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Introduction: During the COVID-19 pandemic, the greatest focus was on the respiratory system, but recently awareness has increased about the cardiovascular manifestations of the COVID-19 disease and the adverse effect of cardiovascular involvement on its prognosis. Since so far no comprehensive study has investigated electrocardiogram changes in patients with COVID-19 in Iran, the purpose of this study is to assess electrocardiogram changes in adults aged 20-70 with and without a history of COVID-19. Materials and Methods: The current study was a cohort study conducted on two groups of working people with a history of COVID-19 and controls without a history of COVID-19. The case and control subjects were selected randomly from the participants of the Yazd Health study and the Shahdieh cohort study. ECG was taken from both groups before and after Covid-19 and then QTc interval and ST segment measurements were recorded and interpreted. Results: In the present study, 77 patients including 45 patients with COVID-19 (58.4%) and 32 non-COVID-19 patients (41.6%) were selected. Heart rate/min before and after COVID-19 was 69.08±10.89 and 73.5±14.05, respectively (P0.05). Conclusion: According to the results of the present study, COVID-19 disease is associated with a change in heart rate in the two studies' participants, but no effect was observed on the parameters of QTi, and QTC. Therefore, it seems that echocardiography is not necessary in patients with COVID-19.

Abstract Background Coronavirus disease 2019 (COVID‐19) results in several complications and mortality in intensive care unit (ICU) patients. Limited studies have investigated the effect of enteral nutrition (EN) on the survival of COVID‐19 patients in the ICU. The aim of this study was to investigate the association of EN with biochemical and pathological indices associated with mortality in ICU patients with COVID‐19. Methods This case–control study was conducted on 240 patients with COVID‐19 hospitalized in the ICU including 120 eventual nonsurvived as the cases and 120 survived patients as the controls. All of the patients received EN as a high protein high volume or standard formula. Data on general information, anthropometric measurements, and the results of lab tests were collected. Results The recovered patients received significantly more high protein (60.8% vs. 39.6%, p = .004) and high volume (61.6% vs. 42.3%, p = .005) formula compared to the nonsurvived group. Mortality was inversely associated with high volume (odds ratio [OR]: 0.45 confidence interval [CI]95%, p = .008) and high protein (OR: 0.42 CI95%, p = .003) formula. The results remained significant after adjusting for age and sex. Further adjustment for underlying diseases, smoking, body mass index, and the acute physiology and chronic health evaluation II (APACHE II) score did not change the results. Conclusion The findings of the study showed that there was a significant inverse association between mortality and high volume and high protein formula in patients with COVID‐19. Further investigation is warranted.

Background: Elevated serum levels of osteopontin (OPN) have been associated with cardiovascular disease, diabetic nephropathy, and autoimmune disease activity. The aim of this study was to investigate the relationship between OPN serum levels and renal damage in type 2 diabetes patients.Methods: This analytical cross-sectional study was carried out in Yazd, Iran from April to September 2017. Micro-albuminuria and creatinine (Cr) in 750 patients were measured and 180 included patients were divided into the three groups of 60 subjects based on the level of micro-albuminuria; normal (group A), micro proteinuria (group B) and macro proteinuria (group C). Body weight, height, blood pressure, body mass index (BMI), HbA1c and OPN were assessed.Results: Among 179 patients, 60 of them were normal for proteinuria, 59 patients had micro-proteinuria and 60 ones had macro- proteinuria. The mean age of participants was 58.96 ( ± 11.10) years (range 26-80 years), 90 patients (50.8%) were males and 88 ones (49.2%) were females. The mean OPN levels were significantly higher in group C compared to group B, and in group B compared to group A (P = 0.0001). Serum OPN was correlated positively with HbA1c (P: 0.012), Cr (P = 0.010) and glomerular filtration rate (GFR) (P = 0.002). There was a significant difference in the mean of OPN level among the subgroups with the history of ischemic heart disease (IHD) and HbA1C (P=0.035, and 0.047 respectively).Conclusion: These findings suggest that OPN is involved in chronic disease activity, and there is an independent association between plasma levels of OPN, and nephropathy in diabetic patients.

