امیر رهنما

According the importance of iodine monitoring in the prevention of iodine deficiency disorders, this study aimed to evaluate the clinical iodine and goiter deficiency in 7-12 year-old students in Rafsanjan in 2018-19.

The statistical population of this cross-sectional study included all students of 7-12 years old who were covered by Rafsanjan Education Management in 2018. From 21218 students aged 7 to 12 years living in the city, 1203 students (601 boys and 602 girls) based on inclusion criteria were enrolled in the study. After obtaining informed consent from the parents, the students were examined clinically by an internal trained resident. In this study, the presence and severity of goiter were evaluated based on the World Health Organiaztion classification. Then, 10 ml of the morning urine sample of 10% of all samples was taken to measure iodine by acid digestion method.

The mean and standard deviation of age of participants was 9.48±1.71. In addition, mean and standard deviation of urinary iodine was 183.33±80.52 Ug / dl. In the study of the prevalence of goiter in the community, 87.1% (1047 samples) had no goiter, 9.7% (117 samples) had D1 grade and 3.2% (39 samples) had D2 grade. It was also found that the prevalence of goiter was not statistically significant in terms of age and sex.

The findings of this study indicate that the iodine deficiency control program and consumption of iodized salt has caused a significant decrease in the prevalence and severity of goiter, and also adequacy of the received iodine, given a marked increase in urinary iodine excretion in Rafsanjan city.

The etiology of some liver diseases is unknown, but oxidative stress has an important role in liver pathogenesis. Pistachio (Pistacia Vera) has compounds with known antioxidant properties, including coenzyme 10, vitamin E and beta-carotene. This study designed to evaluate protective effect of hydro-alcoholic extract of Pistacia Vera on liver enzymes following induction of hepatotoxicity.
In this experimental study 40 male rats (200-250 g) were divided into five experimental groups. Carbon tetrachloride (CCl4) was used to induce hepatic toxicity. In normal group, no intervention was done. Vehicle group received intraperitoneal injection of 50% CCl4. Treatment groups were gavaged by three doses of Pistacia Vera hydro-alcoholic extract (10, 50 and 100 mg/kg) for 1 month. Plasma activity of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), total blood protein, plasma concentration of high density lipoprotein (HDL) and low density lipoprotein (LDL) were measured.
Gavage of different doses of pistachio extract in rats poisoned by CCl4 leads to decrease in plasma activity of AST and ALT and also the plasma concentration of LDL, while the plasma activity of ALP and plasma concentration of total protein and HDL were not changed in these animals.
Result of this study demonstrated that chronic gavage of pistachio hydro-alcoholic extract could decrease hepatotoxicity induced by CCl4. More investigation is needed for possible clinical usage of pistachio on liver insufficiency.

Re-expression of self-renewal genes is one of the causes of cancer. So, expressional profile of self-renewal genes including, OCT4, NANOG, KLF4, SOX2 and Nucleostemin in two cell lines (5637 and HT1376), cancer and normal tissues of five bladder cancer biopsy tissues were analyzed.
In this experimental study, the cell lines were cultured in RPMI1640 medium. Cancer tissue samples were selected from samples referred to the pathology laboratory, according to clinical symptoms and laboratory findings. Tissue edges were selected as healthy tissue. Expressional profile of interested genes (mRNA expression) was carried down by Real-Time PCR, data were analyzed by ∆∆ct formula and expressional rate reported as fold changes.
The Real-Time PCR results showed that the expression of studied genes in cancer cell lines and tumor tissues were down by similar pattern but did not expressed in healthy tissue.
The expression of OCT4, NANOG, KLF4, SOX2 and Nucleostemin genes were necessary for induction of self-renewal potency. The results showed that these genes were expressed in cancer tissue and cancer cell lines in compared to normal tissues. The investigation of re-expression of mentioned genes is recommended.

