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The goal of this study was to investigate the probable difference in auditory perception and speech intelligibility performance amongst cochlear implanted children who experienced hyperbilirubinemia or auditory neuropathy in comparison to the cochlear implanted children with unknown etiology for hearing loss. This case–control study was carried out on 106 cochlear implanted children with mean age of 32.36 ± 11.98 months who were purposively selected and allocated into four groups. Out of the total, 30 had no specific etiology for hearing loss, while the others had experienced auditory neuropathy or hyperbilirubinemia with/without blood exchange. The auditory perception and speech intelligibility performance of all the participants who had received auditory verbal therapy were assessed after 6 and 12 months of rehabilitation. Then, the data was analyzed, using the Statistical Package for Social Sciences-version 21(SPSS-21). Results indicated poor auditory perception and speech intelligibility performance of the cochlear implanted children with hyperbilirubinemia and blood exchange (P ≤ 0.05), while the participants in the control group with no specific etiology for hearing loss, the children with hyperbilirubinemia with no blood exchange, and those who suffered from auditory neuropathy performed better, respectively. Also, a significant correlation between auditory neuropathy and hyperbilirubinemia was observed. Despite lower improvement of auditory perception and speech intelligibility of the hearing impaired children who were experiencing moderate to severe degrees of hyperbilirubinemia or auditory neuropathy, cochlear implantation is highly recommended not only for children with unknown etiology for severe hearing loss but also for this group of hearing impaired children.

Background and Objective:The behavior of COVID-19, clinical symptoms, and mortality rate are not the same in different regions. Due to lack of knowledge about the cited issues, we aimed to investigate the clinical symptoms, case fatality rate, and some risk factors of COVID-19. Materials and Methods:This longitudinal study was started from the late February 2020 and lasted to the mid-July 2020 in Jiroft, Kerman province, Iran. The course of the disease, clinical signs and symptoms, underlying diseases, patients' exposure history, travel history, adherence to health instructions, and the fatality rate of the disease were evaluated in the patients. The descriptive statistics and frequency were analyzed in different groups using IBM SPSS statistics version 20. Results:In this study, 2977 definitive cases of COVID-19 were detected using RT-PCR test. The frequent clinical symptoms were fever (45.2%), body aches and bruises (38.8%), and cough (36.4%), respectively. The fatality rate of the disease was 4%. Evaluation of the patients’ exposure history showed that almost 50% of the cases had no exposure. Among the studied individuals, 33% had the history of exposure to a definite COVID-19 case. Conclusion:Personal hygiene, social distancing, and use of face mask are of great importance in reducing the disease morbidity and mortality. Public awareness about COVID-19 should also be increased, especially in the elderly individuals with the history of underlying and chronic diseases. Keywords:Coronavirus,COVID-19,Epidemiology,Mortality,Patient

Background and Purpose: COVID-19 could be a threat to healthcare workers' mental health. This study was conducted to investigate job burnout and its relationship with the resilience level of the personnel in the COVID-19 treatment hospital in southern Iran. Methods: This descriptive-analytical cross-sectional study was conducted in 2021 on 496 personnel of Hazrat Ali Asghar (AS) Hospital selected as the center of COVID-19 in southern Iran. The participants of the study were selected using the census. Data collection tools were the standard Maslach Burnout Inventory (MBI) and Connor-Davidson Resilience Scale (CD-RISC). Data analysis was performed using t-test, ANOVA, Pearson correlation coefficient, and multiple linear regression in SPSS23 at a significance level of 0.05. Results: The mean scores of job burnout and resilience were 76.95 ± 14.36 (of 132) and 71.21 ± 8.24 (of 125), respectively which indicated the moderate level of these two variables. There was a significant inverse correlation between job burnout and resilience (P

Objective: The purpose of this study was to determine the safety behavior predictors related to the food safety of greenhouse products among the greenhouse owners of Jiroft city based on the Protection Motivation Theory (PMT). Methods: A cross-sectional study was conducted with a descriptive-correlation approach in 2018 on 228 greenhouse owners. A researcher-made questionnaire that included demographic variables, PMT structures, and safety behavior was administered. Results: Of the surveyed greenhouse owners, 98.2% were men. The participants were aged from 21 to 70 years. The mean scores of all PMT constructs other than response costs, and safety behaviors other than that of preventing the prevalence of pests were at a moderate level. The prediction rate of safety behaviors by PMT constructs was 74.4%. Meanwhile, perceived costs' construct (β = −0.349), response efficacy (β = 0.251), and protection motivation (β = 0.424) had important roles. Conclusion: Given the predictive power of PMT constructs for safety behaviors related to food safety, educational interventions based on this theory are required.

Introduction Chronic use of methamphetamine induces neuropsychological deficits and neurochemical changes in frontostriatal regions. This study aimed to examine the relationship between brain metabolites alterations in frontostriatal regions and neuropsychological deficits in patients with methamphetamine use disorder. Method A total of 30 methamphetamine users and 20 control participants were selected and a battery of standardized executive function, attention, and memory tasks, including the Wisconsin Card Sorting Test, Stroop Test, and Wechsler Memory Scale, was administered to them. Proton-Magnetic resonance spectroscopy (H-MRS) of N-Acetylaspartate/Creatine (NAA/Cr), Choline/Creatine (Cho/Cr), and glutamate + glutamine/creatine (Glx/Cr) in dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), and basal ganglia (BG) were also undertaken. Results Current findings indicated that there were significant differences between two groups in metabolite ratios including NAA/Cr, Cho/Cr, and Glx/Cr in three areas, except for Glx/Cr in BG. Moreover, compared to healthy controls, methamphetamine users showed poorer performance in all neuropsychological tests. Finally, a significant relationship was found between regional metabolites alterations, particularly in the ACC, and neuropsychological deficits in methamphetamine users. Conclusions In addition to neurochemical changes and neuropsychological deficits in patients with methamphetamine use disorder, current results highlighted the relationship between these changes in DLPFC, ACC, and BG with cognitive deficits in methamphetamine users.

Understanding the laser ablation mechanism is highly essential to find the effect of different laser parameters on the quality of the laser ablation. A mathematical model was developed in the current investigation to calculate the material removal rate and ablation depth. Laser cuts were created on the workpiece with different laser scan speeds from 1 to 10 mm s−1 by an ultrashort pulse laser with a wavelength of about 1000 nm. The calculated depths of laser cuts were validated via practical experiments. The variation of the laser power intensity on the workpiece’s surface during laser radiation was also calculated. The mathematical model has determined the laser-material interaction mechanism for different laser intensities. The practical sublimation temperature and ablated material temperature during laser processing are other data that the model calculates. The results show that in laser power intensities (IL) higher than 1.5 × 109 W cm−2, the laser-material interaction is multiphoton ionisation with no effects of thermal reaction, while in lower values of IL, there are effects of thermal damages and HAZ adjacent to the laser cut. The angle of incidence is an essential factor in altering incident IL on the surface of the workpiece during laser processing, which changes with increasing depth of the laser cut.

Brain tumors are responsible for high morbidity and mortality worldwide. Several factors such as the presence of blood-brain barrier (BBB), sensitive location in the brain, and unique biological features challenge the treatment of brain tumors. The conventional drugs are no longer effective in the treatment of brain tumors, and scientists are trying to find novel therapeutics for brain tumors. In this way, identification of molecular pathways can facilitate finding an effective treatment. c-Myc is an oncogene signaling pathway capable of regulation of biological processes such as apoptotic cell death, proliferation, survival, differentiation, and so on. These pleiotropic effects of c-Myc have resulted in much fascination with its role in different cancers, particularly brain tumors. In the present review, we aim to demonstrate the upstream and down-stream mediators of c-Myc in brain tumors such as glioma, glioblastoma, astrocytoma, and medulloblastoma. The capacity of c-Myc as a prognostic factor in brain tumors will be investigated. Our goal is to define an axis in which the c-Myc signaling pathway plays a crucial role and to provide direction for therapeutic targeting in these signaling networks in brain tumors.

