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Background and aim: Up to now, proper wound care management has remained as an important clinical challenge. Chitosan nanosheets (CNSs) showed a great potential in tissue engineering, but our knowledge about their wound healing effectiveness is based on very limited data. Thus, the aim of this research was to evaluate the wound healing potential of CNSs and honey as a vehicle for these nanoparticles. Methods: The skin e xcisional wound injury model was made in adult male BALB/c mice ( n  = 60) by creating two identical sized wounds (5mm) on either side of their dorsal midline. The animals were divided into five groups ( n  = 12 each) as untreated control, honey, polyethylene glycol, and CNSs dissolved either in honey or polyethylene glycol. Animals were received their relative topical treatments twice per day for 14 consecutive days. Tissue sampling was carried out on days 4, 7, 10, and 14 post wounding. The histological parameters including inflammatory cells infiltration, fibroblast proliferation, re-epithelialization, granulation formation, and collagen formation were evaluated in all studied time points. Results: Compared to the control group, CNSs showed significant wound healing activities with lower inflammatory cells infiltration, higher fibroblastosis and new epithelium thickness, and greater granulation area and collagen fibers density in the ulcer bed. In addition, honey synergistically increased the wound healing activity of the studied nanoparticles. Conclusion: These results showed that CNSs have promising wound healing activity specially when dissolved with honey concurrently., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Although evidence-based guidelines and effective treatments exist for dyslipidemia, a significant disparity remains between guidelines and clinical practice. In this study, we investigated adherence to statin therapy per the 2018 ACC/AHA Guideline recommendations., Methods: This is a retrospective, descriptive-analytical study involving 1,224 individuals who presented to the laboratories located in Birjand, Eastern Iran, from June 2022 to March 2023. Analyses were conducted on 700 patients. Data collection utilized a checklist and serum value measurements of laboratory factors deemed necessary for the study., Results: Treatment was administered per the guidelines for 348 out of the 700 patients (49.7%). With 60.7%, the diabetes group exhibited the highest level of adherence to guidelines. In the atherosclerotic cardiovascular disease (ASCVD) group, 31.7% followed the recommendations. The lowest adherence rates were in groups with a 10-year ASCVD risk score of ≥20% and severe hypercholesterolemia, respectively (0% and 2.8%). In our study, atorvastatin was the most frequently prescribed statin, with the majority of patients consuming a moderate-intensity statin. None of the severely hypercholesterolemic patients achieved the LDL goal. Moreover, LDL-C goal achievement was low among the ASCVD group and those with an ASCVD risk score of ≥20%., Conclusion: Patients with hypercholesterolemia adhere inadequately to the AHA Guideline. Consequently, training courses are needed to inform medical doctors, particularly general practitioners, of the latest dyslipidemia treatment recommendations as the AHA advises., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2024 Behdani, Kazemi, Zardast, Khosravi Bizhaem and Jafari.)

Background: Chlorpyrifos (CPF) is an organophosphate pesticide that inhibits acetylcholinesterase (AChE) activity. Investigations have also focused on its neurotoxicity, which is independent of AChE inhibition. Here, we evaluated the effect of CPF on oxidative indices in the brain tissue and explored the protective effect of curcumin (Cur) against its toxicity., Methods: Forty male Wistar rats were divided into five groups, each consisting of eight rats (n = 8) per group. Animals were administrated by oral gavage for 90 days with the following treatments: control (C), CPF, CPF + CUR 25 mg/kg, CPF + CUR50, and CPF + cur 100 received olive oil, CPF, CPF plus 25 mg/kg of CUR, CPF plus 50 mg/kg of CUR, and CPF plus 100 mg/kg of CUR, respectively. After anesthetization, animal brain tissues were obtained for assessment of oxidative stress indices., Results: The concentration of MDA significantly increased in the brains of the CPF group as compared to the control group (p < 0.01). Also, a significant decrease in MDA concentrations was observed in the brains of rats in the CPF + Cur 100 group compared to the CPF group (p < 0.05). A significant decrease was noted in the GSH concentration in the brains of the CPF group compared to the control group (p < 0.05). Treatment with Cur at 100 mg/kg exhibited a significant increase in GSH concentrations in the brains of the CPF-exposed group compared to the CPF group without Cur administration (p < 0.05). The concentration of NO exhibited a significant increase in the brains of the CPF group when compared to the control group (p < 0.05). Also, a significant decrease in NO concentration was observed in the brain tissue of the CPF + Cur 100 group compared to the CPF group (p < 0.05)., Conclusion: Our data establish that chronic exposure to CPF induced oxidative stress in brain tissue, which was reversed by CUR administration. Additional experimental and clinical investigations are needed to validate the efficacy of CUR as a potential antidote for CPF poisoning., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Objective: The present study aimed to investigate the impact of cinnamon on liver regeneration in a rat model of partial hepatectomy (PH)., Materials and Methods: Thirty-two old male Sprague-Dawley rats (12 weeks old) were randomly divided into two equal groups (n=16). One group was fed with a standard diet (control) while the other group was fed with the same diet containing 1% cinnamon for 41 weeks. Then, all animals were subjected to the PH procedure and their livers were studied on postoperative days 2, 10 and 28. The liver contents of hepatic growth factor (HGF), insulin, malondialdehyde (MDA), nitric oxide metabolites (NOx), superoxide dismutase (SOD) and tumor necrosis factor-alpha (TNF-α) were evaluated. Also, the serum levels of liver function markers (alanine aminotransferase (ALT) and aspartate aminotransferase (AST), MDA, NOx and SOD activity were measured., Results: The regenerated liver weight was significantly higher in cinnamon-treated animals than the controls on both day 10 and 28 post hepatectomy. The hepatic MDA levels in the cinnamon-treated animals were significantly lower than the control rats. Cinnamon led to a significant increase of SOD on day 2 after hepatectomy in serum and liver content. The basal level of HGF in the liver of cinnamon-consuming rats was significantly higher than in the control rats. Hepatic insulin level was significantly increased relative to baseline and control on day 2 in the cinnamon-consuming rats. Hepatic TNF-α levels dramatically decreased on postoperative days (POD) 2 relative to baseline in the control and cinnamon-treated rats., Conclusion: Long-term cinnamon consumption enhanced liver regeneration outcomes in old rats., Competing Interests: The authors have declared that there is no conflict of interest.

Objective: Diabetic nephropathy is one of the most common microvascular complications of diabetes mellitus that finally leads to complete loss of kidney function. Therefore, this study aimed to evaluate the effect of crocin and losartan on TGF-β gene expression and histopathology of kidney tissue in a rat model of diabetic nephropathy., Materials and Methods: Forty male Wistar rats were randomly divided into five groups (n=8): Untreated control, Diabetic (D), D + crocin, D + losartan, and D + losartan + crocin. Induction of diabetes was performed using streptozotocin (50 mg/kg/ Intraperitoneal injection). At the end of the eight-week period, the rats were sacrificed. Spectrophotometry measured serum glucose, urea, creatinine, and uric acid levels. Microalbumin and creatinine levels were measured in 24-hour urine. Real-time PCR was used to determine the relative expression of the TGF-β gene in kidney tissue. Renal tissue histopathology was also examined., Results: The results showed that hyperglycemia increased biochemical factors associated with diabetes, TGF-β gene expression, and kidney damage. Separate treatment with crocin and losartan led to a decrease in renal function factors and TGF-β gene expression and improved kidney damage., Conclusion: Our results showed that crocin could improve kidney function in diabetic conditions. In addition, we showed that crocin increases the effectiveness of losartan. Consequently, we suggest that crocin in combination with chemical drugs can be a potential therapeutic agent for diabetes and its complications. Nonetheless, human studies are needed to make firm findings., Competing Interests: The authors have declared that there is no conflict of interest.

