فهرست مطالب elham zarei

Current data indicate that serum vitamin D and susceptible C-reactive protein (hs-CRP) levels, both indicative of the inflammatory state, have the potential to predict the onset and severity of chronic pain. Therefore, the objective was to assess the intensity of pain experienced after breast cancer treatment and its relationship with these two parameters.
In this cross-sectional study between 2019 and 2021, 201 patients were enrolled. The McGill Pain Questionnaire was employed to evaluate localized pain intensity at the site six months after the conclusion of cancer treatments. Patients were stratified based on the type of breast surgery, with or without a tissue expander, axillary region surgery, chemotherapy treatment, radiotherapy treatment, serum vitamin D levels, serum hs-CRP levels, and pain intensity. Data analysis was performed using SPSS 21 software with a significance level set at 0.05.
Among the patients, 67.6% (136 individuals) reported mild pain, 31.3% (63 individuals) reported moderate pain, and 1% (2 individuals) reported severe pain. The results of this study demonstrated a positive correlation between high serum hs-CRP levels and increased pain intensity, with serum marker levels being higher in patients experiencing more severe pain compared with those with milder pain. However, no statistically significant association was observed between various serum concentrations of vitamin D and pain intensity (P = 0.12).
Elevated levels of inflammatory factors, such as hs-CRP, are linked to a higher likelihood of developing chronic post-surgical pain.

Uterine sarcomas (US) represent a rare and heterogeneous spectrum of tumors characterized by diverse clinical behaviors and tumor responses. This study aims to assess patient and tumor characteristics and oncologic outcomes. This historical cohort study encompassed all patients with histologically confirmed diagnoses of the US who were referred to two oncology centers affiliated with Mashhad University of Medical Sciences (Iran) between March 2011 and April 2020. Data analyses were conducted using STATA version 14.02. Survival estimation was carried out utilizing the Kaplan-Meier method. The significance level was established at 0.05. A total of 33 patients were included in this study, comprising 23 with US and 10 with carcinosarcoma (CS). The mean age was 49.3 years for CS and 62.4 years for US (P = 0.0001). Nearly all patients were overweight, with a mean body mass index of 27.1 (confidence interval: 25.6-28.7). The majority of patients were diagnosed at an early stage. The Federation of Gynecology and Obstetrics (FIGO) stage, patient's anemia, and surgical resection were identified as significant prognostic factors. The median overall survival was 50.88 ± 5.7 months. The survival rates at 2, 3, and 5 years were 75%, 56%, and 41%, respectively. No significant difference was observed between CS and US regarding overall and disease-free survival. Despite the typical early-stage diagnosis for US patients, the 5-year survival rate remains low. This study underscores the pivotal role of FIGO stage, tumor size, and surgical resection as vital prognostic factors for survival.

 Despite the COVID-19 pandemic, there is little information about the different clinical aspects of COVID-19 in children. In this study, we assessed the clinical manifestations, outcome, ultrasound, and laboratory findings of pediatric COVID-19.

 This retrospective study was conducted on 185 children with definitive diagnosis of COVID-19 between 2021 and 2022. The patients’ information was retrieved from hospital records.

 The average age of the patients was 5.18 ± 4.55 years, and 61.1% were male. The most frequent clinical manifestation was fever (81.1%) followed by cough (31.9%), vomiting (20.0%), and diarrhea (20.0%). Mesenteric lymphadenitis was common on ultrasound and found in 60% of cases. In-hospital death was identified in 3.8% of cases. The mean length of hospital stay was 8.5 days. Mandating intensive care unit (ICU) stay was found in 19.5% and 5.9% of cases were intubated. Acute respiratory distress syndrome (ARDS), lower arterial oxygen saturation, higher white blood cell (WBC) count, and higher C-reactive protein (CRP) were the main determinants of death. Lower age, respiratory distress, early onset of clinical manifestations, lower arterial oxygen saturation, lower serum hemoglobin (Hb) level, and higher CRP level could predict requiring ICU admission.

 We recommend close monitoring on CRP, serum Hb level, WBC count, and arterial level of oxygenation as clinical indicators for potential progression to critical illness and severe disease. Mesenteric lymphadenitis is a common sonographic finding in pediatric COVID-19 which can cause abdominal pain. Ultrasound is helpful to avoid unnecessary surgical interventions in COVID-19.

