Tehran University Medical Journal

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Background: The number of patients suffering from diabetic ulcers has been increased in recent years and the current therapies have faced failure. This study aimed to investigate the effects of Wharton’s jelly stem cells (WJMSCs) on the diabetic wound in an animal mode.
Methods: During this laboratory experimental study carried out in Skin and Stem Cells Research Center from March 2021 to November 2021, WJMSCs were isolated and their differentiation capability to osteocytes and adipose cells was assessed using the colorimetric method, and the expression of specific markers was evaluated using flow cytometry. 12 male Wistar rats weighing 200 to 250 grams were purchased from the Pasteur Institute and kept in the animal room in standard condition. Streptozotocin was used to induce diabetes in male Wistar rats. Animals were divided to control (normal saline injection: n=6) and WJMSCs injection (n=6) groups. Wounds with 0.8 cm in diameter were made on the back of rats. After subdermal injection of normal saline and WJMSCs, wound healing was evaluated 7, 14 and 21 days using the photography method. Data were analyzed using a t-test and analysis of variance.
Results: The results showed that the isolation process should be performed no later than a few hours after the cesarean section. Storing the sample for one day or more caused sample contamination leading to significant failure in cell proliferation and differentiation. WJMSCs were positive for specific mesenchymal stem cell markers (CD44, D73, CD90 and CD 105, and negative for CD45 and CD 34. They were capabale to differentiate into osteocytes and adipose cells and had a high viability rate (83.1%). Subdermal injection of WJMSCs in diabetic rats resulted in acceleration of diabetic wound healing compared with the control group.

Conclusion: Subdermal injection of WJMSCs can effectively accelerate diabetic wound healing. According to which, applying Wharton’s jelly stem cells can be considered in cell therapy particularly in the field of diabetic wound healing.

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Results: The result showed that LIV-1 protein was well purified and also the camel polyclonal antibody was able to detect LIV-1 protein in ELISA, western blot and also it can detect LIV-1 on the cell surface as shown by flow cytometry test. Conclusion: In recent years, LIV-1 has been shown to be a good candidate as a marker in breast cancer, so polyclonal antibodies against LIV-1 can be used for early detection of breast cancer by various diagnostic methods. In this study, it has been shown that polyclonal camel antibodies can be used in laboratory methods and can be considered for immunological tests and therapeutic applications.

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Results: The mean age was 39.54±9.52 years for the patients and 28.14±5.32 years for the controls, respectively. The mean BMI were 26.3±3.18 kg/m2 and 27.3±3.52 kg/m2 for the patients and the controls, respectively. In addition, the results showed that the prevalence of surgical disc in patients with L4-L5 levels was 52.1% and L5-S1, with 31.1%. This study showed, rs1676486 in alpha1 type11 collagen gene was associated with modified intervertebral disc degeneration at age ≤50 years and this gene increases intervertebral disc degeneration risk at age >50 years. SNP rs1676486 had the significant association with the intervertebral disc degeneration (P=0.019), and patients were found to have higher frequency of AA than the controls. Conclusion: This observation shows that type XI collagen is related to age and genetic factor in intervertebral disc degeneration disease.

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Breast cancer is one of the most common types of cancer in women. Screening mammography is a low‑dose X‑ray examination of breasts, which is conducted to detect breast cancer at early stages when the cancerous tumor is too small to be felt as a lump. Screening mammography is conducted for women with no symptoms of breast cancer, for early detection of cancer when the cancer is most treatable and consequently greatly reduce the death rate from the breast cancer. Screening mammography should be performed every year for women age 45-54, and every two years for women age 55 and older who are in good health. A mammogram is read by a radiologist to diagnose cancer.
To assist radiologists in reading mammograms, computer-aided detection (CAD) systems have been developed which can identify suspicious lesions on mammograms. CADs can improve the accuracy and confidence level of radiologists in decision making and have been approved by FDA for clinical use. Traditional CAD systems work based on conventional machine learning (ML) and image processing algorithms. With recent advances in software and hardware resources, a great breakthrough in deep learning (DL) algorithms was followed, which revolutionized various engineering areas including medical technologies. Recently, DL models have been applied in CAD systems in mammograms and achieved outstanding performance. In contrast to conventional ML, DL algorithms eliminate the need for the tedious task of human-designed feature engineering, as they are capable of learning useful features automatically from the raw data (mammogram). One of the most common DL frameworks is the convolutional neural network (CNN). To localize lesions in a mammogram, a CNN should be applied in region‑based algorithms such as R‑CNN, Fast R‑CNN, Faster R‑CNN, and YOLO.

