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  Hydatid disease infection in humans is caused by larva of Echinococcus granulosus. Definitive hosts are carnivores such as dogs, while intermediate hosts are herbivores. Humans can also be intermediate hosts. Hydatid disease is clinically related to the presence of cysts, most frequently in the liver and the lungs and less frequently in the other organs such as kidney, spleen, brain, heart and bone. In this article, a case of splenic hydatid cyst is reported. A 50-years-old man was admitted to the clinic with a abdominal pain lasting for two weeks. Sonography and computed tomography (CT) scan revealed a splenic cyst. Cyst was removed by a surgery. The diagnosis of a hydatid cyst was confirmed by histopathology.

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Background & objectives: Chronic Obstructive Pulmonary Disease (COPD) is accompanied by systemic inflammations and is characterized by irreversible airflow limitations. Leptin is a cytokine with pre-inflammatory effect. However, there have been no studies on the effect of conjugated linoleic acid (CLA) on the serum leptin concentration in COPD patients. Therefore, the present study aimed to explore the effect of CLA on the serum leptin level, lung function and quality of life in COPD patients.
Methods: This interventional study was conducted on 90 COPD patients. The patients were randomly divided into two groups (supplement and placebo) with 45 patients per group. After obtaining written consent from the patients and recording their demographic characteristics, the spirometry was performed and COPD assessment test (CAT) score was calculated. Moreover, a fasting blood sample was collected from each of them in order to analyze their serum leptin concentration. After that, the patients in the supplement group were administered with 3.2 g/day of CLA for 6 weeks. The patients in another group received placebo. After the intervention, spirometry, CAT score calculation and blood sampling were repeated for all of the patients and the obtained results were analyzed.
Results: after the intervention, a significant decrease both in the serum leptin level and in CAT score as a quality life marker  was observed in the supplement group (p<0.05). Moreover, the FEV1 levels as a lung function test, increased significantly in the supplement group after the intervention (p<0.05). Although, the difference between the two groups was not significant.
Conclusion: The use of CLA supplement can improve COPD patients’ quality of life through decreasing the serum level of leptin in their blood.
 

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Background: Primary sclerosing cholangitis is a rare and progressive cholestatic disease characterized by narrowing of the biliary tract. Despite high levels of ulcerative colitis, early diagnosis of primary sclerosing cholangitis before the diagnosis of inflammatory bowel disease is rarely reported.
Case history: A 28-year-old woman with no history of medical disease visited our clinic because of a mild generalized pruritus. In initial blood laboratory tests with elevated liver enzymes was observed. In Magnetic resonance cholangiopancreatography (MRCP) was introduced primary sclerosing cholangitis to the patient. Therefore, the patient was under colonoscopy and extensive colitis with terminal ileum involvement was detected and the diagnosis of ulcerative colitis was confirmed in the pathology.
Conclusion: Patients diagnosed with primary sclerosing cholangitis should undergo biopsy colonoscopy to rule out inflammatory bowel disease, even if they have no digestive tract symptoms

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Background & objectives:  Hydatid cyst is a major hygiene problem in Iran. In 80% of cases, only one organ is involved. However, multiorgan involvement has also been rarely reported. But it seems, the prevalence of hydatid cyst with the involvement of more than one organ in Iran is more than other world. The aim of this study was to evaluate the patients with hydatid cyst multi organ involvement in Ardabil province in northwest of Iran.
Methods: In this retrospective study, 34 patients with hydatid cyst with involvement in more than one organ were included. For each patient, a pre-designed questionnaire including name, age, education level, occupation, place of residence, cyst location, clinical manifestations and serologic test results were completed. Patients, who had previously a history of treatment due to hydatid cyst, were excluded from the study.
Results: The mean age of patients was 36.41 years. 61.8% of the patients were housewives and 64% were rural residents. The most commonly involved organs was liver and simultaneous involvement of liver and lung was observed in 38.2% of patients and was more in women. The association of the right lung cyst with the liver cysts was greater than that of the left lung. Only in 43% of the patients, the serologic test was positive for hydatid cyst, and the relationship between serologic test and type of involvement was not significant.
Conclusion: Regarding the high incidence of hydatid cyst involvement in more than one location in our region, in all patients, especially women with liver hydatid cyst, other organs, especially the lungs, should be investigated
 

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Background & objectives: Endoscopy is an invasive and painful procedure. The use of sedatives, especially in children, is expanding. The aim of this study was to compare the sedative effects of ketofol and the combination of midazolam-ketamine in upper endoscopy in children aged 1 to 14 years who referred to Taleghani Hospital in Gorgan.
Methods: In this study, 55 children entered the study 1 to 14 years after obtaining parental consent. They were then divided into two groups, ketamine-propofol (KP) and ketamine-midazolam (KM), by simple randomization. At all stages of the work, patients underwent cardiac and respiratory monitoring. All hemodynamic parameters and ramsy sedation score (RSS) were recorded for all participants in the 5 time periods before, during and after endoscopy. ANOVA test and bonferroni tracking test were used in spss software to analyze and compare data.
Results: 54.5% were male patients. The ANOVA test showed that the scores of the two groups at the time of the study had a statistically significant difference (p=0.02). In the KM group, the mean blood pressure and heart rate of patients increased at all times compared to before the intervention (p=0.005). Blood pressure in the KP group had a steady trend over time (p<0.001).
Conclusion: There was a statistically significant difference between the scores of the two groups and the group (KM) had higher scores, but the use of two drug regimens Propofol-Ketamine and Ketamine-Midazolam caused a good sedation in pediatric endoscopy. The propofol-ketamine compound resulted in greater hemodynamic stability in cardiovascular parameters during and after endoscopy