Cancer diagnosis is a threatening and traumatic experience. Confusion caused by distressing thoughts about cancer can lead to additional suffering and, along with avoidance, can be a key factor in maintenance of traumatic reactions. The current research aimed at comparing the effectiveness of Unified Protocol (UP) of transdiagnostic intervention and mindfulness based schema therapy (MBST) on posttraumatic avoidance (PA) and chronic illness-related cognitive fusion (CICF) in patients with breast cancer (BC).

A semi-experimental study with pretest-posttest design and a follow-up period of 45 days was performed. Statistical population included all female patients with BC in Mashhad, Iran 2018-2021. Cognitive Fusion Questionnaire-Chronic Illness (CFQ-CI) and Posttraumatic Avoidance Scale (PAS) were administered. Forty one patients were selected using purposive sampling and were randomly divided into two experimental groups and a control group. UP of transdiagnostic intervention and MBST were applied in intervention groups for 10 weekly sessions. The control group attended two educational sessions. Data analysis was done using multivariate covariance analysis and Bonferroni post hoc test.

The mean scores for CICF and PA were significantly different between the intervention groups and the control group at post-test and follow-up (P<0.001). Findings showed no significant difference between the effectiveness of UP and MBST at post-test and follow-up (P>0.05).

MBST and UP are suggested to be applied in patients with BC to reduce their psychological problems.

Brain glioblastoma multiforme with leptomeningeal metastasis is a rare medical condition. Although autopsy series have demonstrated a higher incidence of leptomeningeal metastasis, it is usually a late complication in the course of the disease. The disease progression is almost always rapid, resulting in a poor performance status and short survival. There is no single standard treatment but different individualized choices including chemotherapy (standard, anti-angiogenic, intrathecal, immunotherapy), and radiation have been utilized. In this manuscript, we report a male patient with glioblastoma multiforme of left prefrontal lobe that presented with concomitant cervical leptomeningeal metastasis. Because of poor performance, he received hypofractionated radiotherapy of brain and cervical spine which consisted of a total dose of 45 Gy in 10 fractions with 300c Gy per fraction and 30 Gy local boost to the areas of enhancement. Despite this treatment, there was no response and the patient died three days after the completion of the treatment.

 Differentiation of patients with central precocious puberty (CPP) from healthy individuals and patients with CPP-like conditions [isolated premature thelarche (IPT) and isolated premature adrenarche (IPA)] is important for selecting an appropriate treatment. The gonadotropin-releasing hormone stimulation test is used as the gold standard for differentiating CPP from other conditions. Despite its high specificity, this test has disadvantages, such as low sensitivity, time-consuming sampling, and need for multiple blood samples.

 This study aimed to investigate the use of pelvic ultrasonography (US) and its parameters in distinguishing CPP patients from those with similar conditions and healthy individuals.

 In this case-control study, a total of 183 patients, who were referred to the endocrinology department of Ali Asghar Hospital in Tehran, Iran for the evaluation of CPP, were recruited cconsecutively from 2015 to 2019. All the participants were Iranians and classified based on the clinical and laboratory findings. Pelvic US parameters were evaluated in all groups. One-way analysis of variance (ANOVA) was used to compare the mean values of continuous variables between the groups. Moreover, a post-hoc test was performed for pairwise comparisons between the groups if the result of ANOVA test was statistically significant. Finally, the receiver-operating characteristic (ROC) curve analysis was performed to determine the best cutoff points for US parameters.

 Of 183 children, 62 were allocated to the control group (33.87%), 93 to the CPP group (50.81%), 16 to the IPT group (8.74%), and 12 to the IPA group (6.55%). The results showed no significant difference between the groups regarding chronological age and body mass index, while the bone age (107.76 ± 19.81 months) (P < 0.001) and height (129.53 ± 8.97 cm) were significantly higher in the CPP group compared to the other groups (P = 0.003). All US parameters were significantly different between the CPP and control groups. There were also significant differences between CPP patients and those with IPT and IPA in terms of all parameters, except for the cervical anteroposterior diameter and ovarian volume. The best parameters for differentiating CPP from other conditions were the uterine volume (cutoff value, 1.40; 75.27% sensitivity; 75.56% specificity), uterine transverse diameter (cutoff value, 13.5 mm; 72.04% sensitivity; 71.11% specificity), and fundus/cervix (F/C) ratio (cutoff value, 0.98; 78.49% sensitivity; 70% specificity).

