مجله دانشگاه علوم پزشکی بابل
سال بیست و ششم شماره 1 (پیاپی 141، فروردین 1403)

Although chemical drugs are effective for postpartum pain, herbal medicines with relative safety and fewer side effects are more suitable. The aim of the present study was to compare the impact of “Ginger-Lavender” and “Mefenamic acid” capsules on postpartum pain.

This triple-blind clinical trial study enrolled 94 multiparous women complaining of moderate to severe postpartum pain in Valiasr Hospital, Fasa, in 2021. They randomly divided into 2 groups (n=47): the “Ginger-Lavender” 300 mg capsules (A) and the “Mefenamic acid” 250 mg capsules (B). Measuring the pain score started 2 hours after delivery and continued every 6 hours, before and 1 hour after receiving the related drugs, until 24 hours using VAS.

The demographic information of the two groups, including mothers' age and BMI, weight of newborns, breastfeeding, receiving oxytocin and the number of pregnancies and deliveries, were not significantly different. Before the intervention, there was no significant difference in pain severity between the two groups (A=5.02±1.24, B=4.72±0.97). Consuming “Ginger-Lavender” and “Mefenamic acid” capsules at different hours decreased pain severity significantly (p<0.05). No significant differences were found between the “Ginger-Lavender” and “Mefenamic acid” groups for the mean postpartum pain severity at different hours after the first (A=2.38±0.922, B=2.553±0.928), second (A=2.0217±1.242, B=2.021±1.188), third (A=1.55±0.97, B=1.61±1.07), and fourth (A=1.42±1.01, B=1.38±0.99) interventions.

Since “Ginger-Lavender” capsules reduced postpartum pain, it is recommended to use them instead of standard drug, “Mefenamic acid” capsules, as an effective and safe herbal medicine.

Dermoid cysts or mature cystic teratoma are one of the most common benign ovarian tumors. In this study, a case of rare ovarian dermoid cyst containing hair, teeth, bone and intestine is reported.

Case Report: 

The patient is a 36-year-old woman who referred with abdominal pain, nausea and change in menstruation since 2 months ago. The pain was not related to menstruation and there was no tenderness in the abdomen. Diagnosis of the mass was performed with ultrasound and MRI, and a cystic mass was detected in the right and left ovary. The patient underwent laparoscopic surgery. During the operation, the right ovary and the left ovarian cyst were removed completely and without damage. The dermoid cyst of the right ovary contained hair, teeth, bones and nails. The patient was discharged 1 day after the operation, and no complications from the surgery were reported in the follow-up. In the pathological examinations, intestinal tissue was seen in the cyst, which is important, so this case was reported.

According to the results of this reported case, intestinal tissue may be present in dermoid cyst. Complete resection is recommended in these patients.

Acute appendicitis is one of the common reasons for abdominal surgery in any age group, and most cases are rarely diagnosed, which causes unnecessary surgery (negative appendectomy). The aim of this study is to determine the diagnostic value of C-reactive protein (CRP) and interleukin-6 (IL-6) in the prevention of negative appendectomy.

This cross-sectional study was conducted on 208 patients with acute abdominal surgery and primary diagnosis of acute appendicitis at Fatemi Hospital in Ardabil in a period of 6 months. C-reactive protein (CRP) and interleukin-6 (IL-6) levels were measured before surgery in all patients. Patients were divided into positive and negative groups based on pathology results. Then the laboratory results were compared with histopathological findings after surgery.

The level of IL-6 in the positive group was 107.25±3.54 and in the negative group was 75.50±2.41, and the difference was statistically significant (p=0.032). The mean CRP was 35.5±12.1 in the positive group and 11.1±5.3 in the negative group (p<0.001). There was a statistically significant relationship between IL-6 in normal patients and IL-6 in positive patients with purulent (p=0.006) and gangrene (p<0.001) pathology. There was a significant relationship between IL-6 positive patients with follicular hyperplasia pathology and IL-6 positive patients with purulent and gangrene pathology (p<0.001). Moreover, there was a statistically significant relationship between IL-6 positive patients with inflammatory pathology response and IL-6 positive gangrene patients (p<0.001). Sensitivity, specificity, positive predictive value, negative predictive value for IL-6 were 83, 88, 86, 79 and for CRP were 83, 85, 89, 81, respectively.

The results of the study showed that the simultaneous measurement of CRP and IL-6 are useful biomarkers in the diagnosis and prevention of negative appendectomy.

Family-centered care is a new healthcare standard that allows parents to be involved in their baby's healthcare. Considering that parents play an important role in caring for the baby in the hospital as well as at home after discharge, family-oriented care is always emphasized. Therefore, the aim of this study is to investigate the viewpoint of parents of newborns hospitalized in neonatal special care unit about the implementation of family-oriented care in this unit.

This cross-sectional study was conducted on 100 mothers and fathers of newborns hospitalized in the neonatal intensive care unit of selected hospitals of Shahid Beheshti University of Medical Sciences in Tehran. After obtaining informed consent, the researcher completed the questionnaires in a period of three months by explaining the objectives of the research as well as family-oriented care in groups and individually. The demographic information of the parents and the newborn was collected and analyzed using a researcher-made questionnaire to examine the views of the parents in different areas about the implementation of family-centered care in the neonatal special care unit.

The mean score of the questionnaires for the mothers of babies was 172.7±19.8 and the mean score of the questionnaires for the fathers was 152.5±30.9. In the area of education and information provision, the mean score of mothers was 49±3.5 and the mean score of fathers was 42.6±3.5; mothers score was significantly higher than that of fathers (p<0.001). In the area of respect for parents' rights, the mean score of fathers was 16.7±1.6 and the mean score of mothers was 11.3±5.8; in this area, the mean score of fathers was significantly higher than the score of mothers (p<0.001). In other areas, there was no statistically significant difference between the views of fathers and mothers.

The view of fathers and mothers in the field of family-centered care in special care units for newborns has been positive and satisfactory. This shows the necessity of different programs in order to improve the views of fathers and mothers.

Colon surgery is one of the important operations in the abdominal area, but according to the type and conditions of surgery and clinical conditions, they can have different results and complications. The aim of this study is to determine the complications and related factors in patients who underwent colon anastomosis in emergency and elective surgery.

In this cross-sectional study, 70 patients over 18 years of age and in need of colon anastomosis, who visited Kowsar Hospital in Sanandaj in 2017-2020, were examined in both emergency and elective groups. The patients were examined for complications such as bleeding, abscess, anastomotic leak, partial obstruction, fistula, and death, and the patients were followed up for six months, and if any of the complications occurred, the patient was hospitalized and examined further.

The patients of the two groups did not have statistically significant differences in terms of demographic variables of age and gender, and surgery time. The highest frequency of the cause of surgery in the emergency group was volvulus in 10 cases (28.7%) and in the elective group was colon cancer in 26 cases (74.3%); in this regard, a statistically significant difference was observed between the two groups (p<0.001). The most common anastomosis site in the emergency group was the descending colon region (13 [37.1%]) and in the elective group was the ascending colon region (14 [40%]). The most common complications during and after anastomosis surgery include bleeding, infection, anastomosis leak and death, and the death rate in the emergency group was 7 people. The most common cause of death was peritonitis with 3 cases, followed by cardiorespiratory failure, embolism, disseminated intravascular coagulation and COVID-19 with peritonitis, with 1 case each. The history of hypertension and intraoperative bleeding had a statistically significant relationship with the incidence of colon anastomosis complications in both study groups (p=0.01).

Based on the results of this study, the incidence of anastomosis complications is higher in the emergency group, including increased intraoperative bleeding, and in emergency situations, the decision to perform primary anastomosis should be made according to the patient's clinical conditions.

Fasting before surgery can cause metabolic stress and insulin resistance. The aim of this study is to investigate the effect of oral carbohydrates before surgery on blood sugar levels and hemodynamic indicators in children under three years of age who are candidates for inguinal hernia surgery.

In this double-blind clinical trial, 207 children under three years of age who were candidates for inguinal hernia surgery were randomly divided into three groups. Patients in the carbohydrate group received 5 cc/kg of 20% dextrose solution orally, in the water group, 5 cc/kg of drinking water 2 hours before surgery, and in the control group, standard fasting was applied before surgery. Mean arterial pressure, heart rate and blood sugar at different times (5, 10, 15 and 20 minutes) as well as the incidence of vomiting were compared between the three groups.