Abstract Background Despite the confirmed association between higher BMI with increased risk of the acute respiratory distress syndrome (ARDS), the association between obesity with mortality in critically ill patients with coronavirus disease 2019 (COVID‐19) is not clear. The present study aimed to investigate the association between obesity with treatment duration, ICU length of stay, and the risk of death in critically ill patients with COVID‐19. Methods This case–control study was performed on 223 patients with COVID‐19 including 148 surviving patients as the control group and 75 eventually dead patients as the case group in Rasht, Iran. Data on demographic factors, comorbidities, anthropometric measurements, the length of hospitalization and the mortality were obtained from patients' medical records. Results The mortality rate was significantly associated with weight (OR = 1.04, 95% CI: 1.002–1.083, p = .04), but not with BMI after adjustments for age, gender, length of stay in ICU, chronic diseases and smoking. The results did not change after further adjustments for biochemical and pathological factors. Conclusions Weight was positively associated with mortality after controlling for confounding variables. Further studies should consider the patient's body composition such as fat mass to establish the relationship between obesity and COVID‐19 outcomes.

Objective The objective of this study is to find out whether the self-sacrificing veterans as role models have succeeded to institutionalize religiousness and the degree of adherence to it, as one of the important factors in the emergence of the spirit of self-sacrifice in their children, in passing on their values. Method To answer this question, the present study was conducted to compare the dimensions of religiousness and religious identity of two generations: veteran parents and their children. This study was an applied one in terms of purpose and a descriptive-post-event one in terms of nature and method. The statistical population included all freedmen of imposed war and veterans of Bandar-e Lengeh city and all their male children aged 20 to 30 years from among whom 25 fathers and 25 male children were selected through purposive sampling and were assessed using two religiosity questionnaires: Glock and Stark (1965) and Serajzadeh’s religious identity questionnaire (2013). Finding The findings show that the average religious identity of the children in emotional dimension (M=21.6) and ritual dimension (M=21.5) is higher than their parents’ average of the two dimensions: emotional (M=20.4) and ritual (20.5); and the parents are higher in the belief dimension (M=22.2) than their children (M=16.5). In addition, the average scores of young people in the intellectual dimension (M=16.5) and consequence of religiousness (M=19.9) were higher than their parents in the intellectual dimension (M=13.1) and consequence of religiousness (M=18.4). The parents are also higher in the belief dimension (M=20.3) than their children (M=16.6). Conclusion: In general, the parents of the present study do not experience a different intellectual atmosphere with their children.

Background: The paradigm shifts in target theory could be defined as the radiation-triggered bystander response in which the radiation deleterious effects occurred in the adjacent cells. Objective: This study aims to assess bystander response in terms of DNA damage and their possible cell death consequences following high-dose radiotherapy. Temporal characteristics of gH2AX foci as a manifestation of DNA damage were also evaluated.Material and Methods: In this experimental study, bystander response was investigated in human carcinoma cells of HeLa and HN5, neighboring those that received high doses. Medium transfer was performed from 10 Gy-irradiated donors to 1.5 Gy-irradiated recipients. GammaH2AX foci, clonogenic and apoptosis assays were investigated. The gH2AX foci time-point study was implemented 1, 4, and 24 h after the medium exchange. Results: DNA damage was enhanced in HeLa and HN5 bystander cells with the ratio of 1.27 and 1.72, respectively, which terminated in more than two-fold clonogenic survival decrease, along with gradual apoptosis increase. GammH2AX foci temporal characterization revealed maximum foci scoring at the 1 h time-point in HeLa, and also 4 h in HN5, which remained even 24 h after the medium sharing in higher level than the control group. Conclusion: The time-dependent nature of bystander-induced gH2AX foci as a DNA damage surrogate marker was highlighted with the persistent foci at 24 h. considering an outcome of bystander-induced DNA damage, predominant role of clonogenic cell death was also elicited compared to apoptosis. Moreover, the role of high-dose bystander response observed in the current work clarified bystander potential implications in radiotherapy.