 The pelvic US parameters can improve the diagnosis of CPP and play an auxiliary role in distinguishing the treatment needed. Based on the findings, the best diagnostic parameter and its cutoff value can vary depending on ethnicity and type of study.

Vesicoureteral Reflux (VUR) is a common urinary tract disorder among pediatric population and defined as the retrograde flow of urine from the bladder into the ureters and renal collecting systems due to a failure in the ureterovesical valve function (1). Identifying children with VUR at an early age provides an opportunity to prevent episodes of acute pyelonephritis and the consequent renal scarring (2) . Voiding cystourethrography (VCUG) is the modality of choice for diagnosis and grading of VUR (3). In VCUG, the child is catheterized and radiocontrast material is injected through the catheter to fill the bladder (3). Disadvantages of this procedure are catheterization discomfort, complications and considerable radiation exposure of the children who are relatively more vulnerable to the adverse effects of ionizing radiation. In addition, the risk of carcinogenesis is higher in children as they have a longer life expectancy following the procedure than adults (4). Considering the mentioned disadvantages of VCUG, many attempts have been made to find a non-invasive alternative modality with adequate accuracy to detect VUR. Ultrasound (US) is a proper modality for evaluation pediatric urinary tract system due to its accuracy, accessibility and non-invasiveness (5, 6). However, there is controversy among clinicians regarding the accuracy of US for diagnosis of VUR. VCUG allows grading of VUR using the five-level International Reflux Scale (IRS). Grade of VUR is strongly associated with the outcomes such as spontaneous resolution, recurrence of UTI and renal scarring (7). Recent guidelines recommend clinical decision-making based on the grade of VUR on VCUG, including observation (without medical therapy) for selected children with grade I or II VUR But higher grades of VUR need medical or surgical interventions (7, 8). The diagnostic accuracy of VCUG for diagnosing reflux is very high and nearly 100% for high-grades of reflux (grade III -V) (9).The objective of our study was to determine the accuracy of ultrasound for detecting VUR in comparison with VCUG in children with UTI.

In this cross-sectional study, the total numbers of 540 children younger than  8 years old with UTI referred to Ali-Asghar children’s hospital, a pediatric center in Tehran, Iran were enrolled, from April 2017 to May 2019. All patients underwent US and VCUG to detect VUR.All patients with obstructive nephropathy were excluded from the study. US was performed immediately after diagnosis, and VCUG were performed after the resolution of fever and confirmation of a negative urine culture.US was performed by a single radiologist using a Philips Affiniti 50 ultrasound machine  with 4–7 MHz convex  and  7-10 MHZ linear transducers with the bladder being both full and empty. The most important ultrasonographic findings related to VUR, were dilatation of the renal pelvis or the ureter. Additionally, changes in kidneys size and cortical echogenicity, reduction in the thickness of renal parenchyma, irregularity of the kidneys margin, and increase of urothelial thickening were also noted.Grading system for VUR on VCUG is according to the International Reflux Study Committee:o   Grade I: reflux into the ureter;o   Grade II: reflux into the ureter and renal pelvis without dilatation;o   Grade III: reflux with mild dilatation;o   Grade IV: reflux with moderate dilatation, rounded fornices;o   Grade V: gross dilatation of the ureter, ureter tortuosity, papillary obliteration.Grades I and II were classified as low grade and grades III, IV, and V as high grade reflux (7).We used the mean and standard deviation and percent for reporting the descriptive statistics of quantitative and qualitative variables, respectively. Qualitativevariables were compared using the Chi square test and one way analysis of variance (One-way ANOVA) was used to compare the mean of quantitative variables. We used the sensitivity, specificity, positive predictive value, negative predictive value, overall accuracy and kappa agreement coefficient to investigate the efficacy of US for prediction of VUR based on the actual presence or absence of VUR confirmed by VCUG. Data was analyzed using Stata software, version 12 (StataCorp, TX) and p-value <0.05 was considered as the level of significant.

