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L-glutamate is the major excitatory neurotransmitter in the central nervous system (CNS). It contribute in various physiological conditions such as brain development, synaptic plasticity, memory and learning. However, increasing of the extracellular glutamate concentration and overactivation of glutamate receptors in particular ionotropic subtypes leads to excitotoxicity which is the fundamental pathological pathway of neuronal injury. Due to lack of extracellular enzymatic destruction, the removal of released glutamate is achieved through the excitatory amino acid transporters (EAATs) which are distributed in glia that tightly surround the synaptic clefts, as well as in neurons. EAATs which known as Na+-dependent high-affinity glutamate transporters are the main responsible for maintaining extracellular glutamate concentration below excitotoxic levels. Moreover another membrane transporters regulating the flux of glutamate in different areas of the CNS. This system is cystine-glutamate exchanger (XCG-) that is Na+-independent system. Dysfunction of EAATs has been implicated in both acute insults e.g. stroke, trauma and chronic neurological and neuropsychiatric disorders e.g. amyotrophic lateral sclerosis, epilepsy, schizophrenia and Alzheimer's disease. Therefore, the purpose of this review article is to explain the pathway of glutamate biosynthesis, its release into CNS, discribing and elaborating Glutamate transporters, activites and their role in excitoxcity in CNS.

Objective: Considering the prevalence of Human Papillomavirus (HPV) infection and the lack of HPV vaccination program in Iran among young women and the importance of quality of life and sexual performance in women, we decided to conduct a study to examine the relationship between HPV infection and sexual dysfunction and quality of life in Iranian women. Materials and methods: In this cohort study, 250 married women who infected with HPV were recruited via convinence sampling from colposcopy clinic of Arash women hospital (Tehran, Iran) from April 2020 to May 2022.They were evaluated concerning their sexual function in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain with the female sexual function index (FSFI) questionnaire (the total FSFI score is calculated by the sum of the nineteen items). Sexual quality of life-female (SQOL-F) items (Likert-type scale with a cut-off of 65 points) were organized into four sub-scales: psychosexual feelings, sexual and relationship satisfaction, self-worthlessness, and sexual repression. All patients filled out the female sexual function index (FSFI) and sexual quality of life (SQOL) questionnaires. Variables were analysed via correlation coefficient and linear regression tests. Results: Mean age and mean marriage duration were 38.5±4.5 and 12.2±7.2, respectively. There was a weak correlation between FSFI and SQOL (r=0.15, p=0.001).Time of marriage and genital warts were the predictors on the FSFI and SQOL. Conclusion: The findings suggest that HPV infection can impair sexual function and quality of life. This research contributes valuable insights, especially considering the prevalence of HPV.

Objective: This study aimed to evaluate the effect of random biopsy and endo-cervical curettage (ECC), alone and together, in the diagnosis of high-grade cervical lesions in women with normal colposcopy. Materials and methods: This cross-sectional study was conducted on 356 women who underwent colposcopy examination in the gynecology-oncology clinic of Roointan-Arash Women’s Hospital, affiliated with Tehran University of Medical Sciences. All eligible women underwent colposcopy. In colposcopy examination, up to four biopsy samples were randomly taken for each quartile of the cervix and ECC was performed. Finally, the rate of intraepithelial neoplasia (CIN) and the relation between random biopsy and ECC and CIN diagnosis was determined. Results: In total, 27 (7.6%) low-grade squamous intraepithelial lesions (LSIL) and 19 (5.3%) high-grade squamous intraepithelial lesions (HSIL) were detected in cases that underwent random biopsy. There was a significant association between the abnormal random biopsy results and having multiple sexual partners (p=0.001), cigarette (p=0.041), and hookah (p=0.033) smoking. Furthermore, 31 (8.7%) LSIL and 42 (11.8%) HSIL were reported in women who underwent ECC. There was a significant relation between the abnormal results of ECC and hookah consumption (p=0.008) and human papillomavirus (HPV) infection (p=0.011). The concordance (p=0.001) between random biopsy and ECC result was 71.2% and only in 28.8% of the cases one of the methods was normal and the other was abnormal. Conclusion: The present study showed that the simultaneous use of ECC and random biopsy in women with normal colposcopy increases the detection rate of precancerous lesions by up to 28.8%.

