مجله دانشگاه علوم پزشکی بابل
سال بیست و چهارم شماره 1 (پیاپی 139، فروردین 1401)

Diabetic ketoacidosis and severe hypoglycemia are common and recurrent acute complications of type 1 diabetes and are associated with high mortality and morbidity. The aim of this study was to determine the frequency of diabetic ketoacidosis and hypoglycemia in children with type 1 diabetes.

In this retrospective cross-sectional study, 480 patients with type 1 diabetes admitted to the Children Hospital in Qazvin were enrolled by census method. Demographic characteristics, season of referral, place of residence, existence of type 1 diabetes in the family, kin relationship of parents, cause of hospitalization (hyperglycemia, hypoglycemia and diabetic ketoacidosis) and length of hospital stay were extracted from the files and examined.

Most patients (62.9%) were female. 46%, 44.4% and 9.6% of patients were admitted with diabetic ketoacidosis, hyperglycemia and hypoglycemia, respectively. 47.96% of patients had severe diabetic ketoacidosis. 49.3% of patients had ketoacidosis with infection and 20% of known cases were hospitalized due to poor insulin compliance. Hospitalization days were significantly higher in patients with ketoacidosis (p=0.00).

According to the results of this study, the occurrence of infection and lack of adherence to insulin use were the main cause of hospitalization in patients with diabetes, which led to an increase in hospitalization days in these patients. Adequate training to regulate blood sugar reduces the rate of hospitalizations.

Human T-cell leukemia virus type 1 (HTLV-1) is a virus that is endemic in some parts of the world, and as a pathogen, it can lead to severe infections in humans. Since no antiviral treatment is currently available and the only way of confrontation is prevention and identification of infected blood, this study was performed to determine the frequency of antibodies against HTLV-1 in patients with rare bleeding disorders receiving blood in Zahedan.

The study population included 180 patients with rare bleeding disorders referred to Ali Asghar Hospital in Zahedan selected by census method and 90 healthy individuals who referred to hospital lab selected by convenience sampling method in 2020. Age range was 1 to 39 years. Blood samples were collected from all participants and antibody test against HTLV-1 was confirmed using ELISA kit and positive ELISA test was confirmed using Real-time PCR.

In the case group, there were 86 men (47.8%) and 94 women (52.2%) and in the control group there were 43 men (47.8%) and 47 women (52.2%). Antibodies against HTLV-1 were found in 2 patients (1.1%) with rare bleeding disorders and none in healthy individuals. The first was a 29-year-old man with Glanzmann's disease who had severe Glanzmann's thrombasthenia. The second case was a 23-year-old woman with severe forms of factor V and factor VIII deficiency whose family history of Rare Bleeding Disorders (RBD) was positive.

The results of the study showed that the risk of HTLV-1 transmission through plasma-induced blood products and new types of coagulation factors seems negligible.

 Glucagon-like peptide 1 (GLP-1) has anti-diabetic, antioxidant and anti-inflammatory properties that change under different conditions. This peptide is known as a therapeutic target in diabetes and obesity. The aim of this study was to investigate the relationship between GLP-1 and oxidative stress in preterm infants.

In this case-control study, 40 term and preterm infants (gestational age less than 37 weeks) were used. GLP-1 concentration was measured by ELISA. Total antioxidant capacity (TAC), total oxidant status (TOS) and uric acid concentration were measured.

Serum GLP-1 level in preterm infants was significantly higher than term infants (p=0.003). Serum TAC level in preterm infants (973.16±235.53) was significantly lower than term infants (837.00±218.97) (p=0.006). Serum TOS level in preterm infants (65.46±33.52) was significantly higher than term infants (31.50±14.62) (p<0.001). Uric acid levels in preterm infants (5.83±1.73) were statistically higher than term infants (5.13±0.90) (p=0.02). Serum GLP-1 level in preterm infants was negatively and significantly correlated with TAC (p<0.001, r=-0.674) and positively and significantly correlated with TOS (p<0.001, r=0.754) and uric acid (p<0.001, r=0.633).

The results showed that the levels of GLP-1, TOS and uric acid in preterm infants were higher than term infants and GLP-1 had a negative correlation with TAC capacity and a positive correlation with TOS and uric acid in these infants.

Fluoride compounds are widely used for the control of dental plaque. Considering the effect of different fluoride compounds on the mechanical properties of orthodontic wires, this study was conducted to analyze the effect of different methods of fluoride administration at different concentrations on the load-deflection properties of rhodium-coated NiTi orthodontic archwires.

This clinical trial was conducted on 30 patients aged between 15 and 25 years referring to Babol University of Medical Sciences due to dental crowding and didn't have vertical skeletal defects. 0.016-inch Rhodium-Coated A-NiTi wire was placed on patients' maxillary brackets. Patients were randomly divided into three groups of ten: The control group used only fluoride toothpaste, the second group used fluoride toothpaste with sodium fluoride mouthwash (0.05%) and the third group used fluoride toothpaste with Acidulated Phosphate Fluoride gel (1.23% APF). After six weeks, the values of unloading force (N), yield strength (N/m2) and stiffness (N/m) of the wires were obtained using a three-point bending test.

The mean unloading force and stiffness of the second group wires were higher than that of the other groups and in the first group, they were higher than the control group in all values, but no significant differences were found between the groups. There was a significant difference between the yield strengths of different groups (p=0.038). The mean yield strength in the second group was higher than the other groups (0.94±0.16 N/m2) and was significantly different from the control group (0.75±0.19 N/m2) (p=0.030).

According to this study, method of fluoride administration does not affect the unloading force and stiffness but the yield strength of rhodium-coated NiTi archwires increases with an increase in the fluoride concentration.

Periodontal disease is one of the most common chronic oral diseases worldwide. A variety of foods may affect periodontal health. Due to the importance of periodontal health in the old age, this study was designed to investigate the association between carbohydrate intake and periodontal health in the elderly in Amirkola, northern Iran.

This cross-sectional study is part of the second phase of the Amirkola Health and Ageing Project (AHAP). The evaluated participants included 400 elderly people (200 men and 200 women). Socio-demographic data of all subjects were recorded in the information form. Periodontal status, including plaque index (PI), periodontal disease index (PDI) and Oral Hygiene Index (OHI) were evaluated. Then, the Semi-Quantitative Food Frequency Questionnaire (SQFFQ) was completed in order to receive daily carbohydrates in grams per day for all Participants. Then, the relationship between carbohydrate intake and periodontal health was evaluated.

The participants consumed an average of 316±102.4 gr/day carbohydrates. The mean range of PI, OHI, PDI and in the high carbohydrate intake (>300 gr) group were 2.18±1.39, 2.84±1.51 and 1.51±0.86, respectively, and this rate was lower than the group with low carbohydrate intake (<300 gr) (1.96±1.52, 2.56±1.53 and 1.37±0.91), but the difference between the two groups was not significant.

In the present study, there was no relationship between periodontal health indices and carbohydrate intake.

One of the most important problems of old age is physical health and cognitive problems that have a significant effect on their quality of life. Balance training can improve motor and cognitive function in the elderly. Therefore, the aim of this study was to investigate the effect of balance training on cognitive and occupational performance of the elderly.

This quasi-experimental study (pretest-posttest design) was performed on 13 elderly people aged 60-75 years in Kahrizak Charity Center in Tehran. Elderly people with the ability to walk independently, with a score of at least 20 on the Mini-Mental State Exam (MMSE) and a score of 20-40 on the Berg Balance Scale (BBS) underwent the cognitive tests of the Tower of London, the N-back task, and Advanced Reaction Time in the first week, each of which measures the variables of problem-solving, working memory, reaction time (simple, diagnostic, and selective), respectively, while the Canadian Occupational Performance Measure (COPM) was used to assess performance and satisfaction. Then, balance training was performed in twenty sessions for ten weeks, two sessions per week for each elderly person, and in the last week of the intervention, cognitive tests and occupational performance were repeated and the results were compared before and after the experiment.

The mean score of working memory before and after the intervention increased significantly from 21.92±5.47 to 30.38±5.36 (p<0.001) and problem solving from 13.15±9.92 to 19.38±11.87 (p=0.003), respectively. The mean score of occupational performance increased significantly from 6.47±1.53 to 7.07±1.71 (p=0.002) and variable of satisfaction from 6.51±1.79 to 7.10±1.61 (p=0.02). However, no significant change was observed in the reaction time variable (simple, diagnostic, and selective).

The results of the study showed that participating in a balance training program can have positive effects on a number of cognitive functions such as problem solving, working memory and also occupational performance (performance, satisfaction) in the elderly.

Considering the anti-cancer effects of statins on colon cancer previously reported in epidemiological studies and uncertainty about the mechanisms of action, this study was performed to investigate the effect of statins in combination with chemotherapy on colon cancer cell lines.

The present study, which is a laboratory study, was performed on HT-29 cell line as colon cancer cell line and normal HFF cell line. After cell culture, atorvastatin at doses of 15 and 30 μM, rosuvastatin at doses of 30 and 60 μM, simvastatin at doses of 10 and 20 μM and 5-fluorouracil (5-FU) at 20 μg/ml were used for interventions in this study. Interventions were performed alone and in combination. Finally, MTT test was performed to evaluate cell viability.

Mean cell viability in simvastatin (20 μM) and simvastatin (20 μM)+5-FU (20 μg/ml) on colorectal cancer cell lines was 58.46±7.58 and 55.73±15.33 (p=0.999), respectively, in rosuvastatin (30 μM) and rosuvastatin (30 μM)+5-FU (20 μg/ml) was 91.63±10.3 and 56.2±10.27 (p=0.026), respectively, and in atorvastatin (30 μM) and atorvastatin (30 μM)+5-FU (20 μg/ml) was 82.3±26.9 and 52.16±9.49 (p=0.24), respectively.

The evaluation of cell proliferation showed that the addition of rosuvastatin to standard chemotherapy, unlike atorvastatin and simvastatin, had an increasing effect on cytotoxicity.

The mortality in children aged 1-59 months is one of the important indicators in assessing the general health status of a community. The death control system for children aged 1-59 months is used to record and review this indicator in Iran. This study was performed to investigate the mortality rate in children aged 1-59 months in affiliated healthcare centers of Babol University of Medical Sciences based on ICD10.