Among 572 patients evaluated for VUR, 540 patients entered our study. A total of 269 (49.8%) were boys and 271(50.2%) were girls. All patients underwent VCUG and US. Mean age of children who had VUR was 2.5 years old. Fifty-three cases (37%) had low-grades and 90 cases (63%) had high-grades of VUR. US was abnormal in 97 of 143 patients (67.8%) with confirmed VUR on VCUG and in 163 of 397 cases (41%) without VUR on VCUG.The overall sensitivity and NPV of US for detecting VUR were 67.83% and 37.31%, respectively. Among 90 children with high-grade VUR (grade III–V) on VCUG, 72 (80%) had abnormal findings on US and sensitivity and NPV of US among these cases, were 88% and 93.6 % respectively. All cases of grade V and 83.9% of grade IV VURs had abnormal US findings.

There is considerable interest in prompt and early detection of VUR as it is linked to recurrent UTIs, renal scarring and renal insufficiency. VCUG is the modality of choice for detecting VUR (10, 11). However, owing to some disadvantages such as bladder catheterization and pediatric radiation exposure, there is a growing interest in finding alternative and less invasive methods with acceptable accuracy to detect VUR (12). In this study, we evaluated the accuracy of US in predicting VUR among children hospitalized with UTI. Several studies have evaluated the efficacy of US in diagnosis of VUR and their results have been conflicting with some reporting unreliability of ultrasound in evaluation of VUR.Mehnat and colleagues showed that the sensitivity and specificity of US for detecting VUR were 40% and 76%, respectively and demonstrated that renal US was neither sensitive nor specific for detection of VUR in children with a first-time UTI (11). In another investigation, Adibi and colleagues demonstrated the sensitivity, specificity; NPV and PPV of US in diagnosis of VUR were 70.9%, 51.4%, 69.6% and 52.9% respectively. They suggested that US is a sensitive but not specific method in diagnosis of VUR (12). In a review article in 2016, Shaikh N. and colleaguesconcluded that US could not replace VCUG in detecting VUR.On the other hand, some studies reported that US is a reliable modality for evaluation of VUR (3). Hey-young Lee and colleagues demonstrated that 95.3% of high grade VUR cases could be detected by US . However, they also stated that the diagnosis of VUR by US had some limitations in cases of low-grad VUR and detection ratio of these cases was only 62.5% (13).Similar to other investigations, we found that sensitivity and specificity  of US to detect low-grade VURs are low (respectively 67.83% and 58.94%). However for high-grade VURs, the sensitivity (88%) and NPV (93.6 %) of US are acceptable. Regarding high frequency of spontaneous resolution of low grade VUR whilechildren grow up, it can be recommended that VCUG be performed only in children with abnormal findings on US, avoiding many unnecessary VCUG procedures.Although ultrasound is not sufficiently accurate to detect all grades of VUR, but has enough sensitivity and NPV for ruling out high-grade VUR. So avoiding unnecessary VCUG in children with normal ultrasound finding is recommended.

Atypical teratoid/rhabdoid tumor (AT/RT) is a very rare tumor, mostly found in the posterior fossa of children aged under three years. Combined modality treatment appears to improve the results. Herein, this report aimed to present a case of intramedullary intradural AT/RT of the anterior thecal sac in a 17-year-old girl with subtotal resection by undergoing adjuvant radiotherapy and sequential chemotherapy.

Ever since coronavirus disease 2019 (COVID-19) has emerged as a global public health problem, risk factors for severe disease have been reported in studies from Western countries. However, apart from studies of Chinese origin, few reports are available on COVID-19 severity among the Asian population. This study investigates potential risk factors for development of critical COVID-19 in an Iranian population.

In this retrospective cohort study, we included all adults with COVID-19 from 2 tertiary centers in Iran who had been diagnosed between February 20 and April 1, 2020, in either inpatient or outpatient settings. “Critical COVID-19” was proposed when a hospitalized patient was scheduled for admission to intensive care unit, assisted by mechanical ventilation, or pronounced dead. We used univariable and multivariable logistic and linear regression models to explore the potential risk factors associated with critical COVID-19, admission to hospital, and length of hospital stay.

