- Pharmacology is the cornerstone of health science courses the same as biomedical programs in educational setting. New educational intuitions and methodical progresses in teaching and learning, as well as recent findings in pharmacology research, can help pharmacology educators reconsider and regulate their teaching approaches. Thus, the aim of this article is to review existing studies on the different methods of teaching pharmacology and investigate different outcomes in this regard. In the present investigation, recent articles in the databases of Web of Science, PubMed, Scopus, Embase, Google Scholar, IranDoc and Scientific Information Database (SID) were examined, and the delegated documents were reviewed. The gathered data showed that students’ cognitive, metacognitive, and cooperative learning besides collaborative skills are effective factors for teaching. Additionally, application of blended learning or flipped instruction via technologies such as computer ameliorates the process of teaching and learning pharmacology in academic setting. Consequently, to overcome the difficulties in managing the data overload, it sounds necessary to introduce new teaching methods in academic context. Therefore, the current investigation is useful for practitioners, curriculum designers and educational administrators in medical and paramedical educational context.

Epidural analgesia (EA) is an effective and common method of pain relief during labor. However, EA may also have some adverse effects like prolonged labor, increased risk of operative delivery, and some unwanted complications. It's unclear how maternal position affects the outcomes of natural birth with EA. This study aimed to compare mode of delivery and maternal and neonatal outcomes between recumbent and upright positions in nulliparous women with EA. This randomized clinical trial involved 540 women who received EA at cervical dilatation of 4 to 6 cm. During the second stage of labor, they were instructed to adopt upright or recumbent position. The main outcome was the mode of delivery. The secondary outcomes included duration of labor, pain intensity, the Apgar score, and other maternal and neonatal complications. Finally, 528 women were included in the final analysis. The upright group had a higher rate of cesarean section than the recumbent group. The duration of the labor stages did not differ between the groups. The pain intensity in the second stage was higher in the upright position. The Apgar score at 1 and 5 minutes was higher in the recumbent group. There was no difference in terms of other outcomes between the groups. Recumbent positions are beneficial in the case of rate of cesarean, mother’s pain, and Apgar score in women with EA. So, adopting a recumbent position during the second stage of labor may be preferable for women with EA.

This study aims to determine the effect of gestational hypertension on neonatal hemoglobin levels. This cohort study was performed on 150 pregnant women, 60 of whom had gestational hypertension and 90 were healthy. Participants were selected using sequential and quota non-probability sampling methods, respectively. The data were collected from interviews and examination forms. The newborns’ umbilical cords were clamped 30-60 sec after the delivery in both groups. Umbilical cord blood samples were taken to determine neonatal hemoglobin levels and sent to the laboratory immediately. Independent t-test was used to compare the two groups in terms of mean hemoglobin; general linear model with an identical link function was used to compare the two groups in terms of mean hemoglobin, considering the effect of confounding variables. SPSS software version 25 was used for the statistical analysis of the data. The statistical significance level in this study was considered to be 0.05. The mean neonatal hemoglobin level in women with gestational hypertension was significantly higher than that in the healthy group (16.73±1.81 gr/dl vs. 15.56±1.79, P<0.001). This difference remained significant after adjusting for demographic and background variables as well as medical records of the participants (P=0.008). The results revealed the hemoglobin level of newborns of mothers who had gestational hypertension, was higher than newborns of healthy mothers. Therefore, performing proper screening tests and knowledge of the hemoglobin level in these infants routinely helps the healthcare staff to prevent, decide and provide more and more useful services.

