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Cellulose-based composites have aroused increasing interest as potential replacements for fossil fuel-based plastics. In this work, transparent cellulose-grafted-PLA nanocomposite films were prepared by grafting polylactide (PLA) onto cellulose. PLA was synthesized by in situ ring opening polymerization from a regenerated cellulose matrix, using zinc oxide nanoparticles (ZnONPs) in 1-ethyl-3-methylimidazolium acetate (EmimAc) as solvent. A facile route was devised to modify the starting material (cellulose paper) by partial dissolution and regeneration that used an ionic liquid (IL) as a smart nanowelding agent to assemble nanometric cellulose structures. The influence of the proportion of ZnONPs (1–5 wt%) and $$\textit{L}$$ L -lactide (LA) monomers (10–70 wt%) used on the properties of the resulting nanocomposite films was examined by comparison with an all-cellulose composite (ACC) and pure cellulose paper. Incorporating ZnONPs and PLA was found to enhance the mechanical, barrier and optical properties of the films. The maximum tensile strength and best barrier properties were those of a film obtained from 5%ZnONPs and 70%LA. FTIR spectra confirmed a new form of interaction between PLA and the regenerated cellulose matrix. Also, XRD spectra revealed a transition from cellulose I to II and an increase in the proportion of noncrystalline cellulose through partial dissolution and regeneration. Although the surface morphology of the nanocomposite films was influenced by the presence of ZnONPs and PLA chains, their color and chemical structure were not. The transparent cellulose-grafted-PLA nanocomposite films obtained are highly promising as packaging materials.

ObjectiveThis study aimed to measure the duration and recovery rate of olfactory loss in patients complaining of recent smell loss as their prominent symptom during the coronavirus disease 2019 outbreak.MethodThis was a prospective telephone follow-up observational study of 243 participants who completed an online survey that started on 12 March 2020.ResultsAfter a mean of 5.5 months from the loss of smell onset, 98.3 per cent of participants reported improvement with a 71.2 per cent complete recovery rate after a median of 21 days. The chance of complete recovery significantly decreased after 131 days from the onset of loss of smell (100 per cent sensitive and 97.7 per cent specific). Younger age and isolated smell loss were associated with a rapid recovery, whereas accompanying rhinological and gastrointestinal symptoms were associated with longer loss of smell duration.ConclusionSmell loss, occurring as a prominent symptom during the coronavirus disease 2019 pandemic, showed a favourable outcome. However, after 5.5 months from the onset, around 10 per cent of participants still complained of moderate or severe hyposmia.

Retinal biomarkers in neurodegenerative disorders have attracted much attention in recent years. Recent studies have reported visual dysfunction in Huntington's disease (HD). However, little is known about retinal structural changes in HD.A total of 50 subjects, including 25 motor-manifest HD patients and 25 gender- and age-matched controls, were enrolled. Unified Huntington's Disease Rating Score-Motor part was assessed in HD patients. Spectral-domain Optical Coherence Tomography (SD-OCT) was used to evaluate the macular thickness and peripapillary retinal nerve fiber layer (pRNFL). Superficial and deep capillary plexus densities were measured using OCT angiography (OCTA). To account for inter-eye correlation, generalized estimating equation (GEE) model was used.HD patients had a significant reduction in macular thickness in both inner and outer superior sectors and the inferior outer sector. Inferior pRNFLs were significantly decreased in thickness. There was no significant difference in retinal capillary plexus density between the two groups. Age and disease duration were negatively correlated with macular thickness in HD patients. However, the severity of motor involvement was not correlated with SD-OCT or OCTA parameters.We observed attenuated pRNFL and macular retinal thickness in patients with HD, independent of macular capillary plexus parameters. It can support the hypothesis that the retina may be a potential biomarker for monitoring the neurodegenerative process in HD.

