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Abstract Nanotechnology is one of the most impressive sciences in the twenty-first century. Not surprisingly, nanoparticles/nanomaterials have been widely deployed given their multifunctional attributes and ease of preparation via environmentally friendly, cost-effective, and simple methods. Although there are assorted optimized preparative methods for synthesizing the nanoparticles, the main challenge is to find a comprehensive method that has multifaceted properties. The goal of this study has been to synthesize aminated (nano)particles via the Rosmarinus officinalis leaf extract-mediated copper oxide; this modification leads to the preparation of (nano)particles with promising biological and photocatalytic applications. The synthesized NPs have been fully characterized, and biological activity was evaluated in antibacterial assessment against Bacillus cereus as a model Gram-positive and Pseudomonas aeruginosa as a model Gram-negative bacterium. The bio-synthesized copper oxide (nano)particles were screened by MTT assay by applying the HEK-293 cell line. The aminated (nano)particles have shown lower cytotoxicity (~ 21%), higher (~ 50%) antibacterial activity, and a considerable increase in zeta potential value (~ + 13.4 mV). The prepared (nano)particles also revealed considerable photocatalytic activity compared to other studies wherein the dye degradation process attained 97.4% promising efficiency in only 80 min and just 7% degradation after 80 min under dark conditions. The biosynthesized copper oxide (CuO) (nano)particle’s biomedical investigation underscores an eco-friendly synthesis of (nano)particles, their noticeable stability in the green reaction media, and impressive biological activity.

Abstract The aim of this work was to provide a novel approach to designing and synthesizing a nanocomposite with significant biocompatibility, biodegradability, and stability in biological microenvironments. Hence, the porous ultra-low-density materials, metal–organic frameworks (MOFs), have been considered and the MIL-125(Ti) has been chosen due to its distinctive characteristics such as great biocompatibility and good biodegradability immobilized on the surface of the reduced graphene oxide (rGO). Based on the results, the presence of transition metal complexes next to the drug not only can reinforce the stability of the drug on the structure by preparing π–π interaction between ligands and the drug but also can enhance the efficiency of the drug by preventing the spontaneous release. The effect of utilizing transition metal complex beside drug (Doxorubicin (DOX)) on the drug loading, drug release, and antibacterial activity of prepared nanocomposites on the P. aeruginosa and S. aureus as a model bacterium has been investigated and the results revealed that this theory leads to increasing about 200% in antibacterial activity. In addition, uptake, the release of the drug, and relative cell viabilities (in vitro and in vivo) of prepared nanomaterials and biomaterials have been discussed. Based on collected data, the median size of prepared nanocomposites was 156.2 nm, and their biological stability in PBS and DMEM + 10% FBS was screened and revealed that after 2.880 min, the nanocomposite’s size reached 242.3 and 516 nm respectively. The MTT results demonstrated that immobilizing PdL beside DOX leads to an increase of more than 15% in the cell viability. It is noticeable that the AST:ALT result of prepared nanocomposite was under 1.5.

Abstract Doxorubicin (DOX) is a potent anti-cancer agent and there have been attempts in developing nanostructures for its delivery to tumor cells. The nanoparticles promote cytotoxicity of DOX against tumor cells and in turn, they reduce adverse impacts on normal cells. The safety profile of nanostructures is an important topic and recently, the green synthesis of nanoparticles has obtained much attention for the preparation of biocompatible carriers. In the present study, we prepared layered double hydroxide (LDH) nanostructures for doxorubicin (DOX) delivery. The Cu–Al LDH nanoparticles were synthesized by combining Cu(NO3)2·3H2O and Al(NO3)3·9H2O, and then, autoclave at 110. The green modification of LDH nanoparticles with Plantago ovata (PO) was performed and finally, DOX was loaded onto nanostructures. The FTIR, XRD, and FESEM were employed for the characterization of LDH nanoparticles, confirming their proper synthesis. The drug release study revealed the pH-sensitive release of DOX (highest release at pH 5.5) and prolonged DOX release due to PO modification. Furthermore, MTT assay revealed improved biocompatibility of Cu–Al LDH nanostructures upon PO modification and showed controlled and low cytotoxicity towards a wide range of cell lines. The CLSM demonstrated cellular uptake of nanoparticles, both in the HEK-293 and MCF-7 cell lines; however, the results were showed promising cellular internalizations to the HEK-293 rather than MCF-7 cells. The in vivo experiment highlighted the normal histopathological structure of kidneys and no side effects of nanoparticles, further confirming their safety profile and potential as promising nano-scale delivery systems. Finally, antibacterial test revealed toxicity of PO-modified Cu–Al LDH nanoparticles against Gram-positive and -negative bacteria.

