Background: Acute appendicitis is one of the most commonly diagnosed surgical diseases that its accurate diagnosis is still a problem, and there is no certainty. Ultrasound is recommended for diagnosis of appendicitis as an easy and noninvasive method. Therefore, due to the spread of disease and the urgent need to accurately diagnose in all educational centers, we decided to determine the diagnostic value of this inclusive method in identifying acute appendicitis. Materials and Methods: This is a descriptive cross-sectional research that was conducted on 540 patients referring to Educational Center of Ayatollah Kashani Hospital. All individuals suspected to appendicitis, and undergone ultrasound was included in the study, and then the result of ultrasound was compared to the obvious pathological results. Data were entered into statistical software of SPSS 20 and were analyzed. Results: According to the ultrasound findings, appendicitis was diagnosed as negative in 351 ones and positive in 189 ones. Ultrasound sensitivity in the diagnosis of appendicitis was 37.1%, while its specificity was 87.2%. The positive predictive value was 96.8% and the negative predictive value was only 11.7%. Conclusion: Considering very low-negative predictive value in educational centers, it is suggested that ultrasound is done for diagnosis of appendicitis only in complicated cases of appendicitis and differential diagnose (kidney stones, and ovarian cysts). In addition, it is recommended that routine ultrasound be avoided for all patients.

Background: Pelvic fracture (PF) is the second-most prevalent cause of mortality after brain trauma among multiple trauma patients. Our aim was to examine the reliability of suggestive criteria for having no PF (NPF) according to the common reported clinical signs and symptoms (CSSs). Materials and Methods: In the current prospective study, 3527 patients with multiple trauma were recruited according to the guideline of emergency medicine. Information on age, gender, pelvic pain or tenderness, sacrum and coccyx pain or tenderness, the ability to active straight leg raising (SLR), and distracting injury was collected, and PF was examined by either X-ray or computed tomography (CT) scan. Results: The CSS sensitivity of NPF was 39.75% and the specificity was 100%. The no distracting injury was not significantly different according to the CSS criteria and results of X-ray and CT scan (P = 0.269); however, the difference of other criteria was significant (P < 0.0001). No pelvic pain or tenderness and the ability to active SLR considerably affected the prediction of NPF (P < 0.0001). No distracting injury can be omitted from the criteria without any effect on specificity, but with increased sensitivity (60.8% with three criteria vs. 39.7% with four criteria). Conclusion: According to our results, it can be said that due to the high predictive value of our suggestive criteria, it could be applicable as the important criteria for defecting NPF among patients with the possibility of PF. This approach can reduce the necessity of imaging in these patients which helps to reduce the health cost and hazards of X-ray used for imaging and exhaustion of medical devices.

Background: Given the high prevalence of adverse perinatal outcome in the developing countries and the association between uterine artery (UtA) blood flow and fetal status in the uterine, in the current study, we assess the association between UtA pulsatility index (UtA-PI) at 30–34 week's gestation and adverse perinatal outcome. Materials and Methods: This cohort study included 100 pregnant women at 30–34 weeks' gestation. At baseline, UtA-PI was evaluated with color Doppler through abdominal ultrasound. Then, adverse perinatal outcomes including preterm labor, intrauterine fetal death, preeclampsia, low 5-min Apgar score (<7), low umbilical arterial cord blood pH, admitted to Intensive Care Unit in the first 3 days of birth, low birth weight, infant with low weight, death of newborns, cesarean section for respiratory distress, and meconial amniotic fluid were recorded. Ultimately, the collected data were analyzed using SPSS, version 20. Results: The presence of small-for-gestational-age fetuses indicated the highest prevalent adverse prenatal outcome with the incidence of 13.3% and 58.5%, respectively, among pregnancies with normal UtA-PI as well as those with high UtA-PI (P < 0.001). Overall, given that sensitivity and specificity of high UtA-PI were 37.5% and 73.3%, respectively, it could not properly predict adverse perinatal outcome (P = 0.360). Conclusion: According to the results, although the incidence of some of adverse perinatal outcomes in pregnant women with high UtA-PI was higher compared to those with normal UtA-PI, this factor alone cannot predict adverse perinatal outcome well. Therefore, this factor may predict these outcomes well, in the subgroups with high-risk pregnancies or with some blood factors or with pregnancy complications.

Background: Anthropometric indices are one of the ways to assess physical growth and nutritional status of children and adolescents considering the importance of nutrition in children and the role of healthy nutrition in preventing diabetes, obesity and other chronic diseases, the objective of this study is determine the relationship between nutritional knowledge and anthropometric indices in children and adolescents in Isfahan. Materials and Methods: This survey conducted using multistage cluster sampling on 1776 students aged 15–7 years old in Esfahan province in 2015. Nutritional knowledge was measured by questionnaire and height, weight, and body mass index (BMI) were measured as anthropometric index. Pearson and Spearman coefficients, regression, and T Independent were used to analyze the data; regression analysis was used to adjust the variables. Results: The mean age of students were 12.6 ± 1.9 years. About 50.3% of students were male, and most of them were studying in 5^th grade of elementary school (23.8%). Most of them had normal status in terms of BMI (60.6%) and height (77.8%). There was no significant relationship between the level of BMI and height of children and adolescents, and the total score of nutritional knowledge and its domains (P > 0.05), direct and significant relationship was found between nutritional knowledge in two domains of meals and food habits and age. Conclusion: As no relationship between nutritional knowledge and anthropometric index in our study, other factors are effective in this regard, and studies are required to be conducted to examine the nutritional attitude and performance, in addition to knowledge.

