Objective: In this study we investigated the epidemiology of MS and some related environmental factors in Kerman province, southeastern Iran. Methods: The MS diagnosis was based on the revised Mc-Donald criteria. The patients were those registered at the Iran MS society, Kerman branch; those in the MS registration centers of Kerman and Rafsanjan University of Medical Sciences, and the Department of Neurology at Shafa Medical Center were studied. Results: The prevalence of MS was 31.5 per 100,000 population in Kerman province, and 57.3 per 100,000 population in Kerman city. The male to female ratio was 1:3. Average age at onset was 28.35 years, and 3.9% of cases were early onset at ≤16 years of age. A linear relationship was observed between prevalence and average environmental temperature as prevalence tended to be lower in areas where the annual average temperature was higher. However, in the town of Shahrbabak which has cold weather, prevalence was low, which might be related to the presence of copper in this area. Average disability was 4.5± 1.9 (4.83 ± 1.9 in men and 4.26 ± 1.8 in women, p=0.0035) on the Kurtzke Disability Status Scale. The mean duration of illness was 8.2 ± 1 year. Almost all patients in this study used beta-interferon for a period of at least 4 years. Conclusion: The prevalence of MS in Kerman province was 31.5 per 100,000 people. A linear relationship between an increase in prevalence and low average temperature was observed. Copper may have a preventive effect.

Drug resistance is a great challenge in cancer therapy using chemotherapeutic agents.Administration of these drugs with siRNA is an efficacious strategy in this battle.Here,the present study tried to incor-porate siRNA and paclitaxel(PTX)simultaneously into a novel nanocarrier.The selectivity of carrier to target cancer tissues was optimized through conjugation of folic acid(FA)and glucose(Glu)onto its surface.The structure of nanocarrier was formed from ternary magnetic copolymers based on FeCo-polyethyleneimine(FeCo-PEI)nanoparticles and polylactic acid-polyethylene glycol(PLA-PEG)gene delivery system.Biocompatibility of FeCo-PEI-PLA-PEG-FA(NPsA),FeCo-PEI-PLA-PEG-Glu(NPsB)and FeCo-PEI-PLA-PEG-FA/Glu(NPsAB)nanoparticles and also influence of PTX-loaded nanoparticles on in vitro cytotoxicity were examined using MTT assay.Besides,siRNA-FAM internalization was investi-gated by fluorescence microscopy.The results showed the blank nanoparticles were significantly less cytotoxic at various concentrations.Meanwhile,siRNA-FAM/PTX encapsulated nanoparticles exhibited significant anticancer activity against MCF-7 and BT-474cell lines.NPsAB/siRNA/PTX nanoparticles showed greater effects on MCF-7 and BT-474 cells viability than NPsA/siRNA/PTX and NPsB/siRNA/PTX.Also,they induced significantly higher anticancer effects on cancer cells compared with NPsA/siRNA/PTX and NPsB/siRNA/PTX due to their multi-targeted properties using FA and Glu.We concluded that NPsAB nanoparticles have a great potential for co-delivery of both drugs and genes for use in gene therapy and chemotherapy.

STUDY DESIGN: Prospective study. PURPOSE: We compared the effects of two methods of epidural steroid injection in patients with recurrent disc herniation. OVERVIEW OF LITERATURE: To our knowledge, there is no previous report of such a comparison in these patients. METHODS: The study was performed with 30 patients with relapsed lumbar disc herniation whose pain was not relieved by conservative remedies. The patients were divided into two groups, each of 15 patients, and entered the study for caudal or transforaminal injections. The degree of pain, ability to stand and walk, and the Prolo function score were evaluated in both groups before the injection and 2 months and 6 months after the injection. RESULTS: The degrees of pain reduction in the caudal injection group in the second and sixth months were 0.6 and 1.63, respectively, and in the transforaminal injection group were 1.33 and 1.56, respectively. The difference between the two methods was not statistically significant. Similarly, no other evaluated criterion showed a significant difference between the methods. CONCLUSIONS: In the current study, the caudal and transforaminal steroid injection methods showed similar outcomes in the treatment of relapsed lumbar disc herniation. However, more detailed patient categorizing may help in finding possible subgroups with differences.
Humans ; Prospective Studies

Objectives: To elucidate the possible ways by which hydroxyurea molecules affect globin chain (αor β-like) synthesis.Methods:5 and 26 years were treated for five months with 15 mg/(kg·day) of hydroxyurea. Hemoglobins electrophoresis and globin chain electrophoresis was performed on each sample at different time points before and during the treatment. A total of 23 thalassemia intermedia patients (13 male and 10 female) aged between Results: Fetal hemoglobin increased significantly in most patients and average episodes of transfusion decreased. Both Gγ and Aγ-globin chains increased significantly andα-globin:Nonα-globin chain as well as Gγ-globin:Aγ globin chains ratios decreased. Conclusions: Improvement in α:non-α ratio and consequent decrease of free α-globin chain might be the cause of beneficial effects of hydroxyurea therapy. Two patients who felt better didn’t show significant increase in their fetal hemoglobin level, and this is in contradiction with the hypothesis claiming that the HbF level increase is the cause of such therapeutic effect. In spite of the unclear mechanism of action of this drug, hydroxyurea therapy had noticeable impacts on thalassemia intermedia and also sickle cell disease and even patients suffering from thalassemia major.

