Objectives:To investigate the parenting stress,care burden,and coping styles in mothers of autistic children during the pandemic of COVID-19.The outbreak of COVID-19 and the closure of education and care centers for t...Objectives:To investigate the parenting stress,care burden,and coping styles in mothers of autistic children during the pandemic of COVID-19.The outbreak of COVID-19 and the closure of education and care centers for these children may affect stress,care burden,and adaptation of these mothers.Methods:This study was a cross-sectional research.A total of 110 mothers completed questionnaires.Data were analyzed by descriptive statistics(frequency,percentage,mean,and standard deviation),independent t-test,ANOVA,and multiple linear regressions.Results:Findings showed that parenting stress has a strong and direct correlation with caring burden(P<0.001,r=0.95),and a strong and indirect correlation with coping styles(P<0.001,r=−0.91).Variables of caring burden,coping strategies,mother’s age,mother’s job,mother’s education,number of autistic children,economic status,children’s age,and functional level of autism in children can predict 72.21%of the variance in parenting stress in these mothers.Conclusions:In the present study,parenting stress of mothers of autistic children was reported to be high during the COVID-19 pandemic.Based on the findings of this study,it can be concluded that pediatric nurses and health policymakers should provide a suitable educational and supportive environment for mothers of autistic children to enhance the coping level of these mothers and consequently reduce their parenting stress and care burden.展开更多
Celiac disease （CD） is an entropathy with malabsortive condition in which an allergic reaction to the cereal grain-protein （gluten） causes small intestine rnucosal injury. CD is a multifactorial disorder in which ...Celiac disease （CD） is an entropathy with malabsortive condition in which an allergic reaction to the cereal grain-protein （gluten） causes small intestine rnucosal injury. CD is a multifactorial disorder in which both genetic and environmental factors contribute to the disease development. Mechanisms have been described to explain the pathology of CD. T cells specific for multiple gluten peptides are found in virtually all patients. Generation of such a broad T cell response may be a prerequisite for disease development. CD is associated with multiple extraintestinal presentations, including neurological deficits. Recent studies have shown a significant correlation between anti-ganglioside antibodies and neurological disorders in patients with underlying CD. Gangliosides are glycosphingolipids which are abundant in nervous system and in other tissues including gastrointestinal tract. It is not known what triggers the release of anti-ganglioside antibodies in people with gluten sensitivity. But, the mechanism is likely to involve the intestinal immune system response to ingested gliadin, a component of wheat gluten. Studies showed that mechanisms different from gluten exposure may be implicated in antibody formation, and other environmental factors may also exist. In addition, considering the fact that genetic predisposition dysregulating mucosal immune responses in the presence of certain environmental triggers like gastrointestinal infections may be strong etiological factors for developing chronic intestinal inflammation including CD, the hypothesis raised in our mind that antiganglioside antibody formation in CD may play a role not only in development of neurological complications in celiac patients, but also in development of CD itself. As presence of Campylobacter jejuni in other diseases with antigangliosides antibody formation has been established, we propose the possible role of Campylobacter jejuni in development of CD in association with other genetic and environmental factors by the mechanism that molecular mimicry of gangliosides-like epitopes common to both lipo-polysacharide coats of certain strains of Campylobacter jejuni and gangliosides in cell structure of gastrointestinal mucosa may cause an autoimmune response and consequently lead to atrophy and degeneration of mucosa possibly by apoptosis.展开更多
BACKGROUND: Controversy exists about the correlation between liver ultrasonography and serum parameters for evaluating the severity of liver involvement in non-alcoholic fatty liver disease (NAFLD). This study was des...BACKGROUND: Controversy exists about the correlation between liver ultrasonography and serum parameters for evaluating the severity of liver involvement in non-alcoholic fatty liver disease (NAFLD). This study was designed to determine the association between liver ultrasonography staging in NAFLD and serum parameters correlated with disease severity in previous studies; and set optimal cut-off points for those serum parameters correlated with NAFLD staging at ultrasonography, in order to differentiate ultrasonographic groups (USGs). METHODS: This cross-sectional study evaluated outpatients with evidence of NAFLD in ultrasonography referred to a general hospital. Those with positive viral markers, abnormal serum ceruloplasmin or gamma-globulin concentrations were excluded. A radiologist performed the ultrasonography staging and stratified the patients into mild, moderate, and severe groups. Fasting serum alanine aminotransferase (ALT), aspartate aminotransferase, alkaline phosphatase, triglyceride (TG), high and low density lipoprotein (HDL, LDL), and cholesterol were checked. RESULTS: Two hundred and forty-five patients with a mean age (±standard deviation) of 41.63(±11.46) years were included. There were no significant differences when mean laboratory concentrations were compared between moderate and severe USGs. Therefore, these groups were combined to create revised USGs ('mild' versus 'moderate or severe'). There were associations between the revised USGs, and ALT, TG, HDL levels, and diabetes mellitus [odds ratios=2.81 (95% confidence interval (CI): 1.37-5.76), 2.48 (95% CI: 1.29- 4.78), 0.36 (95% CI: 0.18-0.74), and 5.65 (95% CI: 2.86-11.16)respectively; all P values <0.01]. A cut-off value of 32.5 mg/dL for ALT gave a sensitivity of 70% and a specificity of 62%, for differentiating between the revised USGs. CONCLUSIONS: Serum ALT, TG, and HDL concentrations seem to be associated with the staging by liver ultrasonography in NAFLD. They might be used to predict the staging of liver ultrasonography in these patients.展开更多
We systematically reviewed the clinical trials which recruited antioxidants in the therapy of pancreatitis and evaluated whether antioxidants improve the outcome of patients with pancreatitis. Electronic bibliographic...We systematically reviewed the clinical trials which recruited antioxidants in the therapy of pancreatitis and evaluated whether antioxidants improve the outcome of patients with pancreatitis. Electronic bibliographic databases were searched for any studies which investigated the use of antioxidants in the management of acute pancreatitis （AP） or chronic pancreatitis （CP） and in the prevention of post-endoscopic retrograde cholangio-pancreatography （post-ERCP） pancreatitis （PEP） up to February 2009. Twenty-two randomized, placebo-controlled, clinical trials met our criteria and were included in the review. Except for a cocktail of antioxidants which showed improvement in outcomes in three different clinical trials, the results of the administration of other antioxidants in both AP and CP clinical trials were incongruent and heterogeneous.Furthermore, antioxidant therapy including allopurinol and N-acetylcysteine failed to prevent the onset of PEP in almost all trials. In conclusion, the present data do not support a benefit of antioxidant therapy alone or in combination with conventional therapy in the management of AP, CP or PER Further double blind, randomized, placebo-controlled clinical trials with large sample size need to be conducted.展开更多