The medical curriculum consists of basic pre-clinical and clinical parts. Basic sciences are required for diagnostic and clinical reasoning but students do not have a positive attitude toward basic sciences, mostly because of the lack of clinical relevancy. Basic sciences have many applications in the prevention, diagnosis, and treatment of a broad range of diseases but do not attract the attention of medical students. The aim of this study was to investigate the influence of clinical experts' opinions on the attitude of medical students toward basic sciences, particularly immunology. The opinion of six clinical specialists in different fields was recorded in a video clip, presenting the application of basic sciences and immunology in their routine practice. The attitude of second-year medical students toward the basic science courses was evaluated by a questionnaire containing four ranking questions and one short answer. The video clip was streamed and after that, students were answering the same questions. In total, 188 students including 129 s-year students (M/F ratio: 0.92) and 59 third-year students M/F ratio: 0.90) participated in the study. For all ranking questions, the mean score was significantly increased after watching the interviews' film streaming. Before watching the video clip, only 14.9% of students considered immunology as an important course but after that, the percentage significantly increased to 58.5% ( P  < 0.001). The results of this study showed that knowing clinical specialists' opinions about basic sciences significantly improved the attitude of students toward basic science courses, in particular immunology., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s) under exclusive licence to International Association of Medical Science Educators 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Background: Digoxin poisoning commonly occurs in people treated with digoxin. It has been suggested that treatment with dantrolene may be a suitable strategy for digoxin-induced cardiotoxicity., Objective: The aim of this study was to evaluate the protective effect of dantrolene on digoxininduced cardiotoxicity in male rats., Methods: This study was approved by the ethics committee of Birjand University of Medical Sciences (Ethical number: IR.BUMS.REC.1400.067). Forty-two Wistar rats weighing between 300- 350 gr were randomly allocated to 7 groups (n = 6) as follows: Normal Saline (NS) group, Normal Saline + Ethanol (NS + ETOH) group, Normal Saline + dantrolene 10 mg/kg (NS + Dan 10) group, Digoxin (Dig) group), Digoxin + dantrolene 5 mg/kg (Dig + Dan 5) group, Digoxin + dantrolene 10 mg/kg (Dig + Dan 10) group, Digoxin + dantrolene 20 mg/kg (Dig + Dan 20) group, Dig was injected intravenously at 12 mL / h (0.25 mg / mL). Dan (5, 10 and 20 mg/kg) was injected intravenously at 5-8 min/mL. After 1 hour, blood samples were obtained from the animals' cavernous sinus and each animal's heartremoved. The blood sample was rapidly centrifuged at 2,500 rpm for 10 minutes and the serum was separated for measurement of creatine phosphokinase (CPK), potassium (K), sodium (Na), calcium (Ca), and magnesium (Mg). The samples were stored at -20°C. The heart samples were fixed in formalin 10% for histopathological evaluation., Results: K levels slightly increased in the dig group versus the NS group. A significant increase in the K levels was observed in the Dig + Dan 20 group versus the NS group ( p < 0.001). Dig slightly decreased Ca levels in the treated group versus the NS group. The levels of Ca significantly increased in the Dig + Dan 10 group versus the Dig group ( p < 0.05). Histological examination of the heart tissue in the dig group showed cardiomyocyte degeneration, increased edematous intramuscular space associated with hemorrhage, and congestion. Focal inflammatory cell accumulation in the heart tissue was also seen. Cardiomyocytes were clear and arranged in good order in the Dig + Dan 10 group., Conclusion: dantrolene (10 mg/kg) was cardioprotective in a model of digoxin-induced cardiotoxicity, secondary to cardiac remodeling and hyperkalemia. However, further research is necessary to determine dantrolene's cardioprotective and cardiotoxic doses in animal models., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

In recent years, nanotechnology and the subsequent production of nanoparticles have developed excellent methods for medical applications, including wound healing. One of these nanoparticles is bentonite nanoparticles (BNPs) which show high ability in tissue engineering. But our knowledge of its effectiveness in wound healing is based on little data. Therefore, the main purpose of this study was to evaluate the wound healing ability of BNPs and in the next step the suitability of honey as a solvent for these nanoparticles. Methods: In this experimental study, an excisional wound injury model was developed in adult male BALB/c mice (n = 60) by creative two equal-sized wounds (5 mm) on either side of their back midline. The animals were allocated into five groups (n = 12 each) as untreated control (U), honey (H), polyethylene glycol (P), and (BNPs) dissolved in honey or polyethylene glycol (H + BNPs, P + BNPs). Animals have received their relative topical treatments twice per day for 14 consecutive days. Tissue sampling was carried out on days 4, 7, 10, and 14. The tissue sections were stained with hematoxylin and eosin and Trichrome-Masson staining methods. The histomorphological parameters including inflammatory cells infiltration, fibroblasts, re-epithelialization, granulation formation, and collagenases were evaluated in all tissue sections. Data were analyzed by SPSS 16 software. Comparison between the groups was performed by one-way analysis of variance following Tukey's post-hoc test. Compared to the control group, BNPs showed significant wound healing activities with lower inflammatory cells infiltration, higher fibroblastosis and new epithelium thickness, and greater granulation area and collagen fibers density in the ulcer bed. In addition, honey as a solvent synergistically increased the wound healing activity of the studied nanoparticle. These results for the first time are clearly showing that BNPs have a promising wound healing activity, especially when applied with honey concurrently.

Purpose: Prostatic complications are common among diabetic patients. Previous research demonstrates that Teucrium polium ( T. polium ) has beneficial effects in diabetic cases. This study, therefore, aimed to evaluate the impacts of T. polium aqueous extract on the prostate of diabetic rats., Methods: Diabetes was induced in male Wistar rats by intraperitoneal injection of streptozotocin (50 mg/kg). a total of 40 Rats were randomly divided into the following groups: Control, Control + TP100 (TP100), Diabetic, Diabetic + TP100 (DTP100) and Diabetic + TP200 (DTP200). The intervention was done orally once per day for 56 days (8 weeks). An oral glucose tolerance test was conducted, glucose and insulin levels were assessed. Microscopic features of the ventral prostatic lobe were evaluated pathologically., Results: T. polium at both doses significantly reduced glucose levels in an insulin-independent pathway. T. polium at both doses significantly improved prostate weight, prostate epithelium height, and prostate secretory activity in comparison with the diabetic group. Interestingly, treatment of T. polium to healthy rats led to decreased epithelial height., Conclusion: It could be deduced that T. polium has useful impacts on glucose control and may prevent prostatic complications., Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-022-00979-4., Competing Interests: Conflict of interestThe authors report no conflicts of interest, (© The Author(s), under exclusive licence to Tehran University of Medical Sciences 2022.)

Introduction: Intra-abdominal adhesions (IAAs) are secondary to peritoneal injuries such as previous surgery or intra-abdominal infections (IAIs). Accordingly, it is crucial to employ fitting techniques to minimize the likelihood of adhesions in any surgery. Due to a paucity of similar data available, this study sought to explore the effects of induced high serum ascites albumin gradient (SAAG) and low serum ascites albumin gradient (SAAG) on the rate of post-operative microscopic and macroscopic adhesion in a mouse model., Material and Methods: Sixty mice were compared in six groups of ten each. Control groups (1 &4) received normal saline, groups 2&5 received high SAAG ascites fluid, and groups 3&6 received low SAAG ascites fluid intraperitoneally. These groups underwent exploratory laparotomy on day zero, followed by the same procedure on the 10th (groups 1,2,3) and the 30th (Groups 4,5,6) day of surgery. Then, microscopic and macroscopic IAAs were evaluated. Data were analyzed in SPSS software and compared with a p-value less than 0.05., Results: By comparison, the least microscopic and macroscopic IAAs after 10 and 30 days were found in the low SAAG ascites group. Revealing a statistically significant difference compared to the other two groups (P = 0.01). After 10 days of surgery, macroscopic IAA in the high SAAG group was significantly lower compared to the control and Low SAAG ascites groups., Conclusion: Intraabdominal low SAAG ascites fluid can significantly decrease the probability of postoperative fibrosis and adhesion band formation., Protocol Number: IR. BUMS.REC.1399.503., Competing Interests: The authors declare no competing interest., (© 2022 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.)

