Tehran University Medical Journal

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Background: Tuberculosis with high prevalence in HIV/AIDS patients is the main reason for morbidity and mortality in these patients. About one-third of patients with HIV infection have concomitant tuberculosis. Lack of appropriate infection control on many social and economic communities will impose. Comprehensive study on the effects of anti-tuberculosis drugs in patients with HIV infecting less done, also due to the importance of reducing morbidity and mortality, reduce the cost of disease, identifying drug pharmacokinetics, the importance of completing treatment tuberculosis, this study was performed to evaluate the effects of anti- tuberculosis drugs on HIV infection and to identify the drug pharmacokinetics and so more complete tuberculosis treatment.
Methods: A historical cohort study was performed on patients referring to the research center for HIV/AIDS, consultation center, department of infection diseases of Imam Khomeini Hospital in Tehran, Iran. A total number of 75 cases with HIV negative versus HIV positive patients with pulmonary tuberculosis and positive sputum smear in accordance with inclusion and exclusion criteria were selected.
Results: In this study, the frequency of peripheral neuropathy 27(73%), arthralgia 31(83.8%), vomiting 18(48.6%), headache 26(70.3%), dizziness 20(54.1%), renal toxicity 4(10.8%) and of skin rash 10(27%) in patients with HIV virus infection were significantly more than HIV- negative patients. Hepatotoxicity, fever and anemia were not significantly more common in patients who infected with HIV virus.
Conclusion: The HIV patients, who have not received antiretroviral drugs during tuberculosis treatment, may show higher incidence of anti-tuberculosis drugs complications.

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Background: Many chemotherapeutic regimens used in the treatment of cancer generate free radicals that may be a part of their beneficial effects. The aim of this study was to assess the oxidative status in patients undergoing chemotherapy for acute myeloid leukemia (AML).

Methods: Thirty-eight patients with AML (17 female and 21 male patients) with a mean age 34.05±12.49 years were included in the study. All the patients received cytarabine and daunorubicin as their standard induction therapy. Serum levels of malondialdehyde (MDA), total antioxidant capacity (TAC), and also the erythrocyte superoxide dismutase and glutathione peroxidase activities were measured before and 14 days after chemotherapy.

Results: Plasma malondialdehyde concentrations increased significantly (from a former 2.68±0.89 nmol/ml to 3.14±1.29 nmol/ml) 14 days post chemotherapy (p=0.04). Moreover, the total plasma antioxidant capacity changed from 1.09±0.15 mmol/L to 1.02±0.14 mmol/L (p=0.005). Erythrocyte superoxide dismutase and glutathione peroxidase activity decreased over time from 1157.24±543.61 U/gHb to 984.01±419.09 U/gHb (p=0.04) and 46.96±13.70 U/gHb to 41.40±6.44 U/gHb (p=0.02), respectively.

Conclusion: In this study, an increase in malondialdehyde levels and a decrease in the levels of antioxidant enzymes and total antioxidant capacity were observed. It seems that chemotherapy by cytarabine and daunorubicin generates enormous amounts of free radicals in patients undergoing the treatment for AML. Use of antioxidant supplementation during chemotherapy i is discouraged as it may interfere with the generation of free radicals that may be a part of the therapeutic efficacy of these drugs.

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Background: Lactobacillus species are genetically diverse groups of Lactic Acid Bacteria (LAB) that have been introduced as probiotics, because of some characteristics such as their anti-tumor properties, helping the intestinal flora balance, production of antibiotics, stimulation of host immune response, etc. The aim of this study was to investigate the effects of cytoplasmic extraction and cell wall of Lactobacillus species isolated from the intestine of common carp on human chronic myelocytic leukemia or K562 cancer cell lines.
Methods: The intestinal contents of 115 common carp captured from the natural resources of West Azerbaijan province in Iran were examined for LAB. After isolation, the identification of Lactobacilli was done according to traditional and molecular bacteriological tests. Subsequently, a suspension of each bacterium was prepared and the protein content of the cytoplasm was extracted. Cell wall disintegration was done by cell lysis buffer and sonication. The effects of cytoplasmic extraction and cell wall on K562 cell line proliferation were investigated by MTT assays.
Results: The cytoplasmic extraction of the isolated Lactobacilli had significant (p<0.05) anti-proliferative effects on K562 cells. The cytoplasmic extractions of Lactobacillus paracasei and Lactobacillus casei inhibited K562 cell proliferation by 66.56% and 54.28% at 83.33 μg/ml concentration, respectively.Nevertheless, the Lactobacillus cell wall could not inhibit the proliferations of K562 cells (p<0.05).
Conclusion: In this study, the cytoplasmic extractions of the isolated Lactobacilli from the intestine of common carp had anti-proliferative effects on K562cell line.

