Background: Hearing loss (HL) is a highly prevalent heterogeneous deficiency of sensory-neural system with involvement of several dozen genes. Whole-exome sequencing (WES) is capable of discovering known and novel genes involved with HL. Materials and Methods: Two pedigrees with HL background from Khuzestan province of Iran were selected. Polymerase chain reaction-sequencing of GJB2 and homozygosity mapping of 16 DFNB loci were performed. One patient of the first and two affected individuals from the second pedigree were subjected to WES. The result files were analyzed using tools on Ubuntu 16.04. Short reads were mapped to reference genome (hg19, NCBI Build 37). Sorting and duplication removals were done. Variants were obtained and annotated by an online software tool. Variant filtration was performed. In the first family, ENDEAVOUR was applied to prioritize candidate genes. In the second family, a combination of shared variants, homozygosity mapping, and gene expression were implemented to launch the disease-causing gene. Results: GJB2 sequencing and linkage analysis established no homozygosity-by-descent at any DFNB loci. Utilizing ENDEAVOUR, BBX: C.C857G (P.A286G), and MYH15: C.C5557T (P.R1853C) were put forward, but none of the variants co-segregated with the phenotype. Two genes, UNC13B and TRAK1, were prioritized in the homozygous regions detected by HomozygosityMapper. Conclusion: WES is regarded a powerful approach to discover molecular etiology of Mendelian inherited disorders, but as it fails to enrich GC-rich regions, incapability of capturing noncoding regulatory regions and limited specificity and accuracy of copy number variations detection tools from exome data, it is assumed an insufficient procedure.

Background: Heat loss and core-to-peripheral redistribution of body heat occur in patients undergoing neuraxial anesthesia resulted to decrease of core temperature and early reach of shivering threshold. Because shivering has deleterious metabolic and cardiovascular effects, it should ideally be prevented by pharmacologic or other means. Tizanidine is an alpha-2 agonist. We evaluated the usefulness of oral tizanidine (TI) and tramadol in preventing of shivering in patients undergoing spinal anesthesia for transurethral resection of the prostate (TURP). Materials and Methods: Ninety patients, scheduled for TURP with spinal anesthesia, were prospectively enrolled. Patients were randomly assigned to 1 of 3 groups. 90 min before spinal anesthesia, 30 patients received 4 mg oral TI, 30 patients received 50 mg tramadol, and 30 patients received placebo as control group. Spinal anesthesia was induced at the L3–L4 or L4–L5 interspaces with 12.5 mg bupivacaine. An investigator blinded to the drugs recorded the frequency and degree of shivering. Results: The overall frequency and severity of shivering were significantly lower in patients treated with TI and tramadol compared to placebo (P = 0.04) (P = 0.001). There was not much difference in the nausea and vomiting of both the drugs (P = 026) (P = 011). There was no difference in hemodynamic parameters between three groups (P = 0.08) (P = 013). Conclusions: Oral TI and tramadol were comparable in respect to their effect in decreasing the incidence, intensity shivering when used prophylactically in patients who underwent TURP with spinal anesthesia.

Background: Women with breast cancer experience various challenges. Prescription of health information provides appropriate information at appropriate time to the appropriate person and plays a role in empowering self-care and improving health. The current research aims to evaluate the effect of health information prescription on self-care power of women with breast cancer. Materials and Methods: This semi-experimental quantitative study was done using pretest and posttest method in one group of 61 women with breast cancer selected from the Women's Cancer Center of Khatamolanbia Hospital using purposive sampling method. Data were collected by an author-made self-care questionnaire and patients' self-care score was calculated at the first visit (before health information prescription) and the second visit (after health information prescription). Data were analyzed using the SPSS version 23 software and analysis of variance at a statistical significance level of P < 0.05. Results: Total mean score of self-care in women with breast cancer was 40.97 and 115.3 before and after health information prescription, respectively. Increase of mean was observed in all subscales of self-care score from pretest to posttest so that change in posttest was higher in subscales of effective implementation of treatment and prevention from disabilities and personal functioning regulation (39.44), specialized knowledge on breast cancer (30.46), searching medical services and cooperation with treatment group (28.59), and awareness and attention to impacts and results of breast cancer (16.81). Conclusion: Health information prescription improves self-care power of women with breast cancer, and it is necessary to provide health information services in order to support women's self-care by the health authorities.

Background: Youth violence is an important public health challenge, and the literature on this problem in developing countries has been limited. The present study aims to determine the prevalence of violence its related risk factors in in a sample of students in Isfahan, Iran.Materials and Methods: In this cross-sectional study, 2800 middle and high school, aged 11–18 years in urban and rural areas selected in a multistage sampling procedure and were questioned using a self-administered questionnaire. Collected data included sociodemographic and family characteristics, students' knowledge, verbal and physical violence (as a perpetrator and/or victim), risk-taking behaviors (weapon carrying, threatening behaviors), family violent status, watching movies, and accessibility of sport facilities. Results: The prevalence of verbal and physical violence in studied students was 45% and 33.3%, respectively. The prevalence of verbal and physical victimization was 45.8% and 23.6%, respectively. The prevalence of physical violence was higher in middle school students than high school students (P = 0.0001) and in boys was higher than in girls (P = 0.0001). Being boy, carried a weapon out of home or in school, victimization, feel unsafe at school, and violence in the family are the significant related risk factors with students violence (P < 0.05). Conclusion: The prevalence of students' violence in Iranian students is similar to the most of other developing countries, although, high rate violence and related risk factors emphasize the need for comprehensive and interventional prevention programs to reduce and manage student violence and associated risk behaviors.