Background & objectives: There is evidence that COVID-19 may have some long-term effects on the patients' blood biochemical and hematological factors. The purpose of this study was to investigate and compare the changes in biochemical and hematological factors in adults with and without past history of COVID-19. Methods: The present study is a cross-sectional study including 72 cases with a past history of COVID-19 (PCR+ test) and 52 controls without a history of COVID-19. All participants were from two prospective cohort studies, namely Yazd Health Study (YaHS) and Shahedieh Cohort Study. Biochemical parameters such as blood glucose, lipid profiles, liver, kidney and hematological factors of cases and controls were extracted from the databases and analyzed. Results: The mean red blood cell count in patients with COVID-19 was significantly higher than in non-COVID-19 patients (p0.001). However, no significant difference was found between the two groups in terms of lipid and kidney profiles and liver enzymes. Conclusion: No significant difference was found between the two groups of patients exposed to COVID-19 and patients not exposed to COVID-19 in terms of liver enzymes, lipid and kidney profiles, which probably indicate that COVID-19 has no long-term effect on these variables. However, a significant difference was observed between the two groups (p

Background: The coronavirus disease 2019 (COVID-19) has become the leading source of pneumonia outbreaks in the world. The present study aimed to compare the condition of intensive care unit (ICU) and non-ICU COVID-19 patients in terms of epidemiological and clinical features, laboratory findings, and outcomes in three cities across Iran.Methods: In a cross-sectional study, 195 COVID-19 patients admitted to five hospitals across Iran during March-April 2020 were recruited. Collected information included demographic data, laboratory findings, symptoms, medical history, and outcomes. Data were analyzed using SPSS software with t test or Mann-Whitney U test (continuous data) and Chi square test or Fisher’s exact test (categorical variables). P40 years, body mass index

Abstract Background Adipose tissue-derived stem cells (ASCs) are promising candidate in stem cell therapies, and maintaining their stemness potential is vital to achieve effective treatment. Natural-based scaffolds have been recently attracted increasing attention in nanomedicine and drug delivery. In this study, Dihydroartemisinin (DHART)-loaded polycaprolactone collagen nanofibers (PCL/Col NFs) were constructed as effective biocompatible scaffolds through adjusting the proportions of hydrophobic/ hydrophilic polymers for enhanced osteoblastic differentiation of human adipose-derived stem cells (hADSCs). Results The designed NFs were characterized through FTIR, XRD, TGA, FE-SEM, and tensile testing. DHART-loaded PCL/Col electrospun NFs provide an ideal solution, with the potential of sustained drug release as well as inhibition of drug re-crystallization. Interestingly, inhibiting DHART re-crystallization can improve its bioavailability and provide a more effective therapeutic efficacy. Besides, the data set found through FE-SEM, MTT, PicoGreen, qPCR, and alkaline phosphatase (ALP) assays revealed the improved adhesion and proliferation rate of hADSCs cultured on PCL/Col/DHART (5%) NFs after 14 and 21 days of incubation. Conclusions These findings confirmed the potential of the designed NF scaffolds for sustained/controlled release of DHART therapeutic molecules toward bone tissue regeneration and engineering. Graphical Abstract

Background: Establishing a predictive assay of radiosensitivity (as an appropriate, practical and cost-effective method) has been challenging. Objective: The purpose of this study is to evaluate the capability and relationship of various endpoints, including GammaH2AX, micronuclei; and apoptosis in determining the human tumor cell lines radiosensitivities compared with clonogenic survival.Material and Methods: In an experimental in-vitro study, the response of carcinoma cell lines of HN5 and HeLa to 2 Gy of 6 MV photon beam was investigated via various assays. Results: Survival fraction at 2 Gy (SF2) of HeLa and HN5 was indicated as 0.42 ± 0.06 and 0.5 ± 0.03 respectively, proposing more radioresistance of HN5. This finding was confirmed with “2 Gy apoptosis enhancement ratio” which was 1.77 and 1.42 in HeLa and HN5. The increased levels of DNA DSBs were observed after irradiation; significant in HeLa with enhancement rate of 19.24. The micronuclei formation followed an ascending trend post irradiation; but with the least difference between two cells. Although the relationship between micronuclei and clonogenic survival was moderate (R2 = 0.35), a good correlation was observed between apoptosis and clonogenic survival (R2 = 0.71). Conclusion: The results of studied endpoints agreed with the SF2, highlighting their capabilities in radiosensitivity prediction. In terms of the enhancement ratio, gammaH2AX foci scoring could be a valid indicator of radiosensitivity but not the exact surrogate marker of survival because no correlation was observed. Moreover, considering the chief determents comprising lack of time and money, the apoptotic induction might be an appropriate indicator with the best correlation coefficient.

