Iranian Red Crescent Medical Journal
Year:2016 | Volume:18 | Issue:7|Papers Count:25

Introduction: Osteomas are benign bone tumors. They generally lead to a local thickness on the frontal bone in calvarium. When they occur on the forehead, they often cause a cosmetic disorder without any neurological symptoms. The significant problem is the repair method of the cranium defect.Case Presentation: The rib of a 34-year-old female was split and used for a small cranium defect of 33.5 cm. The preferred method and the obtained results were presented under the guidance of the literature.Conclusions: Along with the technological advancement, different materials are employed according to the size of the cranium defect and the age of the case. The application of split costa cranioplasty for the small cranium defects in the region of patient’s face is the method with the least possibility of complications, and its cosmetic and functional results are quite promising.

Background: Since life recovery after disasters is a subjective and multifaceted construct influenced by different factors, and survivors’ main concerns and experiences are not clear, the researchers intended to explore this process.Materials and Methods: This study was conducted in 2011 - 2014 based on the grounded theory approach. Participants were selected by purposeful sampling followed by theoretical sampling to achieve conceptual and theoretical saturation. Data were collected through interviews, observation, focus group discussion, and document reviews. Data were analyzed by Strauss and Corbin’s (2008) recommended approach.Results: Transcribed data from 26 interviews (managers, health care providers, and receivers), field notes, and other documents were analyzed, and 1,652 open codes were identified. The codes were categorized, using constant comparative analysis, into five main categories including reactive exposure, subsiding emotions, need for comprehensive health recovery, improvement of normalization (new normality achievement), and contextual factors. The process of life recovery after disaster was also explored.Conclusions: The results clarified a deep perception of participants’ experiences after disaster. The path of life recovery after disasters involves participants’ striving to achieve a comprehensive health recovery, which starts with the need for all-inclusive health recovery as a main concern; this is the motivator for a responding strategy. This strategy is participatory, and the process is progressive; achievement of a new normality is the final goal, with new development and levels of empowerment.

Background: There are some specific measures for the evaluation of postpartum quality of life, and each have some limitations.Objectives: This study investigated the validity and reliability of the Persian version of a postpartum women’s quality of life (PQOL) questionnaire at the eighth week of postpartum.Patients and Methods: This was a methodological research, and subjects were 500 women, ages 18 - 42, eight weeks postpartum, randomly selected from half of the public centers in Tabriz, Iran, who completed questionnaires in a self-administered manner.Data was collected during a two-month period during 2014 - 2015. A standard forward - backward translation procedure was used to translate the English version of the PQOL into Persian. Content, construct, discriminant, and criterion validity was assessed. The reliability was evaluated by internal consistency and test-retest reliability.Results: The PQOL showed good content validity; content validity ratio (CVR) ranged from 0.67 to 1.00 and content validity index (CVI) ranged from 0.78 to 1.00. Construct validity evaluation by exploratory factor analysis (EFA) led to extraction of six factors from the data. Due to the lack of theoretical justification for items’ relocation in the extracted factors and poor-fitting indices obtained by confirmatory factor analysis (CFA), the exploratory model was eliminated, and the original model was presented and incorporated into the CFA, indicating an acceptable fit for the model (root mean square error of approximation [RMSEA]=0.038 [0.034; 0.042]; comparative fit index [CFI]=0.90; normed fit index [NFI]=0.80; non-normed fit index [NNFI]=0.90; incremental fit index [IFI]=0.90). The intergroup differences in total and all dimensions of the PQOL, except for social support, indicated the discrimination ability of the questionnaire. The questionnaire indicated a medium correlation with the short form health survey (SF~12) questionnaire (r³0.50). Cronbach’s alpha coefficient (0.70-0.88) indicated a good internal consistency, and the intraclass correlation coefficients (0.87-0.92) showed good test - retest reliability.Conclusions: The findings of this study confirmed the validity and reliability of the Iranian version of the PQOL questionnaire in Iranian women as a specific measure to evaluate the women’s quality of life.

