Although laparoscopic total proctocolectomy with ileal pouch‑anal anastomosis has recently been used for this group of patients, there are rare reports of its treatment outcomes and postoperative complications. For this purpose, the very aim of the present study was to evaluate the complications of this surgery after 6 months in patients with familial adenomatous polyposis (FAP) and ulcerative colitis (UC).

The present cross‑sectional study was performed on 20 patients undergoing restorative proctocolectomy with ileal pouch‑anal anastomosis (RPC‑IPAA) for FAP or UC during 2009–2014. Outcomes of patients were recorded 6 months after surgery for complications and satisfaction.

There were 11 (60%) males and 9 (40%) females with a mean age of 30.65 ± 9.59 years. There were 12 patients (60%) with FAP and eight patients (40%) with UC. The length of stay (LOS) ranged from 4 days to 10 days with the mean of 6.40 ± 1.76 days. The incidence of complications including leak, urinary retention, and wound infection were 10%, 5%, and 10%, respectively. Moreover, no postoperative mortalities occurred. Male patients had no problems during sexual activity or micturition. All patients were highly satisfied with the outcome of the surgery.

According to the results of the present study, laparoscopic RPC‑IPAA was a surgery with the least complications and the highest level of satisfaction for young patients with FAP and UC. Therefore, it seems that this surgery can be a suitable surgical method for the mentioned patients.

The surgery for a breast imaging‑reporting and data system (BIRADS) IV lesions needs imaging or pathology supporting data. The roll of breast scintigraphy for this purpose is unclear.

In a prospective design, 16 patients with 25 BIRADS IV lesions who were scheduled for surgery were included. Before the surgery, breast scintigraphy was done using a nondedicated dual head gamma camera in the prone position employing a shaped foam pad providing imaging at breast pendulous position. Twenty mCi 99 mTc methoxy‑isobutyl‑isonitrile was injected and two 15 and 60‑min delayed imaging were done (anterior, bilateral, and single photon emission computed tomography [SPECT] projections). Pathology reports were collected and tumor to nontumor uptake ratio (T/NT) was analyzed, accordingly.

Out of all lesions, 12 were malignant (invasive ductal and lobular carcinoma ductal carcinoma in situ). At 15 min, T/NT was insignificantly higher in the malignant compared to benign lesions (22.8 ± 23.9 vs. 10.1 ± 10.1; P = 0.109). The optimal T/NT cutoff for discrimination of malignant and benign lesions was 20. Only 1 out of 13 benign lesions presented uptake >20 (7.7%; false‑positive rate; P = 0.047). The diagnostic accuracy, sensitivity, and specificity for T/NT calculated at 0.68, 0.42, and 0.92, respectively. The T/NT at 60 min remained unchanged for either benign or malignant lesions (22.3 ± 30.2 vs. 11.7 ± 17.1; P = 0.296).

Breast scintigraphy with general purpose gamma camera employing SPECT imaging may assist the selection of BIRADS IV lesions in need for surgery. All uptake positive cases should undergo surgery and decision for uptake negative cases should be made based on other data.

Cerebral palsy in children is considered a non‑progressive brain injury due to abnormal brain development. The aim of this study was to investigate the effect of eight weeks of aquatic exercises on muscle strength in children with cerebral palsy.

This study was performed on three boys with cerebral palsy with a mean age of 6.5 years. In this research, a single case study method with A1‑B‑A2 design has been used. After determining the position of the baseline, the intervention began and during 24 sessions of individual intervention, aquatic exercises were presented to the subjects and all three subjects were followed up for 2 consecutive weeks and one month after the end of the intervention. The strength of the flexor muscles of the arms and legs was measured by a power track dynamometer made by JTECK with a threshold of 4.4 N.

Based on the indicators of descriptive statistics and visual analysis, the intervention was effective for all three participants in muscle strength, and the strength of individuals after the intervention has improved compared to the baseline stage (percentage). Information overlap for the first and second participant in the strength of right thigh flexors was 75% and for the third participant was 100%. The strength of the upper and lower torso muscles improved after the end of the training compared to the basic stage.

Aquatic exercises can increase the strength of children with cerebral palsy and provide a favorable environment for children with cerebral palsy

A trigger finger is recognized as the most common hand tendinopathies that reduce functional ability. The present study compares the clinical outcomes of open classic release surgery with ultrasound‑guided percutaneous surgery in cases of multiple finger involvement.

