Tehran University Medical Journal

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Background: Urinary tract infection (UTI) is one of the most common infections in infants and children, especially in their first decade of life. These patients are more susceptible to renal scars and other possible complications like growth retardation, arterial hypertension, proteinuria, isostenuria, and finally chronic renal failure. Trace elements like vitamins and minerals are essential for efficient metabolism and proper function of various body systems namely immune system. In this trial we compared the relation between serum levels of zinc, vitamins A and D in children inflicted with UTI and control group.
Methods: This was a cross-sectional study on 25 patients with UTI admitted to pediatric wards of Rasul Akram Hospital and Bahrami Hospital. They were compared to 40 other patients admitted in surgical wards for elective surgery. Serum levels of zinc, vitamins A and D were measured in both groups.
Results: Seventy two percent of the patients were male and 28% female. The average age was 2.17. Despite the lower levels of vitamins A and D in cases than controls, the difference was not significant (P=0.4 and P=0.9, respectively). However, serum levels of zinc were significantly lower in cases than controls (P<0.05).
Conclusion: Vitamins A and D may play some role in patients’ vulnerability to UTI, but this supposition needs more research on larger samples, considering differences among patients of various age groups and their nutritional status.
According to the study, lower levels of zinc were associated with susceptibility to UTI thence, its administration might be helpful.

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Background: Malassezia Species are often commensal of the human skin and scalp that opportunistically in exist of particular predisposing factors, their proliferation increases as, in dandruff and seborrheic dermatitis which both togather affect more than 50% of humans, the excess proliferation of yeast in scalp, leads to scalp-flaking and causes physical and mental disorder in peaple, spacially in youth that their health and hiar hygiene and beauty is more important for them. Thus, this survey has been done for rapid, easy and inexpensive method to diagnosis of abnormal proliferation and invasive condition of Malassezia yeast and can be more benefical for proper treatment.
Methods: Sampling with scalpel scraping from scalp of volunteer persons that had not bathed at least two day ago were done and preparation of direct microscopic slides and staining with methylene blue were accomplished. Then, survey of morpholgic characte-ristics, yeast quantification and mycelium detection were done by direct microscopic examination.
Results: From 140 scalp samples of adult persons of both gender (male and female) with different age groups, observation of malassezia yeast in 93.5% (131) were positive and 6.5% (9) were negative in direct microscopic examination. Results of yeast quanti-fication in positive cases were: mild or normal flora 25.2%, intermediate 24.5%, severe 50.3%. Detection of mycelium in positive cases were 22.9% (30) (P=0.007 df=2).
Conclusion: Application of an accessible, easy and inexpensive method and a determi-nated pattern (yeast quantification with direct microscopic examination) to distinguish normal flora from abnormal condition (excess proliferation and mycelium production) in cases of Malassezia yeasts can be more useful to rapid diagnosis of abnormal pro-liferation and invasive condition in order to initiate a proper antifungal treatment.

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Background: Although a few studies have shown the positive correlation between patients’ serum concentration of 25 OH-Vitamin D3 and type II diabetes mellitus, metabolic syndrome, and insulin resistance, there are controversies regarding the relationship between 25 OH-Vitamin D3 as a risk factor for cardiovascular atherosclerotic diseases that has to be cleared. The aim of this study was to evaluate the association between the rate of 25 OH-Vitamin D3 and the presence and severity of coronary artery disease (CAD) in Patients with suspected CAD. Methods: This study was a cross sectional study that has been conducted in the department of cardiology in Imam Khomeini Hospital complex in collaboration with endocrinology research center. In this study 178 patients with suspected coronary artery disease (CAD) were enrolled. Based on their history and clinical findings coronary angiography was performed in all patients. Severity of CAD has been assessed by using Gensini score, based on their coronary angiography findings. The relationship between severity of CAD and their serum level of 25 OH-Vitamin D3 was evaluated. Serum level of 25OH- Vitamin D3 was measured by the enzyme-linked immunosorbent assay (ELISA) method by Euroimmiune kits (from Germany). Results: Of 178 patients, 50 (28.1%) were female and 128 (71.9%) were male. Mean±SD of their ages was 56.2±11.8 years old. Significant coronary artery stenosis (stenosis more than 50% luminal diameter) was observed in 91 (51.1%) of patients. Mean±SD of serum level of vitamin D3 in patients with CAD was 45±35 nm/l and in patients without CAD was 55±44 nm/l (P= 0.047). Mean±SD of Gensini score was 26.3±21.1, as well. Therefore correlation coefficient between 25 OH-Vitamin D3 and Gensini score was -0.262 (P= 0.043). Conclusion: Although there is a trend toward association between deficiencies of 25 OH-Vitamin D3 and the presence of CAD but their association is not statistically significant. For achieving more convincing findings larger studies are needed.