Background Olfactory dysfunction has shown to accompany COVID-19. There are varying data regarding the exact frequency in the various study population. The outcome of the olfactory impairment is also not clearly defined. Objective To find the frequency of olfactory impairment and its outcome in hospitalized patients with positive swab test for COVID-19. Methods This is a prospective descriptive study of 100 hospitalized COVID-19 patients, randomly sampled, from February to March 2020. Demographics, comorbidities, and laboratory findings were analyzed according to the olfactory loss or sinonasal symptoms. The olfactory impairment and sinonasal symptoms were evaluated by 9 Likert scale questions asked from the patients. Results Ninety-two patients completed the follow-up (means 20.1 (± 7.42) days). Twenty-two (23.91%) patients complained of olfactory loss and in 6 (6.52%) patients olfactory loss was the first symptom of the disease. The olfactory loss was reported to be completely resolved in all but one patient. Thirty-nine (42.39%) patients had notable sinonasal symptoms while rhinorrhea was the first symptom in 3 (3.26%). Fifteen patients (16.3%) had a taste impairment. Patients with sinonasal symptoms had a lower age (p = 0.01). There was no significant relation between olfactory loss and sinonasal symptoms (p = 0.07). Conclusions Sudden olfactory dysfunction and sinonasal symptoms have a considerable prevalence in patients with COVID-19. No significant association was noted between the sinonasal symptoms and the olfactory loss, which may suggest that other mechanisms beyond upper respiratory tract involvement are responsible for the olfactory loss.

Post-traumatic olfactory dysfunction (PTOD) is associated with a significant decrease in quality of life. The present study aimed to explore whether PTOD is associated with depression and changes in sexuality. There were two groups in this case–control study. The patient group consisted of patients with PTOD (n = 55), and the control group comprised healthy individuals without the olfactory disorder (n = 115). Olfactory function, depression, partnership, and sexual satisfaction were assessed using the Iranian version of the Sniffin’ Sticks test (Ir-SST), Beck Depression Inventory (BDI), Enrich Couple Scale (ECS) and Sexual Satisfaction Scale for Women (SSSW). The BDI scores were higher in the patient group than in the control group (p

Background Healthcare-associated infections (HAIs) challenge modern medicine. Considering their high prevalence in Iran, we aimed to provide knowledge on the subject, and to teach about the importance of infection prevention and control (IPC) to a broad audience of pre-graduate healthcare professionals, focusing on education as the cornerstone of IPC. Main body We invited Iranian medical students to present ideas on “how to reduce HAIs.” Projects were eligible if being original and addressing the call. Accepted projects were quality assessed using a scoring system. Forty-nine projects were submitted, of which 37 met the inclusion criteria. They had a mean score of 69.4 ± 18.3 out of the maximum possible score of 115. Four reviewers assessed the 37 projects for clinical applicability, impact on patient safety, and innovation, and selected the best 12 to compete at the 2nd International Congress on Prevention Strategies for Healthcare-associated Infections, Mashhad, Iran, 2018. The competition took place in three rounds. The selected teams presented their projects in the first round and debated one by one in a knockout manner, while the jury reviewed their scientific content and presentation skills. In the second round, the top 5 projects competed for reaching the final stage, in which the teams presented their ideas in front of a panel of international IPC experts to determine the first three ranks. At the end of the contest, the participants gained valuable criticisms on how to improve their ideas. Moreover, by its motivating atmosphere, the contest created an excellent opportunity to promote IPC in medical schools. Conclusions Using innovation contests in pre-graduates is an innovative education strategy. It sensitizes medical students to the challenges of IPC and antimicrobial resistance and drives them to think about solutions. By presenting and defending their innovations, they deepen their understanding on the topic and generate knowledge transfer in both ways, from students to teachers and vice versa.

