فهرست مطالب

Galen Medical journal - Volume:8 Issue:1, 2019
  • Volume:8 Issue:1, 2019
  • تاریخ انتشار: 1398/09/10
  • تعداد عناوین: 81
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  • Shohre Kaviani, Fatemeh Kasbi*, Afshin Samaei, Ehsan Shahverdi Page 1
    Background

    Aphasia is the most frequent disorder that could occur following a stroke. Aphasia has a negative impact on the patient’s communication ability through language. One of the common consequences of aphasia is naming deficits that can lead to communication disorders. Therefore, the treatment of aphasia is necessary. The aim of the current study was to investigate the effect of video modeling and clinician modeling on naming skills of patients with chronic aphasia.

    Materials and Methods

    The design of this prospective single subject study was ABA that performed on four patients with chronic aphasia. participated. This study was administered during three phases including the baseline (three sessions); the intervention (nine sessions); and a follow-up phase (three sessions). The outcome measure was taken in three phases including baseline, intervention, and follow-up. For each patient, the naming score for items modeled by the clinician, the naming score for items modeled video modeling by other, the naming score for self-video modeling, and the reaction time score were recorded.

    Results

    A total of three patients complete the study and one of them refused to continue treatment. The naming score of all modeling types increased in all patients. In the other words, the intervention helped the patients be improved in naming. Also, the results of the reaction time indicated that the video modeling, as well as clinician modeling, could decrease the response time that means the intervention could increase the speed of retrieval processes.

    Conclusion

    In our study, all three types of modeling could improve the naming scores in patients with chronic aphasia. Additionally, the findings demonstrate that the clinician and video modeling might increase mental processing for naming verbally

    Keywords: Aphasia, Video Modeling, Clinician Modeling, Naming Skills
  • Masoumeh Saeedi, Mohammad Hossein Khosravi*, Mohammad Ehsan Bayatpoor Page 2
    Background

    The fastest and safest treatment method of BPPV is repositioning maneuvers. In Iran, this methods are not widely used, and many physicians use medical therapy, despite their side effects, for management of BPPV.

    Materials and Methods

    In this randomized clinical trial patients with BPPV were randomly allocated to Epley repositioning maneuver or Cinnarizine (25mg every 8 hours) for two weeks. The patients were evaluated for symptoms using visual analogue scale (VAS) scoring system before intervention, first and second weeks after intervention. In the second and third visitd the results of hallpike test was recorded for both groups.

    Results

    43 patients with a mean age of 46.88±11.08 years in two Epley and Cinnarizine group underwent analysis. The mean VAS score for improvement of symptoms after intervention was 1.66±1.06 in Epley and 1.50±0.91 in Cinnarizine group (P=0.57).

    Conclusion

    we found that there is no significant difference between Epley maneuver and Cinnarizine for treatment and controlling symptoms of BPPV.

    Keywords: Benign Paroxysmal Positional Vertigo, Cinnarizine, Epley Maneuver, Vertigo
  • Marzieh Bakhshayeshkaram, Jamshid Roozbeh, Sayed Taghi Heydari, Behnam Honarvar, Mohammad Hossein Dabbaghmanesh, Maryam Ghoreyshi, Kamran Bagheri Lankarani * Page 3
    Background

    Currently, we are facing a significant increase in the new cases of the end-stage renal disease in developing countries. Hence, it seems vital to work on strategies aimed at reducing its development and progression. Determining the related risk factors can provide an insight into achieving these policymaking goals. Therefore, this study was conducted to identify risk factors associated with chronic kidney disease (CKD) in the Iranian adult population.

    Materials and Methods

    This cross-sectional study was performed in Shiraz, Southern Iran, through a cluster random sampling technique that involved 819 subjects, including 340 male and 479 female adult participants. Factors such as the body mass index, waist circumference, blood pressure, and biochemical profile were determined. We evaluated the prevalence of CKD according to the glomerular filtration rate (GFR), as well as possible risk factors associated with it. GFR was calculated on the basis of the “Chronic Kidney Disease Epidemiology Collaboration” creatinine equation.

    Results

    The cluster comprised 58.5% females and 41.5% males. The mean age of our participants was 43.0 ± 14.0 years. Our results showed that 16.6% of adult urban inhabitants in Iran had CKD (stages 3 to 5, eGFR ≤60), that is, GFR less than 60 mL/min/1.73 m2. The proportion of participants having hypertension, obesity, high waist circumference, diabetes mellitus, and history of cardiovascular disease was 17.3%, 19.3%, 35%, 9.4%, and 5.3%, respectively. Multiple regression analysis indicated an independent correlation between age, sex, dyslipidemia, and hypertension with CKD.

    Conclusion

    This study indicates that CKD is a substantial health burden in Iranian adult population. Additionally, the results of this study addressed the importance of integrated strategies that aimed to identify, prevent, and treat noncommunicable diseases fueling the development of CKD.

    Keywords: Prevalence, Risk Factors, Chronic Kidney Disease
  • Shabnam Movassaghi, Zeinab Khazaei Koohpar, Mehrdad Hashemi, Sourena Jafari Semnani, Zahra Nadia Sharifi* Page 4
    Background

    3,4-Methylenedioxymethamphetamine is psychoactive and hallucinogenic and has been shown to produce neurotoxicity both in animals and in humans. Recently, vasodilator drugs such as pentoxifylline (PTX) have been introduced as an alternative with neuroprotective effects. There is no study about the protective effect of PTX on hippocampal apoptosis due to high-dose administration of 3,4-Methylenedioxymethamphetamine (MDMA), so in this study, the protective effect of PTX on the hippocampus of male Wistar rats following high-dose of the drug has been investigated.

    Materials and Methods

    Twenty-four male Wistar rats weighing 250-300 g were randomly divided into four groups: control, sham (MDMA injection), experimental (MDMA+PTX injection), and vehicle (MDMA+saline) groups. Two weeks later, the brains were removed and prepared for TUNEL and western blot techniques. Concomitantly the hippocampus was removed to study the change in Bcl-2 and BAX mRNA expression with quantitative real-time polymerase chain reaction.

    Results

    Data showed that the number of apoptotic bodies significantly decreased in the experimental group compared to the other groups, except for in control. Also, further investigation revealed that BAX reduced considerably, while Bcl-2 mRNA expression increased dramatically after PTX treatment.

    Conclusions

    Our results suggest that PTX may be a neuroprotective agent, and its neuroprotective potential may contribute to reducing the severity of lesions in the hippocampus following a high dose administration of MDMA.

    Keywords: Pentoxifylline, 3, 4-Methylenedioxymethamphetamine, Apoptosis, Hippocampus
  • Parastou Kordestani Moghadam, Mohamad Nasehi*, Fariba Khodagholi, Mohamad, Reza Zarrindast Page 5
    Background

    Sleep deprivation (SD) in the long term can cause multi-organ dysfunction as well as neurocognitive disorders. Daytime sleep or napping is a biological compensate due to insomnia or sleep deprivation. Metabolic responses to this biological rhythm may being as a biological indicator or biomarker to compare the effect of them. Glucose transporter type 1 (Glut1) is one of the metabolic biomarkers that is affected by several conditions such as stress, seizure, malignancy, and neurocognitive disorders. We studied the effect of SD, circadian reversed (R) and napping models on the Glut-1 expression level in the right and left amygdala.

    Materials and Methods

    Sixty-four Wistar rats were divided into eight groups as follow: Intact group that rats were placed in a cage without any intervention. In the sham group, rats were on the stable pedal of the SD apparatus (turn off). Experimental groups include total SD48, total SD48- (plus short nap), total SD48+ (plus long nap), R48, R48- (plus short nap), and R48+ (plus long nap). The Glut-1 expression level in the right and left amygdala were measured by western blotting.

    Results

    Our findings demonstrated the significant effect of both SD for 48 hours and reversed circadian on the expression of Glut-1 from sham and intact groups. The long nap plus them could decrease the elevation of Glut-1 in the left amygdala. However, the short nap could not reduce this elevation of Glut-1.

    Conclusion

    Left amygdala is vulnerable to the fluctuation of hypothalamicpituitary-adrenal axis and stress. In other words, sleep disorders are affecting by Glut-1 as a metabolic biomarker in left amygdala alone.

    Keywords: Sleep, Circadian Rhythm, Glucose Transport Protein, Amygdala
  • Hossein Pourghadamyari, Mohammad Rezaei, Mohsen Basiri, Yaser Tahamtani, Behrouz Asgari, Seyedeh, Nafiseh Hassani, Reza Meshkani, Taghi Golmohammadi*, Hossein Baharvand Page 6
    Background

    Diabetes is a major worldwide health problem. It is widely accepted that the beta cell mass decreases in type I diabetes (T1D). Accordingly, beta cell regeneration is a promising approach to increase the beta cell mass in T1D patients. However, the underlying mechanisms of beta cell regeneration have yet to be elucidated. One promising avenue is to create a relevant animal model to explore the underlying molecular and cellular mechanisms of beta cell regeneration. The zebrafish can be considered a model in beta cell regeneration studies because the pancreas structure and gene expression pattern are highly conserved between human and zebrafish.

    Materials and Methods

    In this study, the Tol2 transposase was exploited to generate a Tg(Ins:egfp-nfsB) zebrafish model that expressed a fusion protein composed of enhanced green fluorescent protein (EGFP) and nitroreductase (NTR) under control of the Ins promoter.

    Results

    Metronidazole (MTZ) treatment of Tg(ins:egfp-nfsB) zebrafish larvae led to selective ablation of beta cells. Proof-of-concept evidence for beta cell regeneration in the transgenic larvae was observed two days after withdrawal of MTZ.

    Conclusion

    This study suggests that the Tg(ins:egfp-nfsB) zebrafish can be used as a disease model to study beta cell regeneration and elucidate underlying mechanisms during the regeneration process.

    Keywords: Diabetes, Pancreatic Beta Cells, Regeneration, Genetically Modified Animals
  • Mohammad Rezaei, Mohsen Basiri, Seyedeh, Nafiseh Hasani, Behrouz Asgari, Hadis Kashiri, Ali Shabani*, Hossein Baharvand Page 7
    Background

    Transgenic animals have a critical role in the advancement of our knowledge in different fields of life sciences. Along with recent advances in genome engineering technologies, a wide spectrum of techniques have been applied to produce transgenic animals. Tol2 transposase method is one of the most popular approaches that were used to generate transgenic animals. The current study was set out to produce an ornamental fish, which express enhanced green fluorescent protein (EGFP) under control of mylpfa promoter by using Tol2 transposase method.

    Materials and Methods

    Polymerase chain reaction (PCR) cloning method was performed to insert zebrafish myosin promoter (mylpfa) into Tol2-EGFP plasmid at the upstream of EGFP. In vitro transcription method was used to prepare the transposase mRNA. The Tol2-EGFP plasmid and transposase mRNA were then co-injected into the one-cell stage of zebrafish zygotes. After two days, the fluorescent microscopic analysis was used to select transgenic zebrafishes.

    Results

    Our data showed that the optimum concentration for recombinant Tol2 vector and transposase mRNA were 50 ng/ul and 100 ng/ul, respectively. The results also revealed that the quality of embryos and quantity of injected construct had the important effects on Tol2 transposase method efficiency.

    Conclusion

    Data showed that Tol2 transposase is an appropriate method to generate zebrafish transgene. Our finding also showed that mylpfa promoter is a strong promoter that can be used as a selected promoter in the ornamental fish industry.

    Keywords: Myosin, Transposase, Injection, Plasmid
  • Faezeh Feizi, Nazli Namazi, Roja Rahimi, Mohammad Hossein Ayati* Page 8

    Insomnia is one of the most troubling sleep disorders and can be characterized by an inability to fall asleep and/or inadequate sleep duration and/or waking up multiple times during the night. Herbal medicine has been used to treat a range of sleep disorders for centuries. This study aimed to review medicinal plants investigated experimentally or clinically for sleep disorders, as well as their potential mechanisms of action and active components. Electronic databases and literature were systematically investigated to assess all in vitro and in vivo trials and clinical evidence of the efficacy and potential mechanisms of actions playing major roles in sleep induction or insomnia treatment. Among many herbal studies and trials on insomnia, some showed no significant difference between herbal remedies and placebos. While others showed improvements in sleep parameters (sleep latency, total sleep, non-rapid eye movement (NREM) and rapid eye movement (REM) sleep duration, delta activity in NREM sleep, wakefulness anxiety-associated insomnia). In this study, in vitro, animal, and clinical studies investigating a variety of herbal treatments for insomnia were systematically reviewed. The mechanisms of action of herbal medicines in treating insomnia are mainly related to gammaaminobutyric acid (GABA)-synthesizing and GABA-metabolizing enzymes that influenced sleep outcomes. Overall, herbal remedies were not associated with more benefits than nonbenzodiazepines, although side effects were less. The results suggest that herbs have some benefits in improving the quantity and quality of sleep and could be a promising alternative therapy.

    Keywords: Insomnia, Sleep, Herbs, Plants
  • Solmaz Khalifeh*, Fariba Khodagholi, Mehrad Moghtadaei, Ali Behvarmanesh, Afshin Kheradmand, Hamed Ghazvini Page 9
    Background

    Early life stress (ELS) models such as maternal deprivation (MD) are used to investigate behavioral changes in rodents under stressful situations. MD is a situation in which rat pups are separated from the dam; MD has different paradigms. The purpose of this research is to evaluate the effects of maternal deprivation on anxiety, depression, and empathy in adult Wistar rats.

    Materials and Methods

    MD was applied to pups as per specifically designed protocol to compare rats of the control group with maternal deprivation rats and also the group, which faced novel objects. Each group consisted of eight rats. In this study, separation started from postnatal day (PND) 14 for various periods up to PND 60. EPM test was undertaken to measure anxiety; moreover, FST was used to indicate levels of depression. Also, changes in the empathy ratio were also demonstrated. One-way analysis of variance (ANOVA), Tukey’s post hoc analysis, and t-test were applied to analyze the results.

    Results

    MD-treated rats showed a significant decrease in anxiety and empathy indexes compared with those in the control group (P<0.05). However, MD significantly increased depression in both male and female rats (P<0.05). Finally, exposure to novel objects decreased depression but did not have any effect on anxiety and empathy levels in MD rats (P<0.05).

    Conclusion

    ELS may lead to various states of mood and behavior in adulthood. According to the findings of this study, depression increases due to MD, though both anxiety and empathy decrease in both male and female Wistar rats. Moreover, exposure to novel objects decreases depression, while anxiety and empathy do not change significantly with exposure to novel objects.