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Background: Atrial fibrillation is the most common arrhythmia after cardiac surgery. Vitamin C as an antioxidant has an important role in reducing the incidence of postop-erative atrial fibrillation. The present study aimed at administrating vitamin C as a way to reduce the incidence of post-CABG atrial fibrillation. Methods: In this double-blind, parallel clinical trial, 170 patients with coronary artery disease who underwent CABG surgery, by using a table of random numbers are di-vided into intervention and control groups to receive placebo or vitamin C. The clinical and surgical characteristics of the patients in the two groups were similar. The interven-tion group received 2 mg of vitamin C intravenously, the night before surgery. This drug followed by 500 mg, twice a day for five days after surgery. On the other hand patients in the control group received placebo (normal saline intravenously). After operation two groups were compared regarding Important outcomes such as postoperative arrhythmia, ICU stay and hospital stay. Results: One hundred eighteen men and fifty two women with a mean age of 59.1±9.8 years were enrolled in the study in two vitamin C and placebo groups (each consisting of 85 patients). The incidence of postoperative atrial fibrillation was 12.9% in the vita-min C group and 29.4% in the control group (P=0.009). ICU stay in the vitamin C group were 2.5±1.4 days versus 3.0±1.6 days in controls (P=0.035) and hospital stay in the vitamin C group were 6.6±1.5 days versus 8.2±2.3 days in controls (P<0.001). Conclusion: Vitamin C is relatively safe, inexpensive, well tolerated and has a low complication. According to the 44% reduction in the incidence of atrial fibrillation in vitamin C patients undergoing coronary artery bypass grafting surgery, this drug can be prescribed as a prophylaxis for prevention of post-CABG atrial fibrillation.

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Background: Severity of respiratory infection in children is depended on various fac-tors such as causative organism and the host immunologic response to the organism. Vitamins and micronutrients play an important role in this response with supporting the immune system and therefore, the response to infections. Nutritional deprivations in children, especially vitamins and micronutrients such as zinc, vitamin A and vitamin D are very common in middle east and other countries in Asia, which is due to inappro-priate diet and nutrient loss in recurrent infections. This study aimed to evaluate the se-rum levels of vitamins A, D and zinc in hospitalized children aged six months to five years. Methods: This analytic cross-sectional study was performed in 65 children aged six months to five years who were hospitalized in pediatric and surgical wards of Rasul Akram Hospital and Bahrami Hospital in Tehran. All of samples were evaluated ac-cording to WHO cri-teria for acute respiratory infection, and underwent measurement of serum vitamin A, vitamin D and zinc levels by using Atomic, Elisa and spectropho-tometer methods. Results: Serum levels of vitamins A in patients with acute respiratory infection was 0.27±0.16 µg/ml and in children without infection was 0.41±0.2 µg/ml, that different wasn’t statistically significant (P=0.4). Serum levels of vitamins D in patients with acute respiratory infection was 35.37±34.68 ng/ml and in children without infection was 45.78±21.05 ng/ml, that different wasn’t statistically significant (P=0.1). Serum levels of zinc in patients with acute respiratory infection was 87.93±23.34 µg/dl and in chil-dren without infection was 106.95±23.70 µg/dl, the difference was statistically signifi-cant (P=0.002). Conclusion: According to finding in this trial, there is a correlation between lower levels of zinc in serum, and chance of respiratory tract infection in children. Future larger studies could provide the correlation between serum levels of vitamins A & D and chance of respiratory tract infection.