In this study, we aimed to evaluate changes of vertical palpebral fissure height （VPFH） after unilateral lateral rectus muscle recession. Twenty-five and twenty-six patients who were candidates for lateral rectus mu...In this study, we aimed to evaluate changes of vertical palpebral fissure height （VPFH） after unilateral lateral rectus muscle recession. Twenty-five and twenty-six patients who were candidates for lateral rectus muscle recession were assigned into “with” and “without” intermuscular septum dissection study arms. The VPFH was measured at one-day before surgery and in two weeks and three months, postoperatively. Three months after surgery, significant increase of VPFH was observed in both groups （Paired t-test; P=0.005）. Also, less widening of VPFH was observed in “with intermuscular septum dissection” group （Change in VPFH in “with intermuscular septum dissection” vs “without intermuscular septum dissection” groups： 0.48 mm vs 1.34 mm; ANCOVA test; P〈0.001）. However, such results were not observed two weeks post-operatively （Change in VPFH in “with intermuscular septum dissection” vs “without intermuscular septum dissection” groups： -0.28 mm vs 0.28 mm; ANCOVA test; P=0.302）. Intermuscular septum dissection is recommended in lateral rectus muscle recession to partially prevent the undesirable increment of VPFH.展开更多
Objective:To investigate the prevalence of viral myocarditis worldwide.Methods:We conducted a systematic search for the prevalence of the most common viruses in myocarditis and 75 studies were included for statistical...Objective:To investigate the prevalence of viral myocarditis worldwide.Methods:We conducted a systematic search for the prevalence of the most common viruses in myocarditis and 75 studies were included for statistical analysis of the prevalence of adenovirus,hepatitis C virus,cytomegalovirus,Ebola virus,human herpesvirus 6,influenza virus,parvovirus,and non-polio enteroviruses.Results:The highest prevalence was related to B19(25.0%)and non-polio enteroviruses(18%).The prevalence of human herpesvirus 6,cytomegalovirus,and Ebola virus was12.8%,5.5%,and 3.1%,respectively.Hepatitis C virus accounted for 6.1%of the disease,the adenoviruses contributed to 5.2%of viral myocarditis.The lowest incidence was related to the influenza virus with 2.0%.Conclusions:Treatment of myocarditis is still problematic and may depend on the etiologic diagnosis.So it is important to know the commonly occurring viral factors in myocarditis and timely diagnosis and treatment are also imperative.展开更多
AIM: To assess possible relationships of knowledge and related factors with educational level and osteoporosisrelated life habits.METHODS: This was a cross sectional study conducted on 268 women(≥ 35 years old) from ...AIM: To assess possible relationships of knowledge and related factors with educational level and osteoporosisrelated life habits.METHODS: This was a cross sectional study conducted on 268 women(≥ 35 years old) from June 2011 to August 2011. The sample collection was done in outpatient clinics in three university hospitals in Isfahan, Iran. We used a demographic questionnaire containingquestions that evaluated osteoporosis-related life habits, including exercise, smoking, intake of calcium and vitamin D supplements and so on. We also used the Osteoporosis Knowledge Assessment Tool to measure osteoporosis knowledge of women.RESULTS: The mean level of knowledge about awareness of osteoporosis, its risk factors and preventive factors were 56, 55 and 22, respectively. The relationship of education level and awareness of osteoporosis, its risk factors and preventive factors was significant, with R = 0.76, R = 0.73 and R = 0.83, respectively(P < 0.001). The relationship of education level and osteoporosis-related life habits was not significant(R = 0.03 and P = 0.56). The relationship of osteoporosis-related life habits and awareness of osteoporosis and its risk factors was significant, with R = 16%, P = 0.006 and R = 16%, P = 0.008, respectively, but the relationship of osteoporosis-related life habits and preventive factors was not significant(R = 0, P = 0.99).CONCLUSION: Iranian women with a higher education level have significantly better knowledge about osteoporosis than women with a lower educational level but they do not use this knowledge in their life.展开更多
Alkylphenols(APs), considered as xenoestrogenic compounds, mainly exist as 4-nonylphenol(4-NP) and 4-tertoctylphenol(4-t-OP) in environments. The high stability and accumulation of APs in aquatic systems have caused e...Alkylphenols(APs), considered as xenoestrogenic compounds, mainly exist as 4-nonylphenol(4-NP) and 4-tertoctylphenol(4-t-OP) in environments. The high stability and accumulation of APs in aquatic systems have caused endocrine disruption. In this study we measured APs in the wastewater influent and effluent samples, from the urban, rural, livestock, commercial and hospital wastewater treatment plants(WWTPs) in Iran. Dispersive liquid–liquid microextraction(DLLME) combined with gas chromatography–mass spectrometry(GC–MS) was used for the extraction and determination of 4-NP and 4-t-OP. In these treatment plants, various processes such as activated sludge, aerated lagoon, moving bed biofilm reactor and activated sludge along with wetland were applied. The highest concentration of 4-NP and 4-t-OP was observed in commercial and livestock sewages. The activated sludge along with wetland and then the MBBR process showed the highest removal rates of pollutants. The rates of biodegradability and accumulation in sludge were determined and also the specific adsorption coefficient Kdand the organic carbon–water partition coefficient kOCof the sludge for APs were calculated.展开更多
AIM: To investigate the effect of stem cells from human exfoliated deciduous teeth(SHED) transplanted for bone regeneration in the dog mandibular defect.METHODS: In this prospective comparative study, SHEDs had been i...AIM: To investigate the effect of stem cells from human exfoliated deciduous teeth(SHED) transplanted for bone regeneration in the dog mandibular defect.METHODS: In this prospective comparative study, SHEDs had been isolated 5 years ago from human exfoliated deciduous teeth. The undifferentiated stem cells were seeded into mandibular bone through-andthrough defects of 4 dogs. Similar defects in control group were filled with cell-free collagen scaffold. After 12 wk, biopsies were taken and morphometric analysis was performed. The percentage of new bone formation and foreign body reaction were measured in each case. The data were subject to statistical analysis using the Mann-Whitney U and Kruskalwalis statistical tests. Differences at P < 0.05 was considered as significant level.RESULTS: There were no significant differences between control and SHED-seeded groups in connective tissue(P = 0.248), woven bone(P = 0.248) and compact bone(P = 0.082). There were not any side effects in transplanted SHED group such as teratoma or malignancy and abnormalities in this period.CONCLUSION: SHEDs which had been isolated and characterized 5 years ago and stored with cryopreservation banking were capable of proliferation and osteogenesis after 5 years, and no immune response was observed after three months of seeded SHEDs.展开更多