Background: Domperidone (DOM), a dopamine receptor antagonist, is used as antiemetic for the treatment of gastroparesis, vomiting, and nausea. The low water solubility of DOM leads to a low dissolution rate and variable bioavailability. The aim of this study was to enhance the solubility of DOM by the preparation of micron-sized particles. Materials and Methods: The in situ micronization process was carried out using solvent change method in the presence of Soluplus® or PEG₆₀₀₀as stabilizing agents. DOM was dissolved in appropriate solvent (acetone and methanol 1:1 v/v), and the stabilizing agent was dissolved in water (as nonsolvent). The nonsolvent was poured rapidly into the drug solution under stirring by a homogenizer, and the resultant was freeze dried. The crystalline shape and particle size of DOM and interaction of DOM with stabilizers were investigated by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), and differential scanning calorimetry (DSC), and then, dissolution test was carried out. Results: Optimum formulation was composed of DOM (0.5%) and PEG_{6000 (}0.1%) with the lowest particle size (3 μm) and the highest DE_60%(95.95%) as compared to pure DOM (particle size of 13.4 μm and DE_60%52.18%). Conclusion: SEM micrographs showed uniform and spherical shape of microcrystals. FTIR, XRD, and DSC studies indicated the micron size of the microcrystals and no interference between the drug and the stabilizer.

Background: Marine organisms produce a variety of compounds with pharmacological activities, including anticancer effects. They contain several secondary metabolites with interesting biological activities. This study attempted to find cytotoxicity of Hexane, Dichloromethane and Butanol partitions of Holothuria leucospilota and Echinometra mathaei. Materials and Methods: H. leucospilota and E. mathaei were collected from Persian Gulf. The animals were extracted by maceration with methanol-ethyl acetate (1:1). The H. leucospilota extract was partitioned by Kupchan method to hexane, dichloromethane, butanol, and water partitions. The cytotoxic activity of the extracts was investigated against HeLa (cervical cancer) and human umbilical vein endothelial cells cell lines by mitochondrial tetrazolium test assay after 72 h. Results: The cell survivals of HeLa cell were decreased by increasing the concentration of extracts. A significant reduction in cell viability at the doses of 30 (μg/ml) of dichloromethane (DCM) partition, 0.3, 3, and 30 (μg/ml) of ButOH partitions of sea cucumber, and 0.5 (μg/ml) of E. mathaei was observed. The median growth inhibitory concentration value of Hex, DCM, ButoH, and water partitions were 0.301, 0.21, 2.29, and 0.229 μg/ml, respectively. Conclusion: This study reveals that different partitions of H. leucospilota and total extract of E. mathaei have cytotoxic activity against cancer cell lines. More study is necessary to find the active metabolites in the more active partitions.

Background: The previously established methods for type 2 diabetes (T2D) have mainly concentrated on overt diabetes model development. Here, our intention was to create an animal model passing through distinct phases such as obesity with insulin resistance, prediabetes, and gradual progress to the overt diabetes stage. A high-fat high-carbohydrate diet formulation was prescribed combined with multiple low-dose streptozotocin (STZ) injections after obesity establishment. Materials and Methods: Sixteen male Wistar rats were separated randomly into two groups and fed a normal diet for 1 week after which the body weight and biochemical indices of each rat were measured and recorded. Subsequently, one group (n = 8) switched to the high-fat high-carbohydrate diet formulated by us for 10 weeks, whereas the other group (n = 8) continued with the normal diet. Body weight and biochemical indices of the rats in the high-fat diet (HFD) group were measured at the end of 10 weeks, and each rat received 30 mg/kg intraperitoneal STZ injections with 1-week intervals in two steps and was continued on a high-fat high-carbohydrate diet. The differences between the groups were analyzed using the Student's t-test or one-way analysis of variance and by post hoc multiple comparisons. Results: A significant change in weight, fasting blood glucose, and triglyceride was observed in rats fed with a HFD after 10 weeks. The HFD rats showed typical characteristics of T2D mellitus (T2DM) such as insulin resistance and hyperglycemia following 30 mg/kg STZ. Conclusions: The novel high-fat high-carbohydrate formulation we used, along with multiple low doses of STZ, can mimic peculiar characteristics of T2DM development.

Carnitine membrane transporter deficiency or primary carnitine deficiency (PCD) is an autosomal recessive disorder of fatty acid oxidation, in which the transport of carnitine into cells is impaired. Carnitine plays an important role in transporting fatty acids into the mitochondria and carnitine deficiency block oxidation of long-chain fatty acids in the mitochondria that leads to heart and hepatic disease, myopathy, nonketotic hypoglycemia, and neurological complications. PCD has a wide range of symptoms and can reveal itself as symptomatic cardiomyopathy or even asymptomatic. In this study, we reported twin brothers with PCD. One of them had symptoms of disease and cardiomyopathy and was under treatment with carnitine. Another twin was asymptomatic and was diagnosed during follow-up period of his brother.