Metabolic syndrome (MetS) is a cluster of the most dangerous risk factors for cardiovascular disease and type 2 diabetes. Vitamin D deficiency may have a role in MetS. The purpose of this study was to determine some of the factors of MetS including abdominal obesity, hypertension (HTN), and impaired fasting blood glucose (IFG) according to the new IDF (International Diabetes Federation) definition among the employed women in the administrative section of Rafsanjan University of Medical Sciences in 2012. This cross sectional study was conducted in 2012. Women were selected by census method (N=161). The formal consent was received individual questionnaire was completed for each part icipant. Blood pressure and anthropometric indices including height, weight and waist circumference were measured using standard equipment. Participants were asked for taking fast blood sample in a special private laboratory. HTN, abdominal obesity, and impaired fasting glucose or diabetes mellitus were detected by IDF criteria. Vitamin D was detected equal or more than 31 ng/dl as adequate and less was considered as deficiency or insufficient. Results showed that 6% of participants have sufficient vitamin D and 94% of them had vitamin D deficiency. Accompaniment of vitamin D concentration and fasting blood glucose was observed. The mean level of vitamin D in individuals at risk of raised blood pressure, IFG and central obesity was lower compared to the normal individuals. The prevalence of HTN, central obesity and IFG were 16.6%, 84.5% and 26.6%, respectively. Accompaniment of vitamin D concentration and fasting blood glucose may be a predicator of diabetes mellitus. High prevalence of HTN, central obesity and IFG are alarming, because they will increase the risk for cardiovascular disease and type II diabetes in future.

Appendicitis is one of the most common causes of emergency abdominal surgery in children. Diagnosis before surgery has always been a problem. One of the symptoms in dealing with patients with suspected appendicitis is dry and scaly lips. Therefore، the present study was conducted to investigate the relationship of this sign with appendicitis. This cross-sectional study was conducted in a three-month period، all the patients under 18 admitted with complaints of abdominal pain were entered into the study. Possible diagnosis was appendicitis based on history، clinical examinations، laboratory tests and abdominal sonography. Alvarado score pediatric appendicitis score (PAS) and pathological results were recorded. Collected data were analyzed by descriptive statistics using SPSS software. Out of 25 patients who entered the study، 11 patients (44%) were males and 14 patients (56%) were females with mean age and SD of 11. 88± 4. 77 years old. The pathology reports were as follows: 13 patients (52%) acute appendicitis، 10 patient (40%) acute suppurative appendicitis with periappendicitis، one patient (4%) ruptured appendicitis and for one patients (4%) nomal appedix. Pain shifting in 20 patients (80%) and dry lips in 22 patients (88%) were observed. Alvarado average score of the patients was 7. 04± 2. 28 and PAS average score was 7. 24± 1. 71. Early diagnosis and appendectomy before gangrene or rupture of the appendix will reduce complications of this disease. Therefore، early diagnosis of this disease is important. Sign of dry lips in 22 patients (88%) compared with other signs and symptoms is important. Based on this study it is concluded that dry lips can be a diagnostic sign along with other signs. According to the findings of this study further studies are recommended.

Coronary artery disease (CAD) in young people shows a different clinical، angiographic and pathophysiologic behavior in comparison to older age patients. Lipoprotein a (LPa) as a risk factor has a role for CAD; so its serum measurement can be valuable for detecting people dispose to this group of diseases. We did a cross-secotinal study on a 120 people in 4 equal groups; (patients with myocardial infarction and normal population، more and less than 45 years old). The data collected according to clinical examination and results of serum LPa، LDL، HDL levels. Then، data analyzed using to descriptive and analytical statistical tests i. e. the t test. LPa level in both groups of normal people was 28. 53±3. 39 and both group of patients was 47. 88±5. 12 mg/dl (p= 0. 015). Average LPa level between both groups of women less than 45 age old، in control 44. 40±4. 66 and patients group 81. 03±12. 14 was significant (p= 0. 004). This value was significant between both group of women more than 45 years old in control 24. 95±3. 07 and patients groups 34. 73±2. 84 too (p= 0. 001). Average LPa level between men less than 45 years in control 17. 38±1. 94 and patients groups 31. 11±2. 73 (p= 0. 010) and men more than 45 years، in control 27. 2±3. 91 and patients groups 53. 62±6. 01 (p= 0. 007) that was significant. Our study showed remarkable LPa level in coronary artery disease patients.

