Archives of Iranian Medicine
Volume:19 Issue: 9, Sep 2016

The aim of this study was to determine the effects of amniotic membrane impregnated with betamethasone on regeneration of transected sciatic nerve injury in adult albino Wister rats.
In this research, 42 male adult rats were divided into six equal groups. 1) Normal (intact) group: healthy rats without any injury; 2) Control group: sciatic nerve was cut and sutured; 3) Sham group: 0.2 mL culture medium was injected on the epineurium in the injury; 4) Amniotic membrane group (AM): Acellular amniotic membrane was used around the damaged sciatic nerve; 5) Betamethasone group (B): 0.2 mL Betamethasone (4 mg/mL) was injected in the site of damaged nerve and 6) Amniotic membrane group and Betamethasone (AM/B) group: Acellular amniotic membrane impregnated with 0.2 mL betamethasone was used around the damaged sciatic nerve. The rate of recovery was studied by Sciatic Functional Index (SFI), withdrawal reflex latency (WRL) test and electroctrophysiological assessments at 2, 4, 6 and 8 weeks after surgery. Histological assessment was done 8 weeks after surgery.
At 8 weeks after surgery, SFI, WRL test and electrophysiological values in AM/B group were significantly improved compared to control and sham groups (P The present study showed the positive effects of Amniotic membrane and Betamethasone on nerve regeneration of transected sciatic nerve in a rat model.

Climatic factors with desired and sometimes undesired effects lead to changes in the human body, such as hypothermia, influenza, heart disease, stroke, asthma, etc. The present study investigates the role of temperature in respiratory mortality in Mashhad, Iran.
Among the respiratory mortality data, daily temperature, wind speed and relative humidity from 2004 to 2013 were used. First, Tmrt parameter was calculated through Ray Man software and the values of UTCI index were obtained using Bioklima software. Finally, the correlation between the thresholds of the above-mentioned index and temperature as well as mortality was calculated. In addition, the mortality risk ratio in all of these thresholds was calculated.
The results show that the UTCI index has changed from 32°C to 40°C C in Mashhad. There is a strong and negative relationship between the maximum temperature (r = -0.90, P-value Generally, mortality increases with decreasing temperature and increasing cold stresses and the mortality risk increases by 1.36% per 10°C reduction.

Group A Rotaviruses (GARV) are the main viral cause of acute gastroenteritis, leading to 870,000 deaths annually in the developing world and representing a major health problem. Therefore, diagnosis and treatment of this disease are crucial. Gene rearrangement within segmented viruses as well as rotavirus is seen throughout chronic rotavirus infection in immunodeficient young children and through serial passage of rotavirus in cell culture at a high multiplicity of infection. Detailed knowledge of rotavirus biology allows design of a vaccine against rotavirus by engineered antigens. The aim of this study was to develop Poly (A) -Tailed universal Reverse Transcription Polymerase Chain Reaction (RT-PCR) method and compare the efficacy of this procedure with specific multiplex PCR protocol for detecting normal and rearranged segments.
Virus was propagated on confluent monolayer of MA-104 cells and aliquots of each passage were kept frozen for further RNA genomic profiles analysis by polyacrylamide gel electrophoresis. Purified Rota virus RNA was polyadenylated and used for the amplification and detection of normal and rearranged segments of rotavirus using RT-PCR.
The generation of gene rearrangement through multiple serial passages of rotavirus was shown using MOI ≥ 1 . The rearranged RNA segments of NSP1 and NSP3 genes with different migration pattern in PAGE were detected by poly(A)RT-PCR.
In the current research, a novel Poly(A) -Tailed Universal Reverse Transcription PCR method was introduced for the high throughput amplification and analysis of the informative untranslated regions of the rotavirus genome.

Evidence indicates that NAFLD patients are vitamin D deficient. Vitamin D has new roles in lipid and glucose metabolism. The aim of this study was to examine the effects of calcitriol supplementation on the NAFLD progression based on liver lipid accumulation, serum lipid profile and insulin resistance.
We randomly assigned 73 patients with NAFLD-confirmed by ultra-sonography to 12 weeks of treatment with hypocaloric diet (reduction of 500 kcal per day) plus 25 µg of calcitriol supplement or a hypocaloric diet plus placebo. Before and after treatment, we assessed anthropometric parameters, grade of fatty liver, serum lipoproteins, liver enzymes and insulin level.
Baseline variables were not significantly different between groups. A statistically significant reduction in anthropometric measures was observed over the 12 weeks in both groups. However, no significant differences were seen between groups after intervention. Compared with the placebo, reductions in triglyceride and an increase in HDL cholesterol were seen over the 12 weeks of intervention in the calcitriol group (P = 0.002 and P = 0.004). AST level was decreased in the calcitriol group (-4.2 ± 4.3 µmol/L, P Calcitriol supplementation combined with weight loss diet showed no significant effects on anthropometric measures in NAFLD patients. However, it may have positive effects on lipid profile, liver enzyme tests and insulin sensitivity during a weight-loss program.

