leila alizadeh

Acute pancreatitis (AP) is considered a gastrointestinal disorder that may lead to a systemic inflammatory response and requires urgent hospitalization. Currently, the bedside index of severity in acute pancreatitis (BISAP) scoring system is used to estimate the severity of the disease. This study sought to investigate the significant relationship between the infectious inflammatory components of the neutrophil-to-lymphocyte ratio (NLR), which can only be obtained by a simple blood test. Then, this ratio was compared with the BISAP scoring system.

This cohort study was conducted at Imam Reza Hospital of Tabriz University of Medical Sciences in 2017‒2018. A total of 98 hospitalized patients with our desired criteria were included in the study. A complete blood count differential was obtained, and the BISAP score was calculated and analyzed, along with demographic data.

The NLR and the age of patients had a significant relationship with the BISAP variable (P < 0.05). For one unit (year) increase in patients’ age, the chance of being placed in the higher categories of the BISAP score increased by 1.14 and 1.09 times, respectively. Gender, smoking, and underlying diseases had no significant relationship with the BISAP score (P > 0.05).

  The initial values of the NLR can be used to determine the prognosis and severity of the disease in patients with acute pancreatitis in a quick, easy, and accessible way.

Human papillomavirus (HPV) is the most important initiator of cervical cancer and its mortality. Despite the significant effectiveness of the HPV vaccine in preventing this cancer, vaccination rates remain low in many communities. The present study was conducted with aim to review the challenges and barriers to vaccination based on the health belief model (HBM) in women of childbearing age.

In this review study, the reliable databases were searched by two independent researchers following PICO guidelines and using MESH keywords including: Papillomavirus Infections, Human papillomavirus, Papillomavirus Vaccines, Health Belief Model, Self-Care, Patient Participation, Health Education, needs assessment and women. The process of selecting articles was based on the PRISMA flowchart and quality assessment of articles was done using the NOS and CASP checklists.

After reviewing and evaluating the quality of 2258 articles, 13 articles with 6030 women entered the review. According to the results, challenges and barriers were in three major categories: individual, psychosocial, and organizational. The most significant individual barriers included inadequate or incorrect information about the virus and perceived invulnerability against its pathogenicity. The most significant psychosocial barriers included fear and shame among women and the taboo of Sexually transmitted diseases. Unavailability of HPV vaccine, ineffective communication with clients, and communication and care gaps were also the major organizational barriers.

According to the results of this study, strategic approaches including enhancing women's knowledge of HPV, providing sexual counseling services, and implementing routine and free HPV vaccination should prioritize in national sexual health policies and programs. Furthermore, health care providers should be trained to establish effective and continuous communication with clients.

This article discusses the diagnosis and monitoring of patients with colorectal cancer using liquid biopsy. Colorectal cancer is one of the most common types of cancer worldwide; moreover, its diagnosis and monitoring is of great importance due to various factors such as lifestyle, environmental and genetic factors. There are various methods for diagnosing and monitoring colorectal cancer which can be used as the basis for selecting appropriate treatment methods such as surgery, chemotherapy, targeted therapy, immunotherapy, gene therapy and combination therapies.

Methods and Materials:

the current study has been performed through searching “Liquid biopsy”, “Colorectal Cancer”, “Tumor educated platelets”, “Biomarker”, and “Chemotherapy” keywords in various databases including PubMed, Scopus, Web of Science, and Google Scholar until Dec 2023. Out of the 297 articles, 49 articles were selected and they were included in the study based on the inclusion and exclusion criteria.

Liquid biopsy-based analysis of circulating tumor cells (CTCs), circulating tumor DNA (ctDNA), and tumor-educated platelets (TEPs) provide useful tools for early detection, monitoring treatment response, detecting disease recurrence, and identifying tumor heterogeneity and drug resistance mechanisms in colorectal cancer.

