Journal of Kerman University of Medical Sciences
Volume:25 Issue: 6, Nov-Dec 2018

Methotrexate is used in the treatment of Low-risk Gestational Trophoblastic Neoplasia. The purpose of this study was to compare the therapeutic responses and side effects of two therapeutic methods which were prescribed for patients suffering from Low-risk Gestational Trophoblastic Neoplasia. One method was the daily use of Methotrexate-Folic Acid (for 8 days) and the other was the weekly use of Methotrexate. This study is a randomized double-blind clinical trial which was undertaken on 122 patients suffering from Low-risk Gestational Trophoblastic Neoplasia, who referred to AfzaliPoor Hospital in Kerman City, Iran. The patients were randomly divided into two groups: one group took Methotrexate-Folic Acid daily for a period of 8 days (muscular taking of one milligram/kilogram of Methotrexate in days 1,3,5 and 7; and 0.1 milligram/kilogram of Folic Acid in days 2,4,6 and 8); the other group took the same medication weekly (muscular taking of 30 to 50 milligrams per each square meter of body mass every week). Findings showed that 95% of the patients effectively responded to the 8-day regimen and 90% responded to weekly regimen. Five percent of the 8-day regimen group and 10% of the weekly regimen group needed a second treatment. This difference was not significant. Concerning the related side effects, only one patient in the weekly regimen group experienced nausea and vomiting, and one patient experienced neutropenia; while 4 patients in the 8-day regimen group experienced nausea and vomiting, one patient had mucositis, 2 patients had conjunctivitis, two patients experienced neutropenia, and one patient had thrombocytopenia. Considering the related costs, the 8-day regimen was significantly more economical and affordable than the weekly regimen.

Epidemiological studies show that computed tomography (CT) is one of the main sources of ionizing radiations. Shielding of radiosensitive organs is one of the dose reduction methods. This study aimed to assess the eye lens dose reduction and image quality resulting from the use of radio-protective bismuth shield in brain CT imaging. Bismuth shields were constructed with two different thicknesses (0.02 and 0.06 cm) and two different geometries including: direct contact with eye (contact setup) and 4 cm above the eye (distant setup). The lens dose was determined using thermo luminescent dosimeter (TLD)-207A chips inside an anthropomorphic head phantom during the CT examinations. Noise, SNR (signal to noise ratio), and CNR (contrast to noise ratio) were calculated to evaluate the image quality. The lens dose reduction was higher using the shield with 0.06 cm thickness and in ‘contact setup’. On the other hand, the bismuth shield with the thickness of 0.02 cm and in ‘distant setup’ had lower dose reduction and better image quality. Bismuth shield with the thickness of 0.02 cm and in ‘distant setup’ could decrease the lens dose to the acceptable levels, while providing a better image quality in comparison with the contact shield setup and with 0.06 cm thickness. Using the bismuth shield is a simple and low cost method for protecting the eye lens in brain CT scans with conventional scanners especially in low income or developing countries.

Long non-coding RNAs, as a big part of non-coding RNAs, are considered functionally more than past. These transcripts could be involved in carcinogenesis. SNHG6, as a long non-coding RNA, has been reported to be expressed more in colorectal cancer tissues than non-cancerous ones.  Colorectal cancer as a malignancy needs fast prognostic and diagnostic methods for well-timed treatment. SNHG6 RNA and its relative variants can be considered as biomarkers for a well-timed treatment of colorectal cancer. RNA extraction from 32 colorectal cancer tissues and their relative non-cancerous tissues were carried out and cDNA of the mentioned RNAs was synthesized and RT-qPCR was performed. Relative expression of SNHG6 201 and 203 were studied in colorectal cancer samples with different clinicopathological characteristics. The expression patterns of SNHG6 201 and 203 variants were different. SNHG6 203 was expressed significantly higher in colorectal tumor tissues than non-cancerous ones. In spite of SNHG6 203, SNHG6 201 was expressed significantly in colorectal non-cancerous tissues more than tumor ones. Additionally, expression of these variants in different colorectal cancer cell lines was different. It seems that SNHG6 203 transcript might be considered as a prognostic and diagnostic biomarker in colorectal cancer case studies and treatments. Also, SNHG6 201 can distinguish precisely the tumor and non-tumor tissues in colorectal cancer.

