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Background: Scoliosis is a three-dimensional deformity of the spine with lateral curvature in addition to the rotation of vertebral bodies. The aim of the present study was to determine the prevalence of adolescent idiopathic scoliosis (AIS) in our society and its demographic-related factors. Materials and Methods: This was a cross-sectional study that took place from November 2014 to March 2015 in Isfahan, Iran. During the period of study, 24 schools were randomly chosen from six zones by a simple random sampling method. In each school, about 120 students were randomly selected and evaluated. Anterior forward bending test and scoliometry were done in all students and suspicious ones referred to Alzahra spine clinic for further evaluation. The diagnosis of AIS was based on radiographic finding and Cobb angle more than 10°. Data about age, sex, height, body mass index, hand dominancy, and type of schoolbag were recorded. Results: A total number of 3018 children were evaluated and 19 were diagnosed with AIS that showed the prevalence of 0.62%. None of the study variables had a significant relation with the presence of AIS. The cutoff point for the detection of AIS with scoliometry was calculated as 3.5, with a sensitivity of 73.7% and specificity of 86.7%. Conclusion: The prevalence of AIS in our area was 0.62%, which was lower than previous reports and did not have a relation with demographic factors; however, screening surveys identify a significant number of children with AIS who could benefit from preventive treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND Aryl-carbon receptor (AhR), a ligand-activated transcription factor, is best known for its ability to mediate the effects of environmental toxins such as 2,3,7,8-tetrachlorodibenzo-p-dioxin. AhR is expressed in several tumor cells and regulates the expression of genes in the signal transduction pathways. In this study, we examined the soluble levels of AhR in patients with pancreatic cancer. METHODS 123 samples, including 59 (48%) samples of pancreatic ductal adenocarcinoma based on histological evidence and 64 (52%) healthy control samples, were evaluated to determine plasma levels of AhR by Enzyme-linked immunoassay. RESULTS The median of AhR among patients was 0.280 ng/mL, which differed considerably from 0.07 ng/mL in the control group (p < 0.001). Significant differences of the AhR were observed between the plasma samples of the patients compared with the healthy group, with respect to male sex (p < 0.001), age groups (p = 0.001), diabetic status (p < 0.001), body mass index (BMI) categories (p = 0.035), and constantly smokers (p < 0.001). We also observed significant differences between the level of AhR expression between men and women (p = 0.01) and ever to never smokers (p = 0.009) in the case group. In addition, the age of 65 and a BMI of 25 or less were significant factors in plasma AhR levels ([1.61 95%CI 1.08-2.38] and [1.84 95%CI 1.22-2.77], respectively). CONCLUSION The results of this study can add diagnostic information to pancreatic cancer involving AhR and the potential efficacy of this receptor in therapeutic strategies. [ABSTRACT FROM AUTHOR]

Background and Objectives. The null hypothesis of this study was that TA has no effect on postsurgical bleeding in patients undergoing TKA. Methods. This study was a double-blind randomized trial. In the first group (T) patients received 500 mg of intravenous Tranexamic acid (TA) twice (once preoperatively and once 3 hours postoperatively) and in the second group (P) they received slow infusion of normal saline as placebo. The primary outcome of the study was the level of Hb 48 hours after surgery. Results. Hb levels 48 hours after surgery as the primary outcome were 10.92±0.97 and 10.23±0.98 (g/dL) in groups T and P, respectively, and the difference was statistically significant (P=0.001). Statistically significant differences were also observed in Hb levels 6 and 24 hours after surgery, the drain output 48 hours after surgery, and the number of units of packed cells transfused between study groups (P<0.05). There was no significant difference in duration of hospitalization between the study groups (P = n.s.). Conclusions. The low dose perioperative intravenous TA significantly reduces blood loss, requirement for blood transfusion, and drain output in patients undergoing TKA. However, duration of hospitalization did not change significantly. [ABSTRACT FROM AUTHOR]

