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Objective(s): Prescription of ibuprofen as a non-steroidal anti-inflammatory drug is limited by its gastrointestinal side effects and poor aqueous solubility. It was shown that phospholipid-association (PA) can lead to assembling assembly of the micellar form, thereby improving solubility of non-steroidal anti-inflammatory drugs solubility and reducing their gastrointestinal side effects. Materials and Methods: Ibuprofen in PA form was prepared and its interaction, crystallinity, and particle size were evaluated. Conventional ibuprofen and PA pellets in different drug contents were prepared by extrusion-spheronization. The mMorphology, shape factors, mechanical strength, and drug content of pellets were investigated. The dissolution test also was conducted in an intestinal-simulated medium and a gastric-simulated medium. Results: The results showed that PA micelles of ibuprofen were demonstrated to be formed, amorphous, and in an acceptable size range. Using a suitable composition of solid components and granulation fluid, pellets with desirable size, shape, and sphericity could be produced. All pellets have had plastic mechanical properties and the strength of formulations were decreased with increasing PA ratio. The PA-pellet formulation had faster drug release compared to conventional ibuprofen pellets, via increasing ibuprofen solubility by reducing crystallinity in solid state and micelle formation in dissolution media. Moreover, ibuprofen solubility in a gastric-simulated medium was decreased and might result in reduced gastrointestinal side effects.Conclusion: Due to the demonstrated bioavailability advantages of PA-pellets, they can be considered for further studies.

Cannabis is frequently detected in forensic investigations and is associated with an increased risk of fatal car crashes. This study aims to develop a method to detect and measure ∆9-tetrahydrocannabinol (∆9-THC) in blood and its metabolite, 11-nor-9-tetrahydrocannabinol-carboxylic acid (∆9-THCCOOH), in urine. The procedure employs two liquid-liquid extraction methods in conjunction with GC–MS in SIM mode. Both compounds were successfully processed, demonstrating the method's ease of use and efficiency. The method was validated for selectivity, identification capability, linearity, precision, limit of detection (LOD), limit of quantification (LOQ), and accuracy. Its effectiveness was further demonstrated by applying it to 30 authentic urine and blood samples from cannabis-related cases, establishing it as a valuable option for routine cannabinoid analysis in forensic toxicology labs. • The linearity range was 25–300 ng/mL for ∆9-THC in blood, and 50–300 ng/mL for ∆9-THCCOOH in urine, and calibration curves for both analytes showed R² values consistently above 0.989, confirming their linearity. • The LOD and LOQ for THCCOOH in hydrolyzed urine were 25 ng/mL and 50 ng/mL, respectively, and for THC in blood, they were 15 ng/mL and 25 ng/mL, respectively. • The variation coefficients were below 14%, and recoveries exceeded 81% for both compounds.

Background and Aim: Impairment of social interaction is one of the prominent features of autism spectrum disorder (ASD). The aim of this study was to compare the effects of visual activities schedule (VAS) and social narratives (SN) on social interaction in the children with ASD. Materials & Methods: In a quasi-experimental and single-subject study with ABAB design, eight boys with ASD were selected from a population of 7-12 year-old children by convenience method in Welfare Centers in Mashhad City. The children assigned to two groups including visual activities schedule and social narratives groups. In order to determine the content of each intervention, target behaviors recognized through interview with family, mentor, and observation of the child’s behavior.Each group attended 20 intervention sessions (five times a week; 30 minutes per session). The information collected through systematic observation and Autism Social Skills Profile and data were analyzed using baseline diagrams, effect size, and improvement percentage. Results: Findings showed that 15.34% and 10.45% of social interaction in children with ASD were due to receiving visual activities schedule and social narratives respectively. In addition, visual activities schedule and social narratives led to improvement of 16.09% and 9.24% in social reciprocity, 11.27% and 7.93% in social participation, 38.70% and 16.34% in detrimental social behaviors respectively. Systematic observation showed that visual activities schedule led to increased social reciprocity and social participation in four children and reduced detrimental social behaviors in one child respectively. Although, social narratives led to improvement of social reciprocity in four children, social participation in two children and detrimental social behaviors in three children. Conclusion: Since, both interventions (visual activities schedule and social narratives) were effective in the improvement of social interaction, it seems that similar intervention for children with ASD can improve social interaction and prevent behavior disorders.

