imanansari

Obesity is a growing public health problem worldwide. Bariatric surgery is considered the safest and most effective therapeutic option, although it is associated with various metabolic and neurohormonal consequences. This study aims to evaluate the effect of sleeve gastrectomy (SG) on hypothyroidism within one year following surgery.

In this single-center prospective cross-sectional study, patients with morbid obesity who were candidates for SG were included. Body mass index (BMI), levothyroxine dosage, and thyroid function tests were compared at baseline and 12 months after surgery.

Patients’ BMI, levothyroxine dosage, TSH, and T4 levels decreased significantly after surgery (P<0.0001). The effect of SG on T3 levels was not statistically significant. The results of this study demonstrate that SG can significantly improve thyroid function tests in patients with morbid obesity and reduce their need for levothyroxine within one year following surgery.

Bariatric procedures are associated with various micronutrient and vitamin deficiencies, including vitamin D.

The aim of the study was to assess the effect of laparoscopic sleeve gastrectomy (LSG) on serum vitamin D levels in a 4-year follow-up of obese patients.

All obese patients undergoing LSG at Modarres Hospital were included in this study. Patients were evaluated 4 years after surgery, and their serum levels of calcium, parathyroid hormone (PTH), and vitamin D were measured.

Analytical analysis demonstrated a statistically significant difference in vitamin D and calcium levels before and after LSG (P-value < 0.001 for both). However, the change in PTH levels before and after LSG was not statistically significant. Additionally, the analysis showed no statistically significant relationship between vitamin D levels and PTH levels.

The results of the present study showed that, four years after LSG, vitamin D and calcium levels significantly increased in patients with morbid obesity, although the observed increase in PTH levels was not statistically significant.

The COVID-19 pandemic, caused by the SARS-CoV-2, has presented unprecedented challenges to healthcare systems worldwide. This study aims to explore the incidence and outcomes of laparotomy in COVID-19 patients, with a specific focus on those admitted to Shahid Modarres Hospital between 2019 - 2021.  

In this descriptive-analytical study, 50 patients who underwent emergency abdominal surgery at Shahid Modarres Educational and Research Hospital and were either diagnosed with COVID-19 at the time of surgery or during hospitalization were examined for mortality rates and various post-operative complications. The complications assessed included mortality, pulmonary complications, cardiovascular complications, myocardial and cerebral infarction, renal injury, infection, intraoperative and postoperative bleeding, rectus sheath hematoma, thrombosis and pulmonary embolism, and ICU admission and related complications.  

The mean age of patients was 56.72 ± 13.28 years, and 66% were male. 52% of the patients were discharged post-surgery, while 48% succumbed to the illness. 56% of the patients were admitted to the ICU, with an average ICU stay of 5.86 ± 7.03 days. The history of underlying disease has a significant relationship with the length of hospital stay (P = 0.005), ICU admission (P < 0.001) and mortality (P < 0.001).  

Laparotomy in COVID-19-diagnosed patients is associated with higher mortality and complication rates, especially in those with comorbid pneumonia and a positive medical history. The most common complications observed in these patients were pleural effusion, thrombocytopenia, and acute kidney injury.

Gentamicin (GM) induced nephrotoxicity is one of the most common causes of acute kidney injury and limits its administration. Evidence suggests that pre-treatment with oxygen increases the activity of antioxidant enzymes and protects tissues against different kinds of damage. In this study, the effect of daily normobaric heperoxia pre-treatment on alleviating gentamicin induced nephrotoxicity was investigated.

Twenty-eight male Wistar rats were randomly divided into four groups (n=7): Control (room air); Gentamicin (100 mg/kg, IP, for 9 days); Hyperoxia60 (60 min daily pretreatment with 95% oxygen and then 100 mg/kg gentamicin, IP, for 9 days) and Hyperoxia180 (180 min daily pretreatment with 95% oxygen and then 100 mg/kg gentamicin, IP, for 9 days). Then 24 h urine was collected and on day 10, the rats were sacrificed for serum, urine and renal tissue sampling.

Results showed that hyperoxia significantly enhanced renal antioxidative capacity and decreased serum creatinine and renal failure index. Histological examination and SPECT scan also showed that tissue damage in the hyperoxia groups was lower compared to the gentamicin group. However, hyperoxia effect on body weight, kidney-to-body weight ratio, urine volume, blood urea nitrogen and glomerular filtration was not significant.

