مجله دانشگاه علوم پزشکی بابل
سال بیست و دوم شماره 1 (پیاپی 137، فروردین 1399)

Sertraline is one of the antidepressants whose effects on the reproductive system has faced controversial reports. This study was performed to evaluate the efficacy of vitamin E against sertraline-induced injuries on serum and sperm parameters.

In this experimental study, 40 adult male mice were divided into eight groups of 5. Four groups of mice received vitamin E at 100 international units per kg body weight via gavage for 42 days. In three of the above groups, sertraline was administered orally at 5, 10 and 20 mg/kg body weight four hours after receiving vitamin E. One group was considered as the control group. Twenty-four hours after the final treatment, blood samples were collected from the heart and sperm quality parameters including count, motility, viability, chromatin density, abnormal forms, and sperm DNA damage were measured.

Sertraline significantly increased abnormal sperm (25.8±2.04) and significantly decreased the count (30.2±2.77), motility (68.30±2.94), viability (75.4±3.20) and maturation (84.0±1.58) of sperm compared to control group (10.4±1.14, 39.6±2.07, 89.37±1.87, 92.6±3.71, and 97.4±1.14, respectively) (P<0.05). Vitamin E administration significantly improved abnormal sperm (17.8±2.28), count (37.2±1.92), motility (78.27±2.10), viability (83.2±2.38) and maturation (83.4±1.81) of sperm (p<0.05).

The results of this study showed that vitamin E decreases the reproductive toxicity of sertraline in mice by improving serum and sperm parameters.

Nicotine is one of the most common addictive substances that has many effects on the central nervous system, including dose-dependent anxiety that is mediated by various proteins. Since the mechanisms and proteins involved in nicotine anxiety are unclear, the purpose of the present study was to investigate the role of p-CREB (cAMP Response Element-Binding Protein) and c-Fos proteins in the basolateral amygdala (BLA) on nicotine-induced anxiety behaviours.

In this experimental study, 24 male Wistar rats were divided into three groups of 7 (saline, nicotine 0.3 and 0.7 mg/kg, intraperitoneally) in behavioral experiment and four groups of 3 (control: no injection and test, Saline, nicotine 0.3 and 0.7 mg/kg) in immunohistochemical experiments. Anxiety-like behaviours were evaluated with % OAT (Open Arm Time), %OAE (Open Arm Entry), and locomotor activity in the elevated plus maze. The expression of p-CREB and c-Fos proteins in BLA region was also assessed by immunohistochemistry.

Intraperitoneal administration of nicotine at a dose of 0.7mg/kg decreased %OAT (5.4±0.42) and %OAE (29.4±0.61) compared to saline group (15.2±0.82) and (42.1±0.45), indicating an anxiety-like effect (respectively, p<0.001, p<0.01). In addition, there was a significant difference in the expression of p-CREB (H(3)= 6.99, p<0.05) and c-Fos (H(3)=13.11, p<0.01) protein in the BLA between treatment groups. P-CREB protein expression was higher in the BLA area of control group than in the other groups. C-Fos protein expression was significantly lower in the BLA region of the animals of control, nicotine 0.3 mg/kg and 0.7 mg/kg groups compared to saline group (p<0.01).

The results of this study indicated that systemic administration of nicotine induced anxiety-like behaviors at high doses. Also, the expression of P-CREB and c-Fos protein was unchanged and decreased in the treatment groups, respectively.

Busulfan is a chemotherapy drug that has side effects such as hepatic and renal injury. Pistacia atlantica from the family Anacardiaceae has a potent antioxidant agent due to phenolic compounds. The purpose of this study was to investigate the effects of Pistacia atlantica on histopathology and liver and kidney function indicators in busulfan-induced liver and kidney injuries in adult mice.

A total of 28 BALB/c mice were randomly divided into four groups (control, busulfan, bene and bene+busulfan). The busulfan group received 10 mg/kg busulfan as a single dose and intraperitoneally. The bene group received plate containing 10% of bene for 35 days. The bene+busulfan group received 10 mg/kg busulfan+10% bene. Then, liver enzymes alanine amino transferase, aspartate amino transferase, urea, creatinine and histopathology of liver and kidney investigated.

The mean urea (P= 0.009) and creatinine level (P= 0.02) in the busulfan group was 55.2±4.23 and 0.8±0.11 mg/dl that it was significantly higher than the bene + busulfan. A significant decrease in ALT level in the bene + busulfan group compared to the busulfan treated group (P= 0.03). In the bene treated group steatosis, necrosis and fibrosis in the liver parenchyma and glomerular sclerosis, inflammation and tubular atrophy in kidney tissue, was not observed.

The results of present study indicated that administration of 10% bene for 35 days improved histopathology of kidney and liver as well as functional index of liver and kidney after renal-liver injury.

Many deaths from cancer are due to metastases, a process which involves the epithelial-mesenchymal transition (EMT). On the other hand, regular exercise plays an important role in inhibiting the progression of breast cancer. Therefore, the purpose of this study was to investigate the influence aerobic interval training on expression of mesenchymal biomarkers, and tumor volume in mice with breast cancer.

In this experimental study, Thirty-two female BALB/c mice, aged 3-5 weeks (17±1g) were used. The mice were allocated to four groups: Exercise Tumor, Exercise (aerobic Interval training was performed six weeks (40 minutes) before and four weeks (30 minutes) after the induction of carcinoma with active recovery), Rest Tumor, Rest (Control- without exercise), Rest, Tumor, Exercise, (four weeks after the induction of carcinoma) and Exercise, Tumor, Rest (six weeks before the induction of carcinoma). The real-time PCR method was used to evaluate the expression of Vimentin and Twist.

The results of present study demonstrated that tumor tissue Vimentin expression in the Exercise Tumor Exercise (223.0±0.073) group decreased significantly (p= 0.0001), Also, the expression of Twist gene was significantly reduced in Exercise Tumor Exercise group (0.24±0.227) compared to control group (p=0.008). A significant decrease in tumor volume was observed in both RTE and ETE groups compared to the control group (RTR) (p = 0.0001).

Based on the results of this study, a period of interval aerobic training can decrease the expression of Vimentin، Twist and decrease the tumor volume ratio.

Abnormal head posture can lead to pain, physical limitations, falls and fractures that have a negative impact on peoplechr('39')s quality of life. Since head orientation in sagittal view varies according to different body postures, this study was conducted to investigate the effect of two standing and sitting postures on sagittal view.

This observational study was performed on 70 elderly people referred to Elderly Health Center of Babol University of Medical Sciences. In order to measure the craniovertebral angle to determine the direction of the head in the sagittal view, participants were photographed in both standing and sitting positions. After initial evaluation, participants were divided into two groups of head posture (forward head posture and normal head posture) based on craniovertebral angle, with an angle of less than 51° as abnormal head posture.

The mean age of the subjects was 67.9±3.8. The size of the craniovertebral angle in sitting position (52±8.3) was greater than in standing position (48.1±6.5) (P<0.0001). In addition, two subgroups of forward head posture and normal posture showed increased craniovertebral angle in sitting position (forward head posture: 48.3±7.2, normal: 59.6±4.6) comapred to standing position (forward head posture: 43.7±6.5, normal: 56.9±4.2) (P<0.003, P<0.0001, respectively).

According to the results, the craniovertebral angle increases in sitting position compared to the standing position.

Matrix metalloproteinases (MMPs) are a group of enzymes responsible for extracellular matrix breakdown. Increased activity of type 13 is involved in invasion of oral squamous cell carcinoma. This study was performed to compare the level of matrix metalloproteinase13 (MMP13) in saliva and serum of patients with oral squamous cell carcinoma and healthy controls.

In this experimental in vitro study, 24 saliva and 24 serum samples were collected from patients with primary oral squamous cell carcinoma after histopathologic confirmation, whereas 21 saliva samples and 21 serum samples were collected from healthy subjects with mucosal health confirmation. Clinical examination was done for MMP-13 levels in saliva and serum, and the results were compared by ELISA.

MMP-13 levels in serum (7.47±2.36) and saliva (8.42±2.69) of patients with oral squamous cell carcinoma compared to healthy subjects increased respectively by 5.39±1.90 and 6.72±2.11 (P= 0.002 and P= 0.025, respectively). The levels of MMP13 in saliva and serum to determine the existence of oral squamous cell carcinoma has a "good" diagnostic value, with sensitivity and specificity of 88% and 86% respectively for serum, and 88% and 71% respectively for saliva.

According to the results of this study, the levels of MMP13 in saliva and serum of patients with oral squamous cell carcinoma was higher than in healthy individuals and this biomarker had good diagnostic value in the diagnosis of oral squamous cell carcinoma.

The overuse of antibiotics in hospitals and the entry of these pollutants into water resources is one of the major challenges to the health of the community and the environment. Removal of antibiotics from hospital wastewater and other aquatic environments is possible through the adsorption process. This study was performed to evaluate antibiotic removal using plantain wood due to being cheapn and natural.

In this in vitro study, the effect of pH (2, 4, 6, 8, 10 and 12), contact time (5, 10, 20, 40, 60, 80, 100 and 120 minutes), initial metronidazole concentration (10, 50 and 100 mg/L) and biosorbent dose (0.2, 0.4, 0.6, 0.8, 1, 1.2 and 1.4 g) on metronidazole removal rate in synthetic solution were evaluated, and the isothermal kinetic and thermodynamic results of the adsorption process were investigated in this study. Concentration of metronidazole in aqueous solution was measured by Hach DR 5000 UV-Vis Laboratory Spectrophotometer.

Maximum removal of metronidazole (91%) was obtained at pH=6.5, 60 min, initial concentration of 50 mg/l, adsorbent dose of 0.8 g and 25 °C and maximum adsorption capacity (11.38 mg/g) was obtained at a dosage of 0.1 g. In this study, the reaction rate followed the pseudo-second order and adsorption isotherm followed Langmuir equation. The adsorption thermodynamic results showed that the adsorption process is physical in nature and is a spontaneous endothermic reaction.

The results of the study showed that biosorbent prepared from plantain wood is a natural material and has the ability to remove metronidazole antibiotics from hospital wastewater and other aquatic environments.

