and 1.25 ± 5.35 mm² in both fixed and not-fixed groups, respectively and changes in testicular size had no significant difference between the two groups. (P &#61; 0.68). Conclusions: Type of fixation had no effect on the size of testes or relevance to the level of retraction. The above management protocol did very well in our hands, and we recommend it for application in the management of undescended testis.

Background: End stage renal disease (ESRD) is a state of micro inflammation that attenuates patient's life span and quality of life. Inflammatory markers like interlukin 6 (IL-6) and C- reactive protein (CRP) can predict inflammatory state in ESRD patients. Dietary limitations are risk factors for omega-3 deficiency in these patients. Omega-3 supplementation is an attractive material that proposed in inflammation modulation. The aim of this study is evaluation of effect of omega-3 supplementation on IL-6 and CRP level in chronic ambulatory peritoneal dialysis (CAPD) patients. Materials and Methods: This randomized controlled double-blind clinical trial is performed in 40 CAPD patients in two academic hospitals in Isfahan, Iran. One group received 1000 mg omega-3 capsule (each capsule contains 180 mg Eicosapentanoic and 120 mg Dosahexanoic acid) three times a day orally for 8 weeks (n = 20) and the other matched group by placebo (n = 20). Serum level of IL-6 and quantitative CRP (Q-CRP) were measured in beginning and the end of the study. Finally all data were analyzed by SPSS version 18. Results: Mean age of patients was 53 years old in omega-3 group patients and 54 years old in placebo group. There were not any differences in CRP and IL-6 level in the beginning and the end of study between two groups (P: 0.81 and 0.10 for CRP and 0.26 and 0.23 for IL-6, respectively). Conclusion: Omega-3 supplementation did not effect on inflammatory markers (Q-CRP and IL-6) in CAPD patients after 8 weeks.

Background: Previous publications reported that an individual's month of birth (MOB) might have an important correlation to that consequent risk of multiple sclerosis (MS). Aim: The aim of this preliminary study was to investigate the distribution of different MOBs inpatients with MS in Isfahan, Iran. Materials and Methods: This investigation was conducted to the Isfahan Neurosciences Research Centre. 1283 patients with MS were studied. Clinical data were recorded in d-Base and analyzed using SPSS (version 18) for Windows. Results: Of the total population studied there were 979 females and 304 males. The mean age of all the patients was 34.6 years (range 10-87 years). Within the total population, the MOBs in the 62% of patients were in the season's spring and summer, and in 38% of patients they were in the season's autumn and winter. As the MOB might be recognized to have a bearing on an individual's risk of contracting MS, the highest and lowest correlations seem to be linked with April, September, May (↑), and November (↓), respectively. Conclusions: The seasonal relationship between MOBs and MS risk might be pointed toward a potential function for vitamin D throughout pregnancy or the early life of the newborn. Further studies are needed to confirm these correlations.

Background: Multiple sclerosis (MS) is a multifactorial disease that could result from demyelination of the myelin sheath. The aim of this study is to investigate the demographic features and  rank the immunomodulating drugs in patients with MS. Materials and Methods: This study was conducted in the MS clinic of the Isfahan Kashani Hospital, from 22 May, 2011 to 18 March, 2013. The data analyses (n = 1067) were divided  into two periods: (1) 2011/05/22 to 2012/03/18 denoted as P1 and (2) 2012/04/02 to 2013/03/18 denoted as P2. Results: Most of drugs prescribed within the population studied were: Avonex, Betaferone, and Rebif. There was an increase in the number of female (n = 811) and male subjects (n = 256). During P1/P2 there was an increase from 460 to 607 in the total number of patients, respectively. The number of patients who attended the MS clinic once was 250 (P1) versus 430 (P2), and those more than four times was 71 (P1) versus 59 (P2) correspondingly. Conclusion: The number of females increased from 2011 to 2013. Because of dissimilar ingredients additive of different pharmaceutical companies, it could be suggested that pharmacotherapy strategies, especially in Iranian population of MS with first-line treatment using Avonex, Betaferone and Rebif, more spotlighted on inter- and intra-individual variability based on clinical pharmacokinetics parameters.

Background: Aphasia is a language disorder caused by left hemisphere damage. For treatment of aphasia, in some of therapeutic approaches, the right hemisphere (RH) abilities, such as, emotional perception, is used for stimulation of the language process in the left hemisphere. The aim of this study is to investigate emotional word repetition in aphasia after a stroke, in Persian language patients. Materials and Methods: Fifteen aphasic patients (eleven male and four female) between 45 and 65 (58/4 ± 7/8) years of age, participated in this cross-sectional study. A list of 20 emotional words and a list of 20 neutral words as stimuli were prepared and the patients were asked to repeat each word after five seconds; if a patient needed to repeat a word again, it was repeated for him/her again, and the total score for each subject was calculated. The paired t-test was used to test group mean differences and the significant level was 0.05. Results: The mean and standard deviation for emotional word repetitions were 6.93 ± 1.72 and for non-emotional word repetition was 7.10 ± 2.23, and the P value = 0.892, thus, no significant difference between emotional and non-emotional word repetitions was noticed. The mean and standard deviation for the positive emotional word repetitions were 3.53 ± 3.29 and for negative word repetitions were 3.40 ± 3.56, (P = 0.751), with no significant difference between positive and negative emotional word repetitions. Conclusion: Despite the main hypothesis that the right hemisphere is involved in the processing of emotions, it can be stated that both hemispheres are involved in the processing of emotional words, albeit in a different and probably complementary manner.

Background: Single-incision laparoscopic cholecystectomy (SILC) is a newly developed method of performing cholecystectomy and has been increasingly used. The aim of this study is to see if SILC has any advantages over conventional (three-port) laparoscopic cholecystectomy (CLC). Materials and Methods: In this cross-sectional study, 52 patients who underwent SILC (group A) during the period from May 2011 to March 2013 were compared with 62 patients who underwent CLC (group B) at two centers affiliated to Shiraz University of Medical Sciences in Shiraz, Iran. Data were gathered on operation time, pre- and postoperative complications, patients' postoperative pain, pain reliever use, duration of hospital stay, and return to work, and these data were compared using SPSS software version 16. Results: The mean age of patients was 38.01 ± 13.24 in group A and 44.82 ± 15.11 in group B. Mean body mass index (BMI) was 23.97 ± 4.78 and 26.22 ± 4.67 in groups A and B, respectively. The mean operation time was 76.4 ± 29.0 min in group A and 72.9 ± 24.1 min in group B (P = 0.496). Preoperative complications were 3.8% in group A and 0 in group B (P = 0.206). Postoperative complications were 17.3% in group A and 11.3% in group B (P = 0.423). The mean for early postoperative pain revealed no significant difference (P = 0.814), but the mean pain on discharge was significantly higher in group A patients (P = 0.034). Regarding the mean admission time and return to normal activity, we found no significant differences. Conclusion: SILC does not have any special advantages over CLC with regard to surgical outcomes, but it can be a safe alternative to CLC, especially in patients concerned about cosmoses.

Background: Cytokine gene single nucleotide polymorphisms (SNPs) are widely used to study susceptibility to complex diseases and as a tool for anthropological studies. Materials and Methods: To investigate cytokine SNPs in an Iranian multi-ethnic population, we have investigated 10 interleukin (IL) SNPs (IL-1β (C-511T, T-31C), IL-2 (G-384T), IL-4 (C-590T), IL-6 (G-174C), IL-8 (T-251A), IL-10 (G-1082A, C-819T, C-592A) and tumor necrosis factor-alpha (TNF-α) (G-308A) in 415 Iranian subjects comprising of 6 different ethnicities. Allelic and genotypic frequencies as well as Hardy-Weinberg equilibrium (HWE) were calculated by PyPop software. Population genetic indices including observed heterozygosity (H _o ), expected heterozygosity (H _e ), fixation index (F _IS ), the effective number of alleles (N_e ) and polymorphism information content (PIC) were derived using Popgene 32 software. Multidimensional scaling (MDS) was constructed using Reynold's genetic distance obtained from the frequencies of cytokine gene polymorphism. Results: Genotypic distributions were consistent with the HWE assumptions, except for 3 loci (IL-4-590, IL-8-251 and IL-10-819) in Fars and 4 loci (IL-4-590, IL-6-174, IL-10-1082 and TNF-α-308) in Turks. Pairwise assessment of allelic frequencies, detected differences at the IL-4-590 locus in Gilakis versus Kurds (P = 0.028) and Lurs (P = 0.022). Mazanis and Gilakis displayed the highest (H _o = 0.50 ± 0.24) and lowest (H _o = 0.34 ± 0.16) mean observed heterozygosity, respectively. Conclusions: MDS analysis of our study population, in comparison with others, revealed that Iranian ethnicities except Kurds and Mazanis were tightly located within a single cluster with closest genetic affinity to Europeans.

Background: In this study, it is aimed to purify POD from leaves of Rosmarinus officinalis L. and determine its some biochemical properties. PODs are a group of oxidoreductase enzymes that catalyze the oxidation of a wide variety of phenolic compounds in the presence of hydrogen peroxide as an electron acceptor. Materials and Methods: In this investigation, POD was purified 9.3-fold with a yield of 32.1% from the leaves of Rosemary by ammonium sulfate precipitation and ion-exchange chromatography. The enzyme biochemical properties, including the effect of pH, temperature and ionic strength were investigated with guaiacol as an electron donor. For substrate specificity investigation of the enzyme, Michaelis constant and the maximum velocity of an enzymatic reaction values for substrates guaiacol and 3,3Ͳ, 5,5Ͳ-TetraMethyle-Benzidine were calculated from the Lineweaver-Burk graphs. Results: The POD optimum pH and temperature were 6.0 and 40°C. The POD activity was maximal at 0.3 M of sodium phosphate buffer concentration (pH 6.0). Sodium dodecyl sulphate polyacrylamide gel electrophoresis was performed for molecular weight (M _w ) determination and M _w of the enzyme was found to be 33 kDa. To investigate the homogeneity of the POD, native-PAGE was done and a single band was observed. Conclusion: The stability against high temperature and extreme pH demonstrated that the enzyme could be a potential POD source for various applications in the medicine, chemical and food industries.

Background: The most important cause of kidney injury is renal ischemia/reperfusion injury (IRI), which is gender-related. This study was designed to investigate the protective role of Γ-aminobutyric acid (GABA (against IRI in male and female rats. Materials and Methods: Thirty-six female and male wistar rats were assigned to six experimental groups. The IRI was induced by clamping renal vessels for 45 min then was performed reperfusion for 24 h. The group sex posed to IRI were pretreated with GABA and were compared with the control groups. Results: Serum levels of creatinine and blood urea nitrogen, kidney weight, and kidney tissue damage score increased in the IRI alone groups, (P < 0.05), while GABA decreased these parameters in female significantly (P < 0.05), but not in male rats. Uterus weight decreased significantly in female rats treated with GABA. Testis weight did not alter in male rats. Serum level of nitrite and kidney level of malondialdehyde (MDA) had no significant change in both female and male rats. Kidney level of nitrite increased significantly in female rats experienced IRI and serum level of MDA increased significantly in males that were exposed to IRI (P < 0.05). Conclusion: GABA could ameliorate kidney injury induced by renal IRI in a gender dependent manner.

Background: The existing methodological weakness in conducted researches concerning music therapy (MT) for children with autism led to ambiguity and confusion in this scope of studies. The aim of the present research is to identify the effectiveness of MT method in improving social skills of children with autism and its stability, as well. Materials and Methods: In the form of a clinical trial study with design of pretest/posttest/follow-up with control group, among the children with autism in community of Tehran city, on the basis of childhood autism rating scale, 27 children with mild to moderate autism were chosen and were divided into two groups of experiment (n = 13), and control (n = 14). Social skills' level of both groups was measured and recorded with the help of social skills rating system scale. The children of the experiment group participated in MT programs of Orff-Schulwerk for 45 days in 12 sessions (two sessions of 1-h/week), whereas the control group received no intervention. The data were analyzed with Statistic Package For Social Science (SPSS) software t-test and analysis of covariance was used to compare groups. Results: In posttest, the results of covariance analysis showed a significant increase in social skills' scores of the experiment group (P < 0.001). Also, results of the paired-sample t-test showed that the effectiveness of MT has been persistent up to the follow-up phase. Conclusions: The study showed that MT is an effective method with deep and consistent effects on improving social skills of children with autism.

Background: Pseudomonas aeruginosa is an opportunistic pathogen that is commonly responsible for nosocomial infections. The aim of this study was to perform a genotyping analysis of the Pseudomonas aeruginosa-resistant isolates by the multilocus sequence typing (MLST) method at the university teaching hospital in Iran. Materials and Methods: Antimicrobial susceptibility was analyzed for P. aeruginosa isolates. Ceftazidime-resistant (CAZ _res ) isolates with a positive double-disc synergy test were screened for the presence of extended-spectrum β-lactamase-encoding genes. Phenotypic tests to detect the metallo-β-lactamase strains of P. aeruginosa were performed on imipenem-resistant (IMP _res ) isolates. Selected strains were characterized by MLST. Results: Of 35 P. aeruginosa isolates, 71%, 45% and 45% of isolates were CAZ _res , IMP _res and multidrug resistant (MDR), respectively. Fifty-seven percent of the isolates carried the bla_OXAgroup-1 . All the five typed isolates were ST235. Isolates of ST235 that were MDR showed a unique resistance pattern. Conclusion: This study shows a high rate of MDR P. aeruginosa isolates at the university teaching hospital in Iran. It seems MDR isolates of P. aeruginosa ST235 with unique resistance pattern disseminated in this hospital.

Background: Lead poisoning has been an old but perpetual public health problem in developing countries. Lead has an adverse effect on fertility, and this study aimed to examine the effect of consuming green tea extract (GTE) on fertility parameters in rats exposed to lead. Materials and Methods: In this experimental study, 70 rats have been classified, as it is described later, into 4 groups of 10 and were studied over 2 months. Group 1: Normal diet and tap water; Group 2: 10 mg/kg intraperitoneal lead acetate weekly over 8 weeks; Group 3: Lead acetate + 100 mg/kg green tea, Group 4: Extract green tea. Distal epididymal sperm samples were collected to assess the sperm counts, motility, and morphology. Testicular tissue and blood level of testosterone were also studies. Data were analyzed by SPSS-17 software using ANOVA and independent t-test with a significant level of 0.05. Results: The rats exposed to lead acetate had the lowest weight, and green tea had the highest weight. Green tea consumption in rats exposed to lead, reduced the effect of lead and the difference in mean body weight in these rats, compared to other groups, was minimized (P < 0.05). The group exposed to lead acetate had the highest sperm abnormalities, and the lowest sperm abnormalities were observed in groups taking green tea. Conclusion: Consumption of green tea can reduce the adverse effects of lead, and also can effectively prevent fertility reduction.

Background : Uterine receptivity for the implantation is a complicated process, that ovarian factors (hormonal), endometrium and embryo simultaneously are involved in this phenomenon. A successful implantation needs appropriate development of the endometrium. Furthermore, embryo must be capable of reacting with the endometrium and producing suitable adhesion molecules. This study aimed to examine one of endometrial maturation indices in mice before implantation, i.e., proliferation of stromal cells. Materials and Methods: A total of 40 adult female mice were divided into four groups: Control, gonadotropin, gonadotropin + progesterone, and gonadotropin + sildenafil citrate. The three experimental groups were first injected 7.5 IU of human chorionic gonadotropin (HCG) and then 7.5 IU of human menopausal gonadotropin (HMG). Then, every two female mice were placed in a cage with a male mouse for mating. Two groups were injected 1 mg of progesterone and 3 mg/kg of sildenafil citrate at intervals of 24, 48, and 72 h after injection of HMG. After 96 h, all the mice were killed, and their uterine samples subjected to tissue passage and prepared for analysis. Immunohistochemical method, Ki-67, and stromal mitotic cell count were used in this study. Results: Our observations in all groups showed changes in the luminal epithelium. ANOVA analysis Ki-67-positive stromal cells among all groups were not statistically significant. Conclusion: The results showed that administration of HMG and HCG following that of progesterone and sildenafil citrate could change the indices of endometrial maturation, and they were not involved in the phase immediately before implantation in stromal mitotic index.

Background: Anterior and posterior vaginal repair (APR) is a common surgery for women with prolapse of pelvic organs which creates post-operative pain because of damage of tissues that we should manage and control this pain. For this purpose, this study was conducted in order to evaluate the effect of preemptive pudendal nerve block on post-operative pain in anterior and posterior vaginal wall repair. Materials and Methods: In a double-blinded clinical trial study, 60 women candidates of APR were randomly divided to two groups. In both of them was injected 0.3 cc/kg bupivacaine 0.25% for the intervention group or normal saline for the control group in pudendal nerve tract with the guide of nerve stimulator. A visual analog scale was used to measure pain during the first 48 h after the surgery. Data were analyzed by repeated measures analysis of variance (ANOVA). Results: Compared with the intervention group, the control group experienced greater pain during rest and walking. There were significant differences between the two groups from the first post-operative hour (P = 0.003) until 48 h after the operation (P = 0.021). Furthermore, the mean ± SD values of pain in the sitting position was not significantly different between control and intervention groups at the same time (P = 0.340). Conclusion: Preemptive pudendal nerve block can reduce post-operative pain score in anterior and posterior vaginal wall repair and this method was suggested in anterior and posterior vaginal wall repair.

Background: Diagnosis and typing of Mycobacterium genus provides basic tools for investigating the epidemiology and pathogenesis of this group of bacteria. Polymerase chain reaction (PCR)-restriction fragment length polymorphism analysis (PRA) is an accurate method providing diagnosis and typing of species of mycobacteria. The present study is conducted by the purpose of determining restriction fragment profiles of common types of mycobacteria by PRA method of rpoB gene in this geographical region. Materials and Methods: Totally 60 clinical and environmental isolates from February to October, 2013 were collected and subcultured and identified by phenotypic methods. A 360 bp fragment of the rpoB gene amplified by PCR and products were digested by MspI and HaeIII enzymes. Results: In the present study, of all mycobacteria isolates identified by PRA method, 13 isolates (21.66%) were Mycobacterium tuberculosis, 34 isolates (56.66%) were rapidly growing Nontuberculosis Mycobacteria (NTM) that including 26 clinical isolates (43.33%) and 8 environmental isolates (13.33%), 11 isolates (18.33%) were clinical slowly growing NTM. among the clinical NTM isolates, Mycobacterium fortuitum Type I with the frequency of 57.77% was the most prevalent type isolates. Furthermore, an unrecorded of the PRA pattern of Mycobacterium conceptionense (HeaIII: 120/90/80, MspI: 120/105/80) was found. This study demonstrated that the PRA method was high discriminatory power for identification and typing of mycobacteria species and was able to identify 96.6% of all isolates. Conclusion: Based on the result of this study, rpoB gene could be a potentially useful tool for identification and investigation of molecular epidemiology of mycobacterial species.