Sponges and sea anemones do not have specialized defense organs. Instead, they rival harmful microorganisms by producing certain compounds. These compounds can also be useful against some human pathogens. This study aimed to investigate the antimicrobial effects of bioactive products from these marine animals. Two species of sea anemone (Zoanthus sansibaricus and Cerianthus lloydii) and one species of sponge (Callyspongia sp.) were collected at the Persian Gulf. The active metabolites of these two marine animals were extracted by methanol and dichloromethane solvents. The antimicrobial activity of each extract was performed against six human pathogenic bacteria including: Pseudomonas aeruginosa, Acinetobacter baumannii, Bacillus cereus, Klebsiella pneumoniae, Escherichia coli, and Staphylococcus aureus, using disk diffusion and agar well plate methods. The MIC and MBC were determined. The inhibitory effect of these extracts on biofilm formation was also studied. The effect of sponge extracts against planktonic forms of bacteria showed that the most sensitive bacteria to Callyspongia sp. extracts were K. pneumoniae and S. aureus. However, C. lloydii did not have any inhibitory effect on K. pneumoniae. The results of this study confirmed that both sponge and sea anemones extracts had sufficient effects against biofilm formation of pathogenic bacteria.However, Callyspongia sp. extracts had the lowest inhibitory effect against biofilm formation of P. aeruginosa. The highest inhibitory effect was observed on biofilm formation of K. pneumoniae. The Callyspongia sp sponge extract (Dichloromethane: Methanol) has an excellent antimicrobial effect against six pathogenic bacteria in planktonic and biofilm forms. There was a direct correlation between the increase in the concentration of sea anemones extracts and the inhibitory effect of biofilm formation.

Due to the importance of sleep in brain development of infants, this study was designed to compare the effects of environmental and behavioral Interventions on sleep cycle of preterm infants in NICU. In this prospective crossover clinical trial, 40 preterm infants with fetal age of 32 to 36 weeks hospitalized in NICU were selected. Infants were randomly divided into the two groups of environmental-behavioral intervention and behavioral -environmental intervention, based on the order of the performed interventions. The study included three courses of control, first intervention and second intervention each held for 2 hours. Sleep states were assessed by Prechtl sleeping and waking assessment tool. Mean of quiet sleep time in three different courses showed significant differences and in behavioral intervention course was more in comparison to the two other courses (p<0.05). Mean of active sleep time in the behavioral course was significantly less than that in other courses. But, there was no significant difference between the control and environmental courses. Both behavioral and environmental interventions can increase total time of sleep and quiet sleep but behavioral intervention has more effect on quiet sleep. Therefore, infants sleep in NICU can be improved by behavioral interventions.

Diabetes is considered as one of the health problems in all societies. Exercise training and herbal medicines are some approaches to improve diabetes. The present study investigated the effect of a six weeks exercise training program and/or Pistacia atlantica (mastic) extract on thyroid hormones and lipid profile as well as antidiabetic effects in diabetic rats. Forty male Wistar rats were randomly divided into five groups: Healthy control (Ctrl), diabetic control (D), Diabetic + exercise (DE), Diabetic + mastic extract (DM) and Diabetic + exercise + mastic extract (DEM). The six-week period exercise program included aerobic training on a treadmill (five sessions per week, 40 minutes per each session, with a speed of 20 m/min and 5% incline). Pistacia atlantica extract was fed 5 days per week (25 mg/kg). Forty eight hours after the last training session, the level of T3, T4, triglyceride, cholesterol and HDL were assessed. Triglyceride levels in DEM group was significantly lower than diabetic group (p<0.05). The mean level of cholesterol and HDL (high density lipoprotein) was not significantly different among groups. Plasma concentration of T 3 and T 4 in diabetic control was significantly lower than normal control. Applying mastic extract alone or together with exercise markedly enhanced T4 levels in diabetic rats. Pistacia atlantica extract and exercise training might be good in the improvement of hypothyroidism and hyperlipidemia resulting from diabetes.

