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Behnaz Tehrani, Soheil Sobhanardakani,
Volume 74, Issue 6 (9-2016)
Abstract

Background: The use of pesticides is essential to pests control in horticultural crops for the production of an adequate food supply for an increasing world population and for the control of insect-borne diseases. Therefore, pesticide residues in environment and food have a negative impact on the health of living organisms especially human. In this regard, the present study was carried out for assessment and comparing of propineb residues in Iranian tea and imported consumed tea.

Methods: In this experimental study, according to the Cochran's sample size formula, 12 samples from 4 brand of imported tea and 6 samples from 2 brand of Iranian tea were collected from market basket of Hamadan City in 2015. After preparation and processing the samples in the laboratory, propineb residues in samples determined using a spectrophotometric method to a wavelength range of 400 nm in 5 replications. Recovery tests were carried out using pesticide-free samples. Also, all statistical analyses were performed using the SPSS statistical package version 19 (Chicago, IL, USA).

Results: The mean concentration of propineb residues in Iranian tea samples were 1.60±0.27 µg/kg and in imported tea samples were 0.78±0.63 µg/kg, respectively and lower than the maximum residue limit (MRL) provided by the European Commission (100 ppb). The results of the comparison of the mean concentration of pesticide residues between Iranian and imported tea samples revealed no statistically significant differences between all the samples together (P=0.17).

Conclusion: The results showed that the residues of propineb were found in all analyzed tea specimens. But according to the mean concentrations of propineb residues in tea samples marketed in Hamedan City were lower than MRL, therefore, no adverse health effects have been established from controlled consuming of tea. Also, concerning increased use of agricultural inputs especially kind of pesticides for pest management by farmers, regular periodic monitoring of chemical pollutants content in Iranian and imported tea are recommended for food safety.


Elmira Mohammadi , Shahin Gavanji , Faezeh Khozimeh , Zahra Golestannejad , Mohammadreza Golestannejad , Mahin Bakhshi , Hazhir Yousefshahi, Mohsen Doostmohammadi ,
Volume 74, Issue 10 (1-2017)
Abstract

Background: Protective antigen of anthrax toxin, after touching the cell receptors, plays an important role in the pathogenesis of toxin. The purpose of this study was to investigate the interaction of anthrax toxin protective antigen and four great combination propolis included caffeic acid, benzyl caffeate, cinnamic acid and kaempferol using the softwares and bioinformatics web servers.

Methods: Three-dimensional structure of protective antigen (receptor) obtains from Protein Data Bank (PDB). Four of the main components from propolis were selected          as ligand and their 3D-structures were obtained from ChemSpider and ZINC     compound database. The interaction of each ligand and receptor was assessed                   by SwissDock server (http://www.swissdock.ch/) and BSP-SLIM server (http://zhanglab.ccmb.med.umich.edu/BSP-SLIM). Docking results appears with Fullfitness numbers (in kcal/mol). Identification of amino acids involved in ligand and receptor interaction, was performed using the Chimera software; UCSF Chimera program (http://www.cgl.ucsf.edu/).

Results: The results of interaction between propolis components and protective antigen by BSP-SLIM server showed that the most interaction was related with benzyl caffeate, caffeic acid, kaempferol and cinnamic acid, respectively. Results for the desired ligand Interaction with protective antigen genes using SwissDock server showed that the caffeic acid had ΔG equals -9.10 kcal/mol and FullFitness equal to -993.16 kcal/mol respectively. The analysis of interaction between ligands with amino-acids of protective antigen indicated that the interaction of Caffeic acid whit Glutamic acid 117 had energy -15.5429 kcal/mol.

Conclusion: Finding strong and safe inhibitors for anthrax toxin is very useful method for inhibiting its toxicity to cell. In this study the binding ability of four flavonoids to protective antigen was studied. Glutamic acid 117 is very effective in protective antigen binding and cell receptor and subsequent in virulent of anthrax toxin. Effective interaction of caffeic acid in propolis and glutamic acid 117 can be as useful in preventing the toxic effect on cell. According to our results, all four flavonoids tested in this study have binding activity to protective antigen and are good choices for fighting against anthrax.


Mohammd Javad Fatemi , Shirin Chehroudi , Tooran Bagheri , Sahar Saleh , Amir Atashi , Mohsen Saberi , Seyed Aboozar Hoseini , Shirin Araghi ,
Volume 74, Issue 12 (3-2017)
Abstract

Background: Acute and chronic wound healing has always been problematic. Stem cells with or without the scaffold carrying these cells have been proposed as new methods in the treatment of wounds. In this case study we have tried to examine the effect of scaffold made of polyether sulfone (PES) alone, with stem cells and along with stem cell and growth factor on wound healing in rats.