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Background: The renal sympathetic nerve activity (RSNA) is enhanced in renal failure. Paraventricular nucleus in hypothalamus is an important central site to regulate sympathetic activity. There are angiotensin II (Ang) II receptors in this nucleus. The aim of this study was to evaluate the effects of angiotensin II in hypothalamic paraventricular nucleus (PVN) on renal ischemia-reperfusion injury and RSNA. Methods: This study was done at 2013 in Physiology department of Tehran University of Medical Sciences. One week before the induction of renal Ischemia-Reperfusion (IR) in Sprague-Dawley rats, a cannula was inserted into the right PVN for microinjection of different doses of Ang II (3, 30, and 300 ng). Then right nephrectomy was done. After one week recovery, renal IR injury was induced by clamping the left renal artery for 45 minute and then reperfusion for 3 or 24 hour. Ten minutes before the induction of renal ischemia-reperfusion, administration of different doses of angiotensin II were done in different groups. In all animals, left renal sympathetic activity was recorded before and during renal ischemia. After 3 or 24 hours reperfusion the blood, kidney and brain were collected to assay renal function and histology and oxidative stress indices Superoxide Dismutase, SOD and Malondialdehyde, MDA) in PVN. Results: Administration of different pharmacological doses of angiotensin II into PVN exaggerated the renal IR injury. Angiotensin II in different doses increased the plasma creatinine and BUN levels and renal histological markers in comparison to renal IR in-jury (P<0.05). Angiotensin II had detrimental effects on RSNA and oxidative stress in-dices Super Oxide Dismutase (SOD) and Malondialdehyde (MDA) in PVN as the dose was increased (P<0.05). Conclusion: These data showed that the PVN is a responsive site for central Ang II-induced damage in renal IR injury. We suggested the central effects of Ang II in the PVN on renal IR injury are mediated by oxidative stress in the PVN, and the peripheral effects by a sympathetic pathway.

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Background: Any time before labor that termination of pregnancy for mother and fe-tus is better than keeping pregnancy, this is indication of induction for labor. The condi-tion of cervix is the most important factor for labor induction. Cervical condition, In many cases that candidate for induction of labor before labor pain, is poor. As the cervical ripening is quite important for success of labor induction. This study is attempting to compare two methods of cervical ripening. Methods: During this clinical study, 100 patients admitted in Ahwaz Imam Khomeini Hospital from 2010 to 2011. All of these patients had BISHOP score bellow 5, were di-vided to two groups for cervical ripening. Group one: trans cervical catheter and group two: laminaria. After placing transcervical foley catheter and laminaria for patient in-duction with oxytocin was started according to classic protocol. Then the time lapse from the beginning of induction to enter the active phase of labor and also from start of induction till delivery and appearing the side effect in both group was assessed. The result was analysed by SPSS 16 program. Results: Fifty three of patient (53%) were primiparous and the rest 47 (47%) were mul-tiparous. All of them had bishop score bellow 5. The average age for the patient group 1 was 27.1 and the average age for other group was 27.18. The time lapse from start of induction to enter active phase of labor in first group was 5.7±2.67 hours and this time for 2nd group was 7.51±2.33 hours. Also the time interval between the start of induction and delivery in group 1 was 10.3±4.35 hours and this time for group 2 was 12.5±4.9 hours. In both cases there was meaningful difference between two groups. There was no difference between both group for appearing the side effects. Conclusion: Based on this study, it seems using trans- cervical catheter for cervical rip-ening and aid to successful induction of labor is beneficial.

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Background: Hormonal, physical, and psychological fluctuations occur during the menstrual cycle. Previous studies have shown that hormonal changes during the normal menstrual cycle affect anesthesia and analgesia. The limitation of previous studies are that they did not measure luteal hormone (LH), Follicular stimulating hormone (FSH), estradiol, progesterone and cortisol levels. Our goal was to find more suitable conditions in menstrual periods for intubation of patient. Methods: American Society of Anesthesiologists physical status I patients, 16 to 40 years, undergoing general anesthesia for elective surgery were enrolled in this study and conducted at Imam Khomeini Medical Center in 2013. The patients were assigned into two groups according to the phase of their menstrual cycle. Levels of sex hormones and hemodynamic variables were recorded for all the patients and statistical analysis performed. Results: In 77 patients, 38 women were in the luteal phase (49.4%) and 39 women were in the follicular phase (50.6%). All tracheal intubations were successful on the first attempt with a mean duration of 2558±5.07 and 25.84±5.32 seconds in groups F and L, respectively (P=0.489). None of the patients were excluded for long tracheal intubation time. Systolic blood pressure after intubation in the follicular phase (138.4±20 mm Hg) was significantly higher vs. the luteal phase (127.7±18 mm Hg) (P<0.01), as well as the women’s heart rate after intubation in the luteal phase (90.7±12 beats per minute), was significantly higher than in the follicular phase (85.3±11 beats per minute) (P=0.05). Heart rate was higher in the luteal group than the follicular group thus the women’s heart rate after intubation in the luteal phase (90.7±12 bpm) was significantly greater than the follicular phase (85.3±11 bpm) (P=0.05). Conclusion: Reviewing and comparing the results show that elective surgeries are bet-ter to be done in the luteal phase because of stable hemodynamic conditions.

