bluuebunny/crossref_metadata_2025 huggingface dataset:
The prevalence of prolonged jaundice due to breast milk jaundice in hospitalized newborn; a study among Iranian neonates
Authors: Eghbalian Fatemeh , Raeisi Roya , Eslah Shadi , Jiryaee Nasrin
Published: September 2021

Introduction: Breast milk jaundice is considered as the most common cause for neonatal jaundice; however, its epidemiological aspects in some population remain unclear. Objectives: The present study aimed to assess the prevalence of breast milk jaundice and its main determinant among a group of neonates in western Iran. Patients and Methods: This cross-sectional study was conducted on 413 neonates hospitalized due to prolonged jaundice in Besat hospital in Hamadan, Iran. The study information was collected by reviewing the hospital’s recorded files. Results: In total, 413 neonates hospitalized were assessed in this study. The main reason for appearing jaundice included; 72.4% of cases of jaundice were due to breast milk, urinary tract infection in 4.2% of cases, glucose-6-phosphate dehydrogenase deficiency (G6PD) in 5.8% of cases, hypothyroidism in 1.2% of cases. Out of 299 neonates suffering from breast milk jaundice, 126 (42.1%) were male, and 173 (57.9%) were female with the overall average age of 16.68 ± 2.14 days. Jaundice appeared at less than two days of age in 29.4% of neonates, between 15 to 20 days of age in 64.9%, and more than 20 days of age in 5.7% of cases. Conclusion: Breast milk jaundice is considered as the most common reason for neonatal jaundice in our population, which affects more than two-thirds of our neonates. Additionally, the peak age of this phenomenon is between 15 and 20 days. The appearing breast milk jaundice is independent of gender, age, and birth weight or baseline total serum bilirubin level.
Treatment of chemotherapy induced anemia; a randomized clinical trial to compare quality of life in patients taking intravenous versus oral iron
Authors: Hajigholami Ali , Maghsoodi Ahmad-Reza , Ansari Hourieh , Kafeshani Marzieh
Published: September 2021

Introduction: Malignancy is one of the causes of anemia in chronic diseases. Anemia can commonly complicate the malignancy process. Objectives: This study aimed to compare improvement in the quality of life and hemoglobin levels between cancer patients with chemotherapy-related anemia receiving erythropoietin and injectable iron supplement versus patients receiving erythropoietin and oral iron supplement. Patients and Methods: This investigation was a randomized clinical trial carried out on 79 anemic individuals with metastatic and non-metastatic carcinoma who were undergoing chemotherapy. Individuals included in the study were randomly assigned to the two groups. The first group received erythropoietin and Venofer while the second group received erythropoietin and ferrous sulfate for 6 weeks. The quality of life for patients was assessed using the European Organization for Research and Treatment of Cancer quality of life questionnaire (EORTC QLQ-C30). Results: Hemoglobin levels in both groups increased significantly while the difference between them was not significant. Despite improvement in more indexes of the questionnaire, post-treatment quality of life in both groups had no significant statistical difference (P>0.05). The changes in indices after interventions showed no difference between the oral and injectable iron supplements groups (P>0.05). Conclusion: The results of this study showed that administration of erythropoietin and iron supplements, either orally or intravenously, even with a shorter duration of treatment could increase hemoglobin levels in chemotherapy-induced anemia group, however to improve the quality of life, it may be necessary to employ larger sample sizes and prolong treatment courses. Trial registration: This randomized controlled trial was registered in the Thai Clinical Trials Registry (identifier: TCTR20200915003; http://www.clinicaltrials.in.th).
Delirium treatment in intoxicated patients in ICU: A randomized, double-blind clinical trial
Authors: Mesbahi Javad , Shadnia Shahin , Hassanian-Moghaddam Hossein , Zamani Nasim , Erfan Talab Evini Peyman , Hazegh Fetratjoo Delara , Kargar Alireza , Rahimi Mitra
Published: September 2021

Objective: Delirium is one of the most common complications in patients admitted to intensive care units (ICUs). Delirium is a definite cause for more extended hospital stays, higher mortality rates, and possibly persistent cognitive decline in the future. Antipsychotics have been frequently evaluated as first drugs of choice, but the most appropriate, evidence-based treatment is yet to be discovered. This study aims to compare the efficacy of haloperidol and olanzapine in patients admitted to our toxicology ICU. Methods: This double-blind, randomized controlled clinical trial was undertaken on 35 ICU admitted patients with delirium in Loghman Hakim hospital in Tehran, Iran. The diagnosis was based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria for delirium, and clinical toxicologists included the patients according to the study’s inclusion and exclusion criteria. Patients received either haloperidol or olanzapine based on computerized randomization. The severity of delirium was measured with the Memorial Delirium Assessment Scale (MDAS) scoring on days 0 and 3 of ICU-admission. Results: The total sample size was 35 in which 16 patients received haloperidol, and 19 patients received olanzapine. The doses of haloperidol and olanzapine were 3 mg three times a day and 5 mg three times a day, respectively. There was no significant difference in baseline characteristics and the scores of MDAS between groups. Conclusion: Olanzapine and haloperidol have the same efficacy in the management of delirium in toxicology ICU-admitted patients. They can be interchangeably used for delirium treatment in these patients.
An overview of the prevalence and pattern of maxillofacial trauma in the south of Iran
Authors: Yadollahi Mahnaz , Sahmeddini Sarina
Published: September 2021