The reason for the increasing bioavailability and biocompatibility of the porous nanomaterials in the presence of different (bio)molecules is still unknown. The role of difference functional groups and their interactions with the potential bioavailability and biocompatibility is of great importance. To investigate the potential contribution of the electronic effects (especially on the surface of the porous nanomaterials) on their biomedical behavior, a series of surface-decorated green ZnCr-layered double hydroxide (LDH) porous nanocarriers is developed as a non-viral vector. Different conjugations investigated these porous LDHs for optimizing and minimizing the cytotoxicity for targeted breast cancer therapy. Quick low-temperature synthesized ZnCr-LDH nanocarriers method with enlarged drug delivery windows decorated with leaf extracts and benzamide-like molecules revealed a push-pull electronic synergistic effect on cytotoxicity and enhanced cell viability, biocompatibility, aggregations, and interactions with the cell membranes. The pre-defined model drug, doxorubicin (DOX), unraveled chemotherapy performance in response to MCF-7 cell lines, with ≈ 60% drug payload contributed from functional groups of leaf extracts. Moreover, electron-poor and electron-rich benzamide-like molecules attached to the ZnCr-LDH surface enhanced the relative cell viability up to 29% and 32%, respectively. The in vivo experiments on breast cancer of treated mice (H&E) revealed unaggregated cellular arrays and antibacterial activity against E. coli (gram-negative) and S. aureus (gram-positive) bacteria. Benzamide-like ZnCr-LDH nanocarriers showed a suitable zone of inhibition beyond 10 mm, compared to the standard. Cytotoxicity control achieved herein seems promising for the future ahead of nanomedicine.

Background: Remote ischemic preconditioning (RIPC) protects other organs from subsequent lethal ischemic injury, but uncertainty remains. We investigated if RIPC could prevent acute kidney injury (AKI) in patients undergoing coronary artery bypass graft (CABG) surgery. Methods: This parallel-group, double-blind, randomized, controlled trial was done on adults undergoing elective or urgent on-pump CABG surgery from 2013 to 2017 in Shiraz, Iran. Patients were allocated to RIPC or control groups through permuted blocking. The patients in the RIPC group received three cycles of 5 min ischemia and 5 min reperfusion in the upper arm after induction of anesthesia. We placed an uninflated cuff on the arm for 30 min in the control group. The study primary endpoint was an incidence of AKI. Secondary endpoints included short-term clinical outcomes. We compared categorical and continuous variables using Pearson χ2 and unpaired t tests, respectively. P

Background: Chlamydia trachomatis and Neisseria gonorrhoeae are the most prevalent bacterial sexually transmitted diseases in women. Objective: The purpose of this study was to investigate the prevalence of gonorrheal and chlamydial infections and determination of related risk factors in married women with vaginal discharge attending gynecological outpatient department (OPD) in Zanjan in 2013-2014. Materials and Methods: In this cross sectional study, 100 married women aged 18- 49 years with vaginal discharge were evaluated for signs and symptoms of gonococcal and chlamydial infections. Then cervical discharge samples and blood samples were collected from each subject for the detection of Nisseria gonorrhea and Chlamydia trachomatis by bacterial culture and serological tests, respectively. Results: The overall prevalence of Chlamydia trachomatis and Nisseria gonorrhoeae were 16% and 4%, respectively. There was no significant relationship between the contraception methods, previous history of vaginal infections, previous history of urinary tract infections, number of coitus per week and self-reported symptoms (itching, burning, abdominal pain) with prevalence of Nisseria gonorrhoeae and Chlamydia trachomatis. Conclusion: According to our results, the prevalence of gonococci infection in Zanjan was remarkable and relatively was higher than other parts of Iran, therefore it is necessary to put emphasis on education and further preventive and therapeutic programs.