Colorectal cancer is one of the growing cancers in Iran and one of the few preventable cancers in the World Health Organization. One of the most important ways to early diagnose this malignancy and its underlying lesions (polyps) and subsequently to prevent it is screening. Colorectal cancer is one of the growing cancers in Iran and one of the few preventable cancers in the World Health Organization. One of the most important ways of early detection of this malignancy and its underlying lesions (polyps) and consequently its prevention is screening. Different protocols have been developed for the diagnosis of first degree relatives of known hereditary cases such as HNPCC and FAP, but the diagnosis plan for first degree relatives has not been defined as a group of familial colorectal cancers without known mutations (type X colorectal cancer). The purpose of this study was to evaluate the results of colonoscopy screening in first-degree relatives of these patients.

This cross-sectional study was performed on the families of patients with suspected Lynch syndrome who had no deficiency in the expression of repair proteins. Data were collected from the medical records system of colorectal cancer patients who had been enrolled in the system for prevention and early detection of colorectal cancer at Shahid Beheshti University of Medical Sciences Research Center from 1387 to 1397.

The results of colonoscopy revealed that 18 out of 77 subjects had 23% polyps or tumors in their colon, out of which 55% were polyps and the rest were adenomas. About 60% of polyps were in the rectum and sigmoid and the rest in the colon and cecum. Also, 4 patients in this screening showed tumors in their colon, all of which were newly diagnosed, and 2 patients in this screening were diagnosed with inflammatory bowel disease.

According to the results of this study, in the case of colon polyps, the families of these patients appear to be at high risk like those of Lynch syndrome families and need regular colonoscopy care.

To reduce neonatal death, it should be studied the causes of it in any region or medical centers and with appropriate measures we can improve quality of health care and treatment. To achive this goal, this study was conducted in one of the 3rd referral mother-infant care level centers.

This cross-sectional study was done in intensive care unit (NICU) of Ayatollah Rohani Hospital, affiliated by Babol University of medical science, from 2009 to 2017. The causes of neonatal death were identified based on ICD10 (International Classification of Diseases, Tenth Revision) by laboratory, clinical and Para clinical evidence recorded in patients sheets.

Of the total number of 4029 admitted infants in NICU, 276 cases (6.7%) died that 99 (35.9%)of them died within the first 24 hours. The average annual death was 6.7±1.85 and the gestational age was 29.9±4.77 weeks. These infants were born with an average birth weight (g) of 1300.5±810.04 and lived at average 7.99±10.14 days. The most common causes of death in neonates were sepsis and DIC fallowing it 33.4%, extreme premature less than 26 weeks 18.4%, congenital anomalies 14.8% and respiratory distress syndrome 14.1%.

According to the results of this study, although severe sepsis and prematurity were the most common causes of death after the first 24 hours, RDS management was more favorable than sepsis, and measures should be taken to reduce sepsis.

Identification of cancer risk factors in the community and prevention planning in high-risk groups can be helpful in cancer prevention program. Hence, the aim of this study was to investigate the relationship between reproductive factors and breast cancer in the Tabari population-based cohort study in a case-control design.

This case-control study was performed on the enrolment phase of the Tabari population-based cohort. Patients with breast cancer were considered as case group (51) and non-cancerous individuals (204) as a control group. The two groups were matched based on age category and oral contraceptive pill (OCP) intake. The studied variables included breast cancer history, demographic and reproductive factors.

Mean age of first pregnancy (22.76±4.99 vs. 20.8±4.16, p=0.005), mean age at first birth (23.57±4.94 vs. 21.66±4.07, p=0.006) and age of marriage (22.24±5.75 vs. 19.54±4.92, p=0.001) in the case group were significantly higher than the control group and the number of pregnancies (3.76±2.22 vs. 4.67±2.76, p=0.032) and number of children (3.27±1.97 vs. 4.16±2.44, p=0.019) in the case group was significantly less than the control group. According to multivariate analysis, the odds of incidence of breast cancer in people with first pregnancy over 22 years was 2.76 times more than (p= 0.027) those with first pregnancy age below 22 years.

“Age at first full-term pregnancy” is one of the major risk factors for breast cancer in the area.

Pain and sensitivity to thermal irritation after amalgam restoration is one of the most common problems, causes frequent recurrence of these patients to dental clinics. Since low-level laser has several benefits in reducing inflammation, pain and sensitivity, the aim of this study was to evaluate the effect of low-level Ga-Al-As laser on the treatment of dentinal sensitivity after amalgam restoration.

In this double-blind clinical trial study, 21 patients with short-term sensitivity to thermal irritation after amalgam restoration (from the time of repair to two months) were evaluated. The case group was treated with Ga-Al-As laser in 4 sessions with intervals of three days. For the control group, the similar condition was applied except that the device was off. The sensitivity was assessed based on VAS criteria prior to treatment, immediately after treatment, and 3 and 6 months after treatment.

Pre and post-treatment pain in case group was 7.3±1.16, 4.5±3.03 and in control group was 6.45±1.75, 4.27±3.04 respectively. The reduction in pain immediately after treatment was significant only in the case group (p= 0.004). In the follow-up period of 3 and 6 months, the mean VAS in the case group was significantly higher than that in the control group (p= 0.026 and p= 0.020, respectively).

Based on the results this study, the Ga-Al-As low-level laser has a decreasing effect on the sensitivity of post-amalgam restorations in a short term.

Despite the increased chance of premature survived infants, the morbidity of these infants is still significant. The number of NRBCs in the cord of these neonates may be effective in predicting the long-term complications of these neonates. The purpose of this study is to investigate the relationship between the number of nucleated red blood cells in the peripheral blood of preterm infants and the same prognosis about children at the age of two.

The present study is a cohort study, has been performed on 290 preterm infants younger than 32 weeks old admitted in neonatal ward of Ghaem hospital of Mashhad during years of 93 to 96 with available sampling. Cord blood samples were taken to determine NRBC/100WBC count. Data have been collected by a researcher-made checklist including neonatal, maternal, and laboratory characteristics. Infantschr('39') development up to two years of age has been studied. NRBC/100WBC numbers of infants were compared with normal prognosis (Denver 2 normal test) and abnormal prognosis (death or developmental delay).

Of 290 neonates, 160 of them (55.2%) had normal development, 61 cases (21%) died and 69 neonates (23.8%) had abnormal development. The mean number of mm2 /NRBC and NWBC/100WBC in neonates with abnormal prognosis were 4025.11±210.04 and 31.83±15.14 and in normal neonates were 367.47±76.91 and 5.5±5.29, respectively (p<0.001). An absolute NRBC count> 300/mm2 suggests a poor prognosis at the age of two with a sensitivity of 75% and a specificity of 63%.

According to these results the mean of NRBC2/mm2 and NRBC/100WBC can be helpful in determining neonatal prognosis at the age of two.

Micro leakage is one of the major causes of failure to repair and subsequent caries. The difference in the structure of enamel and dentin in deciduous teeth can affect the selection of bonding agents. The purpose of this study was to compare the micro leakage of class 5 restorations using self-etch universal bonding and fifth-generation total etching in primary anterior teeth.

In this in-vitro study, 45 healthy anterior deciduous extracted teeth were randomly divided into three groups of 15 each. Class 5 cavities were created on the buccal surface of all teeth. Then restoration was done in first group by using Universal Self-etch Bonding Saremco, in the second group using Universal Self-Bonding G Permio Bond and in the third group using 5th generation Total-etch TNT Tetric-Bond, and using Filtek Z250 composite. Micro leakage was investigated using methylene blue based on the intensity of 0 to 3.

In Tetric-N Bond group, 33.3% had no micro leakage, 53.3% had first degree micro leakage, and 13.3% had second degree micro leakage. In group G Permio Bond, 33.3% had first degree micro leakage, 53.3% had second degree micro leakage and 13.3% had third degree micro leakage. In Saremco-Bond group, all teeth had grade 3 micro leakage. The distribution of micro leakage intensity in the Saremco group was significantly different from the Tetric-N group (p= 0.000) and the G-permio group (p= 0.002).

The results of the present study showed that the Universal Self-etching Saremco Unibond had more micro leakage than the other two bonds.

Due to the proximity of epicardial adipose tissue (EAT) to the myocardial tissue, it is considered that EAT be more pathogenic than subcutaneous adipose tissue. The aim of this study was to evaluate the alterations of PGC-1α andUCP1 gene expression in EAT and orexin-A following aerobic exercise in high-fat diet induced and obese male wistar rats.

In this study, 32 male wistar rats aged 6-week and weight of 180-200 g, assigned randomly in: 1) Normal fat diet (NFD), 2) High-fat diet induced obesity (HFDO), 3) Normal fat diet after high-fat diet induced obesity group (HFDO-NFD) and Aerobic exercise group with normal fat diet after high-fat diet induced obesity group (HFDO-AEX). After obesity-induced in HFDO group (8-week diet with 60% fat) and 48 hours after eight weeks of aerobic exercise (60% of maximal training capacity, 4 sessions/week) in other groups, fasting levels of OXA, Lee index, lipid profile, and gene expression of PGC-1α and UCP1 in EAT have been measured.

The results revealed that HFD significantly decreased serum OXA, HDL-c, gene expression of PGC1α and UCP1, also caused a significant increase in Lee index, TG, LDL-c, cholesterol and EAT mass (p≤0.001), but aerobic exercise significantly improved the OXA (34.74%), HDL-c (23.65%), gene expression of PGC-1α and UCP1 (61.28% and 82.67%), lipid profile, EAT mass (76.19%) and Lee index (18.34%) to the normal levels (P≤ 0.001).

Aerobic exercise by affecting OXA and gene expression of PGC-1α and UCP1 in EAT, probably could reduce the risk factors of cardiovascular diseases due to high-fat diet.

Prematurity is a serious health problem and an important risk factor in neonatal mortality. This study aimed to determine the incidence rate of preterm newborns in the neonatal care unit and to study their different causes and risk factors in relation to their outcomes.

We conducted a prospective cross-sectional study in Misan Hospital for Child and Maternity during the whole year of 2018. All preterm neonates with gestational age 26-37 weeks needed ventilation support and associated with risk factors were enrolled in this study. Different preterm variables were studied in relation to their outcome including gestational age, birth weight, length, head circumference, gender, type of pregnancy, mode of delivery, presence of congenital anomaly, ventilation support. While maternal variables include age, address, antenatal care, education, past maternal history, and maternal risk factor such as antepartum hemorrhage, premature rupture of membrane, hypertension, diabetes mellitus, previous cesarean section, and previous premature labor.

