asrin babahajian

Female sex workers (FSWs) in most societies run a high risk of health problems, including sexually transmitted infections (STIs) such as viral infections and syphilis. The present study examines the prevalence of viral infections and syphilis among FSWs.

This cross-sectional study recruited 100 female sex workers (April 2019 to April 2020) who visited the Counseling Center for Behavioral Diseases or were selected via purposeful (snowball) sampling. A questionnaire (demographic information and STI risk factors) was completed in a face-to-face interview with the participants. Blood samples were then taken to test the markers for HBV, HCV Ab, HIV Ab, Rapid Plasma Reagin (RPR) for syphilis and a PCR was taken to test for HPV (in vaginal sex workers from the cervix and anal sex workers from the anal region). The data were analyzed in Stata 14.

Among 100 FSWs, 6 (6%) were infected with HIV, 1 (1%) with hepatitis B, and 2 (2%) were anti-HCV positive. 1 (1%) participant was suspected of having syphilis. Based on the PCR tests, 16 (16%) participants were infected with HPV. Moreover, 68 (68%) FSWs reported having unprotected sex.

Due to the prevalence of viral infections and syphilis and unprotected sex in FSWs, immediate preventive measures are critical for this vulnerable group to control the transmission of these viral infections in society.

 The emergence of antimicrobial-resistant pathogens in intensive care units (ICU) makes treatment of these infections very difficult.

 This study aimed to survey the resistance phenotype, risk factors, and possible treatment options for hospital-acquired infections (HAI) at ICUs in a referral university hospital.

 Samples were prepared from ICU patients with HAIs. Pathogens were isolated, and the resistance phenotype, prescribed antibiotics, mortality rate, associated risk factors, and clonal relationship of the isolates were assessed.

 From 100 patients admitted to ICUs, 76 (76%) showed clinical symptoms of HAIs. The most common sources of infection were lung secretions (51.8%). The isolated bacteria were Gram-negative (77, 90.6%) and Gram-positive (9.4%). The most common isolated microorganism was the Acinetobacter baumannii complex (63.5%). The most effective antimicrobials were colistin (96.1%) and linezolid (100%) for Gram-negative and Gram-positive isolates, respectively. An extensively drug-resistant (XDR) phenotype was documented in all isolates of A. baumannii, Pseudomonas aeruginosa, and Serratia marcescens. The XDR phenotype was a significant risk factor only for mortality. A. baumannii had the highest mortality rate (66.6%) among all the isolates. While A. baumannii strains had limited diversity, the other species were highly divergent.

 The results revealed a high mortality rate for Gram-negative isolates, especially in adenosine triphosphate-binding cassette (ABC). The high genetic similarities of ABC strains might be an indication of neglecting infection control prevention. The use of cotrimoxazole and colistin instead of carbapenems can be promising for mortality reduction in the studied ICUs.

Developing novel diagnostic and screening tools for exploring intracranial injuries following mi-nor head trauma is a necessity. This study aimed to evaluate the diagnostic value of serum glial fibrillary acidicprotein (GFAP) in detecting intracranial injuries following minor head trauma.

An extensive searchwas performed in Medline, Embase, Scopus, and Web of Science databases up to the end of April 2022. Hu-man observational studies were chosen, regardless of sex and ethnicity of their participants. Pediatrics studies,report of diagnostic value of GFAP combined with other biomarkers (without reporting the GFAP alone), arti-cles including patients with all trauma severity, defining minor head trauma without intracranial lesions as theoutcome of the study, not reporting sensitivity/specificity or any other values essential for computation of truepositive, true negative, false positive and false-negative, being performed in the prehospital setting, assessingthe prognostic value of GFAP, duplicated reports, preclinical studies, retracted articles, and review papers wereexcluded. The result was provided as pooled sensitivity, specificity, diagnostic score and diagnostic odds ratio,and area under the summary receiver operating characteristic (SROC) curve with a 95% confidence interval (95%CI).

Eventually, 11 related articles were introduced into the meta-analysis. The pooled analysis impliesthat the area under the SROC curve for serum GFAP level in minor traumatic brain injuries (TBI) was 0.75 (95%CI: 0.71 to 0.78). Sensitivity and specificity of this biomarker in below 100 pg/ml cut-off were 0.83 (95% CI: 0.78to 0.89) and 0.39 (95% CI: 0.24 to 0.53), respectively. The diagnostic score and diagnostic odds ratio of GFAP indetection of minor TBI were 1.13 (95% CI: 0.53 to 1.74) and 3.11 (95% CI: 1.69 to 5.72), respectively. The level ofevidence for the presented results were moderate.

