Jentashapir Journal of Cellular and Molecular Biology
Volume:7 Issue: 3, Jun 2016

Context: For the prevention and management of thromboembolic complications, warfarin is the most extensively recommended anticoagulant. It is categorized as a drug with a narrow therapeutic window. Therefore, warfarin prescription requires special attention related to therapeutic drug monitoring.
Evidence Acquisition: By categorizing the clinical implications of warfarin, this manuscript aims to provide a comprehensive (albeit somewhat brief) conclusion associated with its pharmacotherapy. The key words relevant to the topic were searched. Consequently, articles relevant to the pharmacotherapeutic management of warfarin were selected and reviewed in their entirety.
To obtain a reasonable level of stability between the required antithrombotic treatment and the risk of bleeding, an analysis of the literature revealed that the prothrombin time in terms of the international normalized ratio (INR) was found for each individual. The best model for stable warfarin dosage prediction was found to be based on multiple linear regression. Genotype-guided procedures were established to: 1, improve the time in the therapeutic range; 2, reduce time to the first therapeutic INR; and 3, reduce the time for the stable doses. Vitamin K epoxide reductase is an enzyme with an important role in vitamin K metabolism, and warfarin is metabolized in hepatocytes via a monooxygenase, cytochrome P450 2C9. In patients carrying 2C9*1/*2 and 2C9*2/*2 or 2C9*1/*3 alleles, the dose is recommended to be reduced by 18% - 40% and 21% - 49%, respectively..
Race, age, body surface area, chronic kidney disease, CYP2C9*3 level, and VKORC1 variants could affect the dose of warfarin. To administer the proper doses of warfarin, patients and physicians might achieve the best results with the pharmacologist proficient anticoagulation database and recommended continuation program. Owing to its’ unpredictability, caution must be taken when prescribing warfarin. More advanced warfarin pharmacotherapy studies are recommended based on a linear regression model specifically in the Iranian population.

Context: Hemorrhoidal disease is the most common anorectal disorder that requires surgical intervention. Hemorrhoids require treatment when they result in symptoms such as bleeding or prolapse. Surgical intervention is indicated for significant prolapse, and a number of accepted and viable methods are available for treating prolapsing hemorrhoids that do not reduce spontaneously (Grade III and IV). Excision hemorrhoidectomy remains the gold standard treatment for Grade III and IV hemorrhoids despite great interest in alternative procedures such as stapled hemorrhoidopexy and Doppler-guided hemorrhoidal artery ligation with mucopexy. A large body of evidence demonstrates that excision hemorrhoidectomy is an effective, safe, and affordable procedure. Nevertheless, the main drawback of excision hemorrhoidectomy remains its notorious association with significant postoperative pain.
Evidence Acquisition: A comprehensive literature search was conducted through MEDLINE and the Cochrane database of systematic reviews. Only prospective case-controlled studies, review articles, and meta-analyses were considered.
Many strategies have been put forward in the literature to address the issue of pain after excision hemorrhoidectomy. These strategies can be broadly categorized into surgical techniques (e.g., LigaSure hemorrhoidectomy) and pharmacological adjuncts (e.g., intradermal methylene blue and chemical sphincterotomy with glyceryl trinitrate ointment). In recent years, meta-analyses and randomized controlled trials have been performed to evaluate their effects.
This article evaluates the evidence behind these strategies and outlines the new methods available to improve the outcomes of an old technique.

Context: According to published articles, thrombosis is the main reason for death all over of the world. With stroke time missing is brain missing, therefore, the FDA-approved drug r-TPA, could be administered as initial IV bolus in less than 3 - 4.5 hours from onset of Acute Ischemic Stroke (AIS). The aim of this review was to provide updated pharmacotherapy related to r-TPA in AIS.
Evidence Acquisition: Searches for associated published articles were conducted in major databases until September 2015. The main terms used in the search were a combination of words and phrases such as ischemic stroke and tissue plasminogen activator.
Age, time of onset, systolic blood pressure, diabetes, stroke severity, co-morbidities and premorbid medical situation, stroke scale according to national institute of health and outcomes related to CT (head, angiogram and perfusion) were considered when determining successful treatment by endovascular thrombectomy. According to the 2015 guidelines, strategies related to successful pharmacotherapy management should be based on class I evidence-care on a stroke unit, IV-r-TPA within 3 - 4.5 hours of stroke onset, aspirin commenced within 48 hours of stroke onset, and decompressive cranioctomy for supratentorial malignant hemispheric cerebral infarction. Hemorrhagic stroke (intraparenchymal, subarachnoid, intraventricular, intracerebral such as orolingual angioedema), hematoma (epidural and subdural) and head trauma are the absolute contraindications related to r-TPA prescription..
Due to considerable inter- and intra- heterogeneity among studies performed by other centers such as differences in study project, background, and population features, determining a pharmacotherapy model based on Safe Implementation of Treatments in stroke or SITS seem advantageous..