A cohort study has been performed from March 2019 to December 2020 by participating 34 trigger finger patients with multiple involvements. These patients were treated using classical open release and ultrasound‑guided percutaneous release methods and both methods were compared in patients. The pain severity and functional ability obtained from the quick disabilities of the arm, shoulder, and hand (Quick‑DASH) test scores were compared.

The pain intensity in the classical open surgery patients was not significantly different from the ultrasound‑guided group, and a one‑month follow‑up showed that the pain intensity in the ultrasound‑guided patients was significantly less than in the other group (P = 0.02). Besides, no significant difference was observed between the functional abilities before and after the one‑month follow‑up. Indeed, the two groups had the same situations. Also, the recovery time in the ultrasound‑guided percutaneous release group was significantly faster than in the other group. These cases had statistical differences as P = 0.001 and P < 0.001, respectively. The surgical release was 100% successful in both groups. The patients’ satisfaction rates in the ultrasound‑guided and open classic surgery treatment methods were 94.1 and 76.4%, respectively.

Classical open release and ultrasound‑guided percutaneous surgery could successfully treat multiple trigger fingers. However, ultrasound‑guided percutaneous surgery provided faster recovery and less pain intensity than the other method.

Multi‑leaf collimator (MLC) is one of the efficient and cost‑effective methods for protecting sensitive tissues around the target. This study aimed to evaluate the protective effect of MLC on the protection of sensitive organs in patients with left breast cancer.

This study was performed on computed tomography (CT) scans of 45 patients with left breast cancer. Two treatment plans were completed for each patient. Only the heart and left lung were considered organs at risk in the first treatment plan, and in the second treatment plan, the left anterior descending artery (LAD) was also considered the organ at risk. It was covered as much as possible by the MLC. Dosimetric results of tumor and organ at risk (OARs) were extracted from the dose‑volume histogram and compared.

The results showed that more LAD coverage by MLC leads to a significant reduction in the mean dose of OARs (P‑value <0.05). The mean dose for heart, LAD, and left lung decreased by 11%, 7.4%, and 4.9%, respectively. The values of V5 (volume received the dose of 5 Gy) and V20 for the lung, V10, V25, and V30 for LAD, and V5 , V20, V25, and V30 for the heart also decreased significantly (P‑value <0.05).

In general, better protection of LAD, heart, and lungs can be achieved by maximal shielding organs at risk by MLC in radiation therapy for patients with left breast cancer.

Acne is a dermatologic condition with a high burden in terms of psychosocial consequences as a result of scars remaining on the skin. Its effects are severe in adolescence and finding treatments with short therapy courses, superior results, and fewer adverse effects are of high importance.

We included 30 individuals with acne vulgaris scars in Al‑Zahra academic training hospital from June 2018 to Jan 2019. Each individual received both fractional CO2 and fractional Er:YAG lasers on right and left sides of the face, respectively. Three sessions of laser treatment were applied to each side with one‑month intervals. Results were evaluated by patients according to subjective satisfaction and physicians’ assessment and photo evaluation by two blinded dermatologists. Improvement was graded by a quartile grading scale: less than 25%: mild, 25% to 50%: moderate, 51% to 75%: good, and 76% to 100%: excellent response. Assessments were obtained at baseline and one month after the last visit.

Based on subjective satisfaction (p < 0.05) and physicians’ assessment (p < 0.01), fractional CO2 laser was significantly more effective than Erbium:YAG laser. Also, Post‑treatment side effects were mild and transient in both groups.

Laser therapies are common in the treatment of scars and each modality has special advantages and disadvantages. Choosing among them should be based on various criteria. Fractional CO2 lasers have been revealed favorable results in most reports. Large comprehensive trials could help experts in choosing among alternatives for different subgroups.

In the current study, we aimed to evaluate the association between pregnancy‑related plasma protein‑A(PAPP‑A) levels measured in the first trimester and pregnancy outcomes.

This is a descriptive‑analytical study that was performed in 2019‑‑2021 on 1061 pregnant women in their first trimester. Demographic and basic information of all women were collected. These data included age, weight, parity, and date of delivery. Then the quantity of PAPP‑A was recorded in three groups including less than 0.5 MOM, 0.5 to 2.5 MOM, and more than 2.5 MOM.

