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Purpose: Hypertension (HTN) is one of the most common risk factors for non‐communicable chronic diseases. The aim of the current study is to evaluate the prescribing patterns of antihypertensive medications in Kermanshah Province, west of Iran. Methods: The Ravansar Non‐Communicable Diseases (RaNCD) cohort study is the first Kurdish community‐based study; subjects' age ranged from 35 to 65 years. In order to examine the use of medications to control blood pressure, participants were asked to bring all prescribed medications to the study center. Treatments were compared with 2013 European Society of Hypertension (ESH)/European Society of Cardiology (ESC) Guidelines for the management of arterial HTN. Results: From a total of 10 040 participants in RaNCD cohort, 1575 (15.7%) individuals were hypertensive, of whom, 1271 (80.7%) people were aware of their condition. From 1153 (73.20%) people under treatment, 840 (72.8%) had their HTN properly controlled. The most common medications used to treat HTN were losartan (27.5%), metoprolol (14.3%), and captopril (11.9%). Regardless of type of treatment, 49.3% of all patients have received the medication for l 6 ≥ years. The most commonly used drugs were β‐blockers and angiotension receptor blockers as 620 (31.0%) and 612 (30.6%), respectively. Multivariable analysis showed that female gender, those receive ≥3 antihypertensive agents, and using preferred combinations were associated with a better blood pressure control. In addition, the probability of hypertension control was less likely with increasing duration of treatment (i.e >6 years) and in obese patients with ≥35 kg/m2. Conclusions: Even though adherence to the international guidelines was acceptable, improvements can be made for better control of HTN. Therefore, it is imperative to educate healthcare professionals on improving their selection of antihypertensive medications and combination therapy for hypertensive patients. [ABSTRACT FROM AUTHOR]

Introduction: Animal studies indicated the protective effect of resveratrol against cerebral ischemic damages, but it has not been researched well in human ischemic stroke. In the present study, the effect of resveratrol on recovery outcomes after acute ischemic stroke was investigated among patients with ischemic stroke who were not eligible for taking recombinant tissue plasminogen activator as an accepted intervention for stroke condition. Materials and Methods: In this double-blind clinical trial, 100 patients with ischemic stroke who suffered from the territory of the middle cerebral artery were randomly allocated to either resveratrol or placebo group. In the intervention group, resveratrol was administered orally at a dose of 500 ± 10 mg daily in three 170 mg divided doses, whereas the placebo group was treated with lactose, both for 30 consequent days. Systolic and diastolic blood pressures and the National Institute of Health Stroke Scale (NIHSS) were measured at the stroke onset and during discharges. Besides, the Barthel index and Modified Rankin Scale (MRS) were performed 3 months after the intervention. Results: Resveratrol had no significant effects on NIHSS (P = 0.97), systolic (P = 0.17), and diastolic blood pressure (P = 0.42) compared with placebo. There were no significant differences in the Barthel index (P = 0.84) and MRS (P = 1.00) between the two groups 3 months after treatment. Conclusion: Resveratrol did not improve functional recovery measured by the NIHSS, MRS, and Barthel index in patients with acute ischemic stroke. In addition, it had no significant effect on blood pressure. [ABSTRACT FROM AUTHOR]

Background: Anti-cancer potential of silymarin has been shown in cell culture. However, no prospective clinical study has been conducted in this relation. Methods: In a randomized double blind pilot study, we compared effects of addition of standard chemotherapy along with silymarin (420mg/day) versus placebo on clinical response of advanced tumors after three cycles of cisplatin-based chemotherapy. Results: There was no significant difference in tumor size after three consecutive chemotherapy courses but a trend toward lower metastasis rate in chemotherapy + silymarin group. Concomitant use of silymarin and chemotherapy was very well tolerated but didn't significantly increase clinical response. Conclusion: Due to the trend towards significantly lower metastasis in silymarin group, further study with larger sample size is needed to better clarify probable role of adjunctive therapy with silymarin in patients with solid tumors. [ABSTRACT FROM AUTHOR]

Introduction: Cisplatin is a widely used chemotherapeutic agent with a major side effect of nephrotoxicity. Delayed increase in serum creatinine after cisplatin injection makes serum creatinine not to be an ideal marker for early detection of cisplatin nephrotoxicity. Recently several new biomarkers such as neutrophil gelatinase-associated lipocalin (NGAL) have been proposed for early detection of acute kidney injury (AKI). This study assessed kinetic of urine NGAL-creatinine ratio in patients who received cisplatin-containing chemotherapy. Materials and Methods: Patients with a glomerular filtration rates greater than 45 mL/min who received cisplatin-containing chemotherapy were included. Urine creatinine and NGAL concentrations were measured before cisplatin infusion and 6, 24, 48, and 72 hours after cisplatin administration. To minimize hydration effects, urine NGAL levels were adjusted according to urine creatinine. Results: Twenty-four patients were assessed. According to the Acute Kidney Injury Network criteria, 2 patients (8%) experienced cisplatin-associated AKI. The median increases in urine NGAL-creatinine ratio  were 335% (interquartile range, 320% to 350%) in the patients with AKI and 100% (interquartile range, 73% to 190%) in those without AKI (P = .02) during the first 24 hours after cisplatin administration. A urine NGAL-creatinine ratio greater than 26.9 ng/mg 24 hours after cisplatin infusion had a sensitivity of 86% and a specificity of 50% to detect cisplatin-associated nephrotoxicity. Conclusions: Urine NGAL-creatinine ratio significantly increased in patients with cisplatin-associated AKI. Urine NGAL-creatinine ratio within the first 24 hours after cisplatin infusion may better predict cisplatin-associated nephrotoxicity than serum creatinine level. [ABSTRACT FROM AUTHOR]