Background: Endothelial progenitor cells (EPCs) are present in circulation and contribute to vasculogenesis in adults. The aim of the present study was to determine the number of circulating EPCs in patients with optic neuritis (ON). Materials and Methods : Fifty patients with ON were diagnosed by expert neurologist and optometrist at the Feiz Hospital, Isfahan, Iran (2012-2013). Blood samples were collected from ON patients in the first attack. The number of EPCs was measured by flow cytometry through the assessment of CD34 ⁺ and CD309 ⁺ in patients and healthy individuals. Results : With using flow cytometry, CD34 ⁺ and CD309 ⁺ cells detected in peripheral blood cells of patients (n = 50) with ON, and healthy individuals (n = 30). Patients with ON had (mean = 66.71 ± 17.82) CD34 ⁺ and CD309 ⁺ cells compared with healthy controls (mean = 28.72 ± 22.46). In addition, there was no significant difference in CD309 ⁺ cells in both groups. Conclusion: This study showed elevated CD34 ⁺ and CD309 ⁺ cells in the early stage of the disease. Regarded to EPC increment in neural repair, it expected the EPC level be increased in these patients, but no detectable differences were observed among both markers in healthy and patient with first attack.

Background: Cholecystokinin (CCK), a peptide hormone found in the gut is the most abundant peptide neurotransmitter in the brain as well, and its effects on learning, memory, and anxiety have been shown. However, it is not clear whether this substance acts as a mediator for anxiety and stress induction or inhibits them. Hence, the purpose of this study was to evaluate the effects of CCK on memory function under stress conditions. Materials and Methods: Male Wistar rats were divided into four groups: The control, the control-CCK, the stress, and stress-CCK. To induce stress, the rats were placed within adjustable restraint chambers for 6 h daily, for 24 days. CCK-8S (cholecystokinin sulfated octapeptide was injected before induction of stress (1.6 μg/kg, intraperitoneal) for 24 days. Passive avoidance learning test was used for evaluation of learning and memory. Rats received foot electrical shock before stress induction and CCK injection and step through latencies were evaluated 1-day after the last session of stress and treatments. Results: Stress impaired memory significantly (P < 0.05). Although CCK per se decreased memory (P < 0.05), it prevented the memory impairments in the stress group as there was no significant difference between the control and stress-CCK groups. Conclusion: Stress has a profound effect on cognition and CCK probably acts as a mediator for its action. Our results showed that a high concentration of CCK during stress may be helpful in alleviating the effects of stress on the brain.

Background: The key enzyme in biotin-(strept) avidin systems, Escherichia coli BirA biotin ligase, is currently obtained by overexpression of the long protein-tagged versions of the gene to prevent its toxic effect in E. coli. Herein we describe a rather simple and efficient system for expression of E. coli BirA without the application of long-tag proteins. Materials and Methods: The coding sequence of BirA gene was isolated by polymerase chain reaction using DNA extract of E. coli-DH5α as template. BirA amplicon harboring a GS-linker at its C-terminal was cloned into NdeI-XhoI sites of pET24a(+) vector under control of T7 promoter and upstream of the vector-derived 6xHis-tag. pET24-BirA transformed BL21-cells were induced for protein expression by IPTG and analyzed by SDS-PAGE and Western blotting. Protein expression yields were assessed by image analysis of the SDS-PAGE scans using ImageJ software. Result: Agarose gel electrophoresis indicated proper size of the BirA gene amplicon (963 bp) and accuracy of the recombinant pET24-BirA construct. Sequence alignment analysis indicated identical sequence (100%) of our isolate with that of the standard E. coli-K12 BirA gene sequence (accession number: NC_000913.3). SDS-PAGE and Western blot results indicated specific expression of the 36.6 kDa protein corresponding to the BirA protein. Image analysis estimated a yield of 12% of total protein for the BirA expression. Conclusions: By application of pET24a(+) we achieved relatively high expression of BirA in E. coli without application of any long protein-tags. Introduction of the present expression system may provide more readily available source of BirA enzyme for (strept) avidin-biotin applications and studies.

Background: Smoking is one of the most important risk factor in increasing of non-communicable disorders, especially chronic diseases such as cancer, stroke, heart and respiratory diseases. Cigarette smoking could damage the cochlea and causing hearing loss. The otoacoustic emission (OAE) is a source of information for determining cochlear responses to sound stimuli and how to change the response of the auditory system in some diseases. OAE test was sensitive to outer hair cells (OHCs) activity. Materials and Methods: In this study, tried to evaluate a hearing threshold of the smoker group versus non-smoker ones through pure tone audiometery, transient evoked otoacoustic emission (TEOAE) and distortion product otoacoustic emission (DPOAE) tests. Results: The results indicated that significant decrement of 8000 Hz threshold, reduced DPOAE/TEOAE amplitude in the smoker group than non-smoker one (P < 0.05). DPOAE amplitudes decline reflects the cochlear damage caused by smoking. Conclusion: OAEs test was clinically non-invasive, accurate, and objective evaluation of the performance of cochlear OHCs.

Background: The aim of the present study was to evaluate a non-destructive fabrication method in for the development of sustained-release poly (L, D-lactic acid)-based biodegradable clindamycin phosphate implants for the treatment of ocular toxoplasmosis. Materials and Methods: The rod-shaped intravitreal implants with an average length of 5 mm and a diameter of 0.4 mm were evaluated for their physicochemical parameters. Scanning electron microscopy (SEM), differential scanning calorimetry (DSC), Fourier-transform infrared (FTIR), and nuclear magnetic resonance (1H NMR) studies were employed in order to study the characteristics of these formulations. Results: Drug content uniformity  test confirmed the uniformity in different implant batches. Furthermore, the DSC, FTIR, and 1H NMR studies proved that the fabrication process did not have any destructive effects either on the drug or on the polymer structures. Conclusion: These studies showed that the developed sustained-release implants could be of interest for long-term sustained intraocular delivery of clindamycin, which can provide better patient compliance and also have good potential in terms of industrial feasibility.

Background: Global burden of hospital-associated infection (HAI) is on the rise and contributes significantly to morbidity and mortality of the patients. Mobile phones are indispensible part of communication among doctors and other health care workers (HCWs) in hospitals. Hands of HCWs play an important role in transmission of HAI and mobile phones which are seldom cleaned and often touched during or after the examination of patients without hand washing can act as a reservoir for transmission of potent pathogens. This study aimed to investigate the rate of bacterial contamination of mobile phones among HCWs in our tertiary care hospital and to compare it with personal mobile phones of non-HCWs (control group). Materials and Methods: The mobile phones and dominant hands of 386 participants were sampled from four different groups, hospital doctors and staff (132), college faculty and staff (54), medical students (100) and control group (100). Informed consent and questionnaire was duly signed by all the participants. Samples were processed according to standard guidelines. Results: 316 mobile phones (81.8%) and 309 hand swab samples (80%) showed growth of bacterial pathogens. The most predominant isolates were Coagulase-negative Staphylococcus, Staphylococcus aureus, Acinetobacter species, Escherichia coli, Klebsiella pneumoniae, Pseudomonas species and Enterococcus species. Conclusion: Hundred percent contamination was found in mobile phones and hands of HCWs indicating mobile phones can be the potential source of nosocomial pathogens. Our study results suggest that use of mobile phones in health care setup should be restricted only for emergency calls. Strict adherence to infection control policies such as proper hand hygiene practices should be followed.

Background: Helicobacter pylori colonizes not only on the surface of mucous membrane, but also beneath the surface mucous gel layer (SMGL). As diclofenac Na decreases the secretion of SMGL, in this study we examined this drug as an adjuvant therapy to a quadruple therapy for H. Pylori eradication. Materials and Methods: One hundred and seventy-two patients were randomly assigned to three groups. Fifty four patients received quadruple therapy, that is, azithromycine 250 mg, amoxicillin 500 mg, bismuth subcitrate 240 mg, and omeprazole 20 mg bid for 1 week (group A) and 65 patients received the same dosage of those agents plus diclofenac Na tab, 100 mg daily for 1 week (group B). Sixty two patients received the quadruple therapy for 2 weeks (group C). Eradication of the infection was assessed 4-6 weeks after completion of treatment by stool antigen assay for H. pylori. Results: While the rate of H. pylori eradication in the groups A and B was 66.7% and 82.1%, respectively (P = 0.062), the rate of H. pylori eradication in groups B and C were 82.1% and 82.3% respectively (P = 0.987). Conclusions: It seems that diclofenac Na can shorten anti-H. pylori regimens for 1 week. More investigations are needed for more clarification of the efficacy of NSAIDs for successful eradication of H. pylori. (IRCT code: IRCT201204059256N2)

Background: The enhancement of glycosylation by applying glycoengineering approaches has become widely used to boost properties for protein therapeutics. The objective of this work was to engineer a new hyperglycosylated analog of erythropoietin (EPO) with appropriately targeted N-linked carbohydrates through bioinformatics tools. Materials and Methods: The EPO protein sequence was retrieved from NCBI protein sequence database. Prediction of N-glycosylation sites for the target protein was done using the prediction server, NetNGlyc. The three-dimensional model of glycoengineered EPO (named as kypoetin) was constructed using the homology modeling program. Ramchandran plot obtained from PROCHECK server was used to check stereochemical property. Meanwhile, 3D model of kypoetin with attached N-carbohydrates was built up using the GlyProt server. Results: In the new modified analog, three additional N-glycosylation sites at amino-acid positions 30, 34 and 86 were inserted. Ramchandran plot analysis showed 81.6% of the residues in the most favored region, 15.6% in the additional allowed, 1.4% in the generously allowed regions and 1.4% in the disallowed region. 3D structural modeling showed that attached carbohydrates were on the proper spatial position. The whole solvent accessible surface areas of kypoetin (15132.69) were higher than EPO (9938.62). Conclusions: Totally, various model evaluation methods indicated that the glycoengineered version of EPO had considerably good geometry and acceptable profiles for clinical studies and could be considered as the effective drug.

Background: Breast milk is known as the most crucial postpartum issue in metabolic and immunologic programming of neonatal health. Human milk microbial changes over Lactation. The factors influencing the milk microbiome as well as potential impact of microbes on infant health have not yet been discovered. The objective was to identify pre- and post-natal factors that can potentially influence the bacterial communities inhabiting human milk. Materials and Methods: Breast milk samples (n = 40) with all full-term breastfed infants were collected from lactating randomized. Information on personal characteristics, dietary habits, information about infants were collected after birth. The samples were plated with serial dilutions on three selective culture media man rogosa sharp and then colonies were counted. Colonies tested for catalase reaction, Gram-staining and microscopic examination. Results: The result of this study showed that the overall incidence of positive Lactobacillus in mother's milk was 87.5%. The results based on (infant gender, mode of delivery, rural or urban and lactation time) rural or urban and lactation time were significant (P < 0.05). The results showed that all of the variables were significant in this regression model (P < 0.001). The median of log ₁₀ Lactobacillus counts in rural mothers, vaginal delivery, infant male gender and Lactation time for first 3-month were meaningfully high. Conclusions: The findings of this study about the breast milk Lactobacillus potential probiotic bacteria of healthy Iranian mothers, suggested that the breast milk microbiome is significantly influenced by several factors, mode of delivery, rural or urban and lactation time.

Background: Gastric cancer is the second most common cancer worldwide. In Iran, the incidence of gastric cancer is well above the world average, and is the first common cancer in Iranian men and the third one in women. Located at chromosome 14q23, SIX1 is a homolog of the Drosophila 'sine oculis' (so) gene and is highly conserved in numerous species. In addition to the role of SIX1 in the development, its expression is frequently dysregulated in multiple cancers. This study aimed to evaluate the clinicopathological features of the expression of SIX1 gene in gastric adenocarcinoma. Materials and Methods: Thirty pairs of gastric tissue samples from patients with gastric adenocarcinoma were evaluated for SIX1 gene expression using quantitative real-time polymerase chain reaction. A paired t-test or one-way ANOVA with post hoc multiple comparisons were used to analyze the differences between groups. Statistical significance was defined as P ≤ 0.05. Results: SIX1 expression was decreased in tumoral samples. However, its expression increased significantly in diffuse-type gastric cancer. Furthermore, there was a trend toward statistical significance in increasing SIX1 gene expression with higher grades. Of note, the difference was significant between grades I and III. Conclusions: The results suggest that SIX1 gene expression might be used in the future as a potential biomarker to predict the outcome of the disease as diffuse-type and grade III of gastric tumors are associated with poor prognosis.

Background: Carpal tunnel syndrome (CTS) is a common entrapment neuropathy. Diagnosis of CTS is usually based on a combination of clinical symptoms and electrodiagnostic study (EDS). Ultrasonography (US) also has been shown to be a useful diagnostic tool in CTS and is based on an increase in the median nerve cross-sectional area (CSA) at the level of the pisiform bone. In this study we assessed findings in US in correlation with severity of CTS. Materials and Method: This was a cross-sectional case-control study, which was carried out on November 2012 to July 2013. Subjects were chosen from patients who referred to the Alzahra Hospital (Isfahan, Iran). Patients were classified as having mild, moderate, and severe CTS according to EDS and high-resolution US was performed for CSA measurement at the tunnel inlet. Results: A total of 87 individuals screened and 52 subjects (81 hands) met all inclusion and no exclusion criteria. The mean ± SD of the CSA was 0.12 ± 0.03 cm ² (range, 0.08-0.18) in mild, 0.15 ± 0.03 cm ² (range, 0.08-0.19) in moderate, and 0.19 ± 0.06 cm ² (range, 0.11-0.32) in severe CTS. We detected a significant correlation between MN CSA and the severity of CTS (P < 0.001). Conclusion : In conclusion it is expected that sonography may serve as an additional or complementary method which is useful and reliable in assessing the severity of CTS.

Background: Secondary palatal fistula and velopharyngeal insufficiency (VPI) are two major complications of palatoplasty. Various methods have been introduced for surgical repair of these complications; however, most of them are associated with a high recurrence rate and morbidity. This study was designed to evaluate the use of the buccinator myomucosal flap in the reconstruction of palatal fistula and velopharyngeal insufficiency following primary palatoplasty. Materials and Methods: This study was performed on 25 patients who had either secondary palatal fistula or velopharyngeal insufficiency. Their defects were repaired by buccinator myomucosal flaps (BMFs). Patients were followed for 8 weeks and follow-up visits were arranged at 1, 2, 4, and 8 weeks after discharge. Results: All BMFs were harvested and transposed successfully. The length of the soft palate increased 15.14 ± 1.13 mm postoperatively. One patient (4%) had flap dehiscence 6 days after the operation with no flap ischemia or necrosis. Another patient (4%) experienced recurrence of the palatal fistula with marginal necrosis of the BMF 6 weeks after the operation. Otherwise, no case of fistula recurrence, infection, flap ischemia or necrosis and donor-site morbidity was observed during follow-up sessions. Conclusion: This study demonstrated that using BMFs could be a safe, effective and promising method of treatment for post palatoplasty fistula and VPI. However, further investigations on a larger sample size with longer follow-up are recommended for more accurate conclusion.

Background: Methylphenidate (MPH), a neural stimulant, can cause damages to brain; the chronic neurochemical and behavioral effects of MPH remain unclear. Exercise lowers stress and anxiety and can act as non-pharmacologic neuroprotective agent. In this study protective effects of exercise in MPH-induced anxiety, depression and cognition impairment were investigated. Materials and Methods: Seventy adult male rats were divided randomly into five groups. Group 1 served as negative control, received normal saline (0.2 ml/rat) for 21 days, group 2 and 3 (as positive controls) received MPH (10 and 20 mg/kg) for 21 days. Groups 4 and 5 concurrently were treated with MPH (10 and 20 mg/kg) and forced exercise for 21 days. On day 21, Elevated Plus Maze (EPM), Open Field Test (OFT), Forced Swim Test (FST) and Tail Suspension Test (TST) were used to investigate the level of anxiety and depression in animals. In addition between 17 ^th and 21 ^th days, Morris Water Maze (MWM) was applied to evaluate the effect of MPH on spatial learning and memory. Results: MPH-treated animals indicated a reflective depression and anxiety in a dose-dependent manner in FST, EPM and TST which were significantly different from the control group and also can significantly attenuate the motor activity and anxiety in OFT. Forced exercise by treadmill can attenuate MPH-induced anxiety, depression and motor activity alteration in OFT. MPH also can disturb learning and memory in MWM and forced exercise can neutralize this effect of MPH. Conclusion : We conclude that forced exercise can be protective in brain against MPH-induced anxiety, depression and cognition alteration.

Background: No previous study has been done to evaluate the admission serum potassium level as a predictor of morbidity or need for mechanical ventilation. The aim of this study is to determine the predictive ability of serum potassium on admission, in critically ill trauma patients, and to evaluate the relation of the potassium level to organ failure, length of stay, ventilator need, and duration of mechanical ventilation. Materials and Methods: A prospective, observational study was done on 100 patients >16 years old, admitted to the Medical-Surgical Intensive Care Units (ICU), for over one year. Patients were classified into Group A: Patients who required equal or less than five days of mechanical ventilation and Group B: Patients who required more than five days of mechanical ventilation. The total serum potassium concentrations were measured and the Sequential Organ Failure Assessment (SOFA) score was recorded at the time of admission to the ICU, when connected to the ventilator, and then at the time of weaning from the ventilator. Results: There was no significant difference between the Serum K concentrations between the two groups, on admission. However, there were significant difference between the Serum K concentrations at times of receiving and weaning from mechanical ventilation (MV) between the two groups. We found the best cut-off point of 3.45 for serum potassium concentration, to predict the need for longer duration of MV. Conclusion: Development of hypokalemia during an ICU stay is associated with the need for mechanical ventilation. Monitoring of the serum potassium levels may be a good prognostic factor for the requirement of mechanical ventilation.

