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Background and Purpose: Today, one of the most effective and appropriate treatment strategies for edentulous areas is the use of dental implants to improve esthetics and chewing, which may affect the oral health-related quality of life (OHRQoL) in patients. This study aimed to investigate the impact of dental implant treatment on OHRQoL in patients referred to specialized private practices. Materials and Methods: In this retrospective study, 349 patients who underwent dental implant procedures in private practices of maxillofacial surgeons or periodontists in Sari from 2018 to 2022 were randomly selected. These patients were asked to complete the OHIP-14 questionnaire to evaluate their OHRQoL. The variables of age, gender, implant site, and the number of implants were examined in relation to quality of life. Based on the average scores from the questionnaire, each patient was categorized into one of the following groups: very good (0–11), good (12–22), average (23–34), bad (35–45), and very bad (46–56). The data were then analyzed using an independent t-test, ANOVA, and multiple regression tests, with a significance level set at P=0.05. Results: A total of 325 questionnaires were completed, with 167 (51.4%) patients being female, and the mean age of the participants was 44.18 ± 8.46 years. The overall mean OHRQoL after implant treatment was good (16.80±3.56). In total, 98.8% of the patients reported good OHRQoL, while only 1.2% reported poor OHRQoL. Significant differences were found between the number of implants, implant site, time elapsed since implant treatment, and gender in relation to OHRQoL (P

Background: The association between dietary patterns and chronic diseases and mortality risk has been demonstrated in recent studies. Considering that dietary patterns can provide an approach that is comprehensive to both disease prevention and treatment, this study was conducted to find out prominent dietary patterns among Bandare-Kong participants. Materials and Methods: This population-based cross-sectional study was performed on Bandare-Kong non-communicable disease (BKNCD) Cohort study participants aged 35-70. A food frequency questionnaire was used to determine food intake. The factor analysis method with the principal component analysis approach was employed to extract major dietary patterns. Results: Healthy, Western, and traditional diets were identified as the three major dietary patterns. The healthy pattern was the prominent dietary pattern (10.2%). Healthy, Western, and traditional nutritional patterns explain 10.20%, 6.30%, and 4.28% of the variance in food intake, respectively. Conclusion: Our findings indicated that consumption of a healthy dietary pattern in BKNCD participants tended to be high, followed by Western as the second pattern. It is recommended that further longitudinal studies be conducted to assess the role of dietary patterns in cardiometabolic disease incidence.

There is little data regarding the impact of renin-angiotensin system (RAS) gene polymorphisms on tuberculosis. The current study designed to survey the possible association between RAS polymorphisms and the risk of pulmonary tuberculosis (PTB) in a sample of the southeast Iranian population. This case-control study was done on 170 PTB patients and 170 healthy subjects. The AGT rs699 C>T, ACE rs4341 C>G and AT1R rs5186 C>A variants were genotyped using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) and ACE rs4646994 (287bp I/D) variant by PCR method. Regarding AT1R rs5186 A>C polymorphism, the findings revealed that AC genotype and C allele significantly decreased the risk of PTB (OR=0.39, 95% CI=0.22–0.67, p=0.001, and OR=0.53, 95% CI=0.25–0.72, p=0.002, C vs. A, respectively). The TC genotype and C allele of AGT rs699 T>C significantly associated with decreased the risk of PTB (OR=0.45, 95% CI=0.28–0.74, p=0.002, TC vs. TT and OR=0.51, 95% CI=0.32–0.80, p=0.005, C vs. T, respectively). The ID genotype of ACE 287bp I/D significantly increased the risk of PTB (OR=1.88, 95% CI=1.12–3.17, p=0.017). Our finding did not support an association between ACE rs4341 C>G variant and the risk of PTB. In summary, the findings revealed an association between AT1R rs5186 A>C, AGT rs699 T>C and ACE 287bp I/D polymorphisms and the risk of PTB in a sample of the southeast Iranian population. Further investigation with higher sample sizes and diverse ethnicities are required to confirm our findings.

ObjectiveAlthough milk and dairy products are almost complete food, they can contain toxic heavy elements with potential hazards for consumers. This review aims to provide a comprehensive report on the occurrence, concentration, and health risks of selected heavy metals in pasteurized and sterilized milk recorded worldwide.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to develop this systematic review. Databases included the Web of Knowledge, Scopus, Scientific Information Database, Google Scholar, and PubMed from inception until January 2023. Keywords related to the terms "Heavy metals", "Arsenic" and "Pasteurized and sterilized milk" and "Risk Assessment" were used. The potential health risks to human health from milk daily consumption were estimated using extracted data on heavy metals concentration based on metal estimated daily intake, target hazard quotient, and carcinogenic risk.ResultsA total of 48 potentially relevant articles with data on 981 milk samples were included in the systematic review. Atomic Absorption Spectroscopy, atomic absorption spectroscopy, inductively coupled plasma-mass spectrometry, and inductively coupled plasma-optical emission spectrometry were the most common valid methods to measure heavy metals in milk samples. Following the initial evaluation, Cu, Cd, Zn, and Pb were the most contaminants, which exceeded the maximum permissible criteria in 94%, 67%, 62%, and 46% of the milk samples tested. Relying on target hazard quotient and carcinogenic risk results, milk consumers in 33(68.75%) and 7 (14.5%) studies were exposed to moderate to high levels of carcinogenic and non-carcinogenic risk, respectively. The highest level of risk is due to the consumption of pasteurized and sterilized milk detected in Pakistan, Brazil, Egypt, Slovakia, and Turkey.ConclusionThe elevated levels of heavy metals in milk samples, especially Pb and Cd is a public health concern; therefore, maximum control and strict regulations must be adopted to decrease heavy metals contaminants in the dairy industry. Further studies are required to develop safe milk processing and handling methods for the decontamination of heavy metals in milk and its products.

