Crescent Journal of Medical and Biological Sciences
Volume:6 Issue: 1, Jan 2019

Substituting antidotes with longer half-lives may decrease the danger of unobserved respiratory depression in opioid overdose. The present triple-blind controlled trial aimed to compare two different doses of naltrexone (i.e., 50 vs. 100 mg) in the maintenance therapy regarding methadone-overdosed in opioid-naïve patients. Seventy opioid-naïve methadone-intoxicated patients with a mean age of 26 ± 9 years were prospectively included in this study and were treated with naloxone. They were then consecutively assigned to A or B groups (including 35 patients each) receiving 100- and 50-mg naltrexone capsules, respectively. The patients were followed for 48 hours in the hospital and re-evaluated by a phone call follow-up after discharge. Finally, they were compared regarding re-development of the toxicity signs and symptoms, a need for re-administration of naloxone, and the final outcome. Based on the results, only diastolic blood pressure, serum bicarbonate, and base excess were significantly different between the groups. During hospitalization, one patient in group A experienced apnea while none of the patients in group B had such an experience (P > 0.05). In addition, in follow-up evaluations and after the hospital discharge, the mean venous blood gas (VBG) parameters were found to be identical between both groups. Hospitalization period was similar (all P values were greater than 0.05). In general, 2 different 50- and 100-mg regimens of naltrexone have the same efficacy in preventing the apnea and respiratory depression in methadone-intoxicated opioid-naïve patients. However, the 50-mg dose is the superior regimen recommended in this respect.

Polyunsaturated fatty acids (PUFAs) are useful in reducing the deleterious effects of ischemia-reperfusion (IR). This study was designed to compare the impacts of treatment with flaxseed oil (FLO), rich in linoleic and alpha-linolenic acids, and fish oil containing long PUFAs, as well as eicosapentaenoic and docosahexaenoic acids (DHAs), on IR injury in the rat kidney. In this experimental study, 32 male Wistar rats were randomly divided into 4 groups (8 rats each) including Sham, IR, FLO, and fish oil (FO). Correspondingly, experimental groups were administered saline and flaxseed or FO at doses of 0.4 g/kg by gavage. After 4 weeks, the rats underwent right nephrectomy and 45-minute clamping of the left renal arteries followed by 24 hours reperfusion. Renal function was assessed by measuring the serum creatinine (Cr) and blood urea nitrogen (BUN) levels. The oxidative stress and serum aspartate aminotransferase (AST) activity were measured. Each kidney was sectioned into 2 equal parts. One part was used for pathological evaluations after hematoxylin-eosin staining and the other one was applied in assaying the malondialdehyde (MDA) level. Serum Cr and BUN levels, AST activity, and tissue MDA content increased in the IR group. Both FO and FLO decreased tissue MDA levels (P < 0.05 vs. IR), but could not lead to a significant reduction in the levels of the renal markers. In addition, histological damages which were increased following the IR were markedly reduced by these 2 oils. Generally, FLO and FO may provide protection against IR-induced renal injury and oxidative stress. However, these effects were not significant between the 2 supplementations.

The implantable cardioverter-defibrillator (ICD) is a device that is used for patients who suffer from dangerous ventricular dysrhythmia like ventricular tachycardia or ventricular fibrillation by preventing them from sudden cardiac death. Our knowledge about psychological reactions and adaptability after insertion of ICD is not enough, so we did this study to assess and compare anxiety level in patients before and after ICD implantation. In this comparative cross-sectional study, after providing written informed consent, 95 eligible patients (30 females and 65 males) were selected through convenience sampling in Shahid Rajaee heart hospital and the medical centers related to Tehran Arrhythmia Clinic. A demographic questionnaire and HADS (Hospital Anxiety and Depression Scale) questionnaire were used to measure anxiety level before and 4 weeks after implantation of ICD. In this study, data were collected and analyzed using SPSS software version 14.0. The mean ± SD of anxiety was significantly lower in male patients than in females prior to inserting ICD device (M = 7.55±4.95 vs. F = 10.93±5.34, P = 0.003) and also after insertion (M = 7.76±5.76 vs. F = 12.06±6.68, P = 0.001). We found that women had a higher level of anxiety before and after ICD implantation. Since sex is a predisposing factor for encountering a higher level of anxiety, health care providers need to notice the role of gender when providing psychological support for patients with ICD.

