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Background: Adherence to diet is effective for metabolic control in patients on hemodialysis. There are educational pamphlets or booklets to improve patients' knowledge about healthy diets. As video presentation is more desirable than the presentation of readable materials, we designed an educational video on healthy diets in renal failure patients who was played during several sessions of hemodialysis. We compared the effect of this modality on the knowledge, attitudes and metabolic control of the patients before and after the intervention., Methods: In this interventional study, all the patients who were referred to the hemodialysis ward at Ashrafi-Esfahani Medical Center (Tehran, Iran) between May 2018 and March 2019 were enrolled (N = 190). Totally, 130 patients had inclusion criteria. An educational video about a healthy diet was shown seven times (once a week in the first month, once every two weeks in the second month, and once in the third month) during hemodialysis for the patients. The nephrologist prepared a video in the form of a lecture with graphic images for 20 min based on the healthy nutrition of the Kidney Federation of Iran's Guide for hemodialysis patients. The questionnaire was completed in terms of awareness and attitudes, and blood and urine tests were performed at the 1st, 3rd, and 12th months. Serum parameters, including electrolytes, lipid profile, CBC-diff, dialysis efficacy (Kt/V), and the URR (urine filtration rate) were examined. Pre and post intervention values were compared via the statistical analysis performed using IBM SPSS. P-Value < 0.05 was significant., Results: The data of 128 people were analyzed at the end of the study. 55% of patients were 10-40 years old and 60% were male. 56% of patients were illiterate or had an elementary school education. The most common underlying diseases were hypertension and diabetes mellitus. Ten to 19% of participants had enough knowledge about the various components of a healthy diet for patients on hemodialysis. Approximately 25%, 14%, and 45% of the participants consumed a healthy diet for breakfast, lunch and dinner, respectively. A comparison of the mean values of the serum parameters before and after the intervention revealed significant changes in phosphorus, blood urea nitrogen, and hemoglobin with mean differences of -118.41 ± 22.84, 21.51 ± 10.38 (both P < 0.001), and 0.29 ± 1.18 (P = 0.044), respectively. The mean Kt/V was similar at all phases., Conclusion: The use of an educational video was effective for normalizing the metabolic parameters in patients under hemodialysis and can be an appropriate option, especially for illiterate patients., Trial Registration: IRCT2016082229481N1., (© 2024. The Author(s).)

Heat Shock Protein 27 (HSP27), an anti-HBV factor, exists in the intracellular and extracellular spaces. As an inflammatory modulator, serum HSP27 (sHSP27) is associated with elevated pro-inflammatory cytokines and a higher likelihood of hepatocellular carcinoma in chronic hepatitis. SHSP27 results in natural antibody production (anti-HSP27-Ab) that is more stable and easily detectable compared to sHSP27. We aimed to investigate any potential association between anti-HSP27-Ab level and chronic hepatitis B (CHB) progression and inflammation indicated by liver cell injury and HBV replication. This cross-sectional study was conducted on 91 patients with CHB and 92 individuals without CHB. Following demographic data collection, anti-HSP27-Ab, serum lipids including total cholesterol, triglyceride, LDL-C, HDL-C, and aminotransferase levels were measured using enzymatic assays in participants' serum samples. HBV DNA was also measured by quantitative PCR in CHB patients. Bivariate and multivariate analyses showed a significantly higher mean level of anti-HSP27-Ab in CHB than in healthy individuals (0.304 vs. 0.256AU/ml, P value = 0.015). These levels held significant differences in the CHB subgroups of male patients, at the age of 50 years and above, with non-smoking status, elevated aminotransferase levels, and hypotriglyceridemia ( P value < 0.05). However, no difference was found between the antibody levels and HBV DNA copies ( P value > 0.05). This study provides evidence that anti-HSP27 antibody levels can reflect the degree of liver necrosis indicated by aminotransferase levels. Regarding the higher incidence rate of HBV-associated complications in 50 to 60-year-old men, monitoring the antibody can be beneficial in managing this group of CHB patients, which deserves further investigation., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© The Author(s), under exclusive licence to Association of Clinical Biochemists of India 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.)

Introduction: One of the main complications of multiple sclerosis (MS) is imbalance and walking problems that can lead to falls. This study investigated the association between a fall measurement scale called the Hopkins Falls Grading Scale (HFGS) and motor function tests in patients with MS., Material and Methods: This cross sectional study was conducted using convenience sampling on 85 patients referred to the MS Association of Mashhad, Iran, in 2023. The HFGS examined falls during the past year and divided them into 4 degrees, and the function test included the timed 25 foot walk (T25FW) test and the timed up and go (TUG) test. Kruskal-Wallis test and Spearman's correlation coefficient were used for data analysis., Results: A statistically significant association was obtained between HFGS and functional tests (T25FW and TUG) (for both P < 0.0001). A significant association was observed between the variables of age ( P = 0.006), duration of the disease ( P = 0.03), the use of mobility devices ( P = 0.05), and HFGS., Conclusion: Considering the association between HFGS and motor function tests in MS patients, clinical experts should pay attention to patients who have slower movement and evaluate them in terms of falling status when performing motor function tests., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

