bluuebunny/crossref_metadata_2025 huggingface dataset:
Removal and Reuse of Collagen, Gelatine and Total Chromium from a Raw Leather Industry Wastewater using a Sequential Up flow Anaerobic Sludge Blanket Digestion (UASB) / Aerobic Forward Osmosis (FO) Reactor Configuration
Authors: Öztekin Rukiye
Published: December 2023

Collagen, gelatine and total chromium recovery was achieved from the sequential upflow anaerobic sludge blanket digestion (UASB) reactor sludge and concentrate of forward osmosis (FO) treating raw leather industry wastewater. It is aimed to reduce the cost of raw materials in leather industry process by reusing the collagen, gelatine and total chromium from the leather industry process during tanning. The recoveries of collagen and gelatine, total chromium was 78%, 80% and 27% respectively from the waste sludge in UASB process while the recoveries of these chemicals were 95%, 96% and 99% in the concentrate of FO. The maximum 85% CODtotal, 94% CODdissolved, 89% total-N, 88% total-P, 87% color, 87% total chrome (Cr+3 + Cr+6), 86% TOC, 87% SO3-2, 90% percentage of exchangeable sodium, 87% sodium adsorption rate (SAR), 84% sodium carbonate residue (RSC), 92% Cl-1, 92% SO4-2, 93% total salt, 88% B+3, 94% NO3-, 94% NH4+, 99% fecal coliform, 94% TSS, 93% EC25x106 removal efficiencies were measured to output anaerobic UABS reactor in leather industry wastewater. The maximum 99% CODtotal, 99% CODdissolved, 99% total-N, 99% total-P, 99% color, 99% total chrome (Cr+3 + Cr+6), 99% TOC, 99% SO3-2, 99% percentage of exchangeable sodium, 99% sodium adsorption rate (SAR), 99% sodium carbonate residue (RSC), 99% Cl-1, 99% SO4-2, 99% total salt, 99% B+3, 99% NO3-, 99% NH4+, 99% fecal coliform, 99% TSS, 99% EC25x106 removal efficiencies were observed to output aerobic FO reactor in leather industry wastewater. The costs of anaerobic UASB and aerobic FO processes are 0.57 euro and 0.145 euro, respectively, to treat 1 m3 leather industry wastewater. The cost of the consecutive total system is 0.715 euro for the treatment of 1m3 leather industry wastewater. The methane gas obtained in the UABS reactor is electrical energy and the electrical energy income was calculated as 1.9 euro from 1 m3 anaerobic waste sludge. The income to be obtained from the recovery of total chromium, collagen and gelatine from UABS and FO process is 2.75 Euro/l. As a result, the total cost decreases from 1.55 Euro/l to 0.715 Euro/l after aerobic FO process. The cost of these consecutive treatment processes is reduced by the production of methane gas and is increased the recovery of economic chemicals.
Dichotomous Profile of Thoraco-Lumbar Dislocation Fractures. Case Report and Review of the Literature
Authors: Maoneo Azabali Israël
Published: December 2023

Dislocated thoracolumbar fractures are uncommon injuries following a major trauma. We report a case of thoraco-lumbar dislocated fracture of which radiological finding was in discrepancy with clinical aspect and postoperative neurological recovery. A 32-year-old female admitted in Neurosurgery Department of the University Hospital of Kinshasa for low back pain, functional impotence of lower limbs and urinary retention following a road traffic accident three weeks prior. She presented a painful swelling at level of T12-L2 spinous processes and Wagner's grade IV gluteal pressure sores. Neurologically, on both limbs, the sensation was preserved and motor strength was graded 3/5 globally. CT-Scan showed a fracture of the vertebral body and pedicles of L2 with retrolisthesis of L1/L2 grade IV (Magerl B.3.3). She underwent posterior spinal decompression followed by spinal stabilisation with pedicle screws. The gluteal ulcers were debrided and sutured during the same surgery. Postoperatively, the pressure ulcers healed and the patient recovered full motor and urinary sphincter functions after twelve months of physiotherapy. This case report demonstrates the possibility of discordance between radiological images of dislocated thoracolumbar fractures and spinal cord injury clinical.
Quantiferon in the Diagnosis of Tuberculosis
Authors: Amer Hamida
Published: December 2023

Quantiferon test (QFT) is an indirect diagnostic test for latent tuberculosis (TB) infection and active TB. Objectives: The aim of this study is to investigate the role of Quantiferon-TB Gold test as one of the interferon-gamma release assays (IGRAs) in detecting LTBI. Research methodology: This study was conducted at private lab in Tripoli during the period from October 2022 to January 2023, Diagnosis of 254 sample recorded. QFT was performed in accordance with the manufacturer’s instructions. Results: The study include (n= 254 cases), (58 sample 22.8 %) show positive results by Quantiferon test while (196 sample 77.1%) show negative test. Females constituted 118 (46.4%) of the total cases, while the males constituted 136 (53.6%). the age (31-40 years) for the negative includes (35 cases 13.7%) while (41-50 years and (61-70 years) for positive include (11cases 4.3%). Discussion: This study confirmed previous reports that the QFT test had greater sensitivity for detecting active TB than the 100-year-old TST. Conclusion: It was concluded that the quantiferon TB-2G test is a more useful diagnostic method for tuberculosis infection. QFT-Plus assay showed good sensitivity for active TB and was particularly useful for the evaluation of children with suspected LTBI, giving a low rate of indeterminate results in this group. More studies are needed to properly evaluate QFT-Plus ability in discriminating active disease from latent infection.
Letter to the Editors on the Article by Azevedo e Silva et al
Authors: Rotava Giovana
Published: December 2023