Available methods for treating bone defects occasionally include limitations regarding supplying and applying the biological agents, thus mediators of bone regeneration still the safe method. The current study aimed to determine the possible effects of eggshell as an agricultural waste product in the form of nanocomposite containing ostrich eggshell (NCOE) on calvaria bone formation in rabbits. A number of 15 adult male New Zealand white rabbits were used in this study. Four full-thickness skull defects were created in the calvarial bone. The first defect (control) was kept unfilled. However, the second and third defects were filled with nanomaterial and using an autogenous bone, respectively. In addition, the fourth one was filled with a mixture of NCOE and autogenous bone. On the 30th, 60th, and 90th days after surgery, the blood samples were obtained and red blood cells, white blood cell, hemoglobin (HGB), hematocrit (HCT), mean cell volume (MCV), mean cell HGB, and platelets (PLT) were determined. On the above-mentioned days, the animals were sacrificed and the bone density was determined using radiography images. Based on the results, a significant difference was observed on bone formation in control (0.18 ± 0.01 mm Al equivalent), autograft (0.1 ± 0.01 mm Al equiv.), NCOE (0.12 ± 0.01 mm Al equiv.), and NCOE + autograft (0.07 ± 0.01 mm Al equiv.) defects at day 30 post-surgery (P < 0.05). Further, significant differences were found on bone density in control (0.09 ± 0.01 mm Al equiv.), autograft (0.13 ± 0.01 mm Al equiv.), NCOE (0.14 ± 0.01 mm Al equiv.), and NCOE + autograft (0.20 ± 0.01 mm Al equiv.) defects at day 60 post-surgery (P < 0.05). Furthermore, significant differences were detected regarding bone density in control (0.15 ± 0.01 mm Al equiv.), autograft (0.21 ± 0.01 mm Al equiv.), NCOE (0.22 ± 0.02 mm Al equiv.), and NCOE + autograft (0.29 ± 0.01 mm Al equiv.) defects after 90 days (P < 0.05). The results revealed that the NCOE + autograft defect had a better bone formation in all stages of the study (P < 0.05). However, no significant effect was observed on blood hematology indexes (P > 0.05). Generally, based on the results, NCOE + autograft had positive effects on calvaria healing in the rabbit.

In recent years, using male contraceptive methods has exceeded those of the female in several societies due to the increasing involvement of men in family planning. Hence, the present study divided the contraceptive methods into male and female methods and examined the prevalence, trend, and socioeconomic factors associated with using male methods. The population of this cross-sectional survey included all married men and women in Tehran out of whom 1272 samples with a 49-year-old woman or younger in their households were selected by the multistage cluster sampling technique. Data were analyzed by Cramer"s V, phi and logistic regression tests using SPSS version 21. Based on the results, about three-fourths of the families in Tehran used male contraceptive methods. In addition, the results revealed that using male contraceptive methods has increased over the last 2 decades. In other words, using a condom, as a contraceptive method, increased among the married men while withdrawal decreased. Multivariate analysis indicated that the use of male contraceptive methods was more prevalent among younger, more educated, as well as less religious people and those with egalitarian gender attitudes. Generally speaking, knowledge of failure rate of male contraceptive methods, teaching the side-effects of female methods, and greater familiarity of families with emergency contraceptive pills are essential.

This study aimed to evaluate the anti-oxidative potential of Galega officinalis extract on oxidative damages in the testes and sperm parameters of diabetic rats. In this experimental study, 32 male Wistar rats were segregated in 4 groups: Control, Diabetic control, Diabetic treated with G. officinalis extract and healthy group that received G. officinalis extract. An instillation of distilled water was performed in the control and diabetic groups. Also, treatment groups received Galega extract (50 mg/kg body weight) for 8 weeks. After treatment period all of subjects were anesthetized, their blood samples were taken, the serum level of insulin and glucose were measured then the testicles and epididymis were removed and sperm parameters and oxidative stress markers were assessed. Treatment of diabetic rats with G. officinalis extract significantly increased the Johnson score and diameter of seminiferous tubule as well as reduced the glucose plasma levels (P = 0.001) and increased the insulin levels (P = 0.001). Furthermore, during diabetes an upsurge in the level of malondialdehyde (MDA) and a decrease in the levels of superoxide dismutase (SOD) and catalase (CAT) enzymes activity were observed in the testes. Administration of G. officinalis extract (50 mg/kg BW) significantly rectified these parameters (P < 0.05). Moreover, the sperm parameters decreased in the diabetic group, while the use of G. officinalis significantly improved the mentioned disorders in the treatment groups (P < 0.05). The results of this study confirm the antioxidant role of hydroalcoholic extract of G. officinalis in the improvement of the testicular oxidative damage caused by diabetes.