Lead (Pb) is a prevalent environmental toxic metal that may harmfully affect the function of the thyroid gland. Our information about the effects of lead on thyroid function in lead poisoning is limited. The present study aimed to evaluate thyroid function in lead-poisoned patients compared with the healthy group. In this study, two groups of lead poisoning subjects (lead concentrations ≥ 25 μg/dL) (n = 56) (HBLC group) and randomly selected age and gender-matched healthy individuals with lower blood lead concentrations (BLC < 10 μg/dL) (n = 58) (LBLC group) were included. Thyroid function tests, including thyroxine (T4), triiodothyronine (T3), and thyroid-stimulating hormone (TSH) concentration, were measured for each patient in both groups (for the HBLC group, it was taken on admission). The linear regression model was used to investigate the effects of lead poisoning on thyroid function tests. A p-value of less than 0.05 was considered significant. Our study showed no significant difference between the two groups in terms of age and gender. The mean concentration of T3 and TSH in the HBLC group was significantly lower than the LBLC group, but the mean levels of T4 were significantly higher in the HBLC group (p < 0.05). Based on the linear regression model results, the T3 and TSH levels in the LBLC group were significantly higher by 13.86 and 0.43 units than the HBLC group, respectively. The current study results showed that lead poisoning affects thyroid function, reduces TSH, and increases T4., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Abstract., (This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide, affecting about 80% of women up to the age of 50. The persistent infection of high risk-HPV types (HR-HPV) is the leading cause of cervical cancer, the fourth most common cancer of women. Therefore, we aimed to evaluate the frequency and typing of HPV in the genital lesions in the Iranian population., Methods: This descriptive-analytic study was conducted on a population in the South-Khorasan province of Iran. All of the participants were sexually active and were checked for evident cervical warts. Biopsy samples were collected from various lesions, and all samples were tested for detection and genotyping of HPV using a reverse dot blot hybridization method (HPV direct flow CHIP)., Results: In overall, 370 samples were evaluated; 10 cases (2.7%) were male and the rest were female. The mean age of patients was 33.3 ± 8.5 years, of which 48.1% were in the age range from 25 to 36 years. Among the samples, 345 (93.2%) were positive for HPV-DNA; the low risk HPV types (LR-HPV) and HR-HPV were identified among 80.9% and 15.5% of tissue samples, respectively. Among the LR-HPV, HPV-6, 11, 42 and 54 were the most common genotypes, and HPV-16 and 39 were prevalent HR-HPV types detected. The number of pregnancies, marriage age, and partner infection were not significantly related to the HPV types. Types 42 had a declining pattern toward aging, and HPV-11 was increasing toward aging., Conclusion: The number of samples with HR-HPV was rather high. Due to the greater frequency of infection in the age range of 25-35 years, it is advised that all individuals referred to gynecological clinics at gestational age be tested for HPV types., (© 2022. The Author(s).)

The aim of the present study was to investigate the protective effect of the Sophora pachycarpa (S. pachycarpa) seed extract against carbon tetrachloride-induced toxicity on body organs, blood, and biochemical factors. In this investigation, 40 male Wistar rats weighing 200-250 g were randomly divided into 5 groups: group I was used as control, group II received carbon tetrachloride (CCl 4 ) (IP, 1 mL/kg) on day 21, group III and group IV received S. pachycarpa seed extract at doses of 150 mg/kg and 300 mg/kg, respectively for 21 days by oral gavage and CCl 4 on day 21, group V received silymarin (300 mg/kg) for 21 days by oral gavage and CCl 4 on day 21. CCl 4 showed an increase of serum renal and hepatic markers creatinine, urea, blood urea nitrogen (BUN), and uric acid, alkaline phosphatase (ALP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Also, it significantly increased MDA level, and decreased CAT, FRAP, GSH, and SOD in the liver and kidney tissues. These changes and also hematological and histopathological alterations were significantly ameliorated by S. pachycarpa seed extract before CCl 4 administration. In conclusion, the data obtained in our investigation confirm the protective effect of S. pachycarpa against acute exposure to CCl 4 -induced organ toxicity in rats., (© 2022. The Author(s).)

Radiofrequency electromagnetic radiation emitted from cell phone has harmful effects on some organs of the body, such as the brain, heart, and testes. This study aimed to assess the effects of cell phones on sperm parameters, DNA fragmentation, and apoptosis in normozoospermic. Normal sperm samples were divided into two groups of control and case. The samples from the case were placed for 60 min at a distance of approximately 2.5 cm from the cell phone set in the active antenna position. Control samples were exposed to cell phones without active antennas. All specimens were analysed by World Health Organization criteria. Sperm viability, sperm with chromatin abnormality and maturity, DNA fragmentation, and apoptosis were examined. Viability and motility in the case were significantly lower than the control (p < .001, p = .004 respectively). The percentage of apoptotic sperms and DNA fragmentation were significantly higher in the case when compared with the control (p = .031, p < .001 respectively). The other parameters studied such as morphology, chromatin abnormality, and maturity showed no significant difference between the case and control groups. Cell phone waves had a detrimental effect on human sperm's biological features. Therefore, it is recommended to keep the cell phone away from the pelvis as much as possible., (© 2021 Wiley-VCH GmbH.)

Background: The present study was performed to investigate the factors related to the expression level of estrogen and progesterone receptor in patients with colorectal cancer. Material and Methods . This crosssectional study was performed on 54 patients suffering from colorectal cancer referring to Imam Reza Hospital in Birjand during 2018-2019. After the biopsy performed during surgery, the specimen was sent for immunohistochemistry, and the status of receptors was determined. Eventually, the data were analyzed by SPSS 22., Results: Out of the 54 patients studied, 64.8% were male. The mean age of the patients was 62.28 ± 14.03 years. The level of expression of beta-estrogen receptors and progesterone receptors had a significant relationship with age, consuming drugs of abuse, and familial history ( P = 0.001). Also, the level of expression of estrogen and progesterone receptors of patients with a more advanced stage of cancer was significantly lower ( P = 0.001)., Conclusion: The extent of expression of estrogen and progesterone receptors affects the progression and prognosis of disease. Thus, through hormone therapy, a step can be taken to reduce the progression and even to treat colorectal cancer., Competing Interests: The authors declare that they have no competing interest., (Copyright © 2021 Saleheh Salehi far et al.)

Introduction: Intra-abdominal adhesions are typically found after the most surgical procedures. Normally, most adhesions are asymptomatic; however, few individuals experience postoperative adhesion-related problems such as small bowel obstruction, pelvic pain, infertility, or other complications. We aimed to evaluate the preventive effect of the ascites fluid for postoperative peritoneal adhesions in rat models., Material and Methods: This experimental trial was conducted in Sixty Syrian male rat randomly assigned to six groups of 10 animals each as follows: control (group 1&4); normal saline (group 2&5): 2 mL of normal saline was poured into the peritoneal cavity; and case (group 3&6): 2 mL ascites fluid was poured into the peritoneal cavity. All animals in the six groups underwent laparotomy and measurable serosal injury were created with a standard technique. 10 and 30 days after initial surgery, the rats underwent another laparotomy in groups 1, 2, 3 and 4, 5, 6, respectively to assess macroscopic and microscopic adhesions, which were scored by an examiner who was blind to the animals̕ group assignment. Data analyzed by SPSS version 18, using the kruskal Wallis and Bonferroni-corrected Mann-Whitney U tests. P-values of less than 0.05 were considered significant., Results: The mean scores of both microscopic and macroscopic adhesion were significantly different between all the groups (P < 0.05). Total macroscopic and microscopic adhesion scores were significantly lower in the ascites fluid treatment than in the control (P = 0.0001) or the normal saline (P < 0.001) group. There was no significant difference between adhesion intensity 10 and 30 days after laparotomy (P > 0.05)., Conclusions: Ascites fluid can decrease the possibility of post-operative intraperitoneal adhesion formation., Competing Interests: The authors declare no competing interest., (© 2021 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.)

Background: In 2013, there was an estimation of greater than 4.5 million Afghan refugees who had migrated to the least developed countries. Over one million are legally registered in Iran. We assessed the heart health status as described by the American Heart Association (AHA) in the Afghan refugee populace., Methods: This cross-sectional survey was carried out on 1,634 Afghan refugees, including 746 males (45.7%) and 888 females (54.3%), selected through a convenience sampling method in 2016. The American Heart Association's seven cardiovascular health metrics were evaluated to specify the status of heart health in Afghan refugees. Differences with age and sex were analyzed using the χ 2 test., Results: Only one (0.1%) participant met the ideal for all seven cardiovascular health metrics. No significant differences were found between women and men in meeting the ideal criteria for more than five cardiovascular health metrics. As age increased, the proportion of refugees who met the ideal for more than five cardiovascular health metrics declined., Conclusions: Refugees were not meeting the ideal cardiovascular health for some of the assessed metrics. Intervention to improve and monitor heart health in Afghan refugees is needed., Competing Interests: Conflict of InterestThe authors declare that they have no conflict of interest., (© Springer Nature Switzerland AG 2021.)

