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Background and purpose: Renal ischemia/reperfusion (IR) injury is a pathologic phenomenon that caused to increase risk of mortality. The main objective of this study was to investigate the effect of sodium hydrogen sulfide (NaHS) on renal IR injury in male and female rats. Experimental approach: Fifty-eight male and female rats were randomized into 4 groups of control, sham, IR, and IR + NaHS. The IR was performed by 45 min of ischemia by vessel clamping followed by 24 h reperfusion. The NaHS (100 µmol/kg) treatment was applied 10 min prior to IR. Finally, after 24 h of reperfusion, the measurements were performed. Findings/Results: The serum levels of blood urea nitrogen, creatinine, tissue level of malondialdehyde, and kidney tissue damage score (KTDS) were increased by IR. Urine volume, creatinine, and urea clearances decreased by IR. NaHS administration improved some parameters in males but exacerbated KTDS and serum markers related to renal function. Conclusions and implications: Our data demonstrated that NaHS didn’t protect female rats against renal IR injury. In males, it has null effects or just a few protective effects via antioxidant activity.

Schwannoma is a rare tumor in the colon which originates from the peripheral nerve plexus. Most of the cases have been asymptomatic but occasionally present as an obstructive mass. Abdominal investigations are effective in some cases, but usually, they are not informative. A significant number of cases have been detected after their operation by histopathology examination. Immune and histochemical staining shows the spindle cells that have been positive for S-100 and vimentin, but negative for CD34 and smooth muscle actin. If the diagnosis of Schowannoma is confirmed preoperatively, segmental resection is recommended. In this case report, we presented a 58-year-old woman with pelvic mass and normal colonoscopy that mimic extramural large uterine myoma with extraluminal pressure effect on the rectosigmoid.

Background: The growing supply and prevalence of waterpipe (WP) smoking among Iranian adolescents have become a concern for both families and policymakers. The aim of this study was to determine the factors underlying WP use and also to design an intervention program based on social cognitive theory (SCT) aimed to reduce the demand for WP smoking among male adolescents. Methods: This quasi-experimental study involved 189 high-school students in Kerman, Iran, who were split into two groups, an intervention group and a control group. A validated questionnaire based on SCT constructs was used to collect data. The intervention was performed over four sessions with a focus on preventing WP smoking. Results: Before intervention, the lifetime and current-use prevalence of WP smoking across both groups was 48.5% and 20.2%, respectively. In the intervention group, the most change was related to knowledge score from 10.70 ± 4.38 to 16.52 ± 3.89 (P < 0.0001) and outcome values score from 12.40 ± 3.81 to 13.53 ± 4.23 (P = 0.007); however, in the control group, no significant changes were seen in posttest scores. The scores for self-efficacy (P = 0.21), outcome expectations (P = 0.09), and environment constructs (P = 0.06) did not show any statistically significant changes after the intervention in both groups. Overall, there was no significant difference in the rate of WP smoking after the intervention. Conclusions: Based on the results of this study, although some construct scores showed significant differences after the intervention, there was no significant change in the prevalence of WP smoking. More effective educational interventions based on this theory but with a greater focus on self-efficacy and environmental influences may be warranted.

Background: Noninvasive respiratory support techniques are widely used to treat respiratory distress syndrome (RDS) in preterm infants, and the effectiveness of these methods should be compared. In the current study, nasal continuous positive airway pressure (NCPAP), nasal intermittent mandatory ventilation (NIMV), and heated humidified high-flow nasal cannula (HHHFNC) were compared. Materials and Methods: In the current bicenter clinical trial, 109 preterm infants with RDS not treated with surfactant were randomly assigned to three groups: NCPAP, NIMV, and HHHFNC. The initial outcomes including the failure of treatment within the first initial 72 h, and the duration of RDS treatment, and the secondary outcomes including the need for intubation, the need for surfactants, the duration of oxygen dependency, the incidence of pneumothorax, the patent ductus arteriosus, intraventricular hemorrhage, length of stay, and mortality were compared among the groups. Results: The frequency of HHHFNC treatment failure (54.3%) was significantly higher compared with those of NIMV (21.6%) (P < 0.001, hazard ratio [HR] = 9.12, 95% confidence interval [CI] = 2.59 – 32.07) and NCPAP (35.1%) (P = 0.004, HR = 21.25, 95% CI = 2.51–180.08). The median duration of RDS treatment was longer (40 h) in the HHHFNC group, although it was not significantly different from those of NIMV (31.16 h) and NCPAP (38.91 h). Conclusion: Based on the high prevalence of failure of HHHFNC treatment than the other two methods (NCPAP and NIMV), HHHFNC is not recommended as the initial treatment of RDS.