Objective: The purpose of the current study is to determine the prevalence and pattern of maxillofacial trauma. Methods: This is a cross sectional study of maxillofacial trauma cases treated in the referral trauma center of south of Iran. Data of 264 patients were extracted from patients’ records and analyzed. Data included patient’s demographics, injury mechanism, types of maxillofacial injuries, Injury Severity Score (ISS), associated injuries, length of hospital stay and outcome. Binary logistic regression by backward method was applied to determine the effects of independent variables on mortality odds ratio. Results: 85.23% of patients were males and of all patients 87.5% survived. The mean of age was 34.95 ± 16.51. The commonest cause of maxillofacial injury was road traffic accidents (86.31%). The median of ISS was 20.39± 10.24 and patients aged 30-39 years had the highest ISS. Overall, the most common maxillofacial injuries were orbital (59.47%, n=157) followed by maxillary (48.11%, n=127); common associated injuries were related to head (81.44%, n=215) followed by thorax (58.33%, n=154). Age and gender (being male) increased the odds ratio of mortality. An increase in ISS decreased the odds ratio of mortality, but it was not significant. Conclusion: Most of maxillofacial trauma patients suffered from orbital injuries and there were a huge percentage of associated injuries. Gender (male), age and length of hospital stay were the significant variables of mortality in maxillofacial patients. The findings of the current study sheds light on further investigation to treat these patients and enforce road traffic legislation and public education to prevent these traumas.
How to deal with the mental health consequences of global health emergencies? A nutshell of telemental health services and its requirements
Authors: Jannati Nazanin , Yazdi-Feyzabadi Vahid , Ershad Sarabi Roghayeh , Salehinejad Simin
Published: September 2021

The coronavirus disease (COVID-19) pandemic is a global health crisis of our time. The mental health and wellbeing of whole societies have been severely impacted by this crisis and are a priority to be addressed urgently. In addition, the COVID-19 pandemic has disrupted or halted critical mental health services in many countries worldwide. One way to overcome this situation is to use Telemental health services and people can take advantage of these services to meet their mental health needs. However, there are some barriers to provide Telemental health services, which should be considered by policymakers before the crisis.
Midwakh (pipe) and seizure: The overlooked link
Authors: Eid Mustafa Mahmood
Published: September 2021

Objective: Numerous drugs and medications from various pharmacological classes can lead to seizures as an unwanted side effect. Midwakh is a pipe commonly used to smoke tobacco blend in small quantities. Midwakh use is increasing, especially among young people. Case Presentation: A 17-year-old patient with a history of seizures was provoked by smoking midwakh, despite having no previous disease history. Conclusion: Although the patient had a negative workup for epilepsy, midwakh should be classified as an epileptogenic drug. More studies need to be conducted on the effects of midwakh on the neurological system.
Pharmacoligical characterization of the iranian Cerastes cerastes gasperettii (Reptilia: Ophidia: Viperidae) venom
Authors: Zaeri Sasan , Aghaei Zohre , Mashayekhi Navid Reza , Salemi Ali , Seyedian Ramin
Published: September 2021

Objective: Snake envenomation is common in tropical and subtropical countries of the Middle East areas including Iran. Cerastes cerastes gasperettii is a dangerous snake living in southwestern provinces of Iran. It causes massive edema at the bite site and coagulopathy leading to death if untreated. Methods: The purpose of this preliminary animal study was to evaluate the toxicity and proteomic of this venom for the first time in Iran. Moreover, the hemodynamic changes with intravenous injection of the venom were assessed and inotropic in addition to arrhythmogenic properties of this venom were investigated. Results: The estimated amount of the LD50 with intraperitoneal injection was slightly less than the similar experiment in Saudi Arabia (1.32 mg/kg versus 978 µg/kg body weight). There were 8 distinct protein bands between 12 and 66 kDa in SDS-PAGE analysis that were different with Moroccan experiment due to inter and intra species variation. Inotropic potencies were not significant since the lethal dose with intravenous injection was much lower than the Arabian experiment in guinea pigs (2.4 mg/kg versus 0.8 mg/kg). Conclusion: According to the low hemodynamic changes induced with the venom, it seems that coagulopathy and edema are the most dangerous effects of this rare snake in Iran.
How much can a small bursa stretch? A curious case of massive superficial infrapatellar bursitis in the emergency department
Authors: Dharmshaktu Ganesh Singh , Pangtey Tanuja
Published: September 2021

Introduction: Inflammation of the infrapatellar bursa results from various causes like trauma, infection and overuse. Superficial skin or soft tissue infection can also lead to occasional septic bursitis. Infrapatellar bursa has two parts, superficial and deep bursae. Superficial bursa inflammation reactive to adjacent superficial skin infection may occasionally lead to secondary bursitis. Case Presentation: We report a rare finding of acute right knee pain with extraordinary amount of fluid collection within superficial part of infrapatellar bursa in an elderly male patient. A secondary, septic and massive superficial infrapatellar bursitis was unusual in its appearance mimicking neoplastic lesion. Judicious use of clinical assessment and imaging helped to diagnose the condition. Conclusion: Early diagnosis and treatment of bursitis can ensure optimal outcome and it can be used to check further complications. Atypical presentation of any bursitis should be acknowledged and the judicious use of clinical assessment and imaging is critical for prompt diagnosis and treatment.
Oxford MEST classification in Iranian patients with IgA nephropathy, with regards to extracapillary proliferation; a single center experience
Authors: Akhavansepahi Mohsen , Rafieyan Maryam , Nasri Hamid
Published: September 2021