    Keywords: Maternal Deprivation, Empathy, Anxiety, Depression, Wistar Rat
  • Hossein Rezaeizadeh, Maryam Abbasi* Page 10
  • Hossein Rezaeizadeh, Roja Rahimi, Maryam Abbasi* Page 11

    Fatigue is one of the most debilitating symptoms of multiple sclerosis (MS), and its definite pathophysiology is unclear. Studies have suggested some correlates for it including dysfunction or atrophy in different parts of the brain. This narrative review study compares the viewpoint of conventional medicine and Persian medicine (PM) about fatigue due to MS and introduces the treatments used for this complaint in PM with an evidence-based approach. PM scholars have used the term I’ya equal to fatigue and stated that I’ya might be due to exertion or not, while the latter (spontaneous I’ya) can be prodromal of a disease. This pathologic fatigue can be seen in a wide variety of neurologic diseases, though it is the most common in MS patients. Fatigue in MS can be considered one of the equivalents of spontaneous I’ya. According to PM texts, neurotonic herbs like Ferula, Citrus medica, Asarum europaeum, Ficus carica, and Juglans regia may be beneficial in alleviating fatigue by brain reinforcement. Different pharmacological mechanisms have been introduced for these plants including antioxidant and/or anti-inflammatory activities. The medicinal plants can be assumed as a valuable source for discovering new medicines for fatigue in MS. Designing preclinical and clinical studies evaluating the effects of mentioned medicinal herbs in fatigue is proposed for obtaining more conclusive results.

    Keywords: Fatigue, Medicinal Herbs, Multiple Sclerosis, Medicinal Plants, Traditional Medicine
  • Elnaz Razavian, Setareh Tehrani* Page 13
    Background

    The 33-mg/mL hyaluronic acid (HA) formulation is a highly concentrated, crosslinked, cohesive, smooth, and completely reversible volumizing filler approved by Conformité Européene. For the first time, we aimed to evaluate the long-term efficacy and safety of the 33mg/mL HA filler for soft tissue augmentation in the treatment of facial wrinkles.

    Materials and Methods

    After optimal wrinkle correction was achieved in the patients undergoing treatment by injecting the 33-mg/mL HA filler at the injection site plus one touch-up at a 2-week interval, the safety and efficacy of the filler were assessed on the 5-point Facial Volume Loss Scale through the 1-year study period. Patients were evaluated daily for 14 days and after 6 and 12 months post-treatment.

    Results

    A total of 86 subjects were treated. The mean wrinkle scores of the patients were 3.95+0.79 (range of 3-5) before treatment, 2.3+0.94 (range 1-5) six months after treatment, and 2.93+1.29 (range of 1-5) one year after treatment. Clinically significant mean wrinkle correction (P=0.001) was still evident at>12 months of treatment through 33-mg/ mL HA formulation. A clinically significant correction at>12 months after treatment was maintained by 79% of patients. Nodule formation and swelling were more frequent when the 33mg/mL HA filler was used compared with the use of less concentrated HA fillers. One patient developed angioedema-like swelling and induration last few months.

    Conclusion

    The 33-mg/ mL HA filler can provide long-term correction lasting for one year or more. Adverse effects, especially swelling and nodule formation were more common in this filler compared with less concentrated HA fillers. The side effects were correlated with the volume of the injected filler. We recommend using this concentration with low volume or combining high volume with lower concentration.

    Keywords: Hyaluronic Acid, Wrinkles, Aging Face, Dermal Filler
  • Seyyed Saeid Anvari, Mohammad Nasehi *, Mohammad, Reza Zarrindast Page 14
    Background

    The endogenous opioid system plays a basic role in pain suppression. The opiate analgesia is the most powerful and useful technique for reducing severe pain in many medical conditions. Transcranial direct current stimulation (tDCS) is a neuromodulator technique by which the cerebral cortex is stimulated with a weak and constant electrical current by the painless and non-invasive method.

    Materials and methods

    In this experimental study, we investigated the effect of tDCS on morphine (1.25, 2.5 and 5 mg/kg)-induced pain responses; as we applied left prefrontal anodal stimulation with 0.2 mA intensity and 20 minutes.

    Results

    our results revealed that the acute (One-time electrical stimulation 24 hours after the last administration of morphine three days) and subchronic (three times electrical stimulation; one session/day before each administration of morphine three days) left prefrontal anodal tDCS does not alter pain perception induced by different dose of morphine significantly.

    Conclusion

    Finally, our data indicated that there is no potentiated effect between acute tDCS or subchronic tDCS and morphine administration with tested parameters significantly.

    Keywords: tDCS, Prefrontal Cortex, Morphine, Pain, Anodal
  • Mahsa Hadipour Jahromy, Abdolhamid Najafi*, Farzaneh Majdi Nassab, Mahya Moiniyan Page 15
    Background

    Bacterial keratitis is an ophthalmic infection that may result in irreversible corneal damage. This study aimed to examine the effectiveness of povidone-iodine eye drop 1% in eye infection caused by inoculation of Streptococcus pneumoniae and Escherichia coli of mice.

    Materials and Methods

    In this study, 49 adult male CBA/J mice were used that divided into seven equal groups. The corneas of all mice were scratched and infected with a clinical strain of either S. pneumoniae or E. coli topically, except control group. Subgroups received chloramphenicol 0.5% eye drop twice daily in case of S. pneumoniae infection or ciprofloxacin 0.3% eye drop every 4 hours following E. coli infection from or povidoneiodine 1% eye drop in both groups, from post infection (PI) day 3 to7. Slit lamp examinations (SLE) of the corneas and eyes were performed every day to examine detectable or intense corneal opacity and erosion.

    Results

    In all infected mice, SLE scores were significantly higher than the control group on PI day 3. Scores increased steadily by time in all infected groups without treatment, reached to maximal value on PI day 7. In infected groups, treatment with either povidone-iodine 1% or chloramphenicol 0.5% or ciprofloxacin 0.3% on day 3, significantly decreased the SLE scores on PI day 7.

    Conclusion

    Povidone-Iodine 1% was effective to decrease S. pneumoniae and E. coli induced-keratitis symptoms in mice. Treatment with povidone-iodine 1% was observed time-dependently and was comparable to common eye drop antibiotics.

    Keywords: Streptococcus pneumoniae, Keratitis, Cornea, Escherichia coli, Mouse
  • Solmaz Khalifeh , Mehdi Khodamoradi , Vahid Hajali , Hamed Ghazvini *, Lelia Eliasy , Afshin Kheradmand , Vahid Farnia , Javad Akhtari , Kaveh Shahveisi , Hossein Ghalehnoei Page 16
    Background

    Methamphetamine (METH) as a synthetic psychostimulant is being increasingly recognized as a worldwide problem, which may induce memory impairment. On the other hand, it is well established that naloxone, an opiate antagonist, has some beneficial effects on learning and memory. The present research aimed at evaluating naloxone effects on spatial learning and memory impairment triggered by a neurotoxic regimen of METH in male rats.

    Materials and Methods

    The animals received the subcutaneous (sc) regimen of METH (4×6 mg/kg at 2-h intervals), intraperitoneal (ip) naloxone (4×1 mg/kg at 2-h intervals), or normal saline at four events. The Nal-METH group of rats received four naloxone injections (1 mg/ kg, ip) 30 min before each METH injection (6 mg/kg, sc) at 2-h intervals. Seven days later, they were evaluated for spatial learning and memory in the Morris Water Maze (MWM) task.

    Results

    METH regimen induced hyperthermia, as well as a poor performance, in the acquisition and retention phases of the task, indicating spatial learning and memory impairment compared to the controls. Naloxone administration (1 mg/kg, ip) before each METH injection led to significant attenuations of both hyperthermia and METH adverse effects on the rat performance in the MWM task.

    Conclusion

    The results revealed that pretreatment with the opiate antagonist naloxone could prevent METH adverse effects on body temperature and memory performance. It seems that the opioidergic system and hyperthermia may, at least partially, be involved in METH effects on spatial memory.

    Keywords: Methamphetamine Hydrochloride, Naloxone Hydrochloride, Spatial Memories, Hyperthermia
  • Reza Dehghani, Afshin Borhanihaghighi, Abdolhamid Shariat, Mohammad Nami, Masoume Nazeri, Amin Abolhasani Foroughi, Samrad Mehrabi, Masoumeh Emamghoreishi* Page 17
    Background

    National Institute of Health Stroke Scale (NIHSS) and Modified National Institute of Health Stroke Scale (mNIHSS) are two valid and reliable questionnaires that assess stroke severity. This study aimed to examine and compare the validity and reliability of Persian versions of NIHSS and mNIHSS in hospitalized patients.

    Materials and Methods

    The English versions of NIHSS and mNIHSS were translated to Persian (forward and backward), and three neurologists examined the face and content validity of both questionnaires. The Persian versions of NIHSS and mNIHSS were used in 75 hospitalized stroke patients (hemorrhagic and obstructive) admitted to Namazi teaching hospital, Shiraz, Iran. The reliability and validity of the Persian versions were examined by Cronbach’s alpha coefficient and convergent validity.

    Results

    The values of Cronbach’s alpha for Persian versions of NIHSS and mNIHSS were 0.81 and 0.86, respectively. The scaling success of convergent validity in NIHSS and mNIHSS were 80% and 100%, respectively.

    Conclusion

    The Persian versions of NIHSS and mNIHSS were reliable and valid. However, mNIHSS was more valid and reliable than NIHSS. Persian version of mNIHSS can be suggested to be used for assessing stroke severity in hospitalized stroke patients by neurologists and researchers.

    Keywords: National Institute of Health Stroke Scale, Modified National Institute of Health Stroke Scale, Persian Version, Stroke
  • Nastaran Hajizadeh, Ahmad Reza Baghestani, Mohamad Amin Pourhoseingholi*, Sara Ashtari, Hadis Najafimehr, Luca Busani, Mohammad Reza Zali Page 18
    Background

    Some errors may occur in the disease registry system. One of them is misclassification error in cancer registration. It occurs because some of the patients from deprived provinces travel to their adjacent provinces to receive better healthcare without mentioning their permanent residence. The aim of this study was to re-estimate the incidence of gastric cancer using the Bayesian correction for misclassification across Iranian provinces.

    Materials and Methods

    Data of gastric cancer incidence were adapted from the Iranian national cancer registration reports from 2004 to 2008. Bayesian analysis was performed to estimate the misclassification rate with a beta prior distribution for misclassification parameter. Parameters of beta distribution were selected according to the expected coverage of new cancer cases in each medical university of the country.

    Results

    There was a remarkable misclassification with reference to the registration of cancer cases across the provinces of the country. The average estimated misclassification rate was between 15% and 68%, and higher rates were estimated for more deprived provinces.

    Conclusion

    Misclassification error reduces the accuracy of the registry data, in turn causing underestimation and overestimation in the assessment of the risk of cancer in different areas. In conclusion, correcting the regional misclassification in cancer registry data is essential for discerning high-risk regions and making plans for cancer control and prevention.

    Keywords: Bayesian Analysis, Gastric Cancer, Incidence
  • Masoumeh Abedi Nejad, Mohsen Nikbakht, Masoomeh Afsa, Kianoosh Malekzadeh* Page 19
    Background

    Acute lymphoblastic leukemia (ALL) is a highly prevalent pediatric cancer accounting for approximately 78% of leukemia cases in patients younger than 15 years old. Different studies have demonstrated that B-cell translocation gene 3 (BTG3) plays a suppressive role in the progress of different cancers. Genistein is considered a natural and biocompatible compound and a new anti-cancer agent. In this study, we evaluate the effect of genistein on BTG3 expression and proliferation of ALL cancer cells.

    Materials and Methods

    ALL cell lines (MOLT4, MOLT17, and JURKAT) were cultured in standard conditions. Cytotoxicity of genistein was detected using MTT assay. The cells were treated with different concentrations of genistein (10, 25, 40, and 55μM) for 24, 48, and 72 hours, and then cell viability and growth rate were measured. The quantitative real-time polymerase chain reaction was applied to investigate the effect of genistein on BTG3 expression.

    Results

    The percentage of vital cells treated with genistein significantly decreased compared to the non-treated cells, showed an inverse relationship with an increasing genistein concentration. The present study suggests a dose of 40μM for genistein as a potent anticancer effect. Genistein could elevate BTG3 for 1.7 folds in MOLT4 and JURKAT and 2.7 folds in MOLT17 cell lines at transcription level conveged with 60 to 90% reduction in the proliferation rate of cancer cells.

    Conclusion

    Upregulation of BTG3 as a tumor suppressor gene can be induced by genistein. It seems that BTG3 reactivation can be introduced as another mechanism of anti-proliferative effect of genistein and could be considered as a retardant agent candidate against hematopoietic malignancy.

    Keywords: Acute Lymphoblastic Leukemia, Anti-Proliferation, B-cell Translocation Gene-3, Genistein
  • Mahin Dianat, Khojasteh Hoseiny Nejad*, Alireza Sarkaki, Yaghoub Farbood, Mohammad Badavi, Mohammad Kazem Gharib Naseri Page 20
    Background

    Cerebral ischemia/reperfusion (I/R) could increase the reactive oxidative stress in the cardiomyocytes. Also, some studies report cardiac arrhythmias following oxidative stressor such as I/R. Hence, this study was aimed to investigate the effects of ellagic acid (EA) against arrhythmias in a cerebral I/R model.

    Materials and Methods

    Thirty-two male rats were randomly allocated into four groups: Sham (normal saline, 10 days), EA (100 mg/kg EA, 10 days), I/R (20 min ischemia followed by 30 min reperfusion, 10 days), and EA + I/R (100 mg/kg EA before I/R). In all animals, electrocardiogram (ECG) was recorded pre-ischemia and postischemia on the first and 11th days, respectively.

    Results

    The I/R group showed an abnormally prolonged QTc interval after ischemia compared to the preischemia and control groups. EA administration in the EA+I/R group significantly reduced this prolonged QTc interval (P< 0.01). In the I/R group, ischemic/reperfusion resulted in a prolonged QRS complex and an elevated ST, which EA significantly prevented (P<0.01). In addition, EA significantly prevented the dramatically shortened RR interval induced by reperfusion (P<0.01). The incidence of ventricular fibrillation significantly increased in the I/R group; then it dramatically decreased following the administration of EA (P<0.0001).

    Conclusion

    EA pretreatment repaired the adverse effects of I/R on the ECG parameters, which can be attributed to its negative chronotropic effects. EA pretreatment can prevent the cerebral I/R-induced heart arrhythmias.

    Keywords: Ellagic Acid, Ischemia, Reperfusion, Arrhythmias
  • Solmaz Azimzadeh, Jafar Sadegh Tabrizi, Shirin Nosratnejad, Mostafa Farahbakhsh, Saber Azami Aghdash, Hossein Mashhadi Abdolahi* Page 21

    Utilization is one of the dimensions of equity in health systems. Identifying the factors affecting utilization of health services can be helpful for interventional purposes. This study systematically reviewed the factors affecting the utilization of inpatient, outpatient, diagnostic, and pharmaceutical services. This systematic review was conducted between 2016 and 2017. The search was performed using keywords based on MeSH in valid databases such as Scopus, Embase, ProQuest, ScienceDirect, PubMed, and Web of Science in the fields of title, abstract, and keyword. Related papers published from 2000 to 2017 were searched. First, the retrieved studies were screened and checked for quality; then, the useful data were extracted and analyzed. Out of the 1178 retrieved publications, 20 studies were included in the final analysis. The identified factors were categorized into 5 areas, including demographic (4 items), socioeconomic (13 items), health services–related (13 items), health status–related (7 items), and health insurance–related factors (2 items), and reported. The findings of this study can be a useful source and a comprehensive body of evidence on the utilization of health services. The results can be used by the policy makers and managers in designing interventions for changing the utilization patterns of health services.