# BACKGROUND: There is a lack of data on familial aggregation of colorectal cancer (CRC) in Iran. We aimed to determine the frequency of hereditary nonpolyposis colorectal cancer (HNPCC) and familial colorectal cancer (FCC) and to determine the frequency of extracolonic cancers in these families in Isfahan. # METHODS: We reviewed documents of all patients with a pathologically confirmed diagnosis of CRC admitted to Isfahan referral hospitals between 1995 and 2006. We also studied our CRC registry at Poursina Hakim Research Institute from 2003 to 2008. We found HNPCC and FCC families based on the Amsterdam II criteria and interviewed them for family history of CRC and extracolonic tumors. The family history was taken at least up to the second-degree relatives. # RESULTS: During 1996 to 2008, a total of 2580 CRC cases have been diagnosed. We found 14 HNPCC and 53 FCC families. Mean age of CRC at diagnosis was 48.0 ± 14.6 and 49.0 ± 13.9 years in the HNPCC and FCC families, respectively (p > 0.05). The total numbers of observed extracolonic tumors were 70 (21.6%; mean age = 53.6 ± 11.0 years) and 157 (13.8%; mean age = 54.8 ± 18.0 years) in HNPCC and FCC families, respectively (p > 0.05). CRC was respectively found in 52 and 76 members of the HNPCC and FCC families, revealing the frequency of HNPCC and FCC as 2.0% (52/2580) and 2.9% (76/2580), respectively. # CONCLUSIONS: We found a relative high frequency of HNPCC (2.0%) and FCC (2.9%) among CRC cases in our society and high incidence of extracolonic tumors in their families. Further studies focusing on molecular basis in this field and designing a specific screening and national cancer registry program for HNPCC and FCC families should be conducted. [ABSTRACT FROM AUTHOR]

Background: Total hip arthroplasty (THA) is an effective surgery for patients with end-stage hip joint degenerative arthritis. This study aimed to determine peri-operative factors that impact the length of stay (LOS) and design a formula to predict LOS in patients undergoing THA., Methods: This cross-sectional study was performed from September 2019 to January 2020. For this study, all patients who underwent THA over a period of 12 years since 2005 were included in the study. Data about the LOS and several variables including demographic variables, surgery-related variables, transfusion, intensive care unit (ICU) admission, past drug history, comorbidities, and laboratory data, were gathered. Qualitative variables are presented as numbers (%), and quantitative variables are presented as mean Mann± standard deviation. Mann Whitney test , Kruskal-Wallis test, and Spearman's rank correlation test were also used., Results: A total of 524 patients were included in the study; 12 were excluded .261 (51%) were female and 251(49%) male. The mean age was 56.13±17.04 years. In the univariate analysis, the day of admission, surgery indication, transfusion, diabetes mellitus, oral anti-diabetic drugs, American Society of Anesthesiology (ASA) score, preoperative hemoglobin (Hb) level, and type of prosthesis showed significant relation with LOS. Significant variables entered to zero truncated negative binomial regression. Among them, the day of admission, ASA score, preoperative Hb level, and type of prosthesis showed significant relation with LOS ( P < 0.05) and were used for model design., Conclusion: Preoperative Hb level, ASA score, day of admission, and prosthesis type have an impact on LOS and can predict LOS in patients who are candidates for THA., Competing Interests: The authors declare that they have no competing interests., (© 2023 Iran University of Medical Sciences.)

Background: Degenerative changes and inflammation in the rotator cuff (RC) are the most important causes of shoulder pain. The aim of the present study was to determine the effectiveness of platelet-rich plasma (PRP) in patients with chronic RC tendinopathy., Materials and Methods: This study was an open-label study performed at Kashani Hospital between April 2012 and June 2014. Patients with a <1 cm partial tearing of the bursal side of RC with no or little response to conservative management were included. PRP injection was done using ultrasonography guide via posterior subacromial approach. Demographic data were obtained in all patient before the study, and shoulder function was evaluated using Constant shoulder score (CSS) before and 3 months after PRP injection., Results: A total number of 17 patients were enrolled. The mean of CSS before and after intervention was 37.05 ± 11.03 and 61.76 ± 14.75, respectively ( P < 0.001). There was no statistically significant correlation between the pain score before the study and the improvement in CSS ( P = 0.45, r = 0.03). Significant relation was observed between the individuals' age and improvement of CSS ( P = 0.02, r = -0.49). There was no significant difference in CSS improvement between genders ( P = 0.23)., Conclusion: Single injection of PRP is effective to reduce pain and improve range of motion in patients with bursal side partial tearing of RC who failed to respond to conservative treatments., Competing Interests: There are no conflicts of interest.