Proper training of a DL‑based CAD requires a large amount of annotated mammogram data, where cancerous lesions have been marked by an experienced radiologist. This highlights the importance of establishing a large, annotated mammogram dataset for the development of a reliable CAD system. This article provides a brief review of the state‑of‑the‑art techniques for DL‑based CAD in mammography.

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Results: In two groups of intervention and control; Mean maternal age, body mass index, and birth weight were not significant (P>0.05) In the intervention group, at the 8th and 16th weeks after delivery, the mean score of total sexual function, and the total score of female urinary and fecal incontinence was a significant difference. (P<0.05). Compared between the groups, the mean sexual function and pelvic floor irritation at 16 weeks postpartum were significantly different between the two groups. Physiotherapy and pelvic floor exercise intervention reduce pelvic floor irritation and improve sexual function.

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Conclusion: Anemia has a relatively high prevalence in the center of Baharloo Hospital, Tehran, Iran. So screening and further investigation for anemia and related factors are critical. According to the results of our investigation, studies showed that anemia is a multifactorial disease that depends on different factors. The existence of variable results in different studies requires evaluating more parameters that affect the incidence of microcytic anemia, such as iron deficiency, eating habits, level of parental education, and use of iron supplements in pregnancy. Management of this disease requires screening and early diagnosis for more effective treatment and reduction of its potential complications.

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Conclusion: The results of this study help to understand the current position of medical negligence studies in the country to identify the cause of the malpractice and develop new studies for the future.

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Background: This study aimed to evaluate the effect of intravenous Ibuprofen Apotel analgesia in comparison with intravenous Morphine alone regimen in patients undergoing lubmar disc surgery.
Methods: This study was a double-blind clinical trial that was performed on patients with moderate to severe lumbar disc pain (VAS score or Visual analog scale more than 4) in August 2019 at Shohada Tajrish hospital. Patients in the Ibuprofen-Apotel group (group A) recieved intravenous Ibuprofen (800 mg) in 100 cc Normal saline in the first 30 minutes of Recovery, then 400 mg in 100 cc Normal saline every 6 hours (48 hours after surgery), plus 30 mg Apotel for each kilogram in100 cc Normal saline in 15 minutes every 8 hours. In group B, Morphine has injected with 70 µg/kg bolus and then 20µg/kg/h infused with a PCA pump with a Maximum Rate of 1mg/hr. Then 60 minutes after surgery, patients' pain was measured using an analog scale.
The primary outcome was defined as a reduction in pain intensity of 3 or more VAS units (which was considered as therapeutic success) and the incidence of side effects was considered as secondary outcomes.
Results: Based on the results of this study, the mean age of the subjects was 33.28±12.48 years. Also, the mean age in the group of Ibuprofen-Apotel and Morphine alone were 35.4±13.6 and 31.16±11.75 years. So, there is not a significant difference between the groups. 77.14% of the subjects (54 people) were male and 22.86% (16 people) were women. In comparing the frequency distribution of individuals in terms of gender and the method of creating analgesia, no significant difference was observed between the groups studied.
According to the results, after the intervention, the highest pain intensity in both groups was significantly decreased. However, no significant difference was observed between the two groups.
Conclusion: The study indicated that Ibuprofen can be effective in controlling postoperative pain. 