Introduction: Plasma cell dyscrasias are characterized by a monoclonal neoplastic proliferation of plasma cells. Solitary bone plasmacytoma (SBP) is a local form of the disease with the vertebrae and long bones being the most frequently encountered sites.Its prevalence in the maxillofacial area is extremely rare.Case Presentation: A 70-year-old Caucasian male patient was referred for the extraction of his mobile premolar tooth with a poorly defined radiolucent lesion. Histopathological analysis revealed an SBP and no distant lesion or serum M protein was noted on radiological and hematological examinations. The patient was under follow-up care with no recurrence at 2 years of follow up.Conclusions: Diagnosis of an SBP is based on local radiological and neurological symptoms and similar systemic manifestations of multiple myeloma that are also distinctive for SBP. Skeletal radiological analysis including CT and PET-CT, bone marrow biopsy, and serum protein electrophoresis are essential for confirmation of the diagnosis. Although surgery, chemotherapy, and radiation, or a combination of these modalities, have been successfully used in the treatment of SBP, it should be managed in relation to its possible long-term evolution.

Introduction: Lithium overdose can be associated with cardiac toxicity, especially in those with underlying heart disease. Toxic levels of serum lithium are associated with cardiotoxic effects ranging from simple ECG disorders to dysrhythmias, cardiomyopathy and even acute myocardial infarction (AMI). This report describes a patient with AMI accompanied by high blood levels of lithium. Case Presentation: A 62-year-old woman was admitted to the emergency department due to weakness and acute chest pain. Her ECG revealed ST elevation in leads DI, aVL and V5-6, with a ventricular rate of 80 bpm. Blood chemistry and complete blood count were within normal limits. The patient’ s blood lithium level was measured as 2. 3 mmol/L (N: 0. 5-0. 8 mmol/L), and her troponin I level was 0. 892 ng/mL (N: 0-0. 01 ng/mL). Coronary angiography produced normal findings, concurrent with the resolution of electrocardiographic abnormalities following elimination of lithium. The clinical course in the intensive care unit was uneventful and the patient was discharged on the seventh day. Conclusions: Lithium intoxication should be considered in the differential diagnosis, especially in elderly patients on lithium therapy who are admitted to the emergency department with chest pain.

Background: There are few effective drugs for pediatric functional constipation (FC). Objectives: Comparing the effectiveness of Cassia fistula’ s emulsion (CFE) with Polyethylene glycol (PEG4000) in FC; and evaluation of safety of both drugs in the treatment of FC. Materials and Methods: A randomized open label, prospective, controlled, parallel-group clinical trial was carried on 109 children (M/F: 63/46; mean age  SD: 59. 7  28. 8 months) in Amirkola children’ s hospital, Babol, Iran. The inclusion criteria were based on diagnosis of FC according to the Rome III criteria and age range between 2-15 years. They received CFE or PEG randomly for 4 weeks. Frequencies of defecation, severity of pain, consistency of stool, fecal incontinence and retentive posturing were compared between the two groups and with baselines. Children were counted as improved when they exited from Rome III criteria of FC. Results: Fifty seven patients were assigned to receive PEG and 52 patients received CFE. After 4weeks of medication, 86. 5% of children in CFE group and 77. 1% in PEG group (RR = 1. 121, CI95%: 0. 939-1. 338) exited from the criteria of FC. All measurable criteria improved in both groups without any significant difference, except in the frequency of defecation that in CFE group (10. 96 5. 7)wassignificantly more than PEG group (6. 9  3. 5) (P < 0. 0001). Compliances of PEG were significantly better in the 2 first weeks (P = 0. 002, 0. 008) but not in third and fourth week (P = 0. 061, 0. 062). None of these two drugs cause clinically significant side effects. Conclusions: CFE can be as effective as PEG in the 4-weeks treatment of children with FC.

Background: Sleep patterns may change over a person’ s lifetime; however, the quantity and quality of sleep always depend on individual factors such as age, sex, and psychological and environmental factors. In children, sleep is as important as development. Quantitative sleep problems related to sleep onset and qualitative sleep disorders such as frequent awakenings may lead to insufficient sleep. Objectives: This study aimed to assess the prevalence of sleep disorders among children 4-6 years old attending the health centers of Shahid Beheshti University of Medical Sciences, Tehran, Iran, in 2013. Patients and Methods: This was a cross-sectional study on 400 children selected using a multistage sampling method. Data were collected by interviews. The questionnaire included two sections: a demographic section with questions about the demographic characteristics of the children and parents and a children’ s sleep habit questionnaire (CSHQ). Data were analyzed by SPSS 16 and different statistical tests were used (P < 0. 05). Results: The mean age of the children was 64. 27 9. 3 months. The prevalence of sleep disorders was 36. 25%. Sleep disorders were significantly associated with age, height, body mass index, residence of children, father’ s occupation, mother’ s diseases, father’ s drug abuse, and parents’ marital status (P < 0. 05). Conclusions: Sleep disorders in children threaten growth and development, and are dangerous for their health. Sleep disorders should be considered in the differential diagnosis of children’ s learning and behavioral problems.