In a recent issue of CSP, Azevedo e Silva et al. 1 highlighted in their study important evaluations of cervical cancer control actions, based on data recorded in the Unified System in Health (SUS), at the period in 2013 To 2020. This study showed a diversity of factors related (still) to the great fragility of our health system regarding the prevention and screening of cervical cancer, which contribute too much to this neoplasm being ranked third among the most common cancers. incidents It is at fourth position in number in deaths in between women.
Teaching can be perfect by acting
Authors: Jana Prasenjit
Published: December 2023

How to teach a student or how to create an artificial environment to make a good student? Teaching is not so easy. Teacher must know the acting to understand the student's mind. The teacher must act in front of a student like he or she knows sometimes less sometimes more than the student. Artificially created environments surrounding the student can help a student to be a good student. When the relationship between teacher, parents and students are made with friendship then the actual teaching can happen.
Veno-Venous Coiling as A Strategy to Wean Extracorporeal Membrane Oxygenator Post Adult Fontan Completion
Authors: C. Frost Charlotte
Published: December 2023

We discuss a case of veno-venous collaterals in a patient with Fontan circulation post complex redo-surgery, which impeded veno-venous extracorporeal membrane oxygenation (VV-ECMO) weaning. A 31-year-old male, born with complex congenital heart disease (D-transposition of the great vessels, tricuspid atresia, aortic coarctation, ventricular septal defect, and hypoplastic right ventricle) with single ventricle physiology. The patient underwent multiple cardiac surgeries leading to Fontan completion. He subsequently developed significant aortic regurgitation with progressive left ventricular dilatation requiring multiple readmissions for congestive heart failure. Despite maximal medical optimisation he remained symptomatic and was offered further surgery. Complex 6th redo-operation with aortic valve replacement, modification to intracardiac fenestrated Fontan and insertion of intra-aortic balloon pump was performed. At 72 hours postoperative, VV-ECMO was required for refractory hypoxia. Right heart catheterisation was performed with coiling of two large fistulous venous connections. Post-coiling saturations improved from 92% to 98%. The patient was successfully weaned from VV-ECMO and decannulated the following day. This case demonstrates successful embolisation for veno-venous collaterals causing significant right to left shunt and hypoxia, in a patient with Fontan circulation.
Aloarthroplasty of the Hip After Pathological Fracture of the Right Femoral Neck and Right Femoral Dyaphysis and Osteosynthesis after Fracture of the Left Femoral Dyaphysis in 41-Year-Old Female Patient with Polyostotic Fibrous Dysplasia? Case Report
Authors: Erceg Marinko
Published: December 2023

A 41-year- old female patient with pathological basicervical right femoral neck fracture and fractures of both femoral bones 15-20 cm distally from the small trochanter is presented. Skeletal scintigraphy was performed and multiple pathological accumulations of radioactive substances were found in almost the entire locomotor system. First, we implanted a partial biarticular hip prosthesis with long stem in right femur, and one year later osteosynthesis of the left femoral diaphysis was done. Pathohistological examination did not find tumor cells and polyostotic fibrous dysplasia also was not clear. Our patient had not problems with bones earlier and she was never treated for this disease, except surgery of femoral fractures. Today, 11 years later the patient is in good general state, she has no pain in her legs and fractures of femur bones healed completely. We did not find a case in literature that a two fractures of proximal right femur bone (femoral neck and proximal diaphysis) and fracture of the left femoral diaphysis were solved with long stem prosthesis, and osteosynthesis of another femoral bone in patient who, we believe, has fibrous dysplasia and was never treated for this disease.
SARS-CoV-2-Related Persistent Pulmonary Affection Case in A 55-Year-Old Gastric MALT Lymphoma Patient on Rituximab
Authors: Landete Pedro
Published: December 2023

Following a mild symptomatic SARS-CoV-2 infection, a 55-year-old patient with gastric MALT lymphoma, currently treated with rituximab, experienced persistent symptoms. Over subsequent months, the patient exhibited low-grade fever, dyspnea, and progressive desaturation, leading to respiratory failure necessitating home oxygen therapy. A PCR test confirmed SARS-CoV-2 infection, prompting suspicion of persistent COVID-19. Imaging and biopsy results were consistent with cryptogenic organizing pneumonia (COP), but the patient showed no response to treatment, including corticosteroids and immunosuppressants. Remdesivir treatment yielded partial improvement but failed to achieve full resolution. Plitidepsin (2.5 mg/day for 3 days) under compassionate use led to negative PCR tests and normal respiratory function restoration within 3 days after treatment. SARS-CoV-2's impact on immunocompromised patients is concerning due to unique clinical features, challenges in viral clearance and immunization, and varied responses to approved treatments. A phase II clinical trial is underway to assess plitidepsin's efficacy in immunocompromised COVID-19 adults requiring hospital care.
Aleksander Łappa (1802-1869) – ostatni marszałek szlachty guberni mińskiej z wyboru. Część II: Gubernialny marszałek szlachty (1859-1863)
Authors: Snapkouski Yury
Published: December 2023

