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Objective: Asthma is a common disease and curcumin has modest effect in inflammatory disorders. This study investigated the efficacy of nano-curcumin on asthma.Materials and Methods: In this double-blinded randomized clinical trial, 60 patients with non-atopic bronchial asthma were randomly stratified in two groups of intervention (N=30) and control (N=30) groups. Apart from their standard treatment, the intervention group received 40 mg nano-curcumin (soft gel) three times daily while the control group received placebo. During the 60-day study, patients were assessed using spirometry to measure Forced expiratory volume in first second (FEV1). Asthma control test (ACT) was completed every 30 days and asthma quality of life questionnaire (AQLQ) was completed at the first and end of the study.Results: Totally, 31 patients (51.7%) were male and the mean age was 51.45±12.58 years. FEV1 was improved but there was no significant difference between intervention and control groups. ACT and AQLQ domains scores significantly improved. However, it was not statistically different between control and intervention groups.Conclusion: Nano-curcumin at administered dosage had no additive effect on the standard treatment in asthmatic patients.

Objective: Baicalin and baicalein are natural flavonoids reported for the first time from Scutellaria baicalensis Georgi. Recently, attention has been paid to these valuable flavonoids due to their promising effects. This paper aims to have a comprehensive review of their pharmacological effects.Materials and Methods: An extensive search through scientific databases including Scopus, PubMed, and ISI Web of Science was established.Results: According to literature, these compounds have been mainly effective in the treatment of neurological and neurodegenerative diseases, hepatic and cardiovascular disorders, metabolic syndrome, and cancers through anti-inflammatory and antioxidant pathways. Induction of apoptosis and autophagy, and inhibition of migration and metastasis are the main mechanisms for their cytotoxic and antitumor activities. Decreasing inflammation, reducing oxidative stress, regulating the metabolism of lipids, and decreasing fibrosis, apoptosis, and steatosis are their main hepatoprotective mechanisms. Inhibiting the development of cardiac fibrosis and reducing inflammation, oxidative stress, and apoptosis are also the mechanisms suggested for cardioprotective activities. Decreasing the accumulation of inflammatory mediators and improving cognitive function and depressive-like behaviours are the main mechanisms for neurological and neurodegenerative activities.Conclusion: The findings suggest the therapeutic potential of baicalin and baicalein. However, complementary research in different in vitro and in vivo models to investigate their mechanisms of action as well as clinical trials to evaluate their efficacy and safety are suggested.

Background and aims: The novel coronavirus (COVID-19) epidemic has far been the biggest global health threat of the 21st century. Protective measures are still one of the most effective methods for controlling COVID-19. Practicing hygiene and control measures are largely influenced by knowledge and attitude towards COVID-19. This study aimed to investigate the knowledge, attitude, and practice of Iranians towards COVID-19 as well as the demographic factors related to it in April and May, 2020.Methods: The study population in this cross-sectional, descriptive-analytical, and web-based study included 3736 Iranian individuals who were collected via convenience sampling method. A validated Iranian knowledge, attitude, and practices (KAP) Questionnaire about COVID-19 was used for collecting the required data. Ordinal multivariate generalized estimating equations (GEEs) were applied to analyze data.Results: The majority of participants (88.1%) had considerable knowledge, the right attitude (91%), and good practices (90.3%). In the multivariate models, factors related to greater knowledge were age > 20 years (P < 0.001), living in the urban area (P = 0.030), holding a master’s or doctoral degree (P = 0.044), and a moderate financial status (P = 0.001). Females displayed mor positive attitude (P = 0.035). Variables related to more favorable practices were age > 20 years (P < 0.001), and having a good (P = 0.003) or moderate (P = 0.038) financial status.Conclusion: It was concluded that the participants had good knowledge and a positive attitude, as well as adopted sound practices regarding COVID-19. However, this conclusion might not have been generalizable to entire Iranian community; therefore, it was recommended that preventive measures against COVID-19 should receive continued monitoring and emphasis.