There was a predominance of males with mean gestational age and birth weight of (32.6±3.1) weeks and (1755.25±485.8) grams, respectively. Prematurity and its complications were responsible for more than one-third of neonatal hospitalization and their mortality rate was 36.1%. We found a converse significant correlation between the gestational age, as well as, anthropometric parameters of preterm infants and their outcomes (p<0.05). Preterm mortality was more significant in those who delivered vaginally or needed ventilation support. High maternal educational level, urban setting and more antenatal visits were associated with less neonatal death. While antepartum hemorrhage, abortion, and premature rupture of membrane were associated with poor outcome.

A high rate of preterm admission was observed in the neonatal care unit of Misan hospital with subsequent poor outcome. Determining their risk factors can be used to improve the outcome.

Fear of disease progression and rejection of what happened and not being able to distinguish oneself from mental processes cause confusion in mental health. Since acceptance and commitment therapy emphasizes on modification of dysfunctional processes such as avoidance and fusion and their change to acceptance and commitment, the present study was conducted to examine the effectiveness of acceptance and commitment therapy on self-differentiation and fear of disease progression in patients with breast cancer.

This clinical trial was performed on 30 patients referred to the Touba Oncology Center in Sari, who were randomly divided into two groups of experiment and control (n= 15). The treatment was performed in eight 90-minute sessions in the experimental group. Participants were assessed and compared based on questionnaire of self-differentiation and fear of disease progression before the experiment and two months after that.

The results showed that fear of disease progression in the pre-test compared to the post-test decreased in the experimental group (135.11±4.27 versus 126.05±3.12) and in the follow-up period, this decease continued in the experimental group (125.32±3.05) (p< 0.05). In addition, the mean score of self-differentiation in pre-test compared to post-test increased (67.12±12.5 versus 77.17±4.51) and this increase continued in the follow-up period (75.4±3.34)
(p< 0.05).

The results of the study showed that acceptance and commitment therapy management could be effective in increasing self-differentiation and reducing the fear of disease progression in breast cancer patients.

Prematurity and low birth weight are one of the major health problems and the most common causes of infant mortality. Infant massage is potentially beneficial for physiological and psychological health. The present study was conducted to compare the effect of massage with coconut oil and sunflower oil on the growth of premature infants.

This clinical trial was performed on 100 premature infants admitted to the neonatal intensive care unit of Amirkola Childrenchr('39')s Hospital in 2018 in four groups of 25 infants. Infants of the intervention groups with one cc of sunflower oil and coconut oil and the oil-free massage group were massaged for 15 minutes three times a day for seven days with the help of a research assistant, and the control group received only routine care. The weight, height, and head circumference of infants were collected using a personal profile questionnaire and compared in four groups at the beginning and end of the intervention.

Comparison of mean weight and head circumference changes at the end of the first week between coconut oil massage group (0.134±0.334 cm, 6.81±3.04 g), sunflower oil massage group (0.239±1.172 cm, 6.35±2.69 g), oil-free massage group (1.061±1.534 cm, 2.95±2.65), and control group (0.663±1.174 cm, 3.52±4.38 g) showed significant difference (p<0.05). Comparison of mean height changes in different groups (0.413±0.739, 0.448±0.747, 0.458±0.693, 0.429±0.611 cm, respectively) did not show any significant difference.

The results of the study showed that oil massage is recommended as it increases the rate of changes in weight gain and head circumference in premature infants.

Assessing health systems paves the way for reforms in structures and processes to achieve better results. Therefore, the present study was conducted to evaluate the implementation of family physician program in urban and rural areas of Mazandaran province using process approach.

This cross-sectional study was conducted in 2017 among 238 managers, health experts and health insurance experts who were selected by census from 12 cities. Data were collected and evaluated using a researcher-made questionnaire with high validity and reliability, which evaluates urban and rural family physician program in three domains of structure, process and outcomes.

The mean score of the domain of structure (4.27±27.38), process (4.33±0.41) and outcomes (4.31±0.39) of rural family physician program was significantly higher than urban family physician program (p<0.001). In the urban family physician program, the most important dimension in the domain of structure was equipment (3.35±0.76), in the domain of process was care for non-communicable diseases (3.15±1.06) and in the domain of outcomes was reasonable prescription of medicine (3.07±1.02). In the rural family physician program, the most important dimension in the domain of structure was physical space (4.41±0.60) and in the dimensions of process and outcomes, the health of mothers and children (4.20±0.90) and the improvement of health promotion indicators (4.33±0.76) were more important, respectively.

Based on the results of this study in three domains of structure, process and outcomes, the rural family physician program was relatively better than the urban family physician program.

Low levels of vitamin D are associated with clinical effects such as gastrointestinal disorders, cardiovascular disorders, autoimmune disorders, neuropathic diseases, cancer and metabolic syndrome. Carpal Tunnel Syndrome (CTS) is the most common cause of compression neuropathy, which has recently been linked to vitamin D deficiency in the onset or severity of symptoms. Therefore, this study was performed to evaluate the serum levels of vitamin D in patients with carpal tunnel syndrome.

This case-control study was performed on 100 patients referred to the neurology clinic of Ayatollah Rouhani Hospital with clinical symptoms of CTS for at least 3 months and 100 patients as a control group who referred to the same clinic for nerve conduction velocity test and did not show symptoms of CTS in clinical examination and electrophysiology. Patientschr('39') function, disease severity and pain were measured based on the Boston Carpal Tunnel Questionnaire (BCTQ). Serum vitamin D levels were also measured and compared between the two groups.

The mean age of patients was 43.53±10.68 years and controls were 45.48±7.12 years. The mean serum vitamin D levels in patients and controls were 19.18±11.39 ng/dL and 21.39±15.93 ng/dL, respectively. In controls, 57 women suffered from vitamin D deficiency (p<0.05). There was no significant difference between the two groups in terms of disease severity, function status, pain severity, electrophysiological defect, involved hand, dominant hand and symptoms associated with vitamin D deficiency and there was a negative correlation in vitamin D levels with disease severity, function and pain of patients.

The results showed that there was a relationship between serum vitamin D levels and gender. In addition, a negative correlation was observed between serum vitamin D levels and patientschr('39') disease severity and function and electrophysiological defects.

Chronic periodontitis is a slow-growing inflammatory disease that often occurs in adults. In the elderly, periodontal indices may also change due to a number of psychological factors, such as depression and consequent changes in cortisol levels. Therefore, this study was performed to investigate the relationship between depression and periodontal indices in the elderly in Amirkola, Northern Iran.

This case-control study, which is part of the second phase of the Amirkola Health and Ageing Project (AHAP) to investigate the health status of the elderly in this city, was performed on 300 elderly people. After examination, subjects were divided into two groups: periodontitis (n=100) and control (n=200). In both groups, the presence of depressive symptoms was assessed using the Geriatric Depression Scale (GDS), in which a score of 5 or higher is a sign of depression, and periodontal indices including OHIS and PDI were examined based on PDI≥4 periodontitis criterion. Then, the two groups were compared in terms of the association between periodontal indices and depression.

In this study, 133 were female (44.3%) and 167 were male (55.7%). 35 patients (35%) in the case group and 61 patients (30.5%) in the control group had symptoms of depression. The mean GDS score in patients with periodontitis (3.70±3.68) was slightly higher than healthy individuals (3.49±3.40), but no significant correlation was observed between GDS and PDI. Old age, male gender, lower level of education and smoking were higher in patients with periodontitis, which was statistically significant only in smoking and level of education (p=0.042 and p=0.009, respectively). In this study, a positive and weak relationship was observed between age and PDI (r=0.19 and p=0.001).

The results showed that there is a relationship between periodontal indices and depression. Although it was not statistically significant, it is clinically noteworthy.

Transferring a premature infant from the hospital to home is a burden for the family. One of the most important goals of the health system is to facilitate the transition of the infant. The aim of this study was to investigate the effect of the presence of a support nurse on the safe transition of premature infants from the hospital to home.

This clinical trial was performed in the presence of 60 mothers of premature and very premature infants (26-35 weeks) discharged from the neonatal intensive care unit of a hospital in Isfahan (2018). Mothers were randomly assigned to control and intervention groups. Data collection was done through a questionnaire and a researcher-made checklist. The intervention included the presence of a support nurse from the time of discharge, who accompanied them along the way, and stayed at their home for 1 to 3 hours. The nurse supported the family by training and performing the required care. The effect of the nurse s presence on the variables of home environment, infant health status and safe transition conditions was evaluated and compared.

Based on the results of the study, the mean score of home environment (87.73±10.45) and the mean score of safe transition (83.79±17.90) in the control group were higher more than the intervention group (81.45±16.49 and 80.77±16.52, respectively). The mean score of infant health status was the same in the two groups.

The results of the study showed that mothers were well empowered in intensive care units and discharge instructions have been able to provide safe transition for premature infants.

Systemic lupus disorder is a heterogeneous autoimmune disease that can affect any organ of the body. Leptin affects the activation, differentiation and proliferation of immune cells. This study aimed to evaluate the serum level of leptin and its relationship with disease activity and some inflammatory factors in women with systemic lupus erythematosus (SLE).

In this cross-sectional study, 40 women with SLE who were admitted to the rheumatology ward of Urmia Imam Khomeini Hospital during the second semester of 2017 and 40 healthy controls were enrolled. Serum leptin concentration was measured by sandwich ELISA method in two groups. In SLE patients the disease activity was calculated using Systematic lupus erythematous activity index (SLEDAI). Inflammatory factors including CRP (C-reactive protein) and ESR (Erythrocyte Sedimentation Rate) were extracted from the patientchr('39')s records at the time of admission.

Serum leptin level was significantly different in patients (44.51±25.6) and controls (22.37±12.58) (p<0.001). Also, Serum leptin level was significantly higher in the active phase than inactive phase of the disease (active phase: 67.13±24.88, inactive phase: 24.88±12.37) (p<0.001). There was a positive correlation among serum leptin and activity level (r=0.7, p<0.001), ESR (r=0.53, p<0.001) and CRP (r=0.34, p=0.027).

Leptin serum level is high in patients with systemic lupus erythematous and is positively associated with disease activity.

