farzad mokhtari

The aim of this study was to systematically review the existing studies to predict the next ten years of common diseases and to provide effective intervention to reduce risk factors, morbidity and premature mortality due to these diseases in Iran. .

A systematic review conducted in order to predict the next ten year of non-communicable diseases and review the proposed measures of the World Health Organization to prevent and control them.

According to the predictions made in the next ten years, cardiovascular diseases, cancers, diabetes and lung diseases will be the leading diseases causing the most lost years of life or years spent with disability. The World Health Organization to respond appropriately to the growing trend of these diseases, intervene in 4 areas of governance, reduce people's exposure to risk factors for these diseases, strengthen the health care system to respond to these diseases and finally continuously monitor changes in risk factors and diseases Chronic, monitoring the causes of mortality from these diseases as well as continuous monitoring of executive, preventive and control measures for such diseases has suggested.

The basis of the proposed interventions is the integration of preventive and control programs in the health care system so that each individual at high risk of these diseases in the most environmental health levels are identified and preventive care

Alzheimer’s disease (AD) is the main cause of the neurodegenerative disorder, which is not detected unless the cognitive deficits are manifested. An early prediagnostic specific biomarker preferably detectable in plasma and hence non-invasive is highly sought-after. Various hypotheses refer to AD, with amyloid-beta (Aβ) being the most studied hypothesis and inflammation being the most recent theory wherein pro-and anti-inflammatory cytokines are the main culprits.

In this study, the cognitive performance of AD patients (n=39) was assessed using mini-mental state examination (MMSE), AD assessment scale-cognitive subscale (ADAS-cog), and clinical dementia rating (CDR). Their neuropsychiatric symptoms were evaluated through neuropsychiatric inventory–questionnaire (NPI-Q). Moreover, plasma levels of routine biochemical markers, pro-/anti-inflammatory cytokines such as tumor necrosis factor α (TNF-α), interleukin-1 α (IL-1α), IL-1β, IL-2, IL-4, IL-6, IL-8, IL-12p70, IL-10, Interferon-gamma, chemokines, including prostaglandin E2 (PGE-2), monocyte chemoattractant protein-1, interferon gamma-induced protein 10, Aβ peptide species (42, 40) and Transthyretin (TTR) were measured.

Our results revealed that Aβ 42/40 ratio and TTR were correlated (r=0.367, P=0.037). IL-1α was directly correlated with ADAS-cog (r=0.386, P=0.017) and Aβ 40 (r=0.379, P=0.019), but was inversely correlated with IL-4 (r=-0.406, P=0.011). Negative correlations were found between MMSE and PGE2 (r=-0.405, P=0.012) and TNF-α/ IL-10 ratio (r=-0.35, P=0.037). CDR was positively correlated with both PGE2 (r=0.358, P=0.027) and TNF-α (r=0.416, P=0.013). There was a positive correlation between NPI-caregiver distress with CDR (r=0.363, P=0.045) and ADAS-cog (r=0.449, P=0.019).

Based on the observed correlation between IL-1α, as a clinical moiety, and ADAS-cog, as a clinical manifestation of AD, anti-IL-1α therapy in AD could be suggested.

Excessive exposure to the sources of fluoride in drinking water, oral care products, and food is a widespread problem. Fluoride is associated with impairment in child intelligence development. It causes DNA damage, oxidative stress, and mitochondrial dysfunction, mainly due to the production of reactive oxygen species (ROS). It has been postulated that the use of antioxidants such as astaxanthin, may alleviate fluoride’s adverse effects. This study assessed the effects of fluoride on cellular ROS content and rat’s learning and memory ability and investigated the protective potency of astaxanthin with emphasis on the role of glutamate using the Morris Water Maze test, glutamate concentration determination, and western blot techniques. The fluoride treatment of cells results in an increment of cellular ROS, whereas astaxanthin inhibits lipid peroxidation. Fluoride significantly decreases the cellular glutamate uptake and glutamate transporter, protein level, possibly due to the disruption of mitochondrial energy metabolism and defect of the transporter recycle, respectively. The in-vivo study indicated that the treatment of rats with fluoride led to a loss of learning, while astaxanthin improved memory dysfunction. Measurement of ROS and glutamate levels of rat brain hippocampus showed that fluoride increased the ROS but decreased the glutamate. On the other hand, the utilization of astaxanthin decreased the brain ROS content and increased the glutamate level. It seems that fluoride disrupts the normal function of neurons via increment of ROS production and decrement of glutamate level, whereas astaxanthin has neuroprotective potency due to the ROS scavenging ability.