Background: Pelvic and acetabular fractures constitute 2% of all fractures. The aim of the present study was to present acetabular fracture outcome in patients who underwent operative treatment., Materials and Methods: This study was a prospective cohort study, which was performed in Isfahan, Iran. During the period study, all patients who admitted to Alzahra Hospital with acetabular fracture and underwent acetabular surgery were evaluated. Data about age, sex, associated fractures, Intensive Care Unit admission, the time between admission and surgery were gathered. Patients were encouraged to return to the hospital after 1 week, 4 weeks, 6 months, and then yearly for the follow-up., Results: Sixty-five patients with acetabular fractures were referred to our hospital. Of them, 30 patients were indicated for surgical intervention and recruited in the study. The most frequent type of fracture involved posterior wall accounting for 49.9% of all fractures. More than 80% of study patients reached satisfactory results (excellent or good) based on Harris Hip Score (HHS). Female patients had significantly lower HHS in comparison with male patients ( P = 0.01). Heterotopic ossification (HO) formation was more common in whom surgery was performed after 2 weeks ( P = 0.005), however, there was no significant difference in HHS between these groups ( P = 0.28)., Conclusions: It is concluded that the female gender had an impact on the surgical outcome of acetabular fracture and indicated the lower functional outcome. Although there is an increase in HO formation in patients who do not undergo surgery during 2 weeks after the trauma, however, it does not influence the surgical outcome., Competing Interests: There are no conflicts of interest.

Background: The aim of this study was to determine the diagnostic value of magnetic resonance imaging (MRI) in the diagnosis of knee injuries., Materials and Methods: Ninety-eight consecutive patients were enrolled in the study. In all patients, MRI and arthroscopy were performed and the results were compared., Results: MRI was most sensitive in the detection of medial meniscus injuries, and the highest specificity and negative predictive value (NPV) were found in the detection of posterior cruciate ligament injuries., Conclusion: MRI is a valuable tool, and according to its high NPV, normal MRI can prevent unnecessary arthroscopic interventions.

Background: The aim of this study was to determine the efficacy of two methods of colon preparation for colon cleansing in a randomized controlled trial., Methods: In this prospective randomized investigator-blinded trial, consecutive outpatients indicated for elective colonoscopy were randomized into two groups. Patients in Senna group took 24 tablets of 11 mg Senna in two divided doses 24 hour before colonoscopy. In Poly Ethylene Glycol (PEG) group they solved 4 sachets in 4 liters of water the day before the procedure and were asked to drink 250 ml every 15 minutes. The overall quality of colon cleansing was evaluated using the Aronchick scoring scale. Difficulty of the procedure, patients' tolerance and compliance and adverse events were also evaluated., Results: 322 patients were enrolled in the study. There was no significant difference in the quality of colon cleansing, patients' tolerance, compliance and the difficulty of the procedure between two groups (p > 0.05). The incidence of adverse effects was similar between two groups except for abdominal pain that was more severe in Senna group (p < 0.05) and nausea and vomiting that was more common in PEG group (p < 0.05), Conclusions: In conclusion we deduce that Senna has the same efficacy and patient's acceptance as Polyethylene glycol-electrolyte solution (PEG-ES) and it could be prescribed as an alternative method for bowel preparation.

Background: A number of changes in the duodenum are associated with celiac disease (CD), and can be identified endoscopically. Their accuracy becomes crucial as CD markers. This study aimed to determine the diagnostic value of endoscopic markers and to find ways of applying them in the diagnosis of CD., Methods: Seven hundred and sixty-five consecutive patients referred for upper gastrointestinal endoscopy during 18 months were enrolled in the study. The second part of the duodenum was inspected carefully, and biopsies were taken in all patients to detect histologic changes suggestive of CD., Results: Endoscopic features suggestive of CD were observed in 69 (10.6%) patients; of these, 7 (10.1%) patients were finally diagnosed to have CD. Of the remaining 578 patients in whom the endoscopic markers were not seen, 2 (0.3%) patients were found to have CD. The overall sensitivity, specificity, PPV and NPV of the markers for the diagnosis of CD were 77%, 91%, 10% and 99%, respectively. Of the 9 patients who had CD, 5 had typical symptoms of CD and 4 had atypical features of CD., Conclusions: Owing to high NPV of endoscopic markers, a careful observation of the second part of duodenum plays an important role in the diagnosis of CD. In patients in whom endoscopic markers are observed, biopsies are indicated; routine duodenal biopsy in all patients cannot be advocated.