This randomized clinical trial was aimed to evaluate the effect of oral use of tamarind seed powder as an herbal product in patients affected by premature ejaculation (PE).

In this study, 75 patients randomized in tamarind group (25 patients received daily 130 mg tamarind seed powder), paroxetine group (25 patients received daily 20 mg paroxetine), and placebo group (25 patients). Patients received the treatment regimen for 4 weeks. The primary outcome was intravaginal ejaculatory latency time (IELT). The secondary outcomes were PE diagnostic tool score, sexual function using International Index of Erectile Function (IIEF), and complications. Studied sexual functions include erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction.

The mean of IELT in tamarind, paroxetine, and placebo groups at baseline was 35.2 ± 26.5, 38 ± 27.6, and 44 ± 34.9 s and at the end of study was 49.5 ± 48.2, 147.4 ± 209.6, and 46.9 ± 37.6 s, respectively, which in paroxetine group signifi cantly increased compared to other groups. IIEF scores for orgasmic function and intercourse satisfaction for paroxetine after treatment signifi cantly increased than that of other groups. The differences between tamarind and placebo groups for studied variables were not statistically signifi cant. The mean of increases in IELT for tamarind, paroxetine, and placebo groups was 14.35 ± 34.3, 109.4 ± 213.4, and 2.9 ± 9.3 s, respectively, which in paroxetine group was signifi cantly higher than other groups and in tamarind group was signifi cantly higher than placebo.

Paroxetine was signifi cantly better than tamarind seed powder and placebo although side effect in paroxetine was more frequent. IELT signifi cantly more increased in tamarind group compared to placebo.

Allium genus with 750 species is the most diverse genus in the Amaryllidaceae family. Historically, Allium species have been used as medicinal plants, especially for prevention and treatment of cardiovascular diseases and considered as valuable sources of phytonutrients. Phytochemical investigation of Allium tripedale, locally called “Anashq,” which is an edible plant of the “Zagros” region (west of Iran) was conducted in the present study.

Air‑dried bulbs of the plant were extracted in a four‑step extraction method with increasing polarity using hexane, chloroform, chloroform–methanol (9:1), and methanol. Chloroform‑methanol (9:1) extract was fractionated by medium‑pressure liquid chromatography on a RP‑18 column using a linear gradient solvent system of H2O to MeOH. Phenolic‑rich fractions were subjected to the final isolation and purification of the constituents by reversed‑phase high‑performance liquid chromatography method. Structure elucidation of the compounds was performed through comprehensive methods including 1D‑and 2D‑NMR and mass spectroscopy.

Two cinnamic acid derivatives were isolated from the bulbs of A. tripedale; using spectroscopic methods, their chemical structures were determined as 6,7‑dimethoxy N‑trans‑caffeoyltyramine (1) and N‑trans‑feruloyltyramine (2).

Cinnamic acid derivatives are pharmacologically active phenolic compounds, which have been isolated from different Allium species. Isolation of these compounds from A. tripedale is reported for the first time in this study and could be used as a chemical basis for explanation of the plant biological and pharmacological activities

Pseudomonas aeruginosa is a biofilm‑forming bacterium which can result in serious health problems, particularly in burn patients. Biofilm has been assumed to protect the bacteria from environmental fluctuations such as antimicrobial agent. Mucoid strains generate extensive levels of the alginate exopolysaccharide, which is an important factor of its biofilm.

Totally, 100 isolates of P. aeruginosa has been gathered from wound infections of burn patients. Polymerase chain reaction of exoA gene has been carried out to confirm the bacteriologic identification of isolates. The biofilm‑forming capacity has been specified by capsule staining and microtiter plate test as qualitative and quantitative determination, respectively. Antimicrobial susceptibility of the isolates has been specified by disk diffusion method.

All the isolates carried the exoA gene. The antibiotic resistance was imipenem (90%); levofloxacin (93%); aztreonam (87%); piperacillin‑tazobactam (85%); tobramycin (92%); polymyxin b (PB) (2%); and ceftazidime (CAZ) (32%). Totally, multidrug‑resistant (MDR) and extended drug‑resistant (XDR) isolates were 19% and 75%, respectively. Fortunately, pan drug‑resistant (PDR) strain has not been observed. The assessment of biofilm formation has shown that 7% of the isolates were nonbiofilm (N), weak (W) 67%, moderate (M) 22%, and strong (S) 4%.

