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Hassan Ravari1, Ali Jangjoo2, Jalal Motamedifar2, Kasra Moazzami31Vascular and Endovascular Surgery Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, 2Department of General Surgery, Mashhad University of Medical Sciences, Imam Reza Hospital, Mashhad, 3Department of General Surgery, Tehran University of Medical Sciences, Sina Hospital, Tehran, IranBackground: The rate of wound infection after appendectomy without antibiotic prophylaxis is 10%–30%. The role of prophylactic antibiotic therapy in nonperforated appendicitis is still controversial. Metronidazole is against anaerobic organisms and its bioavailability after oral and parenteral administration has been shown to be similar. The objective of the present study is to compare the infective complications rate after open appendectomy for nonperforated appendicitis receiving either oral or intravenous metronidazole as prophylaxis. Methods and Materials: From June 2007 to July 2009 in a randomized controlled trial, 204 patients with nonperforated appendicitis underwent an open appendectomy; 122 male and 82 female with mean age of 25 years. Among these, 102 (case group) received oral metronidazole and in 102 (control group) metronidazole was administered intravenously before surgery. The rate of wound infection and duration of the postoperative hospital stay was studied in the two groups.Results: The rate of wound infection was not significantly different in the two groups. (6% and 4% in study and control group, respectively, P = 0.861). Also the hospital stay was equal in two groups (2.3 days and 2.7 days in study and control group, respectively, P = 0.293).Conclusion: Single dose of oral metronidazole prior to operation can provide a sufficient prophylaxis for nonperforated appendicitis; so, it can be substitute the parental route of antibiotic administration. Keywords: antibiotic prophylaxis, wound infection, appendectomy, complications

"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Seroma formation, or the subcutaneous collection of fluid, is a common problem after surgery for the breast cancer. It may lead to wound-related complications and also can delay adjuvant therapy. The aim of this study was to investigate the effect of various clinical and therapeutic variables on seroma formation."n"n Methods: A prospective cross sectional study of patients who underwent surgical therapy for breast cancer was carried out. Modified radical mastectomy was performed on 67 patients (65%) and 28 patients (27.2%) underwent breast conservative surgery. Simple extended mastectomy was done for the remaining 8 patients (7.8%). Seroma formation was studied in relation to age, type of surgery, tumor size, nodal involvement, preoperative chemotherapy, surgical instrument (electrocautery or scalpel), use of pressure garment, and duration of drainage. All of the patients followed for 4 weeks after surgery."n"nResults: A total of 103 patients with breast cancer were studied. The mean age of the patients was 48.3 years (25-82). Seroma occurred in 27 (26.2%) patients. There was statistically significant relation between age and seroma formation after breast cancer surgery (p=0.005), while other factors studied was found to be significantly ineffective. In addition, there was not any relation between seroma formation and drain duration. However, two factors including type of the operation and level of lymphatic dissection was considerable with confidence interval up to 90%, but it was not statistically significant with confidence interval >95% (p=0.068 and 0.063 respectively)."n"nConclusion: These findings suggest that the age is a predicting factor for seroma formation in breast cancer patients, while other factors do not significantly affect that.

Abstract This paper proposes a new method for improving the partial discharge (PD) localization accuracy by detecting the best places of ultra‐high frequency (UHF) sensors on the power transformer tank. In this way, firstly, the critical sites inside the power transformer that can produce PD are determined. Then the sensors’ positioning is done in such a way that if the PD happens at each point of these critical sites, the distance between the estimated PD location obtained by solving the time difference of arrival (TDOA) equations and the actual PD location is laid in an acceptable range. For this purpose, the TDOA equations are linearized around the critical PD coordinates as a matrix form A.X = B. The configuration of the sensor positions that minimizes the condition number of the matrix A is the best configuration. To evaluate the effectiveness of the proposed method, several simulations and evaluations are performed on a power transformer in the CST software. The obtained results and comparing them with the previous method and also conventional arbitrary sensors positioning confirm the effectiveness of this method.

Background: There are inconsistent results about the effect of gastric bypass surgery on thyroid function tests in morbidly obese subjects. The aim of this study was to investigate the changes in thyroid function tests and insulin resistance status in euthyroid morbidly obese subjects before and three months after gastric bypass surgery (GBS). Methods: Twenty-nine subjects with morbid obesity (BMI≥40) were enrolled in this before-after study. Patients with known thyroid disorders or a history of thyroid ablative therapy, users of drugs that affect thyroid function, or fasting blood sugar and insulin were excluded. TSH, Free T4, total T3, fasting blood sugar and insulin level, and BMI were measured before and 3 months after GBS. Statistical analysis was performed with appropriate tests and p

Objective(s): Sentinel lymph node biopsy (SLNB) has been proven as a safe and efficient procedure in some cancers like breast cancer and melanoma with a reduction of complications and side effects of unnecessary lymphadenectomy in many patients. However, the diagnostic value of SLNB in gastric cancer is a point of debate. This study evaluated the diagnostic value of SLNB using radiotracer and isosulphan blue dye injection in patients with Gastric Adenocarcinomas (GA).Methods: This descriptive study was performed at Imam-Reza HOSPITAL on 39 patients diagnosed with GA with no lymphatic metastasis using two methods: the combination of radionuclide with isosulphan together (R&I) method compared with the isosulphan alone method. Lymphatic dissection was performed in all patients. The pathological results were compared between the sentinel lymph nodes (SLN) and other lymph nodes and their accordance rate was calculated.Results: In the T1 group, the sentinel lymph node biopsy detection rate was 100% for the combination of the R&I method and 60% for the isosulphan method and the false negative rate was zero. These values respectively were 88.8% and 88.8% in the T2 group with a false negative rate of 75%. In the T3 group, the values were 100% for the combination of the R&I method and 93.7% for the isosulphan method with a false negative rate of 40%. In the combination of the R&I method, the sensitivity, specificity, and positive and negative predictive values were 57.9, 100, 100, and 69.2 percent respectively.Conclusion: Based on the false negative rate (47.4%), SLNB by injection of isosulphan blue dye alone is not a diagnostic enough value for predicting lymph node metastasis in GA. Although, SLNB by combination of the R&I had better accuracy compared to the isosulphan alone, more studies with larger samples are needed to prove this result.

Background and aims: The Achillea genus, part of the Asteraceae family, is native to the Northern Hemisphere, from Europe to Asia. These plants thrive in temperate climates and are often found in dry or semi-dry conditions. This research aimed to examine the therapeutic uses of Achillea plants, drawing from traditional medicine texts and laboratory and clinical studies. Methods: This narrative review involved a comprehensive search of major scientific databases to gather information on Achillea and its extracts from native or endemic species within the Achillea genus. The review spanned several decades and utilized sources such as Google Scholar, Scopus, PubMed, Institute for Scientific Information Web of Science, and botanical and local books (1990 - present). Results: Achillea is a medicinal plant used for the treatment of gynecological problems, diabetes control, gastrointestinal disorders, side effects of cancer such as mucositis caused by chemotherapy and radiotherapy, skin reactions caused by radiotherapy, treatment of prostate cancer, breast cancer, cervical cancer, and human gastric cancer. Conclusion: Considering the role of medicinal herbs in improving the side effects of cancer, treating certain types of cancer, controlling diabetes, and treating gastrointestinal problems, it is recommended to use this plant as a complementary medicine alongside routine treatments.