Background: Post-tonsillectomy pain is one of the most common problems after anesthesia, therefore use of a good anesthesia technique with minimum side effect is an important aim. This study was performed to compare the efficacy of peritonsillar infiltration of bupivacaine, tramadol and combination of bupivacaine-tramadol in post-tonsillectomy pain. Materials and Methods: In a double blind trial 120 ASA I and II children condidated for tonsillectomy were randomized into four groups: Peritonsillar infiltration with bupivacaine 1 mg/kg in Group B, tramadol 2 mg/kg in Group T, combination of bupivacaine-tramadol in Group BT and saline in Group C was done. Results: Until 60 minutes in the recovery room, control of pain in the first three groups were better than Group C (P < 0.05) and in the third group it was better than others. Four hours after surgery, control of pain was better in the second and third groups in comparison to Groups B and Group C (P <0.05) and was better in the third group in comparison to the second group. Then, 24 hours after that, only in the group III the control of pain was effective (P < 0.05). Conclusions: In this study we showed that peritonsillar infiltration with combination of bupivacain-tramadol provided less post surgery pain compared with infiltration of bupivacaine and tramadol alone in adenotonsillectomy of children.

Background: Alzheimer's disease (AD) is an age-related progressive neurodegenerative disease, which is characterized clinically by serious impairment in memory and cognition. Current medications only slow down the dementia progression and the present treatment one-drug one-target paradigm for anti-AD treatment appears to be clinically unsuccessful. Therefore, alternative therapeutic strategies are urgently needed. With respect to multifunctional and multitargeted characteristics of Rosa damascena via its effective flavonoids, we investigated the effects of R. damascena extract on behavioral functions in a rat model of amyloid-β (A-β)-induced Alzheimer's disease. Materials and Methods: After preparation of the methanolic extract of the R. damascena, HPLC analysis and toxicity studies, median lethal dose (LD50) and dose levels were determined. For evaluation of baseline training behavioral performance, Morris water maze and passive avoidance tests were used. A-β was injected bilaterally into CA1 area of the hippocampus. Twenty-one days after injection of A-β, the first probe trial of the behavioral tests were used to confirm learning and memory impairment. To examine the potential effects of the extract on behavioral tasks, the second probe trials were performed after one month administration of R. damasena extract. Results: Results showed that the R. damascena extract significantly improved the spatial and long-term memories in the extract- treated groups in a dose-dependent manner, as in the middle and high doses it had significant effect. Conclusion: According to these results, we concluded that R. damascena can reverse behavioral deficits caused by A-β, and may provide a new potential option for prevention and treatment of the cognitive dysfunction in Alzheimer's disease.

Backgrounds: It has been previously demonstrated that the increase of nitric oxide (NO) level may promote cisplatin (CP)-induced nephrotoxicity. The aim of this study was to investigate the role of inducible NO synthase (iNOS) inhibitor to prevent CP-induced nephrotoxicity. Materials and Methods: Four groups of male and four groups of female rats were treated daily with vehicle, S-methylisothiourea hemisulfate (SMT) as a selective iNOS inhibitor (5 mg/kg/twice a day), CP (2.5 mg/kg/day), and CP + SMT for 6 days. Then, all animals were sacrificed and the serum levels of creatinine (Cr), blood urea nitrogen (BUN), nitrite, and malondialdehyde (MDA) were measured. The kidney was removed immediately for histopathological study. Results: Our results showed that inhibition of iNOS by SMT could make different response in male and female animals. SMT therapy in male animals decreased serum BUN, Cr, nitrite, and MDA levels; and it also protected kidney against CP-induced nephrotoxicity. Conclusion: It is concluded that decrease in NO production by SMT has a beneficial effect on reducing CP-induced nephrotoxicity in male. However, such beneficial effect was not observed in female animals.

Background: Cervical ripening for labor induction is one of the most important issues in midwifery. Isosorbide dinitrate (ISDN) is one of the most important choices that have been proposed for cervical ripening, but still there are controversies regarding its prescription. The present study aimed to evaluate the effects of vaginal and oral ISDN compared to the control group for pre-induction cervical ripening. Materials and Methods: In this non-blinded clinical trial, 149 nulliparous women with term or prolonged pregnancy were randomly selected and divided into three groups by block randomization. The intervention group included vaginal (50 subjects, 40 mg) and oral (49 subjects, 20 mg) ISDN groups. The third group was the control group (50 subjects) which did not receive any medication. The amount of ripening was given by Bishop score evaluated before taking medication and 24 h after taking it. Results: After 24 h, Bishop score in vaginal ISDN group significantly increased compared to the oral ISDN and control groups (P < 0.001 for both). Although the increase in Bishop score was lower in the oral ISDN group than in the vaginal group, it had a statistically significant increase in comparison to the control group (P = 0.001). All the three groups were matched regarding pregnancy termination and cesarean causes, and there was no statistically significant difference among the three groups (P > 0.05). Conclusion: Prescribing vaginal ISDN for cervical ripening was effective, and it can be used with confidence.

Background: Leishmania is a parasitic protozoan of trypanosomatidae family which causes a wide spectrum of diseases ranging from self-healing cutaneous lesions to deadly visceral forms. In endemic areas, field trials of different preparations of Leishmania total antigen were tested as leishmaniasis vaccine. Two preparations of killed Leishmania major were produced In Iran, which were heat-killed vaccine called autoclaved L. major (ALM) and thimerosal-treated freeze-thawed vaccine called killed L. major (KLM). In this study, the protein content of both ALM and KLM were compared with that of freshly harvested intact L. major promastigotes using sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Materials and Methods: L. major (MRHO/IR/75/ER) from pre-infected Balb/c mice was isolated with modified Novy-MacNeal-Nicolle (NNN) medium and then subcultured in liquid RPMI 1640 medium supplemented with fetal calf serum (FCS) 20% for mass production. Two preparations of KLM and ALM were produced by Razi Vaccine and Serum Research Institute, Iran, under WHO/TDR supervision. Electrophoresis was performed by SDS-PAGE method and the gel was stained by Coomassie brilliant blue dye. The resultant unit bands were compared using standard molecular proteins. Results: Electrophoresis of the two preparations produced many bands from 10 kDa to 100 kDa. KLM bands were much like those of freshly harvested intact L. major. Conclusion: It is concluded that although there are similar bands in the three forms of Leishmania antigens, there are some variations which might be considered for identification and purification of protective immunogens in a total crude antigen, and detection of their stability is essential for the production and marketing of a putative vaccine.

Background: Knowledge of correct information-seeking behavior by the patients can provide health specialists and health information specialists with valuable information in improving health care. This study aimed to investigate the passive receipt and active seeking of health information by diabetic patients. Materials and Methods: A survey method was used in this research on 6426 diabetic patients of whom 362 patients were selected by a no percentage stratified random sampling. The Longo information-seeking behavior questionnaire was used to collect data and they were analyzed by SPSS 20 software. Results: The most common information source by diabetic patients was practitioners (3.12). The minimum usage among the information sources were from charity organizations and emergency phone lines with a usage of close to zero. The amount of health information gained passively from each source has the lowest average of 4.18 and usage of this information in making health decision has the highest average score of 5.83. Analysis of the data related to active seeking of information showed that knowledge of available medical information from each source has the lowest average score of 3.95 and ability in using the acquired information for making medical decisions has the highest average score of 5.28. The paired t-test showed that differences between passive information receipt (41.68) and active information seeking (39.20) considered as statistically significant (P < 0.001). Conclusion: Because diabetic patients are more passive information receivers than active information seekers, the health information must be distributed by passive means to these patients. In addition, information-seeking behavior during different time periods should be investigated; to identify more effective distribution of health information.

Background: The cyclic nucleotides, cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP), are intracellular second messengers that play an important role in modulating inflammatory cells involved in allergic diseases. In general, cAMP suppresses the activity of immune and inflammatory cells. We aim to evaluate the roles of cAMP and cGMP in regulating basophil activity. Materials and Methods: Basophil-enriched preparations were incubated with analogs and then challenged with anti-IgE or IL-3 (4 or 24 hours). Supernatants were assayed for histamine, IL-4, and IL-13 release. The effects of Sp-8-CPT-cAMPS and Sp-8-CPT-cGMPS on IL-3-dependent mediator release from basophils were determined. The cells were pre-incubated with an analog and then incubated with IL-3 for 24 hours. Results: Sp-8-CPT-cAMPS was an effective (P < 0.05) inhibitor of IL-4, IL-13, and histamine release from basophils. However, paradoxically, Sp-8-CPT-cGMPS enhanced histamine release and IL-13 generation, but by contrast, had little effect on IL-4 generation. Sp-8-CPT-cGMPS inhibited cytokine generation, but enhanced the release of histamine release to a modest extent. Conclusion: This study shows that the cAMP/protein kinase A (PKA) pathway may be inhibitory to the IgE- and non-IgE-dependent release of mediators from basophils.

Background: Angiogenesis-related corneal blindness includes the spectrum of corneal diseases that are caused by pathological angiogenesis, leading to untoward visual impairment. The purpose of this study was to investigate the antineovascularization effect of topical silica nanoparticles (SiNPs) in inhibiting chemical-burn-induced corneal neovascularization. Materials and Methods: A total number of 20 corneas of 10 Wistar Albino rats were included in this study. Silver nitrate cauterization was pressed to the central cornea for 5 s to induce corneal neovascularization. They were randomly allocated to case and control groups (ten eyes in each group). SiNPs were synthesized by the reverse microemulsion method. SiNPs drop 1 mg/ml was started in ten eyes and artificial tear drop was started in the control group (ten eyes) immediately after chemical cauterization. Video-based photography was performed before and after treatment. Corneal image analysis was performed on each cornea using an image analysis software program. All rats were euthanized and the eyes were sent for histopathologic examinations14 days after chemical cauterization. Results: Scanning electron microscopy (SEM) images showed spherical-shaped particles. The mean size and polydispersity index of prepared SiNPs were 30.1 ± 5.6 nm and 0.254 ± 0.11, respectively. Fourteen days after chemical cauterization, the mean vascularized corneal area was 21% of total corneal area in the case group and 85% in the control group (P < 0.05). The control group revealed more extensive intrastromal vascularization compared with the case group in histopathologic examinations (P < 0.05). Conclusions: SiNPs is an effective modality for inhibiting corneal neovascularization following chemical burn in an experimental model. Further investigations are suggested for evaluation of its safety and efficacy in human eyes.

Background: The purpose of this study was to compare the six-minute walk test (6MWT) and the incremental shuttle walk test (ISWT) in terms of the initial onset of pain (IOP), maximal claudicating pain (MCP), maximum walking distance (MWD), initial ankle brachial index (IABI), post ankle brachial index (PABI), and difference in ankle brachial index (DFABI), as well as to correlate changes in IOP and MWD, MCP and MWD, IABI and MWD, PABI and MWD, and DFABI and MWD in the 6MWT and ISWT. Materials and Methods: Participants (n = 19, 17 men and 2 women) were randomly allocated to the 6MWT or ISWT and crossed over to the other test after 24 hours. The baseline ankle brachial index (ABI) measurements were taken using the Doppler, following which the participants performed the tests. Post-test MWD, IOP, MCP, and ABI were measured. The paired t test was used pre- and post the walk test and the Pearson correlation was used to find any relationship between the desired variables. Results: The paired t test at 95% confidence interval for IABI and PABI (P > 0.05) was insignificant for the 6MWT and ISWT. The Pearson correlation of MWD with IOP showed a fair correlation, and the correlation of MWD to MCP showed a strong correlation in ISWT. Conclusion: ISWT can be of vital importance as a tool to assess the functional status of patients suffering from Peripheral Arterial Occlusive Disease (PAOD) in both the clinical and research areas, and reflects a better assessment of the functional limitation when walking with PAOD as compared to the 6MWT.

Background: Preoperative airway assessment tests have been presented to help in anticipating a difficult airway. We conducted this study to compare five methods in prediction of difficult laryngoscopy: Neck circumference (NC), NC to thyromental distance ratio (NC/TMD), the ratio of height to thyromental distance (RHTMD), upper lip bite test (ULBT) and Mallampati test (MMT). These five methods are the most commonly used ones and have different powers for it. It was not clear which of these methods predicts difficult laryngoscopy better. Materials and Methods: Six hundred consecutive patients participated in this study. NC, NC/TMD and RHTMD were measured, and ULBT and MMT were performed and recorded. The laryngoscopy view was graded according to Cormack and Lehane's scale (CLS) and difficult laryngoscopy was defined as CLS grades 3 and 4. Accuracy of tests in predicting difficult laryngoscopy was assessed using the area under a receiver-operating characteristic curve. Results: The area under the curve in ULBT and RHTMD were significantly larger than that in TMD, NC and MMT. No statistically significant differences were noted between TMD, NC and MMT (all P > 0.05) (ULBT = RHTMD > NC/TMD > TMD = NC = MMT). RHTMD (>22.7 cm) exhibited the highest sensitivity (sensitivity = 64.77, 95% confidence interval [CI]: 53.9-74.7) and the most specific test was ULBT (specificity = 99.41%, 95% CI: 98.3-99.9). Conclusion: RHTMD and ULBT as simple preoperative bedside tests have a higher level of accuracy compared to NC/TMD, TMD, NC, MMT in predicting a difficult airway.

Background: Migraine is the most common chronic neurological disorders that may be associated with vasodilatation. According to the role of prostaglandin I2 (prostacyclin) receptor (PTGIR) in migraine as a receptor, which acts in vasodilatation, we decided to study the changes of PTGIR expression in migraine patients in relation to a suitable control group. Materials and Methods: Extracted mRNA from lymphocytes of 50 cases and 50 controls was used to synthesize cDNA. Real-time polymerase chain reaction was performed, and the data were analyzed. Our results show that PTGIR mRNA expression in cases was significantly higher than the control group (P = 0.010). Results: In conclusion, mRNA expression of PTGIR in the blood of people with migraines could be considered as a biomarker. Conclusion: In addition, repression of PTGIR gene expression by methods such as using siRNA is probably suitable for therapy of migraine patients.

Background: Following human radiation exposure in hospital or accidents, dose assessments are of prime importance in radiation accidents. These issues are of continuing importance with respect to socioeconomic policy relating to the industrial and medical uses of ionizing radiation, and also for risk assessment among people who are occupationally exposed to low and/or high linear energy transfer (LET) radiation, such as astronauts, pilots, stewardesses, nuclear power plant workers, and victims of radiation accidents. Materials and Methods: In this study, an assay for assessing radiation dose based on the induction of apoptosis in human T-lymphocytes was done to examine T-lymphocyte cells isolated from the fresh blood of 16volunteers, cultured and exposed to gamma rays. Radiation-induced apoptosis (RIA) was assessed by flow cytometric identification of cells displaying apoptosis-associated DNA condensation. Results: Dose-response experiments showed that at 2Gy dose level of radiotherapy programs, the RIA frequency was significantly above control. Apoptotic levels significantly depend on the dose of radiation rather than the donor. Conclusion: The results demonstrate the potential use of this assay as a biological indicator of radiation toxicity, optimizing patient dose in radiotherapy and biological dosimetry process.

Background: Gastric cancer is the fourth most frequent malignancy and the second cause of cancer-related mortality worldwide. It has been suggested that in gastric carcinogenesis, the C-MYC gene has an important function. The objective of this study is to establish the preference of Chromogenic in situ hybridization (CISH) and Immunohistochemistry (IHC) in the diagnosis and prognosis of gastric cancer. Materials and Methods: Samples comprised of 50 randomly selected patients of whom 40 were male and 10 female. To evaluate the MYC copy number and its protein expression, CISH and IHC analyses were performed for 50 gastric adenocarcinomas, in Iran. Results: The location of the tumor in 64% of the patients was the fundus, and in 72% of patients, the tumors were of a diffuse type; 22 samples showed no amplification, and 28 samples were with amplification. MYC immunoreactivity was observed in 13 samples. Twelve samples showed both MYC amplification and MYC immunoreactivity. In addition, among the 28 CISH+ samples, 12 samples had positive signals for IHC and 16 samples had negative signals for IHC. A majority of the IHC-negative patients had no amplification, but only one patient with IHC positive had no amplification. Conclusion: Our conclusion was that for the management and treatment of gastric cancer, and for special attention of clinicians, for prognosis and tumor progression, the CISH was a better and more feasible test than IHC, in regard to the sensitivity and specificity.

Background: There is an inverse relation between the uterine cervical length during pregnancy and the frequency of preterm delivery. The purpose of this study was to construct a chart and evaluate the cervical length at 8 to 38 weeks of normal gestation in the center of Iran. Materials and Methods: Uterine cervical length was measured on 930 asymptomatic pregnant women by abdominal ultrasonographic technique. For statistical evaluation, regression analysis and calculation of percentiles were performed. Results: Our data show a significant decrease in uterine cervical length with increasing gestational age. The mean uterine cervical length exhibits minimal changes from 10 to 24 weeks for most women in this study, although the shortening is more prominent at 33 to 38 weeks' gestation. The mean shortening of the uterine cervical length between the second and the ninth months was 14.82% (P < 0.05). Also, the cervical length means in trimesters 1, 2 and 3 were 39.30 ± 4.33, 38.28 ± 5.13 and 36.58 ± 4.58 mm, respectively. The third trimester showed a significant reduction (P < 0.05) in cervical length compared to the first and second trimesters (6.92% and 4.44%, respectively). New charts with the 5 ^th , 10 ^th , 50 ^th , 90 ^th , and 95 ^th percentile are presented. Conclusion: Our study provides a new chart and reference values for normal uterine cervical length throughout gestation based on a large sample in the center of Iran. There was a progressive decrease in mean uterine cervical length with increasing gestational age in the population of this study. Our established charts for uterine cervical length throughout gestation might be more useful than a single cut-off value for more efficient prevention and management of preterm birth.

