Background: Intradetrusor injection of botulinum toxin A (BTX-A) might serve as a minimally invasive substitute in patients with refractory idiopathic overactive bladder (RIOAB). The aim of this study was to evaluate the clinical outcomes related to two different doses of abo-BTX-A (AboBTX-A) in patients with RIOAB. Materials and Methods: This prospective clinical trial was performed on 55 women with RIOAB. After determination of trabeculation grade, 300 (no or mild) or 500 (moderate or severe) unit of AboBTX-A (Dysport) was intravesicaly injected. Before 1, 3, and 6 months after intervention, lower urinary tract symptoms during 24 h were recorded. Results: Of the study population, 62% had severe bladder trabeculation. The mean duration of overactive bladder (OAB) was 1.76 versus 5.85 years, for no or mild versus severe trabeculation, respectively. After injections of 300- and 500-unit dosage, there were 19% and 26% early complications such as urinary retention. There was a statistically significant difference between the two groups in OAB score after 1 month (P < 0.001) and duration of OAB symptoms, over three follow-up times (P < 0.001). The mean preinjection OAB scores between patients with and without recurrence were statistically significant (29.36 vs. 25.07; P < 0.03). Urinary tract infection as a late complication was distinguished in four patients. Conclusion: In RIOAB, by adjusted dosage of AboBTX-A related to the grade of bladder trabeculation, in addition to maintain efficacy, consequent complications might not be affected by dosage and the drug dosage could be increased to nearly 60% with less concern associated to complication

Background: There is evidence regarding the relationship between dietary proteins intake and blood pressure (BP), but they had inconsistent results. Therefore, this study was designed to assess the association between different kinds of protein intake (animal and plant protein) and BP. Materials and Methods: Data were collected from Isfahan Healthy Heart Program. We performed a cross-sectional study among 9660 randomly selected Iranian adults aged ≥19-year-old that they were selected from three large Iranian regions in 2007. A simplified validated 48-item-food frequency questionnaire was used to assess dietary intake including all kinds of protein. Systolic and diastolic BPs were measured in duplicate by trained personnel using a standard protocol. Multivariable regressions were applied to assess the relationship between protein intake and BP levels and the presence of hypertension (HTN). Results: More frequent consumption of animal, plant, and total protein intake were inversely associated with BP in a crude model (P < 0.001); however, after adjustment for potential confounders this relationship remained only for plant protein (P = 0.04). The risk of HTN occurrence decreased in the highest quintile of total and plant protein consumption by 19% (odds ratio [OR] = 0.81; confidence interval [CI]: [0.65–0.96]; P for trend = 0.004) and 18% (OR = 0.82; [CI: (0.67–0.94]; P for trend = 0.03), respectively. Conclusions: More frequent protein intake, especially plant protein consumption was inversely associated with BP and risk of HTN among Iranian adults.

Background: Prevalence statistics are essential for cancer control in addition to incidence and mortality data. As we know, there is no published report regarding lung cancer (LC) prevalence in Iran. Herein, we provide model-based estimates of limited time LC prevalence in Iran, 2015. Materials and Methods: Incidence numbers of LC were extracted from Iranian National Cancer Registry reports for 2003–2009. Trends were analyzed by joinpoint regression, assuming a logarithmic poisson model. Incidence numbers were projected up to 2015, using linear regression models which were trained by corrected annual percentage changes. A Monte Carlo-based model was generated, and absolute survival rates, number of incident cases, and incompleteness of Iranian cancer registry for LC were included into it. Limited-time prevalence (within 1, 2–3, and 4–5 years from diagnosis) and its respective 95% uncertainty level (UL) were estimated by age, gender, and histopathological type. Results: Five-year prevalence was estimated to be 4.21 (95% UL: 3.37–5.38) per 100,000 adult person, with a male:female ratio of 2.01. Estimated number of patients within 1, 2–3, and 4–5 years from diagnosis were 1871 (1497–2392), 993 (770–1285), and 420 (322–550), respectively. Most prevalent form of LC were squamous cell carcinoma (802; 579–999) and adenocarcinoma (319; 230–389) in males and females, respectively. Conclusion: According to our results, the most plausible estimates of number of alive LC patients within initial treatment, clinical follow-up, and cure phases were 2392, 1285, and 550 cases in Iran in 2015.