Alexander Łappa held the rank of the Minsk Governorate Marshal of Nobility during a period of widespread social transformations in the Russian Empire and a national and political crisis in the Kingdom of Poland and the Western Governorates. Trying to promote his multifaceted program of reforms in the Belarusian-Lithuanian lands, he relied on deep dialogue with the liberal bureaucratic circles of the Imperial Government and, at the same time, rejected conspiratorial, armed and other kinds of adventurous forms of the national liberation struggle. The polarization among the nobles of the Minsk Governorate increased after the scandalous Noble Elections of 1862. It was aggravated after the outbreak of the January Uprising in the Kingdom of Poland and, connected with it, the growing repressive policy of the civil and military authorities. All of these factors caused Łappa to lose influence in the socio-political life of the nobility and voluntarily resign from his position as marshal.
A Simple Method for Extraction of Lipopolysaccharides from Brucella Melitensis
Authors: Asadikaram Gholamreza , Vakili Sina , Behroozikhah Alimohammad , Khalaf Nesa
Published: December 2023

Background: Brucellosis is the most common zoonotic bacterial disease around the world, and its causative agent is Brucella, a gram-negative bacterium. Lipopolysaccharide (LPS) molecules are the most significant surface antigen of Brucella bacteria. This antigen is used in a high number of research and diagnostic fields. The present study was designed in order to introduce a simple method to extract LPS from Brucella melitensis. Materials and Methods: Smooth strains of B. melitensis were cultured in large quantity, and LPS was extracted through changes in the hot-phenol method. The LPS concentration was measured by using the dimethyl-methylene blue method. The contamination rates of proteins and nucleic acids were determined using the bicinchoninic acid (BCA) method and absorbance measurement at 260 nm, respectively. Results: The amount of the extracted LPS was 1.1% of the wet weight of the bacteria. The rate of contamination with nucleic acid was measured to be 0.2% of the LPS. The protein contamination was not detectable through the BCA method. Conclusion: The advantages of our newly-introduced method are considerable decrease in the time required to extract LPS; independence from nucleic acid and protein digestive enzymes; an extraction rate of LPS equivalent to other applied methods; nucleic acid contamination equal or lower than other methods, and no protein contamination; and independence from equipment such as ultracentrifuge and chromatography. [GMJ.2021;10:e1944]
Contradictory Effect of Notch1 and Notch2 on Phosphatase and Tensin Homolog and its Influence on Glioblastoma Angiogenesis
Authors: Shabani Mostafa , Taghvaei Javanshir Hamid , Bereimipour Ahmad , Ebrahimi Sadrabadi Amin , Jalili Arsalan , Nayernia Karim
Published: December 2023

Many genes induce angiogenesis in tumors, and among them, Notch family genes have received particular attention due to their extensive network of connections with other genes active in this function. Suppression of angiogenic signaling has been studied in various cancers, confirming Notch's fundamental and extensive role. According to studies, four Notch genes work independently with many genes such as vascular endothelial growth factor, phosphatase and tensin homolog, Phosphoinositide 3-kinase/Akt, and matrix metalloproteinases, and so many other genes, as well as proteins (such as hypoxia-inducible factor-1 alpha) significantly affect tumor angiogenesis. Notch1 regular activity in a healthy person causes angiogenesis in body tissues, controlled by normal Notch2 activity. However, in many cases of glioblastoma, whether on patients or tumor xenografts or in vivo models, a mutation in one of these two essential genes or at least one of the genes and proteins that affected by them can cause better angiogenesis in hypoxic conditions and lead to become an invasive tumor. In this review, we examined the contrasting activity of Notch1 and Notch2 and the signaling cascade that each generates in the angiogenesis of glioblastoma, the most invasive cancer of the central nervous system. [GMJ.2021;10:e2091]
Spinal Sagittal Alignment Among Patients with Degenerative Lumbar Canal Stenosis
Authors: Abdollahzade Sina , Khaleghi Mehdi , Jamshidi Sanaz , Rastgoo Nafiseh , Rouhani Reza , Padegane Tahereh , Faghih-Jouybari Morteza , Khadivi Masoud
Published: December 2023

Background: Degenerative lumbar canal stenosis (DLS) is a common spinal pathology characterized by radicular pain and neurogenic claudication. Sagittal alignment and its indices have been affected in several spinal pathologies and may play a key role in surgical planning and outcome. In this case-control study, we aimed to assess sagittal alignment among patients with DLS compared to healthy individuals. Materials and Methods: Sixty patients DLS and 60 healthy volunteers were selected. Pelvic tilt (PT), sacral slope (SS), lumbar lordosis (LL), pelvic incidence (PI), thoracic kyphosis (TK), and sagittal vertical axis (SVA) were obtained in lateral standing X-ray radiographs. Results: Mean LL was lower in DLS patients (35.3Â±10.2) compared to normal controls (44.78Â±12.95), which was statistically significant (P <0.05). In contrast, there were no significant differences in PI, SVA, and SS between the groups. In patients with DLS, TK was lower, and PT was higher when compared to healthy individuals (P<0.05). Conclusion: Patients with DLS utilize decreased lordosis of the lumbar spine as a compensatory mechanism to decompress the thecal sac and spinal roots and improve their symptoms. Consequently, these patients recruit compensatory adjustments such as thoracic hyperkyphosis and increased PT to maintain sagittal alignment. [GMJ.2021;10:e2128]
Shockwave Therapy Versus Dry Needling for the Management of Iliotibial Band Syndrome: A Randomized Clinical Trial
Authors: Maghroori Razie , Khosrawi Saied , Karshenas Leila
Published: December 2023

Background: Iliotibial band syndrome (ITBS) is a common leading cause of lateral knee pain. Despite varieties of medical and non-medical treatments proposed for the management of ITBS, the best therapeutic approach for its treatment remained a significant question. The current study aims to compare the outcomes of dry needling (DN) versus shockwave therapy (SWT) in the management of ITBS.