Background: Platelet-rich plasma (PRP) is ahumanplasma product enriched by platelets, growth factors, and fibrinogen with high hemostatic and healing properties.Objectives: The aim of this study was to evaluate the effect of autologous PRP on wound healing in high-risk women undergoing cesarean sections.Patients and Methods: In this balanced, randomized, and controlled trial, 140 patients were admitted to Arash women’s hospital, Tehran, Iran from May of 2013 to November of 2014 for elective cesarean surgery. The patients were randomly assigned into two groups. The intervention group received PRP after surgery, whereas the control group received the usual care. All patients were evaluated at baseline, five days, and eight weeks after the cesarean section. The primary endpoint used the REEDA scale for assessing the changes in wound healing. The secondary outcome measures used were the Vancouver scar scale (VSS) and the visual analog scale (VAS). All scale scores were analyzed using a repeated measures test for variance.Results: At the end of study, the PRP group showed a greater reduction in the edema ecchymosed discharge approximation (REEDA) score compared to the control group (85.5% reduction in the PRP group; 72% in the control group) (P<0.001). Compared with the control group, the PRP group had a significantly greater reduction in the VANscore, beginning on the fifth day after the cesarean section (-0.7, 38% reduction in PRP group; -0.8, 33% in control group) (P<0.001), and this trend was stable at the end of the eighth week (-0.6, 54% reduction in PRP group; -0.3, 18% in control group). Furthermore, patients treated with PRP experienced a 93% reduction in the VAS score at the end of follow-up, but the control group only observed a 79% reduction (P<0.001).Conclusions: It seems that applying PRP is an effective therapeutic approach for wound healing, and faster wound healing is expected due to the presence of more platelets and growth factors.

Background: Salmonella enterica serovar Typhimurium (S. Typhimurium) causes gastroenteritis in humans and paratyphoid disease in some animals. Given the emergence of antibiotic resistance, vaccines are more effective than chemotherapy in disease control. Objectives: The aim of this experimental study was to evaluate the immunogenicity of diphtheria toxoid (DT) conjugated with S. Typhimurium-derived OPS (O side chain isolation) in mice to determine its potential as a vaccine candidate against salmonellosis. Materials and Methods: Lipopolysaccharide (LPS) was extracted from the bacterial strain. After isolation of the O side chain of LPS, detoxification, and conjugation of the detoxified OPS samples with DT, pyrogenicity, toxicity, and sterility tests were performed. To vaccination, four groups of female Balb/c mice were used in an immunization test. Antibody responses were measured by the ELISA method. Challenging processes were performed to analyze the efficacy of the OPS-DT compound. Results: Two weeks after the first vaccination dose, there was no significant difference in the antibody titers of the OPS and OPS-DT groups. However, after the second and third doses, the antibody titers of the OPS-DT group increased significantly compared with those of the control groups (P < 0. 001). The induction of anti-OPS antibodies was as follows: OPS-DT>OPS. The most anti-OPS IgG antibody was IgG1. Challenging procedure showed successful protective characteristics in clinical examinations. Conclusions: The results indicated that DT increased anti-OPS antibodies against the OPS-DT compound. The antibody response to OPS-DT was greater than that to OPS alone. We conclude that OPS-DT is an appropriate and acceptable vaccine candidate against salmonellosis.

Background: Some studies in the literature support the use of either inhaled or systemic steroids for the treatment of chemical pneumonitis; however, no data have been published on the combined use of inhaled and intravenous (IV) steroids.Objectives: This brief report describes the effective use of inhaled plus systemic steroids in managing six critical pediatric patients.Patients and Methods: Medical records of patients were analyzed retrospectively.Results: Of the six patients, 83.3% (n=5) were male and 16.7% (n=1) were female, with a mean age of 2.1±0.49 years. The most common clinical signs were dyspnea (83.3%), fever (66.6%), and vomiting (66.6%). Owing to supportive treatments and the combined steroid treatment, respiratory distress diminished and there was no need for oxygen in any of the patients after 5 days. All patients were discharged without any sequelae.Conclusions: The use of steroids in treating hydrocarbon pneumonias is still controversial. However, we suggest that the combined use of inhaled and intravenous steroids had positive effects on the clinical and radiological recovery of our patients.