Although pre-treatment with hyperoxia enhances the antioxidant capacity of renal tissue and improves some of the functional and histopathological parameters of the kidney, it failed to completely restore the adverse effects of gentamicin-induced nephrotoxicity. Thus, more studies are needed to determine the clinical effect of hyperoxia on gentamicin-induced nephrotoxicity.

With the emergence of a phenomenon called "Fourth Industrial Revolution" and its technologies and applications, developed countries such as: Germany, America, Japan and some developing countries such as: China, India, trying to create suitable infrastructures. They have evaluated and improved their level of readiness in order to enter to the fourth industrial revolution in various industries to achieve its many benefits through digitization. Therefore, it is necessary to evaluate the readiness level of organizations and industries to enter this digital industrial revolution, and in line with that, the necessary strategies to achieve the desired readiness level and implement the technologies and systems of the fourth industrial revolution are determined. Therefore, the present research aims to introduce the best Industry 4.0 readiness models by a wide review of the research literature and analyze the models in order to help organizations to use the appropriate readiness models and evaluate their degree of readiness. The results show that the best model based on the six research evaluation criteria is Impuls readiness model and Warwick University's readiness model is in second place.

To assess the added risk of acute endophthalmitis after intravitreal injections associated with the widespread use of face masks during the COVID-19 pandemic.

In this retrospective, single-center study, records of patients with acute endophthalmitis following intravitreal bevacizumab (IVB) injections during the pre-COVID era—that is, March 1st , 2013 to October 31st, 2019 —and the COVID-19 era—that is, March 1st, 2020 to April 1st, 2021 —were reviewed and compared.

A total of 28,085 IVB injections were performed during the pre-COVID era; nine eyes of nine patients developed acute post-IVB endophthalmitis in this era, giving an overall incidence of 0.032% (3.2 in 10,000 injections). In the COVID era, 10,717 IVB injections were performed; four eyes of four patients developed acute post-IVB endophthalmitis in this era, giving an overall incidence of 0.037% (3.7 in 10,000 injections). The incidences of post-IVB endophthalmitis during these two eras were not statistically significantly different (P = 0.779).

Face masking protocols seem unlikely to impose any additional risk of post-IVB endophthalmitis.

 A significant number of pregnancies are at risk of threatened abortion (TA). Different types of progesterone are used to treat TA.

 In this study, the effects of 2 forms of progesterone on the continuation of pregnancy and TA-caused pregnancy outcomes were compared.

 A total of 190 women with a gestational age of 6 - 13 weeks presenting with uterine bleeding, closed cervix, and absence of fetal heart rate diagnosed by vaginal examination and ultrasound were allocated into 2 groups and treated with either (D) dydrogesterone (10 mg twice a day) or (M) micronized progesterone (200 mg, twice a day) for beyond 2 weeks after the cessation of uterine bleeding to ensure that bleeding would not recur. The participants were followed up and received prenatal care until the end of pregnancy. The outcomes of pregnancy were recorded and compared between the 2 groups.

 The incidence of preeclampsia, gestational diabetes, cesarean section, intrauterine fetal death (IUFD), placenta previa, and abortion was not significantly different between the 2 groups. However, the prevalence of preterm labor and low birth weight (LBW) was significantly lower in M-treated women (P < 0.001 and P = 0.007, respectively). The baby’s weight and gestational age at delivery were significantly higher in the M group than in the D group (P < 0.001). No serious drug side effects were observed in the 2 groups throughout the study.

 The results of this study showed that the incidence of preterm labor and LBW was significantly lower in the patients treated with micronized progesterone than in patients treated with dydrogesterone; however, the prevalence of preeclampsia, gestational diabetes, cesarean section, IUFD, and abortion was not significantly different between the 2 groups.

To evaluate the efficacy of opportunistic case finding in glaucoma detection and to determine factors associated with failure of glaucoma detection by eye health providers.

This study was conducted on 154 new definite primary open‑angle glaucoma (POAG) patients presenting to our glaucoma clinic. A questionnaire was prepared to determine if these subjects had sought eye care up to 12 months before presentation. The type of eye care provider and the principal reason for the visit were probed. The primary outcome measure was the frequency of a correct glaucoma diagnosis in their index visit. The secondary outcomes were factors associated with missed POAG diagnosis.

