Journal of Research in Medical Sciences
Volume:22 Issue: 9, 2017 Sep

Wound healing is a complex biological process. Some injuries lead to chronic nonhealing ulcers, and healing process is a challenge to both the patient and the medical team. We still look forward an appropriate wound dressing.
In this study, starch?based nanocomposite hydrogel sca?olds reinforced by zeolite nanoparticles (nZ) were prepared for wound dressing. In addition, a herbal drug (chamomile extract) was added into the matrix to accelerate healing process. To estimate the cytocompatibility of hydrogel dressings, fbroblast mouse cells (L929) were cultured on sca?olds. Ten, 3?(4, 5?dimethylthiazol?2?yl)?2, 5?diphenyltetrazolium?bromide assay test and interaction of cells and sca?olds were evaluated. For evaluating healing process, 48 male rats were randomly divided into four groups of four animals each (16 rats at each step). Te ulcers of the frst group were treated with the same size of pure hydrogels. Te second group received a bandage with the same size of hydrogel/extract/4 wt% nZ (hydrogel NZE). Te third group was treated with chamomile extract, and the fourth group was considered as control without taking any medicament. Finally, the dressings were applied on the chronic refractory ulcers of fve patients.
After successful surface morphology and cytocompatibility tests, the animal study was carried out. Tere was a signifcant di?erence between starch/extract/4 wt% nZ and other groups on wound size decrement after day 7 (P Starch?based hydrogel/zeolite dressings may be safe and e?ective for chronic refractory ulcers.

Tis study aimed to investigate the bacteria associated with urinary tract infection (UTI) and antibiotic susceptibility pattern of the isolates during 2013–2015 in Northern Iran.
Overall 3798 patients with clinical symptoms of UTI were subjected as samples, and they were cultured and pure isolated bacteria were identifed using biochemical tests and subjected to antibiogram assessment using disc di?usion method.
Totally, 568 (14.96%) from 3798 patients had positive UTI. Four hundred and ninety?seven (87.5%) from 568 isolated bacteria were resistant to at least one antibiotic. Escherichia coli, Staphylococcus spp., and Pseudomonas spp. were the most prevalent bacteria. Isolated bacteria indicated the highest antibiotic resistance to methicillin (76.06%) and ampicillin (89.29%) and also revealed the most sensitivity to imipenem (99.1%) and amikacin (91.57%). Statistical analysis of the resistance pattern trend during 3 years indicated the insignifcant increase (P > 0.05) in antibiotic resistance of the isolates.
Te results of this study revealed a great concern for emerging UTI?related multidrug?resistant strains of bacteria causing UTI in Iran.

In this study, we aimed to determine comprehensive maternal characteristics associated with birth weight using Bayesian modeling.
A total of 526 participants were included in this prospective study. Nutritional status, supplement consumption during the pregnancy, demographic and socioeconomic characteristics, anthropometric measures, physical activity, and pregnancy outcomes were considered as e?ective variables on the birth weight. Bayesian approach of complex statistical models using Markov chain Monte Carlo approach was used for modeling the data considering the real distribution of the response variable.
Tere was strong positive correlation between infant birth weight and the maternal intake of Vitamin C, folic acid, Vitamin B3, Vitamin A, selenium, calcium, iron, phosphorus, potassium, magnesium as micronutrients, and fber and protein as macronutrients based on the 95% high posterior density regions for parameters in the Bayesian model. None of the maternal characteristics had statistical association with birth weight.
Higher maternal macro? and micro?nutrient intake during pregnancy was associated with a lower risk of delivering low birth weight infants. Tese fndings support recommendations to expand intake of nutrients during pregnancy to high level.

Te purpose of this study was to compare the outcomes of anterior cruciate ligament (ACL) reconstruction using the patellar versus hamstring tendon (HT) autograft.
In this randomized clinical trial, ffty patients undergoing arthroscopic ACL reconstruction were randomized into two equal groups: Tose treated with either autogenous patellar tendon grafts (PT group) or HT group grafts. All patients were reviewed immediately after surgery, at 6 and 12 weeks after surgery, and then at 6 months using the International Knee Documentation Committee evaluation form. Infection, severity of pain (visual analog scale), duration of rehabilitation, and clinical and magnetic resonance imaging (MRI) fndings were assessed at the 6?month follow?up. Positive pivot shift and Lachman test were considered clinical signs and symptoms of treatment failure. In addition, the absence of the ACL or transverse ACL rather than the posterior oblique ligament is an MRI fnding that indicates treatment failure.
Comparing changes in pain and range of motion (ROM) in patients frst and 6 months after therapy show that pain had been relief signifcantly (P Considering the better outcomes of HT reconstructions for the two parameters of pain severity and rehabilitation period, we consider HTs to be the ideal graft choice for ACL reconstructions.

In?ammatory bowel disease (IBD) has a signifcant impact on health?related quality of life (HRQOL). Tis study aims to investigate the variables which can be attributed to HRQOL in IBD patients.
Seventy?one patients flled in IBD questionnaire (IBDQ?32), Pittsburgh sleep quality index questionnaire, and sociodemographic questionnaire. Disease activity was assessed by Crohn’s disease activity index (CDAI) and ulcerative colitis activity index (UCAI). Te correlations of sleep quality, sociodemographic variables, and disease characteristics with IBDQ were investigated.
IBDQ?32 mean score was lower in patients who had hospitalization (P = 0.01), poor sleep quality (P Impaired HRQOL was signifcantly associated with poor sleep quality, lack of folic acid consumption, and disease severity in IBD patients. Terefore, evaluation of folic acid level and efcacy of its supplementation in prospective studies is recommended. Treatment of sleep disturbance with pharmacological agents and nonpharmacological methods should be kept in mind as well.

