Background and aim Cholestasis-associated renal injury or cholemic nephropathy (CN) is a serious clinical problem. Previous studies mentioned that oxidative stress and mitochondrial impairment play a role in CN. There is no specific pharmacological intervention for CN. Metformin is an anti-diabetic drug administered for decades. On the other hand, novel pharmacological properties have emerged for this drug. The effect of metformin on oxidative stress parameters has been well-recognized in different experimental models. It has also been found that metformin positively affected mitochondrial function. The current study aimed to evaluate the effects of metformin in an animal model of CN. Methods Rats underwent bile duct ligation (BDL) and were treated with metformin (250 and 500 mg/kg) for 14 consecutive days. Two weeks after the BDL operations, urine, serum, and kidney samples were collected and analyzed. Results Markers of oxidative stress, including reactive oxygen species (ROS) formation, lipid peroxidation, protein carbonylation, depleted antioxidant capacity, and decreased glutathione (GSH) levels were detected in BDL animals. Moreover, mitochondrial indices, including adenosine triphosphate (ATP) level, dehydrogenase activity, mitochondrial membrane potential, and mitochondrial permeability, were impaired in the kidney of cholestatic rats. Renal histopathological alterations in cholestatic animals included tubular degeneration and interstitial inflammation, cast formation, and fibrosis. It was found that metformin significantly alleviated oxidative stress and improved mitochondrial indices in the kidney of cholestatic rats. Tissue histopathological alterations were also mitigated in metformin-treated groups. Conclusions Metformin could be a candidate for managing CN. The nephroprotective role of metformin is primarily associated with its effects on oxidative stress parameters and mitochondrial function.

Purpose:: Trauma may lead to serious complications in children patients. The purpose of this study was to investigate prognosis in children with traumatic injuries. Methods:: This cross-sectional study was conducted on all of the children (<18 years old) who had suffered traumatic injuries and transferred to the emergency department of Imam Hussein Hospital by emergency medical services. After selecting the children, a checklist including information such as demographic characteristics, trauma type, consciousness level, and final outcome was recorded. Finally, the data were analyzed using t-test, Chi-square test and ANOVA. Results:: In total of 564 children were investigated. Among them, 70% were males, and 33.2% were in the age range of 5-12 years. The mechanism of injuries in 97.9% of the cases was blunt trauma. The most common chief complaint among the affected children was nausea. The majority of them had stable vital signs and normal neurological tests results. However, 1.06% of them died during hospitalization. The results indicated that the final outcome in the children affected by traumatic injuries is significantly related to the type of trauma, the location of traumatic event, the vehicle used to transport them to emergency departments and their Glasgow coma scale score (p < 0.05). Conclusion: Considering the young age of the child patients and over half of trauma happened at home, it is important to raise parents' awareness about the risky places and activities, which were likely to result in traumatic injuries for children.

Purpose:Trauma may lead to serious complications in children patients.The purpose of this study was to investigate prognosis in children with traumatic injuries.Methods:This cross-sectional study was conducted on all of the children (＜18 years old) who had suffered traumatic injuries and transferred to the emergency department of Imam Hussein Hospital by emergency medical services.After selecting the children,a checklist including information such as demographic characteristics,trauma type,consciousness level,and final outcome was recorded.Finally,the data were analyzed using t-test,Chi-square test and ANOVA.Results:In total of 564 children were investigated.Among them,70％ were males,and 33.2％ were in the age range of 5-12 years.The mechanism of injuries in 97.9％ of the cases was blunt trauma.The most common chief complaint among the affected children was nausea.The majority of them had stable vital signs and normal neurological tests results.However,1.06％ of them died during hospitalization.The results indicated that the final outcome in the children affected by traumatic injuries is significantly related to the type of trauma,the location of traumatic event,the vehicle used to transport them to emergency departments and their Glasgow coma scale score (p ＜ 0.05).Conclusion:Considering the young age of the child patients and over half of trauma happened at home,it is important to raise parents' awareness about the risky places and activities,which were likely to result in traumatic injuries for children.