Galen Medical journal
Volume:7 Issue: 1, 2018

Metabolic syndrome is a group of different disorders mainly includes, insulin resistance, obesity, cerebrovascular disorders, dyslipidemia, which leads to increase mortality. Patients suffering from related psychotic disorders such as schizophrenia are at the higher risk of developing metabolic syndrome. The aim of this study was to evaluate the association between the first episode of schizophrenia, metabolic syndrome and insulin resistance-related proteins in blood and adipose tissue of mice. Twelve, female Balb/c mice were randomly divided into two groups; one group was injected intraperitoneal MK-801 (0.6mg/kg/d) to induce schizophrenia, and other group received the 0.9% normal saline for two weeks. Body weight, fasting blood glucose (FBG), oral glucose tolerance (OGT), and Homeostatic model assessment (HOMA), were observed. Blood and adipose tissue were collected and Western blotting was done to evaluate the insulin resistance related proteins (GGPPS, FAT, PTP-1B, GRK2, ATGL, FGF21, and PGC-1α) by using GAPDH as an internal standard. There was a significant increase in mean body weight in schizophrenic group (21.76 vs 22.81, P=004). On day 14, the FBG, insulin concentrations and Homeostatic model assessment and insulin resistance (HOME-IR) were high in schizhphrenic group vs control group, e.g. 5.3±0.6 vs 3.47±0.2 (P=0.0001), 28.9±2.2 vs 23.3±0.6 (P<0.005) and 9.2±1.3 vs 3.9±0.2 (P=0.0001) . Impaired glucose tolerance deranged from 4.8mmol/L to 6.4mmol/L. Western blotting showed a marked increase in the expression of GGPPS, FAT, ATGL, and FGF21 proteins in monocytes and PTP-1B, GRK2, and PGC-1α ratios in adipose tissues. There was a positive relation between schizophrenia and metabolic syndrome e.g. insulin resistance and obesity. Certain proteins in adipocytes and blood were responsible for causing insulin resistance.

Chest physiotherapy (CPT) is a care that increases the mobilization of several structures from both muscle and subcutaneous tissue. We planned to investigate the effect of classic CPT on pain, fatigue, satisfaction, and hospital length of stay (LOS) in patients undergoing off-pump coronary artery bypass graft (CABG). This study was a randomized controlled trial that conducted on 50 patients undergoing elective off-pump CABG. The patients have been randomly divided into two groups; in the group A (n=25) patients received physiotherapy at a single session of classic CPT, 4 times during 2nd to 5th days for 15 minutes in every session, in the group B (n=25) patients had not protocol of this exercise therapy (control). The average age of all participants was 62.08 ±9.08 years. Of the 50 patients, 33 (66%) was male. Classic CPT significantly decreased pain (P=0.04), hospital LOS (P=0.010) and could increase in patients’ satisfaction (P<0.001). However, it had no considerable effect on fatigue (P=0.725). According to our findings, classic CPT could improve postoperative care after off-pump CABG surgery.

Bronchospasm (spasm of bronchial muscles) in general anesthesia caused by many reasons. Untreated bronchospasm can cause hypoxia, hypotension and increased morbidity and mortality. Case Report: A 28 years old female scheduled for tonsillectomy surgery. Immediately after induction of anesthesia patient developed with drop in oxygen saturation and difficulty in mechanical ventilation. Bronchospasm should be considered in differential diagnosis of oxygen saturation drop during general anesthesia. This situation is more common in patients without specific respiratory disorder. Tracheal irritants like sputum and blood can cause bronchospasm. Other causes include histamine or serotonin release.

Malignant melanoma (MM) usually present with metastases to unexpected regions of the body. Metastatic MM is a highly lethal condition, and the median survival in this setting is 6 to 7.5 months; however, few reports rarely describe long-term after chemotherapy. Case Report: We describe a 31-year-old man with MM, which got metastatic (to paranasal sinuses) after local and systemic therapy showed complete responses with long-term survival after endonasal endoscopic metastasectomy and radiotherapy of the nasal cavity, paranasal sinuses, and base of the skull. Although long-term survival is rare, few reports describe cases after chemotherapy. MM could be associated with metastasis to any regions and clinicians should be aware of its behavior and perform complete investigation in the presence of any suspicious symptoms, and this should be reinforced periodically. However, the survival is poor in the metastatic setting, and the treatment of choice is debatable, some patients may benefit from metastasectomy and local radiotherapy.

Chronic myeloid leukemia (CML), a hematological cancer of stem cells, is caused by the activation of oncogenic factors alone or/with inactivation of tumor suppressor genes. Curcumin is a hydrophobic polyphenol and the main compound of turmeric, which has been used in daily diets for many years. It is also a safe drug. Nanogels and nanobiotechnology have important roles in the diagnosis and treatment of diseases and drug delivery. To prepare the nanodrug, chitosan nanogels were prepared in 1% acetic acid and cross-linked with stearate by 1- ethyl- 3 (3-dimethylaminopropyl) carbodiimide (EDC) and N-hydroxysuccinimide (NHS). Subsequently, curcumin was loaded in the chitosan-stearate nanogel. Physical and morphological characteristics of the nanodrug were determined by transmission electron microscopy (TEM), dynamic light scattering (DLS), and Fourier transform infrared spectroscopy. Different nanodrug concentrations were prepared and evaluated on the K562 CML cell line. The apoptotic activities of curcumin and nanodrug on the cells were detected by flow cytometry, MTT assay, and trypan blue staining. DLS revealed that the size of the nanodrug was 150 nm, which was confirmed by TEM. The half maximal inhibitory concentration (IC50) values of curcumin and nanodrug were 50 and 25 μg/ml, respectively P < 0.05). Apoptosis of the K562 cell line occurred at 48 h post-treatment with 25 μg/ml curcumin and 12.5 μg/ml nanodrug. The increase in the cytotoxicity of curcumin and nanodrug was directly related to the drug concentration and time. The nanodrug exhibited more cytotoxic effects on the vital capacity of the cells and stimulated more apoptosis compared with curcumin alone.