The present study’s findings demonstrate thatserum GFAP can detect intracranial lesions in mild TBI patients. The optimum cut-off of GFAP in detection ofTBI was below 100 pg/ml. As a result, implementing serum GFAP may be beneficial in mild TBI diagnosis forpreventing unnecessary computed tomography (CT) scans and their related side effects.

Propolis, as a natural product have several biological benefits including antioxidant, anti-inflammatory, and antimicrobial as well as anticancer properties. Its application extensively depends on its composition and the concentrations of the major active components. The aim of, this study was to evaluate the concentrations of chrysin, quercetin and, caffeic acid as three active components, in the Iranian propolis using UV-HPLC method.

Three different samples of propolis were collected from Saral and Avalan regions (Kurdistan Province, Iran) in spring 2017. To separate and measure the concentrations of the three components, the samples were extracted by using an ethanolic solution (80%) and subsequently analyzed by the UV-HPLC system with an isocratic mode at a flow rate of 1ml/min for 20 min and ultraviolet detection at λmax 260 or 310 nm. For evaluation of the quality control of the assay, the linearity and detection limits of the method were calculated.

Chrysin was not detected in our samples. The average concentrations of quercetin and caffeic acid were 65.425 and 27.498 µg/g, respectively.

For the first time, we reported accurately the concentrations of three active components of Iranian propolis which many of propolis's beneficial effects have been attributed to them.

Numerous studies conducted in Iran have shown that the quality of documentation of medical records by physicians and medical staff is not very satisfactory. The purpose of this study was to investigate the quality of medical records documentation in a teaching hospital, Tohid, in Sanandaj, Iran.

In a descriptive-analytical study, the medical records of all patients admitted to various services of Tohid Hospital in Sanandaj in the first six months of 2017 were examined. The investigated variables were collected using a checklist based on the national regulations for the documentation of medical records prepared by the Ministry of Health and Medical Education (Deputy of Treatment). Data were analyzed using SPSS V.20 software and Chi-squared test.

In the present study, the correct diagnosis registration, in accordance with the principles of diagnosis, was observed in 61% of admission forms and the first visit of the physician was recorded in 66% of cases. Compared with the standard, 84% of patients had a visit to a specialist within half an hour of being admitted to the hospital. More than half of the history sheets and most of the initial, daily, and final reports were incomplete. The percentage of evaluation of professors from the history sheets of residents, interns and externs was 41%, 22% and 10%, respectively. About 66 percent of the doctorchr(chr('39')39chr('39'))s prescriptions were properly recorded in the files. The correct registration of medical orders in interns and residents was 69% and 88%, respectively. Medical orders recorded by professors were recorded in 54% of cases without defects. The lowest number of defects was observed in the professors of neurology and emergency medicine and the most cases of defects were observed in the service of the professors of the cardiology. Failure to record the time and date was observed in 80% and 14% of the medical orders, respectively. Emergency medicine records differed significantly from other cases in that they had the correct diagnosis in accordance with the principles of diagnosis, and emergency medicine professors had more control over the recording of information in various forms of each case.

Based on the findings of this study, it is necessary to hold training courses on proper documentation of medical records for physicians and learners in this field and more precise supervision of professors and physicians treating studentschr(chr('39')39chr('39')) performance in all educational hospitals of Kurdistan University of Medical Sciences.

Human fascioliasis is a water and food-borne parasitic disease and has become endemic in the coastal provinces of the Caspian Sea. Limited reports of the disease and its diagnosis have resulted in ignoring the disease and a significant rise in the number of neglected patients in other parts of the country.

