Tehran University Medical Journal

Background: The benefits of aspirin have been proven by repeated examinations, especially in secondary prevention in cardiac infarction, stroke, and after interventional angiography and stent insertion.
Methods: This is a retrospective study on all patients who underwent non-cardiac surgeries between June 2005 and March 2013 in Ghaem hospital in Mashhad and aspirin continued due to many reasons. Most frequent surgeries included laparoscopic appendectomy and cholecystectomy. Information such as bleeding and its amount both during surgery and post-operative, hematoma after surgery, requiring re-operation due to bleeding and cardiovascular events in hospital were recorded and analyzed. Moreover, all patients were followed within one month after discharge from hospital to check whether any cardiovascular events had been happened. Furthermore, bruising in the skin, and bleeding after discharge were evaluated. Data were analyzed using SPSS Version 16 (SPSS, Chicago, IL, USA).
Results: One hundred seventy patients enrolled in the study and all of them underwent general anesthesia. Of all patients 37.06% were male and 62.94% were female. The mean age was 52.78±5.01 years. Majority of operations included laparoscopic cholecystectomy (41.62%). Also in most of the patients (58.38%) surgery were emergency and discontinuation of aspirin were impossible. 91.37% of patients were taking less than 80 mg aspirin per day. Mean bleeding amount during surgery was 100 ml. 13 patients (6.59%) who undergo laparoscopic cholecystectomy and one patients in appendectomy group had bleeding more than 110 ml due to inadequate artery ligation and they underwent conversion to open surgery and bleeding were controlled successfully. Other eight patients (4.06%) treated conservatively without need to conversion to open surgery. In 7.61% of patients, ecchymosis happened which were healed within one month. No patient underwent reoperation due to post-operative hemorrhage. No vascular event and hematoma had been reported during one month follow up after surgery.
Conclusion: Continuing aspirin in perioperative period of non-cardiac surgeries were without additional risk of bleeding and it also helped to reduce risk of vascular evets post-operatively.

Background: Bronchiolitis is one of the most common diseases of the lower respiratory tract in infants. Vitamin D has been shown to be protective against lower respiratory infections; however, there are limited and contradictory results in relation to serum vitamin D level and the incidence of bronchiolitis in children. The aim of this study was to compare serum levels of this vitamin in healthy infants and infants with acute bronchiolitis.
Methods: This case-control study conducted at Abuzar hospital in Ahvaz city, during October to March of 2014. Three groups of 45 eligible infants including control, low and high intensity of bronchiolitis enrolled to study. The severity of bronchiolitis classified according to scores derived from the respiratory distress assessment index. One to eight scores considered as low intensity and 9 to 17 scores considered as high intensity of bronchiolitis. Subsequently, 3 ml of venous blood sample were taken from them and the serum levels of 25(OH)D were measured by using an enzymatic kit.
Results: 60 (44.4%) infants were girls. The mean age of the control, low and high intensity of bronchiolitis groups were 11.2±5.2, 10±5.8 and 9.8±4.7 months, respectively (P=0.1). The mean of 25(OH)D concentrations in the control, low and high intensity bronchiolitis groups were 28.3±19.4, 17.7±11.7 and 13.6±5.7 nm/l, respectively. There was a significant difference in levels of 25(OH)D between the control-low intensity bronchiolitis groups (P=0.001) and the control-high intensity bronchiolitis groups (P=0.002), this difference was not significant between the two groups of bronchiolitis. There was a direct and significant correlation between serum level of 25(OH)D and age (r=0.2, P=0.005), breast milk consumption (r=0.3, P=0.001), and vitamin D supplementation (r=0.6, P=0.000).
Conclusion: In the present study, levels of 25(OH)D were significantly lower in infants with bronchiolitis than control group. In addition, 25(OH)D levels did not affect the severity of bronchiolitis.