Investigation of middle-aged women’s mental and physical health measures should be focused on menopause that is a predictable physiological phenomenon in their lives, because the prevalence of the majority of chronic diseases increases after this period. This study aimed to determine the risk factors of delayed menopause (climacterium tardum). Material and The current cross-sectional research was conducted on 1930 menopausal women who had referred to the cohort study of Fasa University of Medical Sciences during 2014-2015. The data were extracted from the database, and then, the variables were checked for accuracy. Finally, the data were analyzed using logistic regression analysis. This study was conducted on menopausal women with the mean age of 57.98±5.8 years. Among the women, 1555 (80.6%) were married, and the rest were single and widowed. Besides, the mean age at menarche was 13.7±1.64 years. Additionally, 1726 women (89.4%) had experienced natural menopause, while the rest had experienced delayed menopause. The results of the multivariate analysis indicated that delayed menopause was associated with marital status, education level, age at menarche, occupation, abortion, and use of contraceptive methods. However, no significant relationship was found between delayed menopause and smoking, duration of lactation, duration of using contraceptive pills, and the number of childbirths. Considering the increased life expectancy among women, delayed menopause, and its risk factors should be taken into account. Although genetic factors play key roles in menopause age, the role of socio-demographic factors, such as marital status and pregnancy, should not be ignored.

Design, formulation and physicochemical evaluation of dimenhydrinate 25 mg oral tablets that disintegrate in oral cavity in a proper time. This product is easy to use for babies, geriatrics and people who have difficulty in swallowing. 31 formulations were designed in 3 categories via Design-Expert software version 7. Group 1 consist of super-disintegrating bases, group 2 consist of effervescent bases and group 3 consist of super-disintegrating and effervescent bases together. Proposed by Design-Expert software, the optimum formulations were selected in each category and the tablets were produced by direct compression method. Tablets evaluated by friability, thickness, hardness, weight variation, drug content, content uniformity, disintegration time, wetting time, dissolution and moisture uptake tests. The angle of repose and compressibility index of formulations were in the range of 24.65-29.08 and 5.02-9.01 % respectively. Thickness, hardness, wetting time, friability and content uniformity of formulations were in the range of 3.36-3.84 mm, 33.25-38.03 N, 19-37 seconds, 0.31-0.42 % and 96.44-99.02 % respectively. Disintegration time of the groups 1, 2 and 3 were in the range of 16-70, 47-72 and 12-35 seconds, respectively. Mixture of powders and orally dispersible tablets passed all tests. The results showed that formulations containing both of super-disintegrants and effervescent bases had better disintegration time compare to other formulations.

Diabetes is one of the most common endocrine diseases characterized by hyperglycemia. It is caused by an absolute or relative insulin deficiency or an insulin function deficiency. It is one of the major risk factors of depression, with the rate of depression in diabetic patients amounting to as high as 30%. This study examined the role of dopamine receptors in streptozotocin (STZ)-induced depressive-like behavior using the forced swim test (FST). This study was performed on 56 Wistar male rats. STZ at doses of 30 and 60 mg/kg body weight was administered via intraperitoneal (IP) route to induce diabetes and depression in rats. Thereafter, by using halobenzazepine (SCH23390) (D1 dopamine receptor antagonist) and sulpiride (D2 receptor dopamine receptor antagonist), the role of dopamine receptors in STZ-induced depression was studied. The one-way analysis of variance technique, Tukey’s range test, and t-test were used to analyze the data. The P-value less than 0.05 was regarded as statistically significant. Our study showed that STZ at doses of 30 and 60 mg/kg, two weeks after injection, caused prolonged immobility in FST, indicating depressive-like behavior (P<0.05 and P<0.01, respectively). SCH23390 (0.001 mg/mL/kg) and sulpiride (0.1mg/mL/kg) did not change the variables of depression in animals that received STZ (at doses of 30 and 60 mg/mL/kg) two weeks before (P>0.05). According to our study, STZ has a depressive-like behavior two weeks after injection, and dopamine receptors do not play a role in depression associated with STZ use.

Percutaneous coronary angioplasty (PCI) and stent implantation are the most common therapeutic strategies for coronary artery stenosis; however, in-stent restenosis (ISR) is one of its important challenges. Although in some studies, coronary artery disease (CAD) factors are deemed to be the causes of ISR, in some others, the relationship between CAD factors and ISR are not observed. Over the past ten years, there has been no review article on factors affecting the ISR. This article aimed to review the possible factors affecting ISR in patients undergoing PCI. This narrative review study was conducted on PubMed, Web of Science, Scopus, and Google Scholar databases between 1 January 1990 and 30 July 2017. After initial screening of 1728 retrieved articles, 1401 articles were excluded to due irrelevancy to the review; and finally, 39 papers were selected for data collection. Our study results showed that the site and length of implanted stent, hypertension and diabetes are the most probable factors affecting ISR. Further studies are required for evaluation of the effect of other possible risk factors such as genetic sequencing, obesity, chronic infections and hemoglobin A1C levels. [GMJ.2018;7:e961]

Nursing is a critical job in the health care system. However, nurses suffering from poor job conditions suffer from job dissatisfaction, eventually causing burnout. This is a very important concern for the health care system because the turnover of nurses leads to a waste of money and time of this system. Therefore, nurse managers need to find a way to measure and reduce the burnout. The Maslach Burnout Inventory-Human Services Survey (MBI-HSS) is a famous inventory to measure the job burnout in human services. This study aimed to measure the validity and reliability of the Persian version of MBI-HSS. This study was conducted in two hospitals of Fasa University of Medical Sciences, Fars Province, Iran, in July 2017. Nurses participated with their own discretion in this study and filled the MBI-HSS themselves. The questionnaire consisted of 22 items comprising three dimensions. Exploratory factor analysis and Cronbach’s alpha were performed in this study using Stata software, version 12. Overall, 200 nurses were included in this study, with a mean age of 29.48 ± 6 years. The result of the exploratory factor analysis showed that the weight of each item in its own dimension was greater than 0.4 or another dimension. Also, the Cronbach’s alpha for 3 dimensions was greater than 0.7. Our study showed that the Persian version of MBI-HSS has sufficient validity and reliability, similar to that of the original version, for the measurement of burnout in Persian speakers of human services workers.