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Results: There were 834 general hospitals with 108,275 active beds in Iran in 2018. The Iranian general hospitals had an average bed occupancy of 62.8%, an average patient length of stay of 2.6 days, and an average bed turnover of 93.4 times. Almost 15.3% of the hospitals performed well and were located in area 3 of the Pabon Lasso chart. About 36.1% and 48.6% of the hospitals had moderate and low efficiency, respectively. Approximately, 74% and 21% of hospitals had the accreditation status of 1 and 2, respectively. There was a significant relationship between the degree of accreditation of hospitals with their bed occupancy, bed turnover and bed turnover interval. Conclusion: The efficiency of public hospitals is low. A hospital accreditation grade is related to some of its efficiency indicators. Low efficiency and waste of resources will reduce the effectiveness of hospital and, consequently, its accreditation grade. Accordingly, the hospital's revenue will decrease and therefore, the hospital's productivity and accreditation grade will decrease and the hospital will be in a vicious cycle. Strengthening hospital accreditation standards and their proper implementation will increase the efficiency of hospitals.

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The recording of electrophysiological activities of brain neurons in the last half-century has been considered as one of the effective tools for the development of neuroscience. One of the techniques for recording the activity of nerve cells is the multi-electrode arrays (MEAs). Microelectrode arrays (MEAs) are usually employed to record electrical signals from electrogenic cells like neurons or cardiomyocytes. MEAs consist of an array of planar or three-dimensional electrodes that act as electrical interfaces and record cellular signals or stimulate cells. These platforms can be used in different applications including neuroscience studies, prostheses and rehabilitation, deep brain stimulation (DBS), cardiac pacemakers, retinal and cochlear implants, or for brain-computer interfaces (BCI) in general. Multi-electrode arrays are known as long-term recording and non-invasive devices. The MEA structure includes arrays of electrodes with micrometer and nanometer dimensions which are designed to stimulate and record the electrical activity of cells, and are fabricated using micromachining technologies. MEAs should be biocompatible to serve as a substrate for cell growth. On the other hand, they must have low impedance to be able to provide a high signal-to-noise ratio, and small size to offer a suitable spatial resolution for recording. MEAs are usually fabricated on glass substrates patterned with high-conductivity metals such as gold, iridium or platinum, which are insulated with a biocompatible layer. Despite fast progress, current multi-electrode arrays for neural applications still face limitations such as low signal-to-noise ratio and spatial resolution. To achieve better spatial resolution and lower noise levels and therefore more accurate signal, it is necessary to develop arrays with smaller sizes and lower impedance. Meanwhile, many nanostructures such as graphene, carbon nanotubes, gold nanoparticles, and also conductive polymers have become attractive candidates for this application due to their interesting properties. In this paper, the technology of multi-electrode arrays, how it works and its various parts are introduced, and finally, the challenges and developments in this field are investigated. Multi-electrode array technology is used for neuroscience research, neural network analysis, drug effects screening, and neural prosthesis studies.

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Results: In a survey of 33 studies and 97205 participants in the age range of (3-18) years, the general prevalence of asthma in this study based on meta-analysis was 5.1% (CI95%: 4-6.5%). The highest prevalence of asthma was among children from Babol which was 19% (CI95%: 17.8% -20.3%) in 2014 and the lowest prevalence of asthma was among children from Isfahan with 0.7% of prevalence (CI95%: 0.5-1.1) in 2001. Also, with the increase of research years and overall sample size in each study, asthma in children shows increasing and decreasing levels, respectively; and the differences were statistically significant. Conclusion: Based on what was reported in this study, the prevalence of asthma among Iranian children is lower compared to children of developed countries.