Abstract Background The coronavirus disease‐2019 (COVID‐19) has become a worldwide health issue with widespread hospitalization and dependence on the intensive care unit (ICU). Vitamin D has a key role in modulating immune cells and modulating the inflammatory responses. This study aimed to investigate the association of vitamin D supplementation with inflammatory, biochemical, and mortality indices in critically ill patients with COVID‐19. Methods This case‐control study was conducted on critically ill COVID‐19 patients hospitalized in the ICU including the survived >30 day patients as the case group and dead patients as the control group. The status of vitamin D supplementation and inflammatory and biochemical indices of the patients were retrieved from the medical records. Logistic regression method was used to assess the association between 30 days survival and vitamin D supplement intake. Results Compared to the group of COVID‐19 patients who died in

Objective: This study aimed to identify how parents can answer to their children’s religious questions. Method: To achieve this objective, the phenomenological method was used. The statistical population included all parents with primary school children in Bandar Lengeh. The sample size was 35 people, and they were selected by purposive method according to the theoretical saturation limit. Data collection tools were also semi-organized and in-depth interviews. The interviews were recorded, transcribed, and analyzed through the seven-step Colaizzi method. Findings: The findings showed that there were 3 main themes along with some sub-themes. Children’s questions revolved around the questions about Allah, death, the Hereafter, the Prophet, Islam, the creation of the world, acts of worship, and natural disasters. Many parents used some incorrect methods such as inappropriate responses to cognitive development, language development, and comprehension. Furthermore, suppressing of children’s questions, presenting stereotyped answers, not answering their questions, postponing answers were used by parents, but some parents used the correct methods for answering religious questions, such as using allegory, answering, using the child’s tangible knowledge to answer, using games, providing correct answers in accordance with religious sources, and searching for better answers. Conclusion: According to these findings that parents lack the necessary knowledge about cognitive development and educational methods, the institutions involved in education need to plan to teach the parents about answering children’s questions in accordance with principles such as cognitive scaffolding.

Abstract Background Omega-3 polyunsaturated fatty acids (n3-PUFAs) may exert beneficial effects on the immune system of patients with viral infections. This paper aimed to examine the effect of n3-PUFA supplementation on inflammatory and biochemical markers in critically ill patients with COVID-19. Methods A double-blind, randomized clinical trial study was conducted on 128 critically ill patients infected with COVID-19 who were randomly assigned to the intervention (fortified formula with n3-PUFA) (n = 42) and control (n = 86) groups. Data on 1 month survival rate, blood glucose, sodium (Na), potassium (K), blood urea nitrogen (BUN), creatinine (Cr), albumin, hematocrit (HCT), calcium (Ca), phosphorus (P), mean arterial pressure (MAP), O2 saturation (O2sat), arterial pH, partial pressure of oxygen (PO2), partial pressure of carbon dioxide (PCO2), bicarbonate (HCO3), base excess (Be), white blood cells (WBCs), Glasgow Coma Scale (GCS), hemoglobin (Hb), platelet (Plt), and the partial thromboplastin time (PTT) were collected at baseline and after 14 days of the intervention. Results The intervention group had significantly higher 1-month survival rate and higher levels of arterial pH, HCO3, and Be and lower levels of BUN, Cr, and K compared with the control group after intervention (all P

This study seeks to measure the effectiveness of the citizenship skills training on the citizenship rights awareness and practice of these rights according to Law Thesis of Imam Sajjad (as) about citizenship rights. The study was done through a combination of qualitative-quantitative method. In the first part, using the qualitative method, the appropriate educational content was compiled from the law thesis. The quantitative part was performed in a quasi-experimental manner through pre-test-post-test with a control group. The sampling method in the qualitative phase of study was purposeful and there were 5 curriculum planning specialists. In the quantitative part, the statistical population included the first-grade junior high school teenagers of Bandar Lengeh. Using cluster sampling method, 60 people in two experimental and control groups of 30 were replaced. The study with a quasi-experimental pre-test-post-test research design was conducted with a control group in 11 educational sessions. The data collection tool was a researcher-made questionnaire on ‘Awareness of Citizenship Rights’ and ‘Citizenship Behavior’ which had good validity and reliability. Independent T-test and multivariate analysis of variance were used to analyze the findings. The results showed that citizenship skills training increases teenagers’ awareness of citizenship rights and also changes their behavior. According to the findings of this study, social relations can be improved by focusing on teaching the curriculum based on Imam’s law thesis.