Te link between autoimmune thyroid diseases and Vitamin D defciency has been reported. However, there are controversies in this regard. We conducted a double?blind randomized placebo?controlled clinical trial to investigate the e?ect of Vitamin D defciency treatment on thyroid function and autoimmunity marker (thyroid peroxidase antibody [TPO?Ab]) in patients with Hashimoto’s thyroiditis.
ifty?six patients with Hashimoto’s thyroiditis and Vitamin D defciency (25?hydroxyvitamin D level ?20 ng/mL) were randomly allocated into two groups to receive Vitamin D (50000 IU/week, orally) or placebo for 12 weeks, as Vitamin D?treated (n = 30) and control (n = 26) groups, respectively. TPO?Ab, thyroid?stimulating hormone (TSH), parathormone, calcium, albumin, and creatinine concentrations were compared before and after trial between and within groups. Te data were presented as mean (standard error [SE]) and analyzed by appropriate tests.
Mean (SE) of Vitamin D was increased in Vitamin D?treated group (45.5 [1.8] ng/mL vs. 12.7 [0.7] ng/mL, P = 0.01). Mean (SE) of TPO?Ab did not signifcantly change in both groups (734 [102.93] IU/mL vs. 820.25 [98.92] IU/mL, P = 0.14 in Vitamin D?treated and 750.03 [108.7] [IU/mL] vs. 838.07 [99.4] [IU/mL] in placebo?treated group, P = 0.15). Mean (SE) of TSH was not changed in both groups after trial, P = 0.4 and P = 0.15 for Vitamin D?treated and control groups, respectively. No signifcant di?erence was observed between two study groups in none studied variables (P > 0.05).
Vitamin D treatment in Vitamin D defcient patients with Hashimoto’s thyroiditis could not have signifcant e?ect on thyroid function and autoimmunity.

Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic cause of end?stage renal disease. Although imaging techniques are a means of accurate diagnosis when the cysts appear in the third or fourth decades of the patient’s life, they are of little value for early diagnosis. Genetic tests are required for preimplantation genetic diagnosis, decision?making for kidney donation to an a?ected relative. Although mutation of the polycystic kidney disease (PKD1) gene is solely responsible for the most cases of ADPKD, direct genetic testing is limited by the large size of this gene and the presence of many mutations without hot spots. Terefore, indirect diagnosis with linkage analysis using informative microsatellite markers has been suggested.
In this study, we assessed the informativeness of the PKD1 gene markers D16S475, D16S291, and D16S3252 in Iranian population. Using specifc primers, ?uorescent polymerase chain reaction (PCR) was performed on genomic DNA extracted from ffty unrelated individuals. PCR products were analyzed by the ALFexpress DNA sequencer system, and the number and frequency of alleles were determined to calculate the heterozygosity (HET) and polymorphism information content (PIC) values.
We found that the HET and PIC values for the D16S475 marker are 0.92 and 0.91, respectively. Tese two values are 0.82 and 0.80 for D16S291 and 0.50 and 0.47 for D16S3252, respectively.
Based on this data, D16S475 and D16S291 are highly and D16S3252 is moderately informative for indirect genetic diagnosis of PKD1 mutations in this population.

Tis study aims to evaluate the utility of the “Cross?Internal Ring” inguinal oblique incision for the surgical treatment of incarcerated indirect hernia (IIH) complicated with severe abdominal distension.
Patients of IIH complicated with severe abdominal distension were reviewed retrospectively. All patients received operation through the “Cross?Internal Ring” inguinal oblique incision.
Tere were totally 13 patients were included, male to female ratio was 9?4. Te time for patients to resume oral feeding varying from 2 to 5 days after operation, no complications include delayed intestinal perforation, intra?abdominal abscess, and incision infection happened. Average postoperative hospital stay was 5.2 days. All cases were followed up for 6–18 months. No recurrence or iatrogenic cryptorchidism happened.
“Cross?Internal Ring” inguinal oblique incision is a simple, safe, and reliable surgical method to treat pediatric IIH complicated with severe abdominal distension.

We aimed to evaluate the associations of gain?of?function allele of CYP2C19*17 and risk of clinical events in clopidogrel?treated patients with cardiovascular and cerebrovascular diseases (CCVDs).
Literature search was conducted in PubMed, EMBASE, and Cochrane Library. Odds ratio (OR) combined with 95% confidence interval (CI) was the pooled statistics. Subgroup analysis was performed by disease type, bleeding events, and race.
Thirteen eligible studies involving 14,239 patients with CYP2C19*17 carriers or noncarriers were included in the meta?analysis. CYP2C19*17 was significantly related to decreased risk of major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with coronary artery disease (CAD) (OR = 0.76, 95% CI: 0.60–0.98, P = 0.03), however, irrelevant with stent thrombosis in neither CAD nor ischemic heart disease patients. CYP2C19*17 was also significantly linked to decreased risk of high platelet reactivity (HPR) inCCVD patients (OR = 0.61, 95% CI: 0.43–0.88, P = 0.008). Meanwhile, CYP2C19*17 was significantly associated with bleeding risk in CCVD patients (OR = 1.89, 95% CI: 1.09–3.25, P = 0.02) but not related to major bleeding risk (OR = 1.35, 95% CI: 0.87–2.08, P = 0.18). Several outcomes in Caucasian subgroup were reverse to the overall results, such as bleeding events and HPR, which lacked significance.
CYP2C19*17 had a significant effect on the reduced risks of MACCE and HPR as well as increased bleeding risk, but not on the risks of stent thrombosis and major bleeding in clopidogrel?treated CCVD patients. Outcomes might be different in different races