Background: Surfactant administration together with nasal Continuous Positive Airway Pressure (nCPAP) administration is considered to be the basis for Newborn's Respiratory Distress Syndrome (RDS) management. This study evaluated the method of directing the surfactant to the lungs in newborns affiliated with RDS through i-gel (i-gel surfactant administration/i-gelSA) compared to the standard care INSURE method, in a clinical trial. Materials and Methods: This randomized control trial (RCT) was done on newborns weighing ≥2000 g, with RDS, while being supported with Bubble-CPAP. Newborns, which required FiO ₂ ≥0.3 under Continuous Distending Pressure (CDP) ≥5 cm H ₂ O for more than 30 minutes to maintain SpO ₂ in the range of 89 - 95%, were given 100 mg/kg of Survanta. In the interventional group or the i-gelSA (i-gel Surfactant Administration) group, 35 newborns experienced surfactant administration with i-gel and 35 newborns in the control or INSURE group. The average a/APO ₂ before and after surfactant administration, repeated need for surfactant administration, average nCPAP duration, need for invasive mechanical ventilation, pneumothorax, and the average duration of hospitalization in the Neonatal Intensive Care Unit (NICU) were compared. Results: Although the average a/APO ₂ showed no significant difference before the procedure; in the i-gelSA group, this average was meaningfully higher after the administration of the surfactant (P = 0.001). The other factors showed no significant difference. Conclusion: According to the results of this study, the surfactant administration using i-gel was more successful in oxygenation improvement than the INSURE method, and the i-gel method could even be promoted to the standard care position. However, more research is needed in this area.

Background: Poor vitamin D status and low serum insulin-like growth factor-1(IGF-1) are associated with metabolic syndrome (MetS) and its components. But, there is no adequate evidence about this. The aim of this study was to examine relationship of factors with MetS features. Materials and Methods: In this cross-sectional study, 156 women aged 28-76 years with MetS were recruited by consecutive random sampling. Dietary vitamin D, serum 25-hydroxyvitamin D (25(OH) D) and IGF-1 levels and also MetS components were determined. Result: The mean of serum 25(OH) D and IGF-1 concentrations were 20.5 ΁ 10.8, 194 ΁ 47 ng/mL, respectively. Overall, near 54.5% and 24% of subjects were vitamin D deficienct and insufficienct respectively. Univariate regression analysis showed that 25(OH) D concentration was negatively correlated with fasting blood sugar (P < 0.001) and no significant relation was observed between vitamin D status and serum IGF-1 with blood pressure and waist circumference. Multivariate regression analysis showed positive relation of 25(OH) D concentration with HDL-cholesterol (P = 0.031) and also dietary vitamin D is positively correlated with triglyceride (P = 0.026). IGF-1 as a predictor was not related to any of the MetS components. Conclusion: Our findings show that vitamin D status was related to FBS, HDL-C and triglyceride concentration; hence, with regard to findings of previous studies it seems that vitamin D is related to components of MetS. However, to determine the role of vitamin D status and IGF-1 in the development MetS and related components, further longitudinal studies and randomized clinical trials should be prescribed.

Neurofibromas are rare, benign, nerve sheath tumors in the peripheral nervous system. The solitary type is found in those who do not have neurofibromatosis. Solitary neurofibromas are too rare in the giant type. We report a rare case of a solitary giant neurofibroma of the anterior right thigh. The diagnostic criteria, characteristics of imaging studies, and operative approach are represented.

Background: Femoral shaft fractures are among the most common fractures following high trauma injuries. Different kinds of treatment have been suggested for these injuries. Aim: The aim of this study was to compare the results femoral fractures treated by mini open and close intramedullary nailing (IMN) technique. Materials and Methods: A total of 48 adult patients were operated due to fracture of the femur with close or open IMN technique between September 2010 and September 2011. 23 patients operated with close. IMN technique was included in Group I while 24 patients operated with mini open IMN technique constituted Group II. In Group I, all patients. Were operated on the fracture table in the supine position while in Group II, all patients underwent surgery on standard tables in the lateral position. Results: The mean age of patients was 27.3 years, ranging between 16 and 62. The mean age of the close nailing and open nailing groups was 30.5 and 24.5 respectively (P = 0.052). Only one patient from the open nailing group failed to unite. The mean time for union in close and open nailing groups was 13 + 2.4 and 17.7 + 2.3 weeks respectively (P = 0.001). No infection or limb length discrepancies were observed in the two groups. Conclusion: Although close nailing is the preferred methods in most cases, but in poly-traumatized patients or in centers where there are no fracture tables or C-arm, open nailing is a good option.