Beta-Boswellic acid (BBA) is a pentacyclic terpene which has been obtained from frankincense and its beneficial effects on neurodegenerative disorders such as Alzheimer’s disease (AD) have been addressed.

In the present study, thermodynamic and kinetic aspects of BBA interaction with Tau protein as one of the important proteins involved in AD in the absence and presence of glucose has been investigated using surface plasmon resonance (SPR) method. Tau protein was immobilized onto the carboxy methyl dextran chip and its binding interactions with BBA were studied at physiological pH at various temperatures. Glucose interference with these interactions was also investigated.

Results showed that BBA forms a stable complex with Tau (KD=8.45×10-7 M) at 298 K. Molecular modeling analysis showed a hydrophobic interaction between BBA and HVPGGG segment of R2 and R4 repeated domains of Tau.

The binding affinity increased by temperature enhancement, while it decreased significantly in the presence of glucose. Both association and dissociation of the BBA-Tau complex were accompanied with an entropic activation barrier; however, positive enthalpy and entropy changes revealed that hydrophobic bonding is the main force involved in the interaction.

Alzheimer''s disease (AD) is the most common age-related neurodegenerative disorder. One of the hallmarks of AD is an abnormal accumulation of fibril forms of tau protein which is known as a microtubule associated protein. In this regard, inhibition of tau aggregation has been documented to be a potent therapeutic approach in AD and tauopathies. Unfortunately, the available synthetic drugs have modest beneficial efficacy with several side effects. Therefore, pipeline drugs from natural sources with anti-aggregation properties can be useful in the prevention and treatment of AD. Among medicinal plants, saffron (Crocus sativus, L.), as a traditional herbal medicine has different pharmacological properties and can be used as treatment for several nervous system impairment including depression and dementia. Crocin as a major constituent of saffron is the glycosylated form of crocetin. In this study, we investigated the inhibitory effect of crocin on aggregation of recombinant human tau protein 1N/4R isoform using biochemical methods and cell culture. Results revealed that tau protein under the fibrillation condition and in the presence of crocin had enough stability with low tendency for aggregation. Crocin inhibited tau aggregation with IC50 of 100 µg/ml. Furthermore, transmission electron microscopy images confirmed that crocin could suppress the formation of tau protein filaments. Inhibitory effect of crocin could be related to its interference with nucleation phase that led to increases in monomer species of tau protein. Based on our results, crocin is recommended as a proper candidate to be used in AD treatment.

Coronary arteriovenous fistulas (CAVFs) are direct connections from one or more coronary arteries to cardiac chambers or a large vessel. They are mostly of congenital origin. The aim of this study was to describe clinical presentation and also delineate the course and management of CAVF. Clinical data, chest x-rays, echocardiographic and angiographic evaluation of 40 patients with congenital CAVF during 1990 to 2008 were reviewed retrospectively. Seventeen patients were ≤ 20 years old (42.5%) were mostly asymptomatic, and twenty tree cases were older than 20 years old (57.5%), mostly symptomatic (P<0.05). Twenty one (52.5%) patients had pure CAVF and nineteen (47.5%) patients with associated intarcardiac congenital heart disease (15%) or acquired valvular and coronary arteries diseases (32.5%). CAVFs mostly originated from left anterior descending artery (LAD) (42.5%) and mostly drained into the main pulmonary artery (MPA) (35 %). Twenty-four patients underwent CAVF surgical ligation. From twenty-one patients with pure CAVF, eight (38%) patients were complicated by congestive heart failure and aneurism formation of fistula. Unlike some previous reports, in our study, the most prevalent origin site for CAVFs was the left anterior descending (LAD). Most patients with CAVFs especially those who went first diagnosed before 20 years old were asymptomatic. On the other hand, as the continuous murmur is not always detected in children or infants, consequently, cases of spontaneous closure may remain undetected. All symptomatic and asymptomatic patients with moderate to severe shunting should be operated on and minimal morbidity and good surgical results could be expected.