In this study, a 50-year-old man living in a village of Kamyaran, in Kurdistan Province in Iran was referred to a hospital with complaints of weight loss, epigastric pain, and anorexia from two months ago. The patient-reported history of consuming raw vegetables and plant foods. Laboratory studies revealed anemia, leukocytosis, eosinophilia, high ESR, low serum iron, and elevated liver enzymes. A Spiral CT scan of the liver showed hypodense areas without enhancement in the arterial phase and with relatively homogeneous enhancement in the delayed phase. Ultrasound studies showed multiple hetero and hyper-echoic areas without walls in different parts of the liver. Finally, Fasciola hepatica was diagnosed after stool examination by formalin ether concentration method and also positive ELISA test. The patient was treated with triclabendazole 500 mg/day for two days. In the follow-up, the clinical status of the patient was better and we found improved laboratory test results.

The present report highlights the need for paying more attention to the occurrence of this disease in Kurdistan Province by health care systems.
Human fascioliasis, Fasciola hepatica, Kurdistan, Iran

Anal fissure is one of the common anorectal disorders that there are various therapies for it. The aim of this study is to evaluate the effect of Nitroglycerin plus Diltiazem vs either of topical Diltiazem and Bethanechol alone in the treatment of chronic anal fissure.

The present randomized double-blind clinical trial was performed on 90 patients with chronic anal fissure referred to gastroenterology clinic of Tohid Hospital, Sanandaj, Iran, from March 2016 to February 2017, That randomly were divided into three equal groups (n = 30): A: combination therapy (1% Nitroglycerin plus 5% Diltiazem gel), B: Diltiazem (5% Diltiazem gel) and C: Bethanechol (0.1% Bethanechol gel). The drugs were administered topically three times daily for 8 weeks. After 4 and 8 weeks’ administration wound condition, pain and bleeding was assessed. Data were analyzed by SPSS v.19 software with Chi-square test.

At the beginning of the study, there was no significant difference in mean of age, sex, fissure location, hemorrhoids, bleeding and pain between the three groups (P> 0.05). Four weeks after treatment, there was no significant difference between the three groups in terms of the Wound healing (P = 0.41), pain (P = 0.10) and bleeding (P = 0.07). After 8 weeks, there was a significant difference for pain in the treatment groups (P = 0.04), so that in the diltiazem group, pain was significantly decreased in comparison to Betanchenol and There was no significant difference between the three groups in the case of Wound healing (P = 0.10) and bleeding (P = 0.69).

Topical use of diltiazem is a more appropriate option for treatment of chronic fissure than other two drugs.

Helicobacter pylori is a gram-negative bacillus which causes stomach ulcer and chronic gastritis. Curcumin is the effective component of turmeric. Considering the high prevalence of Helicobacter pylori and also safety and antimicrobial effects of turmeric we investigated the effect of curcumin on patients with Helicobacter pylori infection.

We selected 40 patients with gastrointestinal symptoms suspected of Helicobacter pylori infection.  These patients had undergone endoscopy, and their biopsies were positive for RUT. Serum specimens of the participants were tested for serum Hpylori IgG. Patients who had positive samples for both tests were considered positive for Helicobacter pylori. We gave the three-drug treatment regimen including clarithromycin, amoxicillin, and omeprazole as the treatment base to both groups for two weeks. Curcumin capsule (500 mg ) was administered for the treatment group and placebo for the control group in addition to the therapeutic regimen. Then PPI treatment was started for one and a half months after cessation of the three-drug regimen. UBT test was performed two weeks after cessation of the medications in both groups.

The mean age of the patients was 41.53 ± 12.65 years. There were no significant differences between the two groups in terms of gender (P = 0.32) and age (P = 0.6). Also, no significant differences were found between the two groups in relation to other demographic data and risk factors(P> 0.05). Also, eradication rates of the infection in the two groups showed no significant difference (P> 0.05).

The addition of curcumin as a supplement to the standard treatment regimen for Helicobacter pylori infection is not effective in the treatment and eradication of the infection

Identification of high-risk patients with poor prognosis is essential for quick diagnosis and treat-ment of methanol poisoning to prevent death and improve the outcome. The aim of this study was to evaluatethe clinical and laboratory factors in patients with methanol poisoning to determine the prognosis and outcome.

In this retrospective cross-sectional study, all patients with methanol poisoning, who had presentedto the emergency department of Tohid Hospital, Sanandaj, Iran from 2011 to 2019 (8 years) were enrolled usingcensus method. Multivariate logistic regression analysis was performed to find the independent predictive fac-tors of poor outcome in the mentioned patients.