    Keywords: Utilization, Health Services, Inpatient, Outpatient, Diagnostics, Pharmaceuticals
  • Sanaz Jamshidi, Najmeh Hejazi*, Mohammad Taghi Golmakani, Nader Tanideh, Mina Heidari Esfahani Page 22
    Background

    Wild pistachio (Pistacia Atlantica mutica) species with wide distribution in Iran have different nutrition properties and may have therapeutic effects in metabolic syndrome. Metabolic syndrome, as a prevalent health problem, is a main risk factor for different chronic diseases such as diabetes, fatty liver and cardiovascular diseases. The present study aimed to evaluate the preventive effects of mixture, kernel, and hull oil of wild pistachio (WP) on oxidative stress markers, liver function and histopathological findings in metabolic syndrome induced rats.

    Materials and Methods

    After oil extraction by cold press method and chemical analysis, rats were divided into 6 groups. Group 1 received normal saline; group 2 received 2cc fructose solution and 0.5cc normal saline; and groups 3, 4, 5 and 6 received 2 cc fructose solution and 0.5 cc sunflower oil, mixture, hull and kernel oils of WP for 10 weeks, respectively. Then, glycemic indices, oxidative stress, liver enzymes and histopathological examination were determined using standard laboratory tests.

    Results

    WP Kernel and mixture oils notably decreased the fasting blood sugar and insulin resistance compared with the fructose group. Insulin level was significantly increased in the kernel oil group (P<0.05). There was no significant difference in oxidative stress, liver enzymes and histopathology parameters among the groups.

    Conclusion

    Kernel oil of WP improved hyperglycemia, insulin resistance and insulin secretion, but the changes in oxidative stress markers, liver enzymes and histopathologic results were not significant among the groups.

    Keywords: Wild Pistacia, Oils, Liver Function Tests, Insulin Resistance
  • Esmat Radmanesh, Mahin Dianat*, Narges Atefipour Page 23
    Background

    Many risk factors, including nutritional ones, contribute to cardiovascular diseases (CVDs). Increased fructose consumption, for example, can lead to an increase in CVD risk factors, i.e. an increase in blood lipids and the development of insulin resistance.

    Materials and Methods

    In the present study, Sprague Dawley rats were divided into two groups: control group (free access to tap drinking water for seven weeks), and a group that received fructose 10% in drinking water for seven weeks, (n═8 per each group). In all groups, before starting the test period and seven weeks after it, electrocardiogram was recorded by Power lab system. Unpaired t-test and two-way ANOVA were used for data analysis. Also, oxidative stress parameters were measured.

    Results

    In the group received high doses of fructose, a significant reduction (P <0.05) was observed in the PR interval (P<0.001) and a significant increase (P<0.05) in the QTc interval. However, there was no significant change in the RR interval and the voltage of the QRS complex. A significant decrease in catalase, superoxide dismutase and glutathione peroxidase (P<0.05) and a significant increase (P<0.05) in malondialdehyde and lactate dehydrogenase were observed in the group that received fructose in comparison with the control group at the end of the experiment.

    Conclusion

    According to our results, the chance of arrhythmias in the rats receiving high doses of fructose was possibly due to the increased oxidative stress in the healthy rats.

    Keywords: Electrophysiological Parameters, Oxidative Stress, Rat, Fructose
  • Maryam Nasehi, Farshad Ghazalian*, Nader Shakeri, Mohammad Nasehi, Mohammad Reza Zarrindast Page 24
    Background

    Physical exercise is known to have a positive effect on pain responses induced by stress, while chronic stress causes a negative effect on cognitive abilities. Depending on the type, duration, and intensity of the stressor, it can induce analgesia or hyperalgesia. Furthermore, the beneficial effects of traditional Chinese medicine MLC901 on stress processes have been reported. Here, the effects of MLC901 and moderate physical activity on pain response in restraint-stressed mice was investigated.

    Materials and Methods

    Male NMRI mice were used in this study and were restrained in plexiglass mesh restrainers for induction of chronic restraint stress. Treadmill exercise was carried out for moderated exercise, 5 days/week for 4 weeks. MLC901 was intraperitoneally administered in the experimental groups. The pain response of the adult NMRI mice was detected via the hot-plate test.

    Results

    It was showed that intraperitoneal administration of MLC901 dose (0.4 but not 0.1 and 0.2 mg/kg; once/2 days; for 25 days) resulted in the decreased percentage of time in the hot plate, indicating hyperalgesia. Moreover, restraint stress for 3 but not 6 and 9 hours/day elicit hyperalgesia in mice. The data showed that subthreshold dose of MLC901 (0.1 mg/kg) reduced hyperalgesia in 3-day stressed mice. Moderate treadmill running (10 meters/min for 30 min/day, 5 days/ week) potentiated the effect of 6 and 9 days on pain (induced hyperalgesia) that was blocked by MLC901 (0.1 mg/kg).

    Conclusion

    Our findings indicated that subthreshold dose of MLC901 alone or when it associated with moderate exercise decreased hyperalgesia induced by stress, indicating the protective effect of MLC901.

    Keywords: Exercise, Stress, MLC901, Pain, Mice
  • Majid Rezaei Tavirani, Vahid Mansouri, Mostafa Rezaei Tavirani*, Mohammad Rostami Nejad, Davood Bashash, Mona Zamanian Azodi Page 25
    Background

    Severe burns injury can affect several vital systems in the body and can cause inflammation in organs such as the heart, liver, and kidney. Many inflammatory mediators and regulatory hormones related to burn injuries are recognized. In this study, the genes related to burn injury interacted via network analysis, and the central nodes were enriched through gene ontology (GO).

    Materials and Methods

    Disease query of STRING database was used for data gathering, and the network was constructed using Cytoscape software version 3.6.0. After gene screening, the central nodes were enriched via GO analysis by ClueGO. The highlighted genes and pathways were clustered and analyzed in detail.

    Results

    Among 1067 genes, 35 critical genes that are involved in the 14 highlighted biochemical pathways were recognized. Interpretation of the finding indicates that a number of central genes can be considered as potential biomarkers related to burn injury.

    Conclusion

    Can we revise to “Burn injuries have features that are common to several diseases and increases their risk.

    Keywords: Burn, Gene, Biomarker, Protein-Protein Interaction Network, Biochemical Pathway
  • Maryam Bahman, Homa Hajimehdipoor, Soodabeh Bioos, Fataneh Hashem, Dabaghian, Maryam Afrakhteh, Mojgan Tansaz* Page 26
    Background

    Oligomenorrhea is a common complaint in patients with polycystic ovary syndrome (PCOS). There are some useful medicinal recommendations such as Aslagh product (include fennel fruits, carrot seeds, chaste tree fruits) in Iranian traditional medicine for the treatment of oligomenorrhea in PCOS. Hence, the present investigation was designed to compare Aslagh capsule with metformin on the oligomenorrhea.

    Materials and Methods

    One hundred fifty women aged between 18-43 years with oligomenorrhea due to PCOS were randomly divided into Aslagh, metformin, and Aslagh + metformin groups. The occurrence of menstrual bleeding was considered as the primary outcome. Menstrual cyclicity, duration, and volume of the bleeding were also evaluated.

    Results

    Occurrence of menstrual bleeding was 87.2% in all patients, with no significant difference between the three groups (P> 0.05). Menstrual cyclicity significantly improved from baseline in Aslagh and Aslagh+ metformin groups (P=0.02). Duration of menstrual bleeding was significantly higher in Aslagh group in the first and the second menstrual bleeding cycle compared to the other two groups (P<0.05). No significant change was observed in the volume of the bleeding after the intervention in any of the three groups. The occurrence of menstrual bleeding in Aslagh group was significantly (P=0.03) higher than the other two groups in the fourth month (drug-free period).

    Conclusion

    Aslagh capsule showed beneficial effects similar to metformin in the treatment of oligomenorrhea in PCOS women and could be suggested for use as an alternative treatment in these patients.

    Keywords: Aslagh, Polycystic Ovary Syndrome, Iranian Traditional Medicine, Vitex, Oligomenorrheaa
  • Bahareh Kardeh, Alireza Ashraf *, Sina Kardeh Page 27
    Background

    Mechanical neck pain (MNP) is a common health concern. Some studies suggested a relationship between neck pain and visual activity. We assessed the role of myopia as a contributing factor in the development of chronic MNP.

    Materials and Methods

    All medical students at Shiraz University School of Medicine, who were 18 to 22 years old, were invited to participate in this retrospective case-control study from March 2016 to March 2017. Numeric Pain Rating Scale (NPRS) was used to assess the average neck pain severity over the past 6 months in order to enroll participants as the case (≥3) or control (<3) groups. Demographic data and medical profile were obtained. After identifying eligible cases, we assigned age- and sex-matched controls, who also met the study criteria. Subsequently, participants completed the Neck Disability Index (NDI) and Neck Pain and Disability Scale (NPDS) questionnaires and were evaluated for myopia severity. Variables were compared between the case and control groups as well as within the case group. P-value<0.05 was considered statistically significant.

    Results

    From over 700 medical students, around 150 cooperated. Eventually, 31 eligible cases (and 31 controls) were studied. NDI and NPDS were significantly higher in the case group (P<0.001). However, no significant differences were noticed between the groups regarding the severity (P=0.123) and the duration (P=0.417) of myopia. Also, the correlation of myopia severity with NDPS (ρ=0.159, P=0.216) and NDI (ρ=0.201, P=0.116) was non-significant within the case group.

    Conclusion

    Our findings have not supported the influential role of myopia in the development of chronic MNP.

    Keywords: Myopia, Neck Pain, Pain Measurement, Refractive Errors, Visual Acuity
  • Hormoz Karami, Hadi Maleki, Maryam Baghbeheshti*, Mostafa Hashemi, Mehrdad Rouzbeh, Mohammad Afkhami Ardakani Page 28

    The interaction between organs is a crucial part of modern medicine. As a very prerequisite to manage a disease, practitioners should have a full awareness of the related organs. Kidney and heart are two vital organs that are closely interconnected in various fields. These two organs have a lot of common risk factors for making a person unhealthy; therefore, if you prevent the disease in one of them, the other’s morbidity might be alleviated as well. Among them, nephrolithiasis and myocardial infarction (MI) have more risk factors in common, and both could be fatal. Also, these two diseases are important regarding the prevalence, incidence, and burden of disease. Some studies confirm the relationship between MI and nephrolithiasis; however, further researches are needed to discover the exact direction of their relationship. The present review aims to explain the mechanism of MI and nephrolithiasis; clarify the relationship between these two disease based on physiological, pathological, and clinical studies; and propose some solutions for the prevention and treatment of such diseases.

    Keywords: Nephrolithiasis, Myocardial Infarction, Kidney Stone, Cardiovascular
  • Seyedeh Soma Zakariaee, Roonak Shahoei*, Leila Hashemi Nosab, Ghobad Moradi, Mina Farshbaf Page 29
    Background

    Episiotomy or cutting the perineum is the most common operation in obstetrics. Perineal pain is the main complication of episiotomy that affects the quality of life and mental health of the mother. Reducing the pain and side effects of the chemical drugs prescribed for pain relief has attracted the attention of both physicians and scientists. This study was conducted to determine the effects of transcutaneous electrical nerve stimulation (TENS), as an alternative method, on post-episiotomy pain severity.

    Materials and Methods

    This randomized clinical trial was performed on 120 primiparous women who had referred to Sanandaj Besat Hospital in 2018. The patients were divided randomly into three groups, including the intervention group (TENS-On), the placebo group (TENS-Off), and the control group. TENS electrodes were placed near the episiotomy site in genitofemoral and pudendal nerves. The pain was measured after episiotomy in lying, sitting, and activity positions. The pain severity was measured using a pain measurement instrument (numeral rating score) at four-time points, i.e., before the intervention as well as 30, 60, and 120 minutes after the TENS intervention. For data analysis, Pearson correlation, student’s t-test, Kruskal-Wallis test, ANOVA test, and Mann-Whitney U tests were used.

    Results

    Intragroup evaluation results for placebo and control groups demonstrated no significant difference in the pain score (P>0.05). A significant difference was observed between the mean pain severity of the intervention group and that of the group with walking activities (P=0.04). In terms of the intergroup evaluation, there was a significant difference observed between the mean pain severity of the lying position and that of the control group (P=0.008). Regarding the sitting position, no significant difference was observed between its mean pain severity and that of the other two groups (P=0.04).

    Conclusion

    TENS is an effective and safe method for post-episiotomy pain relief and a routine method used in the obstetrics and gynecology ward.

    Keywords: Transcutaneous Electrical Nerve Stimulation, Primiparous, Episiotomy Pain, Postpartum Period
  • Davood Bizari, Hadi Khoshmohabat, Soheila Salahshour Kordestani, Rouhollah Zarepur* Page 30
    Background

    Dialysis access puncture wound bleeding after needle extraction at the end of each hemodialysis session is a very important problem. This study evaluated the effect of HemoFoam® compared to conventional gauze dressing on hemostasis of dialysis access puncture wound bleeding in hemodialysis patients.

    Materials and Methods

    This one-group, before-after, clinical-trial was conducted on 60 hemodialysis patients selected by convenience sampling who underwent hemodialysis through arteriovenous fistula in Shahid Rahnemoon Hospital, Yazd, Iran in 2017. After reviewing the eligibility criteria, the study was performed in two separate sessions. In the first session, only HemoFoam® was used while in the second session; the only conventional dressing was used. Time of hemostasis in each puncture wound was evaluated. Data were analyzed by SPSS 22 (IBM SPSS Statistics for Windows, Armonk, NY: IBM Corp, United States) using paired T-test and Chi-square tests.

    Results

    The mean age of the patients was 55.20±14.25 years. Hemostasis was achieved in 76.6% of cases at the arterial access site in the first two minutes in the HemoFoam® group. The mean homeostasis time in the HemoFoam® group was 2.86±1.87 min at the venous access site and 3.15±1.97 min at the arterial access site (P<0.001). The mean homeostasis time in the conventional dressing group was 10.54±6.65 min at venous access site and 12.74±9.28 min at the arterial access site, which was significantly different between the two groups (P<0.001).