Introduction: During the last decade, the health sector of many countries in general has been faced significantly with the increase of health care costs and in particular with the growth in hospital costs, that a sign...Introduction: During the last decade, the health sector of many countries in general has been faced significantly with the increase of health care costs and in particular with the growth in hospital costs, that a significant part of it is due to the inefficient use of resources. The present study has been calculated the technical efficiency of the Specialty Ophthalmology Hospital of Tehran University of Medical Sciences by the comprehensive data analysis methods and stochastic frontier analysis. Methods: In this article, the technical efficiency of the Specialty Ophthalmology Hospital of Tehran University of Medical Sciences has been calculated by the years of 2009 to 2011, by the comprehensive data analysis methods and stochastic frontier analysis. For this purpose, the form of input-oriented data envelopment analysis approach was used by assuming the variable Productivity to scale and stochastic frontier analysis method and from the five output, the occupied bed days, outpatient admissions, inpatient admissions, inpatient days and bed occupancy factor, and from the six output, it means active beds, number of doctors, nurses, and other personnel, budget and equipment costs were used for the study. For data analyzing, Deap software, edit 1/2 and Frontier edit 1/4, was used. Result: The results of a comprehensive data analysis method showed: 1) The capacity of improving technical efficiency in the studied sector is 34% (average technical efficiency is 0.663 parts);and 2) some of the sectors are met the excess inputs (factors of production). Technical efficiency using stochastic frontier analysis was equal to 0.937. In fact, the stochastic frontier analysis showed the inefficiency is less than the actual value. Conclusion: Reducing excess capacity factors (factors of production) should be conducted in the form of a comprehensive plan and by considering all regarded aspects, that this reduction plays a major role in the hospital and health sector costs reduction.展开更多
Objective: To update current situation of the cutaneous leishmaniasis(CL) in Kazerun County,southwest of Iran and to analyze the epidemiological aspects of the disease during 2005-2015,Methods: Data on CL were obtaine...Objective: To update current situation of the cutaneous leishmaniasis(CL) in Kazerun County,southwest of Iran and to analyze the epidemiological aspects of the disease during 2005-2015,Methods: Data on CL were obtained from the Health Center of Kazerun County,and then were analyzed and mapped using SPSS and Arc GIS 10.3,Results: A total of 700 cases of CL were recorded during the study period with an overall decreasing trend from 2005 to 2015,More than 60% of the patients were inhabitants of rural areas and males were infected more than females,Although there was not a significant difference between gender,job categories,residence and CL infection(P>0.05),age groups were significantly different(P<0.05),But there was no significant correlation between monthly cases of the disease with average temperature(P>0.05),Most of the acute lesions were found to be present on the hand,leg and face,respectively,The average CL incidence in the study area was calculated as 24.9/100 000 population,A hot spot for the disease was found in southern part of the area(P<0.05),Conclusions: This study revealed that CL is present in Kazerun country,Thus,effective monitoring and sustained suveillance system is crucial in counteracting the disease,and if possible,to eliminate it.展开更多
Objective: To study the neurological symptoms of psoriasis patients who used infliximab.Methods: We studied psoriasis patients who used infliximab in two referral general hospitals in Tehran from January 2013 to Janua...Objective: To study the neurological symptoms of psoriasis patients who used infliximab.Methods: We studied psoriasis patients who used infliximab in two referral general hospitals in Tehran from January 2013 to January 2014. We completed neurological symptoms checklists by questioning the patients.Results: Sixty patients with psoriasis were included in this study. Among them, 3 patients had sensory symptoms as side effect and one patient showed motor symptoms as side effect. There was no statistically significant difference between age, gender, and session count with the sensory and motor side effects(P > 0.05).Conclusions: Neurological symptoms can be detected among 6% of patients under treatment with infliximab and there is no significant association between symptoms and gender, duration of drug use as well as age.展开更多
Background Stroke is a major cause of global mortality and disability.Currently,the treatment of acute ischaemic stroke through reperfusion has posed several challenges,raising the need for complementary options to pr...Background Stroke is a major cause of global mortality and disability.Currently,the treatment of acute ischaemic stroke through reperfusion has posed several challenges,raising the need for complementary options to protect the ischaemic penumbra.Recent investigations have indicated that certain epigenetic factors,specifically,histone deacetylases(HDACs)and sirtuins,can be promising for ischaemic stroke therapy,with recent studies suggesting that inhibitors of HDACs or sirtuins may provide neuronal protection after ischaemic stroke.However,the impact of specific HDAC/sirtuin isoforms on the survival of neuronal cells following stroke is still uncertain.This study aims to provide a comprehensive overview of the function of HDACs and their modulators in the treatment of acute ischaemic stroke.Methods This systematic review and meta-analysis will encompass animal intervention studies that explore the efficacy of modulation of HDACs and sirtuins in the acute phase of ischaemic stroke.The review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Electronic searches will be conducted in PubMed,Web of Science and Scopus,with subsequent screening by independent reviewers based on the established eligibility criteria.Methodological quality will be evaluated using the SYRCLE risk of bias tool.The primary outcomes will be infarct volume and functional response,with the secondary outcomes established a priori.Data pertaining to infarct volume will be used for random-effects meta-analysis.Additionally,a descriptive summary will be conducted for the functional response and secondary outcomes.Discussion No systematic review and meta-analysis on the treatment of ischaemic stroke through HDAC modulation has been conducted to date.A comprehensive analysis of the available literature on the relevant preclinical investigations can yield invaluable insights in discerning the most effective trials and in further standardisation of preclinical studies.展开更多