This article examines that due to the molecular characteristics of the tumor during the course of the disease and the genetic and phenotypic heterogeneity of the tumor between primary and metastatic lesions, liquid biopsy can be used as a new solution for diagnosis and monitoring of patients with colorectal cancer.

Adolescence is a period of fundamental change in emotional, social, neurological, and cognitive development that is particularly associated with increased vulnerability to injuries such as car accidents, violent crime, addiction and sexual relations. accordingly the aim of this study was to Evaluating the role of emotion dysregulation in relationship between brain/behavioral system(behavioral activation / behavioral inhibition), impulsivity and delay discounting in high risk behaviors of in secondary high school girls and boys. 321 male and female students were selected by multi - stage cluster sampling method. The scales used in this study include Carver & White (1994) Behavioral Activation / Behavioral Inhibition System Scale; Impulsivity Scale Linam (2013); Kirby & Marakwick Money Selection Scale (1996); Kirby, Petri and Bickle (1999); Graz and Roemer Emotion dysRegulation Disorder Scale (2004); Iranian Adolescents Risk Scale Ali zadeh Mohammadi (2008); Is. Data analysis was performed by Pearson correlation method and structural equation modeling using AMOS software version 24 and SPSS version 23. Behavioral activation/inhibition system and disturbance in emotional regulation had a direct effect on high-risk behaviors. Disturbances in emotion regulation in relation to the behavioral activation/inhibition system and impulsivity had an indirect effect on high-risk behaviors. Based on the results obtained from the present research, it can be said that in order to reduce risky behaviors, attention should be paid to emotional regulation, brain/behavioral system and impulsivity.These findings can have practical achievements in the educational style of teenagers.

Due to the capabilities of the mobile application in the self-care of patients, the present study was conducted to design and evaluate a mobile-based self-care application for patients with liver cirrhosis.

Liver cirrhosis is a progressive and chronic disease that, if left untreated, leads to liver cancer and, finally, the death of the patient.

This study was conducted in six phases, including determining and confirming the validity of the minimum data set and capabilities for the application, designing a conceptual and logical model and determining the technical capabilities, designing the application, evaluating the prototype usability in a laboratory environment by technical experts, evaluation of the application usability in a real environment by 30 patients with QUIS (Questionnaire of User Interface Satisfaction) questionnaire.

The designed application has capabilities such as calculating the patient's MELD score (Model for End-Stage Liver Disease), medication reminder, location in emergency, and conversation with the physician. The results showed that the patients evaluated the application with a score of 7.94 (out of 9 points) at a good level.

The self-care application can help patients with liver cirrhosis and their families access the necessary information related to the special care of the patient at any time and place; it also helps better manage the patient's life, improve the quality of life, and monitor the patient. These applications can effectively manage chronic diseases by reducing the burden of referrals and costs.

Emotion regulation is one of the most important challenges of adolescence. the purpose of this study was to compare the delay discounting, impulsivity and brain/behavioral system in adolescents with and without symptoms of Emotion dysRegulation disorder. The descriptive research method was causal-comparative. The statistical population included all secondary high school students of Kermanshah city, based on the cut point of the emotion dysregulation scale (Gratz and Romer, 2004) and G*Power software, 176 people (88 people in each group) were randomly assigned to The title of the sample size was chosen. From the Monetary Choice scale (Kirby et al. 1999), Short form of Impulsive Behavior Scale (Cyders et al. 2004) the Behavioral inhibition system / Behavioral activation system scale (Carver & White, 1994) and the emotion dysregulation scale (Gratz and Romer, 2004) was used to collect information. The data were analyzed by multivariate analysis of variance with SPSS-25 software. the results showed that the average impulsivity and behavioral brain system between the group with symptoms of disorder in emotion dysregulation and normal group were significantly different ( p < 0.01 ) . There was no significant difference in the mean of delay discounting between the group with emotional dysregulation disorder symptoms and the normal group (P<0.05). attention to disorders in emotion regulation is important as an important criterion in adolescents educational and preventive aspects .The results showed that the average impulsivity and behavioral brain system between the group with symptoms of disorder in emotion dysregulation and normal group were significantly different ( p < 0.01 ) . There was no significant difference in the mean of delay discounting between the group with emotional dysregulation disorder symptoms and the normal group (P<0.05). attention to disorders in emotion regulation is important as an important criterion in adolescents educational and preventive aspects .