Methanol poisoning was diagnosed in 52 (11.55%) ofthe 450 cases admitted to hospital for alcohol intoxication. In multivariate analysis, time interval from methanolintake to hospital admission (OR=1.06; 95% CI= 1.00-1.11; p=0.04), respiratory arrest (OR=25.59; 95% CI= 1.37-478.13; p=0.03), and higher concentration of blood glucose (OR=1.03; 95% CI= 1.00-1.09; p=0.03) had a signif-icant correlation with Poor outcomes.

Based on the findings of this study, delayed admission tohospital, respiratory arrest and hyperglycemia were identified as independent risk factors of poor outcome inmethanol poisoning.

Currently, the basis of acute coronary syndrome (ACS) therapy is dual antiplatelet therapy (DAPT) with Aspirin as a nonsteroidal anti-inflammatory drug and clopidogrel as adenosine diphosphate receptor an- tagonists. Therefore, the aim of the present systematic review is to answer that should DAPT with Aspirin and clopidogrel be continued until coronary artery bypass grafting (CABG) in patients who have ACS?

The search for relevant studies in the present meta-analysis is based on three approaches: A) systematic searches in electronic databases, B) manual searches in Google and Google Scholar, and C) screening of bibliography of related original and review articles. The endpoints included mortality rate, myocardial infarction (MI), cere- brovascular accident (CVA), reoperation, re-exploration, other cardiac events, renal failure, length of ICU and hospital stay, chest tube drainage and blood product transfusion after CABG.

After the initial screening, 41 articles were studied in detail, and finally the data of 15 studies were included in the meta-analysis. DAPT before CABG in patients with ACS does not increase the rate of mortality, CVA, renal failure, MI, and other car- diac events, but increases reoperation, re-exploration, length of ICU, and hospital stay. Chest tube drainage and blood product transfusion rate significantly increased in the DAPT group compared to the control group (non-antiplatelet or Aspirin alone). Increase in chest tube drainage and blood product transfusion rate indi- cates an increase in bleeding, so increase in reoperation, re-exploration to control bleeding, and, subsequently, increase in the length of ICU and hospital stay are expected.

DAPT with Aspirin and clopidogrel be- fore CABG in patients with ACS does not increase the rate of mortality, CVA, renal failure, MI, and other cardiac events despite more bleedings, and it may be suggested before CABG for better graft patency.

Methotrexate (MTX) is commonly used in the treatment of diseases such as rheumatoid arthritis (RA) but, its hepatotoxicity potential, always has been a major concern. The aim of this study is to determine the rate of liver fibrosis by transient elastography (TE) method and its relationship with cumulative dose of MTX and duration of treatment, in rheumatoid arthritis patients receiving MTX.

This cross-sectional study included RA patients receiving MTX for more than 6 months. Hepatic fibrosis was determined by TE on the basis of the rate of liver stiffness. The patients were divided into 2 groups according to the results of liver stiffness measurement. Demographic, clinical and biochemical parameters were compared between the two groups. Correlation of the cumulative dose of MTX and duration of MTX treatment with the liver fibrosis was assessed.

The study included 51patients, with a mean age of 52.53)±9.95) years. 44(86.3%) patients were women. The cumulative dose of MTX was less than 4000 mg in 45 (88.2%) patients and more than 4000 mg in 6 (11.8%) patients with a mean treatment duration of 54.14±(40.94) months. The median (IQR) value of liver stiffness was 4.70 (3.60 – 5.50) kPa. The presence of liver fibrosis was detected in 11 (21.6%) patients. There were no significant relationships between liver fibrosis and cumulative dose (P= 0.21) of MTX and also duration of MTX treatment (P= 0. 30). The multivariate analysis demonstrated that only increased serum level of ALT was associated with presence of liver fibrosis (OR = 1.07; 95% CI: 1.01 to 1.13; p = 0.01).

According to the results of this study severe hepatic fibrosis was not common in the patients who had received methotrexate. Increasing the duration of methotrexate administration and the cumulative dose of the drug had no effect on the incidence of hepatic fibrosis. Increased serum ALT levels in RA patients were associated with high rate of liver stiffness and increased risk of hepatic fibrosis.

Hepatocellular carcinoma (HCC) is one of the most common primary hepatic malignancies and growing challenges of global health. In this study, for the first time in Iran, we investigated the 5‑year survival rate and prognostic factors in patients with HCC.