Introduction: External radiotherapy is the most common method of radiotherapy which the most important problem associated with is that there is no difference between healthy and tumor tissues in dose absorption. One way to differentiate the dose sensitivity is to use metal-based nanoparticles. Bismuth oxide nanoparticles are good candidates for cancer radiotherapy. In this study, we investigated the dose enhancement effect of the synthesized spherical Bi2O3 NPs in 6MV external radiotherapy. Material and methods: Bi2O3 were synthesized and GENIPIN gel dosimeter was produced and divided into two equal portions, one part to fill vials containing pure gel and the other part to be added to a specified amount of nanoparticles to give a concentration of 0.1Mm. Then, the irradiation of the pure gel and gel vials containing the NPs was performed one day after manufacture by a 6MV external radiotherapy device. Gel readout was performed using spectrophotometer and absorption-dose curves were achieved. Results: results show that spherical Bi2O3 NPs cause a decrease in GENIPIN absorbance range compared to gel without NPs. The slope of the absorbance-dose curve in presence of NPs is 0.038 which is more than this slop in the pure gel (0.029) which indicates a DEF of 1.31 in the usage of these NPs in the tumor. Conclusion: we can conclude that by applying these spherical Bi2O3 NPs, dose absorption of the tumor will increase up to 31% which means the efficacy of radiotherapy can be maintained by lower applied dose to the tumor and healthy cells.

IntroductionVitamin C has been reported to have beneficial effects on patients with coronavirus disease 2019 (COVID-19). This study aimed to investigate the effect of vitamin C supplementation on pathological parameters and survival duration of critically ill patients with COVID-19.MethodsThis clinical trial was conducted on 120 hospitalized critically ill patients infected with COVID-19. The intervention group (n = 31) received one capsule of 500 mg of vitamin C daily for 14 days. The control group (n = 69) received the same nutrition except for vitamin C supplements. Measurement of pathological and biochemical parameters was performed at baseline and after 2 weeks of the intervention.ResultsFollowing 2 weeks of vitamin C supplementation, the level of serum K was significantly lower in the patients compared with the control group (3.93 vs. 4.21 mEq/L, p < 0.01). Vitamin C supplementation resulted in a higher mean survival duration compared with that of the control group (8 vs. 4 days, p < 0.01). There was a linear association between the number of days of vitamin C intake and survival duration (B = 1.66, p < 0.001). The vitamin C supplementation had no effect on blood glucose, mean arterial pressure, arterial blood gas (ABG) parameters, Glasgow Coma Scale (GCS), kidney function, cell blood count (CBC), hemoglobin (Hb), platelet (Plt), partial thromboplastin time (PTT), albumin, hematocrit (Hct), and other serum electrolytes including sodium (Na), calcium, and phosphorus (P).ConclusionThe present study demonstrated the potential of vitamin C supplementation in enhancing the survival duration of critically ill patients with COVID-19.Clinical Trial Registrationhttps://www.irct.ir/trial/55074, identifier IRCT20151226025699N5