The purpose of this research was to determine histomorphometric changes in busulfan-induced azoospermia after transplantation of AdSCs in guinea pig. AdSCs were isolated from adipose tissue around the testes of guinea pigs and characterized for mesenchymal properties. Guinea pigs were allocated into three groups, including the control group without any intervention. To induce azoospermia, groups 2 and 3 received a dose of 40 mg/kg of busulfan with 21 days interval. Group 3 received 1×106 AdSCs in their seminiferous tubules of left testes, 35 days following last busulfan injection, while right testis in the group was considered for comparison as controls. Sixty days following transplantation of cell, histomorphometric and histopathologic changes of the experiments were assessed. After AdSCs’ transplantation, normal spermatogenesis appearance was noticed compared to busulfan-induced azoospermia and AdSCs recovered spermatogenesis, and our findings can be added to the literature in treating azoospermic infertilities. The transplanted AdSCs could induce production of germinal cells using testicular seminiferous tubules and were an effective source in treating azoospermia.

Diet plays an important role in cancer prevention. Apigenin, a flavonoid with thechemical formula C15H10O5, is abundantly present in vegetables. Vegetarian foods containing flavonoids are rich sources of bioactive compounds. Flavonoids have been utilized in herbal treatment. Nanogels are drug delivery systems based on polymers and are used in tissue engineering and for drug delivery. This study was conducted to compare the effects of apigenin and a nanodrug on the viability of the K562 cell line of chronic myeloid leukemia at different durations under laboratory conditions. Chitosan was first dissolved in 1% acetic acid, and ethylene dichloride EDC and NHS were added to the solution. Then, the nanodrug was prepared by loading apigenin into stearate–chitosan nanogel (scs nanogel), and its physical and morphological characteristics were evaluated by TEM, DLS, and FTIR. Trypan blue staining, MTT assay, and flow cytometry were used to analyze the effects of various concentrations of apigenin and apigenin-loaded chitosan–stearate nanogel (APG–SCS) at 24, 48, and 72 h after they were applied to the K562 cell line. The diameter of the nanodrug particles was measured using DLS and confirmed by TEM. The K562 cells treated with APG–SCS and with apigenin exhibited significant differences compared with the control (P < 0.05). Apoptosis was detected by flow cytometry. This study showed that the toxic effects of apigenin and the nanodrug improved with increasing concentrations and exposure durations compared to those in the control.The toxic effect of apigenin loaded into the stearate-chitosan nanogel was greater than apigenin, and the toxic effects of both materials were greater compared to the control under laboratory conditions.

The connection between healthcare and tourism industries in many countries has created one of the largest service industries, i.e. "medical tourism industry". Medical tourism services bring significant benefits to the countries. This study aimed to examine internal and external factors affecting Shiraz medical tourism industry as well as the potential capabilities of the industry. This applied research is a mixed method study using both qualitative and quantitative methods in 2017. The study population consisted of all organizations involved in the medical tourism industry. In this study, the deductive qualitative content analysis was employed to determine the internal and external factors affecting Shiraz medical tourism industry. Furthermore, the SWOT technique was used to analyze the data obtained from individual interviews and meetings with expert panels. Internal and external factors were classified into 4 main themes (namely strengths, weaknesses, opportunities and threats) and 10 sub-themes, of which five cases (FORMM) were related to internal factors (i.e. finance, production and products (operations), research and development, marketing and management) and five cases (STEPC) were associated with external factors including socio-cultural, technology, economy, political and competitive ones. Also, the matrix of the internal and external factors indicated an offensive zone for this industry. This industry can make use of the strengths and opportunities to confront the threats and negative points through identifying internal and external factors in order to enjoy benefits such as job creation and revenue gains.

The Persian Registry of Cardiovascular disease/Heart Failure (PROVE/HF) aimed to studied the demographic, clinical, and diagnostic characteristics and treatment of patients hospitalized for heart failure (HF) and to follow them for short- and long-term outcomes. Its pilot phase started in 2015 in Isfahan aiming to evaluate its feasibility to be scaled up at the national level in later stages. This article describes the method and preliminary results of the first year registry. Information of hospitalized patients with preserved and low ejection fraction, were gathered. Patients were followed for 1, 6, and 12 months. During follow-up, information of the patients’ current status, medications used during hospitalization, and in case of death, the cause and place were assessed. PROVE/HF enrolled 787 patients in the first year. The mean age of patients was 70.74 ±12.01 years, and 60.7% of them were men. The most frequent risk factors for the development of HF in the recruited patients was ischemic heart disease (77.9%), and hypertension (63.7%), respectively. The re-admission rate for patients with HF was at least once in 16% and continued until the fifth to ninth re-admission over a one-year period. Among 787 registered patients, 30.9% died in the first year of follow-up, and the in-hospital mortality was 6.2%. The mean hospitalization period was 4.88 days, and 64.2% were hospitalized for >3 days. The annual rate of re-admission and mortality was high, and the use of medication was less than the recommended one inaccordance with the guidelines for the treatment of heart failure.

