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Introduction: Pyrazinamide (PZA) susceptibility testing plays a critical role in determining the appropriate treatment regimens for multidrug-resistant tuberculosis. We conducted a systematic revie...

Blue rubber bleb nevus syndrome (BRBNS) is a rare disorder comprised of venous malformation mostly involving the skin and gastrointestinal (GI) tract but can also involve other visceral organs. The most predominant site of GI tract involvement is the small bowel. In patients with GI lesions, treatment depends on the severity of bleeding, and extent of involvement. Conservative therapy with iron supplementation and blood transfusion is appropriate in cases with mild bleeding but in severe cases endoscopic and surgical interventions would be beneficial. Also, medical therapy with sirolimus significantly reduces bleeding. A 20-year-old woman was referred to our hospital after transfusion of six units of packed cell because of several episodes of lower GI bleeding within the past three months in the form of melena and a single episode of hematochezia. Her last hemoglobin level before admission was 10mg/dl. She underwent various unsuccessful investigations since she was eight years old to find the origin of refractory iron deficiency anemia. In upper endoscopy, five bleeding polypoid lesions were discovered in the jejunum. Lesions were excised by snare polypectomy. Over a six-month follow-up period, no signs of lower GI bleeding were noted and the patient had a normal hemoglobin level.

Background and aims: Postpartum depression has a high prevalence in communities and needs great financial resources. On the other hand, the world views the spiritual health as a new and complementary dimension of health. The aim of this study was to investigate the correlation between postpartum depression and spiritual health.Materials and Methods: This correlational-analytic study was conducted on 152 women who gave birth 8 months ago, referred to Hajar Hospital, Imam Ali hospital, Molavi clinic, or other health centers of Shahrekord, and were also satisfied with participating in the study. They were selected by the simple sampling method and completed the Palutzian and Ellison Spiritual Health Questionnaire. Finally, the collected data were entered in SPSS software and descriptive statistics in addition to the Pearson correlation coefficient and K2 test were used to analyze the data.Results: In the present study, the mean age of the subjects was 29.15 (SD=5.45) with the range of 16-45 years. The mean scores of spiritual health and depression were obtained 96.3 and 8.94, respectively. The results of this study showed that the Pearson correlation coefficient was -75.5% (P˂ 0.001), demonstrating an inverse correlation between the scores of postpartum depression and spiritual health.Conclusion: In general, the correlation between postpartum depression and spiritual health was an inverse correlation and the level of depression decreased by an increase in spiritual health. It can be concluded that without the need for specific treatments, the level of postpartum depression can be reduced by increasing the level of spiritual health.

This article summarizes the effects of sivelestat on ALI/ARDS or ARDS with coagulopathy, both of which are frequently seen in patients with COVID-19. The emergence of the novel 2019-nCoV infection has been a global pandemic. The following databases were searched to identify relevant literature concerning empirical evidence: The Cochrane library, Pubmed, Medline, EMBASE from 1980 through March 2020. COVID-19 patients are more susceptible to thromboembolic diseases including DIC. In this connection, various studies have emphasized on the role of neutrophil elastase (NE) in the development of DIC in patients with ARDS and sepsis. It has been shown that NE inhibition by sivelestat mitigates ALI through amelioration of alveolar epithelium and vascular endothelium injuries as well as reversing the activated neutrophil-mediated increased vascular permeability. Sivelestat is a selective NE inhibitor has not been evaluated for its possible therapeutic effects against SARS-CoV-2 infection and/or COVID-19. Nevertheless, based on its promising beneficial effects in underlying complications of COVID-19, sivelestat could be considered as a promising treatment for the management of ALI/ARDS or coagulopathy in patients with COVID-19.

We determined the impact of Photobiomodulation (PBM) and metformin administration alone and combined on the inflammation and proliferation steps of wound healing of incisions in type two diabetes mellitus (T2DM) rats. 40 rats were divided into 4 groups (n = 10 each group). A non-genetic model of T2DM was induced in all rats, and an incision was made on each rat. There were 4 groups as follows: Group 1 was control group. Group 2 received PBM alone (890 nm, 80 Hz, 0.324 J/cm2, daily). Group 3 received metformin alone (50 mg/kg, i.p., daily) and the fourth group received combination of PBM + metformin. At inflammation (day 4) and proliferation (day 7) steps, tensiometerical, stereological, and immunohistochemical examinations were performed. PBM and PBM + metformin treatments significantly increased wound strength at inflammation and proliferation steps of wound healing respectively. PBM, metformin, and PBM + metformin groups significantly decreased inflammatory cells at inflammation and proliferation steps of wound healing. PBM, metformin, and PBM + metformin groups significantly improved granulation tissue formation by increasing fibroblasts, and new blood vessel formation at inflammation and proliferation steps of wound healing. Metformin significantly increased M2 macrophages than other treatment groups at inflammation and proliferation steps of wound healing. Simultaneously, PBM significantly decreased M2 macrophages than control group. We concluded PBM and PBM + metformin treatments significantly hastened repair at the inflammation and proliferation steps of repairing skin injury in a non-genetic model of T2 DM. PBM + metformin showed a synergistic impact. There were not a positive relation between M2 macrophage number and wound strength in the studied groups. The details of the molecular mechanisms of PBM, and PBM + metformin treatments of repairing wounds in animals, and treatment of DFUs of patients with T2 DM should be elucidated by further research.