Materials and Methods: This randomized clinical trial was conducted on 40 patients diagnosed with ITBS. The patients were randomly divided into two treatment groups of DN (n=20) and SWT (n=20). Visual analog scale for the pain assessment, Lower Extremity Functional Scale (LEFS) for the function evaluation, and length of the iliotibial band were assessed at baseline, immediately after the cessation of the intervention, and within four weeks.

Results: The two groups were similar regarding demographic characteristics (P>0.05). Both approaches could efficiently lead to improved pain (P<0.001) and promoted function based on LEFS (P<0.001); however, iliotibial band length (ITBL) did not alter remarkably (P>0.05). The groups were similar in terms of pain score, LEFS, and ITBL at all of the assessment intervals (P>0.05), but the pain score within four weeks following the interventions that were significantly better in DN (P=0.023).

Conclusion: Based on our results, DN, as well as SWT, could remarkably lead to an improvement in pain and function among patients resenting from ITBS; however, none of the approaches was superior over the other. [GMJ.2021;10:e2174]
Comparison of Mental Health Status between Two Periods during Coronavirus Disease 2019 Pandemic in Iranian Adult Population
Authors: Heydari Seyed-Taghi , Mani Arash , Estedlal AliReza , Akbary Ali , Estedlal Taraneh , Ouladinejad-Rodbali Sara , Shahabi Saeed , Ghaemi Seyede-Zahra , Zarei Leila , Bagheri-Lankarani Kamran
Published: December 2023

Background: One unprecedented year after the coronavirus disease 2019 (COVID-19), the pandemic is no longer a short-term stressor; the unremitting/chronic effects of COVID-19 disease is likely to cause impaired physical and mental health upon population and the implemented public health and social measures to limit transmission and reduce mortality and morbidity from COVID-19 expose many people to social isolation, job loss, and economic recession. This study aims to compare mental status and four mental symptoms (somatization, anxiety, depression, and social functions) between two periods during the first year of the COVID-19 pandemic. Materials and Methods: Current study consists of two cross-sectional mental health surveys on the Iranian adult population carried out in two periods of March to April 2020 and December 2020 to February 2021 in two important Provinces of Iran (Fars and Khorasan Razavi). In the first survey, 1337 individuals participated in the study and completed the General Health Questionnaire-28, while in the second survey, 1205 participants completed the same questionnaire. Results: Among 1337 participants of the first survey, there were 876 (65.5%) females and 461 (34.5%) males with an average age of 37.41Â±10.58 years. In the second survey, there were 1205 participants with mean age of 33.79Â±19.57 years. The rates of females and males were 57.7% and 42.3%, respectively. Compared to the first survey, the second one showed that poor mental health condition that was 1.40 (95% confidence interval: 1.17-1.67) times higher based on the age, sex, education, marital status, economic, alcohol, cigarette, water-pipe, and sedative (P<0.001). Conclusion: Poor mental health status has increased during the first year of the COVID-19 pandemic. These results revealed that the COVID-19 pandemic was a chronic stressor faced by people every day; therefore, more robust mental health-related considerations must be implemented. [GMJ.2021;10:e2199]
COVID-19 Cardiac Manifestations and Scent Perception Genes in Hearts of SARS-Cov-2 Infected Patients: A Meta-Analysis of Gene Expression Data
Authors: Roostaei Davoud , Sohrabpour Mojtaba , Sanie Jahromi Mohammad Sadegh , Vatankhah Majid , Shadmehr Aghdas , Ebrahimi Mohsen , Mogharab Vahid , John Mehramiz Neema , Foroughian Mahdi , Hakemi Arman , Kalani Navid , Hatami Naser
Published: December 2023

Background: COVID-19 induced cardiac events are reported by many papers, while psychophysiology of association of the COVID-19 and cardiac attacks are not fully understood yet. Materials and Methods: Here, we compared gene expression levels of heart autopsies of SARS-Cov-2 infected patients with the cardiac organoid model of human myocardial infarction and controlled healthy cardiac organoids to identify differentially expressed genes (DEGs). Gene Ontology (GO) biological processes were enriched in DEGs. Results: Results showed that smell perception genes were down-regulated in SARS-COV2 compared to myocardial infarction samples; while showing upregulated genes related to the immune system process in contrast to control healthy heart organoids. Our results agree with theories of immune system reactions in COVID-19 infected patientsâ€™ hearts, while our analysis indicates different patterns of heart gene expression from myocardial infarction models. Conclusion: our study suggests that there may be other pathways involved in MI appearance in COVID-19 patients rather than classic is known atherosclerotic and inflammatory pathways. [GMJ.2021;10:e2250]
Baclofen Reversed the Nicotine-Induced Anxiety-Like Behavior: A Beneficial Therapeutic Strategy for Smoking Cessation Aid
Authors: Ghorbani yekta Batool , Kordeforushani Mobina , Aryan Hoda
Published: December 2023