Protein phosphatase-2B or calcineurin (CN) is the main phosphatase and a critical regulator of cellular pathways for learning, memory, and plasticity. Cyclosporine A(CyA), a phosphatase and peptidyl-prolyl cis/trans isomerase inhibitor, is a common immune suppressant extensively used in tissue transplantation. To further clarify the role of CN in different stages of learning and memory, the aim of the present study was to evaluate the role of CyA in an inhibitory avoidance (IA) model in mice. Using intracerebroventricular (ICV) injection of different doses of CyA (0.5, 5, and 50 nM) at different periods (pre-/post-training and pre-test), the effect of the drug was evaluated in a step-down IA paradigm. The latency of step-down (sec) was considered a criterion for memory performance. The pre-training injections of CyA (0.5, 5 nM), however not of 50 nM, impaired IA learning acquisition. The post-training injection of high-dose CyA (50 nM) impaired memory consolidation. The pre-test ICV CyA injection did not impair memory retrieval; the ICV injection of CyA caused no change in locomotion. These findings suggest that CyA selectively interferes with acquisition, retention, but not retrieval, of information processing in mice. Given the crucial role of CN in common signaling pathway of memory performance and cognition, it could be a probable therapeutic target in the treatment of a wide variety of neurological conditions involving memory.

Polycystic ovary syndrome (PCOS) is an endocrine disorder that affects 6-10% of women in reproductive age. The medicinal values of Citrullus colocynthis extract (CCT) stems from its anti-oxidative and anti-inflammatory effects. This study evaluated the comparative effect of CCT and metformin on morphometric ovarian disorders in PCOS rats.

Fifty female Wistar rats having 2-3 consecutive estrous cycles during two weeks were divided into five groups (n=10 each group). The rats in the control group only received sesame oil as estradiol valerate solvent, whereas the rats in the sham group were injected intramuscularly with 4 mg/rat estradiol valerate-induced PCOS. Following PCOS induction, the rats in the metformin group received 50 mg/kg metformin orally for three weeks. Rats in the Extract group were treated with 50 mg/kg plant extract for 21 days following the induction with PCOS. Additionally, the rats in metformin+ extract group were treated with the combination of 50 mg metformin plus plant extract for three weeks. The ovaries were removed and were fixed for tissue processing. The slices were stained by hematoxylin-eosin after clearing and hydration. Follicular count and morphometric changes were evaluated in primordial, primary, pre-antral and antral follicles.

The mean diameter of primordial follicle was similar in all groups, but mean diameter of primary follicle decreased in the sham group (145.50± 49.26 µm) compared to metformin (278.76± 156.64 µm), extract (311.70± 147.74 µm) and metformin+ extract groups (265.35± 88.16 µm). The diameter of pre-antral and antral follicles in the sham group were significantly larger than those in the control group, but were not significantly different in all other groups including metformin, extract, and metformin+ extract in comparison with control group (P< 0.05).

In this study, the data has demonstrated that CCT like metformin could improve follicular morphometric disorders in PCOS rats.

Irritable bowel syndrome (IBS) is the most common gastrointestinal syndrome. Routine histopathology and immunohistochemistry (IHC) evaluations have shown an increase in the number of different inflammatory cells in the colon of IBS patients. In this study, we have compared the number of intraepithelial lymphocytes (IELs), eosinophils, mast cells and CD3+ T cells, in IBS patients and normal subjects. In 2016, seventy-nine patients with IBS and seventy-nine healthy subjects who underwent colonoscopy for other non-specific causes and with no pathologic findings, were enrolled in this cross-sectional study. Biopsy specimens obtained from the colon were stained, using IHC methods to determine the number of IELs, eosinophils, mast cells and CD3+ T cells. Quantitative and qualitative variables were compared between the two groups, using a Chi-square test and Student’s t-test. Seventy-nine patients with IBS, 79.7% females with a mean age of 42.5±14.6 years, were recruited, as the case group, and seventy-nine individuals, 51.9% females with a mean age of 39.7±18.9 years, were enrolled as controls. The average number of IELs per high power fields (hpf) was found to be higher in the IBS group, and this difference was statistically significant (32.8±11.8 vs. 28.6±12.9; P=0.034). Also, the mean count/hpf of CD3+ T lymphocytes (23.1±7.9 vs. 20.2±8.1; P=0.024) and mast cells (7.6±3.1 vs. 6.6±3.0; P=0.041) were significantly higher in the IBS group, compared to the control group. The number of eosinophils was higher in the IBS group, but the differences were not statistically significant (P=0.066). According to the results, we suggest that analysis of immune cells and IELs in intestinal biopsies might be an appropriate method for diagnosis of IBS.

Hypothalamic Melanocortin-4 Receptor (MC4R) and kiss1/kisspeptin systems play roles in reproductive processes. This study was conducted to evaluate changes in MC4R and kiss1 genes expression in the arcuate nucleus (ARC) of the hypothalamus and its relationship with polycystic ovary syndrome (PCOS) in rats. In the current experimental study, 24 female rats were randomly and equally allocated into nulliparous and primiparous groups and then were divided into two subgroups of PCOS and control. PCOS was induced by exposure to continuous light. Sex-related hormones were evaluated by radioimmunoassay or immunoradiometric assay. Expressions of MC4R and kiss1 gene in the ARC of the hypothalamus of the rats were evaluated by real-time PCR. Histomorphometric alterations of ovaries were compared between groups. Number of tertiary follicles and their size and number of atretic follicles in the PCOS subgroups were more than those in the controls (P<0.05) whereas the number of secondary follicles and corpus luteum in the PCOS subgroups were lower than those in the controls (P<0.05). Antrum and total diameters of tertiary follicles in the PCOS subgroups were greater and granulosa layer diameter was lower than those in the controls (P<0.05). The MC4R mRNA expression in the PCOS subgroups was 6.5-fold in nulliparous and 3.5-fold in primiparous groups more than their controls’ pairs (P<0.05). However, parity did not affect the expression of MC4R gene (P>0.05).The kiss1 mRNA expression in the PCOS and control subgroups was not significantly different (P>0.05). Overexpression of MC4R gene after PCOS induction in the ARC of the hypothalamus may link to metabolic disorders of induced PCOS in the rats. However, alteration in the kiss1 mRNA expression after PCOS induction was not observed in the rats.