Introduction This study aimed to evaluate the possible role of urolithin A (UA) and urolithin B (UB) on the mRNA expression levels of LDL receptor (LDLR) and PSCK9 genes, and also of the uptake of LDL particles in HepG2 cells. Material and methods The potential role of UA and UB on the induction of LDL uptake and the expression of its regulatory genes was explored using HepG2 cells and curcumin (20 µM), berberine (50 µM), UA (80 µM), and UB (80 µM) as the treatments in the experimental tests. Results The LDL uptake and cell-surface LDLR were higher in cells treated with UA in comparison with cells treated with UB, and even in relation to the cells treated with curcumin and berberine as positive controls. In addition, cells treated with UB showed approximately 2 times greater LDLR expression levels compared with curcumin (FC = 2.144, p = 0.013) and berberine (FC = 2.761, p = 0.006). However, UA treatment resulted in significantly lower expression levels of LDLR compared with curcumin (FC = 0.274, p < 0.001) and berberine (FC = 0.352, p = 0.009). UB demonstrated approximately 8 times higher LDLR expression levels when compared with UA (FC = 7.835, p = 0.001). Compared with UB, as well as curcumin and berberine as positive controls, UA was more efficient in reducing PCSK9 expression levels. Although UB did not show any significant differences compared with curcumin and berberine, it showed higher levels of PCSK9 expression when compared with the UA group (FC = 3.694, p < 0.001). Conclusions The present results suggest that UA was more effective than UB in promoting LDL uptake as well as cell surface LDLR in HepG2 cells. This effect seems to be mostly mediated through the suppression of PCSK9 expression but not the induction of LDLR expression.

Background and aims: The research investigated the effect of care training during discharge on the stress and anxiety levels of mothers whose babies are undergoing open heart surgery. Parents of children with CHD experience high levels of stress and anxiety starting from the time of diagnosis, throughout the hospitalization for cardiac surgery, and even in the months and years that follow. Methods: In this quasi-experimental study, 60 mothers of children undergoing open heart surgery referred to the Tehran Children’s Medical Center Hospital entered the study through lottery sampling in 2019. Then, the Teach-back Method program was implemented for the intervention group in four sessions. Data were collected before and immediately after the intervention using a Questionnaire measuring parents’ stress and the Spielberger anxiety questionnaire. It was then analyzed using SPSS software version 16. Results: The study found that following the intervention, there was a significant decrease in the average scores of states and trait anxiety compared to the initial scores (P=0.006 and P=0.007, respectively). Additionally, the average stress score after the intervention was significantly lower than the initial score (P=0.001). Conclusion: The findings of this study suggest that offering oral instructions to mothers during the discharge phase of their children’s open-heart surgery can lead to positive outcomes by reducing post-operative anxiety and stress. These results highlight the need for further research to explore the long-term effects of post-operative oral education in various clinical settings.

Key Clinical Message Although gastro‐pleural fistulas after bariatric surgeries are rare, they are life‐threatening complications that should be suspected in patients who present with gastrointestinal or respiratory symptoms after bariatric surgery. Abstract Previous studies showed an incidence rate of 0.2%–0.37% for gastro‐pleural fistulas after bariatric surgery. We report a 56‐year‐old female with a rare presentation of gastro‐pleural fistula after Roux‐en‐Y gastric bypass, simultaneous fistula of the gastric pouch, and remnant to the pleural space.

Introduction. Gastric bypass surgery is a gold standard therapy for severe obesity. This study aimed to evaluate anthropometric predictors for short-term excess weight loss (EWL) after Roux-en-Y gastric bypass surgery (RYGB) in a sample of severely obese patients. Materials and Methods. This cohort study was conducted on severely obese candidates for RYGB bariatric surgery in Mashhad, Iran. Indirect calorimetry, anthropometric measurements, and body composition data were collected before, one, and six months after RYGB. Results. Fifty-four participants (43, 79.6% women and 11, 20.4% men) with a mean age of 39.63 ± 9.66 years participated in this study. The mean total weight and BMI loss within six months were 32.89 ± 20.22 kg and 12.37 ± 7.34 kg/m2, respectively. The mean reduction in adipose tissue and fat-free mass was 24.49 kg and 7.46 kg, respectively. The mean resting metabolism rate (RMR) reduction at one and six months after RYGB was 260.49 kcal and 396.07 kcal, respectively. There was a significant difference in mean RMR between the baseline and one and six months after RYGB (p0.05). Baseline skeletal muscle mass (SMM), excess BMI loss (EBMIL) at first month after surgery, and baseline neck circumference (NC) could predict EWL six months after surgery. Conclusion. Reduced RMR shortly after RYGB may be due to FFM reduction. Some anthropometric and their acute changes after RYGB may predict the short-term EWL in RYGB patients.

Background. Morbid obesity is frequently complicated by chronic liver diseases, including nonalcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis (NASH), and fibrosis. Parathyroid hormone (PTH) is found to be elevated in morbid obesity due to the defective hepatic metabolism of vitamin D. Bariatric surgery is performed to help patients with BMI>40 kg/m2 to effectively lose weight, particularly in patients with obesity who are afflicted with complications such as NAFLD/NASH. Objective. This study aimed to evaluate the PTH level as a predictor of hepatic function in individuals with morbid obesity who have undergone bariatric surgery. Methods. Ninety subjects with morbid obesity referred for Roux en-Y gastric bypass surgery were recruited. After IRB approval, demographic profiles, anthropometric factors, liver biopsy, and laboratory tests were obtained. The two-dimensional shear wave elastography (2D-SWE) technique was applied to assess hepatic stiffness. Results. A significant reduction occurred six months after bariatric surgery in the anthropometric indices p

Background and Aims. Visceral adiposity index (VAI) is a novel marker of fat distribution and function which incorporates both anthropometric and laboratory measures. Recently, several studies have suggested VAI as a screening tool for metabolic syndrome (MetS). Here, we aimed to consolidate the results of these studies by performing a systematic review and meta-analysis. Methods and Results. We searched PubMed and EMBASE online databases for eligible studies that investigated the association of VAI and MetS. After reviewing 294 records, we included 33 eligible papers with a sum of 20516 MetS and 53242 healthy participants. The risk of bias in the included studies was assessed, and the relevant data was extracted. All included studies reported a significant association between VAI and MetS screening, but were highly heterogeneous in their reported effects. We pooled the diagnostic test accuracy metrics of VAI for MetS screening and showed that it has a moderate-to-high accuracy with an area under the summary receiver operating characteristics curve of 0.847, a pooled sensitivity of 78%, and a pooled specificity of 79%. Besides, we pooled the difference in means of VAI between patients with MetS and healthy controls, revealing that VAI was 2.15 units higher in MetS patients. Conclusions. VAI is an accurate, low-cost, and widely available screening marker for MetS. However, further studies are needed to evaluate its applicability in clinical practice, determine an optimal cut-off, and identify populations that would benefit the most from it.

There is evidence in the literature to suggest that low back pain may change spine–pelvis coordination during activities of daily living. This study aimed to compare the variability of the spine–pelvis coordination during sit-to-stand in people with and without LBP. Ten healthy individuals with a history of LBP and ten individuals without history of LBP participated in this study. Three-dimensional kinematic data of the upper trunk (UT), lower trunk (LT), lower back (LB), and pelvis segments during sit-to-stand and stand-to-sit were recorded using a multi-segmental spine and pelvis models using a motion capture system. The coordination patterns and the variability of the adjacent segments (UT, LT, LB, and pelvis) were calculated using the modified vector coding method that was implemented through a custom MATLAB code. An independent sample t-test was utilized to assess the differences in the coordination pattern, and a statistical parametric mapping method was used to quantify the differences in coordination variability between the two groups. The results indicate that there are some differences in coordination patterns between groups during sit-to-stand and stand-to-sit. However, a significant difference in coordination variability was only observed during sit-to-stand. The results showed that LBP can alter the kinematics coordination even in the upper (pain-free) parts of the spine during sit-to-stand by changing the coordination between UT and LT in a way that can lead to an increase in the loading on these segments. Additionally, people with LBP showed more coordination variability during sit-to-stand, which can be associated with a coordination strategy that facilitates an optimal and possibly pain-free coordination pattern.

