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Key Clinical Message Rudimentary left atrial appendage (LAA) is an extremely rare condition with an unclear association with cerebrovascular events. This case report discusses a patient with an unexplained cerebrovascular accident (CVA), where the diagnosis of rudimentary LAA was made using transesophageal echocardiography (TEE) and subsequently confirmed by computed tomography angiography (CTA). Abstract Rudimentary left atrial appendage (LAA) is extremely rare. This report presents the case of a 50‐year‐old woman who experienced a cerebrovascular accident (CVA) and was found to have a rudimentary LAA. The patient had a history of diabetes mellitus (DM), hypertension, and dyslipidemia. An electrocardiogram (ECG) showed sinus rhythm, and Holter monitoring did not detect any atrial fibrillation (AF). Transesophageal echocardiography (TEE) and computed tomography angiography (CTA) were performed to identify the source of cardiac emboli, revealing a rudimentary LAA with no thrombus present.

Key Clinical Message We report a 47‐year‐old man who presented with right‐sided heart failure. Transthoracic echocardiography revealed a tunnel‐shaped communication (ventricular septal defect) between the left ventricle and the right ventricle with a significant left‐to‐right shunt. The VSD is connected to the lateral wall of the right ventricle by a large tunnel.

Abstract Congenital heart disease is a risk factor for infective endocarditis (IE). Ventricular septal defects and ventricular outflow tract obstructions are this population's most common causes of endocarditis. We present a patient diagnosed with leukocytoclastic vasculitis, renal, and pulmonary involvement with right‐sided IE as an etiology for vasculitis.

Background: Blood flow, metabolic rate and oxygen requirements of an organ guide the extent of oxidative stress experienced by any tissue in response to chronic hypoxia. Currently cilnidipine is used in the management of hypertension and its antioxidant actions are gaining wide interest. Aim and Objectives: To evaluate the tissue specific effects of chronic sustained hypoxia with regards to oxidative stress in the context of cilnidipine. Material and Methods: Twenty four adult male Wistar strain albino rats were randomly assigned into four groups: group 1, control, normoxia (21% O ); group 2, chronic hypoxia (CH) (10% O) for 21 days; group 3, normoxia + cilnidipine (Cil) for 21 days; group 4, chronic hypoxia + cilnidipine (CH+Cil) for 21 days. Following 21 days of intervention blood was collected and animals were sacrificed and liver,lung and heart were collected. Serum MDA and MDA in tissue homogenate of liver, lung and heart were estimated. Results: Our results demonstrate the elevated serum MDAlevels in chronic hypoxia exposed rats (group 2). We also observed increased MDA in liver followed by lung and least in the heart in chronic hypoxia exposed rats (group 2). Treatment with cilnidipine reduced serum MDA and heart MDA levels in cilnidipine treated chronic hypoxia exposed rats (group 4). However cilnidipine did not have any influence on MDA levels in the liver and lung in same group of rats. Conclusion: The results demonstrate tissue specific effects of chronic sustained hypoxia with the highest oxidative stress observed in the liver followed by the lung. Although oxidative stress is also observed in the heart it is the least in comparison to the liver and the lung. Cilnidipine, a dual L/N type calcium channel blocker demonstrated beneficial antioxidant actions only in the heart supporting the cardioprotective role of cilnidipine.

Objecttive (s): Silicate bioceramics like Baghdadite with chemical formula Ca3ZrSi2O9, has attracted the attention of researchers in biomedical field due to its remarkable in-vitro and in-vivo bioactivity and mechanical properties.Materials and Methods: Therefore, in the current study the baghdadite powder with Sol-Gel method was synthesized. Then, hydroxyapatite/Baghdadite (HA/Bagh) scaffolds were prepared by the replacing the polyurethane polymeric sponge technique. Afterwhile, the ceramic scaffolds were sintered at 1150ºC for 3 h. The prepared scaffold was then coated by polycaprolactone/bioglass (PCL/BG) polymer nanocomposite. Results: Bioactivity and biomineralization in the simulated body fluid (SBF) revealed that the nanocomposite scaffolds coate with PCL/BG had significant bioactivity properties. The morophology and microstructure investigation of soaked samples in SBF indicate that bone-like apatite formed on the surfaces. Also, ion release in SBF containing the scaffolds was measured by inductively coupled plasma (ICP) analysis. The nucleation positions of apatite crystals were areas with high silicon containing, Si+4 ion positions.Conclusion: The study indicates that scaffold containing 30 wt. % baghdadite had proper bioactivity behaviordue to its ability to form bone-like apatite on the surface of specimens.

Background: Corals have a diversity of prokaryotic communities as an internal or external symbiotic . This review will examine the association between corals and their symbiotic microorganisms from the ecology and biotechnology perspective. Material and Methods: In this study, articles were examined which indexed in Pubmed, Science Direct, Google Scholar and Scirus databases. Keywords we used included coral, symbiotic microorganisms, ecology, and biotechnology. Finally, overall of 120 articles and reports, 103 articles were evaluated by eliminating the same articles. Results: The Corals symbiotic microorganisms stay on in the ecological niches such as the surface mucus layer, tissue and their skeleton. They play role in the cycle of sulfur, nitrogen fixation, production of antimicrobial compounds and protect corals against pathogens. Many bioactive compounds which attributed to invertebrates such as sponges and corals in fact they are produced by symbiotic bacteria. Various metabolites produced by these microorganisms can be used as medicine. Five screening strategies including conventional screening, met genomics, genomics, combinatorial biosynthesis, and synthetic biology are used for marine microbial natural products discovery and development. Conclusion: According to the collected material we can be concluded that, the ecological studies about the natural association between corals and their symbiotic microorganisms were technological prerequisite for biomedical research and they make clear the road to attainment to bioactive compounds in fauna. Also, in the first step, it is recommended that modern technology and advanced screening methods used to identification of marine organisms and then to identify secondary metabolites among them.