Combat or burn injuries are associated with a series of risks, such as microbial infection, an elevated level of inflammatory response, and pathologic scar tissue formation, which significantly postpone wound healing and also lead to impaired repair. Skin engineering for wound healing requires a biomimetic dressing substrate with ideal hydrophilicity, holding antioxidant and antimicrobial properties. In addition, available bioactive specification is required to reduce scar formation, stimulate angiogenesis, and improve wound repair. In this study, we successfully fabricated chitosan (Ch)-based hydrogel enriched with isolated exosome (EXO) from easy-accessible stem cells, which could promote fibroblast cell migration and proliferation in vitro. Full-thickness excisional wound model was used to investigate the in vivo dermal substitution ability of the fabricated hydrogel composed Ch and EXO substrates. Our finding confirmed that the wounds covered with Ch scaffold containing isolated EXO have nearly 83.6% wound closure ability with a high degree of re-epithelialization, whereas sterile gauze showed 51.5% of reduction in wound size. In summary, obtained results imply that Ch-glycerol-EXO hydrogel construct can be utilized at the full-thickness skin wound substitution and skin tissue engineering.

Because of their great scientific and technological potentials, iron oxide nanoparticles (IONPs) have been the focus of extensive investigations in biomedicine over the past decade. Additionally, the surface plasmon resonance effect of gold nanoparticles (AuNPs) makes them a good candidate for photothermal therapy applications. The unique properties of both IONPs (magnetic) and AuNPs (surface plasmon resonance) may lead to the development of a multi-modal nanoplatform to be used as a magnetic resonance imaging (MRI) contrast agent and as a nanoheater for photothermal therapy. Herein, core–shell gold-coated IONPs (Au@IONPs) were synthesized and investigated as an MRI contrast agent and as a light-responsive agent for cancer photothermal therapy. The synthesized Au@IONPs were characterized by UV–visible spectroscopy, transmission electron microscopy (TEM), dynamic light scattering (DLS), and zeta potential analysis. The transverse relaxivity (r 2) of the Au@IONPs was measured using a 3-T clinical MRI scanner. Through a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, the cytotoxicity of the Au@IONs was examined on a KB cell line, derived from the epidermal carcinoma of a human mouth. Moreover, the photothermal effects of Au@IONPs in the presence of a laser beam (λ = 808 nm; 6.3 W/cm2; 5 min) were studied. The results show that the Au@IONPs are spherical with a hydrodynamic size of 33 nm. A transverse relaxivity of 95 mM−1 S−1 was measured for the synthesized Au@IONPs. It is evident from the MTT results that no significant cytotoxicity in KB cells occurs with Au@IONPs. Additionally, no significant cell damage induced by the laser is observed. Following the photothermal treatment using Au@IONPs, approximately 70% cell death is achieved. It is found that cell lethality depended strongly on incubation period and the Au@IONP concentration. The data highlight the potential of Au@IONPs as a dual-function MRI contrast agent and photosensitizer for cancer photothermal therapy.

Objectives: The outcomes of Gamma Knife radiosurgery (GKRS) for cavernous sinus meningioma (CSM) are presented, and factors possibly affecting outcome are investigated. Methods: The medical records and imaging and procedural reports of 166 patients with CSM were retrospectively reviewed. Demographic data, procedural data, symptomatic improvement, radiological regression, and progression-free survival (PFS) rates were evaluated. Results: There were 124 women and 42 men; including 44 postoperative and 122 primary GKRS cases. Mean follow-up was 32.4 months. Mean marginal dose was 13 Gy. Symptomatic improvement was seen in 40.4%, while neurologic deterioration occurred in 9.6%; 50% remained symptomatically stable. Radiological regression was noted in 57.2%; the tumor remained stable in 35.5%, and 7.2% of the patients experienced tumor progression. The actuarial 5- and 10-year PFS rates were 90.1% (±3.3) and 75.8% (±8.8), respectively. History of previous surgery or radiotherapy were associated with lower symptomatic improvement. Higher tumor coverage and isodose lines were accompanied with better radiological prognosis. However, a history of conventional radiotherapy, presence of facial sensory deficits at presentation, a higher tumor volume, and tumor extension to the suprasellar compartment affected the radiologic outcome negatively. Conclusion: This study revealed a high efficacy and safety for GKRS in both postoperative and primary GKRS patients. Achievability of a good profile of tumor coverage and isodose lines at radiosurgical planning predict a better outcome.