As a result, the findings of this survey indicated that PB and CAZ were the most effective antibiotics against P. aeruginosa, which of course indicate a serious problem about the emergence of the PDR strains. There was no relationship between the patterns of biofilm production and antibiotic susceptibility, but high frequency of MDR/XDR and biofilm producer strains has been detected.

Chronic recalcitrant plantar fasciitis is a disabling condition. We presumed if shock wave could increase the permeability of skin and facilitate penetration of topical corticosteroid through the skin; the combinational therapeutic effect would be stronger than using shock wave alone. The study purpose was to utilize the synergistic effect of shock wave and topical corticosteroid in treatment of plantar fasciitis.

Patients in both groups (n = 40) received four sessions of shock wave with the same protocol at weekly intervals. At 30 min before each session, we used an occlusive dressing of topical clobetasol for the intervention group and Vaseline oil for the control group. Pain severity was assessed with visual analog scale (VAS) and modifi ed Roles and Maudsley score (RMS) at baseline and 1 month and 3 months after intervention. Plantar fascia (PF) thickness was measured with ultrasonography at baseline and 3 months after intervention.

One month after intervention, VAS morning showed signifi cant improvement in intervention group (P = 0.006) and RMS showed better improvement in intervention group (P = 0.026). There was no signifi cant difference between the two groups after 3 months in RMS or VAS score. PF thickness was decreased signifi cantly in both groups, but it was not signifi cant between the two groups (P = 0.292).

This combinational therapy yielded earlier pain reduction and functional improvement than using shock wave alone; topical corticosteroid could enhance the effectiveness of shockwave in short-term in the treatment of recalcitrant plantar fasciitis.

The purpose of this study is to report outcomes of total hip arthroplasty (THA) in patients under the age of 35 years regarding pain and joint function.

This preliminary analytic‑descriptive study was performed in prospective consecutive series of forty‑three patients younger than 35 years old who had undergone unilateral THA during a 36‑month period. As the primary outcome, the severity of pain using visual analog scale (VAS) of 1–10, and as the secondary outcomes, joint range of motion (ROM) and the Harris Hip Score (HHS) were assessed in the preoperative visit, 1, 6, and 18 months after operation for each patient. Complications were recorded at 6 months and 18 months after surgery.

The data of VAS showed the mean severity of pain was significant between preoperation measurements and postoperative assessments (P < 0.001). The means of HHS and hip ROM were also statistically significant before the operation in comparison with postoperative assessments (P < 0.001 for both means). A total of 19 patients had postoperative complications including periprosthetic fracture in two patients, infection in two patients, cup loosening in three patients, limb length discrepancy in 10 patients, and heterotopic ossification in two patients. Seven patients had been readmitted.

We believe THA using uncemented prosthesis has a high survivorship with low rate osteolysis in young patients with good bone stock. It is necessary to have longer follow‑up to have a better evaluation on outcomes.

Today, leishmaniasis is a widespread, infectious parasitic disease caused by Leishmania spp. Natural‑derived compounds are likely to provide a valuable source of new pharmaceuticals, and among them, quercetin derivatives may have antileishmanial effects. The antileishmanial activity of 3,5,7,3’,4’‑pentahydroxyflavonol (quercetin) derivatives is partly attributed to the position and pKa of phenolic or catechol hydroxyl groups. Therefore, to optimize their leishmanicidal effect, the structural features of quercetin and its derivatives were improved by acylation or alkylation of hydroxyl groups and changing their pKa and consequently their activities.

In this study, during a regioselective method, quercetin derivatives were synthesized. The structures of synthesized compounds were confirmed by mass, IR, 1H‑, and 13C‑NMR spectral data. The antileishmanial activities of compounds 1–6 were compared with glucantime as the standard drug against promastigotes of Leishmania major using standard cell‑based leishmanicidal assay.