Purpose:The purpose of the National Spinal Cord Injury Registry of Iran(NSCIR-IR)is to create an infrastructure to assess the quality of care for spine trauma and in this study,we aim to investigate whether the NSCIR-...Purpose:The purpose of the National Spinal Cord Injury Registry of Iran(NSCIR-IR)is to create an infrastructure to assess the quality of care for spine trauma and in this study,we aim to investigate whether the NSCIR-IR successfully provides necessary post-discharge follow-up data for these patients.Methods:An observational prospective study was conducted from April 11,2021 to April 22,2022 in 8 centers enrolled in NSCIR-IR,respectively Arak,Rasht,Urmia,Shahroud,Yazd,Kashan,Tabriz,and Tehran.Patients were classified into 3 groups based on their need for care resources,respectively:(1)non-spinal cord injury(SCI)patients without surgery(group 1),(2)non-SCI patients with surgery(group 2),and(3)SCI patients(group 3).The assessment tool was a self-designed questionnaire to evaluate the care quality in 3 phases:pre-hospital,in-hospital,and post-hospital.The data from the first 2 phases were collected through the registry.The post-hospital data were collected by conducting follow-up assessments.Telephone follow-ups were conducted for groups 1 and 2(non-SCI patients),while group 3(SCI patients)had a face-to-face visit.This study took place during the COVID-19 pandemic.Data on age and time interval from injury to follow-up were expressed as mean±standard deviation(SD)and response rate and follow-up loss as a percentage.Results:Altogether 1538 telephone follow-up records related to 1292 patients were registered in the NSCIR-IR.Of the total calls,918(71.05%)were related to successful follow-ups,but 38 cases died and thus were excluded from data analysis.In the end,post-hospital data from 880 patients alive were gathered.The success rate of follow-ups by telephone for groups 1 and 2 was 73.38%and 67.05%respectively,compared to 66.67%by face-to-face visits for group 3,which was very hard during the COVID-19 pandemic.The data completion rate after discharge ranged from 48%-100%,22%-100%and 29%-100%for groups 1-3.Conclusions:To improve patient accessibility,NSCIR-IR should take measures during data gathering to increase the accuracy of registered contact information.Regarding the loss to follow-ups of SCI patients,NSCIR-IR should find strategies for remote assessment or motivate them to participate in follow-ups through,for example,providing transportation facilities or financial support.展开更多
Objective：Thoracic injuries are responsible for 25% of deaths of blunt traumas.Chest X-ray （CXR） is the first diagnostic method in patients with blunt trauma.The aim of this study was to detect the accuracy of CXR ...Objective：Thoracic injuries are responsible for 25% of deaths of blunt traumas.Chest X-ray （CXR） is the first diagnostic method in patients with blunt trauma.The aim of this study was to detect the accuracy of CXR versus chest computed tomograpgy （CT） in hemodynamically stable patients with blunt chest trauma.Methods：Study was conducted at the emergency department of S ina Hospital from March 2011 to March 2012.Hemodynamically stable patients with at least 16 years of age who had blunt chest trauma were included.All patients underwent the same diagnostic protocol which consisted of physical examination,CXR and CT scan respectively.Results：Two hundreds patients （84% male and 16% female） were included with a mean age of（37.9±13.7） years.Rib fracture was the most common finding of CXR （12.5%） and CT scan （25.5%）.The sensitivity of CXR for hemothorax,thoracolumbar vertebra fractures and rib fractures were 20%,49% and 49%,respectively.Pneumothorax,foreign body,emphysema,pulmonary contusion,liver hematoma and sternum fracture were not diagnosed with CXR alone.Conclusion：Applying CT scan as the first-line diagnostic modality in hemodynamically stable patients with blunt chest trauma can detect pathologies which may change management and outcome.展开更多
background Family medicine has become a main prerequisite of providing primary healthcare and a main reforming strategy to ensure the delivery of efficient and high-quality health services.Aim This study aimed to inve...background Family medicine has become a main prerequisite of providing primary healthcare and a main reforming strategy to ensure the delivery of efficient and high-quality health services.Aim This study aimed to investigate general practitioners’(GP)preferences regarding family physician contract.Design and setting Cross-sectional study was conducted among GPs who registered in Ministry of Health and Medical Education(MoHME)family physician plan and were working in the health network of moderately developed regions in Iran.The sample size was calculated to be 150 GPs who were randomly selected from MoHME database.Method Developed questionnaire was distributed to GPs.Results were analysed by ordinal regression model.results Study results confirmed that‘type of employer’had the most significant effect on GPs’preferences(β=0.86).Then attributes including‘allocating quota for being accepted in medical specialty’(β=0.78),‘increased length of contract’(β=0.00.42)and‘capitation payment+15%bonus’had respectively the great effects on participants’decision.Findings also revealed that a scenario of contracting with medical council was 2.4 times more likely to be chosen by GPs compared with a scenario of contracting with a medical university.Furthermore,a scenario that allocated a quota for admission to medical specialty courses was 2.18 times more probable to be preferred by them(p<0.001).Conclusion Successful implementation of family medicine requires development of suitable solutions for attracting and attaining GPs in the programme.It seems that using a variety of incentives and applying them in physicians’work contract would be helpful in this regard.展开更多
Virus-related cancer is cancer where viral infection leads to the malignant transformation of the host's infected cells. Seven viruses (e.g., human papillomavirus (HPV), Epstein–Barr virus (EBV), Kaposi's sar...Virus-related cancer is cancer where viral infection leads to the malignant transformation of the host's infected cells. Seven viruses (e.g., human papillomavirus (HPV), Epstein–Barr virus (EBV), Kaposi's sarcoma herpesvirus (KSHV), Hepatitis B virus (HBV), Hepatitis C virus (HCV), Human T-lymphotropic virus (HTLV), and Merkel cell polyomavirus (MCV)) that infect humans have been identified as an oncogene and have been associated with several human malignancies. Recently, growing attention has been attracted to exploring the pathogenesis of virus-related cancers. One of the most mysterious molecules involved in carcinogenesis and progression of virus-related cancers is circular RNAs (circRNA). These emerging non-coding RNAs (ncRNAs), due to the absence of 5′ and 3′ ends, have high stability than linear RNAs and are found in some species across the eukaryotic organisms. Compelling evidence has revealed that viruses also encode a repertoire of circRNAs, as well as dysregulation of these viral circRNAs play a critical role in the pathogenesis and progression of different types of virus-related cancers. Therefore, understanding the exact role and function of the virally encoded circRNAs with virus-associated cancers will open a new road for increasing our knowledge about the RNA world. Hence, in this review, we will focus on emerging roles of virus-encoded circRNAs in multiple cancers, including cervical cancer, gastric cancer, Merkel cell carcinoma, nasopharyngeal carcinoma, Kaposi cancer, and liver cancer.展开更多
基金supported by Hamadan University of Medical Sciences supported financially this research(No.140005123994).