Data of 1061 women were analyzed. 900 women (84.8%) had term delivery and 155 women (14.6%) had pre‑term deliveries. PAPP‑A levels were normal in 83.4% of women. BMI and number of pregnancies had significant relationships with PAPP‑A (p < 0.001, P = 0.03 respectively). The mean BMI in mothers with PAPP‑A higher than 2.5 was significantly more than mothers with normal or lower PAPP‑A levels (26.2 ± 31, P = 0.04). The frequency of term labor in mothers with normal PAPP‑A was higher than other mothers (86.3%, P = 0.04). The frequency of preeclampsia in recent pregnancies in mothers with normal PAPP‑A was significantly lower than other mothers (p < 0.001) and the frequency of abortions in recent pregnancies in mothers with PAPP‑A less than 0.5 was significantly higher than mothers with normal or elevated PAPP‑A (p < 0.001).

Mothers with low PAPP‑A levels are more likely to have poor pregnancy outcomes such as abortion, pre‑term labor, and preeclampsia.

Various studies have conducted to report the mortality rates and its risk factors in pediatric intensive care unit. This study aimed to determine the mortality prevalence and risk factors in PICU of Imam Hossein Children’s Hospital in Isfahan, which is the main referral pediatric hospital in the center of Iran.

This study was performed on 311 patients during a period of 9 months. The questionnaire which included age, gender, length of stay in the PICU and hospital, mortality, history of resuscitation in other wards and readmission, the causes and sources of hospitalization, pediatric risk of mortality (PRISM)‑III score, respiratory supports, morbidities like nosocomial infections, acute kidney injury (AKI), multiple organ dysfunction syndrome (MODS) confirmed by pediatric sequential organ failure assessment score (P‑SOFA) and glycemic disorders was filled out.

One hundred and seventy‑seven (56.9%) were males and 103 (33%) were belonged to the age group of 12–59 months. The most prevalent causes of hospitalization were status epilepticus (12.9%) and pneumonia (11.2%). Mortality rate was 12.2%. The significant factors associated with mortality were readmission and history of resuscitation. PRISM‑III index showed a significant difference between nonsurvivors and survivors (7.05 ± 6.36 vs. 3.36 ± 4.34, P = 0.001). Complications like AKI, hypoglycemia, MODS and disseminated intravascular coagulation (DIC), length of mechanical ventilation significantly correlated with mortality.

Mortality rate was less than that of other developing countries (12.2%) and this was associated with some risk factors included readmission, history of resuscitation, PRISM‑III Index; complications like AKI, acute respiratory distress syndrome (ARDS), DIC, mechanical ventilation duration, MODS, hypoglycemia, and P‑SOFA index.

Gynecomastia (GM) is the increased fibroglandular tissue in the male breast by more than 2 cm, which is palpated under the nipple and areola.An idealsurgical approach aimsto reduce the breastsize, reach an acceptable breastshape, resect excessive glandular tissue, fatty tissue, and skin fatty tissue and excess skin, relocate the nipple‑areolar complex, and avoid scars. Based on its importance, we aimed to compare outcomes of liposuction with and without periareolar incision in patients with GM.

This was a randomized clinical trial on patients referred for plastic surgery. Patients with GM were allocated into two treatment groups. Group A underwent liposuction without any areolar skin incision and group B had liposuction with the areolar skin incision. Patients were followed‑up after surgery. Data were analyzed by Statistical Package for the Social Sciences (SPSS) version 20.

Sixty patients aged between 20 and 27 years old participated in this study. Three hematomas, two surgical site infections, one nipple hypopigmentation aftersurgery, and one seroma formation were noted in group B. On the other hand, one hematoma and one seroma formation were noted in group A. The patients in group A were highly satisfied after the liposuction without skin incision procedure compared with group B (P = 0.01).

The management of GM by liposuction, either with the periareolar excision technique or withoutskin incision, allowsthe effective removal of fat and glandular tissue of the male breast. Although there was no significant difference regarding postoperation complications between groups, patients’satisfaction should be considered.

Bacterial virulence factors may be influenced by sub‑minimum inhibitory concentrations (sub‑MICs) of antibiotics. The main purpose of this study was to investigate the effects of gentamicin at sub‑MICs (0.5 MIC and 0.25 MIC) on alginate production of clinical isolates of Pseudomonas aeruginosa.

The minimum inhibitory concentrations of gentamicin against 88 clinical isolates of P. aeruginosa were determined using the broth microdilution method. Alginate production of the isolates in the absence and presence of gentamicin at sub‑MICs was assessed by the carbazole method. The presence of alginate in clinical isolates was confirmed by the detection of alginate genes (algD and algU) using the PCR method.