Cancer is a hyperactive disorder which can cause uncontrolled propagation of the cells. Several reports indicated that omega polyunsaturated fatty acids can prove their own antitumor effects on different cancerous cells by stopping the operation of the cellular cycle. Therefore, this study mainly aimed to investigate the impact of omega polyunsaturated fatty acids (PUFAs) on the exposition rate of genes CDK1, CyclinB1, and the cellular cycle of the stomach cancerous tissue in under-chemotherapy patients with stomach adenocarcinoma. The present study was a double-blind clinical trial in which neither the oncologist nor the patients were aware of the treatment before and after the intervention. The patients with stomach adenocarcinoma were first recognized and subjected to chemotherapy. A total of 24 patients were randomly selected and included in the case and control groups. The patients in the control group were treated with cisplatin and placebo while those of the case group first received cisplatin with the complementary capsule of fatty acids, namely, Natural Factors Ultimate Omega Factors with a dose of 1200 mg and 3600 mg daily, encompassing three 1200 mg medicines each course for 3 weeks. Three samples of the stomach biopsy were taken from all patients before and after the chemotherapy. All mRNA tissues were extracted out of the biopsy samples. Then, DNA was synthesized based on these samples and the exposition rate of the desired genes was measured using the real-time polymerase chain reaction (PCR) method. There was a significant decrease in the mean of exposition of the genes in the case group (P = 0.021) compared to the control group (P = 0.001). Generally, the results revealed that using omega fatty acids 3, 6, and 9 along with cisplatin medicine can be effective in stopping the cell cycle phase G2 in cancerous cells of the stomach tissue.

The present study aimed to calculate the efficiency of bismuth nanoparticles shield to protect the breast in chest computed tomography (CT) scan and investigate the alteration of image quality after using the shield. Three groups were included in this experimental research in which phantom was scanned without using nano bismuth shield (group 1), using 0.5 mm nano bismuth shield (group 2), and employing nano bismuth shield with 1 mm thickness (group 3). The polymethyl methacrylate phantom was applied to present the main organ of the chest including the breast and lung. Multi-detector 6-slice CT scan system was utilized for the tests. In addition, the breast radiation dose was measured by ion-chamber which was placed at 12 o"clock position in the phantom according to dosimetry protocol. Further, chest CT image processing was performed once without shield and once in the presence of 10% nano bismuth shield with different thicknesses. Finally, image quality was compared by adding the shield for correct diagnosis. Tests were repeated three time and data were analyzed by ANOVA. Based on the results, using nano bismuth shields, breast dose reduced by 7.2% and 13.8% for 0.5 and 1 mm thickness of the shield, respectively. Furthermore, the CT number and noise increased from 121.3 to 126.36 HU and from 24.53 to 28.1 HU, respectively. Finally, the dose reduction ratio approximately doubled by increasing the thickness from 0.5 to 1 mm. Generally, nano bismuth shields have a noticeable potential for reducing the breast dose with the smallest change in the noise.

Cardiovascular diseases are one of the most common causes of inability and mortality in most countries. External and internal factors, especially circadian rhythms can play a significant role in the incidence of heart attacks and supraventricular arrhythmias. Various changes in the biological conditions of body lead to these rhythmic changes, as well as circadian cycles and seasonal incidence. The occurrence of cardiac arrhythmias fluctuates during the day and night. However, seasonal variations and night-time sleep are among the reasons for a decrease in the incidence of such arrhythmia. This study is descriptive research. The population of the study included patients who referred to the emergency room and inpatient centers of Shahid Madani teaching hospital of Tabriz. A total of 722 patients were examined during September 2008-2010. Data were analyzed using the SPSS, version 16. Two types of arrhythmia including the atrial fibrillation (AF) and none-AF occurred in 480 (63%) and 292 (37%) individuals, respectively. In addition, as regards the seasonal distribution of arrhythmia, the highest incidence rate was 225 (29.1%) in spring. Further, in terms of the hour of incidence and the related percentage, arrhythmias were recorded during a circadian period and as follows: 00.00-4.00 (10. 2%), 4.00-8.00 (5.4%), 8.00-12.00 (34.9%), 12.00-16.00 (19.9%), 16.00-20.00 (16.5%), and 20.00-24.00 (12.6%). Generally, changes in seasonal circadian rhythms are believed to play a role in the incidence of supraventricular arrhythmic attacks. Furthermore, it is assumed that internal hormonal and biochemical changes affect the occurrence of supraventricular arrhythmia. Therefore, identifying these seasonal and circadian rhythms can have important practical applications.

