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  Background: Obese patients are at high risk of numerous chronic diseases including diabetes, hypertension, heart disease, dyslipidemia and stroke. Recently researchers focused on complementary medicine along with routine treatments to reduce obesity complications. Therefore we aimed to investigate the effects of omega 3 fatty acids supplementation on serum lipid profiles, C-peptide and fasting blood glucose in obese individuals.

  Methods: In this randomized clinical trial 56 obese volunteers with the mean age of 33.94±8.15 years were assigned into the supplemented (n=30) and placebo (n=26) groups, given two omega 3 fatty acids soft gel (360 mg EPA and 240 DHA) or placebo respectively for 4 weeks. At the onset and the end of the intervention, blood samples were collected after overnight fasting and serum lipid profiles, C-peptide and fasting blood glucose were measured. Data were analyzed with SPSS program and p-value less than 0.05 considered as significant.

  Results: In comparison with placebo group, omega 3 supplementation resulted in a significant decrease in the mean triglyceride (108.37±11.22 mg/dl vs 148.84±59.40 mg/dl). After 4 weeks, the mean C-peptide concentrations increased in both groups but elevation in omega 3 group was more dramatic (p<0.01). However, we didn’t find any significant changes in the mean total cholesterol, LDL-C and HDL-C levels.

  Conclusion: Our finding indicated that 4 weeks Omega 3 supplementation leads to amelioration in some of serum lipid profiles indices and insulin secretion in

  obese individuals. Although, further studies are needed to achieve precise results.

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  Information technology can increase the quality of medical care and is a target for many of the pioneers in the development of clinical or medical information. Electronic medical record (EMR), one of such technologies, is a well-known and valuable system to access patient information in hospitals. Electronic medical records which are used for the purpose of providing basic health care are available through a network of computers. All units of the hospital such as examination room, conference room, emergency, patient care units, nursing stations, operating rooms, recovery units, laboratory, radiology, pharmacy and medical records should have access to it. Among its advantages are improved quality of care provided to patients, better organized information, improvement in the timeliness of the process, accuracy and completeness of documentation, patient access to electronic copies of records, prevention of medication errors and allergies, reduced medical errors, immediate access to information in different places, decision support technology and improvement in the process of doing . S urely the use of electronic medical records has created a new dimension to patient care and clinical practice and will provide a comprehensive system to support people in the community and enhance the quality of services provided to them.

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  Background & Objectives: Epidemiological and experimental evidences suggest that oxidative stress is elevated in children with Down syndrome (DS). Some studies show that consumption of diets with a high content of fruits and vegetables results in a significant reduction in markers of oxidative stress. We investigated the frequency of fruits and vegetables intake in children with DS and the influence of variations in the level of this consumption on biomarkers of oxidative stress .

  Methods: Frequency of consumption of fruit and vegetables by children with DS were recorded by interview with the children’s parents. Serum malondialdehyde (MDA) and urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) were also measured as biomarkers of oxidative stress. Data analysed using ANOVA and Student’s t-tests .

  Results : Mean consumption of fruits and vegetables was 4.6 and 0.74 servings per week, respectively. No significant relationships were found between consumption of fruits and vegetables with markers of oxidative stress. Based on our findings, the 65.9 % of the children did not eat any vegetables and the rest of the children consumed less than one serving per day. There was a significant correlation between the frequency of fruits and vegetable consumption (r=0.212 p <0.04).

  Conclusion : There wasn’t any significant relationship between fruits and vegetables consumption and indicators of oxidative stress in children with DS. This lack of correlation could be due to low consumption of fruits and vegetables in children with DS.

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  Introduction: Complete Amputation of wrist is physical and psychological trauma that can affect person's life. During recent years, various amputated organs were replanted back into their own body leading to improvement in quality of life, function and body image.