Background: Stress affects brain functions and induces psychological disorders. Previous studies have indicated different effects of crocin and exercise on the improvement of memory in some types of stress. The present study investigated the effect of crocin, exercise, and crocin-accompanied exercise on learning, memory, and memory consolidation in rats under chronic unpredictable stress (CUS). Materials and Methods: Male rats were randomly allocated to different groups: control, sham, stress, stress-exercise, stress-crocin, and stress-crocin-accompanied exercise groups. The CUS and treadmill running were applied 2 h/day and 1 h/day, respectively, for 21 days. Crocin (30 mg/kg) was daily intraperitoneally injected to the rats and their behavioral variables were evaluated as a brain function using the passive avoidance test. Results: Results showed that the CUS significantly decreased learning and memory compared to the control group, while crocin alone and crocin-accompanied exercise significantly improved learning and memory compared to the stressed group. It was found that exercise alone caused learning but did not improve memory in unpredictable stress rats. Conclusion: The data indicated that unpredictable stress had very destructive effects on the brain functions. Furthermore, unlike exercise, crocin improved memory under unpredictable stress conditions. Overall, it seems that the beneficial effects of crocin-accompanied exercise on learning and memory were probably because of crocin, but not exercise.

Background: There have been studies on the outcome of acute intoxication with antidepressants or antipsychotics. We performed outcome prediction analysis in acute poisoning patients with antidepressants/antipsychotics with or without combination with other drugs. Materials and Methods: A cross-sectional study was performed in Khorshid (PBUH) University Hospital affiliated with Isfahan University of Medical Sciences from March 2016 to May 2017. Patients with acute poisoning ingested antidepressants and antipsychotics with or without other drugs were included in the study. The outcome was categorized as survived without complications and complications/death. Binary regression analysis was performed for outcome prediction. Results: The data from 239 patients were analyzed. Most of the patients were female (68.2%), 5.9% of patients admitted to the Intensive Care Unit. About 94.99% of patients survived without complications. There was a significant difference between patients with and without complications with respect to the level of consciousness, hypotension, seizure, electrocardiography findings, pulse rate after 24 hours (h) of admission, and need to endotracheal intubation (P < 0.0001). Binary logistic regression analysis showed admission level of consciousness (stupor/coma) (odds ratio [OR] =8.07; P = 0,005), hypotension (OR = 12.16; P = 0.001), seizure (OR = 11.15; P = 0.009), tachycardia after 24 h of admission (OR = 22.50; P = 0.003), and need for endotracheal intubation (OR = 10.47; P = 0.002) were determinant factors in outcome prediction. Conclusions: Stupor/coma and hypotension were the predictive factors for outcome. Patients with seizure and tachycardia after 24 h of admission; and those intubated and received mechanical ventilation had a higher chance of complications.

Background: At workplaces, the workers exposed to several harmful agents such as physical, chemical, and biological pollutant that cause occupational diseases. There are a lot of jobs that not allow a certain pattern of exposure to this agent. In this article, we introduce a technology named radio-frequency identification (RFID) to estimate the exposure time of workers to harmful agent. Materials and Methods: This applied study was carried out experimentally in an industry in Isfahan province, Iran. Twenty-nine participants selected from the workers without a fixed pattern of exposure. Two methods used to measure the exposure time of them. The first method was based on a self-made RFID device and conducted by the workers. The second method performed by stopwatch, which was carried out by the occupational hygienist. The results were analyzed using SPSS 20 and descriptive statistics, Spearman correlation coefficient, and paired samples t-test. Results: The mean age of the participants was 36.48 ± 5.889 and job experience was 9.06 ± 6.316 years. Spearman correlation coefficient shows that there is a significant correlation between the exposure times measured by the workers and occupational hygienist (R in all zones was higher than 0.9, P < 0.05). Paired samples t-test shows that there are no significant differences between the mean exposure times measured by the workers and occupational hygienist in each zone and in all the zones (P > 0.05). Conclusion: RFID technology is an appropriate method to evaluate the exposure time of workers without fixed pattern of exposure to causative factors of occupational diseases. It can also be used in other fields of occupational health engineering.