Gestational trophoblastic neoplasia (GTN) is a rare neoplasm and is a spectrum of proliferative disorders of placenta. Invasive mole is a subtype of GTN that almost always arises after molar pregnancy. This report presents a 35-year-old woman with an atypical presentation of invasive mole after a normal pregnancy. The patient presented with a complaint of vaginal bleeding after normal vaginal delivery. Invasive mole was diagnosed based on findings of imaging and elevated beta human chorionic gonadotropin (ß-hCG) levels. Hysterectomy was finally decided upon due to severe vaginal bleeding and the patient’s request. Although GTN occurs after normal delivery, the patient recovered without receiving chemotherapy. It is important to consider all subtypes of GTN as a differential diagnosis of patients with abnormal postpartum bleeding and elevated ß-hCG levels even after a normal pregnancy.

Objective: Dual oxidases (DUOX1, DUOX2) belong to the NADPH oxidase (NOX) family, which produce H2O2 necessary for thyroid hormone biosynthesis. This study aims to evaluate gene expression for DUOX1, DUOX2 in PCOS patients and its relation with thyroid hormone and magnesium levels. Materials and methods: Totally 88 cases were studied including 24 people with PCOS and hypothyroidism, 44 people with PCOS and normal thyroid function, and 20 hypothyroid patients without PCOS. In comparison 40 healthy controls in the age group of 16-35 years matched for age group and BMI were evaluated. Using Vegaro syringe 5 cc of blood was sampled from all 128 people and after RNA extraction and cDNA synthesis using Real-Time PCR technique, the expression level of DUOX1 and DUOX2 genes was investigated. Results: The results of hormonal tests showed that there is a significant difference between the level of T4, T3, and TSH hormones in hypothyroid patients with or without PCOS in comparison to the control group. Regarding the level of Mg, the results showed that there is a significant difference between the levels of Mg in PCOS group with or without hypothyroidism in comparison to the control group. Gene expression results showed that the relative changes of DUOX1 gene expression in different groups compared to the control group were significantly reduced P

In Iranian traditional medicine, donkey dung, known as "Anbar-Nesara" is used for its antimicrobial and antiallergic properties. Incorrect medical beliefs can lead to the incorrect use of complementary medicine and the creation of unnecessary harmful effects. Although there have been many reports about the traditional medical benefits and the use of Anbar-Nesara, we describe a woman with severe wound infection following surgical and administration of Anbar-Nesara smoke.

Hyperlipidemia is a major risk factor for the development of cardiovascular disease. In this study, the effects of an unripe fruit extract of Momordica charantia on total cholesterol, total triglyceride and lipoproteins in the blood of mice with hyperlipidemia were investigated. In this study, 28 adult male Wistar rats weighing 210 to 250 g were selected and randomly divided into four groups of seven. One group was on a normal diet and the other groups were fed a high-fat diet for 8 weeks to develop hyperlipidemia. Experimental groups in this study were included group 1: control, oral administration of normal food without any drugs or extracts. Group 2: hyperlipidemia mice, feeding with normal food. Group 3: hyperlipidemia mice with a diet containing 4%. Group 4: hyperlipidemia mice with a diet containing 8%. The animals were fed by gavage at a dose of 4% and 8% of M. charantia powder solution for 15 days. Blood samples were taken and the level of total cholesterol, total triglyceride, and high-density lipoproteins (HDL) were measured enzymatically. The amount of low-density lipoproteins was calculated by Friedewald's formula. Data were analyzed using the analysis of variance. Experimental results showed that immature fruit powder of M. charantia quarantine significantly reduced serum triglycerides in group 8% mice fed rats fed a high-fat diet. Moreover, immature fruit powder of M. charantia increased the level of high-density lipoproteins. There was a statistically significant difference between the level of cholesterol and the level of low-density proteins (LDL). The highest reduction belonged to the group receiving immature powder. The results of the experiment showed that the unripe fruit extract of M. charantia has strong antilipidemic effects on rats fed with a high-fat diet.