Heart rate changes were significantly different between the three groups (p=0.002). The mean changes in heart rate at 10, 15 and 20 minutes were -6.76±0.89, -10.9±1.25 and -12.47±1.3 in the oral carbohydrate group, -4.03±0.65, -7.4±0.75 and -8.76±0.8 in water group and -2.7±0.36, -5.9±0.72 and -6.9±0.73 in the control group, respectively. In the oral carbohydrate group, the mean blood sugar changes during surgery (+4.15±4.8 and p=0.39) and during recovery (-0.35±0.94 and p=0.94) were not significant. The mean changes in blood sugar during surgery (+35.01±1.8) and during recovery (+46.57±1.4) in the water group, as well as blood sugar increase during surgery (42.12±1.5) and recovery (+39±1.3) in the control group compared to before induction of anesthesia were statistically significant (p<0.001).

The results of the study showed that preoperative oral carbohydrate intake provides more stable hemodynamics in children undergoing inguinal hernia surgery. Despite the high blood sugar in the oral carbohydrate group before induction of anesthesia, its changes during surgery and recovery are small compared to the water and control groups.

Kinome refers to the complete set of protein kinases encoded in the genome. The most common type of post-translational modification is phosphorylation, with more than two-thirds of all human encoded proteins being phosphorylated by protein kinases. Phosphorylation as an important regulatory factor in the activity of proteins greatly expands the flexibility of the epigenome. Thus, protein kinases often promote cell proliferation, survival, and migration by participating in intracellular pathways and are associated with carcinogenesis when overexpressed or activated. The main goal of this study is to investigate the role of kinase enzymes in causing cancer and to investigate their potential as drugs in the treatment of various types of cancer.

In this review, by searching Scopus, PubMed, Web of Science and ScienceDirect databases, articles published between 2010 and 2022 were selected and analyzed using the keywords "cancer, human kinome, kinase and kinase inhibitor".

64 articles were selected according to the research topic and 11 articles were excluded due to the lack of relation to the main keywords. In this study, the role of kinases in cell proliferation and human cancers has been investigated, and kinase inhibitors in combination with other common treatments such as chemotherapy or radiation therapy can be mentioned as a new and promising approach in cancer treatment.

Based on the results of this study, kinases are known as one of the most important components of cell growth and proliferation, so that they play an important role in the cancer process with excessive activity. This study shows that controlling and inhibiting the kinase family to overcome cancer cell growth has good benefits.

Infants born prematurely are at an increased risk of experiencing cerebral palsy, respiratory problems and developmental delays. Bacterial vaginosis, a condition that causes inflammation of fetal membranes, vaginitis, and cervicitis, can lead to the premature rupture of membranes and labor. The main objective of this article is to determine the prevalence of bacterial vaginosis among pregnant women experiencing preterm labor between 20 and 36 weeks of gestation.

This cross-sectional study was conducted on 100 cases of preterm labor. To investigate variables associated with bacterial vaginosis. Variables related to bacterial vaginosis and relevant epidemiological and clinical data were collected and analyzed. Amsel's criteria were used to diagnose bacterial vaginosis.

The prevalence of BV among pregnant female with preterm labor was found to be 44 (44%). Among the BV-positive cases, 28 (63.6%) patients aged between 25 and 44 years. 56 people (56%) of those who had a negative bacterial vaginosis test had preterm delivery. A significant correlation was observed between BV and living in urban areas (p<0.05). Furthermore, BV was significantly linked with early rupture of membranes (p<0.05). Vaginal infections were also more prevalent in BV-negative cases (p<0.05). No statistically significant associations were found between BV and threatened abortion or miscarriage.

The results of this study showed that the prevalence of bacterial vaginosis in patients with premature labor is relatively high. Bacterial vaginosis is significantly more common among patients living in urban areas and is associated with premature rupture of membranes and certain types of premature labor.

Non-obstructive azoospermia (NOA) is one of the causes of male infertility. Male infertility can be induced by changes in the expression pattern of a significant number of genes in spermatogenic cells. So, analysis of gene expression profiles of testicular tissues is essential in these patients. Since DAZ1 is an essential gene in spermatogenesis, this study aimed to evaluate the role of DAZ1 gene expression in NOA Iraqi males.

This cross-sectional study enrolled a total of 50 infertile men with NOA attending Teba IVF and genetic Centre from December 2018 to December 2019. All patients had bilateral testicular sperm aspirate (TESA) under local anesthesia and biopsy. The quantitative detection and gene expression analysis of DAZ1 were carried out using the qPCR technique. The correlations between DAZ1 expression levels, testicular spermatogenic patterns, and clinical hormonal indicators were evaluated. The patients' histological phenotype and hormonal profile were also evaluated in gene expression data.

The mean age of the patients was 35.1±6.6 years. DAZ1 gene expression was different in faulty spermatogenesis testes. Hypospermatogenesis patients had the greatest expression level of DAZ1. DAZ1 transcript expression was significantly lower in the six spermatogenic samples without germ cells or Sertoli cells (p<0.05). Men with the worst histology (maturation arrest and no germ cell and Sertoli cell) had higher mean blood FSH levels (36.6±3.9) (p<0.05). DAZ1 expression in testicular samples demonstrated significant positive correlation with the spermatogenic score (p<0.0001).

The differential expression of spermatogenesis-related gene (DAZ1) across the various spermatogenic patterns suggests that this gene may be a molecular marker for NOA spermatogenesis assessment.

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in which the median nerve is compressed in the wrist area while it passes through it, and its early diagnosis will improve the overall outcome and reduce morbidity. Electrodiagnostic testing is the most commonly used techniques to diagnose it but no consensus is reached about which test is the most useful. This research was conducted to evaluate the sensitivity and specificity of the difference in F-wave conduction velocity below and above carpal tunnel for the diagnosis of CTS.

This case-control study included 240 patients clinically diagnosed with CTS with negative nerve conduction test, and these tests included the F-wave conduction velocity of median nerve by stimulating the nerve at two sites, one at mid-palm and the other at the wrist (6 cm proximal to mid-palm stimulation site). After that, distance from stimulating sites to the area between C7 vertebral spine was obtained and the resulting two conduction velocities were compared.

The difference in F-wave conduction velocity across the wrist was 4.9±1.6 m/s in patients with CTS while it was 2±0.1 m/s in healthy control subjects, with statistically significant differences (p<0.05). Also, the study found that at difference of 3 m/s between wrist and mid-palm stimulation, the sensitivity for diagnosing CTS was 90% and specificity was 100%.

The results of this study showed that F-wave conduction velocity of median nerve difference across the wrist is a new technique to test median nerve in CTS and it is highly sensitive and specific.

In recent years, bleaching materials have been used in many clinics, which may have different effects on natural teeth and composite restorations (omnichroma). The aim of this study is to determine the spectrophotometric effect of external bleaching on natural tooth structure and composite restoration.

In this study, cavities were first created on 26 extracted teeth, and then, omnichroma composite restorations were completed for all these teeth. The color of each tooth sample was evaluated with a colorimeter device. Measurements were obtained before the application of the bleaching agent for initial lightness (L0), after the bleaching agent's first application (L1), and after the second application of the bleaching agent (L2). Total color change difference (ΔE) values between the restorations and natural tooth during first (ΔE1) and second (ΔE2) treatment intervals were compared.

This study found that, as lightness values between natural tooth and composite were compared, there are changes of lightness value; L1 (p=0.000) and L2 (p=0.006) showed that there is a significant difference in lightness value (L) between natural tooth and composite restoration during the first and second treatments. However, the comparisons of total color change (ΔE) found no substantial differences between the composite restoration and natural tooth structure during the first and second treatment intervals ΔE1 (p=0.479) and ΔE2 (p=0.821).

According to the results of this study, the value of ΔE decreased significantly from L0 to L2 bleaching treatments. As the tooth becomes brighter, it is clear that there is less of a color difference between the omnichroma restoration and the tooth structure.

Healthy kidneys filter wastes of various molecular masses (up to 40-60 kDa). Traditional hemodialysis only removes low-molecular-weight molecules (500 Da), not middle-weight substances (>500 Da). Therefore, most of these compounds remain as expected uremic toxins. Therefore, this study aims to determine the association of Hepcidin and anemia with inflammatory markers in dialysis cases on high flux hemodialysis (HD) compared with hemodiafiltration (HDF).

This cross-sectional study was conducted on 203 patients in the age range of 20-70 years old with end-stage kidney disease who were undergoing hemodialysis using high flux and hemodiafiltration methods. Venous blood samples were taken without anticoagulation and ferritin, CRP and hepcidin levels were analyzed and compared.

This study involved 203 cases with end-stage renal disease, with 103 in the HD group and 100 in the HDF group. The mean age of the cases was 49.5±15.5 years. Among the patients in the HD group, 79.9% had hypertension, while only 23% of the patients in the HDF group had hypertension. Additionally, 35.9% of the cases in the HD group had diabetes mellitus (DM), while 75% of the cases in the HDF group had DM. There were significant differences between the mean number of white blood cells (8.27±7.95 vs. 6.20±4.14), CRP (13.88±17.45 vs. 6.48±10.40) and hepcidin (2981.47±2325.38 vs. 1010.45±1136.18) between the groups (p<0.05).

