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.

Bronchioloalveolar carcinoma is a form of adenocarcinoma. Its clinical presentation spans the entire spectrum from asymptomatic solitary pulmonary nodule to full presentation with cough, hemoptysis and dyspnea. Clinical symptoms usually are in correlation with the extent of disease. The case we present here is a patient in late stage of disease with few symptoms regarding to the extent of disease involvement.

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.

Background: The dengue virus causes one of the most important mosquito-borne viral diseases. Annually, it affects up to 100 million people. Detection of the secreted NS1 protein represents a new approach to the diagnosis of acute dengue infection. Platelet count is the only non-dengue parameter that can support the diagnosis of the dengue shock syndrome (DSS) and dengue hemorrhagic fever (DHF). This study was done to correlate the platelet count and dengue parameters detected by the immunochromatographic test (ICT). Materials and Methods: Serum samples collected from patients presenting with dengue-like illness and for whom an anti-dengue antibody test was requested between August 2010 and August 2012, were included in this study. A total of 520 serum samples were collected from the suspected dengue fever patients. The samples were tested for NS1 antigen, IgM, and IgG antibodies, using the ICT kit. The platelet count was recorded in dengue parameter-positive and -negative cases. Results: A total of 520 serum samples were collected from the suspected dengue fever patients. Sixty-two samples tested positive for one or more dengue-specific parameters. Out of the 62 samples, 39 (62.9%) were positive for the NS1 antigen, only seven (11.3%) were positive for IgM, and only three (4.9%) were positive for IgG. A platelet count < 1,00,000/ml was observed in 32 cases (51.6%). When the platelet count was done in 100 dengue parameter-negative fever patients (controls), thrombocytopenia was observed in 30% of the cases. Conclusion: Association of thrombocytopenia in dengue parameter-positive cases was highly significant (Z = 2.76, P = 0.006) when compared to thrombocytopenia in dengue parameter-negative patients.

Background: Recent studies proposed an increased risk of atherosclerosis in patients with a history of Kawasaki disease. This study aimed to investigate the persistence of vascular injury after an acute phase of the Kawasaki disease. Materials and Methods: We determined the number of circulating endothelial cells (CEC) in the peripheral blood of 13 patients with a history of Kawasaki disease within four to ten years, in comparison with 13 healthy relative controls. The CECs were counted as CD146+/CD34 + cells by the standard flow cytometry technique, and the independent t-test was employed to compare the mean number of CECs in the two groups. Results: The mean number of CECs was significantly higher in patients than in controls (12 ± 3.03 vs. 2.38 ± 0.87, respectively, P < 0.001). Conclusion: This study elucidates the persistence of vascular injury late after Kawasaki disease. This finding suggests that prolonged administration of vascular anti-inflammatory agents might be beneficial for preventing atherosclerosis in the subsequent years, in these patients.

Hypochondriasis is a persistent preoccupation that despite appropriate medical evaluations and assurance of patient's physical health, the patient insists on having a serious disease. The case which is discussed in this article is a 39-years-old woman that hospitalized for half of her life and no one can perceive her disorder according to her assertions. The mentioned case is a "difficult patient"with fear of oxygen shortage and being choked (Pnigophobia) which leads to continuous tendency to wear oxygen device even during sleep. There is no benefit in exaggerating her condition for herself so there is no fictitious disorder considered. During the therapy she has been assured that she does not have a serious disease and she has learnt to decrease oxygen intake and breath with his mouth. The point that makes this study different from the others is that most of hypochondriacal patients have a fear of getting HIV, cancers, hepatitis and MS but our patient has phobia of pulmonary embolism.

Background: Developmental dysplasia of the hip (DDH) is an anatomical abnormality, which needs early detection and treatment. Ultrasound (US) is a sensitive method to study neonatal hip joint and detection of different types of sonographic hip. This study was aimed to determine relative frequency of different types of DDH ultrasonographically. Methods and Methods: Ultrasound examination was performed on 380 newborns to determine hip joint status according to the Graf ultrasound classification system for infant hips. In addition, hip joint status was compared based on the hip side, gender, and method of delivery. Results: In this study, we observed three sonographic types: Ia (74%), type Ib (20%), and IIa (6%). No significant difference was found in relative frequency of different types of DDH regarding the side of the hip (P = 0.18). Type IIa was found significantly more in the female newborns (P < 0.0001) and in newborns who were born by cesarean section (P < 0.0001). Conclusion: This study supports the role of US detection of different types of DDH; however, the frequency of pathologic types of hip sonography is 6%.

