Tehran University Medical Journal

Herbal essential oils are volatile, natural, complex compounds formed by medicinal plants as secondary metabolites. As reported by international organization for standardization (ISO), the term "essential oils" (EOs) is defined for a product obtained from vegetable raw materials or fruit using distillation with water or steam. The EOs are generally complex mixtures of volatile organic compounds include hydrocarbons (terpenes and sesquiterpenes) and oxygenated compounds (alcohols, esters, ethers, aldehydes, ketones, lactones, phenols, and phenol ethers) compounds. In medicinal plants, the EOs chemical profile usually very varies because of both intrinsic (sexual, seasonal, ontogenetic, and genetic variations) and extrinsic (ecological and environmental aspects) factors, also the EOs composition differs not only in the number and type of molecules but also in their stereochemical structures, and can be very different according to the extraction method. EOs represents a “green” alternative in the nutritional and pharmaceutical fields due to reported antimicrobial, antioxidant, anti-inflammatory and anticancer properties thus, in recent times; EOs has gained great popularity as consumers have developed a particular ever-growing awareness toward the use of natural ingredients, especially in food and household. Therefore, the present review provides a comprehensive summary on the method of preparation of EOs from medicinal plants, chemical composition analysis, their biological and pharmacological effects and their potential benefits on health level. Present information was compiled using keywords “Essential oil, Medicinal Plants and Natural additive in scientific database as Science Direct, Elsevier, PubMed, Google scholar and SID, until 2005 to 2015. EOs have great antimicrobial activity and mostly destroy bacteria, fungi and viruses without harmful effects on consumer’s health. Finding of this study showed that the Thymol, α-Pinene, β-Pinene, Cumin Aldehyde, Carvacrol, Germacrene, Linalool were the main components. Also, EOs have antioxidant, anti-inflammatory and many other pharmacological properties which enhance their potential application. EOs have potential biological and pharmacological activities and so have many applications in pharmaceutical and food industries.

Background: The most common cause of death in thalassemic patients is cardiac involvement especially cardiomyopathy. If the early stages of heart disease in people with thalassemia are diagnosed, mortality of patients reduced significantly. In this case-control study we compare the clinical symptoms, signs and para-clinic finding in thalassemia patients with control group.
Methods: In this case-control study, thalassemia patients who had visited in special clinic of Vali-e-Asr hospital of Birjand University Medical Sciences during January of 2013 to May of 2014 compared with normal subjects. They matched by age and sex. After explaining the aims of the project, the written consent was received from both groups. Clinical examinations including history taking and auscultation of heart and lungs were performed by Pediatrician. Moreover, using the standard methods, the measurement of height, weight and blood pressure were performed. In following, electrocardiography (ECG) was taken in both groups. Also, both groups underwent transthoracic echocardiography by one cardiologist.
Results: 42 thalassemia patients and 42 healthy subjects was compared in this study. Dyspnea was the only different symptom in the two groups. (23.8% in case and 4.8% in control P=0.01) In physical examination respiratory rate (RR) is only higher in patients with thalassemia that controls, but heart rate (HR), abnormal heart and lung sounds were not different significantly between two groups. In ECG, PR interval and QTc interval in patients with thalassemia was longer than healthy subject. In echocardiography, ejection fraction was lower but left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and size of the right ventricle and pulmonary artery pressure (PAP) was significantly higher than those in the control group.
Conclusion: According the result of this study, dyspnea was higher in patients with thalassemia from normal subjects and PR interval and QT interval was longer in thalassemic patients. As well as the size of the left ventricle, size of right ventricle, pulmonary artery pressure were higher than normal population. Also, LV ejection fraction was lower in thalassemia than normal population.