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Background: Propolis (bee glue) is a resinous substance obtained from bee hives living on various plant sources. The purpose of this study was to evaluate the effects of ethanol extract of propolis (EEP) on the experimentally induced Candidial keratitis in rabbits. Methods: The alcoholic extract of propolis was prepared by 80% ethyl alcohol. After suppressing the immune system of 24 male rabbits, experimental Candida albicans keratitis was induced in the animals under local anesthesia and sterile conditions. The animals were later divided into four groups including the control or glycerin group and a nystatin and two 500 and 1000µg/ml EEP groups. Treatment continued for 21 days and after sacrificing the animals by humane methods, histopathological samples of the rabbits’ eyes were prepared. Results: Keratitis was developed in the eyes of all rabbits a week after the yeast inoculation. In the control group in which animals received glycerin, keratitis persisted until day 21. Clinical signs of keratitis disappeared in the Nystatin and 1000µg/ml EEP groups after 14 and 21 days, respectively. The clinical signs of keratitis partially ameliorated in the animals receiving 500µg/ml EEP. Histopathological examination revealed no differences between groups receiving nystatin or 1000µg/ml EEP. Conclusion: It is concluded that, ethanol extract of propolis could completely treat Candida albicans keratitis in 1000µg/ml concentrations. This extract can be used as a safe antifungal agent against Candida albicans and it is a good substitute for synthetic antifungal agents like nystatin.

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Background: Atrial fibrillation is the most common but benign arrhythmia following cardiac surgery. Although this arrhythmia is often self-limited and vanishes in about 24 hours upon surgery a number of arrhythmias might ensue among which some might be really life-threatening. A multitude of therapeutic modalities have been proposed for the prevention of this arrhythmia and one of them is posterior pericardiotomy. This method has not been fully accepted by the peers yet and more studies are needed to prove its efficacy and benefits to the patients. Methods: In this single-blind randomized clinical trial, done over a 2-year period from February 2009 to January 2011, the effects of posterior pericardiotomy were evaluated in 174 patients (87 the case and 87 the control groups) undergoing elective coronary artery bypass grafting (CABG). The case group underwent CABG with posterior pericardiotomy while the control group underwent CABG-only operation. The postoperative incidence of arrhythmia, especially atrial fibrillation, was assessed for a week using statistical methods. Results: The prevalence of postoperative atrial fibrillations were fewer in the group undergoing CABG with posterior pericardiotomy compared with the CABG-only group (P<0.004). Conclusion: Posterior pericardiotomy seems to reduce the incidence of atrial fibrillation following elective CABG therefore, its application is suggested for elective CABGs

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Background: Reconstruction by free tissue transfer and microvascular anastomosis can provide a reliable repair for tissue defects in head and neck surgeries. During this study, we evaluated the clinical characteristics and outcomes of reconstructive surgery by the use of free flaps for defects resulting from head and neck cancers. Methods: This quasi-experimental study included 29 patients having been diagnosed with head and neck cancers and referred to the Plastic Surgery Clinic and Cancer Institute of Imam Khomeini Hospital Complex in Tehran, Iran, for the resection of cancerous tissue. After operation, the patients were followed-up for three months and the surgical outcomes were evaluated. Results: The mean age of participants was 50.8 ± 15.1 yrs. Two patients (6.9%) had total and three (10.3%) had partial flap loss. The rate of total and partial flap loss in this study was less than 10%. There were no differences between groups with total and partial flap loss regarding mean age, mean operation time, and mean perioperative ischemia time. Prothrombin time (PT) and international normalized ratio (INR) were significantly different in patients with total flap loss compared with patients with successful reconstruction. The INR for the group with total loss was 2.2 and 1.2 ± 0.3 for other patients (P=0.0006). The mean ACT was 46 seconds in patients with total flap loss and 82 ± 18.9 seconds for other patients (P=0.08). Conclusion: Considering its high success rate, free tissue transfer can be considered as a method for single-stage reconstruction in almost all major head and neck defects.