Accumulating evidence indicates a remarkable increase in substance addiction. Substance abuse and addiction impose severe social, political, economic, cultural and health-related damages on societies. Little is known, however, about demographic factors and facilitators to addiction abstinence. The purpose of the current study was to explore the factors associated with opioid avoidance. This cross-sectional study was performed to record socio-de mographic data and facilitating factors to abstinence in 600 interviews, according to data collecting forms, with patients who had drug abuse disorders at Shiraz city during 2016. Correlation test, T-test, and ANOVA were employed for data analysis. P<0.05 was considered as the significance level. There was a significant difference between mean abstinence time and demographic factors such as age, sex, occupation and marital status. Also, 53% of people reported that they had the longest abstinence time using the narcotics anonymous (NA) method. TO 33% of patients, the most important facilitating factor in abstinence according to the patient's opinion was family support. Individual, social, psychosocial and medical variables affect the abstinence duration of substance abuse. Identifying the factors associated with longer abstinence can be helpful in designing prevention and treatment programs for variables that affect the recurrence.

This study aimed to determine the normal dimensions of the mitral annulus (MA) in Iranian population. This cross-sectional study was conducted using 88 fresh hearts of male and female cadavers for six months in Mashhad, Iran. Normal data were determined by measuring the exact dimensions of the MA in fresh hearts of patients who had died of non-cardiac causes and considering some parameters such as age, gender, stature, and weight. Images of the valves and leaflets were prepared by marking the anterior (A2, midpoint of anterior) and posterior areas of P1, P2, and P3 using a needle. To analyze the data, SPSS version 16 was used. The means of anatomic area, anatomic perimeter, inter-commissural distance, A2-P1, A2-P2, A2-P3, Base-P1, Base-P2, Base-P3, and Base-A were 14±1.28, 8.3±1, 2.7±0.42, 2.27±0.37, 2.3±0.43, 2.06±0.35, 1.66±0.43, 1.2±0.97, 1.5±0.66, and 3.2±0.52, respectively. Comparison of the age groups regarding valve leaflets showed that Strut-P1 and Base-P2 were significantly different. Comparison of the valve leaflets and sub-valve indicators between the two genders reflected no significant differences. Age groups differed significantly in terms of Strut-P1 and Base-P2 (P=0.004 and P=00.1, respectively). A2-P3, A2-P1, anatomic perimeter, and anatomic area were found to be related to gender. A2-P1 and A2-P2 and some leaflet indicators such as Strut-P1 and Base-P2 were associated with age, whereas Base-P2 was affected by body mass index. [GMJ.2018;7:e1078]

Although ginger is considered a harmless remedial substance for a wide range of medical complaints, according to Persian medicinal texts, its long-term or high-dose consumption is potentially harmful. Case Report: The case of a 43-year-old man, with a complaint of urinary stream interruption, dysuria, and flank pain, following a non-prescribed use of ginger was reported. The symptoms were reported to persist for four years, despite some medical referrals. Remarkably, the symptoms were attested to be shrinking eight weeks after ginger-intake cessation; besides, no further intervention was asserted. The history of herbal remedies use should be considered in patients with any unexplained urinary symptoms.

The assessment of health-related quality of life has become an important primary or secondary outcome measure in clinical and epidemiologic studies. The aim of this study was to validate a Persian version of Celiac Disease Questionnaire (CDQ) for Celiac disease (CD) among Iranian patients. The English version of the CDQ adapted to the Persian language by a forward-backward translation by 3 professional bilingual translators (1 medical, 2 nonmedical). The content validity of translated questionnaire were studied by 5 experts who complete the validity form regarding the questionnaire. Then in a pilot study, translated CDQ completed by 81 CD patients who referred to Taleghani Hospital, Tehran. For assessing the validity and reliability of the questionnaire, confirmatory factor analysis and Cronbach’s alpha coefficient have been done, using Lisrel and SPSS software. Of 81 CD patients entered to this study with mean age of 30.54 years old, 71.6% were female. Also, 56.8% were married and 45.7% were high educated. The mean of CDQ total score was 119.18±34. The calculated Cronbach’s alpha coefficient for CDQ questionnaire was 0.9. Also, for each subgroups the Cronbach’s alpha coefficient were calculated as the following; emotion: 0.92, Social: 0.89, Worries: 0.73, Gastrointestinal: 0.78. Confirmatory factor analysis indicated that all questions could be remain in questionnaire respectively. The reliability of the Persian version of CDQ was excellent with Cronbach’s alpha coefficients and Persian version of CDQ retains the psychometric properties of the original instrument and should be useful to assess outcome in studies and clinical trials involving Iranian patients with CD.

New methods are needed to optimize intracytoplasmic sperm injection (ICSI) outcomes in oligoasthenozoospermic (OAS) men. We evaluated the level of DNA fragment index (DFI) in OAS men and its impact on ICSI outcomes. In addition, we used the zeta potential method for sperm selection to investigate the efficacy of this technique in improving ICSI outcomes. This cross-sectional study was performed on 95 couples. Sperm parameters and sperm DNA fragmentation (SDF) were measured. The couples were divided into the following 3 groups: group I (n=30) where SDF was between 15% and 30%, and routine sperm was selected on the basis of motility and morphology; group II (n=34) where SDF was more than 30%, and the routine sperm selection method was applied on the basis of motility and morphology; and group III (n=31) where SDF was more than 30%, and the sperm selection was performed on the basis of the zeta method. The fertilization rate, embryo development, embryo quality, and implantation rate were evaluated in these 3 groups. The fertilization rate was significantly higher in group I compared with group II (P<0.05). The embryo development rate in group I was significantly higher than that in group II (P<0.001) and group III (P<0.05), and it was significantly lower in group II compared with group III (P<0.05). The embryo quality was higher in group III compared with group II (P<0.01). The implantation rate in group I was significantly higher than that in group II (P<0.05) and group III (P<0.05). The present study indicated that a higher level of SDF has an adverse effect on the ICSI outcome. Furthermore, the zeta potential technique can be a useful method for sperm selection in OAS men.

