The infantile colic is one of the most common complaints in the infancy; however, limited therapeutic approaches are described in the literature. Recently probiotics have been suggested as a potential strategy in the treatment of infantile colic. We conducted this study to investigate the efficacy of probiotics in relieving colic symptoms in Iranian infants. This double-blind clinical trial was performed among 70 infants aged 3 to 16 weeks with the presumed diagnosis of infantile colic according to Wessel criteria who were breastfed or formula fed. They were assigned at random to receive Pedilact® (Bifidobacterium infantis, Lactobacillus reuteri, and Lactobacillus rhamnosus) (N=33) or placebo (N=32). Demographic data were recorded in the questionnaires at the beginning of the study. The number of daily episodes of crying and fussiness, number of weekly crying days, and duration of crying were separately analyzed on 7, 21, and 30th  days of investigation. Baseline demographic data showed no statistically significant difference between intervention and placebo groups. Infants given Pedilact® showed a significant reduction in daily episodes of crying, duration of crying, and the weekly number of crying days at the end of the treatment period compared with those receiving placebo (P=0.000). On 21th day of the study, daily episodes of fuss and crying (P=0.032) and duration of crying reduced significantly in the intervention group in comparison to the placebo group (P=0.000). Administration of Pedilact® drop significantly improved colic symptoms by reducing crying and fussing times in breastfed or formula fed in Iranian infants with colic.

Topical anesthesia (TA) may accompany more discomfort for some patients during cataract surgery. We aimed to evaluate the potential factors that can be used for predicting patient’s cooperation during phacoemulsification surgery under TA. One hundred sixty consecutive cases that were candidate for phacoemulsification surgery were enrolled in this prospective study. Patients’ sex, age, place of residence (urban or rural), education level (literate and illiterate) and physical examination variables (visual acuity, reaction to eye drop, cooperation during tonometry, and reaction to press on the lacrimal sac before surgery) evaluated. Patients’ cooperation during surgery was classified as successful (good and satisfactory) or failed (weak) groups. In this study, 103(64.4%) cases showed good or satisfactory cooperation, and others had weak cooperation. There was no correlation between patients’ cooperation during surgery and sex (P=0.2), age (P=0.7), place of residency (P=0.3), and education level (P=0.3). The successful group showed a higher rate of non-reaction to eye drop (P=0.0001), good cooperation during tonometry (P=0.0001), non-reaction to press on lacrimal sac (P=0.0001), and lower visual acuity (P=0.045). In the multi-logistic regression, non-reaction to eye drop (OR=66.4), good cooperation during tonometry (OR=21.2, good vs. bad and OR=7.2, satisfactory vs. bad), lower visual acuity (OR=7, <0.1 vs. 0.1-0.4 d) are the significant predictors for the success of TA. This study showed that some ocular examination tests before surgery (visual acuity, reaction to eye drop, cooperation during tonometry, and reaction to press on the lacrimal sac) could predict patients’ cooperation during phacoemulsification surgery under TA.

Mechanical ventilation (MV) is among the main basics of supportive treatment for respiratory failure in the intensive care unit (ICU). This supportive treatment may cause undesirable complications that led to the introduction of various MV modes. The current study was aimed to assess and compare outcomes of volume support ventilation (VSV) and pressure support ventilation (PSV) regarding spontaneous breath return, weaning and hemodynamic changes among patients admitted at ICU following surgical procedures. This single-blinded randomized-clinical-trial (RCT) was conducted on 100 patients admitted at ICU in 2018-2019. Patients were randomly divided into two fifty-member groups treated with PSV and VSV modes. Oxygen saturation, systolic (SBP) and diastolic blood pressure (DBP), mean arterial pressure (MAP), arterial blood gas (ABG), extubation and MV time and sedation based on RAMSY criteria were recorded and compared. Mean age (P=0.79) and gender distribution (P=0.57) were not statistically different in the two groups. Time has no effect on patients' hemodynamic (P>0.05) while hemodynamic stability was superior in VSV (P<0.05). ABG showed no statistical difference between groups (P>0.05) except for arterial oxygen pressure that was higher in the VSV group (P<0.001). The duration of MV, extubation time and duration of ICU admission was significantly lower in the VSV group. Furthermore, sedation based on RAMSY criteria showed the superiority of VSV (P<0.05). Use of VSV mode was accompanied with superior outcomes in four entities including earlier and easier weaning, shorter duration of ICU admission, least hemodynamic instabilities and least sedation requirement in comparison to PSV mode.