Background: Health-related quality of life (HRQoL) is an important determinant in a person’s life.Objectives: In this study aimed at physical education students, alcohol consumption and smoking as risk factors and sports as a healthy factor could affect HRQoL.Patients and Methods: This study was an analytical cross-sectional study. For our purpose, the subjects (n=519) were asked to answer the SF-36 questionnaire (short form health survey for HRQOL). To analyze the data, two-way multivariate analysis of variance (MANOVA), one-way analysis of variance (ANOVA), the independent-samples t-test, and Pearson correlation coefficient were conducted. In this study, the P<0.05 was considered a significant difference, and due to a Bonferroni correction, for ANOVAs tests, a P<0.0125 was considered a significant difference.Results: The results suggest that statistically significant differences for alcohol consumption were only obtained from the role emotional (RE) scale, in which drinkers had lower mean scores than nondrinkers. For smoking, significant differences were obtained from the scales of RE, vitality (VT), emotional well-being (EW), social functioning (SF), and general health (GH), in which nonsmokers outdid smokers. The combination of alcohol drinking and smoking led to statistically significant lower scores on the RE scale and strongly destroyed the role-emotional part of HRQOL.Conclusions: It can be concluded that smoking and alcohol consumption may be related to poor HRQOL in physical education and sports students despite the fact that they regularly engage in sports programs that could positively affect their HRQOL.

Background: According to the world health organization, radon is a leading cause of cancer in various internal organs and should be regarded with concern.Objectives: The aim of this study is to evaluate the concentration of soluble radon in the drinking water of the city of Aliabad Katoul, Iran.Materials and Methods: The radon concentration was measured by using a radon meter, SARADTM model RTM 1688-2, according to accepted standards of evaluation.Results: The mean radon concentration in the drinking water of Aliabad Katoul is 2.90±0.57 Bq/L.Conclusions: The radon concentration in Aliabad Katoul is below the limit for hazardous levels, but some precautions will make conditions even safer for the local populace.

Background: Nonunion of distal radius fractures is disabling. Treatment is difficult and the results are not predictable. However, posterior interosseous bone flap (PIBF) has been successful in treating forearm nonunion. Objectives: To treat distal radius fracture nonunion with PIBF as a new procedure. Patients and Methods: This prospective non-randomized cohort study was performed at two hospitals in Tehran between January 2011 and September 2015. PIBFs were applied in nine patients (10 nonunions) with a mean age of 55 years. Union success rate, grip strength, wrist range of motion, and forearm rotation were then evaluated. Results: Although four of the patients had a history of infection, all participants achieved fracture union at a mean time of 3. 8 months. Grip strength improved by 12. 4 kg. There was also 36° improvement in wrist flexion, 20° improvement in wrist extension, 60° improvement in forearm supination, and 46° improvement in forearm pronation. The range of motion and grip strength improvements were significant. Conclusions: Pedicled PIBF is a new option for treating distal radius fracture nonunion. The results are predictable in achieving union and good function, and this technique can be successfully used in cases with extensive soft-tissue damage or infection.

Background: Obesity, particularly morbid obesity, has various physical and mental complications. Excessive daytime somnolence (EDS) is a sleep disorder that reduces individuals’ performance capability and the accuracy of their short-term memory and causes learning problems. This retrospective study aimed to document the presence of EDS in a sample of obese patients in comparison to patients with a normal weight.Objectives: This article compares the excessive daytime sleepiness of obese and non-obese patients in the minimally invasive surgery research center in Tehran, Iran.Patients and Methods: In this case-control study, we compared excessive daytime sleepiness in 55 obese patients who were candidates for laparoscopic surgery, with a body mass index (BMI) of equal to or greater than 30 kg/m2, with 55 controls with a normal BMI (19.5-24.9 kg/m2). The process of selecting the control group in our case-control study is matching in group levels, so that the controls are similar to the case group with regard to certain key characteristics, such as age, sex, and race. The sleep assessment was based on the Epworth sleepiness scale (ESS) questionnaire. Analysis of variance (ANOVA) was used to compare the means of quantitative data, such as the ESS score of groups.Results: Sleepiness was not affected by gender in cases or controls. The sleepiness prevalence was 29 (52.7%) in the cases group and 17 (30.9%) in the control group (OR=2.493 (95% CI 1.144-5.435)). The mean ESS scores in cases and controls were 7.82±3.86 and 10.54±6.15, respectively (P=0.007). Moreover, the prevalence of sleepiness and the mean ESS scores in class III of obesity differed significantly from the controls (16 (57.1%) vs.17 (30.9%)) (OR=2.980 (95% CI 1.162-7.645)) and (11.04±5.93 vs.7.82±3.86) (P=0.013), respectively.Conclusions: Our findings suggest a strong relationship between EDS and obesity, particularly morbid obesity. Therefore, physicians must be familiar with EDS as a mixed clinical entity indicating careful assessment and specific treatment planning.