Background: Obesity is a chronic inflammatory condition associated with increased circulating levels of C-reactive protein (CRP). Bariatric surgery has been reported to be effective in improving both inflammatory and liver status. Our aims were to elucidate the relationships between pre-surgery high sensitivity-CRP (hs-CRP) values and post-surgery weight loss and liver steatosis and fibrosis in patients with severe obesity undergoing Roux-en-Y gastric bypass. Methods: We conducted an observational prospective study on 90 individuals with morbid obesity, who underwent gastric bypass. Anthropometric indices, laboratory assessment (lipid panel, glycemic status, liver enzymes, and hs-CRP), liver stiffness and steatosis were evaluated at baseline and 6-months after surgery. Results: There was a significant post-surgery reduction in all the anthropometric variables, with an average weight loss of 33.93 ± 11.79 kg; the mean percentage of total weight loss (TWL) was 27.96 ± 6.43%. Liver elasticity was significantly reduced (from 6.1 ± 1.25 to 5.42 ± 1.52 kPa; p = 0.002), as well as liver aminotransferases, nonalcoholic fatty liver disease fibrosis score (NFS) and the grade of steatosis. Serum hs-CRP levels significantly reduced (from 9.26 ± 8.45 to 3.29 ± 4.41 mg/L; p < 0.001). The correlations between hs-CRP levels and liver fibrosis (elastography), steatosis (ultrasonography), fibrosis-4 index, NFS, and surgery success rate were not significant. Regression analyses showed that serum hs-CRP levels were not predictive of liver status and success rate after surgery in both unadjusted and adjusted models. Conclusions: In patients with morbid obesity, bariatric surgery caused a significant decrease in hs-CRP levels, liver stiffness and steatosis. Baseline hs-CRP values did not predict the weight-loss success rate and post-surgery liver status.

Keypoints Obesity and NAFLD/NASH are commonly accompanied by inflammation. We tested if serum hs-CRP is associated with indices of NAFLD/NASH and liver fibrosis in morbidly obese patients. hs-CRP was significantly associated with any degree of histologically diagnosed liver damage.

Highlights • Women’s presence in public spaces is affected by environmental factors of built environment. • Among environmental priorities affected on women’s presence in public spaces, Security is most significantly factor in motivating women for active social participation in urban public spaces. • Among the individual characteristics of the respondents, the components of collective memory, identity, freedom, and safety have had a positive correlation with the age of the respondents.

Background: Echinococcus granulosus causes hydatid disease, which is found in various countries of the world, including Iran. The liver and lungs are prevalent involved structures in hydatid disease. One of the least common sites in hydatid disease seems to be the omentum. Seven cases of mesenteric, diaphragmatic, omental, pelvic, and retroperitoneal hydatid cysts have been reported in Iran within last 20 years. The appearance of hydatid disease as a primary mass in the greater omentum without hepatic involvement is very rare and no similar case was introduced in Iran in our searches. Case Presentation: Our patient was a 33-year-old woman who underwent a diagnostic laparoscopy due to abdominal pain and an abdominal mass. During laparoscopy, there was a solid mass with a size of about 10 × 5 cm in the greater omentum that was resected. The histopathological examination of the mass showed the hydatid disease. Conclusion: The hydatid cyst can appear anywhere on the body, and no part of the body is guarded. Since these uncommon locations often cause nonspecific symptoms, the hydatid cyst should be included in the differential diagnosing of omental cysts, particularly in endemic countries like Iran.

Abstract The neighborhood is one of the most fundamental urban elements and acts as the intermediary link between the city and citizens to enhance the quality of life. The present study examined the significance of the relationship between the subjective well-being of citizens and perceived neighborhood environment characteristics in urban historical fabrics for creating healthy neighborhoods. To this end, a survey research method was employed, and the data were collected via questionnaires. The population consisted of all the citizens of the historical neighborhood of Sange Siah in Shiraz, Iran, who lived or worked in the neighborhood and used the neighborhood spaces daily. A Nonparametric Spearman correlation coefficient was run to assess the correlation between the variables. The results showed that the component of social inclusion from among the six components of subjective well-being had a significant positive correlation with perceived neighborhood environment characteristics (r = 0.712). In the following, the components of satisfaction with life (0.614), mental well-being (0.569), positive and negative effect (0.526), and feeling of happiness (0.468) had a moderate positive correlation; and the component of physical and mental health also had a weak positive correlation with perceived neighborhood environment characteristics (0.230). In addition, the concept of subjective well-being with a correlation coefficient of 0.579 had a moderate positive correlation with perceived neighborhood environment characteristics, which indicates that the structural characteristics of the neighborhood have a significant relationship with the subjective well-being of the people living in the neighborhood.

Increasing the ability of crops to maintain growth and productivity under saline conditions is of paramount importance. The effect of salicylic acid (SA) priming on germination and physiological traits of Lathyrus sativus under salinity stress was studied in a factorial experiment based on a completely randomized design. The experimental treatments composed of SA at three levels (0, 0.1, and 0.2 mM) and NaCl salinity at three levels (0, 50, and 100 mM). The effect of salinity level and SA priming was significant on all recorded factors, except from final germination percentage. As salinity level increased, all germination and physiological traits declined compared with control, whereas the mean germination time and percentage of cell death were increased. Moreover, as salinity was intensified, the Hill reaction was decreased significantly. Salinity exhibited the strongest effects at NaCl rate of 100 mM. Seed priming with SA increased germination speed index, reduced mean germination time, and increased leaf relative water content, seedling fresh and dry weight compared with plants from non-primed seeds. Seedling vigor index was increased by 23.4% in primed seeds with 0.2 mM SA. SA priming especially at 0.2 mM rate increased the Hill reaction rate and reduced percentage of cell death. SA priming could be regarded as a practical approach to improve germination traits, seedling growth, and physiological traits of Lathyrus sativus L. under salinity stress conditions.

Background: Postoperative hematoma and seroma, foreign body reaction, infection, mesh rejection, and fistula formation are the complications associated with the use of surgical mesh. Mesh migration is a rare but serious and challenging complication after hernia repair. When this happens, infection, abscess, fistula, and bowel obstruction are the most common seaquelae. Case presentation: Our patient was a 62-year-old woman with a history of appendectomy 30 years ago and then underwent 3 incisional hernia repair surgeries which the last one was 5 years ago using laparoscopic IPOM. The patient was nominated for surgery with a diagnosis of recurrent incisional hernia. The patient underwent laparotomy and after enterolysis, a small bowel loop was seen that adhered to McBurney's region, which was released. There was a mass inside the small bowel. Resection and anastomosis of the involved intestine were performed. After enterotomy, it was determined that this mass was the mesh used in the previous surgery. Conclusion: Mesh migration is a rare consequence of incisional hernia repair with a prosthetic mesh. It can happen years after a hernia repair and it is additionally crucial to consider as a differential diagnosis in all patients who show unusual symptoms or abdominal pain.