Background: Leishmaniasis is still one of the endemic parasitic infections in many countries comprising Iran. During the past decades, several medical and surgical approaches have been applied and studied to achieve the best option to treat the cutaneous leishmaniasis in Iran and the world over. However, there is still no single definite and unique approach available for treatment of the disease with an optimal safety and valuable effect. Some preclinical studies have focused on topical use of traditional herb, Achilles millefolium (Yarrow), as an adjutant therapy to treatment of cutaneous leishmaniasis along with other approaches and showed its interestingly suitable impact on the healing of lesions. This study was carried out to evaluate the effect of topical Achilles millefolium in conjunction with intralesional glucantime on acute cutaneous leishmanial lesions. Methods: sixty patients with confirmed acute cutaneous leishmaniasis were recruited in the study. Patients were randomly allocated into two groups to receive twice daily topical gel of Achilles millefolium 5% (containing 5% poly phenol) (group A) or placebo (group B) for four weeks along with weekly injection of intralesional Glucantime. Findings: there was no significant difference between the two groups according to age, gender, and duration of the disease. Also, there was no significant difference in complete and relative cure rates between the two groups (p=0.35). Application site reactions were occurred in 12 patients including redness in 8 cases in group-A and 2 cases in group-B, severe itching in one case in group-A and increasing wound secretion in another case in group-A) (P=0.014). Conclusion: given the result of the present study, there is no significant difference in cure rates of lesions between yarrow and placebo topical gels as an adjuvant drugs with intralesional glucantime in treatment of acute cutaneous leishmanial lesions. [ABSTRACT FROM AUTHOR]

Introduction. This study was conducted to evaluate the sensitivity and specificity of pyuria detection in centrifuged urine samples of patients on hemodialysis, and its relationship with urinary tract infection. Materials and Methods. Clean-catch midstream urine samples of 90 hemodialysis patients (34 women and 56 men) were obtained and divided into two parts for examination of urine sediment and urine culture. Pyuria was defined as the presence of more than 10 leukocytes per high-power field of microscope. Results. Ninety patients with a mean age of 52.8 ± 14.2 and a mean period of dialysis of 3.3 ± 2.3 years were studied. Forty-five participants had pyuria and only 16 (35.5%) of them had a positive urine culture for infection. Pyuria and urinary tract infection were present in 52.9% and 29.4% of the women and 48.2% and 10.7% of the men, respectively. The sensitivity and specificity of pyuria screening for urinary tract infection was 100% and 61.8%, respectively. The positive and negative predictive values were 35.5% and 100%, respectively. Conclusions. In patients on hemodialysis, because of the low specificity and positive predictive values, samples with positive pyuria should be cultured to confirm urinary tract infections. [ABSTRACT FROM AUTHOR]

Background: Leishmaniasis is still one of the endemic parasitic infections in many countries comprising Iran. During the past decades, several medical and surgical approaches have been applied and studied to achieve the best option to treat the cutaneous leishmaniasis in Iran and the world. This study was carried out to evaluate the effect of topical Achilles millefolium in conjunction with intralesional glucantime on acute cutaneous leishmanial lesions., Materials and Methods: sixty patients with confirmed acute cutaneous leishmaniasis were recruited in the study. Patients were randomly allocated into two groups to receive twice daily topical gel of Achilles millefolium 5% (containing 5% poly phenol) (group A) or placebo (group B) for four weeks along with weekly injection of intralesional Glucantime., Results: There was no significant difference between the two groups according to age, gender, and duration of the disease. Also, there was no significant difference in complete and relative cure rates between the two groups (P = 0.35) using Visual Analog Scale (VAS). Application site reactions were occurred in 12 patients including redness in 8 cases in group-A and 2 cases in group-B, severe itching in one case in group-A and increasing wound secretion in another case in group-A (P = 0.014)., Conclusions: Given the result of the present study, there is no significant difference in cure rates of lesions between yarrow and placebo topical gels as an adjuvant drugs with intralesional glucantime in treatment of acute cutaneous leishmanial lesions.