Background: Pancreatic cancer has poor prognosis by surgical and chemotherapy when it is diagnosed, so other anti-cancerous assistant therapeutic drugs are suggested e.g. epigenetic reversal of tumor-suppressor genes on promoter hypermethylation. 5-Aza-CdR is a nucleoside analog of DNMTi but it has long-term cytotoxicity effects. This study compares the anticancer effect of 5-Aza-CdR and Disulfiram potencies on PANC-1 cell line and up-regulation of p21. Materials and Methods : PANC-1 cell line was cultured in DMEM high glucose and treated by 5-Aza-CdR with 5 and 10 μM concentration for four days and 13 μM DSF (Diulfiram) for 24 hours. MS-PCR and RT-PCR were carried out to detect the methylation pattern and estimate the mRNA expression of RASSF1A and p21 in PANC-1. Result : MS-PCR demonstrated partial unmethylation after treatment with 5-Aza-CdR while there was no unmethylated band after DSF treatment. RT-PCR showed significant differences between re-expression of RASSF1A before and after treatment with 10 μM 5-Aza-CdR (P < 0.01) but not after treatment with 13 μM DSF (P > 0.05). The significant correlation was observed between RASSF1A re-expression and p21 up-regulation before and after treatment with 10 μM 5-Aza-CdR (P < 0.01) but not after treatment with 13 μM DSF (P > 0.05), while p21 up-regulation was significantly higher after DSF treatment (P < 0.01). Conclusion: Our findings indicated that 5-Aza-CdR induces the re-expression of RASSF1A and p21 up-regulation in PANC-1. DSF showed no epigenetic reversion while it affected p21 up-regulation.

Background: The aim of this study was to examine the effects of the presence of continuous support person and routine interventions during labor and delivery in Isfahan, Iran. Materials and Methods: One hundred pregnant women in spontaneous labor were assessed in four groups: Group 1; received routine intervention with a support person, Group 2; received routine intervention without support person, Group 3; received support person without routine intervention, Group 4; did not receive routine intervention or a support person. Sociodemographic, antenatal characteristics, length of stage of labor, instrumental delivery, the cervical laceration, perineal tear, labor pain, satisfaction and Apgar score collected and analyzed. Results: Based on the results there was no significant difference in regard to maternal age, BMI, maternal education and working statutes among the studied groups (P-value >0.05). Also, 1 and 5-min Apgar <7, cervical lacerations and instrumental delivery among studied groups were similar (P-value >0.05). Length of first and second stage of labor, perineal tear, satisfaction score and pain before and after labor were significant among studied groups (P-value <0.05). Conclusions: Presence of a support person and routine intervention during labor did not effect on incidence of cervical lacerations, instrumental delivery and Apgar <7. Labor pain and women's dissatisfaction, and number women with third and fourth degree of perineal tear among women who received routine intervention were increased compare to others. Interventions makes decreased the length of first and second stage of labor. In totally, the presence of a support person during labor in Iranian women decrease length of labor and improved labor outcomes.

Background: Levels of a number of some biomarkers have been associated with spontaneous preterm birth. This study was aimed to evaluate the relation between C-reactive protein (CRP) with preterm labor and response to tocolytic therapy. Materials and Methods: Seventy five pregnant women with symptoms of preterm labor (cases) in compare with 75 term women (controls) were enrolled. Baseline data and CRP was recorded. So, cases were under treatment tocolysis with the use of magnesium sulfate, and then they were followed till delivery time to assess the response to the treatment. Results: Sixteen patients with symptoms of preterm labor did not response to the treatment and delivered prematurely and 59 women response to tocolytic treatment and delivered at term. The curve constructed cut-off value for >3.6 (AUC, 0.683; SE, 0.041; P < 0.0001) for CRP, indicating a significant relationship with preterm labor. Also, there was significant relationship between CRP level with response to the treatment in cut-off >1.8 (AUC, 0.738; SE, 0.076; P = 0.001) for CRP. Conclusions: Maternal concentrations of CRP can be used as appropriate biomarker for predicting preterm labor and response to tocolytic therapy in pregnant women.

