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Abstract In recent years, the exploration of the therapeutic potential of Salvia has gained considerable attention, leading to a growing number of scientific studies emphasizing its pharmacological properties. Despite this, therapeutic applications of Salvia remain underexploited, requiring further investigation. Iran is a major center for sage diversity in Asia, boasting 60 Salvia species, 17 of which are unique to the area. This study aimed to comprehensively explore and compare the extracts of 102 Salvia samples belonging to 20 distinct Salvia species from Iran, providing a deeper understanding of their specific polyphenol content and, consequently, their antioxidant capabilities and potential therapeutic uses. All samples were analyzed to determine the contents of total phenolics, total flavonoids, total tannin, photosynthetic pigments, and ascorbic acid, along with their antioxidant activity. These data were then combined with the forty distinct chemical fingerprints identified by ultrafast high-pressure liquid chromatography coupled with high-resolution mass spectrometry. Multivariate data analysis was employed to find correlations and differences among the huge number of data obtained and to identify Salvia species with similar phytochemical and/or antioxidant properties. The results show that each Salvia species is characterized by a distinct class of polyphenols recognized for their antidiabetic, anti-inflammatory, cardioprotective and neuroprotective properties. Overall, our findings reveal the potential of some Salvia species for targeted therapeutic applications and provide a rational basis for the development of Salvia-derived nutraceuticals, ultimately improving the prospects for the use of Salvia in medicine.

Introduction: Chimeric Antigen Receptor (CAR) T cells have tremendous potentials for cancer treatment; however, various challenges impede their universal use. These restrictions include the poor function of T cells in tumor microenvironments, the shortage of tumor-specific antigens and, finally, the high cost and time-consuming process, as well as the poor scalability of the method. Creative gene-editing tools have addressed each of these limitations and introduced next generation products for cell therapy. The clustered regularly interspaced short palindromic repeats-associated endonuclease 9 (CRISPR/Cas9) system has triggered a revolution in biology fields, as it has a great capacity for genetic manipulation. Method: In this review, we considered the latest development of CRISPR/Cas9 methods for the chimeric antigen receptor T cell (CAR T)-based immunotherapy. Results: The ability of the CRISPR/Cas9 system to generate the universal CAR T cells and also potent T cells that are persistent against exhaustion and inhibition was explored. Conclusion: We explained CRISPR delivery methods, as well as addressing safety concerns related to the use of the CRISPR/Cas9 system and their potential solutions.

Abstract Identifying patients who may develop severe COVID-19 has been of interest to clinical physicians since it facilitates personalized treatment and optimizes the allocation of medical resources. In this study, multi-gene genetic programming (MGGP), as an advanced artificial intelligence (AI) tool, was used to determine the importance of laboratory predictors in the prognosis of COVID-19 patients. The present retrospective study was conducted on 1455 patients with COVID-19 (727 males and 728 females), who were admitted to Allameh Behlool Gonabadi Hospital, Gonabad, Iran in 2020–2021. For each patient, the demographic characteristics, common laboratory tests at the time of admission, duration of hospitalization, admission to the intensive care unit (ICU), and mortality were collected through the electronic information system of the hospital. Then, the data were normalized and randomly divided into training and test data. Furthermore, mathematical prediction models were developed by MGGP for each gender. Finally, a sensitivity analysis was performed to determine the significance of input parameters on the COVID-19 prognosis. Based on the achieved results, MGGP is able to predict the mortality of COVID-19 patients with an accuracy of 60–92%, the duration of hospital stay with an accuracy of 53–65%, and admission to the ICU with an accuracy of 76–91%, using common hematological tests at the time of admission. Also, sensitivity analysis indicated that blood urea nitrogen (BUN) and aspartate aminotransferase (AST) play key roles in the prognosis of COVID-19 patients. AI techniques, such as MGGP, can be used in the triage and prognosis prediction of COVID-19 patients. In addition, due to the sensitivity of BUN and AST in the estimation models, further studies on the role of the mentioned parameters in the pathophysiology of COVID-19 are recommended.

