Background: Cognitive impairment is an unpleasant and progressive mental disorder characterized by learning and memory disabilities. Stress and alcohol are two known environmental factors that increase cognitive impairment. This study was designed to evaluate the relative role of cyclooxygenase 2 in alcohol or stress-induced cognitive impairment. Materials and Methods: Male Wistar rats were randomly divided into groups with six rats in each. The groups included sham, control, alcohol (15% ethanol in drinking water), and restraint stress (restraint 6 h per day). Three separated groups received celecoxib at a dose of 20 mg/kg in addition to those listed above. The treatments continued daily for 28 days. The object recognition task (ORT) and Morris water maze (MWM) are used to evaluate the learning and memory. Results: Alcohol or restrain stress significantly increased the time and distance needed to find the hidden platform in MWM. Furthermore, they decreased the recognition index in ORT compared to the control group. Administration of celecoxib significantly decreased the required time and traveled distance to reach the platform in alcohol-treated animals but not in the stress-exposed rats. Celecoxib also significantly increased the recognition index both in alcohol- or restraint stress-exposed animals. Conclusion: We found that either alcohol or restraint stress impairs memory in rats. In MWM, celecoxib improved the alcohol-induced memory impairment but could not show a reduction in memory deterioration due to restraint stress. In ORT, celecoxib reversed memory impairment due to both alcohol and restraint stress.

Background: Peripheral neurotoxicity is a common side effect of many anticancer chemotherapy drugs, including paclitaxel. Peripheral neurotoxicity may present as changes in sensory function and mild paresthesia that, in turn, can lead to alleviation of the prescribed dose of the medication. The aim of this study was to evaluate the effectiveness of acute and chronic doxepin administration on development and expression of neuropathic pain during the treatment of cancer with paclitaxel. Materials and Methods: Neuropathic pain was induced in mice by paclitaxel (2 mg/kg, intraperitoneally [i.p.,] once daily from day 1 to day 5) that caused mechanical and cold allodynia. Doxepin was administrated every day from day 6 to 10 (10 and 15 mg/kg i.p.). Mechanical and cold allodynia was evaluated on day 11 of the experiment in both the test and the control group. Results: Daily administration of doxepin (2.5, 5, and 10 mg/kg i.p.) from day 1 to 5 significantly inhibited the development of cold and mechanical allodynia. As well doxepin administration (5 and 10 mg/kg i.p.) from the 6^th day, to 10^th day significantly inhibited cold and mechanical allodynia expression. To address the concerns associated with the effectiveness of chemotherapy agents on the tumor, we evaluated paclitaxel cytotoxicity effect in combination with doxepin. Our observations indicate that doxepin even at high concentrations (1 and 10 μg/ml) does not interfere with the cytotoxic effect of paclitaxel (0.05 μg/ml). Conclusions: These results indicate that doxepin, when administered during chemotherapy, can prevent the development and expression of paclitaxel-induced neuropathic pain.

Backgrounds: The prevalence of metabolic syndrome (MetS) is increasing in developing countries that affects the liver in a variety of ways. This study was designed to investigate the protective role of eugenol on liver damage caused by fructose-induced MetS. Materials and Methods: Thirty male Wistar rats were randomly divided into five groups: 1: tap water (control), 2: fructose, 3: fructose + eugenol solvent, 4: fructose + eugenol 50 mg/kg, and 5: fructose + eugenol 100 mg/kg. At the end of the experiment, blood samples were taken for measurement fast blood glucose (FBG), serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic pyruvate transaminase (SGPT), low-density lipoprotein, high-density lipoprotein, cholesterol, and triglyceride. Results: FBG significantly increased in Group 2 compared to Group 1 (P < 0.001); however, it significantly decreased in Groups 4 and 5 compared to Group 2 (P < 0.05). SGOT and SGPT levels significantly increased in Group 2 compared to the control group (P < 0.001). However, SGOT and SGPT levels significantly decreased in Groups 4 and 5. Malondialdehyde (MDA) and liver tissue damage score (LTDS) significantly increased in Group 2 compared with the control group (P < 0.01), whereas MDA and LTDS decreased in Groups 4 and 5 compared to Group 2 (P < 0.05). Conclusion: Eugenol may ameliorate liver damage in a rat model of fructose-induced MetS, and these protective effects may in part be mediated by improving antioxidant status and reducing oxidative stress and lipid peroxidation. It may also reduce hepatic inflammation and fat accumulation as well as fibrosis of liver cells.