Background: Human milk (HM) is the main food for infants, and phospholipids, especially long chain polyunsaturated fatty acids (LCPUFAs), play an essential role in the growth and brain development. This study was designed to evaluate the fatty acid composition in HM of mothers with preterm and full-term newborns and to determine the relationships of dietary intake of docosahexaenoic acid (DHA) and arachidonic acid (AA) of mothers and the content of these fatty acids in their milks. Materials and Methods: The AA and DHA of HM were determined by gas chromatography at the 3 rd day after birth from mothers of 59 term and 58 preterm infants. Mothers were selected from those who delivered in Shahid Beheshti Hospital, a referral teaching hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran. Dietary fat composition of mothers was examined by a food-frequency questionnaire. Total fat content, and DHA and AA levels of HM were compared in both groups. The correlation of dietary DHA and AA with DHA and AA of HM was determined in both groups. Results: We found that maternal age, body mass index (BMI), and self-reported food-frequency questionnaire did not differ in the two groups. The mean AA (0.19 ± 0.10 mg/ml and 0.16 ± 0.09 mg/ml, respectively), DHA (0.10 ± 0.06 mg/ml and 0.08 ± 0.05 mg/ml, respectively), and total fat content (2.58 ± 2.16 g/dl and 2.06 ± 1.22 g/dl, respectively) of HM of mothers with preterm neonates were non-significantly higher than in mothers with term neonates. The percentage of DHA in the HM fat of preterm and term groups (0.45 ± 0.16% and 0.45 ± 0.18%, respectively) and the percentage of AA (0.85 ± 0.26% and 0.84 ± 0.20%, respectively) were comparable with worldwide standards. No correlations were documented between DHA and AA intake and DHA and AA content of HM in both groups. Conclusion: Although DHA and AA content of HM in preterm group was higher than in term group, this difference were not significant. In Isfahan, the percentage of DHA and AA was acceptable in the milk fat of mothers with term and preterm neonates.

Purpose: To compare two different doses of propofol for laryngeal mask airway (LMA) insertion in children undergoing out-patient surgeries. Background: Insertion of LMA just after anesthesia induction is facilitated using propofol. However, the optimal dose of this drug not determined yet as heavy doses may lead to severe complications, whereas lower doses may not be quite as effective. Methods: In a double-blind randomized clinical trial, 120 children undergoing out-patient surgeries were recruited to receive intravenous propofol at a dose of either 2.5 mg/kg (group 1) or 3.5 mg/kg (group 2) for induction. Intravenous midazolam (0.03 mg/kg) and fentanyl (1 μg/kg) were used as pre-medication in all patients and anesthesia induction was initiated using lidocaine (1 mg/kg) prior to propofol administration. Hemodynamic changes, probable complications, quality of the established airway and number of attempts for LMA insertion were compared between two groups. Results: There were no differences in systolic and diastolic blood pressure, heart rate, peripheral oxygen saturation and intraoperative complications between the groups (P>0.05). LMA insertion was successful at the first attempt in 55 (93.2%) and 54 (91.5%) cases in group 1 and group 2, respectively (P>0.05). The efficiency of the established airways was adequate in all the patients of both groups. Conclusion: It seems that propofol doses of 2.5 and 3.5 mg/kg are equally effective for LMA insertion following intravenous midazolam, fentanyl, and lidocaine.

Introduction: The aim of our study was to determine the content of fat and fatty acid composition of breast milk , and its association with the mother′s diet. Materials and Methods: This cross-sectional study was conducted among pregnant mothers who came to health care centers for last prenatal care in Isfahan, Iran. Eight to 72 hours after delivery, 2 to 5 ml of colostrum was collected by hand into tubes. They were kept in an ice box and sent within half an hour to the collaborating health centre for freezing at -20°C until analysis, which was performed at the laboratory of NNFTRI in Tehran. The milk samples were homogenized by Vortex (Heidolph Vortex Shaker REAX 1. 220 V. 30 W Germany) at 2400 rpm for 30 sec. Results: The data of 86 out of 91 samples were complete. The mean maternal age and gestational age was 28.37 ± 5.55 years old and 38.7 ± 1.2 weeks, respectively. The content of fat was 2.17 ± 1.22 g/100 ml breast milk. Arachidonic acid (AA, 20:4n-6) and docosohexaanoic acid DHA (22:6n-3) made 0.8 ± 0.4% and 0.3 ± 0.2% of total fatty acids. Although the AA/DHA ratio in our study is suitable, but the content of DHA is nearly low. Conclusion: Dietary habits of women in reproductive age group should be improved, with special emphasis on the fatty acid content of breast milk. This may have long-term impact on health promotion and disease prevention.