Cancer is the major cause of death in the world and the rate of mortality is higher in developed countries. Therefore, lifestyle could be effective in promoting the cancer. The pancreatic tumors, are 8th cause of mortality due to cancer, which have several types, among them ductal adenocarcinoma is the most common and includes 85% of cases. Since, it is almost impossible to diagnosis the tumor in early stages of the disease, it contributes to high rates of mortality, although if it diagnosis in early stage and the surgery performed for them only 10-20% of patients will be survived. Metastasis occurs when the tumor is smaller than 2 cm in size and because the pancreas is located in the depth of abdomen, typically, it happens after tumor is spread to other organs. A combination of medical imaging, blood tests, and examination of tissue samples are usually made for diagnosis and based on the cancer stage, surgery, radiotherapy and chemotherapy are chosen as treatment options. Some rare genetic variations can cause pancreatic cancer and about 5-10% of cases are linked to inherited genes. However, major risk factors are including age, obesity, tobacco smoking and diabetes. Smoking counts for about 25% of cases, and the diabetes is the main symptoms of pancreatic cancer, which observed in about 80% of cases. But, it is still unclear whether diabetes is a predisposing factor in pancreatic cancer, or the outcome of tumor progression. Recent studies have shown that, diabetes is unique in pancreatic cancer which is not related to common types. Currently, CA 19-9 is the only reliable tumor marker for pancreatic cancer that its frequency also increases in non-bad conditions, such as pancreatitis and obstructive jaundice, so is not sensitive and specific enough for diagnosis of this cancer. Due to researches continue to find more specific markers. In this review the etiology of pancreatic cancer, diabetes associated with this type of cancer and significant biomarkers for diagnosis will be considered.

Pregnancy as a natural event leads to changes in various aspects of physiology, psychology, and social life. The adoption of a health promoting lifestyle is an important strategy for achieving the desired outcomes of pregnancy and is important on the future health of mother and child. The aim of this study was to assess the various aspects of health promotion behaviors during pregnancy. The data was obtained with advanced search in the Iranmedex, Magiran, Scientific Information Database (SID), IranDoc, PubMed, Google Scholar, Web of Science and Scopus databases. Articles containing full text were collected using the proper keywords for Persian articles and their equivalent in Mesh included “Health promotion" OR "Behavior health "OR “Health Promoting Lifestyle” AND pregnancy for English articles with a time limitation of 2010 to 2017. At first 3247 articles obtained after reviewing and evaluation of the references, 4 Persian and 25 English articles with observational and qualitative design were included. A review of studies showed that finding a way to pass pregnancy safely is the most important concern for mothers. Pregnant women do some actions to reach favorable outcomes and they have a high incentive to adopt health behaviors during pregnancy due to fear of fetal health, but there is some obstacle to adopt health behaviors including individual factors like that lack of time and inadequate information about pregnancy or health-related functions and social factors including health system problems and cultural factors. In addition age, level of education, individual’s beliefs and factors associated with pregnancy such as high-risk pregnancy and environmental factors such as social support and health system performance play an important role in the adoption of health behaviors. In order to increase the potential of pregnant women to adopt healthy behaviors, changing the health system approach and paying attention to social determinants of health, in order to carry out the necessary interventions, it is recommended to conduct qualitative studies and appropriate design for deep study of the subject in the cultural background.

Background: Genital warts are one of the most common sexually transmitted infections, 1% of sexually active population have anogenital warts (AGWs). According to previous studies, the disease affects people's quality of life and imposes financial costs on health systems.
Methods: The present study is a case-control study at spring of 2018. The quality of life of 65 patients with anogenital warts that were referred to Boali-sina Hospital in Sari, Iran compared with 65 control subjects. The World Health Organization Quality of Life Brief (WHOQOL-BREF) questionnaires was used.
Results: According to the results, among the patients with anogenital warts, the quality of sexual contact in majority them were not affected by the disease (70%). The total cost of treatment was less than the monthly income of the family until the time of participating in the study (92%). There was no significant difference between the mean and standard deviation of physical health scores and mental health scores in the control and patient groups. (Respectively P=0.14, P=0.93). There was no significant relationship between the mean of physical health scores with disease severity. However, there was a significant difference between the mental health score in the two groups of patients with low and high levels of severity (P=0.01). Physical health scores in the whole sample have a significant relationship with gender, so that, in women, physical health score was lower than that of male, but the mean score of mental health in both male and female patients was not significantly different (P=0.18). In the control group the score of mental health was lower in women (P=0.041).
Conclusion: In patients with anogenital wart, quality of life doesn’t change significantly, although, mental health scores directly related with disease severity.