Background and Objectives: Nowadays, to avoid the use of synthetic preservatives, which do more harm than good, numerous studies are currently focused on using natural ingredients to enhance food product quality and shelf life. Since no study has been conducted on combining coatings with electrolyzed water containing natural antimicrobial compounds, the present study has innovation and priority. In the present study, the effect of chitosan coating prepared through Neutral Electrolyzed Water (NEW) on inhibiting the growth of Escherichia coli O157:H7 inoculated in rainbow trout fillet over 12 days at 4 ˚C was examined. Material and Methods: Fish samples were allocated into six groups following inoculation with E. coli O157:H7 (final concentration: ~ 105 CFU/g). Treatments included control (CON), distilled water (DW), neutral electrolyzed water (NEW), chitosan 2% (CH), chitosan coating prepared by neutral electrolyzed water (CH/NEW), and neutral electrolyzed water followed by chitosan (NEW+CH). Treatments were kept at low temperature (refrigerator) and counting bacteria was done on 0, 1st, 3rd, 6th, 9th, and 12th days. Data analyses were done through repeated measure ANVOA and Bonferroni post hoc tests. Results: As indicated by the findings, the reduction rate of EW, CH, CH+WE, and CH/EW samples were 1.04, 1.45, 2.01, and 2.02 log CFU/g compared with the CON, respectively. The highest reduction rate was observed in the CH/NEW sample, due to the antimicrobial activity of chitosan and neutral electrolyzed water. Conclusion: Chitosan coating can be combined with NEW in fish to increase the safety against pathogenic bacteria and E. coli O157:H7. Therefore, it can suggest the use of these natural antimicrobial compounds in the food industry.

Abstract This study presents the design and synthetic pathway of unsymmetric ligands based on pyridine-pyrazolate scaffold with Donor–Acceptor (D–A) molecular arrays and their boron complexes to achieve a large Stokes shift. Intermolecular charge transfer (ICT) triggered by the uneven molecular charge distribution from electronically dense pyrazolate (donor) part of the ligands to electron-deficient boron centre (acceptor) resulted in a mega Stokes shift up to 263 nm for selected compounds while retaining the characteristic quantum efficiency and chemical stability. The photophysical properties of derivatization of pyrazolate group in the pyridine-pyrazolate scaffold of diaryl boron complexes were explored based on UV–Visible, steady-state and time-resolved fluorescence spectroscopy. An interesting dual emission along with quenching behaviour was also observed for 2-(6-methoxynaphthelene) 5-(2-pyridyl) pyrazolate boron complex (P5) due to the formation of a twisted intermolecular charge transfer (TICT) state from a locally excited (LE) state rendering it a potential candidate for sensing applications based on H-Bond quenching. In addition, the extended excited state lifetime of the reported compounds compared to classical boron-dipyrromethene (BODIPY) makes them suitable as potential probes for analytical applications requiring a longer excited state lifetime.

Objectives: Bee venom (BV) therapy is performed by a bee sting or subcutaneous injection of BV. However, there is not much information on the effect of BV on blood parameters after entering the body. This project aimed to assess the side effects of subcutaneous BV injections in healthy rats by measuring the hematological and biochemical parameters.Methods : Various amounts of BV, including 100, 200, and 500 (μg/day), were subcutaneously injected into rats for 30 days. The results showed that BV affected the metabolism of the liver, kidney, and glands.Results : An increase in blood sugar and a decrease in other biochemical parameters, including cholesterol, triglyceride, urea, creatinine AST, ALT, ALP, and phosphorous, were observed. Results : also showed increased counts of white blood cells, neutrophils (%), and platelets and decreased levels of red cells, hemoglobin, and hematocrit.Conclusion : This study demonstrates that BV therapy in medical clinics requires routine care and testing to prevent eventual metabolic and anemia side effects.

Background and objectives: Neutralized electrolyzed water (NEW) is a novel natural disinfectant. It has been suggested that application of NEW can improve the shelf life of fish. This study aimed to investigate effect of NEW incorporated in alginate coating on growth of Escherichia coli O157: H7 on salmon fillets over a period of 12 days. Methods: Fish fillets were inoculated with E. coli O157:H7 and divided into six different treatment groups: control (no coating), distilled water, alginate, EW, EW & alginate (Samples coated with alginate solution prepared by EW), and EW+ alginate (samples immersed in EW, then coated with alginate solution). The fillets were kept at 4 °C, and the bacterial count was determined on days: 0, 2, 4, 8, and 12. Data analysis was performed using repeated ANOVA and Bonferroni post-hoctest at statistical significance of 0.05. Results: Treatment with alginate coating and EW alone could significantly reduce E. coli O157: H7 count on the salmon fillets. However, maximum reduction (1.27 log CFU/g) of bacteria was achieved when using alginate coating combined with EW. Conclusion: According to the results, the combination of alginate coating with EW can be applied as a natural antimicrobial for increasing safety of food products, especially fish, against pathogenic bacteria such as E. coli O157: H7.