In this historical cohort study, we examined the medical records of 227 HCC patients who were registered in the central tumor registry of our institution from September 2007 to September 2017. Demographic data, clinical parameters, received treatments, and survival curves from time of diagnosis were evaluated. Kaplan–Meier was used for univariate analysis, and multivariable analysis was performed by Cox regression.

A total of 208 (91.63%) patients were dead. The 5‑year survival rate was estimated 19 (8.37%). The average follow‑up in this study was 14.3 months. Overall median survival rate was 12.1 months. Univariate analysis showed that tumor size, metastasis, number of involved lymph node, hepatitis type, and treatment were significantly related to the survival rate, and Cox regression analysis revealed that the tumor size >3 cm (hazard ratio [HR] = 3.06, 95% confidence interval [CI] = 1.68–4.97; P = 0.027), involved lymph nodes >2 (HR = 4.12, 95% CI = 2.66–6.38; P = 0.001), metastasis (HR = 3.87, 95% CI = 3.13–6.54; P = 0.011), combination therapy with surgery and chemotherapy (HR = 0.4, 95% CI = 0.15–0.79; P = 0.023), and coinfection with hepatitis B virus and hepatitis C virus (HR = 2.11, 95% CI = 1.81–4.6; P = 0.036) are the most relevant prognostic factors with 5‑year survival rate in patients with HCC.

Results of this study will help estimate survival rates for patients with HCC according to their clinical status.

Nonalcoholic fatty liver disease (NAFLD) and gallstone disease (GD) are both highly prevalent in the general population and have many risk factors in common. The aim of this study was to evaluate the prevalence of GD in the patients with NAFLD.

In this case-control study, our case group included 145 patients with NAFLD and control group consisted of 215 age-, sex-, and BMI-matched healthy subjects. NAFLD and gallstone disease were diagnosed by sonography. The prevalence and risk factors for gallstone disease were evaluated in the groups and compared between the 2 groups.

The frequency rates of gallstones in the case and control groups were 10/135 (6.9 %) and 5/210 (2.3 %) respectively (p=0.04). The frequency rates of gallstones in the female participants in the case and control groups were 6.8% and 3.4%, respectively, and in the men were 6.9% in the case and 1% in the control groups. We found no significant relationship between sex and frequency of gallstones in both groups (P> 0.05). In the control group, the prevalence rate of GD in the subjects over 50 years of age were significantly higher than that in the subjects under 50 years of age (P = 0.04). However, there was no significant difference between ag e and GD in the case group (P = 0.51). Also, in both groups, the prevalence of GD was significantly higher in obese subjects (BMI> 30) (P> 0.05). There was a significant difference between the grade of fatty liver and the prevalence of GD (P = 0.01). Comparison of the risk factors associated with the GD, showed no significant difference between the two groups.

The prevalence of gallstones was more in NAFLD than in normal population and was associated with grade of fatty liver disease.

Seizure is known to be a serious complication of tramadol consumption even in its therapeutic doses. The aim of this study was to determine the prevalence of seizure and its related factors in tramadol intoxicated patients referred to emergency department (ED).

In this cross-sectional study, all individuals, admitted to ED following tramadol intoxication were divided into two groups based on the presence or absence of seizures. Demographic data as well as clinical, electroencephalogram and imaging findings were compared between the two groups using SPSS software version 22.

167 patients with the median age of 23 (13-45) years were studied (85% male). Seizure was seen in 97 (58.0%) cases. Risk of seizure had increased 3.7 times in patients with a history of seizure (OR: 3.71 Cl 95%: 1.17 - 11.76). Tramadol dose was significantly higher in patients who had seizure more than once (Median: 2800 IQR: 1800-4000), compared to those who had one seizure episode (Median: 850 IQR: 1800-400) (p <0.0001).

Based on the findings of this study, history of seizure increased the risk of seizure in patients taking tramadol, and the increase in dose correlated with a significant increase in seizure frequency.

The present systematic review and meta-analysis aims to investigate the role of Posterior Tibial Nerve Stimulation (PTNS) in the control of fecal incontinence (FI).

