Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 7 2016 07 09 418 421 EN Tahereh Hosseinzadeh Nik Department of Orthodontics, Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Negin Shahsavari Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Hannaneh Ghadirian Department of Orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Seyed Nasser Ostad Department of Pharmacology and Toxicology, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. 2016 06 25 The aim of this randomized clinical study was to investigate the effectiveness of acetaminophen 650 mg or liquefied ibuprofen 400 mg in pain control of orthodontic patients during separation with an elastic separator. A total of 101 patients with specific inclusion criteria were divided randomly into three groups (acetaminophen, liquefied ibuprofen, and placebo). They were instructed to take their drugs one hour before separator placement and every six hours afterward (five doses in total). They recorded their discomfort on visual analog scales immediately after separator placement, 2 hours later, 6 hours later, at bedtime, and 24 hours after separator placement. Repeated measure analysis of variance (ANOVA) was used to compare the mean pain scores between the three groups. Data were collected from 89 patients. The pain increased with time in all groups. Pain scores were statistically lower in the analgesic groups compared with the placebo group (P.value<0.001), but no statistically significant difference was found in mean pain scores between the two drug groups (acetaminophen and liquefied ibuprofen) (P.value=1). Acetaminophen and liquefied ibuprofen have similar potential in pain reduction during separation. https://acta.tums.ac.ir/index.php/acta/article/view/5736 https://acta.tums.ac.ir/index.php/acta/article/download/5736/4818

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 7 2016 07 09 465 470 EN Behdad Gharib Department of Pediatric Intensive Care, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Masoud Mohammadpour Department of Pediatric Intensive Care, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Bahareh Yaghmaie Department of Pediatric Intensive Care, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Meisam Sharifzadeh Department of Pediatric Intensive Care, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Mehrzad Mehdizadeh Department of Radiology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Fatemeh Zamani Department of Radiology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Rouhollah Edalatkhah Department of Pediatric Gastroenterology, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. Reihaneh Mohsenipour Department of Pediatrics, Emergency Ward, Children’s Medical Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 12 2016 03 09 We present a case of caustic ingestion by a 1.5-year-old boy. The caustic agent was drain opener which is a strong alkaline substance. Children in Iran and many other countries are still exposed to not “child proof” (child resistant packaging) toxic substance containers. Ingestion of caustic agents may lead to necrosis, perforation, and strictures. Substances that are ingested more frequently are liquid alkali material which causes severe, deep liquefaction necrosis. Common signs and symptoms of caustic agents are vomiting, drooling, refusal to drink, oral burns, stridor, hematemesis, dyspnea, dysphagia and abdominal pain. Even if no oropharyngeal lesion is seen, a significant esophageal injury which can lead to perforation and stricture cannot be ruled out. If abdominal pain or rigidity, substernal, chest or back pain exists, visceral perforation should be considered. The first thing to be checked is airway assessment. A lot of patients should be admitted to intensive care unit, and endoscopic evaluation, surgical intervention, long-term hospitalization, and worsening quality of life or among the complications. Preventive measures especially at the country level and approving proper legislation for obligating the related industries to produce child proof containers for house hold toxic products are the urgent measures to be followed by all of us. https://acta.tums.ac.ir/index.php/acta/article/view/4952 https://acta.tums.ac.ir/index.php/acta/article/download/4952/4816

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 7 2016 07 09 410 417 EN Omid Toupchian Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Gity Sotoudeh Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Anahita Mansoori Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. AND Nutrition and Metabolic Diseases Research Center, Jundishapur University of Medical Sciences, Ahvaz, Iran. Mahmoud Djalali Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Seyyed Ali Keshavarz Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Ensieh Nasli-Esfahani Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Ehsan Alvandi Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. Fariba Koohdani Department of Cellular and Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran. AND Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 10 2016 03 28 Docosahexaenoic acid (DHA), as an omega-3 fatty acid, in a natural ligand of peroxisome proliferator-activated receptors (PPARs). Regarding the combinative effects of Nutrigenomics and Nutrigenetics and due to the lack of in vivo studies conducted using natural ligands of PPARs, we aimed to evaluate the effects of DHA supplementation on vascular function, telomerase activity, and PPARγ-LXRα-ABCA1 pathway, in patients with type 2 diabetes mellitus (T2DM), based on the Pro12Ala polymorphism in PPARγ encoding gene. 72 T2DM patients (36 dominant and 36 recessive allele carriers), aged 30-70, with body mass index of 18.5 to 35 kg/m2, will be participated in this double blind randomized controlled trial. In each group, stratification will be performed based on sex and age and participants will be randomly assigned to receive 2.4 g/day DHA or placebo (paraffin) for 8 weeks. PPARγ genotyping will be carried out using PCR-RFLP method; Telomerase activity will be estimated by PCR-ELISA TRAP assay; mRNA expression levels of target genes will be assessed using real time PCR. Serum levels of ADMA, sCD163 and adiponectin, will be measured using ELISA commercial kits. The present study is designed in order to help T2DM patients to modify their health conditions based on their genetic backgrounds, and to recommend the proper food ingredients as the natural agonists for PPARs in order to prevent and treat metabolic abnormalities of the disease. https://acta.tums.ac.ir/index.php/acta/article/view/4313 https://acta.tums.ac.ir/index.php/acta/article/download/4313/4772