Pain is a complex set of unpleasant sensory, emotional, and cognitive experiences that are relieved with synthetic and herbal remedies. Of course, medicinal plants are more important than chemical drugs due to fewer side effects. Solanum dulcamara is one of the most important medicinal plants used in traditional Iranian medicine to treat rheumatic and inflammation pains. The aim of this study was to investigate the analgesic, anti-inflammatory and acute toxicity effects of Solanum dulcamara stem in male mice.

In this experimental study, 84 male mice were used in 6 groups such as control and treated groups with essential oils of 30, 100 and 300 mg/kg. In pain assessment tests that included writhing (assessment of abdominal contractions), Tail Flick (assessment of tail jump duration), and formalin (assessment of pain associated with sole of foot), animals were given gavage or oral morphine (intraperitoneally) and naloxone (Intraperitoneally) with a dose of 300 mg/kg of essential oil. In the xylene test (to evaluate inflammation), the animals were divided into 5 groups: control, essential oil (oral) and dexamethasone (intraperitoneal).

Use of 300 mg/kg essential oil in writhing tests (decreased from 41 in control to 13) and tail flick (increased from 2.8±0.2 seconds in control group to 6.1±0.5 seconds) showed significant analgesic effect (p<0.01). Also, in the xylene test, the use of 100 and 300 mg/kg of essential oil reduced the rate of ear inflammation in mice by 4.1±0.8 and 3.8±0.1, respectively, compared to the control group.

It seems that SDEO probably have both analgesic and anti-inflammatory effects in male mice.

Ocular thyroid disease is a common complication associated with Graveschr('39') disease and hyperthyroidism, which in severe cases there is a risk of irreversible loss of vision. The aim of this study was to compare the visual acuity, refractive errors, proptosis and ocular deviation of these patients with healthy individuals.

In this historical cohort study, 65 patients with history of thyroid disease were compared with 65 healthy subjects. Patients in the age range of 24 to 60 years with a history of thyroid disease and healthy individuals were selected from those who referred to the eye clinic who did not have thyroid disease. The proptosis of the eyes was measured with Hertel exophthalmometer. Visual acuity of the patients was measured with Snellen chart and refractive error measurement was done with an auto-refractometer.

Of the patients, 53 (81.5%) were males and 12 (18.5%) were females. Sphere refractive error in patients and healthy individuals was -0.85±2.44 diopters and -0.46±1.26 diopters, respectively. The mean visual acuity in the patient and healthy groups was 0.91±0.13 and 0.96±0.08 in Snellen unit (p≤0.0001), respectively. The mean proptosis in patient and healthy individuals was 17.7±2.55 mm and 16.05±1.86 mm (p≤0.0001), respectively. The mean of total eye astigmatism in patient and healthy individuals was -1.11±1.19 diopters and -0.6±0.66 diopters, respectively (p≤0.0001).

Higher astigmatism and proptosis and decreased visual acuity in the patients, indicating thyroid disease has affected on the involved eye.

Studies have suggested that HLA-G is involved in protecting the fetus against the motherchr('39')s immune system, and upstream polymorphisms of this gene may influence pregnancy success by effecting its expression. The aim of this study was to evaluate the association of upstream HLA-G gene polymorphism, rs1736933, with recurrent spontaneous abortion in East Azerbaijan women population.

This case-control study was performed on 80 women with at least one child and without any history of abortion, and 100 women with at least two recurrent spontaneous abortions which were diagnosed by gynecologist. 2 ml of blood was obtained from the participants and after DNA extraction, a segment of the HLA-G gene promoter was amplified by PCR and analyzed by agarose gel electrophoresis. PCR products were sequenced and genotyped. Allelic and genotypic frequencies of patient and control groups were compared.

Frequency of AA, CA, CC genotypes in the patient group were 8(8%), 37(37%), 55(55%) and in the control group were 16(20%), 33(41.25%), 31(38.75%) respectively. Comparison of genotypic frequencies between the two groups showed that CC homozygous genotype was associated with recurrent abortion (p= 0.015). Statistical analysis also showed a significant difference between the allelic frequencies of the two groups (p= 0.019).

The results of this study showed that the upstream HLA-G gene polymorphism, rs1736933, is associated with the recurrent abortion in East Azerbaijan women population.

Intraoperative bleeding during endoscopic sinus surgery compromises the surgeon s vision for surgery at the surgical field. Since tizanidine causes contraction of peripheral blood vessels and hypotension, which together reduce blood flow to nasal mucosa, this study was performed to evaluate the effect of oral tizanidine on the quality of vision at the surgical field during endoscopic sinus surgery.

This double-blind clinical study was performed on 60 patients. Patients were randomly divided into two groups by computer randomization software (2.0) and received 6 mg tizanidine and placebo before the surgery. During the operation, the quality of the operation field was evaluated and scored by the surgeon based on Boezaart scale. Pain score in recovery and 6 hours after surgery and intraoperative hemodynamic parameters were assessed.

The quality of the surgical field based on the Boezaart scale was significantly better in the group receiving tizanidine (p=0.04). Pain score in recovery was 2.83±1.17 in the case group and 4.53±1.56 in the control group (p=0.001). Pain score 6 hours after surgery in the case group was 3.23±1.22 and in the control group was 4.13±1.33 (p=0.008). Mean arterial blood pressure (p=0.03) and heart rate (p=0.19) during surgery were lower in the tizanidine group.

The results of the study showed that tizanidine as a perioperative medication before endoscopic sinus surgery improves the quality of vision at the surgical field and provides a better hemodynamic profile for patients.

Neuropathic pain is a common complication of diabetes. Today opioid analgesics such as morphine, use for the management of neuropathic pain. Since the respiratory effects of morphine have not been studied in diabetes, the aim of this study was to investigate the effect of chronic hyperglycemia on the effects of morphine on respiration.

32 Male Wister rats were randomly allocated into control group (injection of citrate buffer as streptozotocin solvent), morphine group (injection of citrate buffer as STZ solvent and injection of morphine before respiratory recording) group, hyperglycemia group (STZ injection), and hyperglycemia-morphine group (STZ injection and morphine injection before respiratory recording). Hyperglycemia was induced by injecting streptozotocin (35 mg/kg, i.p.). Respiration was recorded by plethysmography after which respiratory volume, inter-breath interval, and respiratory rate were quantified using MATLAB.

Mean of respiratory rate (in the hyperglycemia was 83±3.9 and control was 101±4 (p<0.05)), coefficient of variation of respiratory rates (in the hyperglycemia was 0.615±0.1 and control was 1.05±0.07 (p<0.05)), mean of respiratory volume (in the hyperglycemia was 1.44±0.19 and was control 1.1±0.11 (p<0.05)), and mean of inter-breath interval (in the hyperglycemia was 1.28±0.01 and control was 0.93±0.03 (p<0.05)). coefficient of variation of respiratory volumes (in the hyperglycemia-morphine was 1.14±0.16 and was morphine was 1.68±0.1 (p<0.05)), mean of respiratory rate (in the hyperglycemia-morphine was 1.24±0.34 and morphine was 0.37±0.04 (p<0.05)), and mean of inter-breath interval (in the hyperglycemia-morphine was 1.09±0.07 and morphine was 0.74±0.05 (p<0.01)).

Our results show that chronic hyperglycemic changed breathing pattern and respiratory response to morphine.

Detecting and accurate determining of vascular embolism dimensions are considered as a challenging issue in CT imaging. Present study aimed to enhance the accuracy of vascular embolism volumetry in managing a proper diagnosis and treatment of the disease.

In this non experimental quantitative study, firstly we simulated coronary and aorta arteries with normal dimensions in a 4D extended NURBS based cardiac-torso phantom in a matrix sizes of 512×512 with slice thickness of 0.116 mm. Then, twenty five venous thromboembolisms with the diameters ranged 0.1-5 and 5-20 mm were created in the coronary arteries and aorta of the Phantom, respectively. The Medical Imaging Interaction Toolkit was used for localization and volume measurement of the produced venous thromboembolisms on the CT images. Finally, Accuracy of the measured data was compared with the simulated measures in the phantom.

The difference on measures with the software was obtained 0.03±0.021 for embolies less than 4.64 mm (0.1 ml), (r=0.67, p=0.02), and 0.02±0.008 mm for embolies greater than 4.64 mm (r=0.99, p<0.001).

According to the acceptable volumetry accuracy of Medical Imaging Interaction Toolkit especially for volumes greater than 0.1 ml, may be used for an accurate thromboembolism and pulmonary embolism measurements.

Postoperative pain management is considered as a part of recovery. Duloxetine (DLX), an anti-depressant medication, is a possible choice for the multimodal anesthetic strategy. We aimed to evaluate the effect of Duloxetine on postoperative hysterectomy pain management in patients who underwent hysterectomy.

In this randomized double-blind clinical trial, 60 patients aged 18-85 years with ASA I and II who were candidates for hysterectomy were randomly assigned to two group of 30 patients taking duloxetine (60 mg capsule) or placebo (starch). Opioid use, postoperative pain due to visual analogue score, vital signs and quality of recovery (Recovery-40 form), vital signs before induction of anesthesia, immediately after surgery, at isoflurane induction and after surgery every 15 minutes were reviewed and compared in two groups.

The amount of opioids in the duloxetine group decreased insignificantly. Postoperative pain in recovery and ward in duloxetine group (2.7±0.99 and 1.8±0.66, respectively) compared to placebo group (4.86±1.51 and 4.86±1.51, respectively) decreased significantly (p= 0.006 in recovery and p= 0.001 in ward). The quality of improvement in recovery (156.22±24.25 in the duloxetine group and 125.48±16.49 in the placebo group) was in favor of the effectiveness of duloxetine (p= 0.001).

In conclusion, DLX is a beneficial drug to be used in multimodal anesthesia strategy especially in improving postoperative pain and quality of recovery in abdominal hysterectomy.

Elevated CRP level is independently associated with the excessive risk of ischemic stroke. However, there is currently no consensus on the use of CRP in detecting and tracking the progression of cerebrovascular diseases. The aim of this study was to determine the relationship between CRP and outcome in stroke patients.

This was an analytical cross-sectional study. Patients admitted with diagnosis of ischemic stroke were enrolled. Demographic, and clinical characteristics, medical history, drug abuse and tobacco use and severity of stroke (National Institute of Health Stroke Scale) were completed in checklist.