A few studies investigated the relationship between allergy and Meniere disease considering complete allergen panel. We aimed to evaluate the serum immunoreactivity in patients with Meniere's disease (MD) compared with healthy people according to common indigenous Iranian inhalation and food allergens.Thirty-nine patients with MD referred to Rasoul Akram Hospital (Tehran, Iran) were evaluated and compared with a 41 membered control group. A panel of common inhalation and food allergens (using an immunoblotting method), as well as total immunoglobulin E (IgE) level (using the sandwich enzyme-linked immunosorbent assay method), were checked on the patients' serum.The mean total IgE level was 193.85 ± 175.43 IU/ml in the patients with MD and 117.61 ± 138.05 IU/ml in the control group, which was significantly higher than the other subjects in the control group (

Background: The effect of Dexamethasone on Post-Dural Puncture Headache (PDPH) after spinal anesthesia has not been well elucidated. The aim of the current study was to evaluate the effect of prophylactic intravenous dexamethasone on the incidence and severity of PDPH in patients undergoing orthopedic surgery. Methods: This randomized, double-blind, placebo-controlled trial was carried out in patients undergoing orthopedic surgery. The subjects were randomly divided into a placebo (n=140) and a dexamethasone (n=140) group. During the surgery, the control group participants were injected 2cc of distilled water, and the dexamethasone group participants were injected 2cc (8mg) of dexamethasone as an infusion in the veins. The incidences of PDPH on the first, third and seventh postoperative days were studied. Data were analyzed using SPSS version 22. Results: A total of 280 patients with a mean age of 32.7 ± 11.0 years were studied. The incidence of PDPH on the first day of post-operative period was lower in the dexamethasone group than the control group (21 vs. 34, Pvs. 26, P0.05). Conclusion: Although the frequency of PDPH was less in patients receiving dexamethasone, the incidence increased days after the operation and reached the level of the placebo group. We do not recommend prophylactic intravenous dexamethasone for the prevention of PDPH.

Background: Unhealthy eating habits are an important cause of Non-communicable Diseases (NCDs). One of the most effective methods to prevent these diseases is the use of health education interventions. The aim of this study was to evaluate the effect of educational intervention performed by Women Health Volunteers (WHV) on knowledge, attitude, and modification of dietary habits among women in Kerman. Methods: This research was a quasi-experimental study performed on 400 women in Kerman. Participants were selected using multistage cluster sampling. Data were collected immediately before and 6 weeks after the intervention by a questionnaire, including demographic information and questions related to knowledge, attitude, and dietary habits. Data were analyzed using Pearson and Spearman correlation, paired t-test, and Wilcoxon-test in SPSS 24. Results: The average age of women was 41.91±12.87 years. Before the intervention, a positive and significant correlation was observed between knowledge and dietary habit (r=0.249) (p Conclusion: Education provided by WHV was effective in promoting knowledge, and attitude, and in modifying the dietary habits of women. Therefore, the use of local human resources can help improve public health.

Background & Aims of the Study: Since beta-thalassemia is the most commonly inherited disease in Iran, its preventive and controlling programs are considered vitally important in the healthcare system. This study was conducted to investigate the incidence rate and epidemiology of major beta-thalassemia (MBT) over the last twenty years in Kerman, Iran. Materials and Methods: This cross-sectional study, as a kind of health system research, carried was out on all patients with beta-thalassemia (born from March 1998 to March 2018) registered in Kerman Health Center. The data, extracted from the national records of genetic diseases, were analyzed in SPSS software (version 16) using Fisherchr('39')s exact test. Results: Based on the results of the present study, the incidence rate of MBT was calculated at 0.99 cases per 10,000 live births. According to this result, 29 subjects with MBT were born from 1998 to 2018. The most important cause of thalassemia was determined as non-identification of thalassemia minor in carrier couples and their lack of awareness about their complication (62%). The other cause was the non-cooperation of screened carrier couples in attending prenatal diagnosis (20.7%). It was revealed that in 23 MBT cases, the parents were relatives (79.3%). The diagnosis of 62% of patients had been made before they turned one year. Conclusion: It is recommended that the following measures been adopted to avoid MBT incidence: strengthening the care team, cooperating with gynecologists in identifying pregnant women suspected of having thalassemia minor in the first weeks of pregnancy and referring them to genetic counseling centers for condition determination, educating families and changing carrier couples attitudes toward abortion, monitoring and improving screening laboratories, and implementing public education programs for specific groups.

Background: Length of stay is a significant indicator of care effectiveness and hospital performance. Owing to the limited number of healthcare centers and facilities, it is important to optimize length of stay and associated factors.Purpose: The present study aimed to investigate factors associated with neonatal length of stay in the neonatal intensive care unit (NICU) using parametric and semiparametric models and compare model fitness according to Akaike information criterion (AIC) between 2016 and 2018.Methods: This retrospective cohort study reviewed 600 medical records of infants admitted to the NICU of Bandar Abbas Hospital. Samples were identified using census sampling. Factors associated with NICU length of stay were investigated based on semiparametric Cox model and 4 parametric models including Weibull, exponential, log-logistic, and log-normal to determine the best fitted model. The data analysis was conducted using R software. The significance level was set at 0.05.Results: The study findings suggest that breastfeeding, phototherapy, acute renal failure, presence of mechanical ventilation, and availability of central venous catheter were commonly identified as factors associated with NICU length of stay in all 5 models (P

Objective (s): Measles is a severe acute respiratory viral infection. The single-stranded RNA morbillivirus from the Paramixoviridea family is easily transmitted among humans through coughing or sneezing droplets. Methods: This was a case-control study that was carried out among people living in cities under coverage of Jiroft University of Medical Sciences, Jiroft, Iran in 2014-2015. Seventy-five patients with confirmed measles (case group) and 150 healthy individuals (control group) were selected for the study. The case group included entered into the study through census method. The control group was randomly selected by simple random sampling from the people who had the inclusion criteria. To control the confounding factors, each case was matched with two persons from the control group for age and gender. Conditional logistic regression was used to analyze the data. Results: After adjusting for confounding variables, a significant relationship between measles and, not receiving the vaccine (OR=14.35, CI 95%=7.03-29.27), the history of contact with the definite cases of measles (OR=1.9, CI 95%=1.09-3.43), non-native residents (OR=5.46, CI 95%=1.88-15.78), motherchr('39')s age of older than 30 years at birth (OR=2.8, CI 95%=1.23-6.38) were identified. Conclusion: Based on the findings independent risk factors for developing measles disease were not having measles vaccine, non-native people, history of contact with definite cases of measles and, motherchr('39')s age at birth.

