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ABSTRACT Background and Aim: Intravenous or oral administration of N-acetylcysteine for acetaminophen poisoning has been a matter of controversy until recently. Each of these routes of administration has its advantages and disadvantages. This study was carried out to compare the effect of intravenous and oral acetylcysteine in the treatment of acetaminophen poisoning. Material and Methods: This study was a parallel RCT study. The study population included all adults over 18 years of age who had been used more than 7.5 gr acetaminophen during a 24 hour interval before admission to poisoning emergency ward of Baharloo Hospital in Tehran. Each group consisted of 30 patients. The study was approved by the Ethical Committee of Tehran University of Medical Sciences. Patients were divided into two groups by block randomization method: oral (72 h) and IV (20 h) N-acetylcysteine treatment groups. Liver enzyme levels were measured at baseline and then daily up to 72 hours after treatment. Side effects of drug administration in both groups were recorded. Data were entered into SPSS16 software and the data frequency tables were prepared. Chi-square, Mann-Whitney U and t-tests were used for data analysis. Results: There were no statistically significant differences between the two groups in relation to different variables at baseline. The two groups showed no significant differences in regard to the mean serum levels of AST, ALT, bilirubin, and prothrombin time24, 48 and 72 hours after treatment and the therapeutic results were similar in both groups. Occurrence of nausea and hypotension after treatment in the oral treatment group was significantly higher than in the intravenous treatment group (57.6٪ vs. 33.3٪ and 12.1٪ vs. Zero respectively) (p<0.05). Considering other complications, no significant differences were noticed between the two groups. Conclusion: Considering the same safety and efficacy of both intravenous and oral acetylcysteine treatment, mild and manageable side effects of oral therapy on one hand and economic status and cultural attitudes in our community about admission and discharge of the patients, it seems more advisable to use oral treatment as the first therapeutic choice for acetaminophen poisoning in the absence of any contraindication to its use. Irct ID: IRCT201112218488N1 Conflict of Interest: Nil Received: Feb25, 2013Accepted: Apr24, 2013

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ABSTRACT Background and Aim: Sialic acid binding adhesin gene is one of the most important factors contributing to adhesin of Helicobacter pylori (H. pylori) to epithelial cell layer of stomach. The prevalence rates of sialic acid binding adhesin gene vary in different geographic areas. The aim of this study was to determine the frequency of sialic acid binding adhesin coding gene in the patients with different gastroduodenal diseases. Materials and Methods: This is a cross-sectional study. One hundred twenty patients with GI symptoms were enrolled in this study. Two gastric biopsy specimens were taken from each of the patients for rapid urease test (RUT) and DNA extraction. Presence of H. pylori was investigated by RUT and urease A gene (ureA) PCR. sialic acid binding adhesin gene was detected by using gene specific primers. Results: Among 120 samples, presence of H. pylori was confirmed in 82 cases, of which 64 strains (78%) were positive for sialic acid binding adhesin gene. The frequency of this gene was 84.6%, 86.7%, 77.8% and 72.2% for gartric cancer, gastric ulcer, duodenal ulcer and gastritis (%66.7) respectively. Conclusion: The frequency of sialic acid binding adhesin gene in different samples was almost the same. Discrepancies in the frequency of this gene in different studies may be related to geographical diversity or use of different primers for detection of this gene. Conflict of Interest: Nil Received: Apr 6, 2012 Accepted: Sep 27, 2012

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Background and Aim: Human is always exposed to natural background ionizing radiation which may have harmful effects therefore, measurement of the natural background radiation is important. In this study, was measured the dose of effective natural background gamma radiation in indoor residential zones of Hamadan Province. Material and Methods: In this cross-sectional study, we selected four stations along the main geographic directions and one in the center of city for measurement of the indoor dose rate in each of the cities in Hamadan Province. Based on the household numbers, some houses were selected randomly in every station and natural background indoor dose was measured by using RDS-110 survey meter. Then, using the results of our previous study about measuring the level of outdoor natural gamma radiation in this province, we determined the level of annual effective exposure dose from natural gamma radiation in Hamadan residents. Results: In Hamadan province cities, maximum and minimum indoor natural background radiation (gamma ray) belonged to Razan City (1.41±0.079 mSv) and Asadabad City (0.955±0.044 mSv), respectively. Mean annual equivalent indoor dose in Hamadan Province was 1.20±0.070 mSv. Also the maximum indoor natural background radiation dose (gamma ray) in the buildings with the age of more and less than 25 years were 1.42±0.219 mSv and 1.44±0.149 mSv, respectively. According to the results of this study and our previous study about outdoor gamma natural background radiation, the annual effective dose in Hamadan Province residents was 0.83 mSv. Conclusion: According to the results of this study, it seems that annual effective equivalent dose due to indoor gamma radiation in Hamadan Province exceeded the mean external exposure amount reported by UNSCEAR (0.5 mSv). Also the annual effective dose due to gamma background radiation in Hamadan Province residents is 0.83 mSv, which is higher than the global average (0.48 mSv) reported by UNSCEAR – 2000. Therefore epidemiological studies to assess the prevalence of chronic diseases associated with natural radiation exposure among Hamadan Province residents are recommended. Received: May 21, 2013 Accepted: Nov 30, 2013 Conflict of interest: None declared