Erectile dysfunction (ED) is common in cardiovascular disease (CVD) and indicates a complication of coronary artery bypass graft surgery (CABG). This study was designed to evaluate the status of erectile dysfunction in patients with CAD before and after CABG surgery. We designed a prospective cohort study on male patient candidates for elective on-pump CABG between June 2006 to October 2012 in 3 hospitals in Sari, Iran (Fatemeh Zahra, Shafa and Nime-Shaban Hospitals). Patient’s primary data were collected based on the International Index of Erectile Function questionnaire (IIEF-5) at baseline 6 months after surgery. The severity of dysfunction was categorized as, normal, mild to moderate and moderate to severe based on HEF score. Four hundred twenty-six male patients with mean age of 58.69±12.49 years participated in this study. 166 patients had DM (38.96%) 230 patients with HTN (54%). 307 patients had three-vessel impairment (72.07%) and 119 patients with one or two vessel impairment (27.93%). The severity of dysfunction results were at 15.02%, 18.07%, 23%, 31.92% and 11.97%, at base changed to 16.90%, 19.95%, 23.71%, 32.22% and 8.21%, respectively (P=0.01). Also, the mean ±SD of IIEF-5 score before and after surgery was 13.95±5.44 and 14.20±5.69, respectively (P=0.001). The result of our study shows that on-pump CABG surgery has a positive effect on the improvement of erectile dysfunction 6 months after surgery.

Erythropoietin (EPO) is known as a regulating hormone for the production of red blood cells, called erythropoiesis. Some studies have shown that EPO exerts some non-hematopoietic protective effects on ischemia-reperfusion injuries in myocytes. Using echocardiography, we evaluated the effect of EPO infusion on reducing ischemia-reperfusion injuries and improvement of the cardiac function shortly after coronary artery bypass graft surgery (CABG). Forty-three patients were recruited in this study and randomly divided into two groups: the EPO group, receiving standard medication and CABG surgery plus EPO (700 IU/kg), and the control group, receiving standard medication and CABG surgery plus normal saline (10 cc) as placebo. The cardiac function was assessed through echocardiography before as well as at 4 and 30 days after CABG. Echocardiography indicated that the ejection fraction had no differences between the EPO and control groups at 4 days (47.05±6.29 vs. 45.90±4.97; P=0.334) and 30 days after surgery (47.27±28 vs. 46.62±5.7; P=0.69). There were no differences between the EPO and control groups in the wall motion score index at 4 (P=0.83) and 30 days after surgery (P=0.902). In the EPO group, there was a reduction in left ventricular end-systolic and end-diastolic diameters (LVESD and LVEDD, respectively), as compared to the control group. Our results indicated that perioperative exogenous EPO infusion could not improve the ventricular function and wall motion index in the immediate post-CABG weeks. Nevertheless, a reduction in LVEDD and LVESD at 4 days and 30 days after CABG in the EPO group, by comparison with the control group, suggested that EPO correlated with a reduction in the remodeling of myocytes and reperfusion injuries early after CABG.Trial Registration Number: 138809102799N1

Congenital dislocation of the knee (CDK) is a rare congenital anomaly and the incidence of the CDK is estimated as 1 per 100،000 births. Diagnosis is made through clinical inspection and X-ray radiography. Our patient is a newborn male with congenital dislocation of the left knee. After diagnosis، the knee was reduced successfully within 24 hours of birth and then serial casting was performed. After one year of follow-up، the knee appears normal and prognosis is excellent. In some reports the best time for reduction of dislocated knee is within 24 hours after birth and delayed reduction is suggested to increase the difficulty of treatment، but some authors have suggested waiting of 1 month for spontaneous reduction of CDK. The aim of this report is emphasis on early reduction of congenital dislocation of the knee، and also precise evaluation for ruling out related disorders.

Pulmonary Adenosquamous carcinoma is an uncommon histological variety of bronchogenic carcinoma, and has histologic areas differentiated as both squamous cell carcinoma and adenocarcinoma and has clinical behavior more like that of adenocarcinoma. Tumor Stage is higher at the time of diagnosis, and survival is poorer. We present a 65 years old woman with bulging in her left frontal site of the head. He also had a dyspnea and abnormal chest X-ray and Histopathological findings for the bronchoscopic biopsy specimen as well revealed bronchogenic adenosquamous carcinoma. Brain MRI with contrast showed a metastasis to skull that resulted in a lytic lesion in frontal bone and leakage of CSF from the skull. Metastasis of lung cancer to the skull is not a common manifestation of this tumor. However, as we showed, the only manifestation of lung cancer can be the metastatic complications of the tumor.