Background: Surgery is one of the treatments commonly used to treat liver hydatid cyst. Remaining of the residual cavity after conservative surgery may lead to some harmful complications. In this study, we evaluated the role of different factors affecting the disappearance of the residual cyst. Materials and Methods: Seventy-five patients were evaluated in 2.5 years. Patients were divided into two groups based on the remaining or disappearance of the residual cavity in follow-up visits. The baseline demographic features, preoperative cysts' size, type of technique used to eliminate the residual cavity, and cavity wall characteristics were compared in the two groups. Results: Residual cavity was disappeared in 46 (61%) patients after 2 years. Calcification of the wall and wall stiffness were more common in patients with the remained residual cavity (89.6% vs. 8.7% [P < 0.001] and 58.6% vs. 30.4% [P < 0.01], respectively). Demographic features, preoperative cysts' characteristics, and the procedure used during surgery were not statistically different between groups. Conclusions: Cyst wall calcification and wall stiffness had a role in predicting residual cavity disappearance. These factors can help surgeons to predict patients at higher risk of posthydatid cyst resection residual cavity.

Background: Osteoporosis is a prevalent elderly complication that is characterized by decreased bone mineral density and increased fracture risk because of dysregulation in bone mineralization and resorption. Physical activity can enhance bone strength by exerting mechanical forces and myokines. Irisin is a myokine that is increased following physical exercise and can affect bones. In this study, 8 weeks of resistance and endurance exercises are applied in mice compared to irisin injection to assess the contribution of the protocols and this myokine to bone strength. Materials and Methods: Thirty-five male NMRI mice were separated into five groups; control, placebo, irisin injection, resistance exercise, and endurance exercise. 8-week of exercise protocols and irisin injection protocol (100 μg/kg/week) was applied. Plasma irisin concentration and bone strength were measured using enzyme-linked immunoassay and 3-point bending assay, respectively. Statistical analyses were done through one-way ANOVA and Tukey test, and P < 0.05 was considered the significant difference. Results: Serum irisin concentration and bone strength in resistance exercise and irisin-injected groups were significantly higher than control and placebo groups (P < 0.0001). Serum irisin concentration, but not bone strength, of the endurance exercise group was also significantly higher than control and placebo groups (P < 0.0001) but lower than resistance and irisin-injected groups. Conclusion: Resistance exercise and irisin injection, but not endurance exercise, are likely to be effective in increasing bone strength. There may be a threshold for plasma irisin level to affect bones which the applied protocols of irisin injection and resistance exercise but not endurance exercise can reach.

Extraintestinal manifestations (EIMs) are common in patients with Crohn's disease (CD). Various reactive cutaneous conditions, including erythema nodosum and pyoderma gangrenosum frequently occur as a part of EIMs. However, cutaneous metastasis of CD is rarely encountered in CD patients. Here, we report a 28-year-old female patient presenting with discharging deep fissures on genital and intergluteal regions. The result of a skin biopsy showed noncaseating granulomas. After rule out all the other differential diagnoses for granulomatous skin lesions, we believe this patient may be a case of CD, presenting with skin metastasis and GI tract involvement has not been occurred during 1-year follow-up. We suggest including cutaneous (metastatic) CD in the list of dermatologic differential diagnoses for cutaneous lesions of these sites. These lesions can occasionally precede gastrointestinal (GI) involvement by months and years, therefore, an appropriate follow-up needs to be done to detect GI lesions as soon as they appear.

Background: Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive method to detect pancreaticobiliary strictures. In this study, we aimed to evaluate the diagnostic performance of MRCP and detect sensitive and specific radiologic features in distinguishing malignant and benign pathologies. Materials and Methods: In this study, 50 patients with biliary obstruction and a confirmed diagnosis using histopathology were included. The pathologies were evaluated using MRCP which were categorized into malignant and benign strictures. The etiology of strictures was detected using histopathology and endoscopic retrograde cholangiopancreatography. The diagnostic performance of MRCP was calculated using SPSS software. P < 0.05 was considered statistically significant. Results: Of 50 patients, 23 patients (46%) had malignant strictures based on MRCP and histopathology. The sensitivity and specificity of MRCP to detect malignancy were 95.7% and 96.3%, respectively. The most sensitive MRCP features to detect malignancy were upstream biliary duct dilation, abrupt tapering, and the presence of a solid mass with sensitivity 100%, 95.7%, and 78.2%, respectively. The malignancy rate was significantly higher in the strictures with length >11.5 mm or wall thickness >2.75 mm (P < 0.05). Conclusion: MRCP is a sensitive method to differentiate malignant lesions from benign pathologies. A long and thick stricture with the presence of a solid mass, upstream biliary duct dilation, and abrupt tapering is highly suggestive of malignancy.

Background: The diagnosis of pulmonary embolism (PE) because of nonspecific clinical presentation remains as a challenge for emergency physicians. Arterial to end-tidal partial pressure of carbon dioxide (P(a-Et)CO₂) gradient may be useful in the evaluation of PE. This aimed to define the diagnostic role of P(a-Et)CO₂ gradient by sidestream capnography, as a noninvasive method, and D-dimer in patients with PE. Materials and Methods: Two hundred and three patients with chest pain or dyspnea who attend the hospital emergency ward were enrolled over a study period at a single academic center. PE was confirmed by multidetector computed tomography (MDCT) scans. PaCO₂, EtCO₂, and D-dimer were measured within 24 h of MDCT by capnograph. Results: The combination of P(a-Et)CO₂ gradient (cutoff >9.2 ng/ml) and D-dimer (cutoff >3011 ng/ml) with sensitivity and specificity of 30.2% and 87.2% showed a significant diagnostic value in detecting PE (area under the curve = 0.577, P = 0.045) but not alone (P > 0.05). Conclusion: As the results show, the combination of P(a-Et)CO₂ gradient and D-dimer can show an acceptable diagnostic value in detecting PE, although it suggests further research on evaluating the diagnostic value of P(a-Et)CO₂ gradient and combining it with other diagnostic criteria to achieve a definite and generalizable result.