Background: The incidence of postoperative nausea and vomiting (PONV) after middle ear surgery is high. In this study we want to compare the effects of intravenous granisetron and oral gabapentin as a premedication before surgery on the incidence and severity of PONV after middle ear surgery in adult patents. Materials and Methods: We enrolled 90 patients that were randomly divided into the three groups of 30 in each. Group I received granisetron 3 mg iv 2 minutes before induction of anesthesia; Group II received oral gabapentin 300 mg 1 hour before anesthesia and Group III received placebo. The incidence and severity of PONV were recorded each 15 minutes in the post-anesthesia care unit (PACU) and each 8 hours until 24 hours after discharge from the PACU. Result: The incidence and severity of nausea and vomiting at different time intervals in Groups I and Group II was significantly lower compared with Group III (P < 0.05). There was no significant difference in the incidence of side effects of study drug administration including respiratory depression, apnea, extra pyramidal disorders, drowsiness, dizziness, vertigo and headache in three groups. Conclusion: The study was shown that using gabapentin and granisetron have equal anti-emetic effects, but significant differences were seen between these two groups compared to the control group. These submit the efficiency of these drugs in preventing PONV.

Background: Residual latency is the time difference between measured and predicted distal conduction time. We investigated ulnar nerve residual latency in patients with ulnar neuropathy at elbow for the possibility of its clinical utility. Materials and Methods: In a cross-sectional study and based on the inclusion and exclusion criteria, ulnar nerve residual latency was calculated by using standard settings in 63 hands of patients who had signs and symptoms suggesting ulnar neuropathy at elbow and 94 healthy hands as the control group. Results: Mean ulnar nerve residual latency for case and control groups were 1.82 ± 0.45 and 1.59 ± 0.54 ms, respectively, which showed a statistically significant difference (P = 0.01). There was no significant difference in mean ulnar nerve residual latency between males and females and also between right and left hands ( P > 0.05). By considering different cut-off points, the sensitivity and specificity of a residual latency of 2.86 ms were 70% and 56%, respectively. Conclusion: Ulnar nerve residual latency may reflect the effects of an axonal injury at elbow on distal ulnar motor fibers. So, its measurement may help in the diagnosis of ulnar neuropathy at elbow.

Background: Kisspeptins (kp) activate a receptor coupled to a Gαq subunit (GPR54 or KiSS-1R) receptor to perform a variety of functions, including inhibition of cell motility, chemotaxis, and metastasis. In this study we have investigated whether kp-10, the most potent member of the kisspeptin family, can modulate CXCR4 (C-X-C chemokine receptor type 4) expression and mesenchymal stem cells (MSCs) migration that may influence the development of tumors. Materials and Methods: We compared the directional migration of MSCs treated with 10-100 or 500 nM kp-10 for 24 hours and no treated cells using an in vitro transmembrane migration assay. In addition, Chloromethylbenzamido Dialkylacarbocyanine (CM-Dil) labeled adipose-derived mesenchymal stem cells treated with 10-100 or 500 nM kp-10 and no treated cells were transfused via the tail vein to the melanoma tumor bearing C57BL/6 mice. After 24 hours, the mice were scarified, the tumors were dissected, and the tumor cell suspensions were analyzed by flow cytometry for detection of CM-Dil ⁺ MSCs. Results: We have found that kp-10 increased the MSCs migration at 100 nM, while it decreased the MSCs migration at 500 nM, both in vitro and in vivo, with a significant increase of CXCR4 expression at 100 nM kp-10 compared to the no treated cells, but it had no significant difference between the various concentrations of kp-10. Conclusion: Thus, our data showed that kp-10 can differently affect MSCs migration in various concentrations, probably through different effects on CXCR4 expression in various concentrations.