  Case Report : The case was a34 years old man with complete amputation at left hand at wrist level, while working with chainsaw. Patient was admitted to the emergency unit at Fatemi hospital of Ardabil city, and underwent tosurgery for replantation.

  Conclusion: Complete amputation of wrist and its successful replantation are among rarely occured and reportable cases . The5 -month follow-up indicated a successful operation . During this period, no abnormalities were found in the blood circulation . The finger grasping and nerve development were acceptable and no symptom of infection was observed

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  Background & objectives: Dental caries is one of the most chronic diseases in children. Various factors were effective in incidence andprevalence of dental caries. The aim of this study was to determine the dental caries prevalence among 6-12 yearsold school children in Ardabil city.

  Methods : In this descriptive–cross sectional study a total of 847 school children (444 girls and 403 boys) were randomly selected from public and private schools in all over of Ardabil city.Clinical examination of children have been done for dental caries according to world health organization (WHO) criteria including determination of DMFT, dmft, DMFS and dental caries prevalence. Data were analysedin SPSS.16 by statistical methods.

  Results: Total prevalence of dental caries was 79.7% in children with 71.1 % in permanent and 88.3 % in primary dentition. The mean of dmft, DMFT, DMFS indexes were 2.74± 0.09, 1.6±0.1, and 3.5± 0.1, repectively.Results showed that there was a significant relation between DMFT, dmft and DMFS and age group.

  Conclusion : Results showed that the dental caries prevalence among 6-12 years-old school children in Ardabil city was higher than the world standard. Therefore, improving the existing dental services, programing and performing education, prevention and treatment programs for oral health between school children seems tobe necessary in the future.

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Background & objectives: One of the most proven trajectories for analyzing the drug consumption patterns in the community is to assess the prescriptions. Using the antibiotics for prevention and treatment of infectious diseases not only leads to the loss of pathogens but also causes various complications, the most important of which is the drug resistance. The aim of current study was investigating the different antibiotics prescript by general practitioners (GPs) for outpatients in Ardabil city.

Methods: This study is designed based on the cross-sectional method. The number of 2,000 copies (according to Morgan) from total of 526000 copies sent to Ardabil health insurance during the 4 seasons of 2013 were randomly evaluated. The collected data were analyzed by descriptive statistics, ANOVA and T-Test using spss software. The P ≤0.05 was considered statistically significant.

Results: In this study the average drug per prescription was 3.6 and 54.9% of the prescriptions included antibiotics so that the cefixime, azithromycin, Co-amoxiclave and penicillin 6.3.3 were the most frequently prescribed antibiotics, respectively. The highest prescriptions belonged to penicillins (39.4%) cephalosporins (27.7%) and macrolides (18.3%). The most expensive antibiotic was cefixime tablet (32% of the total cost). The most of the antibiotics were prescribed to be taken orally (tablets or capsules). The mean price of each prescription was 74539±71050 Rials. The highest rate of antibiotic prescription was related to the autumn and then winter and there was a significant relationship between the the number of antibiotics in different seasons of the year (p = 0.005).

Conclusion: The average drugs of each prescription are in accordance with local statistics, but much higher than the global figures. The frequency of antibiotics prescription was higher than the global, several Middle Eastern and even African countries’ indices but was lower than the average level of some regions in the country. The pattern of prescribing antibiotics among the Ardabil GPs shows the more drugs in number and expensive broad-spectrum. The average price of prescripts was higher than the national average. These findings suggest that prescription and using antibiotics is not desirable in Ardabil.

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Background & objectives: Stroke is third leading cause of death and disability in the most of human communities. Several experimental studies have shown that combination therapy with drugs that act via different mechanisms can produce amplified protective effects. We examined the effects of combination therapy with candesartan and alpha tocopherol against cerebral ischemia.