Abstract The aim of this study was to present and evaluate novel oral vaccines, based on self-amplifying RNA lipid nanparticles (saRNA LNPs), saRNA transfected Lactobacillus plantarum LNPs, and saRNA transfected Lactobacillus plantarum, to neutralize severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) variants alpha and delta. After invitro evaluation of the oral vaccines on HEK293T/17 cells, we found that saRNA LNPs, saRNA transfected Lactobacillus plantarum LNPs, and saRNA transfected Lactobacillus plantarum could express S-protein at both mRNA and protein levels. In the next step, BALB/c mice were orally vaccinated with saRNA LNPs, saRNA transfected Lactobacillus plantarum LNPs, and saRNA transfected Lactobacillus plantarum at weeks 1 and 3. Importantly, a high titer of IgG and IgA was observed by all of them, sharply in week 6 (P

Abstract Background The aim of this study was to evaluate the expression of four up/down-regulated inflammatory miRNAs and their mRNA targets in the serum samples of COVID-19 patients with different grades. Also, we investigated the relative expression of these miRNAs and mRNAs during hospitalization. Methods In this cross-sectional study, 5 mL of blood sample were taken from COVID-19 patients with different grades and during hospitalization from several health centers of Yazd, Tehran, and Zahedan province of Iran from December 20, 2020 to March 2, 2021. The relative expression of miRNAs and mRNAs was evaluated by q-PCR. Results We found that the relative expression of hsa-miR-31-3p, hsa-miR-29a-3p, and hsa-miR-126-3p was significantly decreased and the relative expression of their mRNA targets (ZMYM5, COL5A3, and CAMSAP1) was significantly increased with the increase of disease grade. Conversely, the relative expression of hsa-miR-17-3p was significantly increased and its mRNA target (DICER1) was significantly decreased with the increase of disease grade. This pattern was exactly seen during hospitalization of COVID-19 patients who did not respond to treatment. In COVID-19 patients who responded to treatment, the expression of selected miRNAs and their mRNA targets returned to the normal level. A negative significant correlation was seen between (1) the expression of hsa-miR-31-3p and ZMYM5, (2) hsa-miR-29a-3p and COL5A3, (3) hsa-miR-126-3p and CAMSAP1, and (4) hsa-miR-17-3p and DICER1 in COVID-19 patients with any grade (P

Background and objectives: Chitosan is a preservative that is commonly used in food packaging due to forming a film with antimicrobial activity. Many antimicrobial agents have been used to control the growth of different bacteria, fungi and yeasts in food products using chitosan coating. The present research was conducted to examine inhibitory effects of a coating incorporated with the essential oils of Zataria multiflora (ZEO) and Bunium persicum (BEO) on the growth of Pseudomonas artificially inoculated onto salmon fillets over a period of 12 days at 4 °C. Methods: The antibacterial activity of BEO against P. aeruginosa was evaluated using the microdilution method via determining minimum inhibitory concentration and minimum bactericidal concentration. For the food model investigation, three P. aeruginosa strains were inoculated onto trout fillets as culture cocktail to assess their survival over 12 days of storage. Results: The results indicated that ZEO and BEO had stronger inhibitory effect on P. aeruginosa in trout fillets when applied along with gel type nano-emulsion of chitosan solution. The separate use of each of these substances also significantly inhibited the growth of these pathogenic bacteria compared with the control. In addition, the use of chitosan coating without any antimicrobial agent affected the growth of P. aeruginosa. Conclusion: The gel type nano-emulsion of chitosan coating containing ZEO and BEO can be applied on foodstuff, particularly fish and its products, as an antimicrobial agent.

Mannose-binding lectin (MBL) is an acute phase protein which recognizes the pathogens through its carbohydrate recognition domain. It is an important part of human innate immunity. The aim of the current study was to evaluate the impact of MBL2 polymorphism on pulmonary tuberculosis in a number of patients from the southeast of Iran. In this case-control study, 2 MBL gene polymorphisms (rs1800450, rs7095891) were genotyped using PCR-RFLP method and polymerase chain reaction for detection of 34bp ins/del of MBL2 gene (rs777980157) polymorphism. The study included 170 patients with PTB (pulmonary tuberculosis) and 175 control subjects. The findings indicated that the GA (GA vs. GG: OR=0.172, 95% CI=0.107–0.275, P

Background: Breast cancer is the most prevalent malignancy in females which needs chemotherapy treatment. Studies demonstrated that anti-cancer agents used for chemotherapy in cancer patient causes endothelium dysfunction. Several researches showed the efficacy of angiotensin-converting enzyme inhibitors, Carvedilol and Spironolactone on improving endothelial function. This study aimed to evaluate the effect of the combination of Spironolactone, Carvedilol, and Captopril on endothelial function in breast cancer patients. Materials and Methods: This study is a prospective Randomized Clinical Trial in breast cancer patients who underwent chemotherapy. Patients were divided into two groups who received the combination of Captopril, Spironolactone, and Carvedilol or standard regimen for 3 months during chemotherapy. Before and after intervention, ejection fraction (EF), E/A ratio and e' and flow-mediated dilation (FMD) properties were calculated and then compared. Results: Fifty-eight patients with a mean age of 47.57 ± 9.46 years were evaluated. The mean FMD after the intervention is statistically different in case and controls (