The use of gold nanoparticles in medicine and especially in cancer treatment has been of interest to researchers. The effectiveness of this nanoparticle on cells significantly depends on the amount of its entry into the cells. This study was performed to compare the rate and mechanism of effect of gold nanoparticles coated with different amino acid on PC12 cancer cell line. The PC12 cells line were exposed to various concentrations of amino acid coated and uncoated gold nanoparticles (0.5, 2.5 and 5 μM). Cell death rate was determined according to level of Lactate dehydrogenase (LDH) release from cells and MTT assay. In addition cell morphology and the amount of Cellular Reactive oxygen species (ROS) were studied. The uncoated gold nanoparticles have shown minor effects on cellular life. Gold nanoparticles coated by tryptophan at high concentrations (2.5, 5 and 25μM) increase in cancer cells metabolic activity. Gold nanoparticles coated by Aspartate also produce the largest amount of LDH and ROS in cancer cells and therefore caused of highest rate of apoptosis. The results showed that the nanoparticles coated with amino acids are affected on cellular metabolism and apoptosis more than uncoated nanoparticles. Also the smallest coated nanoparticles (coated by aspartate) have the most influence and by increasing the size, this effect was reduced.

Genotyping and Phylogenetic Analysis of Group B Streptococcus by Multiple Locus Variable Number Tandem Repeat Analysis in Iran
Farzaneh Khodaei, Behrooz Sadeghi Kalani, Naser Alizadeh, Alka Hassani, Mohammad Najafi, Enayatollah Kalantar, Abbas Amini, Mohammad Aghazadeh Group B streptococcus (GBS), also known as Streptococcus agalactiae, is well known as a causative agent for neonatal invasive diseases; it is also a major pathogen in adults. Analytic epidemiology is required to monitor the clinical isolates of GBS. However, there is insufficient information on the genetic background of GBS in Iran, and this information is needed to guide and develop a GBS vaccine. In total, 90 well-characterized GBS isolates were collected from April 2014 to August 2015. In this study, molecular typing was used to disclose a relationship between the multiple-locus variable number tandem repeat analysis (MLVA) types, serotyping, and pilus islands. The isolates were characterized by the types of capsular polysaccharides and pilus islands and were examined by MLVA to study the epidemiological relationship of isolates. The results indicate that there is a significant relationship between the distribution of serotypes and pilus island genes; GBS isolates were differentiated into 12 types by capsular polysaccharides and pilus islands analysis. The discriminatory power of an MLVA analysis was high based on the five most variable numbers of tandem repeat loci and 44 MLVA types that were identified. This study has provided useful insights into the genetic heterogeneity of GBS isolates in Tehran and Alborz, Iran. The extensive distribution of pilus islands in various serotypes and MLVA types throughout the GBS population refers to the advancement of the pilus-based GBS vaccines.

Although leishmaniasis is regarded as a public health problem, no effective vaccine or decisive treatment has been introduced for this disease. Therefore, representing novel therapeutic proteins is essential. Protein-protein Interaction network analysis is a suitable tool to discover novel drug targets for leishmania major. To this aim, gene and protein expression data is used for instructing protein network and the key proteins are highlighted. In this computational and bioinformatics study, the protein/gene expression data related to leishmania major were studied, and 252 candidate proteins were extracted. Then, the protein networks of these proteins were explored and visualized by using String database and Cytoscape software. Finally, clustering and gene ontology were performed by MCODE and PANTHER databases, respectively. Based on gene ontology analysis, most of the leishmania major proteins were located in cell compartments and membrane. Catalytic activity and binding were regarded as the relevant molecular functions and metabolic and cellular processes were the significant biological process. In this network analysis, UB-EP52, EF-2, chaperonin, Hsp70.4, Hsp60, tubulin alpha and beta chain, and ENOL and LACK were introduced as hub-bottleneck proteins. Based on clustering analysis, Lmjf.32.3270, ENOL and Lmjf.13.0290 were determined as seed proteins in each cluster. The results indicated that hub proteins play a significant role in pathogenesis and life cycle of leishmania major. Further studies of hubs will provide a better understanding of leishmaniasis mechanisms. Finally, these key hub proteins could be a suitable and helpful potential for drug targets and treating leishmaniasis by considering their validation.

Posttraumatic stress disorder (PTSD) is known by a number of mental disorders, including recurring memories of trauma, mental appalling, and escaping of sign that make them recall the trauma in question. Clinical interviews serve as the main diagnostic tool for PTSD. With respect to treatment, either pharmacotherapy or psychotherapy or a combination of both is used as a therapeutic method for PTSD. In this study, a number of crucial genes related to PTSD, which can be considered as biomarker candidates, were represented. The genes related to PTSD were extracted from the STRING database and organized in a protein-protein interaction network with the help of Cytoscape software version 3.6.0. The network was analyzed, and the important genes were introduced based on central indices. The biological processes related to the crucial genes were enriched via gene ontology using ClueGO. From a total of 100 genes, 63 genes were extracted that formed the main connected component, and of these, 12 crucial genes¾POMC, BDNF, FOS, NR3C1, CRH, IL6, NPS, HTR1A, NPY, CREB1, CRHR1, and TAC1¾were introduced. Biological processes were classified into the regulation of corticosterone, regulation of behavior, response to fungus, multicellular organism response to stress, and associative learning. The introduced 12 crucial genes can be used as a biomarker panel related to PTSD and can be considered as a diagnostic reagent or drug target; however, more investigations are needed to use these genes as biomarkers.