Background: The increased serum procalcitonin (PCT) level in cardiac patients is known as a sign of postoperative complications., Objective: Considering the importance of predicting the incidence of both complications and mortality caused by coronary artery bypass graft (CABG) surgery, this study was conducted to determine the serum PCT level and its relationship with one-year morbidity and mortality among CABG patients., Methods: This descriptive-analytical study was performed on 100 patients who underwent CABG surgery in Vali-e-Asr Hospital of Birjand, Iran. They were selected by a census sampling method from March 2014 to March 2015. The Elecsys BRAHMS PCT kit (Roche Company) was then used to measure the patients' serum PCT level. The required data were collected using the patients' medical records and telephone interviews with the patient or his/her relatives by passing one year from their discharge. The outcomes of this study comprised of mortality and morbidity causes (e.g., dysrhythmia, infection, and stroke). The data were then analyzed in SPSS version 16 by Mann-Whitney, chi-squared, and Fisher exact tests., Results: The postoperative serum PCT level is significantly correlated with sternum wound infection ( p =0.001), packed cells (PC) transfusion ( p =0.003), and death ( p =0.003). In addition, a significant relationship was found between dyslipidemia and hypertension and early mortality rate in patients with high levels of PCT. Of note, risk-adjusted death did not differ significantly between the serum PCT levels after one year (RR, 0.068; 95% CI 0.008-0.566)., Conclusion: Higher PCT serum levels in CABG patients are associated with the increased early mortality rate, sternum wound infection, and PC transfusion. Additionally, the other factors associated with mortality in the patients under study included dyslipidemia and hypertension., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2021 Ahmad Amouzeshi et al.)

The habit of smoking remains a severe public health problem. Heavy metals in cigarettes and mainstream smoke have been extensively investigated. This study has attempted to determine the essential and toxic elements in a biological sample of smokers and non-smokers. In this case-control study, 100 smokers were compared with 100 age- and gender-matched non-smoker healthy subjects. The smoker group was selected via the snowball sampling method. Serum concentrations of trace elements were determined using ICP-MS (Agilent 7900) for subsequent analysis. Data were analyzed by SPSS software using t test or Mann-Whitney U test along with chi-square test at the significant level of less than 0.05. The results of this study indicated that subjects in the smoker group compared with non-smokers had a significantly higher median of manganese (Mn) (11.5 [5.7-17.2] versus 6 [4-12.5] (μg/L), p = 0.003), copper (Cu) (40 [34-47.2] versus 34 [29-42] (μg/L), p = 0.005), arsenic (As) (39 [9-49.2] versus 12 [5-42] (μg/L), p = 0.007), thallium (Tl) (0.54 [0.27-0.68] versus 0.34 [0.11-0.66] (μg/L), p = 0.04), and lower iron (Fe) concentration (218 [156-508] versus 429 [192-573] (μg/L), p = 0.03). This study found that the concentrations of Mn, Cu, As, and TI in cigarette smokers were significantly higher than those obtained from the control group. These results can provide health policymakers with the necessary information to take public health measures towards preventive interventions in the community, though further studies are still warranted., (© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: Urinary tract stones are one of the most common diseases in the urinary tract. Lack of kidney stone treatment causes irreparable damages to the kidneys, which has many harmful effects. Date palm pits are recommended in traditional medicine as an effective drug in the treatment of kidney stones. The aim of this study was to investigate the effect of aqueous extract of date palm pits on kidney stones induced by ethylene glycol in male rats., Methods: In this study, 40 rats were classified into five groups (n = 8), including the healthy group receiving normal water, the negative control group, the therapeutic groups with doses of 150 mg/kg and 300 mg/kg, and the prevention group with a dose of 300 mg/kg. In order to induce kidney stones, ethylene glycolated water (1%) was used as drinking water in the studied groups. Blood and urine of rats were collected on days 14 and 28 of the study to assess urinary parameters of calcium, creatinine, uric acid and phosphorus, and serum parameters of blood urea nitrogen, creatinine, uric acid, calcium, and phosphorus. Also, the kidneys of rats were removed from the body on day 28 of the study and were given to a pathologist for examination., Results: Results of serum parameters shows that the use of date palm pits extract in the treatment and prevention groups with a dose of 300 mg/kg significantly (P < .05) has reduced the levels of blood urea nitrogen, uric acid, calcium, creatinine and phosphorus. Also, the results of urinary parameters show that the use of the extract caused a significant decrease (P < .05) in creatinine, uric acid and calcium in the prevention group and a significant decrease (P < .05) in creatinine and uric acid in the therapeutic group with a dose of 300 mg/kg. Pathological results show a decrease in the number and size of calcium oxalate crystals in renal tubules in the treatment and prevention groups in a dose-dependent manner., Conclusion: The results of this study showed that the use of aqueous extract of date palm pits has been effective in the treatment and prevention of kidney stones induced by ethylene glycol in rats.

Purpose: The rising prevalence of childhood obesity in the past decades has caused non-alcoholic fatty liver disease (NAFLD) to become the most common cause of pediatric chronic liver disease worldwide. This study was aimed at determining the effect of vitamin D (Vit D) on ultrasonography and laboratory indices of NAFLD and some blood biochemical indicators in children., Methods: In this interventional study liver ultrasonography was performed in 200 children with overweight and obesity. A 108 had fatty liver among which 101 were randomly divided into two groups of study (n=51) and control (n=50). The study group was treated with Vit D, 50000 U once a week whereas the control group received placebo with the same dose and package, both for 12 weeks. At the end of the intervention lab tests and ultrasound study was performed once again to evaluate the response to treatment., Results: It was found out that Vit D supplementation improved the fatty liver grade in the study group. The mean changes in hemoglobin (Hb), uric acid, highdensity lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), insulin, albumin and alanine aminotransferase (ALT) was significantly higher in the study group compared to controls ( p <0.05). After the intervention and means adjustment, a significant difference was obtained in HDL-C, insulin, LDL-C and homeostasis model assessment of insulin resistance (HOMA-IR) between the two groups., Conclusion: Vit D supplementation in addition to improving the fatty liver grade in ultrasonography and increasing the blood Vit D level, increases the HDL and Hb level besides decreasing uric acid, LDL, HOMA-IR, insulin and ALT levels., Competing Interests: Conflict of Interest: The authors have no financial conflicts of interest., (Copyright © 2021 by The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition.)

Background: Lead is a toxic metal that affects almost every organ in the body. Children are more susceptible to lead toxicity because they ingest non-food items (pica), have oral exploratory habits, absorb more substantial amounts of ingested lead compared to adults, and have a developing central nervous system. This study describes venous blood lead concentrations (BLC) in young children living in Birjand, Iran., Methods: A cross-sectional study was performed in 2016 on children 1-7 years of age who were referred to healthcare centers in Birjand City. Demographic information was obtained, and their BLC was tested using atomic absorption spectrometry (AAS)., Results: Four hundred children were tested. Their mean age was 52.37 ± 23.77 months; their mean BLC was 2.49 ± 2.64 μg/dL (median 1.85 μg/dL). Thirty-two (8%) children had a BLC > 5 μg/dL. A logistic regression model revealed that per one unit of increase in age, the chance of an elevated BLC decreased by 3% (OR (95%CI): 0.97 (0.96-0.99), p < 0.01). The risks of an elevated BLC was 61% lower in girls compared to boys (OR (95%CI): 0.39 (0.17-0.92), p = 0.03). Further, per one rate of increase in the BMI, the chance of an elevated BLC was higher (OR (95%CI): 1.13 (1.02-1.24), p = 0.01). Children whose fathers were laborers had higher BLC than those with employee fathers (p = 0.01)., Conclusion: Of 400 children aged 1-7 years old living in Birjand, Iran, 8% had elevated BLC. BLC correlated with the child 's age, gender, body mass index, and father's occupation.