BACKGROUND: In recent years, to achieve the fundamental goal of educating meta-competent future medical doctors, varieties of educational methods have been proposed in all medical schools. In Shiraz Medical School, we implemented an extracurricular theme focusing mostly on medical education's psychosocial aspect. This study aims to discuss the implementation and evaluation of this extracurricular theme. MATERIALS AND METHODS: The present study is a descriptive-analytic one; we included all undergraduate medical students in basic sciences courses who started medical education in 2014 and 2015 in Shiraz Medical School. The evaluation tools were questionnaires designed in different formats and handed out to medical students before and after the workshops. Data were analyzed by paired sample t-test in SPSS Software Version 23. RESULTS: Students' satisfaction was more than 60% in all items of all workshops, except in some items of studying and learning methods and research methods workshops, which were lower than 60%. Students' knowledge about all aspects of communication skills, stress management, critical thinking, studying and learning methods, and research methods workshops improved significantly after participation in these workshops. CONCLUSIONS: Medical students can become meta-competent future medical doctors. They can reach all of the learning outcomes described in the three-circle model of learning. This goal cannot be achieved by implementing a medical curriculum which only contains medical literature. Some extracurricular issues based on students' and societies' requirements must be added to the main curriculum. The whole curriculum must be evaluated continuously, and required changes must be applied.

BACKGROUND: A doctor–patient relationship built on the concept of empathy is so essential to attain the best clinical outcomes in medicine. Since empathy has a positive role in interpersonal relationships and medical outcomes, its assessment is highly crucial. The aim of this study was to assess the empathy in last-year medical students using the Persian version of the Jefferson Scale of Physician Empathy (JSPE) and correlate empathy scores with demographic features. MATERIALS AND METHODS: In this cross-sectional study, last-year medical students at Shiraz Medical School, Shiraz, Iran, were recruited for this study. In this research, we used the Persian version of JSPE. The validity and reliability of the Persian version of this tool were confirmed in the previous research. For the analysis of data, we employed descriptive statistics and the independent sample t-test. RESULTS: One hundred and eighty-five final-year medical students were included in this study. The maximum score of the questionnaire was 140, and the total mean score of empathy was 98.15 ± 13.29. The females' total mean score (102.05 ± 11.89) was higher than the males' score (93.57 ± 13.46). The difference between the mean score of gender and empathy was significant (P value 0.05). CONCLUSIONS: Although physicians would gain the essential characteristics of empathy during their career, attending professors and other responsible policymakers in medical education should focus more on the factors related to physicians' empathy to train better and more professional physicians.

Decorating photocatalysts with noble metal nanoparticles (e.g., Pt) often increases the catalysts’ photocatalytic activity and biomedical properties. Here, a simple and inexpensive method has been developed to prepare a Pt-Ag3PO4/CdS/chitosan composite, which was characterized and used for the visible light-induced photocatalytic and antibacterial studies. This synthesized composite showed superior photocatalytic activity for methylene blue degradation as a hazardous pollutant (the maximum dye degradation was observed in 90 min of treatment) and killing of Gram positive bacterial (Staphylococcus aureus and Bacillus cereus) as well as Gram negative bacteria (Klebsiella pneumoniae, Salmonella typhimurium, Escherichia coli, and Pseudomonas aeruginosa) under visible light irradiation. The antibacterial activity of CdS, CdS/Ag3PO4, and Pt-Ag3PO4/CdS/chitosan against E. coli, Pseudomonas aeruginosa, Salmonella typhimurium, Klebsiella pneumoniae, Staphylococcus aureus, and Bacillus cereus showed the zone of inhibition (mm) under visible light and under dark conditions at a concentration of 20 µg mL−1. Furthermore, the cell viability of the CdS/chitosan, Ag3PO4, Ag3PO4/CdS/chitosan, and Pt-Ag3PO4/CdS/chitosan were investigated on the human embryonic kidney 293 cells (HEK-293), Henrietta Lacks (HeLa), human liver cancer cell line (HepG2), and pheochromocytoma (PC12) cell lines. In addition, the results indicated that the photodegradation rate for Pt-Ag3PO4/CdS/chitosan is 3.53 times higher than that of CdS and 1.73 times higher than that of the CdS/Ag3PO4 composite. Moreover, Pt-Ag3PO4/CdS/chitosan with an optimal amount of CdS killed large areas of different bacteria and different cells separately in a shorter time period under visible-light irradiation, which shows significantly higher efficiency than pure CdS and other CdS/Ag3PO4 composites. The superb performances of this composite are attributed to its privileged properties, such as retarded recombination of photoinduced electron/hole pairs and a large specific surface area, making Pt-Ag3PO4/CdS/chitosan a valuable composite that can be deployed for a range of important applications, such as visible light-induced photocatalysis and antibacterial activity.