Background: Bacterial toxins are toxic compounds which are produced in order to present microbial pathogenicity or to combat with the host immune system response. There is a cumulating evidence indicating bacterial origin for marine toxins such as tetrodotoxin, palytoxin, neosurugatoxin, etc. The most important marine toxins produced by different marine bacteria, their origin, structure and mechanisms of action were evaluated in a systematic review. Materials & Methods: Marine bacteria, marine bacterial toxins, and their mechanisms of action and structure were keywords for a comprehensive search in online databases including Pubmed, Science Direct, Google Scholar and Scirus. A total of 120 papers were evaluated, however, by omitting similar reports, 103 papers were included in the study. Results: The most of marine bacterial toxins are classified in one of the following groups: neurotoxins, hepatotoxins and cytotoxins. These toxins have distinct mechanisms of action including blocking of sodium channels in nerve cells, functioning as agonists of acetylcholine receptors, inhibiting of membrane pumps, the inhibition of protein phosphatases 1 and 2A types' enzyme activities and inhibiting of protein synthesis. Conclusion: The clarification of the marine bacterial toxins structures and their mechanisms of action may be helpful for novel drug design, therapeutic measures and to overcome against bacterial pathogenicity.

Background: Dinoflagellates are the major causative agents of harmful algal blooms. In different studies, it has been shown that many dinoflagellate species produce various natural toxins. Saxitoxin, brevetoxin, yessotoxin, etc can be considered as the most important neurotoxins. The most important dinoflagellate toxins structures, their origin, structure and mechanisms of action were evaluated in a systematic review. Materials & Methods: Marine dinoflagellates, marine toxins, and their mechanisms of action and structure were keywords for a comprehensive search in online databases including Pubmed, Science Direct, Google Scholar and Scirus. A total of 95 papers were evaluated, however, by omitting similar reports, 68 papers were included in the study. Results: Dinoflagellates toxins are usually polycyclic ether and polyketaide compounds that have distinct mechanisms of action including alteration in different ion channels and/or pumps at cell membrane, effect on the normal functioning of neuronal and other excitable tissues, inhibition of serine/threonine phosphoprotein phosphatases, disrupting major mechanisms of controlling cellular functions, and alteration in cellular cytoskeleton. However, the precise mechanisms of action of few toxins are not determined yet. Conclusion: The clarification of the dinoflagellate toxins structures and their mechanisms of action may be helpful for novel drug design, therapeutic measures and to overcome against marine toxicity.

Abstract Background: Isolation of a novel virus belonging to coronavirdae family in September 2012, from patients in Middle East who had died of an acute respiratory illness & renal failure lead to researches on this new virus. Here, a brief review to summarize the events of scientific findings of this new emerging virus. Material and Methods: This review is based on a comprehensive search of three databases (Pubmed, Embase and Cochrane) and WHO reports. The searched keywords were new coronavirus, Middle East, acute respieratory distress syndrom & Saudi Arabia. Results: Due to novelty of virus only limited papers exist on searched databases, so only 50 papers were identified which after omitting repeated case reports, papers related to SARS and updated WHO reports, 30 papers were finally reviewed. Conclusion: WHO recommendation is evaluation of all patients with acute respiratory illness and history of travel to Saudi Arabia or other countries where this novel virus is epidemic.

Background: Human rotaviruses are the major etiological agents of acute viral gastroenteritis in infants and young children worldwide. With the licensure of new rotavirus vaccines, data on the burden of disease and the diversity of rotavirus genotypes circulating are important regarding immunization strategies. The purpose of the present study was to determine the genotypes of VP7 protein rotavirus in hospitalized children in Borazjan. Methods: In this study,375 stool samples from children less than 7 year old with severe diarrhaea hospitalized at 17 Shahrivar hospital in Borazjan, were collected during 2008 to 2009. Group A rotavirus antigen was detected in stool specimens using Enzyme Immunoassay (EIA). Then G-typing of the positive specimens was evaluated by Nested RT-PCR method. Results: Among the collected samples, 24.27% were positive for rotavirus infection. The highest incidence was observed in children aged 12-17 months (6.93%) (p=0.056). The most common prevalence of positive rotavirus was observed in autumn with 54.94% compared to the least prevalence in summer with 2.20% (p=0).The frequency of G1, G4, G9 ,non-typeable genotypes were 51.65%, 2.20 %, 4.40%, 41.76% ,respectively. But, G2, G3, G8, G10 and G12 genotypes weren’t detected. Conclusion: The noticeable frequency of non-typeable genotypes indicates that must be using from another primers for characterization of unusual genotypes. Also because of the high frequency of rotavirus infection, surveillance and expanded program of immunization especially for children less than 2 years is necessary.

Payesh2009; 8: 361-369Accepted for publication: 28 April 2008[EPub a head of print-14 September 2009] Objective(s): To measure self-care behaviors inpatients and to investigate its associations with age, gender, marital status, duration of heart disease, co-morbidity with other chronic disorder and left ventricular ejection fraction.Methods: In a descriptive-analytic study, 250 participants were selected by random sampling. European Heart Failure Self-care behavior questionnaire used to collect data. Results: We found that 74 % of the participants had moderate and low scores of self-care behaviors. The self care behavior had a significant correlation with all variables studied.Conclusion: It seems that there is need for systematic self-care educational programs for patients with heart failure.