Background: Papillary thyroid carcinoma (PTC) is considered the most frequent thyroid malignancy (85-90%) with a good prognosis. However, its frequent recurrence increases mortality and morbidity. In this inquiry we investigated the prevalence of risk factors of PTC recurrence and disease free survival after thyroidectomy and central neck dissection. Method: In this retrospective study, all patients with confirmed PTC who underwent total thyroidectomy and central neck dissection in Imam Reza and Omid hospitals of Mashhad University of Medical Sciences from 2004 to 2011 were included. Total locoregional and distant recurrence rate, 5-year disease free survival rate (DFS) and contributing factors of recurrence were investigated after at least 5 years. Results: In this study 289 patients were included with a mean follow-up of 72.90 ± 11.02 months. 70.6% were female and 29.4% were male. Recurrence occurred in 58 cases from which 10 were distant and 48 were loco-regional. 5-year DFS was 80% and total-survival-rate was 99%. Our analysis showed that primary tumor size, vascular-invasion, extra-thyroid extension, and lymph node ratio (LNR) were significantly related to DFS.

Objective The aims of this study were to characterize the epidemiologic, histologic, and radiologic aspects of sphenopetroclival meningiomas (SpPCMs) and to evaluate the outcome of Gamma Knife radiosurgery (GKRS) either as an adjunct to microsurgery or as a primary SpPCM treatment modality. Methods In this retrospective study, medical records of patients with SpPCM who underwent GKRS at the Iran Gamma Knife Center between April 2003 and March 2012 were analyzed. Results We assessed 122 patients with SpPCMs, including 101 women and 21 men, aged 24–94 years. The mean tumor volume was 12.24 ± 9.30 mL. Patients received 22.32 ± 3.29 Gy and 13.18 ± 1.02 Gy maximal and average marginal dose of GKRS, respectively. The most common complaint was visual impairment, followed by facial sensory impairment and headache. The most frequently involved cranial nerves were III, IV, and VI in 72.1% of patients, followed by II in 52.9%, and V in 35.5%. After radiosurgery, headaches improved in 90.0%, diplopia in 75.0%, and ptosis in 63.0% of patients. On magnetic resonance imaging, tumor size was reduced, unchanged, or increased in 77, 44, and 1 patient, respectively. Progression-free survival at the 5-year follow-up was 56.6%. Younger age (hazard ratio = 0.972, P = 0.011) and lower tumor volume (hazard ratio = 0.959, P = 0.009) were the main prognostic factors for progression-free survival. Conclusion GKRS can be an effective alternative treatment for controlling the progression of SpPCM tumors, producing appropriate clinical outcomes and few complications.

Objective Meningiomas comprise 6–15 % of cerebellopontine angle (CPA) tumors. Surgical treatment is a real challenge because this area is occupied by several critical neurovascular elements. Currently, surgery is the first choice of treatment, however several factors may be present that necessitate choosing the alternative treatments such as Gamma Knife Stereotactic Radiosurgery (GKS). Patients and Methods Ninety-three patients with CPA meningioma who were treated by GKS for a period of 8 years, were retrospectively reviewed. Factors affecting clinical and radiological improvement were analyzed. Results The median tumor volume was 6 cm3. The mean values for maximal and marginal dose were 20.2 and 13.6 Gy, respectively. The mean follow-up time was 31.5 months. Tumor control (lack of progression) was achieved in 96.8% of the patients and 55.9% of the patients showed tumor regression on follow-up MRI. The actuarial 3-year progression-free survival (PFS) rate was 96%. Clinical improvement was seen in 49.5% of the patients while 11.8% experienced worsening or new-onset symptoms. Adverse radiation effects were seen in 4.3% of the patients. A worse symptomatic outcome, male sex, a lower tumor coverage, and marginal doses Conclusion Gamma Knife radiosurgery, either primarily or post- operatively, offers a decent long-term tumor control in CPA meningioma, and is associated with an acceptable complication profile, especially in tumors with lower volumes.