The number of acutely ill patients has risen in general wards due to the aging population, more advanced and complicated therapeutic methods, economic changes in the health system, therapeutic choices and shortage of intensive care unit beds. This may lead to adverse events and outcomes with catastrophic results. The purpose of this study was to describe the conditions of acutely ill patients, from the perspective of caregivers.
The study was conducted in Tehran University of Medical Sciences and its two affiliated general teaching hospitals. Ten nurses and physicians participated in interviews, which were analyzed using qualitative content analysis methods.
Four main categories of difficulties in caring for acutely ill patients in general wards were described: problems in identifying acutely ill patients, problems in clinical management of acutely ill patients, inappropriate use of Intensive Care Unit (ICU) beds, and poor structure for mortality control. The staff do not appropriately diagnose the signs of deterioration. There are problems with the appropriate management of acutely ill patients, even if they are considered to be acutely ill and in need of special attention in general wards.
Many shortcomings exist caring for acutely ill patients, ranging from identification to clinical management; there are also structural and contextual problems. An immediate plan is necessary to circumvent the challenges and to improve the care for acutely ill patients. These challenges highlight the need for changes in current levels of care for acutely ill patients, as well as the need for appropriate support systems.

Abnormal expression of microRNAs (miRNAs) plays an important role in development of several cancer types, including bladder cancer (BCa). However, the relationship between the ratio of miR-181/miR-100 and the prognosis of BCa has not been studied yet. The aim of this study was to evaluate the expression of miR-182, miR-100 and their clinical significance in BCa.
Upregulation of miR-182 and down-regulation of miR-100 were validated in tissue specimens of 134 BCa cases compared with 148 normal bladder epithelia (NBE) specimens using TaqMan-based real-time reverse transcription quantitative PCR (RT-qPCR). The diagnostic and prognostic evaluation of miR-182, miR-100, and miR-182/miR-100 ratio was also performed.
miR-182 was upregulated in BCa and miR-100 was down-regulated in BCa compared with NBE (P The miR-182/miR-100 ratio may serve as a novel promising biomarker for diagnosis and survival prediction in BCa. Further studies are needed to elucidate the role of miR-182/miR-100 ratio as a non‑invasive diagnostic tool for BCa.

The 24-hour urine sodium excretion is considered the gold standard method to estimate salt intake. However, since this method is not easy to perform, this study developed two instruments, including a semi-quantitative food frequency questionnaire (FFQ) and one spot urine sodium excretion, to assess sodium intake. These two methods were then compared with 24-h urine sodium excretion and twelve 24-h recalls during a year.
This study was performed on 219 healthy subjects aged ≥ 6 years in 2014 & 2015. The FFQ was completed twice, at baseline and one year thereafter, to examine the reproducibility of the FFQ. The validity of three spot urine sodium excretions in the morning, afternoon, and evening and FFQ for the assessment of sodium intake were compared against the 24-h urine sodium excretion method. Moreover, the validity of FFQ was examined against 24-h dietary recalls for the assessment of total sodium consumption and contribution of food groups to sodium intake. The content validity of the FFQ was estimated by an expert panel including 10 nutritionists.
Based on their nutrients, the final food items were categorized into 11 groups including: 1) dairy products, 2) fruits, 3) vegetables, 4) meat and egg, 5) grains and legumes, 6) mixed dishes, prepared foods, and restaurant foods, 8) nuts and seeds, 8) oils and fats, 9) sauces and desserts, 10) drinks, and 11) others.
Spot urine and a specific FFQ comprising 136 items were used to develop a method for the assessment of sodium intake and contribution of foods to its intake among the Iranian population. This method can be used in large-scale population studies at the national level.

Traditional standardization methods have been used in medical research for a long time to standardize the effect of interest for one confounder such as age. Model-based standardization extension of these methods is used when we have more than one variable produces an effect which is the population average and has marginal causal interpretation.
In this paper, we discuss the most traditional model-based standardization methods that are used to estimate the marginal causal effect of exposure. We applied these methods to data from Tehran Thyroid Study and estimated the standardized effect of exposure on outcome.
Based on the simulation studies, covariate standardization is preferred except when 1) we have enough information about the mechanism of exposure or 2) the outcome is rare and exposure is frequent, so propensity score standardization is suggested.

Adrenal cell carcinoma is a rare tumor and more than 70% of patients present with advanced stages. Adrenal cell carcinoma is an aggressive tumor with a poor prognosis. Surgical intervention is the gold standard treatment and mitotane is the only drug approved for the treatment of adrenal cell carcinoma. Until recently in 2012, the etoposide, doxorubicin, cisplatin plus mitotane are approved as first-line therapy based on response rate and progression-free survival.
This case illustrates a case of advanced adrenal cell carcinoma in a young girl who presented with huge adrenal mass with inferior vena cava thrombosis and pulmonary embolism. Multi-approach of therapy was used to control the tumor size and metastasis. Therefore, it may prolong her survival rate for up to 5 years and 4 months.

Bone marrow transplantation (BMT) in young children improves results in β-thalassemia major. Graft versus host disease (GVHD) is an important complication of peripheral blood stem cell transplantation. GVHD affects heart with a behavior resembling an autoimmune disease, including pericardial effusion.
We describe a 22-year-old β-thalassemia major patient who underwent bone marrow transplantation with an HLA-identical sibling donor. The patient didn’t have any serious problem until 15 months after transplantation. He presented with chest discomfort and progressive dyspnea. Early echocardiogram showed mild pericardial effusion. Four days later, the effusion had increased, impending to cardiac temponade requiring pericardectomy. Immunospressive drugs and pericardectomy resulted in significant improvement in ventricular filling.
Cardiac cGVHD, an un-common complication of HSCT may be presented as pericardial effusion. Although early initiation of steroids is very important, heart monitoring is necessary to diagnose cardiac temponade.