Abstract The Lamiaceae family encompasses numerous species highly valued for their applications in medicine, food, and cosmetics. In order to screen the Lamiaceae family and discover new sources of phytochemicals and antioxidants, we comprehensively evaluated 20 species from this family, including Phlomis herba-venti, P. tuberosa, P. olivieri, P. kurdica, Nepeta sp., N. cataria, N. saccharata, Stachys sp., S. inflata, Scutellaria albida, Marrubium parviflora, Mentha pulegium, Thymus kotschyanus, Lamium album, Salvia officinalis, S. multicaulis, S. macrochlamys, S. candidissima, S. verticillata, and S. nemorosa. The aerial parts of these species were analyzed to determine their total phenolic (TPC) and flavonoid (TFC) contents, total tannin content (TTC), ascorbic acid content (AAC), antioxidant capacity (assessed by FRAP and DPPH assays), and polyphenolic components (by HPLC). The phytochemical compounds and antioxidant properties varied widely among different species. The highest concentrations of TPC (70.93 mg GAE/g DW), TFC (17.89 mg Que/g DW), TTC (6.49 mg TAE/100 g), and AAC (1.15 mg AA/g DW), as well as the greatest antioxidant activity, were observed in different Salvia species. Additionally, chlorogenic and rosmarinic acids were the primary phenolic compounds identified in the extracts from the investigated Lamiaceae family. According to Hierarchical Cluster Analysis (HCA) and Principal Component Analysis (PCA), three groups of species were identified, characterized by variations in phytochemical composition and antioxidant capacity. The results obtained can provide new natural sources of phytochemicals and antioxidant agents, particularly from Salvia species, for the advancement of new products in the food, agricultural, cosmetics and health industries.

The purpose of this study was to examine the effects of nano-micelle curcumin (NMC)-induced redox imbalance on mitochondrial biogenesis and mitophagy. For this purpose, 24 mature male Wistar rats were divided into control and NMC-received groups (7.5, 15, and 30 mg/kg) groups. After 48 days, the Nrf1, Nrf2, and SOD (Cu/Zn) expression levels, as well as GSH/GSSG, NADP+ /NADPH relative balances (elements involved in redox homeostasis) were analyzed. Moreover, to explore the effect of NMC on mitochondrial biogenesis, the expression levels of Mfn1, Mfn2, OPA1, Fis1, and Drp1 were investigated. Finally, the expression levels of Parkin/PARK and PINK (genes involved in mitochondrial quality control), as well as LC3-I/II (mitophagy marker), were analyzed. Observations showed that NMC, dose-dependently, altered GSH/GSSG, NADP+ /NADPH relative balances, suppressed SOD expression and diminished its biochemical level, and repressed Nrf1 and Nrf2 expression levels. Moreover, it could change the Mfn1, Mfn2, OPA1, Fis1, and Drp1 expression pattern and stimulate the Parkin/PARK and PINK as well as LC3-I/II expression levels, dose-dependently. In conclusion, chronic and high-dose NMC is able to suppress the redox capacity by down-regulating the Nrf1 and Nrf2 expression. Finally, at high-dose levels, it is able to trigger mitophagy signaling in the testicles.

Introduction: A better understanding of the mechanism and / or pathophysiology of shoulder pain syndrome after laparoscopic gynecological surgery leads to an increase in the number of clinical trials to prevent this complication. Therefore, the present study was conducted with aim to define the mechanism and prevention methods of shoulder pain syndrome after laparoscopic gynecology surgeries.Methods: In this narrative review study, to find the articles related to shoulder pain syndrome after laparoscopic gynecology surgeries, the published articles from 2000 including observational and clinical trials, descriptive and correlational studies were searched in the electronic databases of PubMed, Scopus, EMBASE, PEDro, Google Scholar, CINAHL , SID and Magiran with the keywords of shoulder pain syndrome, shoulder pain, surgery, laparoscopy, gynecology, postoperative and gynecology laparoscopy.Results: The main searched mechanisms included the pain mechanism, pain due to surgical incision, causes of shoulder pain syndrome after laparoscopic surgery in women, use of an alternative blowing gas to reduce shoulder pain syndrome, use of low pressure pneumoperitoneum to reduce the shoulder pain syndrome, gas-free laparoscopy and active gas excretion to reduce shoulder pain syndrome, use of heated or heated and humidified CO2 to reduce shoulder pain syndrome, use of sub-diaphragmatic intraperitoneal anesthesia or localized intraperitoneal anesthesia to reduce tip shoulder pain and use of pulmonary recurrence maneuvers in reducing shoulder pain syndrome.Conclusion: Shoulder pain syndrome in laparoscopic gynecological surgeries can be minimized with preventive measures such as the use of hot and humid gas, intraperitoneal administration of local analgesics and pulmonary recovery maneuver.