All the isolates had the ability of alginate production and were positive for algD and algU genes. sub‑MICs of gentamicin significantly increased alginate production of 34 isolates(38.6%). On the other hand, in 49 isolates(55.7%), alginate production was significantly increased after treatment with sub‑MICs of gentamicin. In five isolates(5.7%), the alginate production was reduced in exposure to 0.5 MIC of gentamicin while it was increased by gentamicin at 0.25 MIC.

This study showed different effects of gentamicin at sub‑MICs on the alginate production of clinical isolates of P. aeruginosa. Further research is highly recommended to understand the mechanism of different responses of P. aeruginosa isolates to the exposure of sub‑MICs of gentamicin.

Primary central nervous system lymphoma (PCNSL) is uncommon with scarce cases having involvement of the spinal cord. Cauda equina is unique in its location and shows very rare involvement by diseases  pathologies. When the same occur, they pose a lot of diagnostic difficulties as the location is difficult to access with overlapping radiologic abnormalities. It is an unusual location for lymphomas to occur with only few cases reported in literature. The cauda equina lymphomas may mimic other entities which occur at that site. Histopathology is the gold standard for the same. Here, we report an unusual case of cauda equina lymphoma mimicking a myxopapillary ependymoma in a 50‑year‑old male.

Chitin and chitosan are utilized in many industries such as pharmacy, biotechnology, and medicine. The mealworm beetle, Tenebrio Molitor, is simply breaded and does not require a vast production space.

In this study, we extracted chitin and chitosan using two different methods from Tenebrio Molitor adult beetles. Then we studied their physical and chemical properties along with their antibacterial effect.

Using two new methods we extracted 13, 3%, and 17.7% chitin from the dry mealworm beetle which was higher than in previous studies. The chitosan yield of the extracted chitin was 78.26% and 76.43%, respectively. The observed FTIR peaks for chitin and chitosan in this study were in accordance with the characteristic peaks. The degree of acetylation of chitin was 95.09% and 92.55% and the degree of deacetylation was 75.84%, and 72.6% from the first and second methods, respectively. The extracted chitosan also showed an antibacterial effect against Pseudomonas aeruginosa.

Our study demonstrated that chitin and chitosan extracted from adult mealworm beetles could be considered as a replacement for commercial chitosan and needs further studies.

Laryngeal mask airway (LMA) plays a crucial role in the field of modern anesthesia. There are different techniques to administer LMA. Here we aimed to compare the four methods of standard, 90° rotation, 180° rotation, and thumb placement in LMA mast placement.

This is a clinical trial that was performed on 257 candidates of elective surgical operations requiring general anesthesia. All patients were categorized into four groups of LMA placement with index finger (standard method), mask placement with 90° rotation, 180° rotation method, and thumb finger group. We collected data regarding the success rates of LMA placement, the need for any manipulation when placing the mask, LMA placement time, failure of mask placement, presence of blood on the LMA, and laryngospasm and sore throats 1 hour after surgery in patients.

The 90° rotation method had a significantly higher first attempt success rate than that in the other three methods(98.4%, P = 0.02). Total success rate in 90° rotation method was also significantly higher than the other techniques (100%, P < 0.001). The need for any manipulation when placing the mask (1.6%, P = 0.01), presence of blood on the LMA mask (1.6%, P = 0.33), and frequency of sore throats 1 hour after surgery (21.9%, P = 0.14) were also lower in 90° rotation method than that in the other methods.

The 90° rotation method had significantly higher success rate and lower failure rate regarding the mask placement compared to other three methods.

Non‑alcoholic fatty liver disease (NAFLD) is one of the most common forms of chronic liver disease that affects about 25% of the general population. No definitive treatment for NAFLD has been identified yet. The aim was to determine the effect of atorvastatin (ATO) and flaxseed on related indicators of NAFLD‑induced fat/fructose‑enriched diet (FFD).

Forty male Wistar rats were divided into five groups. NAFLD groups received FFD and carbon tetrachloride (CCl4) to induce NAFLD. After intervention with ATO (10 mg/kg/day) and/or flaxseed (7.5 g/kg/day), liver enzymes and lipid profiles in serum were determined at eight week of interventions.