To determine the incidence and risk factors of nephrocalcinosis in preterm infants, we studied in a prospectively 64 preterm infants of birth weight :5 1500 g from February 2006 to November 2007. Data were collected on gestation, birth weight, gender and family history of renal calculi, respiratory support, and use of nephrotoxic drugs. The parameters of mineral meta-bolism were assessed in blood and spot urine samples at the end of 2 nd and 4 th weeks of age. Forty-nine babies completed the study, and nephrocalcinosis was observed in 13 (26.5%) babies and was bilateral in 7 (14.3%) infants. The mean age of diagnosis of nephrocalcinosis was 52.58 days (range 30-123 days). Gestational age, birth weight, and sex were not significantly associated with increased risk of nephrocalcinosis. The mean duration of ventilation was significantly less in babies with than without nephrocalcinosis (P= 0.020), and the mean levels of urine calcium and phosphate at 4 weeks of age, respectively (P= 0.013, P= 0.048). There were also significant diffe-rences in urine calcium/creatinine ratio (P= 0.001), mean plasma levels of calcium at 2 weeks of age (P= 0.047) and plasma levels of phosphate at 4 weeks of age (P= 0.016) between babies with and without nephrocalcinosis. Using logistic regression analysis, family history of renal stone (P= 0.002) and urine calcium/creatinine ratio (P= 0.011) were significant predictors of nephrocalci-nosis. However, there were no significant differences in the length of stay in the intensive care unit, duration of total parenteral nutrition, and duration and cumulative doses of nephrotoxic drugs between these two groups. We conclude that the incidence of nephrocalcinosis was similar in our population to the previous studies. Family history of renal stone and urine calcium/ creatinine ratio are the major risk factors of nephrocalcinosis in very low birth weight neonates.

Background: Adequate hydration and good urine output improve the efficacy of phototherapy. The aim of this study was to evaluate the effect of intravenous fluid supplementation on decrease of serum bilirubin levels in jaundiced healthy term infants during conventional phototherapy. Methods: Sixty healthy breast-fed neonates with non-hemolytic hyperbilirubinemia were assigned randomly to receive either breast milk exclusively (non-supplemented group; n=30) or intravenous fluid in addition to breast milk (supplemented group; n=30) during conventional phototherapy. Results: The mean total serum bilirubin (TSB) levels at the time of enrollment and within 84 hours after phototherapy were not statistically different between two groups. Similarly, the mean rate of decrease in TSB levels during the first 12 h of phototherapy were 0.13±0.06 and 0.10 ± 0.1 mg/dL/h in supplemented and non supplemented groups , respectively (P=0.13). Duration of phototherapy required in supplemented and non-supplemented groups was 58 ± 13.02 and 63.20 ± 13.71 hours, respectively (P=0.13). Conclusion: These data show that administration of extra intravenous fluid in jaundiced healthy, term, breastfed neonates have no beneficial effect on the rate of serum bilirubin reduction during conventional phototherapy. Keywords: Hyperbilirubinemia, Phototherapy, Neonates, Fluid Supplementation, Dehydration.

Background: Haemophilus influenza (HI) is the most commonly found pathogenic bacteria in pediatric otitis media and lower respiratory tract infections. Bacterial attachment to pharyngeal cells and proliferation may be necessary for infection. In the presence of human milk, attachment of HI to pharyngeal cells and colonization may be inhibited. To evaluate the protecting role of breast milk, we investigated the incidence of HI isolated from the throat of healthy infants with different feeding methods. Methods: Between August 2002 and March 2003, 210 healthy infants (70 purely breast-fed, 70 purely formula-fed, 70 mixed-fed), aged 1-6 months were enrolled into the study and a throat culture was taken in all of them. The incidence of HI was evaluated using Haemophilus Test Agar Bose (HTAB) plates. Results: The incidence of HI in purely breast-fed, mixed-fed and purely formula-fed infants was 2.9%, 42.9% and 75.7% respectively (P = 0.000). The mean age and weight of cases in the three groups were not statistically different. Conclusion: These data suggest that human milk protects the throat of healthy infants from HI colonization especially in purely breast-fed cases. Keywords: Breast milk, Haemophilus influenza, Throat culture