Introduction: IgA nephropathy is the most common glomerulonephritis in the world. Objectives: In this study we aimed to find the relationship between morphological lesions of Oxford classification for IgA nephropathy with clinical findings and some laboratory data. Patients and Methods: All kidney biopsy conducted from 2009 to 2019 conducted in medical centers and were sent to a reference laboratory in Isfahan. All kidney biopsies included two samples for immunofluorescence and light microscopy. After definitive diagnosis of IgAN (IgA nephropathy), the slides were examined to classify the disease based on the Oxford-MEST (M; mesangial hypercellularity, E; endocapillary hypercellularity, S; segmental glomerulosclerosis, and T; tubular atrophy/interstitial fibrosis and also C; crescent) classification. Results: Our study on 238 biopsy proven IgA nephropathy patients showed that 78 patients (32.8%) were male. Mean ± SD of age individuals was 38.00 ±13.68 years. The mean± SD of serum creatinine level was 1.42 ± 0.79 mg/dL and the mean ± SD of proteinuria was 1780.94 ± 1168.75 mg/d. Our study showed no significant association between M, E and S variables with patients’ age. However, a statistically significant relationship between T variable and patients’ age (P=0.028) was detected. Furthermore, morphologic variables of M, E and S were not significantly associated with proteinuria while T variable was positively associated with the quantity of proteinuria (P=0.021). Conclusion: The association of tubular atrophy/interstitial fibrosis (T variable) with quantity of proteinuria showed significance of interstitial lesion on the prognosis IgA nephropathy.
Clinicoepidemiologic profile of patients with poisoning presenting to a tertiary care hospital; a one year preliminary descriptive study
Authors: Kazemifar Amir Mohammad , Mirakbari Seyed Mostafa , Yazdi Zohreh , Bitazar Bita , Soleimani Pouria
Published: September 2021

Introduction: Poisoning is regarded as a matter of concern for health providers as the burden of health resources loss can be high. Since nature and diversity of poisoning are different among various regions around the country, this study was conducted to demonstrate type and reasons for poisonings in Qazvin province, Iran. Objectives: The aim of this study was to demonstrate the reason of toxic events as well as presenting symptoms and outcome of poisonings. Patients and Methods: This prospective, cross-sectional and hospital-based study was conducted during a one-year period. The patients recruited to the study were consecutive intoxicated cases presenting to the hospital with alleged poisoning. Relevant epidemiological and clinical data from patients were collected and then analyzed using SPSS software. Results: A total of 23161 patients were admitted to the hospital, out of which 766 (3.3%) intoxicated patients were enrolled in the study. Mean age was 29.8 years old. Females outnumbered males but difference was not significant. The majority of the poisonings were deliberate (95.2%). Main clinical features of poisoning were decreased consciousness (47.4%), followed by lethargy (38.1%) and nausea/vomiting (31.9%). The benzodiazepines were the predominant agent ingested by patients, followed by opioids. Mortality rate was found to be 1%. Conclusion: Although the majority of poisoning cases are deliberate, however according to the type of pharmaceuticals involved in the poisonings and low-mortality rate, it is believed that the occurrence of the toxic events in many cases arises from impulsive behaviors originated from minor familial conflicts and incompetent life skills. Improving mental health and efficient coping skills can contribute to the reduction of intentional poisonings which in turn reduces the burden of hospital costs.
A randomized clinical trial on improving osteopenia in postmenopausal women after two years of preventive treatment with alendronate; a dose of 35 mg per week is more effective or a dose of 70 mg?
Authors: Karimifar Mansoor , Botlani Negar , Salari Amirhossein
Published: September 2021

Introduction: Osteoporosis is the most common metabolic bone disease worldwide. In this disease, the bone mass decreases and as it progresses, the risk of fracture increases. Osteopenia occurs in the early stages of bone loss. Studies on the effective dose for treatment of osteopenia have been controversial. Objectives: In this randomized clinical trial, low doses versus high doses of alendronate were assessed during the osteopenic stage in postmenopausal women. Patients and Methods: The present study is a randomized clinical trial (RCT) that was performed on 152 postmenopausal women who were visited in Al-Zahra rheumatology clinic between 2016 and 2017. Patients were randomly divided into two groups. The first group with 35 and the second group with 70 mg of weekly alendronate were treated and followed for two years. Densitometry was performed on patients before and 2 years after the intervention, and the findings were compared. Results: The two groups were not significantly different in terms of age, gender, height, weight, body mass index (BMI) and menopause (P>0.05). The bone mineral density (BMD) findings of both groups, including Fracture Risk Assessment Tool (FRAX) hip and vertebra/wrist, T-score hip and vertebrae, as well as Z-score hip and vertebrae, improved significantly after two years (P<0.001), However, a comparison of the two therapeutic doses did not show a significant difference in terms of BMD improvements (P>0.05). Conclusion: The findings of this study reported favorable results for the preventive treatment of alendronate in osteopenic women. In addition, due to gastrointestinal problems that are the main complaint of alendronate use, according to the results, a weekly dose of 35 mg can be recommended
Evaluating the effect of intradialytic exercise on blood pressure, inflammatory markers and dialysis adequacy
Authors: Soltani Parvin , Saeedi Naser , Mashaykhi Navidreza , Rostami Alireza , Tajfar Maryam
Published: September 2021