In this cross-sectional study, all cases of death in children aged 1-59 months registered in affiliated healthcare centers of Babol University of Medical Sciences in 2009-2020 were collected by referring to the reports recorded in the death control system for children aged 1-59 months. Then, information about the cause of death and the trends of mortality during the years 2009-2020 were reviewed.

Out of a total of 303 cases of death in children aged 1-59 months, 179 cases (59.07%) were boys, the mean age of children was 13.08±15.12 months and with 175 cases (57.75%), the highest mortality rate was related to urban areas. The general trend of mortality was declining; from 41 cases in 2009 to 14 cases in 2020 (p≤0.001). Congenital and chromosomal abnormalities in 100 cases (34%), endocrine, nutritional and metabolic diseases in 56 cases (18.48%), nervous system diseases in 23 cases (7.59%) and cancers in 22 cases (7.26%) were respectively the most common causes of death.

The results show a declining trend in the mortality of children aged 1-59 months.

Abu al-Hasan Ahmad ibn Muhammad al-Tabari Toranji, the author of the book "al-mu'alaja al-buqratiya", is one of the greatest physicians of Tabaristan and Iran in the fourth century AH. For this purpose, in the tenth issue (Volume 20, October 2018) of the Journal of Babol University of Medical Sciences, an article entitled "Abu al-Hasan Ahmad ibn Muhammad al-Tabari Toranji; the famous Iranian physician" has been published on pages 72-75 about the biography of this valuable scientist, which seems to have some problems and shortcomings in terms of historical geography. Therefore, the purpose of publishing this article is to critique the published article and draw appropriate conclusions in scientific studies.

Intussusception is one of the most common causes of intestinal obstruction in children 5 months to 3 years, which is the most common cause of acute abdominal pain and its prevalence increases as a result of viral infection. In this report, were present a case of intussusception in a 17-years-old boy following COVID-19.

 A 17-year-old adolescent boy with a known case of steroid-dependent nephrotic syndrome from the age of two has been referred to the emergency department with severe abdominal pain and vomiting. On ultrasound, renal mass and free fluids were shown. Ileocecal intussusception was observed and was repaired without any complications.

Based on the results of this study, intussusception should be considered in every patient with nephrotic syndrome with COVID-19 infection.

Bladder hernias occur in 1% to 4% of cases in the inguinal area. The hernial sac may contain any part of the bladder, such as the bladder diverticulum, all or part of the bladder and ureter. Most of these hernias are diagnosed during surgery. Delay in diagnosis can lead to serious complications and even death. The aim of this case report is to introduce a patient with a rare hernia of the bladder diverticulum in the inguinal region.

 The patient is a 58-year-old man who referred to Namazi Hospital in Shiraz with a bulge in the right inguinal region with symptoms of incarcerated hernia. The patient complained of pain and swelling in the right inguinal region and did not show any signs or symptoms of urinary tract involvement. During laparotomy, the mass was found to be connected to the bladder and the patient underwent inguinal hernia repair. The patient was discharged from the hospital one day after the operation without any problems. No complications were reported in follow-up two months after surgery.

According to our report, hernia of the urinary bladder diverticulum in the inguinal region may be asymptomatic. Therefore, accurate reporting of the patient's history and previous problems and diseases is required for careful surgical planning to prevent severe complications, including bladder injury in these people.

Endometriosis is defined as the presence of endometrial glands and stroma somewhere outside the uterus. The most common site of involvement is the small intestine and colon, and gastric wall involvement is rare. In this study, a case of gastric endometriosis with submucosal mass is reported.

The patient is a 44-year-old woman who referred with abdominal and back pain for 2 months. Pain was not associated with menstruation and no tenderness was seen on abdominal examination. On CT scan, a 3×3 cm mass was reported and surgery was performed. During surgery, pelvic adhesion was seen and there was complete adhesion of the stomach, intestines, and ovaries to each other. In the frozen sample, endometriosis was reported. Due to the extensive involvement, the patient underwent medical treatment.

According to the results of this case, endometriosis may be seen in any area.

The prevalence of male infertility is increasing worldwide and vitamin D deficiency can be one of the causes for this problem. The aim of this study was to investigate the relationship between serum vitamin D levels and reproductive hormones in infertile men with abnormal spermograms.

This cross-sectional study was performed on 220 infertile men with abnormal spermograms. Based on serum levels of vitamin D, they were divided into two groups of vitamin D less than 20 ng/ml (108 patients) and vitamin D greater than or equal to 20 ng/ml (112 patients). Then serum levels of FSH, LH, FT and TT were extracted and compared by referring to the medical records of the subjects.

The mean age and body mass index of participants were 34.46±5.60 years and 25.54±2.40 kg/m2, respectively. Hormone levels of FT, TT, and FSH did not show a statistically significant difference between the two groups. However, LH levels in the group with vitamin D deficiency (3.63±2.53) was significantly lower than the group with normal vitamin D (4.67±4.08) (p= 0.025).

The findings of this study showed a significant relationship only between LH levels in infertile men and their serum vitamin D levels.

Studies show that single nucleotide polymorphisms of the HOTAIR gene are associated with a variety of cancers, including colorectal, breast, and thyroid cancers. The product of the HOTAIR gene is a long non-coding RNA that is involved in regulating gene expression, cell cycle and apoptosis and is considered an oncogene. The present study was conducted to investigate the association between HOTAIR rs1899663 G>T gene polymorphism and thyroid cancer susceptibility in northwestern Iran.

In this case-control study, peripheral blood was obtained from 90 patients with thyroid cancer referred to Tabriz hospitals as well as 198 healthy individuals. After DNA extraction by saturated salt and proteinase K method, single nucleotide polymorphism of HOTAIR rs1899663 gene was examined by tetra-primers ARMS PCR. Then, allelic and genotypic frequencies of control and case groups were calculated and compared.

In this study, the genotypic frequencies of GG, GT and TT in the case group were 23.3%, 49% and 27.7%, and in the control group were 20.2%, 41% and 38.8%, respectively. Allele frequencies of G and T were 48% and 52.2% in the case group and 41% and 59% in the control group, respectively. Allelic and genotypic comparisons between case and control groups showed no significant relationship.

The results of the study showed that HOTAIR rs1899663 gene polymorphism is not associated with any of the clinicopathological features of thyroid cancer.

Candidiasis is one of the most common diseases in the oral cavity. Due to the side effects of chemical mouthwashes, the use of antifungal herbs has increased significantly. Therefore, this study was performed to evaluate the effect of Ginger (Vi-one) mouthwash on the growth of Candida albicans under in vitro conditions.

In this experimental in vitro study, 32 special solid culture media were prepared. 15 special solid culture media containing discs and wells impregnated with ginger mouthwash (Vi-one) and 15 special solid culture media with discs and wells of nystatin extract were prepared. Moreover, two blank sterile cultures with disks and wells containing no mouthwash or extract were prepared. These plates were placed in microaerophilic conditions with the presence of carbon dioxide and were transferred to the incubator at 37°C for 48 hours. After 48 hours, the zone of inhibition was determined using standard methods.

Agar well diffusion method revealed that the zone of inhibition for ginger mouthwash equaled 23.6±0.33mm and for Nystatin equaled 28.2±1.2. Agar disc diffusion method revealed that zone of inhibition for ginger mouthwash equaled 18.3±1 and for Nystatin equaled 28.3±0.1 (p<0.0001).

 Based on the results of this study, it seems that ginger mouthwash (Vi-one) compared to nystatin extract can be effective against the growth of Candida albicans under in vitro conditions.

With the increase in the production of nanoparticles, human beings are exposed to its potential dangers. Research has shown the antioxidant effects of zinc oxide at low doses, but long-term exposure to high doses has pro-oxidant effects and influences the function of the male reproductive system, spermatogenesis and fertility. The present study was conducted to investigate the effect of N-acetyl cysteine on testicular tissue changes and spermatogenesis process in male mice treated with zinc oxide nanoparticles.

In this experimental study, 24 adult male mice were assigned to groups of control (1 ml/kg saline), zinc oxide nanoparticles (50 mg/kg), N-acetyl cysteine (150 mg/kg) and N-acetyl cysteine + zinc oxide nanoparticles. In all groups, intraperitoneal injections were performed daily for 28 days. At the end of the treatment, mean weight and volume of testicles, length and diameter of seminiferous tubules, height of germinal epithelium and number of germ cells were evaluated.

In the group of zinc oxide nanoparticles, a significant decrease was observed in volume (38.86±1.48), length (0.89±0.09), diameter (162.69±1.03), and height of germinal epithelium (41.06±1.73) of the seminiferous tubules, number of spermatogonia (4.15±0.11) ×106, spermatocytes (21.45±0.83) ×106, round spermatid (22.31±0.47) ×106, elongated spermatid (21.74±0.76) ×106 and Sertoli cell (3.08±0.10) ×106 and a significant increase was observed in interstitial tissue volume (18.04±1.84) compared to the control group (p<0.001). In the concurrent treatment group, N-acetyl cysteine improved the above parameters compared to the group of zinc oxide nanoparticles (p<0.01). These parameters were not significantly different in the N-acetyl cysteine group compared to the control group.

Based on the results of this study, N-acetyl cysteine was able to prevent the damage caused by zinc oxide nanoparticles on testicular tissue and spermatogenesis.

With increasing age, the burden of chronic diseases such as cardiovascular disease (CVD) increases. Education seems to be effective in controlling the risk factors for cardiovascular disease to prevent the disease and to control the disease after its development. The burden of cardiovascular disease and its associated risk factors is higher in people with low education. The present study was conducted to investigate the effect of education on the control of risk factors for cardiovascular disease in the elderly in Amirkola, northern Iran.

In this cross-sectional study, which is part of the Amirkola Health and Ageing Project, 356 elderly patients with confirmed CVD were studied. Risk factors for cardiovascular disease including body mass index, waist circumference, physical activity, systolic and diastolic blood pressure, blood cholesterol, blood triglycerides, HDL, LDL, smoking status and blood sugar were compared in illiterate and literate elderly.

Out of 356 elderly patients with CVD (177 males and 179 females), 223 patients (62.6%) were illiterate and 133 patients (38.4%) were literate. Patients did not differ significantly except for controlling the risk factor of low physical activity. Education was effective in controlling the risk factor of physical activity in patients with cardiovascular disease (OR=2.295, CI=1.228-4.289) and these people were more active (p=0.009). In addition, 59.87% of risk factors in the literate group and 58.33% of risk factors in the illiterate group were controlled, which did not show a significant difference.