Methods: Male Sprague-Dawley rats were divided into five groups (n=24): sham, control ischemic, candesartan treated (0.3 mg/kg), alpha tocopherol treated (30 mg/kg) and combined treated ischemic groups. Transient focal cerebral ischemia was induced by 90-min-long occlusion of the left middle cerebral artery followed by 24-h-long reperfusion. Neurological deficit score was evaluated at the end of the reperfusion period. Thereafter, the animals were randomly used for measurement of the infarct volumes and investigation of ischemic brain edema formation using a wet/dry method.

Results: Induction of cerebral ischemia produced considerable brain infarction in conjunction with severely impaired motor functions and edema formation. Combined treatment with candesartan and alpha tocopherol significantly reduced the infarct volume and lowered the water content in the ischemic lesioned hemisphere. These effects on brain edema and oxidative stress biomarkers were significantly more than the monotherapy with candesartan.

Conclusion: The combination therapy with candesartan and alpha tocopherol can noticeably decrease ischemic brain injury and attenuate edema formation likely via increasing the antioxidant activity.

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Background & objectives: Acne Vulgaris is a chronic inflammation of pilosebaceous glands. Some studies have indicated the significant decrease of linoleic acid in the sebum composition of the patients with acne. The aim of this study was to determine the probable therapeutic effects of linoleic acid on moderate acne.
Methods: In a double-blind randomized clinical trial, 40 women with moderate acne were divided into two groups, each group with 20 each with 20 samples. After recording the nutritional and demographic factors, the case group received, 100 mg oral doxycycline daily plus 3 gr conjugated linoleic acid and the control group received 100 mg doxycycline daily plus 4-3 oral paraffin capsules as placebo for one month. The number of acne lesions were counted before and after treatment and the mean of   Acne Severity Index (ASI) and Global Acne Grading System (GAGS) were determined for each group. The collected data were analyzed by SPSS software using chi-square, independent t-test and paired t-test.
Results: The mean age was 22.8±5.5, in the case group and21.7±5.1 in placebo group indicating no statistically significant deference (p=0.51). At the end of treatment there was no statistically significant deference between the two groups in decreasing acne (p=0.31). During the treatment, ASI reduced from 129.5±13 to 77±11.6 in the case group and from 132±18.6 to 67.5±11.6 in the placebo group, –but there was no statistically significant deference between the two groups (p=0.37).
Conclusion: It seems using 3 gr oral conjugated linoleic acid daily for 1 month has no effect on remission of acne.

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Infertility, especially in the last decade, has been rising as a global problem, affecting approximately 10-15% of the world's population. The abundance and origin of various types of infertility are different. Studies have shown that reactive oxygen species (ROS) are involved in infertility, in particular in male infertility. Although ROS is essential for normal physiological functions of sperm such as capacitation, hyper activation, acrosome reactions, and binding to the oocyte, excessive levels can be one of the main causes of defective sperm function, which not only impairs the health of sperm DNA, but also affects fertilization via oxidation of proteins, in particular the fatty acids of the sperm cell membrane. Also, the elevated ROS levels facilitate sperm DNA damage, which leads to activation of apoptotic pathway and cell death. Therefore, the quality of semen is functionally reduced. Since the oxidative damage to sperm DNA is associated with both miscarriage and development abnormalities in the offspring, it is essential to find new strategies to recognize the cellular and molecular biology of sperm. Therefore, considering different mechanisms of oxidative stress affecting sperm can contribute significantly to the etiology of male infertility