Of the 590 recruited patients, 427 (72.4%) were hospitalized, 186 (31.5%) had critical COVID-19, and 107 (18.2%) died. In the multivariable regression analysis, age  >60 years and physical/mental disabilities were associated with critical COVID-19 (odds ratio (OR), 2.33 and 7.03; 95% CI, 1.51-3.60 and 2.88-17.13, respectively); and history of renal, heart, or liver failure was associated with both COVID-19 hospitalization (OR, 4.13; 95% CI 1.91-8.95; p<0.001) and length of hospital stay (Beta 1.90; 95% CI, 0.76-3.04; p=0.001).

Age >60 years and physical/mental disabilities can predict development of critical COVID-19 in the Iranian population. Also, the presence of renal, heart, or liver failure might predict both COVID-19 hospitalization and length of hospital stay.

The European corn borer, Ostrinia nubilalis Hübner, is one of the most important pests of corn. In this study, the influences of corn monoculture (C), sainfoin monoculture (S) and strip-intercropping of corn with sainfoin in the four row ratios: 2C:2S, 2C:4S, 2C:6S and 2C:8S were evaluated on the population density of the European corn borer, diversity and abundance of its natural enemies and yield of both crops in an experimental field during 2016 and 2017. Our results indicated that the densities of eggs and larvae of this pest decreased significantly in the intercrops especially in 2C: 6S and 2C: 8S compared with corn monoculture. The Shannon diversity index (H´) for predators in the intercrops was significantly greater than that in the corn monoculture. Moreover, the percentage of parasitized eggs and larvae were higher in the intercrops, especially in 2C:6S and 2C:8S, compared with the corn monoculture. Furthermore, the percentage of infested plants was also lower in 2C:6S and 2C:8S compared with the other treatments. On the other hand, high values of land equivalent ratio were found in 2C:6S (1.16 in 2016 and 1.15 in 2017) and 2C:8S (1.17 in 2016 and 1.16 in 2017). Therefore, it could be concluded that 2C:6S and 2C:8S intercrops are useful in integrated management of the European corn borer in the field.

Hydatid disease is a parasitic infection mainly caused by Echinococcus granulosus and is endemic in many parts of the world. Although hydatid disease can be found anywhere in the human body, the liver and lungs are the most commonly involved organs. Urinary tract involvement has been seen in about 2% - 4% of the cases; however, the isolated renal cyst is extremely rare. Here, we report a 5-year-old boy with an isolated huge renal hydatid cyst with no scolices or hooklets in aspirated fluid mimicking a simple renal cyst. The clinicians and radiologists should consider hydatid disease in the differential diagnosis of cystic lesions found in any part of the body especially in endemic countries since earlier diagnosis is crucial for appropriate treatment.

Normal cephalogram parameters seem to be gender discriminative and thus applicable in forensic medicine. We assessed validity of cephalogram parameters in gender identification among the Iranian population. This cross-sectional study was conducted on 75 Iranian men and 75 Iranian women aged 25 to 54 years. On their first admission, the physicians requested for simple lateral skull X-ray for all participants. Using area under the ROC curve, gonion-gonion index (AUC=0.741) and vertex- mention index (AUC=0.697) had a moderate value to discriminate male from female gender, while other parameters lacked enough power to differentiate gender. The best cut-off point in gonion-gonion index for discriminating male from female gender was 103.75 with a sensitivity of 74.7% and a specificity of 65.3%. Also, the best cut-off value for vertex-mention index to differentiate two genders was 244.75 with a sensitivity of 74.7% and a specificity of 62.7%. By considering two parameters of gonion-gonion and vertex-mention, it is possible to differentiate males from females with a sensitivity of 82.6% and a specificity of 71.8%. The two gonion-gonion and vertex-mention indices on cephalogram are applicable for gender discrimination.