Burn wound treatment is difficult and one of the most challenging problems in the clinic. Researchers have examined the applications of mesenchymal stem cells as a cell-based therapy for skin regeneration. But the role of human bone marrow mesenchymal stem cell conditioned medium (hBM-MSC-CM) in the treatment of burn injury remains unclear. This research aims at detecting whether hBM-MSC-CM can increase the wound healing of deep second-degree burns in male rats. In this study, 32 adult male rats per each time point were randomly divided into four groups: (1) control group, (2) sham group (DMEM), (3) common treatment group (CT), and (4) conditioned media group (CM). A 3 × 3 cm circular burn was created on the back of the rats. On postsurgical days 7, 15, and 28, the wound closure area of each wound was measured and then the skin samples were removed and analyzed using stereological methods. Wound closure area was significantly increased in the CM and CT groups on the 15th and the 28th day after burn injury compared to the control and DMEM groups. The stereological parameters and immunohistochemistry analysis of the wounds revealed significantly improved healing in the CM group compared to the control and other groups. It is concluded that these findings indicate that hBM-MSC-CM promotes skin wound healing by increasing cell proliferation, regulating collagen synthesis and collagen composition, and inducing angiogenesis at the injury site.

A lack of effective treatments still exists for patients suffering from diabetes mellitus. Photobiomodulation is proved as a beneficial therapeutic modality for wounds.The aim of this study is to examine the effect of degranulation of mast cells and total number of mast cells in the remodeling step of an ischemic model of wound healing under the influence of photobiomodulation and conditioned medium (CM) from human bone marrow-derived mesenchymal stem cells (hBM-MSCs-CM), or CM, administered alone and or in combination.Initially, type 1 diabetes mellitus was induced in 72 male adult rats. Then, after a month, one incision was made on the back of each rat. Subsequently, the rats were divided into four groups. The first group was considered as the control (placebo) group, the second group received CM, the third group received photobiomodulation, and the fourth group received photobiomodulation+CM. On days 4, 7, and 15, samples were extracted from the wound for histological and tensiometric examinations. The total number of mast cells, including the three types of mast cells, was counted by the stereological methods. The tensiometric properties of the repairing tissue were examined.The administration of photobiomodulation and CM, alone or in combination, significantly increased the tensiometric properties within the healing wounds. Histologically, photobiomodulation+CM, CM, and photobiomodulation groups showed a significant decrease in the three types of mast cells and in the total number of mast cells compared with the control group on day 15.We conclude that photobiomodulation and CM alone and or in combination significantly accelerated the healing process in a rat with a diabetic and ischemic wound, and significantly decreased the total number of mast cells and degranulation of mast cells. We suggest that the increased number of type 2 mast cells in the control group adversely affected the tensiometric properties of wounds in this group.

Interventional bronchoscopy procedures are novel and effective modes of diagnosing and treating airway lesions. Airway management and ventilation are a major concern, especially when considering the fire hazard of ventilating during endobronchial thermal therapies. The aim of this study was to evaluate the usage of laryngeal mask airway (LMA) compared to rigid bronchoscopy for the ventilation of patients undergoing diagnostic or therapeutic interventional bronchoscopy procedures.During this prospective randomised clinical trial study, patients were randomly allocated to two groups for ventilation: LMA and rigid bronchoscopy. Vital signs, including blood pressure, heart rate and percentage of blood O2 saturation before and during the procedure, degree of sore throat after recovery and physician's satisfaction, were recorded.A total of 83 patients, including 45 in the "LMA" and 38 in the "rigid" groups, were enrolled in this study. Their mean age was 51±17 years, and 59 (71%) were male. There was a statically significant difference between "rigid" and "LMA" categories regarding the decrease in O2 during the procedure in proportion to baseline figures (p=0.028). Haemodynamic parameters were better maintained using LMA compared to rigid bronchoscopy.Laryngeal mask ventilation maintains better oxygenation and haemodynamic stability and ensures physicians' and patients' satisfaction regarding ease of use, airway access and fewer complications compared to rigid bronchoscopy. Therefore, LMA can be introduced as a reliable alternative for ventilation during interventional airway procedures.