The severity of postoperative pain and hemodynamic changes during and post-cesarean section have a direct effect on the neonatal and maternal condition. This study aimed to compare pain severity, hemodynamic changes, and patient satisfaction following two anesthesia techniques in elective cesarean section. In this blinded study, 60 women who were candidate for cesarean section were allocated into two equal groups of general anesthesia (GA) and spinal anesthesia (SA). Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and O₂ Saturation at pre cesarean (T0), the uterine incision time (T1), end of surgery (T2), 6h (T3), 12h (T4), and 24 hours post-cesarean (T5) were measured. A Visual Analog Scale assessed post-cesarean pain, 6, 12, and 24 hours post-cesarean. Gender, birth weight, first- and fifth- minutes’ apgar score was recorded in the checklists. The VAS score was significantly higher in the GA group at 6h, 12h, and 24 hours post-cesarean (P=0.014, P=0.002, P=0.017, respectively). SBP and DBP at T1 in the GA group were significantly higher than in the S.A group (P<0.001). The heart rate at T0 and T1 in the GA group was lower than the SA group (P=0.001, P=0.045 respectively). The difference between the apgar scores of the two groups was not significant. SA for cesarean section was associated with lower postoperative pain, systolic and diastolic blood pressure. However, the two groups had no significant difference in terms of patients’ satisfaction and apgar scores.

Gestational hypertension or pregnancy-induced hypertension is the emergence of hypertension in a pregnant women after 20 weeks of gestation. This study aimed to evaluate the job-related factors associated with pregnancy-induced hypertension. This cross-sectional study was conducted on 560 pregnant women who referred to the Nursing Clinic of Imam Khomeini Hospital in 2017; of all studied cases, 210 pregnant women with pregnancy-induced hypertension were selected as cases and 350 women without pregnancy-induced hypertension were selected as controls. The data on demographic characteristics, occupational characteristics, and ergonomic dangers were collected by the researchers. Finally, the relationship between job variables and the probability of developing hypertension in pregnant women was measured. The results of the logistic regression analysis showed that the variables of body mass index, fertility, shift work, and service works had a significant relationship with pregnancy-induced hypertension. Women with service work were 2.32 times more likely to develop hypertension than women with other types of jobs (P=0.013). The people who had a shift work were 2.28 times more likely to develop pregnancy-induced hypertension than those who did not have shift work. Based on the results of this study, there was no relationship between ergonomic risks and pregnancy-induced hypertension. It seems that due to the higher frequency of pregnancy-induced hypertension in highly demanding jobs, it is necessary to pay more attention to the assessment of related risk factors, such as psychological variables.

The Minnesota Living with Heart Failure Questionnaire (MLHFQ) has been developed to measure health-related quality of life (HRQoL) status of Heart Failure (HF) patients. The aim of this study was to translate MLHFQ into the Persian version and assess the validity and reliability of the translated version. We used a forward-backward procedure for translation. In a cross-sectional study, 105 HF patients and 50 healthy subjects were selected to assess the reliability and construct validity of the instrument. The face and content validity were used to assess the questionnaire validity. Validity was examined on the HF patients group, using the Persian version of the Short form-36 health survey (SF-36) Questionnaire. In order to assess the questionnaire’s reliability, the Intraclass correlation coefficient (ICC) and Cronbach’s alpha were calculated. Test-retest reliability was examined by re-administering the MLHFQ after 2 weeks. Test-retest results demonstrated that the Persian version has excellent reliability (ICC for all 2 domains were higher than 0.91, P≤0.000). Internal consistency for Physical domain (PD), emotional domain (ED) and total scores using Cronbach’s alpha were 0.90, 0.84 and 0.92, respectively. ICC for PD, ED and total scores were 0.95, 0.94, and 0.97, respectively. Good and very good Pearson's Correlation Coefficient was seen between MLHFQ and SF-36 (r= -0.47 to -0.775, P≤0.000 for PD; r= -0.47 to -0.65, P≤0.000 for ED). The Persian version of the MLHFQ had satisfactory reliability and validity for assessing HRQoL status of Iranian HF patients.

Participating in mass gatherings puts people at risk of incidents. The distribution of resources should be based on need. The purpose of this study was to investigate the distribution of trauma care facilities based on need and access at a religious mass gathering in Iran. This national cross-sectional study is based on obtained data including the number of visits to health centers (NVHC) and the number of injuries visits health center (NIVHC) as needs and the number of physicians, paramedic, ambulance, and treatment center as access in border cities of Iran and Iraq in 2016. Gini coefficient, Lorenz curve and the Pearson correlation coefficient were applied to measure the level of equality in the distribution of trauma care and the correlation between access and need. The facilities were relatively distributed equally at the border towns in Iran; however, were not equally distributed in Iraq. There is no significant association between the paramedic for NIVHC and ambulance for NIVHC and NVHC. Moreover, there was a significant association between physician for NIVHC and NVHC, a paramedic for NVHC, and treatment centers for NIVHC and NVHC. The consequences of incidents could be reduced if distributing trauma care facilities equals at mass gatherings.