Objective: The current study aimed to identify the association between COVID-19 vaccination and prolonged post-COVID symptoms (long-COVID) in adults who reported suffering from this condition., Methods: This was a retrospective follow-up study of adults with long-COVID syndrome. The data were collected during a phone call to the participants in January-February 2022. We inquired about their current health status and also their vaccination status if they agreed to participate., Results: In total, 1236 people were studied; 543 individuals reported suffering from long long- COVID (43.9%). Chi square test showed that 15 out of 51 people (29.4%) with no vaccination and 528 out of 1185 participants (44.6%) who received at least one dose of any vaccine had long long- COVID symptoms (p = 0.032)., Conclusions: In people who have already contracted COVID-19 and now suffer from long-COVID, receiving a COVID vaccination has a significant association with prolonged symptoms of long-COVID for more than one year after the initial infection. However, vaccines reduce the risk of severe COVID-19 (including reinfections) and its catastrophic consequences (e.g., death). Therefore, it is strongly recommended that all people, even those with a history of COVID-19, receive vaccines to protect themselves against this fatal viral infection., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Asadi-Pooya et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Purpose: In this study, we investigated the effects of leukocyte- and platelet-rich fibrin (L-PRF) on implant stability and alterations in the marginal bone surrounding posterior maxillary implants., Methods: This randomized clinical trial was conducted to compare the variable of L-PRF placement around maxillary implants. Resonance frequency analysis (RFA) was used to evaluate the implant stability immediately after surgery and at 1, 2, 4, 6, 8, and 12 weeks after surgery (t 0 to t 6, respectively). In addition, the amount of marginal bone changes around the implant at t 6 was compared with the baseline using periapical radiography., Results: The RFA outcomes were statistically significant within each group (P < 0.001, Eta 2  = 0.322); however, in none of the follow-ups and immediately after the surgery, there was a significant difference between the two groups in terms of the implant stability quotient (ISQ) scores (P > 0.05). At t 0 , the test and control groups' respective mean levels of marginal bone loss around the implants were 0.4836 mm and 0.7343 mm, significantly different from the corresponding values at t 6 . On the other hand, marginal bone loss around the implant was not significantly different between the two groups in t 0 and t 6 (P = 0.532)., Conclusions: L-PRF did not improve the RFA outcomes of implants three months after implant placement, and changes in the ISQ values over time were the same in both groups. In addition, L-PRF had no superior effect on the marginal bone loss around the implants., Trial Registration Number: The research was registered in the Iranian Registry of Clinical Trials on 22 December 2020 (No: IRCT20200624047906N1), available at http://www.irct.ir., (© 2023. Deutsche Gesellschaft für Implantologie im Zahn‐, Mund‐ und Kieferbereich e.V., Japanese Society of Oral Implantology.)

Objective: To assess the influence of systemic sclerosis (SSc) on the survival rate of dental implants in SSc patients receiving implant-supported treatments., Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) Statement and the Cochrane Collaboration's guiding principles were followed during the study's execution. The data from three databases, PubMed, Google Scholar, and Scopus, available until January 2023, were used to compile the material for our research. Only English-language publications were submitted for this research and evaluated based on their titles, abstracts, and full texts. For performing a quality assessment, quality scores were calculated., Results: The total number of patients and implants studied were 37 and 153, respectively, all having had scleroderma. The patients' ages ranged from 28 to 77 years old, with a mean (SD) age of 58.16 (12.88). All the patients in the case reports and most in the case series study were female. The range of follow-up duration was from 1 to 10 years. In case report studies, the survival rate was 100%; in case series, it was 89.2%., Conclusion: The SSc status had no discernible impact on the implant survival rate. Implant-based treatments in SSc patients should not worsen the overall morbidity and should not conflict with systemic treatments. Before starting implant therapy, a thorough risk assessment is essential, though., (© 2023 The Authors. Immunity, Inflammation and Disease published by John Wiley & Sons Ltd.)

Background: Considering the high prevalence and clinical importance of herpes simplex virus (HSV) infection worldwide, we aimed to evaluate the seroprevalence of HSV-1 and HSV-2 in a population aged between 15 and 35 years in Mashhad, Iran., Methods: This cross-sectional study was conducted on 916 cases composed of 288 (31.4%) men and 628 (68.6%) women. Using ELISA method, the presence of IgM and IgG antibodies against HSV-1 and HSV-2 was assessed., Results: Among the population studied, 681 (74.3%) cases were positive for anti-HSV antibodies, while 235 (25.7%) cases were negative. Moreover, no IgMs were found and all positive subjects had IgG antibodies. Age (p < 0.001), occupation (p < 0.001), education (p = 0.006), smoking (p = 0.029), and BMI (p = 0.004) demonstrated a significant association with HSV-1 and HSV-2 infection., Conclusion: Our study indicates a high seroprevalence of HSV infection; however, there was no cases positive for IgM antibodies, suggesting the high prevalence of latent infection.

Introduction: Cancer remains a challenging issue against human health throughout the world; As a result, introducing novel approaches would be beneficial for cancer treatment. In this research, sodium butyrate (Sb) is one of the effective anti-cancer therapeutics (also a potent survival factor for normal cells) that was used for prostate cancer suppression in the platform of modified chitosan (CS) nano-complex (polyethylene glycol (PEG)-folic acid (FA)-Sb-CS). Methods: Different analytical devices including Fourier transform infrared, dynamic light scattering, high-performance liquid chromatography, scanning electron microscopy, and transmission electron microscopy were applied for the characterization of synthetics. On the other hand, biomedical tests including cell viability assay, molecular and functional assay of apoptosis/autophagy pathways, and cell cycle arrest analysis were potentially implemented on human PC3 (folate receptor-negative prostate cancer) and DU145 (folate receptor-positive prostate cancer) and HFF-1 normal cell lines. Results: The quality of the syntheses was effectively verified, and the size range from 140 to 170 nm was determined for the PEG-CS-FA-Sb sample. Also, 75  ±  5% of drug entrapment efficiency with controlled drug release manner (Sb release of 54.21% and 74.04% for pHs 7.4 and 5.0) were determined for nano-complex. Based on MTT results, PEG-CS-FA-Sb has indicated 72.07% and 33.53% cell viability after 24 h of treatment with 9 mM on PC3 and DU145 cell lines, respectively, which is desirable anti-cancer performance. The apoptotic and autophagy genes overexpression was 15-fold (caspase9), 2.5-fold (BAX), 11-fold (ATG5), 2-fold (BECLIN1), and 3-fold (mTORC1) genes in DU145 cancer cells. More than 50% of cell cycle arrest and 45.05% of apoptosis were obtained for DU145 cancer cells after treatment with nano-complex. Conclusion: Hence, the synthesized Sb-loaded nano-complex could specifically suppress prostate cancer cell growth and induce apoptosis and autophagy in the molecular and cellular phases.