  Alfalfa (Medicagosativa L.) is a high-quality forage crop widely grown throughout the world. This plant is attacked by a wide range of pests.Alfalfa weevil, Hyperapostica(Gyllenhal) (Coleoptera:Curculionidae), is a pest of concern in alfalfa on the globe. This introduced pest is most problematic in the early season, causing defoliation and reduced yield and quality. Both adults and larvae feed on alfalfa, but the larvae cause the majority of the damage to terminals, foliage, and new crown shoots. This pest has many natural enemies. Among the beneficial insects, the green lacewing, Chrysoperlacarnea (Stephens) (Neuroptera: Chrysopidae), has received special attention since its larvae are important natural enemies of alfalfa weevil. The control of H. postica was done by chemical pesticides .There is now overwhelming evidence that some of these chemicals do pose a potential risk to humans and other life forms and unwanted side effects to the environment. Palizin (Coconut soap) is a natural compound based coconut extract. In the current research work, the effect of this compound on the adult of H. postica and egg and 1st instars larvae of C. carnea was investigated under laboratory and field conditions. postica: H. postica larvae were collected from alfalfa fields in Miandoab using sweep nets in July 2016 and taken to the laboratory. Larvae were placed in plastic dishes (5 × 10 × 20 cm), fed by alfalfa foliage, and held at 25 ± 2 °C, 75±5% RH to complete their growth and convert to adults. The adults were used for all tests. C. carnea adults were collected from alfalfa field at the Miandoab region, taken to the laboratory for identification of species and reared in the laboratory. Clear plastic cylinder containers (with 15 cm diameter × 25 cm height), which were covered with a mesh cloth were used for rearing. A thin layer of food source (mixture of yeast 50%, water 25% and honey 25%) was smeared to a plastic tape which was inserted into the plastic container. Water was provided for the adults through a wet sponge placed on the mesh cloth. To harvest the eggs, the adults were transferred to fresh containers every day. The eggs were laid on a colored paper which was attached to the interior wall of the cage. The eggs hatched after 3 days and the first larvae were used for bioassay. First, primary experiments were performed to determine the minimum and maximum concentrations. Afterward, seven concentrations and also control were considered. Concentrations used for Palizin were 400, 543, 737, 1000, 1357, 1842 and 2500 ppm and for Fenvalerate were 200, 265, 353, 468, 622, 827 and 1200 ppm. Adult were kept at 4 °C to be inactive. Then, 15 adults were release on the petri plate (with 9cm diameter and 1.5 cm height). Using spray potter tower, 500 microliter of each concentration was sprayed on the petri and the dishes were placed in a growth incubator at 25±2˚C, 65±5% RH. To evaluate the recommended concentrations (2500 ppm Palizin and 1000 ppm Fenvalerate), an experiment was conducted in a randomized complete block with three treatments and five replications under field conditions. The number of H. postica (adults and larvae) and C. carnea (larvae) was counted day before and 3, 7, 14 and 21 days after treatment. Statistical analyses: The mortality results were analyzed using SPSS data processing software. Significant differences among the groups were determined using the unpaired Duncan-test in 5 % level of significance.The percentage of population reduction in the treatments was corrected in relation to the control (water) by Henderson and Tilton’s formula under field condition. Insecticides may be a good option if other options have not sufficiently controlled alfalfa weevil. Several com mercially available products are labeled for control of alfalfa weevil. Although effective, their repeated usagehas disrupted natural biological control systems and led to resurgence of this pest, resulted in the development of resistance and had undesirable effects on no target organisms. In order to prevent resistance, effective chemical control of the pest requires new insecticides with novel modes of action. In laboratory condition, the LC50 values of Palizin and Fenvalerate on H. postica were 601.72 and 321.87 ppm 24 h after treatment, respectively. Toxicity of Fenvalerate for egg and 1st instars larvae of C. carnea was higher than Palizin. The LC50 values of this insecticide were 563.02 and 178.46 ppm and the LC50 values of Palizin were 1664 and 1663 ppm. The results of field trial showed that Palizinhas a longer persistency effect. According to IOBC standards, Palizin and Fenvalerate were categorized as slightly toxic and very toxic to C. carnea, respectively. The plant pesticide used in this research caused the high mortality on the adults of H. posticawith proper persistency. In addition, its toxicity is less than Fenvalerate to C. Carnea and can be applied as an effective alternative to chemical insecticides in alfalfa fields.

Polycystic Ovarian Syndrome (PCOS) is considered as a metabolic disorder and it is one of the most common endocrine and heterogeneous disorders with complex pathogenesis among women in reproductive ages. This study was done to evaluate the accuracy of diagnosis of lipid accumulate product index (LAP), insulin resistance, waist circumference and waist to hip ratio in women with polycystic ovary syndrome.
In this case control study, antropometrics, biochemical parameters, LAP and insulin resistance in 43 women suffering from PCOS as case and 40 healthy women as control were measured. Body mass index (BMI), waist hip ratio (WHR) and waist circumference (WC) was determined for each subject. LAP was defined as [WC (cm)-58´TG (m mol/L)]. PCOS was diagnosed according to Roterdam standard .Insulin resistance was defined based on Homeostatic model assessment – insulin resistance (HOMA-IR).
The mean age, BMI, WHR and LAP index, among PCOS women were 24.06±5.86, 26.61±4.34, 0.81±0.061 and 47.13±4.13, respectively. There was a direct and significant correlation between HOMA-IR index and BMI, WC and LAP in case group (P The WC, BMI and LAP indices are useful in screening the insulin resistance in patients with PCOS.