The results of the study showed that except for low physical activity, other risk factors were not associated with literacy in the elderly with CVD.

Specific treatment for each patient based on their clinical data is one of the medical prospects of the future. Using data mining and machine learning techniques based on computer science in extracting the quantitative features of an image to improve the process of diagnosis, prognosis, prediction and response to cancer treatment is known as radiomics. This article examines the workflow, findings, challenges ahead, and the role of radiomics in precision medicine and individual therapy.

In this review article, we searched well-known indexes such as ISC, web of science, Google Scholar, Scopus, PubMed without time limit and based on the keywords radiomics, radiotherapy, cancer and quantitative imaging and relevant articles were collected.

Radiomics is a combination of everyday computer-aided diagnosis, machine learning methods, deep learning and human skills that can be used for quantitative description of the phenotypes of cancerous tumors. Image collection and processing, tumor segmentation, extraction of features, processing and modeling are some of the basic steps of the process of radiomics. Computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET) and ultrasound (US) methods are among the used images.

According to the results of this study, the prerequisite for the clinical implementation of radiomics is the elimination of deficiencies such as the dependence of the features on the imaging parameters, and the unrepeatability of the features. Therefore, a comprehensive approach should be adopted, stable and reproducible patterns should be developed to accept radiomics as a clinical prognostic tool.

In recent years, with increasing interest in the use of natural substances such as essential oils, extensive studies have been conducted to use them more efficiently in the form of nanoliposomes. The present study was conducted to investigate the anti-cancer effects of nanoliposomes containing Rosemary and Zataria multiflora Boiss essential oils on HepG2 cell line under in vitro conditions.

In this basic-applied research, nanoliposomes containing Rosemary and Zataria multiflora Boiss essential oils were used. The mortality rate of HepG2 cell line was calculated using MTT method and IC50 was obtained. The study groups calculated according to IC50 were: control group, the group receiving 79.72 μg/ml Zataria multiflora Boiss nanoliposome for 48 hours and the group receiving 53.50 μg/ml Rosemary nanoliposome for 72 hours. The rate of apoptosis and necrosis of cancer cells and the type of cancer cell cycle were determined by flow cytometry.

The results showed that nanoliposomes containing Rosemary essential oil after 72 hours (53.50 μg/ml) and Zataria multiflora Boiss after 48 hours (79.72 μg/ml) showed the highest capability to inhibit the growth of HepG2 cell line (p<0.05). The type of cell mortality was significantly apoptotic compared to the control group, as nanoliposomes containing Zataria multiflora Boiss caused apoptosis in 37.3% and Rosemary nanoliposomes in 32.1% of cells (p<0.05). Inhibition of cancer cells was in the G2 phase, which indicates that nanoliposomes inhibit cancer cells in the cell division phase (p<0.05).

The results showed that nanoliposomes containing essential oils have anti-cancer properties, cause cell apoptosis and stop cell growth in the G2 phase of the cell cycle.

Due to the physiological changes caused by estrogen deficiency in menopause and due to the importance of aerobic exercise as one of the non-pharmacological strategies to improve these changes, the present study was performed to evaluate the effect of moderate-intensity aerobic exercise on lipid profile and the number of some plasma blood cells after ovariectomy.

This experimental study was performed on 40 female rats that were divided into two equal groups and one group underwent ovariectomy. After two weeks of recovery, the rats were randomly divided into four groups: control-healthy, control-ovariectomy, exercise-healthy and exercise-ovariectomy. The rats exercised for 25 weeks with 25 meter per minute intensity and blood samples were taken 48 hours after the last training session.

Ovary removal in the control-ovariectomy group increased body weight (240.20±11.37) compared to the healthy-control group (198.36±6.79) (p≤0.01), increased triglyceride (82.33±12.38) compared to control-healthy (36.83±3.55) (p≤0.01), increased total cholesterol (130.66±3.82) compared to healthy-control (95.5±1.33) (p≤0.0001) and increased monocytes (3.73±0.58) compared to the control-healthy (0.233±0.06) (p≤0.0001). Ovariectomy caused an increase in white blood cells in the control-ovariectomy group (6.33±1.39) compared to the healthy-exercise group (3.68±0.74) (p≤0.05). Total cholesterol levels decreased in exercise-ovariectomy (108±3.53) compared to control-ovariectomy (130.66±3.82) (p≤0.001). Eight weeks of aerobic exercise reduced monocytes in the exercise-ovariectomy group (0.268±0.03) compared to the control-ovariectomy group (3.73±0.58) (p≤0.001).

The results of the study showed that ovariectomy increased inflammation due to an increase in white blood cells, monocytes and platelets, and aerobic exercise was able to partially compensate for these changes in lipid and hematological parameters resulting from ovary removal. It seems that aerobic exercise can improve the effects of ovariectomy on white blood cells and platelets after adaptation, which has a significant positive effect on body weight and lipid profile.

Reactive oxygen species are the main factors involved in kidney damage during renal ischemia-reperfusion (RIR). Since D-limonene has antioxidant, anti-diabetic, anti-apoptotic, and lipid peroxidation effects, it prevents mitochondrial dysfunction and inhibits ROS, this study was conducted to evaluate the effects of pretreatment with D-limonene on oxidative stress and antioxidant activity in RIR injury.

In this experimental study, 24 male Wistar rats were randomly divided into 3 groups: control, RIR (ischemia was induced by clamping of renal pedicles for 45 minutes and reperfusion was considered 24 hours after ischemia), and RIR+D-limonene (100 mg/kg by oral gavage for 12 days). Serum and kidney were used to evaluate malondialdehyde (MDA), myeloperoxidase (MPO), paraoxonase1 (PON1), glutathione (GSH), catalase (CAT), glutathione peroxidase (GPX), and nitric oxide (NO).

Serum and renal levels of MDA ([18.2±98.77 vs. 9.21±1.77] and [19.85±3.39 vs. 9.84±1.65]) and MPO ([67.25±32.67 vs. 40.21±6.1] and [18.44±2.86 vs. 10.42±1.68]) and serum level of NO (31.3±36.1 vs. 27.88±2.6) significantly increased in the RIR group compared with the control group (p<0.05). Serum and kidney levels of GSH, activities of CAT and GPX in serum and kidney, and serum activity of PON1 significantly decreased in the RIR group compared with the control group (p<0.05). Pretreatment with D-limonene could significantly ameliorate serum and renal levels of MDA, serum levels of GSH and NO, and serum activity of CAT in rats pretreated with D-limonene in comparison with RIR rats (p<0.05).

This study indicated that pretreatment with D-limonene could ameliorate RIR injuries in rats through its antioxidant activities.

Tension headaches are the most common type of headache which lead to functional decline in patients with this problem. Considering the fact that pharmacotherapy alone cannot be a complete treatment for this problem, the present study was conducted to evaluate the effectiveness of cognitive-behavioral stress management alone and along with pharmacotherapy on the treatment of tension headaches.

In this cross-sectional study, 40 patients with tension headache were selected by convenience sampling method and were divided into four groups of ten. The first group received stress management program, the second group underwent pharmacotherapy, the third group was under pharmacotherapy and stress management, and the fourth group received no treatment. Subjects were treated for eight weeks and they completed Distress Tolerance Scale (DTS) and Tension Headache Questionnaire before and after the intervention and the results were compared.

Mean distress tolerance scores in the first group changed from 41.50±8.38 to 46.50±9.05, the second group from 42.43±7.18 to 42.00±7.46, the third group from 37.00±9.73 to 45.75±9.25 and the fourth group changed from 40.86±9.61 to 38.43±9.67 (p=0.000). Headache severity in the first group changed from 7.50±2.07 to 4.75±1.48, the second group from 7.14±1.95 to 4.57±1.90, the third group from 6.75±2.81 to 2.25±1.66 and the fourth group changed from 6.86±1.95 to 7.71±2.13 (p=0.00). Pairwise comparison of the groups demonstrated that the third group (combination therapy) showed a significant difference in both variables compared to other groups (p=0.04).

The results of the study demonstrated that combination therapy (cognitive-behavioral stress management and pharmacotherapy) showed the greatest effect on distress tolerance and headache reduction. Therefore, stress management can be a suitable complement to medication.

Central retinal vein occlusion (CRVO) is a common age-related vascular retinal disorder and is a condition in which the main vein of the retina is blocked partially or completely. This leads to macular edema (ME) and can cause blurred vision and loss of visual function. The aim of this study is evaluating the prognostic factors of visual acuity (VA) and macular thickness (MT) changes in response to intravitreal bevacizumab therapy.

In this historical cohort study, 107 patients with CRVO were examined and their hypertension, hyperlipidemia and diabetes mellitus status were recorded. All of the patients were treated with an intravitreal injection of 1.25 mg/0.05 ml bevacizumab. Visual acuity and macular thickness were examined at baseline and at all follow-up visits. Follow-up examinations were performed for three months and then VA and MT changes were analyzed.

After the intervention with bevacizumab, there was significant improvement in MT (0.104±0.13 versus 0.296±0.22) and VA (425.41±64 versus 325.94±51.82) (p<0.001, for both). The improvement of MT in response to bevacizumab therapy in hyperlipidemic patients was significantly less than patients with normal lipid profile (p=0.035). No significant relationship was found between MT reduction and hypertension or diabetes mellitus. Also, no significant relationship was observed between VA improvement and hyperlipidemia, hypertension, diabetes mellitus, age and gender.

Bevacizumab therapy was effective to successfully improve VA and MT. Hyperlipidemia has prognostic value in bevacizumab therapy in CRVO patients.

Epidemiological data show a strong correlation between vitamin D deficiency and the incidence of diabetes mellitus. Many studies have reported hypovitaminosis D in patients with diabetic retinopathy, and it is possible that the deficiency of this vitamin plays a role in the pathogenesis of this diabetic complication. Therefore, the aim of this study is to investigate the serum levels of vitamin D in patients with diabetic retinopathy and its relationship with the prevalence of diabetic retinopathy.

In this review article, we searched Scopus, Google Scholar, and PubMed databases using the keywords vitamin D deficiency, serum vitamin D levels, vitamin D supplement, diabetes, and diabetic retinopathy. No time limit was considered for the search. Articles written in English were included in this study. Original and complete articles in English about vitamin D deficiency, diabetes and retinopathy were reviewed. Review articles and animal studies were excluded from this study. The data obtained from these findings were extracted and evaluated by two reviewers.