Of the total 214 patients, the serum CRP levels in 122 cases (57%) were positive. The mortality during the first week of hospitalization included 17 cases (8%). The differences in CRP serum level with underlying disease such as Diabetes Mellitus (82 cases (51%) of positive CRP vs. 77 cases (49%) of negative CRP, p= 0.007) and Hypertension (59 cases (50.4%) of positive CRP vs. 58 cases (49.6%) of negative CRP, p=0.03) were statistically significant. In addition, high CRP was seen in 10 thrombotic (91%) and 4 embolic (67%) of stroke expire patients (p= 0.034). The difference in CRP serum level in mortality cases was statistically significant (14 cases (82%) of positive CRP vs. 3 cases (18%) of negative CRP, p= 0.032).

The positive CRP serum level at the admission was accompanied by more severity of disability in stroke survivor. Checking serum level of CRP in admission is suggested for predicting disability and mortality rate during the first week of post-stroke hospitalization.

Bulk fill composites are an innovative class of dental resin composite materials, developed to simplify the restoration procedures, and are preferred to conventional composites if they have good mechanical properties and marginal seal. The aim of this study was to evaluate the fracture resistance of premolar teeth with mesio-occlusodistal (MOD) cavities restored with bulk and conventional composites.

In this experimental in-vitro study, 40 sound maxillary premolar teeth were randomly divided into five groups: Group I: Positive control, intact teeth. In the remaining four groups, MOD cavities were prepared. Group II: Negative control, unrestored teeth. In other groups, cavities were restored as follows; Group III: (X-tra fil, bulk filling with 4mm-thick increment), Group IV: (X-tra base, bulk filling+Grandio, incremental filling) Group V: (Grandio, incremental filling with 2mm-thick increment). The restored teeth were stored in distilled water for 24 hours at 37oC and thermocycled (500 cycles). Specimens were subjected to a compressive load until fracture, and the fracture resistance was recorded in Newton.

The highest fracture resistance values were obtained in group I (1150±507 N) and the lowest in group II (85±62.51 N), which was significantly lower than other groups (p=0.001). The fracture resistance of bulk fill composites and conventional composite did not differ significantly with intact teeth.

The restoration of teeth with moderate MOD cavity size using bulk fill composites can restore the lost tooth strength to a level comparable to intact teeth and similar to conventional composite.

Today, the use of medicinal plants in the treatment of cancer is more important due to its fewer side effects. Vascular endothelial growth factor (VEGF) is one of the most important factors in stimulating angiogenesis and promoting cancer. The aim of this study was to investigate the inhibitory effect of Valeriana Sysimberifolia root extract on proliferation of lung cancer cells (A549) and VEGF gene expression in treated cells.

The hydro alcoholic extract of Valeriana Sysimberifolia root was prepared by percolation. After preparation of cell line A549 from the Iranian Biological Resource Center, cancer cells were treated in culture medium with different concentrations of plant root extract (50, 25, 12.5, 6.25, 3.12, 1.56, 0.78 µg/ml) at 24, 48 and 72 hours and viability was performed by MTT assay at all three time. Real Time-PCR method was used to evaluate the expression of VEGF gene in cancer cells treated with IC50 concentration of plant extract.

With increasing the concentration of the extract and the treatment time, a decrease in viability of cancer cells was observed. The highest inhibition of cell proliferation was observed at a concentration of 50µg/ml after 72 hours (94% growth inhibition) which was significant compared to the control group (p= 0.0001). Also, with increasing treatment time, decreased VEGF gene expression was seen compared to the control group. Thus, a two times decrease in VEGF gene expression was seen in cells after 72 hours (p= 0.0017).

Valeriana Sysimberifolia root extract has anti-proliferative and anti-angiogenesis activity. It seems that further studies can be used as a biological product in the treatment of cancer.

Intussusception is the most common cause of intestinal obstruction and one of the most common causes of abdominal emergencies in children, which can lead to significant mortality and morbidity if left untreated. Since vitamin D acts as a hormone in the body and plays an important role in preventing infectious and non-infectious diseases and regulating the intestinal immune response, this study was performed to investigate the relationship between vitamin D levels and the occurrence of intussusception.

This case-control study was performed on 86 children under 6 years old and above the neonatal age referred to Amirkola Childrenchr('39')s Hospital in 2017-2018. The diagnosis of intussusception was made by ultrasound and the control group (without intussusception) was selected from patients with elective surgery other than intussusception. Vitamin D levels of children were assessed and compared in the two groups of children with and without intussusception.

In this study, 50 people were in the intussusception group and 36 people were in the control group. The mean age was 27.2±14.6 months in the intussusception group and 24.7±15.9 months in the control group (p=0.447). The mean serum 25-hydroxyvitamin D levels in children with intussusception was 36.5±14.4 ng/ml and in the control group was 32.7±13.1 ng/ml (p=0.212).

According to the results of the present study, there was no association between serum 25-hydroxyvitamin D levels in children with and without intussusception and this vitamin was not associated with the occurrence of intussusception.

Hydatid disease is a common health problem in developing countries. The liver and lungs are the most common organs affected by this infection. Hydatid cyst is very rare in the inguinal area. The aim of this case report was to introduce a patient with multiple hydatid cysts in the right inguinal area who developed symptoms of inguinal hernia.

CASE REPORT: 

The patient is a 92-year-old man who was referred to Imam Reza Hospital in Mashhad due to pain, swelling and redness in the right inguinal area. The patient s blood tests showed an increase in neutrophils, and a decrease in eosinophils, basophil and monocyte. Ultrasound examinations of the patient revealed right inguinal hernia and hydatid cysts in the liver, abdomen and pelvic cavity. Finally, the patient was operated with a diagnosis of incarcerated inguinal hernia. During the operation, multiple cysts were observed in the inguinal area; the cysts were removed and sent to pathology. Pathological findings confirmed the presence of hydatid cyst. After 2 days, the patient was discharged in relatively good general condition and with albendazole (400 mg) twice daily for 6 months. At the end of the treatment period, no signs of recurrence of hydatid cyst were observed in the patient.

According to the cases reported in patients diagnosed with hydatid cyst with inguinal pain, the possibility of migration or hernia of hydatid cyst should be considered, because knowing its presence is useful for preoperative planning and reduction of complications.

Mouth discoloration can be of internal or external origin. Melanotic nevus are the result of benign proliferation of melanocytes, the intraoral type of which is not as common as melanotic skin moles. In addition, they have the potential for malignant changes and can develop into oral melanoma. In this article, a case of Polypoid Intraoral Nevus is reported.

CASE REPORT: 

In intraoral examination, a 21-year-old man who had referred to the Oral Diseases Department for dental scaling and examination showed a prominent black lesion with a smooth, 1×1 cm long lobular surface and a firm consolidation in the buccal mucosa. The lesion was asymptomatic and not sensitive to touch. Chronic stimulation was not reported on clinical examination and history, and the diascopy test was negative. Systemic disease and history of drug and tobacco use were not reported. The lesion was removed by excisional biopsy while maintaining a safe margin. The macroscopic specimen was a brownish-gray lesion with elastic consolidation and the microscopic appearance of benign proliferation of nevus cells and melanin production in the connective tissue was observed. The final diagnosis was an intra-mucosal lesion. The patient referred for regular six-month examinations for two years, during which no recurrence or similar symptoms were observed in the oral mucosa.

In the present case, the histopathological result indicated a mucosal nevus after excisional biopsy.

A high-fat diet can disrupt the antioxidant system and damage the liver. One of the most important ways to control non-alcoholic fatty liver is to use natural compounds with antioxidant properties. Therefore, this study was performed to evaluate the effect of coconut oil on cholesterol, triglyceride and antioxidant status in high-fat diet- induced rat liver.

In this experimental study, 30 male rats were randomly divided into 6 groups of 5 including: 1) control group, 2 and 3) control+10% and 8% virgin coconut oil, 4) only receiving high fat diet, and 5 and 6) receiving high fat diet+10% and 8% virgin coconut oil. Coconut oil was prepared daily and mixed with animal food. At the end of the study, the rats were anesthetized and liver tissue was isolated and used for antioxidant tests.

In this study, the levels of triglyceride (159±11.5) in the high-fat diet group increased significantly compared to the control (64±4.2) (p<0.001). Treatment of high-fat diet group with coconut oil at doses of 8% (104.5±9.1) and 10% (97.5±8.2) was able to reduce triglyceride levels (p<0.05) significantly. Cholesterol (118±6.7) in the high-fat diet group increased significantly compared to the control (60±6.6) (p<0.001). Treatment of high-fat diet group with coconut oil at a dose of 10% (94±5.3) was able to reduce cholesterol (p<0.01) significantly.

According to the results of this study, virgin coconut oil can be useful in the treatment of fatty liver by reducing lipids and increasing antioxidants.

Newborns admitted to the neonatal intensive care unit (NICU) , would be undergo a large number of X-ray imaging due to their involvement with various diseases The most important complication of receiving too much X-rays is an increased risk of various cancers. The aim of this study was to determine the average cumulative dose received by neonates admitted to the neonatal intensive care unit.

This cross-sectional study was performed on 20 neonates admitted to the intensive care unit of Taleghani Children s Hospital who were randomly selected. Infant information registrated including time of birth, arrival time, duration of hospitalization, age, sex, weight and number of radiographs performed on the infant and radiographic information including tube-to-patient distance, tube voltage (kVp) and milliamperes (mAs). The amount of skin absorption dose of each patient was evaluated using MTS700 thermoluminescence dosimeter and the number of imaging was examined.

The amount of entrance skin dose of the studied neonates with an average of 78 micrograys varied from 42 to 121 micrograys (78±19.6). The mean number of imaging and cumulative dose were 6 (6±7.71) and 521 micrograys (521±547.99), respectively. The highest cumulative dose (2106 μg) was related to a neonate who underwent 27 imaging.

According to the results of this study, the need for multiple imaging of these infants can significantly increase their absorption dose, especially in infants with very low weight.

In addition to reducing the costs in hospitals, manpower planning can ensure the quality of patient care. Therefore, this study, which is part of a comprehensive study, was conducted with the aim of applying the birth rate method to estimate the number of midwives required in the maternity ward.