In this study, during a regioselective method, two 7‑O‑quercetin derivatives (5 and 6), and three quercetin acetate derivatives (2, 3, and 4) were synthesized. In detail, the IC50 values found against L. major were (1) 2.5 ± 0.92; (2) 2.85 ± 0.99; (3) 15.5 ± 1.95; (4) 13.5 ± 3.5; (5) 2.6 ± 0.57; and (6) 1.3 ± 0.35 μM while IC50 value of glucantime as the standard drug was 88.5 ± 9.47 μM.

The present study showed an effective antileishmanial activity of quercetin semisynthetic compounds (1–6) against in vitro promastigotes of L. major. Among them, quercetin analogs with more lipophilic and iron‑chelating activity showed more antiparasite activity.

The aim of this study was to evaluate the relation between normal values of extensor digitorum communis (EDC) Hoffmann‑reflex (H‑reflex) latency, upper limb length and age in normal participants, and to determine whether there is any regression equation between them.

In this cross‑sectional study, 120 upper limbs of 76 normal volunteers (55 limbs of 34 men and 65 limbs of 42 women) were participated in this study. The onset latency of EDC H‑reflex was determined with standard electrodiagnostic techniques and was recorded.

The mean EDC H‑reflex latency was 15.89 ± 1.41 ms. There was a positive significant correlation between EDC H‑reflex latency and upper limb length (r = 0.749, P < 0.0001) and also arm length (r = 0.758, P < 0.0001), but there was a nonsignificant indirect correlation between age and EDC H‑reflex latency (r = −0.111, P = 0.227). The relation between H‑reflex and sex was not statistically significant (P = 0.46).

According to our result, there are good predictive values between upper limb length and arm length for the estimation of normal EDC H‑reflex latency.

Candida dubliniensis is a newly diagnosed species very similar to Candida albicans phenotypically and first discovered in the mouth of people with AIDS in 1995. Among the different phenotypic and genotypic methods, a cost‑effective method should be selected which makes it possible to differentiate these similar species.

Polymerase chain reaction (PCR)‑restriction fragment length polymorphism with MspI enzyme and the Duplex‑PCR method were done by DNA extraction using boiling. The sequencing of the amplified ribosomal region was used to confirm the C. dubliniensis species. Direct examination and colony count of the yeasts were applied for bronchoalveolar lavage (BAL) samples and the growth rate of the yeasts were studied at 45°C. To understand the ability formation of chlamydoconidia in yeast isolates, they were separately cultured on the sunflower seed agar, wheat flour agar, and corn meal agar media.

Fifty‑nine (49.2%) yeast colonies were identified from the total of 120 BAL specimens. Twenty‑nine isolated yeasts; including 17 (58.6%) of C. albicans/dubliniensis complex and 12 (41.4%) of nonalbicans isolates produced pseudohypha or blastoconidia in direct smear with a mean colony count of 42000 CFU/mL. C. albicans with the frequency of 15 (42.9%) were the most common isolated yeasts, whereas C. dubliniensis was identified in two nonHIV patients.

Sequencing of the replicated gene fragment is the best method for identifying the yeasts, but the determination of the species by phenotypic methods such as the creation of chlamydoconidia in sunflower seeds agar and wheat flour agar media can be cost‑effective, have sensitivity and acceptable quality.

Metadoxine (pyridoxine pyrrolidone carboxylate) is considered to be a beneficial agent for the treatment of experimental hepatotoxicity due to alcohol, CCl4, and bile duct ligation. Hence, the therapeutic effect of metadoxine and N‑acetylcysteine (NAC) as reference drug was investigated in mice exposed to acute hepatotoxicity induced by a single oral toxic dose of acetaminophen (650 mg/kg).

Metadoxine (200 and 400 mg/kg) and NAC (300 mg/kg) were given orally (p. o.), 2 h after acetaminophen administration. Serum aminotransferases, aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), total bilirubin, hepatic glutathione (GSH), and malondialdehyde (MDA) levels were determined for evaluating the extent of hepatotoxicity due to acetaminophen and its protection by metadoxine.

Findings indicated that metadoxine significantly reduced the level of serum ALT, AST, and ALP but not total bilirubin which increased by acetaminophen intoxication. Administration of metadoxine also attenuated oxidative stress by suppressing lipid peroxidation (MDA) and prevented the depletion of reduced GSH level which caused by acetaminophen toxicity. Besides, metadoxine ameliorated histopathological hepatic tissue injury induced by acetaminophen.