Background: Increased size of kidney is the main symptom of pyelonephritis and renal ischemia in children. Ultrasound and computed tomography (CT) scan methods are the imaging methods for evaluating the urogenital system. The aim of this study is to compare the kidney length obtained from spiral CT scan with the true length obtained from multi-slice CT. Materials and Methods: From 100 patients 200 kidneys were examined in Alzahra Hospital in 2012. Multi-slice CT was used to obtain coronal and sagittal cuts to find the length of kidneys. Results: The mean values of true size of axial sections of the right and left kidneys were 108.37 ± 12.3 mm and 109.74 ± 13.6 mm, respectively. The mean difference of axial sections' lengths in the right and left kidneys was 1.37 ± 1.22 mm. The mean values of length in the spiral CT scan of the right and left kidneys were 98.61 ± 15.8 mm and 103.11 ± 15.9 mm, respectively. The difference in the estimated size by multi-slice CT scan in oblique and axial images was significant (9.77 ± 1.19 mm and 6.63 ± 0.8 mm for the right and left kidneys, respectively (P < 0.001). Conclusion: The average size of both kidneys determined in axial images was smaller than the actual size. The estimation of kidney size in axial images is not reliable, and to obtain the actual size, it is required to have the coronal and sagittal cuts with proper quality, which could be achieved by multi-slice method.

Background: Different approaches to treat myasthenia gravis showed variable outcomes probably because of remained ectopic thymic tissue. The aim of this study is to determine incidence of thymic tissue in cases without any thymic disease. Materials and Methods: Seventy-two patients scheduled for open heart surgery during 2000 and 2007 without thymic disease that were enrolled in the study at Chamran Hospital. Intraoperative biopsies were taken form aortopulmonary window, aortocaval groove and left and right pericardiophrenic regions. Finally, the distribution of ectopic thymic tissue was evaluated in above regions. Results: Thymic tissue was found overall in 70.85% of patients. The most common sites for thymic tissue were left pericardiophrenic (50%) and right pericardiophrenic (31.9%) regions. Frequencies of ectopic thymus in aortopulmonary window and aortocaval groove were 19.4% and 12.5%, respectively. Conclusion: Because of high incidence of ectopic thymic tissue in mediastinum in patients without thymic disease, we recommend wide excision of thymus gland and all of adipose tissue in patients with myasthenia gravis.

Background: The prevalence of isolated hepatitis B core antibody (anti-HBc) varies between 1% and 30% in different populations. Isolated anti-HBc-positive patients who suffer from occult hepatitis B virus (HBV) infection have the potential to transmit HBV infection. So isolated anti-HBc screening is a valuable tool to prevent HBV transmission. Considering the importance of isolated anti-HBc screening and high prevalence of HBV among injected drug users (IDU) prisoners, we designed this study to evaluate the isolated anti-HBc positivity among inmates with the history of IDU in our area. Materials and Methods: We did this cross-sectional study from September 2009 to March 2010 among volunteer male IDU prisoners in Isfahan. Blood samples were taken from all of subjects and tested for HBV markers. Then a questionnaire containing socio-demographic, drug histories and high risk behaviors information was completed for all participants. Data analysis was done utilizing univariate analysis and multiple logistic regressions. A P < 0.05 was considered significant. Results: Totally 970 male IDU prisoners (mean age 32.6 ± 8.1) were included in our study. The prevalence of isolated HBc Ab was 4.5%. Isolated anti-HBc significantly was related to tooth filling (OR: 2.62, CI: 1.20-7.14) and imprisonment (OR: 3.95, CI: 1.39-11.18 ) . We couldn't find any relationship between isolated anti-HBc positivity and addiction duration, incarceration frequency, recent incarceration duration or number of injection per month. Conclusion: For screening high risk groups in parallel with hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb) and other viral markers, maybe it is better to check HBcAb too, because isolated HBcAb-positive patients may have occult hepatitis B infection which could transfer the infection to others.