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Background: The incidence of Patent Ductus Arteriosus (PDA) in premature infants whose birth weight is less than 1500 grams is approximately 30-60%, most of them need medical or surgical interventions. The purpose of this study is to determine the efficacy of prophylactic treatment with oral paracetamol (Acetaminophen- Hakim® Oral Drops 100 mg/ml, Hakim Pharmaceutical Co., Tehran, Iran) for PDA in preterm infants. Methods: A randomized clinical trial conducted from March 2012 to March 2013. Thirty-two preterm newborns whose gestational age was under 32 weeks and birth weight was 1500 grams or less, admitted in neonatal intensive care unit (NICU) of Vali-Asr Hospital, Tehran were studied prospectively. They were randomly assigned in two groups. The prophylaxis group received oral paracetamol for a period of two days starting during first 24 hours of life. No placebo was given to the control group. Echocardiography was performed 24-36 hours after the last given dose in prophylaxis group and on the 4th and 5th day in control group. A p-value less than 0.05 are considered significant. Results: There were 16 newborns in each group (20 boys and 12 girls). In 12 newborns of prophylaxis group the ductus arteriosus was closed although in control group in 8 newborns the duct was closed. No significant difference was observed in sex, gestational age, birth weight, mode of delivery, multifetal gestation and birth order between two groups. The rate of ductal closure was 75% and 50% in prophylaxis group and control group respectively (P=0.27). Conclusion: Our study demonstrated that prophylactic paracetamol is ineffective in PDA closure, although the rate of ductal closure between two groups seems remarkable. Paracetamol as a new strategy for PDA closure because of cost effectiveness and harmlessness may be used in future. However, we presume larger sample size studies are needed to show the efficacy of paracetamol, side effects, and complications in PDA prophylaxis treatment.

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Background: Sexual health is one component of reproductive health that has great impact on the health of individual and society. Sexual health has expressed as a strategy to achieve the millennium development goals. To date, many Iranian studies have addressed the issue of reproductive and sexual health but no study has addressed the definition of sexual health and described its components. Therefore, this study aimed to explore the definition of sexual health and provide a description of its components. Methods: This qualitative study was conducted from June 2009 to November 2013 in Tehran, Iran. Participants were Iranian sexual health experts selected by targeted sampling. Data was collected through semi-structured interviews. All interviews were audio-taped and transcribed verbatim with participants’ permission and then coded by researcher. Development of codes and themes was inductive and arose from the interviews. Data collection was stopped when data saturation was reached. Data was analyzed through conventional content analysis. Results: The theme of individual and family health was extracted from data. From this theme and its categories, the definition of sexual health and its components was extracted including knowledge and information (training needs), physical and mental health, economic needs, social and cultural values and religious values. Based on the results, the sexual health of adults is satisfying from sexual needs by establishing a healthy and socially defined relationship with someone of the opposite sex. Conclusion: According to this study, sexual health has a special definition in each age group and also has different requirements. To start a healthy sexual relationship, at first a correct relationship between a woman and a man must shape. A relationship that is based on customary, religious and social values. Sexual health is a system that consists of abstract components and without proper formation of each of these components we will not be able to access sexual health completely. It seems one of the most important components of sexual health is the knowledge and information about sexual issues. However, further studies are needed to confirm this result.

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Background: Vitamin D deficiency is a widespread problem especially in the developing countries like Iran. The prevalence of vitamin D deficiency differs from moderate to severe among Iranian women, particularly among pregnant women, and it can cause some problems such as preeclampsia, gestational diabetes mellitus (GDM), premature labor and primary cesarean section. The aim of this study was to evaluate whether the mode of delivery is related to serum vitamin D levels or not and if there is any difference in the percentage of cesarean section between vitamin D-deficient and vitamin D-insufficient women. Methods: This cross-sectional study was carried out between the April 2012 and April 2014 in a woman university hospital, Tehran, Iran. One hundred and eighty-six women aged between 17 and 52 years old (Mean age 28.46 and SD5.97) were surveyed in this study. The study group comprised of (N=186) consecutive cases attending Tehran Women General Hospital Clinic for normal vaginal delivery or cesarean section. Women who underwent cesarean section due to previous cesarean delivery were not recruited for the study. The participants were divided into two groups: women with vaginal delivery and women with cesarean section. Serum vitamin D concentration (25(OH) Vitamin D) was measured for each patient. Concentration of serum vitamin D was compared between these 2 groups. Results: One hundred and twenty-eight (68.8%) women had cesarean section and 58 (32.2%) had vaginal delivery. Median and inter-quartile range (IQR) of serum 25(OH) D were 13.64 and 12.47 ng/ml respectively, among women with cesarean section, compared to 11.68 and 12.59 ng/ml in those with vaginal delivery. No statistically significant difference was detected in serum vitamin D between these 2 groups (P=0.72). In addition, no statistically significant difference was detected between women with vitamin D deficiency and women who were vitamin D insufficient (P=0.8). Conclusion: In this study, there was no association between serum vitamin D levels and delivery mode.