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Background: Infections caused by opportunistic yeasts such as Candida species, Trichosporon, Rhodotorula and Saccharomyces have increased in immunocompromis- ed patients and their identification is crucial as intrinsic and acquired resistance of some yeast species to antifungal agents are on the rise. The aim of this study was to identify the organisms to the species level in order to suggest accurate and effective antifungal therapies. Methods: In this study that carried out in Tehran, Iran in 2009, 200 patients with yeast infection were medically examined and clinical specimens were prepared for direct examination and culture on Sabouraud dextrose agar. Subsequently, the isolated yeast colonies were identified using various tests including culture on Corn Meal agar with Tween 80, CHROMagar Candida and casein agar. For the definite identification of organisms some biochemical tests were done based on carbohydrate assimilation by RapID Yeast Plus System kit, and, finally, a molecular method, PCR-RFLP, using Hpa II enzyme, was performed for the remaining unknown yeast species. Results: A total of 211 yeast isolates were identified in 200 patients with yeast infections. The most frequent isolated yeasts were Candida albicans, 124 (58.77%), followed by Candida parapsilosis, 36 (17.06%), Candida tropicalis, 17 (8.06%), Candida glabrata, 13 (6.16%), Candida krusei, 8 (3.79%), Candida guilliermondii, 2 (0.96%), Trichosporon, 3 (1.14%), Rhodotorula, 1 (0.47%), Saccaromyces cerevisiae, 1 (0.47%) and other yeast species, 6 (2.84%). Conclusion: Nail candidiasis was the most prevalent type of yeast infection in the patients and Candida albicans was the most frequent isolated species from all clinical specimens.

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Background: Rosa damascene has a special role in the Iranian traditional medicine due to its sedative, anticonvulsant and analgesic effects. Regarding its alkaloid, flavonoid and other organic compounds, this plant has always been used to reduce nervousness and treat depression and chronic insomnia. In the present time, synthetic drugs with sedative and anxiolytic properties are used for such problems but due to their side- effects and economic issues, the significance of natural medicines with fewer side- effects is of interest. Considering the importance of sedative and anxiolytic effects of Rosa damascene, we decided to compare this plant with synthetic drugs of the same properties. Methods: Two different groups of male Wistar rats received either Rosa damascene extract in doses of 150, 300, 450 mg/kg or Diazepam and dimethyl sulphoxide in doses of 1.2 mg/kg intraperitoneally 30 minutes before assessing the sleep duration, sedation and preanesthetic effects induced by intraperitoneal ketamine, 40 mg/kg. The anti- anxiety effect was evaluated by using an elevated plus maze and a rota rod. Results: The results showed a meaningful increase in the period of sleep induced by Ketamine (P≤0.01) and also a meaningful increase in time spent at the open arms of the device in the group receiving Rosa damascene extract (P≤0.01). Conclusion: The results showed that the Rosa damascene extract dose 450mg/kg has sedative, preanesthetic and anxiolytic effects (P≤0.01).

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Background: Cell-therapy provides a promising alternative for the treatment of type 1 diabetes. Monocytes which have a reprogramming or differentiation potential and are more available than any other types of stem cells, have been recognized as candidates for such investigations. The aim of the present study was to evaluate the differentiation potential of rat peripheral blood monocytes into insulin-producing cells by the use of rat pancreatic extract (2 days after a 60% pancreatectomy).

