Notes

Transcatheter aortic device implantation within degenerated medical aortic valves.
The hepatitis C virus (HCV) outbreak in Iran is increasing. This study investigated the dissemination and transmission routes of HCV genotypes in different regions of Iran. The relationship between serum biochemical markers and viral genotypes was also assessed to find whether liver enzymes level can be considered as the markers for HCV genotypes.

HCV-infected patients from different provinces of Iran (from August 2017 to March 2019) were enrolled. Nested reverse transcriptase polymerase chain reaction (PCR)-restriction fragment length polymorphism and real-time PCR were used to discover the genotypes. The infection transmission routes in the study population were investigated and recorded. Serum samples with equal viral loud from the patients without other liver disorders were recruited to explore the association between the genotypes and the liver biochemical markers.

One thousand serum samples positive for the HCV genome were recruited. Genotype 3a was the most prevalent in the north, while genotype with genotypes and only represented hepatocellular dysfunction.
Oral aphthosis is a painful ulceration of mucus membranes characterized by round or oval lesions with central necrosis and erythematous haloes. Due to unknown etiology, treatment is highly controversial and based mainly on individual experience. The aim of this study was to investigate the safety and efficacy of topical penicillin 6.3.3 for the treatment of recurrent aphthous stomatitis.

This randomized, double-blind, controlled clinical trial was done in Shahid Sadoughi Hospital Clinic in Yazd (2011-2012). Fifty patients aged 15-45 with recurrent oral aphthosis were randomly divided into two groups. After obtaining informed consents, patients in the case and control groups were treated (four times/day for a week), respectively, by topical penicillin 6.3.3 powder and placebo in similar vial. The patients who had acute-onset oral aphthae (≤48 h of appearance) with diameter ≥5 mm were included. History of sensitivity to β-lactam antibiotics and cephalosporin; spontaneous recovery during <5 days in previot penicillin could be a safe and effective option in managing oral aphthosis.
Our study showed a dramatic response to topical penicillin with respect to placebo. Hence, it seems that penicillin could be a safe and effective option in managing oral aphthosis.
The aim of this study was to optimize computed tomography pulmonary angiography (CTPA) protocols with regard to improve vascular attenuation without increasing contrast media (CM) volumes. Therefore, we compared the standard CTPA protocol to an individualized contrast media injection protocols adjusted for the patient's body mass index (BMI).

Two groups of 295 patients with suspected pulmonary embolism (PE) have been receiving CTPA. Group 1 received a standard protocol without taking patient's BMI into account. Group 2 received a CTPA scan, where dose and flow rate of CM injections were adjusted for the patient's BMI. Images were retrospectively analyzed by drawing regions of interests in defined positions in the superior vena cava, descending aorta, the pulmonary main trunk as well as the left and right lower lobe arteries. Intravascular attenuation, contrast volumes, and flow rates were compared using unpaired t-tests. Furthermore, a qualitative image analysis was performed by two experienced readers bled pulmonary artery enhancement improving image quality, particularly in the evaluation of the peripheral pulmonary arteries. Thus, contrast media volumes in CTPA should be adjusted for the patient's BMI.
Parathyroidectomy, the standard treatment of primary hyperparathyroidism (PHP) due to parathyroid adenoma, is not suitable for all patients. We evaluated the efficacy of ultrasound-guided ethanol ablation of parathyroid adenoma in a group of patients with PHP.

In a prospective self-controlled trial, 39 patients with parathyroid adenoma, who were not candidates for surgery, were enrolled. Ethanol injections were performed by two experienced interventional radiologists under the guidance of real-time ultrasonography. Adenoma size changes were assessed at about 1 month later. Serum levels of parathyroid hormone, calcium, phosphate, 25-OH Vitamin D, and alkaline phosphatase were evaluated at the baseline, 1, 3, 6, and 12 months after the injections. The treatment effects on outcome variables were assessed by repeated measures analysis.

Volume of the adenomas decreased during the study period from 1.87±6.45 cm
to 0.38± 0.48cm
(
< 0.001). Corrected serum calcium levels decreased from 10.40 ± 0.96 mg/dl to 8.82 ± 0.58 mg/dl (
< 0.001), and remained stable during one year follow-up. Serum levels of parathyroid hormone decreased gradually from 129.85 ± 63.37 to 72.58 ± 53.86 pg/mL after 3 months and to 44.78 ± 28.04 pg/mL after 1 year (
< 0.001). Overall, 46% of the patients improved after 1 month of ethanol ablation therapy which increased to 84.5% during 1-year follow-up. No major complications were observed.

The current study showed the efficacy of ultrasound-guided ethanol injection in PHP and may be considered as a suitable alternative treatment in patients who are not candidates for the surgery. It has also a good safety profile without major complications if performed by experienced hands.
The current study showed the efficacy of ultrasound-guided ethanol injection in PHP and may be considered as a suitable alternative treatment in patients who are not candidates for the surgery. It has also a good safety profile without major complications if performed by experienced hands.
The production of stress oxidative condition in body which is caused by consumption of ecstasy (3,4-methylenedioxymethamphetamine [MDMA]) leads to a liver damage. As an antioxidant, Vitamin E can protect cells and tissues against the deleterious effects of free radicals. This study evaluates the protective effects of Vitamin E on MDMA induced liver toxicity.