Background and Aim: Dexamethasone affects testis hemostasis through reduction of testosterone level . In one study dexamethasone induced spermatogenesis defects through epithelial vacuolizations and sloughing of germ cell layer. Material and Methods: Forty NMRI mice were randomly divided into four groups. Control and dexamethasone groups received normal saline and dexamethasone (5 mg/kg) respectively for 7 days. Dexamethasone and Nigella sativa(NS) (5 mg/kg) were given to the third group and the fourth group(Nigella sativa group) received 5 mg/kg Nigella sativa for 7 days. Epididymal sperm parameters were used for evaluation of the effects of dexamethasone and Nigella sativa on testis. Results: Epididymal sperm parameters) count,motility and abnormal sperm) showed significant alterations in dexamethasone group (p

Objectives The aim of the present study was to describe and evaluate the results of a new technique in endolymphatic sac decompression surgery. Methods Forty-three patients with intractable unilateral Meniere's disease were selected. Endolymphatic sac was identified after simple mastoidectomy, and its lateral layer was incised, using a sickle knife. Outer layer of the sac was turned around and placed under the anterior bony border. Results Mean duration of the follow-up was 24 months. Mean tinnitus handicap index, pure tone average (PTA) on thresholds at 500, 1000, 2000, and 4000 Hz, mean speech reception threshold, mean speech discrimination score, hearing stage, and mean vertigo score before and after surgery were evaluated. Conclusion The new marsupialization technique with anterior bony border is a safe and effective way to improve tinnitus, vertigo, and ear fullness among these patients. According to PTA and hearing stage, this surgery can control progressive hearing loss. Level of evidence 3.

In this research, the interaction between electroencephalogram (EEG) and, a cardiac parameter, photoplethysmogram (PPG), using connectivity measures to emphasize the importance of autonomic nervous system over the central nervous system during a deception is investigated. In this survey, connectivity analysis was applied, since it can provide information flow of brain regions; moreover, lying and truth appear to be cohered with the flow of information in the brain. Initially, a new wavelet-based approach for EEG/PPG effective connectivity fusion was introduced; then, it was validated for 41 subjects. For each subject, after extracting specific wavelet component of EEG and PPG signals, an effective connectivity network was generated by a generalized partial direct coherence and a direct directed transfer function. The results showed that grand average connectivity patterns were different in some regions for guilty and innocent subjects. The classification results demonstrated that lying could be discriminated from truth with the average accuracy of 84.14% by the leave-one-subject-out method. The present results contribute new information about coupling between EEG and PPG signals.

Micro-grooves have various applications in different industries. Circular laser grooving is a new method for manufacturing micro-grooves on the circumference of cylindrical parts. In this process, the selection of appropriate parameters to reach experimentally the desired groove aspect ratio along with minimum dross formation requires tremendous efforts. Here, the role of a decision-making technique, similarly machine learning is highlighted to evaluate the significance of process inputs and provide the appropriate model for prediction concerning the input parameters. The experiments were conducted with the various inputs such as workpiece rotational speed, laser beam position, duty cycle, power and frequency. The outputs are the groove geometry in terms of width and depth of the circular groove as well as the groove quality considering the dross formation. Then, Random Forest (RF) technique was utilized to derive the most influential inputs on the outputs. The RF analysis revealed that the rotational speed, laser position and duty cycle are the most decisive process parameters in the groove geometry and groove quality. Also, the enhancement of the assist gas pressure does not improve the process outputs according to the results of RF analysis.

ObjectiveThis cross-sectional study investigated vestibular function outcomes after cochlear implantation in patients with inner-ear anomalies.MethodsTwenty-two patients with bilateral symmetric inner-ear anomalies and 28 patients with normal inner ears were included. All were congenitally or progressively deaf persons implanted unilaterally during the previous 15 years. Vestibular system function was assessed by vestibular-evoked myogenic potential and bithermal caloric tests.ResultsThe vestibular-evoked myogenic potential abnormality rate in implanted ears with an inner-ear anomaly was 81.8 per cent, compared with 39.3 per cent in implanted ears with normal anatomy. In the non-implanted sides, the rate was 45.5 per cent (10 out of 22 cases) in the inner-ear anomaly patients compared with 17.9 per cent in patients with normal inner-ear structure. The respective abnormal caloric test rates in inner-ear anomaly versus normal anatomy patients were 81.8 per cent and 17.9 per cent (implanted ears), 77.3 per cent and 14.3 per cent (non-implanted sides).ConclusionInner-ear anomaly and implantation were both associated with more vestibular-evoked myogenic potential abnormalities; when occurring together, these factors showed a synergistic effect. Caloric test abnormality is mainly dependent on the presence of an inner-ear anomaly, but implantation is not associated with caloric abnormality.

Introduction A new coronavirus, called COVID-19, is an acute respiratory disease, which may arouse many psychological disorders since there is no specialized knowledge about it. The present study aimed to investigate the level of resilience and its relationship with hypochondriasis in nurses working in a COVID-19 reference hospital in south of Iran. Methods This cross-sectional study was conducted in 2020, in which 312 nurses participated using the census method. Data collection tools were the Conker-Davidson standard resilience scale (CD-RISC) and the Evans Hypoglycaemia Awareness Questionnaire. Data were analyzed using t-test, ANOVA, Pearson correlation coefficient, and multiple linear regression using SPSS software version 23. Results The mean scores of resilience and hypochondriasis were 72.38 ± 7.11 and 49.75 ± 8.13, respectively, indicating the moderate level of these two variables among nurses. Hypochondriasis in 18.91, 61.22, and 1.28% of the nurses was mild, moderate, and severe, respectively. There was a significant negative correlation between resilience and hypochondriasis (r = − 0.214 and P P P P = 0.001), trust in individual instincts (P = 0.001), and perception of competence (P = 0.002) were detected as the predictors of nurses’ hypochondriasis. Conclusion The nurses had moderate levels of resilience and hypochondriasis. Promoting knowledge about COVID-19and increasing information on how to protect oneself and others against the disease along with supportive packages from their managers are thus recommended.

BackgroundFood insecurity is defined as the limited or uncertain availability of enough food for a consistently active and healthy life. COVID-19 is a highly transmissible viral infection with high mortality due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and, or the uncommon severe pneumonia. This study assesses the relationship between food security and dietary patterns status with COVID-19 in the North Khorasan province, Iran.MethodsThis case-control study will be conducted in the men and women aged 20-60 years improved from COVID-19 infection. The cases (n=124) and controls (n=124) were selected according to the eligibility criteria, including recently improved COVID-19 according to the positive COVID-19 PCR test. People referred to public and private laboratories or employees of public and private factories, offices, and departments of hospitals and universities (for the cases) and negative PCR tests without any clinical signs of COVID-19 infection (for the controls). The North Khorasan province was the target place. The groups are matched for age, sex, and body mass index (BMI). The assessments will include anthropometric measurements and general demographic, USDA 18-item food security (18item-FSSM), and 147-item food frequency (FFQ) questionnaires. Finally, the determination of the relationship between food security and dietary patterns status and associated socioeconomic factors with COVID-19 is done. P-value will be DiscussionThis study would be the first assessment of the relationship between food security and dietary patterns status with COVID-19 disease. It may help planners and policymakers to manage food insecurity and unhealthy dietary patterns and later increasing the immune system and decreasing the incidence of COVID-19. Further studies are suggested.