Background: Progesterone is a steroid hormone that modulates proliferation and differentiation in a cell phase and tissue-specific manner. Its function in breast cancer cells is of great significance since it can predict susceptibility of tumor cells to inhibitory effects of progesterone as adjuvant therapy. Materials and Methods: Stable clones overexpressing cyclin E (EL) and its low molecular weight isoforms (LMW-Es) were generated and treated with various concentrations of progesterone. Cell proliferation was assessed 24 and 48 h after the treatment. Changes in progesterone receptor (PR) expression were measured by real-time polymerase chain reaction. Results: Here we demonstrated that overexpression of EL and LMW-Es have divergent effects with regard to progesterone response. We found that progesterone could significantly decrease the growth rate of EL-expressing cells in the second cell cycle after treatment; however, progesterone was ineffective to arrest growth of LMW-Es expressing cells. PR expression level was at control level in EL-expressing cells but was downregulatedin LMW-Esexpressing clones. Conclusion: These results were in line with progesterone response of studied cells. The drop in PR expression together with altered distribution of p21 and p27 can explain different effects of cyclin E isoforms expression on progesterone responsivity. These data bring cyclin E status of cancer cells as a marker for predicting the efficacy of progesterone treatment.

Background: Molecular deoxyribonucleic acid markers are one of the most important tools in molecular biology labs. The size of DNA molecule is determined by comparing them with known bands of markers during gel electrophoresis. In this study, we have suggested an efficient strategy to produce molecular weight markers in an industrial scale. Materials and Methods: A combination of two previously known methods, restriction enzyme digestion and polymerase chain reaction (PCR), was used. The enzymatic digestion process was based on designing and constructing plasmids which equaled in size with the bands of ladder and produce the DNA fragment by plasmid linearization through digestion. In the PCR method, the DNA fragments with length 102 bp lesser than the related bands in DNA ladder are amplified by PCR and cloned in pTZ57T/A cloning vector. Then, PCRs with forward and reverse 100-bp primers on the resulting plasmids amplify the ladder fragments. F100 and R100 primers bind to the backbone of pTZ57R (without insert) and amplify a 100-bp PCR product. PCR on the plasmid with insert amplifies DNA fragment with 102+ insert length bp size. Results: Upon application of this strategy, 2000-10,000 bp DNA fragments were produced by enzymatic digestion of plasmids of the same size. Moreover, 100-1500 bp fragments were produced during PCR using only a set of forward and reverse (100 bp) primers. Conclusion: The highest advantage of this cost-benefit approach is to produce different types of molecular weight markers by using an effective and short protocol.

Background: Frequency of migraine changes at different times of a woman's reproductive cycle because of fluctuation of estrogen levels. Breast cancer has also a link with hormonal changes. Given this fact that both migraine and breast cancer are affected by estrogen, the prevalence of migraine may be different in breast cancer patients compared to the normal population. Materials and Methods: In this case-control study, two groups of women with and without breast cancer were compared regarding the prevalence of migraine. Each group consisted of 400 women. The diagnosis of different types of headache was made based on The International Headache Society (IHS) guidelines. Type of headache, type and receptor status of breast cancer, as well as history of taking hormonal medications was recorded. Independent t-test and Chi-square tests were used for data analysis. Results: Relative frequency of migraine headache in the normal woman was 38% compared to 19% in the breast cancer group (P < 0.0001). Tension headache was also significantly more prevalent in the normal group (P < 0.001). The frequency of migraine was significantly lower in estrogen receptor (ER)+/progesterone receptor (PR)− women compared to ER−/PR+ (26 and 43 women, respectively; P = 0.04); however, this difference was not significant for tension headache (P = 0.68). Conclusion: This study confirmed the lower frequency of migraine, as well as tension headache, in breast cancer sufferers. This could be contributed to several non-hormonal factors, such as a history of long term use of nonsteroidal anti-inflammatory drugs (NSAIDs), and hormonal factors, although only migraine showed a strong link with hormone status.