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 7 2016 07 09 471 474 EN Abolhassan Ertiaei Department of Neurosurgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mahsa Ghajarzadeh Brain and Spinal Injury Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Azizollah Javdan Department of Neurosurgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Abbas Taffakhori Department of Neurology, Iranian Center of Neurological Research, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Bahaaddin Siroos Department of Neurology, Iranian Center of Neurological Research, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. Mohsen Esfandbod Department of Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Hooshang Saberi Department of Neurosurgery, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND Brain and Spinal Injury Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 11 22 2015 12 15 We present a woman referred with underlying non-Hodgkin's lymphoma (NHL) masquerading clinically with Guillain-Barré syndrome (GBS) like syndrome. At first evaluation, chest CT-Scan along with brain and whole spine MRI were normal. Electrodiagnostic studies were in favor of acute generalized polyradiculoneuropathy. Laboratory evaluation revealed hypoglycorrhachia. She treated with plasmapheresis after two weeks; she was discharged from hospital, but neurological recovery was not complete. After 6 months, she came back with acute onset of weakness in lower limbs, back pain, fever and urinary incontinence. Pinprick and light touch complete sensory loss was found beneath umbilicus. Thoracic MRI with contrast revealed a dorsal epidural mass extending smoothly from T8 to T12 (10 cm) with spinal cord compression. She underwent urgent laminectomy for spinal cord decompression. Histological examination revealed small round cell tumor suggestive of malignant T-cell type lymphoma. In cases with Guillain-Barré syndrome presentation, systemic hematologic disorders such as non-Hodgkin's lymphoma should be considered as one of the differential diagnosis of underlying disease. https://acta.tums.ac.ir/index.php/acta/article/view/5181 https://acta.tums.ac.ir/index.php/acta/article/download/5181/4817

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 7 2016 07 09 422 429 EN Atefeh Aminian Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND Department of Pharmacology, School of Medicine, Arak University of Medical Sciences, Arak, Iran. Shiva Javadi Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Reza Rahimian Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Ahmad Reza Dehpour Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. AND Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran. Fahimeh Asadi Amoli Department of Pathology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Payman Moghaddas Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Shahram Ejtemaei Mehr Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 13 2016 03 10 Nephrotoxicity is a major side effect of cisplatin, a widely used chemotherapy agent. Morphine and other opioids are also used extensively in different types of cancer for the clinical management of pain associated with local or metastatic neoplastic lesions. In addition to its analgesic effects, morphine has also been reported to possess potential immunomodulatory and antioxidant properties. Herein, we investigated the effects of morphine in a rat model of cisplatin-induced nephrotoxicity. Following administration of a single dose of cisplatin (5 mg/kg), animals received intraperitoneal injections of morphine (5 mg/kg/day) and/or naltrexone (20 mg/kg/day), an opioid antagonist, for 5 days. Cisplatin-induced nephrotoxicity was detected by a significant increase in plasma urea and creatinine levels in addition to alterations in kidney tissue morphology. Levels of TNF-α and IL-1β were significantly increased in the renal tissue in cisplatin group. Moreover, glutathione (GSH) concentration and superoxide dismutase activity were significantly reduced in renal tissue in cisplatin group compared with control animals. Treatment with morphine aggravated the deleterious effects of cisplatin at clinical, biochemical and histopathological levels; whereas naltrexone diminished the detrimental effects of morphine in animals receiving morphine and cisplatin. Morphine or naltrexone alone had no effect on the mentioned parameters. Our findings indicate that concomitant treatment with morphine might intensify cisplatin-induced renal damage in rats. These findings suggest that morphine and other opioids should be administered cautiously in patients receiving cisplatin chemotherapy. https://acta.tums.ac.ir/index.php/acta/article/view/4963 https://acta.tums.ac.ir/index.php/acta/article/download/4963/4809