Cirrhosis is the consequence of chronic liver injury Considering the crucial role of oxidative stress in the progression of liver cirrhosis, we aimed to investigate the ameliorative effect of NTX against oxidative stress in carbon tetrachloride (CCl₄)-induced cirrhotic rats. Eighty-four male Wistar rats were randomly assigned into 4 groups (21 rats /group I) receiving CCl₄; (II) NTX+CCl₄; (III) mineral oil (M) (as the control); (IV) NTX+M. The animals in each group were sacrificed in 3 different time-points 2 weeks, 6 weeks (early cirrhosis) and 8 weeks (advanced cirrhosis). Liver function tests, NO metabolites, GSH level, as well as the activity of antioxidant enzymes including superoxide dismutase (SOD), catalase (CAT), glutathione peroxides (GPX), and hexokinase (HK) were assessed. NTX was able to ameliorate liver injury, revealed by attenuation of ALT activity, which was significantly enhanced due to cirrhosis induction, as well as pathological evaluation. HK was also increased significantly after treatment with CCl₄ while NTX moderated this increase. Although CCl₄ treatment did not have a significant effect on GSH levels, NTX was able to considerably increase GSH in blood. The activity of CAT and SOD as well as NO levels were all augmented by NTX in CCl₄-treated rats. Naltrexone demonstrates antioxidative effects in liver cirrhosis and may confer a protective effect against hepatic cirrhosis through modulation of oxidative stress.

Precise categorization of the causes of ischemic stroke (IS) is crucial for optimizing stroke treatment and assessing the prognosis of patients. This cross-sectional study aimed to determine the risk factors and various subcategories of IS in Iranian patients. The study included all patients with IS referred to Golestan Hospital (Ahvaz, Iran) for one year. Their demographics and clinical data were collected. The etiology of IS was classified based on the TOAST (Trial of ORG 10172 in Acute Stroke Treatment) criteria. A total of 1100 patients with IS were evaluated, 658 were male and 442 were female. They had an average age of 66 years (ranging between 20 and 99 years). The majority of them were in the 61-80 age group. The prevalence of risk factors for IS included hypertension (HTN) (71.4%), diabetes (50.4%), smoking (42.4%), history of previous stroke (28%), dyslipidemia (15.4%), and cardiovascular disease (22.5%). Three months after admission, the mortality rate was 10.7% and the majority of patients exhibited a lower level of disability based on the modified Rankin Score (mRS) compared to the time of admission. The frequency of all risk factors, except for HTN, differed significantly between genders (P<0.05). Furthermore, the prevalence of risk factors varied significantly among different stroke etiologic subgroups (P<0.05). The most common etiological factors identified by TOAST classification were associated with large artery atherosclerosis (LAA) and small artery occlusion (SAO). Significant variations were observed in the prevalence of different etiologic subtypes of stroke among genders and across different age groups.

Pinen Hydronoplacton Ribonucleic acid (PHR160) medicine contains compounds that can be useful in the recovery of respiratory patients. The aim of this study was to determine the effect of PHR spray on improving lung function, severity and asthma attacks in patients with severe asthma. This study is a pioneering interventional study (pilot study) conducted during the years 2021-2022 on patients with severe asthma resistant to treatment who referred to the lung clinic of Imam Khomeini, Golestan Hospitals and the private practice of lung specialists of this academic center. The study includes two groups of patients with asthma, both groups were given the usual treatment according to the stage of the disease, in addition, the intervention group was given two puffs of PHR spray every eight hours, and the control group was given a placebo spray with the same dose. Before and after the intervention, GSK 2002 questionnaire, six-minute walk distance (6MWD) and spirometry tests were completed. Among of 60 patients, 27 (45%) were male. The mean age of the patients was 44.33±6.94 years. Based on findings, the forced vital capacity (FVC) and forced expiratory flow between 25% and 75% (FEF 25-75%) were significantly better in the intervention group than the control group (P<0.001 and P=0.019, respectively), but there was a statistically remarkable difference between the two groups in terms of forced expiratory volume (FEV1) and FEV1/FVC (P=0.505, P=0.575, respectively). In addition, the GSK questionnaire score in the intervention group was higher than the control group (P<0.001), however there is no significant difference between the two intervention groups in terms of the 6MWD test and the number of exacerbation (P=0.114 and P=0.09, respectively). It is generally concluded that PHR160 spray can lead to improvement of spirometry parameters and severity of disease in severe asthma patients by affecting small airways.