Background: Nutrient imbalance can frequently occur in patients with indications for parenteral nutrition (PN) after gastrointestinal surgery. This study aimed to compare the recommendations of a surgeon to those of a dietitian in the field of parenteral nutrition.Methods: This study was performed on 256 patients undergoing gastrointestinal surgery who received PN, which included 120 patients who received PN based on recommendations of the surgeons and 136 patients who were referred to receive PN under the supervision of a dietitian in Razi Hospital in Rasht, Iran. Data on PN and clinical outcomes of the patients were collected.Results: Patients under the supervision of dietitians received higher vitamin B complex and lipids and lower vitamin A and vitamin E than the surgeon-supervised patients (all P < 0.001). In the group receiving PN under the supervision of a surgeon, the level of blood glucose (207 vs. 182, P < 0.01), sodium (138 vs. 136, P = 0.01), potassium (3.97 vs. 3.53, P < 0.01), and white blood cell count (9.83 vs. 9.28, P < 0.01) increased significantly at the end of the PN compared to baseline. In the group receiving PN under the supervision of a dietician, the level of serum Cr (1.23 vs. 1.32, P = 0.04), Mg (2.07 vs. 1.84, P < 0.01), and pH (7.45 vs. 7.5, P = 0.03) significantly improved after receiving parenteral nutrition compared to baseline.Conclusion: The amounts of nutrients recommended for PN by the surgeon and dietitian were different. Implementation of dietitian recommendations in critically ill patients under PN can improve patients' clinical parameters.

The purpose of the present study is to investigate the ways to strengthen and deepen praying culture in children. This is a qualitative research, on the basis of grounded theory method. The participants include 25 parents of a high school second grade students in Bander Lengeh. The selected parents were successful in educating their children to adhere to praying. The data were collected through semi-structured deep interview. Data analysis was carried out through three stages of open, pivotal and selective coding. Finally, a model was presented regarding conditions, grounds, and strategy. Validity of the study was provided by a non-member inspector and was evaluated by the members. The results of the final model indicated that parents should have a strong dedication to the religious development of their children in order to accustom them to ritual prayer. This general condition includes underlying factors such as creating a religious attitude in life, modeling, belief-behavior consistency, and promotion of personal growth. Strategies that parents can use are functions that they perform in the pre-birth age, pre-maturity age, maturity age, and post-maturity age of their child(ren). The effective parenting measures in order to control the interfering variables in the training path are adoption of positive and effective parenting style, using problem solving skills and environment immunization. In general, childrenchr('39')s adherence to praying does not accidentally and requires careful planning, study, and parental follow-up from pre-birth age of their offspring.

Introduction: The accuracy of dose calculation algorithm (DCA) is highly considered in the radiotherapy sequences. This study aims at assessing the accuracy of five dose calculation algorithms in tissue inhomogeneity corrections, based on the International Atomic Energy Agency TEC-DOC 1583. Material and Methods: A heterogeneous phantom was scanned using computed tomography and tests were planned on three-dimensional treatment planning systems (3D TPSs) based on IAEA TEC-DOC 1583.Doseswere measured for 6- and 18-MV photon beams with ion chambers and then the deviation between measured and calculated TPS doses were reported. The evaluated five DCAs include Monte Carlo (MC) algorithm employed by Monaco, pencil beam convolution (PBC) and anisotropic analytical algorithms (AAA) employed by Eclipse and Superposition (SP), and Clarkson algorithms employed by PCRT3D TPSs. Results: In Clarkson algorithm, low and high energy photons indicated 7.1% and 14.8% deviations out of agreement criteria, respectively. The SP, AAA, and PBC algorithms indicated 0.9%, 7.4%, and 13.8% for low energy photon and 9.5%, 21.3%, and 23.2% for high energy photon deviations out of agreement criteria, respectively. However, MC algorithm showed 1.8% and less than 1% deviations at high and low energy photons, respectively. Conclusion: The DCAs had different levels of accuracy in TPSs. Some simple DCAs, such as Clarkson, showed large deviations in some cases. Therefore, the transition to more advanced algorithms, such as MC would be desirable, particularly for the calculation in the presence of inhomogeneity or high energy beams.