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 7 2016 07 09 475 478 EN Sayed Mahdi Marashi Department of Forensic Medicine and Clinical Toxicology, Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Zeynab Nasri Nasrabadi Department of Pediatrics, Children’s Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran. Mostafa Jafarzadeh Legal Medicine Research Center, Legal Medicine Organization, Tehran, Iran. Sogand Mohammadi Motahareh Kabiri-Nasab Department of Obstetrics & Gynecology Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Marzieh Agha-Husseini Department of Obstetrics & Gynecology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Omid Azimaraghi Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Gilda Barzin Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ali Movafegh Department of Anesthesiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2016 04 05 2016 04 05 Pain management is crucially important in the postoperative period as it increases patient comfort and satisfaction. The primary outcome of present study was to evaluate the effect of sufentanil added to hyperbaric bupivacaine solution 0.25% in transversus abdominis plane (TAP) block, on postoperative analgesic consumption. Fifty ASA physical status I–II term primiparous single-tone pregnant women aged 20–40 years scheduled for elective cesarean delivery with Pfannenstiel incision under general anaesthesia were enrolled in this randomized, double-blind, placebo-controlled trial. Ultrasound guided TAP block was performed at the end of surgery. Patients were randomly enrolled into two groups. Patients in the study group received 20 ml of hyperbaric bupivacaine 0.25% plus 1mL of sufentanil on either side while patients in the placebo group were administered 20 ml of hyperbaric bupivacaine 0.25% along with 1mL of placebo. Post-cesarean delivery visual analogue scale (VAS) for pain and morphine usage were measured and recorded. The morphine consumption was significantly less in the study group (37.2 ± 16.1 mg) than the control group (52.8 ± 16.7 mg, P =0.002).The VAS for pain both in rest and coughing were same in groups. Sufentanil added to 0.25% hyperbaric bupivacaine in TAP block decreases post cesarean delivery morphine consumption. https://acta.tums.ac.ir/index.php/acta/article/view/5552 https://acta.tums.ac.ir/index.php/acta/article/download/5552/4764

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 191 195 EN Azam Moslehi Department of Physiology & Pharmacology, School of Medicine, Qom University of Medical Sciences, Qom, Iran. Fatemeh Nabavizadeh Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Mansoor Keshavarz Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Nematollah Rouhbakhsh Department of Audiology, Tehran University of Medical Sciences, Tehran, Iran. Masoud Sotudeh Department of Pathology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. Ehsan Salimi Department of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran. Amir Barzegar Behrooz Department of Physiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran. 2016 01 16 2016 01 16 Noise is considered as one of the most severe sources of environmental and workplace constraints. Many noise effects are well known on immune function, hormonal levels, cardiovascular and respiratory systems. In this study, our aim is to evaluate the effects of traffic noise exposure on basal and stimulated gastric pepsin secretion. 48 male rats were exposed to traffic noise (86 dB) for a short term of (8h/ day for 1 day) and a long term of (8h/ day for 7, 14, 21 and 28 days) as well as a control group. The gastric contents were collected by the wash-out technique. Pepsin secretion was measured by employing the Anson method. Histological studies were carried out on the epithelial layer. The corticosteroid hormone was measured in the serum for the stress augmentation. The present finding indicated no changes in pepsin secretion content in the short term, but in the 14 and 21 days traffic noise exposure, basal gastric pepsin secretion increased markedly compared to the control group. Histological results showed that the number of oxyntic glands and cell nuclei decreased in comparison with the control group while the thickness of the epithelial layer increases. In addition, the corticosterone levels increase in all groups in comparison with the control. It seems that the increase of gastric pepsin secretion is due to the description and translation processes in the peptic cells and needs enough time for completion. https://acta.tums.ac.ir/index.php/acta/article/view/5367 https://acta.tums.ac.ir/index.php/acta/article/download/5367/4765