STUDY DESIGN: Clinical pilot study. PURPOSE: To objectively evaluate the compliance rate of lumbar-support use in patients with chronic nonspecific low back pain, as well as to assess low back pain intensity, disability, and fear-avoidance beliefs. OVERVIEW OF LITERATURE: Wearing time is an important factor in the assessment of the efficacy of lumbar-support use in patients with chronic nonspecific low back pain. Previous studies have measured lumbar-support wearing time based on subjective assessment, and these evaluations are not easily verifiable and are usually overestimated by subjects. METHODS: Twelve subjects with chronic nonspecific low back pain who had been wearing semirigid lumbar supports for 6 weeks were evaluated. Compliance was objectively monitored using temperature sensors integrated into the semirigid lumbar supports. Subjects wore their lumbar supports for 8 hour/day on workdays and 3 hour/day on holidays during the first 3 weeks. During the next 3 weeks, subjects were gradually weaned off the lumbar supports. Pain intensity was measured using a numerical rating scale. The Oswestry disability index was used to assess the subjects' disability. Fear-avoidance behavior was evaluated using a fear-avoidance beliefs questionnaire. RESULTS: The mean compliance rate of the subjects was 78.16%±13.9%. Pain intensity was significantly lower in patients with a higher compliance rate (p=0.001). Disability index and fear-avoidance beliefs (functional outcomes) significantly improved during the second 3-weeks period of the treatment (p<0.001, p=0.02, respectively). CONCLUSIONS: The compliance rate of patients wearing lumbar supports is a determining factor in chronic low back pain management. Wearing semirigid lumbar supports, as advised, was associated with decreased pain intensity, improved disability index scores, and improved fear-avoidance beliefs in patients with chronic nonspecific low back pain.
Compliance* ; Holidays ; Humans ; Low Back Pain* ; Pilot Projects

BACKGROUND: This study aimed to assess the effects of the topical application of tamoxifen on wound healing of burned skin in Wistar rats by evaluating 3 healing characteristics: fibrotic tissue thickness (FTT), scar surface area (SSA), and angiogenesis in the healed scar tissue. METHODS: Eighteen male Wistar rats were used in this study. A third-degree burn wound was made on the shaved animals’ back, measuring 2×2×2 cm. In the first group, a 2% tamoxifen ointment was applied to the wound twice daily for 8 weeks. The second group received a placebo ointment during the same period. The third group did not receive any treatment and served as the control group. RESULTS: The median (interquartile range=[Q1, Q3]) FTT was 1.35 (1.15, 1.62) mm, 1.00 (0.95, 1.02) mm, and 1.25 (0.8, 1.5) mm in the control, tamoxifen, and placebo groups, respectively (P=0.069). However, the FTT in the tamoxifen group was less than in the placebo and control groups. The median angiogenesis was 3.5 (3.00, 6.25), 8.00 (6.75, 9.25), and 7.00 (5.50, 8.25) vessels per high-power field for the control, tamoxifen, and placebo groups, respectively (P=0.067). However, the median angiogenesis was higher in the tamoxifen group than in the control group. No significant difference was observed in the mean SSA between the tamoxifen group and the control group (P=0.990). CONCLUSIONS: Local application of tamoxifen increased angiogenesis and decreased the FTT, with no change in the SSA in burned skin areas. These effects are expected to expedite the wound healing process, reducing contracture and preventing hypertrophic scar and keloid formation.
Animals ; Burns* ; Cicatrix ; Cicatrix, Hypertrophic ; Contracture ; Humans ; Keloid ; Male ; Rats* ; Rats, Wistar ; Skin* ; Tamoxifen* ; Wound Healing* ; Wounds and Injuries*