Background: Full compliance of recombinant protein peptide mapping chromatogram with the standard reference material, is one of the most basic quality control tests of biopharmaceuticals. Changing a single amino acid substitution or side chain diversity for a given peptide changes protein hydrophobicity and causes peak shape or retention time alteration in a peptide mapping assay. In this work, the effect of different stresses during the recombinant erythropoietin (EPO) purification process, including pH 4, pH 5, and room temperature were checked on product peptide mapping results. Materials and Methods: Cell culture harvest was purified under stress by different chromatographic techniques consisting of gel filtration, anionic ion exchange, concentration by ultrafiltration, and high resolution size exclusion chromatography. To induce more pH stresses, the purified EPO was exposed to pH stress 4 and 5 by exchanging buffer by a 10 KDa dialysis sac overnight. The effects of temperature and partial deglycosylation (acid hydrolysis) on purified EPO were also studied by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and peptide mapping analysis. Removal of sialic acid by mild hydrolysis was performed by exposure to two molar acetic acid at 80°C for 3 h. Results: No significant effect was observed between intact and stressed erythropoietin peptide mapping profiles and SDS-PAGE results. To validate the sensibility of the technique, erythropoietin was partially acid hydrolyzed and significant changes in the chromatographic peptide map of the intact form and a reduction on its molecular weight were detected, which indicates some partial deglycosylation. Conclusions: Purification process does not alter the peptide mapping profile and purification process stresses are not the cause of peptide mapping noncompliance.

Background: Recurrence rate is considerable with current topical treatments of plantar warts. We compared the efficacy of topical pyruvic acid (70%) with salicylic acid (16.7%) compound in treating multiple plantar warts. Materials and Methods: In this randomized controlled trial, 60 patients with multiple plantar warts were equally randomized to receive either pyruvic acid 70% or compound salicylic acid solution (salicylic acid 16.7%, lactic acid 16.7%, and collodion 100%) that was topically applied twice a day for 4 weeks. Patients were visited every 2 weeks for 1 month after starting treatment and then every 1 month for another 2 months. The number and size of warts, treatment complications (pain, burning, scar, pigmentation, and crust), and recurrence were evaluated. Results: Warts' number was decreased by -13.12 ± 25.6% with pyruvic acid and by -23.0 ± 28.0% with compound salicylic acid (P = 0.159) after treatment. Warts' size was decreased by -43.47 ± 57.0% with pyruvic acid and by -37.40 ± 32.76% with compound salicylic acid (P = 0.615) after treatment. There was no difference between the two groups in cumulative incidence of treatment complications (P > 0.05). Also, there was no difference between the two groups in recurrence rate at 2 months (10 vs. 16.7%, P = 0.500) or at 3 months after treatment (3.3 vs. 6.7%, P = 0.335). Conclusion: Topical pyruvic acid and compound salicylic acid had the same efficacy and complications in treating plantar warts. Decision for choosing the treatment can be made based on the costs and individual factors as well as patients preferences.

Background: Diabetes is the most prevalent disease that has involved 177 million people all over the world and, due to this, these patients suffer from depression and anxiety and they should use special methods for controlling the same. The aim of this research is the study of the effect of problem solving and decision making skill on the rate of the tendency to depression and anxiety. Materials and Methods: This research is a quasi-experimental (case-control) study. Statistically, the population of the present study was all diabetic patients of Qaemshahr who were controlled by physicians in 2011-2012. Thirty files were selected randomly from them and divided into two 15 patients' groups (control and subject group) randomly. The measurement tools were Back depression inventory (21 items) and Zank anxiety questionnaire that were distributed among two groups. Then, the subject group participated in eight sessions of teaching problem solving and decision making courses separately, and the second group (control group) did not receive any instruction. Results: Finally, both groups had passed post-test and the data obtained from the questionnaires were studied by variance analysis statistical methods. Conclusion: The results showed that teaching problem solving and decision making skills was very effective in reducing diabetic patients' depression and anxiety and resulted in reducing their depression and anxiety.

Background: Knee replacement is one of the most frequently performed surgical procedures in the world. Local data on revision total knee arthroplasty (TKA) are limited. This study aims to assess the rates and causes of revision TKA in Kashani Hospital (Isfahan, Iran) from 2011 to 2013. Materials and Methods: We assessed all primary TKA and revision TKA procedures performed from 2011 to 2013 for the rate and causes of failures. Demographic data, duration from primary TKA to revision TKA and underlying diagnosis for primary TKA were also assessed. Results: Overall, 353 primary TKA procedures carried out in this period. The overall revisions following primary TKA in this period was 24 cases, indicating a revision burden of 6.8%. The most common cause of revision TKA was infection, which was in 16 cases (44.4%). Other causes included patellar complications, mechanical loosening of both tibia and femur, mechanical loosening of tibia, instability, and periprosthetic fracture. The main revision procedures were all component revision, tibial component revision, isolated tibial insert exchange and patellar tendon repair. The most common revision procedure was two stage all component revision, which was carried out in 13 subjects (36.1%). Conclusion: Local indications for revision TKA are mainly similar to those in other large centers. As compared with other centers, with considering the follow-up time, revision burden is relatively higher in this center.

Background: Acinetobacter baumannii is one of the most important pathogens in hospital-acquired infections especially in intensive care units (ICUs). This opportunistic pathogen can be easily isolated from water, soil, and hospital facilities. A. baumannii as a nosocomial opportunistic pathogen is resistant to a wide range of antibiotics and responsible for multiple infections, including bacteremia, pneumonia, meningitis, urinary tract infections, and surgical wounds. The aim of this study was to determine frequency and resistance patterns of A. baumannii isolated in ICUs of Isfahan Hospitals. Materials and Methods: During 1 year period (2012-2013), 350 specimens were collected from ICUs of Isfahan hospitals. The isolates were characterized as A. baumannii by conventional phenotypic, biochemical tests and confirmed by PCR for OXA-51-like gene. Susceptibility of isolates was determined by standard disk diffusion method according to CLSI. Results : From total of 350 specimens, 43 isolates were A. baumannii. The antimicrobial patterns of isolates showed that 53.5% of isolates were resistant to amikacin, 83.7% to tetracyclin, 86% to ceftazidime, 90.7% to Trimethoprim sulfametoxazol, 93% to imipenem, cefepime, meropenem, ampicillin-sulbactam. All isolates were resistant to ciprofloxacin. Conclusion: This study showed a high resistance of A. baumannii to a wide range of antimicrobial agent. It is necessary to adopt appropriate strategies to control the spread of the bacteria in care unit centers and wards.

Backgrounds: The new lifestyle increases the incidence of hypertension. In Iranian folk medicine, it is believed that Verjuice obtained by unripe grape (Vitis vinifera) could control blood pressure. We tested the effects of unripe grape extract (UGE) in blood pressure alteration, serum antioxidant level and aorta endothelial permeability in rats. Materials and Methods: Four groups of rats were treated daily by placebo and three different doses of UGE (50, 150 and 300 mg/kg/day). Four weeks later, the animals were anesthetized and catheterized. The direct mean arterial, systolic and diastolic pressures (MAP, SP and DP) were recorded. The endothelial permeability was determined and the serum levels of superoxide dismutase (SOD), malonaldialdehyde (MDA) and nitrite were measured. Results: High dose of UGE increased MAP and SP significantly (P < 0.05) when compared with the control group. Decrease of MDA and increase of SOD and nitrite also were detected statistically in animals treated with high dose of UGE (P < 0.05). No difference in aorta endothelial permeability was observed between the groups. Conclusion: The effect of UGE on blood pressure was dose dependent. High dose of UGE increased MAP and SP although its antioxidant activity was significantly high. Such observation mechanisms need to be defined.

Background: Dysphagia is a common disorder among patients with Parkinson's disease (PD). It occurs in up to 80% of all (PD) patients during the early stages of the disease and up to 95% in the advanced stages; but professionals may not hear from the patients about dysphagia symptoms until these symptoms reach an advanced stage and lead to medical complications. Materials and Methods: Thirty-three PD patients (mean age 66.09 ± 9.4 years; 24 men, nine women) participated in this study at our Neurology Institute, between April 20, 2013, and October 26, 2013. They were asked two questions; one about saliva control and the other about silent saliva penetration and aspiration. Next, they underwent the videofluoroscopic swallowing study (VFSS). Results: The Pearson Correlation coefficient between the Penetration-Aspiration Scale (PAS) scores and question 1 scores was 0.48 (P < 0.05, =0.25), and there was a significant correlation between the PAS scores and question 2 scores, and also question 1 scores + question 2 scores (r = 0.589, P < 0.05, =0 and r = 0589, P < 0.05, =0). Conclusions: This study showed a significant correlation between the questions about saliva control, silent saliva penetration, and aspiration, and laryngeal penetration and aspiration during VFSS. Therefore, by using these two questions, the potential silent laryngeal penetration and aspiration during meals could be detected before it led to aspiration pneumonia. Taking the benefit of these questions, as a part of the swallowing assessment of PD patients, is recommended.

Background: This study was designed to evaluate the protective effect of Echium amoenum total anthocyanin extract (ETAE) on partial/transient cerebral ischemia in the rats. Materials and Methods: Rats received ETAE (50, 100 and 200 mg/kg, i.p.) 30 min before the induction of cerebral ischemia. Cerebral ischemia was induced by bilateral common carotid arteries occlusion (BCCAO) for 30 min, followed by 72 h reperfusion. The neurological deficit, brain performance, and sensory motor function were assessed 48 h and 72 h after surgery. After sacrification, the brains were evaluated for myeloperoxidase (MPO) activity and histopathological changes. Results: Our results showed that motor function significantly decreased in ischemia/reperfusion (I/R) group as compared to the sham group. Histopathological analysis exhibited the shrinkage and atrophy of the neurons in I/R group. ETAE at the dose of 200 mg/kg improved spontaneous activity and memory induced by cerebral ischemia compared to the control group and also decreased brain MPO activity following cerebral ischemia. However, it could not affect the ability to climbing, body proprioception, vibrissae touch and brain water content. In addition, pretreatment with ETAE at higher doses significantly reduced ischemia-induced neuronal loss of the brain. Conclusion: The anthocyanin rich fraction from E. amoenum was found to have protective effects against some brain damages postischemic reperfusion . However, further researches are required for investigating the exact mechanisms of the effect of this plant in the prevention of cerebral ischemia in human.

Background: Coma is one of the most important complications of brain injury. Comatose patients in the intensive care units are exposed to sensory deprivation. This study aims to survey the effect of family members' voice on level of consciousness of comatose patients hospitalized in the intensive care units. Materials and Methods : In this single-blind randomized controlled trial, 40 comatose patients with brain injury with acute subdural hematoma in intensive care units were randomly assigned into two groups. The intervention group was stimulated twice a day each time 5-15 min with a recorded MP3 from family members' voice for 10 days. The patients' level of consciousness was measured with Glasgow Coma Scale before and after auditory stimulations. In the control group, GCS was measured without auditory stimulation with the same time duration like intervention group. Data analysis in software SPSS version 15 and using Chi-square test, independent t-test, paired t- test and analysis of variance with repeated measures was done. Results: On the first day before the intervention, there was no a statistically significant difference between the mean of GCS in both groups (P = 0.89), but on the tenth day after the intervention, there was a significant difference (P = 0.0001) between the mean GCS in both control and intervention groups. Also, there was a significant difference between the mean daily GCS scores in two groups (P = 0.003). The findings during ten days showed the changes in the level of consciousness in the intervention group from the 4 ^rd day of the study were more in the mean daily GCS scores than control group. Conclusion : This study indicated that family members' voice can increase level of consciousness of comatose patients with acute subdural hematoma.

Background: Inorganic antibacterial factors have bacterial resistance and high thermal stability. Inorganic nanomaterials which have new structures with biological, chemical and physical properties have been made since their applications due to their nano size. In this study, the antibacterial effect of cadmium oxide nanoparticles on Staphylococcus aureus and Pseudomonas aeruginosa bacteria was investigated. Materials and Methods: The different concentrations (10 μg/ml, 15 μg/ml and 20 μg/ml) of cadmium oxide nanoparticles were prepared and their effects were studied against considered bacteria in both solid and liquid media. Results: The results showed that there is a direct relationship between inhibitory effect and amount of consumer dose of nanoparticles. Furthermore, it was observed that antibacterial properties of cadmium oxide nanoparticles on activity and growth of Staphylococcus aureus was more effective than Pseudomonas aeruginosa. Conclusion: This study showed that antibacterial effects of cadmium oxide nanoparticles on positive gram bacteria are stronger than negative gram bacteria and antibacterial effects of cdo nanoparticles against both bacteria, but Staphylococcus aureus bacteria were more sensitive to nanoparticles as compared to Pseudomonas aeruginosa.

Background: Human brucellosis is caused by infection with certain species of the genus Brucella and is characterized by bacterial persistence and inflammation of many host tissues. Handling all live Brucella involves risk of laboratory infection and very strict biosafety rules must be observed. In order to avoid these disadvantages, method based on the PCR-RFLP shows excellent typeability, reproducibility, stability, and epidemiological concordance. The omp2 locus contains two gene copies (named omp2a and omp2b) coding for porin proteins and has been found particularly useful for molecular typing and identification of Brucella at the species, biovar, or strain level. This study is designed to evaluate the molecular epidemiology of Brucella spp from human and livestock in Isfahan province, central region of Iran in order to use the findings in efficient disease prevention programs. Materials and Methods: One hundred ninety blood samples were collected from human and cattle with active brucellosis and 40 aborted ewes fetuses were collected and genotyped using PCR-RFLP technique, DNA polymorphisms such as the restriction patterns of the PCR-amplified omp2a and omp2b genes. Results: The molecular characterization performed to assess the species and the biovar of the Brucella strains. Analysis of the 230 isolates examined in this study generated three unique RFLP profiles. One of the profiles was the most common being present in 134/180. Conclusion: Our findings confirm abundance of B. melitensis, particularly biovar 1 in human and sheep are identical but B. abortus biovar 3 as the etiological agent of cattle brucellosis most frequently isolated in the Isfahan area.

Background: This study aimed to determine how age groups effect on the phenotype of metabolic syndrome (MetS) among Iranian population. Materials and Methods: This cross-sectional study was conducted as part of Isfahan Healthy Heart Program. Height, weight, waist circumference, and blood pressure were measured by trained health-care professionals. MetS was defined as having three or more of the National Cholesterol Education Program III criteria. The relation between different age groups and different phenotypes of MetS was examined using the multinomial logistic regression. Results: We found low high-density lipoprotein-cholesterol (HDL-c) was the most common feature, followed by hypertriglyceridemia (HTG), abdominal obesity (ABO), hypertension (HTN), and high fasting blood glucose in decreasing order of prevalence. The most prevalent combination of MetS components was hypertrigeceridemia, low HDL-c and ABO (50.7%) in all subjects and especially in younger age group (63.2%). In elder age group, the most prevalent three components combination was HTG, Low HDL-c and HTN (43.9%). Logistic regression analysis demonstrated that elder subjects were at approximately 12 times higher risk of having the combination HTG, ABO, low HDL-c, and HTN (P < 0.001) compared to the middle age subjects who had a lower risk for the same combination; (2 [1.49-3.49]) (P < 0.001). Conclusion: This study provides a nationally representative estimate of the prevalence of different phenotypes of MetS across different age groups. Regarding different phenotypes of MetS in various age groups need to have important implications in the clinical management of these patients and the implementation of public health.

Background: Purses hardly get washed and are discarded, mostly, when they are no longer usable. This study aims to investigate whether women's and men's purses can serve as fomites. Materials and Methods: A total of 145 purses from 80  women and  65 men were swabbed and cultured. The bacteria were identified by gram staining and with the standard biochemical tests. Results: A total of 138 purses (95.2%) showed bacterial contamination, out of which 49.4% had a single growth and 50.7% had mixed growth. The material of the purse was found to affect bacterial growth. Synthetic purses showed higher mean colony-forming unit (CFU) counts (P < 0.05). Micrococcus (64.8%) and coagulase-negative Staphylococcus (64.1%) were the most common bacteria isolated, followed by Bacillus spp. (13.8%). Micrococcus was found with a higher prevalence on men's purses, while Bacillus spp. were more prominent on women's purses (P < 0.05). The difference between the rates of bacterial growth from the purses of women and of men was found to be statistically significant (57.2% and 44.7%; P < 0.05). Furthermore, the mean CFU count was higher for men's purses than for women's purses (P < 0.05). Conclusion: Purses from both men and women are potential vectors for transmission of diseases across the community. The use of synthetic purses should be discouraged, as they contribute to  increased bacterial colonization.

Background: Moringa peregrina (Forssk.) Fiori. is a tropical tree growing in southeast of Iran. All parts of this plant have nutritional uses and pharmacological activities. The present study was designed to evaluate the effect of hydroalcoholic extract from the leaves of M. peregrina in dexamethasone (Dex)-induced hypertension in rats. Materials and Methods: Male Wistar rats received Dex (30 μg/kg, subcutaneously; s.c.) or saline (as vehicle, 1 ml/kg, s.c.) for 14 days. In a prevention study, the rats received M. peregrina extract (100, 200 and 400 mg/kg, orally) for 4 days, followed by Dex for 14 days. In a reversal study, the animals received M. peregrina extract orally from day 8 to 14. The systolic blood pressure (SBP) was measured using tail-cuff method. The hydrogen peroxide (H ₂ O ₂ ) concentration and ferric reducing antioxidant power (FRAP) were assessed in plasma samples. Results: Dex significantly increased the SBP and the plasma H ₂ O ₂ and decreased the plasma FRAP value (P < 0.001). M. peregrina extract at a dose of 400 mg/kg prevented (P < 0.01) but did not reverse Dex-induced hypertension in rats. It also dose-dependently reduced the plasma H ₂ O ₂ concentration and improved the FRAP value upon Dex administration. Conclusions: The findings of the present study indicated the antioxidant and partially antihypertensive effects of the hydroalcoholic extract from the leaves of M. peregrina in Dex-induced hypertension. Further experiments on other fractions of the leaves and also other parts of this plant are suggested for better evaluation of its antihypertensive effect and finding its mechanisms of action.