Background: Diffusion-weighted imaging (DWI) is one of methods in evaluation of breast lesions. We aimed to investigate the apparent diffusion coefficient (ADC) values in breast tumors and their accuracy in differentiating benign versus malignant lesions.
Methods: In this cross-sectional study, 72 patients with 88 breast lesions were investigated by 1.5-T breast MRI from 2015 to 2017 in Athari Imaging Center in Tehran, Iran. Nearly all patients has undergone histopathology evaluation. One small region of interest (ROI) were placed on the most restricted region inside the solid part on the ADC map. Care was taken to avoid cystic or necrotic, fatty regions and hematoma inside the mass. A large round ROIs were placed in healthy fibroglandular tissue of contralateral breast ADC values were measured and compared in normal breast tissue and in most restricted parts of breast lesions (mass and non-mass). After determining cut-off for differentiation of benign and malignant lesions, sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated.
Results: Mean age of patients was 43.3 years. The average tumor size of benign and malignant lesions were calculated 26.0 mm, 35.3 mm respectively and 23 mm and 46 mm in mass and non-mass respectively. Invasive ductal carcinoma include the majority of pathology result (in 37.5% of the patients). Our results revealed that the measured ADC values in normal breast tissue were higher than breast lesions (P≤0.01). Mean ADC value in benign lesions was 1.40×10-3 mm²/s and for malignant lesion was 1.08×10-3 mm²/s. ADC value in the normal breast tissue was 1.79×10-3 mm2/s and was significantly higher than ADC value of breast lesions (benign and malignant). Cut-off value in non-mass was not valid, but in mass was 1.19×10-3 mm²/s with sensitivity, specificity, positive predictive value, negative predictive and accuracy of 89.7%, 83.8%, 87.5%, 86.6%, and 87.1% respectively.
Conclusion: In DWI imaging, ADC value can differentiate benign and malignant masses with high sensitivity and specificity but not helpful in non-mass lesions.

Background: Researchers and health specialists are increasingly obtaining information on chronic illnesses from self-reports. This study validates self-reports of hypertension, based on a recently fielded survey in Mashhad City, Iran.
Methods: In this cross-sectional study, we used the results of 2015 census in Mashhad City, a population based survey of people over the age of 30 (n=300745) to determine the proportion of self-reported hypertension. In this study, the data of the studied population was extracted from the databank of Sina Electronic Health Record System (SinaEHR®) and patients with ICD10 codes including I10 and I11 approved by doctors as a reference. Finally using SPSS software, version 20 (SPSS Inc., Chicago, IL, USA) and MedCalc (https://www.medcalc.org/calc/odds_ratio.php), sensitivity, specificity, positive predictive value, negative predictive value were calculated with 95% confidence interval.
Results: Sensitivity of self-reported hypertension was 23.92% (CI95%: 23.43-24.41), specificity 97.03% (CI95%: 96.97-97.09), Positive Linkelihood Ratio 8.06% (CI95%: 7.82-8.30), Negative Linkelihood Ratio 0.78% (CI95%: 0.78-0.79), Positive Predictive Value 46.34% (CI95%: 45.60-47.08), Negative Predictive Value 92.25% (CI95%: 92.20-92.29). The self-reported sensitivity to hypertension in males, Iranian individuals, single, aged 60 and over, body mass index lower 18.5 individual with university education was higher, which was 24.67%, 31.09%, 30.07%, 32.43% and 26.03% respectively.
Conclusion: Although the sensitivity of self-reported hypertension was poor in this study, but specificity and positive and negative predictive values were fairly good.

Background: TRX training is a new training method that has beneficial effects on improving balance and strength. However, the role of these types of training on the factors associated with function and mitochondrial biogenesis is not understood. Therefore, the purpose of present study was to determine the effect of eight weeks of TRX training on serum levels of Peroxisome proliferator-activated receptor-γ coactivator 1α (PGC-1α) and citrate synthase in overweight women.
Methods: All subjects gave written informed consent after a detailed description of the study procedures. The protocol of this study was approved by the Research Ethics Committee of Sport Sciences Research Institute (SSRI) in Iran. The present study was experimental and was conducted in Shahid Ghaffari women's club in Tehran under the supervision of Alzahra University from May 2018 to January 2019. For this purpose, 30 overweight women after primary alignment on basis of body mass index (25-30 kg/m2) were divided into two groups: control (n=14) and TRX training (n=16). The TRX training protocol was performed for eight weeks and 3 sessions per week, which included 6 main movements (squat, rear deltoid row, biceps curl, chest press, low row, rotational ward) that lasted 60 minutes per session. According to consideration the physical condition of each person, the subjects were free to modulate the exercise intensity by changing the body inclinations. Each exercise provided 4 sets of 12 repetitions separated by one-minute rest. Blood sampling was performed in two stages of pre-test and 48 hours after the last session of the exercise in overnight fasting state. After collection of serum samples, enzyme-linked immunosorbent assay (ELISA) method was used to measure serum levels of PGC-1α and citrate synthase.
Results: The results showed that TRX training caused no significant change in the body weight and body mass index compared to the control group. In addition, TRX training increased significantly the serum levels of PGC-1α and citrate synthase compared to the pre-test and the control group.
Conclusion: The findings of the present study indicated that eight weeks of TRX training could increase serum levels of PGC-1α and citrate synthase in overweight women.