Beingthe first teeth to erupt, first molars have the most complex root system and canal morphology and are among the most susceptible teeth to decay and destruction.The aim of this study is to determine the frequency of morphological variations of the canal and root of the mandibular first molar in cbct images so that appropriate treatment can be performed with a better understanding of the anatomy of the root and canal of the molar tooth.Materials & Methods:In this descriptive cross-sectional study, the morphological variation of the mandibular first molar canal and root was investigated in 170 cbct radiology image samples. In this study, the age and gender of the individual, the number of roots and canals of the mandibular first molar, the morphology of the canal in each root, the presence of the midmesial canal and the presence of the distolingual root were also investigated. In the end, frequency and percentage indicators were used to analyze data and chi-square test was used to compare frequencies.Results:The average age of the subjects studied was 39.2 years. The subjects included 86 women and 84 men. The most seen sample was a molar tooth with two roots and three canals. In terms of canal morphology in the mesial root, the most common canal morphology was type 4 and then type 2. In terms of canal morphology in the distal root, the most common canal morphology was type 1. In the studied samples, midmesial canal was not found in 99.4% of cases and distolingual root was not found in 94.7% of cases.Conclusion:Two-rooted and three-channel molar without midmesial canal and without distolingual root was the most common case found in this study. The most common canal morphology in the mesial root was type 4 and the most common canal morphology in the distal root was type 1.

Background: Despite the high prevalence of acute radiation dermatitis (ARD) in breast radiation treatment, data about its prevention is inconsistent. We conducted the present research to investigate whether the use of topical corticosteroids with different potencies or moisturizing cream could prevent ARD. Method: In this double-blind randomized trial, 120 patients, who had undergone breast conserving surgery for breast cancer, were randomly assigned to use Mometasone 0.1% cream or hydrocortisone 1% cream or moisturizing base cream from the first day of radiotherapy throughout the entire course. CTCAE v. 4 scale was utilized to score the grade of ARD. The outcomes were analysed with relevant statistical methods. Results: 105 subjects were analysed. Mometasone delayed the incidence of grade 1 ARD in a week. However, no differences were observed among the groups concerning the incidence of the maximum ARD grade (χ2 (6, N= 104)=8.12, P=0.2). Moreover, the timing of the maximum ARD was not significantly different among the groups (χ2 (4, N =84) = 2.87, P=0.58). Conclusion: This study demonstrated that the application of corticosteroid creams (hydrocortisone 1% or Mometasone 0.1%) does not result into a significant difference concerning the timing and incidence of ARD occurrence when compared with daily skin care and use of emollient.

Background: Multi-leaf collimator (MLC) is one of the efficient and cost-effective methods for protecting sensitive tissues around the target. This study aimed to evaluate the protective effect of MLC on the protection of sensitive organs in patients with left breast cancer. Materials and Methods: This study was performed on computed tomography (CT) scans of 45 patients with left breast cancer. Two treatment plans were completed for each patient. Only the heart and left lung were considered organs at risk in the first treatment plan, and in the second treatment plan, the left anterior descending artery (LAD) was also considered the organ at risk. It was covered as much as possible by the MLC. Dosimetric results of tumor and organ at risk (OARs) were extracted from the dose-volume histogram and compared. Results: The results showed that more LAD coverage by MLC leads to a significant reduction in the mean dose of OARs (P-value

Background: Intra operative cytology (IC), including touch imprint (TI) and crash preparations (CP), in general has been demonstrated to be a diagnostic tool for many organs but its validity and reliability for diagnosis of thyroid nodules remain controversial. We evaluate the diagnostic value of frozen section, touch imprint, crash preparation and the combination of touch imprint and crash preparation and the combination of frozen section, touch imprint and crash preparation. Materials ans Methods : 55 intra operative specimens from patients with thyroid nodules who underwent thyroidectomy were evaluated at Alzahra and vali-Asr hospital laboratories. For all of the patients frozen section (FS), touch imprint (TI) and crash preparation (CP) was obtained and reviewed by two pathologists at the same time. Serial TI and CP, and FS, TI and CP were reviewed by the same pathologists. Sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and accuracy were calculated according to the permanent section as the gold standard test. Results: In our study sensitivity, specificity and accuracy for FS was 100%, 97.6% and 98.1% respectively; for TI they were 78.6%, 95% and 92.4%; for CP they were 78.6%, 92.7% and 89.9%; for serial TI and CP they were 85.7%, 92.7% and 90.9%; and for the combination of FS and TI and CP they were 100%, 97.6% and 98.18% respectively. Conclusions: Intra operative cytology (including TI and CP) seems to be a useful, valuable and inexpensive method in clinics, which do not have equipment for frozen sections. Intra operative cytology combined with FS increased the overall accuracy of diagnosis. Further studies are needed to validate the obtained results of this study.