文摘Objectives:To investigate the parenting stress,care burden,and coping styles in mothers of autistic children during the pandemic of COVID-19.The outbreak of COVID-19 and the closure of education and care centers for these children may affect stress,care burden,and adaptation of these mothers.Methods:This study was a cross-sectional research.A total of 110 mothers completed questionnaires.Data were analyzed by descriptive statistics(frequency,percentage,mean,and standard deviation),independent t-test,ANOVA,and multiple linear regressions.Results:Findings showed that parenting stress has a strong and direct correlation with caring burden(P<0.001,r=0.95),and a strong and indirect correlation with coping styles(P<0.001,r=−0.91).Variables of caring burden,coping strategies,mother’s age,mother’s job,mother’s education,number of autistic children,economic status,children’s age,and functional level of autism in children can predict 72.21%of the variance in parenting stress in these mothers.Conclusions:In the present study,parenting stress of mothers of autistic children was reported to be high during the COVID-19 pandemic.Based on the findings of this study,it can be concluded that pediatric nurses and health policymakers should provide a suitable educational and supportive environment for mothers of autistic children to enhance the coping level of these mothers and consequently reduce their parenting stress and care burden.
文摘Celiac disease （CD） is an entropathy with malabsortive condition in which an allergic reaction to the cereal grain-protein （gluten） causes small intestine rnucosal injury. CD is a multifactorial disorder in which both genetic and environmental factors contribute to the disease development. Mechanisms have been described to explain the pathology of CD. T cells specific for multiple gluten peptides are found in virtually all patients. Generation of such a broad T cell response may be a prerequisite for disease development. CD is associated with multiple extraintestinal presentations, including neurological deficits. Recent studies have shown a significant correlation between anti-ganglioside antibodies and neurological disorders in patients with underlying CD. Gangliosides are glycosphingolipids which are abundant in nervous system and in other tissues including gastrointestinal tract. It is not known what triggers the release of anti-ganglioside antibodies in people with gluten sensitivity. But, the mechanism is likely to involve the intestinal immune system response to ingested gliadin, a component of wheat gluten. Studies showed that mechanisms different from gluten exposure may be implicated in antibody formation, and other environmental factors may also exist. In addition, considering the fact that genetic predisposition dysregulating mucosal immune responses in the presence of certain environmental triggers like gastrointestinal infections may be strong etiological factors for developing chronic intestinal inflammation including CD, the hypothesis raised in our mind that antiganglioside antibody formation in CD may play a role not only in development of neurological complications in celiac patients, but also in development of CD itself. As presence of Campylobacter jejuni in other diseases with antigangliosides antibody formation has been established, we propose the possible role of Campylobacter jejuni in development of CD in association with other genetic and environmental factors by the mechanism that molecular mimicry of gangliosides-like epitopes common to both lipo-polysacharide coats of certain strains of Campylobacter jejuni and gangliosides in cell structure of gastrointestinal mucosa may cause an autoimmune response and consequently lead to atrophy and degeneration of mucosa possibly by apoptosis.
基金supported by a grant from the Kashan University of Medical Sciences(5764)
文摘BACKGROUND: Controversy exists about the correlation between liver ultrasonography and serum parameters for evaluating the severity of liver involvement in non-alcoholic fatty liver disease (NAFLD). This study was designed to determine the association between liver ultrasonography staging in NAFLD and serum parameters correlated with disease severity in previous studies; and set optimal cut-off points for those serum parameters correlated with NAFLD staging at ultrasonography, in order to differentiate ultrasonographic groups (USGs). METHODS: This cross-sectional study evaluated outpatients with evidence of NAFLD in ultrasonography referred to a general hospital. Those with positive viral markers, abnormal serum ceruloplasmin or gamma-globulin concentrations were excluded. A radiologist performed the ultrasonography staging and stratified the patients into mild, moderate, and severe groups. Fasting serum alanine aminotransferase (ALT), aspartate aminotransferase, alkaline phosphatase, triglyceride (TG), high and low density lipoprotein (HDL, LDL), and cholesterol were checked. RESULTS: Two hundred and forty-five patients with a mean age (±standard deviation) of 41.63(±11.46) years were included. There were no significant differences when mean laboratory concentrations were compared between moderate and severe USGs. Therefore, these groups were combined to create revised USGs ('mild' versus 'moderate or severe'). There were associations between the revised USGs, and ALT, TG, HDL levels, and diabetes mellitus [odds ratios=2.81 (95% confidence interval (CI): 1.37-5.76), 2.48 (95% CI: 1.29- 4.78), 0.36 (95% CI: 0.18-0.74), and 5.65 (95% CI: 2.86-11.16)respectively; all P values <0.01]. A cut-off value of 32.5 mg/dL for ALT gave a sensitivity of 70% and a specificity of 62%, for differentiating between the revised USGs. CONCLUSIONS: Serum ALT, TG, and HDL concentrations seem to be associated with the staging by liver ultrasonography in NAFLD. They might be used to predict the staging of liver ultrasonography in these patients.