Introduction: In late December 2019, a sudden severe respiratory illness of unknown origin was reported in China. In early January 2020, the cause of COVID-19 infection was announced a new coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Examination of the SARS-CoV-2 genome sequence revealed a close resemblance to the previously reported SARS-CoV and coronavirus Middle East respiratory syndrome (MERS-CoV). However, initial testing of drugs used against SARS-CoV and MERS-CoV has been ineffective in controlling SARS-CoV-2. One of the key strategies to fight the virus is to look at how the immune system works against the virus, which has led to a better understanding of the disease and the development of new therapies and vaccine designs. Methods: This review discussed the innate and acquired immune system responses and how immune cells function against the virus to shed light on the human body's defense strategies. Results: Although immune responses have been revealed critical to eradicating infections caused by coronaviruses, dysregulated immune responses can lead to immune pathologies thoroughly investigated. Also, the benefit of mesenchymal stem cells, NK cells, Treg cells, specific T cells, and platelet lysates have been submitted as promising solutions to prevent the effects of infection in patients with COVID-19. Conclusion: It has been concluded that none of the above has undoubtedly been approved for the treatment or prevention of COVID-19, but clinical trials are underway better to understand the efficacy and safety of these cellular therapies., Competing Interests: Authors declare no conflict of interest in this study., (© 2023 The Author(s).)

Coronavirus disease 2019 (COVID-19) can be fatal in severe cases. Accordingly, predicting the severity and prognosis of the disease is valuable. This study examined the role of electrolyte imbalances in predicting the severity of COVID-19. In this cross-sectional study, 169 hospitalized patients with COVID-19 were included and categorized into three groups based on the severity of the disease (moderate, severe, and critical). Serum levels of electrolytes (calcium [Ca], phosphorus [P], sodium [Na], potassium [k], and magnesium [Mg]), inflammatory markers (D-dimer, C-reactive protein [CRP], ferritin, and lactate dehydrogenase [LDH]), and 25OHVitamin D were measured. The mean age of patients was 53 years, and 54% were male. They had moderate, severe, and critical illnesses in 22%, 47%, and 31%, respectively. CRP, D-dimer, and ferritin increased with the severity of the disease. The lower median values of Mg, Na, 25OHVitamin D, Ca, LDH, and higher median lymphocyte counts were observed in the moderate vs. the severe group (P < 0.05). These parameters have acceptable sensitivity and specificity at the suggested cut-off level to discriminate the moderate and critical cases. Serum parameters introduced in this study are appropriate for differentiating between critical and moderate cases. The electrolyte imbalance can predict critical patients., (© 2022. The Author(s).)

Objectives: Antiepileptic drugs are among the most common triggers of cutaneous adverse reactions. About 5-17% of epileptic patients develop idiosyncratic skin reactions at some point during their treatment course, most of which occur within the first two months of drug initiation. This study aimed to investigate the pattern of cutaneous drug reactions associated with anticonvulsant use among the pediatric population in Iran to identify high-risk individuals., Materials & Methods: In this retrospective descriptive study, medical records of children aged two months to 14 years, who were diagnosed with drug reactions due to anticonvulsant drugs between April 2007 and March 2018, were reviewed, and relevant information were extracted. This multicenter study was conducted in several provinces of Iran., Results: A total of 186 cases with a final diagnosis of the antiepileptic drug-induced eruption were evaluated. The median age of participants was 36 months (range: 2-168), and 56% were male. In approximately 70% of the children, the phenobarbital was the culprit. The median time interval between initiation of the causative drug and development of rash and fever was 10 and 7 days, respectively. The most common rash type was maculopapular rashes (69%). Overall, 33% of the patients only received antihistamines after discontinuation of the causative drug., Conclusion: Similar to previously published studies in Iran, phenobarbital was the main cause of cutaneous drug reactions to antiepileptic drugs, indicating the necessity of paying more attention when prescribing phenobarbital for Iranian pediatrics., Competing Interests: None, (© 2022 The Authors.)

Purpose: Despite the promising therapeutic effects of gene silencing with small interfering RNAs (siRNAs), the challenges associated with delivery of siRNAs to the tumor cells in vivo , has greatly limited its clinical application. To overcome these challenges, we employed gold nanoparticles modified with trimethyl chitosan (TMC) as an effective delivery carrier to improve the stability and cellular uptake of siRNAs against epidermal growth factor receptor (EGFR) that is implicated in breast cancer. Methods: AuNPs were prepared by the simple aqueous reduction of chloroauric acid (HAuCl 4 ) with ascorbic acid and coated with synthesized TMC. EGFR-siRNA was then complexed with the AuNPs-TMC via electrostatic interaction to make AuNPs-TMC/EGFR-siRNA with a w/w ratio of 10:1. Nanoparticles were assessed for physicochemical characteristics and in vitro cellular behavior on MCF-7 breast cancer cell line. Results: Spherical and positively charged AuNPs-TMC (67 nm, +45 mV) were successfully complexed with EGFR-siRNA (82 nm, +11 mV) which were able to retard the gene migration completely. Confocal microscopy and flow cytometry analysis demonstrated complete cellular uptake of Cy5 labeled AuNPs-TMC in the MCF-7 cells after 4 h incubation. MTT test after 48 h incubation showed that the AuNPs-TMC were safe but when combined with EGFR-siRNA exert significant cytotoxicity while the cell viability was about 50%. These nanocomplexes also showed a high gene expression knockdown (86%) of EGFR and also a high apoptosis rate (Q2 + Q3 = 18.5%) after 24 h incubation. Conclusion: This study suggests that the simply synthesized AuNPs-TMC are novel, effective, and promising nanocarriers for siRNA delivery, and AuNPs-TMC/EGFR-siRNA appears to be a potential therapeutic agent for breast cancer treatment., 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., (Copyright © 2022 Baghani, Noroozi Heris, Khonsari, Dinarvand, Dinarvand and Atyabi.)