Methods: This experimental study was conducted in Animal Laboratory of Hazrat Fatemeh Hospital in 2012. In this study, 48 rats were randomly divided into four groups. A wound created on the back of each rat at the size of 3×3 cm. The surface of the wound in the first group is covered with PES seeded with adipose-derived stem cell (ASC) and growth factor (GF), in the second group with polyether Sulfone seeded with ASC, in the third group only with PEWS, and in the fourth group (control) with Vaseline gauze. On 20th and 35th days, the surface of the wound was assessed by photography in order to understand the process of healing. In addition, on days 20 and 45, the histopathology characteristics of the samples were studied with a biopsy of the wounds.

Results: The Results of wound healing in the control group was better than the other groups and its statistical difference between others was meaningful. (P=0.008, P=0.013, P=0.001) On day 20, by examining histopathological characteristics including epithelialization, the number of inflammatory cells, the amount of angiogenesis and collagen synthesis in control group, we gained better results. (P=0.000), But on day 45, the results in different parameters were not equal.

Conclusion: polyether sulfone scaffold alone or with adipose-derived stem cells couldn’t improve the process of wound healing. Also adding vascular endothelial growth factor (VEGF) did not change the results significantly.


Soraya Shahrokh , Seyed Abolhasan Emami , Mohammad Javad Fatemi , Mir Sepehr Pedram , Saeid Farzad Mohajeri , Seyed Jaber Mousavi , Seyed Aboozar Hoseini , Tooran Bagheri , Shirin Araghi ,
Volume 75, Issue 1 (4-2017)
Abstract

Background: Cartilage grafts is one integral component in the various fields of plastic surgery particular rhinoplasty. Surgeons usually use from various sources, including the septum of the nose, ears and rib. Complications such deformity and reabsorbtion may be created with use of the cartilage. Area of the removal of cartilage can prevent these complications. The aim of this study was to compare the absorption rate and viability of cartilage autograft between two common donor site, the rib and the concha.

Methods: This experimental study was performed on October 2014 in animal laboratory of Hazrat Fatima Hospital, Tehran, Iran. In this study, 15 New Zealand white male rabbits, weighing 2000-2500 g, approximately 12 to 16 weeks of age were used. In each rabbit, a piece of one ear and one cartilage was excised. After careful weighting of grafts, we implanted the rib cartilage graft into the left pocket and the conchal cartilage graft into the right one. After 8 weeks, the grafts were removed and weighed precisely and photography was carried out. The specimens were fixed in 10% formalin solution for histologic examination was. An example of hematoxylin and eosin staining and cut (H&E) were performed and samples of live chondrocytes and fibrosis were examined by a pathologist.

Results: We lost 3 rabbits during our study. The results showed that the average weight of a graft from the ear within 2 months, but this increase was not statistically significant (P= 0.152). In the rib graft weight loss over 2 months, and this reduction was statistically significant (P= 0.009). The resorption between two group was not significant but the amount of fibrosis was more in conchal cartilage graft.

Conclusion: According to the study it can be concluded that absorption rib cartilage is somewhat better results than the cartilage of the ear. More studies, in addition to cartilage implants longer human studies can contribute to more accurate conclusions.


Razieh Zarifian Yeganeh , Abbas Shakoori Garakani , Saman Mehrabi , Nader Ebadi, Maziar Motiee Langroudi , Mohammad Reza Noori Daloii,
Volume 75, Issue 7 (10-2017)
Abstract

Background: Head and neck squamous cell carcinoma (HNSCC) is the malignancy of squamous cells (the epidermal layer of skin) in cavities in head and neck includes: larynx, pharynx, paranasal sinuses and oral cavity. The main goal of this research was to understand the effect of mutations in two important genes (KRAS and BRAF) in RAS/MAP kinase (EGFR) signaling pathway in tumor cells with head and neck squamous cell carcinoma in Iran.
Methods: The present cross-sectional study performed from October 2015 to September 2016 on 40 patients suffering from head and neck squamous cell carcinoma, all confirmed by pathology department of Imam Khomeini hospital. Tumor samples were achieved from the surgical cancer department of Imam Khomeini hospital and stored in liquid nitrogen until starting tests. The tests done in genetic laboratory of Tehran University of Medical Sciences. Techniques we used in this research, were DNA extraction based on phenol-chloroform approach, Multiplex PCR (M-PCR) to amplify mentioned exons and KRAS/BRAF strip assays to detect mutations in mutated hotspots in exon 2 of KRAS and codon V600E in BRAF gene.
Results: In this study, we observed 7 mutations in codons 12 and 13 exon 2 in KRAS gene (about 17.5%) and 4 mutations in codon V600E in BRAF gene (about 10%) of obtained tumor samples. The hotspot mutation in codon 12 were Asp (10%) and Ser (5%) respectively. In BRAF, the most common mutation, as we expected according to other researches, was observed in codon V600E. We also observed that 29 people of these patients were male (about 72.5%) and 11 patients were female (about 27.5%). Moreover, 28 patients were over 50 years, while 7 patients were below the age of 50.
Conclusion: The results of this study showed that mutations in genes KRAS and BRAF especially in studied hotspots, and the effects on their molecules in EGFR signaling pathway are important in involving head and neck squamous cell carcinoma, as other cancers. These findings may be considered in choosing drugs for targeted chemotherapy.