Background and aims: Knowledge, attitude, and practice (KAP) toward coronavirus disease 2019 (COVID-19) are important factors for adherence to protection strategies. The aim of this study was to construct and validate a questionnaire about the KAP of Iranians regarding COVID-19. Methods: Initially, a questionnaire about the KAP with regard to COVID-19 was constructed in this cross-sectional study. The initial questionnaire was prepared based on a review of the extensive research literature and global and national guidelines. This researcher-made questionnaire was developed using the COVID-19-KAP questionnaire, which was originally used in China in 2020, and the influenza epidemic KAP Questionnaire (2015), the MERS KAP Questionnaire (2015), the H1N1 flu KAP questionnaire (2017), and the WHO KAP questionnaire about COVID-19. The applied questionnaire consists of three parts including knowledge- (n = 26), attitude- (n = 8), and practice-related (n = 11) questions, respectively. Then, the face, content, and construct validity and the reliability of the questionnaire was determined, and analyzes were performed using SPSS v. 26 and AMOS v. 24 software. Results: In the face validity stage, 2 questions with an impact score of less than 1.5 were excluded from the questionnaire. In the content validity check, all questions had a content validity index (I-CVI) of more than 0.7. However, the content validity ratio (CVR) for 6 questions was less than 0.51, and these questions were removed accordingly. The compliance of the CVI with the chance agreement was close to one for all questions, indicating the lack of a chance agreement. In the exploratory factor analysis stage, the Kaiser-Meyer-Olkin (KMO) value of 0.90 was obtained, implying the adequacy of the sample size for factor analysis. The significance of the Bartlett test (chi-square: 5820.06, df: 630, P

Purpose: Reovirus type 3 Dearing (ReoT3D), a wild type oncolytic virus (OV) from the Reoviridae family, kills KRAS mutant cancer cells. However, the use of OVs has faced with some limitations such as immune responses, and delivery of OVs to the tumor sites in systemic therapy. To solve this, and also to increase the anti-cancer effects of these OVs, mesenchymal stem cells (MSCs) might be used as an effective vehicle for OVs delivery. In this study, we examined the anti-cancer effects of human adipose derived-MSCs (AD-MSCs) as a vehicle of ReoT3D against human glioblastoma cells. Methods: Here, AD-MSCs were characterized and toxicity of ReoT3D on them was determined by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) assay. Then, capability of AD-MSCs for virus production was assessed by real-time polymerase chain reaction (PCR), and different in vitro anti-cancer experiments were applied for our anti-cancer purposes. Results: Our results from toxicity assay revealed that the isolated and provoked AD-MSCs were resistant to nontoxic concentration multiplicity of infection (MOI) >1 pfu/cells of ReoT3D. In addition, the results indicated that AD-MSCs were susceptible for virus life cycle complementation and were capable for production of virus progenies. Furthermore, our results showed that AD-MSCs had oncolysis effects and increased the anti-cancer effects of ReoT3D. Conclusion: AD-MSCs as a susceptible host for oncolytic reovirus could increase the anti-cancer activity of this OV against glioblastoma multiforme (GBM) cell line.

Backgrounds: One of the most frequent complications of high-dose chemotherapy regimen before hematopoietic stem cell transplantation (HSCT) is oral mucositis (OM). Vitamin D (VD) has well-known immunoregulatory, anti-inflammatory, and antioxidant properties. Objectives: This study aimed to evaluate the association of baseline VD levels with OM as well as neutrophil and platelet engraftments in patients with multiple myeloma, Hodgkin’s and non-Hodgkin’s lymphoma after autologous HSCT. Methods: A sample of 71 patients was included after obtaining informed consent. Serum samples were collected in the morning prior to the administration of conditioning regimen to measure the baseline 25-OH-D. OM was examined daily during hospital stay. The WHO scale was used for scoring the OM. Absolute neutrophil count and platelet count were determined daily from transplantation until engraftment. Results: Patients aged between 18 to 65 years. Mean length of hospital stay was 15.8±5.7 days. OM was detected in 44/71 (62.0%) of patients. Mean time to the engraftment of neutrophils and platelets were 11.8±4.0 and 17.2±7.3 days, respectively. Mean level of baseline 25-OH-D was 17.5±14.0 ng/ml. VD deficiency (