Cystic fibrosis (CF) is a progressive genetic disorder. So far, no study, to the best of our knowledge, has investigated the psychiatric disorders of CF patients in Iran. Therefore, the present research aimed to determine the frequency of psychiatric disorders in patients with CF. A number of 40 patients (24 boys vs. 16 girls) with CF within the age range of 5-18 years were included in this descriptive cross-sectional study, who attended the CF Clinic of Tabriz Children"s hospital. A demographic questionnaire and the Farsi version of Kiddie Schedule for Affective Disorders and Schizophrenia-present and lifetime (K-SADS-PL, a semi-structured interview) were administered to determine the psychiatric disorders of these patients. Based on the results, separation anxiety was the most common psychiatric disorder (52.5%) among the patients followed by oppositional defiant (35%), major depressive (35%), general anxiety (32.5%), and enuresis (22.5%) disorders. The average age of the patients was 9.95 ± 0.85 years. In addition, the frequency of major depressive disorder was significantly higher in patients above 11 years old. Finally, the incidence of separation anxiety disorder was higher in girls within both age groups while enuresis disorder was significantly more frequent in boys of two age groups. The importance of screening psychiatric disorders was identified based on a high frequency of psychiatric disorders in patients with CF. Therefore, early determination of psychiatric disorders allows for early referral to psychiatric services and thus may result in improving their life quality.

The present study evaluated the effect of combining 2 drugs, namely, ondansetron and metoclopramide-phenylephrine on intra- and postoperative nausea and vomiting (PONV) in patients who selectively underwent cesarean section (C-section) surgery using spinal anesthesia. This randomized double-blind clinical trial controlled with placebo was conducted on 110 patients with class I and II ASA who underwent C-section with spinal anesthesia. Patients within the age range of 20-30 years were divided into 2 groups including 55 subjects. The first group received 10 mg IV metoclopramide while the second group received 10 and 0.4 mg bolus of the metoclopramide-phenylephrine combination before the spinal anesthesia and after closing the umbilical cord, respectively. Prophylactic phenylephrine was injected after the spinal anesthesia. In addition, the patients were anesthetized using bupivacaine 10 mg plus fentanyl 10 mg. Hemodynamic was monitored every 3 minutes. Further, intraoperative and postoperative complications, nausea and its intensity, cut-off point, sedation score, and epinephrine were recorded. No significant difference was found regarding demographic characteristics. (P > 0.05). The incidence and severity of nausea and vomiting were significantly lower in metoclopramide-ondansetron group compared to the metoclopramide group (P = 0.033 & P = 0.03, respectively). As regards the phenylephrine infusion, there were no significant differences in blood pressure, heart rate, and ephedrine consumption between the 2 groups. Furthermore, the incidence of other complications like shivering and pruritis was similar in both groups. Generally, it was revealed that combination therapy with metoclopramide and ondansetron along with prophylaxis of the hypotension with phenylephrine can significantly reduce intra and PONV and its severity in patients undergoing C-section surgery during spinal anesthesia.