One of the viewpoints about bodily resurrection is Ghazali's theory, which believes in the alike of the otherworldly body and the worldly body. On the other hand, Mulla Sadra explained the physical resurrection according to the principles of his philosophical system and concluded that the soul and the body will be the same. Mulla Sadra criticizes Ghazali's theory; He considers the most important criticism of Ghazali's theory to be that it is not compatible with rational principles and that his opinion requires reincarnation. In this article, we have examined Mulla Sadra's criticisms of Ghazali on the issue of physical resurrection, and following that, we have stated the similarities and differences between the theories of these two thinkers. The similarities and differences between these two theories can be found through the method of intellectual analysis and through the analysis of Mulla Sadra's discussion on Ghazali. Similarities can be seen between the theory of these two thinkers regarding the survival of the soul after death and the intellectual celibacy of the soul, although these two theories are distinct and different from each other in their approach to the nature of the human soul and the relationship between the soul and the body. Therefore, in the quality of the afterlife body, they interpreted it as the similarity or objectivity of the afterlife body with the worldly body, but this difference is in the interpretation, and in fact, the meaning of these two thinkers is the same thing, and that is that the identity between the person in the afterlife and the world is established.

Key Clinical Message Proper diagnosis and treatment of vascular stenosis which is a possible complication of renal transplant is important in improving patients' quality of life and prognosis. Abstract One known consequence among recipients of renal transplants is graft renal artery stenosis. Early identification and therapy are crucial to avoid graft malfunction and the serious consequences that might arise due to elevated hypertension in several organs. We report a rare case of transplant renal artery stenosis in a mid‐aged woman who presented with edema, hypertension, and increased creatinine 2 months after kidney transplant. The patient had normal renal arterial resistive index (RI) and perfusion index (PI), and there was only a modest decrease in perfusion on duplex ultrasound. Following the patient's renal stenting treatment, angiographic resolution was observed. After 14 days of regulated blood pressure following renal artery stenting, she was discharged from the hospital with her edema resolved. Considering complications in patients with clinical manifestations such as hypertension resistant to treatment and graft dysfunction, vascular stenosis is a notable issue to consider even in the context of normal renal arterial RI, PI, and duplex ultrasound. Proper diagnosis and treatment are of importance to improve patients' quality of life and prognosis.

Background: Professional neglect is a civil responsibility for any specialist or individual with a specific skill, including therapists, and is not limited to any particular profession. Case Presentation: A man 41-year-old drug abuser was diagnosed with a heart problem due to methamphetamine abuse. Despite his drug history, he was once admitted to the emergency room for chest pain, where acetaminophen and diazepam were prescribed. For the second time, he went to another medical center due to continued chest pain, and due to the suspicion of contracting COVID-19, a CT scan of the chest was performed, yielding negative results, and then he was discharged. The patient was found deceased in his bed the following day. An autopsy revealed a thinned heart wall, subendocardial hemorrhages, and severe atherosclerosis. Methamphetamine, amphetamine, and acetaminophen were detected in urine samples, and ethanol was detected in blood and vitreous humor samples. Conclusion: The case highlights the importance of medical negligence in treating patients with drug abuse.

Background: It is possible to identify drugs and poisons present in cadavers by analyzing blowfly larvae and pupae col­lected during forensic autopsies. The main purpose of this study was to use Lucilia sericata’s larvae and pupae to iden­tify drugs and poisons present in human cadavers. Methods: In an investigation, immature L. sericata fed meat treated with methamphetamine (MA) at various concentra­tions (45, 90, and 180 ng/mg) were analyzed to detect MA. Acetylation derivatization and liquid-liquid extraction (LLE) were used as sample preparation methods prior to gas chromatography-mass spectrometry (GC-MS) analytical instru­men­tation to find MA. Results: According to this study, L. sericata can be used in toxicological testing to identify MA in a host body. All L. seri­cata larval stages, particularly the third stage larva, pupa and empty pupa tested were positive for MA. Larvae in their first instar produced weak peaks. The L. sericata post-feeding instar following the 45 ng/mg treatment showed the highest MA concentration. For the first time, derivatization using the acetylation approach was used to prepare samples, and successfully, excellent results were obtained. Conclusion: Low quantities of MA can be easily found in immature fly samples using GC-MS. It is important to ana­lyze all samples including human tissues and insect samples, for postmortem drug testing. They can be utilized to find entire MA before they are excreted in excretory samples such as urine. Also, third instar larvae are a great and reliable sample for toxicological study.