Background and Aim: The present study compared the retreatment efficacy of D-RaCe, SP1, and R-Endo rotary files in gutta-percha removal from the mesiobuccal canal of mandibular molars by micro-computed tomography (micro-CT). Materials and Methods: In this experimental in vitro study, 30 mandibular molars were prepared with Denco-D-Super files and filled using gutta-percha and AH Plus sealer by the lateral compaction technique. Root canals then underwent micro-CT, and the amount of root filling material was measured on images using LOTUS InVivo-REC software. The teeth were randomly assigned to three groups (n=10) for retreatment with D-RaCe, SP1, and R-Endo systems. They underwent micro-CT again after retreatment, and the volume of residual root filling material in the root canals was calculated. The percentage of cleaning efficiency of each system in removal of gutta-percha from the mesiobuccal canal was calculated and compared among the three groups by two-way ANOVA and Tukey’s test (alpha=0.05). Results: File type (P=0.05) and root canal region (apical, middle, or coronal third) (P

Background: Parturient health is a priority worldwide. In this regard, the promotion of natural childbirth has always been considered by health policy makers. However, the most important cause of parturient tendency to caesarean section is fear of labour pain and lack of information about surgery complications, leading to inappropriate rate of caesarean. Midwives, attending in prenatal visits and labour, may have a key role in encouraging pregnant patients through labour analgesia. In this study we evaluate midwives’ attitude through necessity of labour analgesia and their understanding of neuraxial analgesia for labour pain. Methods: One hundred and five midwives working educational hospitals, participated in this observational study. All participants were asked to fill questionnaires. Each questionnaire consists of 15 questions, each answer had 1 to 3 points. Total score of 15 to 25 was considered as poor, score 26 to 35 as intermediate and 35 to 45 as good attitude. Results: Forty-nine percent of midwives had experience with labour analgesia. Forty-one percent participated in relevant educational workshops. About 40% presumed these techniques would result in immobility, while 66% assumed it will lengthen the procedure. 63% believed labour analgesia will increase mother’s satisfaction. Overall, 73% of them agreed with regional analgesia. In regards to attitude score, 22% were scored poor, 65% intermediate and 13% good. Conclusion: Midwives’ attitude was estimated low. Participating in workshops improved their attitude, yet the difference was not significant. Attitude of those who participated in labour analgesia was significantly better than others.

Background and Aim: Achieving adequate pulpal anesthesia could be challenging in mandibular molars. There are some disagreements about the success rate of local infiltration anesthesia with articaine as primary injection. Therefore, the aim of this study was to assess the efficacy of 4% articaine lingual subperiosteal injection as the primary injection for permanent mandibular second molars in comparison with inferior alveolar nerve block (IANB). Materials and Methods: Fifteen healthy adult volunteers participated in this study. A randomized, split-mouth, single-blind design was used to allocate each side of the mandible in each patient to the test or control group. On the test side, lingual subperiosteal injection with 4% articaine and 1:100,000 epinephrine was performed for the mandibular second molar; whereas, in the control group, an IANB with 2% lidocaine and 1:80,000 epinephrine was administered. Electric pulp testing was done at baseline, and also at 5, 8, 11, 15, 20, 25, 30, 45, 60, 75, and 90 minutes after injection. Statistical analysis was carried out using t-test and Chi-square test. Results: The success rate of IANB was significantly higher than that of lingual subperiosteal injection (P=0.0001). The difference in the onset of action between the two groups was significant (P