Methods: Rat peripheral blood monocytes were isolated and cultured. Adherent monocytes were induced to differentiate into programmable cells in RPMI supplemented by 10% FCS, &beta-mercaptoetanol, M-CSF and IL-3 for six days. The dedifferentiated cells were analyzed by invert microscopy. Cultures of Programmable Cells of Monocytic Origin (PCMOs) were continued in RPMI, containing 10% FBS, pancreatic extract and 5 mmol/L glucose for 15 days. The medium was replaced every three days. At the end of the protocol, insulin and c-peptide excreted by the differentiated cells were tested by radioimmunoassay on days 6, 14, and 21. In order to verify insulin production in the cells, dithizone-staining, which is a method for insulin identification, was employed.

Results: The results showed that the cells cultured in rat pancreatic extract secreted insulin and c-peptide relative to the control group. Dithizone-staining was positive in the aforesaid cells (P<0/05).

Conclusion: The results of the current study showed that pancreatic extract treatment can differentiate rat peripheral blood monocytes into insulin-producing cells which can be regarded as a potential source for the treatment of diabetes.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: Syndactyly is the most common congenital malformation of the hand, with an incidence of 1 in 2000-2500 live births. In this study we evaluated the surgical outcomes and complications of patients with syndactyly.
Methods : The surgical outcomes and complications of 42 patients, 27 male and 15, female, undergoing surgery for syndactyly were evaluated. The study took place in Imam Khomeini Hospital, in Tehran, Iran during 1996 to 2011. Having had the inclusion criteria, the patients were assessed for function, cosmetic outcome, sensation and occurrence of complications. The patients were followed-up for at least 3 years.
Results : The mean age of patients was 4.4 years. There was a positive familial history for the disease in 8 patients. 71.4%, 90.4% and 73.8% of the participants had good results regarding cosmetic outcome, sensation and function, respectively.
Conclusion: The overall results of surgery for syndactyly in this study were interpreted as good in 78.5%, moderate in 12.5% and fair in 8.4% of the patients. This study confirmed better surgical outcomes in patients older than 18 months.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: More than 80 years, the standard treatment of locally advanced cervical cancer was radiotherapy. However, based on several phase III randomized clinical trials in the past decade, concurrent cisplatin-based chemoradiotherapy is the current standard of treatment for this disease. Gemcitabine has potent radiosensitizing properties in preclinical and clinical trials, so it can be utilized simultaneously with radiation.
Methods:  Thirty Women with untreated invasive squamous-cell carcinoma of the cervix of stage IIB to stage IVA were enrolled in the study in Radiation Oncology department of Imam Khomeini Hospital in Tehran from September 2009 to September 2010. Sixty mg/m² gemcitabine followed by 35 mg/m² cisplatin were concurrently administered with radiotherapy to the whole pelvic region on day one of each treatment week for five weeks One and three months after treatment, patients underwent a complete physical examination and MRI to determine the response to treatment.
Results:  The mean age of the participants was 58.13±11.83 (29-78) years. After 3 months of treatment, 73.3% had complete and 26.7% had partial response to treatment. Grade 3 anemia was seen in 10%, grade 3 thrombocytopenia in 3.3% and grade 3 leukopenia in 10% of the patients.
Conclusion: According to the positive results of this study in stage IIB, further phase II and III clinical trials are suggested to evaluate the role of chemoradiation by gemcitabine in advanced cervical cancers.