BACKGROUND: This study aimed to assess the effects of the topical application of tamoxifen on wound healing of burned skin in Wistar rats by evaluating 3 healing characteristics: fibrotic tissue thickness (FTT), scar surface area (SSA), and angiogenesis in the healed scar tissue. METHODS: Eighteen male Wistar rats were used in this study. A third-degree burn wound was made on the shaved animals’ back, measuring 2×2×2 cm. In the first group, a 2% tamoxifen ointment was applied to the wound twice daily for 8 weeks. The second group received a placebo ointment during the same period. The third group did not receive any treatment and served as the control group. RESULTS: The median (interquartile range=[Q1, Q3]) FTT was 1.35 (1.15, 1.62) mm, 1.00 (0.95, 1.02) mm, and 1.25 (0.8, 1.5) mm in the control, tamoxifen, and placebo groups, respectively (P=0.069). However, the FTT in the tamoxifen group was less than in the placebo and control groups. The median angiogenesis was 3.5 (3.00, 6.25), 8.00 (6.75, 9.25), and 7.00 (5.50, 8.25) vessels per high-power field for the control, tamoxifen, and placebo groups, respectively (P=0.067). However, the median angiogenesis was higher in the tamoxifen group than in the control group. No significant difference was observed in the mean SSA between the tamoxifen group and the control group (P=0.990). CONCLUSIONS: Local application of tamoxifen increased angiogenesis and decreased the FTT, with no change in the SSA in burned skin areas. These effects are expected to expedite the wound healing process, reducing contracture and preventing hypertrophic scar and keloid formation.
Animals ; Burns* ; Cicatrix ; Cicatrix, Hypertrophic ; Contracture ; Humans ; Keloid ; Male ; Rats* ; Rats, Wistar ; Skin* ; Tamoxifen* ; Wound Healing* ; Wounds and Injuries*

BACKGROUND: Since the presence of a co-driver can be considered as a companion, partner, or friend for a driver through eliminating driver's loneliness, it plays a significant role in health and safety of drivers. The objective of this study was to investigate the effect of co-drivers on depression and occupational stress on male truck drivers. METHODS: This study was an interventional case-control study. Seventy truck drivers were selected and divided into two groups: case (33 truck drivers with co-drivers) and control (37 truck drivers without co-drivers). Two Goldberg depression inventories (for evaluating driver's depression) and the Karasek job content questionnaire (for evaluating driver's job stress) were used to collect data which were completed by interview. RESULTS: The results showed that job content values for the case group were higher in all dimensions except job nature. The comparison of the percentages showed significant difference between two groups. Depression rate in drivers with co-driver is truly less than depression rate in drivers without co-driver. There was significant positive relationship between dimensions of job content and depression rate. CONCLUSION: According to the results of this study, it can be claimed that a co-driver decreases stress and loneliness of drivers, as well as increases work performance and job satisfaction, and, in turn, leads to a decrease in job-related depression.
Case-Control Studies ; Depression ; Equipment and Supplies ; Friends ; Humans ; Job Satisfaction ; Loneliness ; Male ; Motor Vehicles ; Work Performance

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has infected many people around the world. Children are considered an important target group for SARS-CoV-2, as well as other viral infections such as respiratory syncytial virus infection. Both SARS-CoV-2 and respiratory syncytial virus can affect the respiratory tract. Coinfection of SARS-CoV-2 and respiratory syncytial virus can pose significant challenges in terms of diagnosis and treatment in children. This review compares the symptoms, diagnostic methods, and treatment of COVID-19 and respiratory syncytial virus infection in children.

OBJECTIVES: The incidence of type 2 diabetes mellitus has increased significantly in recent years. With the development of artificial intelligence applications in healthcare, they are used for diagnosis, therapeutic decision making, and outcome prediction, especially in type 2 diabetes mellitus. This study aimed to identify the artificial intelligence (AI) applications for type 2 diabetes mellitus care. METHODS: This is a review conducted in 2018. We searched the PubMed, Web of Science, and Embase scientific databases, based on a combination of related mesh terms. The article selection process was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Finally, 31 articles were selected after inclusion and exclusion criteria were applied. Data gathering was done by using a data extraction form. Data were summarized and reported based on the study objectives. RESULTS: The main applications of AI for type 2 diabetes mellitus care were screening and diagnosis in different stages. Among all of the reviewed AI methods, machine learning methods with 71% (n = 22) were the most commonly applied techniques. Many applications were in multi method forms (23%). Among the machine learning algorithms applications, support vector machine (21%) and naive Bayesian (19%) were the most commonly used methods. The most important variables that were used in the selected studies were body mass index, fasting blood sugar, blood pressure, HbA1c, triglycerides, low-density lipoprotein, high-density lipoprotein, and demographic variables. CONCLUSIONS: It is recommended to select optimal algorithms by testing various techniques. Support vector machine and naive Bayesian might achieve better performance than other applications due to the type of variables and targets in diabetes-related outcomes classification.
Artificial Intelligence ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Classification ; Decision Making ; Delivery of Health Care ; Diabetes Mellitus ; Diabetes Mellitus, Type 2 ; Diagnosis ; Fasting ; Incidence ; Lipoproteins ; Machine Learning ; Mass Screening ; Methods ; Support Vector Machine ; Triglycerides