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 196 200 EN Ramina Mahboobi Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Davoud Afshar Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mohammad Reza Pourmand Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Rahil Mashhadi Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 12 01 2015 12 08 Pneumococcal autolysins are enzymes involved in cell wall turnover and cellular division physiologically. They have been found to be involved in the pneumococcus pathogenesis. The aim of this study was to identify the autolytic activity of Spr1754 as a novel protein of Streptococcus pneumoniae. Moreover, the binding of the recombinant protein to plasma proteins was also determined. The spr1754 gene was amplified by PCR and cloned into the pET21a(+) prokaryotic expression vector. The constructed pET21a(+)/spr1754 recombinant plasmid was transformed into E. coli Origami (DE3) and induced using IPTG. The recombinant protein of Spr1754 was purified by Ni-NTA affinity chromatography and confirmed by SDS-PAGE and Western blot analysis using anti-His tag monoclonal antibody. Autolytic activity and the ability of the recombinant protein in binding to plasma proteins were performed using zymogram analysis and western blot, respectively. The spr1754 with expected size was cloned and overexpressed in Escherichia coli Origami (DE3), successfully. After purification of the Spr1754 recombinant protein, the autolytic activity was observed by zymography. Of the four plasma proteins used in this study, binding of lactoferrin to Spr1754 recombinant protein was shown. The Spr1754 recombinant protein has a bifunctional activity, i.e., as being autolysin and lactoferrin binding and designated as Aap (autolytic/ adhesion/ pneumococcus). Nevertheless, characterization of the Aap needs to be followed using gene inactivation and cell wall localization. https://acta.tums.ac.ir/index.php/acta/article/view/5228 https://acta.tums.ac.ir/index.php/acta/article/download/5228/4766

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 201 210 EN Zohreh Heidary Deputy of Research, Tehran University of Medical Sciences, Tehran, Iran. Eshagh Bandani Department of Pharmaceutical Biotechnology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Mohamad Eftekhary Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Ali Akbar Jafari Young Researchers and Elite Club, Parand Branch, Islamic Azad University, Parand, Iran. 2016 04 05 2016 04 05 Virulent and resistant strains Pseudomonas aeruginosa (P. aeruginosa) is one of the most important cause of UTIs in pediatrics. The present study was carried to investigate the frequency of virulence factors in the multi-drug resistant strains of P. aeruginosa isolated from pediatrics hospitalized due to the UTIs. One - hundred and forty three urine samples were collected from pediatric patients suffered from UTIs. Samples were cultured and those that were P. aeruginosa positive were analyzed for the presence of putative virulence genes. Seventy one out of 143 samples (49.65%) were positive for P. aeruginosa. Monthly, sex and age-dependent prevalence were seen for P. aeruginosa. Bacterial strains had the highest levels of resistance against ampicillin (95.77%), gentamicin (92.95%) and ciprofloxacin (81.69%). Of 71 P. aeruginosa isolates, 12 strains were resistant to more than 9 antibiotics (16.90%). The most commonly detected virulence factors in the cases of urethral infections were exoU and plcH while those of pyelonephritis and cystitis were were exoS and lasB. Our findings should raise awareness about antibiotic resistance in hospitalized pediatrics with UTIs in Iran. Clinicians should exercise caution in prescribing antibiotics, especially in cases of UTIs. Such information can help in identifying these virulence genes as useful diagnostic markers for clinical P. aeruginosa strains isolated from UTIs. https://acta.tums.ac.ir/index.php/acta/article/view/5553 https://acta.tums.ac.ir/index.php/acta/article/download/5553/4767