Background: We evaluated the sequential changes of interleukin (IL)-10 and IL-13 serum levels with tuberculosis (TB)-related radiographic changes during pulmonary TB (PTB) treatment., Materials and Methods: In this cross-sectional study during two consecutive years, forty cases with PTB were recorded, and finally, 24 cases were completed the study. Serum levels of IL-10 and IL-13 were measured on admission time, and 6 months later. Furthermore, chest radiography was performed on admission and 6 months later in the treatment course., Results: Radiography at the baseline indicated pulmonary infiltration in all patients ( n = 24). Fifteen (62.5%) cases had abnormal and 9 (37.5%) cases had normal radiography at the end of 6 months treatment course. IL-10 and IL-13 upregulated during the treatment time course, and their relationship with radiographic changes shifted from negative ( r = -0.14 and P = 0.71) on admission to positive ( r = 0.80 and P < 0.001) at the end of 6 months treatment course in normal radiography group. IL-10 level at the start of the treatment was 121.90 ± 88.81 in patients with normal and 82.68 ± 41.50 in patients with abnormal radiography ( P = 0.31)., Conclusion: Sequential increase in IL-10 and IL-13 during PTB treatment course may have a role in clearing the TB-related radiographic infiltration and preventing scar formation., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Research in Medical Sciences.)

Chlorpyrifos (CPF), an organophosphorus pesticide (OP), has been implicated in metabolic diseases; however, the data are controversial. Rising age has been found as a main risk factor for metabolic diseases, and it has been proposed that advanced age increases susceptibility to the toxic effects of OPs. Therefore, this investigation aimed to evaluate the impact of CPF on hyperglycemia, hypercholesterolemia, and inflammation in animals with different ages. CPF (5 mg/kg) for 45 consecutive days was administered orally to male Wistar rats with different ages including 2-, 10-, and 20-month-old. The results indicated an increase in glucose and inflammatory indices, and also lipid profile was changed in the serum of aged animals in comparison with the 2-month-old animals. CPF administration amplified these parameters in the 20-month-old rats in comparison with that of aged-matched controls. The histopathological examination also indicated that CPF caused slight to moderate changes in the liver of 2-, 10-, and 20-month-old animals. Cholestasis was also observed in the CPF-administrated 20-month-old rats. In conclusion, aging may increase the susceptibility to CPF-induced metabolic disturbances in the animal models. It is proposed that advancing in age elevates the susceptibility to the metabolic effects of CPF.

Exercise training and antioxidant supplementation may improve unintentional weight loss and programmed cell death associated with cancer cachexia. The aim of this study was to examine the alterations of body weight and apoptotic indices in skeletal muscle of 4T1 breast cancer-bearing mice with cachexia following 4 weeks of high-intensity interval training (HIIT) and saffron aqueous extract (SAE) supplementation. Female BALB/c mice following induction of breast cancer were divided into ( i ) controls, ( ii ) HIIT, ( iii ) SAE, ( iv ) HIIT+SAE, and ( v ) sham groups. Mice were euthanized and gastrocnemius muscle was collected after intervention. The control group elicited a significant weight reduction during third and fourth weeks of tumor injection, while other treatments such as HIIT and SAE, but not HIIT+SAE, showed that they counteracted this adverse event. Furthermore, HIIT and SAE treatments (not HIIT+SAE) demonstrated reduced caspase-3 and Bax levels compared with the control group. The level of Bcl-2 was elevated following both HIIT and SAE treatments compared with the control group. Finally, the ratio of Bcl-2 to Bax was significantly higher in both HIIT and SAE groups, but was lower in HIIT+SAE group compared with sham group. It is likely that either HIIT or SAE intervention alone (not HIIT+SAE) represents a readily applicable approach in the regulation of muscle wasting and apoptosis in cancer cachexia. Novelty HIIT is associated with a reduced risk of cancer-related muscle wasting. SAE enhances the improvement of muscle loss and apoptotic indices. Combination of HIIT and SAE does not improve cancer-related loss of muscle mass and mediate apoptotic activation.

Bentonite is an inorganic clay material that is often easily dispersed as fine particles by air and water circulation, and most people are exposed to different concentrations of bentonite particles. Therefore, the inhaled effects of bentonite nanoparticles (BNPs) were studied in Wistar rats. Seventy-five rats were divided into five groups of 15: four exposure groups (0.1, 0.5, 2, and 10 mg/m 3 of BNPs) and one control group. The rats were exposed for 30, 60, and 90 days to BNPs for 5 days a week (6 h/day) in whole-body inhalation chambers. Blood samples were collected to measure the levels of antioxidant activity of the contents such as total antioxidant capacity (TAC) and malondialdehyde (MDA). X-ray diffraction and scanning electron microscopy were used to identify nanoparticles. The results showed no significant difference in the effect of nanoparticles on levels of TAC and MDA in the studied groups based on the concentrations of nanoparticles. However, the level of MDA increased significantly with extending exposure time; there was a significant increase in the level of MDA content 90 days postexposure compared to 30 days postexposure at concentrations of 0.5, 2, and 10 mg/m 3 . Histopathological examination showed that inhalation exposure of rats to BNPs led to different histopathologic responses in the lung tissue, such as inflammatory infiltration, granulomatous inflammation, acute neutrophilic reaction in the early stages, and lung fibrosis. At the lowest concentration, BNPs have low or no toxicity, and inhalation of these nanoparticles at low concentrations does not affect the levels of MDA and TAC content. However, increased concentration and exposure time caused correspondingly greater increases in MDA and more damage to lung tissue.

Purpose: Polycystic ovary syndrome (PCOS) is a gynecological endocrine disorder that is characterized by disturbances in ovarian blood flow and angiogenesis. The aim of this study was to determine the association of vascular endothelial growth factor (VEGF) and thrombospondin-1 (TSP-1) serum levels with the body mass index (BMI) in patients with PCOS compared with healthy subjects., Methods: The study was conducted with 80 subjects in 3 PCOS groups, including normal weight, overweight, and obese PCOS groups, and a control group of healthy subjects (n=20). The participants in all groups completed a questionnaire comprising sociodemographic and obstetric questions. The PCOS diagnosis in the study subjects was confirmed based on the Rotterdam criteria, BMI was determined according to the World Health Organization guidelines, and the lipid accumulation product index was calculated for all groups. Venous blood samples were collected from all participants after fasting to measure the serum levels of fasting blood glucose (FBG), lipids, insulin, VEGF, TSP-1, and leptin., Results: Our findings showed that the serum VEGF level was significantly higher in the normal BMI PCOS group than that in the control group ( P =0.03), and the TSP-1 level was significantly lower in the obese PCOS group than that in the control group ( P =0.04)., Conclusions: Our study demonstrated that alterations in VEGF and TSP-1 concentrations are dependent on BMI. Because abnormal ovarian angiogenesis is considered to be the main feature of PCOS, the study of ovarian angiogenic imbalance is proposed as a new tool for PCOS diagnosis and management., Competing Interests: Conflict of interest: The authors have no conflicts of interest to declare related to this study., (Copyright © 2019 Korean Society of Obstetrics and Gynecology.)

Invasive aspergillosis of the paranasal sinuses is a rare and often misdiagnosed disease. This study reported a case of maxillary aspergillosis with a complete headache and eye pain after tooth extraction with a large abscess in the relative jaw. Tenderness in the right temporal, lower jaw numbness and right eye proptosis was found. Histopathological examination was the suggestion of maxillary sinusitis with a fungal ball of aspergillus., (Copyright© 2019 Iranian Neuroscience Society.)