The present study was conducted to investigate the detection and identification of Cryptosporidium species via molecular techniques and evaluate the serum concentrations of inflammatory factors in Cryptosporidium species. The fecal samples (n = 256) were collected from pre-weaned (≤ 2.00 months) calves and the positive samples were identified utilizing Ziehl-Neelsen staining. Nested species-specific multiplex PCR (nssm-PCR) and restriction fragment length polymorphism (RFLP) were used to identify the species and sub-species. The serum concentrations of IL-1β, IL-6, IL-12, TNF-α, and IFN-γ were also assessed. The results revealed that 10.54% of samples were positive. The results of Nested-PCR showed that 92.59% of the samples were positive for C. parvum while 7.41% were positive for C. andersoni . The results of RFLP confirmed 92.59% of the samples for C. parvum , 3.70% for C. muris / C. andersoni , and 3.70% for C. muris . The serum concentrations of IL-1β, IL-6, IL-12, TNF-α, and IFN-γ were significantly higher in the infected calves compared to those in healthy calves. However, the serum concentration of IFN-γ was significantly higher in the calves infected with C. parvum while the serum concentrations of TNF-α and IL-6 were significantly higher in those infected with C. andersoni . In conclusion, C. parvum was prevalent in the region and the calves demonstrated inflammatory responses to Cryptosporidium species., Competing Interests: The authors have no conflict of interest to declare., (© 2022 Urmia University. All rights reserved.)

Purpose: To compare two methods for treating inferior oblique overaction (IOOA): disinsertion versus myectomy of the muscle., Methods: In this prospective interventional case series, patients were randomly assigned to undergo either IO myectomy or disinsertion. The changes in vertical and horizontal deviations following these two surgical procedures were evaluated. The postoperative IO function of grade 0 or +1 and the fundus extorsion of grade 0 or +1 was considered as the successful outcome., Results: Thirty-six patients (50 eyes) with a mean age of 12.67 ± 4.05 years were included. In the myectomy group, the mean preoperative hyperdeviation in adduction was 29.5 ± 9.32 prism diopter (PD), which decreased to 9.15 ± 7.86 PD after surgery ( P = 0.001). In the disinsertion group, these measurements were 32.73 ± 12.42 and 12.65 ± 9.34 PD before and after the surgery, respectively ( P = 0.001). The success rate of surgery based on the IOOA grading was 87.4% and 92.3% in the myectomy and disinsertion groups, respectively ( P = 0.780). The successful correction rate of abnormal fundus torsion was 91.6% in the myectomy and 88.4% in the disinsertion group ( P = 0.821). In comparison, 48% of the cases in the myectomy group and 50% in the disinsertion group were within the normal range of torsional position postoperatively ( P = 0.786). There was no statistically significant difference in terms of changes in the horizontal or vertical deviations, V-pattern, and dissociated vertical deviation between the two groups., Conclusion: Both surgical techniques seem to be effective for treatment of inferior oblique muscle overaction., Competing Interests: The authors do not have any conflicts of interest., (Copyright © 2021 Abri Aghdam et al.)

Objectives: Mycobacterium tuberculosis ( M. tuberculosis ), an intracellular pathogen, causes 1.5 million deaths globally. Bacilli Calmette-Guérin (BCG) is commonly administered to protect people against M. tuberculosis infection; however, there are some obstacles with this first-generation vaccine. DNA vaccines, the third generation vaccines, can induce cellular immune responses for tuberculosis (TB) protection. In this study, optimized DNA vaccine (pcDNA3.1-Mtb72F) entrapped in poly (lactic-co-glycolic acid) (PLGA) nanoparticles (NPs) was used to achieve higher immunogenicity., Materials and Methods: Plasmid Mtb72F was formulated in PLGA NPs using double emulsion method in the presence of TB10.4 and/or CpG as an adjuvant. Female BALB/c mice were immunized either with NP-encapsulated Mtb72F or naked Mtb72F with or without each adjuvant, using the BCG-prime DNA boost regimen., Results: These NPs were approximately 250 nm in diameter and the nucleic acid and protein encapsulation efficiency were 80% and 25%, respectively. The NPs smaller than 200 nm are able to promote cellular rather than humoral responses. The immunization with the formulation consisting of Mtb72F DNA vaccine and TB10.4 entrapped in PLGA NPs showed significant immunogenicity and induced predominantly interferon-ɣ (IFN-ɣ) production and higher INF-ɣ/interleukin-4 (IL-4) ratio in the cultured spleen cells supernatant., Conclusion: PLGA NPs loaded with Mtb72F DNA-based vaccine with TB10.4 could be considered as a promising candidate for vaccination against TB. These results represent an excellent initial step toward development of novel vaccine for TB protection.

Background: Survival time is one of the indicators used for evaluation of the quality of care in different types of malignancies, including breast cancer. The present study aimed to estimate the survival rate of breast cancer and its related factors among Iranian patients., Methods: Overall, 3148 cases of breast cancer who referred to the Cancer Research Center in Shahid Beheshti University of Medical Sciences, Tehran, Iran during 1994-2017 participated in this longitudinal study. Survival estimates were calculated using the Kaplan-Meier method and the Bayesian generalized Birnbaum-Saunders model with cure rate from geometric distribution. Clinical, pathological, and biological variables as potential prognostic factors were entered in univariate and multivariate analyses.In order to identify the significant prognostic factors, 95% highest posterior density (HPD) intervals were used., Results: The overall 1, 5, 10, 15, 20 and 25-year survival rate were 95%, 75%, 60%, 47%, 46% and 46%, respectively. A significant relation was observed between survival time and the variables such as age, size of tumor, number of lymph nodes, stage, histological grade, estrogen receptor, progesterone receptor, and lymphovascular invasion., Conclusion: The findings of this study might help the health managers to plan long-term programs considering regional determinants, public education, and screening for early detection of breast cancer cases which can eventually influence the overall survival rate of these patients., Competing Interests: Conflict of interests The authors declare that there is no conflict of interest., (Copyright© Iranian Public Health Association & Tehran University of Medical Sciences.)