Background: Studies have shown that pentoxifylline (PTX) in addition to protective effects on blood vessels probably has positive influence against the brain inflammation. Therefore, the aim of this study was to evaluate the effects of PTX on serum levels of interleukin 10 (IL-10) and interferon gamma (IFN-γ) and passive avoidance learning in lipopolysaccharide (LPS)-induced inflammation in rats. Materials and Methods: Inflammation was induced by intraperitoneal (i.p.) injection of LPS (0.5 and 5 mg/kg) in male Wistar rats. After a week, PTX (25 mg/kg; i.p.) was injected for 14 days. Passive avoidance learning test was used for evaluation of learning and memory. Serum levels of cytokines were measured by enzyme-linked immunosorbent assay. Results: The behavioral results did not show any significant effect of LPS and PTX on learning and memory. Both doses of LPS (0.5 and 5 mg/kg) decreased IL-10 significantly (P < 0.05). PTX prevented this reduction just in the LPS 0.5 mg/kg + PTX 25 mg/kg group. Serum level of IFN-γ was increased only in the LPS 0.5 mg/kg + PTX 25 mg/kg group comparing to the LPS 0.5 mg/kg group (P < 0.05). Conclusions: The results showed that LPS-induced inflammation decreased the serum levels of IL-10. PTX could prevent these decreases only in mild inflammation. Both PTX and LPS-induced inflammation had no significant effects on learning and memory; therefore, their effects on CNS require further study.

Background: Magnesium (Mg) is an essential mineral required to regulate body temperature, nucleic acid, and protein synthesis with an important role in maintaining nerve and muscle cell electrical potentials. It may reduce fetal growth restriction and preeclampsia as well as increase birth weight. This study aimed to assess the effects of consuming Mg supplementation during pregnancy on pregnancy outcomes. Materials and Methods: This is a randomized controlled trial with three sixty populated groups of pregnant women. Participants were randomized to treatment or control groups through random table numbers. Participants with Mg serum levels more than 1.9 mg/dl considered as control group A randomly. They just received one multimineral tablet once a day until the end of pregnancy participants with hypomagnesemia consider as Group B and C. Participants in Group B received one multimineral tablet daily until the end of pregnancy. Participants in Group C received 200 mg effervescent Mg tablet from Vitafit Company once daily for 1 month, and also they consumed one multimineral tablet from Alhavi Company, which contains 100 mg Mg, once a day until the end of pregnancy. Intrauterine growth retardation, preterm labor, maternal body mass index, neonatal weight, pregnancy-induced hypertension, preeclampsia, gestational diabetes mellitus, cramps of the leg Apgar score were compared between three groups. Results: In all pregnancy outcomes, Group C that received effervescent Mg tablet plus multimineral showed a better result than other groups, and frequency of complications of pregnancy was fewer than the other two groups and showed a significant difference. Conclusion: Mg supplement during pregnancy likely decrease probability occurrence of many complications of pregnancy.