Background: The aim of this study was to determine the efficacy of two methods of colon preparation for colon cleansing in a randomized controlled trial. Methods: In this prospective randomized investigator-blinded trial, consecutive outpatients indicated for elective colonoscopy were randomized into two groups. Patients in Senna group took 24 tablets of 11 mg Senna in two divided doses 24 hour before colonoscopy. In Poly Ethylene Glycol (PEG) group they solved 4 sachets in 4 liters of water the day before the procedure and were asked to drink 250 ml every 15 minutes. The overall quality of colon cleansing was evaluated using the Aronchick scoring scale. Difficulty of the procedure, patients′ tolerance and compliance and adverse events were also evaluated. Results: 322 patients were enrolled in the study. There was no significant difference in the quality of colon cleansing, patients′ tolerance, compliance and the difficulty of the procedure between two groups (p > 0.05). The incidence of adverse effects was similar between two groups except for abdominal pain that was more severe in Senna group (p < 0.05) and nausea and vomiting that was more common in PEG group (p < 0.05) Conclusions: In conclusion we deduce that Senna has the same efficacy and patient′s acceptance as Polyethylene glycol-electrolyte solution (PEG-ES) and it could be prescribed as an alternative method for bowel preparation.

Introduction: In recent decades, medical education has been following new approaches to early clinical exposure. This study was designed to determine early clinical exposure (ECE) objectives and their availability and importance from the participants’ viewpoint. Methods: In a descriptive study, 70 students who had participated in ECE at Isfahan Medical University were asked to complete a questionnaire based on ECE goals in other similar studies. The questionnaire included 22 items based on Likert scale and asking about two aspects of importance and availability of objectives. The total score for importance and availability and their relationship are reported. Items resulted in the greatest degree of agreement are presented as well. Results: Seventy two percent of the students took part in the study and Cronbach’s alpha for the questionnaire was equal to 0.91. The median of all items indicating the importance of objectives was 4 and higher. The availability items had the median score equal to 3 in 7 items and equal or greater than 4 in the rest of items. The mean of total importance score was 3.98±0.7 and of total availability score was 3.51±0.53 out of 5. There was a small correlation between importance and availability of objectives. Conclusion: The determined goals were appropriate for our ECE program in the case of importance and availability but more attempts is needed to help students with basic sciences and clinical education integration. This study provided a good model to determine ECE objectives based on each university’s specific needs. More studies are recommended to design these educational goals in an objective manner.

Multiple Sclerosis (MS) is an autoimmune disease characterized by recurrent episodes of demyelination and axonal lesion mediated by CD4+ T cells with a proinflammatory T helper (Th)1 and Th17 phenotypes, macrophages, and soluble inflammatory mediators. The overactive pro-inflammatory Th1 cells and clonal expansion of B cells initiate an inflammatory cascade with several cellular and molecular immune components participating in MS pathogenic mechanisms. In this scenario, autoantibodies and autoantigens have a significant role in immunopathogenesis, diagnosis and therapeutic targets of MS. In this review, we try to introduce the autoantigens and autoantibodies and explain their roles in pathogenesis of MS.

Safranal, a component of saffron, indicates anti-tumor activities; however, the precise mechanism of this effect has remained elusive. In this study we investigated tubulin assembly and structure in the presence of safranal to open the new horizons about the potential of safranal as an anti-tumor agent via microtubule disfunction. Anti-microtubule activity of safranal was evaluated by turbidimetric method and transmission electron microscopy (TEM). Safranal (0.1–70 μM) was incubated with tubulin (5 μM) and tubulin structural changes was surveyed using fluorometry. Tubulin binding site with safranal was estimated by molecular docking. Microtubule polymerization decreased significantly in the presence of safranal, regardless of its concentration and the IC 50 value was obtained 72.19 μM. Safranal was situated between α and β tubulin closer to α-tubulin and hydrogen bond with Gly 142 and hydrophobic interactions played critical roles for safranal molecule stabilization in binding site. It seems that decline of tubulin assembly could result from tubulin structural changes through safranal bindings between alpha and beta tubulin with Δ G 0 of −5.63 kcal/mol. Safranal can be taken into account as an anticancer agent; however, in vivo experiments are required to confirm this conclusion. [ABSTRACT FROM AUTHOR]