Cirrhosis is a common disease that destroys liver cells, and it has various etiologies. The early diagnosis of cirrhosis can be effective in improving prognosis. Considering the availability and affordability of ultrasound devices throughout the world, in this study we evaluated the diagnostic value of hepatic vein ultrasound examination in the early detection of liver cirrhosis. In this study, 45 patients referred to the radiology department of Ghaem Hospital for liver biopsy were evaluated for changes in the hepatic veins under ultrasound with a transducer of 5-7MHz. One piece of the hepatic vein was selected for ultrasound, and the wall of hepatic veins was examined for straightness and uniformity of echogenicity. Subsequently, patients underwent biopsy by ultrasound guide. Of all the study subjects, eight patients presented mild chronic hepatitis without fibrosis, four patients were diagnosed with fatty liver, and 33 patients had severe cirrhosis or chronic hepatitis with fibrosis. Our results showed that hepatitis patients with or without fibrosis had irregular and wavy hepatic vein wall (impairment in straightness) with non-uniform echo (impairment in uniformity of echogenicity). While patients without hepatitis and cirrhosis, but diagnosed with fatty liver, had a smooth and regular hepatic vein wall with a uniform echo. The present study showed that hepatic vein examination in terms of echogenicity and straightness could be used to diagnose hepatitis, its severity as well as its course towards fibrosis and cirrhosis.

Psoriasis is defined as a chronic inflammatory disease involving keratinocytes hyperproliferation of the epidermis with the acceleration in the epidermal turnover time, which is affected by various factors including genetic, immunologic, and environmental factors. There is a high risk for the development of premature cardiovascular diseases among patients with psoriasis as well as one of the life-threatening events is an aortic aneurysm (AA). Case Report: We report a 60-year-old man with the diagnosed psoriatic disease that an enlargement of the abdominal AA was incidentally found by annual check-up. Further large-scale studies are needed to find the prevalence of abdominal AA in psoriasis and the appropriate screening time of that in this disease.

Extensive distribution of glucocorticoid receptors (GCRs) in different brain areas along with disruption of hypothalamic-pituitary-adrenal (HPA) axis in major depressive disorder (MDD) and the cross talk between GCRs and HPA proposes genetic variants of GC receptor genes as potential contributors in MDD. Among the GCR polymorphisms, rs41423247, rs6195 and rs6189/rs6190 are suggested to be involved in MDD. We investigated the association between rs41423247, rs6195 and rs6189/rs6190 and MDD in a case-control study. One hundred MDD patients along with 100 healthy individuals were enrolled in this study. genetic variants of rs41423247, rs6195 and rs6189/rs6190 were determined in extracted DNAs using PCR-RFLP. The prevalence of heterozygote and mutant carriers of rs41423247 were significantly and by 1.9 fold greater in cases versus controls (P=0.033; OR; 95%CI=1.9; 1.1-3.3). Moreover, carriers of the mutant (G) allele were by 1.8 fold more prevalent in MDD group (P=0.013; OR;95%CI=1.8; 1.1-2.8). Specific carriers of rs41423247 might be more susceptible to developing MDD. This supports the hypothesis of the involvement of GCRs in pathophysiology of MDD.

Cisplatin is a cytotoxic agent in cancer therapy. Nephrotoxicity is considered as a side effect of cisplatin usage. Using rate models, we studied the possible protective impact of corn-silk (CS) extract against cisplatin-induced nephrotoxicity. Thirty-five experimental rats were divided into five groups (n=7 per each group) as follow: C1: Control received distilled water only; C2: received one dose of cisplatin, and CS: received 300 mg/kg/day of CS. Both CS1 and CS2 received 200 and 300 mg/kg/day of the CS extract orally, individually, for eight consecutive days. CS1 and CS2 received a single dose of cisplatin on the first day only. The specific biochemical markers and histopathological alterations were evaluated. According to our results, cisplatin administration could have induced severe degeneration in all parts of the nephron tubules and liver. Pre-treatment with CS exhibited a significant decrease in the malondialdehyde (MDA) levels as compared to the values obtained after treatment with cisplatin alone (P<0.01). Moreover, the CS extract with 200 mg dose showed significant (P<0.01) protection against the cisplatin-induced elevation of blood urea nitrogen. Further, the serum levels of alanine transaminase and aspartate transaminase were higher in the cisplatin-treated groups, when compared to the control group (P<0.05). Furthermore, the hepatic function was also improved in cisplatin-treated animals, which were pre-treated with CS. CS has the potential to attenuate nephrotoxicity and lipid peroxidation induced by cisplatin in rats.

The basal-cell carcinoma (BCC) as one of the most common type of skin cancers reported to have an increasing trend during past years. Molecular approaches can be useful to advance diagnosis and treatment goals in this cancer. In this sense, one of the recent popular investigations, protein-protein interaction network analysis (PPI), was applied in this study to better facilitate molecular view of BCC. Cytoscape v3.6.0 and its plug-ins analyzed and explored the topological and annotation features of the constructed network. Among TP53, EGFR, AKT1, ERBB2, HRAS, and CCND1 as central agents of the network, five of them were also present in the first prominent cluster of the network in which considered for further analysis. It is suggested that there are significant related biological processes, actions, and expression changes for this highlighted cluster that may be related to BCC risk. Therefore, the studied complex of proteins may worth considering for clinical studies and therapeutic interventions after validating by related tests. What is more, among these genes, EBBR2 has more to offer and consequently with additional values.

Bladder cancer (BC) has remained as one of the most challenging issues in medicine. The aim of this study was to investigate the differential network analysis of stages 2 and 4 of BC to better understand the molecular pathology of these states. We chose gene expression data of GSE52519 from Gene Expression Omnibus (GEO) database analyzed by the GEO2R online tool. Cytoscape version 3.6.1 and its algorithms are the methods applied for the network construction and investigation of differentially expressed genes (DEG) in these states. Our result revealed that the analysis DEGs provides useful information about a common molecular feature of stages 2 and 4 of BC. Consequently, the network finding revealed that more investigation about stage 2 is required to achieve an effective therapeutic protocol to block the transition from stage 2 to stage 4.