Background: Fusion of Hepatitis B virus surface antigen (HBsAg) to a DNA construct might be considered as a strategy to enhance cellular and cytotoxic T-lymphocytes (CTL) responses of a Hepatitis C Virus core protein (HCVcp)-based DNA vaccine comparable to that of adjuvanted protein (subunit) immunization. Materials and Methods: pCHCORE vector harboring coding sequence of HBsAg and HCVcp (amino acids 2-120) in tandem within the pCDNA3.1 backbone was constructed. The corresponding recombinant HCVcp was also expressed and purified in Escherichia coli. Mice were immunized either by adjuvanted HCVcp (pluronic acid + protein) or by pCHCORE vector primed/protein boosted immunization regimen. The cellular immune responses (proliferation, In vivo CTL assay and IFN-g/IL-4 ELISpot) against a strong and dominant H2-d restricted, CD8 ⁺ -epitopic peptide (C39) (core 39-48; RRGPRLGVRA) of HCVcp were compared in immunized animals. Result: Proper expression of the fused protein by pCHCORE in transiently transfected HEK 293T cells and in the expected size (around 50 kDa) was confirmed by western blotting. The immunization results indicated that the pCHCORE shifted the immune responses pathway to Th1 by enhancing the IFN-g cytokine level much higher than protein immunization while the proliferative and CTL responses were comparable (or slightly in favor of DNA immunization). Conclusion: Fusion of HBsAg to HCVcp in the context of a DNA vaccine modality could augment Th1-oriented cellular and CTL responses toward a protective epitope, comparable to that of HCVcp (subunit HCV vaccine) immunization.

Background: In some opinions, opium consumption has traditionally been considered to be a means to lower blood lipids and to put off heart diseases. In this study, the relationship between opium consumption and risk factors of coronary artery diseases, hemodynamic factors and cardiac related functions before and after surgery was evaluated. Materials and Methods: In a cross-sectional study 325 patient's candidate for elective coronary artery bypass grafting were enrolled in a period of 6 months. Opium addicted patients were recognized based on taking history from the patients by an anaesthesiologist. Serum lipid profile was determined at the beginning of the study. Frequency and distribution of coronary artery diseases were assessed according to the pre-operative coronary angiography. Results: From 325 patients, 117 patients were opium abusers and 208 patients were not. Mean duration of opium abuse was 12.6 ± 7.7 years. Mean total serum cholesterol levels were not significantly different in abusers and non-users patients (185 ± 47 vs. 190 ± 49, P > 0.05). Mean level of low-density lipoprotein cholesterol was significantly higher in addicted group (121 ± 27 vs. 81 ± 22, P < 0.05). Mean triglyceride level was also higher in addicted patients (203 ± 114 vs. 162 ± 98, P < 0.05). The prevalence of diabetes and glucose levels was considerably lower in opium addicted cases. Mean body mass index was also lower in addicted patients significantly (25.3 ± 3.7 vs. 27.5 ± 4.1, P < 0.05). Conclusion: There may be a relationship between opium abuse and aggravating lipid profile and hypercholesterolemia and coronary artery disease.

Background: Narrowing of the airway caused by tracheolaryngeal edema is one of the most common complications of endotracheal intubation particularly among patients requiring mechanical ventilation longer than 36 h that can cause other complications and increase mortality rate. The aim of this study was to investigate the efficacy of nebulized budesonide in comparison with intravenous (IV) dexamethasone administration before extubation in prevention of post-extubation complications. Materials and Methods: This double-blind clinical trial was carried out at the intensive care unit (ICU) of a tertiary care center (Alzahra Hospital in Isfahan). The study's population was comprised of 90 patients who had been admitted in the ICU and required intubation at least for 48 h. All patients were between 18 and 65 years of age. Having randomly divided the patients into two equal groups, the first group received nebulized budesonide while the second group was treated by IV dexamethasone 1 h before extubation. The treatment continued up to 48 h after extubation. The collected data from both groups was then subjected to statistical analyses to come to results. Results: There was no significant difference between the two groups; hence, both drugs were found to be effective in prophylaxis of the complications due to tracheal extubation. According to the findings of the current study, since nebulized budesonide has no systemic complications of IV corticosteroid, it can be used as the first choice in reducing the complications attributed to extubation. Conclusion: Considering the very low systemic absorption of nebulized budesonide; however, we recommend it for prevention of post-extubation complications instead of IV dexamethasone.