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Background: Today obesity and overweightness are the major health problem all over the world. The relation between decreasing serum level of vitamin D and some chronic diseases such as diabetes and obesity was shown in the available studies. The aim of this study was to determine the prevalence of vitamin D deficiency among obese and overweight Iranian population and its relation with age, sex, occupation, body fat percentage and body weight according to body mass index. Methods: In a descriptive cross-sectional study, all patients who were referred to obesity clinic of Imam Khomeini Hospital, Tehran, for weight management throughout one year were included to the study. The prevalence of vitamin D deficiency with serum level lower than 30 ng/ml among 107 subjects was evaluated. The data were analyzed by SPSS, ver. 19 (SPSS, Inc., Chicago, IL, USA). Quantitative variables were presented as mean±SD and qualitative variables were presented as relative frequency. The groups were compared with independent samples t-test and Chi-square test. The level of significance for comparing the groups was considered at P<0.05. Results: In 107 participants, vitamin D deficiency in 81 subjects (75.7%) was reported. The prevalence of deficiency in participants with body mass index between 25 to 29.9, 30 to 34.9 and equal or greater than 35 kg/m2 was 77.3%, 83.7% and 69.4%, respectively. However, the differences between overweight and obese groups were not significant (P=0.193). The prevalence of moderate and severe vitamin D deficiencies among the participants was 50.5% and 25.2 %, respectively. Vitamin D deficiency was more common in participants below 50 years of age compared with those older than fifty (P=0.001). Conclusion: The prevalence of vitamin D deficiency was high in obese and overweight population especially among individuals younger than 50 years. It seems that, it is necessary to add prevention and management of this deficiency to obesity treatment protocols especially in the young adults.

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Background: Recently, the role of inflammation and oxidative stress in the pathophysiology of atrial fibrillation (AF) after cardiac surgery has been emphasized. Vitamin C as an antioxidant important role in reducing the incidence of postoperative atrial fibrillation. This study aimed to investigate, administration of vitamin C, as a way to reduce the incidence of atrial fibrillation after coronary bypass surgery.

Methods: In this double-blind clinical study, 290 patients in Rajaee Heart Center, from March 2013 to December 2014 who underwent coronary artery bypass surgery were randomly divided into intervention and control groups to receive vitamin C and placebo. The intervention group before the surgery in the operating room received 2 grams of vitamin C intravenously then one gram per day for four days prior to surgery. After the operation, the two groups were compared in terms of the following: Atrial and ventricular arrhythmias after surgery, ICU stay and hospital stay and duration of intubation.

Results: 113 cases and 177 controls (191 men and 99 women) with a mean age of 55.40±14.40 years in both groups (vitamin C and placebo) were enrolled. The incidence of postoperative atrial fibrillation was 55% in the placebo group to 35% in the vitamin C group decreased (P= 0.001). Duration of intubation in the intervention group 11.8 and the control group was 14.14 hours (P= 0.004). The amount of drainage was lower in vitamin C group (P= 0.003). Vitamin C had no effect on the rates of hospital and ICU stay (P= 0.075). There was no significant reduction in threatening arrhythmia (VT) and VF in this period (P= 0.159).

Conclusion: Vitamin C supplements may reduce atrial fibrillation after coronary artery bypass surgery also can improve conditions such as reducing the duration of intubation. With regard to the safety, these supplements can be recommended for the prevention of atrial fibrillation before coronary artery bypass surgery.

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Background: Pain control after orthognathic surgeries due to severity of pain and limitations of opioids use in these patients are particular importance. The aim of this study was to evaluate the effect of oral gabapentin and intramuscular ketorolac in combination with intravenous acetaminophen for pain control after this surgery.