Background: One third of the world’s population is infected with TB, and the disease is known as the second deadly global infection, even more severe than measles. The disease kills about 2 million people a year. Approximately 8 million people in the world are affected by advanced tuberculosis (TB). Objective: The current study aimed to determine the frequency of resistance to the antibiotics isoniazid and rifampin in positive culture pulmonary TB patients in Zahedan city during 2013-2016. Methods: This descriptive cross-sectional study studied 100 samples from patients who referred to Boo-Ali hospital of Zahedan city from 2014 to 2016. First, the isoniazid solution was prepared, and then the rifampin solution was prepared. After that, 200 μL of mycobacterium suspension was added to the antibiotic and antibiotic-free control. Results: Of 100 patients participating in the study, 50 (50%) were male and 50 (50%) were female. Participants had an average age of 51.69 ± 20.41 years (95-12 years), 79 (79%) were Iranians and 21 (21%) were Afghans. Of the 100 samples, 55 (55%) were from the year 2013, 21 (21%) were from 2014, 10 (10%) were from 2015, and 14 (14%) were from year 2016. The samples examined showed that 4 (4%) were resistant and 96% were sensitive. Conclusion: The results of the current study showed that out of 100 samples, 4 cases (4%) had resistance and 96% were sensitive; 2% were resistant to isoniazid, and 2% were resistant to isoniazid and rifampin.

ABSTRACT Background and objectives: Utilization of essential oils instead of chemical preservatives has received significant attention in recent years. The present study aims to evaluate chemical composition and antibacterial and antioxidant properties of essential oils of Zataria multiflora, Artemisia deracunculus and Mentha piperita. Methods: Chemical profile of the essential oils was analyzed by gas chromatography/mass spectrometry. The microwell dilution and agar disk diffusion methods were used to evaluate the antibacterial properties of the essential oils. Total phenolic content, β-carotene-linoleic acid bleaching test and 2,2-diphenyl-1-picrylhydrazyl (DPPH) assays were carried out to determine the antioxidant properties. Results: Menthol (39.18%) and mentone (21.64%) were the main components of the essential oil of M. piperita, while estragol (34.75%) and limonene (15.72%) were the major components of the essential oil of A. dracunculus. The main components of the essential oil of Z. multiflora were carvacrol (36.81%) and thymol (33.04%). The essential oils of M. piperita and Z. multiflora showed greater antimicrobial effects. Moreover, Z. multiflora showed the greatest antioxidant activity among the essential oils. The total phenolic content of Z. multiflora was 228.14±0.45 mg gallic acid equivalent/g. Conclusion: Given their favorable antioxidant and antimicrobial properties, the essential oils of Z. multiflora, A. deracunculus and M. piperita can be used as natural food preservatives. Keywords: Zataria multiflora, Artemisia deracunculus, Mentha piperita, antibacterial effect, antioxidant effect.

Background: In the world, cardiovascular diseases are the major cause of death, as 31% of global mortality is from them. Due to problems such as the lack of technologies such as echocardiography, and limited access to cardiologists in deprived areas, automatic methods for detecting heart abnormalities in phonocardiogram (PCG) are used. Methods: In this study, to distinguish between normal and abnormal cases, three categories of features in PCG were estimated and evaluated. First, the extraction of the heart rate and heart rate variability; second, some of the features used in speech analysis and pattern recognition; and third, the time center, the frequency center, and the frequency variance of the signal. Some methods were proposed for extracting desired features, and the data were analyzed using t-test. Findings: The results of evaluation of the 10 proposed features, with the p-value of less than 0.010, showed that 8 features had significant distinction to detect abnormal cases from the normal ones. Conclusion: Regarding the patterns of the extracted features, the distinction between normal and abnormal signals was observed, which can be used to classify PCGs. Moreover, in the future, new features can be extracted from these patterns using some other analysis such as correlation.

Background: Mortality due to acute coronary syndrome (ACS) has dramatically diminished because of performing life-saving interventions. This study aims to assess the metabolic risk factors and heart healthy lifestyle following the first episode of ACS under percutaneous coronary intervention (PCI) treatment after the 6-month follow-up. Materials and Methods: This is a longitudinal study conducted on 40 patients who underwent PCI because of the first episode of ACS. The patients' information including age, weight, abdominal circumference, smoking, functional capacity, patients' metabolic equivalent of task (METS), and laboratory tests including triglycerides (TGs), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), creatinine, fasting blood sugar (FBS), and hemoglobin A1C were recorded before discharge and reassessed after 6-month follow-up. Results: The patients were dominantly male (92.5%) with an average age of 56.8 ± 7.11 years. Physical activity and functional capacity (METS) significantly improved within 6 months (P = 0.019). BMI significantly improved; however, although the abdominal circumference decreased, it was not significant (P = 0.28). The number of smokers (P = 0.12) and the daily number of smoked cigarettes (P = 0.37) nonsignificantly decreased within 6 months. However, HDL-C (P = 0.013) and LDL-C (P = 0.027) changes were not desirable. TG, FBS, and blood pressure did not statistically significant change (P > 0.05). Conclusion: Although BMI, physical activity, and METS remarkably improved, waist circumference decreased nonsignificantly and lipid profile got worse paradoxically. Although this population is limited for generalization, this study shows that we require further schedules to improve ACS secondary prevention practice in our community.