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Background and Aim: Malassezia furfur is the cause of pityriasis versicolor. Phenolic compounds in the walnut leaf have antimicrobial effects. The purpose of this study was to examine the antifungal effects of alcoholic and aqueous extracts of walnut leaf on M. furfur, in vitro. Material and Method:Alcoholic and aqueous extracts of walnut leaf were prepared by simple distillation and Rotary method and then we studied the antifungal effects of these extracts on M. furfur by using disc and Well method, in vitro. Then the minimum inhibitory concentration (MIC) and minimal fungicidal concentration (MFC) were determined. SPSS18 software, two-way ANOVA and Bonferroni test were used for data analysis. Result:The largest growth inhibition zone diameters for water, ethanolic and methanolic extracts were 30, 28.66and 46.33 mm, respectively, that were observed at a concentration of 110 mg/ml. MIC of aqueous extract for M. furfur was 25×103 mg/ml and its MFC was 5×104 mg/ml. The MIC and MFC of walnut leaf ethanolic extract were 6250 and 125×102 mg/ml, respectively. Also MIC and MFC of methanolic extract were 25×103 and 5×103 mg/ml, respectively. Statistical results showed that extracts had a different effect on the diameter of inhibition zones and increased concentration of the extracts led to increased inhibition zone diameters (p<0.05). Conclusion:According to the results of this study, extracts of walnut leaf can be a promising therapy in the future for the treatment of infections caused by M. furfur. Keywords:Antifungal effect, Walnut leaf, Extract, Malassezia furfur Received: Apr16, 2014 Accepted: Nov17, 2014

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Background and Aim: Shoulder injuries are common in wrestling which can result in functional and psychological problems in the wrestlers. In case of high-intensity injuries, they can lead to discontinuation of the sport. On the other hand, fatigue may be one of the major risk factors for injury. Thus, the aim of this study was to compare fatigue of groups of shoulder girdle muscle during a simulated wrestling match.

Material and Methods: Fourteen amateur wrestlers (age 20.7±3.2 years, weight 70.3±12.9kg, and height 174.2±5.8cm) were selected using convenience sampling method. After a preliminary warm up, strength of the shoulder girdle muscles of both sides during 10 shoulder motions were measured by a portable isokinetic dynamometer. After 2 rounds of three-minutes, high-intensity freestyle wrestling with 30 seconds rest between the two spans, the measurements were repeated and force loss percentage for every movement was calculated. Dependent T-test was used to determine the difference between the mean values of the pre and post-tests.

Results: The results indicated that a significant reduction in the muscle strength of all selected motions was made after the simulated wrestling match, except for the non-dominant external rotation (p<0.05). The highest degree of fatigue occurred in the scapula stabilizing muscles (retractor, protractor and elevator muscles).

Conclusion: The results can be used to design a fitness program in order to prevent shoulder joint injuries, increase muscle performance, and improve the wrestling quality.

Keywords: Muscle endurance, Muscle fatigue, Rotator cuff, Scapular stabilizer, Competitive wrestling.

 

Received: Jul 28, 2015      Accepted: Dec 08, 2015

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Background and Aim: Leiomyosarcoma (LMS) of the prostate is an uncommon adult prostate tumor that represents less than 0.1 % of prostate malignancies. A highly aggressive clinical course and poor outcome are characteristics of this tumor. Diagnosis at early stage and radical surgery may be curative.
Case report: A 60-year-old man referred with history of obstructive urinary symptoms refractory to medical therapy. The patient underwent simple open transvesical prostatectomy. Pathologic examination revealed primary LMS of prostate. Complementary studies including CT scans of the chest, abdomen and pelvis, as well as a whole-body bone scan were negative for metastasis. Radical prostatectomy and extensive pelvic lymphadenectomy were performed. All tumor margins and lymph nodes were free from tumor and there was no evidence of residual tumor. No evidence of disease recurrence was observed in a follow up period of 3 years.
Conclusion: Acceptable oncological and functional outcomes can be achieved in the management of low grade LMS, by less extensive radical surgery including radical prostatectomy without removal of intra pelvic organs. However, the main recommendation is multimodal therapy including surgery and chemo-radiation therapy.