Background: People strive to maintain the best look and have a youthful appearance. The skin around the eye is an area without many oil glands and collagen in comparison to the body rest, so it is more prone to fine lines and dehydration, which makes it look dull. The aim of this research is to develop and evaluate in vivo efficacy of an anti-wrinkle and dark circle eye pad consisting of 3% w/w caffeine and 1% vitamin K in a convenient, healthy, and cosmeceutical base. Materials and Methods: Pre-emulsions containing selected ingredients in a specified effective concentration were prepared. The selected formulation, based upon pharmaceutical parameters, was coated on a nonwoven fabric in an eye counter shape, and stored in a jar. Then in vivo trial was carried out for investigation of its anti-wrinkling efficacy on 11 healthy women. In a single blind trial, the sample pad was applied under the right eye and the placebo pad, consisting of water, was placed under the left eye simultaneously. The efficacy and safety of the formulation was evaluated visually and with a multi skin test MC 900 instrument. Result: After four weeks, the skin around the right eye of all the subjects experienced a reduction in the depth of wrinkles and dark circles, and from a subjective point of view, the appearance and elasticity of the skin were improved. Conclusions: The caffeine pad containing vitamin K in an Emu oil base shows an improvement in eye counter appearance with anti-dark circle capacity and as an emollient.

Background: Biodegradable elastomeric materials such as poly glycerol sebacate (PGS) have gained much current attention in the field of soft tissue engineering. The present study reports the synthesis of PGS with molar ratios of 1:1, 2:3, and 3:2 of glycerol and sebacic acid via polycondensation reaction and tests the effect of PGS on human corneal epithelial (HCE) cells viability in vitro. Materials and Methods: PGS films were prepared by the casting method. We tried to fabricate PGS with different compositions and various properties as being a viable alternative to the corneal stroma in cornea tissue engineering. The chemical properties of the prepared polymer were investigated by means of attenuated total reflectance - Fourier transform infrared spectroscopy (ATR-FTIR) analysis and the in vitro cytotoxicity was investigated by the Alamarblue method. Results: The functional groups observed in the PGS FTIR spectrums of PGS with various molar ratios were the same. However, the main difference was the time of completing the cross-linking reaction. The PGS prepared by 2:3 ratio as a molar ratio had the fastest and the 3:2 ratio had the lowest cross-linking rate because of the higher amount of sebacic acid. Results of the Alamarblue cytotoxicity test assay showed no deleterious effect on HCE cell viability and proliferation. Conclusions: PGS is a potentially good candidate material for corneal tissue engineering because of its lack of in vitro HCE cell toxicity.

Background: Investigation of strategies and methods of therapy in stutterers regarding to its characteristics, length of treatment, and relapse of stuttering is very important. Acupuncture has been introduced as a therapeutic method for the treatment of stuttering. The aim of the present research was the identification of the results of intervention of laser acupuncture in comparison with speech therapy in stutterers. Materials and Methods: This clinical - trial and case control research was conducted on 20 stutterers and 20 non-stutterers. In the present study, speech therapy and laser acupuncture were used on 10 persons who had developmental stuttering from childhood. Results: The results were compared with the data of speech therapy and placebo laser in 10 control subjects. All of the subjects were followed up for 12 weeks after the intervention. The obtained data showed that accompanying of speech therapy with laser acupuncture resulted the increasing of maintenance and therapeutic effects of stuttering treatment and decreasing of relapsing. The speech rate and percent of stuttered words before and after the intervention in both groups (A and B) were decreased. Following the results after 12 weeks showed that the results were stable in laser group more than the other group and there was a significant difference between the two groups. Conclusion: The results of the present study showed that using of laser acupuncture therapy accompanying by speech therapy has many effects on the treatment of stuttering and prevents the relapsing of stuttering that is very common.