Introduction: Sulfate is one of the important groundwater pollutant sources in many parts of the world and it can enter into groundwater from various sources, such as lithology (dissolution of evaporative and pyrite oxidation), atmosphere (sea water spray), industrial (combustion of fossil fuels, sulfide- minerals production, and agricultural fertilizers), and etc. Identifying sources of soluble sulfate in water sources is important. The sulfate in groundwater can be investigated using isotope and geochemistry techniques. Using isotope (34S and 18O) and hydro geochemical techniques, it can be possible to find out: sulfate origins and the effective processes/reactions on sulfate concentrations and hydrogen sulfide gas (H2S) production. In this paper, for the first time, the sulfate source in groundwater of Sarpol Zahab and the parameters affecting sulfate concentration and its isotopic compositions (d34S and d18O) in groundwater were studied. Sarpol-e Zahab is located in the catchment area of Alvand river in the west of Kermanshah province, west of Iran. The formations of the region, based on age from old to new, include the Ilam, Gurpi, Amiran, Telezang, Pabdeh, Asmari, Gachsaran, Aghajari, Bakhtiari and Quaternary alluvium formations. Asmari formation and Quaternary alluvial sediments form the largest area of the region. Gachsaran formation contains evaporative materials which is reducing the quality of groundwater in the region. Ilam formation is effective in providing the organic matter required for the bacterial sulfate reduction process. Materials and Methods: 13 water samples were taken from the water resources (wells, springs and river) of Sarpol-e Zahab region in two steps (December 2014 and September 2015). Measuring field parameters (T, pH, Eh, Ec, and TDS) and sampling of water resources were performed according to the instructions of Groundwater and Geothermal Research Center (GRC), Ferdowsi University of Mashhad. Field parameters were measured by VWR Handheld Multi parameter Research meter at the location of each water source. The concentration of cations and the anions were determined by the devices inductively coupled plasma elemental analyzer (ICP-EA) and ion chromatography (IC), respectively. Chemical and isotopic analyses of all water samples were performed in Ottawa university geochemistry laboratory and Waterloo university isotope laboratory, respectively. The measurement reference for isotopic sulfate and oxygen were VCDT and VSMOW, respectively, and the value isotopic are expressed as permil ((‰. Results and Discussion: The sulfate concentrations in different water resources of the region varied from 5 to 950 mg L, however, it is very high in Gandab spring’ water, due to the association with hydrocarbons, and in Patagh Tunnel water, due to discharging of water from Gachsaran Formation (339.6 mg L and 950.1mg L, respectively). Chenarpiran spring has the lowest sulfate concentration because it is located in highlands and is discharged from Asmari formation with good water quality. The amount of d18O varied between 5.8 to 13.1 VCDT ‰ and the amount of d34S ranges from 9.5 to 31.8 VSMOW ‰. In Gandab spring’ water, due to sulfate reduction by microorganisms, in addition to the unpleasant smell of sulfide hydrogen (H2S), the d34S and d18O values were enriched than the isotopic composition of other water sources ( about 31.8 ‰ and 10.3 ‰, respectively). In other hand, the Gel va Darreh spring's water, due to the effect of upstream bath waste water (soap and detergent with a value of about 1 ‰ for d34S), indicated depleted isotope values. Conclusion: The concentration and isotopic composition of sulfate in the water resources of the Sarpol-e Zahab region are affected by the geological, atmospheric, human and hydrocarbon materials. The impact of human and hydrocarbon factors on the concentration and isotopes of sulfate is local, however, the lithology effects are on all water resources of the region. Since, Gachsaran formation forms the alluvial aquifer bedrock of Ghaleshahin plain, the dissolution of gypsum has an effective role in the hydro chemical evolution of the alluvial aquifer of this plain. The lithology of the area is often limestone and evaporation. Due to the high solubility of these materials in water, they have been able to have a significant effect on sulfate isotopic in water sources. The amount of measured isotopic values indicated that the origin of evaporators and atmospheric sulfate is in water. The dissolution of the evaporation formation has reduced the water quality. The association of bedrock in the Gandab spring has led to have a reduction environment and the occurrence of sulfate reduction and production of hydrogen sulfide gas (H2S). The human activities (by making bath upstream) caused oxidizing conditions, isotopic depletion and contamination of the Glodarreh spring.

Introduction: The pituitary gland is frequently irradiated during radiation therapy of head and neck tumors which can influence the quality of life of the patients after radiation therapy. This study aimed to estimate the normal tissue complication probability (NTCP) for the pituitary gland in head and neck cancers using two radiobiological models. Material and Methods: 53 patients including 20 cases with nasopharyngeal cancer and 33 cases with brain tumor were studied. The dosimetric properties of each plan including minimum, mean and maximum doses were extracted from the dose-volume histogram curve. For estimation of pituitary gland response for each patient, the BIOPLAN software was used to calculate NTCP by LKB model and Matlab software was applied to calculate NTCP by equivalent uniform dose (EUD) model. Models’ parameters including TD50, , and‘a’ were extracted from a previous study of radiobiological modeling of pituitary gland response to radiation therapy. For statistical analysis, the T-test was used to compare two models. Results: The average mean doses of 30.42 and 51.29 (Gy) of the pituitary gland were obtained for nasopharyngeal and brain tumor patients, respectively. The average NTCPs of the pituitary gland for nasopharyngeal patients estimated by LKB and Log-logistic models were 3.84 and 3.91%, respectively. In brain tumors, the average NTCP was 16.33% for LKB and 16.41% for Log-logistic models. The results showed that the log-logistic and LKB models provided comparable results and no statistically significant difference (P-value< 0.05) was found between two models. Conclusion: The NTCP results indicated that the average NTCP of the pituitary gland for nasopharyngeal patients was approximately four times lower than that of brain tumors. Finally, implementation of follow up studies and modeling investigations are recommended for accurate estimation of pituitary gland complications following radiation therapy.

Introduction:Gastric bypass surgery is an intervention used to treat class III obesity and its complications. Evidence is scarce regarding its benefits among the Iranian population, especially its role in resolving obesity-related complaints and comorbidities. The present study aimed to investigate the impact of gastric bypass surgery on the improvement of obesity-related complaints and comorbidities in morbid obesity. Methods:This study was conducted on 35 morbidly obese patients who volunteered to undergo gastric bypass surgery. Anthropometric data, comorbidity status, and dietary habits were collected at baseline and six months postoperatively. Data analysis was performed in SPSS version 16.0. Results: The majority of the patients were female (80%). A significant difference was observed in the frequency distribution of normal dietary habits (five regular meals per day) before and after surgery (P = 0.01). In comparison, the distribution was not significant for snacking and three large meals per day (P > 0.05). All complaints of eating disorders according to self-reports (e.g., overeating and night eating syndrome) significantly improved (P < 0.05 ). Moreover, the dose of the medications prescribed for the comorbidities associated with obesity reduced significantly (P = 0.001). The frequency of several obesity-related complaints (e.g., knee pain, hirsutism, acanthosis nigricans, and sleep apnea) also decreased significantly (P < 0.05). However, no significant improvement was observed in hair loss, brittle nails, and menstrual dysfunction (P > 0.05). Conclusion: Accordingly, gastric bypass surgery could improve obesity-related complaints six months postoperatively. Also, according to the patients’ self -declaration, patients’ adherence to “normal eating habits” increased during this period, and their eating disorders like night eating syndrome (NES) and overeating behaviors decreased compared to before the surgery.

Background & Objective: As the composition of lipids in atherosclerosis is one of the main factors for indicating plaque vulnerability, a sensitive and accurate diagnostic method is desirable in the inspection of interiors of veins and arteries. In this regard, Intravascular Photoacoustic (IVPA) imaging modality is developed as a new and fast-growing medical diagnostic method. In this project, a novel analytical and signal processing methodology for increasing the axial resolution of a frequency-modulated photoacoustic imaging system is considered. Materials & Methods: In this study, a photoacoustic imaging modality using an orthogonal correlated signal processing algorithm has been considered. The method uses a 1210 nm CW diode laser which modulates coherently-synchronously by pre-programmed and synthesized chirped signal. Results: The orthogonal correlated coherent photoacoustic imaging technique was developed as a novel method to increase the axial resolution of frequency-modulated photoacoustic system. The ultimate attainable axial resolution was ~ 20 um for cholesterol oleate. Conclusion: Medical Photoacoustic imaging uses non-ionizing radiation to detect targets that harm living organisms in the human body. Different methods, in terms of modulation and signal processing, have been developed to render the chemical and topological properties of specific biological compounds. In this work, a novel frequency-modulated PA imaging based on an orthogonal correlation signal processing approach was developed. According to the experimental results and theoretical predictions, the present method was able to reach as low as ~20um axial resolution for cholesterol oleate.

BACKGROUND: Atrial fibrillation (AF) is the most common tachyarrhythmia in patients with cardiovascular diseases (CVDs) and may have significant complications such as stroke. The present study aims to evaluate endothelial dysfunction in patients with lone atrial fibrillation (LAF) through flow-mediated dilation (FMD) in the brachial artery, as a non-invasive method for evaluating functional and structural markers of endothelial dysfunction.METHODS: In this case-control study, 43 patients with LAF were selected. 51 age and sex-matched healthy individuals were selected as the control group. The brachial artery diameter of the subjects in both groups was measured through FMD. The obtained data were analyzed by SPSS software.RESULTS: Patients with LAF and healthy subjects did not have any difference in terms of gender, heart rate (HR), and systolic blood pressure (SBP) (P > 0.05 for all). FMD of the patients with AF was significantly lower (P = 0.04) than FMD of the healthy controls.CONCLUSION: Our findings showed that LAF was associated with systemic endothelial dysfunction. AF plays an important and independent role in reducing FMD.