Background: According to the direct connection between congenital hypothyroidism and iodine deficiency in pregnant women, also relatively high incidence of congenital hypothyroidism in some areas of Kerman province, especially Raver district located in North of Kerman province, this study was performed to determine and compare the urinary iodine concentration (UIC) in pregnant women referring to health centers.
Methods: This cross-sectional study was done during March 2014 and May 2015. Inclusion and exclusion criteria to be considered and UIC were measured by spectrophotometry in 384 and 374 pregnant women in Ravar and Kerman cities, Iran. Sampling method for this study was all of pregnant women in Ravar and random stratified sampling in Kerman. data were collected using a structured questionnaire. All statistical analyses were performed using SPSS Software, version 20.0 (IBM SPSS, Armonk, NY, USA). Chi-square test, Pearson's correlation coefficient and Logistic regression were used for associations and differences.
Results: The mean UIC was 200.21 µg/L in pregnant women of Ravar and 238.79 µg/L in pregnant women of Kerman. 22.7% of pregnant women were with low concentrations of iodine, 57.8% within the normal range and 19.5 percent were with high iodine concentrations in Ravar. While 5.3 percent of pregnant women were with low concentrations of iodine, 54.5% were within the normal range and 40.1% were with high UIC in Kerman. There were no significant differences between demographic variables and UIC in the two regions (P> 05/0). Multivariate regression models showed significant connections between the residence and UIC pregnant women (P< 0.001).
Conclusion: The results of this study showed that UIC in pregnant women of Ravar was significantly lower than Kerman and the place of living can be considered as a predictor of UIC in pregnant women.

Background: The study of their knowledge, attitude, and behavior toward health is an essential step for health planning. In the urban area, there are several concerns about environmental pollution, health status, the dangers of insecurity, and bad dietary habits. The aim of the study was the determination of knowledge, attitude, and behavior of Tehran citizens in order to plan better municipal services.
Methods: This descriptive, cross-sectional study was conducted on 13000 participants between 15-84 years in 22 districts of Tehran, Iran University of Medical Sciences, in August and September of 2011. Cluster sampling and self-administered reliable and valid questionnaire were used for data gathering. The inclusion criteria are all of citizens of Tehran. Age, sex, marital and job status, obesity, physical activity, hypertension, myocardial infarction, accidents, diabetes, nutrition, stroke, psychological behavior, smoking, addiction and drugs, musculoskeletal, sexual behavior, anemia, physical environment, fat blood, cancer, chronic obstructive pulmonary disease, dietary habits and socioeconomic status were measured under standard protocols and by using calibrated instruments. 
Results: From 13000 participants in the study, 11753 (90%) was fulfilled the questioners. Nonresponse rate from 11753 participants was 8.6%. The proportion of obesity/overweight was 50% and 29.5% of people had appropriate physical exercise, 37.6% reported a tobacco consumer in their family and 4.5% reported an experience of substance misuse. Also, 29.2% and 24.8% from these had anomalistic consuming of salt and soft drink, respectively. Of the participants, 44.8%, 89.1% had a good knowledge and attitude, respectively. Cronbach alpha coefficient was 0.82 and 0.79 for knowledge, attitude and behavior, respectively. In additional, the correlation coefficient between test and re-test questions was 0.91. 
Conclusion: This study was a comprehensive study to measure the knowledge, attitude and practice of Tehran citizens using reliable and valid questionnaires about general health status. A considerable percentage of Tehran citizens suffering from overweight, obesity, hypertension, diabetes, high blood lipids and smoking consuming and using anomalistic from TV and computer. The results can be used as a framework and guide to prioritize problems and planning health education interventions in Tehran

Background: Association of Addison's disease with connective tissue diseases such as scleroderma and Sjogren have been rarely reported. Anti-centromere antibody (ACA) has been associated with exocrine gland dysfunction in anti-Ro, anti-La negative Sjogren’s syndrome and may be one of the causes of xerostomia in community. The purpose of this article was to introduce a rare case of scleroderma-Sjogren intermediate phenotype with positive anti-centromere antibody in a known case of Addison’s disease admitted for dental caries and xerostomia.
Case Presentation: A 29-year-old woman with Addison’s disease referred to a dental clinic due to recurrent dental caries. Addison’s disease was confirmed by low basal serum cortisol level and unresponsive serum cortisol level to adrenocorticotropin hormone (rapid ACTH stimulation test). Signs of xerostomia, xerophthalmia, Raynaud’s phenomenon, gastro-esophageal reflux, masked face, osteoporosis, positive anti-centromere antibody, negative anti-Ro and anti-La antibodies and failure to match the pathology of the minor salivary gland of lip with Sjogren's disease were found. The diagnosis of scleroderma-Sjogren intermediate phenotype was raised with considering some of the symptoms of scleroderma and Sjogren and not the exact classification criteria for each of these two diseases. Hydroxychloroquine, fluoride and Biotene® mouthwash (Laclede, Inc., CA, USA) (oral moisturizing saliva), chewing gum containing xylitol plus artificial tear droplet was prescribed. Drinking plenty of fluids was recommended. Due to gastroesophageal reflux and osteoporosis, Pantoprazole and CinnoPar® (Cinnagen, Iran) (parathyroid hormone analogue) plus calcium and vitamin D supplements was administered. Regarding adrenal insufficiency, Prednisolone and Fludrocortisone were continued.
Conclusion: For evaluation of recurrent dental caries, especially in patients with autoimmune disease, anti-centromere antibody may be useful to identify the cause of dry mouth, as well as early detection of limited scleroderma or scleroderma-Sjogren intermediate phenotype.