Background: Takayasu’s arteritis (TAK) is an idiopathic large-vessel vasculitis. Sensori­neural hearing loss is a rare complication in patients with TAK. In this study, we report an adult woman with hearing loss associated with TAK who underwent cochlear implantation (CI). The Case: The case was a 28-year-old hearing-impaired woman with TAK who underwent uni­lateral CI. The surgery improved the patient’s speech perception and perceived sound quality. However, her auditory and speech performances changed over time. Conclusion: The present case report highlights the importance of monitoring auditory and spe­ech performance of CI patients with TAK. Keywords: Cochlear implantation; Takayasu arteritis; hearing loss

Background: The growing trend of substance use among students is a serious threat for the health of young adults. Using Network Scale-up (NSU) method Objectives: The present study was designed to indirectly estimate the prevalence of substance use among students of medical science universities in the eighth macro-region of Iran to attract government attention to this problem. Materials and Methods: This cross-sectional study was performed on 3,900 students from medical science universities in the eighth macro-region of Iran (2300 from Kerman and 1600 from Sistan and Baluchestan provinces) in 2019. The sample size of each university was determined using a multistage non-random sampling approach. The participants were asked to introduce their academic close friends who did high-risk behaviors during last year by researcher-made questionnaire. The chi-squared test was used for comparing two proportions. Statistical analysis was carried out by Excel and SPSS software version 19. Significant level was set as 0.05. Results: Out of 3,900 participants, 1,872 (48%) were males and 2,028 (52%) were females. Students from all academic degrees contributed to this study. The prevalence of alcohol, marijuana, hemp, chewing tobacco, tramadol, methylphenidate, and opium use were 20.6% (95% CI: 19.3 - 21.9), 13.5% (CI: 12.4 - 14.5), 4.1% (CI: 3.5 - 4.7), 6.3% (CI: 5.5 - 7.1), 3.1% (CI: 2.6 - 3.7), 6.5% (CI: 5.7 - 7.3), and 4.0% (CI: 3.1 - 4.9), respectively. Also, the prevalence of substance use was higher among male students than females. Conclusions: Male students are more at risk for substance use. The rates of alcohol and marijuana consumption were higher among students. Training programs are recommended to increase awareness level of young people and the society about disadvantages of these behaviors.

Background: Distal radius fracture is a common type of bone fracture in patients of all ages. Most of the complications of this type of fracture are related to intra-articular fractures. Aim: This study aimed to compare the treatment results of distal radius fracture with two closed pinning and plate plastering methods in young patients admitted to Imam Khomeini Hospital in Jiroft in 2019. Method: The sample size was 176 patients with distal radius fractures admitted to Imam Khomeini Hospital in Jiroft in 2019. The patients were randomly divided into two treatment groups: (1) closed reduction and percutaneous pinning, and (2) plastering with plates. Finally, patients were compared in terms of the mentioned variables immediately after surgery and three months after that. The collected data were coded, entered, and analyzed by using SPSS. Results: The mean age of the selected patients in the closed pinning treatment group was 27.32 years and in the plate plastering group was 27.72 years. The minimum age of patients was four years, and the maximum was 59 years. Patients in the plate plastering treatment group seemed to have a higher mean age than those in the closed pinning treatment group, but this difference is not statistically significant ( [Formula: see text]). There was no statistically significant difference between men’s and women’s ratio in terms of being in the two treatment groups ( [Formula: see text]). There was no statistically significant difference between the right hand and left dominant hand ratio in the two treatment groups ( [Formula: see text]). There was a statistically significant difference between the ability and disability ratio to perform the activity in the two treatment groups ( [Formula: see text]). There was no significant difference between the subjective ratio of no pain, minor pain, and occasional pain in the two treatment groups ( [Formula: see text]). There was a significant difference between the ratio of movement limitation less than 20%, limitation 20–50%, and limitation more than 50% in the two treatment groups ( [Formula: see text]). There was a significant difference between the ratio of normal wrist strength, strength 30–60, and strength 60–90 in the two treatment groups ( [Formula: see text]). There was no statistically significant difference between the uncomplicated ratio and partial crepitation in terms of placement in the two treatment groups ( [Formula: see text]). Finally, there was no statistically significant difference between the total score ratio, closed pinning, and plate plastering treatment groups ( [Formula: see text]). Conclusion: According to this study results, there is no difference between the two treatment methods of closed pinning and plastering with a plate. However, the pinning treatment group had the highest frequency of excellent scores than the plate plastering method.

Background: COVID-19 pandemic has been one of the most stressful situations, worldwide in the twenty first century, and healthcare providers, at the frontline of this crisis, have been exposed to high viral loads through their patients. Therefore, in addition to being at risk of contracting the virus they have also been under mental distress. In this study, we assessed how the healthcare providers in Shohadaye-Khalije-Fars hospital, located in Bushehr, Iran, psychosocially reacted to this outbreak and what were their coping mechanisms. Methods: This is a descriptive cross-sectional study which was conducted between March and July 2020. The population were 177 of the providers and staffs in infectious disease and general medicine wards which were selected via simple random sampling method. The online survey was carried out using GHQ-28 mental health and COPE coping skills questionnaires.Results showed that the mean score of mental health symptoms in female participants (mean=28.65 and standard deviation=12.71) were higher than in male participants (mean=23.97 and standard deviation=10.073), which was statistically significant. Using Chi-square test, there was an outstanding correlation between coping methods and gender. The majority of female participants made use of emotional coping mechanisms (70 out of 113 women) while male participants employed problem-oriented techniques (36 out of 64 men). The results of Pearson’s correlation coefficient test revealed that emotion focused and avoidance oriented coping skills were significantly associated with the incidence of mental health illnesses and presentation of anxiety symptoms.Conclusion: The utilization of emotion-oriented and avoidant–oriented coping skills by the healthcare providers and ward staffs aggravated their anxiety symptoms and increased mental health problems in this population during the COVID-19 pandemic. On that account, offering workshops and trainings in regards with coping skills will improve their ability to understand their emotions, detect signs of anxiety early and learn how to manage them in unpredictable stressful situations.

Introduction: Critical limb ischemia (CLI) considered as the most severe form of peripheral artery disease (PAD). Current therapy for CLI are surgical reconstruction and endovascular therapy or limb amputation (for patients with no treatment options). Neovasculogenesis induced by stem cells including mesenchymal stem cells (MSCs) therapy is a promising approach to treat CLI. But this method of treatment faces challenges such as: MSCs survival and paracrine secretion. MicroRNAs are post transcriptional regulatory molecules that regulate many biological processes including VEGF pathway. MicroRNAs could be used to increase viability and angiogenic potential of MSCs. This study was conducted to reinforce and increase the angiogenic potential of BM-MSCs by using microRNA-126 and evaluate the effect of this stem cell gene therapy on treatment of ischemic tissues in CLI mouse models. Methods: BM-MSCs were isolated from male C57 BL/6 inbred mice and characterized by morphology, flow cytometry, differentiation to osteocyte and adipocyte. Transformed BM-MSCs containing miR-126 were produced by using lentiviral vector. Then femoral artery ligation and total excision of the femoral artery was performed on C57BL/6 mice to create CLI model. Animals were allocated to control, BM-MSCs, virus and BM-MSCs miR-126 groups and defined number of the cells and virus were injected 24 h after surgery. In order to determine in vitro and in vivo effects, the following tests were performed: wound healing assay, behavioral tests including: Tarlov, Ischemia, Modified ischemia, Function and the grade of limb necrosis scores, donor cell survival assay, real-time PCR and histological analysis. Results: Results indicated that during 28 days after transplantation, BM-MSCs and virus groups had an enhancing effect on angiogenesis. BM-MSCs miR-126 group had remarkable effect on endothelial cell migration, muscle restructure, functional improvements and neovascularization in ischemic tissues and led to more effective treatment. In vivo evaluation showed that miR-126 could increase BM-MSCs survival and paracrine secretion of angiogenic factors such as VEGF, and led to remarkable functional improvements and neovascularization in ischemic tissues. Conclusions: According to the obtained results, it could concluded that combination of BM-MSCs and miR-126 leads to more effective recovery from critical limb ischemia compared to using them alone. In fact, miR-126 can be used as a strong modifier to reinforce the angiogenic potential of BM-MSCs, leading to more effective treatment for CLI.