Neurodegeneration with brain iron accumulation 5 (NBIA5) is a distinctive type of NBIA phenotype that is caused by mutations in the WDR45 gene. This disorder is inherited in an X-linked manner. Here, we report three Iranian cases affected with this condition. Whole-exome sequencing revealed the following pathogenic variants within WDR45 gene in these cases, respectively: c.697 C > T (p.R233X), c.657_658del (p.F221X) and c.1004_1005del (p.Y335Cfs*5). Hypothyroidism was detected in two cases. Other clinical manifestations did not significantly differ from cases reported in the literature. All cases occurred de novo. Similar mutations have been reported in the literature. The present study broadens the insight about the genetics of this disorder in the mentioned population. [ABSTRACT FROM AUTHOR]

Background: Effective cervical intraepithelial neoplasia (CIN) treatment and detection of high-risk recurrence patients is very important. Objectives: The present study aimed to compare the recurrence rate of CIN after loop electrosurgical excision procedure (LEEP) versus cold knife conization (CKC). Methods: This cross-sectional study involved 329 patients who underwent either LEEP (294 cases) or CKC (35 cases) in the colposcopy clinic of referral hospitals between March 2016 and March 2021. The study population was followed up every six months for two years after their first conization to monitor for any recurrence of the disease. Results: There was no significant difference between the two groups regards. Thirty-two patients experienced recurrence within two years after surgery. The rate of CIN recurrent was 30 (10.2%) cases in the LEEP group and 2(5.7%) cases in the CKC group, with no significant differences (P-value = 0.553, RR= 1.78; 95% CI = 0.44-7.15). Conclusions: The present study compared the benefits and harms of LEEP and CKC. The recurrence rate and surgical complications associated with both methods appeared to be similar with no significant differences. However, further high-quality and comprehensive research with a long-term follow-up is necessary to confirm our findings. [ABSTRACT FROM AUTHOR]

This paper develops an approximate cost function for a three-echelon supply chain that has two suppliers, a central warehouse and an arbitrary number of retailers. It takes an integrated approach to multi-echelon inventory control and order-splitting problems. It assumes that all facilities apply continuous review policy for replenishment, demand at the retailers follows a Poisson process, and lead times are stochastic with no predetermined probability distribution. Unsatisfied demand is considered as lost sales at the retailers and backlogged at the warehouse and suppliers. Due to information sharing between the existing echelons, order quantity at each higher level is assumed to be an integer multiple of the lower level. Order placed by the warehouse gets divided between the two suppliers and re-order point is not restricted at the warehouse or suppliers. The main contribution of this paper is its integrated approach and the practical assumption that it uses for the order arrival sequence and the unsatisfied demands. It adds two suppliers as the third echelon to the traditional two-echelon supply chain and considers dynamic sequence of orders arrival to the warehouse at each cycle. The fact that inventory control and sourcing decisions are interdependent and act as the main challenge of supply chain management, considering them in an integrated model can significantly influence operating costs and supply chain’s efficiency. Such approach can even have greater impact when blended with practical assumptions that consider lead-time as unpredictable and unsatisfied demand as lost sales. Total cost of the three-echelon inventory system is approximated based on the average unit cost and its accuracy is assessed through simulation. Numerical results with relatively low errors confirms the accuracy of the model. It also shows how to further enhance its accuracy by either increasing the holding cost at all echelons or the penalty cost at the retailers.

Background: Uterine fibroids are one of the most common benign tumors that cause abnormal bleeding and pain in women of reproductive age. One of the objectives of this study is to evaluate the effect of cabergoline drug on the size and volume of uterine bleeding as well as menopausal symptoms in women with uterine myomas. Methods: This double-blind clinical trial was conducted among 80 women with fibroid myomas and Abnormal Uterine Bleeding (AUB). The participants were allocated to two groups after random allocation. Group I received Cabergoline, 1 tablet (0.5 mg/w) orally once a week for 3 months. Group II obtained a placebo tablet (0.5 mg/w), taken at the same time. Results: 80 patients were included in the study (40 patients in the control group and 40 patients in the cabergoline treatment group). No statistically significant difference was observed between the two groups in terms of age, number of pregnancies, number of births, body mass index, uterine myoma characteristics, myoma type, myoma volume, and myoma number. A 37% decrease in myoma size was observed in the cabergoline recipients, as well as a 25% decrease in the placebo group, which is not statistically significant (p-value >0.05). Conclusion: Cabergoline drug reduces the volume of bleeding and the number of uterine myomas, but this reduction is not statistically significant and requires more studies in this field. [ABSTRACT FROM AUTHOR]