Introduction: Processing odor information by the olfactory system depends greatly on the odor concentration. In order to use an odorant in a smell identification test (SIT), the minimum identification concentration (MIC) needs to be determined. Materials and Methods: This study was conducted in 60 healthy native individuals aged 20 to 60 years, selected from patients’ companions in a tertiary hospital. In the first step, 25 odorants were presented to evaluate familiarity among the subjects. Then, the MICs for the eligible odorants were measured using the ascending method of limits. Results: Out of 25 odorants, only one (cacao) was distinguished by less than 70% of the subjects, and was therefore removed from the list. The MICs of the remaining 24 odorants ranged from 6.87±2.74% for menthol to 27.62±18.98% for cantaloupe. There was significant correlation between age and the MIC only for coffee (P=0.02, r=−0.300). There was a significant difference in MIC between men and women only for hazelnut (P=0.03). Conclusion: We present the MICs of 24 culturally-familiar odorants in a sample of the Persian population in a SIT.

Background Neonatal diabetes mellitus with hyperglycemia during the first 6 months of life is a rare disorder that can occur in all races and societies. Case presentation In this study, we introduced an Iranian (Persian) 65-day-old patient with neonatal diabetes mellitus with novel homozygous mutation in the pancreatic and duodenal homeobox 1, PDX1, gene, which is also known as IPF1 gene, located in exon 2. This case was a newborn boy born in Vali-Asr Hospital, Tehran; he was diagnosed as having hyperglycemia on 28th day. Genetic analysis detected a homozygous mutation on PDX1 gene on chromosome 13. It is a novel homozygous mutation in the PDX1 gene (NM_000209.3), p.Phe167Val. This mutation was confirmed by Sanger sequencing. There was no evidence of agenesis of the pancreas. Conclusions We reported a case of neonatal diabetes mellitus due to novel homozygous mutation in the PDX1 gene without exocrine pancreas manifestations. Electronic supplementary material The online version of this article (10.1186/s13256-019-2149-x) contains supplementary material, which is available to authorized users.

To evaluate the impact of nasoseptal flap (NSF) elevation on sinonasal quality of life (QOL) in patients with pituitary adenomas who underwent endoscopic endonasal trans-sphenoidal approach (EETSA), the data of 106 eligible patients were included from February 2011 to December 2014. The scores of Sinonasal Outcome Test (SNOT-22) Questionnaire were assessed in case (that received reconstruction with NSF) and control groups preoperatively as well as 1, 3, 6, and more than 12 months postoperatively. Nine most related sinonasal questions were evaluated separately (9Q). There were no significant inter-group differences in the mean SNOT-22, 9Q, and sense of taste/smell scores in preoperative and all postoperative assessments. Within each group, a significant improvement of SNOT-22 and 9Q scores were noted after 12 months of surgery compared to preoperative data. In the NSF group, comparison of the pre- and first postoperative evaluation revealed a significant deterioration in 9Q score (p = 0.007) and "sense of taste/smell" (p < 0.001) which both returned to baseline in the 3rd month. Patients who used nasal paper mask for more than 100 "hour-days" showed a better SNOT-22 scores at 1st (p = 0.04) and 3rd (p < 0.001) months after surgery. Patients with adrenocorticotropic hormone (ACTH) secretory adenomas showed significantly higher scores of SNOT-22 in all postoperative assessments compared to the others. Although nasal symptoms deteriorated at first postoperative month (compare to preoperative data) in the NSF group, no negative impacts on the sinonasal QOL was showed comparing to the control group. ACTH-secreting adenomas could be assumed as a risk factor for poorer sinonasal QOL in EETSA.