Background and Aim: This study aimed to compare the cytotoxicity of AH Plus and DC Canal SE sealer after final setting. Materials and Methods: In this in vitro, experimental study, human gingival fibroblasts (HGFs) were cultured in Dulbecco’s modified Eagle’s medium supplemented with 10% fetal bovine serum, 100 U/mL penicillin, and 100 µg/mL streptomycin, and incubated at 37°C and 5% CO2. Cells at a density of 5000 cells/well were seeded in a 96-well plate for the methyl thiazolyl tetrazolium (MTT) assay. The cells were incubated with AH Plus and DC Canal SE sealers. Specimens of freshly mixed sealers were fabricated with 4 mm height and 10 mm diameter, and incubated at 37°C for 24 hours for setting. Each specimen was incubated with 10 mL of diluted culture medium at 37°C and 5% CO2 for 24 hours. Finally, the solution was filtered using a 0.22-µm filter. Different dilutions (1, 1/2, 1/4, 1/8) were prepared, and cell viability was assessed at 24 and 72 hours by measuring the optical density of the solutions spectrophotometrically. Data were analyzed by ANOVA and Tukey’s test. Results: Cell viability in presence of all concentrations of AH Plus and DC Canal SE was significantly lower at 72 hours compared with 24 hours (P

In recent years, the exploration of the therapeutic potential of Salvia has gained considerable attention, leading to a growing number of scientific studies emphasizing its pharmacological properties. Despite this, therapeutic applications of Salvia remain underexploited, requiring further investigation. Iran is a major center for sage diversity in Asia, boasting 60 Salvia species, 17 of which are unique to the area. This study aimed to comprehensively explore and compare the extracts of 102 Salvia samples belonging to 20 distinct Salvia species from Iran, providing a deeper understanding of their specific polyphenol content and, consequently, their antioxidant capabilities and potential therapeutic uses. All samples were analyzed to determine the contents of total phenolics, total flavonoids, total tannin, photosynthetic pigments, and ascorbic acid, along with their antioxidant activity. These data were then combined with the forty distinct chemical fingerprints identified by ultrafast high-pressure liquid chromatography coupled with high-resolution mass spectrometry. Multivariate data analysis was employed to find correlations and differences among the huge number of data obtained and to identify Salvia species with similar phytochemical and/or antioxidant properties. The results show that each Salvia species is characterized by a distinct class of polyphenols recognized for their antidiabetic, anti-inflammatory, cardioprotective and neuroprotective properties. Overall, our findings reveal the potential of some Salvia species for targeted therapeutic applications and provide a rational basis for the development of Salvia-derived nutraceuticals, ultimately improving the prospects for the use of Salvia in medicine. [ABSTRACT FROM AUTHOR]

Background: Faculty Development Programs (FDPs) aim to improve the academic careers of faculty members. This study was designed to assess the attitudes of faculty members and the impact of FDP on their academic improvement. Methods: 12 faculty members took part in the research from 2016 to 2019. Using a Delphi method, an open secure questionnaire was provided to 12 junior faculty members in the Department of Anesthesia, Critical Care (DACC), Shahid Beheshti University of Medical Sciences (SBMU), Tehran, Iran. Then, the keywords of the latter were analyzed, leading to a 32-item closed-answer questionnaire, filled out by the same participants. Also, the impact of the study was assessed using bibliometric improvement indices. Results: Both the response rate and participation rate were 100%. Approximately all the participants considered FDP an advantageous and promising academic program. 65 percent of the participants had academic improvement, from "Assistant Professor" to "Associate Professor" rank. Besides, the cumulative number of citations to the participants had a 16.2 times improvement. Both latter results were significantly higher than the mean improvement of the cohort faculty members in the DACC, SBMU. Conclusion: Faculty members of DACC, SBMU had positive attitudes towards FDP and described it as "a well-designed multilateral academic teamwork, thriving ethical, educational, managerial and research-related capacities". Also, objective improvement in some academic indices was observed. In many academic environments including developing countries, FDPs are effective scientific investment methods. [ABSTRACT FROM AUTHOR]

Examination and intervention are always the causes of agitation, anxiety, and fear in children’s lives. This study aimed to investigate the effectiveness of promethazine hydrochloride in reducing children’s agitation during the ocular examination for trauma. In this interventional-clinical trial study, a total of 62 children referred to Al-Zahra Ophthalmology Hospital in Zahedan, Iran, were evaluated in two matched groups (case (n = 31) and control (n = 31)) for an initial examination of ocular trauma. Finally, the intervention was performed (giving placebo or promethazine hydrochloride cough syrup 20 minutes before the initial ocular examination at 0.5 mg/kg), and the demographic information form and researcher-made questionnaire modeled on the Cohen-Mansfield Agitation Inventory (CMAI) were completed. The obtained results revealed that the mean scores of physical/aggressive behaviors (p ˂ 0.001), physical/nonaggressive behaviors (p = 0.013), verbal/aggressive behaviors (p ˂ 0.001), and hiding behaviors (p ˂ 0.001) were significantly lower in the promethazine hydrochloride-receiving group than the placebo group. These findings demonstrated that promethazine hydrochloride cough syrup facilitated the examination among the pediatric patients who suffered from traumatic ocular injuries. However, further studies in this field need to be carried out through randomized controlled trials.