Mohsen Sheykhhasan , Mahdieh Sadat Ghiasi ,
Volume 76, Issue 5 (8-2018)
Abstract

The cartilage is a connective tissue that, due to the strength of its extracellular matrix, allows the tissue to tolerate mechanical stress without undergoing permanent deformation. It is responsible for the support of soft tissues and due to its smooth surface and elasticity, gives the joints the ability to slip and bend. excessive weight, excessive activity, or trauma can all cause cartilage to injury. The injury can lead to swelling, pain and varying degrees of mobility loss. The process of repairing musculoskeletal (orthopedic) injuries has led to problems in the medical field, which can be attributed to the inherent weakness of adult cartilage tissue. Therefore, this necessitates research focused on the development of a new restructuring strategy by combining chondrocytes or stem cells with scaffolds and growth factors to address these problems. Correspondingly, the recent tissue engineering strategies strongly support the simultaneous use of stem cells, scaffolds and growth factors. It has also been observed that due to the relatively low proliferation of transplanted chondrocytes, new cartilage models construction have examined the use of adipose-derived stem cells. Mature adipose tissue is produced as an important source of multi-functional stem cells that can be easily separated from the stromal vascular fraction (SVF) by adipose liposuction digestion. The adipose-derived stem cells are easily accessible without any serious complications and have the power to differentiate into several cell lines, including chondrocytes as well as, they evidence self-renewal when trapped in gel scaffolds such as collagen. Also, recent studies demonstrate some of the mechanisms involved in the process of making cartilage of adipose-derived stem cells in vitro and their restorative ability in bio-engineered scaffolds in the presence of growth factors. In addition, the important role of non-encoding mRNA molecules (miRNAs) has been identified in the process of chondrogenic differentiation of adipose-derived stem cells. Furthermore, in several studies, the effect of several miRNAs has been confirmed on the regulation of the cartilage differentiation of the adipose-derived stem cells and has also been associated with effective results. In this article, we will present an overview of the advance in adipose-derived stem cells application in cartilage regeneration.

Sogand Tourani , Salman Bashzar , Shekoufeh Nikfar , Hamid Ravaghi , Mehran Sadeghi ,
Volume 76, Issue 6 (9-2018)
Abstract

Background: Thrombolytic therapy, an appropriate treatment option, if primary angioplasty is not available for the treatment of these patients in the early hours after the onset of the symptoms. The aim of this study was to evaluate the safety and effectiveness of new tenecteplase (TNKase) drug vs. streptokinase in the treatment of ST elevation myocardial infarction (STEMI) patients in Iran.
Methods: A systematic review and meta-analysis that was conducted in Iran University of Medical Sciences in September 2017. We searched the MEDLINE, Cochrane Library (DARE-EED-HTA, Web of Science and EMBASE (1980 to March 2017) with number of strategies by the words “myocardial infarction, heart infarction, streptokinase, tenecteplase” in combination with other names of drugs and brands for clinical effectiveness. We hand searched US, European, and Iranian cardiovascular journals. Clinical trials and related observational studies in one of the Persian, English and Korean languages were included in this study. Two review authors independently assessed randomized controlled trials (RCTs) and non-RCT studies eligibility and quality, and extracted the data using data extraction form for interventions reviews. We cross-checked and resolved discrepancies by discussion to reach consensus. Finally, the data were entered to the Review Manager, Version 5.3 (The Nordic Cochrane Centre, Cochrane Collaboration, 2014, Copenhagen, Denmark), and then the Cochran-Mantel-Haenszel test (CMH) were used to analyzed the data. The I2 test has been used to calculate the Heterogeneity.
Results: We included 4 observational studies. Observational study assessment by strengthening the reporting of observational studies in epidemiology (STROBE) checklist and quality was high described. All studies entered the final analysis after the quality assessment. All studies reported mortality. In the meta-analysis of mortality, three studies with a sample of 812 people entered. No difference was observed between tenecteplase and streptokinase in the risk of mortality (RR=0.45, CI 95%: 0.20-1.03, P=0.40), hypotension (RR=1.86, CI 95%: 0.53-6.49, P=0.33), bleeding (RR=1.40, CI 95%: 0.49-3.99, P=0.53), and no difference was observed in the ST Segment resolution >50% (P=0.81).
Conclusion: The results of this study showed that the effectiveness and safety of streptokinase are similar to the tenecteplase drug.