Hypothesis: Rhinoplasty is one of the most common aesthetic surgeries. The aim of the study was to evaluate facial proportions and patient satisfaction with the appearance of their nose after rhinoplasty compared to preoperatively., Methods: This cross-sectional study was conducted at Islamic Azad University, Mashhad Branch. Eighty-two candidates with indications for primary cosmetic rhinoplasty were selected. Facial proportions and patient satisfaction with their nasal appearance were evaluated before and 6 months after rhinoplasty. Patient satisfaction was assessed using the Rhinoplasty Outcome Evaluation questionnaire., Results: Eighty-two patients referred for cosmetic rhinoplasty (13.4% men and 86.6% women) with a mean age of 28.5 (6.4) years underwent open rhinoplasty and were evaluated. Facial proportions, including nasofrontal, nasolabial, and nasomental ratios increased significantly, while the nasofacial ratio, nasal tip projection, columellar show, alar base, and nasal length reduced significantly after rhinoplasty ( P < .05). Furthermore, patient satisfaction with the appearance of their nose increased significantly after surgery ( P < .001)., Conclusion: All of the facial proportions changed significantly following rhinoplasty. Although patient satisfaction with nose appearance increases significantly after the operation, there is no significant association between patient satisfaction and facial proportions. As beauty is a subjective, relative and qualitative issue, facial proportions may not be a proper tool to determine facial beauty and predict the satisfaction rate following rhinoplasty., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Some of the single-nucleotide polymorphisms in miRNA genes have been studied to date to find their association with the risk of breast cancer (BC). However, no study has been conducted to investigate the association of the mir-520f rs75598818G>A in BC. In the present study, rs75598818 association with BC in an Iranian population has been investigated, and an in silico analysis was performed to predict the function of rs75598818 polymorphism in BC. The rs75598818 was genotyped in 129 BC patients and 144 healthy women, using the PCR-RFLP method. The frequency of alleles and genotypes were considered to find the associations between rs75598818 alleles/genotypes, and BC risk and pathological characteristics of the patients. Statistical analysis showed that the rs75598818 GA genotype was significantly associated with BC (GA versus GG, OR=0.50, 95% CI: 0.25-0.98, P =0.041), highstage BC (stage III/IV versus I/II, GA versus GG, OR=0.27, 95% CI: 0.09-0.81, P =0.015), and HER-2 positive status (GA versus GG, OR=19.00, 95% CI: 4.64-77.82, P <0.001). Notably, the rs75598818 GA genotype has a negative association pattern since it reduces the risk of BC and high stage BC. Conversely, it increases the risk of HER-2 positivity. Computational results suggested that the rs75598818 polymorphism affects the stability of mir-520f stem-loop and as a result miR-520f -3p production that is a potential tumour suppressor. A contribution of the mir-520f rs75598818 polymorphism to BC had been unexplored before. In the present study, we performed an association study and a bioinformatics approach to evaluate this polymorphism in BC. However, further functional experiments and large-scale association studies with various ethnicities are required to elaborate our findings.

Background: Treatment of the ischemic stroke has remained a major healthcare challenge. The phenolic compound, sesamol, has shown promising antioxidant and neuroprotective effects, however, fast clearance may negatively affect its efficiency. This, prompted us to incorporate sesamol into the nanostructured lipid carriers (S-NLCs) and evaluate its therapeutic potential in in vitro and in vivo models of ischemic stroke., Methods: S-NLCs formulations were prepared by high-pressure homogenization followed by physicochemical characterization, evaluation of the bioactivity of the optimal formulation in oxygen-glucose deprivation (OGD) and global cerebral ischemia/reperfusion (I/R) injury and implication of phosphatidylinositol 3-kinase (PI3K) pathway in this regard. Two- or three-way ANOVA, Mann-Whitney U test, and Student's t-test were used for data analysis., Results: Formation of S-NLCs which exhibited a controlled release profile, was confirmed by scanning electron microscope and differential scanning calorimetry. 1- and 8-h OGD followed by 24 h re-oxygenation significantly reduced PC12 cell viability, increased lactate dehydrogenase activity and the number of condensed nuclei, and induced oxidative stress as revealed by increased malondialdehyde level and decreased glutathione content and superoxide dismutase and catalase activities. Sesamol (80 and 100 μM) reduced the cytotoxicity, oxidative stress, and cellular damage only after 1-h OGD, while, S-NLCs (containing 80 and 100 μM of sesamol) were effective at both time points. Intravenous injections of S-NLCs (20 and 25 mg/kg) into rats markedly attenuated I/R-induced neurobehavioural deficits, cellular damage, and oxidative stress, while, free sesamol failed. Pre-treatment with PI3K inhibitor, LY294002, abolished the protective effects against OGD or I/R., Conclusions: S-NLCs improve the pharmacological profile of sesamol and provide longer lasting protective effects for this phenolic phytochemical. This nanoformulation by activating PI3K pathway may serve as a promising candidate for neuroprotection against the cerebral stroke or other neurodegenerative disorders. Sesamol-loaded NLCs, a promising nanoformulation against the ischemic stroke.

Background: Although the role of enteroviruses has been proved in heart diseases, extensive information is not available on the association between enteroviruses and unstable angina. In the present study, the authors compared the prevalence of enteroviruses in patients with and without unstable angina., Methods: Blood samples were taken from 51 patients with unstable angina and 55 patients without unstable angina or myocardial infarction that were admitted to Imam Reza and Ghaem hospitals (Mashhad, northeast of Iran). Reverse transcription polymerase chain reaction (RT-PCR) was performed using specific primers for the detection of the enteroviruses in blood samples of study subjects., Results: Patients with and without unstable angina were similar in age with mean ± standard deviation of 62.6 ± 12.8 and 59.7 ± 12.7 years, respectively (P = 0.243) and there were no differences in gender in these two groups (P = 0.174). Prevalence of the enteroviruses in patients with unstable angina was higher only in 66-80 years age group compared to the control group (patients without unstable angina, P = 0.032). There was a higher prevalence of enterovirus RNA positivity in the blood samples of women with unstable angina (75.9%) than those without unstable angina (41.7%, P = 0.011), however, no significant difference was observed in men (P = 0.983)., Conclusion: Our data showed that enteroviral RNA positivity was higher in patients with unstable angina compared to those without unstable angina. However, the differences between the two groups were not statistically significant.