Background and Aims: Pulpal exposures originated from the external cervical root resorptions have major effects on the treatment and prognosis. Therefore, the aim of this study was performed to compare the two different imaging systems-digital radiography with PSP (Photostimulable Phosphor) sensor in three horizontal different views and CBCT (cone beam computed tomography) images to assess the pulpal exposure in simulated cavity of external cervical root resorptions that was performed in 1398 in the School of Dentistry of Azad University. Materials and Methods: 40 intact maxilla anterior teeth with straight roots were included. Teeth were randomly divided to two groups (20 teeth with and 20 without pulpal exposures). Each sample was assessed using PSP digital radiography (in 3 horizontal angles) and CBCT image system, to detect the presence of pulpal exposures. False negative and false positive results in 2 imaging procedures were judged with ratio test. Results: The results showed in CBCT (P.P.V=85.7%) and (N.P.V=89.5%), and in digital intraoral radiography (P.P.V=80%) and (N.P.V=80%) in proximal defects. Ratio test showed that there were no significant differences in the proximal defects (P

Coronavirus disease 2019 (COVID19), caused by the severe acute respiratory syndrome coronavirus 2 (SARSCoV2), was first discovered in China in late 2019 and quickly spread worldwide. Although nasopharyngeal swab sampling is still the most popular approach identify SARS-CoV-2 carriers, other body samples may reveal the virus genome, indicating the potential for virus transmission via non-respiratory samples. In this study, researchers looked at the presence and degree of SARS-CoV-2 genome in stool and plasma samples from 191 Iranian COVID-19 patients, and looked for a link between these results and the severity of their disease. SARS-CoV-2 RNA shedding in feces and plasma of COVID-19 patients was assessed by reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Medical data were collected and evaluated, including Clinical features, demographics, radiological, and laboratory findings of the patients. Plasma samples from 117 confirmed laboratory patients were evaluated and 24 out of 117 patients (20.51%) tested positive for SARS-COV-2 RNA. Besides, 20 out of 74 patients (27.03%) tested positive for SARS-COV-2 RNA in stool samples. There seems to be no relationship between the presence of SARS-CoV-2 genome in fecal and plasma samples of Covid-19 patients and the severity of illness. We provide evidence of the SARS-CoV-2 genome presence in stool and plasma samples of Iranian COVID-19 patients.

The prevalence of COVID 19 encouraged physicians and researchers to study the pathology of the disease and changes in patients' immunological factors. What has been proven today is the occurrence of an inflammatory outbreak in the body of patients with this infection, which causes severe immunological reactions in them. Hemoperfusion, as an extracorporeal purification method, has the potential to act as an aid in modulating or controlling this inflammatory phase. Therefore, the present study evaluates the role of hemoperfusion in controlling inflammatory conditions in patients with COVID 19.

In the last days of 2019, a novel strain of coronaviruses reported in Wuhan and spread rapidly all over the world which called 2019 novel coronavirus (2019- nCoV). Almost a few months later in the early 2020 (January 2020), the WHO declared the outbreak of COVID-19 a Public Health Emergency which Compared with the other SARS- CoV, has a stronger transmission capacity. Although respiratory problems are the main clinical symptoms of COVID-19, some patients also experience other conditions and injuries, such as severe vascular damage. Therefore, it can be said that understanding the damage caused by this infection to the vascular system and its underlying mechanisms is of great importance.