The purpose of this study was to investigate the effects of Fibrin Glue (FG) and activated platelet-rich plasma (a-PRP) on the proliferation and osteogenic differentiation of human dental pulp stem cells (h-DPSCs). Therefore, we planned to investigate in vitro behavior of porous composite scaffolds based on chitosan-gelatin/nanohydroxyapatite (CS–G/nHA) treated with FG and a-PRP. The porous structure of CS–G/nHA was prepared using combination of particle leaching and freeze-drying methods. The a-PRP was prepared from the centrifugation of whole blood activated with calcium chloride. Four groups of composite scaffolds were fabricated to seed h-DPSCs: (1) a-PRP–FG/CS–G/nHA; (2) FG/CS–G/nHA; (3) a-PRP/CS–G/nHA; (4) CS–G/nHA. The 14 days SEM image reveled organized fibrin network on scaffolds surface. All groups treated with FG and a-PRP, showed improved adhesion of seeded h-DPSCs compared to CS–G/nHA. Cytotoxicity of the composite scaffolds was assessed by MTT. Alizarin red staining confirmed the formation of bone minerals by h-DPSCs after 21 days of cell seeding. In addition, the a-PRP–FG treated scaffolds exhibited significantly elevated bone gamma-carboxyglutamic acid-containing protein (BGLAP), bone morphogenetic protein 2 (BMP2), and runt-related transcription factor 2 (RUNX2) gene expression. The present result the composite scaffolds treated with FG and a-PRP showed a fibrin network, preferentially on the surface of composite scaffold increasing the mineralization and osteoblastic differentiation of harvested cells. In addition, a-PRP–FG/ CS–G/nHA scaffold increased bone marker gene expressions from day 7 to day 21.

Objectives: A correlation between hyperhomocysteinemia, and depression has been reported. Saffron (Crocus sativus) is recommended for treatment of depression; hence, in this study the effect of co-administration of saffron and fluoxetine on plasma homocysteine and depression was evaluated. Material and methods: This was a 4-week randomized and double-blind clinical trial which was conducted from March 2013 to February 2014. In this trial, 40 male and females (20-55 years old) diagnosed with severe depression were selected and following filing the Beck form, were randomly divided into two groups. Experimental group was treated with fluoxetine 20 mg/day and saffron 30 mg /day and the control group received placebo and fluoxetine 20 mg/day for four weeks. Before treatment and at the end of the study, fasting blood samples were collected. For females, blood samples were collected on the third day of their menstrual cycle. Results: A significant reduction of homocysteine levels was observed in both sex in the experimental group compared to before treatment (p

Objective Parents' satisfaction with the services for children with hearing loss is one of the most important indicators in evaluating the effectiveness of therapeutic and rehabilitation programs for such children. Accordingly, in the present study, the validity and reliability of the questionnaire for parents' satisfaction with the services provided for hearing-impaired children under the age of 6 years are examined . Materials & Methods In this descriptive and analytical research work, the questionnaire under study was completed by 60 randomly selected parents in Tehran who had used the training and rehabilitation services of these centers for at least one year. Fifteen of these parents were re-tested to assess reliability. The questionnaire was composed of 5 subtests of satisfaction of structural facilities (7 questions), satisfaction of sanitation conditions (10 questions), satisfaction of services and performance of the center (18 questions), satisfaction of the communication and the behavior of the staffs (12 questions), and satisfaction of fees against the services (3 questions). Internal consistency in level item and scale, items correlation with the total scale, test-retest repeatability, face validity, and content validity were also evaluated. Finally, the available data were analyzed by using SPSS (version 17) software. The other statistical methods included the Cronbach's alpha coefficients, Spearman correlation, and the tests of Kolmogorov-Smirnov Friedman, Kruskal-Wallis, and U-Mann Whitney. Results In relation to psychometric properties, 0.79 validity of the questionnaire and 90% reliability of internal consistency were obtained. Adequate correlations with the total scale were found for each item. In addition, the test-retest reliability was 75%. Most of the parents were found to be satisfied or pretty satisfied with most of the service areas of the centers, including overall satisfaction (69.5%), structural and environmental facilities (80.66%), sanitation conditions (75%), services and the performance of the center (91.66%), communication and stuff attitude (91.66%), and cost (55.5%). Among the items of the questionnaire, the greatest satisfaction was related to communication and staff attitude (SD=0.31, M=4.72), and the lowest satisfaction was with the fees of the service center (SD=0.62, M=3.27). The result of Spearman correlation between specific dimensions and overall satisfaction showed significantly positive correlation (P

Thrombocytopenia has been reported as an adverse effect of numerous medicines including vancomycin. Due to contribution of other suspected causes and lack of a standard diagnostic test, vancomycin-induced thrombocytopenia has been less addressed in clinical practice. In the current study, we present a suspected case initially diagnosed as heparin-induced thrombocytopenia but further workup proposed vancomycin as the offending medicine. Following discontinuation of vancomycin, the thrombocytopenia resolved which confirmed the diagnosis of vancomycin induced thrombocytopenia. We tended to highlight vancomycin-induced thrombocytopenia which is usually not considered in differential diagnosis of thrombocytopenia in comparison with heparin induced thrombocytopenia which is well known for clinicians; a scenario commonly encountered in clinical practice. This is important regard to high possibility of concomitant use of vancomycin and heparin in every day clinical practice. In accordance with educational aims of the current case, differential diagnosis of thrombocytopenia and clinical approach to thrombocytopenia is well documented in this patient.