Competing Interests: All authors declare no conflicts of interests.

Introduction: Tinnitus is a common complaint in patients referred to otorhinolaryngology clinics and is a condition where one hears a sound without any distinguishable external acoustic source or electrical stimulus. About 3-30% of adults experience different degrees of tinnitus during their life. This study aims to ascertain and compare personality traits between patients with tinnitus and a control group., Materials and Methods: In a case control study, 66 participants were assessed. The case group consisted of 33 patients who suffered from tinnitus for at least two months, in addition to 33 healthy volunteers who were selected among their family (preferably of the same age and sex). A standard demographic questionnaire and an Eyzenck personality questionnaire were filled for both groups. A tinnitus severity index (TSI) questionnaire was only filled for the case group. Data from each group was compared by Mann-Whitney U and Chi-Square tests. SPSS V.18 was the selected software., Results: Statistical analysis showed a meaningful difference in neuroticism (P=0.001) and extraversion (P=0.001) between the patients and the controls; however, there was no statistical difference between these groups regarding psychotism., Conclusion: Tinnitus can be associated with personality characteristics. This study showed that in patients with tinnitus, neuroticism increases and extraversion decreases. Considering the personality and psychotic traits observed in the patients with tinnitus, psychiatric consultation is recommended.

Background: Transforming growth factor-β1 (TGF-β1) has been found to play a crucial role in early central nervous system development. Several studies have illustrated decreased TGF-β1 levels in sera and brains of autistic children. Two point mutations in the TGF-β1 signal peptide at 869T/C and 915G/C have been reported to influence TGF-β1 expression. The aim of the present study was to investigate the correlation of TGF-β1 polymorphisms and their haplotypes with autism., Methods: This study was performed on 39 autistic patients and 35 age- and sex-matched normal controls in an Iranian population, using the sequence specific primed-polymerase chain reaction (PCR-SSP) technique. Patients were divided into mild-to-moderate and severe groups according to the childhood autism rating scale., Results: No significant differences were observed for allele, genotype, or haplotype frequencies between the autistics and controls. Only a slight difference was observed in GC25 between the controls and all children with autism., Conclusion: Thus, these results indicate that the polymorphisms in TGF-β1 gene may not play an important role in the development of autism.

Background: Hepatitis delta virus (HDV) is dependent on the hepatitis B virus for transmission and propagation. Based on isolated HDV sequences from different parts of the world, at least three major different genotypes with different geographic distributions are suggested. Studies have shown that genotype 1 is the predominant genotype of HDV in different parts of Iran; however, the genotype distribution of this virus has not been identified in Mashhad, northeast Iran., Objectives: This current study determines the frequency of HDV major genotypes in Mashhad, Iran., Patients and Methods: Twenty-five participants were enrolled in this study. All samples were positive for HBsAg (determined by Enzyme-linked immunosorbent assay (ELISA)) and anti-HDV. RNA extraction and cDNA synthesis was performed. Then, PCR was performed and HDV genotypes were determined by restriction fragment length polymorphism (RFLP)., Results: Of 25 patients, 12 (48%) were positive for HDV RNA. Genotype analysis of HDV RNA revealed that the prevalence of HDV genotypes I and II was 83.3% (n = 10) and 16.7% (n = 2), respectively., Conclusions: This study showed that the most prevalent genotype of HDV in Mashhad was genotype I. It was of interest that in contrast to other provinces of Iran, HDV genotype 2 was observed in Mashhad. Similar studies with larger sample sizes could provide valuable information regarding the molecular epidemiology and geographical distribution. It may also help control and prevent the spread of hepatitis D virus infections. In addition, the genotyping of HDV may predict the severity of the disease.

Background: It is not yet known which types of Toll-like receptors (TLRs) are most effective in Helicobacter pylori (H. pylori) recognition. It is also not known which gastric zones have the most prominent roles in TLR-mediated bacterial recognition. The aim of this work was to analyze the expression of TLR2 and TLR4 in biopsy specimens from H. pylori-infected patients., Methods: Thirty-eight patients with gastrointestinal disorders were divided into four groups in this study. The groups were: (A) H. pylori infection and peptic ulcer (n=15), (B) peptic ulcer only (n=5), (C) H. pylori infection only (n=10) and (D) control, with neither H. pylori infection nor peptic ulcer (n=8). Biopsy specimens from sites of redness or atrophic mucosa from gastric antrum and body in patients with gastritis were collected. RNAs from the antrum and body specimens were isolated. TLR2 and TLR4 mRNA expression was assessed by RT-PCR and quantified as densitometric ratios of TLR2 and TLR4/β-actin mRNA., Results: In the antral zones of H. pylori-infected patients (Groups A and C) TLR2 and TLR4 expression was significantly greater than in uninfected patients (Groups B and D) regardless of peptic ulcers (p < 0.05). In the gastric body samples TLR2 expression was significantly greater in Group C (H. pylori infection only) than in Group B (peptic ulcer only) and TLR4 expression was significantly greater in group A (H. pylori infection and peptic ulcer) than in Group B (peptic ulcer only) (p < 0.05). No significant differences in expression of TLR4 and TLR2 were observed between samples from the antrum and body in same groups., Conclusions: We conclude that H. pylori infection leads to significant increase in TLR2 and TLR4 molecules expression in antral region related to the control group. Considering the stimulatory effect of H. pylori on TLRs expression in the gastric tissue, we assume that colonization of H. pylori infection might occurs more in the gastric antral region than in the gastric body.