Articular cartilage has a limited potential for self-repairing due to the scarce number of chondrocytes and avascularity. As regards the low proliferative potential of chondrocyte under in vitro conditions, nowadays mesenchymal stem cells are introduced for osteoarthritis (OA) treatment. Accordingly, the present study aimed to evaluate whether co-culture of chondrocytes with 2 different sources of mesenchymal stem cells, namely, adipose and Wharton"s jelly derived can promote the expression of cartilage specific genes by chondrocytes. Mesenchymal stem cells were isolated from both adipose tissue and Wharton"s jelly. The obtained cells were co-cultured with chondrocytes or cultivated alone as control for 3 days. Then, cartilage specific genes including collagen II, Sox9, cartilage oligomeric matrix protein (COMP), and aggrecan were evaluated using the real time Reverse transcription polymerase chain reaction (RT-PCR). The expression of genes in chondrocytes alone was significantly higher compared to the co-culture of chondrocytes with both stem cell types. In addition, the results revealed that co-culture of Wharton jelly derived stem cells (WJSCs) with chondrocyte led to higher expression of genes compared to WJSCs alone. However, the co-culture of the adipose-derived stem cells (ASCs) demonstrated no significant change. Generally, no up-regulation of cartilage specific genes was observed by co-cultivation of chondrocytes with ASCs or WJSCs compared to chondrocytes. Further, stem cells derived from Wharton"s jelly expressed higher levels of the above mentioned genes compared to those of the ASCs.

Transconjunctival sutureless vitrectomy (TSV) is a common procedure in eye surgery and is performed with needles 20, 23, and 25. This study compared the 2 methods of 20 and 23 in terms of various parameters. A total of 36 patients were admitted to Nikookari hospital, from which 18 patients were operated with the standard 20G vitrectomy and 18 patients with 23G TSV. Intraocular pressure (IOP), corneal anterior surface-based keratometry, corneal anterior surface-based curvature radius, and the corneal thinnest part thickness were evaluated before, a week after, and one month after the surgery. The results were compared through statistical methods using the SPSS software, version 22. Based on the results, IOP, corneal anterior surface-based keratometry, corneal anterior surface-based curvature radius, and corneal thinnest part thickness had no significant difference between the 2 methods at different times (P > 0.05). However, IOP significantly reduced in the 20G standard vitrectomy one week after the surgery (P = 0.023). However, K1 and K2 in the 20G standard vitrectomy significantly increased one week after the surgery compared to the time before surgery (P < 0.05). In addition, the corneal thinnest part thickness in the 23G TSV significantly increased a week after the surgery compared to the period before the surgery (P = 0.007). In general, no statistically significant difference was observed between the 2 methods in terms of the studied parameters using one week and one month after the surgery.

In women with breast cancer, self-efficacy leads to better coping with the disease, improve the mental image, and promote health. This research aimed to investigate the effectiveness of group counseling on self-efficacy in mastectomized patients. This randomized controlled trial was conducted on 76 mastectomized patients who referred to the Breast Cancer Supportive Association and Shahid Ghazi Tabatabaei hospital in Tabriz-Iran during 2017-2018. Participants were randomly allocated to counseling and control groups. Totally, six 60-90-minute counseling sessions were held for the counseling group regarding health promotion and health-promoting lifestyle including self-efficacy. General self-efficacy questionnaire was completed by the patients pre-intervention and 4 weeks post-intervention through interviews. Independent t test and analysis of covariance (ANCOVA) test were used to analyze the data. No significant difference was observed between the study groups in terms of demographic variables and the pre-intervention score of self-efficacy (P > 0.05). The results of ANCOVA test by adjusting the pre-intervention score indicated that the mean score of the perceived self-efficacy was significantly more in the counseling group compared to the control group at four weeks post-intervention (adjusted mean difference =7.1; 95 % CI = 5.5 to 10.5; P < 0.001). In general, group counseling can enhance the perceived self-efficacy in mastectomized women. Therefore, considering the role of self-efficacy in promoting the health of breast cancer patients, counseling sessions should be held for mastectomized women to improve their self-efficacy.

Changes in maternal hemoglobin during pregnancy affect the incidence rate of preeclampsia and gestational diabetes mellitus (GDM). The present study aimed to investigate the relation between the second and third trimester hemoglobin and the incidence of preeclampsia and gestational diabetes. A total of 600 patients who referred to Milad hospital in 2011 participated in this study. Second and third trimester hemoglobin levels were measured. The association between the level of maternal hemoglobin and the incidence rate of preeclampsia and gestational diabetes was evaluated. In addition, the association between the second and third trimester hemoglobin level and education, job, history of abortion, as well as the use of calcium, folic acid, iron, and multivitamin pills was evaluated. The results indicated that the second and third trimester maternal hemoglobin levels were high in patients with gestational diabetes and preeclampsia. Further, the relative risk of GDM was 2.12 times higher in the high hemoglobin group during the second trimester of pregnancy compared to the normal hemoglobin group (CI = 1.14-3.94) and it was 1.47 times higher in the third trimester (CI = 0.78-2.7). Furthermore, the relative risk for preeclampsia in the high hemoglobin group was 2.33 times more than normal one (CI = 1.16-4.66) and in the third trimester, it was 1.33 higher (CI = 0.66-2.66). The high hemoglobin, especially in the second trimester is associated with a higher risk of subsequent preeclampsia and GDM. Hence, women with high hemoglobin in their second trimester are at greater risk of developing GDM and preeclampsia. Therefore, early detection and prevention reduce undesirable effects.