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Background & objectives: Trauma is one of the most common causes of death in  the age range 1 to 44 and the third cause of death regardless of age. Abdominal trauma is one of the most common types of trauma. This study aimed to investigate the frequency of causes of laparotomy in penetrating and blunt abdominal traumas in 2016.
Methods: This descriptive study was conducted on 120 medical records of patients hospitalized for penetrating and blunt abdominal traumas in Fatemi Hospital, Ardabil, 2016. The inclusion criterion consisted of all patients undergoing laparotomy due to abdominal trauma. In this study, age, gender, education level, type of trauma (blunt or penetrating), results of laparotomy surgery, physical examination and paraclinical findings of patients before operation were collected by a researcher- made checklist.
Results: The results showed that 80% of the patients were male and 35% were in the age range 20-29years. Of patients, 38.3% had penetrating trauma and 61.7% blunt trauma. The most common mechanism of blunt abdominal trauma was car accident (83.8%). Penetrating object was the cause of all penetrating abdominal traumas. Peritoneal stimulation symptoms were observed in 56.5% of penetrating abdominal traumas and 62.2% of blunt abdominal traumas. Hypotension was observed in 21.7% of patients with penetrating abdominal trauma compared with 62.2% in patients with blunt abdominal trauma. The most prevalent damaged organ in patients with blunt trauma was spleen (51.4%). The most prevalent damaged intraabdominal organ was small bowel (17.4%). Negative laparotomy was significantly higher in patients with penetrating trauma than those with blunt trauma (p<0.0001). Moreover, 9.2% of all patients had died and mortality rate was higher in patients with blunt trauma than penetrating trauma (p<0.05) .
Conclusion: The results of this study showed that: 1. Road traffic accident and penetrating object were the most common causes of laparotomy in patients with blunt and penetrating trauma respectively; 2. Spleen and small bowel were the most prevalent damaged organs in blunt and penetrating abdominal trauma respectively and; 3. Young males were at highest risk of abdominal traumas.

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Background & objectives: In recent years, the hypothesis of using anti-androgens has been increasingly addressed in the treatment of acne in women. One of these drugs is flutamide, which there is no strong evidence of its efficacy in treatment of acne in women. The aim of this study was to compare the effect of combination therapy of flutamide-cyproterone compound with flutamide-doxycycline in severe type of acne in women.
Methods: In an interventional study, patients were divided in to two groups. One group (n=30) received flutamide - cyproterone compound and another group (n=30) received flutamide-doxycycline which were followed for six months. Both groups also received 1% topical clindamycin twice a day. Counting the number of lesions, changes in severity index and grading of acne were used to evaluate the patients. Patient satisfaction was also evaluated.
Results: The mean age in the flutamide-doxycycline group was 19.4±4.67 and in the flutamide-cyproterone compound group was 19.06±11.3. This difference was not statistically significant. The mean of the acne severity index at the onset of intervention between the two groups was not significant (p= 0.7). The mean of the acne severity index at the start of treatment in the flutamide-doxycycline group was 306.07±155.46 and at the end of treatment reached to 19.18±19.5, and also in the flutamide-cyproterone compound group, decreased from 293.21±15.21 to 10.5±21.8 at the end of treatment. This difference was not statistically significant (p=0.1).
Conclusion: Both therapeutic regimen were effective in the treatment of severe type of acne and can possibly be used as an alternative treatment for severe acne.

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Background & objectives: In recent years, Acinetobacter baumannii has been shown to be associated with several nosocomial infections, including pneumonia, bacteraemia, urinary tract infections, wound infection and meningitis. This organism can survive in the hospital environment and rapidly develops resistance to many antibiotics. The molecular genotyping can increase our knowledge about the spread of A. baumannii strains from one hospital to another and their drug resistance. Therefore, this study aimed to determine the prevalence of antibiotic resistance profile as well as phylogenetic relationships of A. baumannii strains in Shahrekord teaching hospitals.
Methods: In this study, antibacterial susceptibility patterns of A. baumannii strains isolated from different clinical specimens (urine, blood, sputum) to amikacin, ampicillin/sulbactam, aztreonam, cefepime, ceftazidime, ciprofloxacin, gentamycin, imipenem, meropenem, norfloxacin, ofloxacin, piperacillin/tazobactam, tobramycin were tested using disk diffusion )Kirby-Bauer( method. Finally, genotyping of A. baumannii strains was performed using REP-PCR method.
Results: During this study, 50 samples of patients were identified as A. baumannii) 71%(, and their drug resistance rates were assessed. All A. baumannii strains were resistant to ceftazidime and cefepime and also a high rate of resistance to aztreonam, norfloxacin, ciprofloxacin, amikacin, imipenem, gentamycin, and ampicillin-sulbactam were observed. On the other hand, our results demonstrated nine genotype groups among A. baumannii strains based on REP-PCR method.
Conclusion: Due to the high prevalence of antibiotic resistance among isolated A. baumannii strains, similarities between different genotypes and the dispersion of these genotypes in different parts of Shahrekord hospitals, the implementation of infection control programs in different parts of the hospital is necessary.
 