Background: The rate of dementia is increasing rapidly. With the recognized high rate of illiteracy among geriatric patients, preparing an appropriate device for special screening among the low-educated elderly seems to be necessary. The aim of this study is to prepare and assess the psychometric properties of the Persian version of the Kimberley Indigenous Cognitive Assessment (KICA) in Iranian adults, in 2012. Materials and Methods: One hundred and eighty elders participated in this psychometric study. Ninety patients with dementia according to the Diagnostic and Statistical Manual of Mental Disorders, fourth Edition, Text Revision (DSM-IV-TR) criteria, who had been admitted to Geriatrics and Neurology in some of the private clinics in Esfahan, Iran, in 2012, were selected. The rest of the participants were normal persons with the same demographic characteristics as the dementia group, who were selected from the patients' acquaintances and from the Retired Personnel Organization. The statistical tools were the KICA scale, Mini-Mental State Examination (MMSE), and Modified Mini-Mental State Examination (3MSE). Results: The best clinical cutoff point of the test was 31, with a sensitivity of 92% and specificity of 88%. The Cronbach's alpha coefficient of KICA was 0.93. Among the KICA's subscales, the maximum Cronbach's alpha coefficient belonged to Praxis (α = 0.933) and the minimum one belonged to Delayed Recall (α = 0.927). The correlation coefficients of the KICA score with MMSE and 3MSE were 0.58 and 0.57, respectively. Conclusion: The KICA test has been seen to be a reliable and valid tool to assess cognitive impairment in the aged people of Iran. The KICA test can be used as a cognitive assessment test for distinguishing patients with dementia, especially illiterate ones from other healthy people in Iran.

Background: Decreased concentration of tissue factor pathway inhibitor (TFPI) is a risk factor for development of deep venous thrombosis and coronary heart disease, but there is no evidence for the relationship between TFPI and cerebral venous and sinus thrombosis (CVST). The aim of this study was to determine the level of TFPI in healthy population and in patients with CVST. Materials and Methods: We determined the plasma level of TFPI in 20 patients with CVST (cases) and 31 healthy volunteer subjects (as control group) by enzyme linked immunoassay method. We also examined the association between TFPI and the risk of CVST. Continuous variables were compared between groups using Student's t test, and odds ratio was calculated by multiple logistic regression analysis. Results: The mean TFPI was significantly lower in the CVST group compared with the control group (8.60 ± 4.05 ng/mL; 14.6 ± 8.6 ng/mL; P = 0. 005), respectively. The odds ratio for CVST associated with low (<25 ^th percentile) levels of TFPI was 5.429 (95% CI, 1.487-19.82, P = 0.012). Conclusion: Our investigation demonstrates that reduced TFPI may be one of the risk factors of CVST and associated with increasing the risk of developing CVST.

Background: Myelosuppression is the most common dose-limiting side effect of chemotherapy. Cassia occidentalis plays a vital role in preventing health disorders, but its hematological effects have not been documented much. This study is designed to investigate the myeloprotective activity of the crude methanolic leaf extract of C. occidentalis in cyclophosphamide-induced bone marrow suppression. Materials and Methods: Twenty-eight Wistar rats aged two to three months, weighing 120-170 g were used for the study. The rats were divided into four groups of seven rats each, labeled A to D. Groups A and B were administered with 3 mg/kg of cyclophosphamide intraperitoneally daily for three days to induce bone marrow suppression, after which groups B and C were orally fed with 250 mg/kg body weight of the crude leaf extract once daily for 14 days. Group D served as control without receiving the extract. On Day 15, blood samples (3.0 ml) were collected from each rat through the retro-orbital plexus of the median canthus into K ₃ -EDTA containers for hematological analysis using standard operative procedures. Data were analyzed with Pearson's correlation test and multivariate analysis of variance using Statistical Package for Social Sciences (SPSS) version 17 and results were expressed as mean ± SD. The level of significance was determined at 95% confidence level. Results: Myelosuppression was achieved in Group A rats. Group B rats showed a significant increase in hemoglobin (Hb), hematocrit (Hct), and total white blood cell count (TWBC) compared with Group A. The Group C rats revealed a significant increase (P < 0.05) in Hb, Hct and TWBC when compared with control. Conclusions: Crude methanolic leaf extract of C. occidentalis may possess myeloprotective properties when orally administered in cyclophosphamide-induced bone marrow suppression.