DOR: 98.1000/2383-1251.1399.7.151.13.1.1575.41 Extended abstract Introduction: Seed deterioration is a physiological phenomenon that affects all germination, biochemical, cytological, and growth characteristics of plants. So it is necessary to use seed vigor enhancement methods to resolve these problems. One of these methods is the application of seed priming techniques to reduce deterioration effects. Therefore, the present study aimed to investigate the effect of different pre-treatments by using Nano-zinc, ascorbic acid, humic acid, gibberellin and KNO3 on germination indices and chromosomal aberration of aged onion seeds. Material and Methods: This experiment was performed as factorial based on a completely randomized design with 3 replications (100 seeds per replicate) in the faculty of agriculture at Urmia University. The first factor was the level of aging at 4 levels (control, 12h, 24h, and 48h) and the second factor was seed pre-treatments at 6 levels (control, Nano-zinc (30 mg), ascorbic acid (100 mg), humic acid (150 mg), gibberellin (200 mg/l) and KNO3 (0.1%). Given that the germination was not similar at different levels of aging, the seeds were germinated at control and 12h of aging after 6 days, at 24 and 48h of aging after 8 and 9 days, respectively. Hence, germination percentage, germination rate, normal seedling, mean germination time, and seed vigor were evaluated after the mentioned times. Chromosomal aberrations were also examined. Results and Discussion: The results showed that the interaction effect of aging and seed pre-treatments on germination indices were significant at %1 probability level. By increasing the period of aging, all germination characters decreased significantly. The highest germination percentage (80%, 70%, 50%) and germination rate (5.350, 3. 316, 1.525 seed/day) were obtained by using Nano-zinc At 12h, 24h and 48h ageing levels. Nano-zinc and gibberellin had the highest effect on seedling vigor and normal seedlings. Seedling vigor increased significantly by using Nano-zinc and gibberellin at 12h (1133, 933.9), 24h (742.9, 692), and 48h (369.9, 323.3). The chromosomal aberration was reduced by using pre-treatment. Conclusion: In this study, the most effective pre-treatments to improve germination characteristics and reduce chromosomal aberrations were gibberellin (200 mg/l) and Nano-zinc (30 mg). Therefore, it can be stated that the use of Nano-zinc and gibberellin as seed pre-treatments can significantly reduce the effects of deterioration on onion seeds. Highlights: 1- Nano-Zinc and gibberellin were the most effective priming treatments on seed germination and growth characteristics of the aged onion seeds. 2- Priming treatment reduced the percentage of chromosomal aberration in the onion and the highest effect was obtained using Nano-zinc and gibberellin.

Introduction: The current study aimed to compare the performance of radiobiological models in predicting acute esophagitis (AE) complications after three-dimensional conformal radiation therapy (3D-CRT). Material and Methods: Out of a total of 100 patients, 50 patients with concurrent chemotherapy and 50 patients without such therapy were treated with different total doses and a daily dose range of 1.8-2.4 Gy on the basis of 5 days a week for 3 months. Predictions of AE were based on Lyman–Kutcher–Burman (LKB) and equivalent uniform dose (EUD)-based radiobiological models. Consequently, 3 months of follow-upwere performed to monitor the complication incidence among the studied patients. Receiver operating characteristic (ROC) and univariable logistic regression analyses were carried out to determine the effect of mean dose, volume percentage, and weight loss percentage on the probability of AE grade ³ 2. Results: The EUD-basedmodel showed a better concordance with the clinical data for all patients (area under the curve [AUC]=0.919) and the concurrent chemoradiotherapy (CCRT) group (AUC=0.986). For the radiation therapy group, the LKB model had a better performance than the EUD-based model (AUC=0.921). Grade ³ 2 esophagitis occurred 37.94±4.0 and 68.39±7.1 days after the initiation of radiation therapy in the chemoradiation and radiation therapy groups, respectively. Conclusion: The EUD-basedmodel showed a higher agreement with the follow-up data. The incidence time of grade ³ 2 AE in the CCRT was approximately two times shorter than that in the non-CCRT group.

Background: To compare thyroid volume, thyroid stimulating hormone (TSH), free t4 and the prevalence of thyroid nodules between obese and non-obese subjects. Also, the association between BMI and insulin resistance status with various parameters of thyroid gland was evaluated. Methods: Fifty–two patients with obesity and 38 volunteers aged 20-50 years with normal body mass index (BMI), were enrolled in this cross-sectional study. Patients with diabetes, history of thyroid disorders, and patients, who were taking medications that influence their blood glucose or insulin levels or modified thyroid function tests, were excluded. TSH, free t4, insulin and glucose and thyroid sonography were carried out and the results compared between two groups. P

Corona-virus infection that arose from China is now a global pandemic. It presents with a variety of pulmonary manifestations, most commonly in the form of ground glass pulmonary lesions and opacities. Less common manifestation such as pnuemothorax has been reported by some authors. In this study we report a 56-year-old man with Corona-virus disease presenting with tension pneumothorax, a rare and life-threatening complication of Corona-virus infection that has not been reported previously. In our case, after insertion of thoracostomy tube, the patient's symptoms improved. After about 1 year of Corona-virus pandemic, it still presents with some rare pulmonary and extrapulmonary manifestations, so, familiarity with these manifestations is important for a correct diagnosis and treatment.

Timeliness is a fundamental feature of the relevance of financial reporting information to managers, enabling them to make informed business unit decisions. The purpose of this study was to investigate the role of the moderator of auditor's expertise on the relationship between the audit committee's characteristics and the delay in the audit report. This research is from the point of view of applied research type and the point of view of nature and method, including descriptive and correlational research. The research sample includes 135 companies listed on the Tehran Stock Exchange in the years 2013 to 2017. After controlling the control variables, the hypothesis test's findings showed that the auditor's specialization in the industry negatively correlates the relationship between the audit committee's independence and the audit committee's size and the delay in the audit report.

One of the most important processes in today's industrial world, the Nexus Interaction, is known as Water, Soil and Wastewater (WSW). The purpose of this research is to provide a network model that can be used to determine the state of the hazards caused by Irrigation of land with untreated municipal wastewater. Methods of this study include the stages: knowledge of the study area, quantitative and qualitative assessment of surface water of the ministry of the earth, determination of stability indicators and interlinkeges matrices, evaluation of interveners, comparison of interventions and management solutions. According to the measurements, the water quality index for groundwater was 71% It has a relatively bad pollution and 29% is relatively bad. Also, the amount of metals in the house has only four parameters of barium, lead and vanadium in some places higher than the standard, and in vegetables, the amount of lead and cadmium is more than the limit. According to the Nexus radar chart, the highest The pressure from pollution in the first stage is on agricultural products and then on the health and environment of the community

Existing conditions for locating urban equipment and facilities require a set of limiting and reinforcing factors. Interaction of environmental, industrial, social and political changes in our rapid growth adds to the complexity of regional systems. Locating takes place by various methods, in which the priority is the application of modern methods leading to reduced uncertainty. The present study aimed to select the best location using nine criteria (slope, distance from fault, distance from river, distance from road, and distance from villages, soil type, land use, average temperature, and average rainfall) in GIS software for mapping. Fuzzy logic and fuzzy-analytical hierarchy process (FAHP) model were applied to reduce location uncertainty. The accuracy of the results was checked using field data, in which six stations designated for the establishment of industrial estates in the study area were compared with the results of the FAHP model. The results of FAHP model in GIS software and their validation showed that the proposed model has excellent capabilities in locating industrial estates.