Background: Complete blood count (CBC) parameters may associated with multiple diseases. Urinary stone disease is common public problem. Predictive value of CBC parameters may be associated with urinary stone disease Objectives: To analyze the association between complete blood count (CBC) parameters and urinary stone disease.Patients and Methods: This study was a retrospective observational study of 3, 099 patients who were admitted to the urology outpatient clinic or diagnosed with urinary stone disease in the emergency services department. There were 353 patients included in the study that had ultrasonography (USG) and/or non-contrast computerized tomography (NCCT) and a CBC. Patients who had nonurinary system inflammatory disease in USG or NCCT, had fever, non-urinary system infection, anemia or diagnosed hematologic malignancy were excluded (n=27). Patients were divided into two groups: a stone group (n=74) and a control group (n=252). Data of patients were retrieved from the hospital database and statistical analysis was performed.Results: An increase in RDW, MPV, PDW, WBC, granulocyte percentage and a decrease in lymphocyte percentage is statistically associated with urinary stone disease (P<0, 001, P<0.001, P=0.006, P<0.001, P=0.003, P=0.034, respectively). Microscopic hematuria is associated with urinary stone disease and the odds ratio for urinary stone prediction is 67.7 (P<0.001). In addition, none of the CBC parameters were associated with stone burden.Conclusions: When evaluating flank pain in patients, it is important to remember that CBC parameters may support urinary stone disease, and considering CBC results may be useful in the diagnosis of urinary stone disease.

Background: Sleep disorders are accompanied by several complications, and currently used soporific drugs can induce unwanted effects such as psychomotor impairment, tolerance, amnesia, and rebound insomnia.Objectives: The present study was carried out to investigate if Ocimum basilicum has a sleep-prolonging effect.Materials and Methods: This work was an experimental study on 72 mice which were randomly divided into 9 groups: saline (control); diazepam (3 mg/kg, positive control); hydro-alcoholic extract (HAE) of Ocimum basilicum (25, 50, or 100 mg/kg); ethyl acetate fraction (EAF, 50 mg/kg); n-butanol fraction (NBF, 50 mg/kg); water fraction (WF, 50 mg/kg); and saline containing 10% DMSO (vehicle for EAF and NBF). All the test compounds were injected intraperitoneally (IP) 30 minutes before pentobarbital administration (30 mg/kg). Duration and latency of pentobarbital-induced sleep were recorded. Also, LD50 of HAE was determined and the cytotoxicity of HAE was tested on neural and fibroblast cells using the MTT assay.Results: HAE increased the duration of pentobarbital-induced sleep at doses of 25, 50, and 100 mg/kg (P<0.001). The hypnotic effect of HAE was comparable to that induced by diazepam. Similarly, WF, EAF, and NBF at 50 mg/kg could increase sleep duration. The sleep latency was decreased by HAE (P<0.01-P<0.001) and NBF (P<0.001), but not by WF and EAF. The LD50 value for HAE was found to be 2.4 g/kg. HAE had no effect on the viability of neuronal PC12 cells and L929 fibroblast cells.Conclusions: The present data demonstrated that Ocimum basilicum potentiates sleeping behaviors without any cytotoxicity. The main component (s) responsible for the hypnotic effects of this plant is most likely a non-polar agent (s) which is found in NBF. Isolation of the active constituents may yield a novel sedative drug.