Background: Nicotine dependence is the most widespread form of substance abuse. Anxiety is one of the prominent symptoms in withdrawal syndromes of nicotine. Nucleus Accumbens (NAc) is a principle area which participates in several behavioral responses (e.g., anxiety), and several studies reported that receptors are involved in the modulation of anxiety. This study was aimed to examine the interaction of baclofen and nicotine on anxiety behavior in NAc shell. Materials and Methods: Rats weighing between 220 and 250g were used. The guide cannulas were implanted bilaterally into the shell of the NAc. Nicotine (0.025, 0.05 and 0.5 Î¼g/rat) and baclofen (0.25, 0.5 and 2 Î¼g/rat) and the co-administration of nicotine (0.025, 0.05 and 0.5Î¼g/rat) with baclofen (0.25 Î¼g/rat) were microinjected through the infusion cannula. The elevated plus-maze (EPM) was used to evaluate the anxiety-like parameters, and all data were recorded and analyzed. Results: Intra-NAc administration of nicotine (0.5Î¼g/rat) decreased anxiety (P<0.001). Microinjections of baclofen (0.5 and 2 Î¼g/rat) decreased anxiety (P< 0.001). However, there were no significant changes in anxiety-like parameters at the lowest dose of baclofen (0.25Î¼g/rat). Co-administration of an ineffective dose of baclofen (0.25 Î¼g/rat) with 3 doses of nicotine (0.025, 0.05 and 0.5 Î¼g/rat) reversed the effects of nicotine in an effective dose (0.5Î¼g/rat). Conclusion: Our result indicated that GABAergic agonist baclofen in ineffective doses could reverse the effects of nicotine on anxiety symptoms. Furthermore, our result suggested that enhancement of GABA transmission through activation of GABA-B receptors on NAc shell could reverse nicotine anxiety-related effects. It may be a strategy of treatment for smoking cessation aid.[GMJ.2017;6(2):118-27]
Drugs Induced Alzheimerâ€™s Disease in Animal Model
Authors: Malekzadeh Samira , Edalatmanesh Mohammad Amin , Mehrabani Davood , Shariati Mehrdad
Published: December 2023

Alzheimerâ€™s disease (AD) can be described by characteristics like dementia, mental and cognitive dysfunctions, and memory impairment. Nowadays, with progresses of science, attempts to treat many diseases have increased. Laboratory animals help to discover new ways of treating disease. AD induced by chemical drugs in animal models can be useful in better understanding the mechanisms of disease and treatment of AD. In recent decades, many researchers have reported transgenic rat models of AD but this modeling has a great problem and does not contain all kinds of AD. There are two types of AD, including familial (5% of all AD) and sporadic, but the transgenic model does not show the complete model of AD, especially in sporadic form of AD, which is 95% of AD cases. We decided to describe another modeling of AD using chemical drugs such as colchicine, scopolamine, okadaic acid, streptozotocin, and trimethyltin.[GMJ.2017;6(3):185-196] DOI:10.22086/gmj.v6i3.820
Quantitation of Colonic Cells as Severity Markers in Patients with Irritable Bowel Syndrome
Authors: Rostami-Nejad Mohammad , Miri Mohammad Bagher , Sadeghi Amir , Moradi Afshin , Ehsani-Ardekani Mohammad-Javad , Asadzadeh-Aghdaei Hamid , Safari Mohammad-Taghi , Zali Mohammad Reza
Published: December 2023

Background: Irritable bowel syndrome (IBS) is the most common gastrointestinal syndrome. Routine histopathology and immunohistochemistry (IHC) evaluations have shown an increase in the number of different inflammatory cells in the colon of IBS patients. In this study, we have compared the number of intraepithelial lymphocytes (IELs), eosinophils, mast cells and CD3+ T cells, in IBS patients and normal subjects. Materials and Methods: In 2016, seventy-nine patients with IBS and seventy-nine healthy subjects who underwent colonoscopy for other non-specific causes and with no pathologic findings, were enrolled in this cross-sectional study. Biopsy specimens obtained from the colon were stained, using IHC methods to determine the number of IELs, eosinophils, mast cells and CD3+ T cells. Quantitative and qualitative variables were compared between the two groups, using a Chi-square test and Studentâ€™s t-test. Results: Seventy-nine patients with IBS, 79.7% females with a mean age of 42.5Â±14.6 years, were recruited, as the case group, and seventy-nine individuals, 51.9% females with a mean age of 39.7Â±18.9 years, were enrolled as controls. The average number of IELs per high power fields (hpf) was found to be higher in the IBS group, and this difference was statistically significant (32.8Â±11.8 vs. 28.6Â±12.9; P=0.034). Also, the mean count/hpf of CD3+ T lymphocytes (23.1Â±7.9 vs. 20.2Â±8.1; P=0.024) and mast cells (7.6Â±3.1 vs. 6.6Â±3.0; P=0.041) were significantly higher in the IBS group, compared to the control group. The number of eosinophils was higher in the IBS group, but the differences were not statistically significant (P=0.066). Conclusion: According to the results, we suggest that analysis of immune cells and IELs in intestinal biopsies might be an appropriate method for diagnosis of IBS.Â [GMJ.2018;7:e1063]
Cytotoxic Effects of Coated Gold Nanoparticles on PC12 Cancer Cell
Authors: Aidun Amir , Zare Marzouni Hadi , Tarkhan Fazel , Shahzamani Kiana , Jahan Tigh Hamid Reza , Malekshahian Sareh , Esmaeil Lashgarian Hamed
Published: December 2023

Background: The use of gold nanoparticles in medicine and especially in cancer treatment has been of interest to researchers. The effectiveness of this nanoparticle on cells significantly depends on the amount of its entry into the cells. This study was performed to compare the rate and mechanism of effect of gold nanoparticles coated with different amino acid on PC12 cancer cell line.