Candida is one of the common causes of infections in late sepsis of very low birth weight neonates. The outcome ranges from a mild focal disease to a fatal septicemia and multi-organ dysfunction.
Acute renal failure was found in a seven-week-old preterm infant due to bilateral renal fungal balls and hypoplastic renal pelvises. He had previously been treated with courses of broad-spectrum antibiotics for respiratory distress and sepsis during the first weeks of life. The infant did not respond to standard antifungal therapy and needed surgical removal of fungal balls from his kidneys, open nephrostomy tube placement and pyeloplasty.
Obstructive uropathy by fungal balls is rare and acute renal failure as a result of bilateral obstructive uropathy due to fungal balls requires early detection and prompt treatment to salvage the kidney function.

Autosomal recessive polycystic disease (ARPKD) is a heritable but phenotypically variable disorder characterized by varying degrees of nonobstructive renal collecting duct ectasia, hepatic biliary duct ectasia and fibrosis of both liver and kidney. The phenotypes of the ARPKD are distinguished by the age of the diagnosis at presentation and the predominance of renal over hepatic manifestations or vice versa. Sonography is currently the imaging technique of choice in children with renal cystic disease. Classic ARPKD is evident at birth with symmetrically enlarged kidneys with increased Parenchymal echogenicity at ultrasound with using a curved array transducer. In previous reports, nephromegaly is a constant imaging finding at the time of diagnosis. Asymmetrical enlargement has only been reported in one case report and the current case report is the second observation in this regard.
A preterm neonate with suspicious RT renal mass and oligohydramnios at prenatal ultrasound was hospitalized due to respiratory distress and hypertension. Although postnatal ultrasound showed enlarged echogenic Rt kidney and normal sized echogenic Lt Kidney, regarding to linear array transducer findings, ARPKD was considered rather than renal mass. The diagnosis was confirmed after nephrectomy and histologic examination.
Because the abnormality in ARPKD affects the renal tubules, high resolution sonographic techniques with linear array transducer are well suited to the imaging of this disease. Although, the patient showed asymmetric renal enlargement, unique findings on linear array transducer help to diagnosis of ARPKD regardless of renal size. Also, the finding of asymmetric renal enlargement in this patient adds another radiologic finding that could be associated with ARPKD.

Although preventative nephrology is the effective management of childhood kidney diseases, it is hard to provide it in this undesirable conditions. In this study, we aimed to document the kidney disease profile of Syrian refugee children admitted to our hospital.
One hundred and thirty Syrian refugee children were admitted to the Pediatric Nephrology Department of the University of Gaziantep from September 2012 to January 2015. Demographic data, history, symptoms, physical examination findings, laboratory investigations, diagnosis, disease outcome, and therapeutic procedures such as peritoneal dialysis and hemodialysis were obtained from patient files.
Of the 130 admitted children, 74 were girls (59.6%). The average age was 6.97 ± 4.2 years (range, 1 month to 17 years). Congenital abnormalities of the kidney and urinary tract were found in 34 children (26.2%). Other morbidities were chronic kidney disease in 30 (23.1%), nephrotic syndrome in 24 (18.5%), urolithiasis in 9 (6.9%), acute kidney injury in 4 (3.1%), glomerulonephritis in 5 (3.8%), enuresis in 12 (9.2%), and others in 12 (9.2%).
Congenital abnormalities of the kidney and urinary tract and chronic kidney disease were highly prevalent in Syrian refugee children. Although free health care have been provided to all of these children, the continuation of political crisis and instability would increase the number of admissions and affect the quality of life of those children in a different environment from the home country.