Background: Nigella sativa has been a nutritional flavoring factor and natural treatment for many ailments for so many years in medical science. Earlier studies have been reported that thymoquinone (TQ), an active compound of its seed, contains anticancer properties. Previous studies have shown that TQ induces apoptosis in breast cancer cells but it is unclear the role of P53 in the apoptotic pathway. Hereby, this study reports the potency of TQ on expression of tumor suppressor gene P53 and apoptosis induction in breast cancer cell line Michigan Cancer Foundation-7 (MCF-7). Methods: MCF-7 cell line was cultured and treated with TQ, and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was carried out for evaluating the half-maximal inhibitory concentration (IC50) values after 24 h of treatment. The percentage of apoptotic cells was measured by flow cytometry. Real-time polymerase chain reaction (PCR) was performed to estimate the messenger RNA expression of P53 in MCF-7 cell line at different times. Results: The IC50 value for the TQ in MCF-7 cells was 25 mM that determined using MTT assay. The flow cytometry and real-time PCR results showed that TQ could induce apoptosis in MCF-7 cells, and the P53 gene expression was dramatically up-regulated by ascending time, respectively. Hence, there was significant difference in 48 and 72 h. Conclusions: Our results demonstrated that TQ could induce apoptosis in MCF-7 cells through up-regulation of P53 expression in breast cancer cell line (MCF-7) by time-dependent manner.

Background: The objective of this study was an investigation of the association between depression and sleep quality. Materials and Methods: This cross-sectional study was performed on 360 delivered women that referred to thirty health-care centers in Ardabil, Iran. The Standard Pittsburgh Sleep Quality Index questionnaire was used to the investigation of sleep quality. We used the Edinburgh Postnatal Depression Questionnaire to assess postpartum depression. Logistic regression was used to examine the association of sleep quality with postpartum depression. Results: Chance of depression in women with poor sleep quality was 3.34 times higher than those with good sleep quality (odds ratio = 3.34; 95% confidence interval: 2.04–5.48; P< 0.001). After controlling for some risk factors, an association observed between sleep quality and depression in postpartum women. Conclusion: we found an association between sleep quality in women who had given birth in the last 3 months and symptoms of postpartum depression.

Background: Chromomycin A3 (CMA3) staining is one of the staining methods for detecting protamine deficiency in sperm nucleus. CMA3 is a fluorochrome that competes with protamines for binding to DNA double helix. It has been shown in our previous studies that percentage of CMA3 positive spermatozoa in semen has a close significant relationship with the fertilization rate in in vitro fertilization (IVF). The aim of this study was to examine the ultrastructural differences between sperms in patients who had high fluorescent percentages of yellow or red in CMA3 staining (protamine deficient) with patients with low fluorescent percentages. Materials and Methods: Semen samples are taken from five patients with high fluorescent percentages and five patients with low fluorescent percentages. Then the samples are passed for the different steps of preparing for electron microscopy. After the sectioning and mounting on grids, they are investigated under the transmission electron microscope. Results: Sperms in patients with low percentages of positive spermatozoa often have a normal appearance. Sperms in high fluorescent samples frequently have unpacked chromatin. Furthermore acrosomes of these sperms are thinner or disturbed. Also sometimes there are irregularities in sperm head membrane. Conclusion: Protamine deficiency in sperm nucleus can cause ultrastructural anomalies in sperm chromatin such as unpacking of it. It also is concomitant with acrosome and sperm membrane disturbances.

Background: Sperm DNA in human beings and most vertebrates is packed by protamines into highly compact form of chromatin. There are many staining methods to assess sperm chromatin. Three different methods of staining were used simultaneously in this study and the goal was to determine which of these sperm tests has a relation with fertilization rate in intracytoplasmic sperm injection (ICSI). Materials and Methods: Thirty couples who referred to Yamagata University Hospital (Yamagata, Japan) for ICSI were included in this study. The greater part of semen was prepared for ICSI. The remaining part was used for staining with aniline blue, acridine orange, and chromomycin A3 (CMA3). For evaluation of abnormal morphology and abnormality of head, Papanicolaou-stained smears were used. The analysis of data was done using Spearman coefficient of correlation and logistic regression model. Receiver operator characteristic (ROC) curve was used for discrimination of CMA3 staining power to identify ICSI rates. Results: Percentage of CMA3 positivity, unlike those of aniline blue and acridine orange, showed significant negative correlation with fertilization rate. Moreover, the percentage of CMA3 positivity showed a positive correlation with the percentage of abnormal morphology and abnormality of head. By dividing patients into CMA3 48% groups, the area under the curve was 0.646. Conclusions: CMA3 staining (protamine deficiency) could be considered as a useful tool for evaluation of male fertility prior to infertility treatment.