Background: Evolving wrist arthroscopy requires creating new portals, and creating portals reciprocally leads to increased indications for arthroscopic wrist procedures. To facilitate access to the lunate bone and fossa for new arthroscopic procedures, a new portal was used. This is a cadaveric study of this portal. Objectives: In this cadaveric study, we evaluated a portal in wrist arthroscopy for procedures involving the lunate bone and lunate fossa. Materials and Methods: Seventeen wrists from 10 fresh cadavers were included in this study. After diagnostic arthroscopy, a portal (Trans-4) was made through the fourth extensor compartment, exactly along the lunate’ s long axis under direct visualization from the 3-4 portal. Strand retractors were used to protect the extensor tendons and posterior capsule. Lunate bone core decompression and osteoscopy were done through the portal. At the end of the procedure, the position of the decompression hole in the lunate and any possible injury to the extensor tendons, distal radius cartilage, lunate cartilage, and perilunate ligaments were investigated. Results: Lunate bone decompression was performed successfully in all cases using the trans-4 portal. In 15 wrists, the lunate hole was located in the middle third. In the other two wrists, it was located slightly radial in one case and slightly on the ulnar side in the other case. There was no cortical penetration during decompression, and no extensor tendon, superficial nerve branches, or peri-lunate ligament injuries were observed. Conclusions: The trans-4 portal could be a safe working portal in wrist arthroscopy that enables access to the lunate bone and lunate fossa.

Background: Psoriasis is a common, chronic skin disease that causes challenges such as stigma and labeling from both the community and individuals due to its effects on appearance.Objectives: The objective of this study was to describe and explain the social stigma and rejection experienced by patients with psoriasis.Patients and Methods: The present research is a qualitative study with a hermeneutic phenomenological approach conducted among psoriasis patients referring to the dermatology clinic and ward of Imam Khomeini hospital in Ahvaz, Iran between June and December 2014. In this study, 15 patients with psoriasis were selected by purposeful sampling, and they were asked to express their experience of stigma and rejection. The data were collected through in-depth semi-structured interviews, and Diekelmann and colleagues’ method was used for data analysis.Results: After analysis of interviews, four themes were extracted: lack of social support, unrealistic and inappropriate labeling, rejection and isolation, and feeling of absurdity and futility. These can be indicative of the patients’ experience from social stigma and rejection phenomena.Conclusions: Patients’ experiences of stigma and rejection phenomena indicated that all aspects of their lives are affected. Moreover, these findings highlight the significance of stigma and rejection concepts in providing better care to these patients.

Introduction: Tuberculosis remains a major public health problem in developing countries. Diagnosing extrapulmonary tuberculosis can be difficult, as it requires a higher index of suspicion than primary tuberculosis. Extrapulmonary tuberculosis may mimic malignancies and many other diseases, so it should be included in the differential diagnosis. Here, we present a case of extrapulmonary tuberculosis associated with Pott’s disease and hip arthritis in a patient who recovered after 12 months of antituberculosis therapy.Case Presentation: A 16-year-old girl presented to the outpatient otolaryngology clinic with painless swelling of the neck, and to the physical medicine and rehabilitation clinic with complaints of hip and low back pain that mimicked spondyloarthropathy.She was eventually referred to the outpatient pediatric clinic. Her acute-phase reactants were high, and hilar lymphadenopathy was evident on chest x-ray. On computerized tomography, a Pott’s abscess involving the T8, T9, and T10 vertebrae was suspected.Magnetic resonance imaging of the dorsal vertebrae and hip was performed, and a Pott’s abscess and hip tuberculous arthritis were confirmed. The patient had been exposed to tuberculosis 10 years earlier, and her purified protein derivative (PPD) test was 16 mm.After antituberculosis treatment, our patient recovered and the Pott’s disease and hip tuberculous arthritis regressed.Conclusions: Extrapulmonary tuberculosis may mimic many other diseases, so it should be kept in mind in the differential diagnosis.It is essential to diagnose osteoarticular tuberculosis early, as late diagnosis or inadequate treatment may cause permanent disability.