Zahra Esfandiari, Mohammad Reza Marasi , Fatemeh Estaki , Vahid Sanati , Elnaz Panahi , Nader Akbari , Roya Alsadat Madani, Jila Mosberian Tanha ,
Volume 77, Issue 1 (4-2019)
Abstract

Background: Nutrition education and introduction of procedures for choosing healthier food have an important role to reduce the rate of non-communicable diseases. It was shown the amount of risk factors of non-communicable diseases such as energy, salt, sugar, fat and trans fatty acid on the traffic light of food labelling. The status of risk is presented through three colors of red, yellow and green that are the signs of risk, precautious and safe use of food. The object of this study was to evaluate the influence of education on the knowledge, attitude and practices of Isfahan University of Medical Sciences students to the traffic light on food labeling.
Methods: This project was an empirical study performed by random sampling of 379 students of nine schools in Isfahan University of Medical Sciences from January 2017 to March 2018. The knowledge, attitude and practices of students toward the traffic light were assessed by self-administered and structured questionnaire. Education was performed face to face with the usage of pamphlet. In the period of three to six months, questionnaires were refilled out by students to determine knowledge, attitude and practice. Descriptive statistics were calculated using SPSS in mean± SD. Paired t-test was performed to assess the influence of education in total score of knowledge, attitudes and practices in test-retest. P value was considered less than 0.05 as statistically significant.
Results: Before education, the average of scores for knowledge, attitude and practice was 1.12±0.84, 14.44±4 and 2.25±2.2, respectively. Afterwards, the scores were increased to 11.72±0.75, 18.67±3.18 and 17.69±4.7 after education. Significant difference was observed in the scores of knowledge, attitude and practice of students before and after education (P<0.05).
Conclusion: Education of traffic light had a significant role in the improvement of knowledge, attitude and to some extent of practice of students in selection of healthier food.

Arash Abdolmaleki, Mohammad-Bagher Ghayour, Saber Zahri, Asadollah Asadi , Morteza Behnam-Rassouli ,
Volume 77, Issue 2 (5-2019)
Abstract

Background: Tissue engineering is a developing multidisciplinary and interdisciplinary field involving the use of bioartificial implants for tissue remodeling with the target for repair and enhancing tissue or organ function. Acellular nerve has been used in experimental models as a peripheral nerve substitute. The purpose of the present study was to evaluate the mechanical and histological characteristics of acellular nerve scaffolds compared to the fresh nerve for application in environmental nerve repair.
Methods: This experimental study was conducted in Ferdowsi University of Mashhad Regeneration Research Laboratory, Mashhad, Iran, from May 2017 to October 2018. In this study for preparing the scaffold. The rats were sacrificed by intraperitoneal anesthesia with 10 % Chloral Hydrate solution. Then sciatic nerve fragments of the rats were removed above the nerve branching site and after cleansing of the tissues were decellularized by Sondell method, briefly nerves were treated with a series of detergent baths consisting of distilled water for 8 h, Triton X-100 for 12 h, and sodium deoxycholate for 24 hours according to the Sondell protocol. All acellularization steps were performed at room temperature. Then decellularized scaffolds were evaluated histologically and mechanically.
Results: The results of tissue evaluations showed that decellularization of scaffolds were done completely, this was demonstrated by hematoxylin and eosin staining and DAPI staining. Also the specialized tissue evaluations by picro-fuchsin staining and evaluation the scaffolds by scanning electron microscopy (SEM) micrographs showed that the collagen and elastin strands are relatively preserved in the extracellular matrix in comparison with control groups. As well as mechanical examination of scaffolds in tensile test showed that extracellular matrix of scaffolds was relatively preserved the main components of tissue compared to control group and scaffolds have good mechanical resistance quality for use in tissue engineering.
Conclusion: The results of the present study showed that decellularized scaffolds that prepared with Sondell decellularization method by preserving the main components of the tissue can be a good platform for investigating cellular behaviors.