In this study, out of 52 studies found, 15 articles were reviewed according to the inclusion criteria. The results showed that vitamin D deficiency is very common in people with diabetes and diabetic retinopathy and there is a strong inverse relationship between vitamin D deficiency and diabetic retinopathy. In addition, the use of its supplements is also necessary to prevent the progression of diabetic retinopathy.

The results of this study suggest that the reduction of vitamin D serum levels is very common in patients with diabetic retinopathy and can be one of the risk factors for developing retinopathy. Its plasma level can have a high diagnostic value in order to prevent and control the onset of this complication.

Genitourinary neurofibroma is a benign nerve sheath tumor commonly found in patients with neurofibromatosis type 1. This disease is very rare and can appear in all urinary tracts. Considering the rarity of neurofibromatosis of the bladder, the present case report is introduced with the aim of showing the importance of this pathology.

The patient is a 25-year-old man who visited the urology clinic last month due to hematuria. The patient did not mention any other clinical symptoms. An ultrasound was requested for the patient, and a mass was reported in the bladder. The patient underwent mass resection through the urethra. In the pathological and immunohistochemical studies, the patient was diagnosed with neurofibromatosis. The general condition of the patient after surgery is good and the patient's symptoms are resolved.

According to the results of this study, the patient was symptomatic and had a mass in the bladder on ultrasound. Due to the lack of a previous diagnosis of neurofibromatosis type 1 for the patient and the lack of a definite diagnosis about the type of mass, the best treatment approach is surgery and complete removal of the mass. After the final diagnosis based on histopathological and immunohistochemical evaluations, the best approach is to follow up the patient with imaging.

In the epidemic of COVID-19, intensive care units usually bear a heavy burden due to overcrowding of patients who need hospitalization, which can be due to liver involvement in these patients. This study was conducted to assess the relationship between liver enzymes in COVID-19 patients and the need for hospitalization in the intensive care unit, as well as to investigate its relationship with the length of stay in the intensive care unit.

In this analytical cross-sectional study, 622 hospitalized patients with COVID-19 who referred to Firoozgar Hospital were investigated in terms of length of stay, recovery or death and its relationship with abnormal liver enzymes.

The mean level of AST and ALT in people hospitalized in ICU was 49 (95% CI: 43.4-54.6) and 29.2 (95% CI: 24.1-34.2), respectively, and it was 42.5 (95% CI: 36.7-48.3) and 31.2 (95% CI: 25.8-36.6), respectively, in the general ward. The mean level of AST and ALT in patients hospitalized for less than 7 days was 49.4 (95% CI: 43.9-54.8) and 27 (95% CI: 21.6-32.3), respectively, and in patients hospitalized for more than 7 days was 41.6 (95% CI: 35.6-47.5) and 32.2 (95% CI: 37.3-27.1), respectively. None of the abnormal data was significant based on hospital department and length of stay.

The results of this study did not show any significant relationship between the need for admission to ICU and the abnormal levels of liver enzymes. Furthermore, no relationship was found between the length of stay and the severity of liver involvement based on the assessment of abnormal liver enzymes.

Polycystic ovary syndrome is the most common endocrine disorder in women of reproductive age. Therefore, in this study, the prevalence of hirsutism, overweight and menstrual disorders, which have a high comorbidity with this syndrome, and its relationship with age, marriage, and the use of related medications were investigated among students in the dormitory of Kerman University of Medical Sciences.

This cross-sectional study was conducted among students in the dormitory of Kerman University of Medical Sciences in 2019-2020. The prevalence of hirsutism, menstrual disorders, polycystic ovary syndrome (based on NIH criteria) and overweight were calculated. The polycystic ovary syndrome screening questionnaire was used for screening and its relationship with age, marriage and the use of related medications was measured.

636 students with an average age of 21.99±3.61 participated in this study. 13.9% of students had a menstrual cycle of more than 35 days. 70.6% had a menstrual cycle of 25 to 34 days. In terms of the growth of thick dark hair, 17.1% experienced hair growth in more than two areas of the body, and most reports of hair growth were related to chin, chest, and abdomen with 31.4%, 29.9%, and 23.2%, respectively, and 45.3% of subjects did not report hirsutism. Moreover, 30.8% were overweight and 4.7% had galactorrhea. With a confidence interval of 95%, the prevalence of polycystic ovary syndrome was 10.6 (3.2-18.0). Age and the use of medications had a significant relationship with these symptoms.

The results of this study showed that the prevalence of polycystic ovary syndrome among students is not higher than the average of the society, and it occurs more in people over 22 years of age and people who take medications.

Syncope is a sudden, transient and complete decline in the level of consciousness during which the patient cannot maintain his/her muscle tone and falls to the ground. Recovery is usually spontaneous and quick. Stimulants such as standing for a long time, hot bath and emotional stress are associated with this type of syncope. A significant percentage of cases of syncope occur while standing. Standing leads to the transfer of 500-800 ml of blood to the abdomen and organs. To deal with hypovolemia and reduce venous return, elastic compression stockings can be considered for treatment.

Failure to follow the standard guidelines in the selection and monitoring of infants before and during home phototherapy can result in unfavorable outcomes. The present study was conducted to determine the performance and complications of failure to follow the standard guidelines in infants undergoing home phototherapy in Mashhad, Iran.

In this cross-sectional study, a total of 202 infants who were referred to neurology clinic or hospitalized at the emergency or neonatal wards due to acute or chronic outcomes of home phototherapy were included in 2020-2021. Gestational age, gender, birth weight, age at jaundice onset, age and duration of phototherapy, weight on admission, etiology of jaundice, referrer, phototherapy service providing center, type of breastfeeding, hyperthermia incidence, serum or skin bilirubin levels at the beginning and end of phototherapy, hematocrit, direct and indirect Coombs test, reticulocyte count, TSH, T4, G6PD, maternal age and blood type, parity, type of delivery, and pregnancy and delivery problems were recorded.

The mean age of infants was 7.7±7.6 days, birth weight 2746±707 gr, admission weight 2601±771, bilirubin before home phototherapy 15.58±3.7 mg/dl, bilirubin on admission 17.5±5.8 mg/dl, and home phototherapy duration was 2.5±0.7 days. The frequency of causes of jaundice was as follows: ABO incompatibility (n=30), Rh incompatibility (n=22), urinary tract infections (n=13), fever and dehydration (n=19), hypothyroidism (n=7), biliary atresia (n=5), galactosemia (n=2), and etc. Thirty infants had pathologic weight loss, six had kernicterus, and three needed exchange transfusion.

According to the findings of the present study, it seems that the non-compliance with the guidelines and standards for the selection of babies eligible for home phototherapy along with the lack of monitoring of the health status and serum bilirubin of these infants lead to serious consequences (dehydration and pathological weight loss, need for exchange transfusion and kernicterus) in them. It is necessary to closely review and monitor the process of diagnosis and referral of babies with jaundice who need phototherapy and treatment to phototherapy centers at home or hospital.

Psoriatic arthritis (PSA) is a multifactorial disease that affects 5-8% of patients with psoriasis. This disease is rarely reported in temporomandibular joint (TMJ). Female patients are generally prone to temporomandibular disorders (TMDs), and disorders affecting this joint cause secondary symptoms such as general mouth and face pain, headache, masticatory myalgia, and sleep disturbance. A rare case of temporal bone and temporomandibular joint involvement in psoriatic arthritis is reported here.

 The patient is a 62-year-old woman who referred with pain in the right ear, physical imbalance, restricted mouth opening, along with the habit of clenching. CBCT findings showed evidence of reduced joint space on the right and left TMJ, the presence of erosive lesions on the right condylar head. Dehiscence of the roof of the middle ear was also present on the right and left sides. Also, the petrotympanic fissure or the foramen tympanicum was open on the right and left sides. She had previously used a soft night guard on the right side for TMJ pain, but due to the treatment failure, a prosthodontist recommended the use of a hard night guard.

Based on the results of this study, temporal bone involvement should also be considered in people with a history of psoriasis.

Hyponatremia is associated with adverse outcomes and increased mortality in acute stroke patients. However, the role of hyponatremia as a negative prognostic indicator has been controversial. This study was conducted to determine the relationship between serum sodium level and impairment and disability in stroke patients in Babol, northern Iran.

This cross-sectional study was conducted in 6 months on 125 stroke patients admitted to Ayatollah Rouhani Hospital in Babol. The National Institutes of Health Stroke Scale and the Modified Rankin Scale were used to determine the impairment and disability caused by stroke. Venous blood was collected to determine the serum concentrations of sodium. The normal ranges were defined as 135-145 mEq/L.

Of 125 stroke patients, 108 cases (86.4%) were ischemic stroke. Eighty-two cases (65.5%) had hyponatremia. The type of stroke showed statistically significant difference with hyponatremia in 14 hemorrhagic stroke cases (17%) versus 68 ischemic stroke cases (83%) (p=0.01). Furthermore, the difference in gender showed statistically significant difference with hyponatremia in 49 women (59%), and 33 men (41%) (p=0.02). In hyponatremic patients, the severity of impairment at admission (p=0.01) and disability at discharge time (p=0.02) was higher than patients with normal sodium serum level. In patients with a history of smoking, 9 cases (21%) had normal sodium level while 33 cases (79%) had hyponatremia (p=0.03).

The results of the present study showed that the severity of impairment and disability at the time of discharge in stroke patients is related to serum sodium level. Therefore, paying attention and correcting serum sodium level should be considered more in acute stroke patients.

One of the first cities that announced the outbreak of COVID-19 in Iran was Babol, in the north of Iran. Geographic Information System (GIS) is an important tool in tracking and dealing with the spread of diseases. The aim of this study is to investigate the effect of the weekly GIS reports on the spread of the disease in controlling COVID-19.

This cross-sectional study was conducted for two months, from the third week of the beginning of the epidemic till the end of the first wave of COVID-19. The geographic address of hospitalized patients was extracted and pinned on the map of Babol. Coding was done in the Python program (python 3.7.6) and the information was placed in an online map that can be enlarged and separated to show the alleys and houses. Moreover, the information was entered into the GIS software and the weekly output was obtained in HTML and PNG formats. The output results of the maps were used as the basis for follow-up in the deputy health department, and after the creation of operational teams, the follow-up of points with high prevalence was done on a weekly basis until the end of the first peak of the COVID-19 epidemics.