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Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background: One of the difficulties in acetabulum surgery is appropriate exposure of the site of surgery. Trochanteric flip osteotomy is one of the surgical methods for superoposterior and posterior acetabulum exposure. However, due to possible complications some surgeons prefer to avoid this procedure. This study was undertaken to determine the outcome of surgical treatment of acetabular fracture using trochanteric flip osteotomy.
Methods : In this prospective cohort study, 14 patients with acetabular fracture who had been admitted in Imam Khomeini Hospital in Tehran, Iran, during 2003-2006 underwent trochanteric flip osteotomy. The patients were followed for at least one year post-surgically. Demographics, radiologic findings, intensity of pain using visual analogue scale (VAS), Harris hip score (HHS), force of hip abductors and complications were noted. Data analysis was performed using SPSS ver. 13.
Results : The mean HHS was 82.5 (55-95). Heterotopic ossification was observed in three patients. There were no cases of postoperative infection or non::::union::::. Only two patients showed displacement of osteotomized fragments. Reduction was anatomic in 10 patients. In one patient, the force of hip abductors was three-fifth. The mean hip pain was 3.4 based on VAS. There were no cases of femoral head osteonecrosis. With respect to HHS, the final hip status was excellent and good in four and six patients, respectively. Three patients had fair and only one patient had poor condition.
Conclusion: It seems that trochanteric flip osteotomy has much fewer complications in comparison to other methods justifying its use in such cases.

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Background: The characteristic of stem cells in self renewal and differentiation to different types of cells has stimulated the interests for using stem cells as a starting material for generating insulin secreting cells. We've evaluated the differentiation potential of Programmable cells of monocytic origin (PCMOs) into insulin producing cells effected from the growth factors and fibroblasts conditioned media (FCM).

Methods: Peripheral blood monocytes of rat were cultured for 6 days in RPMI with 15% FBS, β- mercaptoethanol, MCSF and interleukin-3. Then, these cells were incubated in differentiation media with HGF, EGF, Nicotinamide, 15% fibroblasts conditioned media and glucose for 15days. Morphological differences of cells were studied by invert microscope. In several stages, the amounts of insulin in supernatant of cells were measured by radioimmunoassay kit. Also productions of insulin from differentiated cells were studied with DTZ special staining.

Results: In response to MCSF and IL-3, monocytes dedifferentiated. These programmable cells of monocytic origin (PCMOs) were capable of differentiating into insulin producing cells in differentiation media. The morphology of differentiated cells was similar to Beta cells and the amount of insulin in supernatant of differentiated cells was much higher than PCMOs (P<0.05).

Conclusion: HGF, EGF, Nicotinamide and fibroblasts conditioned media are differentiation factors of PCMOs into insulin producing cells. According to the results insulin producing cells can be differentiated from programmable cells of monocytic origin in presence of fibroblasts conditioned media.

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Background: Paraoxonase-1 (PON1) moves with high-density lipoprotein (HDL) particles in blood and prevents low-density lipoprotein (LDL) particles from oxidation. The aims of this study were to investigate the correlation between fatty acid composition of HDL phospholipids with pon-1 polymorphisms and response to lovastatin treatment in people with high blood cholesterol.

Methods: In this descriptive study, 265 patients were selected and divided into two groups based on LDL-C concentrations 131 patients with LDL-C greater than 130 mg/dl (cases) and 134 patients with LDL-C lower than 130 mg/dl (controls). Fatty acids of HDL phospholipids were measured with gas chromatography and lipid profile (cholesterol, triglyceride, LDL-C, HDL-C), apolipoprotein A1 and apolipoprotein B were measured by relevant commercial kits. Oxidized LDL was measured by ELISA method and activity of paraoxonase was determined by a relevant standard manual method. Genotypes of L55M polymorphism were determined by polymerase chain reaction-restriction fragment length polymorphism procedure.

Results: Prevalence of L allele from L55M polymorphism was 0.65 and 0.53 in the case and control groups, respectively (P=0.04). PON1 paraoxonase activity in LL homozygote genotype was higher than other genotypes upon treatment with lovastatin. Concentrations of oleic, linoleic and eicosapentaenoic acids in LL genotype were increased by lovastatin administration.

Conclusion: Allele (L) from L55M polymorphism had a higher frequency in patients with higher LDL-C concentrations. PON1 genotypes seemed to have a modifying role on paraoxonase-1 activity after lovastatin therapy.

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Background: Carpal tunnel syndrome is the most common focal neuropathy that results from pressure on a nerve. The goal of this study was to assess carpal tunnel syndrome and its associated factors such as occupation, sex, and accompanying complications in a teaching general hospital.