Mohadeseh Mozafari , Seyyed Abolghasem Mehri Nejad , Jamshid Bagheri , Mehrangiz Peyvstegar , Masoud Saghafinia ,
Volume 78, Issue 3 (6-2020)
Abstract

Background: Previous researches have provided contradictory results about on working memory performance after the coronary artery bypass graft (CABG). In addition, studies have focused on the elderly community. For this reason and with regard to the importance and direct effects of working memory on the quality of life human. This study was designed to compare working memory of young CABG patients with age range of 30-55 years one year postoperatively with healthy subjects.
Methods: In this Case-control study, which was conducted from February 2017 to October 2018, two groups of people, 40 patient men with coronary artery bypass graft that admitted to the heart center of Tehran in last year and 64 healthy males were selected with using available sampling method. Both groups were tested with Wechsler's working memory scale.
Results: The results of the study showed that the mean and standard deviation of the age of coronary artery bypass graft patients were 52.65 and 5.559, respectively, and the mean and standard deviation of healthy subjects were 41.81 and 8.619, respectively. The results showed that The two group had significantly difference (P<0.01), in the sub scales of the working memory including of the forward auditory memory and reverse auditory memory, total score of auditory memory, reverse visual memory and auditory memory span and the two groups had significantly difference (P<0.05), in the total score of visual memory. But the two group had not significantly difference (P>0.05) in the forward visual memory (CABG [mean=5.40 & standard deviation=1.41] Healty people [mean=6.13 & standard deviation=3]) and visual memory span (CABG [mean=5.35 & standard deviation=1.12] Healty people [mean=5.56 & standard deviation=1.97]). The results showed that Patients with CABG than healthy people have overall poorer results for all sub scales the of working memory test.
Conclusion: The results of this study confirm the prevalence of relatively high cognitive decline, especially in working memory after CABG, and provide a pattern of persistence of cognitive decline after one year of coronary artery bypass surgery in young patients aged 30 to 55 years.

Abolghasem Pourreza, Ali Mohammad Mosadeghrad , Masoumeh Parvizi-Shad ,
Volume 78, Issue 5 (8-2020)
Abstract

Background: Medical errors are those mistakes committed by healthcare professionals due to wrong execution of a planned healthcare action or execution of a wrong healthcare action plan whether or not it is harmful to the patient. Medical errors may cause patients to suffer and have huge financial costs for the healthcare system. Identifying and measuring medical errors and adverse events are essential for improving patient safety. The objectives of this research were to measure medical errors and adverse events rates, to identify their severity and also analyze their underlying causes in a general educational hospital in Tehran, Iran by using The Global Trigger Tool.
Methods: A descriptive, cross-sectional, and retrospective approach was used in this study. The medical records of 377 hospitalized patients between April 2015 and March 2016 were examined using simple random sampling method. Patient’s records were reviewed by a nurse using The Global Trigger Tool. Then, a physician authenticated the findings of the adverse events and rated their severity. The causes of adverse events were identified using brain storming and Ishikawa Cause And Effect Diagram.
Results:  A total of 205 triggers were detected, and 60 adverse events were identified. About 15.9 percent of patients experienced an adverse event. The rate of adverse events was 19.1 per 100 admissions and 5.7 per 100 Admission days or hospitalization days. Almost half of the adverse events were in the E and F categories (temporary harm). Bleeding, nosocomial infections, and patient fall were the leading adverse events. Employees and working processes were the underlying causes of the medical errors and adverse events. The Global Trigger Tool found 100 times more adverse events than the voluntary reporting method.
Conclusion: The adverse event rate of this study was high. Hospital managers should take appropriate actions to reduce medical errors and adverse events and enhance patient safety. The Global Trigger is a Powerful, reliable, strong tool for identifying adverse events and measuring their severity.

Zahra Esfandiari, Fatemeh Amani, Meraj Pourhossein, Hedayat Hosseini,
Volume 78, Issue 12 (3-2021)
Abstract

The development of industry and technology, changes in agriculture, trade and global travel, and the adaptation of microorganisms are important factors in the occurrence of emerging diseases. Currently, the world is facing a pandemic caused by an emerging virus called the novel coronavirus (Covid 19) in 2020. This disease led to infect more than one million people worldwide and the death of more than five hundred thousand people during six months. Covid 19 causes death in patients with respiratory problems of varying severity. Fever, soreness, dry coughs, shortness of breath, runny nose, and nasal congestion were observed in coronavirus-infected individuals. Fever was one of its common symptoms. Other unusual signs such as diarrhea and nausea were reported for this disease. For the first time, the bat was introduced as the host of the novel coronavirus in China. Therefore, identifying the initial route of transmission of the novel coronavirus is necessary to prevent the occurrence and its widespread distribution. The virus enters into a human through respiratory particles as well as touching the surfaces contaminated by nasal, mouth and eye secretions. Viruses are obligate intracellular pathogens needing host cells to survive. These microorganisms cannot proliferate in foods and require live cells for existence. Food is introduced as a carrier of viruses to the consumer. There have been no reports of novel coronavirus transmission through food. However, it is important to observe the principles of health and safety by assuming the spread of the virus due to food contamination. Regarding the presence and proliferation of novel coronavirus in the gastrointestinal tract and aerosol formation of this microorganism in the feces and the possibility of re-transmitting it to people from various environmental sources, the most important priority is to remove the virus from food environments. It is also important to update the methods of disinfecting surfaces, especially areas with high contact of hand as well as personal hygiene. Therefore, it is recommended to educate the staff about managing the novel coronavirus and improving health guidelines. Furthermore, keeping distance and washing hands is in priority in different food-related environments.