The number of hospitalized patients in hospitals of Babol had an upward trend from the beginning of the disease until March 12, 2020. After that, according to the measures taken (including the preparation of patient distribution maps), at first a steady trend and after ten days, a downward trend was observed. A total of 174 pollution points were found in Babol city and Babol county, of which 60 pollution points were related to Babol city.

Based on the results of this study, the preparation of distribution maps of COVID-19 patients in Babol and targeted follow-ups helped to control the first peak of this outbreak within 10 days.

Central serous retinopathy (CSR) is an idiopathic retinal disease that causes visual impairment and metamorphopsia. Due to the unknown etiology of CSR, the present study was conducted to investigate the role of metabolic disorders such as hyperlipidemia, diabetes, hypothyroidism, and hypertension (as a cardiovascular disease) in the treatment outcome of CSR patients.

This cross-sectional study was performed on 55 CSR patients whose problem was approved by ophthalmologic examinations in the Ophthalmology center of Ayatollah Rouhani Hospital, Babol, Iran. The patients were then treated with intravitreal injection of 1.25 mg/0.05 ml bevacizumab (Avastin®) 3 to 4 millimeters away from limbus under sterile conditions. Based on having and not having hypertension, diabetes, hypothyroidism and obesity, all patients underwent ophthalmological examination, including visual acuity (VA) and central macular thickness (CMT) by optical coherence tomography (OCT) before injection and one month after that.

The mean age of CSR patients (32 men and 23 women) was 42±11.50 years. After treatment, the CMT value in hypertensive patients (328.66±34.00 µm) was significantly higher than non-hypertensive patients (302.56±41.79) (p=0.025). The CMT value after treatment was considerably lower in non-diabetic patients (306.08±42.49 µm) compared to diabetic patients (336.77±17.42 µm) (p=0.039). Neither VA nor CMT was significantly different between hyperlipidemic patients and non-hyperlipidemic patients. In addition, there were no significant differences in VA and CMT between patients with hypothyroidism and without hypothyroidism.

The results of this study showed that hypertension and diabetes are important factors in CSR patients’ response to bevacizumab injection.

Colorectal cancer is one of the most common cancers among men and women in the world. Of all the risk factors of colorectal cancer, nutritional factors are among the most important and preventable risk factors. Epidemiological studies as well as laboratory evidence have investigated the effect of omega-3 intake in the prevention of colorectal cancer, and considering the contradictory results in this area, the present study was conducted to investigate the effect of this nutrient on colorectal cancer.

In this systematic review and meta-analysis, eligible studies were carefully and independently searched by two researchers using the keywords “colorectal cancer” or “colon cancer”, “Omega 3 fatty acids”, “fish oil”, “n-3 PUFAs” and “ω-3” in ISI, PubMed, Scopus, ProQuest and Embase databases from 1993 till the end of 2017, and the search was restricted to English language. The abbreviations RR, OR, and HR were extracted with a 95% confidence interval and subjected to statistical analysis based on the random effects model.

Among 6554 articles, 15 prospective cohort studies were finally included in the research. Despite the lower rate of colorectal cancer in both genders (p=0.394, 95% CI: 0.85-1.06, RR: 0.95) as well as men (p=0.395, 95% CI: 0.79-1.09, RR: 0.93) and women (p=0.583, 0.74-1.17, 95% CI: 0.74-1.17, RR: 0.93) who consumed omega-3, no statistically significant difference was found between consumers and non-consumers.

The results of this study demonstrated that there was no significant relationship between the intake of omega-3 and its subtypes and the incidence of colorectal cancer.

Parasomnia occurs due to various hereditary reasons, psychiatric or medical diseases, as well as substance or medication use. The occurrence of medication-induced parasomnia not only causes concern for the patient and family, but also causes the patient to refuse to continue the treatment. The aim of this case report is to consider melatonin as one of the causes of medication-induced parasomnia.

The patient is a 17-year-old woman who referred to the Sleep Disorders Clinic of a university center due to delayed sleep phase disorder. After ruling out medical causes and diagnosing delayed sleep-wake phase disorder, she was treated with 1.5 mg melatonin by a psychiatrist. The patient experienced visual hallucinations, sleep paralysis and nightmares that night. A month and a half later, similar symptoms appeared after re-taking melatonin. After discontinuing the medication, there were no symptoms in the 6-month follow-up.

According to the results of this study, melatonin can cause parasomnia. In the above patient, due to the possibility of parasomnia-related risks and low acceptance of treatment, it is necessary to give the necessary warnings to the patient and family and seek help from non-pharmacological treatments.

Spermatogenesis is a complex phenomenon that is influenced by various genes. One of these genes that is likely to be effective in causing azoospermia is CLCA4. This study was conducted to investigate the association between rs763763348 and rs190628533 single nucleotide polymorphisms in CLCA4 gene and azoospermia in Iranian men.

In this cross-sectional study, blood samples were collected from 100 men suffering from non‐obstructive azoospermia referred to Jihad Daneshgahi Infertility Treatment Center in Qom, as well as 100 fertile men who had at least one child and had healthy sperm test. The DNA of the samples was extracted by salting out method. Then, Tetra-primer ARMS PCR technique was used to check single nucleotide polymorphisms and the relationship between single nucleotide polymorphisms (SNPs) and male infertility was investigated.

The mean age of healthy people was 33.12±2.789 years and the mean age of patients was 32.54±2.571 years. The mean level of FSH hormone in healthy and sick subjects was 6.86±1.214 and 15.05±2.078, respectively (p<0.0001). The mean level of LH hormone in healthy people (4.12±1.04) and in sick people (11.44±1.54) showed a significant relationship (p<0.0001). In all studied subjects, the genotype of 100% of the subjects regarding rs190628533 was CC and the genotype of 100% of subjects regarding rs763334876 was GG. There was no significant difference between the healthy and sick groups in the evaluation of these two SNPs.

According to the results of this study, single nucleotide polymorphisms of rs190628533 and rs763334876 are not the cause of infertility due to azoospermia among Iranian men.

Zinc deficiency has been suggested as a risk factor for adverse pregnancy outcomes. Since dealing with zinc deficiency is an easy and inexpensive method, this study was conducted with the aim of investigating the relationship between adverse pregnancy outcomes and zinc concentration of amniotic fluid and maternal plasma in the second trimester and biomarkers of the first and second trimester.

This cross-sectional study was conducted on 102 pregnant mothers who were candidates for amniocentesis in Mousavi Hospital in Zanjan in 2018 through convenience sampling. Women with normal amniocentesis results were followed up until delivery in terms of adverse pregnancy outcomes (incidence of preeclampsia, intrauterine growth retardation, premature delivery, fetal death, and low birth weight) and were divided into two groups with adverse pregnancy outcomes (first group) and without adverse pregnancy outcomes (second group) and were compared in terms of zinc concentration in plasma and amniotic fluid.

The concentration of zinc in the plasma of the mothers of the first group (59.53±15.88 µg/dl) was significantly lower than that of the mothers of the second group (71.44±19.25 µg/dl) (p=0.02). However, there was no significant difference in the concentration of zinc in the amniotic fluid of the two study groups. In this study, the best cutoff point to determine people at risk of adverse pregnancy outcomes was determined to be 60.5 µg/dl.

Based on the results of this study, there seems to be a relationship between low zinc concentration of plasma in pregnant women and adverse outcomes.

Traumatic brain injury is the most important cause of death among young people in the world. Considering the neuroprotective effect of losartan on the recovery of brain damage, the present study was conducted to investigate the effects of losartan on neurological severity scores, blood-brain barrier health, cerebral edema, and histological changes after the induction of traumatic brain injury in male rats.

In this experimental study, 60 male Wistar rats weighing 250 to 280 grams were assigned into 7 groups: 1) Intact, 2) Surgery Sham, 3) Traumatic brain injury, 4) Losartan solvent (saline), 5) Low dose of losartan (5 mg), 6) Medium dose of losartan (10 mg), 7) High dose of losartan (20 mg) and 6-8 rats were used in each group. 30 minutes after brain trauma, different doses of losartan were injected intraperitoneally based on the Marmarou weight drop model. Neurobehavioral testing was performed, and cerebral edema and blood-brain barrier health were evaluated in all groups and the animal's brain was then used for tissue staining.

Losartan in doses of 5 mg (79.75±4.36) and 10 mg (70.375±5.60) was able to reduce cerebral edema (p<0.001) and neurological severity scores (11±1.41, and 12.75±1.90), and improve the animal's coordination on the balance beam task (11.125±3.313) and (6.875±2.94), respectively (p<0.001). In the dose of 10 mg, the effects were more significant (6.875±2.94) (p<0.001). In terms of histology, losartan decreased perivascular edema, and neuronal necrosis, and decreased astrocytic edema. Losartan had no effect in the dose of 20 mg (p>0.05).

The results of the study showed that losartan improves the outcomes of brain injury, which requires more studies in the future to investigate the mechanisms of this effect.

The nature of Narrative version of Islamic medicine (NIM) is based on Quran and hadith, exclusive attention to Islamic narrative references and rejection of the strategies of other medical schools. This study was conducted to criticize NIM.

In this qualitative study of content analysis, after collecting the opinions of 6 prominent scholars of NIM, the criticisms of these opinions were presented and categorized by three doctors specialized in Persian medicine, a cleric in the field of Islamic jurisprudence and a methodologist by holding expert panel meetings.

Criticisms were raised based on three points of view. The intra-religious area including the routine of Ahl al-Bayt (The holy family of the Prophet Muhammad) in illness and the role of physicians, the place of reason and experience in Islamic sciences, differences in geographical areas, not mentioning the full history of patients and newly occurring diseases was brought up. From a medical point of view, the important points include lack of a research method to check the effectiveness of a medical narrative, lack of diagnostic aspects and an approach to screening. From the viewpoint of religious and social consequences, religious trauma resulting from lack of response to treatment attributed to Ahl al-Bayt, approach to other manifestations of Western civilization, ethical issue of producing, prescribing and selling drugs by a group and loss of life and money due to waste of time in cases with definitive or relative treatment was raised in other medical schools.

Based on the results of this research, the introduction of this theory to society without sufficient investigations in the seminaries and universities of medical sciences may cause physical, mental and religious trauma at the individual and social level.