Introduction: Osteoarthritis (OA) as a progressive destructive disease of articular cartilage is the most common joint disease characterized by reduction of joint cartilage thickness, demolition of cartilage surface and new bone formation. To overcome these problems, the purpose of the current research was to evaluate and compare the in vivo effects of Synovial membrane-derived MSCs (SMMSCs), platelet rich plasma (PRP) and conditioned medium (secretome) on collagenase II-induced rat knee osteoarthritis (KOA) remedy. Methods: For the first step, SMMSCs were isolated and characterized. Also, secretome was collected from SMMSCs culture. Furthermore, PRP was collect from the rat heart venous blood. Second, two injection of collagenase II with an interval of 3 days was performed in the knee intra- articular space to induce osteoarthritis. Two weeks later, animals were randomly divided into 6 groups. Control group without treatment, positive group: taken an intra-articular Hyalgan injection (0.1 cc), treatment groups taken an intra-articular injection of; treatment 1: SMMSCs (5 × 106), treatment 2: SMMSCs (5 × 106) + secretome (50 µl), treatment 3: SMMSCs (5 × 106) + PRP (50 µl), and treatment 4: SMMSCs (5 × 106) + secretome (50 µl) + PRP (50 µl). Three months later, rats were sacrificed and the following assessments were executed: radiography, histopathology, and immunohistochemistry. Results: Our findings represented that a combination of the SMMSCs with PRP and secretome had a considerable effect on GAGs and collagen II contents, articular cartilage preservation, compared with other groups. In addition, combination of the SMMSCs with PRP and secretome showed the lowest expression of mmp3, while SOX9 had the highest expression in comparision with other groups. Also, SMMSCs -injected groups demonstrated better results compared with positive and control groups. Conclusions: Injection a combination of the SMMSCs with PRP and secretome resulted in better efficacy in terms of joint space width, articular cartilage surface continuity and integrity, sub chondral bone and ECM constituents such as collagen II. Indeed, transplantation of this combination could be considered as a promising therapy for patients with KOA.

Background: Cervical spondyloptosis is usually caused by trauma, and correlated with significant neurological deficits that can include quadriplegia, respiratory disorders, vertebral artery injury, and death. Case Description: A 34-year-old male presented with C2-C3 spondylolisthesis after a fall from a tree. Although he had no neurological deficits, CT and X-ray studies confirmed C2-C3 a spondyloptosis. He was treated with emergent anterior and posterior cervical reduction, decompression, and fixation, remaining neurologically intact in the postoperative period. Conclusion: Patients with C2-C3 spondyloptosis documented on X-ray/CT studies should be considered for circumferential decompression/fusion to preserve neurological function.

Understanding the neural mechanisms associated with time to contact (TTC) estimation is an intriguing but challenging task. Despite the importance of TTC estimation in our everyday life, few studies have been conducted on it, and there are still a lot of unanswered questions and unknown aspects of this issue. In this study, we intended to address one of these unknown aspects. We used independent component analysis to systematically assess EEG substrates associated with TTC estimation using two experiments: (1) transversal motion experiment (when a moving object passes transversally in the frontoparallel plane from side to side in front of the observer), and (2) head-on motion experiment (when the observer is on the motion path of the moving object). We also studied the energy of all EEG sources in these two experiments. The results showed that brain regions involved in the transversal and head-on motion experiments were the same. However, the energy used by some brain regions in the head-on motion experiment, including some regions in left parietotemporal and left frontal lobes, was significantly higher than the energy used by those regions in the transversal motion experiment. These brain regions are dominantly associated with different kinds of visual attention, integration of visual information, and responding to visual motion.

Being able to track objects that surround us is key for planning actions in dynamic environments. However, rigorous cognitive models for tracking of one or more objects are currently lacking. In this study, we asked human subjects to judge the time to contact (TTC) a finish line for one or two objects that became invisible shortly after moving. We showed that the pattern of subject responses had an error variance best explained by an inverse Gaussian distribution and consistent with the output of a biased drift-diffusion model. Furthermore, we demonstrated that the pattern of errors made when tracking two objects showed a level of dependence that was consistent with subjects using a single decision variable for reporting the TTC for two objects. This finding reveals a serious limitation in the capacity for tracking multiple objects resulting in error propagation between objects. Apart from explaining our own data, our approach helps interpret previous findings such as asymmetric interference when tracking multiple objects.

Introduction: In order to treat the symptoms of otosclerosis, various surgical and medical treatments are suggested. Surgical treatments are the choice. This study aimed to determine the incidence of vertigo and its cause in Iran, and the present study focused on this issue. Methods: This was a prospective cohort study carried out on patients with otosclerosis undergoing stapedotomy referred to Rasoul Akram hospital, Tehran during 2017-18. The patients aged below 18 or those who had a history of vertigo were excluded. Diapasonic and audiometric tests were carried out. The follow-ups included the time of admission (the day after surgery) for the presence of vertigo using visual analogue scale and diapasonic tests, one week after surgery using visual analogue scale and diapasonic tests, and one month after surgery using visual analogue scale and audiometry. The data were imported to SPSS v.22 software and analyzed. Results: The surgical complications that occurred after stapedotomy for patients in this center were as follows: 12.1%of subjects had vertigo one day after surgery, 8.6% had vertigo one week later, and 1.7% had vertigo one month later, thus, the frequency of vertigo was reduced overtime. Meanwhile, 91.4% of the patients had a better sense of hearing and only 1.7% suffered from tympanic membrane perforation. In 8.6% of subjects, there was a disturbance in the taste. Tinnitus was only observed in 5.2% of the surgical patients in this center. Among women, vertigo was higher one day and one week after surgery. Logistic regression showed that age is significant predictor of dizziness one day after surgery (OR: 1.37, P=0.03). Conclusion: According to the results, the frequency of vertigo was decreased overtime. In this study, it was found that the complications of stapedotomy surgery were less than other surgical methods, but those who were older had significantly higher vertigo a week and one day after surgery indicating effective role of age on postoperative complications. Those who underwent surgery by tympanomeatal method had a better vertigo one day and one week after surgery.

Background The prevalence of food insecurity (FI) as “the limited or uncertain availability of enough food for an always active and healthy life” and diabetes as “the most common metabolic disease” are rising in Iran. The aim was to assess the FI, depression, and socioeconomic status as risk factors for type 2 diabetes (T2D). Methods This case-control study was conducted on 135 patients with T2D as cases (99 females, 36 males, mean age 46.83 years) and 135 subjects without diabetes (89 females, 46 males, mean age 45.93 years) as controls. They had been referred to clinics of Shiraz University of Medical Sciences, Shiraz, Iran. The prior major inclusion criterion for diabetes was fasting blood sugar (FBS) ≥126 mg/dl. General, demographic, and socioeconomic characteristics and FI status were assessed using the general and 18-items United States Department of Agriculture (USDA) household food security questionnaires, respectively. Chi-square, t-test, and uni-and multi-variate logistic regression tests and SPSS16 statistical software were used. Results The prevalence of FI was 66.7% in cases and 41.5% in controls. According to final analysis model, FI (Odds Ratio [OR] = 1.9, P = 0.016), depression (OR = 2.0, P = 0.018), body mass index (BMI) ≥ 25 kg/m2 (OR = 1.8, P = 0.025), number of children ≥4 (OR = 1.7, P = 0.046), and having children under 18 years. (OR = 2.1, P = 0.011) were significant independent risk factors for T2D. Conclusion The prevalence of FI in patients with T2D was significantly higher compared to the controls. FI was an important risk factor for T2D, even after controlling for the potential confounders. Further studies are suggested.