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Background & objectives: Nowadays, bacterial resistance and the increase in the therapeutic costs are considered as the most important global concerns of medical care system regarding complicated infections. Imipenem is a member of the carbapenem class of beta-lactam antibiotics prescribed mostly in our hospitals because of its broad activity against bacterial infections. Drug Utilization Evaluation (DUE) process is an official, ongoing and systemic program that collects information in order to identify and improve the adverse effect of drugs and the cost of medicalization. The objective of this study was to evaluate the administration and use of imipenem in the educational Imam Khomeini hospital in Ardabil in 2018.
Methods: In this prospective, descriptive, cross- sectional study, 110 hospitalized patients, who received imipenem from September to December of 2018, were included in this study. Patient's demographic data, dosing, dosage adjustment in renal failure and other co-prescribed antimicrobial drugs were extracted from current medical file of hospitalized patients and evaluated with medical guidelines.
Results: 64% of patients received imipenem in the first day of hospitalization and 75.5% of patients were empirically received imipenem while antibiogram test was ordered for only 24.5% of patients. Serum creatinine were ordered for most of the patients, but correct dose regimens for patients who get non-empiric antibiotic therapy were only 25.5%.
Conclusion: High rate of empiric prescription without considering the result of antibiogram test and immediate initiation of antimicrobial therapy at the time of admission were the most important aspects of irrational use of imipenem observed in this study. Paying more attention to sampling, culturing and sensitivity test and prescription of imipenem based on specific guidelines are recommended.
 

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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: Oxaliplatin is a third-generation of platinum drug which is the main therapeutic agent for the treatment of colorectal cancer. Oxaliplatin not only inhibits DNA replication but also transcription and also induces apoptosis or necrosis in cancer cells and rapidly dividing cell lines. Although it is widely used clinically, there is no enough information regarding its effect on ovarian structure. This study was designed to determine morphometric features of 30- and 60-day-old offspring ovaries using precise and unbiased stereological technique following administration of oxaliplatin during perinatal period in mice.
Methods: In the present experimental study, 32 adult female mice were used for experimental (pre-pregnant, pregnant and lactation) and control groups. Mice were placed in separate cages for mating. Control group received 0.2 ml saline intraperitoneally (IP) during 21 days of pre-pregnancy, pregnancy and lactation periods. Experimental groups including pre-pregnancy, pregnancy and lactation groups received 3 mg/kg oxaliplatin thrice in a week IP during 21 days before mating, during pregnancy and lactation periods, respectively. At the 30th and 60th postnatal days (PND), the offspring were euthanized and the ovaries from eight offspring in each group were collected for stereological analysis.
Results: The results showed that the mean volume oocytes of antral and preantral follicles and also the mean volume of antral follicles were decreased in experimental groups in comparison with the control group in 30 PND offspring (p<0.05). In 60 PND, offspring, the total volume of follicles, mean volume of antral follicles and also mean volume of oocyte of antral follicles in experimental groups showed significant decrease in comparison with the control group (p<0.05). Total volume of ovary, cortical volume and mean volume of preantral follicles decreased in pregnant experimental group compared to control group (p<0.05).
Conclusion: The present results demonstrated that oxaliplatin induces adverse effect on the morphometrical features of the ovary following administration during the perinatal period especially in pregnancy time.