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder and diet can affect it. Considering the high prevalence of polycystic ovary syndrome in women and its negative consequences on fertility, this review study was conducted with aim to investigate the role of micronutrients on the fertility of women with polycystic ovary syndrome. In this systematic review study, to find the related articles, international databases (ScienceDirect, Embase, Scopus, PubMed) and Persian language databases (Magiran, SID and IranMedex) were searched with different combinations of keywords related to "polycystic ovary syndrome" and " "micronutrients" and "fertility" without time limit until February 2023 using the Verhagen scale. Out of 1080 reviewed articles, finally 13 articles were included in the study. Five studies investigated the indirect mechanisms of micronutrients on factors affecting fertility; in two studies, no statistically significant difference was observed, and in three studies, beneficial effects on insulin metabolism and lipid parameters, regulation of menstruation, regulation of LH/FSH ratio were reported. Of the eight studies that investigated ovarian function, seven studies found improved ovarian function. Most of the studies showed the positive effects of micronutrients on the fertility of women with polycystic ovary syndrome. Micronutrients seem to be associated with improved fertility in women with polycystic ovary syndrome.

Ultrasonography is a common tool for assessing muscle morphology. This study aims to investigate the intra-rater reliability of ultrasonography measurements of the masseter and lateral pterygoid muscles (LPM) in subjects with and without temporomandibular disorder (TMD) and to compare the measurements between the two groups.

A total of 30 individuals (15 subjects with TMD and 15 subjects without TMD) participated in the study. Imaging of the masseter muscle at rest and contraction, in addition to LPM, was performed using sonography in 2 sessions with a 2-day interval and the thickness of these muscles was measured. To assess the reliability, the intraclass correlation coefficient (ICC(3, 3)), standard error of measurement, minimal detectable change, and limits of agreement were used. Additionally, for the between-group comparison of measurements, the independent sample t-test was used. The Cohen d was used to determine the size of the differences.

ICC(3, 3) for intra-rater reliability of masseter thickness in rest and clenched positions and LPM were 0.89, 0.80, and 0.86 in the asymptomatic group, and 0.88, 0.80, and 0.90 in the TMD group, respectively. The values of absolute reliability parameters, such as standard error of measurement and minimal detectable change were in a small range. Additionally, compared to the asymptomatic group, the TMD group had thicker masseter muscle in the rest position and the effect size revealed a large difference between the groups. No significant differences were found between the groups for the thickness of the masseter muscle in contraction position and LPM.

The results of the intra-reliability study revealed that ultrasonography is a reliable method to measure the thickness of the masticatory muscles in TMD subjects and asymptomatic subjects. Additionally, TMDs can change the thickness of the masticatory muscles.

Cervical cancer is one of the most common cancers in women and the HPV is an important factor to induce it. According to the contradictory findings about the role of antioxidants in cancer control, the present study was conducted with the aim of a systematic review of the existing studies on the role of these elements and the risk of HPV infection and cervical intraepithelial neoplasia (CIN).

This systematic review was performed by a search in the reliable databases of PubMed, Web of Science, Google Scholar, Embase, Scopus, Magiran and SID by two researchers, based on the PICO guidelines and the use of Mesh terms including antioxidants, vitamins, nutritional status, diet, uterine cervical neoplasms, papillomavirus Infection, and Human papillomavirus and their combination using AND and OR operators that included observational studies and clinical trial and were published in English or Persian in the recent ten years (2012-2022). NOS checklist was used to evaluate the quality of articles.