Evaluation of the research status of the academic institution provides it with the possibility of accurate research policymaking. Scientometric indicators are important tools for evaluating scientific activities of individuals, groups, and institutions. The current research aims to analysis the research performance of medical universities in Northern Iran based on quantitative and qualitative scientometric indicators. In this cross-sectional descriptive study, the Scopus-indexed scientific documents provided by medical universities in the Northern Iran have been studied in terms of number of publications, number of citations, average number of Citations per Publication (C/P), Field-Weighted Citation Impact (FWCI), scientific collaborations, the number of in top 10% citation percentile, and the number of publications in top 10% journal percentile according to CiteScore, Source Normalized Impact per Paper (SNIP), and SCImagoJournal Rank (SJR) indicators during a five years period. According to the findings, Mazandaran University of Medical Sciences has gained the highest position in terms of the number of publications and citations, number of publications with international and national collaborations, and  academic-industrial collaborations., while Golestan University of Medical Sciences has gained a higher position in terms of scientific outputs in top 10% citation percentile and journal percentile, CiteScore, SNIP, SJR and C/P. In terms of the FWCI indicator, Golestan University of Medical Sciences has achieved the highest value. Considering academic status and research capabilities of medical universities in the Northern Iran, increasing academic-industrial collaboration, expanding academic collaboration with superior universities and institutions around the world can be effective in increasing the quality of research and upgrading academic ranks of universities at national, regional and international levels.

Desmoplastic fibroma is a rare, benign fibrous tumor of bone which is locally aggressive. The mandible is the most prevalent affected of the facial bones. Nevertheless, reports of desmoplastic fibroma affecting the mandible are seldom in the literature. It causes bone destruction and has a high tendency for local recurrence. In this case report, we report a case of desmoplastic fibroma which is located in mandibular angle and extended to coronoid process, in 20-year-old female patient.

The immunosuppressive state after organ transplantation leads to infectious complications responsible for high mortality rate. Fungal infections account for 5% of all infections in Renal Transplantation (RT) recipients. A 53-year-old man was admitted with acute loss of consciousness. He had a history of renal transplantation 1 month before admission. Brain CT showed acute hydrocephalus with periventricular edema. A right frontal external ventricular drain was inserted urgently. One day later the consciousness further decreased, and CT scan showed unilateral left lateral ventricle dilatation and a hyperdense mass at the septum pellucidum. The patient was operated via endoscopic trans-middle frontal sulcus approach. The interventricular septum was pushed contralaterally, and a very adherent mesh-like thick layer covered the surface of lateral ventricle and foramen of Moro. The Monro foramen was opened, and septostomy was done. The mass inside the septum was found posterior to the foramen, punctured, and partially removed. Histopathological study revealed aspergillus infection of the lateral ventricles. CNS Aspergillosis should be considered in the differential diagnosis of altered consciousness among immunocompromised hosts. This report further implies that isolated ventricular involvement by aspergillus infection may be considered as the cause of hydrocephalus in immunocompromised patients.

Ectopic increase of adrenocorticotropic hormone (ACTH) or ectopic Cushing syndrome is a rare initial presentation of small cell carcinoma and carcinoid tumor of the lung. Here, we reported a 36-year-old male with atypical symptoms of Cushing syndrome managed by Etomidate that had a central pulmonary nodule, and pathologic evaluation of pulmonary lobectomy revealed the diagnosis of well-differentiated, low-grade typical carcinoids of lung.

Mesenteric ischemia is a rare disease with a high rate of mortality because of the non-specific symptoms which leads to delay in diagnosis and intervention. The main symptom is abdominal pain; which has a broad list of differential diagnosis. This study introduces a 17 years old girl who presents to the emergency department with severe abdominal pain and hematemesis. Further evaluations revealed thrombosis in the mesenteric vein which leads to ischemia and gangrene of the small intestine. Her past medical history and drug history was negative, except she was taking Levonorgestrel and cyproterone acetate for a 5 months period. Since long-term treatment with oral contraceptive pills, counts as a risk factor for venous thrombosis, this case seems to be uncommon.

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