Methods: This cross-sectional study investigated 362 patients with the diagnosis of carpal tunnel syndrome admitted in the orthopedic ward of Imam Khomeini Hospital affiliated to Tehran University of Medical Sciences in Tehran, Iran during 2000-2010.

Results: The difference in the mean age of men and women was statistically significant (P<0.0001). The percentage of men with the disease was significantly different from that of the women. The prevalence of idiopathic carpal tunnel syndrome was significantly different (P<0.0001) in comparison with carpal tunnel syndrome due to its leading causes. The most common occupation in women was first housekeeping and then hairdressing while in men it was being a worker. Diabetes Mellitus and hypothyroidisms as the leading causes of the syndrome were highly correlated with the disease (r=08, P<0.001).

Conclusion: According to the findings, most cases of the syndrome were idiopathic. Identifying the leading causes of the disease is important because their diagnosis probably prevents unnecessary surgery. By identifying such causes and/or correction of activity styles incidence of carpal tunnel syndrome and unnecessary surgical procedures would be prevented. Evaluation of patients for underlying causes can be useful, especially in severe forms of the disease to realistically assess the need for surgical treatment.

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Background: Anosmia is a physical sign in post-traumatic patients, which significantly reduces the quality of life. Anosmia occurs in up to 30% of cases with head trauma. In this study we aimed to compare the Olfactory Bulb Volume (OBV) in patients with posttraumatic anosmia in different impact positions and also with healthy individuals to find the relation between the two variables.
Methods: Thirty-eight patients with posttraumatic anosmia and 27 healthy individuals with normal olfactory function were recruited in this case-control study performed in Amir Alam Hospital in Tehran, Iran. Variables of age, sex, time of trauma, site of trauma (frontoparietal/occipital), side of trauma, OBV, the results of olfactory identification tests and olfactory threshold were extracted and evaluated. We used non-contrasted 1.5-Tesla coronal brain MRI for the measurement of OBV.
Results: There were no significant differences between cases and controls regarding sex and age. Olfactory bulb volume was significantly smaller in cases compared to the controls (P=0.004). Among the case group, OBV was smaller in anterior versus posterior head traumas (P=0.02). OBV was also smaller in ipsilateral rather than the contralateral side of trauma (P=0.01).
Conclusion: The direction of trauma had a significant effect on OBV and it was smaller in traumas to the anterior and also ipsilateral sides of the head. It seems that changes in OBV differ due to the direction of head trauma and it can be helpful in predicting the prognosis of posttraumatic anosmia. Further studies are required for more conclusive statements.

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Background: The high number of breast cancer patients who receive radiation therapy after surgery has caused many to think about a shorter period of radiotherapy, which can significantly reduce the radiotherapy machine time, labor hours, and fewer patient visits. This study was designed to evaluate the acute skin effects and cosmetic outcomes of short course radiotherapy in early-stage breast cancer in comparison with the conventional treatment method.
Methods: Fifty-two patients with operable breast cancer (pT1-3pN0M0) who underwent breast conservation surgery in Tehran Cancer Institute during January 2011 to January 2012, were randomly assigned to undergo radiotherapy by either receiving conventional treatment (dose: 50 Gy in 25 fractions) with subsequent electron boost or a short-course hypofractionated radiotherapy (dose: 42.5 Gy in 16 fractions) and a subsequent electron boost.
Results: There were no skin changes during the first or the second week of treatment in the two groups. Cutaneous complications began after the third week as grade 1 skin toxicity after termination of the short-course radiotherapy but there were no difference in complication rate after four weeks of treatment. Six months and one year after treatment, there were no differences in terms of skin complications or cosmetic outcomes between the two groups.
Conclusion: Although the use of a whole-breast irradiation with a hypofractionated schedule was associated with desirable outcomes, in term of skin toxicity and cosmetics, but longer follow-up periods with larger sample sizes are needed to confirm these results.