Due to high prevalence of diabetes in our region (16.3%) and no data on the frequency of gastrointestinal (GI) symptoms in this population, we performed a cross-sectional study to evaluate the frequency of GIsymptoms in diabetic patients and its association between microvascular complications (retinopathy and nephropathy) and gastrointestinal symptoms in diabetic subjects.This analytical cross-sectional study was conducted from 2014 to 2016 on 233 patients with type 2 diabetes mellitus (T2DM), 30-65-year, referred to Yazd diabetic research center. They were selected by convenient sample method. A questionnaire according to Rome III Criteria was used to collect digestive information related to diabetes. Last HbA1c (Since 2-3 months ago) was available in the patient's medical folder. Diabetic nephropathy defines to increased excretion rate of albumin in the urine in the range of above 30 mg/g creatinine. Diabetic retinopathy was examined by an expert ophthalmologist (retinal specialist). For the current study, 233 patients (age 30-65 years with mean age of 57.43±10.49 years, 102 (43.8%) males and 131 (56.2%) females) were included. Among 233 patients, 91 cases (39.1%) had nephropathy,and 111(47.6%) subjects had different degrees of retinopathy. Bloating and early satiety and upper GI symptoms were higher in the subjects with retinopathy than another group. In summary, this study provides evidence that GI symptoms in diabetic subjects are independently linked to diabetic complications, particularly to retinopathy.

Purpose: In this work, we have focused on fabrication and validation of a respiratory belt that produces respiratory signals from the patient’s abdominal and thorax. Materials and Methods: A load cell transducer was attached to the belt to create an electrical signal from respiratory movement. It converts a force or load into an equivalent electrical signal or digitized load value. The accuracy of the signals from our respiratory control belt was evaluated according to a comparison with the signals from commercial SOMNO medical device. Results: The pattern of the signals from our respiratory belt is in good agreement (4%/3mm) with the pattern of commercial SOMNO medical device. Conclusion: The manufactured respiratory control belt can be used during imaging and radiotherapy procedures for breath control in a patient's abdominal and thorax region.

Background & Aim: Sedation after coronary artery bypass graft surgery can prevent the side effects of the treatment. The purpose of this study was to determine the effect of controlled sedation based on the Richmond scale on the duration of mechanical ventilation and the changes of blood pressure in patients following coronary artery bypass graft surgery. Methods & Materials: In a single blind randomized clinical trial (IRCT2017050517693N2) from June to August 2017, a convenience sample of 80 patients after coronary artery bypass graft surgery, hospitalized in the intensive care unit of Heshamat Center, Rasht, were selected and randomly allocated into two groups (each group=40). Sedative drug dose was determined using the Richmond agitation sedation scale in the intervention group and determined routinely (based on hemodynamic changes) in the control group. Pain as a confounding variable was evaluated using CPOT tool. Data were analyzed by descriptive statistics and Chi-square, Mann-Whitney, independent t-test and repeated measures ANOVA using the SPSS software version 22. Results: The mean age of samples was 59.89±7.53 and 66.7% of them were male. There was a significant difference between two groups in the duration of mechanical ventilation (P

Background: The mechanism of cadmium induced osteoporosis is not well understood, so in this study, we examined the toxicity of bone marrow mesenchymal stem cell (MSCs) following treatment of rats with CdCl2 in drinking water, to revile the effect of this chemical on differentiation potential of MSCs. Methods: At the end of third passage, MSCs were grown in the osteogenic medium for 21 days. To study the differentiation property the viability, morphology, intracellular calcium, and matrix mineralization via quantitative alizarin red were evaluated. Besides, biochemical parameters including activity of alkaline phosphatase (ALP), aspartate amino transaminase (AST), alanine amino transaminase (ALT) as well as antioxidant enzyme such as superoxide dismutase, catalase, and peroxidase were determined too. In addition, level of lipid peroxidation based on determination of malondialdehyde (MDA) content was studied. Results: The results showed significant reduction in the viability of cells after differentiation compared to control (P