Congenital tumors of the oral cavity are not common. Teratoids are the most common tumors، and in rare cases are associated with cleft soft palate. In this paper a rare case of Epignathus with cleft soft palate، bifida tongue، jaw malocclusion، tongue lipoma، Hypertelorism and low-set ears has been presented. A female infant with a large mass covered with skin and hair arising from hard palate، cleft soft palate، bifida tongue with lipoma، inability to close mouth and inability to suck and eat was referred to us on the 3rd day after birth. After clinical evaluation، during one stage of surgery the first large mass of hard palate was removed، Then، glossoplasty was performed after excision of the lingual mass. The patient had no problem after the surgery and was discharged 10 days later in good condition and ability to be breastfed. Histologically، the palatal mass was diagnosed as epignathus and the mass of the tongue dorsum was diagnosed as lipoma.

One of the most common causes of Abnormal Uterine Bleeding (AUB) in adolescents is endometrial carcinoma. Evaluation of endometrial cancer in women of childbearing age، especially in the presence of other risk factors، is necessary. This study aimed to determine the frequency of pathological specimens of diagnostic curettage in patient admitted to Niknafs hospital and determining the predisposing factors for malignant cases. In this descriptive study، all the patients over 35 with complaint of abnormal bleeding in Niknafs hospital، the only maternity hospital in Rafsanjan، who had the diagnostic curettage performed on them from 2006 to 2009، were studied. Data were extracted from the patients'' history of records and the samples were referred to the pathology center of Ali-ebn-abitaleb hospital and by questionnaire. Data were analyzed using descriptive statistics. Most pathology reports (45. 5%) were hyperplasia and 4% cancer and 24. 6% were normal. Most complaints was menorrhagia bleeding (53. 6%). Average of Fertility number was 4. 9±2. 4. Thirteen and one tenth percent of cases were taking contraceptive pills and 4. 7% were diabetic and 16. 5% had hypertension. Of all cases، only one case had the history of breast cancer in her and there was no case of cancer in the family history. Seventy five percent of endometrial cancer were affected with the complaint of menorrhagia. People with normal endometrium had lowest fertility rate and were younger. The age of the patients and the multiplicity of their fertility with the diagnosis of abnormal endometrial curettage in pathological specimens showed a direct relationship. There were no direct relationships between oral contraceptive use and incidence of diabetes in people with cancer.

Apoptosis is a physiological mechanism of cell death and it can be triggered by a variety of internal and external stimuli. It has been shown that some opium derivatives promote cell apoptosis. This study was designed to examine the influence of opium addiction on testicular cell apoptosis in Wistar rats. This experimental study was performed on 7 opium-addicted as case group and 7 normal rats as control group. In the case group, animals treated with peritoneal injections of opium twice a day at 8 a.m and 8 p.m for 8 days based on the following regimen; at the first day 30 mg/kg, second day 60 mg/kg, third day 90 mg/kg, forth day 120 mg/kg, and from fifth to eighth day 150 mg/kg. The control group received only normal saline. Apoptosis was then evaluated by TUNEL and DNA fragmentation assays. The results of this study showed that the rate of testicular cells apoptosis in opium-addicted rats were significantly higher than the normal rats (p<0.001). These results indicated that opium addiction may play an important role in testicular cells apoptosis and as a result can cause testicula dysfunction and reduced testosterone production which may culminate in infertility.