Objective: The reasons that some of these studies have offered for aerobic training’s lack of tangible effect on the level of angiogenesis, are subjects’ readiness and the conditions of their diseases, while others have detected the intensity and the frequency of doing the aerobic trainings as the factors preventing the effectiveness of them on the level of angiogenesis. Thus, the present study studied the effects of taking interval and continuous aerobic trainings on the degrees of angiogenesis and nitric oxide. Materials and Methods: Sixty eligible old men in Kahrizak nursing home among volunteers were selected and studied in three groups (Continuous, Interval and Control). First, the initial blood samples were gathered to record of serum WEGF by ELISA kit. In the second stage NO in saliva were measured by conversion of nitrate to nitrite and by Griess reaction. After the 48 hours, experimental group in both continuous and interval carried out training for 6 weeks and the control group continued their daily activities. Post-test data measured and recorded in the same conditions with the pre-test. Obtained data were analyzed by using one-way ANOVA, Scheffe post hoc and dependent T-test. Results: The results showed that WEGF serum and salivary NO levels after performing the aerobic training to both continuous and interval methods was not any significantly different (P>0.05). However, the percentage change recorded data for the experimental group than in the control group despite the lack of significant difference of nearly a significant increase in the WEGF serum and saliva levels of NO were observed (No: Continuous and Interval≈ 0/05 increase, Control: 0/01 increase, VEGF: Continuous= 0/03 Increase, Interval= 0/05 Increase, Control= 0/02 Decrease). According to the paradox observed in obese and diabetes subjects can be said that apply the aerobic training in elderly subjects with such conditions requires specific design and likely to be that the implementation of traditional aerobic trainings will not have a significant effect on the WEGF serum and NO saliva levels. Conclusion: In the present study, we found that doing aerobics training in both continuous and interval courses had no significant effects on the level of angiogenesis and nitric oxide in the old men under study. However, we can maintain that taking aerobic trainings by subjects who suffer from diabetes, hypertension and obesity, based on results from previous studies has no positive effects. Patients suffering from diabetes, hypertension and obesity would see no significant change in their angiogenesis rate after doing continuous or interval aerobic trainings.

Background: Rupture of an atherosclerotic plaque or endothelial erosion with superimposed thrombosis in coronary arteries are primary causes of acute coronary syndromes. This study aimed to evaluate the anatomic distribution of culprit lesions by coronary territories, also to find any association between long-term outcomes and culprit lesion location in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods: Patients presented at the emergency room of a tertiary cardiac center with symptoms suggestive of ACS, possible candidates for elective coronary angiography (CAG), were enrolled and followed up every year for five years for major adverse cardiac events (MACEs). Findings: The subjects had a mean age of 60.6 ± 11.3 years, whom 74.4% were men. CAG revealed that among 98 lesions in coronary arteries, the left anterior descending (LAD) artery was the most common accused artery with frequency of 46%. Five-year follow-up results showed that 32.2% of patients experienced MACE which developed more in the LAD (38%) and then the right coronary artery (RCA) territories (27.6%) with no significant differences between other territories. Conclusion: Although we found no significant differences between MACEs scores in different groups of coronary territories, but cardiologists may be able to plan follow-ups by the primary lesion. According to our study, the most frequent MACE was repeated percutaneous coronary intervention (PCI), which showed the importance of intervention in early diagnose, follow-up and treatment. Further studies with higher sample sizes are needed to show the prognostic value of culprit lesion territory in patients with ACS.

Background: Vascular diseases and cognitive impairment are prevalent in elder people. Association between cardiovascular diseases and cognitive dysfunction is reported in previous studies and there are limited studies followed patients with cardiovascular diseases for cognitive functions. This study aimed to evaluate patients with coronary artery diseases and over 65 years of age for cognitive function. Methods: This was a prospective cohort study on patients undergoing coronary artery angiography in Sina and Chamran hospitals, Isfahan City, Iran, during 2015-2016. At first, Neuropsychiatry Unit Cognitive Assessment Tool (NUCog), Tower of London (TOL) test, Color Trail Test (CTT) and Mini-Mental Status Exam (MMSE) were done for all participants and after one year, these patients were again evaluated for cognitive function. Findings: 85 patients with mean age of 65.78 ± 5.30 years were evaluated; of them, 85.9% were men. The mean score of NUCog test was not statistically different between the beginning and end of the study (P = 0.670). The mean scores of MMSE and TOL tests and also the mean time of TOL test were statistically different between the first and second evaluation (P = 0.030, P = 0.020, and P < 0.001, respectively). The mean score differences during the study were significantly improved in CTT1 but not in CTT2 (P = 0.007 and P = 0.220, respectively). Conclusion: Generally, presence of cardiovascular disease especially coronary artery disease can deteriorate cognitive function in elder patients over times.

Background: Diagnostic invasive coronary angiography is known as an important tool for identifying patients with obstructive coronary heart disease. Angiography performance is recommended in patients with high risk of ischemic heart disease. Methods: Coronary arteries angiography data of 1100 subjects from a large population of patients referred to four main heart disease centers in Isfahan city, Iran, were collected during 2016 January-March. Demographic information, cardiac noninvasive test results, body mass index (BMI), smoking habits, hypertension, diabetes mellitus and family background of ischemic heart disease were recorded in using a questionnaire. Data were analyzed using ANOVA and chi-square statistical tests in SPSS software to determine the association between angiography results and cardiovascular risk factors. Findings: In angiography, 40% of patients did not show any significant obstructive coronary disease and normal angiography was approximately two times more in women than men in the studied populations. 26% and 44% of subjects had a history of diabetes mellitus and hypertension, respectively. 19% of patients had past history of myocardial infarction (MI) and 21% had history of cigarette smoking. Most of the subjects (72%) had overweight and obesity (BMI > 25%). Non-invasive testing, including exercise test and heart scan, was performed in only 42.0% and 2.7% of patients, respectively. Conclusion: Due to significant economic cost of angiography for the national healthcare system, beside the importance of angiography performance in diagnosing coronary artery diseases, we recommend more studies to clear patient need to angiography.