Background: The objective of this study is to indicate the role of urokinase plasminogen activator receptor (uPAR), soluble uPAR (suPAR), and β1 integrin in tumor growth and invasion of lymph nodes from Hodgkin's lymphoma (HL) patients. Materials and Methods: In this study, 25 lymph nodes from HL patients were analyzed for the expression of β1 integrin and uPAR on mononuclear cells using two-color flow cytometry and immunohistochemical analysis. Moreover, the levels of suPAR in the serum samples of HL patients were measured and compared with 32 healthy controls. Results: Flowcytometry and immunohistochemical results indicated no significant association of uPAR expression with tumor size, different stages, or different histological subtypes of HL; however, an increased expression of β1 integrin was detected in the advanced stages of HL. Higher expression of β1 integrin was detected in nodular sclerosis compared to lymphocyte predominant. No significant difference was observed between the serum levels of suPAR in patients with different stages of HL and healthy controls. Moreover, the levels of suPAR were significantly higher in nodular sclerosis in comparison with other subtypes. Conclusions: This study showed that the levels of suPAR and β1 integrin varied between different histological subtypes of HL. Although uPAR may play only a minor role in the growth and metastasis of lymphoma, β1 integrin may be important in predicting prognosis and metastasis in HL.

Background: Nutritional intake is an important issue in adolescent athletes. Proper athletes' performance is a multifactorial outcome of good training, body composition, and nutritional status. The aim of the present study was to assess nutritional status, body composition, and cardiometabolic factors in adolescent elite athlete's province of Isfahan, Iran. Materials and Methods: In this cross-sectional study, 100 adolescent elite athletes from volleyball, basketball, and soccer teams were selected for the study. Demographic, anthropometric, and cardiometabolic parameters were assessed. Nutritional intakes of participants were recorded using three 24-h recall questioners. Results: Thirty-four female athletes and 66 male athletes participated in this study. Body mass index had not significantly different between the sexes. Energy, protein, carbohydrate, iron, and fat intakes were significantly higher in male athletes (P = 0.02), but calcium and folic acid intakes were not significantly different between the sexes, and Vitamin D intake was significantly higher in females (P = 0.01). Systolic and diastolic blood pressure was significantly higher in males (P = 0.04) and heart rate had not significantly different between the sexes (P = 0.09). Heart murmurs and heart sounds in the majority of participants were normal. Conclusion: All the evaluated anthropometric and cardiometabolic parameters were in normal range in the majority of participants. The results showed that dietary intake in these athletes is approximately normal but micronutrients intake status in these athletes needs to be investigated further and longer.

Background: Arteriovenous fistula (AVF), permanent catheter (PC), and vascular graft are three vascular access types used for hemodialysis procedure. Due to insufficient reliable information on the comparison between AVF and PC, this study was conducted to compare AVF and PC regarding dialysis adequacy. Materials and Methods: This prospective study was carried out from March, 2013 to September, 2013. In this study, 76 hemodialysis patients were enrolled and assigned to two unequal groups of AVF and PC. Before and after the dialysis session, blood samples were taken for laboratory examinations and measurement of urea reduction ratio (URR) and Kt/V. The patients were followed up for six months, and then laboratory examinations were repeated. Results: Of the 76 hemodialysis patients, 30 had AVF and others PC. During the 6-month follow-up, 24 patients in PC group but only one patient in AVF group showed infection (P = 0.006), while in each group, three cases of thrombosis were seen (P = 0.58); however, catheter dysfunction was seen in 13 patients of PC group but no patients of AVF group (P = 0.004). There was no difference between the two groups in Kt/V and URR at the beginning of the study; however, after six months, Kt/V and URR were greater in AVF group (P < 0.05). Conclusions: In addition to some advantages of AVF over PC, such as lower rate of infection and thrombosis, we also found better dialysis adequacy in AVF group. We recommend that AVF be created in all of patients with chronic kidney disease who are candidates for hemodialysis.