Background: Electromagnetic fields (EMF) are associated with oxidative stress, which is in turn associated with reactive oxygen species (ROS), anemia, and hypoxia.Objectives: This study focused on the synergistic effects of lead ions and EMF on oxidative modifications in hemoglobin (Hb) and plasma proteins.Patients and Methods: In this experimental study, the blood samples were obtained from age- and sex-matched healthy subjects at Arak University of Medical Sciences, Arak, Iran. The collected bloods were prepared as 55 samples and then divided into different groups for incubating with 0 to 100 uM of lead ions in 2 mT and 50 Hz of EMF for 120 minutes. The carbonyl group was determined to be an oxidative biomarker in plasma proteins. The ferric reducing ability of plasma (FRAP) was considered to be an antioxidant power of human plasma. The conformational changes in hemoglobin, met-Hb, and hemichrome were considered to be oxidative markers in red blood cells. To predict the factors affecting the oxyHb, the artificial neural network (MLP: 11, 2, 2, 1) in SPSS software was applied.Results: The test subjects showed increased concentrations of metHb (1.8±0.19 vs.1.36±0.25) and hemichrome (6.01±0.57) in relation to the control subjects. The decreased absorbance at 340nm (0.88±0.09 vs.1.07±0.08) demonstrated the reduced interaction between the globin chain and the heme ring. The decreased absorbance at 420nm (Soret band) (2.96±0.13) and the increased absorbance at 630nm (0.07±0.002 vs.0.064±0.005) indicated the conversion of oxyHb to metHb, which confirmed the oxidative damage to the erythrocytes. The linear regression analysis showed significant positive correlations between lead concentration and the percentage of plasma carbonyl content (R2=0.96), the relation of plasma carbonyl content to Hb absorbance at 630 nm (R2=0.97), and the relation of plasma carbonyl content to metHb concentration (R2=0.95) after 120 minutes incubation with lead ions in 20 millitesla and 50 hertz EMF. The artificial neural network analysis showed the significant importance of hemichrome, PCO, metHb, and lead concentration to the oxyHb content of erythrocytes.Conclusions: Lead contamination in the presence of an EMF exacerbates the oxidative damage to plasma proteins as well as the conformational changes inHb. Anartificial neural network can be used as a predictive tool for the oxidative danger posed to workers in industrial fields, battery manufacturing companies, and power plants.

Background: Melissa officinalis (MO) has potent antioxidant activity. Recent research has demonstrated the anti-ulcer properties of some medicinal plants through their antioxidant properties.Objectives: The aim of this study was to evaluate the effects of methanolic extracts of MO on experimental gastric ulcers in rats.Materials and Methods: Male Wistar rats (200 - 250 g) were starved for 24 hours prior to the induction of gastric ulceration by either indomethacin (48 mg/kg/oral) or water immersion restraint (WIR) stress. Experimental rats received either ranitidine (25 mg/kg) or MO extract (150, 300 and 450mg/kg) orally 2 hours prior to WIR stress or indomethacin treatment, for the evaluation of their gastroprotective effects. The control group received the same volume of saline. Gastric lesions were scored according to the surface of lesions on the ulcer index. Superoxide dismutase (SOD) and glutathione peroxidase (GPX) were determined as measures of antioxidant defense, and malondialdehyde (MDA) was determined to measure tissue oxidation.Results: MO extract (150 and 300 mg/kg) significantly decreased the ulcer index in both the indomethacin (1.3±0.09 and 1.5±0.19, respectively) and WIR stress groups (1.5±0.17 and 1.5±0.22, respectively), as compared to the control rats (2.5±0.28) (P<0.01). MO extract (450 mg/kg) significantly reduced ulcer index readings in WIR stress rats (1.8±0.31 vs.2.4±0.15 in the WIR group), however, MO extract at a dose of 450 mg/kg did not prevent indomethacin-induced gastric ulceration (2.4±0.26). There was no significant difference in the ulcer index for MO extract- (150 and 300 mg/kg) and ranitidine-treated rats (P>0.05). Also, MO extract (150 and 300 mg/kg) significantly reduced MDA serum levels (0.69±0.6 mmol/L and 0.85±0.24 mmol/L, respectively, vs.4.5±1.9 mmol/L in the saline group) and significantly increased antioxidants’ SOD activities (296.3±146.4 U/mL and 561.4±120 U/mL, respectively, vs.190.2±63.8U/mL in the control group) and GPX levels (8273±3049 U/mL and 14574±5012 U/mL, respectively), compared to the control (3236±1699 U/mL).Conclusions: Our results showed that MO extract may have a gastroprotective effect against experimental gastric ulcers in rats. The exact mechanism has not yet been determined, but it may be due to enhancing enzymatic antioxidant defenses and inhibiting lipid peroxidation.