The results of this study showed that individuals receiving HDF have low-grade inflammation, less anemia, and a superior response to erythropoietin. Therefore, for patients with elevated inflammatory markers, the HDF dialysis modality is suggested.

The pain and anxiety caused by ordinary dental syringes in children has led to the invention of needle-free injection, which can affect the attitude of young patients towards dentistry. The aim of this study is to compare the needle-free syringe (NumBee) and the conventional one in terms of anesthesia efficiency and pain perception during anesthetic injection and tooth cavity preparation.

In this cross-sectional study, 30 patients aged 6-8 who had no experience of visiting a dentist and all of them needed Class I tooth restoration for their mandibular 1st permanent teeth, were selected. They received local anesthetic by NumBee for one side and a conventional dental syringe for the other in two randomized sequential dental treatments. Wong Baker Faces pain scale was used to assess pain perception during local anesthetic injection and cavity preparation. Efficiency was evaluated by reported symptoms during cavity preparation and the need for rescue anesthesia.

NumBee injections induced less pain than cavity preparation for 12 out of 17 girls (p=0.019). However, when the children were anesthetized with NumBee, cavity preparation was significantly more painful than with inferior alveolar nerve block (p=0.013).

According to the results of this study, NumBee injection was less painful than inferior dental nerve block. However, NumBee supplies less anesthesia than the inferior alveolar nerve block.

Cephalometric analyses are an important tool for diagnosis and orthodontic treatment planning. Some cephalometric analysis programs cannot be used due to the high cost and inability to use all the facilities due to the sanctions. CephNinja® is an available program for cephalometric analyses. The aim of this study is to evaluate the reliability and accuracy of the CephNinja® program for orthodontic cephalometric tracing and compare it with the common manual method in Iranian society.

This cross-sectional study included 100 lateral cephalometric radiographs prepared by the 3D Promax device; The patient's teeth were selected to be in maximum intercuspation and the patient's head was in natural head posture. In every 100 lateral cephalometric radiographs, 24 landmarks were identified and then 20 desired variables were measured by traditional manual method based on Steiner's analysis. Also, the digital file of the same 100 lateral cephalometric radiographs was entered into the CephNinja® software (version 3.51). Again, 24 landmarks were determined and then 20 desired variables were measured based on Steiner's analysis. The obtained data were entered into the software and compared.

The average ANB was 4.02±3.01 degrees in the traditional manual method and 3.08±4.04 degrees in the CephNinja® method. The average Wits was -1.12±3.90 mm in the traditional manual method and -1.13±4.16 mm in the CephNinja® method. The results show that there is no significant difference in the measurements of the two traditional manual methods and the CephNinja® software.

Based on the current study, it can be concluded that CephNinja® software is reliable and can be used similar to traditional manual method for cephalometric analysis in orthodontic patients.

The use of cuffed catheters for hemodialysis in patients with chronic kidney failure has increased. Thrombosis of cuffed catheter tip is a dangerous complication that can lead to catheter dysfunction and even threaten the patient's life. This study was conducted with the aim of determining the prevalence and causes of cuffed catheter tip thrombosis in order to maintain its function.

This cross-sectional study was conducted in 2020 on patients with chronic kidney failure in Babol who were referred by a nephrologist due to dysfunction of the cuffed catheter. After recording demographic information, all patients were candidates for echocardiography and then venography through the catheter in the angiography unit to determine the cause of cuffed catheter dysfunction. The presence of thrombosis in the catheter tip, the formation of fibrin sheath and the location of the catheter tip were investigated.

91 patients, including 54 men (59.3%) and 37 women (40.7%) were included in the study due to lack of effective dialysis caused by cuffed catheter dysfunction. The average age of the patients was 62.01±14.66 years with a minimum age of 29 and a maximum of 88 years. The most common location of catheter placement was the right internal jugular vein in 79 cases (86.8%). The incidence rate of thrombosis in cuffed catheter tips was 53 cases (59%), with inappropriate location of the catheter tip in 31 cases (58.49%) as the most common cause, while formation of fibrin sheath in the catheter tip in 12 patients (22.64%) and inappropriate catheter length in 10 patients (18.86%) were respectively the other common causes of thrombosis in the tips of cuffed catheters.

The results of the study showed that inappropriate location of the catheter tip was the most common cause of thrombosis in cuffed catheter tips. Therefore, it is recommended to use fluoroscopy during cuffed catheter insertion to ensure the correct placement of the catheter tip inside the right atrium.

In patients with breast cancer, the administration of an additional dose of radiotherapy to the tumor bed after breast treatment is associated with a decrease in local recurrence. Electron source is mainly used due to proper dose distribution and lack of skin irradiation. Nevertheless, access to electrons is not possible in all medical centers. Therefore, continuing treatment using smaller photon fields may be a reasonable option. The aim of this study is to investigate and compare the outcome of treatment and skin complications in tumor bed boost radiotherapy using photons or electrons in breast cancer patients after breast-conserving surgery.

In this retrospective cohort, 280 patients with non-metastatic breast cancer who underwent breast-conserving surgery and adjuvant radiotherapy were included in the study. After whole breast radiotherapy with conventional regimen (50 Gy in 25 sessions), the patients underwent tumor bed boost with electrons or photons (with a dose of 10 Gy in 5 sessions) (electron: 145 people, photon: 135 people). Survival values, cosmetic results (Harvard Harris criteria) and skin toxicity (5th edition of General Toxicity Criteria and Adverse Effects) were compared between the two groups during the follow-up of patients.

Recurrence-free survival in the same breast was not significantly different in two groups (recurrence-free survival in photon boost 95% (with a 95% confidence interval between 9% and 97%) and electron boost 93% (with a 95% confidence interval between 79% and 97) (p=0.69). There was no difference between radiotherapy-induced dermatitis and subcutaneous toxicity at the end of the treatment between the two treatment groups. However, one month after the end of the treatment, the cases of severe radiotherapy-induced dermatitis were higher in the photon treatment group (88% vs. 65.5%, p=0.007). However, the subcutaneous toxicity 2 months after the end of treatment was significantly higher in the electron boost group (0% vs. 7.5%, p<0.05). Mild pain in the same breast 6 months after the end of the treatment was higher in the photon treatment group (0% vs. 8.9%, p<0.001).

Based on the results of the present study, using an electron or photon source to boost the dose to the tumor bed following whole breast radiotherapy in breast cancer patients undergoing breast-conserving surgery is associated with similar treatment results in terms of recurrence in the same breast. Of course, the toxicity profile, especially the skin toxicity, is different between the two approaches.

Hemophilia A is the most common type of this disease. For the treatment of hemophiliacs, the injectable concentrate of human factor VIII, derived from plasma and recombinant, is available in the market. Due to the risk of contracting infectious diseases due to blood transfusions or donated blood products, including plasma-driven factor VIII, recombinant factor VIII can be used, which is safe and has a higher purity than the blood-derived sample, while showing a longer half-life in the blood of consuming patients. The aim of this study is to evaluate the expression and synthesis of recombinant human factor VIII using a cell-free eukaryotic expression system as a new strategy for the synthesis of recombinant drugs.

In this experimental study, pcDNA3 vector containing the gene fragment without B-domain of blood coagulation factor VIII was transformed into susceptible DH5α bacteria. After the multiplication of the bacteria and the increase of the target vector, the amplified vector was extracted at this stage and its quality and concentration were determined. Then CHO-K1 eukaryotic cells were cultured and cell extract was prepared from the density of more than ten million of their cells. The extracted vector was combined with cell extract and expression solution, and the expression process was carried out at 30°C and 37°C. The level of expression was evaluated by ELISA and dot blot techniques.

Based on the ELISA technique adopted in this study, the expression level of recombinant human blood coagulation factor VIII in the base sample at a temperature of 30°C, sample 2 at a temperature of 30°C, base sample at a temperature of 37°C, and sample 4 of negative control at a temperature of 30°C were respectively reported as 275, 276, 273 and 0 ng/ml in a period of 20 hours. In the dot blot technique, the mentioned quantitative results were qualitatively confirmed by the color intensity of the spots.

The results showed that the cell-free expression method can be used for the synthesis of recombinant factor VIII. Under the conditions used in this research for cell-free expression of recombinant factor VIII, volume ratio of 50/50 of CHO-K1 cell extract was suitable, and the basic expression solution at 30°C showed the highest concentration of the product. Due to the use of CHO-K1 eukaryotic cell extract, the synthesized recombinant human factor VIII has post-translational modifications, which are very important for the functionality of this protein in the human body.