In this analytical study, 334 patients who referred to the delivery ward of two hospitals affiliated to the Social Security Organization in Khorasan Razavi province were selected by systematic random sampling. Retrospective data were collected from patients  medical records using the Birthrate Plus (BR+) model questionnaire consisting of 34 items related to maternal and neonatal clinical factors based on scores obtained in five groups (score 6 in group one, score 7-9 in group two, score 10-13 in group three, score 14-18 in group four, and score 19 and above in group five). Then, the data were analyzed.

The results showed that the duration of stay in the maternity wards of the province and district hospitals was 12.07±5.18 and 7.17±4.22 hours, respectively (p<0.001). The mean duration of midwife s care in the two hospitals was significantly different (p<0.001). The results indicated more patients with complex conditions in the maternity ward of the province hospital. According to the "BR+" model, about 60% of patients in the province hospital were in groups 4 and 5, while it was 18% in another hospital. The number of midwives required in district and province hospitals was 27 and 72, respectively, based on full-time equivalent (FTE), which was obtained by converting it into an index equivalent to one midwife for 142 and 95 annual deliveries in the mentioned hospitals.

The results of the study showed that the use of the BR+ model, considering the length of stay and the severity of clients symptoms, is a suitable model for determining the midwifery staff in the maternity ward.

Cardiovascular disease is the leading cause of a large percentage of deaths worldwide. With the improvement in the survival of coronary artery disease patients in recent decades, continuous self-care programs (based on education and prevention) are increasingly recommended. The aim of this study was to evaluate the effect of continuous care model on quality of life, self-efficacy and adherence to the treatment regimen of patients undergoing coronary artery bypass graft.

This quasi-experimental study was performed with a single group before and after the intervention among 85 patients undergoing coronary artery bypass grafting in Tehran Social Security hospitals in 2016. Data were collected based on demographic questionnaires, McNew quality of life (lowest score 27 and highest score 189), general self-efficacy (lowest score 10 and highest score 40), and researcher-made regimen questionnaire (3 areas of diet, medication, and physical activity), (score of each domain 0-100%, undesirable adherence: less than 50% of the total score, desirable adherence: more than 75% of the total score). The intervention was based on the continuous care model (orientation, sensitization, control, evaluation). Training sessions were held for 4 weeks (stages 1 and 2) while control and evaluation were performed during 8 weeks after that. Questionnaires were completed and analyzed by patients before and 3 months after the intervention.

The results showed that the scores of quality of life, self-efficacy and treatment regimen of patients before the intervention were 72.08±3.55, 25.08±2.48 and 180.18±9.61, respectively, and after the intervention were 85.13±0.63, 38.76±1.11, and 287.94±2.36, respectively. There was a statistically significant difference between the mean score of self-efficacy, quality of life and treatment regimen before and after the intervention (p<0.001).

According to the results of this study, the continuous care model has a positive effect on increasing the quality of life, self-efficacy and treatment regimen of patients.

Trigger finger is a condition in the finger that is locked in flexion or has a heterogeneous movement and is one of the most common causes of pain in the hand; the first line of treatment is the use of corticosteroids. Due to the fact that corticosteroid injection has side effects in diabetic patients, therefore, this study was performed to compare the results of injecting non-steroidal anti-inflammatory drugs (NSAIDs) as an alternative treatment instead of corticosteroid injection in trigger finger therapy.

This double-blind clinical trial study was performed on 84 patients with trigger finger referred to Shahid Beheshti Hospital in Babol which were divided in two equal groups of 42 individuals of injections of diclofenac and methylprednisolone. The severity of the disease was compared according to the Quinnell classification (with a score of 0-4) and the rate of improvement in the two groups in the first, third, sixth weeks and third, sixth and twelfth months.

The mean age in the diclofenac injection group was 52±9 years and in the prednisolone group was 53±7 years. There was no statistically significant difference between the two groups in terms of age, sex, presence of underlying disease, symptoms and duration of disease. The need for re-injection due to no improvement in symptoms was 34 patients (81%) in the diclofenac group and 20 patients (46%) in the methylprednisolone group (p=0.001). In the methylprednisolone group, the mean Quinnell rank was 1.4±0.8. The rate of recovery was higher in the methylprednisolone injection group than in the diclofenac group. From the beginning of the study to week 6th and from the beginning of the study to the 12th month, the improvement rate in the methylprednisolone injection group was significantly better than the diclofenac group (p=0.0001).

The results of the study showed that both treatments are effective in improving the symptoms of trigger finger disease. But corticosteroid injections are associated with better and faster results in long-term and short-term studies.

Preeclampsia is a common disease during pregnancy that may be associated with maternal and fetal mortality. Since the pathogenic process of preeclampsia begins during the first trimester of pregnancy, it is very difficult to identify biomarkers of early detection of preeclampsia. The aim of this study was to determine the predictive validity of systolic, diastolic and mean arterial blood pressure in the first trimester of pregnancy in the diagnosis of preeclampsia.

This case-control study was performed on 200 pregnant women referred to Ayatollah Rouhani Hospital in Babol within a historical cohort. The data of the records of 100 pregnant women with preeclampsia diagnosis (case group) and 100 healthy women (control group) were filled in special forms and compared.

According to ROC curve analysis, in the first trimester for systolic blood pressure at the cut-off point of 117.5, sensitivity of 56% and specificity of 70%, for diastolic blood pressure at the cut-off point of 72.5, sensitivity of 68% and specificity of 63% and for mean arterial pressure at the cut-off point of 87.5, sensitivity of 67% and specificity of 66% were calculated. Based on the area under the ROC curve, the diagnostic power was 0.706, 0.663 and 0.709, respectively (p<0.001).

The results of the present study indicate that arterial pressure can be used as an effective method in identifying women at risk for preeclampsia as a selection criterion in testing, treatment or prevention.

The effectiveness of ovarian function suppression therapies in patients with non-menopausal breast cancer has not yet been established. This study was performed to evaluate the role of gonadotropin-releasing hormone agonist (GnRH agonist) receptor in reducing local recurrence or metastasis in non-menopausal women with localized breast cancer.

This clinical trial was performed on 104 non-menopausal women with localized and advanced localized breast cancer (in stages 2 and 3) with positive hormone receptor (HR+) in the two groups of control and intervention with GnRH analog. The control group received standard treatment at the time of the study, which included tamoxifen. The GnRHa group received 3.75 mg triptorelin subcutaneously per month in addition to the standard treatment. Patients were evaluated for local recurrence and metastasis within 36 months.

The mean age of patients was 39.78±3.99 years. 9 patients in the control group (mean metastasis time of 17±6.65 months) and 6 patients in the GnRHa group (mean metastasis time of 14.33±8.12 months) had metastasis (p=0.498). The 36-month disease-free survival was 83.3% in the control group and 88% in the GnRHa group (p=0.518). 36-month disease-free survival in patients with HER2, 1+ or higher levels was greater in the GnRHa group compared to controls (p=0.049). In patients who received GnRH analogues, patients with HER2/neu 1+ and above had 20.7% less metastasis than patients with HER2 0 (p=0.029). However, this significant difference was not seen in the control group and other variables.

According to the results of this study, GnRH analogues do not have a significant effect on reducing the rate of metastasis in patients who received it compared to other patients in a short-term period.

Chronic ankle instability is a common injury in athletes that leads to postural control disorders. The aim of this study was to compare the effect of external focus of attention and postural task alone on center of pressure sway in athletes with chronic ankle instability and healthy athletes during dual task training.

This cross-sectional study was performed on 29 male volleyball athletes with a referral from a specialist and 29 healthy athletes matched with the affected group in terms of age, height and weight. Subjects in the two groups were on the balance board with single-leg and double-leg stance, standing in the center of the force plate for 60 seconds and performing postural tasks alone and with external focus. The degree of displacement of the pressure center was measured to investigate the variables of standard deviation of amplitude and mean velocity.

In double-leg stance, standard deviation of amplitude in medio-lateral (14.2±2.1) and anterior-posterior (16.7±3.3), mean velocity in medio-lateral (39.2±9.8) and anterior-posterior (40.7 ± 6.1) directions in patients during external focus were significantly less than the standard deviation of amplitude in medio-lateral (12.2±1.5) and anterior-posterior (13.9±2.4), mean velocity in medio-lateral (46.2±13.1) and anterior-posterior (48.4±9.6) directions during the single task. In single-leg stance, standard deviation of amplitude in medio-lateral (16.1±2.1) and anterior-posterior (13.1±1.7), mean velocity in medio-lateral (42.2±13.3) and anterior-posterior (40.7±8.6) directions in patients during external focus were significantly less than the standard deviation of amplitude in medio-lateral (11.1±2.1) and anterior-posterior (17.4±3.3), mean velocity in medio-lateral (47.8±16.6) and anterior-posterior (55.2±17.4) directions during the single task.

The results of the study showed that external focus task leads to distraction from postural control and reduces postural sway in athletes with chronic ankle instability.

Hydatidosis is possible in all organs. However, brain involvement is only observed in only 1-2% of patients and is very rare. Common symptoms of brain involvement include headache, vomiting, seizures, behavioral disorders, or unilateral symptoms such as paralysis of one half of the body. Here we present a patient with cerebral hydatidosis that has recurred due to drug interactions between phenytoin and albendazole.

CASE REPORT: 

The patient is a 19 -year- old man with a history of cerebral hydatidosis who underwent two surgeries with complaints of generalized tonic-clonic seizures. CT scan of the brain showed a lobule cyst with internal septa in the right hemisphere of the brain with an adjacent lesion that has wall calcification, suggesting cerebral hydatidosis. To control the patient s seizures, sodium valproate was substituted for phenytoin and oral albendazole was recommended in consultation with the Infectious Diseases Service. The patient was discharged after five days in good general condition.

According to this case, concomitant use of anticonvulsant drugs including phenytoin, phenobarbital, and carbamazepine with albendazole has been reported to reduce plasma levels of albendazole and reduce its efficacy. Therefore, to control seizures in patients with cerebral hydatidosis treated with albendazole, it is better to use other anticonvulsant drugs.

Stroke is caused by a disturbance in the blood flow to a part of the brain, and it is the most common disorder that requires long-term care. Maintaining the stability of vital signs in stroke patients with modern non-pharmacological methods is very important, so this study was conducted to investigate the effect of foot massage duration on vital signs of patients with cerebrovascular accidents in the intensive care unit.