Background: Human papillomavirus (HPV) is a large group of DNA viruses that cause skin and mucosal warts. Zinc is used in the treatment of skin diseases. Zinc has been used in the treatment of various skin and systemic diseases. Warts are benign proliferation of the skin and mucosa. The prevalence of skin warts is higher in children and its peak is in adolescence and then decreases with age. Some species of HPV can cause malignancies. The effective role of zinc in the treatment of warts has recently been discussed. This study aimed to evaluate the serum zinc levels in patients with cutaneous warts compared to healthy controls.
Methods: This case-control study was performed on patients, aged 18 to 60 years old, referred to the Dermatology Clinic of Bo’Ali Sina and Razi Hospitals, Mazandaran Province in, Iran, from April to March 2016. Serum zinc level and severity of disease were assessed in case and control groups. Data were analyzed by SPSS software, version 22 (SPSS Inc., Chicago, IL, USA).
Results: A total of 94 subjects (47 in the case and control group) entered the study. The mean age of the case group was 26.40±9.33 years and in the control group 28.32±7.35 years. The gender status was 42 (44.7%) male and 52 (56.3%) female. Single and married were 63.8% and 36.2%, respectively. The mean zinc level in patients with cutaneous wart was 82 and the control group was 85.65. The mean number of warts was 5.09±6.33. The most frequent site of lesions were on the hands and foot with 48.93% and 40.42%, respectively, and the face (3.2%) had the lowest rate. Almost half of the patients were affected by the disease for 12 to 18 months. There was no significant relationship between age, sex, and severity of disease with serum zinc level (P>0.05). Serum zinc level was significantly associated with the duration of warts involvement (P=0.043).
Conclusion: Serum zinc levels were lower in patients with cutaneous warts than in healthy controls, but this difference was not statistically significant. Serum zinc level and duration of warts involvement were related. The duration of warts and serum levels were inversely correlated.

Background: Despite exist several centers of excellence in the various medical field in the country, most of them lack a single procedure and organizational structures in their functioning, organizing, targeting, etc. So the study aimed to design an organizational model that meets the goals and mission of them in the field of medical sciences.
Methods: This qualitative and applied research was conducted in two comparative and analytical stages from May 2016 to February 2017 in Iran. The location of the study includes a university, research institute, health center, or research center known as a center of excellence. In the analytical stage, 10 experts and managers of the top centers were selected through a targeted sampling method as a study sample. In the comparative section, all 50 centers of excellence and similar specimens in the world were selected. The data collection tool was a semi-structured interview in the analytical section and the ministry of health's documents. In comparative section data, bases and official sites of the centers were analyzed.

Background: Non-viral Nano carriers such as liposomes and cationic polymers based on engineered properties are regarded in gene delivery field. Although these carriers do not have weaknesses of viral vectors, but they are less efficient than viruses and they still need to be improved as favorable gene delivery carriers. Amongst non-viral carriers, cationic liposomes have been proposed for clinical applications, but limitations such as low nucleic acid transfer and endosome escape and conduction of plasmid to the nucleus have challenged their use in clinical trials. Therefore, the combination of liposomes and cationic polymers for nucleic acid transfer has been considered because this approach makes it possible to use the desirable properties of liposomes and polymers so that it is even suggested for the gene treatment of some diseases such as Parkinson's. In this study, a combination of liposomes and cationic polymers were used for the preparation of lipopolyplexes. This approach allows simultaneous utilizing of the desirable properties of liposomes and polymers.
Methods: This interventional-experimental study was conducted in the medical faculty of Mashhad University of Medical Sciences from April 2017 to February 2018. In this study, PEI-based lipopolyplex with a molecular weight of 25 and 10 kDa and a liposome-to-polymer ratio of 1:1 were combined with plasmid containing the GFP (Green Fluorescent Protein) marker. The physicochemical properties of the synthesized carriers such as size, cytotoxicity and gene transferability in human prostate cancer (PC3) cells were evaluated.