Considering the lack of knowledge and the difference in the prevalence of hyponatremia in non-bacterial meningitis and bacterial meningitis, this study was conducted with the aim of determining the relationship between hyponatremia and bacterial and non-bacterial meningitis and its complications.

This cross-sectional study was conducted on 183 children with meningitis referred to Shafizadeh Amirkola Children's Hospital in three age groups: 1 month to 2 years, 2-5 years, and 5-18 years. Based on cerebrospinal fluid analysis, cases of bacterial meningitis were considered to be WBC>100 with preference for PMN, glucose less than 40% of serum sugar and protein more than 1 g/L or positive culture or smear. Cases of non-bacterial meningitis were considered as WBC<100 with preference for lymphocyte, glucose more than 60% of serum sugar and protein less than 1 g/L or negative culture or smear. Gender of children, duration of hospitalization and occurrence of seizures in two groups of bacterial and non-bacterial meningitis with and without hyponatremia were investigated and compared.

In this study, the mean age of boys (68.26±47.10) with meningitis was higher than that of girls (42.56±32.50) (p<0.001). The mean age of meningitis patients with hyponatremia (51.87±47.56) was lower than that of patients without hyponatremia (72.54±45.03) (p=0.002). The frequency of hyponatremia in children with meningitis aged less than 2 years compared to other age groups (52 patients) (p=0.002), as well as infants who had seizure (37 patients) (p=0.001) has been significantly higher. In children who had hyponatremia, the duration of hospitalization was significantly longer (108 patients) (p=0.01).

Based on the results of the present study, it was found that younger children are at greater risk for hyponatremia, and the presence of hyponatremia at the beginning of diagnosis suggests a greater risk for seizures and increased length of hospitalization. However, the risk of hyponatremia in both types of bacterial and non-bacterial meningitis is almost the same.

During sperm freezing, its functional indices, including survival and motility, are damaged and lead to a decrease in sperm quality and fertility. Studies have been performed to lower these damages, including adding antioxidants to the freezing environment. This study was conducted to investigate the effects of antioxidants melatonin and L-carnitine on the quality of sperm parameters after freezing and thawing.

In this interventional study, 40 sperm samples were divided into 4 groups including: control group (no antioxidant), melatonin group (0.01 mmol melatonin), L-carnitine group (100 μmol L-carnitine) and combined group (0.01 mmol melatonin and 100 μmol L-carnitine). The samples were thawed two weeks after freezing, then the motility, survival and morphology parameters were evaluated by Eosin-nigrosin staining and were counted. Lipid peroxidation was evaluated by measuring MDA with thiobarbituric acid reaction and DNA fragmentation through Tunnel kit.

The results showed that the combined use of melatonin and L-carnitine in the freezing medium had a significant effect on the rate of motility and survival (increase from 15% to 25%), DNA fragmentation (decrease from 32% to 23%) and MDA level (decrease from 10 to 6.5 µm/dl). However, the examination of sperm morphology did not show any significant difference between the studied groups.

The results of the study showed that melatonin and L-carnitine can reduce the damage caused by sperm manipulation during the freezing and thawing process.

Polycystic ovarian syndrome (PCOS) is associated with autoimmune thyroid disease and is thought to be one of the most frequent endocrine diseases in women of reproductive age. This research aims to compare the levels of TSH, LH, Insulin, HOMA-IR, and testosterone in women with polycystic ovary syndrome (PCOS) versus healthy subjects of same age and BMI.

This case control study was conducted among 100 patients who referred to Al-elwyah Teaching Hospital. The samples were selected on the basis of symptoms of hypothyroidism, and fertility problems, and polycystic ovary syndrome in two groups of 50. They were diagnosed by specialized doctors in the hospital. The first group consisted of fifty healthy women, and the second group also consisted of fifty women with polycystic ovary syndrome, reproductive problems, and hypothyroidism. Hormonal analyses were performed using a ready-made kit according to the manufacturer's instructions, Roche Cobas, using an ELISA microplate analyzer.

Mean body mass index, insulin, HOMA-IR, testosterone, anti-TPO, anti-TG, thyroid stimulating hormone, and luteinizing hormone, as well as age group (31-40) were respectively as follows: (35.96±0.34, 23.12±0.31, 6.64±0.07, 98.80±0.75, 7.70±0.10, 10.27±0.30). LH and anti-TG insulin levels were positively correlated with their BMI. There was also an inverse relationship between body mass index and HOMA-IR, and between anti-TG and testosterone.

The results of the study showed that in patients with polycystic ovary syndrome, increased risk of thyroid disease is related to increased thyroid autoantibody markers and measured hormones, insulin and HOMA-IR.

The Osteoblast differentiation is an essential process that causes bone stability and homeostasis. Zingerone (ZG) 4-(4-hydroxy-3-methoxyphenyl)-2-butanone isolated from the ginger plant is involved in many biological processes and can be used to treat diseases as an anti-inflammatory and antidiabetic agent. This study aims to identify ZG potential to bone tissue regeneration by investigating the effect of Zingerone on human umbilical cord stem cells (hUC-MSCs) and their differentiation into osteoblasts.

In this cross-sectional study, the effect of Zingerone toxicity on 2×106 hUC-MSCs cells was investigated in 4 groups; one control group without any ZG and 3 groups threated with 50µM, 100µM and 200µM ZG. Cell viability was evaluated by the MTT method after 24, 48 and 72 hours. The gene expression of miR-590 and Smad7 and differentiation markers such as Osterix (OSX) and runt-related transcription factor 2 (RUNX2) were investigated by quantitative real-time polymerase chain reaction (qRT-PCR). The expression level of this enzyme was checked by an alkaline phosphatase (ALP) reaction.

Zingerone has significant proliferative effects on hUC-MSCs cells in 200µM (p<0.05). Zingerone positively affects the differentiation process of osteoblasts by influencing the expression of specific markers such as ALP (p<0.05 in 200µM), RUNX2 (p<0.001 in 200µM), and OSX (p<0.001). The expression of miR-590 is increased in 200µM (p<0.05), while that of Smad7 is decreased under the influence of different Zingerone concentrations (p<0.001). In fact, miR-590 suppresses Smad7 and helps the differentiation of osteoblast cells.

The results of this study showed that Zingron causes the differentiation of osteoblast cells by increasing the expression of specific markers of osteoblasts (OSX, RUNX2 and ALP). In addition, increasing the expression of miR-590 suppresses Smad7 and helps the differentiation of osteoblast cells.

Thalassemia is the most common heritable disorder globally, characterized by the synthesis of low atypical hemoglobin and erythrocytes destruction. There are inadequate data about the epidemiology and other thalassemia traits in Iraq. This study was conducted to inspect the thalassemia epidemiology in Babylon, Iraq.

This single-center retrospective study involved 306 thalassemic patients. Patients were recruited from those recorded at ‘’Babylon Hereditary Blood Disorders Center’’. Information related to demographic characteristics, age at first diagnosis, socio-economic status, family history, place of residence, frequency of blood transfusions, chelation therapy and serum ferritin measurement were collected and analyzed.

The mean age of the studied patients was 2.3-17.9 years, which included 185 males and 121 females. 75% of the patients had thalassemia major, 12% had thalassemia intermedia, and 0.3% suffered minor thalassemia. 3.3% had thalassemia with G6PD deficiency, 2% had sickle thalassemia, 1.3% had alpha thalassemia, and 4.6% had beta-thalassemia. The patients received regular blood transfusions about once or twice monthly in the majority of the cases (85.6%). The mean serum ferritin concentrations were high (2976.9 μg/L). The growth in the males was affected more than in females (p=0.05). Most of the patients were from rural areas and 2/3rd of the thalassemia patients had a family history of thalassemia and a high rate of parental consanguineous marriage (p=0.001). The majority of the patients had one or more complications of thalassemia. All the children under 10 years of age included in the study revealed stunted growth significantly.

According to the results of this study, the management of thalassemia necessitates early diagnosis of irregular transfusion programs, and associated comorbidities, besides prompt actions. Comprehensive premarital screening, paternal counseling programs, and ongoing regulation can all aid in bringing down prevalence to far lower levels.

Previous cesarean sections are the most common cause of increased cesarean section in many parts of the world, although it is not always necessary. Considering the high statistics of cesarean section in Iran and especially the high rate of repeat cesarean section and creating motivation for vaginal birth after cesarean section, this study was conducted in order to investigate the maternal and neonatal outcomes of vaginal birth after one cesarean section.