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Background and Aim: Cardiac function and resistance to ischemia/reperfusion (I/R) injury are affected by various factors including sex hormones, especially androgens and estrogens. The aim of this study was to examine the effects of prenatal testosterone exposure on cardiac tolerance to I/R injury in male rats during adulthood.
Materials and Methods: The hearts of male rats exposed to testosterone during the critical period of fetal development (experimental group) and also rats in the control group were isolated and perfused in a Langendorff apparatus. Values of hemodynamic parameters, including left ventricular systolic pressure (LVSP), left ventricular developed pressure (LVDP), rate pressure product (RPP) and peak rates of positive and negative changes in left ventricular pressure (±dp/dt) were recorded using a power lab system. Generalized linear regression model and generalized estimation equation model were used for data analysis.
Results: At baseline (before ischemia), adult male rats in the experimental group demonstrated significantly higher values of LVSP, LVDP, RPP and ± dp/dt, compared to the rats in the control group (P < 0.05).
After reperfusion, the values of LVSP, LVDP, RPP and ±dp/dt significantly decreased in the experimental rats compared to the rats in the control group (P < 0.05).
Conclusion: The present study showed that fetal hyperexposure to testosterone led to lower cardiac tolerance to I/R injury in male rats, in adulthood.

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Background and Aim: Despite the theoretical superiority of oral contraceptives (OCs) containing antiandrogenic progestins, to the products with androgenic activity, the clinical benefits of these compounds remain unknown. This study aimed to compare the efficacy of OCs containing desogestrel (DSG) or drospirenone (DRSP) on the hormonal, clinical and metabolic parameters of the patients with polycystic ovary syndrome (PCOS).
Materials and Methods: This study was a randomized clinical trial and included 126 patients with PCOS. Patients were randomly assigned to one of the intervention groups using OCs containing DSG or DRSP. Outcomes of interest, including serum androgens, Ferriman-Gallwey score, and anthropometric and metabolic parameters were measured at the baseline, third, and sixth months of treatment.
Results: After 3 to 6 months of treatment with OCs, we found no significant difference between the two groups in regard to serum androgen levels. There were also no significant differences between the two treatment groups, in terms of Ferriman-Gallwey score and anthropometric parameters, except for waist circumference in the sixth month of treatment (P = 0.011). After 3 months of the intervention, patients treated with OCs containing DSG had higher levels of low-density lipoprotein cholesterol (LDL) (P = 0.017), higher systolic (P = 0.013) and diastolic blood pressures (P = 0.008) than those treated with OCs containing DRSP.
Conclusion: Although use of OCs containing antiandrogenic and androgenic progestins had the same effects on hormonal profiles, anthropometric and hirsutism parameters, compounds containing DSG were associated with more negative effects on serum lipids and blood pressure.

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Background and Aim: Sperm cryopreservation is an important assisted reproductive technique. However, due to increased production of reactive oxygen species and oxidative stress, it can impair sperm function and reduce quality of fertility. The aim of this study was to investigate the effects of nicotinic acid and folic acid on maintenance of sperm function during cryopreservation by evaluation of sperm parameters and chromatin concentration.

Material and Methods: Thirty samples were collected from normozoospermic men and examined for chromatin quality, viability, membrane integrity, morphology and motility. The samples were frozen and placed in 4 groups: control, folic acid (50 nM), nicotinic acid (10 mM) and a combination of both. After cryopreservation, the four groups were compared with one another in regard to the sperm parameters. Also the sperm parameters were compared before and after freezing in every group. We assessed chromatin quality by TB staining, viability by eosin-nigrosin staining, membrane integrity by hypo osmotic swelling test, and morphology and movement by CASA software.