Background: The increase in life expectancy and changes in lifestyle have led to prevalence of non-communicable diseases including diabetes whose treatment and care requires effective teamwork. This study was conducted to examine the effect of inter-professional education on performance and diabetes care knowledge of health care teams. Materials and Methods: This quasi-experimental study was performed as an inter-professional education on 6 healthcare teams (34 people) based on Kolb's Learning Cycle and consisted of a set of training activities to improve individual, group, and inter-professional capabilities of members of the health care team. The pre- and post-tests included Team Climate Inventory (TCI) and a knowledge assessment tool performed before the workshop and 3 months later. Results: Mean scores for knowledge of health care team before intervention and 3 months later were 7.06 ± 1.04 and 7.97 ± 0.97 out of 10, respectively, that showed a significant difference (P < 0.0001). Mean score of the pre-test and post-test for inter-professional performance comprised 47.03 ± 6.7 and 49.44 ± 5.54 out of 70, respectively, which did not show any significant difference. However, these mean scores had a significant difference for the domains of knowledge and exercising objectives of the teamwork (10.62 ± 1.37 and 11.41 ± 1.76 out of 15, respectively) (P = 0.013). Conclusion: It seems that inter-professional education can improve the quality of health care to some extent through influencing knowledge and collaborative performance of health care teams. It also can make the health-related messages provided to the covered population more consistent in addition to enhancing self-confidence of the personnel.

Introduction: Aflatoxins are secondary toxic metabolites produced by certain group of Aspergillus species in suitable conditions. These toxins are highly toxic, immunosuppressive, mutagenic, teratogenic and carcinogenic metabolites. The purpose of this study was to detection aflatoxin M ₁ concentration in mother's milk from rural area of Khorrambid town of Fars Province. Materials and Methods: In this study, 87 milk samples of mothers were collected by cluster sampling methods in the period between June and July 2011 and the amount of aflatoxin M ₁ was measured by a competitive ELISA method. Results: From 87 mother's milk, 24 (27.6%) samples were contaminated with aflatoxin M ₁ with mean concentration of 0.56 ΁ 1.23 pg/ml (range 0.13-4.91 pg/ml). Conclusion: The amount of aflatoxin M ₁ in mothers' milk was lower than 50 ng/l (Europe Union and Iranian standard). Detection of Aflatoxin M ₁ in mothers' milk is due to consuming contaminated food. This contamination not only threatens the health of the mothers but also has irreversible effects on the growth and health of their babies.

Background: The aerobic Actinomycetes are a large group of soil-indwelling bacteria that are distributed in world-wide. These Gram-positive bacteria are most commonly associated with opportunistic infections in both immunocompromised and immunocompetent hosts. Materials and Methods: In this study, three phenotypic and deoxyribonucleic acid (DNA) extraction methods for isolation and identification of Nocardia genus were compared. Samples were taken in five different locations of Isfahan's suburb from hospitals area, parks, agricultural lands, gardens, arid lands with different soil temperature and pH. Results: In this study, showed that slip-buried-method was better than two other phenotypic methods; 14 out of 70 soil samples (20%) were positive for Nocardia spp. DNA of positive samples were extracted with three techniques and DNA extraction by microwave technique was better than others. This technique was confirmed with observation of DNA bands on 1% agarose gel. Conclusions: These bacteria are important in immune deficient patients such as cancer patients, transplant recipients, tuberculosis; acquired immunodeficiency syndrome etc., Their affluence is unsteady in different zones of the world. In this study, among the three phenotypic methods for the isolation of Nocardia slip-buried method was better than other methods. Among DNA extraction techniques, DNA extraction by microwave method would be selective method for DNA extraction of Nocardia spp. compared with others techniques.