This cross-sectional study was conducted on 104 pregnant women with a previous caesarean section and transverse incision on the lower segment in Ayatollah Rouhani Hospital of Babol in two groups; 50 people in the first group who underwent repeat emergency cesarean section and 54 people in the second group who consented to vaginal birth after cesarean section (VBAC). Demographic characteristics and maternal and neonatal complications were investigated and compared between the two groups.

In this study, there were no significant differences between the two groups in terms of demographic characteristics. Infant mortality rate was reported in 6 cases (12%) in the first group and 2 cases (3.7%) in the second group. Furthermore, 3 babies (6%) in the repeat cesarean section group and 9 babies (16.7%) in the vaginal birth group after cesarean section were admitted to the neonatal intensive care unit. The 5-minute Apgar was also significantly higher in the babies of the vaginal birth group after cesarean section (p=0.04). The duration of mother's hospitalization was 3.98±5.53 and 2.11±0.31 days in the repeat cesarean and vaginal birth groups, respectively (p=0.02).

According to the results of this study, maternal and neonatal complications did not increase in vaginal birth after cesarean section, and if the mother wishes, vaginal birth can be performed after one cesarean section.

Astrocytoma is a tumor of neurological origin, arising from special supportive cells in the brain and spinal cord called the astrocytes. Astrocytoma is classified according to grade, site, and molecular features. The aim of this study is to investigate the relationship between histopathological and clinical parameters and gender, age, location and different grades.

This cross-sectional study included 36 cases of astrocytoma from April 2017 to June 2020 from the archive of AL Shaheed Gazi AL Hariri Hospital. The cases reached the final diagnosis by H&E staining with 16 cases stained by immunohistochemical stain for confirmation of diagnosis. SPSS was used for analysis.

Thirty-six cases of astrocytoma were included in this study. Their ages were ranging from 1 to 56 years, with a mean age of 31.43±0.015 years. Assessment of age reveals that the most frequent age (25%) was in the 3rd decade of life. The predominant grades were grade I and grade IV with 11 cases for each (32.5%). Whereas patients of grade II and III compose 10 (27%), and 4 (11%) cases, respectively. The relationship between the age of the patients and their grades shows a positive significant correlation between age and grade (p<0.001), and tumor grade increases with the increase in the age of the patients.

The results of the study show that there is a significant relationship between tumor grade and clinical-pathological characteristics, because tumor grade increases with age and is more aggressive in female patients.

Assisted reproductive technologies (ART), including in vitro fertilization (IVF) and embryo transfer, have achieved considerable success, largely due to controlled ovarian hyperstimulation (COH). However, there remains a shortage of studies on the estimation of various ovarian response markers linked to the GnRH agonist-controlled ovarian stimulation (COS) regimen. The objective of the current study is to assess the productiveness of Follicle Stimulating Hormone (FSH) and Anti-Mullerian Hormone (AMH) in determining ovarian responses in infertile patients undergoing controlled ovarian stimulation.

This cohort study involved 90 females, aged 20 to 43 years, with primary and secondary infertility lasting between 3 and 13 years, attending the Al-Najef fertility center for ICSI cycles between June 2020 and January 2021. Patients with a history of ovarian surgery, polycystic ovary syndrome (PCOS), and premature ovarian failure (POF) were excluded. FSH and AMH levels were calculated on second 2 of the menstrual cycle, and the association between these indicators and outcome factors was evaluated.

AMH demonstrated a negative link with age and a positive link with the antral follicle count, total number of follicles after induction, and retrieved oocyte count (p<0.05). FSH exhibited a significant negative link by the total number of follicles after induction (p<0.05). AMH demonstrated the best sensitivity and specificity, positive predictive value (PPV) and negative predictive value (NPV) for predicting ovarian response. Specificity, sensitivity, PPV and NPV for AMH with cut-off values >2 ng/mL test providing 84%, 80%, 86%, 57% in comparison to FSH with cut-off values >4 IU/mL yielded 67%, 68%, 50% and 54%, respectively.

In conclusion, our findings suggest that AMH is a superior predictor of ovarian response compared to FSH.

Several studies show that prophylactic drains in simple laparoscopic cholecystectomy are unnecessary and even harmful. Considering that the drainage of the gallbladder bed after laparoscopic cholecystectomy can be free of complications, the aim of this study is to compare the effectiveness of prophylactic drainage in patients undergoing laparoscopic cholecystectomy and the effectiveness of subhepatic drain.

This prospective study was conducted in Al-Imamain Alkadhumian medical city during the period from first of January 2019 to the end of December 2020. During the study period, 61 adult patients undergoing elective cholecystectomy participated after written consent was taken from them. 31 of them received subhepatic drain and 30 patients did not. The level of pain and complications was compared in the two groups.

In the group that had a drain, the average pain scale was 16.5±0.9 degrees, and hospitalization after surgery was 2.1±0.6 days. They had subhepatic collection of 29.4±4.8 ml and 19.4% of patients had complications. However, people without drains had an average pain score of 2.3±1.1, hospitalization days of 0.633±0.61, subhepatic collection of 20.6±4.08 ml, and 33.3% of patients had complications. There was a positive and direct relationship between postoperative pain scale and drainage (p<0.05). In addition, the subhepatic collection of the first group was significantly different from the subhepatic collection of the second group (p<0.05). However, no statistically significant relationship was found between age and drain.

Based on the results of this study, routine drainage tube placement during laparoscopic cholecystectomy increases post-operative discomfort, hospital stay, and sub hepatic collection without reducing complications from operation.

Laryngeal Mask Airway (LMA) is commonly used in short-term surgical anesthesia. Intravenous lidocaine is used for better patient tolerance after LMA insertion. Regarding the side effects of intravenous lidocaine, the aim of this study is to compare the effect of lidocaine spray versus intravenous lidocaine on blood pressure, heart rate, sore throat, cough, laryngospasm, and other side effects including nausea, vomiting, and convulsions after LMA insertion.

This double-blind randomized clinical trial was conducted on 120 patients aged 18-65 years with indications for short-term elective eye surgery, in 2 equal groups of 60 people. The first group was given 1% intravenous lidocaine at the rate of 1.5 mg/kg, and the second group was administered with 5 puffs of 10% lidocaine spray in the throat. Then, blood pressure by a sphygmomanometer, heart rate by a heart rate monitoring system, sore throat intensity based on VAS criteria, and cough intensity based on mild, moderate and severe were measured and compared in the two groups.

79 men (65.8%) and 41 women (42.2%) participated in this study. Clinically, there was no significant change in blood pressure in the two groups. The mean intensity of sore throat two and three hours after waking up in lidocaine spray group (0.51±1.33 and 0.41±1.07) compared to intravenous lidocaine (1.15±2.02 and 1.9±1.08) showed a significant decrease (p<0.05). Also, there were no significant changes in heart rate, cough and laryngospasm between the two groups. In addition, no cases of nausea, vomiting and seizures were found in the two groups.

Based on the results of this study, lidocaine spray can be suggested to reduce the severity of sore throat caused by LMA insertion.

Oxidative stress contributes to insulin resistance, beta-cell dysfunction, and hyperglycemia-induced cellular damage, leading to diabetes mellitus. The purpose of this study is to explain the effect of aerobic exercise and berberine chloride on the expression of UCP-1 and PPARγ genes in the visceral fat tissue of diabetic rats.

In this laboratory study, 32 adult male Wistar rats weighing about 240-280 were randomly divided into four groups (n=8): diabetes (DM), diabetes-berberine (DMB), diabetes-aerobic exercise (DMT), diabetes-aerobic exercise-berberine (DMTB). The rats became diabetic by injecting 60 mg/kg STZ. The rats whose blood sugar was higher than 300 mg/dl were included in the present study as diabetic animals. The exercise groups then performed an incremental aerobic exercise program (10-18 m/min, 10-40 min/day, five days/week) on a treadmill for six weeks. The supplement group also received berberine chloride (30 mg/kg/day) orally by gavage once a day.

Data analysis showed that there is a significant difference in the expression of UCP-1 (p=0.000) and PPARγ (p=0.002) genes between the groups. Furthermore, the results showed that the expression of UCP-1 gene in the diabetes-exercise group (2.96±1.85 and p=0.015), diabetes-berberine chloride (2.88±1.16 and p=0.02) and diabetes-exercise-berberine chloride (4.7±0.97 and p=0.000) showed a significant increase compared to the diabetes group. Also, PPARγ gene expression in the diabetes-exercise-berberine chloride group (1.6±0.36 and p=0.002) showed a significant increase compared to the diabetes group.

According to the results of this study, aerobic exercise and berberine chloride is one of the possible ways to prevent inflammation and damage caused by diabetes.

Sepsis is the third most common cause of death, and the umbilical cord is a significant source of sepsis in the first month of life. This study aimed to compare the effect of Eau de Dalibour and distilled water on umbilical cord separation time and infection in neonates at Kowsar Hospital of Qazvin University of Medical Sciences.