    Conclusion

    HemoFoam® is effective in reducing the time of homeostasis in the vascular access site of hemodialysis patients. Therefore, its use in hemodialysis wards is recommended for hemostasis in the dialysis access puncture wound bleeding.

    Keywords: Hemodialysis Patients, Hemostasis, Hemostatics, Bandages, Arteriovenous Fistula
  • Maryam Rouhani, Malihe Motavasselian, Ali Taghipoor, Parvaneh Layegh, Javad Asili, Shokouh Sadat Hamedi, Shapour Badiee Avval* Page 31
    Background

    The most prevalent endocrine disorder in women of reproductive age is polycystic ovary syndrome (PCOS). The purpose of this study was to evaluate the efficaciousness of a Persian herbal remedy, as well as electroacupuncture and the combination of them on metabolic profiles and anthropometric parameters in these patients.

    Materials and Methods

    Eighty overweight women with PCOS were randomly divided into four groups. All of them received metformin 1000 mg and the second group received 5 g of herbal medicine per day (main components: Foeniculum vulgare, Urtica dioica, and Daucus carota), the third group were subjected to 20 electroacupuncture sessions, and the fourth group received both therapies.

    Results

    After 12 weeks, the body fat and body mass index decreased the most in the herbal medicine+electroacupuncture group, and waist to hip ratio decreased the most in the electroacupuncture group. A significant decrease was also observed in fasting insulin, homeostasis model assessment of insulin resistance. A significant increase was seen in the quantitative insulin sensitivity check index in all intervention groups, but there was no noteworthy difference in these parameters in the control group. Total cholesterol and lowdensity lipoprotein cholesterol decreased significantly in the electroacupuncture groups and herbal medicine+electroacupuncture. Also, a significant decrease was observed in triglycerides, aspartate aminotransferase, and alanine aminotransferase in the herbal medicine groups and herbal medicine+electroacupuncture.

    Conclusion

    It is advisable to use this herbal remedy and electroacupuncture for better treatment of metabolic complications and overweight problems in these patients.

    Keywords: Polycystic Ovary Syndrome, Obesity, Insulin Resistance, Phytotherapy, Electroacupuncture
  • Saeed Sadeghi, Mahdi Jalali*, Mohammad Reza Nikravesh, Mojtaba Sankian Page 32
    Background

    Hyperthyroidism is one of the disorders of the thyroid gland, an organ that controls the cellular and molecular behaviors of the seminiferous tubule basement membrane (BM), and ultimately, influences its evolutionary process. We aimed to investigate the effects of hyperthyroidism on immunohistochemical characteristics and gene expression levels of collagen IV and laminin-α5 in seminiferous tubules BM of Balb/C mice.

    Materials and Methods

    Twenty male Balb/C mice were divided into experimental and control groups. The experimental group received 500 mg/l of levothyroxine (L-thyroxine) diluted in drinking water for two months to inducing hyperthyroidism, which was confirmed by radioimmunoassay. At the end of the study, the mice were sacrificed, and their testes were extracted for immunohistochemistry and real-time polymerase chain reaction assays.

    Results

    Although a weak reaction was observed in the experimental specimens, no significant enhancement was noted in color intensity of type IV collagen in the seminiferous tubules BM of the experimental group as compared to the control group (P>0.05). Collagen IV gene expression results in the experimental group were not significantly different from the controls (P>0.05). Thus, there was a significant increase in laminin α5 gene expression compared to the control group (P=0.016).

    Conclusion

    Considering the key role of collagen IV and laminin-α5 in the seminiferous tubule BM in the testes, the results of this study indicated that hyperthyroidism has important effects on both structures and functions of these two components.

    Keywords: Collagen Type IV, Laminin, Gene Expression, Hyperthyroidism
  • Mona Zamanian Azodi, Mostafa Rezaei Tavirani, Majid Rezaei Tavirani* Page 33
    Background

    Currently, the prevalence of autism spectrum disorder (ASD) is increasing, which widely spurs the interest in the molecular investigation. Thereby, a better understanding of the given disorder mechanisms is likely to be achieved. Bioinformatics suiting protein-protein interactions analysis via the application of high-throughput studies, such as protein array, is one of these achievements.

    Materials and Methods

    The gene expression data from Gene Expression Omnibus (GEO) database were downloaded, and the expression profile of patients with developmental delay and autistic features were analyzed via Cytoscape and its relevant plug-ins.

    Results

    Our findings indicated that EGFR, ACTB, RHOA, CALM1, MAPK1, and JUN genes as the hub-bottlenecks and their related terms could be important in ASD risk. In other words, any expression modification in these genes could trigger dysfunctions in the corresponding biological processes.

    Conclusion

    We suggest that differentially expressed genes could be used as suitable targets for ASD after being validated.[

    Keywords: Autism Spectrum Disorder, Transcriptome, Protein Interaction Maps, Gene Ontology
  • Zoleikha Khoshbakht, Ehsan Khashabi, Laleh khodaie*, Mohammadali Torbati, Farzaneh Lotfipour, Hamed Hamishehkar Page 34
    Background

    Dental plaques as adhesive microbial aggregates on tooth surfaces are considered the first stage of tooth decay as well as gingivitis. Accordingly, the effect of different antimicrobial mouthwashes on removing dental plaques and preventing their formation has been evaluated in various studies. This study aimed to evaluate the efficacy of herbal mouthwashes containing hydro-alcoholic extract of Zataria multiflora (ZM), Frankincense (FR), and a combination of both (ZM+FR) and compare it with chlorhexidine (CHX) mouthwash in subjects with gingivitis.

    Materials and Methods

    In this randomized, controlled, clinical trial a total of 140 patients with gingivitis were divided into four groups including CHX (control group), ZM, FR, and ZM+FR groups. Plaque index (PI), gingival index (GI), and gingival bleeding index (GBI) were measured in days 1, 14, and 21.

    Results

    All three herbal types of mouthwash significantly improved plaque, gingivitis, and gingival bleeding throughout days 14 to 21 (P<0.001). There was no difference between herbal mouthwash with CHX groups. CHX mouthwash showed the most side effects (54.3%), while ZM mouthwash showed the least side effects and the highest consumer satisfaction (5.7% and 94%, respectively).

    Conclusion

    All of the herbal mouthwashes can be good candidates for controlling gingivitis. Comparing with CHX mouthwash, herbal mouthwashes have lower side effects and negligible alcohol content. Among the herbal mouthwashes, ZM outperforms FR and FR+ZM due to its lower side effects and higher levels of patients’ satisfaction.

    Keywords: Frankincense, Zataria multiflora Boiss, Mouthwashes, Chlorhexidine
  • Shabnam Movassaghi, Zahra Nadia Sharifi, Mojtaba Koosha, Mohammad Amin Abdollahifar, Shahrzad Fathollahipour, Javad Tavakoli , Shabnam Abdi* Page 35
    Background

    Skin wounds are a significant public health risk, and treatment of wound remains a challenging clinical problem for medical teams and researchers.

    Materials and Methods

    In the present study, we aimed to investigate the healing effects of honey/polyvinyl alcohol (PVA) hydrogel loaded with erythromycin as wound dressing on skin wounds in rats, based on histological studies. In this study, 60 male Wistar rats, with a 1.5 ×1.5 cm2 diameter full-thickness wounds on the backs were divided into four groups: honey/PVA with the erythromycin hydrogel group, honey group, PVA group, and the control group, with no treatment. Skin biopsies were prepared at days 4, 7, and 14 for microscopic analyses. The stereological analysis, including the mean area of the wound, length of vessels, numerical density of fibroblast, macrophage, basal cell and volume of the epidermis, dermis, and fibrous tissue were performed.

    Results

    Wounds area in the honey/PVA hydrogel with the erythromycin group were significantly (P<0.05) smaller than in the other group. The numerical density of fibroblast, macrophage, basal cell and volume of the epidermis in the honey/PVA hydrogel with the erythromycin group were significantly higher than other groups.

    Conclusion

    According to our results, honey/PVA hydrogel with erythromycin may promote early wound healing and has a positive influence on fibroblast proliferation and re-epithelialization, and its administration is recommended after further validation of clinical data.

    Keywords: Erythromycin, Honey, Polyvinyl Alcohol, Wound Healin
  • Alireza Vakilian, Mohaddaseh Fekri, Habib Farahmand * Page 36
    Background

    Creutzfeldt-Jakob disease (CJD) is a progressive and fatal prion disease in human and its annual incidence is estimated one per million. Sporadic form of CJD is the most common form of the disease that involved 85% of cases.

    Case Report

    We presented two cases of CJD with the different clinical presentation; a 58-year-old woman who referred with amnesia, depression and a 59-year-old woman with ataxia as her chief complaint. Based on the findings and roled-out the other differential diagnosis, the CJD was confirmed. Both of them died before 12 months after diagnosis.

    Conclusion

    Although CJD is a rare disease with different clinical manifestation, it is considered as one the differential diagnosis of progressive dementia.[

    Keywords: Creutzfeldt-Jakob Disease, Incidence, Dementia
  • Maryam Hassanzad, Keyvan Maleki Mostashari*, Hosseinali Ghaffaripour, Habib Emami, Samane Rahimi Limouei, Ali Akbar Velayati Page 37
    Background

    We examined the efficiency and safety of a specific synbiotic compound, brand name Kidilact®, in the treatment of asthma in children 12 years of age or younger.

    Materials and Methods

    This double-blinded, randomized, placebo-controlled clinical trial was conducted in Tehran, Iran, from May 22, 2016, to May 21, 2017. One hundred children, 12 years of age or younger, who suffered from mild to moderate asthma were recruited in this study. The subjects were randomly divided into two groups; the experimental group received a sachet of Kidilact®, and the control group received a sachet of placebo once a day for six months. Both groups were compared in terms of the frequency of asthma attacks that were severe enough to require administration of fast-acting medications, the number of outpatient visits for asthma-related problems, and the frequency of hospitalization due to exacerbated symptoms of asthma.

    Results

    There were fewer complaints of drug-induced side effects, e.g., vomiting, headache, stomachache, and diarrhea, exacerbated cough, and constipation in the experimental group than in the control group. Overall, a significantly greater number of participants in the experimental group were satisfied with the therapeutic intervention than those in the control group, as verified by the participants and their parents/guardians self-report. There was no significant difference between both groups in the frequency of asthma attacks and hospitalization due to exacerbated symptoms of asthma. The only significant difference between both groups was the count of outpatient visits. While the control group made 55 outpatient visits to the hospital, participants in the experimental group visited the hospital only 19 times (P=0.001).

    Conclusion

    Results of our study indicates that synbiotic compound Kidilact® generally alleviates the symptoms of asthma in children of 12 years of age or younger, resulting in less frequent outpatient visits to the hospital due to asthma-related problems while rarely causing any side effects. Due to ease of use, the rarity of side effects, and their indirect positive effects on quality of life of asthmatic patients, we recommend that synbiotics be incorporated in regular treatment and management of children with asthma.

    Keywords: Asthma, Synbiotics, Probiotics, Iran, Kidilact
  • saeed Sardari, Faramarz Fallahi, Fatemeh Emadi, Ali Davati, Narjes Khavasi, Mohammad Gholamifesharaki, Seied Saeid Esmaeili* Page 38
    Background

    Dyslipidemia leads to micro- and macro-vascular complications. Atorvastatin is the main therapeutic drug used for dyslipidemia, but it causes side effects such as new type 2 diabetes mellitus onset and elevation of liver enzymes. Herbs may be useful in reducing atorvastatin doses. Caper fruit, an herbal drug in Persian Medicine, has hypolipidemic effects. Hence, the effect of atorvastatin therapy with and without daily caper fruit pickle (CFP) consumption was assessed on hyperlipidemia.

    Materials and Methods

    In this single-blinded, randomized, controlled trial, 60 hyperlipidemic patients were allocated in two groups and treated with 10 mg atorvastatin plus 40-50 g CFP (A10+CFP) or atorvastatin alone (A10) for eight weeks. Biochemical parameters were measured at baseline, 4, and eight weeks of the intervention. One-way repeated measure ANOVA and mixed ANOVA were used to measure the effect of the two treatments and the interaction between the type of treatment and time on lipid profile.

    Results

    Serum total cholesterol and low-density lipoprotein cholesterol (LDL-C) were significantly decreased in the A10+CFP group compared with the A10 group (P<0.001 and P<0.001, respectively) from baseline up to the week 8. At week 4, mean changes of LDL-C was significantly higher in the A10+CFP compared with the A10 (P=0.01). Adjusting for the baseline variables, the mean difference of alanine aminotransferase (P<0.01) and triglyceride (P=0.003) were significantly higher in the A10+CFP group at the end.

    Conclusion

    This study reports that the intake of CFP along with atorvastatin daily may have synergistic effects which improve the lipid profile in hyperlipidemic patients

    Keywords: Caper, Atorvastatin, Lipid Profile
  • Khadijeh Sarayloo, Robab Latifnejad Roudsari*, Amy Elhadi Page 39

    Female genital mutilation (FGM) is a general health concern. The World Health Organization has recognized it as a condition that endangers women’s health. This review study aimed to identify the types of health outcomes of FGM. Therefore, a systematic review was conducted to create a critical view of the current evidence on the effect of Female genital on girls and women’s health. In this study, we focused on the health risks of female Female genital. Academic databases such as PubMed, Science Direct, Scopus, Google Scholar, Cochrane Database of Systematic Reviews, SID, IranMedex, Irandoc, and Magiran were searched with regard to the health consequences of FGM from January 1990 until 2018. Eleven review studies met the criteria and contained 288 relevant studies on the risks of FGM. It was suggested that FGM had various physical, obstetric, sexual, and psychological consequences. Women with FGM experienced mental disturbances (e.g., psychiatric diagnoses, anxiety, somatization, phobia, and low self-esteem) than other women. Our study can provide evidence on improving, changing behaviors, and making decisions on the quality of services offered to women suffering from FGM.

    Keywords: Female genital, Female, Obstetric Labor Complications, Pregnancy Complications, Emotional Aspects
  • Farhad Jeddi, Shahriar Alipour, Nowruz Najafzadeh, Mehdi Dadashpour, Farhad Pouremamali, Mohammad Reza Sadeghi, Nasser Samadi, Narges Soozangar*, Amir Mahdi Khamaneh Page 40
    Background

    MicroRNAs (miRNAs) play critical roles in different pathological processes including cancer development and progression. To find novel molecular diagnostic and prognostic markers and promising therapeutic tools for gastric cancer (GC), we aimed to investigate the relationship of the expression levels of miR–28–5p or miR–200a–3p with the clinicopathological criteria and to explore their impacts on the progression of human GC.

    Materials and Methods

    Quantitative RT–PCR was performed to analyze miR–28 and miR–200a expression in 60 GC and 60 non–GC tissue samples.