The great majority of study subjects (132 cases, 85.7%) had sought at least one ocular examination within 1 year before presentation. Among these patients, 73 cases (55.3%) had remained undiagnosed after the examination. Among the probed variables, age, gender, visual acuity, visual field defects, intraocular pressure, cup/disc ratio, nerve fiber layer thickness of the worse eye at presentation, and family history of glaucoma were comparable between correctly diagnosed and missed POAGs. The only factors significantly associated with missed POAG diagnosis were lack of significant refractive errors and visiting an optometrist rather than an ophthalmologist.

The efficacy of opportunistic case finding for POAG seems to be less than ideal in our settings. Lack of a significant refractive error and visiting an optometrist rather than an ophthalmologist were associated with a missed diagnosis of POAG. These observations reflect the need to adopt policies to improve glaucoma screening by eye care providers.

Burns are one of the most important health problems in communities. Traumatic injuries, especially Traumatic Brain Injury (TBI) associated with burns, may increase disability and mortality. In addition to preventing burns, any action for a better treatment approach and early detection of concomitant traumatic injuries can reduce complications, disability, and treatment costs. We aimed to investigate the outcome of children with burn injury with and without TBI.

In this cross-sectional study, 392 children with burn injuries treated at Motahari Hospital in Tehran, Iran from 2018-2019 were enrolled. Patient demographics, burn injury information and TBI-related information including head trauma and fracture were recorded in a checklist. Patients were divided into two groups of death (24 people) or discharge (368 people) in terms of outcome and the underlying variables were compared in the two groups.

There was no significant difference between the mean age of patients and gender in the two groups. The difference in the length of hospital stay, inhalation injury and skull fracture in the two groups was not statistically significant. The mean burn severity based on Total Body Surface Area (TBSA) and the frequency of TBI in the deceased group was significantly higher (P=0.001).

The severity of burns based on TBSA and TBI is associated with increased mortality among children with burn injuries. The results suggest the need to examine children with burn injuries for TBI using clinical examination or imaging.

We reported a case of corneal perforation due to longstanding exposure keratopathy treated successfully with lamellar corneal patch graft, conjunctival flap, and lateral tarsorrhaphy. A 75-year-old male presented with ocular pain and decreased visual acuity in his right eye since 2 weeks ago. On external examination, lagophthalmos in the right eye was evident. Visual acuity was hand motion on slit-lamp examination. 2×3 mm perforated area in the right cornea accompanied by adjacent corneal melting and diffuse punctate epithelial keratopathy were observed. The anterior chamber was flat. Intraoperatively, a 7×2.5 mm-diameter corneal patch graft was fashioned manually; its thickness was reduced and placed over the perforated area, successfully sealed the cornea, a partial bipedicle conjunctival flap was also applied over the graft, and lateral tarsorrhaphy was performed. Four weeks after surgery, Corrected Distance Visual Acuity (CDVA) improved to Counting Finger (CF) 20 cm. The lamellar corneal patch graft was intact without a leak, and the conjunctival flap was partially removed retracted. Corneal perforation can occur in patients with severe exposure to keratopathy, and corneal patch graft is a good option when a sizeable corneal perforation (≥3 mm diameter) is not amenable to corneal gluing.

The current study aimed at evaluating the effect of flavonoid apigenin on contractile response and relaxation of aorta in streptozotocin (STZ)-induced diabetic rats. Thirty-two rats were randomly divided into four groups of control, apigenin, diabetic (DM), and DM + apigenin. DM was induced in rats using intraperitoneal (i.p.) injection of STZ at 60 mg/kg. The two treatment groups received apigenin at a dose of 10 mg/kg i.p. every other day for four weeks. At the end of the study, the contractile responses of aorta to potassium chloride (KCL), phenylephrine (PE), and the relaxation response of the aorta to acetylcholine (ACh) were measured. Treatment with apigenin significantly reduced plasma glucose in diabetic rats in the 2nd and 4th weeks as compared to those of the DM group (P = 0.01). The DM+apigenin group had less contractile response as compared to that of the DM group, although the difference was not statistically significant (P >0.05). Treatment of diabetic rats with apigenin could significantly reduce the maximum contractile response as compared to that of the DM group (P = 0.05). The contractile response to ACh was significantly higher in the DM + apigenin group as compared to that of the DM group (P = 0.05). The results of the current study indicated the hypoglycemic effects of apigenin in diabetic rats. In addition, it was observed that the administration of apigenin to diabetic and healthy rats could reduce contractile response of aorta to PE and increase the relaxation response to ACh.