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 54 3 2016 04 05 211 217 EN Seyed Mohammad Seyedmehdi Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Faezeh Dehghan Department of Occupational Medicine, School of Medicine, AJA University of Medical Sciences, Tehran, Iran. Mostafa Ghaffari Brain and Spinal Cord Injury Research Center (BASIR), Neuroscience Institute, Tehran University of Medical Sciencences, Qazvin, Iran. Ezzatossadat Haj Seyed javadi Department of Gynecology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran. 2015 10 06 2015 10 06 The use of corticosteroids is one of the methods put forward for the strengthening and speeding up the process of labor. After identification of glucocorticoid receptors in human amnion, the role of corticosteroids in starting the process of labor has been studied in numerous studies.The purpose of this study was to determine the effect of intravenous Dexamethasone on preparing the cervix and on labor induction. A randomized, clinical, and double – blind trial was conducted on 172 women divided into a control and an experimental group. The inclusion criteria were that they had to be primparous, in or before the 40 the week of pregnancy, and with Bishop scores (B.S.s) of 4 or lower. The exclusion criteria were diabetes, preeclampsia, macrosomia, twin pregnancy, rupture of the membrane (ROM), breech, and women suffering from background diseases. The B.S.s of the women was measured in charge of the study, and each woman was intravenously injected with eight milligrams of Dexamethasone or eight milligrams of distilled water. Four hours after the injections, the B.S.s of the participants was measured, and they were put under the conditions of labor induction using oxytocin. Information was collected in checklists A and B. The patients were compared with respect to B.S., the time the induction started, the average interval between the start of induction and the beginning of the active phase of childbirth, and the average length of time between the start of the active phase and the second stage of childbirth.The first and five minutes Apgar scores of the two groups of women were compared. The frequencies, the means, and the standard deviations were calculated using the SPSS – 16 software, and analysis of the results was performed with the Student’s t- test and the chi-square test with P<0.05. There were no statistically significant differences between the two groups in terms of their age, period of pregnancy, and B.S. at the start of the study. The average B.S. of women four hours after the injections with Dexamethasone was 5.9 ± 1.57, and the corresponding figure for women in the control group was 4.6 ± 1.72. These figures were significantly different at P<0.001. The average interval between labor induction and the start of the active phase in the, group injected with Dexamethasone was significantly less than that of the control group (2.87±0.93 versus 3.80± 0.93 at P<0.001). The average duration of the active phase of the second stage of childbirth was 3.47±1.10 hours in the experimental group and 3.6 ± 0.99 hours in the control group at P<0.49. These two figures were not significantly different. The Apgar scores of the first and fifth minutes after the birth of the children of the two groups of women were not significantly different. It was found that intravenous Dexamethasone improves the Bishop score of the cervix and thus causes softening of the cervix and reduces the length of time between labor induction and the start of the active phase of childbirth.     https://acta.tums.ac.ir/index.php/acta/article/view/4295 https://acta.tums.ac.ir/index.php/acta/article/download/4295/4250

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 573 578 EN Ramin Mehrdad Department of Occupational Medicine, Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran. Khosro Sadeghniiat Haghighi Department of Occupational Medicine, Occupational Sleep Research Center (OSRC), Tehran University of Medical Sciences, Tehran, Iran. Amir Hossein Naseri Esfahani Department of Occupational Medicine, School of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran. 2015 10 06 2015 10 06 Professional firefighting is among the most demanding jobs. Prior studies have showed the notable prevalence of poor sleep quality among professional firefighters that may result in catastrophes. The aim of this study was in field confirmation of zolpidem usage (10 mg/PO/bed time) for short term management of poor sleeps quality among professional firefighters. In a double-blind, randomized, placebo-controlled crossover clinical trial among professional firefighters, 27 poor sleepers were assigned randomly to one of the two groups. Two 14 days experimental periods were separated by a 14-day washout phase. Sleep quality was assessed using the Persian version of Pittsburgh Sleep Quality Index (PSQI). Six of the 27 enrolled voluntaries dropped out. Two rare side effects of zolpidem occurred in the study. A significant improvement of the PSQI score was detected in zolpidem period versus placebo in both groups (7.14 ± 3.02 vs 12.38 ± 2.51, PP=0.89). Zolpidem significantly improved all components of PSQI (Subjective sleep quality, Sleep latency, Sleep duration, Habitual sleep efficiency, Sleep disturbances and Daytime dysfunction) in the current study except the use of sleep medication. Sleep onset latency was the component of PSQI with the greatest degree of abnormality among firefighters in a previous study. Interestingly, sleep latency was the component of PSQI with the most treatment effect of zolpidem in the current study. Zolpidem can be used as a part of treatment regimens in short time management of poor sleep quality among professional firefighters. https://acta.tums.ac.ir/index.php/acta/article/view/4296 https://acta.tums.ac.ir/index.php/acta/article/download/4296/4251

Tehran University of Medical Sciences Acta Medica Iranica 0044-6025 53 9 2015 10 06 579 581 EN Zarrin Keihani Douste Department of Pediatric Neurology, Imam Khomeini Medical Complex, Tehran University of Medical Sciences, Tehran, Iran. Mohhamad Taghi Haghi Ashtiani Department of Pathology, Children Medical Center, Tehran University of Medical Sciences, Tehran, Iran. M