In most parameters examined, the effect of metadoxine was comparable to NAC. Hence, metadoxine could be considered as a beneficial therapeutic candidate to protect against acute acetaminophen hepatotoxicity.

Neu–Laxova syndrome (NLS) is an autosomal recessive disorder characterized by central nervous system anomalies, facial dysmorphic features, anomalies of limb and genitalia, intrauterine growth retardation, skin disorders, and other congenital abnormalities. In this article, we present a newborn infant who was born with facial dysmorphic features, flat nose, ichthyosis, rocker bottom feet, and fixed flexion contractures. We believe that these clinical findings in this patient are consistent with features of NLS.

Nosocomial infections are one of the most leading causes of morbidity and mortality in patients with cancer. The emergence of multiple‑drug‑resistant (MDR) strains of Gram‑negative bacteria causing nosocomial infection has become a serious concern in cancer patients. Therefore, the present study aimed to determine the spectrum and antibiotic resistance pattern of Gram‑negative bacteria related nosocomial infections among Iranian cancer patients.

This descriptive cross‑sectional study was conducted during the 6 months from December 2015 to May 2016 in two tertiary care centers located in Isfahan and Arak Province. Gram‑negative bacteria obtained from different clinical specimens from hospitalized patients with cancer and were identified using standard microbiological methods. Antibiotic susceptibility pattern was determined by the disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) recommendation.

Of totally 259 culture positive cases, Escherichia coli showed the highest isolation rate (60.6%) followed by Klebsiella pneumoniae (26.6%) and Proteus spp (11.2%). The rate of MDR isolates were 91.5% (237/259). Overall, the most frequent source of bacterial isolation was urinary tract infection (65.6%) followed by skin and soft‑tissue infection (23.6%). The antibiotic susceptibility results showed meropenem (MEN) and ceftazidime as the most effective antibiotics for E. coli, K. pneumoniae, and Proteus spp. isolates. Moreover, MEN was the most effective antibiotic against MDR isolates.

The study findings showed a significant distribution of MDR Gram‑negative bacteria which may increase the burden of healthcare‑associated infections in cancer patients. Although, carbapenem can be considered as effective agents toward MDR strains for empirical antibiotic therapy in our region.

Exercise reverses retention deficit induced by morphine. The present study investigated the effect of aerobic exercise on tolerance to morphine usage and pain modulation.

Male Wistar rats were divided into four groups as follows: (1) saline group (S), (2) morphine group (M), (3) saline + exercise (S + E), and (4) morphine + exercise group (M + E). The rats were initially trained to receive small pellets of food by pressing an active lever in the self‑administration apparatus. The tail‑flick and hot‑plate tests were used for pain assessment. To perform the experiment, the jugular vein was exposed and cannulated. After recovery, the animals were placed in the self‑administration apparatus and allowed to self‑administer morphine in 2 h sessions over 11 consecutive days.

The morphine group was found to record a higher number of active lever pressings than did the saline one while this parameter decreased in the morphine + exercise group compared with the morphine one. Moreover, the morphine + exercise exhibited lowered pain sensitivity as evidenced to have reduced morphine use in the hot plate test.

The exercise might be suggested to reduce using of morphine and modulate pain probably through the release of endogenous opioid.

Positive and negative emotional states are the most important factors in treatment and prevention process of psychosomatic diseases. This research aimed to investigate the effectiveness of emotional schemas’ therapy on emotional schemas’ modifi cation and diffi culties of emotion regulation in women with irritable bowel syndrome (IBS).

This research was implemented in the framework of single-subject experimental design using step-wise multiple baselines plan. Five patients with IBS were selected as convenience sampling on the base of their willingness to participate and then they received emotional schema therapy (EST). Research tools included ROME III scale, SCID interview, emotional schemas questionnaire, and diffi culties of emotional regulation. The analysis of data was done using visual analysis charts, recovery percentage, and reliable change index.

The results showed a decrease of scores in some maladaptive schemas and increase of some adaptive schemas than baseline in patients who received EST (P ≤ 0.05). Furthermore, this treatment decreased scores of some emotion regulation diffi culty components (P ≤ 0.05).

It seems that EST is an appropriate option for treatment of these patients because it is effective in improvement of emotional schemas and diffi culties of emotional regulation.