Background: Tuberculosis remains a global epidemic, especially in developing countries, including Iran. Rapid diagnosis of active Mycobacterium tuberculosis infection plays a critical role in controlling the spread of tuberculosis. Conventional methods may take up to several weeks or longer to produce results. In addition to multiplicity of steps involved in conventional detection, including isolation, identification and drug susceptibility testing, the slow growth rate of M. tuberculosis is also responsible for this lengthy time., Objectives: The aim of this study was to compare the polymerase chain reaction (PCR) and culture methods for the detection of M. tuberculosis in different clinical specimens., Materials and Methods: This study was performed on different samples (urine, gastric aspirate, bronchoalveolar lavage, pleural fluid, cerebrospinal fluid, ascetic fluid and joint fluid specimens) of tuberculosis suspected patients. M. tuberculosis DNA was extracted directly from different samples using two different protocols. Next, PCR was performed using three sets of specific primers to detect members of Mycobacterium genus, M. tuberculosis complex and non-tuberculosis Mycobacteria. The results were then compared with that of the culture method, which is considered as the gold standard method., Results: The concordance rate between the three sets of primers was calculated and IS6110/buffer PCR method showed good agreement with the LJ culture method (κ = 0.627, P < 0.0001). The sensitivity of IS6110/buffer PCR was 58.33%, with specificity of 77.78%; the positive and negative predictive values were 100% and 78.26%, respectively. Buffer method for DNA extraction was proved to give a higher accuracy to PCR in comparison with the boiling method., Conclusions: PCR method is a valuable, cost-effective and alternative tool for quick diagnosis of active tuberculosis in different clinical specimens.

Background/aim: Infection with the human papillomaviruses (HPVs) is associated with the development of several cancers, including oral, esophageal, skin, lung, and cervical. However, the association of HPVs and colorectal cancers remains controversial. The aim of this study was to evaluate the association between HPV infection and paraffin-embedded colorectal tissue samples in Mashhad in the northeast of Iran., Materials and Methods: Paraffin-embedded tissue specimens from 111 patients with colorectal cancer were subjected to DNA extraction. The quality of extracted DNA was confirmed by amplification of a P-globin fragment using polymerase chain reaction (PCR) and GH20/PCO4 primers. PCR with GP5+/GP6+ primers was then performed on positive samples to evaluate the sequence of HPVs., Results: A total of 100 colorectal samples with positive results for the P-globin gene were analyzed. The age of patients ranged from 18 to 72 years (mean: 52). Sixty-four patients (56.7%) were male and 47 patients (43.4%) were female. One (1%) out of 100 patients with colorectal cancer was found to be positive for HPV DNA., Conclusion: Results of the current study suggested that HPV infection is not common in patients with colorectal cancer in our population. We concluded that HPV types that are associated with malignant transformations do not meaningfully contribute to adenocarcinoma of the colon among our population.

Background/aim: Several types of the hepatitis C virus (HCV), with variations in different parts of the genome, have been isolated from different regions of the world. Based on heterogenic sequences in the isolated genome, HCV is classified into different genotypes and subtypes. Data on distribution of HCV genotypes in a certain region could be important to patient management. Therefore, this study was conducted to determine the distribution of HCV in Mashhad, Northeast Iran., Materials and Methods: This cross-sectional study was conducted on 103 patients with HCV infections in Mashhad. Among the participants, at least 22 (21.4%) were intravenous drug users. HCV seropositivity was determined by an enzyme-linked immunosorbent assay and was confirmed by reverse transcriptase polymerase chain reaction. HCV-positive samples were selected for HCV genotyping using genotype specific primers., Results: Of 103 subjects, 43 (41.7%) and 34 (33.0%) had genotypes 1a and 3a, respectively. Other genotypes including 1b, 2a, 2b, 3b, and 5a were found in 4 (3.9%), 1 (1.0%), 3 (2.9%), 4 (3.9%), and 1 (1.0%), respectively. Coinfections with 2 genotypes were also observed in 11 (10.7%) patients. Genotyping for 2 (1.9%) of 103 samples did not produce any results., Conclusion: Genotypes la and 3a were found to be the most prevalent HCV genotypes in Mashhad, Iran.

Introduction: Anthracosis of the lung is the blackening of bronchial tissues which can lead to chronic bronchial obstruction. Many studies have shown association of bronchial anthracosis and tuberculosis. The aim of this study was accumulation of scattered studies and getting the definite conclusion about the association between anthracosis and tuberculosis., Matherials and Methods: We conducted a systematic search that included studies with sufficient information about the frequency of tuberculosis in anthracosis (anthracofibrosis) patients and non-anthracotic control group. Moreover, tuberculosis should be confirmed by microbiologic (smear or culture) or histopathological methods., Results: Twelve studies (eight studies on anthracofibrosis and four studies on anthracosis as a general term) comprising of 6280 patients was entered into our meta-analysis. The frequency of tuberculosis in all anthracosis patients was 22.5 % (32.3 % for anthracofibrosis and 16.6 % for anthracosis), which was significantly higher than the control group. Determination of risk showed that the cumulated odds ratio of tuberculosis in all studies of anthracosis was 3.16 (95 % CI = 2.49 - 6.85), which revealed significantly higher risk than the control group. The analysis of the subgroups showed that the cumulated odds ratio of tuberculosis in subgroups of anthracofibrosis (3.28; 95 % CI = 2.16 - 9.12) was significantly higher than anthracosis as a general term (2.85; 95 % CI = 1.73 - 6.61)., Discussion: The association of tuberculosis with all types of anthracosis of the lung was confirmed and a proper mechanism should be defined.