Mohammad Hossein Mirzaii Dizgah, Mohammad Reza Mirzaii Dizgah, Iraj Mirzaii Dizgah ,
Volume 79, Issue 3 (6-2021)
Abstract

Background: spacecrafts rotate around the Earth every 90 minutes, so the 24-hour cycle turns to 90 minutes. Retinoic acid, an active metabolite of vitamin A, plays a role in regulating the circadian rhythm and its deficiency can impair the biological clock function and consequently impair the circadian rhythm of locomotor activity. The goal of the study was to assay the effects of simulated spaceship conditions on serum and hippocampal retinoic acid levels in rats.
Methods: The tail-hanging, hindleg-weightlessness rat model was applied to mimic the microgravity conditions from June to September 2017 in the zoo of the Aja University of Medical Sciences. Thirty-two male Wistar rats weighing 200-250 gr/in an experimental study were randomly assigned into 4 groups (n=8): 1) control animals with 12/12 h day-night rotation, 2) animals with 12/12 h day-night rotation under 14 days unloading, 3) control animals with 45/45 min day-night cycle, and 4) animals with 45/45 min day-night cycle under 14 days unloading. At the termination of the simulation step, rats were anesthetized, and blood samples were collected and the entire brain was removed and each brain was segmented into Hippocampus. ELISA assays were used to detect retinoic acid in the serum and homogenized hippocampus. Data were statistically assayed using two-way ANOVA and Bonferroni as a post hoc test. P<0.05 was considered significant.
Results: The circadian cycle of 45/45 min compared to the 12/12 h dark cycle increased the levels of retinoic acid in serum (F=4.901, P=0.037) and hippocampus (F=5.793, P=0.029) in rats. But simulated weightlessness had no effect on retinoic acid content in serum (F=0.149, P=0.703) and hippocampus (F=0.004, P=0.952).
Conclusion: It seems that retinoic acid content in serum and hippocampus is affected by circadian cycle change, and weightlessness has not affect.

Fariba Behnamfar , Maryam Nazemi,
Volume 79, Issue 8 (11-2021)
Abstract

Background: Enhanced recovery after surgery (ERAS) is now firmly established as a global surgical quality improvement initiative that results in both clinical improvements and cost benefits to the healthcare system. ERAS guidelines are based on the highest quality evidence available and as such require updating on a regular basis. The ERAS Gynecologic/Oncology guidelines were first published in February 2016. This is the first updated Enhanced Recovery After Surgery (ERAS) Society guideline presenting a consensus for optimal perioperative care in gynecologic/oncology surgery.1,2
Methods: Starting from the original ERAS Gynecologic/Oncology guidelines, the first author and senior authors identified topics for inclusion. International authors known for their expertise in gynecologic/oncology perioperative care were invited to participate in the guideline update. A database search of publications using Embase and PubMed was performed. Studies on each item within the ERAS gynecologic/oncology protocol were selected with an emphasis on meta-analyses, randomized controlled trials, and large prospective cohort studies. These studies were then reviewed and graded according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system,3 whereby recommendations are given as follows: Strong recommendations: The panel is confident that the desirable effects of adherence to a recommendation outweigh the undesirable effects, weak recommendations: The desirable effects of adherence to a recommendation probably outweigh the undesirable effects, but the panel is less confident.
Results: The evidence base, recommendations, evidence level, and recommendation grade are provided for each individual ERAS item below. The table 1 shows all the ERAS items with emphasis on changes for the 2019 guideline update. The (Table 2) shows items: (pre-operative optimization, pre-anesthetic medication, nausea and vomiting prophylaxis, urinary drainage, and early mobilization). These items not updated in 2019 guideline (no change in recommendation/evidence. All recommendations on ERAS protocol items are based on the best available evidence. The level of evidence for each item is presented accordingly.
Conclusion: The updated evidence base and recommendation for items within the ERAS gynecologic/oncology perioperative care pathway are presented by the ERAS® Society in this consensus review.
 