Background: Hypothermia is likely to cause enormous dangers for patients undergoing cesarean section. Objectives: This study aims to comparison between the effect of using two different temperatures of IV fluids (37.5°C versus 21-22°C) in body temperature drop and the post-operative pain. Methods: This experimental study was double-blind clinical trial, conducted in 2017 (April, 2017 to January, 2018). The method of sampling was simple random sampling. The randomly selected mothers, undergoing cesarean section, were assigned into two groups of equal number (the hexagonal blocks of A and B) in this clinical trial. The experimental and control group participants received IV fluid at the operation room temperature (25°C) and the IV fluid of 37.5°C, respectively. The core intraoperative body temperature was measured by Microlife Infrared Tympanic-IR100 thermometer. Severity of the experimental and control group patients’ post-operative pain was also measured and compared for 24 hours (since when the patients were discharged from the recovery ward) by the VAS (0-10). Results: A total of 80 patients underwent this study. The demographic information of the two group members showed no difference of significance (p>0.05). The average intraoperative body temperature of the experimental group participants was higher in the level (p=0.001) of significance than that of the control group members. There was no difference of significance (p=0.41) between the mean severity of pain of both groups’ participants in the first 24 hours. Conclusion: The intraoperative IV fluid warming seems not to have any tranquilizing effect in the postsurgery pain.

A mathematical model is developed to find the depth of laser ablation and laser-material interaction in laser processing of Si3N4 (SL200-BG) by an ultrashort (picosecond) pulse laser. The model is verified with experiments which were carried out at different laser scan speeds from 1 mm/s to 100 mm/s. Experimental validation shows a model accuracy of 85%. Additionally, the results show that in laser intensities (IL) higher than 1.5 × 109 W/cm2, the laser-material interaction is “Multi Photon Ionization” (MPI) with no effects of thermal reaction while in lower values of IL, there are effects of thermal damages adjacent to the laser cut.

Background Understanding tuberculosis (TB) treatment programs' process and the outcome is one of the critical strategies to prevent the disease's occurrence and accelerate achieving sustainable development goals to reduce TB cases. The present study aimed to evaluate directly observed treatment short-course (DOTs) for tuberculosis. Methods The present cross-sectional, descriptive-analytical study extracted information from the tuberculosis surveillance system's recorded data by a researcher-made checklist with questions from patients and health system staff. We analyzed the data by SPSS version 20. Results The outcome of patients' treatment was 85.39% improved, and the rest were death and failure of treatment and absence from treatment. The mean and standard deviation of the onset of the first symptom and diagnosis and detection of the disease was 117 and 126 days, respectively. The mean and standard deviation of the interval between diagnosis and treatment was 5.53 and 8.03 days, respectively. Regarding the treatment length, 95.5% of the cases followed the treatment length, and the rest were not observed. The history of hospitalization was 45.3% among patients, and the rest had no history of hospitalization, and the mean and standard deviation of the day of hospitalization were 6.68 ± 9.50 days. Conclusions The existence of an appropriate program for early diagnosis of tuberculosis, observing the length of treatment, training private and public centers to strengthen the care system, and strengthening the DOTs program to control tuberculosis seems to be necessary.

Glioblastoma multiforme (GBM) is one of the worst brain tumors arising from glial cells, causing many deaths annually. Surgery, chemotherapy, radiotherapy and immunotherapy are used for GBM treatment. However, GBM is still an incurable disease, and new approaches are required for its successful treatment. Because mutations and amplifications occurring in several genes are responsible for the progression and aggressive behavior of GBM cells, genetic approaches are of great importance in its treatment. Small interfering RNA (siRNA) is a new emerging tool to silence the genes responsible for disease progression, particularly cancer. SiRNA can be used for GBM treatment by down-regulating genes such as VEGF, STAT3, ELTD1 or EGFR. Furthermore, the use of siRNA can promote the chemosensitivity of GBM cells. However, the efficiency of siRNA in GBM is limited via its degradation by enzymes, and its off-targeting effects. SiRNA-loaded carriers, especially nanovehicles that are ligand-functionalized by CXCR4 or angiopep-2, can be used for the protection and targeted delivery of siRNA. Nanostructures can provide a platform for co-delivery of siRNA plus anti-tumor drugs as another benefit. The prepared nanovehicles should be stable and biocompatible in order to be tested in human studies.

Water security, a key policy objective for sustainable development, is under stress as a result of land use and climate change, especially in (semi-)arid areas like Iran. Land use change alters surface runoff and affects basin-wide hydrological processes and water consumption, while climate change modifies precipitation and temperature patterns and consequently evapotranspiration and water supply. In this study, water yield, supply and consumption are simulated in a watershed draining into the Caspian Sea in northern Iran, using the water yield model in the Integrated Valuation of Environmental Service and Tradeoffs (InVEST) tool. The novelty of this study is found in the combined modelling of the impacts of climate and land use change scenarios on water security, translating these results into a water stress indicator, and estimating the associated economic costs of reduced future water supply. The results show substantial spatial variation of the negative impacts of water supply and future water security across the watershed, further increasing the pressure on its inhabitants, their economic activities and ecological values. The estimation of the economic costs of increased water insecurity allows us to inform policy and decision-makers about future investments in climate adaptation and mitigation.

Introduction Critical limb ischemia (CLI) is the most advanced form of peripheral arterial disease (PAD) characterized by ischemic rest pain and non-healing ulcers. Currently, the standard therapy for CLI is the surgical reconstruction and endovascular therapy or limb amputation for patients with no treatment options. Neovasculogenesis induced by mesenchymal stem cells (MSCs) therapy is a promising approach to improve CLI. Owing to their angiogenic and immunomodulatory potential, MSCs are perfect candidates for the treatment of CLI. The purpose of this study was to determine and compare the in vitro and in vivo effects of allogeneic bone marrow mesenchymal stem cells (BM-MSCs) and adipose tissue mesenchymal stem cells (AT-MSCs) on CLI treatment. Methods For the first step, BM-MSCs and AT-MSCs were isolated and characterized for the characteristic MSC phenotypes. Then, femoral artery ligation and total excision of the femoral artery were performed on C57BL/6 mice to create a CLI model. The cells were evaluated for their in vitro and in vivo biological characteristics for CLI cell therapy. In order to determine these characteristics, the following tests were performed: morphology, flow cytometry, differentiation to osteocyte and adipocyte, wound healing assay, and behavioral tests including Tarlov, Ischemia, Modified ischemia, Function and the grade of limb necrosis scores, donor cell survival assay, and histological analysis. Results Our cellular and functional tests indicated that during 28 days after cell transplantation, BM-MSCs had a great effect on endothelial cell migration, muscle restructure, functional improvements, and neovascularization in ischemic tissues compared with AT-MSCs and control groups. Conclusions Allogeneic BM-MSC transplantation resulted in a more effective recovery from critical limb ischemia compared to AT-MSCs transplantation. In fact, BM-MSC transplantation could be considered as a promising therapy for diseases with insufficient angiogenesis including hindlimb ischemia.