Proliferative diabetic retinopathy (PDR) is one of the most important microvascular complications among the patients with diabetes. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) agent enacts a key role in PDR. Some studies have dealt with the systemic exposure to these agents after intravitreal administration. However, renal dysfunction following this therapy has scarcely been reported. Hence, this study aimed to determine the effect of intravitreal bevacizumab treatment on the deterioration of renal function and proteinuria. This present prospective observational study was performed on 40 patients with diabetic nephropathy and PDR and/or significant diabetic macular edema as the candidates for receiving intravitreal injection of bevacizumab. To evaluate renal function, changes in the urinary albumin-to-creatinine ratio (UACR), serum creatinine (SCr), and estimated glomerular filtration rate (eGFR) one month after injection were measured. Also, changes in systolic and diastolic blood pressures (BPs), plasma VEGF level, platelet, white blood cell (WBC) counts, and hemoglobin (Hb) level were measured at the baseline and one month after treatment. The mean age of the patients was 60.3 ± 9.2 years, and 33 patients were female. The decrease in the plasma VEGF level and platelet count, as well as the increase in diastolic BP, and Hb level were significant. However, systolic BP and WBC count remained unchanged. There were no significant changes in UACR, SCr, and eGFR after the injection as compared to baseline (P>0.05). Our study indicated that intravitreal bevacizumab injection was not associated with renal dysfunction and proteinuria in patients with diabetic nephropathy. Nevertheless, diastolic BP and Hb level could increase after one month.

Patient satisfaction is a multi-dimensional concept that can be influenced by social, cultural, and economic factors. This study was designed to evaluate the determinants that could predict patient satisfaction with nursing care in an orthopedic and urologic Population at a selected surgical ward in Kashan, Iran during 2018. This cross-sectional study was performed on 250 male patients with orthopedic and urologic diagnosis that were hospitalized in men surgical ward of Shahid Beheshti hospital affiliated to Kashan University of Medical Sciences. Patients satisfaction was assessed by a researcher-made questionnaire. The data was analyzed by the independent t-test, analysis of variance, correlation, and multiple regression analysis statistical tests. The mean score of patient satisfaction was 136.05±48.10 (possible range 45-225). The age, marital status, education, diagnosis, the length of stay in the hospital, and the verbal communication of nurses with patients showed a significant correlation with patient satisfaction (P<0.001). Regression analysis revealed that age (P=0.013), marital status (P<0.001), education level (P=0.038), the length of stay in hospital (P=0.002), and verbal communication (P<0.001) could make a meaningful model with patient satisfaction in surgical wards. Many personal and professional factors can determine patient satisfaction in orthopedic and urologic population. Verbal communication between nurses and patients is an important factor for patient satisfaction.

Insulin-like growth factor 2 (IGF-2) is a growth factor and an anti-inflammatory cytokine that plays a pivotal role in memory. In this study, we examined the effect of recombinant IGF-2 on memory impairment due to intracerebral hemorrhage (ICH). Avoidance and recognition memory, locomotor activity, neurological deficit score (NDS), and the level of the IGF-2 gene expression were evaluated. To induce ICH, 100 μL of autologous blood was injected into the left hippocampus of male Sprague Dawley rats. Recombinant IGF-2 was injected into the damaged hippocampus 30 minutes after the induction of ICH. Then, over two weeks, NDS, locomotor activity, passive avoidance, and novel object recognition (NOR) test were evaluated. Finally, the level of IGF-2 gene expression was evaluated by using the real-time polymerase chain reaction technique. Our results indicated that recombinant IGF-2 injection significantly increased step-through latency (P<0.001) and total time spent in the dark box (P<0.01). However, no significant difference was seen in recognition memory and NDS. Locomotor activity did not significantly change in any group. A significantly reduced level of IGF-2 was observed after two weeks (P<0.05). The results of this study show that a single dose of recombinant IGF-2 injection can influence hippocampus-dependent memories. Importantly, IGF-2 did not change locomotor activity and NDS after two weeks, which probably represents its specific function in memory.

Cardiac arrest (CA) and differentially expressed genes (DEGs) relative to post-CA have attracted the attention of scientist to prevent damages, which threaten patients. In the present study, metabolites relevant to DEGs of post-CA condition investigated via protein-compound interaction to understand the pathological mechanisms in the human body. STITCH plug-in integrated into Cytoscape V.3.6.1 was used to detect the most significant interacting compounds relative to DEGs of pig’s brain after 5 minutes’ CA. The genes were obtained from the Gene Expression Omnibus database. The identified elements were considered for further evaluation and validation by literature survey. Findings indicate that biochemical compounds including magnesium, calcium, glucose, glycerol, hydrogen, chloride, sulfate, and estradiol interact with DEGs in the two up- and down-regulated networks. The compounds interacting with DEGs are suitable subjects to analysis for re-regulation of the body after CA.[GMJ.2018;7:e1380]

Atrial fibrillation (AF) is considered as the most common sustained arrhythmia in adults, whose incidence rate is on the rise due to the increase in the mean age of the global population. In recent years, many efforts have been made to identify effective factors in the incidence of AF to prevent them and thereby reduce the consequences of AF. Physical activity is one of the topics that attracted much attention in the last two decades. According to some findings, extreme and prolonged exercise itself can be considered as a risk factor for the onset of AF; however, other studies have shown that exercise can be regarded a protective factor against AF in the general population. The present study reviews the findings of studies on the relationship between AF and exercise and discusses possible mechanisms for this relationship. Additionally, we present some recommendations for researchers and physicians about exercise management in association with AF prevention. [GMJ.2018;7:e1401]

Atrial fibrillation (AF) is a growing health problem worldwide. In recent years, there has been a rising interest in the relationship between sleep disorders and AF. Several studies have reported higher prevalence and incidence rates of AF in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS). However, some believe that OSAHS is not a risk factor for AF; but AF, by itself, is regarded as one of the possible triggers for OSAHS. In this study, the related literature investigating the association between OSAHS and AF was reviewed, and then the possible mechanisms of this interplay were discussed. To conclude, recommendations for further research in this field were presented to researchers and some points were highlighted for physicians.[GMJ.2018;7:e1416]