Vahid Hatami, Hamed Tavan, Sajad Hatami , Ali Delpisheh, Mina Mamizadeh,
Volume 79, Issue 10 (1-2022)
Abstract

Background: Healing involves complex processes that are not yet fully known. The wound healing process consists of three stages. In all these stages, normal wound healing requires platelet activation, release of cytokines and growth hormones, and chemotaxis and cell differentiation. Platelets play a key role in homeostasis and wound healing and growth factor production of more than 30 carried out by them. Platelets regulate the healing process with their chemotactic effect. Antilogous PRP platelet count in about 3 to 5 times increase and consequently also increases the number of growth factors, for this reason, they are being used in surgical procedures and clinical therapy.
Methods: At Ilam Medical Center in Imam Khomeini Hospital, 20 patients with two similar donor graft sites were gradually selected to participate in a clinical trial from January to March 2017. The two regions have the same skin graft patients, an area of Honor conventional and other areas with the topical administration of platelet-rich plasma That immediately after surgery and in the days after the fifth and eleventh, eightieth and after washing the wound with a topical serum Physiology rubbed on the wound and thus treated The rate of wound healing clinically and using X-ray photo-checked and compared.
Results: Seven are male and thirteen are female and the age range of patients is between 17 and 67 years. After collecting wound healing times in two groups, we used the means comparison method to evaluate the effect of PRP on wound healing rate and analyzed the results (T-Test). Because the data followed a normal distribution, we used the Independent T-test method, which resulted in 0.416, which was higher than the alpha level equal to 0.05.
Conclusion: In this study, we found that PRP had a positive effect on wound healing time and increased the speed of wound healing. It is suggested that the effect of the PRP method on various organs that have not been tested before, be discussed in future studies.
 

Firoozeh Raisi , Seyyed Taha Yahyavi, Zahra Shahvari , Ehsan Kazemi Khaledi , Mehdi Soleimani, Agaah Ashrafi,
Volume 79, Issue 10 (1-2022)
Abstract

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: After determining the content and face validity, a tool was obtained with 16 True/False items in the knowledge section (with one score for each correct answer and the total score range from 0 to 16) and 16 five-point Likert scale items in the behavior section (with each question score range from 0 to 3 and the total behavior score range from 0 to 48, the lower score defined safer behavior). The correlation coefficient of the scale scores in the test-retest method was calculated to be 0.880 (P<0.001) and 0.951 (P<0.001) in the sections of knowledge and behavior, respectively. The Cronbach's alpha coefficient was 0.809 for the section of knowledge, 0.756 for the section of behavior, and 0.782 for the whole questionnaire. Exploratory factor analysis confirmed the existence of 4 factors in the knowledge section and 3 factors in the behavior section.
Conclusion: The present 32-item questionnaire was designed based on experts' opinions and important statements of patients about sexual health, simple scoring, good reliability and validity, is a suitable tool for assessing the safe sex knowledge and behavior in patients with severe mental illnesses.

Mohsen Barouni , Zohreh Shaker, Zinab Shaker , Asma Sabermahani ,
Volume 80, Issue 10 (1-2023)
Abstract

Background: Cerebral palsy is a movement disorder syndrome in early childhood. Signs and symptoms vary among people and over time but include poor coordination, stiff muscles, and weak muscles. Some affected children can achieve near-normal adult lives with appropriate treatment. In recent years, transplantation of human mesenchymal stem cells (hMSC) has become a promising therapeutic strategy for CP. Every year, a lot of costs are spent on the treatment and management of this disease. The purpose of this study is to investigate the safety and effectiveness of this method on CP.
Methods: This article is a systematic review. At first, a search strategy was written and performed in Scopus, PubMed, and Google Scholar databases(The search was conducted from March 14 to March 28, 2021), and the inclusion and exclusion criteria were determined. Study inclusion criteria: review studies, cohort studies, clinical trial studies (randomized and non-randomized), control case, and retrospective , exclusion criteria: non-English articles and studying on animals. After removing duplicate articles, two authors independently reviewed the studies according to the inclusion and exclusion criteria. Disagreements among the authors were resolved through discussion.
Findings: In total, 9236 articles were found in the initial search, after reading the titles, of 37 articles, 21 articles were selected in the abstract stage and 18 articles remained in the full-text stage. We finally found 18 articles that showed that using stem cell technology as a scientific method could improve sick patients’ quality of life and movement defects.
Conclusion: According to the available evidence and limited studies, stem cell technology can be safeand cost-effective in improving CP patients, but there is insufficient evidence. On the other hand, there are many studies confirming the effectiveness of these cells in the treatment of movement impairment. In conclusion, stem cells may have a very promising future. Finally, stem cell technology combined with innovative biotechnologies may soon bring promising results to patients.