In this clinical trial, 64 patients were randomly assigned into two groups (32 people) of intervention 1 and 2. Samples were selected from patients with cerebrovascular accidents with lowered level of consciousness admitted to the intensive care unit. A four-step foot massage was performed similarly 5 minutes in group 1, and 10 minutes in group 2. In the groups, vital signs were measured and compared 2 minutes before the massage and in the first and fifth minutes after the massage.

According to the findings, the mean heart rate (79±10.62 and 76.50±9.72) and respiration (16±3.20 and 15.03±3.02) decreased in the intervention groups (1 and 2) in the first minute and the fifth minute after massage (p<0.001). Mean arterial pressure in intervention group 2 (95.15±12.54 and 92.09±12.63) decreased in the first and fifth minutes after massage (p<0.001). Body temperature in group 1 in the fifth minute after massage (36.99±0.37 and 36.95±0.36) showed a decrease (p=0.005). There was no statistically significant difference between the two groups in changes of physiological indices.

According to the results of this study, foot massage duration has no effect on the stability of vital signs and short-term massage has the same effect as long-term massage.

Understanding the status and trend of changes in mortality due to road accidents over time is an important step for health policy making in order to reduce mortality. The aim of this study was to investigate the trend of deaths due to road accidents in Iran.

In this cross-sectional study, the trend of deaths due to road accidents in Iran between: 2006-2017 were examined including the number of annual deaths by gender and province, population each year, using the sites of the Forensic Medicine Organization and the Statistics Center of Iran. The Bayesian approach connection point regression analysis method was used to analyze the data. Data analysis was performed using R3.5.1 and JAGS 4.3.0 software.

On average, 27 people per 100,000 people were killed in traffic accidents during 2006-2017. The highest negative growth rates were related to 2007 and 2011 with 15.4% and 10.7%, respectively. The most victims were men and the highest number of casualties were in Semnan and Markazi provinces with 52.6 and 43 people, respectively, and the lowest in Tehran-Alborz and Ardabil provinces with 12.1 and 17.9 people, respectively, per One hundred thousand people during the years 2009-2010.

The results of this study showed that the mortality rate due to road accidents during the study period has been decreased.

Health behaviors, includes physical activity, nutrition, spiritual growth, responsibility, interpersonal relationships, and stress management. Since there is no specific tool for measuring the health behaviors of Iranian pregnant women, this study was conducted for the first time in the Iranian population in order to psychoanalyze the Persian scale of prenatal health behaviors scale.

This cross-sectional psychometric study was performed on 200 pregnant women in Babol and Amol pregnancy clinics by available sampling method. During the pregnancy care visit, women with a gestational age of 14 weeks or more completed demographic questionnaires and pregnancy health behaviors with a score range of 0-48. Scale psychometrics were performed using Cronbach s alpha and internal consistency obtained from retesting, exploratory and confirmatory factor analysis and with Amos software.

The mean health-promoting behaviors of pregnant women were 24.8±5.5 and destructive health behaviors were 23.7±14.2. The results of factor analysis showed that this scale in Iranian pregnant women has four domains of behavioral habits / destructive health nutrition, behavioral habits / health promoting nutrition, physical health promoting activities, destructive physical health habits with explained variance of 65.13%. Intra-cluster correlation index in all four areas of the questionnaire and also the total score of the test was above 0.9, which confirms the repeatability of this test.

According to the results of this study, the Persian scale of pregnancy health behaviors has a validity and reliability to assess the health and destructive behaviors of pregnant women in Iranian society and can be used in clinical and research situations.

Professional assistants are among the learners whose ability in terms of professional ethics and commitment influences their future performance after graduation so that, as an excellent physician, they can combine patient care with confidence and desirable medical skills. Considering that no comprehensive assessment of the national guideline on regarding of establishment of medical residents to the professional ethics has been published, so far this study aimed to evaluate the activities of medical universities to conduct this program.

This cross-sectional study was conducted to assess the activities of the major medical universities in region one, where had medical residents, during 2015-2018. Information on the formation of committees related to the evaluation of feedback, teaching the basics of professional ethics and how to respond to residents by asking managers of different levels of the university in the Medical Ethics Council, the Vice Chancellor for Education, medical School, department heads and departments Educational and medical centers with assistants.

Four universities of medical sciences (80% of the target population) with 4 faculties, 8 educational hospitals and 8 educational departments were evaluated. The implementation and activities of committees to investigate the professional ethics of assistants in the educational departments and hospitals of different universities has not been exactly in accordance with national guidelines. The hospital committee and the medical school committee have been established in accordance with the national guideline only at one university. None of the universities in the region had a fourth-level university committee.

This study shows the establishment of a national program of commitment of medical assistants to the principles of professional ethics in the majority of macro medical universities in region one and the attention of different levels of universities, including senior administrators, faculties, educational centers and clinical departments in different dimensions of this program especially training for assistants to commitment to professional principles in these universities.

Insects are the cause of excessive spread of parasites and pathogens. Insect population control faces the challenges of increasing resistance to chemical pesticides and the environmental hazards posed by them. Therefore, the use of natural insecticides is important. The aim of this study was to investigate the synergistic effect of geraniol and betacitronellol on the larvae of Culex Pippins complex.

In this cross-sectional study, samples were taken from the Insectarium of Babol University of Medical Sciences. Yield of geraniol, betacitronellol and their combination in ratios of 4:1, 3:2, 2:3 and 1:4 in a total of 6 groups on the larvae of the third stage of the mosquito culex Pippins complex at concentrations of 0.5, 1, 2, 5, 10 and 20 μg/ml were evaluated with 5 replications. Needle test was used to determine whether the larvae were dead or alive. The LC50 of each group was then recorded after 24 hours.

The highest mortality of larvae belonged to the geraniol group with LC50 equal to 48.1 µg/ml. While betacitronellol with LC50 equal to 49.10 µg/ml had the lowest toxic dose. Among the four combined ratios of geraniol-betacitronellol, the highest toxicity was related to the ratio of 1:4 and the lowest toxicity was related to the ratio of 4:1 with LC50 of 3.32 and 7.71 µg/ml, respectively, and antagonistic effect was observed in all ratios (p<0.05).

The results of the present study showed the antagonistic effects of the combination of geraniol with betacitronellol on mosquito larvae of Culex Pippins complex.

Mothers with premature infants often experience a lot of anxiety, and since music has positive effects on anxiety, the present study was conducted to investigate the effect of music on the anxiety of mothers of infants admitted to the neonatal intensive care unit.

This clinical trial was performed on 120 mothers with infants admitted to the neonatal intensive care unit of Rouhani Hospital in Babol and Bu-Ali Sina Hospital in Sari. Samples were randomly divided into two groups of experimental and control each consisting of 60 patients. In the experimental group, relaxing music was played daily through mobile phones and headphones for each mother individually for 10 minutes in 10 sessions. No intervention was performed for the control group. Both groups of mothers completed the Spielberger State-Trait Anxiety Inventory (STAI) before the start of the study and on the tenth day and were compared.

The mean age of mothers was 27.8±5.71 years and the mean age of infants was 3.92±3.88 days. In this study, anxiety was relatively severe or severe in 60% of mothers before the intervention. Levels of overt anxiety and covert anxiety in mothers of music groups before the intervention (59.48±13.66), (55.62±12.26) showed a significant decrease compared to after the intervention (31.27±6.57), (33.08±8.66), respectively (p<0.0001).

The results of the study showed that music is effective in reducing the anxiety of mothers with infants admitted to the neonatal intensive care unit.

 The platelet-to-lymphocyte ratio (PLR) might be an important and critical measure in evaluating and anticipating undesirable outcomes in patients with acute coronary syndrome (ACS). What was discussed in this study was systemic evaluation of the role of PLR in predicting adverse outcomes of ACS (including mortality and MACE) both in the short term and in the long term.

 In this systematic review, studies related to platelet counts, lymphocytes, acute coronary artery syndrome were searches in Medline, Web of knowledge, Google scholar, Scopus, and Cochrane databases. Finally, 15 related studies were reviewed, including 7 prospective studies and 8 retrospective studies.

 In a review of 15 articles, a total of 8304 patients in the group with low PLR and 5822 patients in the group with high PLR were considered. The increase in PLR can increase the risk of short-term and long-term mortality by 0.3 and 1.8 times, respectively.

 Based on the results of this study, the increase in PLR can effectively predict early and long term adverse events in patients with ACS

 Giant hemangiomas are less likely to be present at birth. This syndrome is caused by obstruction of the portal veins of the liver and requires surgical intervention. Treatment of hepatic hemangiomas varies depending on the symptoms, location and size. In this study, giant hepatic hemangioma in a patient with Budd-Chiari syndrome was reported.

CASE REPORT:

 The patient is a 57-year-old woman with a giant hemangioma in the liver who has referred to Montaserieh Hospital in Mashhad with symptoms of liver failure, anorexia and early satiety and obstruction of hepatic portal veins. She did not mention any specific drug or food allergies. Except for the heartbeat, all other vital signs were in the normal range. Initial examinations diagnosed giant liver hemangiomas and ascites. After performing the required diagnostic tests, the liver weighing about 10 kg was removed and a liver transplant was performed. After 13 days, the patient was discharged in good general condition.

 One of the rare indications for liver transplantation is giant hepatic hemangioma, which causes liver dysfunction and Budd-Chiari syndrome. Liver transplantation in these patients improves their life and shows good results.

 Proportional relationship between different facial structures, including soft tissue thickness and dental and skeletal components, is the key to beauty. Today facial soft tissue harmony is the primary goal of orthodontic treatment, unlike the past which focused only on hard tissue and dental occlusion. The aim of this study was to measure facial soft tissue thickness in the northern population of Iran with class I skeletal pattern in lateral cephalometry and compare these values between males and females to use the results in orthodontic treatment and craniofacial reconstructions.

 In this cross-sectional research, 180 lateral cephalometry of 77 male and 103 female, aged between 18-24 years who had referred to private orthodontic offices, were traced on acetate paper. Then, 10 anatomical variables were measured in Glabella, Nasion, Rhinion, Subnasal, Upper lip, Stomion, Lower lip, Labiomental region, Pogonion and Menton parallel to the Frankfurt plan.

 Facial soft tissue thickness in males was significantly higher than females in Nasion (male=5.65±1.55, female=4.38±1.47), Rhinion (male=3.07±0.64, female=2.5±0.57), Subnasal (male=16.39±2.55, female=14.05±1.44), Upper lip (male=15.51±2.29, female=13.57±1.64), Lower lip (male=16.48±1.85, female=14.64±1.39), Labiomental (male=11.02±1.46, female=10.49±1.67) and Pogonion (male=11.4±1.64, female=10.32±1.77) (p<0.05).