Background: Dermatophyte is a group of keratinophilic fungi that cause various skin lesions depending on the affected area. Dermatophytosis is usually diagnosed by clinical manifestation and confirmed by direct microscopy or fungal culture. There might be diagnostic difficulty with the presence of atypical dermatophytosis. Atypical dermatophytosis presents with clinical appearances ranging from eczematous, psoriasiform, pustular lesions, and others, that interferes with early diagnosis and disturbs patient’s life quality. Genital dermatophytosis is an uncommon presentation of cutaneous fungal infection; moreover, its manifestation without the involvement of the inguinal area, and simulating wart is a rare sign. In this study, we introduce a rare case of dermatophytosis with a wart-like appearance that was restricted to the skin of the genitalia.

Background: SLC39A6 Protein (solute carrier family 39) or LIV-1 is a zinc transporter protein that is overexpressed in positive estrogen cancers such as breast cancer. The LIV-1 protein transfer zinc into the cytoplasm through the plasma membrane. Today it is known that just as a decrease in the concentration of zinc in the cell can cause cancer, an excessive increase in the concentration of zinc can also stimulate irregular cell division and caused cancer. Thus, inhibition of zinc transporter protein may play a role in preventing malignancies and metastasis. It can also be used as a diagnostic marker in the diagnosis of cancers in various laboratory methods. The present study was performed to prepare a polyclonal camel antibody for the detection of LIV-1 protein at the cell surface.
Methods: This study was started in the Pasture Institute of Iran in 2018 September and finished in February 2020. An expression construct containing the human LIV-1 gene was prepared and transferred to the E.coli BL21 by chemical (CaCl2) and heat shock method. The expression of the protein was induced by IPTG and then protein was purified by affinity (Ni-NTA) chromatography. After preparing recombinant protein one female camel was immunized, 6 times at two weeks intervals with Freund's adjuvant. After immunization, the isolated polyclonal antibody was evaluated by ELISA, western blotting and flow cytometry in the detection of LIV-1 protein.

Background: Patients with severe mental illnesses are more prone to experience sexual health problems. Herein, we developed a "Safe Sex Knowledge and Behavior Questionnaire for Patients with Severe Mental Illnesses"(SSKBQ-SMI).
Methods: The present study was conducted in the form of methodological research in 4 stages. In the first stage, items of the questionnaire were selected and the item pool was formed by using similar studies and experts' opinions. During the next steps, the psychometric properties of the questionnaire were assessed using content validity, face validity, reliability and construct validity. The content validity was tested using the Content Validity Index and Content Validity Ratio. The charts of content validity were given to 13 specialists expert in sexual health including psychiatrists, clinical psychologists, gynecologists, urologists, and infectious disease specialists. The reliability was tested by using the test-retest method in 70 patients with two-week intervals. The construct validity was tested using exploratory factor analysis in 265 patients. The internal consistency was calculated by using Cronbach's alpha index.

Results: Female students whose mothers were illiterate were 3.51 times more likely to develop head lice. Students who bathed once a week were 0.03 times more likely, and those who shared personal items were 3.6 times more likely to develop the disease.   In terms of father occupation, the highest incidence of head lice among the subjects was 8 people (66.7%) related to people whose father job was free and the lowest was related to other occupations of 4 people (33.4%). There was no significant relationship between     father's job and head lice infection in the subjects (P=0.061). Conclusion: The results of this study indicate the high infection rate of head lice in elementary school students of Kerman. This high level of infestation can cause more contamination among female students consequently, and may cause students to drop out of the school. Serious attention to reducing this infection by holding educational classes for school principals and teachers, as well as parents, seems necessary.