This study aimed to estimate the natural course of vitreomacular traction (VMT) disorder during a 6-month follow-up using the high-resolution spectral-domain optical coherence tomography (SD-OCT). In addition, it attempted to evaluate the visual and anatomical outcomes of the patients who underwent a follow-up or vitrectomy for VMT syndrome. In this prospective study, 45 eyes from 45 patients with VMT syndrome underwent SD-OCT imaging and eye examinations. All the patients were observed for the 6 subsequent months. Further, those patients who demonstrated no spontaneous resolution of adhesion during this period underwent 3 port standard pars plana vitrectomy. Two patients were excluded from the study, then all the remaining patients were observed for 12 months. The mean observation period of all the patients was 18 months. Changes in visual acuity (VA) before and after the study were compared between the 2 groups. The mean age of patients was 64.21 ± 7.712 years (51-80 years). After 6 months follow-up, 20 patients (44.45 %) represented the spontaneous release of VTM. Furthermore, mean LogMAR VA improved from 0.7042 ± 0.21 (Snellen"s equivalent of 20/100) to 0.585 ± 78 (Snellen"s equivalent of 20/76). Baseline VA was greater than or equal to LogMAR VA of 0.7 (Snellen"s equivalent of 20/100) in most of the patients who revealed a spontaneous resolution of VMT after a six-month follow-up. Moreover, all the patients with spontaneous release of VMT, indicated improvement in VA compared to the baseline, from mean baseline LogMAR VA of 0.5650 (Snellen"s equivalent of 20/73) to 0.4700 (Snellen"s 20/59). Finally, the mean baseline LogMAR VA improved from 0.8435 (Snellen"s equivalent 20/138) to 0.7000 (Snellen"s equivalent 20/100) in vitrectomy group. Approximately 44.5% of the patients demonstrated the spontaneous resolution of vitreoretinal adhesion during the 6-month follow-up. The greater was the initial VA, the higher became the spontaneous separation rate, and eventually a better visual outcome.

Breast cancer is one of the most common diseases in women and hypothyroidism is an important risk factor for developing this cancer. Therefore, the present study aimed to investigate the relationship between hypothyroidism and breast cancer development in women. In addition, the effect of age and weight on hypothyroidism was studied in patients with breast cancer. A total of 200 women who referred to Shams, Amir-al-Momenin, and Noor-Nejat hospitals of Tabriz located in East Azarbijan were selected during a 4-month period in order to participate in this case study. The participants included 100 women with a definite diagnosis of breast cancer vs. 100 healthy women. The levels of thyroid hormones (T3, T4, & TSH) were analyzed and the correlation between these levels and the incidence of breast cancer was determined. Based on the findings, no significant difference was observed between both groups regarding the age, weight, and levels of thyroid hormones (P > 0.05). Further, the results revealed that the correlation between the age and weight of the studied women and the level of hormones was negligible. However, in patients with breast cancer, there was a significant relationship between T3 serum level and age (P = 0.005). Generally, no significant relationship was found between the development of breast cancer and hypothyroidism in the patients with breast cancer.

Osteocalcin which is s non-collagenous protein plays an important role in bone metabolism and its carboxylation depends on vitamin K. In addition, warfarin inhibits vitamin K epoxide reductase complex and has an anticoagulant effect and therefore interrupts the activity of osteocalcin. Accordingly, this study aimed to estimate the effects of warfarin on bone metabolism. In other words, it was attempted to evaluate the changes in serum levels of bone metabolism in warfarin-taking patients and find the relationship between the inhibition of vitamin K metabolism by warfarin and their synergistic effects on bone metabolism. A total of 72 individuals were selected including healthy controls (n = 36) and patients (n = 36) who referred to clinical laboratories of Tabriz after consuming warfarin. Nearly 5 ml blood samples were collected and non-carboxylated osteocalcin experiments, parathyroid hormone (PTH), vitamin D3, calcium, phosphorus, magnesium, and alkaline phosphatase were performed for all the samples of each group. In this study, non-carboxylated osteocalcin, PTH, and international normalized ratio (INR) increased significantly in the case group while increasing of Mg2+ was non-significant in this group. However, vitamin D3, Ca2+, alkaline phosphatase (ALP), and P demonstrated a significant decrease in the case group compared to the control group. In general, the consumption of warfarin leads to bone and vessel wall damages, causing cardiovascular diseases.