Finally, 7 articles with13211 participants included in this study. Antioxidants included zinc, selenium, carotenoids, flavonoids, manganese, and vitamins B12, C, A, D, B2, E, and folate. The results showed that antioxidants by neutralizing the effect of oxidative stress and cellular DNA damage following a virus attack reduce the incidence of persistent HPV and neoplastic changes. In women with higher serum levels of antioxidants, the risk of infection and the chance of progression to CIN is significantly reduced compared to the control group.

According to various evidence about the role of antioxidants in reducing HPV infection and cervical intraepithelial neoplasia, concurrently with other care and treatment, diets or supplements containing these elements can be used to prevent infection in women at risk.

In the present study, the properties of polylactic acid marker film combined with red cabbage and beet anthocyanins were investigated. There were four samples: 1 (polylactic acid without anthocyanins), 2 (polylactic acid containing red cabbage anthocyanins), 3 (polylactic acid containing beet anthocyanin) and 4 (polylactic acid containing beet anthocyanin and red cabbage). Thickness, solubility, mechanical properties and changes in color indices were analyzed. The results showed that there were no statistically significant differences in the thickness of the film samples (p> 0.05). The highest solubility belonged to the sample 1 and the minimum solubility was detected insample 4. The highest increase in elongation at break was seen in samples 3 and 4 and the lowest increase in elongation at break belonged to sample 1 (p≤0.05). In all the films except sample 1, by pH rise (up to pH = 14), L * factor increased significantly (p≤0.05). In all pH ranges, sample 1 had the highest L * and sample 3 had the lowest one (p≤0.05). a * indice in sample 3, at pH = 1-6, had an increasing trend and then decreased to pH = 14 (p≤0.05). In samples 2 and 4 at pH = 1-13, a decreasing trend was observed and then up to pH=14 an increasing trend was observed (p≤0.05). For b *in sample 2 there was a decline at pH = 1-12, then up to pH = 14, an increasing trend was detected (p≤0.05). The b * of sample 3 and 4 had a fall until pH=11 and 12 respectively following an increasing trend up to pH=14 (p≤0.05). The best sample was sample 4 due to suitable physical properties and clearer color changes at different pH.

The footprint of Neuregulin 1 (NRG1) / ERbB4 in the pathophysiology of some neurological disorders and TRPV1 regulation has been indicated. The alterations in NRG1 and ErbB4 as well as the TRPV1 signaling pathway were investigated during the development of absence epilepsy in the genetic animal model of absence epilepsy.

Male WAG/Rij and Wistar rats were divided into four experimental groups of two and six months of age. The protein levels of NRG1, ERbB4, and TRPV1 were measured in the somatosensory cortex and hippocampus. 

The cortical protein levels of NRG1 and ErbB4 in the 6-month-old WAG/Rij rats were lower than in Wistar rats. Protein levels of TRPV1 were lower in two- and six-month-old WAG/Rij rats compared to age-matched Wistar rats.Hippocampal protein levels of NRG1 in 6-month-old WAG/Rij rats were lower than two-month-old WAG/Rij rats. Low levels of ErbB4 protein in two-month-old and high levels in six-month-old WAG/Rij rats were found compared to Wistar rats. Protein levels of TRPV1 were lower in the two-month-old and higher in the six-month-old WAG/Rij rats compared to age-matched Wistar rats. Furthermore, a high correlation between NRG1/ERbB4 and TRPV1 expressions in the cortex and hippocampus was indicated. The expression of NRG1/ERbB4 and TRPV1 followed a similar pattern during the life span of Wistar and WAG/Rij rats.

Our findings indicated the potential role of the NRG1/ErbB4 pathway as well as TRPV1 in the pathogenesis of absence epilepsy. The regulatory effect of the ERbB4 receptor on the TRPV1 expression has been suggested following the similar pattern of expression.