The world has experienced a pandemic due to novel Severe Acute Respiratory Disease Corona Virus-2 (SARS-CoV2) since December 2019. The clinical spectrum of the disease known as Coronavirus Disease 2019 (COVID-19) is so much wide, starting from an asymptomatic state to paucisymptomatic clinical presentation, pneumonia, respiratory failure to even death. Supplemental oxygen therapy is essential in managing COVID-19. Also, there is sparse evidence regarding use of non-invasive ventilation (NIV) in pandemics like SARS-CoV-2. This study reviews the currently available methods for respiratory support in COVID-19 with a discussion about using these modalieties in the COVID-19 pandemic.

Abstract Background: This study compares the effects of epidural analgesia with infiltration analgesia in postoperative pain control for total knee arthroplasty. Materials and methods: 47 females and 13 males with an average age of 65.7 years were randomly allocated into epidural (EA; n=30) and local infiltration anesthesia (LIA; n=30) groups. All patients received spinal anesthesia and were inserted epidural catheter. In LIA group, 50mL of a mixture, containing bupivacaine, ketorolac, morphine sulfate, and epinephrine was injected in to periarticular tissue and in EA group normal saline was injected. In the EA group, after surgery, an epidural catheter was attached to the patient-controlled analgesia (PCA) infusion pump with 25cc bupivacaine diluted in 75mL of normal saline but in LIA group, the PCA pump of the epidural catheter contained 100cc of normal saline, and the pump was blocked. Results: The difference in demographic data was not significant between the groups. The mean VAS score (Pain) of EA group was significantly higher than LIA group until 12 hours after surgery, At 24 hours, there was no significant difference between two groups, and Pain of EA group was significantly lower than LIA group at 48 hours after the surgery. Dranage volume and hemoglobin drops were lower in LIA group. Knee range of motion in the LIA group was not superior to that of the EA group two weeks after surgery. The patients’ ability to perform active straight leg raise had no significant difference between two groups one day after the surgery. Conclusion: local infiltration analgesia is better than epidural for postoperative pain control at first 12 hours. However, epidural analgesia can control postoperative pain more effectively at 48 hours after surgery. There was no significantly difference between two groups regard to patients ability to perform straight leg rising and Knee range of motion was similar in two groups.

In this report, we presented our experience in treating severe postpartum post-dural puncture headache with low-dose propofol. Short-term use of low-dose propofol provided rapid and complete relief of the headache without recurrence.

Severe infection with COVID-19 disease can be associated with respiratory failure, kidney disorders, and in more advanced stages, organ failure and death. Unfortunately, there is currently no definitive cure for this disease, and damage to the immune system caused by inflammatory storms leads to widespread and varied complications that make an early diagnosis of the disease difficult. Therefore, eliminating or inhibiting the production of factors involved in inflammatory storms can be effective in improving the clinical condition of patients. According to specialized studies on the role of hemoperfusion in inhibiting advanced levels of COVID-19 disease, the present study was performed to investigate the use of hemoperfusion as a potential treatment option for this disease.

Objective: COVID-19, which is an international concern by far, had fundamental impacts on mental health of medical staff. Healthcare workers are the high-risk group to endure the emotional outcomes brought about by the outbreak. This study assesses the mental consequences of healthcare workers during the acute phase of COVID-19 pandemic in Tehran. Method: We conducted a cross-sectional study on healthcare workers from two tertiary referral hospitals in Tehran province. A total of 222 of the staff participated in the study. Our questionnaires comprised Impact of Event Scale-Revised (IES-R) and 12-item General Health Questionnaire (GHQ-12), which were handed to participants to obtain data on their general mental problems in addition to the psychological impacts of the evolving virus on this particular group. Epidemiologic and sociodemographic information of participants, level of perceiving exposure to disease, and underlying diseases of each of them were gathered during the recruitment period. Results: Results showed high probabilities (98.2%) in mental disorders among healthcare workers. Since our study was done during the initial phase of the pandemic, development of mental issues due to the newly emerged infectious virus was expected. However, we recorded mild (41.4%) to moderate (31.5%) impact of this novel virus. The possibility of having mental problems was much higher in females, assistant nurses, individuals with lower education, and those who provided care for COVID-19 patients. Conclusion: COVID-19 has brought about increased distress among healthcare workers. Noticeably, the forefront group in combating this virus bear the most emotional complications. Thus, efforts should be taken into practice to provide proper psychological support for this vulnerable group.