Background: Double lumen tube (DLT) is used in lung surgeries. Classically, the patient should undergo fiberoptic bronchoscopy (FOB) to confirm the location of the DLT and its proper function. However, the sensitivity of ultrasound and clinical methods in diagnosing the correct position of DLT has not yet been definitively determined. This study was designed to assess the accuracy of point-of-care ultrasound and auscultation versus Fiberoptic Bronchoscope in determining the position of the Double-Lumen Tube.
Methods: This cross-sectional study of diagnostic value measurement type was conducted on patients who were candidates for double lumen implantation. After induction of anesthesia, DLT with the appropriate size was implanted, and then the position of DLT was evaluated. In the first step, the lungs were examined by auscultation, then the ultrasound was performed, and two signs of lung pulse sign and lung sliding sign were examined as signs of normal lung and ventilated lung. FOB was performed by an anesthesiologist. At the end, by opening the chest after surgery, the surgeon's opinion about the quality of lung collapse was recorded.

Results: In our study, the correct placement of the tube was correct in 37 cases and wrong in 3 cases, which were checked and corrected by FOB. Vital signs of the patients were stable before and during the operation. There were no problems with anesthesia during the surgery. Diagnostic sensitivity of lung auscultation clinical examination was 64.9% and chest ultrasound was 91.9%. The sensitivity of ultrasound compared to auscultation was not significant (P=0.242), but there was a clinically significant difference in the positive predictive value of the two, so that the positive predictive value of lung auscultation was 88.9% and lung ultrasound was 91.9%. In terms of surgeon satisfaction level, 22 cases (59.5%) had excellent satisfaction and 15 cases (40.5%) had moderate satisfaction. The sensitivity of ultrasound was not significant in comparison with the surgeon's satisfaction. Conclusion: Ultrasound can be a good substitute for FOB. Although ultrasound cannot have all the functions of FOB, but having advantages such as lower cost, speed of operation, and non-invasiveness, makes it more practical than FOB.

Background: The aim of this study was to identify the associated risk factors of premature rupture of membranes (PROM) and preterm premature rupture of membranes (PPROM).
Methods: This retrospective case-control study was conducted at Firooz-abadi Hospital between 2019 and 2021. The study included 90 pregnant women diagnosed with PROM or PPROM (case group), compared with 90 women without this complication (control group) who presented to the hospital during the specified period. Demographic and clinical information of the case group was collected and compared with data from 90 pregnant women in the control group, matched for gestational age and other relevant factors. Statistical analysis was performed to assess the differences between the groups.

Results: Maternal age and weight were found to be significantly lower in the case group compared to the control group (P=0.02, P<0.001, respectively). This suggests that younger age and lower maternal weight may be risk factors for PROM and PPROM. Furthermore, the number of women with a history of PROM or PPROM was significantly higher in the Case group (P<0.001), indicating that a previous occurrence of membrane rupture increases the risk of subsequent incident. In addition, the study findings showed a significantly higher rate of smoking among pregnant women in the case group compared to the control group (P=0.04). Moreover, the occurrence of urinary tract infections during pregnancy and chorioamnionitis was significantly higher in the case group (P<0.001), suggesting that these infections may contribute to membrane rupture. Conclusion: In conclusion, our study provides valuable insights into the risk factors associated with PROM and PPROM. It highlights that lower maternal age and weight, a history of PROM or PPROM, lower gestational age, a history of gestational diabetes mellitus and first-trimester bleeding, smoking, and urinary tract infections during pregnancy are significantly associated with an increased risk of PROM and PPROM. These findings emphasize the importance of early identification and management of these risk factors in order to prevent or mitigate the occurrence of PROM and PPROM, ultimately improving maternal and neonatal outcomes. Further research and public health initiatives are warranted to raise awareness and promote preventive measures targeting these identified risk factors.

Background: Prostate cancer is one of the most common cancers in the world, which is associated with a high prevalence, especially in the elderly male population. Treatment options for non-metastatic prostate cancer usually include active surveillance, radiotherapy and surgery, so the aim of the present study is a systematic review of brachytherapy in the treatment of prostate cancer.
Methods: The study conducted is a systematic review article in which a review of the treatment of prostate cancer with brachytherapy has been done. The information used is taken from articles published in Persian and English in Google scholar, SID and PubMed databases from 2000 to 2022. The selected keywords in this article included Brachy therapy, Prostate cancer, Radio therapy, Prostate neoplasms, High dose rate, Low dose rate and External beam radio therapy. Selection of studies was done according to PRISMA guidelines.