Background: Breast lumpectomy is an integral part of the treatment of mammary masses in women. This study was conducted to evaluate and compare two-drug combinations of propofol–ketamine (PK) (ketofol) and propofol–fentanyl (PF) (fenofol) on quality of sedation and analgesia in lumpectomy. Materials and Methods: This was a randomized, double-blind, clinical trial performed on 64 patients aged 15–70 years with breast cancer lumpectomy referred to Isfahan's Seyed Al-Shohada Hospital. Consequently, patients were divided into two groups of 32 patients, each group receiving PF combination or PK combination during anesthesia. Results: The patients in two groups, PF and PK, were compared in their sedation levels, severity of pain, and other variables. The mean arterial blood pressure, systolic blood pressure, and heart rate (HR) did not show any significant difference at the beginning of the study in the two groups, but the fenofol (PF) group had a significantly lower oxygen saturation than the ketofol (PK) group. The sedation level was significantly lower in the fenofol group than the ketofol group (P < 0.001). The mean pain intensity was significantly lower in the PF group than the PK group (P < 0.001). Conclusion: The two combinations of ketofol and fenofol cause rapid, favorable, safe anesthetic with minimal side effects and hemodynamic effects but it may be a superior alternative to fenofol combination, in terms of respiratory depression.

Background: Preeclampsia (PE) is one of the main causes of maternal and perinatal mortality and morbidity. Evidence shows that oxidative stress plays an important role in the pathophysiology of the PE. As catalase is a key enzyme in antioxidant enzymatic defense which protects cell from oxidative damage, in this study, we aimed to investigate the relationship between CAT-21A/T (rs7943316) polymorphism and PE susceptibility. Materials and Methods: This case–control study was conducted on 155 PE women and 159 normotensive pregnant women. Polymerase chain reaction-restriction fragment length polymorphism method was used for genotyping. Results: There was no association between CAT-21AT and TT genotypes and PE susceptibility. However, the CAT-21A/T polymorphism was associated with 1.6-fold higher risk of PE in dominant model (AA vs. AT + TT) (odds ratio [OR] 1.6 [95% confidence interval [CI]: 0.9–2.9]; P = 0.04). However, the CAT-21A/T polymorphism was not associated with PE in recessive model (TT vs. AA + AT) (OR 1.3 [95% CI: 0.8–2.1]; P = 0.4). Conclusions: The CAT-21A/T polymorphism could be a risk factor for PE susceptibility in dominant model.

Background: Seidlitzia rosmarinus which is commonly called “Oshnan” or “Eshnan” in Persian belongs to Chenopodiaceae family. Conventionally, it is believed that this plant is toxic. This study was aimed to evaluate the cytotoxic effect of S. rosmarinus against HeLa and HepG₂ cell lines. Materials and Methods: S. rosmarinus was collected from the desert near Yazd, Iran. Hexane, chloroform, chloroform/methanol (9:1), and butanol extracts of aerial parts of S. rosmarinus were prepared. Doxorubicin and dimethyl sulfoxide 10% were used as positive and negative control, respectively. The cytotoxic activity was measured using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Results: All extracts significantly and concentration dependently reduced viability of HeLa and HepG2 cells. Hexane, chloroform, and butanol extracts at doses of 200, 500, 750, and 1000 μg/ml significantly reduced HeLa cell viability (P < 0.05). Chloroform/methanol extract at doses of 100–500 μg/ml significantly reduced HeLa cell viability (P < 0.05). Hexane, chloroform, and butanol extracts at doses of 500, 750, and 1000 μg/ml significantly reduced HepG2 cell viability (P < 0.05). Chloroform/methanol extract at doses of 200, 300, 400, and 500 μg/ml significantly reduced HepG cell viability (P < 0.05). The most cytotoxic extract was chloroform/methanol extract in both cell lines. Furthermore, in the both cell lines, the second potent extract was chloroform extract. Conclusions: It can be concluded from the findings of this study that S. rosmarinus is a good candidate for further study to find new cytotoxic agents. Phytochemical investigation on chloroform/methanol extract and their structures is recommended.

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a recent increase in prevalence. A timely appropriate treatment for the disorder may play a crucial role in improvements in behaviors, interactions, and communications in an individual's life. It appears that evaluation of therapeutic approaches to the patients is essential and of importance. Thus, the aim of this study was to evaluate the efficacy of memantine as adjunct therapy in children with ASD. Materials and Methods: This randomized single-blind clinical trial included 60 children with ASD aged <14. The children undergoing applied behavior analysis (ABA) were divided into two groups of placebo and memantine (5 mg/day: a half of tablet in the morning and a half in the evening). After a 3-month course, improvements in symptoms of ASD were evaluated in both groups based on Gilliam autism rating scale. The collected data were analyzed with SPSS (version 20) using independent samples t-test, paired samples t-test, Chi-squared test and Fisher's exact test. Results: Both groups were similar in baseline characteristics including age, gender, and ASD symptoms (P > 0.05) but post intervention, total scores of ASD symptoms in both groups of memantine (mean score₁ =95.20 ± 14.49; mean score₂=73.50 ± 9.81) and control group (mean score_before = 91.50 ± 14.35; mean score_after = 89.63 ± 13.95) showed a decrease which was only significant in intervention group (P < 0.001). Conclusion: Accordingly, memantine administration as adjunct therapy can be more effective in improvement of ASD symptoms in children than ABA alone. Thus, it can be considered as a new selective adjunct therapy.