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Background & objectives: Acne is a chronic inflammation of pilosebaceous units and in severe form reflects a different response to treatment in an oral regime of antibiotics. The purpose of this study is to compare the effect of the combination of erythromycin and low dose oral isotretinoin with erythromycin and low dose flutamide in women suffering from severe acne.
Methods: In a randomized controlled clinical trial, 80 women suffering from severe acne participated in the study and they were studied for 2 months. The first group received 800 mg oral erythromycin, together with 20 mg oral isotretinoin every two days and the second group received 800 mg erythromycin, together with 62.5 mg flutamide daily. The treatment efficiency was evaluated by the count of acne lesions and computing the acne severity index. The data of the study were analyzed using the version 16 of spss software.
Results: In the present study, 40 patients participated in the research in each group. Finally, 61 people completed the study. The mean acne severity index in the flutamide group was 195.9±15 at the beginning of treatment and this index reduced to 52.8±5.8 at the end of treatment. The mean acne severity index in the isotretinoin group was 247.8±19.7 at the beginning of treatment and this index reduced to 76.3±12.5 at the end of treatment. The difference in reduction between the two groups was not statistically significant (p=0.15).
Conclusion: The treatment effectiveness of the above-mentioned methods in female severe acne was acceptable and this combination therapy can be presented as a better alternative compared to treatments with high dose individual treatment including oral isotretinoin and oral flutamide.

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Background & objectives: Obesity and a high-fat diet (HFD) lead to metabolic disorders in the liver by affecting the signaling pathways of fat and glucose metabolism. Exercise and dietary habits are of special interest to prevent and counteract obesity and its associated metabolic disorders. Also, Capsaicin ameliorates diet-induced obesity in rodents and humans. The aim of the present study was to examine the effect of aerobic exercise and capsaicin on the gene expression level of AMP-activated protein kinase (AMPK) and protein kinase B (Akt) in the liver of HFD rats.
Methods: in this experimental study, 40 male Wistar rats were fed a normal diet (ND, n=8) or high-fat diet (HFD) (n=32) for 8 weeks. After 8 weeks, all rats were divided into 5 groups: normal diet (ND), high-fat diet (HFD), high-fat diet-training (HFDT), high-fat diet-capsaicin (HFDCap), high-fat diet-training-capsaicin (HFDTCap). Training groups have performed a moderate- intensity aerobic running program (60-50% VO2max, at 15-25 m/min, 30-60 min/day, and 5 days/week) on a motor-driven treadmill for eight weeks. Capsaicin (4 mg/kg/day) was administered orally, by gavage, once a day.
Results: Induction of diabetes was associated with decreased AMPK expression (p=0.0001) and increased Akt (p=0.0001). The results showed that training and capsaicin significantly increased AMPK expression (p=0.032 and p=0.045, respectively) and decreased Akt expression (p=0.045 and p=0.049, respectively) in HFD rat hepatocytes. Also, the interaction of training and capsaicin had a significant effect on the expression of AMPK (p=0.017) and Akt (p=0.0001).
Conclusion: The results showed that HFD impaired hepatocyte function and that aerobic exercise and capsaicin increased lipogenesis with increasing AMPK and decreasing Akt expression. However, the interaction effect of training with capsaicin was greater.