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Background: Chlamydia trachomatis is the most common bacterial sexually transmitted infection in the world, but the effect of this infection on male fertility is still controversial. Despite reports of interaction between Mycoplasma genitalium and sperm, this pathogen in semen samples of infertile men is less studied. We studied, the prevalence of Chlamydia trachomatis and Mycoplasma genitalium infection in infertile men.
Methods: Among attending Avicenna Infertility Center, 120 men who had abnormal semen analysis tests were selected and the samples were taken. After detailed analysis of semen quality, DNA was extracted from each sample by chelex. Samples were evaluated for these two pathogens by multiplex PCR. Results were statistically analyzed.
Results: Chlamydia trachomatis and Mycoplasma genitalium was detected in 23/3% and 12/5% of the samples, respectively. Although, Mycoplasma genitalium infection rises by increasing (P=0.640) and decreasing in age of first sexually activity (P=0.203), and also positive cases of Chlamydia trachomatis infection showed increase regarding age increase (P=0.619) and age decrease in first sexually activity (P=0.511), but these differences were not statistically significant.
Conclusion: All in all, regarding to the increased prevalence of Chlamydia trachomatis infection compared with the only similar study in Iran and high prevalence of Mycoplasma genitalium infection in infertile men, this assessment was done. A multiplex PCR protocol rapidly and simultaneously identify these organisms in comparison with uniplex from clinical samples. Based on our results screening for Chlamydia trachomatis and Mycoplasma genitalium infection among infertile men seems to be valuable.

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Background: The aim of this study was to evaluate the effect of extracted cell walls from Lactobacillus casei and Lactobacillus paracasei as probiotic bacteria (isolated from common carp intestine) on K562 and the role of cell concentration on the results of MTT [3-(4,5-Dimethylthiazol-2-yl)2,5- Diphenyl tetrazolium Bromide] test.
Methods: For this purpose, bacteria were cultured in specific medium (MRS broth) at anaerobic condition for 24-48 hour. After incubation period culture medium was centri-fuged, then the cells were washed twice with PBS buffer to remove additional medium. Finally, collected bacterial cell disrupted by Sonication and cell walls were separated from other components by centrifugation. After that, different concentrations of cell walls (500, 1000, 2000 and 4000 µg/ml) were prepared in RPMI medium for each bacteria, separately. Then anticancer properties of the cell walls were determined in vitro at 12, 24, 48 and 72 h, also the effect of K562 concentration was assayed with MTT technique.
Results: The results showed extracted cell wall from both probiotic statistically (P=0.098) have anti turmeric properties in K562 and their properties will arise in relation with concentration. As well as, we found that the number of cell had not any affect on the result of MTT assay.
Conclusion: We conclude that the cytotoxicity property of extracted cell wall is related in the type of bacteria, but this anticancer property would warrant further study on the clinical application of extracted cell wall.

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Background: Serum estradiol level is a controversial prognostic factor in the outcome of labial adhesion. The aim of this study was to evaluate serum estradiol levels and topical estrogen response in patients with labial adhesion.
Methods: A prospective interventional study was conducted among girls with labial adhesion that referred to Pediatrics clinic in Taleghani University Hospital, Gorgan city, Iran in 2011. One hundred patients entered the study. The diagnosis was conducted by clinical examination of vestibule area. Inclusion criteria were, three months to eight years old prepuberty girls, no ambiguous genitalia, lack of vulvovaginitis symptoms, labial adhesion more than twenty five percent, no history of previous topical estrogen treatment since two weeks ago and previous incomplete treatment. The patients who did not use proper amount and duration of drug and also with adverse drug reactions during treatment period were excluded from the study.
Results: The maximum frequency of labial adhesion was in the group of less than one year old. The minimum frequency of labial adhesion was in the 7-8 years old group. Eighty six patients had complete or partial remission. No evidence of an improvement was observed in fourteen children. Severity of adhesions did not worsen in our patients. Serum estradiol levels were lower in patients who had a positive response to treatment. There were significant differences in serum estradiol levels between full or relative improvement with no improvement groups (P=0.044).
Conclusion: Findings of this study showed that the labial adhesion patients with low serum estradiol level had better treatment response after using topical estrogen.