Torque teno virus (TTV) belongs to the Circoviridae family and was separated from Japanese patients with elevated levels of serum alanine transferase for the first time. Following this, extensive studies have been carried out around the world.
The present study was designed to investigate and determine the frequency of TTV genotypes in patients with chronic hepatitis B and C in Ahvaz city in 2012.
Patients and Samples from 30 patients with chronic hepatitis C and 30 patients with chronic hepatitis B were studied and compared with 30 healthy subjects as controls. TT virus DNA was investigated using semi-nested PCR. The basic primers used were 5’ UTR.
Out of the 90 specimens tested, nine samples (10%) were TTV-DNA positive. Of the hepatitis C samples, four samples (13.3%) were positive. Of the hepatitis B samples, two (6.67%) were positive and 3 (10%) of the control group samples were positive. Both tth4 and tth31 isolates were separated.
TTV is a DNA virus, but its genetic diversity is increasing. The PCR methods used were not efficient enough and were not able to identify the types of TTV in blood. The frequency obtained from our study is inconsistent with some countries but is consistent with a study conducted in India. In general, a relationship between sex and age and the prevalence of TTV was not found, and this result is the same as most other studies.

One consequence of an industrial age is overweight and obesity. The accelerating rate of obesity, especially in adolescent girls, has led to growing concern regarding the health of this generation.
The objective of this study was to examine the food consumption patterns of and obesity in female adolescents in Khorramshahr high schools.
This cross-sectional study involved 200 high school girls from Khorramshahr. The study sample was selected via multistage random sampling. Body weight and height were measured and the body mass index (BMI) values were calculated. Underweight, overweight, and obesity were defined as the 5th, 85th, and 95th percentiles, respectively, using the centers for disease control and prevention (CDC) BMI-for-age growth charts for girls. More data were collected by using the Food frequency questionnaire. Analysis was done using the SPSS software, Kruskal-Wallis test, and median measures.
Findings showed that according to their BMI, 3% of the students were underweight, 82% had normal weight, 11% were overweight, and 4% were obese. There were significant relationships between the consumption of bread, dough, and sugar cubes and the BMI (P The findings of this study offer information regarding the current dietary patterns among adolescent girls that can be used to design educational programs to promote healthy eating in this group.

Cutaneous leishmaniasis is endemic in 11 Iranian provinces, and almost 80% of all cases are the rural cutaneous form caused by Leishmania major. The main important drug used to treat leishmaniasis is a five-capacity antimony compound that has hinders disease recurrence, drug resistance, complications, and long treatment duration.
It seems necessary to search for new, natural medicine to replace the use of drugs, particularly herbal compounds with no side effects.
Different dilutions of extracts were prepared with 1 mg/mL of the extracts in 96-well plates. Cultivated 106 Leishmania major promastigotes in culture flasks containing RPMI1640 medium and 10% of brain heart infusion (BHI) were counted using neobar lam and poured into each well. Following 72 hours incubation, MTT solution was added to each well, and then absorbance was documented with an enzyme-linked immunosorbent assay (ELISA) reader at 570 nm.
IC50 of Allium hirtifolium (87 μg/mL) and Ziziphus spina-christi (112 μg/mL) extracts showed higher efficiency in inhibiting the growth of promastigotes over 72 hours.
Allium hirtifolium and Z. spina-christi extracts showed the most efficient activity in the inhibition of promastigote growth, but this was not total. The remaining plant extracts indicated ineffective or very weak efficiency on the Leishmania promastigotes. There is a possibility of achieving better results by changing the extraction method; determining materials affecting promastigotes and extracting these materials exactly; or converting extracts to other medicinal forms, such as ointment or gel.