This work presents the results of an investigation on the physiochemical and structural characteristics of polyacrylonitrile (PAN) nanofiltration (NF) membranes prepared using a novel concept of binary solvents for nickel (Ni) removal from wastewater streams. The thermodynamic and kinetic aspects are emphasized aiming to optimize dope formulation, membrane performance, and durability. The fabricated membranes were characterized by scanning electron microscopy (SEM), porosimetry, tensile stress/strain, and flux and rejection. Results revealed that the use of an equal (1:1) mixture of n‐methyl‐2‐pyrrolidone (NMP) and dimethylformamide (DMF) as dope solvents led to the formation of membranes with enhanced performance, offering pure water flux of 2.33 L·m−2·h−1·bar−1 and Ni rejection of 90.84%. Moreover, the incorporation of 0.5 wt.% PEG as a pore‐forming agent to the dope solution further boosted pure water flux to 4.97 L·m−2·h−1·bar−1 with negligible impact on Ni rejection. Besides attractive performance, the adopted strategy offered membranes of exceptionally high flexibility with no sign of defect or failure especially during module fabrication and testing enabling smooth and hassle‐free scale‐up and extension to other applications. Practitioner Points: Optimized solvent mixture: A 1:1 blend of n‐methyl‐2‐pyrrolidone (NMP) and dimethylformamide (DMF) as solvents resulted in enhanced membrane performance.High flux and Ni rejection: The fabricated membranes exhibited a pure water flux of 2.33 L·m−2·h−1·bar−1 and a remarkable Ni rejection of 90.84%.PEG enhancement: Incorporating 0.5 wt.% PEG as a pore‐forming agent further improved the membrane's pure water flux to 4.97 L·m−2·h−1·bar−1, without compromising Ni rejection.Exceptional flexibility: The adopted strategy yielded membranes with exceptional flexibility, making them suitable for scale‐ups and other applications. [ABSTRACT FROM AUTHOR]

Objective: Considering the prevalence of Human Papillomavirus (HPV) infection and the lack of HPV vaccination program in Iran among young women and the importance of quality of life and sexual performance in women, we decided to conduct a study to examine the relationship between HPV infection and sexual dysfunction and quality of life in Iranian women. Materials and methods: In this cohort study, 250 married women who infected with HPV were recruited via convinence sampling from colposcopy clinic of Arash women hospital (Tehran, Iran) from April 2020 to May 2022. They were evaluated concerning their sexual function in the domains of desire, arousal, lubrication, orgasm, satisfaction and pain with the female sexual function index (FSFI) questionnaire (the total FSFI score is calculated by the sum of the nineteen items). Sexual quality of life-female (SQOL-F) items (Likert-type scale with a cut-off of 65 points) were organized into four sub-scales: psychosexual feelings, sexual and relationship satisfaction, self-worthlessness, and sexual repression. All patients filled out the female sexual function index (FSFI) and sexual quality of life (SQOL) questionnaires. Variables were analysed via correlation coefficient and linear regression tests. Results: Mean age and mean marriage duration were 38.5±4.5 and 12.2±7.2, respectively. There was a weak correlation between FSFI and SQOL (r=0.15, p=0.001). Time of marriage and genital warts were the predictors on the FSFI and SQOL. Conclusion: The findings suggest that HPV infection can impair sexual function and quality of life. This research contributes valuable insights, especially considering the prevalence of HPV. [ABSTRACT FROM AUTHOR]

