Objective To evaluate the effect of propofol,sevoflurane,and dexmedetomidine on respiratory complications in children undergoing fiberoptic bronchoscopy(FOB).Methods This double-blind randomized clinical trial was conducted among 120 children aged 1 month to 3 years undergoing FOB.The patients were randomized into 3 groups(n=40)for anesthesia induction with sevoflurane inhalation,1 mg/kg propofol,or 1 μg/kg dexmedetomidine before bronchoscopy,and the changes in hemodynamic parameters,sedation level,and respiratory complications during and after the procedure were assessed.Results The patients'heart rate during bronchoscopy was significantly lower and the mean arterial blood pressure significantly higher in dexmedetomidine group than in sevoflurane and propofol groups(P<0.05).Cough during bronchoscopy did not occur in any of the cases in propofol group,while the highest frequency of cough was recorded in dexmedetomidine group.The incidence of laryngospasm in the propofol group(12.5%)was significantly lower than those in sevoflurane and dexmedetomidine groups(30%and 32.5%,respectively)(P<0.05).Conclusion Sevoflurane and propofol are safe and suitable for anesthesia induction in children below 3 years of age undergoing diagnostic FOB and can achieve better sedative effect and lower the incidences of cough and respiratory complications as compared with dexmedetomidine.

Objective To evaluate the effect of propofol,sevoflurane,and dexmedetomidine on respiratory complications in children undergoing fiberoptic bronchoscopy(FOB).Methods This double-blind randomized clinical trial was conducted among 120 children aged 1 month to 3 years undergoing FOB.The patients were randomized into 3 groups(n=40)for anesthesia induction with sevoflurane inhalation,1 mg/kg propofol,or 1 μg/kg dexmedetomidine before bronchoscopy,and the changes in hemodynamic parameters,sedation level,and respiratory complications during and after the procedure were assessed.Results The patients'heart rate during bronchoscopy was significantly lower and the mean arterial blood pressure significantly higher in dexmedetomidine group than in sevoflurane and propofol groups(P<0.05).Cough during bronchoscopy did not occur in any of the cases in propofol group,while the highest frequency of cough was recorded in dexmedetomidine group.The incidence of laryngospasm in the propofol group(12.5%)was significantly lower than those in sevoflurane and dexmedetomidine groups(30%and 32.5%,respectively)(P<0.05).Conclusion Sevoflurane and propofol are safe and suitable for anesthesia induction in children below 3 years of age undergoing diagnostic FOB and can achieve better sedative effect and lower the incidences of cough and respiratory complications as compared with dexmedetomidine.

Background: Sinonasal malignancies are a rare group of head and neck cancers. We aimed to report the oncological outcomes based on histological types in patients who underwent radiotherapy. Materials and Methods: In this single-institution study, we retrospectively retrieved and analyzed data of patients with sinonasal carcinomas who underwent radiotherapy during 2011–2016 as part of their treatment. The 3-year rate of local, regional, and distant recurrences, and overall survival were evaluated according to the histological type. Results: A total of 28 patients were evaluated in this study, the majority of whom were male (60%). Squamous cell carcinoma (SCC), adenoid cystic carcinoma (ACC), and adenocarcinoma (ADC) were found in 15 patients (53.5%), 8 (28.5%), and 5 (18%), respectively. The highest rates of local and regional recurrences were observed in ACC and SCC, respectively. Distant recurrences were numerically more common in ADC. The 3-year OS was 48%, 50%, and 73% in SCC, ADC, and ACC, respectively. Conclusion Different histopathologies of sinonasal cancer seem to have different patterns of failure, and this may be considered in the treatment approach.