A brain tumor is an intracranial neoplasm within the brain or in the central spinal canal. Primary malignant brain tumors affect about 200,000 people worldwide every year. Brain cells have special characters. Due to the specific properties of brain tumors, including epidemiology, growth, and division, investigation of brain tumors and the interpretation of results is not simple. Research to identify the genetic alterations of human tumors improves our knowledge of tumor biology, genetic interactions, progression, and preclinical therapeutic assessment. Obtaining data for prevention, diagnosis, and therapy requires sufficient samples, and brain tumors have a wide range. As a result, establishing the bank of brain tumors is very important and essential.

Background: Shivering associated with spinal anesthesia is a common complication. It also causes more usage of oxygen, increased production of carbon dioxide (CO2), and lactic acidosis with movement of clots and bleeding after surgery. This study was performed to compare the different dosages of intrathecal meperidine and their effects on shivering during and after surgery and to compare these to the control group. Materials and Methods: This study is a clinical trial. Target population consisted of the patients who were candidates for lower limb orthopedic surgery under spinal anesthesia. About 120 patients were chosen and randomly divided into four groups. In group 1, spinal anesthesia was performed with 3 ml marcaine 0.5% and 0.1 mg/kg meperidine. In group 2, 3 ml marcaine 0.5% and 0.2 mg/kg meperidine was given. In group 3, 3 ml marcaine 0.5% and 0.3 mg/kg meperidine, and in the fourth group, 3 ml marcaine 0.5% and normal saline in the same volume were injected. During surgery and recovery, hemodynamic index and shivering were recorded. Results: Based on the analyzed data, in the fourth group 23 patients (76.7%) had shivering. While the prevalence of shivering in the first, second, and third groups was 15 patients (50%), 11 patients (36.7%), and 3 patients (10%), respectively. Chi-square test showed significant difference in the four groups (P < 0.001). Conclusions: Using higher dosage of intrathecal meperidine (0.3 mg/kg) was more effective than using lower dosage of meperidine (0.1 mg/kg and 0.2 mg/kg) in reducing the incidence and severity of shivering during spinal anesthesia in lower extremity orthopedic surgeries.

Osteochondroma or exostosis is a bony developmental anomaly, which arises from exophytic outgrowth on bone surfaces in a characteristic manner. Osteochondroma is asymptomatic and grows away from the nearby joint. This paper reports an unusual presentation of osteochondroma in which the patient was surprisingly completely symptomatic. The lesion grew toward the nearby joint and the radiographic findings were not compatible with surgical findings

Background: Type 2 diabetes (T2D) is a multifactorial disease with susceptibility of several genes that are related to T2D. Insulin secretion pathway starts with potassium channels in pancreatic beta cells. KCNJ11 gene encodes ATP-sensitive potassium channel subunits. Some studies suggested that KCNJ11 (E23K) mutation increases the risk of T2D. Therefore, present study was designed to investigate the association between E23K polymorphism of KCNJ11 gene and type 2 diabetes mellitus (T2DM) in the Iranian population. Materials and Methods: The type of study was case-control and 40 unrelated subjects, including 20 healthy controls and 20 diabetic patients were recruited (diagnosed based on American Diabetes Association criteria). Blood samples were used for isolation of genomic deoxyribonucleic acid (DNA). Having extracted the genomic DNA from human blood leukocytes by means of High Pure PCR Template Preparation Kit, PCR-restriction fragment length polymorphism method was used to detect KCNJ11 E23K gene polymorphism. BanII restriction enzyme was used for digestion. Data were analyzed using Chi-square or Fisher exact test or independent t-test, as appropriate. P < 0.05 was considered. Results: We found that the carrier homozygous for KK genotype are susceptible to T2D (0.049) and in patients the frequency of K allele was higher than control subjects (0.048). Conclusion: The present study suggests that KCNJ11 (E23K) gene polymorphism is associated with T2DM.