Abstract Background Lung cancer remains one of the most lethal carcinomas worldwide because of its late diagnosis. One of the DNA modifications is methylation, one of the primary alterations of tumor development, consisting of fascinating indicators for cancer diagnosis. This study investigated ZMYND-8 and RARβ2 gene methylation in NSCLC as a new epigenetic tool. Methods First, to find out the potential diagnostic capability of ZMYND-8 and RARβ2 genes methylation, we entirely surfed DNA methylation microarrays from the Cancer Genome Atlas (TCGA) data of NSCLC samples. Additionally, we took advantage of using q-MSP in several pieces comprising NSCLC tumors and neighboring normal tissues; ZMYND-8 and RARβ2 genes methylation grades were acquired. Results Our finding displayed significant hypomethylation of ZMYND-8 and hypermethylation of RARβ2 in NSCLC samples compared to neighboring standard specimens, which significantly correlated with the clinical stage of malignancy. In addition, the incredible precision of ZMYND-8 and RARβ2 methylations as reliable cancer diagnosis indicators in NSCLC was confirmed, drawing the ROC curve analysis with an AUC value of 0.751 and 0.8676, respectively, for ZMYND-8 and RARβ2. Additional studies of other dominant cancer entities in TCGA displayed that RARβ2’s higher methylation degree and ZMYND-8 lower methylation degree are prevalent changes in tumor evolution which could be possibly considered as a potential diagnostic biomarkers for lung cancer. Conclusion Based on this study, ZMYND-8 and RARβ2 methylation are reliable biomarkers for lung cancer.

Abstract A methanol poisoning outbreak occurred in Iran during the initial months of coronavirus disease 2019 (COVID-19) pandemic. We aimed to evaluate the epidemiology of the outbreak in terms of hospitalizations and deaths. A cross-sectional linkage study was conducted based on the hospitalization data collected from thirteen referral toxicology centers throughout Iran as well as mortality data obtained from the Iranian Legal Medicine Organization (LMO). Patient data were extracted for all cases aged > 19 years with toxic alcohol poisoning during the study period from February until June 2020. A total of 795 patients were hospitalized due to methanol poisoning, of whom 84 died. Median [interquartile ratio; IQR] age was 32 [26, 40] years (range 19–91 years). Patients had generally ingested alcohol for recreational motives (653, 82.1%) while 3.1% (n = 25) had consumed alcohol-based hand sanitizers to prevent or cure COVID-19 infection. Age was significantly lower in survivors than in non-survivors (P 8, six of whom were completely alert on presentation to the emergency departments. The time from alcohol ingestion to hospital admission was not significantly different between provinces. In East Azerbaijan province, where hemodialysis was started within on average 60 min of admission, the rate of sequelae was 11.4% (compared to 19.6% average of other provinces)—equivalent to a reduction of the odds of sequelae by 2.1 times [95% CI 1.2, 3.7; p = 0.009]. Older patients were more prone to fatal outcome and sequelae, including visual disturbances. Early arrival at the hospital can facilitate timely diagnosis and treatment and may reduce long-term morbidity from methanol poisoning. Our data thus suggest the importance of raising public awareness of the risks and early symptoms of methanol intoxication.

Background and purpose: Medicinal plants are among highly consumed natural drugs. Many herb shops produce and sell this products without any license. Traditional herbal distillates are widely used in Iran, so, the aim of this study was to determine ethanol and methanol concentrations in handmade herbal distillates in Tehran herb shops. Materials and methods: A total of 140 samples from 14 traditional handmade herbal distillates were obtained from Tehran herb shops and analyzed using headspace gas chromatography. Results: In this study, no sample contained ethanol. Peppermint distillate had significantly higher methanol content (334.62±153 ppm) compared with other distillates (P

Objectives: Acroptilon repens (L.) DC is an Asian native plant belongs to the Asteraceae family. It has been cultivated the United States and Canada in recent years. This study investigated the effects of antibacterial, anti-biofilm, and cytotoxicity of A. repens ethanolic extract and its components. Materials and Methods: We used disk diffusion and well diffusion strategies to screen antimicrobial activity of A. repens against Staphylococcus aureus and Staphylococcus epidermidis. Then, the minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of extract and fractions were determined by the small dilution broth methodology for S. aureus and S. epidermidis. The impact of extract and fractions on biofilm formation was evaluated by microtiter plate assay The MTT assay determined the toxicity effect of samples on Vero cells. The results are expressed because of the viability. Results: Results showed that A. repens extract and fragments inhibit the growth of gram-positive bacteria. The ethanolic extract and its fractions showed stronger inhibition zones for S. aureus and S. epidermidis. According to the antibiofilm test, the ethanolic extract and water fraction of A. repens have the highest antibiofilm effect on S. aureus and S. epidermidis. The value of LC50 (50% mortality) in MTT assay results was 30, 60, 30, and 2/5 mg/mL for ethanolic extract, chloroform, ethyl acetate and water fractions of A. repens, respectively. Conclusions: Extract of A. repens and its fractions have an antibacterial and antibiofilm effect on S. aureus and S. epidermidis without significant cytotoxic effect.