The most important factor initiating cervical cancer is human papilloma virus (HPV) infection; although the HPV vaccine can significantly prevent the infection in women, there is contradictory findings about its side effects such as premature ovarian failure (POF). The present systematic review was conducted with aim to determine the association between this vaccine and POF.

This study was conducted by search in the reliable databases of PubMed, Web of Science, Google Scholar, Embase, and Scopus by two researchers independently based on the PICO guidelines and the use of Mesh terms including Papillomavirus vaccine, Human Papillomavirus Recombinant Vaccine Quadrivalent, Primary Ovarian Insufficiency and Premature Ovarian Failure. Newcastle - Ottawa checklist was used to evaluate the quality of articles.

After review and evaluation of the quality of 128 primary articles, finally 7 articles were included in the systematic review. According to the results of population-based studies, there was no significant relationship between the HPV vaccine and POF; but there are case series which support the association between the HPV vaccine and POF. They declared that the cause of this complication was the induction of autoimmune response by the vaccine and the side-effects of the adjuvant used in it.

Considering that the HPV vaccine is currently the most effective approach in preventing cervical cancer, it seems more reasonable to use preventive benefits of this vaccine. Further studies emphasizing the possible side effects of the vaccine can minimize the challenges associated with this vaccine in the future.

There is a possibility of more accumulation of environmental pollutants due to lower levels of iron in the body of women. Different results have been reported on the association of lead with breast cancer, therefore, this systematic review study was performed with aim to determine the relationship between lead and breast cancer.

In this review study, to find the related articles, international databases (Web of Science, Embase, Scopus, Google Scholar and PubMed) and national (Irandoc, Magiran, SID and IranMedex) were searched with different keyword combinations related to "Lead" And "Breast Cancer" obtained from MESH in 2000 to 2022. Selection of articles was based on inclusion and exclusion criteria and articles' quality was assessed using the Newcastle Ottawa scale.

Out of 4057 articles reviewed, 13 articles had good quality. All studies were in English and were observational. According to most studies, serum lead levels were not associated with breast cancer, but lead levels in bone and breast tissue were also associated with exposure to lead as an environmental contaminant with breast cancer.

Different ways of exposure to lead have led to different results and it cannot be certainty said that exposure to lead causes breast cancer, while this relationship also depends on the method of measuring lead. In this regard, long-term studies with accurate measurement of environmental lead and body tissues, especially for women at higher risk are recommended.

School revitalization plays an important role in students' academic performance. Therefore, the purpose of the present research was to present an integrated curriculum model in order to revitalize elementary schools.

The present study was applied in terms of purpose and descriptive survey in terms of methodology. The research population included the professors, experts of the Education Department of Tehran province, and the sample size was determined 289 people using the Cochran formula. Participants were selected using stratified random sampling method according to their job position. The data collection tool included a researcher-made questionnaire of an integrated curriculum aimed at revitalizing elementary schools, whose content validity was confirmed by the opinion of experts and its reliability was obtained 0.83using Cronbach's alpha method. Data analysis was carried out using exploratory factor analysis and structural equation modeling methods in SPSS and AMOS software.

The results showed that the integrated curriculum model for revitalizing elementary schools consisted of 68 design items, i.e. goal (8 items) content (9 items), content organization (5 items), characteristics of learning activities (5 items), learning activity strategy (5 items), and evaluation (8 items), of which only the factor loading of 40 items was higher than 0.40. Also, the integrated curriculum model for revitalizing elementary schools had a good fit and the integrated curriculum for revitalizing elementary schools had a significant effect on all six components of goal, content, content organization, characteristics of learning activities, strategies of learning activities and evaluation (P<0.05).

According to the results of this research, an effective step can be taken to revitalize elementary schools through the items of each of the six components of the integrated curriculum, including the goal, content, content organization, characteristics of learning activities, strategies of learning activities and evaluation.