Methods: This study was a randomized clinical trial (RCT) on 75 patients (18-60 years old American Society of Anesthesiologists (ASA) physical status classification system, I, II) that undergo orthognathic surgery in Sina University Hospital, Tehran University of Medical Sciences, Tehran, Iran from June 2013 to August 2014. The patients were randomly divided in 3 groups. All of groups received 1 gr (intravenous acetaminophen) 30 minutes before the end of surgery. The control group (n= 25) received placebo. The second group (n= 25) received 30 mg ketorolac intramuscular after induction of anesthesia and the third group (n= 25) received 600 mg Gabapentin orally 30 minute before the induction of anesthesia. The pain severity score assessed by visual analogue scale (VAS), the level of sedation assessed by Ramsey scale, opioid requirement, nausea and vomiting was recorded in the post-anesthesia care unit (PACU) at 1, 3, 6, 12 and 24 hours after surgery. For rescue pain management intravenous morphine was administered.

Results: Seventy-five patients were enrolled in this study. Use of Ketorolac and gabapentin declines the pain intensity, level of agitation and morphine requirement in the recovery room and early hours in the ward (P= 0.011). The 24-hour opioid consumption, nausea and vomiting was significantly higher in control group compared with the both intervention groups (15±1.4 vs. 5±0.5 mg) (P< 0.05) retrospectively. Mean arterial pressure and heart rate changes was significantly lower in ketorolac and gabapentin groups compare to control group in recovery room (P< 0.05).

Conclusion: The result of this study suggest that ketorolac as well as gabapentin can decline the pain intensity and opioid requirement with less nausea and vomiting and good hemodynamic control after orthognathic surgery.

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Background: Nano scale dendrimers are macromolecules synthetic which frequently used in medical and health field. Because traditional antibiotics inevitably induce bacterial resistance, which is responsible for many treatment failures, there is an urgent need to develop novel antibiotic drugs. This study was aimed to examine Synthesis and the antibacterial effect of NanoPolyamidoamine-G7 (NPAMAM-G7) dendrimer on Escherichia Coli, Proteus Mirabilis, Salmonella Typhi, Bacillus Subtilis and Staphylococcus Aureus.

Methods: In this experimental study that has been conducted in June 2015 in the Laboratory of Microbiology, Iran University of Medical Science, NPAMAM-G7 dendrimers was synthesized by Tomalia’s divergent growth approach. The antibacterial effects of NPAMAM-G7 dendrimer were studied by disc diffusion and micro-dilution method. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against gram-positive and gram-negative bacteria were determined according to Clinical and Laboratory Standards Institute (CLSI) guideline. Standard discs were prepared using different concentrations of dendrimer on Mueller-Hinton agar plates.

Results: Zone of inhibition in concentration 25 μg/ml of NPAMAM-G7 dendrimers for Escherichia Coli, Proteus Mirabilis, Salmonella Typhi, Bacillus Subtilis and Staphylococcus Aureus were 26, 38, 36, 22 and 25 mm, respectively. Regarding the zone of inhibition in gram negative bacteria with gram positive ones was P= 0.16 and was not significant difference. The MIC for Salmonella Typhi was 0.025, for Proteus Mirabilis, Bacillus Subtilis, Staphylococcus Aureus and Escherichia Coli was 0.25 μg/ml. The MBC for Salmonella Typhi was 25μg/ml, for Proteus Mirabilis and Bacillus Subtilis was 50 μg/ml and for Escherichia Coli and Staphylococcus Aureus was 100 μg/ml. The least of sensitivity against NPAMAM-G7 related to Escherichia Coli and Staphylococcus Aureus and the most of sensitivity related to Salmonella Typhi.

Conclusion: The NPAMAM-G7 dendrimer with end amine groups exhibited a positive impact on the removal of standard strains, gram-positive and gram-negative bacteria. Therefore, it is possible to use these nanodendrimers as antibacterial in the future.

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Background: Lots of vitamin D functions are mediated by its steroid family receptor (VDR). Vitamin D role in infertility is reported by significant fertility reduction in many male laboratory animals with vitamin D deficiency. The reason for reduced fertility in male VDR-null mouse model has been reported to be reduced sperm count and sperm motility. Vitamin D has effects on sperm motility, sperm-ovum coupling, and acrosome reaction stimulation. As VDR is expressed in human male reproductive system, the aim of the current study was to investigate the role of rs2228570 polymorphism of VDR gene in male infertility.