Background: Glioma is one of the most common and deadliest primary malignant tumors in the brain. A large part of the gene expression products are non-coding protein RNA. LncRNA THRIL gene is an antisense LncRNA and one of the most important mediators of the NF-KB signaling pathway, that express in many tissues of the body, including the central nerve system (CNS). The aim of the present study was to investigate the alternation in the expression of LncRNA THRIL gene in cells of the adenocarcinoma glioblastoma T98G cell line, under treatment with temozolomide chemotherapy drug.
Methods: This case-control study was conducted in Research Center of Islamic Azad University of Zanjan, Iran, from April to September 2017. Cells of T98G cell line was treated with various doses of temozolomide chemotherapy drug (25-50-100 μM) and at different times (72-48-48 hours), Respectively RNA extraction and cDNA synthesis were performed. Then LncRNA THRIL gene expression was studied by real-time PCR method and the results were analyzed by relative quantitative and livak methods.
Results: The THRIL gene expression in 24 hours’ time with 25 and 100 μM doses (P< 0.001) had significant decreased expression and 50 μM dose had non-significant increase. It had significant increase in 48 hours time with 50 μM dose (P< 0.001), except 25 μM (P< 0.001) and 100 μM (P< 0.001) doses had significant decreased expression. It had significant increase during 72 hours time with 50 μM dose (P< 0.001), in contrast 25 μM (P> 0.001) and 100 μM (P< 0.001) concentrations of temozolomide chemotherapy drug demonstrated decreased expression of the LncRNA THRIL gene (P< 0.001).
Conclusion: As a result, the THRIL gene expression alterations after cancer cells treatment by temozolomide chemotherapy drug depends on the time and dose of the drug and the 48 hours treatment time with 50 μM dose (P< 0.001) had the highest effect on cancer cells of the T98G cell line, due to the expression of the THRIL gene.

Background: Breast cancer is a common malignancy in which early breast cancer detection by the help of imaging can improve the treatment outcome. Thermography utilizes infrared beams which are fast, non-invasive, and non-contact and the output created images by this technique are flexible and useful to monitor the temperature of the human body.
Case presentation: Our patient is a 25-year-old woman who was referred to Tehran's Imam Khomeini Hospital, Tehran University of Medical Sciences, in October 2014 and June 2017 to perform clinical examinations of breast cancer at the Invasive and New Radiology Research Center of Tehran. The results of the sonography for the left breast and bilateral axillary regions and sonography guided biopsy from the left axillary region indicated that:  it was consistent with the tangential prominence at 11-12 O’ clock in the left breast tissue and echo gene was found without any suspected findings. Then, using the non-contact infrared imaging camera VisIR 640 (Thermoteknix Systems Ltd, Cambridge, UK), the feasibility of thermography method in the patient's follow-up was investigated.
Conclusion: Thermography can be used to detect abnormal areas in the breast tissue that may have cystic origin. The results indicated that the accuracy of the identification and matching of patient cysts in mammography and ultrasonography with the results of thermography in both periods of October 2014 and June 2017. Considering the results, it is noteworthy that the diagnostic clock of the breast cysts in the patient is consistent with the results of the clinical trials with the thermography. Moreover, in a 2 years intervals, the status of thermal morphology status of the cystic region did not considerably change which showed a relatively stable status.