To determine the effect of opium smoking cessation on the frequency and type of microorganisms in the nasopharynx of opium smokers. This was a cross-sectional study performed in psychology and ENT department of Moradi Hospital of Rafsanjan University of Medical Sciences in 2008 (Kerman, Iran). Nasopharyngeal cultures were taken from 50 opium smokers before and 2 to 3 months after cessation of opium smoking. Potential pathogens were identified. Eight potential pathogens were isolated from nasopharyngeal cultures obtained from 43 individuals before opium smoking cessation, and 4 were recovered from 33 individuals after cessation (P < 0.0001). Streptococcus pneumonia, staphylococcus saprofiticus, streptococos α hemolytic, and staphylococcus aureus in 2nd culture were not seen.The most sensitivity to antibiotics was related to ceftriaxone (84%), ciprofloxacin (74%) and cloxacillin (72%); the most resistance was to amoxicillin (26%) and the least resistance was to chloramphenicol. In our study, some potential pathogens decreased or even disapeared after opium cessation. Our patients have not been advised to change their number of cigarettes. We have used methadone pill for substitution of opium. It seems that opium smoking affects nasopharyngeal flora.

Poor educated people in some parts of Iran use burned mantles as a wound healing powder to prevent the bleeding and infections caused by injuries. Some lantern mantles contain low levels of radioactive thorium for maximizing the light output, while non-radioactive mantles contain yttrium. Although radioactive lantern mantles may cause a minimal radiation health hazard, it is generally believed that it would be dangerous when inhaled or ingested. This study was conducted to evaluate the effect of burned radioactive lantern mantles on wound healing. Twenty rats were divided randomly into two groups of 10 animals each. After inducing general anesthesia, full thickness excision wound (314±31.4 mm2) was made on the dorsal neck in all animals. The 1st group received topical burned radioactive lantern mantle powder at 1st-3rd day after wound excision. The presence of radioactivity in the mantle was detected using a Monitor-4 survey meter. The 2nd group received non-radioactive lantern mantle powder at the same days. Accurate blind surface measurement of the wounds was performed by transparency tracing to assess the wound healing at 1st, 3rd, 7th, 10th and 15th days after excision. A progressive reduction in the wound area of both groups was observed. However, for thorium treated group, the rate of recovery was significantly enhanced compared to that of the control group. Although this value in the thorium group was not significantly different from that of the control group at the 3rd and 5th days after wounding, a statistically significant difference was observed between these two groups at the day7, day10 and day 15. The mean wound surface in thorium and control groups were 150.20±15.87 and 186.37±12.68 mm2 at day7 (p<0.001), 92.90±15.97 and 134.12±14.19 mm2 at day 10 (p<0.001), 1.40±0.41 and 8.56±2.04 mm2 at day15 after wounding, respectively (p<0.01). These findings suggest that low-level radioactive burned mantle accelerates wound healing in rats. However, as thorium oxide is a known human carcinogen, more research is needed to clarify if low levels of radioactive burned mantle can be utilized for enhancing wound healing.

Coronary artery diseases (CAD) is the most common cause of death in the developing counteries. Atherosclerosis is the leading cause of CAD. A number of studies have shown that total leukocyte count is a risk factor for CAD but there is little information on the role of eosinophilia and allergy. The aim of this study was to determine the relationship between eosinophilia and history of allergy with CAD. This case-control study was performed on 95 cases with known CAD and 95 age and sex matched controls. History of allergy was taken by physician. Blood samples were collected from all subjects early in the morning. The white blood cells(WBC), neutrophils and eosinophils count and eosinophil/leukocyte ratio were determined by the use of blood coulter and evaluation of the peripheral blood smear. Mean and standard error of means (SEM) of leukocyte count was 8802±253 and 9813±351 cell/mm3 in case and control groups respectively. This difference was statistically significant (P<0.05). The mean and SEM of eosinophil count was 124.8±15.6 and 79.1±11.8 in case and control groups, this difference was statistically significant (P<0.05). Eosinophil to leukocyte ratio was 1.43 and 0.88 percent in case and control groups respectively. This diference was also statistically significant (P<0.01). There was no significant difference between the two groups for history of allergy. T here is a positive correlation between peripheral blood eosinophilia and CAD, therefore blood eosinophilia may predict higher rate of CAD.