A significant percent of infertile varicocele patients remained infertile after varicocelectomy and finally most of them refer for assisted reproductive technique (ART) procedures as intra uterine insemination (IUI), in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). In order to achieve the best results, more strict and accurate standards for assessment of sperm parameters, as Kruger standards, are required. The main goal of this study was to evaluate the efficacy of varicocelectomy onimproving selection of ARTs on the base of Kruger strict morphology test. In a randomized clinical trial study, the results of sperm parameters analysis by Kruger strict morphology test were compared between a group of 67 infertile operated patients and a group of 71 matched no operated men in one-year duration. The selection of better ART levels (IUI vs. ICSI) after varicocelectomy was higher in the operated group than controls (p<0.05). Pregnancy rates (achieving full-term pregnancy by natural cycle intercourse), after one year, were respectively 53.84% and 42.25% in the two groups of operated and non-operated (p=0.082). According to our results, varicocelectomy improves the ART level selection and also may improve pregnancy success rates (both by natural cycle intercourse and ART procedures).

The impact of continuous and intermittent training on diabetes mellitus condition and its mechanism is not well understood. The aim of the present study was to assess the changes in glucose uptake after 6 weeks of continuous and intermittent exercise training protocols in healthy and streptozotocin (STZ)-induced diabetic rats. Sixty male albino Wistar rats (13 weeks old) were randomly divided into six groups including healthy control, healthy continuous, healthy intermittent, diabetic control, diabetic continuous, and diabetic intermittent groups. Animals ran continuously and intermittently on treadmill for 6 weeks. They got diabetes using STZ (50 mg per kg of body weight). STZ increased blood glucose levels and insulin resistance in diabetic rats. In contrast, STZ reduced insulin, insulin receptor (IR), glucose transporter type 4 (GLUT4), and 5' adenosine monophosphate-activated protein kinase (AMPK) levels in diabetic rats. However, both continuous and intermittent exercise training protocols improved insulin resistance and prevented the reduction of GLUT4 and AMPK in diabetic rats. Neither of continuous and intermittent exercise trainings had any effect on insulin and IR receptor. Continuous and intermittent exercise trainings comparably reduce blood glucose and subsequently improve insulin resistance by increasing GLUT4 and AMPK independent of insulin and its receptors.

Cardiac hydatid cysts are uncommon and pericardial involvement is extremely uncommon. We report a rare case of a cardiac hydatid cyst that was surprisingly found during an emergent tamponade surgery in a woman. She was pale, febrile, ill and toxic and 300cc turbid and purulent fluid was drained. In taking history, it was found that the patient had six sheep dogs in her house. Laboratory analysis revealed elevated C-reactive protein, elevated white blood cell count (neutrophil 80% and eosinophils less than 5%), anemia and negative immunoglobulin ELISA. Complete reevaluation revealed two relatively large hydatid cysts; the biggest one (5cm diameter) was in the lateral side of the left atrium and the other one (2.5cm diameter) was in the inferior of ascending aorta. Surgical removal of the cyst was performed via median sternotomy and cardiopulmonary bypass. The patient had pericarditis, fibrinous adhesions and heart inflammation. Postoperative period was uneventful and the patient received Albendazole for six months. There was no recurrence during the one- year follow-up period.

The prevalence of alcohol consumption in Iran cannot be estimated because large variations have been observed in the reported prevalences of alcohol consumption. The main aim of this study was to assess the methodological challenges in estimation of the life time prevalence of alcohol consumed in Iran. By the same token we provided a standard approach for future researches in this regard. Published articles were reviewed systematically. Using the risk of bias tool, 49 out of 600 articles met the eligibility criteria. Based on the population of alcohol consumers, the included studies were categorized into 5 groups: general populations, patients, school students, university students, and specific population (first relatives of opium addicts and women who were faced with epistemic violence). There was a paucity of reliable information in about 40% of provinces. Almost all studies applied the direct size estimation methods, but 11 studies used face to face interview and 38 studies used self-administered questionnaires. The non-response bias seemed prominent in entire studies except those on school students. It is important to mention that 97% of papers in general population did not represent any information about the non-response rate. The reported prevalence ranged from 1.37% in university students to 88.8% in patient population. Even among university students, the prevalence varied considerably (1.37% to 34.7%). The observed huge variations in the reported prevalence of alcohol consumption, due to the methodological consideration, appear largely in Iran. Therefore, it is necessary to develop a standard protocol for data collection and sampling to harmonize the findings in future studies. In addition, it is recommended to assess the frequency of alcohol use by indirect methods such as the Network Scale Up method.