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Background & objectives: Mitochondrial dysfunction is one of the main risk factors for neurological diseases which are associated with aging. On the other hand, aerobic exercise has beneficial effects on the brain health and cognitive function, and also improves mitochondrial dynamics. Therefore, the aim of the present study was to investigate the effect of 4 weeks of aerobic exercise on spatial learning, memory performance and mitochondrial dynamics in the hippocampal tissue of old rats.
Methods: For this purpose, 14 male Wistar rats at 20 months of age were randomly divided into 2 groups: aerobic exercise (n=7) and control group (n=7). The exercise group performed 4 weeks of treadmill training (5 days per week at a speed of 10 to 15 m/min). Forty-eight hours after the last training session, the animals underwent behavioral tests. Twenty-four hours after the behavioral test, all rats were killed and hippocampal tissue was extracted. The mRNA expression of OPA1, Mfn2 and Drp1 genes were assayed using Real Time-PCR. The Independent t test was used for statistical analysis.
Conclusion: Aerobic exercise in old animals improved spatial learning and memory performance, increased hippocampal OPA1 gene expression, and decreased Drp1 gene expression compared to the control group (p≤0.01).
Conclusion: It seems that aerobic exercise can improve the function of brain mitochondria by modulating fusion and fission processes and it can be considered as an effective non-pharmacological method to deal with aging-related learning and memory perturbations.

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Background & objectives: Exercise, with beneficial effects on brain health and cognitive function reduces the destructive effects of some neurological diseases such as Alzheimer's. The aim of this study was to evaluate the effect of four weeks of aerobic exercise on cognitive function and expression of Sirt1, CREB and BDNF genes in the hippocampus of male Wistar rats with Alzheimer's disease.
Methods: The statistical population included 18 male Wistar rats from the Pasteur Institute. Rats were randomly divided into three groups including Alzheimer's group, Alzheimer's disease-exercise group and a healthy control group. Alzheimer's disease group was induced by injecting Aβ42 into the hippocampus. Seven days after surgery, the rats performed the aerobic exercise for four weeks (five sessions per week at a speed of 10-15 m/min). They underwent behavioral tests 48 hours after the last training session. Twenty four hours later, rat hippocampal tissue was extracted. Sirt1, CREB and BDNF mRNAs were measured using Real time-PCR.
Results: Learning and spatial memory performance decreased in rats of Alzheimer's disease group compared to a healthy control group (p˂0.001). Decreased mRNA expression of Sirt1, CREB and BDNF genes was observed in the hippocampal tissue of Alzheimer's disease group compared with the healthy control group (p˂0.001). Alzheimer's rats with intermittent aerobic exercise had improved learning function, spatial memory and increased mRNA expression levels of Sirt1, CREB and BDNF genes in comparison with Alzheimer's disease group (p˂0.001).
Conclusions: Periodic aerobic exercise in rats with Alzheimer's disease can improve spatial learning and memory by positively regulating the Sirt1/ CREB/ BDNF signaling pathway in hippocampal tissue.

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Background & objectives: Even though clinical empathy is one of the clinical competencies of medical students and there is a high emphasis on teaching and learning, it decreases during medical education. This study investigated the relationship between burnout, quality of life and clinical empathy in medical students.
Methods: this exploratory cross-sectional study used the Jefferson empathy questionnaire, WHO quality of life questionnaire and burnout inventory. All three questionnaires are standard, and their validity and reliability have been confirmed in various studies in Iran. The research population was the Ardabil University of Medical Sciences internship medical students, for which the census sampling method was used. Various statistical tests, such as Pearson and spearman correlation, Chi-square, etc., were used for data analysis.
Results: Out of 130 students, 128 (98.4%) completed all of the questionnaires. Data analysis showed that 98% of students suffered from moderate burnout and 2% of them had severe burnout. About 44% of students were satisfied or very satisfied with their health status and 33% of students were dissatisfied or very dissatisfied. The mean score of clinical empathy in students was 79.46±9.82. Data analysis showed a statistically significant inverse relationship between quality of life and burnout (p=0.0001).
Conclusions: Considering that the situation of students was not very favorable in terms of all three variables, non-curricular programs seem to be essential for improving student adaptation mechanisms to the job-related situations in medical students and promoting clinical empathy.
 

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Background: The main purpose of this study was to investigate the effects of dry needling on pain and pain pressure threshold (PPT) in patients with non-specific chronic low back pain (NSCLBP).
Methods: 29 patients with NSCLBP were randomly allocated into two experimental (N=14) and control (N=15) groups. The dry needling intervention was considered for quadratus lumborum, gluteus medius, and lumbar multifidus, in 6 sessions, and subjects of the control group followed their routine lifestyle. The measurements included pain and PPT, which were evaluated in the pre-test, post-test, and follow-up periods. The pain was a variable that had a three-month follow-up assessment. Analysis of variance of combined measurement with repeated measurement and Benferoni's post hoc test were used to investigate the effect of the intervention on the outcome measurements.
Results: Three sessions of trigger point dry needling did not lead to a significant change in pain. However, after five sessions of dry needling, a significant decrease in pain was observed (p<0.05), and the positive changes significantly remained until one and three months after the end of the intervention (p<0.05). Furthermore; significant changes in PPT scores were detected following five sessions of trigger point dry needling treatment (p<0.05). These changes remained constant in the one-month follow-up assessment (p<0.05).
Conclusion: Dry needling for the trigger points of the QL, GM, and LM muscles can improve pain intensity and PPT in patients with NSLBP.