Scrotal pain presentation has many differential diagnoses such as testicular torsion is surgical emergency. For this reason, it is necessary for surgeons to differentiate between diseases for choosing the best treatment approach. We have reported a rare condition of 19-year-old male case had an atypical scrotal pain presentation of appendicitis. He was admitted to emergency service with 4 days history of pain in abdomen and testis. In physical examination, there is tenderness in right lower quadrant, right inguinal region and scrotum. Testicular torsion and appendicitis were roll-out in sonography. Because of low sensitivity of sonography in diagnose of appendicitis and high suspicious of surgeons, the case was candidate for an open appendectomy surgery. Acute suppurative appendicitis that presenting testicular pain is rare for making the best diagnosis and prevents multiple surgeries in such cases, cooperation of urology, general surgery and radiology specialists with high index of suspicion is required

Establishing high standards for educational accountability and informing those not already familiar with the basic components of a strong accountability system is a fresh avenue in EFL context, particularly in Iran, where the perceived shortcomings of English learning in the public sector are evident. The present mixed methods study used educational accountability as a theoretical framework to determine the level to which its elements (Goals, Performance Indicators, Design Decisions, Consequences, Communication, Support, and System Evaluation, Monitoring, and Improvement) differ in Iranian high schools and English language institutes when concerning school principals, English teachers, parents, and students. To this end, 300 EFL learners, 120 parents, 100 English teachers, and 60 principals were selected to complete the piloted and validated educational accountability questionnaires. The reliability of all questionnaires was around 0.95. To better understand the results of the questionnaires, 86 semi-structured interviews were conducted. The results of the t-tests indicated a statistically significant difference between the levels of accountability in both EFL contexts. The only exception was the aspect of Communication, which was almost the same in both educational contexts. The results of the semi-structured interviews also confirmed those of the questionnaires. Several remedies were offered by the researchers of the study. The findings of this study suggest that the EFL agents and policymakers can take advantage of educational accountability systems.

The central role of teachers in enhancing education quality and promoting education reform has been largely acknowledged by various researchers. However, professional development (PD) in Iran is far from satisfactory. This paper initially outlines major shifts in professional development. It then provides a critical appraisal of professional development in Iran in both pre service and in service education. Finally, it concludes by offering ways to revitalize continuing teacher professional development.

The present article aims to investigate the impact of interactions through Skype on Iranian EFL learners’ speaking ability. To meet this end, forty elementary students who were studying English at the Kish Language Institute, Shiraz Branch, Iran participated in the study. Of this number, twenty eight were female and twelve were male students. Their age range was between twenty to thirty five and they were divided into two groups randomly. During the instruction which lasted for two and a half months, the participants of the experimental group interacted with the teacher on their course-related topics for one hour per week according to a schedule besides their weekly four hour face-to-face classes. The speaking paper of the Key English Test (KET) was administered as to assess the participants’ speaking ability. The findings of the study indicated that the participants of the experimental group outperformed those of the control one. This outperformance can be accounted for by the Long’s Interaction hypothesis (1996), Krashen's Input hypothesis (1977), and lower affective filters.

This study aimed to investigate the effects of three writing assignments (sentence making, composition writing and cloze test) on vocabulary learning and tried to compare the effectiveness of these assignments to see which one has the best effect. Accordingly, 102 homogeneous pre-intermediate EFL female learners, studying English at an institute in Shiraz, Iran, were randomly divided into three groups. At the beginning, an unannounced researcher-made pre-test including 60 multiple choice tests (60 vocabulary items, from all parts of speech) was administered which showed no learners knew all the items. Then during 6 sessions the 60 vocabulary items were taught (each session 10 items). Each session, in the first group the participants were asked to write a sentence for each of the 10 items. In the second group the participants were asked to write a composition using the 10 newly taught vocabulary, and in the third group the participants were asked to fill in the blanks of a cloze-test. After the 6 th session a post-test which was the same as the pre-test was administered. To analyze the data obtained from the tests, two one-way ANOVAs and three paired t-tests were utilized. The results indicated that all three assignments were significantly effective to help learners learn new vocabulary items and that the learners were not significantly different from each other in the pre-test. Moreover, the group which was to write a composition did significantly better in the post test than the two other groups but the difference between the two other groups was not significant. An interview was done by the researcher after the treatment period. The interview results confirmed the beneficial effects of these assignments on learners' vocabulary learning.

Learning environments have turned to a hot discussion among language scholars. Very popular nowadays, blended learning is not a new concept. It enjoys the advantages of face-to-face classrooms and virtual learning. This study is an attempt to discover whether conventional or blended learning environments can better enhance the reading comprehension for EFL learners. 107 Iranian students majoring in English at Abadeh Islamic Azad University and Zand Institute of Higher Education in Shiraz were selected. A reading comprehension test was administered as the pretest. Then, the participants were put in control and experimental groups. For the treatment, the experimental group received the instruction in the classroom and had assignments through virtual environments whereas the control group had the instruction and assignments in conventional mode. A post-test of reading comprehension was administered, and the participants' performances in both tests were compared. The results indicated blending traditional classroom instruction with technology can help learners outperform in their reading comprehension.

The present study intends to investigate the effect of cooperative learning on English language achievement of undergraduate students in higher education classrooms. This quasi-experimental research used a pre and post-test group design. Fifty four Iranian undergraduate students in different majors at Shiraz Azad University who were taking general English course were involved in this research. Some cooperative learning methods were implemented in reading comprehension and writing. The students were asked to do the pretest for the sake of homogeneity and the final exam as the post test for the sake of academic achievement. The average was taken to indicate students’ overall English language achievement. An independent t-test was run to compare the achievement scores of the experimental and control groups. Results indicated significant difference between cooperative learning and teacher-fronted method of instructions in language learning in General English course.