    Result

    Our results revealed that the expressions of miR–200a and miR–28 were significantly downregulated in GC in comparison with non– GC tissues. Tumors with low miR–28 expression had larger tumor size, more advanced histological grade, and a higher incidence of lymph node and distal metastasis than the tumors with high miR–28 expressions. Furthermore, receiver operating characteristic (ROC) analyses demonstrate that the expression of miR–28 is a predictive biomarker allows predicting the histological grade, tumor size, and occurrence of nodal and distal metastases. We also found a significant inverse association between miR–200a expression and the rate of lymph node metastasis (p = 0.010, r = –0.334).

    Conclusion

    Our findings suggest that the miR–28 and miR–200a have tumor–suppressor functions and may be considered as potential biomarkers for gastric cancer diagnosis and prognosis.

    Keywords: Biomarkers, Gastric cancer, miRNA–28, miRNA–200a, Quantitative Real-time PCR
  • Saeid Ziaei, Mostafa Rezaei Tavirani*, Abdolreza Ardeshirylajimi, Ehsan Arefian, Masoud Soleimani Page 41
    Background

    THAP11 is a recently discovered pluripotency factor and described as an important gene that involved in embryonic stem cells self-renewal and embryo development, which works independently with other known pluripotency factors. We aimed to overexpressed the THAP11 gene in primary fibroblast cells to determine the effects of the THAP11 on these cells.

    Materials and Methods

    The THAP11 gene was amplified using PCR followed by ligation into pCDH vector and lentiviral particle production in HEK293T cells by using psPAX2 and pMD2.G helper vectors. The human fibroblast cells were transduced using viral particles and after confirmation overexpression, the key pluripotency factors were estimated using real-time PCR and changes in proliferation rate was measured by the 3-[4, 5-dimethylthiazol-2-yl]-2, 5 diphenyltetrazolium bromide (MTT) test.

    Results

    The overexpression of THAP11 in fibroblast cells leads to increase the expression level of Sox2, Oct4, Nanog and Klf4 as key pluripotency genes and a decrease in proliferation rate according to MTT results.

    Conclusion

    Our results confirm that we are faced with a molecule with double features, which could be involved in pluripotency and proliferation suppressor simultaneously. It seems that the roles of THAP11 in pluripotency are so complex and attributed to other regulatory molecules.

    Keywords: Cell Differentiation, Stem Cells, THAP11 Protein
  • Ali Tavakoli, Meysam Shirzad, Alireza Taghavi, Mohammadreza Fattahi, Mohammadmahdi Ahmadian Attari, Leila Mohammad Taghizadeh, Mahsa Rostami Chaijan, Masih Sedigh Rahimabadi, Rahimeh Akrami, Mehdi Pasalar* Page 42
    Background

    Ulcerative colitis is the most common form of inflammatory bowel disease worldwide, which presents with superficial ulcers in the rectum and colon. The aim of this study was to assess the effectiveness of rose oil soft capsules over placebo on the clinical outcomes in moderate to severe ulcerative colitis.

    Materials and Methods

    This study was a pilot randomized, double-blind clinical trial, and the 40 patients were assigned into rose oil and placebo groups (n=20 per group). All patients were instructed to use their prescribed two soft capsules three times daily for two months. The clinical symptoms, quality of life the patients, and calprotectin level were evaluated via partial Mayo clinic score, irritable bowel disease questionnaire (IBDQ-9), and calprotectin kit as primary outcome measures.

    Results

    The mean age of the participants was 41±10 years. Most of them (53.6%) were male, and the remaining (46.4%) were female. The demographic and baseline data showed no differences between the two groups. Partial Mayo clinic scores decreased in both groups after the treatment, but the difference between the rose oil and placebo groups was not statistically significant (P=0.99). IBDQ-9 score also increased in both interventions before and after the treatment (P=0.012), though the differences between these two groups were not statistically significant (P=0.61). There were no significant differences between the two study groups either in terms of calprotectin level (P=0.219).

    Conclusion

    This study showed that rose oil might improve ulcerative colitis clinical outcomes, but for a better evaluation, it is imperative to conduct experiments with a large sample size and longer follow-up observation.

    Keywords: Ulcerative Colitis, Rose Oil, Clinical Trial, Calprotectin
  • Mostafa Rezaei Tavirani, Mona Zamanian Azodi*, Davood Bashash, Naybali Ahmadi, Mohammad Rostami Nejad Page 43
    Background

    Management of breast cancer (BC) as a heterogeneous disease is very challenging. Biomarker discovery has been shown promising for this aim. Protein interaction mapping could provide further knowledge of the vital roles of these markers.

    Materials and Methods

    Cytoscape and its plug-ins are used for network construction and evaluation. The plug-ins used in this study are STRING, Network Analyzer, GeneMANIA, and CluePedia.

    Results

    The central proteins are enriched in transcription regulatory region DNA binding, regulatory region nucleic acid binding, regulatory region DNA binding, Fc receptor signaling pathway, cell cycle arrest, and immune response-regulating cell surface receptor signaling pathway.

    Conclusion

    The introduced biomarkers and their related biological processes may show useful for the breast cancer diagnosis and monitoring; however, has to encounter more validation studies to be clinically applicable.

    Keywords: Breast Neoplasms, Protein Interaction Maps, Algorithms, Gene Ontology
  • Ali Razei, Abdol Majid Cheraghali, Mojtaba Saadati*, Mahdi Fasihi Ramandi, Yunes Panahi, Abbas Hajizade, Seyed Davar Siadat, Ava Behrouzi Page 44
    Background

    Final elimination of some intracellular bacterial agents, such as Brucella, is often a complex issue and impossible to achieve, primarily due to the presence and survival of the bacteria within phagocytic cells. By penetrating into the cell membrane, drug delivery nanosystems can reduce the number of intracellular bacteria. The aim of this study was to assess the efficacy of chitosan nanoparticles on the delivery of gentamicin into Brucella infected J774A.1 murine cells in vitro.

    Materials and Methods

    Chitosan nanoparticles (NPs) were synthesized using ionic gelation technique. The shape, size and charge of NPs, loading rate and release of the drug were investigated. Finally, the effects of gentamicin-loaded chitosan NPs (Gen-Cs) and free gentamicin on J774A.1 murine cells infected with these bacteria were examined.

    Results

    The mean size and charge of NPs were computed as 100 nm and +28mV, respectively. The loading capacity of NPs was 22%. About 70% of the drug was released from NPs during the first 8 hours. Antimicrobial activity of the two formulations showed that MIC (minimum inhibitory concentration) of the Gen-Cs and free drug was 3.1 and 6.25 µg, respectively. The minimum bactericidal concentration of the NPs-loaded drug and free drug was 6.25 and 12.5 µg, respectively. Cell culture analysis revealed that there was a significant reduction in the load of the intercellular bacteria in J774A.1 murine cells in both formulations.

    Conclusion

    Our results showed the Gen-Cs have a proper potential for optimal treatment of intracellular bacterial agents.

    Keywords: Brucella melitennis, Brucella abortus, Chitosan, Gentamicin, Nanoparticles
  • Mohammad Ali Davarpanah, Amirreza Dehghanian, Ali Akbari, Behnam Dalfardi * Page 45
    Background

    Cutaneous leishmaniasis (CL) is the most form of leishmaniasis that caused by intracellular parasites, Leishmania.

    Case Report

    A 39-year-old woman, known case of HIV infection, presented with a 6-month history of skin lesions initially on her face, then extending onto the chest, abdomen, and extremities. Laboratory examinations revealed leukopenia and a CD4 cell count of 280 cells / mm3. A biopsy was taken from skin lesions, and histopathological studies showed aggregates of macrophages filled with numerous Leishman bodies, the diagnosis of diffuse CL was confirmed. Consequently, she received liposomal amphotericin B (total dose of 40 mg/kg) as a case of diffuse CL. The skin lesions showed significant improvement after completion of treatment.

    Conclusion

    Diffuse CL should be considered as a differential diagnosis in all patients with diffuse skin lesions mainly in the cases that suffer from disorders of cell-mediated immunity.

    Keywords: HIV, Infectious Disease Medicine, Leishmaniasis, Skin Diseases
  • Sina Kardeh*, Bahareh Kardeh Page 46

    From ancient times to the era of industrialization, medical and philosophical scholars have long been wondering about the nature and the underlying mystery of cancer. Despite the extensive efforts in recent decades trying to shed light on the true histopathologic basis of malignancies, many questions remain to be elucidated. Thus, it’s not surprising that even the most notable predecessor physicians knew only very little about cancer and metastasis. In this paper, we present a brief review of the historical assumptions about the origin and spread of tumoral growths. Subsequently, we will look at an impressing notion by Avicenna about the possibility of local metastasis, which had remained unacknowledged so far and highlights the intellect of this great Persian physician even further.

    Keywords: Avicenna, Breast, Cancer, Metastasis
  • Mohammad Nouri, Fereshteh Farajdokht, Mohammadali Torbati, Fatemeh Ranjbar, Sanaz Hamedyazdan, Mostafa Araj khodaei*, Saeed Sadigh Eteghad Page 47

    Pharmacological researches in the area of herbal medicine have considerably increased over the last two centuries. Echium amoenum (known as Gol-e-Gavzaban in Persian) is a medicinal plant that has been widely used in Iranian folk medicine. In this review, databases including PubMed, Scopus, and Google Scholar were searched up. Data collecting was completed by January 2019 and available scientific reports regarding the processing methods, main chemical constituents, and effects of E. amoenum on different neuropsychiatric disorders are summarized. Thirteen five studies met the inclusion criteria. According to results, the important phytochemicals of the plant was phenolic compounds, fatty acids, rosmarinic acid, anthocyanidins, and flavonoids. Also, experimental and clinical studies demonstrated the effectiveness of E. amoenum in the treatment of several neuropsychiatric disorders such as anxiety, depression, ischemic stroke, seizure, Alzheimer’s disease, and pain. Many of these effects are, at least in part, due to its rosmarinic acid or polyphenolic compounds such as flavonoids and natural pigments such as anthocyanins. Also, fatty acids such as gamma-linolenic acid play critical role in neuroactive properties of this herb. Among these effects, only the antidepressant and anxiolytic properties of the plant extract have been examined both experimentally and clinically. There was some controversy over its toxicity effects. It seems that E. amoenum protects neurons via attenuation of oxidative stress and inflammation as well as blocking of apoptosis in the nervous system. However, more studies are necessary for assessing exact mechanisms of action in neuropsychiatric disorders, finding of bioactive ingredients, and processing methods of this plant.

    Keywords: Echium amoenum, Rosmarinic Acid, Phenolic Compound, Antioxidant, Anti-inflammatory, Neuropsychiatric Disorders, Persian Medicine
  • Maryam Massaeli, Masoud Shahabian* Page 48
  • Babak Pezeshki, Ehsan Bahramali*, Amir Ansari, Aliasghar Karimi, Mohammad Sabet, Mojtaba Farjam, Azizallah Dehghan Page 49
    Background

    Diabetes mellitus (DM) is a common metabolic disease worldwide and has many complications. Vascular events are the major complication of DM, which have an important effect on mortality and disability. Physical activity (PA) enhances the vascular function by several pathways. The aim of this study was to evaluate the relationship between PA and vascular diseases in patients with DM.

    Materials and Methods

    This study was performed as a case-control study extracted from a prospective epidemiological research study in Iran. Patients with type 2 DM for more than six months as a case group were compared to sex- and agematched healthy control subjects. The metabolic equivalent of task score was used to evaluate the level of PA and blood glucose, lipid profile, body mass index, overweight, dyslipidemia, glomerular filtration rate, myocardial infarction, unstable angina, and stroke.

    Results

    Overall, 1242 patients with DM were extracted, and 2484 non-DM subjects were investigated. In the case group, 355 (28.6%) and 887 (71.4%) subjects were men and women, respectively, and 710 (28.6%) men and 1774 (71.4%) women were in the control group. The mean metabolic equivalent of task score was 30 and 40.97 in the DM and non-DM groups, respectively (P˂0.001). The frequency of myocardial infarction, stroke, and cardiac ischemia was 44 (3.5%), 37 (3%), and 267 (21.5%) in the DM group, and 54 (2.2%), 43 (1.7%), and 389 (15.7%) in the non-DM group, respectively.

    Conclusion

    The incidence of vascular events associated with PA level in patients with DM and adherence to regular PA reduced vascular events and DM complications.

    Keywords: Physical Activity, Diabetes Mellitus, Vascular Diseases, Myocardial Infarction, Stroke
  • Anahid Safari, Afshin Borhani Haghighi, Mehdi Dianatpour, Seyed Taghi Heydari, Farzaneh Foroughinia, Gholamhossein Ranjbar Omrani* Page 50
    Background

    Both vitamin D and inflammation were investigated as important players in the pathogenesis of postmenopausal osteoporosis. This study compared vitamin D, inflammatory the biomarkers serum levels and their association with bone mineral density (BMD) in case and control groups to evaluate the possible immune-regulatory effect of vitamin D in this population.

    Materials and Methods

    Participants in post-menopausal age, were categorized to 44 osteoporotic vs. 44 healthy aged-matched women according to WHO criteria. Total BMD, T- scores, Z-scores as well as fracture risk were measured in both groups, using Hologic system Dual-energy X-ray absorptiometry (DEXA). Serum 25-OH vitamin D, high sensitive CRP (hs-CRP) and serum amyloid A (SAA) were compared between groups. The association between serum biomarkers level and BMD were also investigated. The same evaluations were performed for vitamin D deficient (<20 ng/mL) and non-deficient (≥20 ng/mL) subgroups.

    Results

    Vitamin D deficiency was higher in the osteoporotic group (32.6%) in comparison with the control group (25.6%), but the differences were not significant (P=0.47). There were no significant differences in serum levels of hs-CRP and SAA (P=0.83 and P=0.39) as well. No significant association between serum inflammatory biomarkers, vitamin D, and BMD were detected (P≥0.05). The results were the same for vitamin D deficient and non-deficient subgroups (P≥0.05).

    Conclusion

    In the current study, the beneficial effects of vitamin D as a result of its immune-regulatory mechanisms was not reached. Larger scale studies might pave the way to define vitamin D benefits in postmenopausal osteoporosis.

    Keywords: Osteoporosis, Postmenopausal, Vitamin D, C-Reactive Protein, Serum Amyloid A Protein, Bone Density
  • Mahmoud Osanloo, Mohammad Mehdi Sedaghat, Alireza Sanei Dehkordi, Amir Amani* Page 51

    Mosquito-borne diseases are currently considered as important threats to human health in subtropical and tropical regions. Resistance to synthetic larvicides in different species of mosquitoes, as well as environmental pollution, are the most common adverse effects of excessive use of such agents. Plant-derived essential oils (EOs) with various chemical entities have a lower chance of developing resistance. So far, no proper classification based on lethal concentration at 50% (LC50) has been made for the larvicidal activity of EOs against different species of Aedes, Anopheles and Culex mosquitoes. To better understand the problem, a summary of the most common mosquito-borne diseases have been made. Related articles were gathered, and required information such as scientific name, used part(s) of plant, target species and LC50 values were extracted. 411 LC50 values were found about the larvicidal activity of EOs against different species of mosquitoes. Depending on the obtained results in each species, LC50 values were summarized as follows: 24 EOs with LC50 < 10 µg/mL, 149 EOs with LC50 in range of 10- 50 µg/mL, 143 EOs having LC50 within 50- 100 µg/mL and 95 EOs showing LC50 > 100 µg/mL. EOs of Callitris glaucophylla and Piper betle against Ae. aegypti, Tagetes minuta against An. gambiae, and Cananga odorata against Cx. quinquefasciatus and An. dirus having LC50 of ~ 1 µg/mL were potentially comparable to synthetic larvicides. It appears that these plants could be considered as candidates for botanical larvicides.