Optic disc pits are rare and congenital or acquired anomalies of the optic disc, usually remaining asymptomatic. However, serous macular detachment or optic disc maculopathy is the most common complication, causing significant visual deterioration, without a current consensus about treatment. A 55-year-old woman with a past medical history of diabetes mellitus and systemic hypertension was referred for an abnormal finding in the retina. The Corrected Distance Visual Acuity (CDVA) was 20/40 in the right eye and 20/30 in the left eye. Marcus-Gunn was negative and Slit-lamp biomicroscopy revealed no pathologic findings in both eyes. Funduscopic examination showed an excavation in the inferotemporal part of the Optic Nerve Head (ONH) with serous macular detachment extending to the optic disc. Based on clinical examination and paraclinical imaging fluorescein Angiogeraphy (FAG) Optical Coherence Tomography (OCT), optic pit maculopathy was diagnosed and the patient underwent Juxtapapillary Laser Photocoagulation (JLP). After 2 years of follow-up, there were anatomical and functional improvements.

Ectopic pregnancy (EP) and its treatment methods may affect subsequent fertility outcomes.

To compare methotrexate (MTX), laparoscopic salpingostomy, and salpingectomy methods of EP treatment and their effects on fertility outcomes.

This retrospective cohort study was performed on women receiving a definitive diagnosis of tubular EP from 2014 to 2017 at Arash Medical Center, Tehran, Iran. In total, 194 women were studied, of which 64 were treated with MTX, 52 underwent salpingostomy, and 78 underwent salpingectomy, depending on their clinical status. Basic information, obstetrics history, and major outcomes of the treatment after an 18-month follow-up, including recurrence of EP, miscarriage, and successful intrauterine pregnancy (IUP), were recorded and variables were compared among the three groups.

There was no significant difference in fertility outcomes among the three groups. Among the studied variables, predictors of successful IUP after EP treatment were multiparity (Hazard Ratio (HR): 1.37; 95%CI: 1.06-1.77), no history of miscarriage (HR: 2.37; 95%CI: 1.01-5.56), and a higher number of live births (HR: 1.54; 95%CI: 1.01-2.37). On the other hand, predictors of EP recurrence included nulliparity (HR: 1.61; 95%CI: 1.02-2.53) and a lower number of live births (HR: 3.84; 95%CI: 1.43-10.98). The effect of other factors, including the utilized therapeutic modalities, was not statistically significant.

The current study results demonstrated that after an 18-month follow-up, fertility outcomes, including recurrence of EP and successful IUP, were not significantly different among the subjects with EP treated with MTX, salpingostomy, or salpingectomy. Further studies with long-term follow-ups are recommended.

To report a patient with avascular bleb after trabeculectomy who showed promising results after subconjunctival erythropoietin injection.

Case Report:

 A 45-year-old woman with the diagnosis of primary open-angle glaucoma and history of trabeculectomy three years prior was admitted to our center. The corrected distance visual acuity (CDVA) was 20/20 in both eyes. Her ocular examination revealed an avascular and cystic bleb in the right eye. Seidel test was negative while bleb sweating was observed after fluorescein staining of the bleb area. Intraocular pressure (IOP) was 5 mmHg in the right eye. Erythropoietin (2000 unit in 0.1 ml) was injected subconjuctivally around the bleb area in the temporal quadrant. Six weeks after the injection, the bleb area just superior to the conjunctiva showed an increased fibrosis formation while the IOP remained the same as before injection.

Erythropoietin might play a role in preventing the progression of a cystic avascular or hypovascular bleb to a leaking bleb.

To report a case of progressive Chiari malformation type I (CIM) in a patient with unilateral sporadic retinoblastoma (RB) treated with intra-arterial chemotherapy (IAC) and enucleation.

A 5-year-old male patient with a history of RB in his left eye treated with IAC and enucleation presented to our clinic for routine RB surveillance. Radiotherapy had not been used for the treatment of his RB.

A progressive herniation of cerebellar tonsils through the foramen magnum was detected on follow-up magnetic resonance imaging (MRI). Brain and cervical MRI revealed no central nervous system mass, hydrocephalus, or syringomyelia. There was no history of head trauma.