Introduction: The Questionnaire for Olfactory Dysfunction (QOD) is a self-reporting olfactory-related quality of life questionnaire. The aim of this study was to determine the reliability and validity of the Persian version of this questionnaire. Materials and Methods: One hundred and thirteen patients with olfactory problems were enrolled in this study. The English version of the QOD was first translated into Persian. The reliability was then tested by determining the Cronbach alpha coefficient to assess internal consistency. The QOD was reviewed by a panel of experts, followed by calculating the content validity index to determine the content validity. Results: Based on the reliability analysis, the total Cronbach alpha was 0.88. The items in the “life quality” and “parosmia” domains had a good internal consistency in total, as well as in both genders and in different age subgroups. For the “sincerity” domain, however, low internal consistency was revealed (Cronbach alpha = 0.25). When questions related to the sincerity domain were omitted, the Cronbach alpha reached 0.89. The overall scale validity index for clarity and relevance were 0.88 and 0.87, respectively. Conclusion: The Persian version of the QOD seems to be a reliable and valid tool for the assessment of quality of life in patients with olfactory dysfunction. The “sincerity” domain cannot be used separately or should be substantially modified in order to be applicable to the Iranian population. However, there is no need to change the whole format of the questionnaire.

Introduction: Vitamin D has been suggested to play a considerable role in the function of the immune system in various infectious, inflammatory, and autoimmune conditions. Otitis media with effusion (OME), defined as the presence of non-purulent fluid within the middle ear without signs or symptoms of suppurative otitis media, has a number of inflammatory predisposing factors. This study was designed to explore the association between vitamin D deficiency and OME. Materials and Methods: In this cross-sectional study, 74 children aged 2–7 years with an obstructive indication for adenotonsillectomy were included. Patients were divided into two groups based on the need for ventilation tube insertion for OME. Thirty-two children were enrolled in the OME group and 42 in the control group. The mean vitamin D level was compared between the two groups. Results: Mean vitamin D concentration in all patients was 11.96±5.85 ng/ml (9.79±4.36 ng/ml in the OME group and 13.61±6.33 ng/ml in the control group; P=0.003). There was also a significant difference in levels of vitamin D in patients referred in winter (9.0±2.94 ng/ml) compared with the summer (19.85±4.21 ng/ml; P=0.001). Data analyzed based on the season in which the patients were referred showed no significant difference between the OME and the control group. Conclusion: Although our results showed lower serum levels of vitamin D in OME patients, the difference was not significant when seasons were taken into consideration. Therefore, the season is an important confounding factor in any research related to vitamin D due to the effect of sun-induced vitamin D.

Colon cancer is one of the most common and most prevalent Neoplasma in men; adenocarcinomas make up 95 percent of all colon cancer cases. Due to the side effects of conventional treatment methods such as chemotherapy, today, attentions have been attracted to natural compounds that have less side effects and anticancer properties. This study aims to investigate the effect of Verbascoside as a natural compound in inhibiting HT-29 signaling pathway which is an effective route in the metastasis, angiogenesis and cell migration in the human cell line of HT-29 colon cancer; and also investigates the possibility of enhancing and raising the effect of this herbal drug by cold atmospheric pressure plasma jet. A the first step, HT-29 cells were treated at different concentrations of verbascoside 10, 20, 30, 40, 50, 70, 100 μg / ml for 24 hours, then MTT test was used to calculate the inhibitory concentration. The colon cancer cell migration was evaluated by scratch test and HIF-1α gene expression was evaluated by Real Time PCR. The results of the MTT assay showed that verboscoside dose-dependent inhibition of cancer cells. The HT-29 colon is at a concentration of 50 μg / ml. Scratch repair tests showed that verboscoside reduced the migration of cells in a dose-dependent manner, and the results of Real Time PCR showed a decrease in the expression of HIF-1α gene expression. Cancer tumors undergo some changes in oxygen deficiency conditions, including increasing the expression of the HIF-1α gene, which in turn play an important role in activating and enhancing the expression of genes involved in metastasis, angiogenesis and migration. At the second step of this study, verboscoside was primarily treated by cold atmospheric plasma jet then the same procedure has been taken for plasma activated verboscoside. In this study helium jet has been used. The findings of this study showed that verboscosid with inhibitory expression of HIF-1α has a significant anti-metastatic, cellular angiogenesis and migration effect and may be a good option for reducing metastasis and angiogenesis in colon cancer models; it has been also showed that plasma activated verboscosid is more efficacious in all of the above mentioned features.