Oral squamous cell carcinoma (OSCC) is one of the commonest malignant neoplasms in the oral cavity. Although human papillomavirus has been considered as one of the risk factors for oral cancer, the extent of its involvement in squamous cell carcinoma (SCC) has remained unclear. The present study aimed to detect the prevalence of HPV in the patients with OSCC in Tabriz, northwest of Iran. Genomic DNAs of 30 normal non-smoking cases and 30 cases with tongue SCC who underwent surgery in Tabriz, Iran, were extracted and used for amplification of HPV L1 fragment using MY09/MY11 and GP5/GP6 primers by polymerase chain reaction (PCR) and nested PCR. The positive PCR products were sequenced to confirm the presence of HPV. Among 30 OSCC samples analyzed, two cases (6.6% of 30) were positive for HPV in PCR performed by MY09/MY11 primer, and none of them showed a positive result with GP5/GP6 primers. Nested PCR by MY/GP primers showed higher sensitivity in three positive cases (10% of 30) of SCC subjects. According to these findings, HPV infection may not be a causative agent in tissue samples obtained from OSCC patients in Tabriz.

Pelvic fractures in women significantly affect the urogenital organs, and thus may cause urinary, genital, and sexual problems. The present study aimed to assess the incidence of pelvic fractures and the correlation between genital and sexual complications in different kinds of pelvic fractures among women of reproductive age. The population of this cross-sectional study included 180 women with pelvic ring fractures who referred to Shohada teaching hospital of Tabriz during 2013-2017, out of whom 102 patients were selected based on the inclusion criteria. However, 11 patients discontinued the treatment. The remaining 91 patients were physically examined in terms of the pelvic fracture type, the function of genital and sexual organs, and the mode of delivery after the trauma. The required data were recorded through the questionnaire. Finally, the patients were followed up for 12 months, on average. The mean age was 28.38 ± 6.0 years. In addition, the frequencies of anteroposterior compression (APC), acetabular, combined, LC, and VS fractures were obtained 54%, 24%, 7.6%, 7.6%, and 4.3%, respectively. A number of 28 women (25.2%) reported symptoms of pelvic floor dysfunction while the other women complained about pelvic pain (n = 16), dysmenorrhea (n = 9), a sensation of vaginal prolapse (n = 8), and pelvic organ prolapse (n = 1). Further, only 6 women (out of 18 births, 33 %) had a cesarean section due to the complications of pelvic fracture. Furthermore, 21 women described their problems during the sexual intercourse, 12 reported dyspareunia, 3 had coital incontinences, 4 had anorgasmia and 15 had a reduced frequency of intercourse. Finally, the frequency of pelvic floor dysfunction symptoms and sexual problems was high in the VS and combined fractures. In general, the frequency of APC fracture was higher than the other types of fractures. However, genital and sexual complications were higher in VS and combined fractures. Eventually, pelvic pain and dyspareunia were the most common complications among these patients.

Persian medicine (PM) encompasses preventive medicine, as well as disease control and treatment fields. PM believes in the existence of cold and hot natures in humans (Mizaj). A person›s temperament is mostly related to the recognition of the most appropriate diet and way of life in order to promote health. Accordingly, the present study aimed to examine the correlation between uterine temperament and primary dysmenorrhea. This research which is a cross-sectional descriptive-correlational study was conducted on 105 students within the age range of 18 to 35 years old who lived in dormitories of Tabriz University of Medical Sciences for 3 months during 2017. These students were selected by random sampling technique. Data were analyzed using the SPSS software, version 24 by the chi-square, biserial rb, and Mann-Whitney tests. The frequency of cold-dry temperament in patients with dysmenorrhea was higher than that of other temperaments (26.2 %). In addition, no significant correlation was found between the intensity of pain and body temperament (P = 0.421) or between the intensity of pain and uterine temperament (P = 0.508). However, there was a meaningful relationship between the duration of pain and body temperament (P = 0.049) and between the duration of pain and uterine temperament (P = 0.027). Generally, the duration of menstrual pain was longer in patients with cold temperament compared to those with hot temperament. Accordingly, adherence to traditional Iranian medicine recommendations in dealing with cold temperament can be effective in reducing the duration of pain in these patients.