Introduction Recently, weeks after the COVID-19 prevalence, there were reports of brain involvement and neurologic presentations in the COVID-19. Case presentation We present five cases of COVID-19 and cerebrovascular events. A 34-year-old woman with IVH and ischemic stroke. A 60-year-old man with multiple small hemorrhagic foci and mild IVH in the occipital horn. A 63-year-old woman with large left parietooccipital intracerebral hemorrhage (ICH) and IVH. A 56-year-old man with left hemispheric and midbrain ICH, lateral ventricular IVH, and hydrocephalus. A 85-year-old woman with right parietal hemorrhagic infarct. The coagulation profile was normal in all of them. The chest CT scan showed the typical ground-glass appearance of COVID-19. Conclusions Recently, there were reports of brain involvement and neurologic presentations in the COVID-19. These reports and the present study necessitate the aimed and designed studies with emphasis on neurologic presentations in COVID-19 patients to illustrate the exact effects of coronavirus-2 on the central nervous system.

Background: Osteoarthritis (OA) is a progressive degenerative disease. Previous treatment strategies have tried to slow the progress of OA. Objectives: The present study aimed to stop and reverse the progressive nature of OA by the paracrine effects of synovial stem cells. Methods: Fifty male Sprague Dawley rats were randomly allocated to five equal groups (n = 10). The control group received no treatment. The second group received an intra-articular Hyalgan injection. The third group received an intra-articular injection of secreta. The fourth group received an intra-articular injection of synovial-derived stem cells (5 × 106). The last group received an intra-articular injection of secreta combined with synovial-derived stem cells (5 × 106). Three months after treatment, the samples were harvested and evaluated by histopathological and radiological analyses. Results: Histopathological and radiological findings demonstrated significant differences between the synovial stem cell combined with the secreta group and the control and Hyalgan groups. Significant differences were observed in the subchondral bone and matrix scores between the secreta group and the synovial stem cell and Hyalgan groups (P-value = 0.042 and P-value = 0.0001, respectively). Both secreta and synovial stem cell groups showed better healing in terms of cell population viability index than the Hyalgan group (P-value = 0.015 and P-value = 0.005, respectively). The synovial stem cell combined with secreta group showed a significant difference from the synovia stem cell group in both medial femoral condyle and fabella osteophyte indices (P-value = 0.004 and P-value = 0.011, respectively). Conclusions: The group treated with synovial stem cells combined with secreta showed better outcomes than other groups in histopathological and radiological evaluations.

BACKGROUND Factor XIII deficiency is one of the most severe congenital bleeding disorders with high rate of life-threatening bleeding including central nervous system bleeding, umbilical cord bleeding, and recurrent miscarriages. Due to the highest global incidence of the disorder in Iran, this study aimed to design a premarital screening program in Iran. METHODS This descriptive study was performed on 30 couples with a positive family history of factor XIII deficiency. Underling F13A gene mutation was determined in the family members, and all the selected couples underwent molecular testing mutations by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), tetra primer-amplification refractory mutation system-PCR (T-ARMS-PCR), and sequencing. RESULTS The probability of affected childbirth existed for ten couples. Three couples decided not to marry, while seven got married and three of them decided to have a baby. The genotypes of the fetuses were determined and revealed that none of them was a homozygote for the F13A gene mutation. CONCLUSIONS Because of the importance of factor XIII deficiency diagnosis, it can be helpful to control the incidence of factor XIII deficiency by implementing preventive programs such as premarital screening.

Background Diabetes mellitus is the most common metabolic disorder worldwide. We aimed to determine the metabolic and clinical responses to Bunium Persicum (Black Caraway) supplementation in overweight and obese patients with T2DM. Methods Participant recruitment took place in the diabetic clinic of Bu-Ali hospital in Zahedan. Due to the eligibility criteria, 60 participants were randomly placed into two groups, namely placebo (n = 30) and BP (n = 30). The supplementation was considered one 1000 mg capsule 2 times /day BP by meals (lunch and dinner) for 8 weeks. Physical activity levels, dietary intakes, anthropometric measurements [weight, height, and waist circumference], glycemic indices [fasting blood glucose (FBG) and insulin (FBI)], blood lipids [triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c)], and serum nesfatin-1 level were determined. Homeostasis model assessment-insulin resistance (HOMA-IR), Quantitative insulin sensitivity checks index (QUICKI), and Body Mass Index (BMI) were computed. Results In comparison with placebo, BP significantly decreased FBG, HOMA-IR, and BMI (P ). The differences in the FBI, QUICKI, TG, TC, LDL, HDL, WC, and Nesfatin-1 were not significant (P > 0.05). Conclusion BP supplementation improved serum glucose indices and BMI among overweight and obese T2DM patients. Further trials are needed to confirm results. Trial registration Iranian Registry of Clinical Trials (IRCT), IRCT20181207041876N1, Registered 18/01/2019, https://irct.ir/trial/35752

Objectives: Tinnitus is a common and distressing otologic symptom, with various probable pathophysiologic mechanisms, such as an imbalance between excitatory and inhibitory mechanisms. Acamprosate, generally used to treat alcoholism, is a glutaminergic antagonist and GABA agonist suggested for treating tinnitus. Thus, we aimed to evaluate the efficacy and safety of acamprosate in the treatment of tinnitus. Methods: The current randomized-controlled trial study included 20 subjects with chronic tinnitus. After performing psycho-acoustic, psychometric and electrophysiological evaluations, all studied tinnitus subjects were randomly divided into two groups of acamprosate and placebo. The first group received oral acamprosate (two tablets of 333 mg/d, three times a day), whereas the second group was given placebo treatment (two tablets, three times a day). After the first 30 days, all evaluations were repeated for the studied groups just in the same manner before the study. Subsequently, the final results of each evaluation were compared together with the baseline values. Results: Nine studied subjects randomly received acamprosate, whereas eleven others received a placebo. There was no significant improvement in the psycho-acoustic tests, except a decrease was observed in the pitch match of tinnitus ( P = .039). For those subjects who were receiving acamprosate, a significant reduction was observed in tinnitus handicap inventory ( P = .006), tinnitus questionnaire scores ( P = .007), and the visual analog scores ( P = .007) compared to the placebo group. There was a significant reduction in Action Potential latency ( P = .048) as well as an increase in the amplitude of distortion product otoacoustic emissions at 4 kHz ( P = .048). Conclusions: The study results indicated a subjective relief of tinnitus as well as some degree of the electrophysiological improvement at the level of the cochlear and the distal portion of the auditory nerve among the subjects who received the acamprosate. Clinical trial registration code: IRCT2013121115751N1

Background and Objective: Patients who receive cochlear implants (CIs) constitutes a significant population in Iran. This population needs regular monitor on long-term outcomes, educational placement and quality of life. Currently, there is no national or regional registry on the long term outcomes of CI users in Iran. The present study aims to introduce the design and implementation of a national patient-outcomes registry on CI recipients for Iran. This Iranian CI registry (ICIR) provides an integrated framework for data collection and sharing, scientific communication and collaboration in CI research. Methods: The national ICIR is a prospective patient-outcomes registry for patients who are implanted in one of Iranian centers. The registry is based on an integrated database that utilizes a secure web-based platform to collect response data from clinicians and patient’s proxy via electronic case report forms (e-CRFs) at predefined intervals. The CI candidates are evaluated with a set of standardized and non-standardized questionnaires prior to initial device activation (as baseline variables) and at three-monthly interval follow-up intervals up to 24 months and annually thereafter. Results: The software application of the ICIR registry is designed in a user-friendly graphical interface with different entry fields. The collected data are categorized into four subsets including personal information, clinical data, surgery data and commission results. The main parameters include audiometric performance of patient, device use, patient comorbidities, device use, quality of life and health-related utilities, across different types of CI devices from different manufacturers. Conclusion: The ICIR database could be used by the increasingly growing network of CI centers in Iran. Clinicians, academic and industrial researchers as well as healthcare policy makers could use this database to develop more effective CI devices and better management of the recipients as well as to develop national guidelines