Triglycerides (TG) and cholesterol (CHO) in FFD + ATO, FFD + flaxseed, and FFD + ATO + flaxseed had a significant decrease and low‑density lipoprotein (LDL) level and LDL/high‑density lipoprotein (HDL) ratio showed a significant increase in the FFD + flaxseed compared to the FFD. The levels of aspartate transaminase (AST), alanine transaminase (ALT), and gamma‑glutamyltransferase (GGT) were significantly reduced in the FFD + ATO, FFD + flaxseed, and the FFD + ATO + flaxseed. In addition, Alkaline phosphatase (ALP) levels were significantly different between normal and FFD. Fasting blood sugar (FBS) levels were significantly different in the FFD + flaxseed and the FFD + ATO + flaxseed compared to the FFD.

ATO therapy along with flaxseed controls NAFLD‑related indices and FBS. Therefore, it can be stated with caution that ATO and flaxseed can be used to improve lipid profile and reduce the complications of NAFLD.

Bariatric surgery is a surgical procedure for patients with extreme obesity. Enhanced Recovery after Surgery (ERAS) is a method that provides special peri‑ and post‑operation care. Here, we aimed to compare the effects of ERAS and standard recovery cares.

This is a randomized clinical trial that was performed in 2020‑2021 in Isfahan on 108 candidates for mini gastric bypass. Patients were then randomly divided into two equal groups receiving ERAS and standard recovery protocols. Patients were examined and visited after one month regarding the average number of hospitalization days, the average days required to return to normal activity or work, occurrence of pulmonary thromboemboli (PTE) and the rate of readmission.

Patients that received ERAS had significantly lower frequencies of nausea and vomiting (P = 0.032). Patients that received ERAS had significantly lower hospitalization duration (P < 0.001) compared to controls. No other significant differences were observed between two groups regarding surgery complication, re‑admission rate and occurrence of PTE (P > 0.99 for all).

Patients that received ERAS protocol after gastric bypass had significantly lower hospitalization duration and lower incidence of nausea and vomiting. They also had similar post‑operative outcomes compared to the standard protocol.

Anxiety is a common psychiatric condition in cardio‑vascular diseases. Saffron appears to have a wide range of therapeutic effects on psychiatric conditions and cardio‑vascular disorders. The aim of this study was to determine the effect of saffron on anxiety in hospitalized patients with acute coronary syndrome (ACS).

In this clinical investigation, we selected 80 patients with ACS from Tohid Medical Center, Sanandaj. Patients were divided randomly into two groups, intervention group (n = 41), and control group (n = 39), based on how they received saffron and placebo every 12 hours for 4 days, respectively. The Spielberger Anxiety Inventory was completed before and after the intervention in both groups.

There was no significant difference between the intervention and control groups regarding the mean scores of the trait and state anxiety before and after the intervention (P > 0.05).

The present study did not corroborate the therapeutic effects of saffron on reducing anxiety in patients with ACS.

Endometriosis is a female reproductive system disease in which the endometrial tissue is found in other women’s organs. Various factors are effective in the development of endometriosis, and because of the interaction of genetics and environmental factors, this disease is a multi‑factorial disease. MAPK/ERK and PI3K/Akt/mTOR pathways are activated by growth factors and steroid hormones and are known as two important pathways involved in the processes of growth, proliferation, and survival of endometriosis cells. Raps, monomeric GTPase of the Ras family, are able to activate these pathways independent of Ras. The goal of our study was to evaluate the expression level of Rap1GAP and EPAC1 genes as two important RapGAPs(GTPase‑activating proteins) and RapGEFs(guanine nucleotide exchange factors), respectively, in endometriosis tissues and normal endometrium tissues.

In this study, 15 samples of women without signs of endometriosis were taken as control samples. Fifteen ectopic and 15 eutopic samples were taken from women with endometriosis using laparoscopic surgery. The expression of EPAC1 and Rap1GAP genes was investigated by the real‑time polymerase chain reaction technique, and the results were analyzed by one‑way ANOVA test.

EPAC1 upregulated significantly in ectopic tissues compared to eutopic and control tissues. Rap1GAP expression was lower in ectopic tissues compared to control and eutopic tissues.

Based on these results, it may be concluded that changes in the expression of the Rap1GAP and Epca1 genes may play a role in the pathways involved in the pathogenesis, displacement, and migration of endometriosis cells.

Inflammatory cell death, PANoptosis, has been suggested to orchestrate the lymphocyte decrement among coronavirus disease‑2019 (COVID‑19) patients. The main aim of this study was to examine the differences in the expression of key genes related to inflammatory cell death and their correlation with lymphopenia in the mild and severe types of COVID‑19 patients.