Background: The most important risk that threatens the skin wounds is infections. Therefore, fabrication of a membrane as a wound dressing with the ability of antibiotic delivery in a proper delivery rate is especially important. Materials and Methods: Poly(glycerol sebacate) (PGS) was prepared from sebacic acid and glycerol with 1:1 ratio; then, it was added to gelatin in the 1:3 ratio and was dissolved in 80% (v/v) acetic acid, and finally, ciprofloxacin was added in 10% (w/v) of polymer solution. The gelatin/PGS membrane was fabricated using an electrospinning method. The membrane was cross-linked using ethyl-3-(3-dimethylaminopropyl) carbodiimide ethyl-3-(3-dimethylaminopropyl)carbodiim (EDC) and N-hydroxysuccinimide (NHS) in different time periods to achieve a proper drug release rate. Fourier-transform infrared (FTIR) spectroscopy was being used to manifest the peaks of polymers and drug in the membrane. Scanning electron microscopy (SEM) was used to evaluate the morphology, fibers diameter, pore size, and porosity before and after crosslinking process. Ultraviolet (UV)-visible spectrophotometry was used to show the ciprofloxacin release from the cross-linked membrane. Results: FTIR analysis showed the characteristic peaks of gelatin, PGS, and ciprofloxacin without any added peaks after the crosslinking process. SEM images revealed that nanofibers' size increased during the crosslinking process and porosity was higher than 80% before and after crosslinking process. UV-visible spectrophotometry showed the proper rate of ciprofloxacin release occurred from cross-linked membrane that remaining in EDC/NHS ethanol solution for 120 min. Conclusion: The obtained results suggest that this recently developed gelatin/PGS membrane with controlled release of ciprofloxacin could be a promising biodegradable membrane for wound dressing.

Background: Resuscitation of children in different treatment wards is a challenge. Given that the pediatric drug dosing is based on weight and weighing is not practical in emergency situations, it is critical to employ a fast, easy, and reliable technique. Hence, this study attempted to evaluate the real weight children against Broselow estimation. Materials and Methods: This cross-sectional study involved 1500 children of 2–24 months referred to Isfahan urban and rural health centers in 2015. Children's estimated weights were measured based on the standard Broselow tape and real weights through a digital scale. The factors such as age, sex, height, arm circumference, head circumference, and living place of children were recorded. The collected data were analyzed through independent t-test, ANOVA, and linear regression using SPSS (version 20). Results: The weight difference of children through Broselow estimation was 0.019 kg, and the correlation coefficient was 0.893 (P > 0.05). The difference sorted by age ranges was significant only in >12 months (P < 0.05). It was estimated at error of 10% to be 68.9% correctly. The mean weight estimation error was significant sorted by weight, sex, habitus, and living place of children (P < 0.001). Conclusion: Although Broselow tape has been proved to be accurate it led to a significant error at different age ranges. Hence, the present study estimated the age, arm circumference, and height of Iranian children based on new formulas providing more successful tool through controlling the confounding factors in estimating the real weight.

Background: Candida species can become opportunistic pathogens causing local or systemic invasive infections. Gastroesophageal candidiasis may depend on the Candida colonization and local damage of the mucosal barrier. Risk factors are gastric acid suppression, diabetes mellitus, chronic debilitating states such as carcinomas, and the use of systemic antibiotics and corticosteroids. The aim of this study is collection and molecular identification of Candida species from gastroesophageal lesions among pediatrics in Isfahan, and determination of minimum inhibitory concentration (MIC) ranges for clinical isolates. Materials and Methods: A total of 200 patients underwent endoscopy (130 specimens from gastritis and 70 samples from esophagitis) were included in this study between April 2015 and November 2015. All specimens were subcultured on sabouraud dextrose agar, and genomic DNA of all strains was extracted using boiling method. Polymerase chain reaction and DNA sequencing of the ITS1-5.8SrDNA-ITS2 region were used for the identification of all Candida strains. MIC ranges were determined for itraconazole (ITC), amphotericin B (AmB), and fluconazole (FLU) by E-test. Results: Twenty of 200 suspected patients (10%) were positive by direct microscopy and culture. Candida albicans was the most common species (60%) followed by Candida glabrata (30%), Candida parapsilosis (5%), and Candida kefyr (5%). MIC ranges were determined for FLU (0.125–8 μg/mL), ITC (0.008–0.75 μg/mL), and AmB (0.008–0.75 μg/mL), respectively. Conclusion: Every colonization of Candida species should be considered as a potentially factor of mucocutaneous candidiasis and should be treated with antifungal drugs.