So far, there is much less information about the effects of urinary incontinence on postural control. Therefore the aim of this study is to investigate the differences in postural control using linear and non-linear analyses of the center of pressure (COP) time-series in anteroposterior (AP) and mediolateral (ML) directions between females with and without stress urinary incontinence (SUI).  

This case-control study included 22 continent females and 22 SUI females. In this study, static postural control during four different postural tasks was evaluated using a force plate.  All participants performed separate 60-sec standing trials with eyes open in the empty bladder and full bladder conditions. Mean, range, velocity, area circle of COP displacements, and approximate entropy (ApEn) of COP time-series were calculated from the 60-sec standing trials for all participants.  The independent sample t-test was also used to compare COP variables between the two groups and paired sample t-test was used to assess changes between the full bladder and empty bladder conditions within each group. The effect size of Cohen's d was used to assess the magnitude of the differences between the two groups.  

The findings revealed a significant group × task interaction for the mean of ML displacement and ApEn of COP. SUI females showed more AP displacement range in the full bladder (pvalue= 0.020, effect size=0.74) and a higher velocity (empty bladder: p=0.040, effect size=0.63) (full bladder: p=0.020, effect size=0.75) than the continent group. Generally, the SUI females had lower ApEn than the continent females, although the differences were not significant.  While the variables of COP were unaffected by bladder fullness in the continent group, the SUI group in full bladder condition experienced more AP range (p=0.030), and area circle (p=0.007) of COP sway in quiet standing.          

These results provide more support for the hypothesis that postural control can be impaired following SUI, although future investigations on this topic are recommended.

Temporomandibular joint disorders (TMJDs) are the main musculoskeletal cause of orofacial pain.  This study aimed to assess the efficacy of manual therapy and routine treatment compared with routine treatment on pain, maximum mouth opening (MMO), and cervical range of motion (ROM) in patients with the temporomandibular joint disorder (TMJD).  

This study was performed at the biomechanics laboratory of the physiotherapy department of Iran University of Medical Sciences, Tehran, Iran.  A total of 30 patients with TMJD were randomized into 2 groups: an intervention group (manual therapy plus routine treatment) and a control group (conventional treatment). Treatment included 10 sessions. The primary outcome was pain intensity and the secondary outcomes were MMO, and range of cervical flexion and extension. The outcomes were measured at the baseline, at the end of the treatment, and after a 4-week follow-up period. The repeated measures analysis of variance was used to assess group × time interaction, and the Bonferroni adjustment was used for between-group comparisons. The effects size of Cohen's d was used to determine the magnitude of between-group differences.  

The results showed that there were significant group × time interactions for pain, MMO, and the cervical flexion ROM (P<0.001). In comparion with the baseline, the intervention group showed significant improvements in jaw pain, MMO, and cervical flexion ROM (P<0.001), while in the control group, compared with the baseline, only pain and MMO significantly improved (P<0.05). Results of between-group comparisons revealed that there were significant and clinical differences between the 2 groups after treatment, and the intervention group had lower jaw pain, more MMO, and cervical flexion than the control group (P<0.001). In addition, the efficacy of manual therapy based on the Cohen's d was large for the outcomes of pain, MMO, and cervical flexion.  

The findings showed that adding manual therapy of the upper cervical spine and TMJ to the routine treatment could be an effective intervention for patients with TMD.

Workplace bullying is an occupational hazard with destructive effects. The aim of this study was to assess the antecedents and the consequences of bullying among nurses.

This narrative review was conducted in 2021. An online literature search was performed in several Persian and English databases, namely Magiran, SID, Noormags, Elmnet, IranMedex, PubMed, and Scopus. Search protocol was limited to the time interval between 2010 and 2020. Search key terms were, “bullying”, “coercion”, “healthcare providers”, “nurse”, and “horizontal violence”. Advanced search was also performed in Google Scholar. Inclusion criteria were publication in English or Persian, access to full-text, and publication as an original article.