Two independent reviewers extensively searched in the electronic databases of Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, CINAHL, and Scopus for the studies published until the end of 2016. Only randomized clinical trials were included. The studied outcomes included FI episodes, FI score, resting pressure, squeezing pressure, and maximum tolerable pressure. The data were reported as Standardized Mean Differences (SMD) with 95% confidence interval.

Five articles were included in the present study (249 patients under treatment with PTNS and 239 in the sham group). Analyses showed that PTNS led to a significant decrease in the number of FI episodes (SMD=-0.38; 95% CI: -0.67-0.10; P=0.009). Yet, it did not have an effect on FI score (SMD=0.13; 95% CI: -0.49-0.75; P=0.68), resting pressure (SMD=0.12; 95% CI: -0.14-0.37; P=0.67), squeezing pressure (SMD=-0.27; 95% CI: -1.03-0.50; P=0.50), and maximum tolerable pressure (SMD=-0.10; 95% CI: -0.40-0.24; P=0.52).

Based on the results, it seems that the prescription of PTNS alone cannot significantly improve FI.

Various studies have shown a correlation between the prevalence of hepatitis A and community health level. The aim of this study was to investigate the seroepidemiology of hepatitis A virus and its related factors in the patients referring to medical diagnostic laboratories in Sanandaj. In this descriptive-analytical (cross-sectional) study we selected 200 individuals referring to medical diagnostic laboratories in Sanandaj from January 2016 to May 2017 - and their serum HAV Ab levels were measured by ELISA method. Demographic data and risk factors for hepatitis A infection were recorded in a questionnaire for every participant. We divided the participants into seropositive and seronegative groups. The groups were compared with each other in regard to demographic characteristics and risk factors for hepatitis A infection. 151 (75.5%) subjects were seropositive including 101 (67%) women and 50 (33%) men. Among different age groups, the highest rate of seropositivity was observed  in 43 patients (28.5%), between 30 and 40 years of age and the lowest rate belonged to 4 (6.2%), individuals between 11 and 20 years of age, which showed a significant difference between different age groups (P = 0.000). The percentage of seropositive patients was significantly higher in the age group of less than one year compared to those in the age groups of 1 to 10 years (P = 0.001) and 11 to 20 years (P = 0.005). There was no significant relationship between the groups in regard to gender, place of residence, education level and occupation (P> 0.05). The results of multivariate regression analysis showed that the presence of underlying diseases resulted in a 3 fold increased risk of hepatitis A (OR: 2.71; Cl 95%: 1.13 - 6.48). Comparison of the other risk factors showed no significant relationship between the two groups. Considering the association of this antibody with increasing age, determination of the serum level of this antibody in different parts of the country by public health organizations at different time intervals and in different age groups seems necessary. Also, considering the correlation between underlying diseases in susceptible individuals and antibody- positivity and also the importance of vaccination, close attention of these organizations to this issue is necessary.

Mesenchymal stem cells (MSCs) are widely used in pre-clinical and clinical studies for its highest potentials such as availability, pluripotency, growth factor secretion, and lesser ethical limitations. Among different sources of MSCs, human adipose derived stem cells (hADSCs) because of the easy and safe isolation, produce high level of cytokines such as angiogenic factor, and confirmed safety and efficacy in clinical trials, it has become more acceptable in the last decade.(1-4)
In the regenerative medicine, scientists usually looking for the best and most efficient source of stem cell. We have been working on the extraction and cultivation of hADSCs since 2010 (5-10) and noticed that the growth rate and proliferation of these cells seem to be far higher in winter than in other seasons. In addition, it is possible that the secretory function of hADSCs in winter is higher, too. A Possible explanation for this phenomenon may be related to higher adipose tissue metabolism during winter for energy homeostasis and thermal regulation.(11) Thus, high activation of adipose tissue could be reflected in hADSCs. Acceptance or rejection of this hypothesis needs further in vitro studies to clarify the effect of season on the quality and proliferation of the cultured hADACs.
Whenever this hypothesis is confirmed, it is a very pivotal point in the extraction and processing of hADSCs. If these cells are extracted in the season with the most growth and secretion activity, the best results in the regenerative medicine can be achieved through the transplantation of hADSCs. Therefore, designing and performing comprehensive studies is recommended to determine the variables that affect the achievement of the best and most effective hADSCs production.
The study will be designed and performed as in vitro by choosing a reasonable sample size for adipose sampling. Sampling and isolating of hADSCs will be done in four times, in 15th middle month of each season. It will be done matching method in order to adjust confounders such as demographic information, age, sex, disease, body mass index, extraction of cells time, etc.
The evaluated outcomes can be considered in accelerating of the cell proliferation by recording the time elapsed between the two consecutive passages, number of cell passages without entering the aging stage and amount of secretory activity of the cells (by western blotting-specific cytokines for each sample in each season). Finally, the information is compared between the samples of each season.