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Background: Millions of deaths occur around the world each year due to lack of access to appropriate treatment for chronic kidney disease patients. Given the importance and mortality rate of this disease, early and low-cost prediction is very important. The researchers intend to identify chronic kidney disease through the optimal combination of techniques used in different stages of data mining.
Methods: This cross-sectional research was conducted from February 1999 to May 2014. The used data set included 4145 samples and 32 attributes, where Each sample corresponded to a patient and each attribute corresponded to the demographic and clinical traits. There were several eligibility criteria for the patients for clinical testing. These criteria for the clinical testing included having 18 years of age and older, living in Isfahan city, willing to participate in the study, lack of fever and cold during laboratory tests, no strenuous exercise 48 hours before laboratory tests, and fasting. Individuals who had an incomplete questionnaire or were unwilling to perform accurate tests were excluded from the study. The target variable is kidney disease, the values of which include sick and healthy. Four data mining techniques have been used in the dataset. These techniques are support vector machine (SVM), random forest (RF), artificial neural network (ANN) and Chi-square automatic interaction detection (CHAID).
Results: Accuracy is the evaluation criteria for comparing available data mining methods. Based on the accuracy criterion, the support vector machine performed better than other techniques (random forest, neural network and CHAID). The best rule is that if the patients consume salt in their diet, their age is between 50 and 69, and they have diabetes. they are 82% more likely to develop chronic kidney disease.

Conclusion: The derived rules also showed that if we use salt and we have diabetes, we are at the risk of developing chronic kidney disease. Moreover, having diabetes can increase the risk of mortality in chronic kidney patients. Aged people should also be more careful about getting chronic kidney disease. Because, they are more prone to develop chronic kidney disease.

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Background: one of the growing diseases in the world that affects patient life quality is Inflammatory bowel disease (IBD), including ulcerative colitis (UC). Many environmental factors, including nutritional deficiencies, may influence the development of the disease. This study aims to evaluate the role of the level of vitamin D in UC recurrence.
Methods: We performed this cross-sectional study at Qom University of Medical Sciences from September 2017 to September 2018 on 50 patients with inactive UC, at least six months after diagnosis, in Shahid Beheshti Hospital in Qom. Patients entered the study sequentially from the target population after describing how to perform the plan and obtaining informed consent. Demographic information, including gender, age, medical history, diseases, and body mass index (BMI), were collected using a checklist. Patients were followed for six months for symptoms and the frequency of disease relapse. During the visits, in terms of adherence to treatment and case of recurrence, the number and severity of recurrence were examined, and the results were recorded in the checklist of each patient. At the end of this period, serum vitamin D level was measured. Data were collected by a checklist and analyzed by independent samples t-test, Chi-square, and variance analysis in SPSS version 18.

Results: Examining the correlation between vitamin D levels and demographic variables shows that low vitamin D levels are significantly associated with an increase in the frequency of recurrences. However, there was no significant relationship between disease duration, age, and body mass index. Among 50 patients, 23 (%46) were male, and 27 (%54) were female, with a mean age of 35.24±10.07 and a mean duration of disease for 15.14±6.67 months. The mean frequency of relapse was 1.34±1.89. The mean level of serum vitamin D was 22.30±13.45 ng/dl. It was significantly associated with the frequency of relapse with a P<0.001. Conclusion: Vitamin D insufficiency is associated with an increased risk of recurrence in patients with ulcerative colitis.

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Conclusion: In this study, we investigated the epidemiological and clinical features of neck masses in Kerman. It is obvious that smoking is an important risk factor for neck mass malignancies. Also, the present study revealed that the incidence of malignant tumors increased with age.

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Results: Cumulative kidney activity after calculation with four correcting background radiations techniques such as without correction of background radiation, conventional method, Buijs method, and Kojima method were 14.970±4.776, 13.544±4.357, 13.885±4.451, 13.879±4.449 mCi.min. respectively After comparing the calculated cumulative activity without correcting the background radiations with the cumulative activity calculated by the three techniques of correcting the background radiations such as the conventional method, Buijs method, and Kojima method, the value (P<0.05) was obtained in all cases, which shows that elimination of background radiations is significantly meaningful in the calculations of cumulative activity in the conjugate method for nuclear exams Conclusion: after comparing correcting background radiations techniques to each other, it was determined that the conventional method technique considers the effect and weight of background radiations more than the two other techniques such as the Buijs method and Kojima method in cumulative activity calculations.

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