Background: Osteoporosis is the most common metabolic disease of the bone in the world, and has hit about 200 million people around the world and it increases the risk of fractures. More than 5 million osteoporotic fractures occur annually in the world. Bone mineral density is the standard method of diagnosis of this disease. In this method, proximal of femur (neck) and lumbar vertebra bones (L2, L3, L4, L5) are typically evaluated. The aim of this study was determine the bone density profile of one third of distal radial bone in patients with primary osteoporosis.
Methods: This cross-sectional study conducted at Shahid Beheshi hospital in Hamadan city, from October 2015 to October 2016. Among of the patients, those over the age of 50 years old, 71 patients were selected by convenience sampling method taking into account if they have inclusion criteria (such as: age> 50 years, no systemic diseases, no history of corticosteroid use). For all patients that enter the study, lumbar, femoral neck and one third of distal radial bone densitometry was done by dual X-ray absorptiometry (DXA) method. Osteopenia and normal bone density the World Health Organization criteria were used to determine osteoporosis.
Results: In this research 71 people entered the study. The mean age of the patients was 62.25±9.36 (51-92) years. In term of gender 5.63% of patients were male and 94.37% female. Pearson correlation coefficient showed a positive and significant correlation between the results of one third of distal radius with neck and total femur bone and lumbar bones (P<0.05). Correlation between the T-score of one third of distal radius and total femoral neck was statistically significant (P<0.05). The mean age of patients was 62.25±9.36 years.
Conclusion: According to the findings of this study one third of distal radial bone mineral density has an acceptable sensitivity to detect osteoporosis. Radius bone density decreases much faster than lumbar, vertebra and femoral neck.

Background: Hookah smoking has been growing among people because consumers believe that smoking in the form of hookahs has lesser health effects than cigarettes. However, recent reports showed that water pipe smoking (WSP) increased heart rate, blood pressure, impaired pulmonary function and carbon monoxide intoxication. Chronic bronchitis, emphysema and coronary artery disease are serious problems of long-term use of this kind of smoking. Lung, gastric and esophageal cancers are associated with WPS, as well as periodontal disease, and obstetrical complications. Hence purpose of this study was to survey the relationship between lung cancer and tobacco consumption in the form of hookah through meta-analysis.
Methods: In this meta-analysis study we conducted an electronically search in databases PubMed, MEDLINE and EMBASE to find relevant articles regarding the adverse effects of hookah smoking, using the terms ‘water pipe’ and its synonyms (hookah, shisha, goza, narghileh, arghileh and hubble-bubble) in various spellings in Iran University of Medical Sciences (IUMS), Tehran, Iran from January to May 2017. All articles including Cohort and case-control studies published between 1980 and 2017 and conducted in the world were included without restriction regarding publication language. The cross-sectional studies, case reports, conference abstracts, reviews and studies not conducted on humans were excluded. The article selection process and data extraction were performed by two independent investigators. The articles were evaluated using odds ratios, heterogeneity and distribution models.
Results: In this study, 120 articles related to the effect of hookah smoke on health were found. Of these articles, there were 9 articles related to the effect of hookah smoke on lung cancer. The results showed that hookah smoking could increases the risk of lung cancer with a chance ratio of 3.72 and a confidence interval of 4.85-2.60. Heterogeneity and distribution were not observed among selected articles.
Conclusion: There is accumulating evidence about the association of water pipe tobacco smoking with of lung cancer, which increases the risk of lung cancer due to water pipe tobacco smoking consumption.

Background: Hepatitis B is the most common blood-borne viral infection that is considered as a major public health problem of the world's major health problems. The aim of this study was to investigate the prevalence of hepatitis B virus (HBV) infection among blood donors referring to blood transfusion centers.
Methods: This retrospective cross-sectional study was performed on 216004 volunteer blood donors referring to blood transfusion centers of Iran from the beginning of April 2011 to April 2015. Then the positive hepatitis B surface antigen (HBsAg) test was performed using the enzyme-linked immunosorbent assay (ELISA) and neutralization methods.
Results: Of the 216004 blood donors, 279 (12.12%) were positive for HBsAg, and the incidence of infection was a decreasing trend over a four-year period. Among HbsAg positive cases, 97.14% and 2.86% were male and female, respectively. Significant differences between males and females were found (P=0.000). The number of HBsAg positive cases among married people (238 cases, 85.3%) in compared with single people (41 cases, 14.7%) was significantly higher (P=0.000). The average age of HBV infected cases was 39.6±10.3 years. Most HBsAg positive cases were 45-36 years old (30.8%) and lowest prevalence was seen in the age group above 56 years old (4.6%). Highest infected people with Hepatitis B Virus had low degree of education. Relationships between HBV infection with age and degree of education were statistically significant (P=0.000).
Conclusion: The results of this study showed that based on our findings, prevalence of hepatitis B surface antigen among blood donors have declined significantly during the four years of study.