Some controversy exists about the role of cecostomy in the management of fecal disorders. The present meta-analysis aims provide a comprehensive evaluation on the role of cecostomy on management of fecal incontinence and constipation in children.


An extensive search was performed on the Medline, Embase, Scopus, and Web of Science until July 2017. Two independent researchers screened the title and abstracts of the studies and then relevant studies were included. Finally, pooled effect size was presented as standardized mean difference (SMD) or pooled prevalence with 95% confidence interval (95% CI).


14 articles were entered (740 children). The success rate of cecostomy in management of fecal disorders was 90.6% (success rate=90.6%; 95% CI: 86.4 to 94.2). The most common side effects of this technique include granulation tissue formation (29.6%), cecostomy tube leakage (8.5%), tube dislodgement (7.0%), and tube site infection (2.3%).


The results of the present meta-analysis show that the cecostomy is safe and an effective technique in the management of fecal disorder in children. However, the findings presented on the eligible articles have have shown a low level of evidence and it is suggested that clinical trials should be conducted in this field.

Zinc phosphide (ZnP) is low-cost, accessible, and very effective as a rodenticide. It has been used for many human suicide poisonings around the world, including Iran. Nonspecific gastrointestinal symptoms and cardiotoxicity are the most serious complications of ZnP poisoning, which are associated with a high mortality rate. The aim of this paper was to report a poisoned patient that ingested ZnP with suicidal attempt and faced complications due to hemolysis.

Ubiquitin C-terminal hydrolase-L1 (UCH-L1) is one of the promising candidates, with an accept-able diagnostic value for predicting head computed tomography (CT) scan findings. However, there has beena controversy between studies and still, there is no general overview on this. Therefore, the current system-atic review and meta-analysis attempted to estimate the value of UCH-L1 in predicting intracranial lesions intraumatic brain injury (TBI).

Two independent reviewers screened records from the search of fourdatabases Medline, Embase, Scopus and Web of Science. The data were analyzed in the STATA 14.0 statisticalprogram and the findings were reported as a standardized mean difference (SMD), summary receiver perfor-mance characteristics curve (SROC), sensitivity, specificity, and diagnostic odds ratio with 95% confidence in-terval (95% CI).

Finally, the data of 13 articles were entered into the meta-analysis. The mean serumlevel of UCH-L1 was significantly higher in patients with CT-positive than in TBI patients with CT negative (SMD= 1.67, 95% CI: 1.12 to 2.23, I2 = 98.1%; p <0.0001). The area under the SROC curve for UCH-L1 in the predic-tion of intracranial lesions after mild TBI was 0.83 (95% CI: 0.80 to 0.86). Sensitivity, specificity and diagnosticodds ratio of serum UCH-L1 was 0.97 (95% CI: 0.92 to 0.99), 0.40 (95% CI: 0.30 to 0.51) and 19.37 (95% CI: 7.25to 51.75), respectively. When the analysis was limited to assessing the serum level of UCH-L1 within the first 6hours after mild TBI, its sensitivity and specificity increased to 0.99 (95% CI: 0.94 to 1.0) and 0.44 (95% CI: 0.38to 0.052), respectively. In addition, the diagnostic odds ratio of 6-hour serum level of UCH-L1 in the predictionof intracranial lesions was 680.87 (95% CI: 50.50 to 9197.97).

Moderate level of evidence suggeststhat serum/plasma levels of UCH-L1 have good value in prediction of head CT findings. It was also found thatevaluation of serum/plasma level of UCH-L1 within the first 6 hours following TBI would increase its predictivevalue. However, there is a controversy about the best cutoffs of the UCH-L1.