The present study aimed to evaluate if postpartum diabetes mellitus screening can be performed during post-delivery hospitalization. This case series study was conducted on 130 women with gestational diabetes mellitus (GDM) who had normal blood sugar after the delivery. They took 75 g oral glucose tolerance test (OGTT) before hospital discharge and repeated the test 6-12 weeks later. Totally, 107 (82.3%) patients out of the total participated women were analyzed. Early OGTT, prediabetes, and diabetes were abnormal in 46 (43.0%), 34 (31.8%), and 12 (11.2%) cases, respectively. In addition, they above-mentioned variables were found to be abnormal in 28 (25.2%) 22 (20.6%), and 6 (5.6%) cases 6-12 weeks later. Further, 6-12 weeks later, the OGTT was abnormal (prediabetes and diabetes) in 5 patients (4.7%) with normal early OGTT. Therefore, there was a significant association between the results of early OGTT and those of 6-12 weeks later (P = 0.00). It implies that early OGTT could detect prediabetes and diabetes (abnormal results) with a sensitivity of 82.14% (95% CI, 63.11-93.94) and specificity of 70.89% (95% CI, 59.58-80.57). In general, early postpartum screening effectively diagnosed women who were at high risk of diabetes mellitus and needed undergoing OGTT 6 weeks later. Identifying high-risk patients who need to return later facilitates the management of patients and sensitizes patients to refer for further examination.

A case report on a novel treatment protocol using autologous stem cells, derived from adipose tissue, for the treatment of non-obstructive azoospermia. In this case report, the male partner after undergoing such treatment had restored spermiogenesis and the couple underwent in vitro fertilization (IVF) therapy. Fertilization was successful and good quality embryos were produced.

Hyponatremia and ascites are rare findings in preeclampsia (PE) and have been suggested to be a feature of severity and associated with adverse pregnancy outcomes. The presence of both with PE was reported once in the literature. To our knowledge, this is the second case of PE with hyponatremia and ascites and the first case of recurrent ascites with PE. A 29-year-old gravida 2, para 1, was admitted with early-onset PE at 26 weeks of gestation. Admission labs revealed severe hyponatremia. Ultrasound showed significant maternal ascites and a growth-restricted fetus with abnormal umbilical artery Doppler. Few days later, the patient developed oliguria and had a cesarean section. The maternal hyponatremia was corrected after delivery and the ascites had completely resolved in her post-partum visit. Neonatal hyponatremia was also noted. The exact pathophysiology of these findings is unknown. Nephrotic syndrome with hypoalbuminemia may be the contributing factor.

Bupropion is an anti-depressant drug which is a category of aminoketones. It is a norepinephrine-dopamine inhibitor, which is considered as a nicotine antagonist and is effective in smoking cessation. The patient was a single 21-year-old girl and she was a student and had been referred to Bijan Addiction Treatment Clinic in Tehran with a complaint of chronic smoking. After a period of abstinence from consumption, she experienced anhedonia syndrome and recurrence of consumption. Data were collected from October to February 2016. We used a reversal (ABAB) design with multiple baselines, in which A was the baseline and B was the intervention phase. The entire course was 12 weeks, during which bupropion was presented. In the baseline A1 and A2, only bupropion was presented, and in B1 and B2 stages, in addition to bupropion, cognitive-behavioral therapy (CBT) was also presented. Cigarette Cravings Index and Heaviness of Smoking Index (HSI) were completed at 24 time points by the subjects. Data were analyzed by semi-parametric test of generalized estimation equation. Data analysis indicated that the addition of CBT to bupropion was associated with a significant reduction in the scores of HSI and Cigarette Cravings Index compared to bupropion alone (P<0.01). These findings can reflect the role of complementary psychological interventions in the treatment of addiction and suggest a promising perspective in linking biological and cognitive indices in response to the addiction challenge.