Background & Objective: Gastric motility disorder is common in patients admitted to an intensive care unit (ICU), leading to increased morbidity and mortality. We investigated the effects of different doses of neostigmine in combination with metoclopramide on gastric residual volume (GRV) in ICU patients on enteral feeding. Methods: In this double-blind clinical trial, 144 patients hospitalized in the ICU who were under enteral nutrition through nasogastric (NGT) or orogastric (OG) tube were randomly allocated to four groups. In all four groups, 20 mg of metoclopramide was prescribed IV slowly within one minute. In groups A, B, and C, 1, 1.5, and 2 mg of neostigmine were injected IV, respectively. Group D received only 20 mg of metoclopramide. All patients were gavaged every 4 h with 300 ml. The patient's head was kept at a 45° angle. To determine GRV, aspiration was done through NG tube or OG tube before the start of infusion and then at 3, 6, 9, and 12 h after the end of infusion. Results: There was no significant difference between the studied groups in terms of demographic variables such as age, blood pressure, heart rate and BMI (P > 0.05). The average difference of SOFA and APACHE and laboratory factors between the groups was not significant. The results of the comparison of the marginal averages of the residual volume of the stomach at different hours of the day showed that the amount of the residual volume at all hours had a significant average difference with each other. The addition of different doses of neostigmine had a significant effect on the residual volume of the stomach after 3 and 6 h (P < 0.05). Meanwhile, a dose of 2.0 mg of neostigmine had the most of the change 3 h after administration. Conclusion: Administration of neostigmine in combination with metoclopramide in ICU patients on enteral feeding significantly reduces the residual volume of the stomach within 12 hours after the treatment. [ABSTRACT FROM AUTHOR]

Background and Aim: The main goal of root canal treatment is to prevent or treat apical periodontitis. The aim of the present study was to assess the coronal restoration status, root canal filling quality, periapical health condition, and related factors in endodontically treated teeth at the Dental Faculty of Islamic Azad University of Medical Sciences, Tehran, Iran, in 2011-12. Materials and Methods: In this descriptive, historical cohort study, a total of 160 teeth submitted to endodontic treatment were clinically and radiographically reexamined one year (minimum) postoperatively. Each volunteer answered a questionnaire on demographic and socioeconomic factors. They were also questioned about the factors related to endodontic and restorative treatments. The restoration and root canal filling quality was classified according to the modified criteria introduced by Tronstad et al. The periapical status was evaluated according to the periapical index (PAI) scores. Results: Periapical lesions (diseased/failure) were most prevalent in Inadequate Restoration/Inadequate Root Canal Filling group (70%) followed respectively by Inadequate Restoration/Adequate Root Canal Filling group (52.2%), Adequate Restoration/Inadequate Root Canal Filling group (30%), and Adequate Root Canal Filling/Adequate Restoration group (15.5%). Conclusion: According to the results, an efficient appointment scheduling system has the greatest impact on the completion of coronal restoration after endodontic treatments. Provision of adequate root canal filling and perfect coronal restoration can reduce the prevalence of postoperative periapical lesions and increase the success rate of endodontic treatments.

Scoulerine is a natural compound that is known to bind to tubulin and has anti-mitotic properties demonstrated in various cancer cells. Its molecular mode of action has not been precisely known. In this work, we perform computational prediction and experimental validation of the mode of action of scoulerine. Based on the existing data in the Protein Data Bank (PDB) and using homology modeling, we create human tubulin structures corresponding to both free tubulin dimers and tubulin in a microtubule. We then perform docking of the optimized structure of scoulerine and find the highest affinity binding sites located in both the free tubulin and in a microtubule. We conclude that binding in the vicinity of the colchicine binding site and near the laulimalide binding site are the most likely locations for scoulerine interacting with tubulin. Thermophoresis assays using scoulerine and tubulin in both free and polymerized form confirm these computational predictions. We conclude that scoulerine exhibits a unique property of a dual mode of action with both microtubule stabilization and tubulin polymerization inhibition, both of which have similar affinity values.