In this report we present a novel photoacoustic (PA) modality using pulsed chirp excitation at a fixed wavelength and spectral analysis based on frequency-domain (FD) processing. We introduce Truncated Correlation Photoacoustic Coherence Tomography (TC-PACT), a PA axial resolution enhancement methodology, with an application to closely stacked subsurface multilayers of plexiglass coated with a thin layer of graphite acting as surface absorber. The experimental results demonstrated that the SNR and the axial resolution were higher in TC-PACT than in conventional FD photoacoustics. A ns pulsed laser was also used as PA excitation source with axial resolution results found to be commensurate with TC-PACT. However, the separation distance between adjacent absorbers when the latter approached the axial resolution limit of the transducer was only resolved in TC-PACT compared to pulsed laser PA owing to the lower uncertainty in the former modality involved in determining the location of the absorbers.

Background and Aims: Obesity is one of the major health problems worldwide. Morbid obesity (body mass index >40 kg/m2 or over 35 with a comorbidity) is associated, apart from other diseases, with an increased risk of non-alcoholic fatty liver disease (NAFLD). Moreover, dyslipidemia is an important comorbidity that is frequently found in NAFLD patients. The aim of this study was to analyze whether serum lipids in morbidly obese patients are associated with the spectrum of NAFLD.Methods: Total serum cholesterol, LDL cholesterol, HDL cholesterol, non-HDL cholesterol, VLDL, and triglycerides were analyzed in 90 morbidly obese patients. The association of lipid profile parameters with histopathological, elastographic, and sonographic indices of NAFLD, non-alcoholic steatohepatitis (NASH), and liver fibrosis were explored.Results: The mean levels of serum total cholesterol, LDL-C, and non-HDL cholesterol in patients with positive histology for liver steatosis and NASH were significantly higher than those in patients with negative histology. None of the indices showed a strong association with NAFLD, NASH, or liver fibrosis after adjustment for potential confounders.Conclusion: A slight predictive value of lipid profile is not sufficiently enough to use solely as a non-invasive test in predicting NASH or liver fibrosis.

Environmental impact assessment is an integrated, operational and implemental approach for sustainable development. An attitude is considered in which as an integrated system, everything is got into sustainability in the environment and with the environment, as well. Environmental assessment is a tool that has been developed to prevent environmental degradation caused by human activities. Environmental impact assessment is an approach to evaluate the environmental impacts of a project before and during the project implementation. Therefore, we need to develop a practical and quantitative method to provide a precise planning in order to estimate the effects of a dam and ultimately, to make a decision on the implementation or non- implementation of the project if knowing the impact of all activities on environmental factors. Therefore, we introduced a generalized mathematical model of ICOLD matrix and multi-criteria decision making method (method of analytic hierarchy process) as a quantitative model to analyze the projectâs impacts on the environment. For this purpose, the environmental impact assessment information of the Zaraj-Abad dam, as the study area, was used to demonstrate the validity of the model. Results show that unlike the main implemented method in the dam Zaraj-Abad, who gives the âimplement the Dam projectâ option, this method shows negative effects (45%) of the implementation of the dam on the environment and gives the option of non- implementation.

Background: Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that often involves impaired cognition, communication difficulties and restrictive, repetitive behaviors. ASD is extremely heterogeneous both clinically and etiologically, which represents one of the greatest challenges in studying the molecular underpinnings of ASD. While hundreds of ASD-associated genes have been identified that confer varying degrees of risk, no single gene variant accounts for >1% of ASD cases. Notably, a large number of ASD-risk genes function as epigenetic regulators, indicating potential epigenetic dysregulation in ASD. As such, we compared genome-wide DNA methylation (DNAm) in the blood of children with ASD (n = 265) to samples from age- and sex-matched, neurotypical controls (n = 122) using the Illumina Infinium HumanMethylation450 arrays.Results: While DNAm patterns did not distinctly separate ASD cases from controls, our analysis identified an epigenetically unique subset of ASD cases (n = 32); these individuals exhibited significant differential methylation from both controls than the remaining ASD cases. The CpG sites at which this subset was differentially methylated mapped to known ASD risk genes that encode proteins of the nervous and immune systems. Moreover, the observed DNAm differences were attributable to altered blood cell composition, i.e., lower granulocyte proportion and granulocyte-to-lymphocyte ratio in the ASD subset, as compared to the remaining ASD cases and controls. This ASD subset did not differ from the rest of the ASD cases in the frequency or type of high-risk genomic variants.Conclusion: Within our ASD cohort, we identified a subset of individuals that exhibit differential methylation from both controls and the remaining ASD group tightly associated with shifts in immune cell type proportions. This is an important feature that should be assessed in all epigenetic studies of blood cells in ASD. This finding also builds on past reports of changes in the immune systems of children with ASD, supporting the potential role of altered immunological mechanisms in the complex pathophysiology of ASD. The discovery of significant molecular and immunological features in subgroups of individuals with ASD may allow clinicians to better stratify patients, facilitating personalized interventions and improved outcomes.

The standard therapy for thyroid cancer is total or near total thyroidectomy, followed by the administration of radioactive iodine for remnant ablation or residual disease. Patients with radioiodine therapy are predisposed to second malignant neoplasms in organs such as central nervous system (CNS), breast, prostate, kidney, bone marrow, salivary gland, and digestive tract. Exposure to carcinogen including occupational and therapy related hazard, aging and genetic susceptibility are other causes of second primary cancers. The second primary malignancies are not uncommon and, nowadays, the prevalence of it is mildly increasing due to the increasing survival of cancer patients and advances in early diagnosis and therapeutic modalities. Here, we present a fifty-one-year-old man with papillary thyroid carcinoma (PTC), who developed chronic lymphocytic leukemia (CLL), renal cell carcinoma (RCC), and basal cell carcinoma (BCC) in 15-20 years after radioactive iodine therapy. Second primary tumors are increasing and environmental, genetic susceptibility and increase in survival of cancer patients are the major risk factors.

One of the most common postoperative problems is nausea and vomiting. Although using some anesthetic materials has been considered as the mainstay of this phenomenon, the exact factors are not known. Because of several morbidities associated with postoperative nausea and vomiting (PONV), its prevention and treatment has been a challenge for physicians, so several drugs have been recommended for this purpose. Based on the documented antiemetic specificity of ginger, we evaluated and compared the effects of preoperative administration of ginger on PONV with ondansetron administration as the standard medication. The participants included 100 patients with cholelitiasis who were candidate for laparoscopic cholecystectomy. Patients were divided into two groups: group A comprised 50 patients who received 500 mg oral ginger 1 h before surgery, and group B included 50 patients who received 4 mg intravenous ondansetron before completion of surgery. Antiemetic efficacy was assessed by visual analogue scale scores of nausea intensity at 0, 4, 8, 16, and 24 h after surgery and frequency of vomiting during the evaluation period. Although multifactor analysis showed that nausea severity was significantly lower in the ginger group, the data indicated that except 16 h after operation, the differences between two groups in the frequency of vomiting was not significant. In conclusion, though complementary studies are needed to have a strong suggestion, based on this study, we recommend administration of oral ginger 1 h before operation to control the severity of PONV in patients undergoing laparoscopic cholecystectomy. Keywords: Ginger (Zingiber officinale Roscoe), Postoperative nausea and vomiting, Cholecystectomy, Laparoscopic

Abstract Background An engineered tissue structure is an artificial scaffold combined with cells and signaling factors. Among various polymers, the polylactide-co-glycolide/hydroxyapatite (PLGA/HA) has attracted much attention due to their optimal properties. The aim of this study was to study the behavior of human endometrial stem cell (hEnSC)-derived osteoblast cells cultured on PLGA/HA nanocomposite scaffolds. Methods hEnSCs were isolated and exposed to osteogenic media for 21 days. Differentiated cells were cultured on PLGA/HA synthetic scaffolds. The PLGA/HA-based nanocomposite scaffolds were fabricated using either electrospinning or freeze-drying methods. Behavior of the cells was evaluated a week after seeding hEnSC-derived osteoblast-like cells on these scaffolds. Osteogenesis was investigated in terms of alkaline phosphatase activity, gene expression, immunocytochemistry (ICC), proliferation, and scanning electron microscopy (SEM). Moreover, scaffold properties, such as pore size and morphology of the cells, onto the scaffolds were evaluated using SEM. Furthermore, biocompatibility of these scaffolds was confirmed by 3-(4,5-dimethylthiazoyl-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Results The matrix mineralization was proved by alizarin red staining, and the osteogenic media-treated cultures positively expressed osteocalcin and osteopontin markers. Moreover, qRT-PCR results confirmed the positive gene expression of osteopontin and osteonectin in the differentiated osteoblast-like cells. The results of behavior assessment of the cultured cells on electrospinning and freeze-dried scaffolds showed that the behavior of the cultured cells on the freeze-dried PLGA/HA scaffolds was significantly better than the electrospinning PLGA/HA scaffolds. Conclusion It has been shown that the freeze-dried PLGA/HA nanocomposite scaffolds can appropriately support the attachment and proliferation of the differentiated osteoblast cells and are a suitable candidate for bone tissue engineering.