Introduction: In spite of widely accepted idea that exercise is beneficial in dialysis, it is not easy to incorporate an exercise program into routine clinical practice of these patients. Objectives: The present study was conducted to evaluate the effects of exercise on hemodialysis patients. Patients and Methods: In this non-pharmacologic clinical trial, a total of 49 clinically stable hemodialysis patients were enrolled in the study and were randomly allocated into two groups; the intervention group (n=27) and the control group (n=22). The intervention group conducted at least 30 minutes of cycling during each hemodialysis session for six months. Intradialytic blood pressure, high-sensitivity C-reactive protein (hs-CRP) blood levels and dialysis adequacy were estimated before and after dialysis. Results: At the end of the 6-month study period, a significant reduction in systolic and diastolic blood pressure in all patients of the intervention group (P<0.05) was detected. Although the dialysis quality increased more than 1.2, it was not statistically significant. Moreover hs-CRP was decreased in the exercise group at the end of the study, while these outcomes were not statistically significant too. Conclusion: Intradialytic exercise can lead to a significant reduction in systolic and diastolic blood pressure in hemodialysis patients. Trial registration: This randomized controlled trial was registered in the Iranian Registry of Clinical Trials (#IRCT2015092324152N1, https://irct.ir/trial/20465, ethical code; ARAKMU.REC.1393.168.1).
The concordance of endoscopic and histologic findings of 530 pediatric patients suspicious for celiac disease in a referral center, Isfahan, Iran
Authors: Naimi Azar , Baradaran Azar , Pirpiran Elahe , Nasri Peiman , Akhlaghi Masoud
Published: September 2021

Introduction: The purpose of this study is evaluation of concordance of histologic and endoscopic findings in pediatrics referred to Imam Hossein children’s hospital, in Isfahan for evaluation of celiac disease. An accurate prediction of the likelihood of a histologic finding in the setting of a visually normal endoscopy can help prepare families for unanticipated results. Patients and Methods: This is a retrospective study conducted from 2015-2017. The sampling method is census and all eligible patients are included in the study. At the beginning of the work, obtaining consent for entering the project has been done through interviews. After that, patients information such as file number, age and gender according to the file were entered into the data gathering sheet. Data were analyzed using SPSS software version 22. Pvalue< 0.05 was considered significant. Results: Around 530 patients suspected of having celiac disease participated in the present study. The mean age of the subjects was 6.88 ± 4.31 years. Among them, 57.6% (305 patients) were girls and 42.4% (225 patients) were boys. According to the results, the kappa agreement coefficient is equal to 0.42. There was moderate agreement between endoscopy and pathology findings (kappa = 0.42). Conclusion: The results of the study and the kappa Cohen coefficient indicate the appropriateness of using endoscopy in patients with suspected celiac disease.
Housing and urban design for COVID-19 pandemic; design for prevention of virus spread
Authors: Shahbazian Delaram
Published: September 2021

The new COVID-19 disease, which is affecting the world and has infected and killed many people, has rapidly changed people’s lifestyles and, accordingly, changed people’s needs, including their demands on their living environment. As the disease progressed, people were forced to stay at home to escape the disease. Even cities and public spaces could no longer be used. These situations, as well as the anxiety caused by this unknown disease, quickly led to mental health problems such as depression, isolation, aggression, stress, and physical illnesses due to inactivity. Given that the living environment of people, and above all, their homes, has a direct impact on the physical and mental health of people, profound and fundamental changes and decisions in the design and construction of houses are necessary for this situation where people have to spend most of their time in their homes. On the other hand, people need to socialize with each other and do their daily and essential tasks easily, even in a pandemic situation. Therefore, the urban design must also have significant changes in accordance with these conditions. In this article, we will review the design strategies of the city and the design and construction of houses to better respond to them in such situations.
Effectiveness of neonatal screening for congenital hypothyroidism
Authors: Shayestefard Behrouz , Kia Naim Sadat , Alimohammadi Masoumeh , Ghods Elaheh
Published: September 2021

Introduction: Congenital hypothyroidism (CH) is the most common preventable cause of mental retardation. Newborn screening program considerably increases probability of CH diagnosis and treatment. Objectives: We aimed to investigate the efficacy of running CH screening program to maintain normal IQ and physical growth of hypothyroid children in Semnan city. Patients and Methods: This study was performed on children with definite CH who were treated and followed up in Semnan health centers. Around 41 children born within 2008-2013 (minimum three years of age) participated. Respective weight and height for age were measured. The Z-scores were calculated based on the WHO-Anthro-Anthro Plus Software. Intelligence Quotient (IQ) was measured with Wechsler Intelligence Score for children-revised (WISC-R). Data analyzed with one-tailed t test compared with age and gender-matched group. Results: The mean IQ Score in our study group was 90.09 (1.73) with no significant difference compared to healthy counterparts (P > 0.05). Z-score for weight and height was -0.46 and -0.45 prospectively and was not significantly different from normal children. Conclusion: Newborn screening program for CH has been effective in preventing mental retardation and growth failure.
Problem-based learning; a new pathway towards improving patient safety-based communication skills in nursing students
Authors: Jamshidi Hossein , Parizad Naser , Hemmati Maslakpak Masumeh
Published: September 2021