This clinical trial was conducted on 76 infants in two groups of 38 people, using Eau de Dalibour and distilled water as a placebo. In the Eau de Dalibour group, 2-3 ml of the drug was used on the umbilical stump from 3 hours after birth and once every 12 hours until 2 days after the separation of the umbilical cord. In the distilled water group, the same procedure was done with distilled water. Finally, the time of separation of the umbilical cord and signs of infection in both groups were investigated and compared.

There were no significant differences between the two groups in terms of gestational age, sex, or birth weight. Umbilical cord separation time was significantly shorter in the Eau de Dalibour group than in the placebo group (5.1±2.4 and 7.44±2.3 days respectively; p<0.001). There were no cases of infection in the intervention or placebo group.

According to the results of this study, the application of Eau de Dalibour to the remaining part of the cord reduces the cord separation time and can be used for safe and affordable cord care.

Jaundice is common in infants and occurs because of hyperbilirubinemia, which can lead to brain injury in neonates. Phototherapy, in addition to its serious side effects, does not seem to be enough in resolving jaundice. This clinical trial aims to compare the efficacy of orlistat and phototherapy combination therapy with that of phototherapy alone in the treatment of neonatal jaundice.

This clinical trial was performed on 120 term neonates with jaundice. Block randomization was used to allocate the infants to the intervention and control groups. The intervention group received orlistat (4 mg/kg body weight) for three consecutive oral doses at the first, second and third day of hospitalization, along with phototherapy. The control group received a placebo and phototherapy. Total and direct plasma bilirubin levels were measured at baseline (before intervention) as well as 24 and 72 h after treatment.

There were no statistically significant differences between the two groups in terms of infant sex, weight, or age. The mean total and direct bilirubin levels in the experimental group did not change compared to those in the control group at the end of the trial (10.44±1.35 vs. 10.6±2.8 and 0.4±0.1 vs. 0.5±0.1, respectively).

Orlistat appears to be ineffective in accelerating bilirubin reduction in neonates with jaundice, at least for the first three days of life.

Pharmaceutical costs account for a major part of health-related costs, and the induced demand for medicine imposes a large financial and economic burden on individuals and the whole society. Therefore, the aim of the present study is to identify the factors effective in creating induced demand for medicine in Iran.

This study is based on grounded theory approach and it was conducted in 2022. The interview questions were semi-structured and asked by experts. The initial selection of the samples was based on targeted sampling from among experts and scholars in the field of medicine and treatment from all over the country. The snowball method was used to increase the sample volume until it reached sufficiency. This research was completed by interviewing 20 experts.

The key factors effective in creating induced demand were identified in the form of 4 themes, 8 categories and 31 subcategories. The extracted themes included social, structural-organizational, economic and beneficiary-related factors. Social factors included the categories of society's culture and pharmaceutical literacy, structural-organizational factors included the categories of regulatory mechanisms and educational and political factors, economic factors included the categories of payment and insurance systems, and finally the beneficiary-related factors included the categories of suppliers and demanders.

Based on the results of this study, several factors play a role in the creation of induced demand for medicine, and following these factors can help policymakers formulate appropriate strategies to reduce unnecessary medicine prescription.

Today, abortion treatment is performed legally for reasons such as preserving the health and life of the mother and fetus with disabilities. The aim of this study was to investigate the basic information and determine the main reasons for legal abortions in medical abortions referred from forensic medicine in Babol as a basis for designing and conducting studies in the future regarding the improvement of reproductive health among women of reproductive age.

This cross-sectional study was conducted via census sampling method among 104 cases of medical abortion referred from the forensic medicine of Babol to affiliated hospitals of Babol University of Medical Sciences in 2017-2020. Information related to individual and social factors and maternal and fetal causes leading to abortion was collected by a researcher-made checklist. Then, the data were reviewed and compared in terms of gestational age, termination of pregnancy, and maternal and fetal causes leading to abortion.

The mean gestational age at termination of pregnancy with fetal causes was 16.21±2.35 weeks and for maternal causes was 10.33±3.96 weeks. There was a statistically significant relationship between the history of underlying disease, gender at the time of abortion, gestational age, and the causes of termination of pregnancy (p<0.05). In maternal causes of abortion, the highest frequency (50%) was related to maternal cardiovascular causes, and in fetal causes of abortion, the highest frequency (51.08%) was related to genetic causes of the fetus. Misoprostol was used to terminate the pregnancy of 23.1% of mothers.

The results of the study showed that a large number of cases of medical abortions are related to the fetal cause.

Matrix metalloproteinases (MMPs) reduces the resin-dentin bond and bond strength over time. One of the substances introduced as MMps inhibitors is omega-9. This study aims to investigate the effect of pretreatment of dentin with omega-9 and chlorhexidine (CHX) on the durability of bond strength in certain time intervals and modes of failure.

In this laboratory study, 45 permanent third molar teeth without caries were cut with a disc to expose the dentin of the middle part of the crown. Then, they were randomly divided into three groups: without pretreatment, pretreatment with CHX, and with Omega 9. This experiment was done after etching and before placing Single bond 2. Each group was divided into three subgroups, one day, 3 months and 6 months. A 4mm composite block was placed on the tooth and then cut into dimensions of 1×1 mm and microtensile bond strength test was performed. The failure mode was examined by stereo microscope using X40 magnification.

In the comparison of pretreatment groups with CHX and Omega-9, there was no significant increase in bond strength after 24 hours. After three months, the bond strength in the pretreatment group with CHX (13.40±2.64 MPa) was significantly higher compared to the control group (10.46±3.5 MPa) (p=0.014). Moreover, in the omega-9 pretreatment group, the bond strength (13.16±2.7 MPa) was significantly higher compared to the control group (10.46±3.5 MPa) (p=0.028). Average microtensile bond strength in the Omega 9 and CHX groups decreased after six months compared to three-month period but increased compared to the one-day period, which was not significant.

Pretreatment with omega-9 increases the strength of the resin-dentin bond, and this increase was present for up to 3 months.

Although the likelihood of endophthalmitis after intravitreal injection is low, one of the side effects of this injection is blindness. With the prevalence of the COVID-19 pandemic and the necessity of mask use in patients and physicians, mask use has increased. Previous studies have reported a high risk of endophthalmitis after intravitreal injection in patients who wore masks. The present study was conducted to investigate the pattern of endophthalmitis after intravitreal injection of Avastin (Bevacizumab) in patients wearing masks.

This prospective cohort study was conducted on 3938 patients who underwent intravitreal injection from March 2021 to March 2022 at the eye surgery center. Bevacizumab injection was performed after local anesthesia in the operating room and under sterile conditions. Local antibiotic drops (chloramphenicol) were then used. It should be noted that patients' masks were not removed at any of the stages mentioned. Patients were followed up one week after discharge to be examined for infection.

A total of 3938 patients were included in the study, 56.6% of whom were male and 43.4% were female. The mean age of the patients was 39.61±16.10 years. Moreover, no significant difference was observed between men and women. The highest frequency of injection was related to diabetic macular edema (27.8%) and the lowest frequency was related to neovascular glaucoma (0.5%). Only one patient was diagnosed with endophthalmitis after intravitreal injection. In addition, no significant relationship was found between age, gender, and the occurrence of endophthalmitis.

According to the results of this study, the incidence of endophthalmitis after intravitreal injection is very low, and the use of a face mask in patients has no effect on the occurrence of endophthalmitis.

Accidents as the second cause of disability and the main cause of disability and death can lead to physical and mental disorders and even death. The present study was conducted to investigate the mortality caused by accidents and incidents in Babol, Northern Iran, based on the international classification of diseases.

This cross-sectional study was conducted retrospectively on all the deaths recorded during the years 2016-2022 in registration and classification system of causes of death caused by accidents and incidents at the health department of Babol. Deaths caused by accidents and incidents were extracted and analyzed based on ICD-10.

Out of 18265 deaths, 1305 cases (15.7%) were related to accidents and incidents, of which 686 deaths (52.57%) were caused by traffic accidents. The highest frequency of accidents and incidents was 576 cases (44.13%) due to a person being injured in an unknown (traffic) accident and 182 cases (13.95%) being exposed to an unknown factor. The mean age in deaths caused by accidents and incidents in the traffic accident group was 46.05±22.07 and in the non-traffic accident group was 43.35±23.49 years (p=0.033). As the decades of age increased, the death rate increased (p<0.001).

Based on the results of this study, most of the deaths caused by accidents and incidents based on the classification system of the causes of death were due to the injury of a person in an unknown accident, exposure to unknown factors and poisoning.