Eighty‑eight patients (36 to 60 years old) with mild (n = 44) and severe (n = 44) types of COVID‑19 were enrolled. The expression of key genes related to apoptosis (FAS‑associated death domain protein, FADD), pyroptosis (ASC (apoptosis‑associated speck‑like protein containing caspase activation and recruitment domains (CARD)), the adapter protein ASC binds directly to caspase‑1 and is critical for caspase‑1 activation in response to a broad range of stimuli), and necroptosis (mixed lineage kinase domain‑like, MLKL) genes were examined by reverse transcription‑quantitative polymerase chain reaction (RT‑qPCR) assay, and compared between the groups. The serum levels of interleukin (IL)‑6 were measured by enzyme‑linked immunosorbent assay (ELISA) assay.

A major increase in the expression of FADD, ASC, and MLKL‑related genes in the severe type of patients was compared to the mild type of patients. The serum levels of IL‑6 similarly indicated a significant increase in the severe type of the patients. A significant negative correlation was detected between the three genes’ expression and the levels of IL‑6 with the lymphocyte counts in both types of COVID‑19 patients.

Overall, the main regulated cell‑death pathways are likely to be involved in lymphopenia in COVID‑19 patients, and the expression levels of these genes could potentially predict the patients’ outcome.

Previous evidence revealed an association between folate deficiency and non‑alcoholic fatty liver disease (NAFLD). This study is the first one investigating the effects of folic acid on hepatic steatosis grade, liver enzymes, insulin resistance, and lipid profile in NAFLD cases.

Sixty‑six participants with NAFLD were allocated randomly to take either a placebo or one oral tablet of folic acid (1 mg) on a daily basis within eight weeks. Serum folate, homocysteine, glucose, aminotransferases, insulin, homeostasis model assessment of insulin resistance (HOMA‑IR), and lipids were assessed. Ultrasonography was used for assessing the liver steatosis grade.

The serum alanine transaminase, grade of hepatic steatosis, and aspartate transaminase significantly were decreased within both study groups; however, the between‑group comparison was not statistically significant. Of note, the decrease in ALT was more pronounced in folic acid compared with the placebo group (‑5.45 ± 7.45 vs. ‑2.19 ± 8.6 IU/L). The serum homocysteine was decreased after receiving folic acid compared to the placebo (‑0.58 ± 3.41 vs. +0.4 ± 3.56 µmol/L; adjusted P = 0.054). Other outcomes did not significantly change.

Supplementation with folic acid (1 mg/d) for eight weeks among cases with NAFLD did not change significantly the serum levels of liver enzymes, the hepatic steatosis grade, insulin resistance and lipid profile. However, it was able to prevent the increase in homocysteine in comparison with the placebo. Conducting further research is suggested with the longer duration and different doses of folic acid, adjusted to the genotypes of methylenetetrahydrofolate reductase polymorphism, among NAFLD patients.

Scrophularia striata Boiss. (S.striata) is a flowering plant with several therapeutic properties including antiinflammatory, antioxidant, antimicrobial, and wound‑healing activity. Regarding the side effects of drugs conventionally used for inflammatory bowel disease (IBD) treatment, we investigated the anticolitis properties of aqueous (SSAE) and hydroalcoholic (SSHE) extracts of S. striata on experimental colitis.

The colitis was induced using acetic acid (3%) and 2 h before ulcer induction, each group of rats received orally three doses (150, 300, and 600 mg/kg, p.o.) of SSAE or SSHE for the next 5 days. Dexamethasone (1 mg/kg, i.p.) and mesalazine (100 mg/kg, p.o.) were used as reference drugs. Different parameters including weight of colon/height, ulcer index, total colitis index, levels of myeloperoxidase (MPO) and malondialdehyde (MDA) were investigated.

Total phenolic contents were 4.3 ± 0.2 and 7.1 ± 0.4 mg/g equivalent to gallic acid for SSAE and SSHE respectively. Three applied doses of SSHE and the highest dose of SSAE (600 mg/kg) could reduce all the macroscopic and pathologic indices of colitis and the levels of MPO and MDA. Two lesser doses of SSAE (150, 300 mg/kg) however, couldn’t diminish the histopathologic features of colitis and the values of MPO and MDA.

S. striata, especially SSHE, which also contained more phenolic compounds, had an ameliorating effect on ulcerative colitis and possibly exerts this effect through its antioxidant, antiinflammatory and wound healing properties. Further investigations are required to introduce this plant as a novel alternative herbal drug for colitis treatment.