Background: Radiotherapy as an important treatment modality in head and neck cancer diminishes reactive oxygen system which causes damages to the normal cell/tissue function and cell cycle regulation. Selenium involve in both antioxidant and anti-inflammatory systems. In this study, we aimed to investigate whether there is a difference between selenium levels before and after radiotherapy and the effects of serum selenium levels on radiotherapy oral mucositis (OM) patients undergoing radiation for head and neck cancer. Methods:This prospective study includes 42 head and neck cancer patients treated by external beam radiotherapy at the Cancer Institution of Imam Khomeini Hospital, Tehran University of Medical Sciences. Plasma selenium concentrations were determined before and after RT. The grade of OM was evaluated weekly by the WHO oral toxicity scale. Results: The mean patient age was 54.74 (range=18-81) years. For most of the patients, the histopathological diagnosis of cancer was squamous cell carcinoma (n=28 (66.7%)). There was no significant difference in serum Se levels before and after RT (85.38±30.63 before radiation and 90.32±33.26 after radiation, p-value >0.05). ). Moreover, there was no significant difference between levels of Se after RT in patients who developed severe OM and who did not. Conclusion: In our study, we couldn’t find any significant difference in the levels of Selenium before and after radiotherapy and also there was no association between Selenium levels and oral mucositis developing.

Background: Linezolid has been recognized as a safe and effective medicine against a wide variety of Gram-positive pathogens. Purpose: The primary objective of this study was to assess utilization appropriateness of linezolid and explore the efficiency of protocol intervention to proceed to rational drug usage. Method: The project was conducted in a referral teaching hospital from September 2015 to January 2017 in two phases. In the first step, a six-month survey was performed to evaluate the prescribing appropriateness of linezolid. Patients receiving linezolid were identified using hospital IT system and the medical charts were analyzed based on accurate indications and duration of linezolid prescription. Subsequently, a restrictive protocol was developed and communicated after a consensus by Drug and Therapeutics Committee in May 2016. After introduction of the protocol, an active daily surveillance of patients was done by hospital pharmacists. The appropriateness of linezolid utilization and infectious consultations were compared before and after protocol implementation. Results: In the first phase of the study, the indication of linezolid was appropriate in 56.2% of cases and improved considerably to 68.6% (P value: 0.04) after protocol enforcement. Furthermore the duration of the linezolid consumption was correct in 66.6% of patients, increasing to 88.5% after protocol introduction (P value 0.07). In the first step, 56.9% of linezolid prescriptions were based on infectious disease consultation which enhanced remarkably to 87.5% in the second step (P value 0.001), while, 65.5% and 73.8% of these consultations were appropriate in the study surveys respectively. Conclusion: The protocol intervention could improve appropriate prescribing of linezolid in the hospital setting. However, ongoing audit studies are recommended to maintain the rational prescription of linezolid.

Objectives: Lallemantia royleana (Benth. in Wall.) Benth. (Lamiaceae) is a medicinal plant used in Iranian traditional and folklore medicine in the treatment of various nervous, hepatic, and renal diseases. In the present study, whole seeds of the herb were prepared and evaluated for hypolipidemic activities using an animal model. Materials and Methods: Animals were fed normal diets or diets supplemented with cholesterol (0.5%) for 12 weeks to evoke hypercholesterolemia. Moreover, hypercholesterolemic animals were treated with different doses of whole seeds of Balangu (0, 5, 10, and 20%) for 12 weeks. Results: Results showed that the serum total cholesterol and triglyceride decreased in all groups treated with Balangu seeds pConclusions: Our results showed that L. royleana seeds decreased the serum cholesterol and triglyceride levels in hypercholesterolemic animals but led to the increase of atherogenic index in all treated groups.