Background: Tuberculosis (TB) is an important infectious disease with high mortality in the world. None of the countries stay safe from TB. Nowadays, different factors such as Co-morbidities, increase TB incidence. World Health Organization (WHO) last report about Iran's TB status shows rising trend of multidrug-resistant tuberculosis (MDR-TB) and HIV/TB. More than 95% illness and death of TB cases are in developing countries. The most infections are in South East Asia and West Pacific that 56% of them are new cases in the world. The incidence is actually new cases of each year. Incidence prediction is affecting TB prevention, management and control. The purpose of this study is designing and creating a system to predict TB incidence by time series artificial neural networks (ANN) in Iran.
Methods: This study is a retrospective analytic. 10651 TB cases that registered on Iran’s Stop TB System from March 2014 to March 2016, Were analyzed. Most of reliable data used directly, some of them merged together and create new indicators and two columns used to compute a new indicator. At first, effective variables were evaluating with correlation coefficient tests then extracting by linear regression on SPSS statistical software, version 20 (IBM, Armonk, NY, USA). We used different algorithms and number of neurons in hidden layer and delay in time series neural network. R, MSE (mean squared error) and regression graph were used for compare and select the best network. Incidence prediction neural network were designed on MATLAB® software, version R2014a (Mathworks Inc., Natick, MA, USA).
Results: At first, 23 independent variables entered to study. After correlation coefficient and regression, 12 variables with P≤0.01 in Spearman and P≤0.05 in Pearson were selected. We had the best value of R, MSE (mean squared error) and also regression graph in train, validation and tested by Bayesian regularization algorithm with 10 neuron in hidden layer and two delay.
Conclusion: This study showed that artificial neural network had acceptable function to extract knowledge from TB raw data; ANN is beneficial to TB incidence prediction.

Background: Dermatophytes create the most common fungal disease in humans, called dermatophytosis. The two species of Trichophyton rubrum and Trichophyton interdigital are responsible for over 80% of types of dermatophytosis. So far, several morphological and physiological methods have been used to differentiate these very similar species, but these methods are generally time-consuming and have low specificity. The purpose of this study was to introduce a simple and rapid duplex polymerase chain reaction (PCR) reaction to differentiate these two species from each other.
Methods: This research was an analytical and experimental study that was carried out from 2017 to 2018 in the Medical Mycology Laboratory, School of Public Health, Tehran University of Medical Sciences, Iran. For this purpose, the nucleotide sequences of the 4 regions of internal transcribed spacer (ITS), beta-tubulin, elongation factor 1 alpha and calmodulin in the two considered species of fungi were conducted bioinformatics analysis. The differences and similarities of nucleotides between two species in each of these genes were studied for selecting the primer. The specificity of selected primers was tested for duplex PCR reaction against sequenced isolates of dermatophyte species.
Results: According to the total data, the specific primers were selected from elongation factor 1 alpha gene. These primers produced a product of 173 and 384 bp, in Trichophyton rubrum and Trichophyton interdigital, respectively. They had high specificity in the face of various dermatophytes. The length of nucleotide sequences found in the genebank of this gene in the two species is between 700 and 770 bp. The similarity of the two species in this region is 94.6% and differs by 78 bp. Of the 107 extracted DNAs from clinical dermatophyte isolates, in duplex PCR 24 isolates were positive with Trichophyton interdigital primer and 71 isolates against Trichophyton rubrum. The remaining isolates, which included 6, were negative in this reaction, which included other dermatophyte species.
Conclusion: This method is a specific and fast differential method compared to conventional methods for identifying Trichophyton rubrum and Trichophyton interdigital from each other.