Eye trauma is a leading cause of blindness worldwide. A variety of risk factors can cause eye trauma.
This study was designed to determine the risk factors leading to mechanical eye injuries for planning a blindness prevention program in Ahvaz, Iran.
This was a cross-sectional study conducted on 9,855 patients with ocular trauma who were reviewed at inpatient or outpatient settings in the ophthalmology clinic at Imam Khomeini hospital, Ahvaz, Iran, from March 2009 to March 2010. Data collection was performed by an ophthalmologist.
Males (8,593 patients) were more likely to have eye trauma than females (1,262). The mean age for the outpatient cases was 20.3 ± 16.39 years and for the inpatient cases it was 22.7 ± 18.95 years. The workplace was the most common site for trauma and the cornea was the most reported anatomically injured site. For those patients who had not used safety and protection equipment, 93.1% were referred to the outpatient setting and 95.7% to the inpatient setting.
The risk factors found in this study are preventable in many situations. Preventive strategies such as increasing societal awareness, mandatory training courses for using protective eyewear, and early intervention following an injury could decrease the burden of eye trauma in Ahvaz, Iran.

Due to the higher susceptibility of metabolic syndrome (MS)-afflicted patients to different metabolic abnormalities, treatment programs are vital parts of MS management. One of the possible adjunctive therapies is taking cranberry supplements as important sources of polyphenols that bear antioxidative and health-promoting properties.
The aim of this study was to evaluate the effect of cranberry extract on some components of metabolic syndrome.
Patients and In a randomized, double-blind placebo-controlled clinical trial, 48 obese and overweight females diagnosed with MS were assigned into two groups to receive cranberry supplement or placebo for an eight-week period. Serum glucose, lipoproteins, inflammatory markers and blood pressure were evaluated at the baseline and at the end of the treatment phase.
Cranberry supplements had no effect on any of the variables including glucose, insulin, malondialdehyde (MDA), high-sensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), and blood pressure, except for high-density lipoprotein cholesterol (HDL-c), which significantly increased (P The results of the present study revealed that cranberry supplement might only ameliorate low HDL-c as a component of metabolic syndrome, and not the other risk factors of MS.

Identifying predisposing factors for chronic sinusitis is very important.
Anatomical variation of the lateral nasal wall has been investigated in several studies and it has been suggested as a predisposing factor for sinusitis.
Patients and In this case-control study, 74 patients who were diagnosed with chronic sinusitis (the case group) based on clinical criteria and CT scan were entered into the study and 74 patients without chronic sinusitis were considered as the control group. CT scans of all patients were reviewed by a radiologist to interpret and evaluate anatomic variations of anterior osteomeatal complex including nasal deviation, concha bullosa, agger nasi, lateralized uncinate, Haller’s cells, paradoxical middle turbinate, and maxillary hypoplasia. Data were analyzed using the chi-squared test and Fisher’s exact test with SPSS software version 18. P Results showed that the most common sinus involved was maxillary sinus. Among anatomic variations, septal deviation and concha bullosa were associated with chronic sinusitis (P Among anatomic variations, septal deviation and concha bullosa are predisposing factors for chronic sinusitis and we recommend that patients with chronic sinusitis be treated by surgical procedures.

The source point of the irradiated electron beam must be considered to estimate the output factor and dose distribution during electron therapy.
The aim of this study was to determine the effective source-surface distance (SSDeff) of an electron linear accelerator (Linac), and its dependence on energy and depth.
A Varian Linac 2100CD with electron energies of 4, 6, 9, 12, and 15 MeV, electron applicator size of 20 × 20 cm2, nominal SSDs of 97 to 113 cm, and air gaps of 2 to 18 cm were studied. Using a Farmer (0.13 cc) ionizing chamber, the percentage depth doses were measured in the water phantom (50 cm3) and then the SSDeff was calculated by applying the inverse square law.
For the 100% PDD, the SSDeff values were calculated as 79, 91, 92, 93, and 92 cm for 4, 6, 9, 12, and 15 MeV, respectively. At a depth with a certain PDD, increasing energy also increases SSDeff, and a similar increase is observed at a distinctive energy by increasing the PDD.
Using the maximum dose depth from PDD curves and the inverse square law, the required SSDeff to calculate the dose distribution of the electron beam can be calculated.

Small for gestational age (SGA) fetuses have birth weights below 10th percentile or abdominal circumference less than 10th percentile for gestational age.
This study aimed to determine the prevalence of SGA and its associated risk factors in Iran.
Patients and This is a retrospective study. A total of 341 pregnant women were evaluated in fetal health care clinic of perinatology from January 2013 to January 2014.
Of 312 pregnant women, 33 had SGA fetuses. The average of body mass index (BMI) was lower in SGA group than non-SGA. Pulsatility index has no stastical meaningful between SGA and nonSGA groups. In Gestational age had no difference between 2 groups. Severe SGA ( In conclusion, the prevalence of SGA was approximately one tenth of all pregnancies. SGA incidence was associated with nulliparity and more frequently seen in lower age group.