Maryam Ameri, Atieh Ansari, Abbas Aghabiklooei, Farrokh Taftachi , Leyla Abdolkarimi,
Volume 82, Issue 1 (4-2024)
Abstract

Background: Medical errors are one of the biggest problems of the health system in countries. Identifying the factors responsible for these errors is crucial to designing optimal strategies to reduce such occurrences. The aim of this study was to investigate the type and nature of medical errors.
Methods: In this cross-sectional descriptive study, all documented medical errors that occurred between March 2021 and February 2022 at Firoozgar Educational and Medical Center were thoroughly examined. The data collection involved reviewing records from various departments within the center to ensure a comprehensive analysis of error types. The extracted data were processed and analyzed using SPSS v.22 software, allowing for statistical evaluation and identification of potential patterns or trends in medical errors over the specified period.
Results: A total of 214 cases were reviewed. 45.3% of the recorded medical errors occurred in the morning shift, 20.6% in the evening shift and 34.1% in the night shift. The highest number of medical errors was reported by nurses (40.7%), followed by physicians (16.8%) and paramedics (11.7%). The etiology of most medical errors was systemic errors (63.6%) followed by pharmacological errors (15.4%) and technical errors (13.1%) and the most reported systemic errors were of insufficient supervision. Most of the patients who had medical errors were admitted to the inpatient wards (40.7%) and later to the surgical wards (17.3%) and ICU (12.6%). 62.1% of medical errors did not cause any specific complication and in 33.2% of cases, mild complication, 10.7% moderate complication and 3.3% severe complication occurred for patients. 62.1% of medical errors had no consequences for anyone, and in 36.9% of cases, the consequences of errors were to the patient and 1% of the consequences of errors were to the organization and employees.
Conclusion: Most of the reported medical errors were performed by nurses and were uncomplicated errors. Establishing transparent and accurate self-reporting systems is essential to identify medical errors of all employees.

Mohammad Parsa Mahjoub , Naser Kechuian, Mohammad Haji Aghajani , Hossein Aghamiri , Ainaz Samadi, Fateme Omidi ,
Volume 82, Issue 7 (10-2024)
Abstract

Background: Cardiovascular surgery is sometimes associated with brain consequences such as cognitive disorders. Diagnosis of cognitive disorders risk factors in cardiovascular patients is important for increasing patient satisfaction and success after (CABG). In the present study, the frequency of cognitive disorders in cardiovascular patients and its effective factors were investigated.
Methods: In the current cross-sectional study that was conducted from September 2019 to the February 2022, 60 cardiovascular patients undergoing CABG surgery were selected by convenience sampling method. Demographic, clinical, and intraoperative information was recorded for participants in the data collection form. Mini–Mental State Examination quesionary.
Results: The results showed that 15% of participants had cognitive impairment. Gender and age were the actual variables on the incidence of cognitive disorders after CABG surgery. The frequency of cognitive disorders in women was 14 times higher than men and 6.5 times higher in the elderly. Elderely population was considered as 65 years old or above. The clinical variables such as blood transfusion under surgery and ejection fraction<40% were effective factor for incidence of cognitive disorders in cardiovascular patients.
Conclusion: The CABG surgery may be associated with cognitive disorders in cardiovascular patients, which is more common in women and the elderly. Further studies are recommended to confirm the results of the present study and identify the related risk factors.

Ali Yavari, Hojjat Molaie, Hesam Amini ,
Volume 82, Issue 9 (12-2024)
Abstract

Background: Macromastia can have a significant impact on patients’ quality of life by causing physical discomfort and psychological distress. Reduction mammoplasty can provide both aesthetic and therapeutic benefits. In cases of gigantomastia, where extreme breast hypertrophy prevents the use of traditional pedicled techniques, breast amputation with a free nipple graft is always a considered surgical option. There are different presented methods and designs for this procedure. This surgery is highly beneficial for patients, and most of them report significant improvements in their quality of life and overall satisfaction with the final results.
Case Presentation: In this study, we employed reduction mammoplasty and a free nipple graft with a vertical design and superior pedicle preservation in patients with gigantomastia who were referred to Tehran Imam Khomeini Hospital Clinic during a period of five years (February 2020–February 2025). The patients were out of the range of fertility and were in the range of obesity (most of them had a BMI of over 35(kg/m2)). Then, patient satisfaction and quality of life improvement were evaluated with a standard questionnaire. Finally, complications during and after surgery were recorded. The surgery was performed on 17 patients. The distance from the sternal notch to the nipple was more than 40 cm, and the distance from the nipple to the inframammary fold (IMF) was more than 20 cm in all patients (confirming gigantomastia). Therefore, they were not candidates for pedicled mammoplasty. All the patients were satisfied with the results. Their quality of life, posture, back pain, neck pain, and other symptoms improved significantly. We recorded no cardiovascular complications during or after surgery.
Conclusion: Breast amputation with a free nipple graft is an efficient method for treating gigantomastia and is very safe for patients with diabetes mellitus, cardiovascular diseases, high BMI, and those at infertile ages. A vertical design with superior pedicle preservation can provide both aesthetic and therapeutic benefits, leading to high patient satisfaction and improved quality of life.


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