Background: Postoperative nausea and vomiting (PONV) are among the most frequent complications following laparoscopic cholecystectomy. Recently, some studies have shown ginger, as an herbal medicine, to be effective and safe in PONV prevention; however, there is no evidence of its efficacy in the Iranian population. Objective: The aim of this study was to determine the effect of oral ginger on PONV prevention after laparoscopic cholecystectomy. Methods: This double-blind, randomized, placebo-controlled clinical trial was performed on women who were undergoing laparoscopic cholecystectomy in Imam Raza Hospital, Mashhad, Iran between April and November, 2016. Patients were divided randomly into two groups of G) intervention group (n=75, received 2 capsules containing 250 mg ginger) and P) placebo group (n=75, received 2 placebo capsules) one hour before surgery. Nausea severity and vomiting frequency were evaluated at 2, 4, 6, and 12 hours after the operation. Data analysis was done by SPSS version 16.0 software with Chi-square test, Independent-sample-t-test, repeated measure ANOVA and Mann–Whitney U test. Results: The two groups were homogenous in terms of age, gender and surgery duration. The severity of nausea was lower in the ginger group at the 2, 4, 6, and 12 hours after the operation; however, these differences were statically significant only at 2 (p=0.034) and 12 hours (p=0.043). Although the incidence of vomiting was higher in the placebo group in the 2nd and 12th hours after surgery, the number of vomiting episodes in 2, 4, 6 and 12 hours after surgery was statistically similar in the two groups (p>0.05). The nausea severity was significantly changed during 12 hours of study in both groups (p=0.001), however the nausea severity was always lower in the ginger group (p=0.078). Conclusion: This study demonstrated that 500mg oral ginger one hour before surgery in women who were undergoing laparoscopic cholecystectomy is effective in decreasing severity of PONV. Trial registration: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the Irct ID: IRCT2016122222218N2. Electronic physician Page 6355 Funding: The study was financially supported by Deputy of Research of Mashhad University of Medical Sciences

Background: metalic-Nanoparticles (NPs) is new antifungal materials versus the resistant fungi as Candida albicans (C. albicans) that is the main factor of acrylic-denture candidosis. Whenever Ag NPs as a strong antifungal metalic-NPs exhibit toxic effect on human cells, the aim of this study was evaluation the antifungal effects of ZnO NPs in acrylic resin (polymethyle methacrylate (PMMA)) as a more biocompatible material on C. albicans in comparison to acrylic resin (PMMA) containing Ag NPs. Methods: In this laboratory study, eleven 10-member groups of acrylic resin specimens with ZnO NPs and Ag NPs (totally 110 specimens) were used. The weight percent of NPs 0.5, 2.5, 5, 10, and 20%, that were added to the monomer in each phase and after mixing with powder, flasking carried out in a conventional manner and in a flask with 12 cylindrical cavities with a diameter of 10 mm and thickness of 4 mm in internal space to produce discoid specimens, after deflasking the specimens were finished, polished, cleaned ultrasonically for 5 min in ethanol, rinsed with sterile water and dried in warm air. Afterward they inucleated by 0.1 ml of an inoculating suspension containing 103 concentration of C. albicans (ATCC 10231) and were incubated for 24 hours. Then, the sample was washed with 4.8 ml of 0.9%NaCl solution, and 0.1mL of the washing NaCl solution was taken and cultured on tutrient agar, then incubated for another 24 hours and colony numbers were counted and the data was analyzed by one way ANOVA. Results: Ag & Zno NPs could significantly decrease population of C. albicans after 24 hour of exposure time, meanwhile Ag NPs exhibited stronger antifungal effect than ZnO NPs (P˂0.001). Conclusion: Zno NPs can inhibited the C. albicans. To suggest this technique as a reliable method and determination of technical particle, the efficiency of ZnO NPs should be evaluated in clinical trials.

In order to achieve high quality crystals, it is necessary to purify the raw material. In the present experimental study, the zone melting method was used to purify Lithium Flouride powder. A small amount of melt moves slowly from the solid area in order to remove impurities in the frozen solid. In this case, the number, size and length of the zone melting affect the final result, and cause the optimal distribution of solutes. At the beginning, the regional purification system was equipped. The mechanism of work was moving furnace on a graphic crucible with full of LiF powder by 20 mm/h-1. This procedure was followed in a vacuum for 7, 9 and 14 times. At last the amounts of impurities such as Fe, Ba were measured by ICP (Inductively Coupled Plasma) analysis before and after purification.

Crystal of LiF were grown by a home-made Czochralski system using MgF2 (0.05%), LiOH (0.1%) and Li2CO3 (0.05%) powders as the impurities after purification by the zone-melting method. Another crystal was also grown with raw materials with the normal purity of 99.995%. The grown crystals were found to be colorless and transparent with no cracks. In order to obtain a high concentration of F2+ centers and small concentration of colloids and parasitic aggregate centers, the grown crystals were subjected to the multi-step ionizing irradiation treatments. At the same time, maintaining the highest possible density of F2+-like centers and small cluster centers caused the effective thermal stability of F2+- centers and in particular reduced the formation of the electron color centers which improved the stability of the optical features of the modified LiF:F2+** crystals. As a result, acting as a color center laser medium. A comparing of the features of crystals shows that their optical characteristics are the same as the other samples. The XRD properties of the grown crystals were also investigated for the comparison. They indicated the Faced-Centered Cubic (FCC) structures of the crystals. In addition, the inductively coupled plasma (ICP) analysis was used to measure the Mg2+ ion concentration. The emergence of OH- peaks was specified by a FTIR spectrophotometer. In a long run, the spectroscopic characteristics of the new F2+- centers in LiF:OH, Mg crystals were also studied.

Introduction: Weight gain and obesity are two important public health problems, which are associated with many diseases such as cardiovascular disorders. Various policies such as bariatric surgery have been proposed for the treatment of morbid obesity. Methods: PubMed and Scopus were searched thoroughly with the following search terms (roux-en-y gastric bypass surgery) AND (ventricular function, OR cardiac risk factors OR heart)) AND (BMI OR body mass index) to find the articles in which the effect of roux-en-Y gastric bypass (RYGB) surgery had been evaluated in severely obese patients.Result: Out of 120 articles which were found in PubMed, and 28 records which were found in Scopus, only 18 articles fully met the inclusion criteria. Out of 2740 participants in the included studied, 1706 were patients with body mass index (BMI) over 40 kg/m2 who had undergone RYGB surgery, and 1034 were control participants. Results of the studies showed that RYGB surgery could reduce BMI, and cardiac risk factors, and improve diastolic function, systolic and diastolic blood pressures, and aortic function, postoperatively.Discussion: Obesity is associated with increased risk of cardiovascular diseases, impaired cardiac function, and hypertension. It is shown that RYGB surgery reduces the serum level of biochemical markers of cardiac diseases. Cardiac structure, parasympathetic indices of autonomic function, coronary circulatory function, hypertension, epicardial fat thickness, and ventricular performance improve after bariatric surgery.Conclusions: It is concluded that RYGB surgery is an effective strategy to improve ventricular function and cardiac risk factors in morbid obese patients.