Background: Diabetes mellitus is the most common metabolic disorder worldwide. Our aim was to determine the effects of bunium persicum (BP) on serum glucose indices, lipid profile, and nesfatin-1 levels among overweight or obese T2DM patients.Methods: The place of participant recruitment was the diabetic clinic of Bu-Ali hospital in Zahedan. Based on the eligibility criteria, 60 participants were randomly divided into two groups as BP (n=30) or placebo (n=30). The supplementation was one 1000 mg capsules 2 times/day BP with launch and dinner for 8 weeks. Bodyweight, Waist circumference, serum nesfatin-1, fasting blood sugar (FBS), insulin (FBI), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured. Quantitative insulin sensitivity checks index (QUICKI), homeostasis model assessment-insulin resistance (HOMA-IR) and Body Mass Index (BMI) were also calculated.Results: In comparison with placebo, PB significantly increased QUICKI and decreased FBS, HOMA-IR, BMI and WC (P 0.05). The differences in the FBI, TG, TC, LDL, HDL and Nesfatin-1 were not significant (P>0.05).Conclusion: PB supplement improved serum glucose indices and decreased BMI among overweight or obese T2DM patients; though, further trials are suggested to confirm results.

Many studies have reported that human endometrial mesenchymal stem cells (HuMenSCs) are capable of repairing damaged tissues. The aim of the present study was to investigate the effects of HuMenSCs transplantation as a treatment modality in premature ovarian failure (POF) associated with chemotherapy-induced ovarian damage. HuMenSCs were isolated from menstrual blood samples of five women. After the in vitro culture of HuMenSCs, purity of the cells was assessed by cytometry using CD44, CD90, CD34, and CD45 FITC conjugate antibody. Twenty-four female Wistar rats were randomly divided into four groups: negative control, positive control, sham, and treatment groups. The rat models of POF used in our study were established by injecting busulfan intraperitoneally into the rats during the first estrus cycle. HuMenSCs were transplanted by injection via the tail vein into the POF-induced rats. Four weeks after POF induction, ovaries were collected and the levels of Amh, Fst, and Fshr expression in the granulosa cell (GC) layer, as well as plasma estradiol (E2) and progesterone (P4) levels were evaluated. Moreover, migration and localization of DiI-labeled HuMenSCs were detected, and the labeled cells were found to be localized in GCs layer of immature follicles. In addition to DiI-labelled HuMenSCs tracking, increased levels of expression of Amh and Fshr and Fst, and the high plasma levels of E2 and P4 confirmed that HuMenSC transplantation had a significant effect on follicle formation and ovulation in the treatment group compared with the negative control (POF) group.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is the hepatic component of metabolic syndrome. Despite the beneficial health effects of cardamom on dyslipidemia, hepatomegaly, and fasting hyperglycemia, no previous human study has been conducted on the efficacy of cardamom in NAFLD. The aim of this study was to assess the effects of green cardamom (GC) on serum Sirtuin-1 (Sirt1), inflammatory factors, and liver enzymes in overweight or obese NAFLD patients. METHODS: The recruitment of subjects was conducted at the polyclinic of the central hospital of National Iranian Oil Company (NIOC), Tehran. Eighty-seven patients who participated were divided randomly into two groups according to the ultrasonography and eligibility criteria as cardamom (n = 43) or placebo (n = 44). The intervention involves taking two 500 mg capsules three times per day with meals for 3 months. General characteristics, dietary intake and physical activity status, weight and height were determined. In addition, serum Sirt1, tumor necrosis factor-alpha (TNF-α), high sensitive c-reactive protein (hs-CRP), interleukin-6 (IL-6), alanine transaminase (ALT), and aspartate transaminase (AST) were measured. The degree of fatty liver was determined at beginning and end of the study. RESULTS: In comparison with placebo, GC significantly increased Sirt1 and decreased hs-CRP, TNF-α, IL-6, ALT, and the degree of fatty liver (P 0.05). CONCLUSION: GC supplementation could improve some biomarkers related to fatty liver including inflammation, ALT, and Sirt1 in overweight/obese NAFLD patients. Further trials on cardamom’s potential are suggested. TRIAL REGISTRATION: Iranian Registry of Clinical Trials, IRCT2015121317254N4. Registered 27/12/2015.

Background. Laryngeal cancer is the second most common cancer in the head and neck. Since laryngeal cancer management is a complex process, there is still no standard strategy to treat this disease in order to increase the survival rate of the patients especially among those with advanced form of the disease. Methods. A cohort study was undertaken to analyze factors predicting survival of the patients in advanced stage laryngeal cancer in the Southern Iran among all patients newly diagnosed with laryngeal cancer between 2000 and 2015. Results. Data of a total number of 415 patients who have had been diagnosed with advanced laryngeal cancer during this period was used for analysis. The patients’ 1-, 3-, 5-, and 10-year survival rates were 81%, 62%, 53%, and 38%, respectively. Multivariable Cox regression analyses indicated a significant relationship between patients’ survival and age at diagnosis (P<0.001), disease stage (P=0.002), tumor grade (P=0.008), positive L. node (P=0.008), and type of treatment (P<0.001). As expected, treatment strategy was identified as the most effective factor in survival of the patients. According to the results, patients who undergone surgical treatment experienced a longer survival than those who received other treatments. Conclusion. This study showed that the survival of patients depends on several factors, among which, treatment strategy is the most important. Combination of total laryngectomy plus chemoradiation provides superior local control and better survival compared to either radiotherapy or chemoradiation in patients with advanced laryngeal cancer.

To evaluate the auditory performance and speech production outcome in children with auditory neuropathy spectrum disorder (ANSD). The effect of age on the outcomes of the surgery at the time of implantation was also evaluated.Cochlear implantation was performed in 136 children with bilateral severe-to- profound hearing loss due to ANSD, at four tertiary academic centers. The patients were divided into two groups based on the age at the time of implantation; Group I: Children ≤24 months, and Group II: subjects24 months. The categories of auditory performance (CAP) and speech intelligibility rating (SIR) scores were evaluated after the first and second years of implantation. The differences between the CAP and SIR scores in the two groups were assessed.The median CAP scores improved significantly after the cochlear implantation in all the patients (p value 0.001). The improvement in the CAP scores during the first year in Group II was greater than Group I (p value: 0.007), but the improvement in CAP scores tended to be significantly higher in patients who were implanted at ≤24 months (p value 0.001). There was no significant difference between two groups in SIR scores at first-year and second-year follow-ups. The evaluation of the SIR improvement revealed significantly higher values for Group I during the second-year follow-up (p value: 0.003).The auditory performance and speech production skills of the children with ANSD improved significantly after cochlear implantation, and this improvement was affected by age at the time of implantation.

Many people have irreversible defects and to be death due to burn wounds every year. The current study was conducted to assess the effects of eucalyptus essence (EE) and its mixture with licorice in burn wound healing in rats. One hundred fifty rats were divided to five equal groups. Twenty-four hours after induction of third-degree burn wound, inoculation of 108 colony-forming units of Pseudomonas aeruginosa (PA 103) into the burnt area was performed in form of subcutaneous. Group 1 was given no treatment, and group 2 received gel base. Group 3 (positive control) was treated with silver sulfadiazine (SSD). Groups 4 and 5 used EE 1% and its mixture with licorice gel 10%, respectively. After 3, 7, 14, 21, and 28 days, the animals were euthanized and the wound healing parameters were evaluated through macroscopic and microscopic examinations. Microscopically, the rats treated with EE and mixture gel showed better wound healing than SSD (P