Purpose: The clinical efficacy of Grid therapy has been examined by several investigators. In this project, the hole diameter and hole spacing in Grid blocks were examined to determine the optimum parameters that give a therapeutic advantage. Methods: The evaluations were performed using Monte Carlo (MC) simulation and commonly used radiobiological models. The Geant4 MC code was used to simulate the dose distributions for 25 different Grid blocks with different hole diameters and center-to-center spacing. The therapeutic parameters of these blocks, namely, the therapeutic ratio (TR) and geometrical sparing factor (GSF) were calculated using two different radiobiological models, including the linear quadratic and Hug–Kellerer models. In addition, the ratio of the open to blocked area (ROTBA) is also used as a geometrical parameter for each block design. Comparisons of the TR, GSF, and ROTBA for all of the blocks were used to derive the parameters for an optimum Grid block with the maximum TR, minimum GSF, and optimal ROTBA. A sample of the optimum Grid block was fabricated at our institution. Dosimetric characteristics of this Grid block were measured using an ionization chamber in water phantom, Gafchromic film, and thermoluminescent dosimeters in Solid WaterTM phantom materials. Results: The results of these investigations indicated that Grid blocks with hole diameters between 1.00 and 1.25 cm and spacing of 1.7 or 1.8 cm have optimal therapeutic parameters (TR > 1.3 and GSF~0.90). The measured dosimetric characteristics of the optimum Grid blocks including dose profiles, percentage depth dose, dose output factor (cGy/MU), and valley-to-peak ratio were in good agreement (±5%) with the simulated data. Conclusion: In summary, using MC-based dosimetry, two radiobiological models, and previously published clinical data, we have introduced a method to design a Grid block with optimum therapeutic response. The simulated data were reproduced by experimental data.

Purpose: The aim of this study is to compare the accuracy of different algorithms in EclipseTM Treatment Planning System (TPS) using a heterogeneous phantom. Materials and Methods: The method is based on the International Atomic Energy Agency's TEC-DOC 1583 report. The chest phantom of CIRS, PTW30010 ionization chamber and an electrometer (PTW, Freiburg) were used for the measurements. Three ACUROSE XB (AXB), Analytical Anisotropic Algorithm (AAA) and Pencil Beam Convolution (PBC) dose calculation algorithms available in Eclipse TM TPS were considered in this study. Results: Based on the measurements, the maximum differences between calculated dose by TPS and measured dose in TEC-DOC 1583 tests were 2.5%, 8.6% and 16.1% for the AXB, AAA and PBC algorithms in heterogeneous media, respectively. Conclusion: The Acuros XB algorithm has superior accuracy to predict the dose distribution in the heterogeneous tissues such as lung compared to AAA and PBC algorithms.

Introduction: Gamma Knife is an instrument specially designed for treating brain disorders. In Gamma Knife, there are 201 narrow beams of cobalt-60 sources that intersect at an isocenter point to treat brain tumors. The tumor is placed at the isocenter and is treated by the emitted gamma rays. Therefore, there is a high dose at this point and a low dose is delivered to the normal tissue surrounding the tumor. Material and Method: In the current work, the MCNP simulation code was used to simulate the Gamma Knife. The calculated values were compared to the experimental ones and previous works. Dose distribution was compared for different collimators in a water phantom and the Zubal brain-equivalent phantom. The dose profiles were obtained along the x, y and z axes. Result: The evaluation of the developed code was performed using experimental data and we found a good agreement between our simulation and experimental data. Discussion: Our results showed that the skull bone has a high contribution to both scatter and absorbed dose. In other words, inserting the exact material of brain and other organs of the head in digital phantom improves the quality of treatment planning. This work is regarding the measurement of absorbed dose and improving the treatment planning procedure in Gamma-Knife radiosurgery in the brain.

The aim of this study was to evaluate the morbidity and mortality in patients with operable stage II and III rectal cancers within one or two months after surgery, who has been treated pre-operatively with short course radiotherapy. Twenty-eight patients with rectal adenocarcinoma, consecutively referred to the Cancer Institute of Imam Khomeini Hospital from March 2009 to March 2010, were selected for the study after staging by endorectal ultrasound and CT of abdomen, pelvis, and chest; and if they had inclusion criteria for short course schedule, they were treated with radiotherapy alone at 2500 cGy for 5 sessions, and then they were referred to the surgical service for operation one week later. They were visited there by a surgeon unaware of the research who completed a questionnaire about pre-operative, operative, and post-operative complications. Of 28 patients, 25 patients underwent either APR or LAR surgery with TME. One patient developed transient anal pain grade I and one patient had dysuria grade I; they were improved in subsequent follow-up. Short course schedule can be performed carefully in patients with staged rectal cancer without concerning about serious complications. This shorter treatment schedule is cost-effective and would be more convenient for patients due to fewer trips to the hospital and the main treatment, i.e. operating the patient, will be done with the shortest time the following diagnosis.