Objectives: This exploratory investigation aimed to measure blood lead levels and associated risk factors in exposed workers in Iran, and to derive appropriate reference values for blood lead in this population as a means of epidemiological comparison., Design: Cross-sectional., Setting: Manufacturing plants with potential lead exposure in Southern Khorasan Province, Iran., Participants: The study included 630 workers, selected through stratified random sampling., Primary and Secondary Outcome Measures: The primary measures in this exploratory investigation were venous blood lead concentration (BLC) and associated risk factors of age, gender, work experience, cigarette smoking and history of opium use. The secondary measures were symptoms associated with lead toxicity. Data analyses were conducted using Student's t-test, Mann-Whitney U test, one-way analysis of variance, Kruskal-Wallis test, Spearman correlation coefficient and regression analysis., Results: Mean and median BLCs were 6.5±8.1 μg/dL and 3.9 μg/dL (IQR: 2.9-5.8), respectively. Of the subjects, 85 (13.5%) had BLC ≥10 μg/dL. The derived reference BLC value in this study was 30 μg/dL for men and 14 μg/dL for women. Increasing work experience and age were associated with BLC >10 μg/dL. Radiator manufacturers were up to 12.9 times (95% CI 4.6 to 35, p<0.005) more likely than painters to have BLC >10 μg/dL. Most subjects reported multiple symptoms., Conclusions: The mean BLC was above the maximum recommended concentration. There was a significant relationship between higher BLC and age or working in a printing factory or radiator manufacturing. These findings can direct efforts towards reducing occupational lead exposure., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: The metabolic syndrome and its concomitant complications are a major public health challenge worldwide. Growing evidence implies associations with cancer development and progression. Since there has been no report on this subject in South Khorasan, we studied metabolic syndrome components in gastrointestinal (GI) cancer patients for comparison with a control group in this province. Materials and methods: This case-control study was performed on 68 patients with histopathologically proven gastrointestinal cancers, referred to the oncology center in Birjand city (capital of South Khorasan province, Iran) in 2016-2017, and 100 control subjects without disease. Patients and control subjects completed a researcher-made questionnaire covering demographic characteristics, physical activities and food intake. Also, blood samples were obtained from both patients and control subjects after overnight fast. Anthropometric measurements of height, weight, body mass index, waist circumference and blood pressure were additionally performed. Results: Significant differences in the levels of blood glucose and serum HDL were noted between the two groups (P≤0.001). Also, the percentage of pre-diabetic and diabetic patients in the case group was higher than the control group (17.6 and 16.2% vs. 10.3 and 2.9%) (P=0.009). Multiple logistic regression showed that the risk of gastrointestinal cancer in people with high blood glucose was 3.35 times that in those with normal blood glucose (OR3.35, 95%CI,1.41-7.94; P=0.006) , 2.37 times higher in subjects with lower HDL (OR 2.37, 95%CI,1.18- 4.78), 10.4 times higher in overweight people (OR10.4, 95%CI,2.23-48.5) and 4.3 times higher in individuals with an opium addiction(OR4.3, 95%CI, 1.6-11.5) than those without. The mean consumption of fish (P=0.03) and vegetables and fruits (P=0.027) in the case group was significantly lower than in the control group. Conclusion: Emerging evidence indicates that the metabolic syndrome or its individual components may be important in the etiology and progression of GI cancer. Research to work toward preventing cancers should thus focus on nutritional and lifestyle modifications which may alleviate the metabolic syndrome., (Creative Commons Attribution License)

Objective: The present study was designed to investigate the effects of atorvastatin on serum high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), total antioxidant capacity (TAC), and alpha-1 antitrypsin (AAT) in patients with chronic obstructive pulmonary disease (COPD)., Methods: A clinical trial study conducted on 42 cases of COPD (Vali-Asr Hospital, Birjand, East of Iran, years 2014-16). Patients were randomly assigned to 21 controls and 21 cases who treated with atorvastatin (40 mg/day for 6 months). Inhaled corticosteroid and long-acting β-agonist were administrated in both groups. The trial was registered at the Iranian Registry of Clinical Trials (registration number: IRCT2016042527594N1). TAC was measured by ferric reducing/antioxidant power assay. An enzyme-linked immunosorbent assay was used to determine IL-6, AAT, and hs-CRP. Spearman's rho test and Wilcoxon, Mann-Whitney, paired, and independent t-tests were used for data analysis in SPSS 23. P < 0.05 was considered significant., Findings: A number of patients completed the study were 16 in atorvastatin and 18 in control group. Mean increments (μmol/L) of TAC (mean ± standard deviation [SD]) were 12.81 ± 605.25 ( P = 0.68) in atorvastatin and 160.26 ± 280.54 ( P = 0.14) in control group. Mean decrements of IL-6, CRP, and AAT (mean ± SD) were 1.41 ± 5.51 ( P = 0.71), 0.98 ± 5.68 ( P = 0.72), and 10.94 ± 46.83 ( P = 0.21) in atorvastatin and 0.91 ± 11.70 ( P = 0.75), 3.23 ± 7.00 ( P = 0.19), and 18.77 ± 55.90 ( P = 0.21) in control group., Conclusion: Atorvastatin did not succeed in maintaining TAC and CRP reduction. However, less reduction in AAT and more reduction in IL-6 in the atorvastatin group would be likely a beneficial effect in COPD., Competing Interests: There are no conflicts of interest.

Background: Regarding the limited studies about effects of addiction on coagulation factors as a risk factor for increasing coagulation, and its relation to coronary artery disease, we decided to investigate the effect of opium on inflammatory and coagulation factors in a controlled setting., Methods: This case-control study was performed using two groups of smoking males addicted to opium (27 cases) and not addicted to opium (27 cases). After collecting demographic data, venous blood samples were gathered and sent to laboratory for measuring homocysteine, fibrinogen, prothrombin time (PT), partial thromboplastin time (PTT), International Normalized Ratio (INR), and C-reactive protein (CRP) quantity. In order to analyze the data, we used independent t-test plus Mann-Whitney test with significance level of P < 0.05., Findings: The average age in this study was 32.2 ± 6.2 in case group and 33.3 ± 6.2 in control group. Comparing case and control groups regarding age and education showed no significant difference (P = 0.598 and P = 0.848, respectively). Mean daily smoking in case group was 7.9 ± 5.4 and 8.1 ± 5.0 in control group. Mean smoking duration in case group and control group was 10.1 ± 6.5 and 9.0 ± 7.2 years, respectively. There was no significant difference between two groups regarding smoking duration (P = 0.567). Comparison of inflammatory and coagulation factors showed no significant difference except for CRP and fibrinogen for which P = 0.661 and P = 0.889, respectively. Consumption-based comparison of inflammatory and coagulation factors showed no significant difference except for PT in oral and inhaled consumptions which showed a significant difference (P = 0.035)., Conclusion: Results of this study suggest that opium addiction can be an influential factor in blood parameters and can lead to inflammatory and coagulation processes complications.

Objective: Helicobacter pylori ( H. pylori ) is the most common pathogenic bacteria in the stomach. The aim of the current study was to explore the effect of oral garlic administration on bacterial urease activity inside the stomach and its contribution to the treatment of H. pylori infection., Materials and Methods: In this clinical trial, 15 patients were studied quantitatively with Urease Breath Test (UBT). The patients with gastrointestinal symptoms and a positive serum H. pylori IgG were enrolled. UBT was performed for each patient in three sessions as follows: at the beginning of the study, an initial UBT was performed based on which, the positive cases entered the study and the negative ones were excluded. Second UBT was done three days later in patients who were not receiving any treatment and were considered as the control, whereas the third UBT was performed three days after prescribing two medium-sized cloves of garlic (3 g) with their meal, twice a day (at noon and in the evening). The collected data were analyzed using ANOVA and Bonferroni tests and the significance level was set at p<0.05., Results: the mean UBT significantly differed before and after treatment with garlic cloves, being significantly lower after garlic consumption. No meaningful difference was observed in the mean UBT without garlic consumption between the first and second steps., Conclusion: Raw garlic has anti-bacterial effects against H. pylori residing in the stomach and may be prescribed along with routine drugs for the treatment of gastric H. pylori infection.

Background: The high-density lipoprotein cholesterol (HDL-C) level has been shown to have a significant role in the prevention of cardiovascular diseases and atherosclerosis. Low vitamin D levels have been shown to be correlated with dyslipidemia, but limited data exist on indigenous children., Objectives: We aimed to investigate the effect of vitamin D supplementation on HDL-C levels in school-aged Iranian children., Methods: In this prospective controlled clinical trial, 47 healthy children (23 boys) aged 10 - 14 years, students of Birjand (Iran) elementary schools, were selected and randomly divided into two groups. The study group received a vitamin D supplement (1000 mg capsule) daily for one month, and placebo tablets were prescribed to the controls. Before and after the treatment course, the serum HDL-C and 25-hydroxy vitamin D levels of both groups were measured. The data were analyzed by SPSS, ver. 16, and Chi-square tests, Fisher's exact test, paired-sample t-tests, and Pearson's correlation were used, wherever appropriate. The significance level was set at P < 0.05., Results: Forty children completed the study; their mean age was 11.5 ± 1.175 years. The mean serum levels of both HDL-C and vitamin D showed a significant rise following the treatment in the study group (P = 0.007 and P < 0.001, respectively), whereas both variables decreased slightly in the control group (P = 0.27). There was no statistically significant difference in the mean serum levels of HDL-C and vitamin D between the two groups after the intervention (P = 0.11 and P = 0.20, respectively)., Conclusions: Vitamin D supplements seem to have a positive impact on serum HDL-C levels and may be effective in reducing the risk of cardiovascular diseases in the long term.