Twenty-eight male albino mice were randomly assigned to four equal groups. Group 1 received saline (control), Group 2 received MDMA and saline, Group 3 received MDMA, and Vitamin E and Group 4 received Vitamin E. MDMA was injected with single daily dose, three sequential days/week for 5 weeks. At the end of the period, blood samples were collected for a biochemical analysis and then the mice were sacrificed by cervical dislocation for histopathological and biochemical examinations of liver.

The administration of Vitamin E attenuated the increased levels of alanine transaminase, aspartate transaminase, and alkaline phosphatase enzymes in serum. Vitamin E treatments significantly restored endogenous antioxidant enzymes (reduced glutathione and superoxide dismutase enzyme) activities as compared with MDMA-treated animals. Histological examination of liver revealed significant morphological tissue injuries in hepatocytes after MDMA being used, but in coadministration of vitamin E and MDMA, these morphological alterations reduced.

The study showed that MDMA administration has adverse effects on the liver. Vitamin E lessened the deleterious impact considerably.
The study showed that MDMA administration has adverse effects on the liver. Vitamin E lessened the deleterious impact considerably.
The precise measurement of childbirth satisfaction demands a reliable tool specifically designed for maternal care and birth satisfaction. It was designed to measure the degree of women's satisfaction with childbirth. The purpose of the present study was to translate and analyze the psychometric properties of the Birth Satisfaction Scale-Revised (BSS-R) in Iranian women.

This is a methodological cross-sectional study. Five health centers in various regions of Kashan were affiliated to Kashan University of Medical Sciences, Kashan, Iran. Two hundred and twelve mothers who were referred to the health centers and had childbirth during the last year were included. The face and content validity were obtained after backward-forward translation of the Iranian version of BSS-R by 12 faculty board members in midwifery and reproductive health fields. The construct validity of the tool was determined using confirmatory factor analysis on 212 women in the postpartum period. The internal consistency and reliability of the tool was evaluated by Cronbach's alpha coefficient and intraclass correlation coefficient (ICC). The collected data were analyzed in SPSS (version 16.0) and EQS 6.1.

The result of face and content validity was minor modifications in some words. Confirmatory analysis results indicated that there was an acceptable fit with a three-factor model. Cronbach's alpha was estimated for the whole tool 0.74, and the alpha of the three subscales ranged from 0.698 to 0.801. ICC for determining reliability was 0.77.

The Iranian version of BSS-R was a reliable and valid tool for assessing the women's satisfaction with their childbirth care.
The Iranian version of BSS-R was a reliable and valid tool for assessing the women's satisfaction with their childbirth care.The COVID-19 outbreak is public health emergency, spreads easily from human to human, and may cause acute severe respiratory syndrome. The anesthesia teams who perform this procedure are at risk aerosolization and need special consideration and safety measures. Cardiac anesthesiologist follows two aims, recognition of COVID-19 patients that need surgery and decreasing the risk of perioperative viral transmission to coworkers. An isolated operating room (negative pressure operating room for COVID-19) should be available. It is important to regulate workflow and practices, anesthesia management, healthcare, and staff. Cardiac anesthesiologist and health-care workers must be use guidelines to treat patients with COVID-19.
Primary immune thrombocytopenia (ITP) decreases platelet count as well as increases the risk of bleeding due to platelet destruction in an autoimmune disorder. For many years, prednisone (PDN) has been the standard first-line treatment in ITP practical guidelines. The current randomized clinical trial compared the efficacy of treatments between three-pulse high-dose dexamethasone (HD-DXM) and the traditional PDN regimen among untreated patients with ITP in accordance with platelet count responses and adverse events.

We randomly assigned eligible patients with ITP to receive PDN or a three-pulse regimen of HD-DXM. In the HD-DXM group, 40 mg of DXM was administered intravenously for 4 consecutive days and was repeated in 14-day intervals for three pulses of treatment. Patients in the PDN group received 1.0 mg/kg of PDN orally per day for 4 consecutive weeks. The Mann-Whitney test was used for comparing the median of platelet count between the two groups, and logistic regression was used to evaluate odds ratio (OR) in the response rate of platelet count between the two groups. Blindness was not applied for both patients and physicians.

The initial response rate of platelet count in the HD-DXM group was significantly higher than the PDN group (P < 0.05). According to the results of logistic regression, the initial and sustained response (SR) rate of platelet count in the HD-DXM group was significantly higher than the PDN group (OR 5.68 and 4.17, respectively, P < 0.05). AMG 487 In fact, in the HD-DXM group, more patients reached SR after the 8-month follow-up (88.9% vs. 66.6%, P < 0.05).

In patients with ITP disease who have not received any kind of treatment, HD-DXM was more effective than conventional PDN therapy.
In patients with ITP disease who have not received any kind of treatment, HD-DXM was more effective than conventional PDN therapy.
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