Background: Chicken antibodies have many advantages to the mammalian antibodies and have several important differences against mammalian IgG with regard to their specificity and large-scale production. In this study, the production, purification, and HRP conjugation of polyclonal IgY against hepatitis virus surface antigen (HBsAg) were carried out. Materials and Methods: Single Comb White Leghorn hens were immunized intramuscularly with hepatitis B vaccine in combination with Freund's adjuvants. Blood and eggs were collected before and during ten weeks after the first immunization. Results: A highly purified of 180 KDa with specific activity of 200 mIU/ml was obtained by our purification protocol. One milligram of the purified IgY was labeled with horseradish peroxidase (HRP). Sandwich ELISA was used to determine the optimum titer of anti-HbsAg IgY-conjugate which was found to be 1:20. Conclusions: This study showed that laying hens can be used as an alternative source for production of polyclonal antibodies against HBsAg and anti-HBs IgY could be labeled with HRP enzyme and could subsequently be used successfully as secondary antibody in ELISA for detection of HBsAg in the patients sera.

Background: Poliomyelitis is still an endemic disease in many areas of the world including Africa and South Asia. Iran is polio free since 2001. However, due to endemicity of polio in neighboring countries of Iran, the risk of polio importation and re-emergence of wild polio virus is high. Case definition through surveillance system is a well-defined method for maintenance of polio eradication in polio free countries. Methods: In a cross-sectional survey from 2007 to 2013, we reviewed all the records of under 15 years old patients reported to Acute Flaccid Paralysis Committee (AFPC) in Isfahan province, Iran. All cases were visited by members of the AFPC. Three stool samples were collected from each reported case within 2 weeks of onset of paralysis and sent to National Polio Laboratory in Tehran, Iran, for poliovirus isolation. Data were analyzed by SSPS software (version 22). Student's t-test and Chi-square was used to compare variables. Statistical significance level was set at P < 0.05. Results: In this 6-year period 85 cases were analyzed, 54 patients were male (63.5%) and 31 were female (36.5%). The mean age of patients was 5.7 ± 3.9 years. The most common cause of paralysis among these patients was Guillian-Barrι syndrome (83.5%). We did not found any poliomyelitis caused by wild polio virus. Only one case of vaccine associated poliomyelitis was reported. Conclusion: Since 1992, Iran has a routine and high percent coverage of polio vaccination program for infants (>94%), with six doses of oral polio vaccine (OPV). Accurate surveillance for poliomyelitis is essential for continuing eradication.

Background: Varicose veins are extremely common disease which is due to elevated superficial venous pressures. We aimed to know that if joint hypermobility causes the venous insufficiency following the prolonged standing. Materials and Methods: This prospective cohort study conducted on the soldiers of training periods in a military base of Iran Army in Isfahan in 2013. The active-duty soldiers were first examined by a physician and their Beighton scores (BSs) were obtained. At the onset of the training period, the presence of chronic venous insufficiency was clinically evaluated according to the C class of clinical, etiological, anatomical, and pathological classification. After 3 months, soldiers with and without joint hypermobility were reexamined for manifestations of venous insufficiency based on clinical examination. Results: Of 718 soldiers, 211 subjects were diagnosed for joint hypermobility syndrome (29.3%). The mean BS was significantly higher in hypermobility soldiers (5.5 ± 1.5) than the healthy ones (1.2 ± 1.1). Before the training period, the prevalence of spider and varicose veins in soldiers with joint hypermobility was significantly higher than healthy subjects (P > 0.001). After the training period, the prevalence of venous insufficiency significantly increased in soldiers with joint hypermobility (P > 0.001) while there was no significant difference in healthy group before and after the period of training (P = 0.25). Conclusion: Hypermobility could be considered as a risk factor for the development of venous insufficiency, so it seems necessary to evaluate the population who need to be standing for a long time for evidence of joint hypermobility.

Background: Herniotomy is a common operation done by pediatric surgeons. Recent studies have shown that high ligation in herniation in adult is not necessary, but this method was not fully evaluated in children. We compared non-ligation with high-ligation sac in herniotomy in terms of surgical complications and duration. Materials and Methods: This randomized controlled trial study was done on 104 children with inguinal hernia at Al-Zahra Hospital, Isfahan, Iran, between 2011 and 2013. Patients were equally randomized to undergo herniotomy with ligation of sac at the internal ring level or to undergo herniotomy without sac ligation. Patients were followed up just after the operation, and in the 1 ^st , 6 ^th , and 12 ^th weeks postoperation to discover early (scrotal hematoma, edema, wound infection, and postoperation fever) and late (adhesion and recurrence) complications. Also, duration of operation was recorded for each group. Results: The incidence of early complications (nine cases in high-ligation and eight cases in non-ligation group) was the same in both groups (P = 0.402). No late complication was observed in any group. The mean duration of operation in high-ligation group (18.84 ± 5.47 min) was significantly shorter than non-ligation group (21.46 ± 9.03 min) (P < 0.001). Conclusion: Complications are the same in herniotomy with or without ligation of the sac, but the duration of the non-ligation procedure is shorter than that of high-ligation. We suggest that herniotomy without sac ligation in children be the procedure of choice to save time and also to prevent any other possible complications such as nerve damage, spermatic cord injury, or peritoneal tearing.

Background: Onychomycosis is one of the most common clinical forms of fungal infections due to both filamentous fungi and yeasts. The genus of Candida is one of the most prominent causes of onychomycosis in all around the world. Although Candida albicans is still the most frequent cause of nail infections, use of broad-spectrum antifungal agents has led to a shift in the etiology of C. albicans to non-albicans species. The aim of the present study is rapid and precise identification of candida species isolated from nail infection by using of PCR-RFLP technique. Materials and Methods: A total of 360 clinical yeast strains were collected from nail infections in Iran. Genomic DNA was extracted using FTA^; cards. ITS1-5.8SrDNA-ITS2 region was amplified using universal primers and subsequently products were digested with the restriction enzyme MspI. For identification of newly described species (C. parapsilosis complex), the SADH gene was amplified, followed by digestion with Nla III restriction enzyme. Results: Candida albicans was the most commonly isolated species (41.1%), followed by C. parapsilosis (21.4%), C. tropicalis (12.8%), C. kefyr (9.4%), C. krusei (5.5%), C. orthopsilosis (4.1%), C. glabrata (2.8%), C. guilliermondii (1.4%), C. rugosa (0.8%), and C. lusitaniae (0.5%). Patients in the age groups of 51-60 and 81-90 years had the highest and lowest distribution of positive specimens, respectively. Conclusion: Rapid and precise identification of Candida species from clinical specimens lead to appropriate therapeutic plans.

Background: Autism spectrum disorder (ASD) is a complex, heterogeneous neurodevelopmental disorder with onset during early childhood. Most studies have reported an elevation in platelet serotonin in persons with autism. The serotonin (5-hydroxytryptamine; 5-HT) transporter in the brain uptakes 5-HT from extracellular spaces. It is also present in platelets, where it takes up 5-HT from plasma. Polymorphisms in serotonin transporter gene (SLC6A4) were frequently studied in many neuropsychiatric disorders. Materials and Methods: We have measured the plasma 5-HT levels in 20 autistic male children and 20 control male children by the enzyme-linked immunosorbent assay (ELISA) method. In addition, the SLC6A4 promoter region (5-HTTLPR) insertion/deletion (I/D) polymorphism was studied, using whole genomic DNA. Results: Plasma serotonin was significantly low in autistic children compared to control (P = 0.001), although correlation to severity of autism was not significant. The frequency of short (S) allele in autism cases was 10% and in the control group it was absent. Conclusion: Our study demonstrated an increased prevalence of 5-HTTLPR S allele in autism subjects. Significantly decreased plasma serotonin was detected in autism subjects, with no significant relationship between 5-HTTLPR genotype and plasma 5-HT being evident.

Background: Tissue transplantation plays a pivotal role in the treatment of diseases. Pancreatic beta cell transplantation is the best way to obtain normal blood glucose in patients with diabetes type 1. However, it is not clear how long endocrine pancreas cells can be used for transplantation after the donor's death. The present study was conducted to analyze the performance and viability of pancreatic islet cells after death. Materials and Methods: Pancreas was separated from Balb/c mice at different times (0, 1, 4, 6, 12, and 24 h after death) at temperatures of 4°C and 23°C, and was cultured in Roswell_Park_Memorial_Institute (RPMI) 1640. Insulin shock, MTT assay, aldehyde fuchsin staining, dithizone staining, and florescence microscopy methods were applied to analyze the performance of beta cells, cell viability, islets' diagnosis, islet cells' diagnosis, and viable and necrotic cells diagnosis, respectively. Results: Islets of Langerhans and beta cells were diagnosed. By increasing the temperature and time, the viability and performance of beta cells decreased significantly (P < 0.05). Conclusion: The best condition for keeping the islets of Langerhans in terms of viability and performance is 4 h after death at temperature of 4°C.

Background: A large number of natural products and dietary components have been evaluated as potential chemoprotective agents. In the present investigation we report the effects of treatment with the dietary antioxidant, pistachio, on cisplatin- or vincristine-induced neurotoxicity in male Wistar rats. Materials and Methods: Dietary pistachio (10%) was assessed for its neuroprotective effects through the alteration in performance of hippocampus- and cerebellum-related behaviors following chronic cisplatin (5 mg/kg) or vincristine (0.2 mg/kg) treatment in male rats. We also evaluated the effects of cisplatin, vincristine, and pistachio administration on nociception. Six behavioral tasks were used: open field, rotarod, grasping, Morris water maze (MWM), hot plate, and motor nerve conductive velocity (MNCV). Results: We showed that the exposure of adolescent rats to cisplatin or vincristine resulted in a significant decrease in explorative behaviors and memory retention. Pistachio consumption somewhat improved memory and motor abilities in cisplatin- or vincristine-treated rats, while pistachio alone did not show any significant changes in these abilities compared to saline. Cisplatin and vincristine increased the latency of response to nociception, and pistachio did not reverse this effect. Conclusion: We conclude that pistachio in the diet following anticancer drugs such as cisplatin and vincristine might have a protective effect against anticancer drug-induced disruptions in motor and cognitive function. However, further studies are needed to elucidate the exact mechanisms of this protective effect of pistachio.

Background: In some cases, permanent reduction in cerebral functioning affects a high percentage of patients undergoing cardiovascular surgery. We studied the relationship between the results of preoperative bilateral carotid artery colour Doppler sonography and regional cerebral oxygen saturation (rSO ₂ ) during coronary artery bypass graft surgery (CABG). Materials and Methods: This study was a cross-sectional analytical study conducted with 96 candidates for off-pump CABG. This study determined the percentage of the correlation of rSO ₂ with demographic information, diabetes, hyperlipidemia, hypertension, myocardial infraction (MI), and smoking, and also provided information on the presence and type of plaque, intima-media thickness (IMT), and percentage of stenosis of carotid artery detected through colour Doppler sonography. Data were analyzed by the t-test, the Chi-square test, and simple linear regression. Results: In this study, the mean value of rSO ₂ increased after intubation compared to the mean before intubation, the difference being statistically significant (P = 0.005). A comparison of the mean rSO ₂ of the right side of the brain and the percentage of right carotid obstruction (stenosis of less than 50% vs. stenosis with a range of 50-69%) revealed that the mean rSO ₂ at the time of the partial-clamp between carotid stenosis less than 50% and carotid stenosis with a range of 50-69% was statistically significant (P = 0.043). Conclusions: There is no statistically significant correlation between rSO ₂ and percentage of carotid artery stenosis less than 70%. It is advised that rSO ₂ and carotid stenosis of greater than 70% be studied in future.

Background: On account of the lower electron density in the lung tissue, the dose distribution in the lung cannot be verified with the existing polymer gel dosimeters. Thus, the aims of this study are to make a low density polymer gel dosimeter and investigate the effect of nitrogen gas bubbles on the R ₂ responses and its homogeneity. Materials and Methods: Two different types of low density polymer gel dosimeters were prepared according to a composition proposed by De Deene, with some modifications. In the first type, no nitrogen gas was perfused through the gel solution and water. In the second type, to expel the dissolved oxygen, nitrogen gas was perfused through the water and gel solution. The post-irradiation times in the gels were 24 and 5 hours, respectively, with and without perfusion of nitrogen gas through the water and gel solution. Results: In the first type of gel, there was a linear correlation between the doses and R ₂ responses from 0 to 12 Gy. The fabricated gel had a higher dynamic range than the other low density polymer gel dosimeter; but its background R ₂ response was higher. In the second type, no difference in R ₂ response was seen in the dose ranges from 0 to 18 Gy. Both gels had a mass density between 0.35 and 0.45 g.cm ^-3 and CT values of about -650 to -750 Hounsfield units. Conclusion: It appeared that reactions between gelatin-free radicals and monomers, due to an increase in the gel temperature during rotation in the household mixer, led to a higher R ₂ -background response. In the second type of gel, it seemed that the collapse of the nitrogen bubbles was the main factor that affected the R ₂ -responses.

Background: Since 2003, the incidence of community associated Clostridium difficile infection (CA-CDI) has increased; different types of food have been supposed to be the vectors of C. difficile strains. The purpose of this study is to investigate the occurrence of C. difficile strains in ready-to-eat salads distributed in food services. Materials and Methods: A total of 106 ready-made salad specimens were sampled from different restaurants and food services located in Isfahan, in the center of Iran. Positive isolates of C. difficile were identified and confirmed for the existence of three genes including tpi, tcdA and tcdB by multiplex PCR. Results: A total of six (5.66%) samples were positive for C. difficile strains. Of which, one strain (16.6%) was positive for A and B toxins. Conclusion: The existence of toxigenic C. difficile in ready-made salads could be a caution for public health. Further investigation is required to assess the relationship between the isolated strains in our study and those from diarrheic patients through molecular typing.

Background : The ischemic preconditioning phenomenon can save myocardium against move severe ischemic damages and reduce infarction size and furthermore a heart rhythm disturbance. In this study we examine relationship between troponin I (as a structural myocardial protein) level and anesthetic agents in the children. Materials and Methods: In this study 84 children under 12 years age before cardiac surgery were divided randomly into two groups of 42 each. For anesthetic maintenance sevoflurane with dose of 0.5-1 MAC was used in Group 1 and 100-150 mg/kg/min of intravenous propofol in Group 2 for maintenance of anesthesia. Troponin I level was assessed 2 before and 1 hour after anesthetic induction. Outcome measures included the serum cardiac troponin I level in children before and after surgery in two study groups. Results: There was no significant difference between two groups in indices and both groups were homogenous in this point of view. The troponin I level after surgery was significantly increased in two groups. In the sevoflurane group it was 0.04 ± 0.12 to 0.05 ± 0.09 ng/ml (P value = 0.003) and the propofol group was 0.12 ± 0.26 to 0.19 ± 0.38 ng/ml (P value = 0.001). Conclusions: In this study two Anesthetic regimens were compared to assess the mean troponin I level before and after pediatric closed heart surgery, and it was shown that mean troponin level before and after surgery in the sevoflurane group was less than the propofol group. But this result was not statistically significant. These results indicate that although more protective effects of sevoflurane on myocardial injuries during pediatric cardiac surgery is predominant but this effect has no significant difference in the propofol group.

Background: This study was aimed to evaluate the predictive value of fecal calprotectin in patients with ulcerative colitis from patients with irritable bowel syndrome (IBS). Materials and Methods: Between May and October 2013, 88 adult patients, between the age 18 and 65 years with a history of chronic diarrhea of unknown origin were assessed. Standard colonoscopies were performed in all patients to assess ulcerative colitis. Before colonoscopies, they were asked to supply a stool specimen. Fecal calprotectin value was measured using a commercial enzyme-linked immunosorbent assay kit. Results: The mean of age, gender combination, and body mass index were not significantly different between patients with ulcerative colitis or IBS. The duration of disease in ulcerative colitis patients was significantly higher than IBS patients (P < 0.0001). The level of calprotectin in ulcerative colitis patients was significantly higher than IBS patients (265.9 vs 115.8, respectively, P = 0.001). Also, cutoff value >164 μg/g with sensitivity and specify of 57 (CI: 41%-71.6%), and 75 (CI: 59.7%-56.8%), respectively, was the best for discrimination between patients with ulcerative colitis and those with IBS. Conclusion: Our results show that fecal calprotectin as a noninvasive method, which can be used to identify patients with ulcerative colitis from IBS patients has low sensitivity and specificity.

Background: This study aims to evaluate the impact of the Isfahan Healthy Heart Program (IHHP) interventions concerning healthy behavior, on the prevalence of the metabolic syndrome (MetS) and its components in the Iranian population. Materials and Methods: The IHHP targeted the population at large in three districts in central Iran from 2000 to 2007. Numerous interventional activities were performed to improve lifestyle. The main intervention strategies were public education through mass media, intersectional cooperation, health professional education, marketing and organizational development, legislation and policy development, as well as research and evaluation. MetS was defined based on the Adult Treatment Panel (ATP) III definition. The logistic regression method was applied to explore the relationship between lifestyle factors with components of metabolic risk factors. Results: The mean age of the participants was 44.68 ± 14.43 years in 2001. The mean values of the MetS components differed from 2001 to 2007. The mean of systolic blood pressure (SBP) decreased from 126.7 ± 22.31 to 124.21 ± 20.0 and from 129.47 ± 23.08 to 126.26 ± 21.88 among females in both the intervention and reference areas. Similar changes were observed among males. The mean diastolic blood pressure (DBP) and triglycerides decreased significantly in the intervention area and increased significantly in the reference area in both sexes. High density protein cholesterol (HDL-C) was decreased in both sexes, from 2001 to 2007, in both areas. A strong relationship between tobacco control with high SBP and hypertriglyceridemia was found (P < 0.01). Conclusion: Lifestyle improvement programs could be useful to improve the MetS status among men and women.

Background: Cisplatin (CP) is a chemotherapy drug, with the major side effect of nephrotoxicity. The level of endothelin-1 (ET-1) increases during nephrotoxicity, which is accompanied with vasoconstrictive properties. Bosentan (BOS) is a nonselective ET-1 receptor antagonist, having vasodilatory and anti-hypertension effects. The purpose of this study was to investigate the renoprotective effect of BOS against CP-induced nephrotoxicity in male and female rats. Materials and Methods: Male and female rats were divided into six groups; groups 1-3 and 4-6 were male and female rats, respectively. Animals in groups 1 and 4 were considered as negative control and groups 2 and 5 considered as positive control groups received BOS (30 mg/kg/day) alone and CP (2.5 mg/kg/day) alone, respectively, for 1-week. The animals in groups 3 and 6 were treated with both CP and BOS. Finally, serum parameters were measured, and the kidney tissue was subjected to staining to evaluate tissue damage. Results: The serum levels of blood urea nitrogen and creatinine, kidney tissue damage score and kidney weight elevated, and body weight significantly decreased in both CP alone and in CP plus BOS-treated groups when compared with the control groups (P < 0.05), while BOS did not ameliorate these parameters neither in males nor in females. No significant differences were observed in serum levels of nitrite and malondialdehyde between the groups, but kidney tissue level of nitrite decreased significantly in CP alone and CP plus BOS-treated groups (P < 0.05). Conclusion: Renoprotective effect of BOS, as ET-1 blocker, was not observed against CP-induced nephrotoxicity neither in male nor in female rats. This is while BOS promoted the severity of injuries in females.