ABSTRACT Background and Objective: Cutaneous leishmaniasis is a parasitic disease and a health problem in different parts of Iran, especially two cities of Mashhad and Chabahar. Due to morphological similarities of most Leishmania species and difference in reservoirs of L. major and L. tropica, it is necessary to determine the parasite specie to combat the disease. Thus, this study used gene sequencing and genotyping of 70-kDa heat shock protein (HSP70) to differentiate the two species of Leishmania. Methods: In this descriptive-analytical study, microscope slides and cultures were prepared from 43 patients suspected of cutaneous leishmaniasis in Chabahar and Mashhad. PCR was performed after genomic DNA extraction and then PCR products were sequenced and analyzed. Results: Of the 43 patients studied, 32 direct smear and culture (74.4%) were positive and 11 (25.6%) showed negative results, and were therefore excluded from the study. Using HSP70-specific primers, 1962 bp and 1152bp bands were observed for HSP70 of L. major in Chabahar and L. tropica in Mashhad, respectively. Based on the results, there were 18 nucleotide differences between HSP70 of L. major in Chabahar and L. tropica in Mashhad. Conclusion: Due to the morphological similarities between Leishmania species and inability to differentiate species through parasitological methods, the HSP70 gene can be used for identification of the species, and prevention and treatment of the disease.

Cysteine-cysteine chemokine ligand 5 (CCL5) with immunoregulatory and inflammatory activities has an important role in granuloma formations that activates and stimulates T-cells and macrophages. Cysteine-cysteine chemokine receptor 5 (CCR5) is a chemokine receptor, which is important for migration of immune cells to site of infection. In the present study we investigated the possible association between CCL5 –403G/A (rs2107538), CCL5 –28C/G (rs2280788) and CCR5 Δ32 polymorphisms and pulmonary tuberculosis (PTB) in an Iranian population. This case-control study was performed on 160 patients with pulmonary tuberculosis and 160 unrelated healthy subjects. The CCL5 –403G/A, CCL5 –28C/G and CCR5 Δ32 polymorphisms were genotyped by allele-specific polymerase chain reaction (AS-PCR), tetra amplification refractory mutation system polymerase chain reaction (T-ARMS PCR) and PCR, respectively. Our results showed that GA as well as GA+AA genotypes of CCL5 –403G/A (rs2107538) increased the risk of PTB in comparison with GG genotype (OR=1.70, 95% CI=1.03–2.81, P=0.038 and OR=1.64, 95% CI=1.00–2.68, P=0.049, respectively). No significant association was found between CCL5 –28C/G as well as CCR5 Δ32 polymorphism and PTB risk. In conclusion, our findings proposed that CCL5 –403G>A polymorphism may be a risk factor for susceptibility to PTB in our population. Larger sample sizes with different ethnicities are required to validate our findings.

مقدمه: عدم افزایش مناسب ضربان قلب متناسب با ورزش باعث پیش‌آگهی نامناسب بیماران قلبی می‌شود. علاوه بر این، سطوح فاكتورهای التهابی نظیر C-reactive protein با حساسیت بالا (hs-CRP یا High-sensitivity CRP) با آترواسكروز در ارتباط می‌باشد. در این مطالعه، این دو فاكتور در افراد با و بدون سندرم متابولیك بررسی شدند. روش‌ها: این مطالعه بر روی 123 بیمار با سندرم متابولیك و 203 بیمار بدون سندرم متابولیك كه به طور تصادفی از شركت كنندگان مطالعه‌ی كوهورت اصفهان انتخاب شده بودند، انجام گرفت. اطلاعات دموگرافیك، دور كمر، فشار خون، قد و وزن شركت كنندگان ثبت شد. سپس، سطح سرمی تری‌گلیسرید (Triglyceride یا TG)، قند ناشتای خون ( Fasting blood sugarیا FBS)، كلسترول تام (Total cholesterol یا TC)، لیپوپروتئین با چگالی بالا (High density lipoprotein یا HDL-c)، لیپوپروتئین با چگالی پایین (Low-density lipoprotein یا LDL-c) و hs-CRP اندازه‌گیری شد. تست ورزش بر اساس پروتكل استاندارد Bruce انجام گردید و ذخیره‌ی ضربات قلب (HRR یا Heart rate reserve) ثبت شد. اطلاعات با تنظیم بر اساس سن هر شركت كننده با استفاده از آزمون آماری Student’s t و رگرسیون خطی بررسی شد. یافته‌ها: متوسط سن در افراد با سندرم متابولیك 60/7 ± 29/54 و در افراد بدون سندرم متابولیك 61/8 ± 16/54 سال بود که تفاوت آماری معنی‌داری نداشت‌. در افراد با و بدون سندرم متابولیك به ترتیب میزان LDL-c برابر 55/29 ± 12/125 و 54/24 ± 17/116 میلی‌گرم بر دسی‌لیتر، میزان TG 49/184 ± 99/259 و 65/61 ± 38/140 میلی‌گرم بر دسی‌لیتر، میزان FBS برابر 46/48 ± 13/107 و 90/9 ± 81/81 میلی‌گرم بر دسی‌لیتر، میزان فشار خون سیستولیك برابر 15/15 ± 73/130 و 69/13 ± 06/116 میلی‌متر جیوه و میزان فشار خون دیاستولیك برابر 70/8 ± 84/28 و 69/6 ± 52/76 میلی‌متر جیوه بود و همه‌ی موارد از نظر آماری اختلاف معنی‌دار داشت. دو گروه از نظر ذخیره‌ی ضربان قلب تفاوت معنی‌داری نداشتند (027/0 = P) ولی میزان hs-CRP در گروه با سندرم متابولیك به وضوح بالاتر بود (02/0 = P). نتیجه‌گیری: ما در این مطالعه نتوانستیم ارتباطی بین ذخیره‌ی ضربات قلب و سندرم متابولیك نشان دهیم ولی ارتباط بین hs-CRP و سندرم متابولیك نشان‌دهنده‌ی افزایش میزان hs-CRP به عنوان یك فاكتور التهابی در افراد با سندرم متابولیك است.