Background & Objective: The study aims to determine the adverse effects of a mild COVID-19 infection on maternal and neonatal outcomes in pregnant women living in the eastern part of Tehran. Materials & Methods: In this prospective cohort study, we followed two groups of pregnant women until term and their pregnancy and neonatal outcomes. RT-PCR (reverse transcriptase polymerase chain reaction) positive tests of nasopharyngeal swabs were confirmed in one group, where at least three signs and symptoms associated with COVID-19, and/or chest CT scans identified highly specific findings for the disease were present. The control group is composed of healthy pregnant women tested negative for COVID-19. Results: The study included 319 pregnant women (108 with mild COVID-19 infection and 211 healthy). A higher percentage of mothers with mild COVID-19 infection had preterm births (47.9% vs. 30%, p=0.007), and their neonates required hospitalization more often (45.8% vs. 22.6%, p<0.001). PTB was positively associated with maternal hypertension (relative risk (RR): 5.40), mild COVID-19 infection (RR: 2.05), and older age (RR: 1.05). Among the risk factors for neonatal hospitalization, PTB (RR: 5.94), maternal hypertension (RR: 2.74), and mild COVID-19 infection during pregnancy (RR: 2.57) were significant. Conclusion: The outcomes of pregnancy are significantly impacted by maternal infection with COVID-19, even if it is mild. Preterm births are more likely to happen in mothers with mild COVID-19 infection, and neonates need more hospitalizations. [ABSTRACT FROM AUTHOR]

Objective: Borderline oligohydramnios always produces a dilemma of management and counseling among obstetricians. This study was designed to compare the effect of sildenafil plus fluid therapy versus fluid therapy alone on pregnancy outcomes and AFI improvement in pregnant women complicated by idiopathic borderline oligohydramnios. Materials and methods: This randomized clinical trial was conducted in Arash Women’s Hospital, Tehran, Iran from 2017 to 2020. Fifty-one pregnant women with idiopathic borderline oligohydramnios were allocated to two groups. Group 1 received fluid therapy and Group 2 received fluid therapy and Sildenafil 25 mg three times daily for six weeks. AFI was measured at the time of randomization, 24 h after treatment and then weekly for six weeks. The changes in AFI, type of delivery, gestational age at delivery, and neonatal outcomes were compared between the two groups. Results: After the intervention, the change in AFI between two groups was not statistically significant. Maternal and fetal outcomes are compared between two groups and there was no significant difference between them. The median (Inter-quartile range) AFI after intervention, in Sildenafil group compared with hydration group, were in 24 hours (8.5 vs. 8, p=0.27), first (9.5 vs. 9.1, p=0.74), second (9 vs 10, p=0.12) third (10.4 vs. 9.4, p=0.33), fourth (10.8 vs 9.1, p=0.1) and Fifth week (10 vs 9.3, p=0.5) of follow-up respectively, but none of them were statistically significant. Conclusion: The findings showed that sildenafil plus fluid therapy do not improve the pregnancy outcomes in women with isolated borderline oligohydramnios compared to fluid therapy alone.

Background & Objective: Immunosuppression, HPV persistence, and smoking are the main-related risk factors of Cervical Intraepithelial Neoplasia (CIN) recurrence. However, age as a basic factor may be a main factor related to CIN recurrence. Therefore, our study aimed to detect the potential role of women's age in CIN recurrence. Materials & Methods: This cross-sectional study was conducted on 329 patients who underwent conization in the gynecology-oncology clinics of Arash and Imam Khomeini hospitals affiliated with Tehran University of Medical Sciences between March 2016 and March 2021. Results: Totally, 329 cases were enrolled in the study. Most women were in their thirties. CIN recurrence was about 10.0% (32 cases). The CIN recurrence rate was 8.9% in women younger than 30, 10.2% in 30-40, 11.3% in 40-50, and 5.6% in 50–60 decades. There was no significant (p-value=0.802) difference in recurrence rate among age groups. There was a significant (p-value=0.023) difference in the frequency of endocervical involvement regarding age category, women aged 40 to 50 had the most frequent marginal involvement with 26.8%, while there was no significant (p-value=0.802) difference in frequency of marginal involvement regards age category. Conclusion: CIN cases with age higher than 40 years need to have more caution and tight follow-up visit after conization. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to evaluate the effect of random biopsy and endo-cervical curettage (ECC), alone and together, in the diagnosis of high-grade cervical lesions in women with normal colposcopy. Materials and methods: This cross-sectional study was conducted on 356 women who underwent colposcopy examination in the gynecology-oncology clinic of Roointan-Arash Women's Hospital, affiliated with Tehran University of Medical Sciences. All eligible women underwent colposcopy. In colposcopy examination, up to four biopsy samples were randomly taken for each quartile of the cervix and ECC was performed. Finally, the rate of intraepithelial neoplasia (CIN) and the relation between random biopsy and ECC and CIN diagnosis was determined. Results: In total, 27 (7.6%) low-grade squamous intraepithelial lesions (LSIL) and 19 (5.3%) high-grade squamous intraepithelial lesions (HSIL) were detected in cases that underwent random biopsy. There was a significant association between the abnormal random biopsy results and having multiple sexual partners (p=0.001), cigarette (p=0.041), and hookah (p=0.033) smoking. Furthermore, 31 (8.7%) LSIL and 42 (11.8%) HSIL were reported in women who underwent ECC. There was a significant relation between the abnormal results of ECC and hookah consumption (p=0.008) and human papillomavirus (HPV) infection (p=0.011). The concordance (p=0.001) between random biopsy and ECC result was 71.2% and only in 28.8% of the cases one of the methods was normal and the other was abnormal. Conclusion: The present study showed that the simultaneous use of ECC and random biopsy in women with normal colposcopy increases the detection rate of precancerous lesions by up to 28.8%. [ABSTRACT FROM AUTHOR]