Background: The main objective of this study was to determine the incidence, time to event, and risk factors for posttraumatic seizures (PTS) following traumatic brain injury (TBI) in a five-year follow-up survival design. Materials and Methods: In a cohort study, between September 2008 and October 2013, 411 traumatic brain injury patients referring to the Emergency Units (EUs) of the Isfahan University Hospitals, who met the inclusion criteria, entered the study. Follow-up evaluations were conducted by telephone conversation or clinical examination, if needed. The patients were followed for up to five years after TBI or until a first seizure event if it occurred prior to the five-year anniversary. The survival rate data were collected and measured for all patients under follow-up. Survival analysis on PTS and its related predictors was done using the Kaplan-Meier curves and the Cox proportional hazards regression. All analyses were done using STATA and SPSS statistical software, and P-values smaller than 0.05 were considered to be statistically significant. Results: The median duration of follow-up was 36 months (Interquartile range: 23-50). A significantly greater number of first seizures occurred in the first year after injury than all other years (57.7%). The overall incidence of posttraumatic seizures, in this study population, was 6.33% (95% CI: 3.96-8.69). Among the participants, the incidence rates for early and late posttraumatic seizures were 1.95 and 4.38%, respectively. The result of the Cox regression analysis showed that the Glasgow Coma Scale (GCS) score and trauma severity were associated with PTS. Conclusion: All in all, the present study highlighted the role of the trauma severity and GCS as effective factors in the incidence of seizure in patients with TBI. Particular care is advised for patients with these risk factors during the primary handling in the Emergency Units.

Background: Day-care gynecological procedures require the use of anesthetic agents, which ensure rapid induction and recovery. Although propofol is the gold standard drug in day-care procedures, it has its own side effects like apnea, cardiovascular instability, pain on injection, as well as its cost. The ideal drug combination to achieve this end remains elusive. Therefore, a combination of propofol, thiopentone, and ketamine may be a better alternative. Materials and Methods: This prospective, double-blind, randomized study was conducted on 60 women, aged 18-50 years, American Society of Anesthesiologists (ASA) physical status 1 and 2, undergoing day-care gynecological surgeries. The patients were allocated to two groups. Group T received an admixture containing 10 ml of 1% propofol and 10 ml of 1.25% thiopentone. Group K received an admixture containing 10 ml of 1% propofol and 10 ml of 0.5% ketamine. Results: There was less variation in the mean systolic blood pressure of patients in Group K as compared to patients in Group T. The mean total dose of propofol required in Group K (0.85 mg/kg) was significantly less than that required in Group T (1.12 mg/kg) (P = 0.0004). The mean recovery time in Group T (3.67 minutes) was significantly less than in Group K (6.27 minutes; P = 0.0001). However, the mean discharge time in both the groups was similar. (P = 0.7392). The results were analyzed statistically using the Student's t-test and the Fisher's exact test. Conclusions: Both the propofol-thiopentone and propofol-ketamine admixtures provided adequate anesthesia. Propofol-ketamine proved superior to propofol-thiopentone in terms of hemodynamic stability and requirement of a lesser total dose of propofol. However, the patients in the propofol-thiopentone group had faster recovery.

Background: Rheumatoid arthritis (RA) is a common disease in the community, with various complications. An appropriate solution is immunosuppressive drugs, which may lead to weakening of the cellular immune system and body unresponsiveness to tuberculosis (TB). As TB sensitivity is determined by the amount of induration created in the Purified Protein Derivative (PPD) test, this study aims to evaluate the immune response to the PPD test and its booster in RA patients. Materials and Methods: This cross-sectional study was performed on rheumatoid arthritis patients referred to Alzahra Hospital, Isfahan, treated with ‹20 mg glucocorticoid daily or 7.5 mg Methotrexate (MTX) weekly. The sampling method was simple and accessible. The PPD test was performed in patients using the Mantoux method after 72 hours, and seven days later, the results were interpreted in 72 hours after the PPD booster injection. Induration ≥5 mm was considered to be positive. The data was analyzed using the SPSS software. Results: Nineteen patients had positive results in the initial and reminder tests and 81 patients had negative results in both tests. Six patients (6.9%) with negative results in the initial test changed to positive in the reminder test. There was no positive result in the initial test and negative result in the reminder one. The frequency distribution of the reminder test, based on the initial test was significant (P < 0.001). Also, the McNemar test showed that the changes in the reminder test based on the initial test had a significant difference (P = 0.031). Conclusion: It seems that in the endemic and developing areas, the PPD booster is applicable for diagnosing latent tuberculosis in patients with rheumatoid arthritis.

Background: The smooth muscle contractions of the tracheobronchial airways are mediated through the balance of adrenergic, cholinergic and peptidergic nervous mechanisms. This research was designed to determine the bronchodilatory and B-adrenergic effects of methanolic and aqueous extracts of root Althaea on the isolated tracheobronchial smooth muscle of the rat. Materials and Methods: In this experimental study, 116 tracheobronchial sections (5 mm) from 58 healthy male Sprague-Dawley rats were dissected and divided into 23 groups. The effect of methanolic and aqueous extracts of the root Althaea was assayed at different concentrations (0.2, 0.6, 2.6, 6.6, 14.6 mg/ml) and epinephrine (5 mm) in the presence and absence of propranolol (1 mM) under one g tension based on the isometric method. This assay was recorded in an organ bath containing Krebs-Henseleit solution for tracheobronchial smooth muscle contractions using potassium chloride (KCl) (60 mM) induction. Results: Epinephrine (5 mm) alone and root methanolic and aqueous extract concentrations (0.6-14.6 mg/ml) reduced tracheobronchial smooth muscle contractions induced using KCl (60 mM) in a dose dependent manner. Propranolol inhibited the antispasmodic effect of epinephrine on tracheobronchial smooth muscle contractions, but could not reduce the antispasmodic effect of the root extract concentrations. Conclusion: The methanolic and aqueous extracts of Althaea root inhibited the tracheobronchial smooth muscle contractions of rats in a dose dependent manner, but B-adrenergic receptors do not appear to engage in this process. Understanding the mechanism of this process can be useful in the treatment of pulmonary obstructive diseases like asthma.

Background: Current research findings demonstrate that acupuncture, a traditional Chinese medicine, has beneficial effects on several acute and chronic infectious and inflammatory diseases. Acupuncture promotes tissue healing and regulates immune response in various disease conditions. Cutaneous leishmaniasis (CL) is a parasitic disease caused by protozoan from genus Leishmania. Acupuncture is supposed to accelerate healing of CL because of common mechanisms involved in the cure of the CL lesions. Materials and Methods: 60  BALB/c mice were experimentally infected with L. major strain MRHO/IR/75/ER and divided into three groups: (1) Treatment group received acupuncture 2 times a week for 5 weeks (10 sessions) with intraperitoneal diazepam as a sedative agent. (2) Diazepam control group only received diazepam the same as the treatment group. (3) Control group did not receive any intervention. Size of the lesions was measured before the experiment, on session 5 and 10 and 4 weeks after the experiment. Parasite burden was evaluated by microscopic assay as well as quantitative real-time polymerase chain reaction technique. Results: Size of the lesions decreased significantly on session 5 in treated group in comparison with session 0 (P = 0.02) while the size of the lesions increased significantly in two control groups on session 5 and 4 weeks after treatment (P = 0.04 and P = 0.01 respectively). Mean parasite burden did not show a significant difference between or within groups on session 0 and 10 by any methods. Conclusions: This investigation showed that acupuncture decreased size of the CL lesions by session 5 in the BALB/c mice model, but did not cause a significant reduction in parasite burden.

Background: This study aimed to find a correlation between increased body mass index (BMI), insulin resistance (IR), hyperandrogenism, and anti-mullerian hormone (AMH) serum levels with the number of follicles retrieved in polycystic ovary syndrome (PCOS) patients. Materials and Methods: The descriptive study was taken on 80 women with average ages of 20-35 years at Alzahra Hospital of Tabriz-Iran who referred for in vitro fertilization. Patients were divided into four groups and serum levels of AMH, testosterone and IR were evaluated at the puncture time. Results: The mean number of follicle retrieved was higher in PCOS (P < 0.05) group than non-PCOS patients. There was a negative significant correlation of follicle number with BMI (r = −0.26, P < 0.05). The ratio of follicle numbers in PCOS/overweight group decreased in comparison to PCOS/normal weight group (−30%, P < 0.05) while the follicle numbers in non-PCOS/overweight patients decreased in comparison with non-PCOS/normal weight (−26%, P > 0.05). There was a significant negative association between BMI with AMH (r = −0.59, P < 0.05), BMI with the follicle numbers (r = −0.2, P < 0.05) and a positive association BMI with -IR (r = 0.3, P < 0.05), but there wasn't a significant correlation between BMI with testosterone (r = 0.1, P < 0.5). Conclusion: Our finding provides that increasing BMI with direct effect on AMH levels and IR can affect the number of follicles, which are retrieved in these patients.

Background: Irritable bowel syndrome has significant impacts on the quality of life (QOL) but IBS subtypes may be different in QOL. This study aimed to assess QOL in IBS subtypes and also two prevalent questionnaires applied to evaluate the QOL in IBS. Materials and Methods: In this case-control study conducted in Kashan in 2010-2013. One hundred and eighty- eight patients with IBS with 215 of non-IBS patients were included in the baseline. Subjects divided into three subtypes based on symptoms of diarrhea-predominant (IBS-D), constipation-predominant (IBS-C) and IBS with mixed bowel habits (IBS-M) and in each subtype were 42, 62 and 84 patients, respectively. All IBS subjects completed questionnaires containing the disease-specific QOL for IBS (IBSQOL), World Health Organization QOL Assessment-BREF (WHOQOL-BREF) and IBS severity scores (IBSSS). The non-IBS subjects completed the WHOQOL-BREF only. Results: Mean scores of IBSQOL in person with subtypes of IBS-D, IBS-C and IBS-M were 74.34 ± 19.01, 76.77 ± 22.91 and 73.15 ± 26.51, respectively which was not significantly different (P value = 0.507). As well as mean scores of WHOQOL-BREF in person with subtypes of IBS-D, IBS-C and IBS-M were 81.01 ± 16.23, 88.32 ± 15.66, and 82.65 ± 16.67, respectively, which were not significantly different (P value = 0.412) but mean scores of WHOQOL-BREF in non-IBS subjects was 89.53 ± 11.71 which was significantly different from IBS subjects (P value = 0.022). Strong positive relationship between two instruments was shown (r = 0.826 when P < 0.05). Conclusions: The WHOQOL-BREF instrument showed poorer QOL in IBS patients. The QOL was not different significantly among IBS-M, IBS-C, and IBS-D subtypes. We found that WHOQOL-BREF instrument strongly correlate with QOLIBS instrument.

Background: Serum C-reactive protein (CRP) and ferritin are two acute phase reactants. CRP may be related to metabolic syndrome and ferritin which in turn could cause resistance to insulin and dysfunction of b cells of pancreases. The aim of the study was the evaluation of the relationship of these two acute phase reactants with some indices of diabetic control. Materials and Methods: In a quasi-experimental study, 67 patients with type 2 diabetes, serum CRP, ferritin, Fasting Blood Sugar (FBS), post prandial BS, Hemoglobin A1c (HbA1c), triglyceride, Low Density Lipoprotein Cholesterol (LDL) and High Density Lipoprotein cholesterol (HDL) were checked before and 3 months after the control of hyperglycemia and hyperlipidemia. Results: The mean age of the patients was 56.5 ± 9.7 (30 to 82) years. There was no significant difference between CRP before and after study; however, serum ferritin significantly decreased after study with control of hyperglycemia. FBS, 2 hours post-prandial blood sugar (2hppBS), HbA1c and triglyceride of patients decreased significantly after control of hyperglycemia and hyperlipidemia (P < 0.05); however, HDL and LDL cholesterol didn't change (P > 0.05). Conclusion: Based on our results, serum ferritin decreased after decline of patients' blood sugar, so might be we used it as one of the diabetes control indices for diabetic patients.

Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy that results from compression of the median nerve within the carpal tunnel. In most patients, the diagnosis can be proposed based on patient history and clinical symptoms, with physical findings being attributed only in more severely affected patients. The purpose of this study is to introduce a reliable and accurate method for the proper selection of patients with mild carpal tunnel syndrome (CTS), for surgery. Materials and Methods: Electerodiagnostic studies are performed before and after placement of the cuff of the sphygmomanometer at the arm (Cuff sign), at a mean arterial pressure, for three minutes. Thirty symptomatic patients with mild findings on electrodiagnostic studies and 49 asymptomatic control hands have been included. Results: Fifteen patients reported good pain relief on the first postoperative day (50%), which increased to 21 on the fouteenth postoperative day (70%). The sensory latency changes were significantly higher in the pain relief group, both on the first and fourteenth postoperative days. Conclusion: Considering the fact that cooperation of the patients is not necessary and the double effects of direct pressure and ischemia over the proximal parts of the median nerve leads to prolonged latencies, this test is a useful method for decision-making in patients with severe symptoms of CTS, despite the mild electrodiagnostic findings.

Background: The aim of the present study was to evaluate whether subantimicrobial doses of doxycycline (DOX) and erythromycin (EM) used for the treatment of peri-implant osteolysis due to their anti-osteoclastogenesis can interfere with the osseous wound healing process in rat alveolar socket. Materials and Methods: Forty-five male Wistar rats had their first maxillary right molar extracted and were divided into three groups. DOX and EM at the doses of 5 mg/kg/day orally (p.o.) and 2 mg/kg/day intraperitoneally (i.p.) were administered respectively to two separate groups for 7 days after operation. In the control group the animals received normal saline (5 ml/kg). Five rats were sacrificed at 7, 14 and 21 days post-extraction in each study group. A histomorphometric analysis was used to evaluate new bone formation inside the alveolar socket. Significant level was set at 0.05. Results: The findings showed that the percentage of new bone formation (NBF) enhanced significantly on days 7 and 14. There was no significant difference in the NBF between DOX and EM groups. Conclusion: Short-term treatment with both DOX and EM enhanced new bone formation without any advances in favor of each drug.

Background: Molecular DNA markers are one of the essential tools in molecular biology labs with varied applications. In the present study, we suggest an efficient and available strategy to produce molecular size marker in routine laboratories. Materials and Methods: To achieve the desired sizes of DNA fragments, we recruited PCR and bioinformatics techniques to synthesize 14 DNA fragments ranging from 100 to 3000 bp. Results: Holistic analysis of different parameters in primers design resulted in amplification of fragments in just one PCR program without any by-product and purification step. Our applied method enables researchers to modify amplified DNA fragments by wide range of chemical modifications toward varied applications. Conclusion: Method of home-made DNA ladder production by available ingredients and routine techniques reported in this study can be used in common laboratories for different applications.

Background: We studied the effects of different doses of gold nanoparticles (AuNPs), silver nanoparticles (AgNPs), and zinc oxide nanoparticles (ZnONPs) on oxidative stress markers including glutathione peroxidase (GPX) and catalase (CAT) on male mice. Materials and Methods: Male albino mice of Wistar strain (N = 60), weighing 17-32 g, were used for this study. The mice were randomly assigned to three classes such that in each class, there were four groups of which one was control and the other three groups were fed with ZnONPs and AgNPs at 500, 250, and 125 ppm concentration and AuNPs at 100, 50, and 25 ppm concentration for 15 days. The heart blood was taken to measure GPX and CAT enzyme activities at the end of the treatment. Results: In male mice treated with AgNPs, the GPX and CAT activities were significantly increased, while significant decreases were seen in the GPX and CAT activities in mice treated with ZnONPs (P < 0.05) and in mice treated with AuNPs (P < 0.05). Conclusion: The results of this study showed that AuNPs and ZnONPs caused decreased antioxidant enzyme activities, while nanosilver had the reverse effect and increased the antioxidant enzyme activities and caused decreased stress oxidative.

Background: Gold nanoparticles have many industrial applications; moreover, they are photothermic agents for clinical treatment of cancer. This study was provided to investigate the effects associated with different doses of applied gold nanoparticles by injection and contact procedures on the alterations of the serum levels and certain factors in male mice. Materials and Methods: 72 male mice were randomly assigned into two protocols in terms of touching and injection. The injection protocol was included of five groups: Sham, control, 25, 50, and 100 ppm. They received gold nanoparticles at 25, 50, and 100 ppm concentrations administered in form of 0.3 ml/day for the period of 14 days and that of touching protocol were received 0.2 ml/day gold nanoparticles. Blood sample of which was taken to measure the serum level of creatine kinase phosphate, fasting blood, creatinine, albumin, blood urea nitrogen and eventually, the kidney was dissected for the intent of pathological analysis. Results: The serum level of creatine kinase phosphate and fasting blood sugar at middle dose was significantly different (P 0≤ 0.05) in touching protocol. In both protocols, the serum level of creatinine in high and medium doses showed a significant difference (P < 0.05) associated with the treated group. In the touching method, in high and medium doses administered to the treated group, the alteration was significant (P ≤ 0.05). In the both protocols, the serum level of albumin in high and medium doses of the treated group showed significant difference (P < 0.05). Thus, the gold nanoparticles could result in undesirable effects upon kidney tissue. Conclusion: The result of this study indicated that the administration of gold nanoparticles by touching method was more effective on the serum levels of these factors than that of injection method.