Background/Aims: This study aimed to determine whether vitamin C in addition to indomethacin decreases the occurrence and severity of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) occurrence and severity. Methods: This randomized clinical trial included patients undergoing ERCP. The participants were administered either rectal indomethacin (100 mg) plus an injection of vitamin C (500 mg) or rectal indomethacin (100 mg) alone just before ERCP. The primary outcomes were PEP occurrence and severity. The secondary amylase and lipase levels were determined after 24 hours. Results: A total of 344 patients completed the study. Based on intention-to-treat analysis, the PEP rates were 9.9% for indomethacin plus vitamin C plus indomethacin and 15.7% for indomethacin alone. Regarding the per-protocol analysis, the PEP rates were 9.7% and 15.7% in the combination and indomethacin arms, respectively. There was a remarkable difference between the two arms in PEP occurrence and severity on intention-to-treat and per-protocol analyses (p=0.034 and p=0.031, respectively). The post-ERCP lipase and amylase concentrations were lower in the combination arm than in the indomethacin alone arm (p=0.034 and p=0.029, respectively). Conclusions Vitamin C injection in addition to rectal indomethacin reduced PEP occurrence and severity.

Immunotherapy has been recently considered as a promising alternative for cancer treatment. Indeed, targeting of immune checkpoint (ICP) strategies have shown significant success in human malignancies. However, despite remarkable success of cancer immunotherapy in pancreatic cancer (PCa), many of the developed immunotherapy methods show poor therapeutic outcomes in PCa with no or few effective treatment options thus far. In this process, immunosuppression in the tumor microenvironment (TME) is found to be the main obstacle to the effectiveness of antitumor immune response induced by an immunotherapy method. In this paper, the latest findings on the ICPs, which mediate immunosuppression in the TME have been reviewed. In addition, different approaches for targeting ICPs in the TME of PCa have been discussed. This review has also synopsized the cutting-edge advances in the latest studies to clinical applications of ICP-targeted therapy in PCa.

Objective: Different studies have been performed on the prevalence of tick-borne pathogens in different areas of Iran; however, as far as our knowledge, there is no regional meta-analysis available for consideration and estimation of tick species infected with different pathogens in Iran. Methods: In this review, among different databases, a total of 95 publications were included, and the infection of different tick species to different tick-borne pathogens was determined; furthermore, presence of pathogens (with 95% confidence intervals) in tick vectors was calculated separately for each province, using Comprehensive Meta-Analysis version 2 (Biostat, USA). Results: Totally, among all 95 studies, 5 673 out of 33 521 investigated ticks were positive according to different detection methods. Overall estimated presence of pathogens in tick vectors in Iran was 8.6% (95% CI 7.0%-10.6%, P 0.001). Of all 46 species of ticks in 10 genera in Iran, 28 species in 9 genera, including Alveonasus, Argas, Boophilus, Dermacentor, Haemaphysalis, Hyalomma, Ixodes, Ornithodoros, and Rhipicephalus were infected with at least 20 pathogens in 10 genera including Aegyptianella, Anaplasma, Babesia, Borrelia, Brucella, Orthonairovirus [CrimeanCongo hemorrhagic fever virus (CCHFV)], Coxiella, Ehrlichia, Rickettsia and Theileria in 26 provinces of Iran. The presence of pathogens in ticks collected in western Iran was more than other regions. Hyalomma anatolicum (20.35%), Rhipicephalus sanguineus (15.00%), and Rhipicephalus bursa (14.08%) were the most prevalent infected ticks for different pathogens. In addition, most literatures were related to CCHFV and Theileria/Babesia spp. Conclusions: Public health and veterinary professionals should be aware of diagnosing possible diseases or outbreaks in vertebrates.

Background: Auraptene is a simple coumarin that exhibits multiple protective activities in the brain. Alzheimer’s disease is a complex, multifactorial, and progressive neurodegenerative disease. Microinjection of the β-amyloid peptide (Aβ) into the hippocampus of rat has been recognized as a reliable and stable animal model of Alzheimer’s disease, which mimics the memory deficits. In the present study, the memory enhancing effects of auraptene were studied in rats that Aβ was injected into their hippocampus to create a model of Alzheimer’s disease. Methods: Different doses of auraptene (5, 10 and 25 mg/kg) were administered intraperitoneally to male Wistar rats. The spatial memory performance was tested by Morris water maze after Alzheimer`s induction. The hippocampal expression of pro-apoptotic Bax and anti-apoptotic Bcl-2 proteins were calculated for evaluating the neuroprotective and anti-apoptotic effects of Auraptene in the brain tissue. Results: In comparison with the control group, auraptene significantly decreased the escape latency time in the treated rats. In addition, auraptene increased the percentage of time spent and traveled pathway in the target quadrant. Molecular data showed that auraptene attenuated the Bax/Bcl-2 ratio in the hippocampus of rats. Conclusion: This study demonstrated the memory enhancing effect of Aur after Aβ injection, which could be through inhibiting the apoptotic pathways in the hippocampus of rats.