Progressive CIM may occur in unilateral sporadic RB.

Despite the positive evidence on the effect of progesterone on protection of pregnancy in patients with threatened abortion, the results of studies regarding its drug type have been controversial. This study was performed with aim to compare the effect of vaginal progesterone and dydrogesterone on pregnancy outcome in cases with threatened abortion.

In this single-blind randomized clinical trial, 160 pregnant women with threatened abortion who referred to Qazvin Kowsar Hospital in 2018 were randomly assigned to receive dydrogesterone (Duphaston) 10 mg twice daily or vaginal progesterone (Cyclogest) 400 mg daily. Finally, pregnancy outcomes were compared between the two groups. Data were analyzed by SPSS software (version 18) and Chi-square, independent t-test and Mann-Whitney tests. P<0.05 was considered statistically significant.

Frequency of cesarean section was 27 (33.7%) in the dydrogesterone group and 25 (31.2%) in the vaginal progesterone group (P = 0.736). In general, the incidence of preterm labor was 97 (60.6%) and there was no significant difference between the two groups (P >0.05). In addition, incidence of preeclampsia, gestational diabetes mellitus, placenta previa and intrauterine fetal death as well as neonatal weight were not significantly different between the two groups (P >0.05). Finally, maternal and neonatal complications showed no significant difference between the two groups (P = 0.675).

Pregnancy outcomes after administration of dydrogesterone are not different with vaginal progesterone in the treatment of threatened abortion.

The aim of this study was to evaluate the effect of citalopram on the prevention of migraine headaches as compared to placebo.

This double-blind randomized clinical trial was conducted on patients diagnosed with migraine headaches based on the guidelines of the International Headache Society. 226 patients who met inclusion criteria were randomly allocated to two control and intervention groups. The treatment group was treated with citalopram 30 mg daily for two months and the control group was given placebo the same amount as the treatment group. All the patients were assessed at the beginning of the trial and after 1 month and 2 months and the frequency, severity and duration of their headaches were documented using the Visual Analogue Scale (VAS) and Behavioral Rating Scale (BRS-6). Data were analyzed using SPSS v.16 software.   

Even though initially there was no statistically significant difference between the two groups regarding the severity, duration and frequency of episodes of migraine (P>0.05), the same parameters had drastic changes after the first and second months of treatment and the differences between the citalopram and placebo group regarding severity, duration and frequency of migraine episodes were statistically significant (P<0.05).

The outcome of this experiment showed that citalopram, a serotonin uptake inhibitor (SSRI), possibly through a serotonin-lowering mechanism, results in less exposure of the CNS to this agent, leading to less frequent, less severe and shorter migraine episodes. This medication appears to be useful as a preventive drug used to treat and maintain episodes of migraine headaches, especially in individuals suffering from both migraine headaches and clinical depression.

Neonatal sepsis (NS) is a major cause of mortality and morbidity in neonates. Correct and early diagnosis of NS can prevent its complications. The aim of this study was to investigate the relationship between the levels of thyroid hormones and procalcitonin (PCT) with NS. In this case-control study, 40 term neonates with proven NS diagnosis and 40 term neonates whose NS were rejected due to negative paraclinical findings were compared in terms of thyroid hormone levels, PCT and C reactive protein (CRP). Data were analyzed using SPSS v.17. The most common clinical finding was fever in both groups, while there was no significant difference between the two groups (P = 0.1). The results of laboratory tests showed that the CRP levels ​​in the NS group were significantly higher than the control group (P = 0.03). In terms of thyroid hormones, although TSH and T4 were higher in the NS group, this difference was not statistically significant (P = 0.94 and P = 0.22, respectively). In addition, PCT measurements and comparisons showed that this parameter was significantly higher in the NS group (P = 0.01). The results of this study demonstrated that CRP and PCT levels in NS neonates were significantly higher than non-NS neonates, while there was no significant difference in the level of thyroid hormones in the two groups. Further studies are recommended in this area. Neonatal sepsis (NS) is a major cause of mortality and morbidity in neonates. Correct and early diagnosis of NS can prevent its complications. The aim of this study was to investigate the relationship between the levels of thyroid hormones and procalcitonin (PCT) with NS. In this case-control study, 40 term neonates with proven NS diagnosis and 40 term neonates whose NS were rejected due to negative paraclinical findings were compared in terms of thyroid hormone levels, PCT and C reactive protein (CRP). Data were analyzed using SPSS v.17. The most common clinical finding was fever in both groups, while there was no significant difference between the two groups (P = 0.1). The results of laboratory tests showed that the CRP levels ​​in the NS group were significantly higher than the control group (P = 0.03). In terms of thyroid hormones, although TSH and T4 were higher in the NS group, this difference was not statistically significant (P = 0.94 and P = 0.22, respectively). In addition, PCT measurements and comparisons showed that this parameter was significantly higher in the NS group (P = 0.01). The results of this study demonstrated that CRP and PCT levels in NS neonates were significantly higher than non-NS neonates, while there was no significant difference in the level of thyroid hormones in the two groups. Further studies are recommended in this area.