Colon cancer is one of the most common and most prevalent Neoplasma in men; adenocarcinomas make up 95 percent of all colon cancer cases. Due to the side effects of conventional treatment methods such as chemotherapy, today, attentions have been attracted to natural compounds that have less side effects and anticancer properties. In attempting to investigate factors which may account for cancer treatment, this study raises two interrelated questions. Firstly, what is the effect of Verbascoside as a natural compound in inhibiting HIF-1α signaling pathway which is an effective route in the metastasis, angiogenesis and cell migration in the human cell line of HT-29 colon cancer; second, is it possible to enhance and raise the effect of this herbal drug by cold atmospheric pressure plasma jet? The focus of this study will be investigating the effect of Verbascoside as a natural compound in inhibiting HIF-1α signaling pathway and also examining the effect of atmospheric pressure plasma on the function of Verbascoside. A the first step, 29-HT cells were treated at different concentrations of verbascoside 10, 20, 30, 40, 50, 70, 100 μg / ml for 24 hours, then MTT test was used to calculate the inhibitory concentration. The colon cancer cell migration was evaluated by scratch test and HIF-1α gene expression was evaluated by Real Time PCR. The results of the MTT assay showed that verboscoside dose-dependent inhibition of cancer cells. The HT-29 colon is at a concentration of 50 μg/ml. Scratch repair tests showed that verboscoside reduced the migration of cells in a dose-dependent manner, and the results of Real Time PCR showed a decrease in the expression of HIF-1α gene expression. Cancer tumors undergo some changes in oxygen deficiency conditions, including increasing the expression of the HIF-1α gene, which in turn play an important role in activating and enhancing the expression of genes involved in metastasis, angiogenesis and migration. At the second step of this study, verboscoside was primarily treated by cold atmospheric plasma jet then the same procedure has been taken for plasma activated verboscoside. In this study helium jet has been used.

Dear Editor, The current scientific literature states that Intralipid 10% emulsion has a higher ratio of phospholipids to triglycerides, and contains more lypozomal phospholipids as compared to Intralipid 20% and Intralipid 30%, so it causes higher plasma concentrations of triglycerides, cholesterol and phospholipids (1, 2). It should be noted that serum triglycerides concentration is used as a marker for lipid tolerance and predicting the probability of complications involved with the administration of Intralipid 10%. In view of the fact that Intralipid 10% emulsion is the only currently available Intralipid in Iran, and also used for years, is known to have no significant side effects, we conducted a before and after descriptive, observational study on 20 newborns (10 females and 10 males) hospitalized in NICU of Valiasr hospital, Tehran University of Medical Sciences, that required total intravenous nutrition, and evaluated the effects of Intralipid 10% on neonates’ total plasma triglycerides before TPN and once the dose of Intralipid reached 2.5 g/kg/day. In the first step total plasma triglycerides level was measured. Then continuous daily infusion of Intralipid 10% with 0.5 g/kg/day dose was started increasing daily 0.5 g/kg until enteral nutrition was able to provide approximately 100 to 110 kcal for kg body weight. The outcome was total plasma triglycerides levels higher than 200 mg/dL in newborns receiving intravenous Intralipid 10% nutrition. Heparin was administered routinely with parenteral nutrition; heparin can theoretically release lipase lipoprotein from endothelial cells that may accelerate clearance of lipids from plasma. Total plasma triglycerides was monitored weekly when the Intralipid 10% dosage reached 2.5 g/kg/day and was continued to the end of TPN therapy, or until it reached the maximum level of 150-200 mg/dL, defined in scientific references as the indication for termination of intravenous Intralipid administration. There were no significant differences observed between total plasma triglycerides level before intravenous feeding (62.95 ± 10.46 mg/dL) and after Intralipid terminating dose of 2.5 gr/kg/day (63.15 ± 12.98 mg/dL) (P = 0.9). Also no correlation was observed between birth weight, duration of intravenous feeding and plasma triglycerides level difference (P > 0.005). Viewing the results of this study which has been referred to in detail, we intend to indicate that no significant difference between total plasma triglyceride levels before intravenous feeding and total plasma triglyceride levels after Intralipid 10% dosage has reached 2.5 g/kg/day, was seen (P = 0.9). This study in accordance with previously published studies (3-6) showed that Intralipid 10% is well tolerated by patients and levels of plasma triglycerides did not increase, VLDL and HDL remained in normal range and no significant complication was observed. The last noteworthy point is that the length of infusion can also be an important parameter in modulating possible listed side effects of Intralipid 10% mentioned in other sources. In conclusion, this study showed that in the absence of Intralipid 20% or 30%, the use of Intralipid 10% has not led to high levels of triglycerides in our neonates.