Bloodstream infections (BSIs) are one of the causes of morbidity and mortality in hospitalised patients. This study evaluated BSI’s incidence, trend, antimicrobial susceptibility patterns and mortality in AL Zahra Hospital in Isfahan, Iran.

This retrospective study was conducted in AL Zahra Hospital from March 2017 to March 2021. The Iranian nosocomial infection surveillance system was used for data gathering. The data included demographic and hospital data, type of bacteria, and antibiotic susceptibility findings and were analysed in SPSS‑18 software.

The incidence of BSIs was 1.67% and 0.47%, and the mortality was 30% and 15.2% in the intensive care unit (ICU) and non‑ICU wards, respectively. In the ICU, the mortality was correlated with the use of the catheter, type of organism and year of study, but in non‑ICU, correlated with age, gender, use of the catheter, ward, year of study and duration between the incidence of BSIs and discharging/death. Staphylococcus epidermidis, Acinetobacter spp. and Klebsiella spp. were the most frequent germs isolated in all wards. Vancomycin (63.6%) and Gentamycin (37.7%) for ICU and Vancomycin (55.6%) and Meropenem (53.3) for other wards were the most sensitive antibiotics.

Despite the few rate of BSI in the last four years in AL Zahra Hospital, our data showed that its incidence and mortality in the ICU ward are significantly more than in other hospital wards. We recommend prospective multicentre studies to know the total incidence of BSI, local risk factors and patterns of pathogens causing BSI.

The elderly population is projected to increase from 8.5% in 2015 to 12% in 2030 and 16% in 2050. This growing demographic is chronically vulnerable to various age‑related diseases and injuries like falling, leading to long‑term pain, disability, or death. Thus, there is a need to use the potential of novel technologies to support the elderly regarding patient safety matters in particular. Internet of Things (IoT) has recently been introduced to improve the lifestyle of the elderly. This study aimed to evaluate the studies that have researched the use of the IoT for elderly patients’ safety through performance metrics, accuracy, sensitivity, and specificity. We conducted a systematic review on the research question. To do this, we searched PubMed, EMBASE, Web of Science, Scopus, Google Scholar, and Science Direct databases by combining the related keywords. A data extraction form was used for data gathering through which English, full‑text articles on the use of the IoT for the safety of elderly patients were included. The support vector machine technique has the most frequency of use compared to other techniques. Motion sensors were the most widely used type. The United States with four studies had the highest frequencies. The performance of IoT to ensure the elderly’s safety was relatively good. It, however, needs to reach a stage of maturity for universal use.

Children suffer from a high prevalence of anxiety problems that require prompt treatment. It has been demonstrated that ketamine offers rapid anti‑anxiety effects. This study aimed to evaluate ketamine’s anti‑anxiety impact in the treatment of children with school‑refusal separation anxiety disorder.

In this open‑labeled randomized clinical trial, 71 children (6‑10 years) diagnosed with school refusal separation anxiety disorder were randomly assigned to two groups; a case group, who received ketamine at a weekly rising dose of 0.1 to 1 mg/kg; the control group treated with Fluvoxamine (25 mg/day), which could increase to 200 mg/day if necessary. The SCARED and CATS questionnaires were used to assess anxiety before treatment, at the 8th and 16th weeks of intervention. The data were analyzed using repeated‑measures analysis of covariance.

The mean anxiety scores in the eighth week (19.7 ± 16.1) were significantly lower in the ketamine group than before (31.5 ± 10.8). Until the sixteenth week (19.4 ± 14.6), there was no further decrease in scores in the ketamine group, in the fluvoxamine group, pre‑treatment scores (36.3 ± 16.5) and eighth week (36.9 ± 16.6) were not significantly different, but scores decreased significantly in a sixteenth week (26.2 ± 12.5).

In first eight weeks of treatment, ketamine was more successful than fluvoxamine at reducing anxiety disorder, considering the emergence of this disorder and the lack of major adverse effects of ketamine, it seems to be beneficial in early phases of treatment. Due to the quick onset of ketamine in future trials, their combination therapy is recommended during the initial weeks of treatment.

Bystander cardiopulmonary resuscitation is an important predictor of out‑of‑hospital arrest prognosis in the pediatric population. The purpose of this study was to assess the effectiveness of two educational methods, a video module and Peyton model with manikin, in parent’s education.