Background: Orofacial clefts (OFCs) comprise a wide range of malformations, including cleft lip, cleft palate, and cleft lip with cleft palate, which can vary in terms of etiology, severity, and disease burden. Objective: (s)This study aimed to evaluate the correlation between various risk factors and orofacial cleft disorder spectrum in newborns.Study designA total of 323 cases and 400 controls were enrolled in this study and evaluated in terms of the maternal history of abortion or miscarriage, child’s sex, maternal and paternal age, maternal history of systemic disease, history of medication therapy during pregnancy, birth order, consanguineous marriage, and complications during pregnancy. Results: Analysis of the results suggested that consanguineous marriage, a maternal history of abortion/miscarriage, and complications during pregnancy could potentially increase the risk of OFCs in children (P < 0.05). However, the analyses revealed that the other variables could not potentially increase the risk of OFCs (P > 0.05). Conclusion (s)Multiple cofactors may simultaneously contribute to the formation of such abnormalities; therefore, a comprehensive, multidisciplinary care program is necessary to ensure a successful pregnancy period and the birth of a healthy newborn.

Background: Orofacial clefts (OFCs) comprise a wide range of malformations, including cleft lip, cleft palate, and cleft lip with cleft palate, which can vary in terms of etiology, severity, and disease burden. Objective: (s)This study aimed to evaluate the correlation between various risk factors and orofacial cleft disorder spectrum in newborns.Study designA total of 323 cases and 400 controls were enrolled in this study and evaluated in terms of the maternal history of abortion or miscarriage, child’s sex, maternal and paternal age, maternal history of systemic disease, history of medication therapy during pregnancy, birth order, consanguineous marriage, and complications during pregnancy. Results: Analysis of the results suggested that consanguineous marriage, a maternal history of abortion/miscarriage, and complications during pregnancy could potentially increase the risk of OFCs in children (P < 0.05). However, the analyses revealed that the other variables could not potentially increase the risk of OFCs (P > 0.05). Conclusion (s)Multiple cofactors may simultaneously contribute to the formation of such abnormalities; therefore, a comprehensive, multidisciplinary care program is necessary to ensure a successful pregnancy period and the birth of a healthy newborn.

OBJECTIVES: The aim of this study was to evaluate whether the waist circumference of patients with chronic obstructive pulmonary disease (COPD), had an impact on lung function. METHODS: There were 180 patients with COPD recruited into this prospective cross-sectional study. The age, weight, body mass index and waist circumference (WC) were measured. Spirometry parameters including forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1), were measured and FEV1/FVC calculated. RESULTS: The mean FEV1/FVC in both normal weight and overweight patients, did not statistically significantly correlate with WC. The COPD assessment test, positively correlated with WC ( p = 0.031). A positive correlation with body mass index ( p < 0.001), smoking ( p = 0.027), and global initiative for chronic obstructive lung disease score ( p = 0.009), were observed to positively associate with WC. WC, age, C-reactive protein, duration of disease, and gender (male), were observed to be statistically significant risk factors for the severity of COPD. CONCLUSION: WC was not observed to impact upon lung function in this study but it was a predictive factor for COPD severity in patients.
Body Mass Index ; Body Weight ; C-Reactive Protein ; Cross-Sectional Studies ; Forced Expiratory Volume ; Humans ; Lung ; Lung Diseases, Obstructive ; Overweight ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive ; Risk Factors ; Smoke ; Smoking ; Spirometry ; Vital Capacity ; Waist Circumference