Introduction: Nursing education plays a pivotal role in patient safety in complicated healthcare environments, and problem-based learning (PBL) is an educational method that has gained a remarkable reputation in higher education. Objectives: The present study aimed to assess the effects of nursing education through the PBL method on patient safety-based communication skills in nursing students. Patients and Methods: This quasi-experimental study was performed on 78 fourth-year nursing students. The participants were divided into intervention (n=43) and control (n=35) groups. In the intervention groups, the educational content based on the PBL method was provided in eight sessions (45-60 minutes each). Data were collected using demographic and patient safety-based communication skills questionnaires. Results: No significant difference was observed in the mean score of patient safety-based communication skills in the control groups after the intervention (P=0.162). However, the intervention groups had significantly higher scores after the educational sessions (P=0.001). Conclusion: The implementation of the PBL method affected the patient safety-based communication skills of the nursing students. Thus, it is recommended that conventional teaching methods be replaced by PBL to improve the clinical and cognitive capabilities of nursing students.
Prevalence of contrast nephropathy following the administration of N-acetyl cysteine; a systematic review and meta-analysis
Authors: Khosravani Moghadam Marzieh , Nasri Hamid
Published: September 2021

Introduction: Nephropathy is a serious complication in patients receiving contrast during imaging. N-acetyl cysteine (NAC) can reduce the contrast nephropathy. This review evaluates the prevalence of contrast-induced nephropathy (CIN) following the administration of NAC. Methods: A systematic literature search and meta-analysis was conducted in Scopus, Web of Science and PubMed for articles published by December 30, 2019 including the keywords of "N-acetyl cysteine ", "Acute kidney injury", "Nephrotoxicity", "Contrast media", "Contrast-induced AKI" and "Contrast nephropathy". Results: A total of 29 articles of 537 studies examining 5,980 individuals were incorporated in this systematic review and meta-analysis. Pooled estimation of a meta-analysis of prevalence studies reported a prevalence of 9% (0.09), i.e. nine out of every 100 patients undergoing contrast media resulted in CIN but a prevalence of 14% (0.14) was observed in the placebo group. In addition, 41 out of every 100 patients with hypertension undergoing contrast media resulted in CIN (prevalence: 41%) and 64 out of every 100 patients with diabetes undergoing contrast media resulted in CIN (prevalence: 64%). Conclusion: The prevalence of CIN in the group receiving NAC is lower than those who did not receive this drug. Additionally, in patients suffering from diabetes and hypertension, CIN is more prevalent compared to healthy people.
Anaplastic T cell lymphoma in a patient with autoimmune hepatitis and hepatitis C infection
Authors: Ismail Hina , Akbar Nishat , Abrar Ghazi , Mohammad Arz , Shah Syed Zahid , Majid Zain , Hassan Luck Nasir
Published: September 2021

Lymphomas are rarely associated with liver disease. We hereby present a case of anaplastic T cell lymphoma in a 45-year-old female, who had received four cycles CHOP chemotherapy regimen and was evaluated for abdominal pain, fever along with weight loss. She was later found to have features of chronic liver disease on ultrasound along with varices on screening endoscopy. Serological workup was positive for hepatitis C infection while her liver biopsy showed features of autoimmune hepatitis. She was managed with steroids and azathioprine along with direct acting antiviral agents.
The association of serum uromodulin with allograft function and risk of urinary tract infection in kidney transplant recipients
Authors: Ebrahimzadeh Attari Vahideh , Maddah Arezoo , Shahveghar Asl Zahra , Jalili Mahsa , Ardalan Mohammad Reza , Mokari Saman
Published: September 2021

Introduction: There is some evidence to suggest that low levels of uromodulin in urine and serum are associated with decreased renal function and increased mortality risk. Objectives: This study is designed to measure circulating uromodulin levels and explore their relationship to urinary tract infection and renal function in kidney transplant recipients. Patients and Methods: In this cross-sectional study, 90 eligible kidney transplant recipients were evaluated 6–12 months of post-transplantation. Fasting blood samples were taken to determine the serum level of uromodulin with urea, creatinine, and other biochemical characteristics. Urine samples were taken for analysis and culture. Kidney function was estimated based on the chronic kidney disease epidemiology collaboration (CKD-EPI) creatinine equation and the modification of diet in renal disease (MDRD) equation. Results: Patients’ serum uromodulin levels were significantly correlated with their serum creatinine (P = 0.024) and estimated glomerular filtration rate by the EPI equation (eGFR-EPI, P = 0.038). There was no significant association between serum uromodulin levels and incidence of urinary tract infection of post-transplantation (P > 0.05). Conclusion: Serum and urine uromodulin levels may be regarded as the predictive indicators of renal function. However, given the lack of studies on the association between serum uromodulin levels and urinary tract infection risks in kidney transplant recipients, further research is needed to clarify uromodulin’s protective effect against urinary tract infection.
Evaluation of common polymorphisms of eNOS gene and ACE gene in autosomal dominant polycystic kidney disease patients and their association with hypertension and renal failure
Authors: Malakoutian Tahereh , Madadi Bahareh , Ebrahimi Ahmad
Published: September 2021