Background: Obesity induces endothelial dysfunction even in the pediatric age group. The possible protective effects of fruits and herbal products on the endothelial dysfunction of obese children remain to be determined. This study aims to investigate the effects of lemon and sour orange peels on endothelial function of adolescents with excess weight. Materials and Methods: This triple-masked, randomized placebo-controlled trial was conducted for 1-month among 90 overweight and obese participants, aged 6-18 years. They were randomly assigned into three groups of equal number receiving daily oral capsules containing lemon or sour orange powder or placebo. Flow-mediated dilatation (FMD) was compared between three groups by using analysis of covariance. Results: Overall, 30 participants in the lemon group, 27 in the sour orange group and 29 in the control group completed the trial. After the trial, mean FMD was significantly (P < 0.001) higher in the lemon group (11.99 ± 4.05) and in the sour orange group (12.79 ± 5.47) than in the placebo group (6.45 ± 2.79). FMD percent change was 145.02 ± 24.34 in the lemon group, 142.04 ± 16.11 in the sour orange group, and 46.73 ± 5.16 in controls (P < 0.001). Conclusion: This trial showed that consumption of extracts of lemon and sour orange peels, which contain plenty amounts of antioxidants, flavonoids, pectin, and vitamin C, might have significant benefits on endothelial function in children and adolescents with excess weight. Trial registry code: IRCT201311201434N10.

Background: Aortic stenosis (AS) is the most common primary valvular disease. Currently, there is no pharmacological approach for the medical management of AS. We investigated the effect of osteoporosis therapy with alendronate on hemodynamic progression in patients concurrently affected by AS and osteoporosis. Materials and Methods: In this observational prospective study, we enrolled 37 women more than 60 years old with diagnosis of AS and concurrent osteoporosis from August 2017 to December 2019. These patients were treated with alendronate 70 mg every week added to their routine treatment for AS, and their outcomes were compared with 33 patients only affected by AS. Echocardiographic changes and N-terminal-prohormone of brain natriuretic peptide (NT-pro-BNP) level were evaluated during about 2 years of follow-up. Results: The mean follow-up time for the treated and nontreated groups was 20.89 ± 2.73 and 20.84 ± 2.76 months, respectively. Mean gradient (P = 0.02) and peak gradient (P = 0.04) of aortic valve were significantly different between the groups after follow-up. Aortic valve area was decreased 0.09 cm2 in the treated group by alendronate and 0.23 cm2 in the other group (P = 0.001). Furthermore, NT-pro-BNP was significantly decreased in patients treated by alendronate (P = 0.01), but it was increased in nontreated patients (P = 0.04). Conclusion: Treatment with alendronate in patients with AS and concurrent osteoporosis slows down the progression of stenosis and improves their prognosis. This study could open a new pathway for the treatment of AS. Further studies, particularly randomized controlled clinical trial, should be done for providing more evidence.

Background: Isfahan Antibiotic Resistance Surveillance System-1 has been instituted in Isfahan, Iran to construct a project for surveillance of clinically significant bacteria, and to help raise a logic regional stewardship program for prevention and control of disseminating-resistant organisms. Methods: During March 2016 to March 2018, an antibiotic resistance surveillance system was designed and implemented by Isfahan Infectious Diseases and Tropical Medicine Research Center. The surveillance program was implemented in three general hospitals in Isfahan. In addition to the routine microbiology data, clinical data (differentiation between true infections and contamination, healthcare-associated infections (HCAI) and community-acquired infections (CAI), as well as determination of the infection site) were obtained and analyzed by WHONET software. Results: During a 2-year period, from 7056 samples that revealed growth of bacteria, 3632 (51.5%) isolates were detected as contamination and 3424 (48.5%) true bacterial isolates were identified. Of these, about 32% of isolates were recognized as HCAI. Totally, the most recognized infections were urinary tract infection, bloodstream infection and skin and soft tissue infections. In patients with HCAIs, 70% of isolates were gram negative and in patients with CAIs 73% isolates were gram negative bacteria. Conclusions: The strength of the project is gathering enough clinical information in addition to microbiologic data, which would increase application of the results for empiric treatment and prevention of the infectious diseases in clinical settings.