文摘We systematically reviewed the clinical trials which recruited antioxidants in the therapy of pancreatitis and evaluated whether antioxidants improve the outcome of patients with pancreatitis. Electronic bibliographic databases were searched for any studies which investigated the use of antioxidants in the management of acute pancreatitis （AP） or chronic pancreatitis （CP） and in the prevention of post-endoscopic retrograde cholangio-pancreatography （post-ERCP） pancreatitis （PEP） up to February 2009. Twenty-two randomized, placebo-controlled, clinical trials met our criteria and were included in the review. Except for a cocktail of antioxidants which showed improvement in outcomes in three different clinical trials, the results of the administration of other antioxidants in both AP and CP clinical trials were incongruent and heterogeneous.Furthermore, antioxidant therapy including allopurinol and N-acetylcysteine failed to prevent the onset of PEP in almost all trials. In conclusion, the present data do not support a benefit of antioxidant therapy alone or in combination with conventional therapy in the management of AP, CP or PER Further double blind, randomized, placebo-controlled clinical trials with large sample size need to be conducted.
基金supported by Isfahan University of Medical Sciences
文摘In this study, we aimed to evaluate changes of vertical palpebral fissure height （VPFH） after unilateral lateral rectus muscle recession. Twenty-five and twenty-six patients who were candidates for lateral rectus muscle recession were assigned into “with” and “without” intermuscular septum dissection study arms. The VPFH was measured at one-day before surgery and in two weeks and three months, postoperatively. Three months after surgery, significant increase of VPFH was observed in both groups （Paired t-test; P=0.005）. Also, less widening of VPFH was observed in “with intermuscular septum dissection” group （Change in VPFH in “with intermuscular septum dissection” vs “without intermuscular septum dissection” groups： 0.48 mm vs 1.34 mm; ANCOVA test; P〈0.001）. However, such results were not observed two weeks post-operatively （Change in VPFH in “with intermuscular septum dissection” vs “without intermuscular septum dissection” groups： -0.28 mm vs 0.28 mm; ANCOVA test; P=0.302）. Intermuscular septum dissection is recommended in lateral rectus muscle recession to partially prevent the undesirable increment of VPFH.
文摘Objective:To investigate the prevalence of viral myocarditis worldwide.Methods:We conducted a systematic search for the prevalence of the most common viruses in myocarditis and 75 studies were included for statistical analysis of the prevalence of adenovirus,hepatitis C virus,cytomegalovirus,Ebola virus,human herpesvirus 6,influenza virus,parvovirus,and non-polio enteroviruses.Results:The highest prevalence was related to B19(25.0%)and non-polio enteroviruses(18%).The prevalence of human herpesvirus 6,cytomegalovirus,and Ebola virus was12.8%,5.5%,and 3.1%,respectively.Hepatitis C virus accounted for 6.1%of the disease,the adenoviruses contributed to 5.2%of viral myocarditis.The lowest incidence was related to the influenza virus with 2.0%.Conclusions:Treatment of myocarditis is still problematic and may depend on the etiologic diagnosis.So it is important to know the commonly occurring viral factors in myocarditis and timely diagnosis and treatment are also imperative.
基金Supported by The Isfahan University of Medical Sciences
文摘AIM: To assess possible relationships of knowledge and related factors with educational level and osteoporosisrelated life habits.METHODS: This was a cross sectional study conducted on 268 women(≥ 35 years old) from June 2011 to August 2011. The sample collection was done in outpatient clinics in three university hospitals in Isfahan, Iran. We used a demographic questionnaire containingquestions that evaluated osteoporosis-related life habits, including exercise, smoking, intake of calcium and vitamin D supplements and so on. We also used the Osteoporosis Knowledge Assessment Tool to measure osteoporosis knowledge of women.RESULTS: The mean level of knowledge about awareness of osteoporosis, its risk factors and preventive factors were 56, 55 and 22, respectively. The relationship of education level and awareness of osteoporosis, its risk factors and preventive factors was significant, with R = 0.76, R = 0.73 and R = 0.83, respectively(P < 0.001). The relationship of education level and osteoporosis-related life habits was not significant(R = 0.03 and P = 0.56). The relationship of osteoporosis-related life habits and awareness of osteoporosis and its risk factors was significant, with R = 16%, P = 0.006 and R = 16%, P = 0.008, respectively, but the relationship of osteoporosis-related life habits and preventive factors was not significant(R = 0, P = 0.99).CONCLUSION: Iranian women with a higher education level have significantly better knowledge about osteoporosis than women with a lower educational level but they do not use this knowledge in their life.
基金Vice Chancellery of Research of IUMS for the financial support,Research Project,#394773
文摘Alkylphenols(APs), considered as xenoestrogenic compounds, mainly exist as 4-nonylphenol(4-NP) and 4-tertoctylphenol(4-t-OP) in environments. The high stability and accumulation of APs in aquatic systems have caused endocrine disruption. In this study we measured APs in the wastewater influent and effluent samples, from the urban, rural, livestock, commercial and hospital wastewater treatment plants(WWTPs) in Iran. Dispersive liquid–liquid microextraction(DLLME) combined with gas chromatography–mass spectrometry(GC–MS) was used for the extraction and determination of 4-NP and 4-t-OP. In these treatment plants, various processes such as activated sludge, aerated lagoon, moving bed biofilm reactor and activated sludge along with wetland were applied. The highest concentration of 4-NP and 4-t-OP was observed in commercial and livestock sewages. The activated sludge along with wetland and then the MBBR process showed the highest removal rates of pollutants. The rates of biodegradability and accumulation in sludge were determined and also the specific adsorption coefficient Kdand the organic carbon–water partition coefficient kOCof the sludge for APs were calculated.