Results: Before cryopreservation chromatin quality, membrane integrity, normal morphology, sperm motility were lower and immotile sperms were higher in all groups compared to those after cryopreservation (p <0.001). The highest chromatin quality was detected in the folic acid, folic acid + nicotinic acid groups and the lowest chromatin quality was observed in the control group (p</05). The rates of sperm viability and normal morphology were lowest in the control group and highest in the folic acid and other groups (p <0.05). percentage of membrane integrity was highest in the folic acid group followed by nicotinic acid + folic acid, nicotinic acid and control groups, respectively (p <0.05). Folic acid played an important role in maintaining sperm parameters.
Conclusion: Nicotinic acid and folic acid have a positive effect on maintaining sperm function during cryopreservation

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Background and Aim: The health system's responsiveness to provision of health services displays the ability of the system to meet the non-medical needs of people. The present study aimed to assess Iran's health system responsiveness in providing rehabilitation for people with disabilities (PWD).
Materials and Methods: This population-based cross-sectional study included 1537 PWD referring to physical rehabilitation centers in all provinces of Iran by using a multistage cluster sampling method in 2019. A valid self-administrated questionnaire was used for data collection. Stata software (version 14.0) was used for data processing and analysis.
Results: The frequency rate of good responsiveness to meet physical rehabilitation needs was 64.5%. The health system's highest and lowest frequency rates of good responsiveness were related to rapid response (74.5%), independence  and participation in decision-making (52.5). Having basic health insurance coverage (OR=1.97, 95% CI:1.20-3.25), severity of disability (OR=2.02, 95% CI:1.14-3.60), economic status of individuals (OR=2.04, 95% CI:1.17-3.56), and household size (OR=0.82, 95% CI:0.72-0.94) were significant determinants in regard to poor responsiveness of the health system.
Conclusion: To maintain and enhance responsiveness and eliminate inequalities, interventions such as expanding the rehabilitation facilities, holding special skills training courses for rehabilitation-related assistants, general practitioners, and health workers, and also, empowering PWD are recommended. Further studies are also recommended to identify the causes of poor responsiveness and take measures that can make the health system more responsible.
 

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Background and Aim: Impairment of social interaction is one of the prominent features of autism spectrum disorder (ASD). The aim of this study was to compare the effects of visual activities schedule (VAS) and social narratives (SN) on social interaction in the children with ASD.
Materials & Methods: In a quasi-experimental and single-subject study with ABAB design, eight boys with ASD were selected from a population of 7-12 year-old children by convenience method in Welfare Centers in Mashhad City. The children assigned to two groups including visual activities schedule and social narratives groups. In order to determine the content of each intervention, target behaviors recognized through interview with family, mentor, and observation of the child’s behavior.Each group attended 20 intervention sessions (five times a week; 30 minutes per session). The information collected through systematic observation and Autism Social Skills Profile and data were analyzed using baseline diagrams, effect size, and improvement percentage.
Results: Findings showed that 15.34% and 10.45% of social interaction in children with ASD were due to receiving visual activities schedule and social narratives respectively. In addition, visual activities schedule and social narratives led to improvement of 16.09% and 9.24% in social reciprocity, 11.27% and 7.93% in social participation, 38.70% and 16.34% in detrimental social behaviors respectively. Systematic observation showed that visual activities schedule led to increased social reciprocity and social participation in four children and reduced detrimental social behaviors in one child respectively. Although, social narratives led to improvement of social reciprocity in four children, social participation in two children and detrimental social behaviors in three children.
Conclusion: Since, both interventions (visual activities schedule and social narratives) were effective in the improvement of social interaction, it seems that similar intervention for children with ASD can improve social interaction and prevent behavior disorders.


 

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Background and Aim: Pseudomonas aeruginosa causes numerous therapeutic problems in patients due to the presence of various effective factors in antibiotic resistance such as beta-lactamase enzymes. The aim of this study was to investigate antibiotic resistance pattern in clinical isolates of Pseudomonas aeruginosa and the frequency of beta-lactamase genes of TEM, PER, SHV, CTX-M and GES using PCR.
Materials and Methods: The antibiotic resistance pattern of 150 isolates of Pseudomonas aeruginosa were determined by the Kirby-Bauer method according to CLSI standards. Then, the frequency of beta-lactamase genes of TEM, PER, SHV, CTX-M and GES in the isolates was evaluated using PCR method. The results were analyzed with SPSS software and Pearson's chi-squared test.
Results: The finding of this study showed that, 52% (78 isolates) of Pseudomonas aeruginosa isolates were recovered from tracheal aspirate from ICU wards. Among 150 isolates, the lowest rate of resistance was seen against cefepime (38%) and amikacin (42%). Also, most isolates (78%) showed a minimum inhibitory concentration of ≥512 µg/mL for ceftazidim.The results of genotypic analysis of extended-spectrum beta-lactamases in ceftazidime-resistant isolates showed that the CTX-M gene had the highest frequency and the GES gene had the lowest frequency.
Conclusion: The results of the present study showed that the CTX-M gene seems to play a greater role in antibiotic resistance of Pseudomonas aeruginosa compared to other beta-lactamase genes studied, because the distribution of this gene in resistant isolates was higher than other genes.