Microleakage is one of the most important causes of failure in restoration and secondary caries. This study was conducted in order to compare dentinal microleakage of class II composite restorations using Universal Dental Adhesive, with and without liner.

In this laboratory study, two Class II cavities were prepared in the mesial and distal surfaces of 48 healthy premolar teeth. Then, the samples were divided into 6 groups of 8 according to the application method of Single Bond Universal adhesive and liner: selective etching of enamel (SEE), self-etch (SE) technique, SEE technique and resin-modified glass-ionomer (RMGI) liner, SE technique and RMGI Liner, SEE technique and Flow Liner, and SE technique and Flow Liner. Restoration was done with Filtek Z250 composite. Microleakage was evaluated and compared using 2% fuchsine based on intensity 0 to 3.

In the SEE group, 56.2% of restorations did not have microleakage. 31.2% had grade 3 microleakage and 12.5% had grade 1 microleakage. However, in the SEE+RMGI group, 81.25% and the SEE+Flow group, 81.2% of the restorations had no microleakage. In the SE group, 18.7% of restorations showed zero microleakage, 50% showed grade 3 microleakage, and 31.2% showed grade 2 microleakage. However, in the SE+RMGI group, 81.25% and in the SE+Flow group, 93.7% of the restorations did not have microleakage. The distribution of dentinal microleakage intensity between SEE and SE methods (p=0.067) and between SEE+RMGI and SEE+Flow groups (p=0.194) was not significant. However, in the SE+Flow and SE+RMGI groups, this difference was significant (p<0.001).

The results of this study showed that in the method of using a liner with Universal adhesive, dentinal microleakage in class II composite restoration decreased.

 Two non-invasive treatment methods for treating white spot lesions (WSLs) include resin infiltration and fluoride therapy. Contradictions have been raised regarding the color change and surface roughness of the lesions based on these methods. Therefore, this study was conducted to investigate the color change and surface roughness of white spot lesions after treatment with resin infiltration and fluoride therapy.

 In this laboratory study, 40 buccal and lingual sections were prepared from 20 extracted healthy premolar teeth. 10 samples were considered as the control group, and in the other 30 samples, decayed lesions were created artificially. White spot lesions were randomly prepared in three groups without treatment, 0.05% sodium fluoride solution and resin infiltration (n=10). Then, the rate of color change and surface roughness of the samples after being placed in black tea and also after brushing were measured and compared using spectrophotometer and profilometer.

 The surface roughness of samples in resin infiltration, intact enamel and fluoride groups were 163.46±64.67, 259.6±43.12 and 293.92±41.36 micrometers, respectively (p<0.001). Before placing in tea and after brushing, no significant difference was observed in the color of the samples, but after staining, the color change in WSL (9.14±5.85), fluoride (17.40±4.13) and resin infiltration (12.13±4.88) groups was significant (p=0.004); the fluoride group showed significantly more color change compared to the WSL group (p=0.003), but the difference between the other groups was not significant.

 The results of this study show that if the resin infiltration method is used in the treatment of white spot lesions, less surface roughness and color change is observed compared to fluoride therapy.

Prevention of hyperglycemia caused by surgical stress is a challenging issue. The present study was conducted to compare the effect of spinal anesthesia versus general anesthesia on blood glucose concentration in patients undergoing transurethral lithotripsy.

This cross-sectional study was conducted on 58 patients undergoing transurethral lithotripsy in Imam Khomeini Hospital in Urmia. Group S included patients who chose spinal anesthesia and group G included patients who chose general anesthesia. For both groups, blood glucose and insulin concentrations were measured at different times: five minutes before induction (T1), five minutes after induction (T2), five minutes before the end of the procedure (T3) and 30 minutes after the end of the procedure (T4).

The mean blood glucose in T3 (83.18±37.108) and T4 (82.16±125) in general anesthesia group was significantly higher than T3 (85.16±89.79) and T4 (72.5±10.81) in spinal anesthesia group (p<0.001). Furthermore, in the general anesthesia group, the increase in blood glucose in the time intervals T1-T2, T2-T3, T3-T4 and T1-T4 was significant (p-value: 0.03, 0.003, 0.001, <0.001, respectively). Moreover, in our study, the decrease in insulin secretion between T1 and T4 was significant only in the general anesthesia group (p=0.006).

The results of this study showed that the spinal anesthesia method is a more preferable method to prevent the increase in blood glucose in transurethral lithotripsy.

With the spread of coronavirus disease 2019, secondary ocular manifestations were observed as common complications in COVID-19 patients, which can challenge the diagnosis and treatment of ocular diseases. The aim of this study is to investigate the association between laboratory parameters and ocular diseases and to determine their specificity and sensitivity in the diagnosis of ocular diseases in COVID-19 patients admitted to the intensive care unit.

In this cross-sectional study, 89 patients with COVID-19 admitted to the intensive care unit of Ayatollah Rouhani Hospital in Babol were examined from December 2020 to February 2021. Clinical examinations were performed according to the global standards for ophthalmology examinations for patients, and patients were examined in terms of intraocular pressure, cup-to-disc ratio, ocular manifestations, and ocular diseases. Routine hematology and biochemical laboratory tests were performed for all patients. Patients were compared in the group with an ocular disease (manifestation) and the group without that ocular disease (manifestation).

Out of 89 patients with COVID-19 hospitalized in the intensive care unit, 44 women and 45 men participated in the study and the mean age of the patients was 58.5±14.64 years. The number of white blood cells was significantly lower in COVID-19 patients with pinguecula compared to non-pinguecula patients (p=0.026). Furthermore, the relative percentage of lymphocytes was significantly lower (p=0.003) in COVID-19 patients with cataract (9.64±13.20%) compared to non-cataract patients (14.25±17.95%). The relative percentage of neutrophils was higher in COVID-19 patients with cataract compared to non-cataract patients (p=0.01). RBC is significantly reduced in COVID-19 patients with chemosis (p=0.024). For the relative percentage of neutrophils greater than or equal to 82.55%, cataract for COVID-19 patients admitted to the intensive care unit with 0.83% sensitivity and 66.7% specificity is positive.

The results of the study showed that blood cells and some biochemical parameters are associated with ocular diseases in COVID-19 patients admitted to the intensive care unit.

Irritable bowel syndrome is one of the common gastrointestinal complaints that is often resistant to standard treatment. Since mesalazine reduces abdominal pain and diarrhea through its anti-inflammatory effects, this study was conducted to investigate the effect of mesalazine on pain management in patients with diarrhea-predominant irritable bowel syndrome (IBS-D).

This case-control study was conducted among 100 patients diagnosed with diarrhea-predominant irritable bowel syndrome referred to Ayatollah Rouhani Hospital in Babol. Patients were randomly divided into two groups of 50, receiving standard treatment (amitriptyline 25 mg) and a group that received mesalazine at a dose of 500 mg for 4 weeks three times a day in addition to standard treatment. Subjects were examined and compared in terms of pain intensity and frequency of discharge and recovery.

The intensity of pain after treatment in the case group was lower than before treatment (4.66±2.29 vs. 7.80±2.01) (p=0.004). Out of 50 patients, 38 people (76.0%) in the case group and only 20 people (40%) in the control group recovered (p<0.001). In the case group, the number of bowel movements after treatment (2.20±0.92) was significantly less than before (4.92±0.92) (p<0.001). In the control group, the number of bowel movements showed a statistically significant difference before and after treatment (5.22±1.07 vs. 2.50±1.19) (p<0.001).

Based on the results of this study, mesalazine is significantly effective in reducing the intensity of pain caused by irritable bowel syndrome. However, there was no difference in the number of excretions.

In pregnancies complicated by preeclampsia, it seems that failure of trophoblast invasion and induction of placental inflammation can lead to the production of biomarkers, one of which is CA-125. The aim of this study is to investigate serum CA-125 levels in non-severe and severe preeclampsia and compare it with normal pregnancy.

This retrospective case-control study was conducted on 30 women with normal pregnancy, 27 women with mild preeclampsia and 30 women with severe preeclampsia referring to the midwifery clinic of Shahid Motahari Hospital in Urmia who met the inclusion criteria. The data evaluated in this study included gestational age, systolic and diastolic blood pressure, platelet, AST, ALT, serum creatinine, serum uric acid, serum CA-125 levels, urinary protein level and birth weight. Venous blood samples were collected at delivery for complete blood count, creatinine, uric acid and CA-125 concentration from all participants. Then the results were compared.

The results of the present study showed that the mean CA-125 of women in the control group was 17.83±5.37 u/ml, in the mild preeclampsia group was 40.64±12.40 and in the severe preeclampsia group was 71.73±48.90, which indicates that this value is high in mild preeclampsia compared to the control group as well as severe preeclampsia compared to the other two groups. Statistical comparisons showed that there is a significant relationship between serum CA-125 levels in women with normal pregnancy and non-severe and severe preeclampsia (p<0.001).

The results of the present study showed that CA-125 is associated with the occurrence of preeclampsia (mild and severe) and can be helpful as a marker in the diagnosis of preeclampsia, especially its severe type. Moreover, due to the relationship between this marker and a wide range of other variables, paying attention to its serum level along with other paraclinical variables can be helpful in better diagnosis and management of patients.

Human papillomavirus (HPV) is one of the common infectious and pathogenic agents, and some of its genotypes have the ability to cause malignant changes in the surface of mucous cells. By examining the prevalence of HPV in atypical squamous cells of undetermined significance (ASCUS) Pap smear according to the risk factors, we can make a more correct decision in choosing the evaluation method and directing the patient to report the ASCUS lesion. Therefore, the aim of this study is to investigate the types of human papillomavirus (HPV) in patients with ASCUS Pap smear.

This cross-sectional study was conducted on 200 patients with ASCUS pap smear results and HPV test referred to the colposcopy clinic of Babol Ayatollah Rouhani Hospital during the last two years. Demographic information, history of obstetrics, history of OCP use, history of STD disease and high-risk behaviors, cervical treatments, HPV typing, Pap smear, colposcopy and cervical biopsy results were recorded and analyzed.