Background: Emerging evidence suggests that neighborhood characteristics can have direct and indirect effects on the weight status of the residents.Objectives: To assess the relationship between general and central obesity and the neighborhood environment in two ethnic groups (Azeri Turks and Kurds) living in Urmia city, Northwestern Iran.Patients and Methods: In this cross-sectional study, 723 participants (427 women and 296 men) aged 20 - 64 years from two ethnic groups (Azeri Turks, n=445; Kurds, n=278) were selected from 38 neighborhoods using a combination of cluster, random, and systematic sampling methods. Neighborhood characteristics were obtained by a validated 22-item neighborhood and a health observational checklist. General and central obesity were measured and evaluated using standard methods. Principal component analysis (PCA) was used to define the dominant neighborhood environment. The association of neighborhood characteristics with general and central obesity was analyzed by a logistic regression model.Results: Three common neighborhood environments were identified: 1) modern-affluent, 2) central-high access and 3) marginal. These three factors explained 73.2% of the total variance. Overall, the participants living in a higher tertile of the central-high access neighborhoods had an increased chance of central obesity (OR=1.63, 95% CI: 1.13 - 2.34). Azeri Turks living in the highest tertile of the modern-affluent neighborhoods had a significantly higher likelihood of having general obesity (OR=2.49, 95% CI: 1.37 - 4.01). Adjustment for age, gender, marital status, socioeconomic status (SES), energy intake, and physical activity did not change the results.However, after adjustment for educational level, the association was not significant.Conclusions: The findings point to a relationship between neighborhood characteristics and obesity only in the Azeri Turks. However, educational level was more important than neighborhood quality in predicting the risk of obesity.

Dear Editor: Leptospirosis is known as an emerging zoonotic infectious disease caused by the genus Leptospira. Several studies have shown that the incidence of the disease is significantly higher in tropical and subtropical areas. Some occupations, including veterinarians, rice farmers, butchers, fishermen, sewer maintenance workers, slaughterhouse workers, and laboratory staff, appear to be at higher risk for the disease. The aim of the present study was to investigate the epidemiology of leptospirosis in the Mazandaran province in northern Iran during 2012 - 2013. In this effort, 127 serum specimens were obtained from suspected individuals in different areas of the Mazandaran province during a period of eight months between November 2012 and July 2013. All 127 individuals were suspected of having leptospirosis according to physician diagnosis and the World Health Organization guidelines for diagnosis, surveillance, and control of the disease, including myalgia, neck stiffness, fever, headache, icterus, or a history of the disease prior to sampling.

Background: Resistance to chemotherapy is a growing concern, thus natural anticancer agents are drawing the attention of many scientists and clinicians. One natural anticancer agent, umbelliprenin, is a coumarin produced by many species of Ferula.Objectives: We aimed to examine the inhibitory effect of umbelliprenin on human and mouse bone marrow-derived stem cells (BMDSCs), peripheral blood mononuclear cells (PBMCs), and different cancer cell lines.Materials and Methods: In this in vitro experimental study, the HT29, CT26, MCF-7, 4T1, A172, and GL26 cancer cells and human and mouse BMDSCs and PBMCs were cultured in RPMI-1640 medium supplemented with 10% fetal bovine serum (FBS), incubated at 37°C for 24 hours in a 5% CO2 atmosphere, and then were treated with different concentrations of umbelliprenin dissolved in dimethyl sulfoxide (DMSO) (3, 6, 12, 25, 50, 100, and 200 g/mL) for 24, 48, and 72 hours at 37°C. Each experiment was performed in triplicate.Finally, the cell survival rate was assessed by MTT assay. The IC50 values were calculated based on the log values using GraphPad Prism version 5 software for windows (La Jolla CA, USA) and were expressed as meanSEM.Results: Umbelliprenin inhibited the cancer cells in a concentration-dependent (P<0.05) but not time-dependent manner (P>0.05). The most sensitive and resistant cell lines at the 24-hour incubation time were 4T1 (IC50, 30.9±3.1 mg/mL) and A172 (IC50, 51.9±6.7 mg/mL); at the 48-hour incubation time: 4T1 (IC50, 30.6±2.6 mg/mL) and CT26 (IC50, 53.2±3.6 mg/mL); and at the 72-hour incubation time: HT29 (IC50, 37.1±1.4 mg/mL) and 4T1 (IC50, 62.2±4.8 mg/mL). Both human and mouse BMDSCs showed the highest resistance at the 24-hour incubation time (IC50s, 254.7±21 and 204.4±4.5 mg/mL, respectively) and the highest sensitivity at the 72-hour incubation time (IC50s, 120.4±5 and 159.0±7.3mg/mL, respectively). The PBMCs of both human and mouse origin revealed very strong resistance to the studied concentrations of umbelliprenin (IC50s ranging from 713.5±499.1 to 66513670.7 mg/mL).Conclusions: Our findings indicate that umbelliprenin exhibits concentration-dependent inhibitory effects on various cell types; it is potentially toxic against the HT29, CT26, MCF-7, 4T1, A172, and GL26 cell lines, potentially harmful against BMDSCs, and non-toxic against PBMCs. Therefore, if our results are approved in the future, umbelliprenin can be an appropriate candidate for developing treatments against different cancers.