文摘AIM: To investigate the effect of stem cells from human exfoliated deciduous teeth(SHED) transplanted for bone regeneration in the dog mandibular defect.METHODS: In this prospective comparative study, SHEDs had been isolated 5 years ago from human exfoliated deciduous teeth. The undifferentiated stem cells were seeded into mandibular bone through-andthrough defects of 4 dogs. Similar defects in control group were filled with cell-free collagen scaffold. After 12 wk, biopsies were taken and morphometric analysis was performed. The percentage of new bone formation and foreign body reaction were measured in each case. The data were subject to statistical analysis using the Mann-Whitney U and Kruskalwalis statistical tests. Differences at P < 0.05 was considered as significant level.RESULTS: There were no significant differences between control and SHED-seeded groups in connective tissue(P = 0.248), woven bone(P = 0.248) and compact bone(P = 0.082). There were not any side effects in transplanted SHED group such as teratoma or malignancy and abnormalities in this period.CONCLUSION: SHEDs which had been isolated and characterized 5 years ago and stored with cryopreservation banking were capable of proliferation and osteogenesis after 5 years, and no immune response was observed after three months of seeded SHEDs.
文摘Introduction: During the last decade, the health sector of many countries in general has been faced significantly with the increase of health care costs and in particular with the growth in hospital costs, that a significant part of it is due to the inefficient use of resources. The present study has been calculated the technical efficiency of the Specialty Ophthalmology Hospital of Tehran University of Medical Sciences by the comprehensive data analysis methods and stochastic frontier analysis. Methods: In this article, the technical efficiency of the Specialty Ophthalmology Hospital of Tehran University of Medical Sciences has been calculated by the years of 2009 to 2011, by the comprehensive data analysis methods and stochastic frontier analysis. For this purpose, the form of input-oriented data envelopment analysis approach was used by assuming the variable Productivity to scale and stochastic frontier analysis method and from the five output, the occupied bed days, outpatient admissions, inpatient admissions, inpatient days and bed occupancy factor, and from the six output, it means active beds, number of doctors, nurses, and other personnel, budget and equipment costs were used for the study. For data analyzing, Deap software, edit 1/2 and Frontier edit 1/4, was used. Result: The results of a comprehensive data analysis method showed: 1) The capacity of improving technical efficiency in the studied sector is 34% (average technical efficiency is 0.663 parts);and 2) some of the sectors are met the excess inputs (factors of production). Technical efficiency using stochastic frontier analysis was equal to 0.937. In fact, the stochastic frontier analysis showed the inefficiency is less than the actual value. Conclusion: Reducing excess capacity factors (factors of production) should be conducted in the form of a comprehensive plan and by considering all regarded aspects, that this reduction plays a major role in the hospital and health sector costs reduction.
基金Supported by Hamadan University of Medical Sciences(Project No.941226132)
文摘Objective: To update current situation of the cutaneous leishmaniasis(CL) in Kazerun County,southwest of Iran and to analyze the epidemiological aspects of the disease during 2005-2015,Methods: Data on CL were obtained from the Health Center of Kazerun County,and then were analyzed and mapped using SPSS and Arc GIS 10.3,Results: A total of 700 cases of CL were recorded during the study period with an overall decreasing trend from 2005 to 2015,More than 60% of the patients were inhabitants of rural areas and males were infected more than females,Although there was not a significant difference between gender,job categories,residence and CL infection(P>0.05),age groups were significantly different(P<0.05),But there was no significant correlation between monthly cases of the disease with average temperature(P>0.05),Most of the acute lesions were found to be present on the hand,leg and face,respectively,The average CL incidence in the study area was calculated as 24.9/100 000 population,A hot spot for the disease was found in southern part of the area(P<0.05),Conclusions: This study revealed that CL is present in Kazerun country,Thus,effective monitoring and sustained suveillance system is crucial in counteracting the disease,and if possible,to eliminate it.
文摘Objective: To study the neurological symptoms of psoriasis patients who used infliximab.Methods: We studied psoriasis patients who used infliximab in two referral general hospitals in Tehran from January 2013 to January 2014. We completed neurological symptoms checklists by questioning the patients.Results: Sixty patients with psoriasis were included in this study. Among them, 3 patients had sensory symptoms as side effect and one patient showed motor symptoms as side effect. There was no statistically significant difference between age, gender, and session count with the sensory and motor side effects(P > 0.05).Conclusions: Neurological symptoms can be detected among 6% of patients under treatment with infliximab and there is no significant association between symptoms and gender, duration of drug use as well as age.
文摘Background Stroke is a major cause of global mortality and disability.Currently,the treatment of acute ischaemic stroke through reperfusion has posed several challenges,raising the need for complementary options to protect the ischaemic penumbra.Recent investigations have indicated that certain epigenetic factors,specifically,histone deacetylases(HDACs)and sirtuins,can be promising for ischaemic stroke therapy,with recent studies suggesting that inhibitors of HDACs or sirtuins may provide neuronal protection after ischaemic stroke.However,the impact of specific HDAC/sirtuin isoforms on the survival of neuronal cells following stroke is still uncertain.This study aims to provide a comprehensive overview of the function of HDACs and their modulators in the treatment of acute ischaemic stroke.Methods This systematic review and meta-analysis will encompass animal intervention studies that explore the efficacy of modulation of HDACs and sirtuins in the acute phase of ischaemic stroke.The review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Electronic searches will be conducted in PubMed,Web of Science and Scopus,with subsequent screening by independent reviewers based on the established eligibility criteria.Methodological quality will be evaluated using the SYRCLE risk of bias tool.The primary outcomes will be infarct volume and functional response,with the secondary outcomes established a priori.Data pertaining to infarct volume will be used for random-effects meta-analysis.Additionally,a descriptive summary will be conducted for the functional response and secondary outcomes.Discussion No systematic review and meta-analysis on the treatment of ischaemic stroke through HDAC modulation has been conducted to date.A comprehensive analysis of the available literature on the relevant preclinical investigations can yield invaluable insights in discerning the most effective trials and in further standardisation of preclinical studies.
基金supported by Elite Researcher Grant Committee under award number 972056 from the National Institutes for Medical Research Development (NIMAD),Tehran,Iran,and by Sina Trauma and Surgery Research Center,Tehran University of Medical Sciences,Tehran,Iran grant number 97-02-38-39581.