Materials and Methods: The PC12 cells line were exposed to various concentrations of amino acid coated and uncoated gold nanoparticles (0.5, 2.5 and 5 Î¼M). Cell death rate was determined according to level of Lactate dehydrogenase (LDH) release from cells and MTT assay. In addition cell morphology and the amount of Cellular Reactive oxygen species (ROS) were studied.

Results: The uncoated gold nanoparticles have shown minor effects on cellular life. Gold nanoparticles coated by tryptophan at high concentrations (2.5, 5 and 25Î¼M) increase in cancer cells metabolic activity. Gold nanoparticles coated by Aspartate also produce the largest amount of LDH and ROS in cancer cells and therefore caused of highest rate of apoptosis.

Conclusion: The results showed that the nanoparticles coated with amino acids are affected on cellular metabolism and apoptosis more than uncoated nanoparticles. Also the smallest coated nanoparticles (coated by aspartate) have the most influence and by increasing the size, this effect was reduced.Â [GMJ.2018;7:e1110]
Diagnostic Value of Hepatic Vein Ultrasound in Early Detection of Liver Cirrhosis
Authors: Matinfard Sedighe , Zare Marzouni Hadi , Davachi Behrooz , Rezazadeh Mahdi , Salehi Milani Mahmoud
Published: December 2023

Background: Cirrhosis is a common disease that destroys liver cells, and it has various etiologies. The early diagnosis of cirrhosis can be effective in improving prognosis.

Considering the availability and affordability of ultrasound devices throughout the world, in this study we evaluated the diagnostic value of hepatic vein ultrasound examination in the early detection of liver cirrhosis.

Materials and Methods: In this study, 45 patients referred to the radiology department of Ghaem Hospital for liver biopsy were evaluated for changes in the hepatic veins under ultrasound with a transducer of 5-7MHz. One piece of the hepatic vein was selected for ultrasound, and the wall of hepatic veins was examined for straightness and uniformity of echogenicity. Subsequently, patients underwent biopsy by ultrasound guide.Â  Of all the study subjects, eight patients presented mild chronic hepatitis without fibrosis, four patients were diagnosed with fatty liver, and 33 patients had severe cirrhosis or chronic hepatitis with fibrosis.

Results: Our results showed that hepatitis patients with or without fibrosis had irregular and wavy hepatic vein wall (impairment in straightness) with non-uniform echo (impairment in uniformity of echogenicity). While patients without hepatitis and cirrhosis, but diagnosed with fatty liver, had a smooth and regular hepatic vein wall with a uniform echo.

Conclusion: The present study showed that hepatic vein examination in terms of echogenicity and straightness could be used to diagnose hepatitis, its severity as well as its course towards fibrosis and cirrhosis.Â [GMJ.2018;7:e1140]
Factors Affecting in-stent Restenosis in Patients Undergoing Percutaneous Coronary Angioplasty
Authors: Sajadian Mostafa , Alizadeh Ladan , Ganjifard Mahmoud , Mardani Armin , Ansari Mohammad Ali , Falsoleiman Homa
Published: December 2023

Percutaneous coronary angioplasty (PCI) and stent implantation are the most common therapeutic strategies for coronary artery stenosis; however, in-stent restenosis (ISR) is one of its important challenges. Although in some studies, coronary artery disease (CAD) factors are deemed to be the causes of ISR, in some others, the relationship between CAD factors and ISR are not observed. Over the past ten years, there has been no review article on factors affecting the ISR. This article aimed to review the possible factors affecting ISR in patients undergoing PCI. This narrative review study was conducted on PubMed, Web of Science, Scopus, and Google Scholar databases between 1 January 1990 and 30 July 2017. After initial screening of 1728 retrieved articles, 1401 articles were excluded to due irrelevancy to the review; and finally, 39 papers were selected for data collection. Our study results showed that the site and length of implanted stent, hypertension and diabetes are the most probable factors affecting ISR. Further studies are required for evaluation of the effect of other possible risk factors such as genetic sequencing, obesity, chronic infections and hemoglobin A1C levels. [GMJ.2018;7:e961]

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Trend of Gastric Cancer after Bayesian Correction of Misclassification Error in Neighboring Provinces of Iran
Authors: Pourhoseingholi Mohamad Amin , Baghestani Ahmad Reza , Ashtari Sara , Najafimehr Hadis , Busani Luca , Zali Mohammad Reza
Published: December 2023

Background: Some errors may occur in the disease registry system. One of them is misclassification error in cancer registration. It occurs because some of the patients from deprived provinces travel to their adjacent provinces to receive better healthcare without mentioning their permanent residence. The aim of this study was to re-estimate the incidence of gastric cancer using the Bayesian correction for misclassification across Iranian provinces. Materials and Methods: Data of gastric cancer incidence were adapted from the Iranian national cancer registration reports from 2004 to 2008. Bayesian analysis was performed to estimate the misclassification rate with a beta prior distribution for misclassification parameter. Parameters of beta distribution were selected according to the expected coverage of new cancer cases in each medical university of the country. Results: There was a remarkable misclassification with reference to the registration of cancer cases across the provinces of the country. The average estimated misclassification rate was between 15% and 68%, and higher rates were estimated for more deprived provinces. Conclusion: Misclassification error reduces the accuracy of the registry data, in turn causing underestimation and overestimation in the assessment of the risk of cancer in different areas. In conclusion, correcting the regional misclassification in cancer registry data is essential for discerning high-risk regions and making plans for cancer control and prevention. [GMJ.2019;8:e1223]Â 