Methods: Investigation was done as a case-control study on infertile azoospermic or oligospermic men referring to Avicenna Research Institute from March 2014 to April 2015. Rs2228570 single nucleotide polymorphism (SNP) located in exon 1 of VDR gene was chosen according to its role on protein function. Blood sampling was done on cases and control groups and after DNA extraction the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) reaction was designed and performed on 100 normal cases, 100 azoospermic and 100 oigospermic control samples. Distribution of quantitative age variable was done using Student’s t-test and qualitative variables (genotype and allelic frequencies) was done using SPSS, ver. 22 (Chicago, IL, USA).

Results: Chi-square test didn’t show significant difference between two case groups and controls (Azoosperm and control P=0.5 and oligosperm and control P=0.09). Comparing CC genotype frequency with TT and CT genotypes (azoosperm and control P=0.48 OR=0.77, oligosperm and control, P=0.17 OR=0.77) and in comparing between TT genotype with CT and CC genotypes (azoosperm and control P=0.49 OR=3.03, oligosperm and control P=0.19 OR=7.21) the difference between these groups was not significant and didn’t increase the probability of disease and didn’t show protective role against it.

Conclusion: According to the findings, the association between rs2228570 polymorphism of vitamin D receptor gene and infertility was not significant and investigation of other polymorphisms might show a relationship with male infertility.

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Background: ″Wernicke’s Korsakoff″ syndrome is the most important complication of severe thiamine deficiency. The term refers to two different syndromes, each representing a different stage of the disease. Wernicke’s encephalopathy (WE) is an acute syndrome requiring emergent treatment to prevent death and neurologic morbidity. Korsakoff syndrome (KS) refers to a chronic neurologic condition that usually occurs as a consequence of WE. It is a rare complication of hyperemesis gravidarum that confusion, ocular signs, and gait ataxia are the most prevalent symptoms, respectively. Typical brain lesions of wernicke’s encephalopathy (WE) are observed at autopsy in 0.4 to 2.8 percent of the general population in the western world and the majority of affected patients are alcoholic. The prevalence of wernicke’s encephalopathy lesions seen on autopsy was 12.5% of alcohol abusers in one report. Among those who with alcohol-related death, it has been reported to be even higher, 29 to 59%. The aim of this study was to report a case of wernicke’s encephalopathy following hyperemesis gravidarum. Case Presentation: A 28-year-old-pregnant woman in 19th weeks of gestation referred to the hospital with hyperemesis, gait ataxia, and dysarthria before that she had hyperemesis gravidarum with weight loss and unresponsive to outpatient and inpatient medical therapy. MRI showed hyperdense lesion around thalamus which was characteristic of wernicke’s encephalopathy. Rapid improvement in patient’s condition occurred after high dose thiamine infusion.

Conclusion: In hyperemesis gravidarum, presence of either symptoms of ocular or mental disorder or ataxia must be considered to rule out and appropriate treatment of Wernicke’s syndrome which can cause maternal and fetal death.

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Background: Gestational trophoblastic neoplasia (GTN) consists of a broad spectrum of benign and malignant tumors which are stem in human placental trophoblast. Vitamin D has several biologic rules. Among the effects of vitamin D on cells, we could mention induction of differentiation and apoptosis and also inhibition of proliferation, angiogenesis and metastatic potency. As nutrition plays a pivotal rule in GTN, in this study we compared serum 25-hydroxy-vitamin D [25(OH) vitamin D] in patients with GTN and normal pregnant women.

Methods: In this prospective case-control study, 30 GTN patients and 48 normal pregnant women were considered as control group who referred to Qaem University Hospital, Mashhad, Iran, from July 2013 to October 2015 were included. All included persons to the study had no history of chemotherapy or using vitamin D supplements. After filling informed consent forms and recording demographic data, 25(OH) vitamin D serum level were measured in both group by enzyme-linked immunosorbent assay (ELISA) method.

Results: Age in two groups was the same (P=0.565). There was no significant difference in gestational age between two groups (P=0.887). Pathologic diagnosis in 83.33% (25 patients) was complete hydatidiform mole and in 16.67% (5 patients) was partial hydatidiform mole. 25(OH) vitamin D serum level in 73.3% of GTN patients and 2.1% of normal pregnant women was lower than 10 ng/ml and among all participants, only 6.3% of pregnant patients had 25(OH) vitamin D serum level higher than 30 ng/ml. Mean serum level of 25(OH) vitamin D in GTN patients was significantly lower than pregnant women group (9.09±5.46 vs. 20.06±6.37, P=0.000). 25(OH) vitamin D serum level between complete and partial hydatidiform mole groups had no significant difference (P=0.384).