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Background & objectives: Toxoplasma gondii is an obligate intracellular parasite with global distribution. Diagnosis of Toxoplasma gondii infection with high sensitivity and specificity is very important in managing and treating this disease. The purpose of this study is serological and molecular investigation of toxoplasmosis using B1 gene in HIV- positive patients referred to hospitals affiliated with Iran University of Medical Sciences.
Methods: In this study, 660 blood samples were collected from HIV/AIDS- positive patients referred to hospitals affiliated with Iran University of Medical Sciences. Patient samples were examined for the presence of IgG and IgM antibodies against Toxoplasma gondii using an ELISA kit. Genomic DNA was extracted from the patient's serum, as well as peripheral blood mononuclear cell (PBMC) and whole blood samples, and then Real time-PCR was performed.
Results: Although IgG antibody against Toxoplasma gondii was positive in 158 (23.9%) patients out of 660 HIV- positive patients, IgM antibody was positive in 5 (0.76%) patients. The results of Real-Time PCR showed that 7 (1.06%) patients were positive in PBMC samples, of which five patients were positive for IgM antibodies against Toxoplasma gondii while two patients had high- level Toxoplasma IgG antibody titers.
Conclusion: The results of the study indicate that the Real-time PCR method using PBMC DNA samples is a suitable method for the diagnosis of toxoplasmosis. This method, together with the antibody test, especially the high titer of Toxoplasma IgG antibodies, can be helpful in the diagnosis of toxoplasmosis.
 

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Background: Pneumocystis jirovecii (P. jirovecii) causes Pneumocystis pneumonia (PCP) in people, especially the immunocompromised ones. It is also one of the serious causes of numerous lung problems in affected patients. Since documented data about P. jirovecii is not available in patients with pulmonary infections in Tehran, this study aimed to investigate the molecular epidemiology and parasitology of Pneumocystis to determine the frequency of the organism infection.
Methods: Bronchoalveolar lavage (BAL) samples were collected for 367 patients hospitalized in the lung department of Shariati Hospital in Tehran from July 2022 to July 2023. The samples were analyzed using Giemsa staining and molecular methods. After DNA extraction from samples, Nested polymerase chain reaction (Nested PCR) was employed for the amplification of the 18SrRNA gene and identification of P. jirovecii. The PCR products of Nested PCR were sequenced for final confirmation. 
Results: Out of 367 samples, only one sample (0.27%) and 28 samples (6.7%) were found to be positive through parasitology and NestedPCR analysis, respectively. P. jirovecii was detected in seven (25%) and 21 (75%) immunocompromised and immunocompetent patients, respectively. Fever, shortness of breath and dry cough were the most common clinical symptoms among patients with Pneumocystosis. Patients with pulmonary disorders are prone to colonization by pneumocystis, which increases the risk of pneumocystosis and makes them a reservoir for transmission to susceptible people.
Conclusion: It can be concluded that patients with distinct lung disease are prone to colonization by Pneumocystis and, importantly, are at risk of infection. Also, according to the current study, Nested PCR was a suitable method for detecting P. jirovecii organisms because it had a very high sensitivity and specificity.
 

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Background: Systemic lupus erythematosus is an autoimmune disease in which organs and cells are damaged in the initial stages by tissue-binding autoantibodies and immune complexes. Clinical, demographic and laboratory information of patients with SLE in Ardabil province is the aim of this study.
Methods: The present study is a cross-sectional descriptive study that examines demographic data (age, gender), clinical information such as the first manifestation of the disease, clinical symptoms, etc., and laboratory findings such as CBC, ESR, CRP, proteinuria, FANA, Anti dsDNA, C3, C4, Anti RO and APS Ab of patients who referred to the rheumatology clinic of Imam Khomeini Hospital (RA) in 2021.
Results: Information related to the clinical characteristics of 50 patients, including 46 women (92%) and 4 men (8%), with an average age of 12.14 ± 40.78 years (range: 21-73) and age at diagnosis of 10.62 ± 31.76 years were investigated. The most common initial complaint in the studied patients was related to isolated joint symptoms (28%). The most common clinical symptoms observed in the examined patients were related to joint symptoms along with sensitivity to light with a frequency of 20%. ANA, anti-dsDNA tests positivity and reduced C3 and C4 levels were observed in 88%, 70% and 26% of patients, respectively.
Conclusion: The establishment of a registry system for the structured registration of information of patients with systemic lupus erythematosus in each region is necessary to a better understanding of the characteristics of the disease and better management policy of patients.