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Effective Factors of Utilization of Inpatient, Outpatient, Diagnostic, and Pharmaceutical Health Services: A Systematic Review
Authors: Azimzadeh Solmaz , Tabrizi Jafar Sadegh , Nosratnejad Shirin , Farahbakhsh Mostafa , Azami Aghdash Saber , Abdollahi Hossein
Published: December 2023

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Utilization is one of the dimensions of equity in health systems. Identifying the factors affecting utilization of health services can be helpful for interventional purposes. This study systematically reviewed the factors affecting the utilization of inpatient, outpatient, diagnostic, and pharmaceutical services. This systematic review was conducted between 2016 and 2017. The search was performed using keywords based on MeSH in valid databases such as Scopus, Embase, ProQuest, ScienceDirect, PubMed, and Web of Science in the fields of title, abstract, and keyword. Related papers published from 2000 to 2017 were searched. First, the retrieved studies were screened and checked for quality; then, the useful data were extracted and analyzed. Out of the 1178 retrieved publications, 20 studies were included in the final analysis. The identified factors were categorized into 5 areas, including demographic (4 items), socioeconomic (13 items), health servicesâ€“related (13 items), health statusâ€“related (7 items), and health insuranceâ€“related factors (2 items), and reported. The findings of this study can be a useful source and a comprehensive body of evidence on the utilization of health services. The results can be used by the policy makers and managers in designing interventions for changing the utilization patterns of health services. [GMJ.2019;8:e1236]
A Short Review on the Relationships Between Nephrolithiasis and Myocardial Infarction
Authors: Karami Hormoz , Maleki Hadi , Baghbeheshti Maryam , Hashemi Mostafa , Rouzbeh Mehrdad , Afkhami Ardakani Mohammad
Published: December 2023

The interaction between organs is a crucial part of modern medicine. As a very prerequisite to manage a disease, practitioners should have a full awareness of the related organs. Kidney and heart are two vital organs that are closely interconnected in various fields. These two organs have a lot of common risk factors for making a person unhealthy; therefore, if you prevent the disease in one of them, the otherâ€™s morbidity might be alleviated as well. Among them, nephrolithiasis and myocardial infarction (MI) have more risk factors in common, and both could be fatal. Also, these two diseases are important regarding the prevalence, incidence, and burden of disease. Some studies confirm the relationship between MI and nephrolithiasis; however, further researches are needed to discover the exact direction of their relationship. The present review aims to explain the mechanism of MI and nephrolithiasis; clarify the relationship between these two disease based on physiological, pathological, and clinical studies; and propose some solutions for the prevention and treatment of such diseases. [GMJ.2019;8:e1289]
Efficacy of a Persian Herbal Remedy and Electroacupuncture on Metabolic Profiles and Anthropometric Parameters in Women with Polycystic Ovary Syndrome: A Randomized Controlled Trial
Authors: Rouhani Maryam , Motavasselian Malihe , Taghipoor Ali , Layegh Parvaneh , Asili Javad , Hamedi Shokouh Sadat , Badiee Avval Shapour
Published: December 2023

Background: The most prevalent endocrine disorder in women of reproductive age is polycystic ovary syndrome (PCOS). The purpose of this study was to evaluate the efficaciousness of a Persian herbal remedy, as well as electroacupuncture and the combination of them on metabolic profiles and anthropometric parameters in these patients. Materials and Methods: Eighty overweight women with PCOS were randomly divided into four groups. All of them received metformin 1000 mg and the second group received 5 g of herbal medicine per day (main components: Foeniculum vulgare, Urtica dioica, and Daucus carota), the third group were subjected to 20 electroacupuncture sessions, and the fourth group received both therapies. Results: After 12 weeks, the body fat and body mass index decreased the most in the herbal medicine+electroacupuncture group, and waist to hip ratio decreased the most in the electroacupuncture group. A significant decrease was also observed in fasting insulin, homeostasis model assessment of insulin resistance. A significant increase was seen in the quantitative insulin sensitivity check index in all intervention groups, but there was no noteworthy difference in these parameters in the control group. Total cholesterol and low-density lipoprotein cholesterol decreased significantly in the electroacupuncture groups and herbal medicine+electroacupuncture. Also, a significant decrease was observed in triglycerides, aspartate aminotransferase, and alanine aminotransferase in the herbal medicine groups and herbal medicine+electroacupuncture. Conclusion: It is advisable to use this herbal remedy and electroacupuncture for better treatment of metabolic complications and overweight problems in these patients.Â  [GMJ.2019;8:e1389]Â
The Effect of Health Insurance on the Utilization of Health Services: A Systematic Review and Meta-Analysis
Authors: Shami Elham , Tabrizi Jafar Sadegh , Nosratnejad Shirin
Published: December 2023

Insurance organizations are among the most influential organizations in the health system, which can lead to healthcare efficiency and patient satisfaction in case they are increasingly accessed. The main purpose of the present systematic review was to examine the effect of health insurance on the utilization of health services and also to examine the factors affecting it. The present study was a systematic review that aimed to examine the effect of health insurance on the utilization of health care services. The study was conducted in 2016 using Scopus, PubMed, Web of Science, Science Direct, and ProQuest databases. We examined the utilization rate of health insurance in insured people. The inclusion and exclusion criteria were included based on review and meta-analysis purposes. The utilization of health services increased for inpatient and outpatient services. The utilization rate of inpatient services increased by 0.51% whereas the utilization rate of outpatient services increased by 1.26%. We classified the variables affecting the utilization rate of insurance into three main categories and sub-categories: demographic variables of the household, socioeconomic status, and health status. Our study showed that insured people increased the utilization rate of health services, depending on the type of health services. Thus, health policymakers should consider the communityâ€™s health insurance as a priority for health programs. For now, implementing universal health insurance is a good solution. [GMJ.2019;8:e1411]
Evaluation of the Neurological Complaints during Pregnancy and Postpartum
Authors: Borhani-Haghighi Afshin , Zafarmand Shaghayegh , Javanmardi Haniyeh , Ameri Maryam , Maneshi Masoud , Mansouri-Mehrabadi Susan , Zolghadrasli Yasaman , Moazzam Mahshad , Aramesh Ayda
Published: December 2023