Objective: There are controversies about the benefits of prophylactic antibiotics in the prevention of postoperative surgical site infection (SSI) in mesh herniorrhaphy for a long time. This study aimed to evaluate the effectiveness and efficacy of systemic prophylactic cefazolin in prevention of wound infection in various types of hernia repair with mesh materials. Methods: This is a prospective randomized control study. We evaluated wound infection rates in 395 patients with various kinds of hernia who underwent elective mesh repair using polypropylene mesh from 2007 to 2011. A total of 237 (60.0%) patients received prophylactic cefazolin (study group) and the remaining 158 (40.0%) patients did not receive any prophylactic antibiotics (control group). Patients were followed for infection at the following periods after the operation by an independent surgeon: 10 days, 30 days, 12 months, and then annually for at least 2 years. Results: Eight (2.03%) patients had infection in the site of surgery [2 (1.27%) in the control group and 6 (2.53%) in the study group]. The distribution of infection was not significantly different between the two groups (p = 0.364). The superficial infections were managed by drainage and irrigation. One patient from the study group developed deep SSI and was readmitted and subsequently received antibiotic therapy, drainage, and debridement. Conclusion: Preoperative administration of single-dose cefazolin for prosthetic hernia repairs did not markedly decrease the risk of wound infection. Our results do not support the use of cefazolin as a prophylactic antibiotic for various kinds of abdominal wall hernia repair with mesh.

Leishmaniasis, one of the most important parasitic diseases worldwide, is frequently cited with respect to health risks related to climate change. The current variability of the climate may have different impacts on the transmission of cutaneous leishmaniasis (CL) depending on the various Leishmania species. The number and distribution of CL cases in Khuzestan Province, Southwestern Iran was analysed over the 2010-2014 period with regard to temperature, humidity, rainfall, sunshine hours, evaporation and wind-related climate issues. During the study period, there were 4672 recorded clinical cases of CL, the incidence of which was found to fall into three types of areas, such as high, intermediate and low-level endemic areas. Compared to the intermediate and low-endemic areas, the hyper-endemic areas showed significantly variable meteorological data with regard to rainy days, maximum/minimum temperature and humidity. Decreased temperatures in the eastern part of this province were found to promote the disease towards its centre. We conclude that the meteorological variables and incidence data of CL indicate that the number of rainy days, maximum and minimum temperatures and relative humidity are significant variables that can predict CL incidence. Indeed, the substantial climatic variability occurring during the recent 5-year period (2010-2014) in Khuzestan Province could be the main reason for the change in epidemiology and transmission of CL.

Objective: There is controversy concerning the management of the remaining cavity after the evacuation of a cyst in patients who have undergone surgical operation for liver hydatidosis. This study compares the results of capitonnage and tube drainage of the remaining cavity. Methods: In this retrospective study, participants were selected from two groups of patients with a liver hydatid cyst who underwent capitonnage or tube drainage from 2004 to 2012. The patients were followed for 6–24 months. The data of age, sex, involved liver lobe, size of the cyst, complications, drain duration, and hospital stay were analyzed. Results: Participants included 155 patients consisting of 96 (61.94%) females and 59 (38.06%) males. Most cysts were in the right lobe, and the most common diameter of the cysts was greater than 10 cm. Capitonnage was performed on 90 (58.06%) patients and the tube drainage procedure was performed on the remaining 65 (41.94%) patients. In the tube drainage group and the capitonnage group, the operative times were 2.21 ± 0.65 hours and 2.53 ± 0.35 hours, respectively; the hospital stays were 5.695 ± 3.37 days and 4.43 ± 2.96 days, respectively; the drain duration was 9.2 ± 1.7 days and 2.1 ± 0.4 days, respectively; and the time to return to work was 14.7 ± 2.3 days and 8.3 ± 10.4 days, respectively. All variables were statistically significant, except for the operative time. Cavity infection and biliary fistula were identified in three patients and six patients, respectively, in the tube drainage group and identified in two patients and three patients, respectively, in the capitonnage group. This difference was not statistically significant. Conclusion: This study demonstrated that capitonnage versus the tube drainage method may result in a shorter hospital stay, decreased time to return to work, and low rate of morbidity and complications.

Background: Iran is one of the areas with higher incidence of esophageal cancer in the world. The survival benefit of surgery followed by adjuvant therapy has been demonstrated and widely accepted as a standard therapy in other gastrointestinal malignancies. Definitive chemoradiotherapy (DCRT) is used for locally advanced esophageal cancer and for inoperable tumors, thus is an alternative to surgical treatment. The purpose of the current study was to evaluate the effects of definitive and adjuvant therapy on survival of patients with esophageal cancer. Methods: This retrospective study was conducted in North-West of Iran during 2006-2011, included 331 consecutive patients with esophageal cancer referred to Radiation Oncology Therapy Center of Imam Reza (AS) Hospital in Tabriz, Iran. Health status of patients was followed by telephone contact. Survival rate and the impact of demographic characteristics, treatment modulatory and chemoradiotherapy factors in survival rate was analyzed using Kaplan-Meier Life Table and Cox regression test in SPSS software. Findings: Median survival was 14.2 months (CI 95%: 16.6-12.33). The 1, 3 and 5-year overall survival rates of all patients were 60, 21 and 16%, respectively. The factors influencing survival rate were age at diagnosis (P < 0.001), stage of disease (P < 0.001), tumor differentiation (P = 0.020), treatment modulatory (P < 0.001), radiation dose (P = 0.010), and type of drugs used in chemotherapy (P = 0.010). Among those six significant variables, independent prognostic factor for survival determined via multivariate analysis, was the radiation dose. Conclusion: The results of this study indicate that survival rates of esophageal cancer in our patients are poor. Early detection and improved treatment methods via clinical trials would help to extend the life of patients in the future.

Single Crystals of Orthorhombic BaCl2 and BaCl2:Eu2+ were grown using a home-made Czochralski system by extracting from the melt in a carbon crucible, and argon atmospheric pressure upon using BaCl2 and EuCl2 powders of 99.995% and 99.99% purity, respectively. The results corresponding to XRD analysis for the grown crystals confirm the phase purity and the orthorhombic structural phuse of the grown BaCl2 and BaCl2:Eu2+ crystals. The ICP model Optima-2100 was also used to measure Eu2+ ion concentration. The fluorescence emission, excitation and absorption spectra were obtained using a Cary-Eclipse WinFLR fluorometer and a Cary17D spectrophotometer. The prepared crystaling samples found to be colorless and transparent with no observed cleavage. Therefore, excluding OH-, oxygen and carbon contaminations from the growth system was to some extent a successful result, which is indicating that a transmittance coefficient of about 80% is considered as a suitable optical feature of the BaCl2 single crystal. The study of photoluminescence spectroscopy of BaCl2 single crystals, with and without Eu2+ ion impurity, showed that the occurrence of the high intensity and low band width (FWHM~30nm) PL-band of BaCl2:Eu2+ sample at 400nm are indicating an increase of the optical efficiency compared with and without applying the impurity. As a result, it could be observed that the doped crystals with europium can be served as a luminescence material for radiation detectors.

"nHemangiomas are the most common benign liver masses with a frequency of 0.4-7.3% at autopsy. They are usually discovered incidentally and a few require surgery. Spontaneous or traumatic ruptures are among indications of surgery for hemangiomas. We report a case of giant hepatic hemangioma presenting as hemoperitoneum following use of the slimming belt that underwent an emergent laparotomy. Abdominal exploration revealed that both right and left lobes of the liver were involved with giant hemangiomas. The liver was compressed by tightly packing laparotomy pads. After the operation, the patient was admitted to the surgical intensive care unit. Two days later, a second surgery was performed to remove the laparotomy pads. On the 6th day, the patient was discharged. One month later, to shrink the tumor, percutaneous transarterial embolization of the hepatic artery was performed.