    Keywords: Volatile Oil, Pesticides, Aedes, Anopheles, Culex
  • Marzieh Ashrafmansouri, Fatemeh Sadat Sadjjadi, Seyyedjavad Seyyedtabaei, Ali Haghighi, Mostafa Rezaei Tavirani, Nayebali Ahmadi* Page 52
    Background

    Leishmania major and Leishmania tropica are the main causative agents of cutaneous leishmaniasis. Proteomics as a novel approaches could be used to evaluate protein expression levels in different stages of Leishmania species. We compare the protein contents of amastigote-like forms in L. tropica and L. major using two-dimensional gel electrophoresis (2-DE) and bioinformatics methods.

    Materials and Methods

    Leishmania parasites were isolated from the lesions of Iranian patients and identified using restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR). Five isolates of each two species were cultured in specific media to obtain amastigote-like forms to be prepared for proteomics study. Total protein contents were separated using 2-DE. The gels were stained by silver nitrate and scan was imaged. The protein spots with different expression changes in each gel were analyzed using Progenesis SameSpots software.

    Results

    A total of 354 protein spots were detected in both amastigote-like forms. Comparative analysis of protein spots with different expressions in the two amastigote-like form species showed 173 highly expressed spots of which 74 L. tropica and 99 L. major proteins were spotted with fold≥2. Also, 16 and 20 new protein spots were uniquely found in L. tropica and L. major, respectively. Clustering of different detected proteins using correlation analysis divided the proteins into two clusters based on their expression level. Furthermore, clustering results were confirmed by principal component analysis.

    Conclusion

    Using proteomics methods specially 2-DE and statistical analysis demonstrated significant changes in protein expression levels in amastigote-like forms of L. tropica and L. major isolates.

    Keywords: Leishmaniasis, Proteomics, Leishmania Major, Leishmania Tropica, Two-Dimensional Gel Electrophoresis
  • Bagher Pahlavanzade, Farid Zayeri, Taban Baghfalaki, Farzad Hadaeg, Davood Khalili, Mohammad Shoaib Hamrah, Edwin Paul, Fereidoun Azizi, Alireza Abadi* Page 53
    Background

    Lipid abnormalities are major risk factors of death from cardiovascular disease (CVD). As well as, lipid markers are time-dependent covariates that change with aging. Previous cohort studies have only investigated baseline measurements of lipid markers on CVD mortality.

    Materials and Methods

    The study sample consisted of 4,148 individuals aged over 40 years. Total cholesterol (TC), LDL-cholesterol (LDL-C), and HDL-cholesterol (HDL-C) were measured in five phases. A joint model analysis was used to investigate the association between each longitudinal lipid markers and CVD mortality in men, women and pooled sample. All analysis was performed using the survival and joint modeling packages in R 3.3.3.

    Results

    Totally, 233 CVD deaths occurred during a median follow-up of 12.4 years. For men, CVD mortality increased by 28% (confidence interval [CI]: 14%,44%) for a 10% increased in TC. For women, CVD mortality increased by 43% (CI: 22%, 68%) and 21% (CI:7%, 37%) for 10 % increase in TC and LDL-C and decreased by 18% (CI:7%, 27%) for a 10% increase in HDL-C.

    Conclusion

    Association of lipid ‎markers with CVD mortality is different in men and women, such that high levels of TC ‎and ‎LDL-C and low levels of HDL-C are risk factors of CVD mortality in women, but only TC is a risk ‎factor of CVD mortality in men.

    Keywords: Cardiovascular Diseases High-Density Lipoprotein, Low-Density Lipoprotein, Survival Analysis, Longitudinal Studies
  • Mahsa Moazen, Zohreh Mazloom*, Farideh Jowkar, Nasrin Nasimi, Zahra Moein Page 54
    Background

    Acne vulgaris is a dermatological disorder that is related to inflammation and oxidative stress. Recent studies have also suggested diet as a potential reason for acne. Considering the inconsistency of the few previous reports, the present study aimed to determine the levels of vitamin D, adiponectin, oxidative stress, lipid profile and nutrient intakes in females with acne.

    Materials and Methods

    Forty females with acne vulgaris and 40 age-matched healthy females were included in this study in Shiraz, Iran. Data on their sociodemographic status, acne history, and anthropometric indices were collected. Blood samples were taken to determine the levels of 25-hydroxyvitamin D, adiponectin, malondialdehyde, total antioxidant capacity, and lipid profile. Three 24-hour dietary recalls were also obtained from each of the individuals to evaluate nutrient intakes. Data were analyzed using the Chi-square test, Independent-samples t-test or Mann–Whitney U-test, and Logistic Regression.

    Results

    Patients with acne had a significantly higher family history of acne compared to controls (P=0.006). Serum level of malondialdehyde was significantly higher in cases (P=0.01), while high-density lipoprotein cholesterol was significantly lower (P=0.02). Moreover, significantly lower fiber intake was observed in cases compared with controls (P=0.007). In the multivariate analysis, a family history of acne and increased malondialdehyde levels were risk factors for acne, whereas a higher fiber intake was protective.

    Conclusion

    Family history of acne, oxidative stress, dyslipidemia, and lower dietary fiber intakes may play a role in acne pathogenesis. An early assessment of these parameters may be useful for planning treatment procedures.

    Keywords: Acne Vulgaris, Anti-Inflammatory Agents, Oxidative Stress, Lipids, Nutrition Assessment
  • Marzieh Shahpari, Hadi Aligholi, Mohammad Reza Namavar, Farzaneh Vafaee, Masoumeh Emamghoreishi* Page 55
    Background

    There is no universally accepted behavioral scoring to define the early development of pentylenetetrazole (PTZ) kindling. Therefore, studies investigating alterations of neurogenesis in the PTZ model were mainly focused on full kindled animals rather than early stages of kindling. This study aimed to determine an appropriate behavioral index for categorizing stages of PTZ kindling progress and to evaluate neurogenesis during PTZ kindling.

    Materials and Methods

    Twenty-four mice were intraperitoneally injected with a sub-convulsive dose of PTZ (40mg/kg) every other day until they became full kindled. The first occurrence of different seizure behaviors and their durations were recorded during kindling development, and the different stages of kindling were categorized. Neurogenesis was evaluated in the lateral subventricular zone (SVZ) at each stage of kindling by immunofluorescence staining.

    Results

    First occurrence of restlessness, motionless staring, hind limb tonic extension, Straub’s tail, myoclonic jerk, and tonic-clonic were sequentially observed in more than 80% of animals with increasing PTZ injections. The duration of the myoclonic jerk was significantly longer than the other seizure behaviors. The significantly higher percentage of BrdU-positive cells was found in SVZ of mice showing tonic-clonic in comparison to other seizure behaviors.

    Conclusion

    A hierarchy behavior was observed during the kindling process when considering the first occurrence of seizure behaviors. We defined the first occurrence of restlessness, motionless, hind limb tonic extension and Straub’s tail behaviors as an early phase, myoclonic jerk as a borderline phase and tonicclonic as a late phase of PTZ-induced kindling. Our results indicated an enhanced SVZ neurogenesis at the late phase of kindling.

    Keywords: Neurogenesis, Kindling, Subventricular Zone, Pentylenetetrazole, Seizure Behavior
  • Abdulaziz Almalki*, Abdullah Almalki, Abdullah Kokandi, Bandar Aldosari, Abdulaziz Bin Baz, Shoog Alfadhel, Abdulaziz Alsuwayyigh, Rgad Alsadoun, Bandar Haddad Page 56
    Background

    Depression, which is characterized by persistent sadness, is a highly prevalent and serious medical disease that affects more than 300 million individuals worldwide. It is hypothesized that the onset of depressive symptoms in medical students occurs due to prolonged exposure to the stressful environment of medical colleges. Hence, we aimed to determine the presence of depressive symptoms and compare the level of depression between the first-year and fifth-year medical students in Riyadh city, Saudi Arabia.

    Materials and Methods

    This cross-sectional study was performed with convenient sampling from 2 medical colleges in Riyadh in the Kingdom of Saudi Arabia from October to November 2017. The English version of Beck’s Depression Inventory questionnaire was used in this study. Statistical analysis was administered using SPSS via chi-square test, and P-value less than 0.05 was considered statistically significant.

    Results

    The questionnaire was answered by 241 participants. The age variable shows a bimodal distribution. The mean age of first-year and fifth-year students was 19±0.8 years and 23±2.1 years, respectively. Fifth-year students comprised 53.5% of the total sample, and male students accounted for 63.1% of the total sample. After analysis, the results show that male students scored higher than female students on the lower side of the scale in both years. Most of the firstyear female students scored a higher level of depression compared with male students (P=0.001), whereas no difference between males and females (P=0.04) was found in the fifth-year students’ data.

    Conclusion

    Our study shows a new pattern of reported depressive symptoms among first- and fifth-year medical students. In addition, the study suggests that depression is more common in female medical students as compared with their male counterparts. For future studies, we recommend using randomized sampling in a cohort study including all levels of medical students to further investigate and confirm the findings.

    Keywords: Depression, Medical Students, Cross-Sectional, Beck’s Depression Inventory Questionnaire, Saudi Arabia
  • Nayereh Sadat Roohollahi, Iravan Masoudi Asl*, Somayeh Hessam, Mahmoud Mahmodi Page 57
    Background

    The concept of empowerment requires the abandonment of traditional models. The need to design and develop employee empowerment patterns has been emphasized in several studies. The present study aims to design a comprehensive structural-psychological empowerment pattern for employees of medical sciences universities.

    Materials and Methods

    Our exploratory research was conducted on 410 employees of medical universities of Tehran, Iran, and Islamic Azad University. Firstly, a primary pattern was designed according to a review of available literature, texts, patterns, and tools. Then, the psychometric analysis was done using validation (face validity, content validity, construct validity, factor validity) and reliability (internal consistency and stability). Lastly, the final pattern was introduced after having been approved by experts. Data were analyzed using SPSS version 24 and AMOS made by USA IBM software. P<0.05 was considered as the significance level.

    Results

    Based on our study, 83.9% of participants were holders of bachelor’s degrees or higher degrees. The results of validation (face, content, structure, and confirmation validity) and reliability (internal consistency [α=0.90] and stability [0.91] ) showed that the structural-psychological empowerment pattern was appropriate, which was validated with 31 items and 8 domains. The scope of this pattern included resources, self-sufficiency, competence, support, effectiveness, and opportunity, significance, and information domains. The highest impact on the model was related to the support domain (impact factor=0.87).

    Conclusion

    The present pattern is an appropriate and verified Iranian model in the field of structural-psychological empowerment, which is suggested in the cultural context of Iran, especially in medical universities.

    Keywords: Pattern, Empowerment, Employee, University
  • Zahra Abpeikar, Mostafa Soleimannejad, Akram Alizadeh * Page 58

    Osteoarthritis is one of the most common chronic diseases, which have involved 250 million people around the world. One of the challenges in the field of cartilage tissue engineering is to provide an adequate source of chondrocytes to prevent changes in gene expression profile as a result of multiple passages.We hypothesized that by creating a low invasive lesion by scalpel or shear laser in the outer ear cartilage and stimulation of wound healing process, hyperplasia occurs and will provide an appropriate number of autologous chondrocytes for extraction and use in articular cartilage tissue engineering. Also, due to the effect of platelet-rich plasma and biomechanical forces in stimulating and accelerating of the repair process, these two factors can be used to achieve more desirable results.We describe a new approach to proliferate chondrocytes in the body. To evaluate this idea, various techniques of gene expression at the level of RNA or protein and animal experiments for histological studies can be used. Also, flowcytometry technique can be used to determine the cell viability and counting them.The use of autologous cell sources with minimal changes in gene expression profile can be promising in tissue engineering products.

    Keywords: Chondrocyte, Cell Proliferation, Cartilage, Tissue Regeneration, Osteoarthritis
  • Masoud Hashemi, Payman Dadkhah, Mehrdad Taheri, Mahshid Ghasemi, Ali Hosseinpour*, Mojtaba Farjam Page 59
    Background

    Cervical radiculopathy caused by disc herniation is a frequent public health issue with economical and socio-professional impacts. The objective of the present study is to evaluate the patient-reported outcomes and satisfaction from cervical epidural steroid injection during a 2-year follow-up.

    Materials and Methods

    Results based on patients’ reports from a previously performed intervention of cervical epidural steroid injection on patients with cervical radiculopathy due to cervical disc herniation are prospectively collected. Outcome measures are Neck Disability Index (NDI), numerical rating scale (NRS) for pain assessment, and 5-scale patient satisfaction questionnaire (PSQ) plus opioid medication for pain relief, additional injections, and progression to surgery.

    Results

    Of total 37 cases, 34 were available for follow-up after 2-year postoperatively. The mean preoperative NDI was 21.17 and improved to 17.38, and the mean NRS was 7.7 and improved to 5.00; both were statistically significant. Mean patient satisfaction after 2 years was 3.17 out of 5. 11 cases needed additional injections, and 4 of patients proceeded to surgery.

    Conclusion

    We showed that transforaminal cervical epidural steroid injection for cervical radiculopathy is an effective non-surgical treatment option, providing significant pain relief and functional improvement during 2-years follow-up along with higher-than-average patient satisfaction in most of our patients.

    Keywords: Radiculopathy, Neck Pain, Steroids, Injection, Epidural, Pain Management
  • Soheil Azizi, Amir Shamshirian, Reza Alizadeh, Navaei, Hamed Jafarpour, Zatollah Asemi, Omid Reza Tamtaji, Mohammad Sadegh Vaziri, Reza Homayounfar, Arash Rezaei Shahmirzadi, Reza Alipoor* Page 60

    Methylenetetrahydrofolate reductase (MTHFR) is an enzyme that plays a crucial role as a methyl-group donor in demethylation of homocysteine. The aim of this systematic review and meta-analysis was to study the relationship between MTHFR gene polymorphism and metabolic syndrome (MS). We used search engines and databases such as Science Direct, Google Scholar, Embase, Cochrane Library, and PubMed to identify eligible studies up to 2018. The articles were studied based on keywords including MTHFR, mutation, variant, and polymorphism in combination with MS. Data was analyzed using Comprehensive Meta-Analysis version 2.2.064 software. After extracting the data from seven articles, the total number of subjects was 1280 in the patient group and 1374 in the control group. The odds ratio was estimated to be 1.078 for the allele model of T vs. C (95% confidence interval [CI]: 1.626-0.715), 1.157 for the allele model of CC vs. CT (95% CI: 0.829-1.615), 1.020 for the allele model of CT + TT vs. CC (95% CI: 1.611-0.646) and 0.799 for the allele model of TT vs. CC + CT (95% CI: 1.1850.539). As well, the results showed no statistically significant correlation between polymorphism genotypes of the MTHFR gene and MS (P<0.05). In general, this study showed that the presence of C677T polymorphism in the MTHFR gene has no effect on the incidence of MS.