Background: Pregnancy and postpartum are critical periods for patients with neurological complications. In this study, we aimed to evaluate the clinical characteristics and outcome of pregnant women with neurological conditions. Materials and Methods: This cross-sectional study reviewed pregnant women with neurological signs and symptoms, who were registered in the Medical Care Monitoring Center (MCMC) database of Shiraz University of Medical Sciences 2013-15. A questionnaire was designed to record each patientâ€™s information including demographic variables, past medical history, clinical presentation, obstetric profile, and fetal/maternal outcomes. Results: Totally, 332 mothers were registered in the database. The main neurological complaints in our population were headache, seizure, unilateral neurological symptoms, multiple sclerosis, neuromuscular disorder, and brain tumor. More than half of the patients (54%) experienced headache during the pregnancy and postpartum period. Conclusion: Evaluating the neurological disorders separately, based on the time of symptom onset indicates the importance of follow-up of mothers during peripartum. Our findings suggest that decisions for pregnancy in women with neurological disorders should be based on risks outweighing for the mother and the fetus, particularly regarding the pharmacological side effects. [GMJ.2019;8:e1616]Â
A Review on the Hypotheses about Arterial Hypertension from the Viewpoint of Traditional Persian Medicine
Authors: Hasani Davoud , Bahrami Mohsen , Kamalinejad Mohammad , Ahanghar Hassan , Faghihzadeh Soghrat , Dadmehr Majid
Published: December 2023

Hypertension is one of the most common chronic diseases in recent decades worldwide. It has been distinguished as the main risk factor of coronary artery disease, aortic dissection, heart failure, renal failure, cerebrovascular diseases, and death. In recent years, the global attention has been paid to complementary medicine to preventive, diagnostic and treatment strategies for hypertension, in previous studies, the history of hypertension from the viewpoint of traditional Persian medicine have been reviewed and several hypotheses raised. In this article, we present the concept of an Iranian physician namely Ali ibn Sahl Rabban al-Tabari on hypertension, which has not been considered properly until now. He defined a state called â€œHayajan al-damâ€ that has clinical manifestations similar to hypertension, although these are not the same, also, we reviewed the viewpoint of other Persian medicine scholars namely Rhazes, Haly Abbas, Akhawayni and Avicenna for this topic. [GMJ.2020;9:e1065]
Evaluation of Facilitators and Barriers to Implementing Evidence-Based Practice in the Â Health Services: A Systematic Review
Authors: Ayoubian Ali , Nasiripour Amir Ashkan , Tabibi Seyed Jamaledin , Bahadori Mohammadkarim
Published: December 2023

Background: Evidence-based practice (EBP) is an ambition for health service administrators. We aimed to systematically review the major relevant articles in case of barriers and facilitators to implementing evidence-based practice in health services. Methods and Materials: The type of study was a systematic review. We searched the libraries and online sources such as PubMed, MEDLINE, Wiley, EMBASE, ISI Web of Knowledge, Scopus, Science Direct, Cochrane Library, and Google scholar. We used keywords included â€œEvidence-Based Practiceâ€, â€œEvidence-Based Managementâ€, â€œHealthcareâ€, â€œCare Management, Evidence-Based Healthcare Managementâ€, â€œHealth Careâ€, Healthâ€, â€œBarrierâ€, â€œFacilitatorâ€, policy and â€œEvidence-Based Healthcareâ€. Results: In total, 12 studies were included. Several barriers and facilitators were recognized through the included papers, the factors such as organization support and a helpful education system improved skills, knowledge, and confidence to EBP. The outcomes of studies were identified as the employ of the internet as a highest-rated skill for increasing EBP quality. Conclusion: Generally, the results showed health service administrators should first identify barriers of EBP then transferred them to facilitators to the implementation of proper and efficient EBP. [GMJ.2020;9:e1645]
Tau Abnormalities and Autophagic Defects in Neurodegenerative Disorders; A Feed-forward Cycle
Authors: Samimi Nastaran , Asada Akiko , Ando Kanae
Published: December 2023

Abnormal deposition of misfolded proteins is a neuropathological characteristic shared by many neurodegenerative disorders including Alzheimerâ€™s disease (AD). Generation of excessive amounts of aggregated proteins and impairment of degradation systems for misfolded proteins such as autophagy can lead to accumulation of proteins in diseased neurons. Molecules that contribute to both these effects are emerging as critical players in disease pathogenesis. Furthermore, impairment of autophagy under disease conditions can be both a cause and a consequence of abnormal protein accumulation. Specifically, disease-causing proteins can impair autophagy, which further enhances the accumulation of abnormal proteins. In this short review, we focus on the relationship between the microtubule-associated protein tau and autophagy to highlight a feed-forward mechanism in disease pathogenesis. [GMJ.2020;9:e1681]