Crimean Congo hemorrhagic fever (CCHF) is a viral zoonosis, which is usually transmitted via tick bites or close contact with infected blood or tissue. This disease can cause a case fatality rate of up to 25%-30% in humans. CCHF Infection in birds is less documented. An ostrich can reproduce viruses and can also play the role of a mechanical vector, by transporting infected ticks without becoming ill. In March 2007, three butchers and one worker in an ostrich farm were infected with CCHF in central part of Iran. Considering the role ostriches play in transmitting the disease, serum samples from five ostriches of that farm were taken and sent to the laboratory for CCHF ELISA tests. The result of the IgG test was positive for one (20%) of the ostriches. At the same time, serum samples of eight sheep from the same farm were sent for IgG testing, two (25%) of which were positive. This was the first report of CCHF infection of an ostrich in Iran and tracing CCHF IgG against this ostrich and the afore-mentioned sheep may have revealed that the disease in the worker was the cause of transmission of this disease from these animals or their ticks.

Background: Despite many efforts, the etiology of autism remains unknown. Food allergy has been suggested as a pathogenic factor in Autism Spectrum Disorder (ASD). Our aim in this study was to determine whether food allergy could be considered as a risk factor for autistic children., Methods: Thirty-nine autistic children were examined by the skin prick test (SPT), and total serum IgE was evaluated by ELISA. SPTs were performed for egg whites, oranges, peanuts, tomatoes, tuna fish, walnuts, aubergines, melons, grapes, and cow milk. Parents and teachers were then asked to exclude these items from the childrens' diets for six months. After the treatment period, the autistic children who tested positive for food allergies were re-assessed by a standard questionnaire to obtain further information about their medical histories., Results: Three of the study's 39 autistic children (7.7%) tested positive on the SPT. Total serum IgE levels were elevated in 56.4% of the subjects (mean=164±24.5, cut-off >155 IU/ml). The results showed a decreased mean in the childrens' autistic behaviors on the Children Autism Rating Scale (CARS) after both eight weeks and six months; however, this decrease was not statistically significant., Conclusion: Food allergy may play a role in the pathophysiology of autism. We conclude that avoidance of certain foods benefits the behavior of autistic children.

Background: Vaccines capable of controlling tumor virus based infections are found difficult to develop due to the consistence latent infection in the host. DNA vaccines are attractive tools for the development of HPV vaccines and inducing antigen-specific immunity owing to the stability, simplicity of delivery, safety and cost effectiveness. However, there is a need to increase their potency by procedures such as using HSP70 gene as an adjuvant., Objective: To evaluate a DNA vaccine containing HPV16 truncated E7 C-terminal cytotoxic T-lymphocyte epitopes linked to HSP70 gene (HSP70-tE7) in an animal model., Methods: Mice were immunized with the plasmid DNA after pre-treatment with cardiotoxin. The splenocytes of immunized mice were then tested for CTL activity by detecting the apoptosis and necrosis in target cells, cytokine production by ELISA, CD4 and CD8 frequencies by flow cytometry, and lymphocyte stimulation by MTT assay., Results: The recombinant expression vector was able to elicit immune responses close to that of full length E7 complete gene. Although the use of a small part of a target antigen can induce immune responses equivalent to the full length antigen, it fails to elicit statistically significant stronger immune responses when fused with HSP70 compared to the complete E7 gene alone., Conclusion: The potent immunogenicity of HPV16 E7 was preserved in the HSP70-tE7 vaccine and may represent a target of choice for the therapeutic vaccination strategies. However, to improve the immunogenicity polytope DNA vaccines which elicit multiple effector and memory CTL responses should be considered in future studies of DNA-based cancer vaccines.

Objective: Air leak syndromes including pneumothorax, pneumomediastinum and pulmonary interstitial emphysema are frequent in neonatal period. Mechanical ventilation with positive pressure is one of the most common causes of these syndromes. The aim of this study was to evaluate predisposing factors and incidence of pneumothorax in newborns under mechanical ventilation., Methods: This descriptive cross sectional study was performed in 400 newborns under mechanical ventilation in intensive care unit of a teaching hospital in Iran from April 2004 to December 2008. Predisposing factors leading to ventilation and incidence of air leak syndromes were studied. Sex, gestational age, birth weight, type of delivery, history of surfactant replacement therapy, ventilator settings and mortality rate were recorded. Statistical analysis was done using SPSS software. Univariate analysis and regression analysis were considered., Findings: Among 400 patients under mechanical ventilation, 102 neonates developed pneumothorax (26%). Fifty six (54.9%) of them were boys and 46 (45.1%) girls. 54.9% of newborns with pneumothorax were preterm and 45.1% term. Birth weight less than 2500g was recorded in 59.8%. Fifty two percent of these neonates were born by cesarean section vs. 32% of newborns without pneumothorax. The most common type (62.7%) of ventilation leading to pneumothorax was Inspiratory Positive Pressure Ventilation (IPPV). Surfactant replacement therapy was recorded in 32.4% of cases with pneumothorax compared to 60.4% of neonates under ventilation without pneumothorax, which was significantly different (P= 0.017)., Conclusion: In newborns surfactant replacement therapy can reduce the risk of pneumothorax caused by mechanical ventilation.

Background: Cervical cancer is the most prevalent tumor in developing countries and the second most frequent cancer among female population worldwide. Specific human papillomaviruses and, most notably, HPV types 16 and 18 are recognized as being causally associated with cervical carcinomas. The early HPV type 16 genes, E6 and E7, directly participate in the in vitro transformation of primary human keratinocytes and represent an excellent target for immune therapy of HPV related disease., Objective: The aim of this study was the evaluation of the efficacy of a DNA vaccine containing human papillomaviruse type 16 E7 gene (Iranian isolate) in induction of CTL responses in an animal model., Methods: In this study, the expression vector containing HPV type 16 E7 gene was constructed and chosen as a model antigen in the development of a therapeutic DNA vaccine in an animal model. CTL responses, cytokine assay, lymphocyte stimulation test, CD4 and CD8 staining and flowcytometry were done for evaluating of the immune responses., Results: Our findings indicate that the target DNA vaccine can induce an E7-specific CTL response, which is important in the lysis of infected tumor cells, compared to negative control (p<0.005) after in vivo immunization in the mouse system., Conclusion: The developed vaccine may be promising as an anti-cancer vaccine.