Objective: Febrile seizure (FS) is one of the most common neurological problems during childhood.Pathogenesis of febrile convulsion is unknown. This study investigated some trace elements among children admitted with FS compared with thoseof febrile without seizure attacks., Materials & Methods: This case-control study was conducted on48 children (6 months to 5 yrold) diagnosed with febrile seizure as the cases and 48 age-matched febrile children as the control group. Serum levels of magnesium, calcium, sodium, potassium, and serum zinc were measured. Statistical analysis was performed with SPSS (version 15) using Student t-test., Results: There were no significant differences between the cases and controls in terms of gender or age. The means of serum level of zinc, sodium, calcium and magnesium in the case group was lower than those of the control group. There was no significant difference onserum potassium mean level between the case and control groups., Conclusion: Deficiency of trace elements was correlated significantly with febrile convulsion, while further investigations on trace elements are required.

Background: Helicobacter pylori infects around 50% of the human population and is asymptomatic in 70% of the cases. H. pylori eradication in childhood will not only result in peptic symptoms relief, but will also prevent late-term complications such as cancer. Today, probiotics are being increasingly studied in the treatment of gastrointestinal infections as an alternative or complement to antibiotics., Objectives: In this study we aimed to assess the effect of S. boulardii supplementation on H. pylori eradication among children in our region., Patients and Methods: In this randomized double-blind placebo-controlled clinical trial 28 asymptomatic primary school children with a positive H. pylori stool antigen (HpSA) exam were randomly allocated into the study group, receiving Saccharomyces boulardii, and the control group receiving placebo capsules matched by shape and size, for one month. The children were followed up weekly and were reinvestigated four to eight weeks after accomplished treatment by HpSA testing. The significance level was set at P < 0.05., Results: 24 children completed the study. The mean HpSA reduced from 0.40 ± 0.32 to 0.21 ± 0.27 in the study group, indicating a significant difference (P = 0.005). However, such difference was not observed in the control group (P = 0.89). Moreover, the HpSA titer showed a 0.019 ± 0.19 decrease in the study group whereas the same value was 0.0048 ± 0.12 for the controls, again stating a significant difference (P = 0.01)., Conclusions: Saccharomyces boulardii has a positive effect on reducing the colonization of H. pylori in the human gastrointestinal system but is not capable of its eradication when used as single therapy.

Background: Various studies have indicated that dyslipidemia starts in childhood. There is a relationship between the concentration of blood lipids and atherosclerosis. In this study, we assessed the prevalence of dyslipidemia in elementary school children., Methods: This cross-sectional study was performed on 1,626 (882 girls and 744 boys) elementary school children aged between 6 and 11 years in Birjand in 2012. Samples were selected through multistage random sampling. The lipid profiles (i.e., cholesterol, triglyceride, high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C]) of the subjects were measured after 12 hours' fasting. The definition of dyslipidemia was based on the criteria of The American Children Academia in 2011., Results: Dyslipidemia (at least one abnormal level of a serum lipid) was detected in 31% of the children (31.3% of the girls vs. 30.6% of the boys). Total cholesterol was ≥ 200 mg/dL in 13.4% of the children, LDL-C was ≥ 130 mg/dL in 8.5%, HDL-C was < 40 mg/dL in 11.3%, and triglyceride was ≥ 130 mg/dL in 15.3%. The prevalence of hypertriglyceridemia was significantly higher in the females than in the males (16.3% in the girls vs. 13.8% in the boys; p value = 0.01) - while hypercholesterolemia (12.2% in the girls vs. 14.9% in the boys; p value = 0.16), high LDL-C (8.5% in the girls vs. 8.5% in the boys; p value = 0.05), and low HDL-C (12.7% in the girls vs. 9.5% in the boys; p value = 0.1) were not significantly different between the two sexes., Conclusion: The prevalence of dyslipidemia was high in the school children in Birjand and, thus, requires preventive measures.

The goal of this study was to determine the effect of topical Emu oil on the healing of burn wounds and hair follicle restoration in superficial II-degree burns in the skin of Balb/c mice. Thirty-two male Balb/c mice with burns on the back of the neck were divided into two groups: The Emu oil group received topical Emu oil twice daily, whereas the control was left untreated. Skin biopsies were obtained on days 4, 7, 10, and 14 of the experiment. Then the specimens were viewed with Olympus SZX research microscope. The Emu oil treated burns were found to heal more slowly and inflammation lasted longer in this group. The number of hair follicles in the margins of the wounds increased through time in the Emu oil group compared to the control group. Also, the hair follicles in the Emu oil group were in several layers and seemed to be more active and mature. Moreover, Emu oil had a positive effect on fibrogenesis and synthesis of collagen. The findings indicate that although Emu oil delays the healing process, it has a positive effect on wound healing and it increases the number of hair follicles in the margins of the wound.

Background and Objectives: To determine the prevalence of impaired fasting glucose in adolescents in Birjand city in eastern Iran., Materials and Methods: This cross-sectional study was done on 2653 students aged 11-18 years selected through multi-stage stratified and random sampling. Fasting blood glucose (FBS) of these students was measured applying the enzymatic process. The obtained data were analyzed by means of SPSS software (V: 15) and statistical tests T and X2., Results: The mean age of individual was 14.5 ± 2 years. Mean FBS of the whole population was 89.8 ± 9.8 mg/dl, but it was significantly higher among boys than girls (P < 0.001). Out of the whole subjects (92.4%), 1,328 (95.1%) of the girls and 1,122 (89.3%) of the boys, FBS was less than 100 mg/dl among whom 64.4% had FBS above 86 mg/dl. In 200 subjects (7.5%) of whole population, FBS was 100-125 mg/dl; with that of the boys was 2.3 times than the girls revealing a prediabetes condition: OR = 2.3(CI: 1.7-3.2). Among the students, 3 (0.1%) had an FBS > 126 mg/dl. Mean blood glucose was significant regarding age and sex., Conclusions: High prevalence of high FBS (within normal range) among adolescents is warning and requires special attention of health officials. Screening of children and adolescents in order to identify those at risk and plan for intervening is urgent to prevent type-2 diabetes epidemic and following cardiovascular complications in the Society.

Background: Cardiovascular risk factors begin in childhood and adolescence. This study aimed at assessing serum lipids and prevalence of Dyslipidemia in 11-18 year old students of Birjand., Methods: The present cross-sectional, descriptive, and analytical study was done on 2,643 middle and high school students of Birjand aged 11-18 years (1,396 girls and 1,247 boys). Blood samples were collected for the measurement of blood lipids, including Cholesterol, Triglyceride, HDL, and LDL after a 12-hour fasting period. The defined borderline and abnormal values stated in 2011 by the American Academy of Child, was used., Results: According to our results, it is concluded that: (i) 34.3% (31.3% girls and 37.6% boys) of adolescents had at least one dyslipidemia. (ii) 24.7% of the individuals had HDL lower than 40, where 14% of them TG≥130, 6.1% of cases TC≥200, and 3.5% of cases LDL≥130. Lipid disorder within low HDL type and hypertriglyceridemia were significantly higher in boys (P<0.05) than girls. Hypercholesterolemia and hypertriglyceridemia in the age group of 11-14 years and low HDL in the age group of 15-18 years showed the highest values (P<0.05)., Conclusion: Adolescents of Birjand have high prevalence of dyslipidemia. Preventive measures are recommended to improve lifestyle, including healthy nutrition, encouraging adolescents to exercise, and more mobility.

Objectives: The aim of this study was to evaluate the effects of Malva sylvestris aqueous extract on cutaneous wound healing in BALB/c mice., Materials and Methods: Twenty seven male BALB/c mice (2.5 months of age) were used. A cut wound (superficial fascia depth) was made locally. The mice were then divided into three groups: the first, second and third groups received topical administration of M. sylvestris 1% aqueous extract, silver sulfadiazine topical cream and cold cream (positive and negative control groups), respectively. On days 4, 7 and 10 excisional biopsies were performed and wound healing was evaluated histopathologically. The data were analyzed by the ANOVA and Tukey statistical tests., Results: On days 4 and 7, the numbers of inflammatory cells in the silver sulfadiazine and M. sylvestris-treated groups were significantly lower than the control group and keratinization at the edges of the wound in both groups was significantly higher than the control group. On the tenth day of the study, the Malva-treated mice showed better healing features and less fibrosis and scar formation, and also fewer hair follicles were damaged in this group. On the tenth day of the study, the numbers of inflammatory cells in M. sylvestris and silver sulfadiazine-treated groups were significantly lower than the control group., Conclusion: The present study supports the beneficial effects of M. sylvestris on the wound healing process and suggests a potential clinical application.