Nonneoplastic demyelinating processes of the brain with mass effect on magnetic resonance imaging can cause diagnostic difficulties. It requires differential diagnosis between the tumefactive demyelinating lesion and the coexistence of neoplasm. We document the case of 41-year-old woman with clinical and radiological findings suggestive of multiple sclerosis. Additional investigations confirmed the coexistence of astrocytoma. This report emphasizes the importance of considering brain tumors in the differential diagnosis of primary demyelinating disease presenting with a cerebral mass lesion.

Background: Cisplatin (CP) is accompanied with a nephrotoxicity. L-arginine (LA) plays an important role in the regulation of renal function. The present study was designed to investigate the protective role of LA supplementation in CP-induced nephrotoxicity in a diabetic rat's model. Materials and Methods: Sixteen adult female and male Wistar rats were used and they received a single dose of streptozotocin (STZ) (60 mg/kg i.p.). Diabetic female and male rats were arranged as groups 1–5 and groups 6–10, respectively. Groups 1 and 6 (LA groups) received LA alone. Groups 2 and 7 (CP groups) received CP alone. Groups 3 and 8 (CP + LA [PT] groups) received LA as prophylaxis and then treated with LA and CP. Groups 4 and 9 (CP + LA [T] groups) were treated with LA and CP simultaneously. Groups 5 and 10 (CP + LA [P] groups) received LA as prophylaxis and then treated with CP. Results: The serum creatinine (Cr) level of males in Groups 8 and 9 was significantly increased when compared with LA and CP (P < 0.05), whereas no differences were observed in Cr level in female groups. Blood urea nitrogen/Cr ratio and kidney weight were reduced in all CP-receiving male rats. Such observation was not seen in female rats. Different results related to weight loss were obtained between male and female animals. The kidney tissue damage score in CP + LA (PT) male group was significantly greater than CP group (P < 0.05). Conclusion: Our findings indicate that administration of LA in female and male rats has no protective effect on the severity of nephrotoxicity induced by CP in diabetic rats.

Background: Some studies have shown that a preoperative high concentration of thyroglobulin (Tg) in wash out of fine-needle aspiration cytology of cervical lymph nodes mandate therapeutic lymph node dissection. However, there is disagreement about the minimum concentration of Tg which could have diagnostic value. Hence, according to our literature review, this study is the first one which designed to do intraoperatively. Therefore, this study was conducted and aimed to determine the clinical diagnostic value of Tg lymph nodes in the diagnosis of metastatic thyroid cancer. Methods: In a cross-sectional study, 65 patients with papillary thyroid carcinoma (PTC) who were thyroidectomy candidates were chosen and during surgery, before the removal of lymph nodes in the neck, fine-needle sampling was performed and the level of Tg in the samples, nature of the sample sent for biopsy and Tg levels in affected and unaffected lymph nodes were determined. Results: The mean levels of washout Tg in malignant and nonmalignant lymph nodes were 622.1 ± 66.2 and 1.38 ± 0.43 ng/ml, respectively, and the difference between the two groups was significant (P < 0.001). The Tg cut-off point for the detection of lymph node metastases was 0.7 ng/dl, and according to it, Tg washout sensitivity was 93.8%, specificity of 92.4%, false positives 7.76%, false negatives 6.3%, positive predictive value was 92.3%, and negative predictive value was 93.8% and accuracy was 93.1%. Conclusion: Based on the results, Tg level of cervical lymph nodes in patients with PTC is a suitable criterion for the diagnosis of lymph node which can be determined through fine-needle biopsy. Therefore, it is suggested that in patients with suspicion of lymph nodes involvement during surgery, fine-needle biopsy and determination of the Tg level performed.