Introduction: Autosomal dominant polycystic kidney disease (ADPKD) is the most hereditary renal disease that leads to end-stage renal disease (ESRD). Objectives: Since there is no available parameter to assess the clinical course of ADPKD and its outcome, yet, the aim of our study was evaluation of the association of common polymorphisms of eNOS and ACE genes with clinical manifestations (kidney failure and hypertension) in ADPKD. Patients and Methods: Seventy-five ADPKD patients and 100 control subjects participated in our study. Around 7.5 cc of whole blood was taken from each participant and sent to the genetic laboratory. DNA was obtained from them by the phenol chloroform extraction and ethanol precipitation techniques. Then genotyping for I/D polymorphism of ACE gene and Glu298 ASP and T786C polymorphisms of eNOS gene was performed by PCR electrophoresis and molecular evaluation by special primers for two genes. Results: The frequency of DD polymorphism of ACE gene and TC polymorphism of T786C of eNOS were considerably elevated in ADPKD individuals than control subjects. No significant difference between groups regarding Glu298 ASP polymorphisms of eNOS gene was detected. In ADPKD patients, 29 patients (39%) had hypertension, 5 patients (6.7%) had diabetes and 43 patients (57%) had glomerular filtration rate (GFR) below 60 mL/min/1.73 m2 . The polymorphisms of ACE and eNOS genes were not meaningfully different regarding diabetes, high blood pressure, GFR and plasma creatinine in ADPKD individuals (P>0.05). Conclusion: In our study, we could not find any association between polymorphisms of ACE and eNOS genes with renal insufficiency and hypertension in ADPKD patients.
D-limonene in diabetic rats
Authors: Bagheri Shahrokh , Moradi Sarabi Mostafa , Gholami Mohammadreza , Assadollahi Vahideh , Mohammadrezaei Khorramabadi Reza , Hadipour Moradi Forouzan , Ahmadvand Hassan
Published: September 2021

Introduction: Diabetes mellitus (DM) is a multi-factorial condition associated with oxidative stress. Limonene, as a plant-derived antioxidant, can be used for treating DM. Objectives: An investigation on antioxidant effects in diabetic rats exposed to D-limonene. Materials and Methods: Sixty male Wistar rats were categorized into six groups as follows: control (healthy rats), diabetic control (untreated diabetic rats), sham glibenclamide, diabetic glibenclamide, sham limonene, and finally diabetic limonene. Alloxan (100 mg/dL) was infused intraperitoneally to induce type 1 diabetes in rats. Rats in certain groups were given limonene (100 mg/dL) and glibenclamide (10 mg/dL) orally for 8 weeks. Subsequently, animals were killed, and their kidneys were removed. Serum levels of biochemical factors (including serum creatinine, urea, and glucose) were determined, and factors such as nitric oxide (NO), malondialdehyde (MDA), glutathione (GSH), and myeloperoxidase (MPO) were measured in kidney tissue homogenate. The gene expression and enzymatic activity of glutathione peroxidase (GPx), catalase (CAT), and superoxide dismutase (SOD) in the kidney were measured by real-time polymerase chain reaction (real-time PCR) and spectrophotometry, respectively. Results: Limonene treatment significantly decreased serum glucose, creatinine, and urea. Additionally, MDA, MPO, and NO significantly decreased while GSH increased after treatment with limonene. Real-time RT-PCR showed significant elevation (P<0.05) in mRNA levels of GPx, CAT, and SOD in the limonene-treated compared with the diabetic control group. Conclusion: Our results demonstrated that limonene as an herbal antioxidant had better effects on antioxidant markers compared to glibenclamide in rat models of diabetes.
The effects of hydroalcoholic extracts of watermelon and Persian melon rind on kidney stone prevention in male Wistar rats: Alternative medicine and the role of physician and nurse
Authors: Mahmood Nia Leila , Najafi Dehkordi Saba , Shirani Majid , Hasanpour Dehkordi Ali
Published: September 2021

Introduction: Both watermelon and Persian melon extracts have various pharmacological properties like anti-diabetic, anti-viral, anti-cancer, and anti-urolithiasis effects. Objectives: The present study was conducted to investigate the effects of hydroalcoholic extracts of watermelon and Persian melon rind on kidney stone prevention in male Wistar rats. Materials and Methods: Fifty-six Wister rats were randomly divided into seven groups and treated for 28 days. The first group (healthy control) and the second group (negative control) received drinking water and water containing 1% ethylene glycol, respectively. The third and fourth groups, received 100 mg/kg/d hydroalcoholic extract of watermelon rind and Persian melon rind, respectively in addition to 1% ethylene glycol. The fifth and sixth groups, received 400 mg/kg/d hydroalcoholic extract of watermelon rind and Persian melon rind, respectively in addition to 1% ethylene glycol. The seventh group received 0.5 mEq/kg/d potassium citrate in addition to 1% ethylene glycol for prevention and treatment of kidney stone. A 24-hour urine collection was conducted to determine the levels of sodium, calcium, uric acid, oxalate and citrate concentration. Histological study of calcium oxalate crystals was also performed. The serum levels of urea, creatinine, uric acid, calcium, phosphorus, magnesium, SGPT (serum glutamic-pyruvic transaminase), SGOT (serum glutamic-oxaloacetic transaminase), total antioxidant capacity, and malondialdehyde (MDA) of blood were determined accordingly. Results: In the present study, administration of high-dose extract of watermelon and Persian melon rind (400 mg/kg/d) and potassium citrate showed significant changes in variables of sodium, calcium, uric acid, citrate, urine volume (P<0.01), blood creatinine, blood uric acid, blood calcium, and serum SGPT (P<0.05). The histological study of calcium oxalate crystals showed a significant reduction in oxalate levels in all prevention groups. Conclusion: The extracts of watermelon and Persian melon rind are effective in preventing calcium oxalate stones by decreasing the levels of oxalate, sodium, and calcium and increasing citrate levels and urine volume and affecting the total antioxidant capacity. Persian melon rind extract was more effective than potassium citrate and watermelon rind extract in reducing urine sodium. High-dose watermelon rind extract showed similar effects as potassium citrate.
Assessment of the diagnostic accuracy of home blood pressure monitoring by patients
Authors: Hajian Sepideh , Rastgoo Nafiseh , Jamshidi Sanaz
Published: September 2021