Currently, there are about 37 million people worldwide living with human immunodeficiency virus (HIV) /AIDS, with an estimated two million new cases per year globally. According to estimates from the World Health Organization (WHO), only 75% of the population with HIV know their status. Initially, HIV infection was associated with significantly increased rates of mortality and morbidity. However, the rapid advances in treatment and the advent of different classes of antiretroviral drugs over time have led to change the face of HIV/AIDS from a deadly infection to chronic and manageable disease. There is strong evidence that HIV-infected patients undergoing antiretroviral therapy have longer lives and are less likely to transmit infection to their sexual partners. Since the introduction of zidovudine in 1987 as the first antiretroviral drug, significant strides have been made in antiretroviral therapy. The introduction of potent antiretroviral drugs for the treatment of HIV infection has been one of the significant events in the evolution of modern medicine. Antiretroviral therapy refers to the use of drugs in the treatment of HIV. Generally, these drugs are categorized based on the steps of the HIV life cycle suppressed by them. There are six main classes of antiretroviral agents including nucleoside/ nucleotide reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, fusion inhibitors, co-receptor inhibitors, and integrase inhibitors. Combination antiretroviral therapy should be considered for HIV patients to achieve the highest viral suppression rate, and to reduce the risk of resistance development and morbidity and mortality associated with AIDS. Achieving and maintaining HIV viral load suppression among treated patients has remarkably increased over the last years due to the development of potent and well-tolerated agents which can be co-formulated as a once-daily single-tablet or fixed-dose combination for simplification. However, there are some limitations preventing patients to benefit from this treatment. The main goals of HIV therapy in the future are to overcome the limitations of current treatment, including side effects. This review will provide an overview of advances in the current antiretroviral drugs by focusing on their pharmacokinetics, mechanism of action, dosing recommendations, and adverse events for each drug class.

Background: AIDS is an emerging disease, and despite the fact that it has not been recognized for the first half-century since its inception, it has been known as a century-old disaster. This disease, by proliferation in immune cells and ultimately by weakening the immune system, makes people vulnerable to diseases. Our study seeks to examine existing cases of HIV/AIDS patients in East Azerbaijan province in Iran and provides useful guidance for patient diagnosis, treatment, and care.
Methods: This is a descriptive-analytic study in which the target group includes all HIV-positive or AIDS patients identified or reported from 2004 to 2014 in Tabriz Medical Sciences or Health Centers of East Azerbaijan province. The demographic information of all patients were recorded by a researcher-made questionnaire during visiting the disease-management counseling centers. All data including transmission of the illness (including all possible ways), the diagnostic date, the onset of treatment and the date of death were collected, and then entered into the software Stata, version 11.0 (Stata Corp., College Station, TX, USA). The information were imported in the ArcGIS software, version 10.7.1 (ESRI Inc., Redlands, CA, USA), maps were created, and geographic and spatial data were analyzed.
Results: According to the results of this study, most patients with 89.9% were male, 28.9% were under the age of 36 years, 32.3% had elementary education, and the most common way of transmission with 42.3% is through the shared infusion.
Conclusion: According to the results of this study, the highest prevalence of AIDS in East Azerbaijan province was observed in men under the age of 36 years and primary and lower secondary education in Tabriz and Maragheh cities.

Background: Curcuma longa generally known as turmeric includes curcuminoids and sesquiterpenoids as components, which are known to have antioxidative, anticarcinogenic, and anti-inflammatory activities. Iron, magnetite, and hematite as a micronutrient play an important role in physiological and chemical processes. Chitosan is a natural polymer derived from chitin and is recognized as versatile biomaterials because of their high biocompatibility, nontoxicity, and biodegradability to harmless products. The purpose of this research was to design synthesis and loading of nanocurcumin on iron magnetic nanoparticles modified with chitosan which is used as a targeted drug.
Methods: This laboratory research was conducted in Aja University of Medical Sciences from May to November 2017. Loading of nanocurcumin on iron magnetic nanoparticles modified with chitosan was done in two steps. In the first step, after preparing chitosan and iron magnetic nanoparticles, chitosan is placed as a coating polymer on surface of iron magnetic nanoparticles. In the next step, the final reaction is done by adding nanocurcumin on iron magnetic nanoparticles modified with chitosan. This causes nanocurcumin to penetrate into the polymeric layer core shell nanoparticles.
Results: Findings of transmission electron microscope and scanning electron microscope images show structure, morphology, physicochemical and the presence of nanocurcumin layers on chitosan in nanoparticles with diameter of 20 nm well. In Fourier transform infrared spectroscopy (FTIR), the Fe-O peak indicates magnetic nanoparticles and peak of the O-H in nanocurcumin layers on chitosan. Energy dispersive X-ray spectroscopy spectrum showing iron, carbon, oxygen and nitrogen peaks confirms the presence of these elements in the final composition and shows that chitosan and nanocurcumin groups are well dispersed on iron magnetic nanoparticles. The nanocurcumin loaded at 450 nm wavelength was evaluated by ultraviolet-visible spectrophotometry.
Conclusion: Results of Fourier transform infrared spectroscopy (FTIR), field emission scanning electron microscope image, energy dispersive X-ray spectroscopy spectrum, transmission electron microscope image, vibrating sample magnetometer analysis indicated that nanocurcumin has been successfully loaded on iron magnetic nanoparticles modified with chitosan and can be used as a targeted drug.