Background: Hepatic dysfunction in patients who have undergone allogeneic haematopoietic stem cell transplantation (HSCT) is a major cause of morbidity and mortality. The aim of this study is to evaluate the incidence of post-transplantation hepatic complications in these patients. Methods: A total of 121 patients (age above 15 with no abnormality in their hepatic tests) participated in the study. The influence of a variety of risk factors on the incidence, type, and pattern of hepatic dysfunction as well as the length of hospital stay related to these complications were studied. Results: As a whole, 76 patients (62%)—44 males and 32 females—were diagnosed with hepatic dysfunction after transplantation. As many as 31(25%) of the patients showed increased measures in their hepatic enzyme, while 45(37%) of them ended up with both abnormal enzyme measure and clinical symptoms including diarrhoea, skin rash, jaundice, and anorexia. The hepatic dysfunction rates owing to drug toxicity and GVHD (21.5% and 16.5%, respectively) proved to be the highest in our study. Analysing risk factors, the immunosuppressive regimen could affect the type of hepatic dysfunction—i.e., less patients with GVHD were found in the group who received ATG in their regimen (p-value =0.034). Conclusion: According to these findings, the immunosuppressive regimen can play a role in preventing the incidence of GVHD. Less occurrence of hepatic complications, especially GVHD, may lead to less clinical symptoms and time of hospital stay.

Prolongation of the QT interval is a recognized adverse effect of fluoroquinolone antibiotics. This effect on ventricular repolarization can potentially lead to life-threatening arrhythmias such as Torsade de pointes. Torsade de pointes is a polymorphic form of ventricular tachycardia identified by twisting of the QRS axis around an isoelectric point. We report a case of torsade de pointes induced by ciprofloxacin treatment. The patient experienced an acquired QT interval prolongation followed by Torsade de pointes arrhythmia with ciprofloxacin administration for ileostomy closure surgery and unfortunately expired.

Gross hematuria or macroscopic hematuria is a high risk urologic condition that might occur in different settings. In the case of continued gross hematuria, blood clot size may grow and lead to complete obstruction of urinary outflow. Placement of three-way catheter, continuous bladder irrigation with normal saline, and cystoscopy are conventional treatments. Here we introduce a case with urinary obstruction who did not respond to conventional therapies. A subject of Hodgkin lymphoma with urinary obstruction caused by heavy gross hematuria was presented to emergency department. Three-way catheter was inserted to facilitate urination. However, there was no urinary drainage and bladder was distended. Consequently, 100 ml solution of hydrogen peroxide 0.15% was prepared and administered into the bladder to irrigate and evacuate the clots. A single intravesical infusion of hydrogen peroxide rapidly resolved urinary obstruction and improved patient distress. After administration of hydrogen peroxide solution, blood clots and bloody urine were evacuated successfully. These findings suggest that an intravesical injection of hydrogen peroxide can induce dissolution of blood clots and may be a simple and efficient therapy for urinary obstruction due to gross hematuria.

Objective: Increasing demand for memory assessment in clinical settings in Iran, as well as the absence of a comprehensive and standardized task based upon the Persian culture and language in children population, requires the Persian version of the commonly used neuropsychological measure of verbal learning and memory, the Rey Auditory Verbal Learning Test in this group. Therefore, the purpose of the present study was to evaluate the psychometric properties (validity and reliability) of the Persian version of the Rey Auditory Verbal Learning Test in children with attention deficit hyperactivity disorder. Materials & Methods: In the present study for determining the validity and reliability of the Persian version of the Rey Auditory Verbal Learning Test, 46 normal children and 37 children with Attention Deficit Hyperactivity Disorder, all right-handed and aged between 7 and 11 of both genders, were evaluated using the Persian version of the Rey Auditory Verbal Learning Test and Sustained Auditory Attention Capacity Test. Results: In determining convergent validity, a negative significant correlation was found between the three parts of the Rey Auditory Verbal Learning Test (sum, immediate and delayed recall) and the total score index of Sustained Auditory Attention Capacity Test (r=-0.536, P=0.001). By comparing the test scores between the normal and Attention Deficit Hyperactivity Disorder groups, discriminant validity analysis showed significant differences of their data in all parts of the test (P