The parotid gland is the largest salivary gland in humans, and produces mainly serous secretions. The secretion of this gland reaches the oral cavity through single parotid duct (Stensen's duct). The parotid duct begins at the anterior border of the gland, crosses the masseter, and then pierces the buccinator and open the mouth. The present study reports a rare variation of a unilateral double parotid duct that was observed in the right side of the face of a 75-year-old male cadaver during dissection. The embryological basis of this variation can be explained as follows. A sprout originates from epithelium lining the primitive oral cavity, grows dorsally, and bifurcates. The end parts of these branches invaginate into the adjacent mesenchyme separately, proliferate, and make the parotid gland, while their proximal parts later form communicating ducts (D1 and D2) connecting the gland to the mouth. Furthermore, the clinical importance of this variation was discussed.

Background: Childhood obesity could induce some risk factors for cardiovascular disease (CVD) including serum lipid abnormalities, hypertension, and atherosclerosis. The present study aimed to comparison the lipid profile in normal children with cases having overweight, obesity and central obesity., Methods: In this case control study, which was conducted 2013, serum lipids for three groups of children including cases with overweight (Body mass index (BMI): 85-95th percentiles to age and sex and waist circumference (WC) <90th percentile to age and sex = Case group1), central obesity without general obesity (BMI <85th percentiles and WC ≥ percentile 90 = Case group 2) and central obesity with general obesity (BMI ≥95th percentile and WC ≥ percentile 90 = Case group 3) were compared with control group (BMI < 85th percentiles WC <90th percentile). Data were analyzed using software SPSS-16 by chi-square and ANOVA tests at significance level α=0.05., Results: Each group consisted of 100 individuals. The highest mean of serum lipids and the highest extent of dyslipidemia existed in the children having central obesity along with general obesity. So that 49%, 28%, and 38% students of this group show hypertriglyceridemia, hypercholesterolemia, and low high-density lipoprotein cholesterol (HDL-C). Odd ratio of hypertriglyceridemia, hypercholesterolemia and low HDL-c, in children with at least one abnormal index (BMI and /or WC) compared with control group were 3.73 (95% CI: 1.98, 6.99), 1.37 (95% CI: 1.71, 2.65) and 2.98 (95% CI: 1.51, 5.87), respectively., Conclusions: With regard to the relationship between central obesity and adverse changes in lipid profiles, the screening children for central obesity to prevention of cardiovascular disease are recommended.

Introduction: Metabolic Syndrome (MS) in children and adolescents is becoming a global public health concern. MS tracks into adulthood increasing the risk for type 2 diabetes mellitus and cardiovascular diseases. This study was designed to verify the rate of MS in elementary school students of Birjand, as a representative sample of Iranian children to verify the best preventive measures in this age group., Methods: This descriptive-analytical, cross-sectional study was performed on 1425 elementary school children through multiple-cluster sampling in 2013. Height, weight, waist circumference and blood pressure of children were measured by standard methods. Blood glucose, triglycerides, cholesterol, High-density lipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C) levels were also measured after 12 hours fasting. MS was defined according to the Adult Treatment Panel III (ATP-III) based on the National Cholesterol Education Program. Data were analyzed by SPSS using t test and chi-square test. Significance level was set at P < 0.05., Results: The prevalence of MS was 5.3% which increased with age. 43.5% of the studied cases had one or more components of the MS. The most common components were hypertension, abdominal obesity, hypertriglyceridemia, low HDL-cholesterol and impaired fasting glucose, respectively. MS prevalence was 0.9% in normal weight, 11.3% in overweight and 36.2% in obese children., Conclusion: Regarding the high prevalence of MS in elementary school children in our region, screening for obesity is recommended to prevent adulthood complications. Therapeutic lifestyle changes and maintenance of regular physical activity are the most important strategies for preventing childhood obesity.

Background: Prevalence of obesity in children has been increased during recent decades all over the world. Obesity, particularly, abdominal obesity (AO) is associated with the risk of metabolic syndrome and cardiovascular disease. This study aimed to assess obesity and central obesity within students aged 11-18 of Birjand city., Methods: This cross-sectional and descriptive- analytical study was conducted on 2458 secondary and high school students, including 1345 girls (54.8%) and 1113 boys (45.2%), who had been selected from Birjand Middle and high schools through multiple-cluster sampling in 2012. For determination of AO, waist circumference and the percentage 90 or more regarding age and sex were used. The obtained data were analyzed by using statistical t-tests and χ(2) at the significant level P < 0.05., Results: Among the studied students, average 16.3% (20% of boys and 13.2% of girls) had AO. The obtained data about these two groups shows statistical significant difference of P < 0.001. Chance of AO in boys was 1.6 times greater than that of girls. Odds ratio (OR) = 1.6 (confidence interval [CI]: 1.3-2.1). It was 1.9 times more about under 15-year-old than over 15 aged subjects. OR = 1.9 (CI: 1.5-2.4)., Conclusions: Regarding high prevalence of AO in Birjand adolescents, it is recommended that adolescents and their families should be warned for long-term outcomes of obesity on quality-of-life. Periodic studies are suggested for awareness of obesity trends in the coming years.

Background: Anthropometric indices are widely used to assess the health and nutritional status of children The aim of the present study was determination of malnutrition and compare estimates of under nutrition among young children under 2 years of age from Birjand city of Iran using WHO growth standard and the National Center for Health Statistics (NCHS) references., Methods: The cross-sectional descriptive study conducted on 822 children under 2 years of age mean z scores for weight-for-age and height-for-age and prevalence underweight, stunting and wasting were calculated using the new WHO growth standards and compared with NCHS references., Results: Compared with NCHS reference, the mean height for age were lower and mean weight for age scores were almost similar using the WHO standards. Prevalence underweight, stunting, and wasting using WHO standards were 5.2-8.2% and 1.9%, respectively, compared to 6.5-37.3% and 1% based on the NCHS references., Conclusions: Using WHO standards resulted differences in mean z score for height for age and changes in prevalence of stunting compared with NCHS references in Birjand city children.

Background: Prevalence of obesity in children has been increasing during recent decades all over the world. Obesity, particularly central obesity, is associated with metabolic syndrome and cardiovascular diseases. The present study aimed to assess obesity and central obesity in 6-11 year old Birjand elementary school children, East of Iran., Methods: This cross-sectional study was conducted on 1541 elementary school children, i.e. 851 girls and 690 boys, selected from Birjand elementary schools through multiple-cluster sampling in 2012. In order to determine overweight and obesity the percentile of CDC was used, so that, 85-95th percentile were taken as overweight and >95th percentile was defined as obese with respect to age and sex. For determination of central obesity, waist circumference and the ≥90th percentile were used regarding age and sex. The obtained data was analyzed by means of SPSS software (V: 15) using t and chi-square statistical tests at the 0.05 significant level., Results: Out of the studied children, 9.6% (11% of boys and 8.3% of girls) were overweight and 9.2% of children (i.e. 10.9% of boys and 7.9% of girls) were obese. About 15.7% of children (i.e. 20.3% of boys and 12% of girls) had central obesity., Conclusions: Regarding high prevalence of obesity, central obesity, and overweight in Birjand elementary school children, it is recommended that families should be provided with necessary information with respect to correcting life-style and preventing obesity in children.

Primary tuberculosis of the breast is a rare disease. It usually occurs in female of reproductive age. Any form of tuberculosis mastitis may present with feature of malignancy. Diagnosis is mainly based on identification of tubercle bacilli. We report a 42-year-old woman with primary tuberculosis abscess of the breast, who underwent surgical resection. Fine needle biopsy failed to achieve specific diagnosis before surgical operation. She responded to anti-TB therapy postoperatively. In endemic area, tuberculosis should be considered in the differential diagnosis of breast tumors.