The mean age of the patients was 33.83±8.09 years, and ASCUS pap smear showed 129 cases (64.5%) of high-risk papillomavirus, 16 cases (0.8%) of low-risk papillomavirus and 55 cases (27.5%) of both types. Cervical intraepithelial neoplasia grade 2 was in 18 cases (0.9%), cervical intraepithelial neoplasia grade 1 in 10 cases (0.5%) and cervical intraepithelial neoplasia grade 3 in 2 cases (0.1%). 17.1% of high-risk viruses caused cervical neoplasm. None of the low-risk viruses led to neoplasms and all of them were inflammatory. In both high-risk and low-risk cases, 14.5% neoplasm was seen. However, the relationship between the type of papillomavirus and the incidence of neoplasm was significant (p=0.058).

Based on the results of this study, the ASCUS pap smear needs more detailed investigation such as colposcopy and cervical biopsy under the supervision of experts because it is associated with the high-risk HPV virus in many cases.

Infant mortality is an important health indicator. In order to reduce infant mortality, its causes should be considered in each region so that steps can be taken to improve the quality of health care and treatment. Therefore, this study was conducted in order to determine the causes of infant mortality in Babol, northern Iran.

This cross-sectional study was conducted on all infants who died in public and private hospitals of Babol. The cause of infant death was extracted and analyzed based on the International Classification of Diseases 10th Revision (ICD-10) and also based on laboratory, clinical and paraclinical evidence recorded in the files.

Out of a total of 16,005 live births in Babol, 123 infants (7.6%) died, of which 53 (43.1%) died in the first 24 hours of life. The mean gestational age of the deceased cases was 31.4±5.5 weeks, the mean birth weight was 1705.4±1045.3 grams, and their mean life span was 5.4±6.6 days. The most common causes of infant mortality were prematurity (30%), congenital anomalies (25.3%), sepsis (17.1%) and respiratory distress syndrome (13%).

The results of the study showed that the most common causes of infant mortality are prematurity and congenital anomalies.

Hypotension and bradycardia are among the common side effects of spinal anesthesia. The effect of ondansetron on the reduction of hypotension and bradycardia caused by spinal anesthesia has been studied considering its antagonistic effect on the Bezold–Jarisch reflex. The present study was conducted to determine the effectiveness of two different doses of intravenous ondansetron on the reduction of the incidence of hypotension and bradycardia among candidates for elective caesarean section under spinal anesthesia.

This double-blind clinical trial was conducted in Shahid Beheshti Hospital in Isfahan in 2020 and included 90 patients aged 18 to 45 years in full-term pregnancy who were candidates for elective caesarean section in three groups of 30. 5 minutes before spinal anesthesia, 6 and 8 mg of ondansetron were injected in the first and second groups, respectively, and normal saline was injected in the third group. Vital signs were examined every 15 minutes during surgery and during recovery, and the incidence of hemodynamic disorders, nausea and vomiting was compared between the three groups.

There was no significant difference between the three groups in terms of demographic and baseline variables, blood pressure (systolic, diastolic and mean arterial pressure), heart rate, ephedrine intake and incidence of hemodynamic disorders. The frequency of nausea during recovery was significantly different between the three groups (p=0.035); 12 people in the ondansetron 6 mg group, 12 people in the ondansetron 8 mg group and 21 people in the control group had nausea during recovery (40%, 40%, and 70%, respectively). The frequency of vomiting in recovery was significantly different between the three groups (p=0.002); 5 people in the ondansetron 6 mg group, 1 person in the ondansetron 8 mg group, and 12 people in the control group experienced vomiting during recovery (16.7%, 3.3%, and 40%, respectively).

The results of this study showed that administration of ondansetron at 6 and 8 mg doses in caesarean section under spinal anesthesia has no significant effect in reducing the incidence of hypotension, bradycardia, and administration of ephedrine and atropine. However, it is associated with a reduction in the incidence of nausea and vomiting in the recovery room (ondansetron 8 mg is more effective than 6 mg).

Knowing the position of the inferior alveolar canal and mental foramen is very important in periapical surgeries, administration of local anesthesia and implantation. The aim of this study is to compare the position and view of the inferior alveolar canal and mental foramen in panoramic radiography and CBCT images.

In this cross-sectional study, concurrent panoramic radiography and CBCT images of patients who visited a private radiology clinic for one year were examined. In panoramic radiographs, the indices of canal visibility, mental foramen visibility, proximity of mental foramen to mandibular premolar teeth, canal diameter, mental foramen diameter and distance from mental foramen to alveolar crest were examined. Then all these cases were evaluated and compared in CBCT radiographs (as gold standard).

In this study, concurrent CBCT and panoramic radiographs of 41 patients including 23 men (56.1%) and 18 women (43.9%) with a mean age of 51±13 years were analyzed. The mean values of variables of inferior alveolar canal diameter and distance from mental foramen to alveolar crest in panoramic images were significantly higher than CBCT images (p<0.001). The average diameter of mental foramen in panoramic images (3.9±1.3) was lower than CBCT images (4.2±1.3), but the difference was not significant (p=0.074).

Based on the results of this study, although panoramic radiography can be used in routine treatments and general examination of the mandible, it is necessary to use the CBCT technique in dental practices that require higher accuracy in terms of measurement.

Methadone is an opioid agonist used for the treatment of addiction to opioid drugs. Toxic leukoencephalopathy can cause serious problem and even be life-threatening. Methadone-induced leukoencephalopathy is a rare condition of this toxicity. Because of the importance of this situation and its treatment, we aim to report a case who is diagnosed as Methadone-induced leukoencephalopathy.

Case Report:

A 63-year-old man referred with non-persistent fever, drowsiness, rigidity and suspected of neuroleptic malignant syndrome (NMS). He was addicted to opioid from young age. He was on maintenance therapy with 80 mg methadone syrup from 2 months ago. After the appearance of symptoms including delirium, impaired attention and consciousness, treatment was performed with half a tablet of haloperidol 0.5 mg twice a day before rigidity and fever. Multiple lesions were seen in baseline CT-Scan and MRI. Toxic laboratory examination showed methadone was positive and other toxins and opioids were negative. After two weeks, second MRI showed rapid progressive lesions in white matter. Thus, it was diagnosed as Methadone-induced leukoencephalopathy in addition to NMS. Hydration, bromocriptine tablets 2.5 mg twice a day, methadone tapering and haloperidol discontinuation were performed. After two months, the patient's consciousness was better and his CPK and LDH tests were normal.

Methadone-induced leukoencephalopathy is a very rare condition, but it is important for physicians to consider this diagnosis in patients using methadone, especially when they show neurological and psychiatric signs and symptoms. That’s because early methadone tapering can reduce and stop toxicity on the white matter of the brain.

Tooth decay is the main cause of pulp and periapical diseases, and when the pulp involves the tooth, there is no other choice but to drain the pulp to save the tooth. The emergence of new methods of regenerative treatments has made it possible to restore dental pulp and dentin. Since regenerative treatments have been limited to immature teeth, this study was conducted to regenerate mature pulp tissue by dental pulp stem cell transplantation along with Platelet Rich Plasma (PRP) Matrix in rabbits.

This experimental pilot study was conducted on a maxillary central incisor in a 1-year-old 2kg adult male albino rabbit. After completely cleaning the pulp tissue from the root and crown and washing the root canal, File #30 was passed through the apex to cause bleeding. Then dental pulp stem cells along with PRP were injected into the canal and the crown was sealed with glass ionomer cement. After 14 days, a radiograph was taken from the tooth, the extracted tooth was stained by hematoxylin-eosin and examined by light microscope.

In the histological examination, in the inner wall of the root canal of odontoblasts, small thickness was observed in tubular dentin (about 1 mm) and pseudovascular structures. Furthermore, the entire space of the root canal was filled with a small and scattered number of inflammatory cells and pulp-like living tissue.

Based on the results of this study, the observation of pseudovascular structures indicates the regenerative potential of dental pulp stem cells and opens a window for studies with more samples to effectively regenerate the dental pulp.

 Various techniques have been introduced to improve bond strength of zirconia which may negatively affect flexural strength. This study aims to evaluate the effects of different sandblasting parameters on micro-shear bond strength (MSBS, Mpa) and biaxial flexural strength (BFS, Mpa) of Zirconia.

 In this in vitro study, zirconia blocks were cut into 180 discs for MSBS and BFS tests (90 specimens in each group). For each test, they were divided into one control group and 8 experimental groups according to the type of sandblasting regimen (pressures of 4 or 6 bar, duration of 14 or 21 seconds, and alumina powder sizes of 50 or 110 μm, n=10). A universal testing machine was used to determine MSBS and BFS. X-ray diffraction (XRD) analysis was then performed.

 According to the results, groups with 110 μm particles (4 bar- 14 s, 6 bar- 14 s, 4 bar- 21 s and 6 bar- 21 s with MSBS values of 34.43±5.99, 35.21±6.39, 27.17±3.95 and 28.66±3.92 Mpa, respectively) had significantly higher MSBS values compared to the control group (p<0.001, p<0.001, p=0.034, p=0.005, respectively). Groups with 110 µm- 21 s sandblasting regimen (with pressure of 4 and 6 bar with BFS values of 1031.69±90.00, 1062.56±91.29, 962.30±93.24, respectively) and those with 50 µm- 6 bar- 21 s sandblasting regimen had statistically significant lower BFS values compared to the control group (p<0.001). According to XRD analysis, groups with 110 μm powder size and 21 s sandblasting resulted in more monoclinic phase.

 This study demonstrated that sandblasting with larger powder size and shorter duration could increase MSBS without any negative effects on BFS.

 Anesthetic agents and type of surgery may lead to liver damage after surgery. Inhaled agents are associated with liver dysfunction after surgery. Propofol is expected to have a lower potential for postoperative liver damage. The present study was conducted to compare liver enzyme function after anesthesia with isoflurane and total intravenous anesthesia (TIVA).

 This clinical trial was conducted on 70 patients referred to Imam Ali Hospital in Bojnord. Patients were selected using convenience sampling and then divided into TIVA and Isoflurane groups using block randomization method. During surgery, anesthesia was maintained in the isoflurane group with isoflurane gas (1.2 MAC) and in the TIVA group with infusion of propofol (100 micrograms/kg/minute) and remifentanil (0.1 micrograms/kg/minute). The levels of ALT, AST, ALP, PTT, and INR factors of the patients were examined and compared using laboratory devices before the operation, immediately, 24 and 48 hours after the operation.

 There is no significant difference between the two groups in terms of demographic and interventional variables. ALT enzyme level in TIVA group increased from 17.6±10.7 to 21.2±14.2 and in isoflurane group from 16.7±9.4 to 28.4±16.1 (p<0.05). In other enzymes, this difference was not significant.