Fibrocystic breast disease is the most common benign breast disease in women, and it is necessary to investigate the most effective treatment method to reduce its symptoms. Therefore, the study was conducted to investigate the effect of melatonin supplementation on clinical symptoms and paraclinical outcomes in women diagnosed with fibrocystic breast disease. Investigating the Effects of melatonin supplementation on clinical symptoms and paraclinical outcomes in women diagnosed with fibrocystic breast disease. The present study is a controlled intervention-placebo treatment conducted on women suffering from fibrocystic breast disease aged 18-40. This interventional study was conducted on 66 patients (33 in the intervention group and 33 in the control group). Melatonin supplement of 3 mg was administered to the intervention group and a placebo to the control group for 12 weeks. Patient information, symptoms, and paraclinical outcomes were recorded at the beginning of the study before the intervention and 12 weeks after the intervention. After collecting the data, we analyzed it using SPSS version 16 software and appropriate statistical tests. The findings of this study showed that melatonin administration in patients with fibrocystic breast disease reduced anxiety, depression, improved sleep quality, increased TAC (Total Antioxidant Capacity), and decreased MDA (Malondialdehyde). However, both study groups did not have statistically significant differences in the average pain and hs-CRP before and after the intervention. According to the findings of the study and the identification of the positive effect of melatonin on laboratory indicators and symptoms in patients with fibrocystic breast disease, it is recommended to prescribe melatonin in addition to standard treatment to witness a better and faster recovery, and in this way, the quality of life of patients can be increased.

Fetal abnormalities can cause axillary artery variations. Recognize and document of these variations are essential for surgeons performing interventional or diagnostic procedures for cardiovascular diseases. During routine dissection of an old female cadaver in the department of anatomy of Islamic Azad University, Tehran of Medical Sciences, we came across a variation in the branching pattern of the left axillary artery. The third part of the left axillary artery gave rise to a common trunk which was divided into the subscapular, lateral thoracic, posterior, and anterior circumflex humeral arteries.

Congenital coronary-cameral fistula is an abnormal connection between coronary arteries and a cardiac chamber. Although trans-catheter closure appears to be a safe alternative to surgical treatment but there is an imprecision about modality of choice. We describe a huge left coronary artery fistula to the right ventricle, found in an 8-year-old girl with dyspnea on exertion and chest pain. She was treated with an Amplatzer duct occluder. After procedure, echocardiography revealed, complete closure of fistula orifice and the girl remained completely asymptomatic during 48 months follow-up period. This study demonstrated that Amplatzer duct occluder might be a useful and safe armamentarium for coronary-cameral fistula treatment. Nevertheless, further experience and long-term follow-up studies are required to guarantee our results.

Bardet-Biedl syndrome (BBS) (MIM 209900) is a genetic disorder with a wide spectrum of clinical manifestations including retinal dystrophy, hypogenitalism, polydactyly, obesity, renal abnormalities and mental retardation. We describe a 13-year-old girl, a known case of Bardet-Biedl syndrome, who was going to undergo hysterectomy due to hydrometrocolpous. She was homozygous autosomal recessive for gene BS57. She was obese and had impaired vision, renal abnormality, borderline intelligence, recurrent urinary tract infection, menstrual problems, normal secondary sex chrematistics and corrected polydactylies. She had also big nose, thin upper lip, slightly everted lower lip, small mouth and retrognathia. Her electrocardiography showed incomplete right bundle branch block. We identified atrioventricular septal defect (AVSD). In conclusion, physicians who deal with cases who suffered from Bardet-Biedl syndrome, should be vigilant about seeking for identification of cardiac anomalies such as partial AVSD. This leads to earlier identification of the existing cardiovascular disease which facilitates appliance of curative measures.