Postpartum hemorrhage (PPH) is among the most significant causes of maternal death worldwide. The time of diagnosing and the proper management of hemorrhage are essential in preventing maternal mortality. The current study aimed to evaluate the effect of Bakri balloon on the management of PPH. Bakri balloon was effective in controlling PPH of 92.3% of patients. The most frequent indications for using Bakri balloon was uterine atony (46.1%). Furthermore, Bakri balloon is among the simplest and low invasive methods that can be used to control PPH before invasion methods, like hysterectomy.

Depression is one of the most common psychological problems, which can elevate the risks of cardiovascular complications. This study was performed with the aim of retrospectively reviewing the relationship between these two illnesses in middle-aged people. In this case control study, 200 patients were randomly chosen as the case group from among patients whose diagnosis of ischemic heart disease (IHD) was confirmed by angiography, women younger than 55 and men younger than 45, and another 200 patients without IHD were chosen as control subjects. In order to assess the patients’ depression, Beck’s Depression Questionnaire was used in both groups. Data was analyzed using SPSS v.16 software  . Results of the Beck’s Questionnaire taken from both groups showed a mean score of 13.9±8.48 in the case group and 10±5.93 in the control group (p<0.001). Moreover, the difference between the two groups pertaining to the severity of depression was also found to be statistically significant (p<0.001). Also, more women were found to be clinically depressed compared to men (p<0.001). Depression is considered an independent risk factor for the development of IHD, moreover, based on the previous studies conducted, risk of developing IHD are higher among those already affected by depression and in middle-aged people which needs further analyses and studies to be conducted in order to better understand this relationship and to better develop treatment strategies.

Phototherapy is one of the therapy methods for jaundice caused by hyperbilirubinemia. Vitamin D and bilirubin have two distinct routes of metabolism yet part of their syntheses is common in the liver and thus they may influence each other’s synthesis. One of the consequences of phototherapy not previously studied in detail is hypocalcaemia and hypomagnesaemia. The current study aimed at investigating the effect of phototherapy on serum level of calcium, magnesium, and vitamin D. The current semi-experimental investigation was conducted on 50 term infants with jaundice that had phototherapy indication. Bilirubin, calcium, magnesium, and vitamin D were measured in their blood samples at admission and then 48 hours after beginning the phototherapy. Data were analyzed with SPSS version 16 using paired-samples t test. The serum calcium was 9.85 mg/dL before phototherapy and significantly decreased after it (9.51 mg/dL) (P<0.001). Also, the mean serum magnesium was 2.21 mg/dL before phototherapy and significantly decreased after it (2.06 mg/dL) (P=0.047). The mean of serum vitamin D significantly increased after phototherapy (before 17.44 mg/dL and after 21.77 mg/dL) (P<0.0001). The current study showed that phototherapy could decrease the level of calcium and magnesium and increase the level of vitamin D.