    Keywords: MTHFR, Metabolic Syndrome, Polymorphism, Variant, Meta-Analysis, Methylenetetrahydrofolate Reductase
  • Amir Hossein Zarifkar, Asadollah Zarifkar*, Mohammad Nami*, Ali Rafati, Hadi Aligholi, Farzaneh Vafaee Page 61
    Background

    Treatment of Alzheimer as a disease that is associated with cognitive impairment has been associated with some restrictions. Recently, researchers have focused on non-pharmacological treatments, including non-invasive stimulation of the brain by transcranial electrical stimulation (tES). Four main paradigms of transcranial electrical current include transcranial direct current stimulation (tDCS), transcranial alternative current stimulation (tACS), transcranial random noise stimulation (tRNS), transcranial pulse current stimulation (tPCS). The tDCS is a possible new therapeutic option for patients with cognitive impairment, including Alzheimer disease.

    Materials and Methods

    The study was done on Sprague-Dawley male rats weighing 250-270 g. to develop Alzheimer’s model, the cannula was implanted bilaterally into the hippocampus. Aβ 25-35 (5μg/ 2.5µl/day) was microinjected bilaterally for 4 days. Then, an electrical stimulation paradigm was applied to the animal for 6 days. Animal cognitive capacity was evaluated on day 11 and 12 by novel object recognition (NOR) test.

    Results

    Our results showed that application of tDCS; tACS; tRNS and tPCS reversed beta-amyloid-induced impairment (P<0.05). The tRNS Group spent total exploration time around the objects compared to other groups (P<0.05). There was no significant difference between the four different paradigms in discrimination ratio and the percentage of total exploration time.

    Conclusion

    The results of this study showed that the use of multiple sessions of different tES paradigms could improve Aβ-induced memory impairment in the NOR test. Therefore, based on evidence, it can be expected that in addition to using tDCS, other stimulatory paradigms may also be considered in the treatment of AD.

    Keywords: Alzheimer Disease, Memory, Cognitive Impairment, Novel Object Recognition Test, tES
  • Seyyedeh Seddigheh Hassani, Faramarz Fallahi Arezodar, Seyyed Saeid Esmaeili, Mohammad Gholami Fesharaki Page 62
    Background

    Diabetes mellitus is a major cause of death globally. It causes multiple problems in various organs and incurs heavy costs for patients and the community health system.The present study was conducted to evaluate the effect of fenugreek intake on fasting blood sugar (FBS), HbA1C, body mass index (BMI), waist circumference, blood pressure and quality of life of type 2 diabetes mellitus (T2DM) patients.

    Materials and Methods

    This randomized, double-blinded clinical trial study was conducted on patients with T2DMin Tehran, Iran in 2018. The treatment group received 5 g of fenugreek powder,and the placebo group received 5 g of wheat flour twice daily for two months before meals.

    Results

    This study was performed on 62 patients (50% male and 50% female). Both groups had similar demographic characteristics. The results showed a significant difference between the mean FBS (P<0.001), HgA1C (P<0.001), BMI (P<0.001), waist circumference (P<0.001), diastolic blood pressure (P=0.005), and quality of life (P=0.015). There was no significant difference in mean systolic blood pressure (P=0.189) between groups.

    Conclusion

    Given the positive effect of fenugreek on FBS, hemoglobin, HbA1C, BMI, waist circumference, blood pressure and quality of life, it can be recommended for controlling blood glucose in diabetic patients

    Keywords: Fenugreek Seed Meal, Diabetes Mellitus, Blood Glucose, Glycated Hemoglobin A
  • Khadijeh Sarayloo, Zahra Behboodi Moghadam, Khadijeh Mirzaii Najmabadi*, Sharon Elizabeth Millen , Mohsen Saffari Page 63
    Background

    It is essential to provide key information and support to every woman regarding pregnancy and childbirth to enable all women to make a fully informed decision regarding their choice to reproduce. Of particular importance; however, is that women who suffer from a specific condition that increases risks associated with reproduction, to receive specific information regarding such risks and health complications regarding pregnancy and childbirth. This study aims to explore the feelings, experiences, and needs of women with minor thalassemia in relation to childbearing.

    Materials and Methods

    This sample comprised of 12 Iranian women with minor thalassemia who attended to local health centers in Minudasht, Golestan province, from October 2017 to January 2018. The purposeful sampling technique was employed. The data were collected through deep semi-structured interviews, analyzed using conventional content analysis and processed by using the Graneheim and Lundman method.

    Results

    The findings were based on the participants’ experiences of pregnancy and fertility. Three major themes emerged; ‘Emotional and Physical Experience,’ ‘Satisfaction’ and ‘Social and Cultural Issues.’ The most common problem identified was the impact of emotional problems and difficulties regarding the negative implications of thalassemia on reproduction as well as the views and perceptions of family members and those within the community.

    Conclusion

    From the findings, it is evident that thalassemia imposes a heavy psychosocial burden on those women who suffer from the condition. Local health centers in areas most affected by thalassemia would be considered the most suitable venues to introduce key health educational interventions.

    Keywords: Thalassemia, Pregnancy, Qualitative Research, Iran
  • Mehdi Azizmohammad Looha, Mohamad Amin Pourhoseingholi, Seyyed Vahid Hosseini, Soheila Khodakarim * Page 64
    Background

    Colorectal cancer (CRC) is one of the most important causes of morbidity and mortality worldwide. This study aimed to determine the effect of measurement error of risk factors on the cure fraction of CRC patients.

    Materials and Methods

    This study was conducted using the medical records of 346 patients with CRC, who were followed up between 2006 and 2017 in Shiraz, Iran. In our data, lymph node ratio (LNR) was a characteristic measuring with error. This variable was used in the model with 0.04 and 0.8 of error variance. Nonmixture nonparametric cure rate model and its corrected forms, simulation-extrapolation (SIMEX) and corrected score (CS), were applied to the data.

    Results

    In noncured cases, the mean survival time was 1115.45 (95% confidence interval, 1043.60-1187.30) days. The 1-, 3-, and 5-year survival rates were 0.93, 0.71, and 0.65, respectively. The proportion of cured patients was 65.2%. The SIMEX method did not change the effect of LNR substantially on cure fraction as compared with the naive method when the variance of measurement error was 0.04 and 0.80. The CS method changed the effect of LNR on cure fraction even when the variance of measurement error was 0.04.

    Conclusion

    The best method to assess the effect of LNR on cure fraction was the naive method, and the CS method was not deemed to be a valid method to correct the measurement error in LNR.

    Keywords: Colorectal Cancer, Errors, Survival Rate, Survival Analysis
  • Ali Aminian, Seyde Sedighe Yousefi* Page 65
  • Elham Shami, Jafar Sadegh Tabrizi, Shirin Nosratnejad* Page 66

    Insurance organizations are among the most influential organizations in the health system, which can lead to healthcare efficiency and patient satisfaction in case they are increasingly accessed. The main purpose of the present systematic review was to examine the effect of health insurance on the utilization of health services and also to examine the factors affecting it. The present study was a systematic review that aimed to examine the effect of health insurance on the utilization of health care services. The study was conducted in 2016 using Scopus, PubMed, Web of Science, Science Direct, and ProQuest databases. We examined the utilization rate of health insurance in insured people. The inclusion and exclusion criteria were included based on review and meta-analysis purposes. The utilization of health services increased for inpatient and outpatient services. The utilization rate of inpatient services increased by 0.51% whereas the utilization rate of outpatient services increased by 1.26%. We classified the variables affecting the utilization rate of insurance into three main categories and sub-categories: demographic variables of the household, socioeconomic status, and health status. Our study showed that insured people increased the utilization rate of health services, depending on the type of health services. Thus, health policymakers should consider the community’s health insurance as a priority for health programs. For now, implementing universal health insurance is a good solution.

    Keywords: Health Care Utilization, Health Insurance, Inpatient, Outpatient Care
  • Mohammad Rostami Nejad, Reza vafaee, Mohammad Javad Ehsani Ardakani, Nika Aghamohammadi, Aliasghar Keramatinia, Saeed Abdi *, Hamideh Moravvej Page 67
    Background

    Celiac disease (CD) is an immunological intestinal disorder, which is characterized by response to gluten. In addition to the environmental factors and dysbiosis of the gut microbiota, genetic susceptibility has an important role in the pathogenesis of this multifactorial disorder. Therefore, this study aims to present the crucial involved genes in CD pathogenesis.

    Materials and Methods

    In this bioinformatics analysis study, significant differentially expressed genes of intraepithelial lymphocytes (IELs) samples of celiac patients versus normal patients from Gene Expression Omnibus (GEO) database were screened via the protein-protein interaction (PPI) network. The critical nodes based on degree values, betweenness centrality, and fold changes were determined and enriched by ClueGO to find relative biological terms.

    Results

    According to the network analysis, five central nodes including IL2, PIK3CA, PRDM10, AKT1, and SRC and eight significant differentially expressed genes (DEGs) were determined as the critical genes related to CD. Also, CD4+, CD25+, alpha-beta regulatory T cell differentiation are identified as prominent biological terms in the celiac disease patients.

    Conclusion

    There is a possible biomarker panel related to CD that can be used as a therapeutic or diagnostic tool to manage the disease.

    Keywords: Celiac Disease, Gene, Network, Biomarker
  • Gholam Basati, Saber Abbaszadeh, Arqavan Zebardast, Hassan Teimouri* Page 68
    Background

    Identification of indigenous medicinal plants, including the gathering of information regarding the uses of these plants can help find out their traditional pharmacological activities and their benefits for the community’s healthcare system. In this study, an ethnobotanical investigation was conducted in Shahrekord city, southwest of Iran to indicate the ethnobotanical knowledge about analgesic medicinal plants in the region and the methods of using them.

    Materials and Methods

    To this end, plant antioxidants and analgesic medicinal plants were identified. For this purpose, a questionnaire was used to obtain indigenous knowledge from traditional therapists in Shahrekord regarding pain relief using medicinal plants. This ethnobotanical study was conducted in 2018 with the participation of 29 traditional therapists of the region under purpose. Finally, the data drawn from the questionnaires were analyzed using the Excel software. The frequency of plants use was also calculated.

    Results

    Our study showed that in Shahrekord, 23 species of medicinal plants are used to relieve pain. The highest frequency of use was obtained for Eugenia caryophylata (44%), followed by Alhagi maurorum (31%), Tribulus terrestris (27%), and angustifolia (24%). The Laminaceae family (7 species) was the most frequently used plant family for pain relief. The most frequently used plant organ to relieve the pain was flower (25%), followed by the stem (22%) and leaves (19%).

    Conclusion

    Given the high importance of medicinal plants in Shahrekord, the results of this study and additional scientific investigations can help produce more effective and less harmful drugs from medicinal plants.

    Keywords: Herbal Medicine, Sedatives, Ethnobotany, Shahrekord, Iran
  • Babak Daneshfard, Mahdi Shahriari, Majid Nimrouzi* Page 69
  • Mostafa Bijani*, Ali Asghar Khaleghi Page 70
    Background

    Correct and fast triage is the key to successful performance in emergency departments. Various factors can affect the quality of triage; therefore, the present study was conducted to identify and explore the existing challenges in triage units in emergency departments.

    Materials and Methods

    The present study was a qualitative exploratory work conducted via the content analysis approach. Data were collected using in-depth, semi-structured interviews, and focus group interviews. Accordingly, 22 in-depth, semi-structured interviews were conducted in with 18 triage nurses and four emergency medicine specialists on a face-to-face basis.

    Results

    The challenges related to triage nurses fall into two subcategories; lack of clinical competency and psychological capabilities. The challenges related to emergency management consist of challenges in human resources management, structural, and performance.

    Conclusion

    The challenges existing in triage units are influenced by factors related to triage nurses and emergency management. Emergency administrators can improve the effectiveness and quality of triaging patients by empowering triage nurses and removing structural problems in triage units.

    Keywords: Triage, Nurses, Qualitative Research, Emergency Department
  • Razie Hadavi, Samira Mohammadi Yeganeh, Javad Razaviyan, Ameneh Koochaki, Parviz Kokhaei, Ahmadreza Bandegi* Page 71
    Background

    Triple-negative breast cancer (TNBC) is an invasive and lethal form of breast cancer. PI3K pathway, which often activated in TNBC patients, can be a target of miRNAs. The purpose of this study was bioinformatic prediction of miRNAs targeting the key genes of this pathway and evaluation of the expression of them and their targets in TNBC.

    Materials and Methods

    We predicted miRNAs targeting PIK3CA and AKT1 genes using bioinformatics tools. Extraction of total RNA, synthesis of cDNA and quantitative real-time polymerase chain reaction were performed from 18 TNBC samples and normal adjacent tissues and cell lines.

    Results

    Our results demonstrated that miR-576-5p, miR-501-3p and miR-3143 were predicted to target PIK3CA, AKT1 and both of these mRNAs, respectively and were down-regulated while their target mRNAs were up-regulated in clinical samples and cell lines. The analysis of the receiver operating characteristic curve was done for the evaluation of the diagnostic value of predicted miRNAs in TNBC patients.

    Conclusion

    The findings of our study demonstrated the reverse correlation between miRNAs and their target genes and therefore the possibility of these miRNAs to be proposed as new candidates for TNBC targeted therapies.

    Keywords: Triple Negative Breast Cancer, MicroRNA, PIK3CA, AKT1, Bioinformatics
  • Nayyereh Farajzadeh Moghanjoughi, Sorayya Kheirouri*, Mohammad Alizadeh, Alireza Farsad Naeimi Page 72
    Background

    Dietary patterns of children are determined by their food preferences, and mothers have important implications for these preferences. This study was aimed to investigate the maternal factors associated with children’s food preferences.

    Materials and Methods

    In this cross-sectional study, a total of 576 healthy children aged 3-6 years participated from nursery schools through simple cluster sampling method and maternal factors associated with children’s food preferences were determined using a researcher designed, validated tool through face-to-face interview with mothers. Data were analyzed by SPSS software version 16 using General Linear Model to assess the correlations between different variables.