Objective(s): Folic acid is an essential vitamin, labile to hydrolysis in the acidic environment of the stomach with low water solubility and bioavailability. In order to solve these problems, enteric oral folic acid-loaded microfibers with a pH-sensitive polymer by electrospinning method were prepared.Materials and Methods: Electrospinning was performed at different folic acid ratios and voltages. Fibers were evaluated in terms of mechanical strength, acidic resistance, and drug release. Additionally, DSC (Differential Scanning Calorimetry), FTIR (Fourier-transform infrared spectroscopy), and XRD (X-ray diffraction) analyses were performed on the optimal formulation. Results: Drug ratio and voltage had a considerable effect on fibers’ entrapment efficiency, acid resistance, and mechanical strength. Based on the obtained results, the optimum formulation containing 1.25% of the drug/polymer was prepared at 18 kV. The entrapment efficiency of the optimal sample was above 90% with an acid resistance of higher than 70%. The tensile test confirmed the high mechanical properties of the optimum microfiber. DSC and XRD tests indicated that folic acid was converted to an amorphous form in the fiber structure and the FTIR test confirmed the formation of a chemical bond between the drug and the polymer. The release of the drug from the optimal fiber was about 90% in 60 min.Conclusion: In conclusion, the optimal formulation of folic acid with proper mechanical properties can be used as a candidate dosage form for further bioavailability investigations.

Enhancing customer loyalty is the ultimate goal of relationship marketing. While prior studies have highlighted the significance of hedonic and utilitarian attitudes as key drivers of consumer behavioral loyalty, literature, especially in the service context has left ambiguities regarding: (1) integrative exploration of mechanisms mediating attitudes' impact on behavioral loyalty; and (2) the specific components and connections between attitudinal and behavioral loyalty, along with their origins. This study introduces a novel integrative model that delves into the distinct effects of hedonic and utilitarian attitudes on components of attitudinal and behavioral loyalty, shedding more light on understanding the interplay between these components, their relationships, and their functional connections with trust and attitudes. Structural Equation Modeling was applied to the survey results from 1,028 participants, with the results demonstrating how hedonic and utilitarian attitudes differently impact various components of behavioral loyalty through mediation of trust and attitudinal loyalty components. Furthermore, results show that relationships varied across different services. The findings will help service firms to identify important predicting factors and channels of service behavioral loyalty, thus enabling them to optimize the costs of customer-service relationship management. [ABSTRACT FROM AUTHOR]

Objective(s): Chronic hypertension is a pervasive morbidity and the leading risk factor for cardiovascular diseases. Valsartan, as an antihypertensive drug, has low solubility and bioavailability. The application of orodispersible films of valsartan is suggested to improve its bioavailability. With this dosage form, the drug dissolves rapidly in saliva and is absorbed readily without the need for water. Materials and Methods: For this purpose, valsartan with polyvinylpyrrolidone (PVPK90) polymer were exposed to the electrospinning technique to construct orodispersible nanofilms. The optimum obtained nanofiber, selected by Design-Expert software, was evaluated in terms of mechanical strength for evaluation of the flexibility and fragility of the nanofibers. The drug content, wettability, and disintegration tests, as well as the release assessment of the nanofibers, were performed followed by DSC, FTIR, and XRD assays.Results: The uniform nanofibers’ diameter increased with the increase of the polymer concentration. The tensile test verified a stress reduction at the yield point as the polymer concentration increased. Then, the 492 nm nanofiber with above 90% drug encapsulation, containing 8% polymer and 18% valsartan made below 9 kV, was selected. The wetting time was less than 30 sec and over 90% of the drug was released in less than 2 min. The XRD and DSC studies also confirmed higher valsartan solubility due to the construction alternations in nanofibers. The FTIR examination indicated the chemical bonding between the drug and the polymer.Conclusion: The selected nanofibers of valsartan present the essential drug feature and acceptable drug release for further investigations.