Objective: Aural rehabilitation program after a cochlear implant leads to improve the auditory performance of hearing impaired children. The present study aims to determine the effect of cochlear implants and aural rehabilitation program in the auditory development of children with cochlear implants (CI). Materials & Methods: This longitudinal descriptive-analytical study was conducted on 15 deaf children (m.a. 45.27 mo) who received CI in the AmirAlam cochlear implant center between August 2010 and January 2011. Auditory skills of deaf children were assessed before they received CI, and also 2, 4, 6 and 8 months after implantation. Data was collected interview with parents of deaf children through Newsha developmental scale. After determining the developmental age, Pretest Developmental Rate, Intervention Efficiency Index and Proportional Change Index were calculated. One-way ANOVA and LSD post hoc tests were used for analysis of data. Results: There was a significant increase in Pretest Developmental Rate during the aural rehabilitation after a cochlear implantation (P

Objective(s): In the present study, the effect of tissue incubation with propranolol on functional antagonism of Zataria multiflora Boiss (Z. multiflora) at muscarinic receptors of tracheal smooth muscle was examined. Materials and Methods: The effects of three concentrations of aqueous-ethanolic extract, 10 nM atropine, and saline on muscarinic receptors were tested on incubated tracheal smooth muscle with propranolol (n=5). Results: The EC50 of all concentration of the extract and atropine was significantly higher than that of saline. There was parallel right ward shift in concentration response curves obtained in the presence of all concentrations of the extract. There was not any significant difference in the maximum response and slope obtained in the presence of different concentrations of extract compared to saline. There was significant positive correlation between the concentrations and the values of EC50 (p

Objective: Handedness is the most prominent behavioral asymmetry in human. The term of hand preference points to prefer hand or functional asymmetry in manual tasks. The items were considered in this study were: the comparison of handedness between normal and congenitally deaf students the effects of age, sex, and pressure on using right hand for unimanual tasks on handedness the frequency of left-handers among student’s families, the influence of hand preference on English language capabilities, and the point of view of people rather to left-handers have been investigated. Materials & Methods: This cross-sectional comparative study was conducted on 760 students including 380 normal students and 380 deaf students with congenital severe or profound sensory-neural hearing loss from 12 to 18 years of age by that were selected purposefully, completing Edinburg handedness inventory in Tehran. The students didn’t have any confirmed diseases or neurological disorders, except hearing loss in deaf student. Data were gathered through the completion of the Edinburg Handedness Inventory by the students. The student’s aural records and also the confirmation of the audiologist in the deaf schools were considered in order to determine the kind and degree of hearing loss. Results: The prevalence of left-handedness among normal (9.7%) and deaf (10.3%) students were near to each other, and there was no significant difference between them (P=0.901, z=-1.24). The prevalence of left-handedness was higher in boys rather than girls, but there was no significant influence of sex and age on results (P>0.05). The family and/or teacher pressure for using right hand was 16.0% in normal students and 5.0% in deaf students, and they didn’t report any strict pressure or severity regard this mater. The frequency of left-handers was higher among family of normal students (22.6%) than deaf students (13.2%), and the difference between them was significant statistically (P=0.003, Z=-2.976). In both normal and deaf students, there was no significant difference between left and right-handers relate to English language ability (P>0.05). Regarding point of view people relate to left-handers, there was no significant difference between normal and deaf students (P=0.541, Z=-0.611). Conclusion: In present study, the prevalence of left-handedness was near to it’s prevalence in North-America and Western Europe, and revealed considerable difference with statistics of some Asian countries. The sameness of left-handedness prevalence in normal and deaf students, didn’t confirm the Previc’s hypothesis regard no differential ear sensitivity or advantage in congenitally deaf persons.

Background: The efficacy of amlodipine, a calcium channel blocker, in treating systemic hypertension is well established but the most efficacious brand of this drug is still uncertain. The cost of different brands of amlodipine is tremendously different which may affect decision-making in hypertension treatment. The purpose of this study was to compare the efficacy and safety of different brands of amlodipine (Amlodipine, Amlopress, and Norvasc) in the treatment of hypertension in adult patients. Methods: This was a double-blind, randomized, three-sequence crossover study. Ambulatory patients with hypertension who had the inclusion criteria were enrolled. Patients were randomized and entered into three groups to receive either brand of amlodipine in a crossover method. After every four weeks of treatment completed, the other brand of drug was prescribed. The total period of the study was 12 weeks for all three drugs including four weeks for each brand. Results: A total of 20 patients entered to the study, 15 completed the 12-week treatment schedule. The absolute reductions in seated and supine systolic blood pressure (SBP) and diastolic blood pressure (DBP) were similar with all three brands during the 4 weeks of treatment. Headache, malaise and weakness were the most common reported adverse effects (AE) with all three drugs. Generic amlodipine had the most AE as compared with other brands. These AE were mild and did not require withdrawal of the drug. Conclusion: There is no statistical difference in lowering blood pressure by three different brands of amlodipine thus everyone which has the lowest price can be the first choice.