Attention deficit hyperactivity disorder (ADHD) is the most common behavioral problems that cause hyperactivity, attention deficits, academic failure, and emotional and behavioral problems in preschool and elementary school that is often hidden from the parents’ eyes. The aim of this study was to determine the effectiveness of parent‑based cognitive‑behavioral therapy (CBT) on ADHD symptoms (including attention deficit disorder, restlessness, and impulsivity), overweight and self‑esteem of 6–11‑year‑old obese children with attention deficit hyperactivity in Isfahan.

This quasi‑experimental study was carried out on 40 children aged 6–11 years with ADHD and overweight or obesity (above the 85th percentile in weight for age, height, and sex diagram) that their parents referred to Isfahan child and adolescent psychiatric clinic of Ali Asghar Hospital in 2015. For twenty patients, only ADHD treatment was applied, and they received no other intervention, but the others in experimental group participated in CBT sessions. Analysis tools were Coppersmith Self‑Esteem Scale, ADHD conners’ test, and the body mass index (BMI). Data were analyzed using analysis of variance with repeated measurements.

CBT by teaching parents had a significant effect on ADHD symptoms, the self‑esteem of overweight and obese children with ADHD in posttest and follow‑up. The results also showed that had a significant effect on ADHD symptoms, overweight and self‑esteem of the obese children with ADHD (P < 0.001).

Parents focused CBT can be considered as a complementary treatment for reducing ADHD symptoms and BMI and increased self‑esteem in the obese ADHD children.

The incidence of propofol injection pain during induction of general anesthesia varies from 28% to 90%. This prospective, randomized, double‑blind, placebo‑controlled study evaluated the effect of dexamethasone and granisetron for reducing the incidence and severity of propofol injection pain.

A total of 227 female subjects received 5 mL of preservative‑free saline, 1 mg granisetron (5 ml), or 0.15 mg/kg of dexamethasone (5 ml), intravenously, following exsanguination and occlusion of the veins of the arm. This was followed by a 0.5 mg/kg injection of propofol. Pain scores and intensity of pain recorded immediately following the injection of propofol. Hemodynamic parameters and O2sat were recorded 1, 3, 5, and 10 min after propofol injection.

The incidence pain following the injection of propofol was significantly decreased with both granisetron and dexamethasone (50.7% and 49.4%). Mean pain score in granisetron group was 3.16 ± 1.23, dexamethasone was 2.73 ± 1.03, and in saline group was 4.82 ± 1.73 (P = 0.001). Mean pain intensity in granisetron group was 1.16 ± 0.18, dexamethasone was 1.26 ± 0.14, and in saline group was 2.2 ± 0.99 (P = 0.001). There were no differences in either mean arterial pressure or O2Sate at any time point after drugs injection among the groups. There was a significant difference in pulse rate in third minutes between three groups and in the group who received granisetron was lesser (P = 0.04).

Pretreatment with intravenous granisetron (1 mg) and dexamethasone (0.15 mg/kg) before injection of propofol is effective and safe in reducing the incidence and severity of pain due to propofol injection.

Health information‑seeking behavior is a key concept in the empowerment of women with breast cancer after mastectomy for self‑care management. Thus, a real understanding of their information needs and their information‑seeking behavior may open up new opportunities for their postsurgery cares. The current research was conducted to identify the information needs and information‑seeking motives of women with breast cancer after mastectomy.

This is an applied qualitative research. Samples included 17 women with breast cancer after mastectomy selected from two hospitals of Shahid Mohammadi and Persian Gulf and Omid Central Chemotherapy in Bandar Abbas. Data were collected using semi‑structured interview on winter 2014 and analyzed using qualitative content analysis method.

Three basic contents were extracted including information needs related to mental health, physical health related to disease and personal daily activities along with their subcategories, and representing common experience and perception of mastectomized women seeking for health information. Furthermore, hope, self‑esteem, return to life, and available social support resources were expressed as the main information‑seeking motives.

Considering research findings, mastectomized women need to receive information in wide range of health and thus pursue purposeful behavior. Hence, it is necessary that required actions and measures are taken by health‑care authorities, especially institutions responsible for women health, to support and meet information needs of the patients considering their information‑seeking motives.