Doxorubicin is one of the most common drugs for chemotherapy. The complications of doxorubicin are cardiac toxicity due to oxidative stress. Cydonia oblonga Miller leaf (COL) contains flavonoids and phenolic antioxidants. Due to the presence of antioxidant compounds in COL, the aim of this study was to evaluate the effect of hydroalcoholic extract of COL on doxorubicin-induced cardiac injury in rat. In this experimental investigation, 32 male Wistar rats were divided into 4 groups: control, control under treatment of hydroalcoholic extract of COL, doxorubicin and doxorubicin under treatment of hydroalcoholic extract of COL. In treatment groups, 200 mg/kg of hydroalcoholic extract of COL was injected intraperitoneally one hour after the first dose of doxorubicin for 2 weeks and administered daily. For induction of cardiac toxicity, doxorubicin was injected at a dose of 15 mg/kg intraperitoneally. After two weeks of treatment, the rats were anesthetized with diethyl ether and their heart was removed. After tissue homogenate was prepared, oxidative stress markers were measured using specific kits. The results of this study demonstrated that doxorubicin increases malondialdehyde and reduced glutathione and catalase activity in the cardiac tissue of rats. Two weeks of treatment with hydroalcoholic extract of COL significantly reduced the malondialdehyde level and increased glutathione. The increase in catalase activity was not statistically significant. According to the results of this study, COL with phenolic and flavonoid compounds and antioxidant activity seems to attenuate lipid peroxidation and oxidative stress in doxorubicin induced cardiac toxicity.

Migraines are the third most prevalent diseases and the seventh most debilitating diseases in the world. Medical treatment options for acute migraine episodes are various while none are infinitely effective for all patients. The aim of the present study was to compare fixed combination of acetaminophen, aspirin and caffeine with ibuprofen (AAC) with ibuprofen. This double-blind clinical trial (Registration No. IRCT2017052930680N4) was performed upon patients attending the neurology clinic at Shahid Mostafa Khomeini General Hospital with complaint of headache. Treatment protocol for this study consisted of 2 medications prescribed for 4 consecutive episodes: Ibuprofen 400 mg and AAC tablets. Each patient received two sets of medication each for two episodes of headaches consisting of 2 of each drug. Pain perception was evaluated by 11-point Box Scale at three stages: prior to administration of the medication, and 2 and 6 hours after taking the medications and daily functions of the patient were assessed 6 hours after administering the medications by filling the Behavioral Rating Scale (BRS-6) which is a clinical assessment tool. Results of this study demonstrated that difference in severity of pain after taking 2 Ibuprofen tablets and AAC in the first and second episodes of migraine was statistically significant. Furthermore, AAC as compared to Ibuprofen, helped considerably more by allowing patients to regain enough focus to continue their daily life (P=0.001). The results of this study showed that in patients with migraine, AAC is more effective than ibuprofen on improving patient's function and reducing pain.

In this research, the beneficial effects of oral administration of Hypericum perfo­ratum (HP) on serum glucose and lipids, hepatic enzymes and the amount of malondialdehyde in Streptozotocin-induced diabetic rats are studied.
In this experi­mental study, 32 male rats where randomly divided into 4 groups of control, treatment-control, diabetic and treatment-diabetic. HP was orally administered to treatment groups over a period of 6 weeks. Serum glucose levels, triglyceride, total cholesterol along with HDL and LDL were all evaluated prior to initiation of the treatment, and at 3rd and 6th (last) week of treatment initiation, and in the end of the treatment, malondialdehyde and aminotransferase enzymes of the liver were evaluated. regarding serum glucose levels and body weight measured in the 3rd and 6th week, the treatment-diabetic group didn’t show a significant change compared to the diabetic group, regarding serum total cholesterol and LDL levels, a significant decrease was observed and regarding serum HDL, a significant increase was documented. Furthermore, treating the treatment-diabetic group with HP did not result in any significant decrease in serum triglyceride, malondialdehyde or alanine aminotransferase but, in fact, did cause a significant decrease in aspartate aminotransferase. Oral administration of HP did in fact have a beneficial effect on lowering serum levels of total cholesterol, LDL and the hepatic enzyme as­partate aminotransferase and on raising the levels of HDL in diabetized rats with Streptozotocin.

Congenital abnormalities of the uterus occur due to inappropriate formation, fusion, or absorption (resorption) of mullerian duct in uterus. The present study aimed at evaluating a patient with double uterus and twin pregnancy. This patient was a 19- year- old female and the first day of her last menstrual was on 14/11/2010. We observed transabdominal ultrasound abdomen and pelvis of the uterus and twins in the ultrasound center. On the vaginal ultrasound, the gestational sac and heart rate for both fetuses were observed, then, the patient was taken to the operating room for elective termination of pregnancy, and cesarean section was performed on both the uterus and the healthy boy fetuses were taken out. We concluded from this case that we should consider and manage deliveries and pregnancies before experience clarifies the ideal management.