Abstract Background Ingestion and inhalation are common routes of exposure for lead in humans. Developing countries still have unacceptably high rates of lead toxicity, especially in children. Studies on probable risk factors of lead poisoning in Iranian children are insufficient. In this study, we aimed to evaluate possible environmental factors in children with high blood lead concentrations living in Tehran and neighboring cities. Methods In a prospective cross-sectional study between March 2018 and March 2019 we followed all children referred from two pediatric gastrointestinal clinics with blood lead level (BLL) > 5 μg/dL in metropolitan Tehran to investigate possible environmental risk factors in their home. Household specimens including scratched wall paint, house floor dust, windowsill dust, tap water, and consumed spice were evaluated using atomic absorption method to detect lead concentrations. Epidemiological and environmental data collected through in-depth interviews with parents/guardians. Industrial areas were defined based on municipality maps on industrial places. Results Thirty of 56 parents/guardians with BLL > 5 μg/dL agreed to be followed through environmental investigation. The only categorical statistically significant risk factor was a history of lead poisoning in the family and living in an industrial zone. There was a positive correlation between BLL and interior windowsills dust lead level, r = 0.46, p = 0.01. Scratched paint lead level and BLL showed a significant positive correlation, r = 0.50, p = 0.005. House floor dust lead level (median = 77.4, p

Mesenteric cystic lymphangiomas are benign but rare neoplasms, primarily seen in children. Among internal organs, these masses are commonly found in the ileal mesentery. In this case series, we presented nine pediatric patients with abdominal lymphangiomas admitted to the surgery ward during 2010 and 2020, of which 6 were boys and three girls. Symptoms varied from abdominal distention to chronic and acute abdominal pain, anorexia and vomiting, and a scrotal mass in our patients. Considering various presentations of these patients and possible critical complications, surgeons need to have lymphatic malformations in mind as a differential diagnosis in such cases to improve the outcome.

Background: Poly drug use is a public health threat causing morbidity and mortality all over the world.Combined use of licit and illicit drugs is among the possible causes of death. In this retrospective analyticalstudy, we evaluated forensic toxicology analysis results from 2011 to 2016 in Tehran province, Iran.Methods: All deaths related to poly drug use and referred to the Legal Medicine Organization, Tehran duringthe 6-year study period were evaluated. Postmortem samples were analyzed to detect alcohols, andprescription and illicit drugs using headspace gas chromatography (HSGC), high performance liquidchromatography (HPLC), and gas chromatography/mass spectrometry (GC/MS) in a forensic toxicologylaboratory. Manner of death, demographic characteristics, and different drug categories in postmortemsamples were analyzed.Findings: A total of 1388 poly drug use-associated deaths were investigated during the 6-year study period.Overall, victims were mostly young men of 20-40 years of age (56.8%). The male to female ratio was 7:16.Methadone (n = 660; 47.6%) and amphetamine type stimulants (ATS) (n = 657; 47.3%) were in the highestcategory for poly drug use-associated deaths. Moreover, in some cases, opium (n = 458; 32.9%), tramadol(n = 389; 28.0%), and tricyclic antidepressants (n = 151; 10.9%) had been used with other drugs.Conclusion: The present study provides information about poly drug use-associated deaths in Tehran andhighlights the major role of substance abuse in death.

Purpose: The main objective of the present study was to develop the colonic delivery system for 5-aminosalicylic acid (5-ASA) as an anti-inflammatory drug. Methods: Matrix pellets containing various proportions of alginate, calcium and Eudragit® RS were prepared by extrusion-spheronization technique. Thermal treatment was used to investigate the effect of the curing process on the surface morphology, mechanical and physicochemical properties and in vitro drug release profile of pellets. Based on the obtained results optimal formulations were selected to coating by the Eudragit® RS and subjected to a subsequent continuous dissolution test. Results: Image analysis and also scanning electron microscopy results proved acceptable morphology of the pellets. The fourier transform infrared spectroscopy and differential scanning calorimetry studies ruled out any interactions between the formulation’s components. Curing process did not alter the mechanical properties of pellets. The release rate of the drug from matrices was prolonged due to the decreased porosity of cured pellets. Furthermore, selected cured pellets which coated with Eudragit® RS, prevented undesired premature drug release. Conclusion: Formulation containing 17.5% calcium, 17.5% alginate, and a coating level of 10% demonstrated enhanced drug release so that provided resistance to acidic conditions, allowing complete drug release in alkaline pH, mimicking colonic environment. The slow and consistent drug release from this formulation could be used for treatment of a broader range of Inflammatory bowel disease (IBD) patients especially in whom colonic pH levels have been measured at lower than pH 7.0.