 The results of the study showed that the use of both TIVA and Isoflurane methods has an effect on the level of liver enzymes in patients undergoing laparoscopic cholecystectomy surgery.

Supplying vitamin D during pregnancy is necessary for fetal calcium homeostasis and bone growth and its mineralization, and its deficiency can lead to pregnancy complications. The present study was conducted to investigate the effect of vitamin D level on pregnancy outcomes in pregnant women.

This cross-sectional study was conducted among 450 pregnant women referring to Ayatollah Rouhani Hospital in Babol. Mothers' information was collected using a questionnaire. Blood samples were collected from people to measure the serum 25 hydroxyvitamin D3 level by ELISA method using the EUROIMMUN kit. Patients were divided into two groups (vitamin D level< 25 and vitamin D level> 25) and were compared.

247 people (54.8%) had vitamin D level< 25 and 203 people (44.8%) had vitamin D level> 25. People with lower vitamin D levels had significantly more gestational hypertension (p=0.03) and premature rupture of membranes (PROM) (p=0.04) compared to people with higher vitamin D levels. The variables of labor pain, diabetes, fetal growth restriction and prolonged pregnancy did not show significant differences in people with high and low levels of vitamin D. Pregnancy complications including pre-eclampsia, preterm delivery, placental abruption and fetal growth restriction did not show any significant difference in people with high and low levels of vitamin D. In the evaluation of neonatal outcomes, infant weight, infant gender, fifth minute Apgar, head circumference and admission to the neonatal intensive care unit, no significant differences were found.

The results of the study showed that some pregnancy complications such as gestational hypertension and premature rupture of membranes (PROM) in pregnant women are related to vitamin D deficiency. Therefore, it is necessary to design plans to check the vitamin D level of mothers before pregnancy and correct it during pregnancy.

Studies indicate that single nucleotide polymorphism of ICB-1 gene rs1467465 is associated with breast cancer and ovarian cancer. This study was conducted with the aim of investigating the association between ICB-1 gene polymorphism rs1467465 (A>G) and thyroid cancer susceptibility.

In this case-control study, the peripheral blood of 92 thyroid cancer patients referred to Tabriz hospitals and 203 healthy individuals were prepared. After DNA extraction by saturated salt solution, single nucleotide polymorphism rs1467465 of ICB-1 gene was investigated by TETRA-ARMS-PCR method. Then, allelic and genotypic frequencies of patient and control groups were evaluated and compared.

In this study, the genotypic frequency of AA, AG and GG in the patient group was 4.34%, 68.47% and 27.17%, respectively, and in the control group was 4.92%, 55.66% and 39.40% respectively. The frequencies of A and G alleles were calculated as 38.58% and 61.41% in the patient group and 32.75% and 67.24% in the control group, respectively. In this study, the relationship between this polymorphism and some clinical and pathological characteristics of thyroid cancer, including gender, age, type, grade and size of tumor, involvement of lymph nodes and involved side, was investigated.

This study showed that AG and GG genotypes have a significant relationship with the risk of developing thyroid tumors in the studied population, and this polymorphism may contribute to determining the relative risk of developing thyroid tumors.

Being familiar with the factors that are effective in causing falls plays an important role in reducing the issues and costs related to its treatment. Considering the contradictory results about the use of antihypertensive drugs and falls in older adults, the present study was conducted to determine the association between the use of antihypertensive drugs and falls in older adults.

This cross-sectional study was a part of the first phase of Amirkola Health and Ageing Project (AHAP), which was conducted on three groups of 250 people including healthy elderly, and hypertensive patients with and without taking antihypertensive drugs. Antihypertensive drugs were divided into 6 groups based on the mechanism of action. The variables of age, gender, body mass index, physical activity, diabetes, number of medications, depression symptoms, cognitive status, number of comorbidities, and the frequency of falls during one year before the beginning of the study and during the six-month follow-up were evaluated and compared in different categories of antihypertensive drugs by asking older adults in the three groups.

Out of all studied older adults, 126 people (16.8%) fell during the last 12 months and 36 people (4.8%) fell during the six-month follow-up. No significant relationship was found between falls and the use of antihypertensive drugs, and between the use of different classes of antihypertensive drugs and falls. Variables such as depressive symptoms (OR=2.057, p=0.001), number of comorbidities (OR=0.189, p=0.006) and older age (OR=1.033, p=0.040) had an effective role in causing falls.

The results of the study showed that the use of antihypertensive drugs and their different classes was not associated with the increase in the frequency of falls in older adults.

One of the most important effects of nanomaterials on cells is the induction of programmed cell death (apoptosis). The aim of this study is to investigate the toxicity of graphene oxide-gold nanoparticles and to evaluate the expression of caspase 3 gene in HepG2 liver cancer cell line.

In this experimental study, hepatocellular carcinoma cell line (HepG2) was prepared from Pasteur Institute of Iran. Cells were treated with concentrations of 10 to 500 µg/ml Gold-rGO and untreated cells were used as control. The level of caspase 3 gene expression and cell viability were investigated and compared within 24 and 48 hours in three groups of A, B and control (C). The effect of concentration was investigated by XTT method and acridine orange ethidium bromide staining. Caspase 3 gene expression was measured by relative quantification using real time PCR test.

Based on XTT results, EC20, EC50, EC80 values were calculated as 386.420, 90.680, 24.151 µg/ml in 24 hours and 358.146, 89.536, 22.384 µg/ml in 48 hours. Examining the level of caspase 3 gene expression change in these concentrations compared to untreated cells showed mean fold changes (mean±SEM) of 3.436±1.022 in 24 hours and 4.054±0.02 in 48 hours, according to which the level of gene expression changes significantly. The viability of control cells (C) compared to cells treated with concentrations higher than 50 μg/ml (B) has a relative increase, which was statistically significant (p<0.0001). Examination with AO/EB staining to determine the level of apoptosis showed a higher level of apoptosis with increasing dose.

The results of the study showed that shorter times and lower concentrations should be used in the application of this nanoparticle.

Designing a tooth preparation method for endocrown construction is effective in achieving clinical success. Considering that our knowledge about pulp chamber preparation is insufficient, this study was conducted with the aim of comparing the fracture strength of upper molar and premolar teeth treated with endocrown-reconstructed root based on two different methods of pulp chamber preparation.

In this laboratory study, 15 upper molars and 15 premolars were divided into three groups. The first group (5 healthy teeth) was considered as the control group. The teeth of the second and third groups of root treatment were mounted in an acrylic JIG and their crowns were cut 2 mm above the CEJ. In the second group, the undercut of the pulp chamber wall was eliminated by a dental lathe. In the third group, the undercut was blocked by resin-modified glass ionomer (RMGI) cement. The teeth of the second and third groups were scanned by a laboratory scanner and restored and cemented with lithium disilicate glass ceramic endocrown (EMAXCAD, Ivoclar Vivadent). Then, all the teeth were subjected to a fracture strength test by a universal testing machine with a crosshead speed of 1 mm/min.

The fracture strength of premolar teeth of group two (883.160±186.6) and group three (880.380±262.6) showed no significant difference. The fracture strength of molar teeth of group two (960.120±444.4) and group three (1290.740±400.7) was not significantly different. The mean fracture strength of healthy molars (2194.400±375.4) was significantly higher than restored molars (p<0.05). In terms of fracture type (repairable/non-repairable), there was no significant difference between molar and premolar teeth in the studied groups.

Based on the results of this study, two methods of eliminating the undercut or blocking out the pulp chamber with restorative materials can be used to make endocrowns in upper posterior teeth.

Tonsillectomy is one of the most common surgeries in children, which is associated with pain and bleeding after the operation. This study was conducted to investigate the effect of lidocaine-epinephrine administration in controlling complications after tonsillectomy.

This clinical trial was conducted on 109 patients aged 5 to 18, who had referred to Kowsar Hospital in Sanandaj for tonsillectomy. After dividing the patients randomly, 40 mg of 1% lidocaine and 5 μg of epinephrine (a volume of 5 ml) were injected into the tonsillar bed in the intervention group before the surgery, but in the patients of the control group, surgery was started without lidocaine-epinephrine administration. Blood pressure and heart rate of the patients before, during and after surgery, and pain intensity based on Wong-Baker Faces Pain Scale at minutes 30 and 60 and 6, 12 and 24 hours after surgery, and the amount of bleeding during and after surgery were recorded and compared by calculating the volume of suction and blood pads as well as the length of stay in recovery.

The mean amount of bleeding in the intervention group was 65.5±47.1 ml and in the control group was 113.7±45.7 ml (p=0.0001). The mean pain intensity and hemodynamic changes at minutes 30 and 60, and 6, 12 and 24 hours after surgery in the intervention group were lower than the control group and showed statistically significant differences (p=0.0001). The mean time of discharge from recovery in the intervention group was 0.35±23.2 minutes and in the control group was 50.4±17.5 minutes (p=0.0001).

Based on the results of this study, it seems that the administration of lidocaine-epinephrine in the tonsil bed before tonsillectomy can reduce the amount of pain, bleeding, and hemodynamic changes during and after surgery, and the patient can recover sooner.

Fibromyalgia syndrome (FMS) is considered as a widespread chronic pain disorder of unknown etiology. Since personality traits can play an important role in the development of FMS, this review article was conducted in order to increase the understanding of personality traits related to FMS.

This review article was conducted by searching articles based on PRISMA guidelines for studies published from 2000 to September 2021 in authentic databases using the keywords fibromyalgia syndrome, chronic widespread pain, personality, and personality tests. The results of 30 eligible studies aimed at identifying personality traits in patients with FMS were reviewed and summarized.

According to the theoretical model used, the articles that used the TCI tool reported high traumatic avoidance and low self-regulation. High scores in hypochondriasis, hysteria and depression have been observed using the MMPI questionnaire. Moreover, other studies showed a high score in neuroticism using NEO. In this systematic review, some personality traits related to FMS were identified and explained. In other words, many patients with fibromyalgia show personality traits that are related to the mechanisms involved in FMS.

The findings provide evidence that personality traits can play a key role in the development and persistence of this syndrome. However, studies lack sufficient evidence to support an "FMS personality." The results expand our knowledge about the complex nature of this disorder and facilitate the effective treatment of FMS patients. Overall, these findings support the need for a comprehensive personality model to better understand FMS.