Objective(s):Psoriasis is an autoimmune disease that appears on the skin. Although psoriasis is clinically and histologically well characterized, its pathogenesis is unknown in detail. The aims of this study were to evaluate the proteome of psoriatic patients' sera and to compare them with those of normal healthy human to find valuable biomarkers. Materials and Methods: In a case-control study, twenty cases of white patients with psoriasis vulgaris, 10 males and 10 females and sixteen healthy controls, 8 males and 8 females were enrolled in the study. The serum protein expression patterns obtained after depletion of albumin were compared by using two dimensional gel electrophoresis (2-DE) coupled to MALDI/TOF-TOF to identify disease associated proteins. Results: Differential expression of nine protein spots representing four unique proteins including alpha-1 antitrypsin, retinol binding protein, keratin 10 and an unknown protein (with pI 6.47 and molecular weight of 19941 Da), between psoriatic and healthy human serum were found. Furthermore, expression of four new alpha-1 antitrypsin isoforms with different molecular weight and isoelectric point were observed in psoriatic serums in this research for the first time. Conclusion: A unique proteomic profiling with abnormal expression of alpha-1 antitrypsin and presence of keratin 10 in sera of psoriasis patients were observed that may constitute new and useful findings of psoriasis and offer a clue to a better understanding of the inflammatory pathway.

Background: There are conflicting reports regarding the association between coronary artery disease (CAD) and mild cognitive impairment (MCI). Volumetric Magnetic resonance imaging (MRI) investigations have been considered as an objective biomarker for MCI. In this study, we determined the relationship between the regional brain volumes and the extent of CAD in MCI patients and cognitively normal controls. Materials and Methods: In a case-control study a subset of MCI patients (n = 20) and cognitively normal controls (n = 20), aged 66.4 ± 4.6 and 65.3 ± 3.9 respectively, from subjects who were recently admitted to cardiac catheterization facilities in two general hospitals were selected. All subjects underwent a clinical interview, biochemical measures, neuropsychological testing and Neuropsychiatry Unit COGnitive assessment tool. Video records of coronary angiography were scored with the Gensini method. For volumetric evaluation of regions of interest, brain MRI scans was processed using the FreeSurfer software package the relationship between the regional brain volumes and the extent of CAD in MCI patients and cognitively normal controls were compared. Results: We have found that, there were significant differences between the two groups in volumes of left fusiform (P = 0.039), left pars triangularis (P = 0.003) and left superior temporal gyrus (P = 0.009), after controlling for intracranial volumes. Higher Gensini scores were associated with reduced volumes of total cortical volume (P = 0.047, R = −0.4), left precuneus (P = 0.022, R = −0.5), right inferior parietal lobule (P = 0.011, R = −0.5) and left supra marginal gyrus (P = 0.035, R = −0.04) in MCI. Conclusion: In MCI, a greater degree of coronary stenosis correlates with greater loss of gray matter in specific brain regions relevant to cognitive function. This, however, was not the case for cognitively normal subjects.

Background: Atherosclerosis is a chronic inflammatory disease. There are several inflammatory molecules involved in the development of atherosclerosis. Among them, C-reactive Protein (CRP) is the best known biomarker for disease progression, plaque instability and fragility. This study aimed to determine the correlation of the venous CRP with plaque CRP in patients undergoing elective coronary artery bypass graft (CABG) surgery. Methods: This study was done on 22 men with diabetes mellitus candidate for CABG surgery. Blood samples were taken from patients before surgery to determine the venous blood CRP level. The atherosclerotic plaque was removed from the vessel wall during the surgery. Samples of coronary atherosclerotic plaques were stained with Hematoxilin and Eosin to measure intima and media thickness and calculate the intima to media ratio (IMR). The immunohistochemistry staining was used to determine the CRP expression levels. Venous blood hsCRP concentrations were determined by ELISA method. Findings: There was no significant correlation between the intensity of CRP expression in atherosclerosis plaques and hsCRP concentrations in venous blood; but there was a significant correlation between the venous blood hsCRP concentration and severity of atherosclerosis (the IMR). Conclusion: Increased CRP represents systemic inflammation in the body and is correlated with the severity of atherosclerosis; so, it can be a reliable biomarker of disease progression. Despite of the existence of CRP in the atherosclerotic plaque, there is no correlation between the expression of CRP and hsCRP concentrations.

Background: Studies have shown the association of mood disorders and endothelial dysfunction, and increased risk of cardiovascular disease; however, mediatory mechanisms are not entirely clarified in this regard. We investigated the relationship between depression/anxiety symptoms with systemic inflammation and endothelial function. Materials and Methods: This cross-sectional study was performed in 2011 on employees of an oil company located in the Isfahan city (central Iran). Participants were selected with clustered random sampling. Anxiety and depression were evaluated by Hospital Anxiety Depression Scale (HADS). Systemic inflammatory status was evaluated by measuring sensitive C-reactive protein (high sensitive-CRP). To evaluate the endothelial function flow-mediated dilation (FMD) was measured. Results: During the study period, 254 participants (mean age = 51.4 ΁ 6.1 years) were evaluated. No significant relationship was found between high sensitive-CRP or FMD and any of the variables of anxiety or depression. In multivariate analysis, by controlling the possible confounding factors, no association was found between anxiety score, depression, or the overall score of HADS with high sensitive-CRP or FMD. After the separate analysis of patients with and without diabetes, depression score was correlated inversely with FMD among patients with diabetes (r = 0.525, P = 0.021). Conclusion: According to the results, in the studied population, there was no relationship between anxiety/depression with systemic inflammation or endothelial dysfunction, while in individuals with diabetes, depression was associated with endothelial dysfunction. In this regard more cohort studies are recommended.