Introduction: According to available guidelines, home blood pressure monitoring (HBPM) can be used to diagnose hypertension and monitor its treatment; however, its effectiveness has rarely been studied in developing countries, including Iran. Objectives: This study aimed to evaluate the diagnostic accuracy of HBPM, as compared with that of 24-hour ambulatory blood pressure monitoring (ABPM) and office blood pressure measurement (OBPM). Patients and Methods: This study was conducted on 28 patients suspected of having primary hypertension. The blood pressure of the patients was measured by four methods. Initially, blood pressure was measured by a non-physician using a digital sphygmomanometer in a clinic (OBPM-Digital). After about 1 hour, blood pressure was measured by a physician at the clinic using a mercury sphygmomanometer (OBPM-Mercury). In the third stage, the patient’s blood pressure was monitored for 24 hours by the ABPM method. In the fourth stage, each subject used a digital sphygmomanometer to measure HBPM for seven consecutive days. Results: The blood pressure values measured through the ABPM method were significantly lower than those measured by other methods (P<0.05). The prevalence of hypertension diagnosed by OBPM-Mercury, OBPM-Digital, HBPM, and ABPM method was 82%, 54%, 50%, and 21%, respectively. As compared with ABPM as the gold standard, the diagnostic accuracy of HBPM, OBPM-Digital, and OBPM-Mercury was 64%, 61%, and 32%, respectively. The frequency of white coat hypertension (WCH) diagnosed by HBPM and ABPM methods was 39% and 64%, respectively, and the frequency of masked hypertension (MH) diagnosed was 7% and 4%, respectively. The sensitivity, specificity, and diagnostic accuracy of HBPM, as compared with ABPM, in detecting MH were 100%, 96%, and 97%, respectively; in addition, as compared with WCH, they were 56%, 90%, and 68%, respectively. Conclusion: The findings of the present study showed that HBPM had higher diagnostic accuracy than OBPM in diagnosing hypertension. Also, HBPM was able to detect MH with a high level of diagnostic accuracy, and in more than two-thirds of cases, it was also able to detect WCH and diagnose patients with sustained hypertension.
The relationship between bone mineral indices and survival in patients on peritoneal dialysis
Authors: Yaghoubi Fatemeh , Hakemi Monirossadat , Taghizadeh Hannaneh , Alatab Sudabeh
Published: September 2021

Introduction: Disorders of minerals metabolism are common metabolic problems in patients undergoing peritoneal dialysis (PD) which causes increase in mortality and morbidity in these patients. Objectives: In this study, the relationship between bone metabolic indices and mortality rate in patients on PD was assessed. Patients and Methods: Data were collected from Iranian peritoneal dialysis registry database, covering the period 2009–2015 and comprised 2000 adult patients. Patients with less than three months follow-up and incomplete data were excluded. Demographic and some laboratory data (including age, gender, body mass index, serum albumin, dialysis vintage and comorbidities) of patients recorded. Additionally, the unadjusted and adjusted, hazard ratios (HRs) of serum phosphorus (P), calcium (Ca) and parathyroid hormone (PTH) levels, to find their association with mortality were calculated, using the Cox proportional-hazards model. Results: In total, 1197 out of 2000 patients had the inclusion criteria and were included in the study. We found that serum iPTH (intact parathyroid hormone) over 600 pg/mL significantly increased the mortality rate by 2.7 times compared to iPTH levels between 200 to 600 pg/ mL (HR: 2.7, P=0.002). Additionally, the serum phosphorus level less than 4 mg/dL was significantly (P=0.0001) related to higher mortality rate (HR: 1.6). There was no significant association of serum calcium and alkaline phosphatase (ALP) levels with mortality (P > 0.05). Conclusion: Although high serum iPTH and low-serum phosphorus levels could determine the mortality risk in PD patients, Ca and ALP levels were not risk factors for mortality.
Potential of renin-angiotensin system inhibition to improve metabolic bone disorders
Authors: Momenzadeh Mahnaz , Khosravian Maryam , Lakkakula Bhaskar VKS
Published: September 2021