Differentiated Thyroid Cancer (DTC) is the most common endocrine malignancy with the fastest growing rate worldwide. The aim of this study is to investigate the prevalence of distant metastases in whole-body scans after iodine therapy in DTC patients with low and intermediate-risk and to evaluate its diagnostic role.

In this retrospective cohort study, patients with DTC who underwent total thyroidectomy and were referred for Radioiodine Remnant Ablation (RRA) to the nuclear medicine department of Shahid Beheshti Hospital were included in the study. According to ATA guidelines, patients were divided into two groups with low risk level (LR) and intermediate risk level (IR) and were evaluated for distant metastasis by whole-body scan after iodine treatment with a Single-Head Gamma Camera.

Out of 1039 patients included in the study, 149 (14.3%) were men and 890 (85.7%) were women. Thyroid remnant was present in whole-body scan after iodine treatment in 1030 patients (99.1%). Of these patients, 713 (68.6%) were in the LR group and 326 (31.4%) were in the IR group. The presence of cervical lymph node metastasis was detected in 69 people (LR:28, IR:41), mediastinal involvement in 11 people (LR:3, IR:8), lung metastases in 11 people, and bone metastasis in 3 people out of 101 patients. All of them were in the group of patients with intermediate risk. Multiorgan involvement was seen in 7 of 101 patients (LR:2, IR:5). The mean serum level of thyroglobulin (Tg) in cases of distant metastasis was 2.61±8.57 in the low risk group and 17.45±65.21 in the intermediate risk group, and these values showed statistically significant differences (p<0.001).

The results of the present study showed that the prevalence of distant metastases in whole-body scan after iodine therapy was seen in approximately 10% of patients. Serum thyroglobulin level can also be used as a clinical marker for early diagnosis of distant metastasis.

The use of chemical drugs results in substantial adverse effects and the development of drug resistance. Onion Allium cepa (O. Allium cepa) is one of the most well-known herbal treatments due to its ability to reduce inflammation and strengthen the body's immune system. The aim of this study is to investigate the effect of alcoholic extract as an antimicrobial, antioxidant and anticancer drug biosynthesized from Onion Allium.

In this laboratory study, the ethanolic extract of the onion Allium cepa plant was used to prepare the biosynthesis using a soxhlet with 75% ethanol. The UV/Vis spectrophotometry (UV-vis) and Fourier transmission infrared analysis (FTIR) were employed for characterization of ethanolic extract. Antibacterial activities of ethanolic extract against Escherichia coli (E. coli) and Staphylococcus aurous (S. aurous) were investigated. The cytotoxic effect of alcoholic extract on AMJ-13 breast cancer cell line at different concentrations (6.125, 12.5, 25, 50 and 100) micrograms/ml was evaluated by MTT method and DPPH was used to evaluate the antioxidant activity.

According to the results of Fourier transmission infrared analysis and phytochemical screening, numerous active substances, including polysaccharides, saponins, phenolic compounds, glycosides, and flavonoids were found in this extract. The antimicrobial activity test results revealed the largest inhibition zone in Escherichia coli as compared to Staphylococcus aureus. The AMJ-13 cell line's proliferation was greatly reduced by this extract in a concentration-dependent way when compared to the control, whereas this extract's cytotoxic activity increased with concentration. The findings demonstrated that Onion Allium cepa is a principally valuable source of powerful anti-oxidant.

According to the results of this study, ethanolic extract of the onion Allium cepa plant has antibacterial activity and reduced malignant cell lines' ability to proliferate and showed a strong antioxidant impact.

Knowledge of airway dimensions is important in the process of diagnosing and planning the treatment of orthodontic patients. Therefore, this study was conducted with the aim of performing cephalometric anlysis of airway dimensions in patients with different vertical jaw relations in the specialized clinic of Babol Dental School.

This cross-sectional study was conducted on 150 lateral cephalometric radiographs taken from patients aged 18 to 25 before orthodontic treatment. Based on the FMA angle and Jarabak index, the patients were divided into three groups of 50 according to the vertical skeletal pattern. The width of the upper (UP) and lower (LP) airways was measured in millimeters using McNamara's analysis. Moreover, the width of the nasopharynx (PNS-UPW), oropharynx (U-MPW) and hypopharynx (V-LPW) was recorded in millimeters and compared in three groups.

The studied population included 43 men and 107 women with a mean age of 20.39±2.50 years. The results showed a significant relationship in the dimensions of the upper airway, nasopharynx, and oropharynx between the vertical groups (p=0.001, p=0.001, and p=0.015, respectively). All these parameters in the Hyperdivergent group were significantly lower than the other two groups, and no significant relationship was found between the Hypodivergent and Normodivergent groups. The mean upper airway in Normodivergent group was 13.62±3.05. In addition, the dimensions of the lower airway and hypopharynx were not significantly different between the vertical groups.

The results of the study showed that hyperdivergent patients have a narrower upper airway. However, lower airway dimensions are not affected by vertical growth pattern factors.

Vitiligo is a complex skin disorder that manifests itself with colorless spots caused by the destruction of melanocytes and causes psychological disorders in patients. The aim of this study is to investigate the level of perceived stress in vitiligo patients compared to the control group.

This case-control study was conducted in Razi Hospital affiliated to Tehran University of Medical Sciences from August 2020 to February 2021. 87 vitiligo patients with definite diagnosis (case group) and 130 patients with other skin diseases not related to psychosomatic factors (control group) were selected via convenience sampling and compared with each other in terms of the level of current perceived stress. In this study, the perceived stress was the dependent variable, the clinical type of the disease and the location of the lesion were the independent variables, and the demographic characteristics of the patients were the background variables. The data were collected and compared using a standard questionnaire of perceived stress in which the range of scores is between 0 and 40.

The average perceived stress in vitiligo patients (19.17±6.24) was higher than other skin patients (16.75±6.96), which was significant by controlling the effect of background variables (Coef.=1.98, CI=0.21-3.75, p=0.02). There was no significant relationship between perceived stress and clinical type and duration of vitiligo. Only the occurrence of genital lesions was related to stress experience (p=0.01). Moreover, with the increase in the level of education, the level of stress in patients decreased (p=0.01).

According to the findings of the present study, suffering from vitiligo can lead to increased stress in patients. Since stress leads to negative effects on resilience and the quantity and quality of the treatment period in various diseases, it is necessary to pay attention to the significance of counseling and psychological support in the treatment plan of vitiligo patients.

Polycystic ovary syndrome is one of the most common endocrine disorders, whose symptoms usually begin immediately after the first menstrual period. Previous studies found a significant relationship between dysmenorrhea, premenstrual syndrome and polycystic ovary syndrome. The aim of this study is to investigate the effect of chamomile on dysmenorrhea and premenstrual syndrome in patients with polycystic ovary syndrome.

This clinical trial was conducted on 70 patients diagnosed with polycystic ovary syndrome based on Rotterdam criteria referring to a clinic in Mashhad. Patients were randomly assigned to two groups. The first group received two 500 mg chamomile capsules per day and the second group received two placebo capsules per day for three months. The response to treatment in premenstrual syndrome, dysmenorrhea and oligomenorrhea was evaluated using the Visual Analogue Scale and DSM-IV premenstrual syndrome diagnosis questionnaire.

The mean age of the patients in the intervention group was 25.43±5.58 and in the placebo group was 28.06±5.71 years. The rate of improvement in women with premenstrual syndrome (16.6%), dysmenorrhea (50%) and oligomenorrhea (26.7%) was higher in chamomile group compared to placebo. There was no statistically significant difference in body mass index between the chamomile group (25.17±4.95) and the control group (25.57±6.7).

Based on the results of this study, chamomile improved the symptoms of oligomenorrhea in patients with polycystic ovary syndrome and showed positive effects on dysmenorrhea and premenstrual syndrome. Therefore, chamomile can be used as a simple, low-cost therapy in the treatment of polycystic ovary syndrome patients.

The method of repair in complicated ventral hernia at emergency setting imposes a great challenge to the surgeon worldwide. Using polypropylene mesh is very challenging because of the great concern about risks of complications. This study was conducted to determine the safety and efficiency of polyproline mesh in complicated emergency ventral hernia.

This prospective study was conducted on 60 patients with complicated abdominal hernia who required emergency surgery (obstructed and or strangulated). The cases were divided based on the type of repair into two groups: prosthetic mesh repair and suture repair. Patients were followed up for a median of 14.2 months after operation during which surgical infection, seroma formation and recurrence rate were evaluated in both groups.