We enrolled 140 subjects, 70 in each group. We assess their knowledge, attitude, and practice about pediatric basic life support (BLS) before and after two different types of educational interventions.

Mean attitude, knowledge, and practice score were significantly higher after educational intervention in both groups. Knowledge and total practice score were significantly higher in the Peyton group compared with DVD group (P = 0.02 and 0.000, respectively). The rate of totally correct chest compression was 53% in Peyton/manikin group versus 24% in DVD/lecture group and the difference was meaningful statistically (P = 0.0003).

Any educational intervention has a significant effect on the Iranian parent’s knowledge and practice about child BLS, but education through manikin can increase this impact.

Bacteriocins are a type of antimicrobial peptide that are produced by probiotics. They have been studied as possible therapeutic drugs and have been used to suppress bacterial development in foods. Nisin is a potent bacteriocin having the anti‑microbial and anti‑cancer characteristics produced by Lactococcus lactis. The aim of the present paper is to evaluate the influence of Nisin on cell adhesion and its two related genes, mmp‑2 and mmp‑9, in the colorectal cancer cell line.

For this purpose, HT‑29 cells were treated with various concentrations of Nisin and the cell cytotoxicity, cell adhesion, and gene expression were evaluated using the MTT assay, cell adhesion assay, and real‑time PCR.

Our findings showed that 32 to 1024 µg/ml of Nisin resulted in a significant reduction in cell viability (P < 0.05). Furthermore, 128 and 256 µg/ml of Nisin significantly reduced the cell adhesion, and mmp‑2 and mmp‑9 gene expressions (P < 0.05).

Our findings suggested that Nisin could prevent metastasis and cancer progression.

Weill–Marchesani syndrome (WMS) is a rare connective tissue disorder characterized by locus heterogeneity and variable expressivity. Patients suffering from WMS are described by short stature, brachydactyly, joint stiffness, congenital heart defects, and eye abnormalities. This disorder is inherited in two different modes; the autosomal dominant form of the disease occurs due to a mutation in FBN1, and the recessive form results from mutations in ADAMTS10, ADAMTS17, or LTP2 genes.

The family recruited in this study was a consanguineous Iranian family with an intellectually disabled girl referred to the Sadra Genetics laboratory, Shahrekord, Iran. The clinical history of family members was investigated. Whole‑Exome Sequencing (WES) for the proband was performed. Sanger sequencing was used to assess the segregation of candidate variants in the other family members.

Whole‑exome sequencing analysis revealed a novel heterozygote mutation in the proband located at the third TGF‑β‑binding protein‑like (TB) domain of the FBN1 gene (NM000138: c.2066A>G: (p. Glu689Gly), NP_000129.3, in exon 17 of the gene). Co‑segregation analysis with Sanger sequencing confirmed this mutation in the affected members of the pedigree.

Our findings represent an autosomal dominant form of specific WMS resulting from a substitution mutation in the FBN1 gene. In addition to the typical manifestations of the disorder, mild intellectual disability (ID) was identified in the 8‑year‑old proband. Given the fact that ID is primarily reported in ADAMTS10 mutated cases, this family was clinically and genetically a novel case.

Disease registration is an organized system for collecting, storing, retrieving, analyzing a particular disease or exposure to known substances in a specific population. The aim of this study was to assess the feasibility and design of the registration system for upper gastrointestinal bleeding patients based on patients referring to Al‑Zahra and Khorshid hospitals, Isfahan, Iran.

This study is a research action study in which the members of the registration system team are hospital triage physicians, internal residents in the Emergency department of hospital, subspecialty assistants and gastroenterologists, statisticians (epidemiologists and methodologists), and two trained persons were specified to collect medical information and documents. The data collection tool is a researcher‑made checklist. Based on the available tools, the most important criteria related to gastrointestinal bleeding were selected. In the next step, the criteria selected in the council, including team members, were reviewed and a preliminary draft was prepared to record the information of patients.

The results indicated the final version of the checklist in three parts including demographic variables (age, sex, education, et al.), main variables (as the minimum data required by a person to register in the checklist (patient’s clinical signs)), extended main variables (its information is designed to be used to diagnose, treat, and follow‑up the patient in later stages).

It seems to be predictable by establishing a system for recording gastrointestinal bleeding diseases, disease prevalence, monitoring services and treatment of patients, survival analysis and evaluation of clinical care outcomes, finding patients at higher risk for emergency treatment, reviewing drug interventions, and interventional activities.