Conclusion: Altogether, it was observed that 25(OH) vitamin D serum level is significantly lower in women with GTN than normal pregnant women. Modifying serum levels of vitamin D in molar pregnancy with low level of vitamin D may prevent the development of GTN.

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Background: Thyroid cancer is the most common endocrine malignancy. Accounting for approximately 1-2% of all cancers. Thyroid cancers have been divided into four main types: papillary, follicular, medullary and anaplastic. The active form of vitamin D (1,25- (OH) 2-vitamin D3) by binding to its receptor, using genomic and non-genomic mechanisms inhibits the proliferative effect of TSH on thyroid cells. Therefore, vitamin D may have a role in regulating of thyroid gland cell proliferation. Many studies have shown anti-cancer effects of vitamin D in cancers. Polymorphisms of Vitamin D receptor can influence the prevalence to various cancers. In the present study, serum level of vitamin D and FokI, BsmI and Tru9I polymorphism of vitamin D receptor was investigated.

Methods: This case-control study was performed in the summer of 2015 in Endocrinology and Metabolism Center of Shahid Beheshti University of Medical Sciences, Tehran, Iran. Forty medullary thyroid cancer patients and 40 healthy controls were investigated. Genomic DNA of subjects was extracted with saturated salt/proteinase K and polymorphisms of vitamin D receptor gene investigated by polymerase chain reaction-sequencing. Serum level of vitamin D evaluated by ELISA technique. The results were analyzed by SPSS, ver. 20 (Chicago, IL, USA) and GraphPad Prism, ver. 5 (GraphPad, Inc., CA, USA) softwares.

Results: Genotypic and allelic abundance of FokI and BsmI polymorphisms between test and control groups have not shown significant different. In Tru9I polymorphism, Tt genotype abundance in test group were 45 percent and in control group were 17.5 percent and t allelic abundance in test group were 25 percent and in control group were 8.7 percent which this different were significant. Average serum level of vitamin D in test group was 23.32 ng/ml and in control group was 18.95 ng/ml which was statistically significant.

Conclusion: Unexpectedly, serum levels of vitamin D in test group were higher than control group. Tru9I polymorphism is significantly correlated to medullary thyroid carcinoma prevalence.

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Background: Hypertension is one of the major risk factors for cardiovascular disease. The studies show that factors such as vitamin D, parathyroid hormone, calcium and phosphorus are involved in the regulation of blood pressure. The purpose of this study was to investigate the relationship between blood pressure with vitamin D, parathyroid hormone, calcium, and phosphorus in sedentary postmenopausal women.

Methods: This investigation is in the form of a descriptive correlational study that was performed in September 2015. The statistical population was all healthy and sedentary postmenopausal women 50-70 years old in Urmia city, Iran. Fifty-four sedentary postmenopausal women were selected as subjects and voluntarily and bona fide participated in this study. General and anthropometric characteristics of height, weight, and body mass index (BMI) in subjects were measured by wall-meter with an accuracy of one millimeter, digital scale with precision of 100 g (Beurer, Germany), and dual emission X-ray absorptiometry (DXA) (Hologic, USA) machines, respectively. Diastolic and systolic blood pressure was measured by indicator machine. Serum levels of vitamin D, parathyroid hormone, calcium, and phosphorus were measured by ELISA and Auto-analyzer (BT 1500, Biotecnica, Italy machines, respectively. Results: The mean general, anthropometric, and physiological/laboratory variables of subjects were: age 54 yr, height 156 cm; weight 72 kg; BMI 29 kg/m2; systolic and diastolic blood pressure 76.20 and 110.70, respectively; vitamin D 25.22 ng/ml, parathyroid hormone 33.29 ng/ml, calcium 9.44 ng/ml, and phosphorus 3.26 ng/ml. Moreover, results showed that there was no significant relationship between systolic and diastolic blood pressure and vitamin D (P>0.581 and P>0.619, respectively). There was no significant relationship between systolic and diastolic blood pressure and parathyroid hormone (P>0.623 and P>0.341, respectively). There was no significant relationship between systolic and diastolic blood pressure and calcium (P>0.704 and P>0.141, respectively). There was no significant relationship between systolic and diastolic blood pressure and phosphorous (P>0.058 and P>0.357, respectively). Conclusion: The results suggest that there is no relationship between systolic and diastolic blood pressure with serum levels of vitamin D, parathyroid hormone, calcium, and phosphorous in sedentary postmenopausal women 50-70 years old.