Results: Brachytherapy can be classified into 2 types of permanent implantation and temporary implantation based on the length of the treatment period. In permanent brachytherapy implants for prostate cancer, iodine (125I) or palladium (103Pd) are used as radioactive sources for low dose rate cases and for high dose rate brachytherapy. Iridium (192Ir) is used. Brachytherapy is usually used in two ways, either as a monotherapy in which LDR and HDR are used to treat some low-risk patients, or as a booster treatment after other treatments such as EBRT, which here may be part of the treatment process before, after, or during treatment. In contrast to brachytherapy alone, brachytherapy plus EBRT is an appropriate approach in patients with intermediate-risk and high-risk disease. In high-risk patients, the combined use of EBRT and HDR-BT can lead to better results than EBRT alone. Brachytherapy treatment is not suitable for every disease. Conclusion: One of the main advantages of this treatment method is the ability to administer a high dose of radiation while minimizing radiation exposure to adjacent healthy organs. Since optimal dose distribution occurs in the treatment, quality treatment can be ensured. The results obtained from both forms of brachytherapy are generally suitable and comparable to other treatment methods with fewer side effects.

Background: The mandibular first molar teeth are the most common teeth that undergo endodontic treatment and are anatomically very challenging. Adequate knowledge of the danger zone in the mesial root of the first mandibular molars helps reduce the risk of misdiagnosis of perforation during treatment. The aim of this study was to compare the dentin thickness of the danger zone in the mesial canals of the mandibular first molar in CBCT(Cone Beam Coomputed Tomography) images at intervals of 3, 4, 5 mm below the orifice canal.
Methods: In this study, CBCT images of 144 mandibular first molars from 74 patients aged 18 to 66 years were examined. Mean orifice to Furcation was calculated and mean distal dentin thickness of mesiobuccal and mesiolingual canals was measured at 3, 4 and 5 mm below the orifice. The mean thickness of the distal dentin was examined in terms of age, sex and maxillary side.
Results: The lowest mean distal wall thickness of mesiobuccal and mesiolingual canals was 5 mm below the orifice of the canal. The mean distal wall thickness of mesiobuccal and mesiolingual canals were higher in men than women (P <0.05). The mean distal wall thickness did not show a significant relationship with age. (P=0.745) except in the area of 3 and 5 mm below the orifice in the mesiobuccal canal which was significantly associated with age (P=0.01). No statistically significant difference was observed between the two mandibular sides (P=0.543) except in the 4 mm area below the orifice in the mesiolingual canal (P <0.05).

Conclusion: The present study showed that the danger zone is observed in the distal dentin of the mesiobuccal and mesiolingual canals of the mandibular first molar teeth in men and women 5 mm below the orifice of the canal. The mean dentin thickness of the distal wall was lower in women than in men.

Background: Gliomas are the most common primary brain tumors in adults, with low-grade gliomas making up 15% of cases. These slow-growing tumors often occur in young adults. Radiotherapy is one of the treatment options. New radiotherapy techniques like IMRT may reduce complications by sparing normal tissue. The study aims to determine which tumors benefit most from IMRT based on tumor location and size.
Methods: Patients diagnosed with low-grade glioma who were referred for treatment at the Cancer Institute of Imam Khomeini Hospital between September 2017 and September 2020 were included in this study. All patients underwent CT simulation with a thermoplastic mask for immobilization. A diagnostic MRI (performed within two weeks prior) was fused with the planning CT to define the target volume (GTV/CTV), with contours verified by a neuroradiologist. A doctor outlines the treatment volume and critical organs for both 3D and IMRT techniques. Radiotherapy physics experts design treatment plans using both techniques, which are then approved by a radiation oncologist. The treatment volume coverage and doses to critical organs are compared between the two techniques.
Results: Among 25 patients, 14 patients (56%) with single-lobe involvement, 7 (28%) with two lobes, and 4 (16%) with multifocal disease. Right-side brain involvement was seen in 32%, with the frontal lobe most affected. IMRT significantly reduced the mean and maximum cochlear dose on the treatment side in all patients. It also lowered the mean chiasma dose in those with both lobes involved and reduced cochlear dose on the opposite side in frontal lobe cases. No significant difference was found between the techniques for patients with multiple lobe involvement.
Conclusion: According to our study on 25 patients with low-grade glioma, it was shown that there is no clear difference between the two techniques. Given the young age and long survival of LGG patients, IMRT may be preferred when hearing preservation is a priority. Further studies with larger cohorts are needed to confirm these findings.