Sixteen articles were included in this study. The two main antecedents of workplace bullying were personal and organizational factors and the three main consequences of bullying were physical, mental, and occupational consequences.

As bullying is associated with different physical, mental, and occupational consequences, healthcare managers need to employ strategies to determine and manage bullying antecedents and reduce bullying prevalence.

The present study examines the design of an integrated curriculum model for the revitalization of primary schools. This research is qualitative and phenomenological. The statistical population of this study consisted of professors and experts in the field of educational sciences with a focus on curriculum planning, educational management, psychologists, experts of the General Directorate of Education. Semi-structured interviews with 14 experts were purposefully selected and The seven-step clicher method with the information collected from the interviews with the content analysis technique, including the methods that were analyzed for the analysis of written texts from the interview and Maxqda software. The Delphi method was used to validate the integrated curriculum design model. The Delphi method was used in different ways. One application of this method is to consult experts and specialists to validate the patterns that have emerged from the research. For this purpose, in order to validate the integrated curriculum design model in order to refresh the schools based on the Aker model, a proposed model is presented to experts and specialists and their opinion on the characteristics of curriculum logic and each of the elements of the curriculum. The results showed that the proposed model of the integrated curriculum model in order to revitalize primary schools includes goals, content, content organization, specificity of learning activities, strategies of learning activities and evaluation.

The mechanisms of rabies evasion and immunological interactions with the host defense have not been completely elucidated. Here, we evaluated the dynamic changes in the number of astrocytes, microglial and neuronal cells in the brain following intramuscular (IM) and intracerebral (IC) inoculations of street rabies virus (SRV). The SRV isolated from a jackal and CVS-11 were used to establish infection in NMRI-female mice. The number of astrocytes (by expression of GFAP), microglial (by Iba1), and neuronal cells (by MAP-2) in the brain following IM and IC inoculations of SRV were evaluated by immunohistochemistry and H & E staining 7 to 30 days post-infection. Increased numbers of astrocytes and microglial cells in dead mice infected by SRV via both IC and IM routes were recorded. The number of neuronal cells in surviving mice was decreased only in IC-infected mice, while in the dead group, this number was decreased by both routes.The risk of death in SRV-infected mice was approximately 3 times higher than in the CVS-11 group. In IC-inoculated mice, viral dilution was the only influential factor in mortality, while the type of strain demonstrated a significant impact on the mortality rate in IM inoculations. Our results suggested that microglial cells and their inflammatory cytokines may not contribute to the neuroprotection and recovery in surviving mice following intracerebral inoculation of SRV. An unexpected decrease in MAP2 expression via intramuscular inoculation indicates the imbalance in the integrity and stability of neuronal cytoskeleton which aggravates rabies infection.

The aim of this study was to study the phenomenology of an integrated curriculum in order to revitalize primary schools.

The method of the present study was qualitative and phenomenological. Semi-structured interviews were conducted with 14 purposefully selected experts. Recorded interviews were recorded in writing and analyzed by a seven-step clicher method.

The analysis led to the extraction of 6 categories in the field of integrated curriculum in order to rejuvenate schools.

The categories included objectives, content, content organization, evaluation, specificity of learning activities, strategies of learning activities.

Considering that portal hypertension is principally caused by hepatic fibrosis, some studies postulated the predictive value of serum liver fibrosis indices in the diagnosis of portal hypertension. In this study we assessed the prognostic value of serum indices in the diagnosis of portal hypertension in cirrhotic patients.

One hundred two cirrhotic patients were selected according to inclusion/exclusion criteria. Cirrhosis and the Child-Pugh score was determined by the gastroenterologist. Portal hypertension was diagnosed by the radiologist using the color Doppler method. The fasting blood sample was drawn and different serum indices were determined. The following indices were calculated: FIB4, Fibroindex, APRI, FORNS, LOK.