Background: Potency evaluation of rabies vaccine is a cheap, fast, high precision and consistent with ethical values is critical, so researchers have modified a variety of methods such as: National Institute of Health (NIH) method, Single Radial Immunodiffusion (SRID) and so on. The purpose of the present study was to replace an in vitro method consistent with medical ethics criteria instead of an in vivo method. By recognizing that the potency of the rabies vaccine depends on the amount of glycoprotein antigen content and the monoclonal antibody detect the correct folding of antigen of the rabies virus, then the glycoprotein content could be represent of vaccine potency.
Methods: In this study, we designed an immune-capture enzyme-linked immunosorbent assay (ELISA) with three antibodies (capture, primary and secondary) to determine the existent amount of viral glycoprotein in different rabies vaccines, and compared the results at the same time with measuring potency of those vaccines using the NIH method. This applied study was conducted from September 2016 to September 2018 at the Research Laboratory of the World Health Organization Collaborating Center for reference and research on rabies at the Pasteur Institute of Iran in Tehran.
Results: The slope of the standard line was calculated to R2=0.98 (P=0.0013). In the humans’ vaccines, the mean lied between 5.554-7.336 (SD=0.0463-0.1039) and the coefficient of variation was 0.778-2.436 (SD=0.0041-0.2724), at the same time in the animals’ vaccines the mean were 2.293-5.993 (SD=0.0041-0.2724) and the coefficient of variation was calculated 0.182-4.546. For animal vaccines the Pearson correlation coefficient is 0.99 and for the human vaccines this coefficient was 0.95. Also, the concordance correlation coefficient for animal vaccines was 0.98 and for human vaccines is 0.95, indicating a moderate to high concordance in both animals and humans vaccines.
Conclusion: The designed Immuno-capture ELISA kit had a proper acceptance criterion, intermediate precision, good linearity and robustness for measuring the glycoprotein level of the vaccine, which was directly related to the vaccine potency.

Background: Ensuring adequate depth of anesthesia during surgery is essential for anesthesiologists to prevent the occurrence of unwanted alertness during surgery or failure to return to consciousness. Since the purpose of using anesthetics is to affect the central nervous system, brain signal processing such as electroencephalography (EEG) can be used to predict different levels of anesthesia. Anesthesia disrupts the interaction between different regions of the brain, so brain connectivity between different areas can be a key factor in the anesthesia process. This study aims to determine the depth of anesthesia based on the EEG signal using the effective brain connectivity between frontal and temporal regions.
Methods: This study, which is done from April to December 2018 in Tehran, used EEG signals recorded from eight patients undergoing Propofol anesthesia at Waikato Hospital of New Zealand. In this study, effective brain connectivity in the frontal and temporal regions have been extracted by using various Granger causality methods, including directional transfer function, normalized directional transfer function, partial coherence, partial oriented coherence, and imaginary coherence. The extraction of effective connectivity indices in three modes (awake, anesthesia and recovery) was calculated using MATLAB software. The perceptron neural network is then used to automatically classify the anesthetic phases (Awake, Anesthesia, and recovery).

Background: One of the most important duties of a family physician is primary health care. The family doctor plan is one of the developmental measures to provide easy and low-cost access for patients to health care centers. The family doctor and her team are fully responsible for the health of the individuals and families covered. Therefore, this study was conducted to assess the satisfaction of rural areas of Rafsanjan city with the family physician plan.
Methods: This study is a descriptive-analytical study that was conducted in rural areas of Rafsanjan from October to December 2018. The study population consisted of twelve randomly selected villages in Rafsanjan. The required sample size was examined according to the size of the statistical population of 480 people. In this study, to collect the required data, a researcher-made checklist was used, which was prepared by reviewing the texts of the questions. The sampling method was cluster random. To check the validity of the checklist, the opinions of 10 health education experts were used. To check the reliability, the checklist was provided to 20 villagers and the reliability was determined using Cronbach's alpha method of 82%. The mean was used to describe the data and inferential statistics t-test and ANOVA were used to analyze the data and analyzed by SPSS.