Background: This study was aimed to investigate the alterations of some plasma angiogenic factors after resistance exercise in male rats. Materials and Methods: Twenty male rats were divided into two groups: Sedentary and trained (n = 10 each). The animals in the trained group undertook one training session per day, 3 days/week. After 4 weeks; plasma nitric oxide (NO), vascular endothelial growth factor (VEGF), and soluble form of VEGF receptor-1 (sFlt-1) concentrations were measured. Results: Plasma NO concentration was not different between groups (P > 0.05). Plasma VEGF concentration was also not different between sedentary and trained groups (142.73 ± 3.74 and 144.5 ± 5.1 pg/mL, respectively; P > 0.05). Resistance training did not significantly change plasma sFlt-1 concentration (P > 0.05). VEGF/sFlt-1 ratio did not alter after exercise. Conclusion: Resistance training does not alter plasma angiogenic factors (NO, VEGF, and sFlt-1), at least in normal rats. More studies are needed to show the effect of resistance training on angiogenesis process.

Background: The aim of this study was to compare the response of doxycycline and bleomycin in pleurodesis of malignant pleural effusions. Materials and Methods: The radiologic and clinical responses of doxycycline and bleomycin in pleurodesis of malignant pleural effusions were compared in this randomized clinical trial. Forty-two patients were randomized to receive either bleomycin 45 mg or doxycycline 600 mg as the sclerotherapy agent. Chest X-rays were taken before and after intervention, 10 days and 2 months later to compare the radiologic response. Dyspnea and other side effects, before and after intervention, 10 days and 2 months later were recorded and compared. Chi-square test was applied to analyze the data. Results: The prevalence of dyspnea and its different severities, 10 days and 2 months after intervention were significantly different (P < 0.05) between the two groups. Analysis of pleural effusions revealed a significant difference (P < 0.05) between Doxycycline vs. Bleomycin 2 months after the intervention. Three months after pleurodesis, only one patient in bleomycin group needed pleural fluid drainage. Conclusion: Pleural effusions did not change with use of doxycycline and bleomycin in short time but long-term results of doxycycline sclerotherapy was better than bleomycin sclerotherapy in malignant pleural effusions that was supported by this study. However, additional studies with larger sample size are necessary to confirm the results.

Background: Atherosclerosis, with its major manifestation, coronary artery disease (CAD) is a chronic inflammatory disease. Dietary fatty acids intakes favorably effect on inflammatory responses. This study was conducted to examine the association between dietary fatty acid intakes and inflammatory markers, interleukin 6 (IL-6) and high sensitivity C-reactive protein (hs-CRP), in CAD patients among Iranian population. Materials and Methods: This hospital-based, cross-sectional study was conducted in Chamran Heart Hospital, Isfahan, Iran in 2012. Patients aged ≥45 years with first ever symptomatic CAD confirmed by angiography were included. A semi-quantitative food frequency questionnaire (FFQ) was used to assess the usual intakes of dietary fatty acids. Results: The energy-adjusted daily intakes (mean ± SD) of saturated fatty acid (SFA), monounsaturated fatty acid (MUFA), linoleic acid, α-linolenic acid, and eicosapentaenoic acid and docosahexaenoic acid (EPA + DHA) were 27 ± 9, 22 ± 6, 21 ± 5, 0.4 ± 0.32, and 0.85 ± 0.82 g/d; respectively. After adjustment for potential confounders, SFA was directly related to hs-CRP (P = 0.01) and IL-6 (P < 0.001) concentrations. Intakes of EPA + DHA and MUFA, were significantly adversely related to plasma hs-CRP concentration (P = 0.002 and 0.001, respectively) but not IL-6, albeit MUFA was modestly inversely related to IL-6 (P = 0.08). No significant relationships were observed for other fatty acids, α-linolenic acid, and linoleic acid. Conclusions: These findings suggest that saturated fatty acids, EPA + DHA and MUFA were significantly related to plasma inflammatory markers in CAD patients.