Background: Patients experience severe pain after craniotomy surgery that leads to discomfort. Our target in this study that performed in interventional method is an evaluation of sufentanil and paracetamol effect on postoperative pain control in patients undergone craniotomy surgery at Urmia Imam Khomeini Hospital. Materials and Methods: Totally, 45 patients between the ages 18 and 65 were studied. The effect of sufentanil and paracetamol medicines in pain management, hemodynamic stability, and side effects compared with control group that were receiving morphine (subcutaneous [SC]) in 3 groups of 15 people at time 0, 2, 4, 12 and 24-h were evaluated. Collected data were included and monitoring blood pressure, O ₂ Sat, heart rate (HR) and pain, nausea, vomiting and use of morphine. Results: According to the analysis of results, there was a significant difference between 3 groups on postoperative pain (P < 0.05). In patients that used sufentanil, pain score of visual analog scale (VAS) is lowest and in the paracetamol group the highest VAS score was seen. There was a significant difference in HR between 3 groups (P < 0.05). Maximum average of HR was observed in the paracetamol group. There was a significant difference in mean arterial pressure between 3 groups (P < 0.05). In paracetamol group, there was the highest value (99.3). There was no significant difference in Glasgow Coma scale and SPO ₂ between 3 groups (P > 0.05). Conclusion: Sufentanil compared to morphine (which is routinely used for patients pain control after craniotomy surgery) has better pain control, less nausea and vomiting, and better hemodynamic stability. Although paracetamol has the least nausea and vomiting, it has the lowest quality of pain relief.

Background: Corneal cross-linking (CXL) with riboflavin and ultra-violet A is less invasive in comparison with other procedures such as penetrating keratoplasty. Hence, we planned this study to evaluate the efficacy of CXL in disease progression and to compare keratoconus indices before and 1 year after cross-linking by Pentacam. Materials and Methods: In this prospective clinical trial, we enrolled 37 eyes of 37 patients suffering from keratoconus who were candidates for CXL. All eyes were examined before and one 1 year after surgery with a slit lamp and Pentacam for corneal topography. To compare the mean of each Pentacam parameter and index before and 1 year after the surgery, we used paired t-test. Results: There were 23 males and 14 females. The mean age was 21.5 years 18-30 years). At the 12 ^th month examination, the corneal thickness had decreased (P = 0.0068) and the Index of Height Decentration (IHD) had increased (P = 0.016). There were no statistically significant differences in other indices and parameters 1 year after CXL. Conclusion: Most of the parameters and indices had not changed during 1 year after CXL. The procedure seems to be effective in stopping the disease progression at least for 12 months after surgery.

Background: Night shift workers are more vulnerable to immune-related diseases. Immunoglobulin M (IgM) is a potent activator of complement, and complement has a crucial role in defense against bacterial infections. Circadian type is known as an effective agent on vulnerability and adaptation with shift work due to non-compliance with shift stress. The objective of this study was to investigate the correlation of circadian type and chronic fatigue with the serum concentration of IgM in a group of shift workers. Materials and Methods: This cross-sectional study was performed in an industrial organization in Isfahan, Iran. The study population consisted of 221 male employees working at night shifts who were selected by random cluster sampling. The following questionnaires were used: composite morningness (Torsvall and Akerstedt), circadian type (Folkard), and chronic fatigue (Barton and colleagues). The serum concentration of IgM was measured by the nephelometric method. The data were analyzed with the Pearson coefficient correlation and the path analysis for finding the pattern of the structural equations to evaluate the direct and indirect relationships between variables, using the SPSS 15 and LISREL 8.5 statistical software. Results: Significant correlation was documented between morningness, flexibility, languidness, and chronic fatigue with the serum concentration of IgM (P < 0.01). Conclusion: The results showed that the shift workers with morningness and languidness experienced more problems during the working hours due to more tiredness,and had decreased serum concentration of IgM. Correct management of shift work may attenuate fatigue in workers and also improve many health issues experienced by the shift workers.

Background: Neurotoxicity side effects related to cyclosporine kinetics could lead to dysfunction of kidney graft and patient outcome after transplantation. The aim of this study was evidence-based pharmacotherapy of kidney transplant recipients and to investigate neurotoxic levels of Iminoral. Materials and Methods: The results of 2239 cyclosporine trough levels obtained from 743 patients were studied. Seventy-five adult kidney recipients who received Iminoral were studied for neurotoxicity symptoms. Demographic, clinical, hematology and biochemical data were recorded in d-base and analyzed using SPSS application for windows. Results: The mean value related to cyclosporine C ₀ was 246.3 μg/l. In the 48% the signs of neurotoxicity such as tremor and headache were noted, but only in 9% the levels of cyclosporine C ₀ were >400 μg/l. Further studies on 75 patients showed that the incidence of neurotoxic side effects were as follows: Tremor in 35, headache in 24 and anxiety in 34 recipients of kidney. The prescribed drug regimens from the day of transplant in most patients were based on mycophenolic acid or cellcept, pulse therapy using methylprednisolone (daily from kidney transplant up to 3 days after transplant), cyclosporine or Iminoral plus other drugs related to each individual. Administrations of ganciclovir, thymoglobulin, clotrimazol and prednisolone were also distinguished with immunosuppressant-based therapy simultaneously. Conclusion: Evidence-based study related to pharmacotherapy of Iminoral showed that clinical presentation related to neurotoxic side effects such as tremor, headache and anxiety might be due to many factors such as polypharmacy. Planning immunosuppression to individual patients based on programmed therapeutic Iminoral monitoring, avoiding polypharmacy in terms of removal or drug minimization and focusing on first week after transplant seem to be a realistic option.

Background: Pseudomonas aeruginosa is an opportunistic human pathogen that causes serious problems, especially in people, who have immunodeficiency. In recent times, metallo-β-lactamase (MBLs) resistance in this bacterium has led to some difficulties in treating bacterial infections. The metallo-beta-lactamase family of genes, including blaVIM-1, is being reported with increasing frequency worldwide. The aim of this study is the detection of the metallo-β-lactamase gene blaVIM-1 in imipenem-resistant P. aeruginosa (IRPA) strains isolated from hospitalized patients. Materials and Methods: In this study, 106 P. aeruginosa samples were isolated from various nosocomial infections. The isolates were identified, tested for susceptibility to various antimicrobial agents by the Kirby-Bauer disk diffusion method, and all the imipenem-resistant isolates were screened for the presence of MBLs by using the combined disk (IMP-EDTA). The minimal inhibitory concentration (MIC) of imipenem was determined by E-test on the Mueller-Hinton agar. To detect the blaVIM-1 gene, the isolates were subjected to a polymerase chain reaction (PCR). Results: Of all the P. aeruginosa isolates, 62 (58.5%) were found to be imipenem-resistant P. aeruginosa (MIC ≥32 μg/ml). Twenty-six (42%) of the imipenem-resistant isolates were MBL positive. None of these isolates carried the blaVIM-1 gene using the PCR assay. Conclusion: The results demonstrated the serious therapeutic threat of the MBL-producing P. aeruginosa populations. The rate of imipenem resistance due to MBL was increased dramatically. Early detection and infection-control practices are the best antimicrobial strategies for this organism. None of MBL-producing isolates in this study carry the blaVIM-1 gene; therefore, another gene in the MBL family should be investigated.

Background: Painful sensation has been reported after propofol injection in most of the patients but no definite mechanism for this painful sensation has been proposed yet. The present randomized clinical trial compares analgesic effect of ondansetron, magnesium sulphate (MS) and placebo on patients after propofol 2% injection. Materials and Methods: The present randomized clinical trial with parallel design was performed on 90 patients American Society of Anesthesiologists I-II undergoing general anesthesia within vitrectomy operation with propofol induction. Subjects were randomly allocated into three groups with 30 patients each: (1) MS group (2) ondansetron group and (3) normal saline (NS) group as placebo group. Anesthesia induction and maintenance were the same between groups. Pain intensity of propofol injection in subjects was assessed by a four-point scale (none 0, mild 1, moderate 2 and severe 3) at four time intervals (5, 10, 20 and 25 s) after injection. Results: MS and ondansetron had significant impacts on pain reduction after propofol 2% injection in comparison with NS as placebo. Comparing two trial groups did not have any significant priority for analgesic impact. Conclusion: Using ondansetron or MS had no priority on each other on declining propofol injection induced pain.

Background: This double-blinded, randomized clinical trial was designed to evaluate intraocular pressure (IOP) change in cataract surgery using the combination of propofol and remifentanil or the combination of isoflurane and remifentanil. Materials and Methods: One hundred sixty patients were randomly allocated to a maintenance anesthetic consisting of remifentanil + isoflurane (group I), normal saline + isoflurane (group II), propofol + remifentanil (group III) or normal saline + propofol (group IV). IOP was measured at seven predefined time points, baseline (T0), 3 min after the start of continuous remifentanil infusion (T2), after induction of anesthesia (T3), immediately after laryngoscopy and intubation (T4), 5 min after laryngoscopy (T5), immediately after the block of continuous remifentanil infusion (T6) and 3 min after T6 (T7). Outcomes included IOP, systole blood pressure (SBP) and diastole blood pressure (DBP), mean arterial pressure (MAP) and heart rate (HR). Results: The mean of IOP in Group III was lower than other groups and in group IV was higher than other groups. At time point T4 and T5 differences in the mean of IOP between groups III and IV was significantly different (P > 0.05). The trend in changes in the mean of IOP was statistically significant among groups (P value = 0.01). The trends in changes in the mean of SBP, DBP and MAP were not significantly different among groups (P value = 0.41). HR in group III was significantly lower than other groups. The trend in changes in the mean of HR was significantly different among groups (P value = 0.002). Conclusion: Propofol with remifentanil was more effective than placebo or adding remifentanil to isoflurane in management of IOP in cataract surgery.

Background: The pulsatility index (PI), measured by transcranial Doppler (TCD) ultrasonography, can reflect vascular resistance induced by cerebral small-vessel disease (SVD). We evaluated the value of TCD-derived PI for diagnosing SVD as compared with magnetic resonance imaging (MRI). Materials and Methods: Fifty-six consecutive cases with SVD (based on MRI) and 48 controls with normal MRI underwent TCD. Based on MRI findings, patients were categorized into five subgroups of preventricular hyperintensity (PVH), deep white matter hyperintensity (DWMH), lacunar, pontin hyperintensity (PH), and PVH+DWMH+lacunar. The sensitivity and specificity of TCD in best PI cut-off points were calculated in each group. Results: The sensitivity and specificity of TCD in comparison with MRI with best PI cut-off points were as follows: In PVH with PI = 0.83, the sensitivity and specificity was 90% and 98%, respectively. In DWMH with PI = 0.79, the sensitivity and specificity was 75% and 87.5%, respectively. In lacunar with PI = 0.80, the sensitivity and specificity was 73% and 90%, respectively. In PH with PI = 0.69, the sensitivity and specificity was 92% and 87.5%, respectively. And, in PVH+DWMH+lacunar subgroup with PI = 0.83, the sensitivity and specificity was 90% and 96%, respectively. Conclusions: Increased TCD derived PI can accurately indicate the SVD. Hence, TCD can be used as a non-invasive and inexpensive method for diagnosing SVD, and TCD-derived PI can be considered as a physiologic index of the disease as well.

Background: To report the long-term findings of corneal cross-linking (CXL) with riboflavin drops on the corneal endothelial cell. Materials and Methods: In this prospective non-randomized study, we aim to assess the long-term safety of CXL on the corneal endothelium for the treatment of progressive keratoconus, by endothelial specular microscopy. A total of 68 eyes of 42 keratoconus patients were selected. We checked the corneal thickness (with ultrasonic pachymetry), endothelial cell density, pleomorphism, and polymegathism (with specular microscopy) of the endothelial cells, before CXL and one year after this procedure. Results: The mean ± SD of the preoperative and postoperative corneal thicknesses were 470 ± 40 μm and 469.8 ± 42 μm, respectively (p-value = 0.591). The mean ± SD of the preoperative and postoperative endothelial cell densities were 2753 ± 230 cells/mm ^[2] and 2699 ± 210 cells/mm, ^[2] respectively (p-value = 0.004). We found reduction in the endothelial cell density after CXL, but this reduction was less significant in a corneal thickness of less than 400 μm (which was treated with hypo-osmolar riboflavin 0.1% drops) compared to the corneal thickness of more than 450 μm. We did not find any significant differences in the cell shapes (pleomorphism) (p-value = 0.517), but the cell sizes (polymegathism) were changed after the procedure (p-value = 0.021). Conclusion: We found a significant decrease in endothelial corneal cell density after CXL, but this reduction was low; also the size of these cells increased after CXL. We believe that other parameters besides the corneal thickness may be the determinant factors for the changing of cell density and cell size in corneal endothelial cells.

Background: Multiple sclerosis (MS) is the most common disabling disease of the central nervous system. In these patients, fatigue is the most common symptom that causes disorder in the work, social activities and daily functions of the patients. Given the assumption that MS reduces the patients' psychological well-being, this study aimed at assessing the psychological well-being of both the patients and their primary caregivers. Materials and Methods: Current research as a descriptive study was conducted on 200 MS patients and 200 primary caregivers. For data collection, the Reef questionnaire was used to determine psychological well-being of these individuals. Data were analyzed using SPSS software. Results: According to the obtained results, the mean duration of MS was estimated 6.37 years. The psychological well-being score of the people with MS and their primary caregivers was slightly higher than average. The total score of psychological well-being in primary caregivers was higher than the patients. Conclusion: The mean score of psychological well-being subscales was significantly different in patients and their caregivers. Regarding the autonomy subscale, there was a significant different in patients with MS, that is, it was lower than average. In terms of two subscales of "positive relationship with others" and "personal growth," there was no difference between people with MS and the primary caregivers, and for other subscales, the mean score of caregivers was higher than the patients.

Background: VAP is defined as pneumonia in patients who use ventilators. The acute physiology and chronic health evaluation (APACHE II) scoring system was originally developed for predicting mortality in patients who were admitted to the intensive care unit. Due to the complexity, a simpler score called IBMP-10 was developed. We designed the study to confirm and further investigate these two methods. Materials and Methods: This cross-sectional and analysis-descriptive study was done at the moment of VAP diagnosis on 60 patients in intensive care units. APACHE II and the IBMP-10 scores were calculated. ROC curves were generated to compare the new prediction rule with the APACHE II score. Results were reported as adjusted odds ratios with 95% confidence intervals (CIs). Analyses were performed using SPSS, version 20 and P values of 0.05 were considered to be statistically significant. Results: APACHE II Score means (P < 0.001) and IBMP-10 score (P < 0.001) means had significant increase in Non-survivor patient than in patients who survived. APACHE II can be used as a good prediction measure for mortality rate. In IBMP-10 method, specificity and PPV were greater than APACHE II, but in mc-nemar test, there was no significant difference between the two methods (P = 0.55). Both prediction rules had high NPV. In our study, survivors' prediction value in APACHE II was 46.7%, and in IBMP-10, it was 46.7%. Conclusion: IBMP-10, compared to APACHE II, has greater sensitivity, specificity, and AUC to predict mortality. So the consequence of the use of IBMP-10 was better than APACHE II.

Background: Generally 50 to 70 percent of women suffer from a severe and unbearable pain during their childbirth. Abnormal fetal heart patterns, an increase of caesarian delivery rate, prolonged labor and low APGAR score in newborn are some of adverse effects of labor pain. Disagreement between different studies regarding the efficiency and effectiveness of acupuncture on labor pain led us to do this study. Materials and Methods: This is a clinical trial study. Sampling was done randomly in Esfahan, Shahid Beheshti Hospital, based on the subjects' characteristics. Patients were classified into three groups of control, Pethidine and acupuncture (27-30 women in each group). All women with a first and second pregnancy.VAS pain ruler was used as data collection tool. Data were analyzed in SPSS software, and using ANOVA and kruskal-Wallis tests. Results: The average pain score in control group 30 min after intervention was 7.80, while in Pethidine and acupuncture groups respectively were 6.87 and 5.77. Kruskal-Walis test showed that three groups in pain severity had significant difference at this time. The average length of the active phase of labor in Pethidine and acupuncture groups was 175 min while this time in control group was 243 min that ANOVA test showed a significant difference (P = 0.000). Conclusion: Results showed that acupuncture can significantly reduce labor pain in 30 min after intervention, while it had no effect on labor pain at full dilatation. However, both in Pethidine and acupuncture groups, the length of the active phase has been considerably shortened.

Background: Type 2 diabetes mellitus (T2DM) is a worldwide problem that threatens the public health and economies of all countries. A multifactorial etiology and interaction between environmental factors and genetic components are responsible for triggering and progression of T2DM. Recently, rs7754840 single nucleotide polymorphism (SNP) in the CDKAL1 gene was reported to be associated with T2DM in various populations. However, due to inconsistent results in various populations about the association of rs7754840 with T2DM, and lack of information in the Iranian population, we have evaluated its association with T2DM in a subset of the Iranian population from Isfahan province, central part of Iran. Materials and Methods: The study included 140 patients and 140 controls selected based on the World Health Organization guidelines. Genomic DNA was extracted from blood samples and the rs7754840 SNP was genotyped using a polymerase chain reaction-restriction fragment length polymorphism assay with specific primers and restriction enzyme (Ac1I). Results: The frequency of the C allele in the cases was higher than that in the controls (72.9% vs. 65%; P = 0.045). Using logistic regression analysis, we found a significant risk association of CC genotype with T2DM susceptibility (OR = 2.319, 95% CI = 1.436-3.744, P = 0.001). Furthermore, compared with the CC genotype, individuals with the GC genotype had a lower risk (protective association) of developing T2DM (OR = 0.332, 95% CI = 0.202-0.547, P < 0.001). Conclusions: We confirmed that there is a significant risk association between rs7754840 polymorphism and development of T2DM in a subset of the Iranian population from Isfahan province.