The goal of this study was to investigate the meditative role of self-efficacy and perfectionism dimensions in the relationship between attachment dimensions (Avoidance and Anxiety) and academic buoyancy. The sample group included 340 B.A students (189 female and 151 male) of Yazd University in the academic year 1393-94 that were selected by multi-stage cluster sampling. The participants fulfilled the attachment, perfectionism dimensions, self-efficacy, and academic buoyancy questionnaires. The evaluation of the proposed model was done by the use of path analysis and AMOS software. The results of the correlation matrix revealed that the dimensions of attachment have positive correlation with each other and have negative correlation with the academic buoyancy. Both dimensions of attachment had negative correlation with positive perfectionism and positive correlation with negative perfectionism. In addition, anxiety and avoidance had negative correlation with all three dimensions of self-efficacy. The dimensions of perfectionism had negative correlation with each other whereas the dimensions of self-efficacy had positive correlation with each other. Finally, both dimensions of attachment with the mediation of negative perfectionism, controversial self-efficacy, and emotional self-efficacy predicted buoyancy negatively. The findings were discussed based on previous researches and some suggestions were brought up for further studies in this field.

A study of the stigmaeid and pseudocheylid mites fauna in northwestern provinces of Iran was carried out during 2012-2014. In this survey, 24 and 4 species of Stigmaeidae (belonging to 7 genera) and Pseudocheylidae were collected and identified, respectively. In this paper the male of Mediolata belfieldi Momen, 1987 is described and the female of the later re-described. A key to the genera of the Iranian Stigmaeidae is included.

A high proportion of patients suffering from end stage liver disease are from low socioeconomic classes, which limits their access to liver transplantation as the most effctive treatment of this condition because of cost barrier.. one of the most challenging aspects of liver transplantation is its affordability and utilization by those who need it the most..Patients and Since November 2005, Iran Ministry of Health had covered 100% of the costs of in-patient liver transplantation care. To determine the effects of this policy, patterns of utilization of liver transplantation were compared before and after implementation of the policy. Group one included 112 and group two included 120 individuals who received transplantation before (from early January 2003 to November 2005) and after (from November 2005 to the end of December 2007) the legislation entered into the effect, respectively. Socioeconomic characteristics of these patients were evaluated by data collected about house and car ownership, education level, employment status, and place of residence.. Coverage of the costs allowed more illiterate and semiliterate people (P = 0.032) as well as more unemployed or unskilled workers to receive transplantation (P = 0.021). The number of transplantations also increased in children and geriatric age group. This legislation also led to greater countrywide regional coverage of indigent patients.. This survey provides evidence that coverage of the costs by Ministry of Health was effective in reducing social discrimination in utilization of liver transplantation, and narrowed the gap between low and high socioeconomic classes in Iranian society.

A study of the raphignathoid mite fauna of fields and orchards in Marand, Northwestern Iran, revealed two new species for the mite fauna of Iran, namely: Eustigmaeus ioaniensis Kapaxidi & Papadoulis, 1999 and Agistemus industani Gonzalez-Roodrigez, 1965 and six species for mites new for the fauna of East Azerbaijan province and eight species new for the mite fauna of Marand. Stigmaeidae with 13 species and Barbutiidae and Camerobiidae with one species each had the highest and the lowest number of identified species, respectively. A key to the Iranian families and genera of Raphignathoidea are included.

Purchasing scientific journals take a large amount of university library budget. So choosing journals with a scientific validity that response to universities needs is so important. This Article aims to have a survey on usage rate of Isfahan University of Medical Sciences users on public, environmental and occupational health journals to confirm core journals via Bradford Scattering law and compare them with the ISI Journals list. This is a padding descriptive research that had a bibliometric survey on Isfahan University of Medical Sciences Electronic journals that presented in Iranian National Medical Digital Library (www.inlm.org). Research society was consisting of 191 electronic journals. A checklist was used for data collection and research findings presented by descriptive statistics in Microsoft excel. The findings showed that the core journals of this university in public & environmental health course were Social Science and Medicine, Patient Education and Consulting and Preventive Medicine journals. The most widely used journal by users of the university in this field, in 2008 was not in ISI journal citation reports and most prestigious journal in the ISI in this category was in 32nd place rank of using. The results indicated the little familiarity of the university users with electronic resources in the health field. But we can expect that establishment of training course and electronic collections presentation can help electronic resource cognition in users and increase using them.