Background: With the increasing prevalence of type 2 diabetes mellitus (DM), there is a need to assess if the elevated salivary glucose levels provide an environment conducive to the growth of cariogenic microorganisms specifically Streptocooccus mutans and Lactobacillus acidophilus. Materials and Methods: Forty-five patients were divided into three groups consisting of patients with type 2 DM with caries, patients with type 2 DM without caries and age-matched healthy nondiabetic individuals (control). Saliva samples were subjected to semiautomatic salivary glucose estimation by the glucose oxidase-peroxidase method, using the Tulip glucose estimation kit. Swabs were immediately inoculated onto Mitis Salivarius Bacitracin agar and Man Rogosa Sharpe agar. Results: In Group A, statistically significant positive correlation was found between S. mutans and salivary glucose (r = 0.858) as well as L. acidophilus and salivary glucose (r = 0.853). In Group B, a statistically significant positive correlation was found only between S. mutans and salivary glucose (r = 0.705) and not between L. acidophilus and salivary glucose (r = 0.387). The control group did not show a statistically significant correlation. Conclusion: It is established that salivary glucose levels reflect the diabetic state of an individual. The salivary glucose level predicted a 1.7 times higher caries susceptibility in a diabetic, as shown by results in this study. Salivary glucose causes an increase in the cariogenic load in diabetic patients, thus warranting a modification of the Keyes triad.

Background: There are numerous sophisticated studies which have investigated risk factors of breast cancer (BC). The purpose of this paper is to use benefits of Bayesian modeling to involve such prior information in determining factors affecting the survival of women with BC in Yazd city. Materials and Methods: The checklist included the characteristics of the patients and the factors studied. Then, from the records of patients referred to Radiotherapy Center of Shahid Ramezanzadeh, who had BC, from April 2005 to March 2012, the survival of 538 persons was recorded in the census. Data were analyzed by R software version 3.4.2, and 0.05 was considered the significance level. Results: The mean age of BC diagnosis was 48.03 ± 11016 years. The Bayesian Cox regression showed that surgery (hazard ratio [HR] =1.631 95% PI; 1.102–2.422), ki67 (HR = 3.260. 95% PI; 1.6308–6.372), stage (HR = 5.620, 95% PI; 4.079–7.731), lymph node (HR = 1.765, 95% PI; 1.127–2.790), and ER (HR = 2. 600 95% PI; 2.023–3.354) were significantly related to survival time. Conclusion: The parametric and cox models were compared with standard error, and Cox model was selected as an optimal model. Accordingly, stage, ki67, lymph node, ER, and surgery variables had a positive effect on death hazard.

Background: The present study aims to evaluate the effect of photodynamic therapy (PDT) on the thickness of segmentation layers of the retina in cases with central serous chorioretinopathy (CSCR). Materials and Methods: This was a prospective, observational study on cases with CSCR who were candidates for PDT therapy. All patients had undergone at least 1 month of conservative management without satisfactory resolution. PDT was carried out according to the safe half-dose therapy scheme. Spectral-domain optical coherence tomography was employed to evaluate the changes in morphology and segmentation of retinal layers. Patients were followed up for 3 months. Results: Twenty-seven cases (18 males and 9 females) were included. Age of the patients varied from 39 to 59 years (mean: 46.61 ± 12.48 years). Cases were followed for 92.17 ± 3.28 days. Sixteen cases had functional and anatomical improvement by the treatment. Changes in overall retinal (377.39 ± 61.36 to 323.61 ± 71.36; P = 0.004) and all outer retinal segmentation layers including outer plexiform layer (34.93 ± 10.07 to 29.25 ± 6.12; P = 0.008), outer nuclear layer (63.52 ± 30.44 to 46.44 ± 20.62; P = 0.017), and retinal pigment epithelium (40.66 ± 37.73 to 23.78 ± 29.33; P = 0.016) were statistically significant. On the contrary, inner retinal segmentation layers, especially retinal ganglion cell (RGC) layer (38.29 ± 16.63 to 37.26 ± 16.18; P = 0.387), remained statistically unchanged. Conclusion: We postulate that PDT alleviates outer retinal edema where fluid accumulation occurs mostly, whereas it does not alter inner retinal and especially RGC layer. These findings may indicate that short-term atrophy of the inner retina did not occur following PDT and may point toward safety of this method for cases with CSCR.