Background: Respiratory failure is a major problem in neonatal medicine in all over the world and has different causes. Using mechanical ventilation is one of its major treatments. Objectives: Different strategies have been expressed in this context, including high frequency mechanical ventilation. Patients and Methods: This study is a prospective randomized clinical trial conducted on all newborns with respiratory failure hospitalized in the NICU of Tehran vali-asr Hospital during 2009.These patients were divided in to two groups through block Randomization method; conventional mechanical ventilation group and high frequency ventilation group. Results: Intraventricular hemorrhage (IVH) and air leak (e.g. pneumothorax) were less in HFPPV group than conventional group (P = 0.012 and P = 0.038). The mean time needed for mechanical ventilation was lower in HFPPV group, but this difference was not statistically significant (P = 0.922). Needing to O2 in 28 days of age was almost equal in both groups (P = 0. 99). Mortality, and refractory hypoxia and PVL were lower in HFPPV group, but the difference was not statistically significant (P = 0.301, P = 0. 508, P = 0. 113). Conclusions: Treatment of neonatal respiratory failure with high rate mechanical ventilation may reduce some complications.

Background: Nose is used as a corridor in endoscopic endonasal transsphenoidal approach (EETSA) for pituitary adenoma. Thus, it may affect the nasal airway patency, function and sinonasal-related quality of life. The aim of this study is to objectively and subjectively evaluate these effects. Methods: In this prospective study, 43 patients with pituitary adenoma who were candidates for EETSA from March 2012 to October 2013 were enrolled. The patients were evaluated preoperatively using acoustic rhinometry and rhinomanometry (with/without the use of decongestant drops) and asked to complete the 22-Item Sinonasal Outcome Test (SNOT-22) questionnaire. The tests were repeated at one and three months postoperatively. The preoperative data were compared with the first and second postoperative ones using paired-sample t-test. Results: Without the use of decongestant drops, the total airway resistance increased significantly (p=0.016), and the nasal airflow decreased significantly (p=0.031) in the first postoperative evaluation. However, in the 3rd postoperative month, the difference was not significant. With the use of decongestant drops, the objective parameters showed no significant changes compared to preoperative data even at the first evaluation. The SNOT- 22 scores also did not differ significantly in 1st and 3rd postoperative months. The first postoperative SNOT-22 showed a strong correlation with the second minimal cross-sectional area on simultaneous evaluation, and with the preoperative total airway resistance. Conclusion: EETSA has a transient adverse effect on the nasal patency that quickly improves, making it a safe approach for the sinonasal system. Rhinomanometry is the most sensitive test for detecting these nasal functional changes objectively.