Background: Community pharmacies are considered as ideal settings to provide cardiovascular risk screening (CRS). However, little is known about pharmacists’ views on providing such services in developing countries including Iran. In the present study, we evaluated the pharmacists’ attitudes and perceived barriers to providing CRS services. Methods: In a cross-sectional study, a questionnaire in three sections was developed by the investigators (attitudes, perceived barriers, and demographics). Five likert items (5 points bipolar scale) were designed to evaluate pharmacists’ attitudes about their professional role in providing CRS services in community pharmacies. Seven likert items were designed to assess the pharmacists’ perceived importance of possible barriers to providing the services. The study tool was distributed among a convenient sample of 500 pharmacists, who had participated in a national continuing education event. Results: The response rate was 44% and descriptive statistics and Chi squared test were used to analyze data. Results showed that 70.4% participants had an overall positive attitude to providing CRS services. Pharmacists who were pharmacy owner and pharmacist-in-charge simultaneously were more positive about providing CRS services. Lack of regulatory policy and compensation mechanism, limited physical space in pharmacy and time limitation were reported to be the most important barriers to providing CRS services (> 50% rated as highly important). Low human resource and time limitation were significantly associated with negative attitudes (P: 0.02 and 0.001, respectively). Conclusion: The Iranian pharmacists’ attitudes seem to be positive about providing CRS services; however, their perceived barriers should be addressed prior to CRS service implementation.

Background: Since albumin imposes a relatively high cost to a healthcare system, drug use evaluation for this drug is much more important. This study wants to evaluate pattern of albumin use in a large university affiliated hospital in Tehran, Iran. Methods: A concurrent, cross-sectional study was performed in “Shaheed Rajaei” Cardiovascular, Medical and Research Center. All inpatient adults that were prescribed albumin during the study period were evaluated to register the indications for albumin usage according to the evidence-based guidelines. Results: Only for five patients (4%) the albumin prescriptions were justifiable. Of these cases, intractable edema was the leading cause of albumin misuse (73 patients; 60.8%). The total 1468 vials of Albumin were prescribed for 120 patients during the study period. The most common reasons to prescribe albumin were acute normovolemic (34%), cardiac failure (0.83%), resistance edema with Albumin>2g/dL (61%), nephrotic syndrome (0.83%), plasmapheresis (1.67%), ascetic (1.67%). Conclusion: These data, together with previous national studies highly suggest a mandatory need for educational measures for practicing physicians along with strict regulations for prescription strategies regarding expensive drugs such as albumin.

Auditory integration training (AIT) is a hearing enhancement training process for sensory input anomalies found in individuals with autism, attention deficit hyperactive disorder, dyslexia, hyperactivity, learning disability, language impairments, pervasive developmental disorder, central auditory processing disorder, attention deficit disorder, depression, and hyper acute hearing. AIT, recently introduced in the United States, and has received much notice of late following the release of the sound of a miracle, by Annabel Stehli. In her book, Mrs. Stehli describes before and after auditory integration training experiences with her daughter, who was diagnosed at age four as having autism.

Objective: A “hearing-impaired is defined as abnormal or reduced function in hearing resulting from auditory disorder” (Stach,1997). The goal of any preschool and school screening program should be to accurately identify those children whose hearing has impaired resulting from either conductive and / or sensory - neural pathology. Although some ear pathologies (e.g., middle ear effusion) might not produce a significant hearing loss, screening for these pathologies should be a part of the screening program because they may influence the potential to learn. Materials & Methods: This research was carried out in a cross-sectional descriptive study on 577 children (278 girls and 299 boys) among the 3-6 years old children of kindergartens in Welfare Organization of the Tehran Province from March to June 2001. The otoscopy examination, pure-tone screening and impedance screening was conducted after completion the parents awareness form of the hearing loss existence. Results: In this study, there were 12.58% abnormal conditions of external ear canal, 23.7% abnormal tympanic membrane, 34.3% abnormal tympanograms, 35% no acoustic reflex, 12.6% hearing loss including 9.7% bilateral and 2.9% unilateral hearing loss (12.0% conductive hearing loss, 0.64% sensory-neural hearing loss and 0.36% mixed hearing loss), higher prevalence of left ear disorders and statistically meaning difference between two ears (P