Abstract Background Diabetes mellitus (DM) is associated with poorer outcomes in some cancers. Its effect on ovarian cancer is less clear. We consider the effect of DM on overall survival (OS) and progression free survival (PFS) in patients with epithelial ovarian cancer (EOC). Methods A retrospective cohort study of 215 patients with EOC diagnosed between 2009 and 2016 was performed. Records were reviewed for standard demographic, pathologic and DM diagnosis data. Cox regression was used to evaluate the relationship between disease status and survival after adjustment for age, body mass index (BMI), parity, stage, grade, histology, debulking status, hypertension (HTN), menopause status and neoadjuant chemotherapy. Results Patients with DM (27.97, 95%CI: 23.63 to 32.30) had a significantly shorter OS rates compared to patients without DM (41.01, 95%CI: 38.84 to 43.17). The unadjusted hazard ratio (HR) for the association between OS time and DM was 4.76 (95%CI: 2.99 to 7.59, P

Objective: Dual oxidases (DUOX1, DUOX2) belong to the NADPH oxidase (NOX) family, which produce H2O2 necessary for thyroid hormone biosynthesis. This study aims to evaluate gene expression for DUOX1, DUOX2 in PCOS patients and its relation with thyroid hormone and magnesium levels. Materials and methods: Totally 88 cases were studied including 24 people with PCOS and hypothyroidism, 44 people with PCOS and normal thyroid function, and 20 hypothyroid patients without PCOS. In comparison 40 healthy controls in the age group of 16-35 years matched for age group and BMI were evaluated. Using Vegaro syringe 5 cc of blood was sampled from all 128 people and after RNA extraction and cDNA synthesis using Real-Time PCR technique, the expression level of DUOX1 and DUOX2 genes was investigated. Results: The results of hormonal tests showed that there is a significant difference between the level of T4, T3, and TSH hormones in hypothyroid patients with or without PCOS in comparison to the control group. Regarding the level of Mg, the results showed that there is a significant difference between the levels of Mg in PCOS group with or without hypothyroidism in comparison to the control group. Gene expression results showed that the relative changes of DUOX1 gene expression in different groups compared to the control group were significantly reduced P<0.05. In the polycystic group with hypothyroidism, the gene expression level showed a decrease compared to the normo-thyroid polycystic group and the hypothyroid non-PCO group, which was statistically significant P<0.05. Conclusion: According to the results of the present study and the previous studies that have been published in the field of Duox1, it can be assumed that the reduction of Duox1 expression can interfere with the oxidative stress system. Further studies with other molecular techniques may help to understand the exact action mechanism of these genes. [ABSTRACT FROM AUTHOR]

Development of ICT services specially those presented by mobile phone operators and increasing competition forces operators to offer new and various services. Operators try to motivate users to apply their innovations by presenting appropriate quality and price. Regarding to the importance of this issue, we survey the effect of service quality and users’ satisfaction on innovation adoption by mobile phone users and predict innovation adoption. The relationship between service quality, customer satisfaction, and innovation adoption will be evaluated and compared using Structural Equation Modelling technique. Also, after extracting the appropriate factors, the probability of acceptance of new services will be calculated using logistic regression method. The results showed that customer orientation and flexibility in services have a major effect on innovation adoption by users. Furthermore, the first mobile operator can attract a lot of users.by offering new services and focusing on these factors.