    Results

    The children with diploma-educated mothers had fewer preferences in consuming nuts, vegetables, and fruits, and children with academic-educated mothers had fewer preferences in consuming nuts, beans, vegetables, fruits, drinks, condiments, and snacks (P<0.05). Children with employed mothers had fewer preferences for beans and drinks (P<0.02). Drinks preferences were lower among children whose mothers had good nutritional knowledge score (P<0.03). Proteins, beans, fruits, condiments, and snacks preferences were higher among children whose mothers had good nutritional attitude score (P<0.05). A positive correlation was found between the food preferences of children and mothers (0.377<B<0.570, P<0.001) in all food groups.

    Conclusion

    The results of the study showed that mothers̓ educational level and their high nutritional knowledge and attitude could not guarantee the healthy dietary patterns of children. To promote children’s dietary patterns, it is imperative to improve the food preferences of mothers through specialized training.

    Keywords: Children, Food Preferences, Mothers, Knowledge, Attitude
  • Hossein Azizi, Asie Shojaii, Roshanak Ghods* Page 73
  • Reyhaneh Niknam, Mahmonir Mohammadi* Page 75
    Background

    Cardiovascular disease (CVDs) is important problems in both developing and developed countries. Currently, non-invasive methods for diagnosis of CVD, especially myocardial infarction (MI), is an interesting subject in the cardiology field. Some evidence showed left bundle branch block (LBBB) is more prevalent among patients with MI. Hence, this study aimed to investigate the frequency of LBBB and their contributing factors in patients with MI.

    Materials and Methods

    In this cross-sectional study, 150 patients with ST elevation or non-ST elevation on their admission electrocardiography who referred to Boo-Ali and AmirAl-Momenin hospitals, Tehran from January 2016 to June 2017 entered the study. Frequency of LBBB and right bundle branch block (RBBB) in participants and the contributing factors were determined.

    Results

    In this study, of 150 cases (mean age: 60.35±12.88 years), 109 (72.7%) were male, and 41 (27.3%) were female. Out of 150 cases, 12 (8%) had LBBB, 5 (3.3%) RBBB, and 133 (89.7%) had not RBBB or LBBB. Contributing factors were family history, hypertension, and history of ischemic heart disease (P<0.05).

    Conclusion

    Eight percent of patients with myocardial infarction would develop LBBB, which is related to hypertension, and self and family history of ischemic heart disease.

    Keywords: Myocardial Infarction, Acute Myocardial Infarction, LBBB, RBBB
  • Sina Kardeh*, Seyed Arman Moein, Mohammad Reza Namazi, Bahareh Kardeh Page 76

    Acne vulgaris is a common inflammatory skin disorder which is recognizable by dermato- logical lesions and scars. In addition to some pathogenetic factors such as hyperkeratiniza- tion, upregulated sebum secretion, and immunoinflammatory reactions, recent studies have also connected oxidative stress to the pathogenesis of acne vulgaris. In this article, we will briefly review clinical studies that interrogated alterations in oxidative stress biomarkers by a systematic search conducted in PubMed, Web of Science, and Scopus using “acne”, “ox- idative stress”, and “reactive oxygen species” keywords. Overall, studies have shown that oxidative biomarkers (e.g. lipid peroxidation final products) are higher in acne vulgaris le- sions. A significant positive correlation has also been noted between acne severity and ox- idative biomarkers. In contrast, diminished levels of antioxidant enzymes (e.g. superoxide dismutase and catalase) have been observed in acne. We propose four probable mechanisms for the role of reactive oxygen species (ROS) in acne pathogenesis. We believe that ROS can contribute significantly to the acne vulgaris pathobiology via toll-like receptor (TLR), per- oxisome proliferator-activated receptor (PPAR), mTOR pathway, and innate immune sys- tem, resulting in inflammation by alterations in the generation of several proinflammatory cytokines including IL-1, IL-8, and TNF-α.

    Keywords: Acne Vulgaris, Oxidative Stress, Reactive Oxygen Species, mTOR, PPAR, Inflammation
  • Jamshid Shayanfar, Hassan Ghasemi, Seyed Saeed Esmaili, Fatemeh Alijaniha, Ali Davati* Page 77

    Vision impairment is an important general health issue that imposes many costs on governments and the health system every year. Despite the decline in infectious eye diseases, which has reduced the vision impairment and blindness over the past two decades, vision impairment is still a major health problem in some parts of the world. In traditional medicine books, visual weakness is referred to as “any disturbance in the act of seeing”. Many medicinal herbs have been mentioned in books of Traditional Iranian medicine (TIM) for the management of vision impairment. The aim of this study is to review the medicinal plants mentioned in TIM, which are considered effective for the treatment of vision impairment or its enhancement. In this library- based study, medicinal plants effective in the treatment of vision impairment were searched using 6 valid sources of traditional medicine, including Makhzan ol-Adawiya, The Canon of Medicine, Tuhfat al-Momenin, Al-Abniyah An Haqaiq al-adwiya, Al-Shamil Fi al-Sana’at al- tebiyah, and Ekhtiarate Badiee. This was done in 10 steps (finding keywords, searching for resources, preparing a single list, finding synonyms, classifying, reviewing, extracting plants from compositions, summarizing, scoring and sorting based on the obtained score). A total of 89 medicinal plants were extracted, most of which had a hot and dry temperament. Based on the obtained score, 12 plants got the highest scores (10 and above). The extracted plants can be the basis for further clinical studies to make new effective drugs for the prevention and treatment of vision impairment.

    Keywords: Vision Impairment, Ophthalmology, Medicinal Plants
  • Ali Talebi, Mohammad Ali Sadighi Gilani, Morteza Koruji, Jafar Ai, Mohammad Jafar Rezaie, Shadan Navid, Majid Salehi, Mehdi Abbasi* Page 78
    Background

    Spermatogonial stem cells (SSCs) are considered in fertility management approaches of prepubertal boys facing cancer therapies. However, in vitro propagation has become an important issue due to a small number of SSCs in testicular tissue. The present study
    aimed to investigate a modified soft agar culture system by using a nanofibrous scaffold as a
    new approach to mimic in vivo conditions of SSCs development.

    Materials and Methods

    The SSCs were isolated from neonate mouse testes, cultured on polycaprolactone scaffold, and
    covered by a layer of soft agar for 2 weeks. Then, the number and diameter of colonies formed
    in experimental groups were measured and spermatogonial markers (i.e., Plzf, Gfrα1, Id4, and
    c-Kit) in SSCs colonies were evaluated by a real-time polymerase chain reaction and immunostaining.

    Results

    Our results indicated that the colonization rate of SSCs was significantly higher in the present modified soft agar culture system (P<0.05). Only Plzf indicated a significant
    increased at the levels (P<0.05), the gene expression levels of Id4, Plzf, and Gfrα1 were higher
    in the present culture system. In addition, the expression of the c-Kit gene as a differentiating
    spermatogonia marker was higher in presence of scaffold and soft agar compared with the
    amount of other experimental groups (P<0.05).

    Conclusion

    The culture system by using nanofibrous scaffold and soft agar as a new culture method suggests the potential of this approach in
    SSCs enrichment and differentiation strategies for male infertility treatments, as well as in vitro
    spermatogenesis.

    Keywords: Adult Germline Stem Cells, Cell Proliferation, Tissue Scaffolds, Agar
  • Nadia Rezaei, Mohammad Hassan Eftekhari*, Nader Tanideh, Maral Mokhtari, Zahra Bagheri Page 79
    Background

    Antioxidant therapy has gained attention for the treatment of ulcerative colitis (UC). The excessive generation of reactive oxygen/nitrogen species in the gastrointestinal tract increases oxidative stress, thereby leading to antioxidant defense depletion, lipid peroxidation, inflammation, tissue damage, and ulceration. Spirulina platensis (SP) and honey are excellent sources of potent antioxidants such as polyphenols and other bioactive compounds. We aimed to investigate antioxidant and anti-inflammatory effects of honey and SP in comparison with sulfasalazine (SSZ) and mesalazine on acetic acid-induced colitis (AA-colitis) in rats.

    Materials and Methods

    Fifty-six Sprague Dawley male rats were allocated to seven groups, with each group comprising eight rats. UC was induced, except in normal controls (NC). All groups received oral treatments for seven days. The normal saline solution of 2 mL was intrarectally administered to the NC group. The AA-colitis and NC groups received 2 mL acetic acid intrarectally as a single dose and 2 mL normal saline for seven consecutive days orally. The mesalazine group received 100 mg/kg mesalazine, the SSZ group 360 mg/kg SSZ, the honey or H group 1 mL honey diluted with 1 mL distilled water, the SH group 1g/kg SP and 1 mL honey, and the SP group 1g/kg SP. After clinical activity score assessment, the rats were sacrificed. Colonic weight/length ratio, prostaglandin E2 (PGE2), myeloperoxidase (MPO), nitric oxide (NO), malondialdehyde (MDA), interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), glutathione peroxidase (GPx), total antioxidant capacity (TAC), reduced glutathione (GSH), and superoxide dismutase (SOD) were measured. Colonic histopathological changes were observed microscopically.

    Results

    Treatment of UC with SP, honey, and combination regimen significantly reduced TNF-α, IL-1β, IL-6, MDA, MPO, NO, and PGE2, and increased TAC, GSH, GPx, and SOD in interventional groups compared to the AA-colitis group (P<0.05).

    Conclusion

    Honey and SP might be beneficial food supplements for medical nutrition therapy in UC.

    Keywords: Spirulina, Honey, Ulcerative Colitis, Antioxidant, Oxidative Stress
  • Nazila Vahidi Eyrisofla, Vida Hojati*, Mohammad Reza Yazdian, Morteza Zendehdel, Hooman Shajiee Page 80
    Background

    Today, the use of additives such as antibiotics and growth hormones that increase production efficiency in breeding broiler chickens has become inevitable. However, the use of such additives and antibiotics associated with side effects such as liver damage. Oxidative stress occurs due to an imbalance between oxidants and antioxidants. Studies have shown that olive leaves have an antioxidant effect on free radicals. This study was to evaluate the possible effect of olive leaf extract on carbon tetrachloride (CCL4)-induced liver damage (molecular and tissue) and changes of enzymes in chickens.

    Materials and Methods

    A total of 50 chickens were used and classified into5 groups. Treatment groups received 0.5, 1, and 1.5 mg/kg of the olive leaf extract from day 21 of the experiment. Two control groupshealthy and poisoneddid not receive any extract. On the day 35 of the experiment, 1cc of CCL4 was dissolved with olive oil and injected intraperitoneally into the experimental and poisoned control groups. Blood and liver tissue sampling were performed.

    Results

    The histopathology results showed that at high doses of olive leaf extract, the cells and vessels were regularly curable, and sinusoids were healthy. The expression of B-cell lymphoma 2 (BCL2) increased, and that of BH3 interacting domain death agonist (BID)decreased. Enzymatic tests, including serum glutamic-oxaloacetic transaminase, serum glutamic-pyruvic transaminase, alkaline phosphatase, gamma-glutamyl transpeptidase, showed a reduction in BID expression in the experimental group compared with the control group(P<0.005).

    Conclusion

    We concluded that olive leaf extract boosts the BCL2—an antiapoptotic gene—and reduces BID—an apoptosis gene—in the liver of chicken. It prevents the liver cells from disintegrating and destroys sinusoids and liver blood vessels. The high doses of the olive leaf extract caused liver resistance to CCL4 toxicity in chicken.

    Keywords: Olive, Liver, Carbon Tetrachloride, Chicken
  • Movassaghi, Zeinab Khazaei Koohpar, Mehrdad Hashemi, Sourena Jafari Semnani, Zahra NadiaSharifi* Page 81
    Background

    3,4-Methylenedioxymethamphetamine is psychoactive and hallucinogenic and has been shown to produce neurotoxicity both in animals and in humans. Recently, vasodilator drugs such as pentoxifylline (PTX) have been introduced as an alternative with neuroprotective effects. There is no study about the protective effect of PTX on hippocampal apoptosis due to high-dose administration of 3,4-Methylenedioxymethamphetamine (MDMA), so in this study, the protective effect of PTX on the hippocampus of male Wistar rats following high-dose of the drug has been investigated.

    Materials and Methods

    Twenty-four male Wistar rats weighing 250-300 g were randomly divided into four groups: control, sham (MDMA injection), experimental (MDMA+PTX injection), and vehicle (MDMA+saline) groups. Two weeks later, the brains were removed and prepared for TUNEL and western blot techniques. Concomitantly the hippocampus was removed to study the change in Bcl-2 and BAX mRNA expression with quantitative real-time polymerase chain reaction.

    Results

    Data showed that the number of apoptotic bodies significantly decreased in the experimental group compared to the other groups, except for in control. Also, further investigation revealed that BAX reduced considerably, while Bcl-2 mRNA expression increased dramatically after PTX treatment.

    Conclusions

    Our results suggest that PTX may be a neuroprotective agent, and its neuroprotective potential may contribute to reducing the severity of lesions in the hippocampus following a high dose administration of MDMA.

    Keywords: Pentoxifylline, 3, 4-Methylenedioxymethamphetamine, Apoptosis, Hippocampus
  • Sepideh Ashouri Movassagh, Mehdi Banitalebi Dehkordi, Morteza Koruji, Gholamreza Pourmand, Parvaneh Farzaneh, Sanaz Ashouri Movassagh, Ayob Jabari, Azam Samadian, Farnaz Khadivi, Mehdi Abbasi* Page 82
    Background

    In the males, Spermatogonial Stem Cells (SSCs) contribute to the production of sex cells and fertility. In vitro SSCs culture can operate as an effective strategy for studies on spermatogenesis and male infertility treatment. Cell culture in a three-dimensional (3D) substrate, relative to a two-dimensional substrate (2D), creates better conditions for cell interaction and is closer to in vivo conditions. In the present study, in order to create a 3D matrix substrate, decellularized testicular matrix (DTM) was used to engender optimal conditions for SSCs culture and differentiation.

    Materials and Methods

    After, testicular cells enzymatic extraction from testes of brain-dead donors, the SSCs were proliferated in a specific culture medium for four weeks, and after confirming the identity of the colonies derived from the growth of these cells, they were cultured on a layer of DTM as well as in 2D condition with a differentiated culture medium. In the Sixth week since the initiation of the differentiation culture, the expression of pre meiotic (OCT4 & PLZF), meiotic (SCP3 & BOULE) and post meiotic (CREM & Protamine-2) genes were measured in both groups.

    Results

    The results indicated that the expression of pre meiotic, meiotic and post meiotic genes was significantly higher in the cells cultured on DTM (P ≤ 0.001).

    Conclusion

    SSCs culture in DTM with the creation of ECM and similar conditions with in vivo can be regarded as a way of demonstrating spermatogenesis in vitro, which can be adopted as a treatment modality for male infertility.

    Keywords: Spermatogonial Stem Cells, Decellularization, Testicular Matrix, Proliferation, Diffetentiation