文摘Purpose:The purpose of the National Spinal Cord Injury Registry of Iran(NSCIR-IR)is to create an infrastructure to assess the quality of care for spine trauma and in this study,we aim to investigate whether the NSCIR-IR successfully provides necessary post-discharge follow-up data for these patients.Methods:An observational prospective study was conducted from April 11,2021 to April 22,2022 in 8 centers enrolled in NSCIR-IR,respectively Arak,Rasht,Urmia,Shahroud,Yazd,Kashan,Tabriz,and Tehran.Patients were classified into 3 groups based on their need for care resources,respectively:(1)non-spinal cord injury(SCI)patients without surgery(group 1),(2)non-SCI patients with surgery(group 2),and(3)SCI patients(group 3).The assessment tool was a self-designed questionnaire to evaluate the care quality in 3 phases:pre-hospital,in-hospital,and post-hospital.The data from the first 2 phases were collected through the registry.The post-hospital data were collected by conducting follow-up assessments.Telephone follow-ups were conducted for groups 1 and 2(non-SCI patients),while group 3(SCI patients)had a face-to-face visit.This study took place during the COVID-19 pandemic.Data on age and time interval from injury to follow-up were expressed as mean±standard deviation(SD)and response rate and follow-up loss as a percentage.Results:Altogether 1538 telephone follow-up records related to 1292 patients were registered in the NSCIR-IR.Of the total calls,918(71.05%)were related to successful follow-ups,but 38 cases died and thus were excluded from data analysis.In the end,post-hospital data from 880 patients alive were gathered.The success rate of follow-ups by telephone for groups 1 and 2 was 73.38%and 67.05%respectively,compared to 66.67%by face-to-face visits for group 3,which was very hard during the COVID-19 pandemic.The data completion rate after discharge ranged from 48%-100%,22%-100%and 29%-100%for groups 1-3.Conclusions:To improve patient accessibility,NSCIR-IR should take measures during data gathering to increase the accuracy of registered contact information.Regarding the loss to follow-ups of SCI patients,NSCIR-IR should find strategies for remote assessment or motivate them to participate in follow-ups through,for example,providing transportation facilities or financial support.
文摘Objective：Thoracic injuries are responsible for 25% of deaths of blunt traumas.Chest X-ray （CXR） is the first diagnostic method in patients with blunt trauma.The aim of this study was to detect the accuracy of CXR versus chest computed tomograpgy （CT） in hemodynamically stable patients with blunt chest trauma.Methods：Study was conducted at the emergency department of S ina Hospital from March 2011 to March 2012.Hemodynamically stable patients with at least 16 years of age who had blunt chest trauma were included.All patients underwent the same diagnostic protocol which consisted of physical examination,CXR and CT scan respectively.Results：Two hundreds patients （84% male and 16% female） were included with a mean age of（37.9±13.7） years.Rib fracture was the most common finding of CXR （12.5%） and CT scan （25.5%）.The sensitivity of CXR for hemothorax,thoracolumbar vertebra fractures and rib fractures were 20%,49% and 49%,respectively.Pneumothorax,foreign body,emphysema,pulmonary contusion,liver hematoma and sternum fracture were not diagnosed with CXR alone.Conclusion：Applying CT scan as the first-line diagnostic modality in hemodynamically stable patients with blunt chest trauma can detect pathologies which may change management and outcome.
文摘background Family medicine has become a main prerequisite of providing primary healthcare and a main reforming strategy to ensure the delivery of efficient and high-quality health services.Aim This study aimed to investigate general practitioners’(GP)preferences regarding family physician contract.Design and setting Cross-sectional study was conducted among GPs who registered in Ministry of Health and Medical Education(MoHME)family physician plan and were working in the health network of moderately developed regions in Iran.The sample size was calculated to be 150 GPs who were randomly selected from MoHME database.Method Developed questionnaire was distributed to GPs.Results were analysed by ordinal regression model.results Study results confirmed that‘type of employer’had the most significant effect on GPs’preferences(β=0.86).Then attributes including‘allocating quota for being accepted in medical specialty’(β=0.78),‘increased length of contract’(β=0.00.42)and‘capitation payment+15%bonus’had respectively the great effects on participants’decision.Findings also revealed that a scenario of contracting with medical council was 2.4 times more likely to be chosen by GPs compared with a scenario of contracting with a medical university.Furthermore,a scenario that allocated a quota for admission to medical specialty courses was 2.18 times more probable to be preferred by them(p<0.001).Conclusion Successful implementation of family medicine requires development of suitable solutions for attracting and attaining GPs in the programme.It seems that using a variety of incentives and applying them in physicians’work contract would be helpful in this regard.
文摘Virus-related cancer is cancer where viral infection leads to the malignant transformation of the host's infected cells. Seven viruses (e.g., human papillomavirus (HPV), Epstein–Barr virus (EBV), Kaposi's sarcoma herpesvirus (KSHV), Hepatitis B virus (HBV), Hepatitis C virus (HCV), Human T-lymphotropic virus (HTLV), and Merkel cell polyomavirus (MCV)) that infect humans have been identified as an oncogene and have been associated with several human malignancies. Recently, growing attention has been attracted to exploring the pathogenesis of virus-related cancers. One of the most mysterious molecules involved in carcinogenesis and progression of virus-related cancers is circular RNAs (circRNA). These emerging non-coding RNAs (ncRNAs), due to the absence of 5′ and 3′ ends, have high stability than linear RNAs and are found in some species across the eukaryotic organisms. Compelling evidence has revealed that viruses also encode a repertoire of circRNAs, as well as dysregulation of these viral circRNAs play a critical role in the pathogenesis and progression of different types of virus-related cancers. Therefore, understanding the exact role and function of the virally encoded circRNAs with virus-associated cancers will open a new road for increasing our knowledge about the RNA world. Hence, in this review, we will focus on emerging roles of virus-encoded circRNAs in multiple cancers, including cervical cancer, gastric cancer, Merkel cell carcinoma, nasopharyngeal carcinoma, Kaposi cancer, and liver cancer.