Background: Oral mucositis is a debilitating side effect of cancer treatment for which there is not much successful treatments at yet. We evaluated the effectiveness of topical morphine compared with a routine mouthwash in managing cancer treatment-induced mucositis. Materials and Methods: Thirty head and neck cancer patients with severe mucositis (World Health Organization Grade III or IV) were randomized into the morphine and magic mouthwash groups. Patients received morphine sulfate 2% or magic solution (contained magnesium aluminum hydroxide, viscous lidocaine, and diphenhydramine), 10 ml for every 3 h, six times a day, for 6 days. Both groups received same dietary and oral hygiene instructions and care. Mucositis was graded at baseline and every 3 days after treatment. Patients' satisfaction and drug effect maintenance were also evaluated. Results: Twenty-eight patients (mean age of 49.5 ± 13.2 years, 63.3% female) completed the trial; 15 in the morphine group and 13 in the magic group. There was a decrease in mucositis severity in both of the morphine (P < 0.001) and magic (P = 0.049) groups. However, at the 6 ^th day, more reduction was observed in mucositis severity in the morphine compared with magic group (P = 0.045). Drug effect maintenance was similar between the two groups, but patients in the morphine group were more satisfied by their treatments than those in the magic group (P = 0.008). Conclusions: Topical morphine is more effective and more satisfactory to patients than the magic mouthwash in reducing severity of cancer treatment-induced oral mucositis. More studies with larger sample size and longer follow-up are required in this regard.

Background: Cancer is one of the major fatal human diseases. Natural products have been used in the treatment of cancer for long time. Bee products including honey and propolis have been introduced for malignancy treatment in recent decades. In this study cytotoxicity of bee products and their effects on the expression of proapoptotic genes have been investigated. Materials and Methods: Cytotoxic effects of Astragalus honey, ethanol extract of propolis and a sugar solution (as control) against HepG2, 5637 and L929 cell lines have been evaluated by the MTT assay. Total RNAs of treated cells were isolated and p53 and Bcl-2 gene expression were evaluated, using real-time PCR. Results: Propolis IC50 values were 58, 30 and 15 μg/ml against L929, HepG2 and 5637, respectively. These values for honey were 3.1%, 2.4% and 1.9%, respectively. Propolis extract has increased the expression of the Bcl-2 gene in all cell lines whereas the honey decreased that significantly (P < 0.05). Also, we found that honey and propolis decreased p53 gene expression in HepG2 and 5637 significantly but not in L929 cells. The sugar solution increased the expression of p53 in two cancer cell lines but no significant changes were observed in the expression of this gene in L929 as normal mouse cell. Conclusion: By downregulation of Bcl-2 expression it could be concluded that the cytotoxicity of honey was more than two fold against tested cancer cells compared with the sugar solution. No significant changes were observed in the expression of p53 in honey-treated cells. Propolis had no significant effect on Bcl-2 and p53 gene expressions (P > 0.05).

Background: Migration, expansion and survival of endothelial cells that are an important cellular component of blood vessels plays an important role in the induction of tumor growth. Kisspeptins (kp), peptides that bind to coupled-G protein receptor (GPR54), inhibit each step of metastatic cascade include invasion, migration and homing, angiogenesis, survival and proliferation. In this study we investigated effects of kisspeptin-10, the most potent member of kisspeptin family, on Migration and proliferation of endothelial cells that are necessary for angiogenesis and tumor metastasis. Materials and Methods: We compared migration of Human Umbilical Vein Endothelial Cells (HUVECs) were treated with 10-100 or 500 nM kp-10 for 24 hours and no treated cells using an in vitro trans membrane migration assay and HUVEC proliferation of treated endothelial cells with 10-100 or 500 nM kp-10 for 48 hours and no treated cells was measured by MTT Cell Proliferation Assay Kit. Analysis of data was performed using the Kruskal-Wallis test followed by the Mann-Whitney test. Results: Migration and proliferation of endothelial cells were increased at lower concentration of kp-10 specially at 100 nM while higher concentration reduced both migration and proliferation. Conclusion: Our data showed that different concentrations of kp-10 have distinct effects on migration and proliferation of endothelial cells.

Background: Sperm dysfunction is one of the main causes of male infertility. Petroselinum crispum (P. crispum) is a member of umbelliferae family that contains different vitamins and minerals and has numerous therapeutic properties. The aim of this study was to evaluate P. crispum effect on sperm parameters, testis tissue and serum nitric oxid levels in mice. Materials and Methods: Hydroalcoholic extract of P. crispum was prepared and administered intraperitoneally (0,100, 150 and 200 mg/kg) to 40 mice, which were divided into four groups (n = 10), one control group and three experimental groups, for 14 consequent days. The sperm parameter such as motility, sperm count, morphology, and seminiferous tubules diameter, and weight of prostate and testis, and serum nitric oxide levels were analyzed. Results: P. crispum administration (100, 150 and 200 mg/kg) significantly increased mean percentage of sperm motility, testis and prostate weight and serum nitric oxide compared to the control group (P < 0.05). However, no significant effect was reported for different doses of P. crispum extract on sperm parameters. Conclusion: Administrating hydroalcoholic extract of P. crispum has positive effects on some reproductive parameters.

Background: The best treatment for scaphoid nonunion fractures is still controversial. The main aim of this study was to determine the results of the modified Matti-Russe method of surgery on scaphoid nonunion. Materials and Methods: In this prospective interventional study, 30 patients with nonunion scaphoid fracture recruited from clinics of the Isfahan University of Medical Sciences between October 2007 and March 2011 underwent the modified Matti-Russe method of surgery. Union rate was evaluated four and six months after the procedure. Mayo wrist score (MWS) was calculated for the subjects six months after surgery. Results: Mean age of the subjects was 25.9 ± 7.8 years, ranging from 16 to 35 years. Twenty-seven (90%) were men, and three (10%) were women. Four and six months after surgery, 10 (33%) and 26 (86.7%) subjects had a united fracture. Mean MWS was 75.0 ± 8.8 in all the subjects, ranging from 54 to 90 six months after surgery. Three subjects (10%) were grouped as excellent, 9 (30%) good, 16 (53.3%) satisfactory, and 3 (6.7%) poor. Conclusion: A fracture or nonunion of the scaphoid bone can be a complex and troubling injury, but the modified Matti-Russe method showed satisfactory results six months after surgery.

Background : Hypertension is a non communicable disease of major public health problem resulting increased morbidity and mortality among population. Prehypertension in adolescents and young adults again an important risk factor for developing hypertension in future. So the present study was carried out among medical students with the objectives of (1) to find out the risk factors associated with prehypertension and hypertension, (2) to suggest measures to decrease risk factors. Materials and Methods : It was a cross-sectional study and study duration was from september 2011 to November 2011. The sample size was 200 and the study subjects was selected by systematic random sampling method. A predesigned pretested schedule was used to collect data. Blood pressure (BP) was measured in sitting posture using a standard sphygmomanometer on two different settings and the average was taken for analysis. Results : All the participants were between 18-21 years. Out of 200 study subjects,112 were males and 88 were females. The prehypertension and hypertension percentage was 67% among study subjects. Statistical analysis done was percentage, Chi-square test. Conclusion : Health-care providers should recognize the increased CVD risk of prehypertension and should seek to identify and treat the modifiable risk factors in these persons.

Background: Postoperative nausea and vomiting (PONV) is a common complication after general anesthesia in patients undergoing elective lower abdominal surgery. We aimed to compare the effect of a sub hypnotic dose of Propofol in the prevention of PONV after lower abdominal surgery with that of the conventional antiemetic drug Metoclopramide. Materials and Methods: In this prospective, randomized, double-blind, placebo-controlled study, 104 patients with American Society of Anesthesiologists (ASA) class I or II status, aged 18-65 years, and undergoing elective lower abdominal surgery were randomized to one of four groups (n = 26 each). The patients in the four groups were administered intravenously Propofol 20 mg (G1), Propofol 30 mg (G2), Metoclopramide 10 mg (G3), and placebo (G4), 15 min before skin closure. All episodes of PONV during the first 24 h after anesthesia were recorded by an investigator who was blinded to treatment assignment. Results: There were no significant differences between the treatment groups with regard to their gender, age, ASA class, duration of surgery, duration of recovery time and hospital stay, and also body mass index (BMI) (P > 0.05). The prevalence of PONV 0-6 h after anesthesia was 23.08% with Propofol 20 mg (P = 0.005), 15.38% with Propofol 30 mg (P = 0.016), 15.38% with Metoclopramide 10 mg (P = 0.016), compared to 30.77% with placebo (P = 0.005). Conclusions: Administration of a subhypnotic dose of Propofol (30 mg) was found to be as effective as 10 mg Metoclopramide in reducing the incidence and severity of PONV in adult patients undergoing elective lower abdominal surgeries under Isoflurane-based anesthesia in the early postoperative period.

Background: Precise and accurate measurements of body composition are useful in achieving a greater understanding of human energy metabolism in physiology and in different clinical conditions, such as, cardiovascular disease and overall mortality. Dual-energy x-ray absorptiometry (DXA) can be used to measure body composition, but the easiest method to assess body composition is the use of anthropometric indices. This study has been designed to evaluate the accuracy and precision of body composition prediction equations by various anthropometric measures instead of a whole body DXA scan. Materials and Methods: We identified 143 adult patients underwent DXA evaluation of the whole body. The anthropometric indices were also measured. Datasets were split randomly into two parts. Multiple regression analysis with a backward stepwise elimination procedure was used as the derivation set and then the estimates were compared with the actual measurements from the whole-body scans for a validation set. The SPSS version 20 for Windows software was used in multiple regression and data analysis. Results: Using multiple linear regression analyses, the best equation for predicting the whole-body fat mass (R ² = 0.808) included the body mass index (BMI) and gender; the best equation for predicting whole-body lean mass (R ² = 0.780) included BMI, WC, gender, and age; and the best equation for predicting trunk fat mass (R ² = 0.759) included BMI, WC, and gender. Conclusions: Combinations of anthropometric measurements predict whole-body lean mass and trunk fat mass better than any of these single anthropometric indices. Therefore, the findings of the present study may be used to verify the results in patients with various diseases or diets.

Background: Hyperlipidemia is an associated complication of diabetes mellitus. Lowering of serum lipid levels seems to be associated with a decrease in the risk of vascular disease and related complications. The purpose of the current study was to evaluate the antihyperglycemic and antihyperlipidemic effects of the hydroalcoholic extract of Securigera securidaca seeds in streptozotocin-induced diabetic rats. Materials and Methods: Female Wistar rats were randomly divided into four groups as follows: Control, diabetic, and diabetic rats treated with the Securigera extract at doses of 100 and 200 mg/kg. The animals were rendered diabetic by a single intraperitoneal injection of 55 mg/kg streptozotocin. Diabetic rats received the Securigera extract daily in drinking water from the day on which diabetes was confirmed for 4 weeks. The levels of serum glucose and lipids were spectrophotometrically measured in all groups at weeks 0 (before diabetes induction), 2, and 4. Results: The results showed that there was a significant increase in serum glucose, triglycerides, total cholesterol, and low density lipoprotein (LDL)-cholesterol in streptozotocin-induced diabetic rats, accompanied by a decrease in high density lipoprotein (HDL)-cholesterol. Treatment of diabetic rats with S. securidaca seed extract at a dose of 200 mg/kg over a 4-week period significantly reduced the levels of serum glucose, total cholesterol, and LDL-cholesterol and increased the level of HDL-cholesterol, compared to diabetic untreated rats. Conclusions: Securigera extract at a dose of 200 mg/kg exhibited hypoglycemic and hypolipidemic activities in streptozotocin-diabetic rats during the 4-week treatment period. This provides a valid scientific basis for using it in the treatment of diabetes in Iranian folk medicine.

Background: The release of the anti-toxoplasmosis drug, clindamycin phosphate, from intraocular implants of the biodegradable polymers poly (D, L-lactic acid) (PLA) and poly (D, L-lactide-co-glycolide) (PLGA) has been studied in vitro. Materials and Methods: The preparation of the implants was performed by a melt-extrusion method. The developed extrudates were characterized and compared in in-vitro release profiles for elucidating the drug release mechanism. The formulations containing up to 40% w/w of drug were prepared. Release data in phosphate buffer (pH 7.4) were analyzed by high performance liquid chromatography. The release kinetics were fitted to the zero-order, Higuchi's square-root, first order and the Korsmeyer-Peppas empirical equations for the estimation of various parameters of the drug release curves. Degradation of implants was also investigated morphologically with time (Scanning Electron Microscopy). Results: It was observed that, the release profiles for the formulations exhibit a typical biphasic profile for bulk-eroding systems, characterized by a first phase of burst release (in first 24 hrs), followed by a phase of slower release. The duration of the secondary phase was found to be proportional to the molecular weight and monomer ratio of copolymers and also polymer-to-drug ratios. It was confirmed that Higuchi and first-order kinetics were the predominant release mechanisms than zero order kinetic. The Korsmeyer-Peppas exponent (n) ranged between 0.10 and 0.96. This value, confirmed fickian as the dominant mechanism for PLA formulations (n ≤ 0.45) and the anomalous mechanism, for PLGAs (0.45 < n < 0.90). Conclusion: The implant of PLA (I.V. 0.2) containing 20% w/w of clindamycin, was identified as the optimum formulation in providing continuous efficient in-vitro release of clindamycin for about 5 weeks.

Background: The aim of the present study was to comparison between cell-free placental messenger ribonucleic acid (mRNA) and Doppler ultrasound for the prediction of placental invasion in women with placenta accreta. Materials and Methods: In this cross-sectional study, 50 pregnant women at risk for placenta accreta underwent color Doppler and assessment of cell-free placental mRNA. Real-time reverse-transcription polymerase chain reaction was used for measurement of cell-free placental mRNA in maternal plasma. Based on the findings at cesarean delivery and histological examination, patients were divided into two groups of women with and without placenta accrete. To compare of the mean of mRNA levels between the two groups we used independent t-test and to compare of the mean of age and gestational age at sonography we used Mann-Whitney test. For determination of sensitivity and specificity and the cut-off point of mRNA levels we used the receiver operating characteristic curve. Results: A total of 50 women with a mean age of 30.24 ± 4.905 years entered the study and 12 (24%) patients were diagnosed with placenta accreta. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of Doppler ultrasound were 83.3%, 78.9%, 56% and 94%, respectively. Results of our study showed if we consider a cut-off point equal to 3.325, with sensitivity and specificity of 0.917 and 0.789, respectively and the sensitivity, specificity, PPV and NPV of mRNA with were cut-off point of 3.325 were 91.7%, 78.9%, 57.9% and 96.8%, respectively. Conclusions: Cell-free mRNA is an acceptable, easy made, functional test with sensitivity, specificity, PPV and NPV more than Doppler ultrasound for diagnosis and prediction of incidence of placenta accrete and we recommend the use of cell-free mRNA test for diagnosis of placenta accreta.

Background: Spermatogenesis is a highly conserved and regulated process and it is sensitive to fluctuations in the physical and chemical environment. Gemcitabine is a novel antimetabolic anticancer drug used frequently in the treatment of many cancers. This study aimed to investigate the histomorphometric effects of gemcitabine on spermatogenesis in Swiss albino mice. Materials and Methods: Gemcitabine in high and low doses (80 and 40 mg/kg) injected intraperitoneally to inbred Swiss albino mice. Gross testicular features and seminiferous tubular histomorphometry was studies at the end of 7 ^th , 14 ^th day and at 2 months sperm shape abnormalities were studied. Results: Seminiferous tubular morphology was altered significantly, showing a reduction in height, perimeter and area in a dose dependent manner. Sertoli cell number decreased. Basement membrane thickness was reduced and it appeared to be permanent, with statistically insignificant changes even after 2 months. There was a reduction of intertubular spaces. Sperms have shown banana heading, decapitation and loss of normal hook of head. The effects were partially reversible at the end of 2 months. Conclusion: It was concluded that gemcitabine affects the process of spermatogenesis adversely in a dose and time dependent manner and the effects are partially reversible.

Background: Limited sphincterotomy and endoscopic papillary balloon dilation (EPBD) is a low-risk method for the treatment of choleducolithiasis. Traditionally one minute ballooning time (BT) is applied; however, the effective BT is not clear. In this study, we compare five seconds and one minute ballooning time. Materials and Methods: In this single-blind, randomized, clinical trial 60 patients with common bile duct (CBD) stones documented in ultrasonography or magnetic resonance cholangiopancreatography (MRCP), with no severe hepatic, biliary or systemic diseases, enrolled in the study. The patients were randomly assigned to receive EPBD with either five seconds (n = 31) or one minute (n = 29) ballooning time (BT) after endoscopic retrograde cholangiopancreatography (ERCP) and small sphincterotomy. Then stones were retrieved with an extractor balloon. The patients were followed for 48 hours to check the possible complications. Results: Successful CBD stone removal was the same in the five-second and one-minute BT groups (93.5% vs. 96.6%; P = 0.594). Pancreatitis occurred in three (9.7%) patients in the five-second BT group and in six (20.7%) patients in the one-minute BT group (P = 0.233). No hemorrhage or perforation was noted. Conclusions: After a small sphincterotomy, EPBD in the five-second and one-minute BT groups had a similar efficacy. Small sphincterotomy combined with very short BT is a safe and effective method for CBD stone removal.

Background: The present study was designed to evaluate hypertension and dyslipidemia in prediabetic subjects with a family history of type 2 diabetes (first-degree relatives), and they were compared with the normal glucose-tolerance subjects. Materials and Methods: Three thousand and eighty-six (788 men and 2298 women) subjects were selected from a consecutive sample of patients with Impaired Glucose Tolerance (IGT), Impaired Fasting Glucose (IFG), and Combined (IFG and IGT), and their first-degree relatives formed the control group. Potential risk factors for diabetes including age, gender, body size, HbA1c, cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, blood pressure (BP), urine microalbumin, and family and personal medical history were assessed. Results: The studied participants included 300 IGT patients (9.7%), 625 IFG patients (44.9%), 411 combined patients (13.3%), and 1750 (56.7%) normal subjects. Aging led to increase in hypertension. Increase in body mass index (BMI) led to an increase in the prevalence of hypertension significantly in all groups. The mean triglyceride in the normal group was different in comparison with that of the IGT (P < 0.05) and combined (P < 0.001) groups. Differences in total cholesterol were observed in the normal group when compared with the IGT (P < 0.05) and combined (P < 0.001) groups, and of the combined group in comparison with the IGT (P < 0.05) group. The difference in LDL level was related to the combined group in comparison with IGT, marginally (P < 0.1), and normal in comparison with the combined group (P < 0.05). Conclusion: Prevalence of hypertension was not significantly different between the groups, however, in prediabetic patients it was higher than in the normal group, and prevalence of dyslipidemia in prediabetic subjects was significantly higher than in the normal group.