 Based on the results of this study, there was a significant difference in facial soft tissue thickness between the two genders in the north Iranian population so that males had more facial soft tissue thickness than females in most of the areas.

 Typhoid fever could have a wide range of complications. Pancreatitis is a rare complication in children with typhoid fever. The aim of this case report is to describe a case of typhoid fever presented with acute pancreatitis (AP).

CASE REPORT: 

A 13-year-old girl with fever and abdominal pain around the umbilical region lasting one week was referred to the Amirkola Children’s Hospital. She had recurrent non-bloody, non-biliary vomiting and watery diarrhea while she had dysentery during admission. She had drunk spring water in a recent trip. The stool culture was positive for Salmonella Typhi. The Widal test results were first: TO:1.80, TH:1.80 and after one week: TO:1.320, TH:1.320. Hydrotherapy along with treatment with cefotaxime (50 mg/kg for 14 days) recovered the patient from dysentery, nausea and fever. After one week, she complained of periumbilical abdominal pain, vomiting and tenderness of epigastric region. Lipase level was elevated to 500 U/L and her pain became worse. Spiral abdominopelvic CT scan showed normal liver, spleen, gallbladder and bile ducts. However, the pancreas tail was hypodense and larger than normal. The pancreatitis was treated by hydration and intravenous pantoprazole. After two weeks of admission, she was discharged with remission, and the lab tests and ultrasound examination were normal within a 4-week follow-up.

 According to this case report the pancreatitis should be considered in children with typhoid fever and persistent abdominal pain.

 Recurrent Aphthous Stomatitis (RAS) is one of the most common oral mucosal diseases. Nowadays, the majority of published systematic reviews is increasing, hence healthcare decision makers are meeting much evidence in order to solving their clinical problems. The aim of the present umbrella review was to report current knowledge on etiology, diagnosis and treatment of RAS.

 In the present umbrella review, we searched for systematic reviews using PubMed, ISI web of science, Scopus and the Cochrane Library from the beginning of 2000 up to end of 2018 using the following key words: “systematic review” “Meta-analysis” and “aphthous”. Two investigators independently screened, extracted the data, and quality appraised the papers using Joanna Bridges Institute (JBI) protocol.

 Finally, 18 systematic reviews were included (8 on etiology and 10 on treatment). Out of these papers, findings of 6 meta-analysis suggested that hematologic deficiencies, interleukin polymorphism and helicobacter pylori seem to have association with RAS, however for treatment of RAS (including: topical, systemic and laser therapy) there were not conclusive findings.

 According to results of this study, hematologic deficiencies, interleukin polymorphism and helicobacter pylori are among the novel etiologies of recurrent aphthous stomatitis, although there is no presented unique and conclusive treatment option for this common lesion yet.

 Hyperthermia has been reported as a new and adjunctive treatment of cancer in inhibiting DNA repair, increasing radiation sensitivity of cancer stem cells, increasing the sensitivity of drug-resistant cancer cells, and inhibiting cancer signaling pathways that cause apoptosis, suppression of cancer stem cell proliferation and disruption in cellular function. The aim of this study was to investigate the effect of hyperthermia on the gene expression pattern of drug resistance and cell survival.

 In this in vitro study, two cell lines of human colorectal adenocarcinoma HT-29 and SW-48 were cultured. The cells of the hyperthermia and control groups were exposed to 42 or 43 °C and 37 °C for 2 hours, respectively. Then the effect of hyperthermia on cell survival was investigated by MTT method. The expression pattern of MDR1 and MRP4 genes was also measured using qRT-PCR.

 Hyperthermia reduced cell survival, but this reduction was not significant. Hyperthermia decreased MDR1 gene expression in SW-48 cells (p=0.007). Although MDR1 expression in HT-29 cells was significantly reduced at 42 °C, no significant difference was observed between the hyperthermia and control groups. Hyperthermia also had no significant effect on MRP4 gene expression in SW-48 and HT-29 cell lines.

 The results showed that hyperthermia reduces the gene expression related to drug resistance, but has no significant effect on cell survival.

 The most common cause of spinal cord disorder in adults is cervical spondylotic myelopathy. Surgical treatment of cervical spondylotic myelopathy prevents neurological disorders. The surgical procedure of choice should have the least complications with the best results. Therefore, this study was performed to evaluate the treatment outcomes of posterior approach surgery in patients with cervical spondylotic myopathy.

 This cross-sectional study was performed on 93 patients with cervical spondylotic myelopathy for two years in Al-Zahra Hospital in Isfahan without a history of cervical spine surgery and spinal stenosis who underwent laminectomy. The criterion for measuring the severity of the disease was the Modified Japanese Orthopedic Association (MJOA) index to determine the severity of myelopathy (condition of the upper and lower limbs and sphincter condition). The studied variables included age, gender, disease severity and surgical complications including hematoma, infection, neurological symptoms and dura injury. Patients were evaluated before surgery and 6 months and 12 months later in the spine clinic.

 In this study, 27 men and 66 women with a mean age of 60.06±10.35 years participated. The severity of myelopathy increased from 10.11±3.78 at the beginning of the study to 13.46±2.9 and 13.88±2.7 at six months and twelve months after surgery. In the upper, lower extremities and sensory disorders, a significant improvement was observed in patients in the sixth and twelfth months (p<0.001). Infection was observed in a small number of patients.

 Based on the results of this study, the use of elective surgery improved the symptoms of patients with cervical spondylotic myelopathy in six months and one year follow-up.

High infiltration of glioma cells into the surrounding brain tissue is the cause of treatment failure in glioblastoma. Glioblastoma interactions with endothelial cells increase the migration of cancer cells. The aim of this study was to investigate the effect of tranexamic acid (TXA) on reducing the migration of glioblastoma and endothelial cells and the levels of metalloproteinases-2 and -9 (MMP-2/9) in co-culture conditions.

In this experimental study, cells prepared from Pasteur Institute were treated with different concentrations of TXA in mono-culture and co-culture. Cell survival was determined by MTT assay. The rate of migration was assessed by making grooves in the culture dishes and comparing the groove area at different time intervals in the control and treated groups with 6 and 24 mM TXA. The levels of MMP-2/9 enzymes in the control group and cells treated with 6 mM TXA were assessed by zymography.

Decreased survival of T98G and HUVECs cells was observed in mono- and co-culture from 60 mM TXA and above (p=0.0001). Groove area in HUVECs group treated with 6 and 24 mM TXA were 0.27±0.05 and 0.36±0.04 of initial groove area, respectively, which was significant compared to the control group (p=0.034, p=0.005). No difference in groove size was observed in T98G cells. In co-culture group, the groove size 36 hours after the start of the study in the control group was 0.12±0.01, which was significantly lower than T98G + HUVECs groups treated with 6 (0.28±0.06) and 24 (0.39±0.07) mM TXA (p=0.01 and p=0.002). TXA significantly reduced the levels of MMP-2 (p=0.0001) and MMP-9 (p=0.0001) in co-culture conditions.

The results showed that TXA could reduce the migration of glioblastoma and endothelial cells as well as the levels of MMP-2/9 in co-culture conditions.

Mother - infant attachment is impaired with the hospitalization of the premature infant and separation from the family, which impairs the infant s development and the mother s ability to care for the infant. The aim of this study was to determine the effect of infant massage on attachment behaviors in mothers of premature infants.

This cluster randomized controlled trial was performed on 54 mothers and premature infants 34 to 36 weeks hospitalized in the intensive care unit of Shahid Sadoughi and Afshar hospitals in Yazd. First, the research was divided into control and experimental groups by random draw method and then the samples were selected by convenience sampling. In the experimental group, each mother massaged her infant once a day for 5 consecutive days. The control group received only the routine care. Maternal attachment was measured and compared using Avant s mother-infant attachment behavior questionnaire with a minimum score of zero and a maximum of 195 in both groups during breastfeeding and interaction with the infant, before the intervention, on the third day and fifth day after the intervention.

Mean score of mothers attachment behaviors in the experimental group on the third day (50.63±6.06) and the fifth day (66±9.96) showed a statistically significant difference with the control group on the third day (44.67±4.12) and the fifth day (49.70±4.75), respectively (p<0.001).

The results of the study showed that massage in premature infants can be effective in increasing maternal attachment behaviors.

 Healthy, adequate, balanced and varied nutrition during pregnancy is essential for the health of mother and baby. Considering the need for proper nutrition for fetal growth and supply of mineral reserves and the role of nutrition in preventing pregnancy complications in mother and baby and the importance of sources of nutrition information, the aim of this study was to investigate the nutritional status of women in the first trimester of pregnancy and the role of information sources on it in Tehran.

 In this cross-sectional study, 330 primiparous pregnant women referred to Najmieh and Shahid Mostafa Khomeini hospitals in Tehran in 10-12 weeks of gestation were selected by convenience sampling and their nutritional status was assessed using a 147 item food frequency questionnaire. Demographic characteristics questions and sources of nutrition information during pregnancy were asked by a trained midwife.

 The mean age of the subjects was 26.02±3.70 years. Sources of nutrition information during pregnancy were 29.7% from the Internet and mobile phones, 20.3% from books, 14.2%, mothers, 11.5% radio and television, 9.1% health care staff and 7.6% from other sources and 7.3% of women had no source of information. Mean consumption unit of food groups and subgroups/day during the first trimester of pregnancy for bread and cereals was 7.3±3.12, for meat and eggs was 1.07±0.65, fruit 3.56±2.05, vegetables 2.17±1.15, dairy products 2.18±1.86, protein 2.42±1.23, nuts 1.00±0.79, fat 7.01±3.75, sugar 5.21±3.45, processed meats were 0.04±0.09 and bean was 0.34±0.30 units. The most important sources of nutritional information during pregnancy were Internet and mobile phone and books and a significant relationship was found between the use of Internet, books and mobile phone and the mean consumption of dairy products, vegetables, fruits and grains (p<0.05).

 The results of the study showed that the highest consumption of food groups belongs to the bread and cereals group and the lowest to the dairy group. Furthermore, the best sources of information were the Internet, mobile phones and books.