The patients mean age was 54.39±6.60 years. About 52.94% of the patients were women. The mean liver enzymes level was higher in patients with portal hypertension. In 50.98% of patients, the etiology of cirrhosis was viral hepatitis. Significant differences was observed between the two groups regarding the studied indices (P<0.05). According to the results of the ROC curve, the FORNS index was a better predictive marker of portal hypertension in cirrhotic patients. The maximum AUC (area under the curve) was for the FORNS index. According to the results of diagnostic tests, the FORNS index had adequate sensitivity and specificity in the diagnosis of portal hypertension with the cut-off value of 8.51.

The results of the present study showed that the FORNS index is a better predictor of portal hypertension in cirrhotic patients.

Gastrointestinal (GI) bleeding is the most life-threatening complication of cirrhosis and it's predicting is crucial for the management of cirrhotic patients. The present study aimed to assess the relationship between INR and plasma fibrinogen level and the risk of GI bleeding using in cirrhotic patients.

In the present cross-sectional study, seventy-eight cirrhotic patients were enrolled. We assessed demographic, biochemical, hematologic parameters in all patients. Underlying diseases and the etiology of cirrhosis were documented. The Child-Pugh and the Model for End-stage Liver Disease (MELD) scores were used to assess the severity of liver cirrhosis. The history of bleeding episodes within 6 months before inclusion were recorded. A blood sample was drowned and fibrinogen and prothrombin time (PT) were measured and INR was calculated.

The patients' mean age was 51.23±15.08 years and 40 (51.3%) were male. About 17 patients (%21.7) had a history of GI bleeding within 6 months before the study. The significant difference was observed between the two groups who experienced bleeding and who did not regarding the fibrinogen level (P < 0.05). The fibrinogen level was a better predictive marker of bleeding in cirrhotic patients (AUC: 0.87). According to the results of predictive tests, the fibrinogen level had a sensitivity of (77%) and specificity of (%94) in the prediction of bleeding with the cut-off value of 182.5.

The results of the present study showed that the fibrinogen level is a better predictor of bleeding in cirrhotic patients compared with INR.

Peptic ulcer disease is a common gastrointestinal disorder, the prevalence of which has reduced in recent years due to effective new treatments. Peptic ulcer perforation is an emergent life-threatening condition that causes pneumoperitoneum and septic shock. It often requires surgical procedures. We describe two cases of peptic ulcer perforation with only mild discomfort on the epigastric region since several months before. The patients were treated with a high dose proton pump inhibitor and conservative treatment without surgical procedures. Weekly follow up of the cases showed that the clinical condition of patients remained stable without any new signs and symptoms. This report shows that noninvasive treatment alone can be effective in some cases with mild symptoms.

Prescribing routine Iron supplementation during pregnancy regardless of the maternal hemodynamic condition that may be accompanied with pregnancy and delivery complications. This study conducted to assessing the effect of iron supplementation in pregnant women with high hemoglobin on delivery type and newborn’s Apgar score.
Material &

The randomized double-blind clinical trial performed on 140 healthy pregnant women, 18-35years old, normal BMI, nonsmoker, in the 14th - 18th weeks of singleton pregnancy with Hb> 13.2 g/dL and ferritin > 15 μg/l. Mothers were randomly assigned to experimental and control groups from the 20th week of pregnancy, the experimental group received one ferrous sulfate tablet (50 mg) daily, while the control group received a placebo. Both of them were followed up to delivery and the type of birth and newborn’s Apgar were evaluated and compared.

There was significant differences between the two groups in Hb (P = 0.03) and ferritin (P=0.04) levels after intervention, but the incidence of anemia exhibited no difference between them (P = 0.1). In addition there was no different between the two groups in birth weight (P=0/2), but the incidence of cesarean section (P=0/01) and low birth Apgar score (less than 8) (P=0/02) in drug group more than other group.

Iron supplementation increased the risk of cesarean section and low Apgar score in pregnant women with Hb concentrations greater than 13.2 g/dl; therefore, it should be done with caution in pregnancy.