One of the most important causes of chronic liver disease is hepatitis C virus (HCV), which causes liver cirrhosis and hepatocellular carcinoma. To control the prevalence of the disease, knowledge and information in risk factor of HCV are required. The aim of this study was to compare the risk factors of infection between HCV patients with genotypes 1a and 3a.
This is an observational analytical study. HCV patients who referred to the clinic of hepatology, Rasoul-e-Akram University Hospital from July 2015 to July 2017, were assigned to the genotype 1a and 3a. Demographic (age, sex, family history), clinical (cirrhosis, hepatocellular carcinoma) and laboratory data, history of intravenous drug and alcohol usage, and history of imprisonment were gathered and compared between two groups. All the patients completed the informed consent form. Data analysis was performed by SPSS software, version 22 (IBM SPSS, Armonk, NY, USA). P value less than 0.05 was considered statistically significant.
Overall, 97 HCV patients were included in this study. Mean age was 45±12 years and 78 (80%) of patients were male. Among them, 58 (60%) and 39 (40%) had genotype 1a and 3a. respectively. History of injection drug usage was recorded in 34/39 (87%) of patients with genotype 3a, and significantly higher in genotype 3a as compared to genotype 1a [OR adj: 3.1, CI (1.3-6.2)]. Also, in this study, genotype 3a was significantly recorded in younger patients [OR adj: 1.7, CI (1.2-4.1)]. However, cirrhosis and hepatocellular carcinoma was more common in patients with genotype 1a as compared to genotype 3a [OR adj: 2.05, CI (1.6-5.4) and OR adj: 2.8, CI (1.3-5.7)] respectively.
According to the results of this study, hepatitis C virus transmission risk factors differed in genotypes 3a and 1a. Genotype 3a is found among young patients with a history of intravenous drug usage and genotype 1a in patients with cirrhosis and hepatocellular carcinoma.

esenchymal stem cells (MSCs) are interested to more than other cells and human adipose derived stem cells (hADSCs) more than other types of MSCs due to pluripotency, secretion of different growth factors, high angiogenic factor secretion, high immunity, and fewer ethical problems during In vitro, pre-clinical and clinical studies (1-12) . In the field of regenerative rehabilitation, one of the main goals of the scientists always has been to achieve the best and most efficient type of stem cell. Choosing the appropriate source for extracting these cells is undoubtedly important in achieving the best and most efficient cell. Because fatty tissue in humans is two types of white and brown, the basic question is: hADSCs are extracted from which fat types have the most effective therapeutic action in repair of different tissues? Because fatty brown tissue is metabolically more active than white adipose tissue (13) it may that stem cells extracted from fatty brown tissue are also likely to be more active. The rejection or confirmation of this hypothesis surely is not possible without performimg of in vitro studies to compare the stem cells extracted from brown and white adipose tissue. If this comparison is done, the results of it are a very important point in the extraction and processing of hADSCs. Therefore, it is recommended to design and conduct exact studies to compare stem cells extracted from brown and white adipose tissue.

Phenylketonuria (PKU) occurs due to a mutation in the gene encoding phenylalanine hydroxylase, which results in inability to convert phenylalanine into tyrosine. DNA methylation is an important epigenetic modification of the genome. Many human diseases have been detected to be related to aberrant DNA methylation. Investigating the leukocytes of PKU patients exposed to phenylalanine has shown a wide range of methylation, which indicates DNA methylation changes as a biochemical marker. In this article, we reviewed evidence of DNA methylation in pathophysiology of PKU.

When an abscess is drained, either spontaneously or surgically , the pathway to the infection remains and is lined with epithelial tissue and leads to the formation of anal fistulas. The treatment of fistulas remains a serious challenge for colorectal surgeons with varying degrees of success because extensive surgery to complete control complex fistulas results in fecal incontinence. One of the most recent non-surgical methods is cell therapy, clinical trials for which are ongoing in the third phase. In this method, stem cells with different sources are used to control inflammation and replace the lost tissue in the fistula tract. Therefore, the purpose of this narrative review is to review cell therapy in treatment of anal fistulas along with its weaknesses and strengths. Finally this review of existing studies for anal fistulas suggests that until now, only two sources of stem cells , in both allogeneic and autologous forms, have been used in clinical trials for treatment of anal fistulas: adipose tissue and bone marrow (mainly adipose tissue) and except for the two Phase III clinical trials in 2012 and 2016, all clinical trials in this field were conducted in phase one and two with the aim of determining the safety and efficacy of these cells.