Interleukin-6 plays an important role in inflammatory responses and synthesis of acute hepatic phase proteins and its plasma level changes are used as a reliable prognostic factor for mortality in hospitalized patients. On the other hand, various methods for reducing inflammatory responses, including proper control of pain during and after surgery, and correction of hemodynamic disorders, can be monitored by monitoring of plasma levels of IL-6. Epidural anesthesia is an appropriate method for controlling pain in lower limb surgeries. The aim of this study was to evaluate the effect of adding Dexmedetomidine to lidocaine in the epidural injection for better control of post-surgical inflammatory responses by measuring interleukin-6 plasma levels. Patients referred to Taleghani Hospital in 1396 who suffered from lower limb fractures and requiring surgery were evaluated. 52 patients in two groups receiving Dexmedetomidine doses of media and controls for the quality of epidural anesthesia and IL-6 index. After obtaining written consent, the Dexmedetomidine treatment group and the normal saline control group were prescribed epidural with lidocaine. Finally, the level of IL-6 before surgery and 6 hours after surgery were evaluated. According to the results of statistical analysis, the two groups did not show a significant difference in age and level of interleukin prior to the operation. The mean age of patients in this study was 15.84639 ± 53.4038. The sex distribution of the study included 19 women (36.5%) and 33 men (63.5%). According to the U Mann Whitney test, the second injection time and total drug volume had a significant difference between the control and intervention groups and Dexmedetomidine reduced the volume of total drug needed and increase the time interval until the second injection (p

Background: The purpose of this study is to investigate the impact of different anesthetic techniques on the release of cytokines interleukin IL-6, IL-10 and tumor necrosis factor (TNF)-α in preeclampsia patients who undergo cesarean section.Materials and Methods: In the study 40 patients were enrolled with preeclampsia undergoing cesarean section, allocated into two equal groups to receive either general anesthesia (n = 20) or spinal anesthesia (n = 20). Non-invasive hemodynamic monitoring was used. Serum levels of IL-6, IL-10 and TNF-α were measured before and at the end of surgery.Results: There was no significant rise in serum levels of TNF-α in general anesthesia while IL-6 and IL-10 serum levels increased significantly. Also, compared with patients anaesthetized with general anesthesia patients who received regional anesthesia notably had lower levels of IL-6 and IL-10 after surgery (p < 0.05).Conclusion: Spinal anesthesia causes significant difference in post-operation IL-6 and IL-10 serum levels in preeclampsia patients undergoing cesarean section. Nevertheless, neither general nor spinal anesthesia made such effect on serum level of TNF-α. Further studies with higher sample size and comparing preeclamptic patients to healthy mothers undergoing cesarean section are required.

Background: Regional blocks is a good alternative to general anesthesia in upper extremity surgeries. Supraclavicular is a kind of regional block which can be used to treat nerve block in the upper extremity. The ancillary drugs are nowadays used to enhance the quality and quantity of sensory and motor block. The present study has attempted to investigate the effect of three prescription drugs (composition Dexamethasone with Bupivacaine and Dexmedetomidine with Bupivacaine and Bupivacaine alone) on supraclavicular block. Methods: This parallel Design study was conducted in 2017 as a clinical trial at Ayatollah Taleghani Hospital in Tehran. For this purpose, 60 patients over the age of 18 and in class I, II of the American Anesthesiology Association (ASA) who were candidates for upper limb elective surgery, were enrolled. Patients included in the study (60 patients) were randomly divided into three equal groups (n= 20). Anesthesia procedure was performed for all patients in three equal groups. However, to evaluate the efficacy of selected drugs, different drugs were injected into each group. After completing the design and recording the results of the variables under study, the t-test was used to compare quantitative variables between the two groups. All statistical tests were performed in two domains (5% significance level) and SPSS 21 software was used for data analysis. Results: In the levels of intraoperative factors in the comparative conditions of the BB[i] with BDexa[ii] and BB with BDex[iii] groups. However, Duration of Sensory Block (P=0.004) and Duration of Movement Block (P=0.001) were significantly different in BD and BDex groups. Conclusion: What can be clearly seen in the results are the significant changes of Duration of Sensory Block and Duration of Movement Block compared to the BDexa and BDex groups. Based on these results, in both cases we find a significant decrease in the measured duration in the BDexa group compared to the opposite group. Use of Bupivacaine + Dexamethasone has a more positive effect on Supraclavicular block compared to Bupivacaine + Dexmedetomidine and Bupivacaine alone. [i] Bupivacaine [ii] Bupivacaine + Dexamethasone [iii] Bupivacaine + Dexmedetomidine