Metabolic bone disorder is an abnormality of bones indicated by reduced bone mass and high risk of fractures. Several lines of evidence have demonstrated that the local bone tissue renin-angiotensin system (RAS) is directly involved in bone metabolism and influences the bone health. This review aimed to assess the role of RAS in bone metabolism and comparative effectiveness of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) in reducing the bone fractures. In summary, the clinical trials, in vivo studies, and functional - pharmacological experiments suggested that the RAS regulates bone marrow metabolism and influences the bone health. Hence, it warrants further investigation on the role of ACEIs and ARBs in reducing risk fractures.
ADAMTS13 gene; a novel splicing site mutation in a case with thrombotic thrombocytopenic purpura
Authors: Zununi Vahed Sepideh , Cremaschi Alessandra , Zaker Behzad , Rasi Hashemi Seyed Sadroddin , Ardalan Mohammadreza
Published: September 2021

A plasma protease, ADAMTS13, cleaves the von Willebrand factor (VWF) and its deficiency is associated with the pathogenesis of thrombotic thrombocytopenic purpura (TTP). According to the Human Gene Mutation Database (HGMD), about 150 mutations have been identified in the ADAMTS13 gene. A 23-year-old man, with hematuria and gingival bleeding was admitted to our University Hospital. Four years ago he was diagnosed with a TTP history. During these years, he was under intermittent plasma exchange. A blood sample was taken for genetic study. He effectively responded to one session of fresh frozen plasma replacement and plasma exchange. Genetic study indicated that this case carries two heterozygous mutations in ADAMTS13 gene; a novel splicing variant (c.2610+5G>A) and a nonsense p.Arg910X mutation that previously is reported to relate to TTP. The novel variant predicted to result in an aberrant ADAMTS13 transcript processing.
Understanding kidney injury in COVID-19; a pressing priority
Authors: Ahmadipour Elham , Lakkakula Bhaskar VKS , Vahdani Golnaz , Tolouian Ramin , Ragati Haghi Hedieh , Delgado Doris , da Silva Luiz Augusto Fernandes , Hafizi Masoud
Published: September 2021

The 2019 novel coronavirus disease (COVID-19) is a newly defined infectious and highly contagious acute disease caused by the severe acute respiratory syndrome coronavirus 2 ( (SARS-CoV-2). COVID-19 is mainly characterized by an acute respiratory disease however it can also affect multiple other organ systems such as the kidney, gastrointestinal tract, heart, vascular system, and the central nervous system. Kidney involvement is frequent in patients with COVID-19 and this review aims to explore the available data on kidney and COVID-19. In conclusion, COVID-19 infection can affect renal function and may cause acute kidney injury (AKI), due to several mechanisms that need to be fully elucidated. As only supportive management strategies are available for treating AKI in COVID-19, it is necessary to identify and preserve renal function during SARS-CoV-2 infection.
ECONOMY AND RENTABILITY OF MODERN COMPANIES
Authors: Zlatevski Ljubisa
Published: September 2021

Costs can hugely affect the state of economy and cost-effectiveness of the company. It is crucial to note that not always high income can be an indicator of the company's financial health. To achieve the full picture we need to look at the costs (ie the costs of the enterprise). Each company has its own costs arising from different aspects of the operation. But each enterprise to preserve the economy and cost-effectiveness of its operations should control costs and systematically reduce them. The reduction of costs, as a consequence, contributes to greater profitability of the company, and the greater profitability of the company leads to an increase in the share capital , cash reserves, etc. In the long run, costs always influence the solvency of enterprises because they spend periods of expansion and expansion that increase costs. Therefore, each company should control costs and constantly find ways to minimize them. Cost reduction drives the company ahead of the competition because it can deliver quality but at the same time give it a lower and more attractive price. Cost reduction and increased profitability can contribute to the growth of the enterprise and through mergers and acquisitions, because with the newly created capital and the economy can be developed. In terms of costs, it must be noted that cost cutting and cost control must be carried out consistently regardless of the scope of the enterprise, activity, etc. The economy of an economic entity is the most important feature, since we are witnesses of once successful economic entities that, due to uneconomic, are already part of history. The reasons for this can be found in the growth of costs in times of economic expansion to the state of the peak of prices, when the economy enters correction or recession.
THE ROLE OF CAPITAL IN THE COMPANY AND ITS TYPES
Authors: Dukoski Stojan
Published: September 2021

Every organization without regards to the products and services it produces needs capital.Capital is the driving force behind every organization,and no organization can survive without capial in the business environment.Capital is one of the necessary variables to conduct business and it's volume is determining the size of the company. Without efficient capital allocation the activity and the business dealings of the company will certainly stop.With efficient capital management has profound effect on the financial results of the company. There are two types of capital,fixed assets and working capital. The fixed assets are the capital which is invested in a period that lasts more than a year.These assets are having three forms:material investments,imaterial investments and long term financial investments.The basic characteristic of the fixed assets is that they are not spent at once and they do not transfer their value to the finished products and services.Their costs are seen through the amortization phenomenon. Working capital is the capital that are invested for a period of less than a year.They are also called circular assets.They constantly regenerating.They come in three types: money,materials and claims. Capital is the basic ingredient for success of every company. It shows us that without it the companies would not be able to make purchases and make partnerships. Capital is the basic source of every business and has the power to transform the business and make turnaround if the situation is bad, but also to worsen the situation if there is a lack of capital. Capital can transform economies, but also could destroy economies. That is the reason the monetary policy is loose at some moments, because the lack of capital can ruin a decent economy. Companies know this and they try to capitalize themselves very well, because at times capital can be very scarce.