The common type of hernia encountered in this research was paraumbilical hernia compromising 80% (48 patients) of the total patients followed by recurrent paraumbilical hernia (11.66%). Superficial surgical infection and seroma developed in 15.38% (4 patients) in the mesh group and in 8.82% (3 patients) in the suture repair group with no significant differences. The recurrence rate was 8 people (23.52%) in the suture group and 2 people (7.69%) in the mesh group; however, this difference was not significant.

The results showed that the use of prosthetic mesh in the repair of emergent complicated ventral abdominal wall hernia is feasible choice with low risk of complications.

A partial uncinectomy entails resection of the uncinate process's lower portion. Compared to swing door uncinectomy, partial uncinectomy has a reduced duration of operation, minimal mucosal hemorrhage, and less tissue damage. The aim of this study is to compare the effectiveness of swing-round uncinectomy technique versus partial uncinectomy in middle meatal antrostomy.

This clinical trial was conducted on 28 patients who complained of local diseases of the maxillary sinus and bony obstruction unresponsive to conventional medical treatments and referred for endoscopic functional sinus surgery. 15 patients underwent swing door uncinectomy with MMA. This was performed by taking down the lower tow third of the vertical portion of the uncinate with backbiter while the horizontal portion was removed by submucosal dissection. In the remaining 13 patients, partial uncinectomy was performed by removing just the inferior vertical part of the uncinate using the backbiter and the horizontal portion was removed by submucosal dissection, and the treatment results were compared in two groups.

A total of 28 patients were enrolled in this study. 11 were males and 17 were females, their age ranged from 11 to 50 years with a mean age of 25.58±7.14. In postoperative follow up, it had been shown that partial uncinectomy technique results in shorter operation time, fast recovery, and less complications possibility compared to the swing door uncinectomy. The difference was statistically significant (p<0.05).

The results showed that the technique of partial uncinectomy can be of benefit in cases of isolated maxillary sinus disease. It provides short operation time, fast recovery, and a less complications possibility when compared with the swing door uncinectomy.

Some single nucleotide polymorphisms of the HOTAIR gene are associated with various types of cancer, such as breast, ovarian, colorectal, and lung cancer. The HOTAIR gene product is a long non-coding RNA that is involved in the regulation of gene expression and apoptosis, and is therefore considered an oncogene. This study was conducted with the aim of investigating the rs1899663 G>T polymorphism in breast cancer susceptibility in the northwestern region of Iran.

In this case-control study, the peripheral blood of 164 breast cancer patients referred to Tabriz hospitals and 172 healthy individuals was collected. After DNA extraction using saturated salt and proteinase K, single nucleotide polymorphism rs1899663 G>T of HOTAIR gene was investigated using tetra-primer ARMS-PCR. The association between this polymorphism and some clinical and pathological features of breast cancer including age, tumor type, tumor grade, tumor size, lymph node involvement and involved side was investigated.

The frequency of GG, GT, TT genotypes in sick people was 33.4%, 55.6% and 11%, respectively and in healthy people was 51.7%, 42.3% and 6%, respectively. GG (p=0.001) and GT (p=0.029) genotypes showed a significant association with breast cancer. This polymorphism is not associated with any of the clinicopathological features of breast cancer in this population.

Our data show that patients with GT and GG genotypes of rs1899663 G>T polymorphism of HOTAIR gene are more susceptible to breast cancer, while people with TT genotypes have a lower susceptibility to breast cancer development. The results of in silico analyses also show that these single nucleotide polymorphisms can increase the risk of breast cancer.

Orthodontic appliances are usually in contact with the oral mucosa for a long time due to the length of the long-term treatment and are associated with problems due to the continuous contact and friction created. This study was conducted to investigate the epithelial cells of the mucosa of patients with fixed orthodontic appliances.

In this cross-sectional study, smears were collected from three separate areas in 150 patients referred to the dental clinic of Mazandaran University: Area A (slide A): oral mucosa exposed to friction caused by orthodontic brackets, area B (slide B): oral mucosa exposed to friction with the tube on the orthodontic tape and Area C (slide C): oral mucosa without friction, i.e., the lower area of the oral cavity (control area). For histomorphometric analysis, each slide was evaluated with Papanicolaou staining using a light microscope, and the nuclear area (NA), cytoplasmic area (CA), and the ratio of nuclear area to cytoplasmic area (NA/CA) were recorded in square micrometers.

The mean NA was 65.66±22.11, CA was 717.37±1846.53, and NA/CA was 0.037±0.010 square meters. The difference in NA and CA between slides was significant )p<0.001) (slide A

The findings of the study indicate that fixed orthodontic treatment has a significant impact on the nuclear and cytoplasmic area of affected areas compared to non-affected areas. Only some degree of inflammation may be seen in the areas exposed to the orthodontic appliance.

Oral squamous cell carcinoma (OSCC) is the most common oral cancer. The prognosis of OSCC depends on many factors. The stage of the tumor and the condition of the lymph nodes are two important factors in determining the treatment methods and prognosis. Since the identification of clinicopathological indicators, especially the cervical lymph node involvement, can increase the accuracy in estimating the prognosis and adopting the appropriate treatment method, the aim of this study is to compare the frequency of tissue eosinophils in OSCC with and without cervical lymph node involvement (CLNI).

In this cross-sectional study, 17 OSCC samples with CLNI (group 1) and 17 samples without CLNI (group 2) from the samples registered in the Pathology Department of Ayatollah Kashani Hospital, which were treated by neck dissection surgery, were selected and clinicopathological data were extracted. Then, in order to determine the number of tissue eosinophils, slides prepared with Congo red staining were blindly examined by two oral pathologists with an optical microscope.

88.2% of the group with cervical lymph node involvement had lymphovascular involvement, while 88.2% of the group without lymph node involvement did not have lymphovascular involvement, and this significant difference was reported (p<0.001). Also, the mean number of tissue eosinophils in group 2 (19.95±5.67) was higher than group 1 (7.36±3.39), indicating a significant relationship with CLNI (p=0.039), but no significant relationship was found with any clinicopathological parameters.

According to the results of this study, the number of tissue eosinophils is an important prognostic factor in OSCC, and it can be used to better evaluate patients and provide more appropriate treatment.

Friction between the archwire and bracket is the main problem during tooth movement. Self-ligating bracket systems have become common in recent years. The aim of this study was to investigate and compare the effect of active and passive esthetic self-ligating brackets on static frictional force with different orthodontic archwires under wet conditions.

This in vitro study included 180 ceramic self-ligating brackets, 90 passive brackets (Damon Clear), and 90 active brackets (Empower Clear), which were tested for frictional resistance using three different types of 0.018-inch archwires, namely copper NiTi archwires and two esthetic archwires (Epoxy- and rhodium-coated NiTi archwires). According to the types of brackets and archwires, six groups of ten were defined. An experimental model with three non-leveled brackets in wet condition using artificial saliva was adopted. The friction test was conducted by Instron Tinius Olsen testing device. The test was performed at a room temperature ranging from 24-25°C.

Empower clear with Cu NiTi archwire showed the highest mean value of static frictional force with the mean value of (327.85±53.43) and Damon clear with epoxy coated NiTi archwire showed the lowest mean value (58.06±10.87). There were significant differences in the static frictional forces generated in both bracket systems when coupled with the Epoxy wires (p=0.000) and when coupled with the CuNiTi and Rhodium archwires (p=0.001).

The result of this study showed that the Damon Clear brackets produce lower frictional forces than Empower Clear brackets and Epoxy-coated NiTi archwires can produce lower static frictional force compared to Rhodium-coated NiTi and CuNiTi archwires.

Type 1 diabetes mellitus and its associated comorbidities are regarded as significant health issues. The present research aims to assess the impact of glycemic control on lipid profile of hospitalized patients with type 1 diabetes mellitus and for early diagnosis of dyslipidemia in cases with type 1 diabetes mellitus.

This cross-sectional was conducted at the Pediatric Department of Al-Imamain Al-Kadhmain Medical City from March 2018 to July 2019. Information about the gender and age of the patient, the age of diagnosis and duration of diabetes, insulin therapy: 2-3 times a day, regular blood sugar checking (daily) were collected using a questionnaire. Using American Diabetes Association criteria, cases were separated into excellent and poor glycemic control groups, and lipid profile anomalies were compared.

Out of the total of 128 people present in this study, 86 people (67%) had poor control. Increasing age of patients was associated with poor blood sugar control, so that between the ages of 13 and 18, 47 cases (54.7%) had poor control. It also increased the duration of poorly controlled diabetes. An increase in triglyceride level was evident in 76 people (88.4%), cholesterol in 52 people (60.5%) and low-density lipoprotein in 12 people (14%) among patients with poor control.

The results of the present study showed that increasing age and duration of the disease and high levels of triglycerides, cholesterol and low-density lipoprotein are predictors of poor glycemic control in children with type 1 diabetes.